Panic disorder among patients presenting to endocrine clinic with thyrotoxic like symptoms

Abstract EN

A considerable number of patients who may present with panic like symptoms as part of anxiety disorders in out patient medical clinics have no organic basis for their complaints, but it has been established that such patients are suffering from different types of anxiety and mood disorders.

Objective The aim of this study is to identify panic disorder among patients presenting with thyrotoxic like symptoms at endocrine clinics.

Method A comparative prospective study was conducted at the Endocrine Clinic at the King Hussein Medical Center (KHMC).

A study group of sixty patients (45 females and 15 males) mean age 32.2 years (17 - 45), and 40 subjects as a control group (31 females and 9 males) mean age 33.8 years were seen, evaluated and examined at the King Hussein Medical Center (KHMC); tests included thyroid ultrasound, thyroid function tests and test for phaeochromocytoma were negative in all patients included.

These patients were assessed by the same specialist psychiatrist using the Arabic Version of Panic Scale which is derived from Diagnostic and Statistical Manual of Mental Disorder (IV edition).

Results Fifty out of sixty patients (83.3%) were found to have panic disorder in the study group vs.

16(40%).

in the control group (z static = 4.2438; p < 0.0003), the majority being females 75% (p < 0.05).

The most frequent presenting symptoms were shortness of breath in both group (80%, 40% respectively), followed by palpitation in study group 73.3%, trembling (71.7%) and sweating (63%).

Lower frequencies were obtained in the control group.

The most severe symptoms were fear of dying, palpitation, trembling and sweating in the study group, while chills or hot flushes, shortness of breath and numbness predominated in the control group.

Conclusion This study concludes that panic disorder is rather common in patients presenting to endocrine clinics and therefore such patients can receive more appropriate diagnosis and management if collaborative efforts are made by physicians and psychiatrists.