Characteristic clinical features and clinical course in 270 Japanese outpatients with panic disorder
Abstract We investigated the clinical characteristics of panic disorder (PD) in a Japanese outpatient population comprising 270 patients diagnosed as having PD (among a total of 9219 new outpatients treated at our psychiatric clinic) during a 13-year study period from 1981 to 1994, according to either DSM-III (1981–1987) or DSM-III-R (1988–1994) criteria. The sex ratio was 1:1.14 (males, 126; females, 144). There was no difference between male and female patients in the prevalence of agoraphobia (males, 51; females, 59). Frequencies of the following symptoms during panic episodes in our Japanese patients were significantly lower than those reported in other studies: trembling or shaking, sweating, choking, nausea, sense of depersonalization, numbness or tingling sensations, flushes or chills, and fear of going crazy. Frequency of other symptoms during episodes, such as dyspnea, dizziness, palpitation, and fear of dying, was similar to that reported in the literature. Incidence of comorbidity with major depressive disorder, suicide attempt, or suicidal ideation was very low; none of the patients had been diagnosed with major depression at the first interview, 4.4% had had suicidal ideas, and 0.4% had attempted suicide during the clinical course. These findings suggest that PD in Japanese patients may be characterized by relatively mild panic symptoms and may not feature a depressive component. In 62.2% of all medicated patients, panic attacks disappeared, and duration until disappearance was less than 1 month in most patients. Only 13.3% (27203) of the patients showed complete remission at the follow-up assessment. The chronicity of PD described in the literature was found in this Japanese outpatient population as well.
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