Key result
A detection model correctly identifies panic disorder in ~84% of ED chest pain patients.
Why the study?
Does a detection model using demographic, psychological, and pain variables improve the recognition of panic disorder in emergency department patients with chest pain?
Observational (n=392)
Does a detection model using demographic, psychological, and pain variables improve the recognition of panic disorder in emergency department patients with chest pain?
A brief questionnaire-based detection model can correctly classify up to 84% of emergency department chest pain patients for panic disorder, potentially improving physician recognition.
May aid ED panic disorder detection via brief scales; leaves open impact on outcomes before practice change.
OBJECTIVE: To develop and validate a detection model to improve the probability of recognizing panic disorder in patients consulting the emergency department for chest pain. METHODS: Through logistic regression analysis, demographic, self-report psychological, and pain variables were explored as factors predictive of the presence of panic disorder in 180 consecutive patients consulting an emergency department with a chief complaint of chest pain. The detection model was then prospectively validated on a sample of 212 patients recruited following the same procedure. RESULTS: Panic-agoraphobia (Agoraphobia Cognitions Questionnaire, Mobility Inventory for Agoraphobia), chest pain quality (Short Form McGill Pain Questionnaire), pain loci, and gender variables were the best predictors of the presence of panic disorder. These variables correctly classified 84% of chest pain subjects in panic and non-panic disorder categories. Model properties: sensitivity 59%; specificity 93%; positive predictive power 75%; negative predictive power 87% at a panic disorder sample prevalence of 26%. The model correctly classified 73% of subjects in the validation phase. CONCLUSION: The scales in this model take approximately ten minutes to complete and score. It may improve upon current physician recognition of panic disorder in patients consulting for chest pain.
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Fleet et al. (1997) conducted an observational in Chest pain with potential panic disorder (n=392). Detection model for panic disorder (panic-agoraphobia scales, chest pain quality, pain loci, and gender) was evaluated on Presence of panic disorder. A detection model using psychological scales, pain characteristics, and gender correctly classified 84% of ED chest pain patients for panic disorder (73% in validation), with 93% specificity.
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