Familial patterns in patients with infrequent panic attacks
C. A. Dumas, D. A. Katerndahl and S. K. Burge
Department of Family Practice, University of Texas Health Science Center at San Antonio, USA.
OBJECTIVE: To evaluate the family environment in patients with infrequent
panic attacks. DESIGN: Survey. SETTING: Waiting room of a family health
center at a university-based family practice residency program. The center
primarily serves low-income or underinsured patients, 80% of whom are
Hispanic. PATIENTS OR OTHER PARTICIPANTS: Randomly selected patients
completed the panic disorder section of the Structured Clinical Interview
of the Diagnostic and Statistical Manual of Mental Disorders, Third
Edition. Thirty patients with infrequent panic attacks were compared with
30 control patients without panic attacks matched for age, gender, and
ethnicity. Both groups completed in-depth interviews. INTERVENTIONS: None.
MAIN OUTCOME MEASURES: The in-depth structured interview included family
environment instruments--Family Adaptability and Cohesion Evaluation Scales
and Duke Social Support and Stress Scale--as well as a genogram. Family
violence and sexual abuse were assessed by means of the Conflict Tactic
Scales and the Sexual Stress Questionnaire. RESULTS: Although patients with
infrequent panic attacks were of lower birth order than patients without
panic attacks (Wilcoxon chi 2 = 2.13, P < or = .02), no differences in
childhood or current family functioning were found. However, patients with
infrequent panic attacks reported higher levels of childhood (paired t =
3.97, P < or = .001) and current (paired t = 3.05, P < or = .005)
family stress. Although the prevalence of family violence was similar
between groups, the group with infrequent panic attacks reported more
violent events in the past year (paired t = 2.60, P < or = .02) than did
the group with no panic attacks. Similarly, 60% of patients with infrequent
panic attacks reported childhood sexual abuse, as opposed to 13% of
patients without panic attacks (McNemar's chi 2 = 10.5, P < or = .005).
CONCLUSIONS: Although no association between infrequent panic attacks and
family functioning or support were found, the group with infrequent panic
attacks reported more frequent violent events currently and higher levels
of family stress. The high rate of childhood sexual abuse may have
important causative implications for infrequent panic attacks.
