Quality of well being in panic disorder: the assessment of psychiatric andgeneral disability

Background: Panic disorder is a common and debilitating anxiety disorder wh ich significantly disrupts the lives of patients and their family members. Recent epidemiological studies and analyses of data from clinical trials su ggest that patients with panic disorder suffer significant work and social dysfunction, The authors hypothesized that this dysfunction could be charac terized using both a well-validated, generalized scale of functioning and a specifically designed scale for assessing function in psychiatric patients and that these findings would correlate with symptomatology. Method: Fifty -six patients with panic disorder were characterized using the Sheehan Disa bility Scale, the Anxiety Sensitivity Index, and the Spielberger State Trai t Anxiety Scale. Measures of health related quality of life from the Qualit y of Well Being Scale were compared with ratings for matched, historical, a nd population controls. Results: Patients with panic disorder lost 39 quali ty-adjusted days for each year that they lived with the disorder. This decr ease in quality of life is similar to what is observed in patients with non -insulin dependent diabetes. Diminished quality of life is correlated with the number of panic attacks, state anxiety, and depressive symptoms. These patients also demonstrated significant dysfunction in Sheehan total disabil ity and subscale scores, including work-related functioning. Conclusions: T his study demonstrates that the specific disabilities inherent in panic dis order can be linked to declines in quality of life as measured by the Quali ty of Well Being Scale and by measures of work-related dysfunction. Such an association between disease specific measures and a generalized measure of health related quality of life may offer clinicians a new tool to understa nd panic disorder and to conceptualize it within the broader context of dis ease and disability. (C) 2000 Elsevier Science B.V. All rights reserved.