Correlation of panic attacks and hostility in chronic schizophrenia.

The aim of this study was to investigate the relationship between panic attacks and hostility in patients with chronic schizophrenia. Thirty-two patients with a minimum 2-year history of treatment for schizophrenia were interviewed. The patients took mood stablizers lithium, carbamazepine and valproate adjunctively for hostility and anger attacks. Panic attacks were defined by Structure Clinical Interview of DSM-IV. Severity of psychopathology was assessed by the Hamilton Depression Rating Scale (HDRS) and Brief Psychiatric Rating Scale (BPRS). Functional level was assessed by the Global Assessment of Functioning Scale (GAF). Eight (25%) patients met the diagnostic criteria for panic attacks (DSM-IV) with affective symptoms including hostility and sudden spells of anger. Their HDRS scores were significantly higher (P < 0.01), and GAF scores were significantly lower (P < 0.05) than those of patients without panic attacks. Patients with panic attacks displayed significantly higher hostility in the score of the BPRS (P = 0.01). Those who received higher doses of neuroleptics were more likely to be considered hostile. Multivariate analysis revealed that panic attacks were correlated with more severe depression, greater hostility and lower GAF scores. The results suggest that increased hostility and anger spells may be symptoms of panic attacks, which are overlooked by psychiatrists.