Most people with panic disorder are treated in primary care, which is
not surprising as the physical symptoms of panic disorder can cause
people to seek treatment for what they perceive as a physical illness.
Difficulties
in the diagnosis of panic disorder in this context advocate the
potential value of population screening for the disorder in primary
care, currently recommended for major depression.
Panic
disorder is associated with a severe disability and problems at work in
people receiving primary care, although the effects of comorbid
physical and depressive illnesses are reported.
The quality of primary care given to people with panic disorder (and other anxiety / agoraphobia) is not the best; only 19-40% of people are estimated to receive the agreed minimum standards for evidence-based treatment. Besides
the difficulty of detection and diagnosis, many other obstacles,
including the uncertainty of knowing where to seek help, poor
organization of primary care for chronic disease management and
insurance coverage issues and concerns on the cost of attention (especially the US)
New approaches to overcome these barriers and improve the delivery of health care for people with panic disorder are needed. Other promising approaches that could supplement the care provided by
primary care physicians, or could be used only for some patients,
including self-help treatments for equipment delivery approaches (on the
Internet) are increasingly proposed.
Because
the onset of panic disorder peaks late in adolescence, prevention
efforts could be better directed at or before this critical period of
development. In
one study, 150 people present to the emergency room with panic attacks
were assigned to one hour of contact with a doctor who received
instruction or exposure tranquility.
Exposure group improved in all measures of anxiety and panic after six months, compared to controls. 40% of the sample group met the criteria for panic disorder, so this study was not a study of pure prevention. In
another study, 151 college students were assigned to at least one panic
attack in the past year and sensitivity to moderate anxiety to be on a
waiting list or undergo a cognitive -comportementale 5:00 a.m.
workshop.148 six months, 13.6% of controls developed panic disorder, compared with 1.8% of people in the workshop group. More
research on methods for the detection and identification of individuals
at risk for panic disorder (eg, children of patients with the disease
or behavioral inhibited children) will be crucial.
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