Quality of life and panic-related work disability in subjects with infrequent panic and panic disorder

Background: Panic disorder is associated with poor quality-of-life (QOL). However, little is known regarding the impact of panic disorder or infrequent panic on work-related disability. The purpose of this study was (1) to document QOL and panic-related work disability in subjects with panic disorder or infrequent panic, (2) to identify independent predictors of QOL and disability, and (3) to compare outcomes in subjects with panic disorder versus infrequent panic. Method: This cross-sectional community survey included 97 subjects with panic and matched controls. Subjects were screened for panic disorder or infrequent panic using the Structured Clinical Interview for DSM-III-R. The QOL questionnaire addressed life satisfaction as well as panic-related work disability. A structured interview assessed possible predictors of impaired QOL including comorbidity, illness attitudes and behaviors, coping style, family measures, and symptom perceptions. Results: QOL was significantly (p ≤.001) poorer in subjects with panic than in controls. Comorbid depression, social support, worry, and severity of chest pain predicted QOL. Although subjects with infrequent panic reported a lower QOL than controls, subjects with panic disorder had more panic-related disability and poorer QOL than those with infrequent panic. Predictors of work disability included panic frequency, illness attitudes, family dissatisfaction, and gender. Conclusion: Although both infrequent panic and panic disorder impact QOL and disability, panic disorder has a greater effect. Using predictors, patient education, provision of support, and focused therapy could potentially improve QOL and disability.