Panic disorder among Vietnamese refugees attending a psychiatric clinic: Prevalence and subtypes

This study surveys Vietnamese refugees attending two psychiatric clinics to determine both the prevalence of panic disorder (PD) as well as panic atta ck subtypes in those suffering PD. A culturally valid adaptation of the SCI D-panic module (the Vietnamese Panic Disorder Survey or VPDS) was administe red to 100 Vietnamese refugees attending two psychiatric clinics. Utilizing culturally sensitive panic probes, the VPDS provides information regarding both the presence of PD and panic attack subtypes during the month prior t o interview. Of 100 patients surveyed, 50 (50%) currently suffered PD. Amon g the 50, patients suffering PD, the most common panic attack subtypes duri ng the previous month were the following: "orthostatic dizziness" (74% of t he 50 panic disorder patients [PDPs]), headache (50% of PDPs), wind-induced /temperature-shift-induced (24% of PDPs), effort-induced (18% of PDPs), gas tro-intestinal (16% of PDPs), micturition-induced (8% of PDPs), out-of-the- blue palpitations (24% of PDPs), and out-of-the-blue shortness of breath (1 6% of PDPs). Five mechanisms are adduced to account for this high PD preval ence as well as the specific profile of subtypes: 1) a trauma-caused panic attack diathesis; 2) trauma-event cues; 3) ethnic differences in physiology ; 4) catastrophic cognitions generated by cultural syndromes; and 5) a modi fication of Clark's spiral of panic. (C) 2001 Elsevier Science Inc. All rig hts reserved.