Symptom severity and perceptions in subjects with panic attacks

Objectives: To (1) identify aspects that defined the self-perceived worst p anic attack, (2) determine how subjects with panic attacks perceive symptom s compared with control subjects, and (3) determine the role of symptom per ceptions in seeking care for the worst panic attack. Design: Cross-sectional survey. Setting: Community-based. Patients or Other Participants: Ninety-seven subjects with panic attacks as defined by the Diagnostic and Statistical Manual of Mental Disorders, Revi sed Third Edition (with or without panic disorder), and 97 demographically matched controls. Intervention: None. Main Outcome Measures: Subjects and controls completed the Symptom Percepti on Scales, and subjects with panic attacks completed the Acute Panic Invent ory and a questionnaire concerning care-seeking behavior for their self-per ceived worst attack. Results: Compared with controls, subjects with panic attacks perceived many symptoms as more embarrassing but differed little in their perceptions of need for treatment, threat to life, and disruption of functioning. Particul ar symptoms (ie, dyspnea, fear, dizziness, and faintness) tended to differ in most perceptions. However, symptom perceptions did not play a significan t role in care-seeking behavior for the worst attack. Conclusions: Subjects with panic attacks perceive symptoms as more embarras sing than controls, and have different perceptions about particular symptom s. Cognitive approaches addressing negative patient perceptions may reduce anxiety, inappropriate use of health care services, and adverse outcomes.