The Implications of Medical and Psychiatric Comorbidity With Panic Disorder

The frequent presentation of patients with panic disorder in medical settings may, in part, be explainedby the physical symptoms inherent in panic disorder. However, a number of medical disordershave symptoms that overlap with panic disorder symptoms, and elevated panic disorder prevalence iscomorbid with a number of medical illnesses, including respiratory disorders, vestibular dysfunction,and hyperthyroidism and hypothyroidism. The presence of medical comorbidity complicates the identification,presentation, and treatment of panic disorder. In addition, comorbid mood disorders occurcommonly and result in greater severity, poorer quality of life, and greater impairment. Recent worksuggests that panic disorder occurs more commonly with bipolar disorder than major depressive disorder,resulting in substantial impairment, as well as poorer response to treatment. The implications ofmood disorder and its medical comorbidity for the identification and treatment of panic disorder arediscussed.