Panic attacks linked to poor prognosis in mood disorder patients

MedWire News: A history of recurrent panic attacks is associated with a greater severity of depression-associated symptoms in patients with mood disorders, particularly those with bipolar disorder, research shows.

Previous studies have shown that panic attacks are common in patients with mood disorders, explain Dr Nick Craddock, from Cardiff University in the UK, and colleagues.

But they add that it is not clear whether panic attacks are associated with illness course in patients with mood disorders.

To investigate, the researchers studied data on 290 patients with bipolar I disorder and 335 patients with major depressive disorder.

The results of interviews, questionnaires and examination of patient records revealed that 47% of the bipolar disorder patients and 58% of those with major depressive disorder had a lifetime history of panic attacks.

The researchers found that, in patients with bipolar disorder, those with a history of panic attacks were 1.8 times more likely to have a history of suicidal behavior than those who did not experience panic attacks. Bipolar patients with a history of panic attacks also experienced more frequent and severe depressive episodes than other bipolar patients.

Furthermore, a history of panic attacks was associated with a two-fold increased risk of slowed activity and insomnia, and nearly a four-fold increased risk of early-morning waking and agitated activity in bipolar disorder patients, compared with no such history.

In patients with major depressive disorder, those with a history of panic attacks were twice as likely to experience suicidal thoughts and to receive inpatient treatment as those without a history of panic attacks.

The researchers found no association between the lifetime presence of panic attacks and clinical characteristics of illness relating to mania.

Dr Craddock and team conclude in the journal Bipolar Disorders: “The presence of recurrent panic attacks in bipolar and unipolar disorder may be indicative of a course of illness associated with a greater depressive morbidity [disability resulting from illness].”