Biobehavioral approach to distinguishing panic symptoms from medical illness

Summary & key facts

This paper reviews how panic attacks produce sudden, scary physical symptoms that often look like real medical problems. The authors looked at research on six common symptoms — chest pain not caused by the heart, heart palpitations, shortness of breath, dizziness, stomach problems, and tingling or numbness. They argue for a biobehavioral approach, which means using both medical checks and psychological understanding, to help doctors tell harmless panic symptoms apart from real illness. That could cut down on unnecessary tests and treatments and shorten people’s suffering, but careful evaluation is still needed because some medical conditions can cause very similar symptoms.

Key facts:

• Panic disorder causes sudden and intense physical symptoms that often mimic real medical illnesses.
• People with panic disorder commonly use more personal and healthcare resources while trying to find a medical cause for their symptoms.
• This review focuses on six somatic symptoms linked to panic attacks: chest pain that is not from the heart, heart palpitations, shortness of breath, dizziness, abdominal distress, and tingling or numbness.
• The authors review medical conditions that can look like panic and list risk factors and features that help distinguish panic from medical illness.
• The paper recommends a biobehavioral approach — combining medical checks and psychological understanding — to avoid costly and unnecessary tests and prolonged suffering.
• The review also discusses cultural factors and mentions long COVID as an example of an illness that can produce panic-like physical symptoms.

Abstract

Panic disorder is a common psychiatric diagnosis characterized by acute, distressing somatic symptoms that mimic medically-relevant symptoms. As a result, individuals with panic disorder overutilize personal and healthcare resources in an attempt to diagnose and treat physical symptoms that are often medically benign. A biobehavioral perspective on these symptoms is needed that integrates psychological and medical knowledge to avoid costly treatments and prolonged suffering. This narrative review examines six common somatic symptoms of panic attacks (non-cardiac chest pain, palpitations, dyspnea, dizziness, abdominal distress, and paresthesia), identified in the literature as the most severe, prevalent, or critical for differential diagnosis in somatic illness, including long COVID. We review somatic illnesses that are commonly comorbid or produce panic-like symptoms, their relevant risk factors, characteristics that assist in distinguishing them from panic, and treatment approaches that are typical for these conditions. Additionally, this review discusses key factors, including cultural considerations, to assist healthcare professionals in differentiating benign from medically relevant symptoms in panic sufferers.

Topics

Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Long-Term Effects of COVID-19 Psychosomatic Disorders and Their Treatments

Categories

Health Sciences Medicine Psychiatry and Mental health

Tags

Anxiety Clinical psychology Distress Intensive care medicine Medicine Palpitations Panic Panic disorder Psychiatry

Conditions & symptoms

Anxiety Panic disorder and phobias Anxiety or worry Panic