Identifying and treating panic disorder in primary care.

Many individuals who experience a panic attack at some point in their lives will meet criteria for panic disorder. However, although most primary care physicians recognize broad-spectrum mood and anxiety disorders, they may not make a specific diagnosis such as major depressive disorder or panic disorder. Comorbid panic disorder and other anxiety conditions are a well-established phenomenon in depressive disorders and can have a negative impact on treatment and worsen prognosis. This negative impact underscores the importance of specifically identifying these disorders and their comorbidities. Although an analysis of other potential causes of presenting symptoms is at times indicated, diagnosis should be made positively by identifying the symptoms diagnostic of the anxiety conditions rather than negatively by eliminating other conditions. Treatment of patients with panic disorder can improve quality of life and productivity as well as reduce health care costs. Pharmacotherapy, cognitive-behavioral therapy, and collaborative relationships with patients and psychiatrists can all aid primary care physicians in providing acute and long-term treatment for patients with panic as well as other mood and anxiety disorders.