Environmental Factors in Panic Disorder

Letter to the Editor

Sir: Recently, mental health professionals in the Anxiety and Depression Clinic at Montefiore Medical Center, New York, noticed that a substantial subgroup of patients with panic disorder described hot weather and humidity as potential triggers of panic attacks. Since these findings raised important questions concerning the role of environmental factors in panic disorder, Montefiore clinicians developed a questionnaire to systematically evaluate the prevalence of hot weather, humidity, and various other conditions as catalysts for panic attacks. The questionnaire asked patients to rate on a scale from 0 to 3 whether panic was triggered or worsened by such conditions (0 = never, 1 = sometimes, 2 = most of the time, and 3 = always).