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Nonfearful Panic Disorder in Chest-Pain Patients: Status After Nine-Year Follow-Up

Received October 16, 2006; revised December 15, 2006; accepted January 4, 2007. From the Dept. of Psychiatry, Ullevaal University Hospital, 0407 Oslo, Norway; the Medical Faculty, University of Oslo, 0317 Oslo, Norway; the Dept. of Cardiology, Ullevaal University Hospital, 0407 Oslo, Norway; the Faculty Division, Ullevaal University Hospital, University of Oslo, 0318 Oslo, Norway; the Institute of Psychiatry, University of Oslo, 0317 Oslo, Norway; and the Dept. of Behavioural Sciences in Medicine, University of Oslo, 0317 Oslo, Norway. Send correspondence and reprint requests to Christine Bull Bringager, M.D., Dept. of Research and Education, Psychiatric Division, Ullevaal University Hospital, 0407 Oslo, Norway. e-mail: christine.bringager{at}medisin.uio.no
© 2008 The Academy of Psychosomatic Medicine

BACKGROUND: Nonfearful panic disorder (NFPD) is a type of panic disorder (PD) that was first described in 1987 among cardiology patients who had panic attacks without the experience of fear. NFPD may be considered a subtype of PD with significant impact on the long-term outcome of chest pain patients. OBJECTIVE: The authors sought to explore the long-term outcome of NFPD and PD. METHOD: Authors studied 199 patients previously referred to cardiology outpatient investigation because of chest pain. Assessments comprising cardiological and psychiatric (SCID–I) examinations were conducted after 9 years. RESULTS: At follow-up, no patients suffered from NFPD, but 18% had panic disorder with fear (PD). There were no significant differences between the baseline NFPD (N=11) and PD (N=44) patients regarding psychiatric comorbidity, chest pain, healthcare utilization, and health-related quality of life at follow-up. CONCLUSION: NFPD can have a significant impact on the long-term outcome of chest pain patients even though they may not seek psychiatric treatment.

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