Clinical Markers of Panic and Generalized Anxiety Disorder: Overlapping Symptoms, Different Course and Outcome

Summary & key facts

Researchers studied 290 outpatients with Panic Disorder (PD) or Generalized Anxiety Disorder (GAD) in Milan and Monza, Italy. They found that GAD was linked with more medical and psychiatric co‑morbidities, more treatment discontinuation, and different treatments than PD. PD was more often treated with SSRIs, while GAD was more often treated with atypical antipsychotics or GABAergic drugs and with psychodynamic psychotherapy. The authors say GAD patients may have a worse course, but they call for larger studies to confirm these findings.

Key facts:

• The study sample included 290 outpatients diagnosed with Panic Disorder or Generalized Anxiety Disorder in mental health services in Monza and Milan, Italy.
• GAD was associated with having multiple psychiatric co‑morbidities that started after the anxiety onset (p = 0.05).
• GAD was also associated with multiple medical co‑morbidities (p = 0.02).
• Treatment with selective serotonin reuptake inhibitors (SSRIs) was associated with a diagnosis of Panic Disorder in this sample.
• GAD diagnosis was associated with treatment using atypical antipsychotics or GABAergic drugs (p = 0.03).
• Psychodynamic psychotherapy was more often used in patients with GAD than PD (p < 0.01).
• Discontinuation of the most recent pharmacological treatment was more common in people with GAD than in those with PD (p = 0.02).
• The authors report that GAD patients may have a worse prognosis than PD patients because of more frequent co‑morbidities, relapses, and poorer treatment compliance, and they state this needs confirmation in larger studies.

Abstract

Generalized Anxiety Disorder (GAD) and Panic Disorder (PD) share underlying neurobiological mechanisms and several clinical features which, with medical comorbidities, may increase misdiagnosis and delay proper treatment. The aim of the study was to evaluate the association between clinical/socio-demographic markers and GAD/PD diagnosis. Outpatients (N = 290) with PD or GAD were identified in mental health services in Monza and Milan (Italy). Descriptive analyses and a binary logistic regression model were performed. Post-onset psychiatric (p = 0.05) and medical (p = 0.02) multiple co-morbidities were associated with GAD; treatment with selective serotonin reuptake inhibitors (SSRIs) was associated with PD, while GAD diagnosis was associated with treatment with atypical antipsychotics or GABAergic drugs (p = 0.03), as well as psychodynamic psychotherapy (p < 0.01). Discontinuation of the last pharmacological treatment was associated with GAD diagnosis rather than the PD one (p = 0.02). GAD patients may have a worse prognosis than PD patients because of more frequent multiple co-morbidities, relapses and poorer treatment compliance. The different treatment approaches were consistent with the available literature, while the association between GAD and psychodynamic psychotherapy is an original finding of our study. Further studies on larger samples are necessary to better characterize clinical factors associated with GAD or PD.

Topics

Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Child and Adolescent Psychosocial and Emotional Development Mental Health Research Topics

Categories

Experimental and Cognitive Psychology Psychology Social Sciences

Tags

Anxiety Aripiprazole Clinical psychology Discontinuation Generalized anxiety disorder Internal medicine Logistic regression Medicine Panic Panic disorder Psychiatry Psychology Schizophrenia (object-oriented programming)

Conditions & symptoms

Anxiety Panic disorder and phobias Panic