B44-47 Panic in COPD

Rationale Panic and anxiety symptoms are highly prevalent in chronic obstructive pulmonary disease (COPD) and may exacerbate dyspnea, impair quality of life, and increase emergency department visits or healthcare utilization. Quantitative data describing the frequency of panic attacks, severity of individuals’ distress, and acceptable treatment modalities of panic symptoms in adults with COPD are limited. We surveyed individuals with COPD to determine the prevalence of panic and/or limited symptom attacks and to assess willingness to undergo interventions. Methods A cross-sectional online survey of the COPD Foundation COPD360social support community was conducted to assess the frequency of panic and limited symptom attacks, severity of distress, prevalence of anticipatory anxiety, and openness to behavioral interventions in survey respondents with a self-reported diagnosis of COPD. Panic attacks were defined as sudden episodes of intense fear or anxiety that come on without warning with greater than four associated panic symptoms (tachycardia, diaphoresis, chest pain or tightness, dizziness/lightheadedness, nausea, tremors, chills/hot flashes, or shortness of breath). Limited symptom attacks are the sudden onset of four or less symptoms of a panic attack. Results We received 69 survey responses. The majority of participants (39.1%) fell in the 65-74 age range, 61% were female, and self-reported race was 84% White, 5.8% Black, and 8.7% Other. Panic or limited symptom attacks in the past year were reported by 92.7% of respondents. 56% describing weekly episodes ranging from 1-2 full attacks/multiple limited symptoms attacks to full attacks occurring one or more times a day most days of the week. Panic-related distress was moderate to severe in 76%, and 68% reported frequent or constant anxiety about future attacks. Worry that attacks indicated a physical or mental problem occurred frequently in 52% of respondents. Emergency department visits for panic were reported by 28% of respondents. Interest in receiving treatment for panic or limited symptom attacks was expressed in 92% of respondents, with 83% specifically interested in a smartphone-based intervention. Conclusions Panic and limited symptom attacks are common, distressing, and clinically significant among individuals living with COPD. The strong interest in behavioral interventions suggests that a technology-delivered intervention to manage panic and limited symptom attacks is feasible in COPD.