Objectives: To (1) identify aspects that defined the self-perceived worst panic attack, (2) determine how subjects with panic attacks perceive symptoms compared with control subjects, and (3) determine the role of symptom perceptions in seeking care for the worst panic attack. Design: Cross-sectional survey. Setting: Community-based. Patients or Other Participants: Ninety-seven subjects with panic attacks as defined by the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (with or without panic disorder), and 97 demographically matched controls. Intervention: None. Main Outcome Measures: Subjects and controls completed the Symptom Perception Scales, and subjects with panic attacks completed the Acute Panic Inventory and a questionnaire concerning care-seeking behavior for their self-perceived worst attack. Results: Compared with controls, subjects with panic attacks perceived many symptoms as more embarrassing but differed little in their perceptions of need for treatment, threat to life, and disruption of functioning. Particular symptoms (ie, dyspnea, fear, dizziness, and faintness) tended to differ in most perceptions. However, symptom perceptions did not play a significant role in care-seeking behavior for the worst attack. Conclusions: Subjects with panic attacks perceive symptoms as more embarrassing than controls, and have different perceptions about particular symptoms. Cognitive approaches addressing negative patient perceptions may reduce anxiety, inappropriate use of health care services, and adverse outcomes.
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