Panic disorder in emergency department chest pain patients: Prevalence, comorbidity, suicidal ideation, and physician recognition

To establish the prevalence of panic disorder in emergency department (ED) chest pain patients; compare psychological distress and recent suicidal ideation in panic and non-panic disorder patients; assess psychiatric and cardiac comorbidity; and examine physician recognition of this disorder. Cross-sectional survey (for psychiatric data). Prospective evaluation of patient discharge diagnoses and physician recognition of panic disorder. The ambulatory ED of a major teaching hospital specializing in cardiac care located in Montreal, Canada. Four hundred and forty-one consenting, consecutive patients consulting the ED with a chief complaint of chest pain. Psychiatric diagnoses (AXIS I). Psychological and pain test scores, discharge diagnoses, and cardiac history. Approximately 25% (108/441) of chest pain patients met DSM-III-R criteria for panic disorder. Panic disorder patients displayed significantly higher panic-agoraphobia, anxiety, depression, and pain scores than non-panic disorder patients ( P