Identifying and Treating Panic Disorder in Primary Care

Many individuals who experience a panic attack at some point in their lives will meet criteria forpanic disorder. However, although most primary care physicians recognize broad-spectrum mood andanxiety disorders, they may not make a specific diagnosis such as major depressive disorder or panicdisorder. Comorbid panic disorder and other anxiety conditions are a well-established phenomenonin depressive disorders and can have a negative impact on treatment and worsen prognosis. This negativeimpact underscores the importance of specifically identifying these disorders and their comorbidities.Although an analysis of other potential causes of presenting symptoms is at times indicated,diagnosis should be made positively by identifying the symptoms diagnostic of the anxiety conditionsrather than negatively by eliminating other conditions. Treatment of patients with panic disordercan improve quality of life and productivity as well as reduce health care costs. Pharmacotherapy,cognitive-behavioral therapy, and collaborative relationships with patients and psychiatrists can all aidprimary care physicians in providing acute and long-term treatment for patients with panic as well asother mood and anxiety disorders.