
Psychosomatics 41:311-320, August 2000
© 2000 The Academy of Psychosomatic Medicine
Non-Fearful Panic Disorder
A Variant of Panic in Medical Patients?
Richard P. Fleet, Ph.D.,
Jean-Pierre Martel, Ph.D.(C),
Kim L. Lavoie, M.A.,
Gilles Dupuis, Ph.D., and
Bernard D. Beitman, M.D.
Received July 21, 1999; revised December 1, 1999; accepted December 29, 1999. From the Research Center, Montreal Heart Institute, Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada; Department of Psychology, Concordia University, Montreal, Quebec, Canada; Anxiety Disorders Clinic, Sacré-Coeur Hospital, Montreal, Quebec, Canada; Department of Psychiatry and Neurology, University of Missouri-Columbia, Columbia, MO. Address reprint requests to Dr. Fleet, Research Center, Montreal Heart Institute, 5000 Bélanger Street East, Montreal, Quebec, H1T 1C8, Canada.
Is it possible to have panic attacks without fear? Beitman et al. reported that 32% 41% of panic disorder (PD) patients seeking treatment for chest pain have non-fearful panic disorder (NFPD). To replicate and extend this work on NFPD, the authors compared NFPD patients (N= 48), PD patients (N=60), and No-PD patients (N=333) at the time of an emergency department visit and follow-up approximately 2 years later. The authors compared comorbid Axis I diagnoses, panic attack symptoms, and scores on self-report measures. A significantly greater proportion of PD patients had comorbid generalized anxiety disorder and agoraphobia than NFPD patients. NFPD patients had self-report scores that were between no-PD and PD patients or similar to no-PD patients, with the exception of the Beck Depression Inventory. At follow-up, NFPD patients, like PD patients, were still symptomatic and had either not improved or had worsened according to scores on all self-report measures. NFPD should be recognized as a variant of PD, both because of its high prevalence in medical settings and its poor prognosis.
Key Words: Panic Disorder
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