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Jeffrey S. Markowitz, DrPH; Myrna M. Weissman, PhD; Robert Ouellette, MPhil; Jennifer D. Lish, PhD; Gerald L. Klerman, MD

Arch Gen Psychiatry. 1989;46(11):984-992.

Abstract
• Data from the Epidemiologic Catchment Area study showed that a lifetime Diagnostic Interview Schedule/DSM-III diagnosis of panic disorder was associated with pervasive social and health consequences similar to or greater than those associated with major depression. These consequences included subjective feelings of poor physical and emotional health, alcohol and other drug abuse, increased likelihood of suicide attempts, impaired social and marital functioning, financial dependency, and increased use of psychoactive medications, health services, and the hospital emergency department for emotional problems. Comorbidity of panic disorder with major depression, agoraphobia, and alcohol or other drug abuse did not explain these findings. The social and health consequences of panic disorder (quality of life) should be considered, as risks and benefits of currently available acute and maintenance treatments are evaluated. Clinical trials of panic disorder, whether of drugs or behavioral treatment, should include quality of life assessments as outcome measures. Long-term prospective studies based on clinical samples of patients with panic disorder are indicated to relate the illness more precisely to social morbidity.

Author Affiliations
From the Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute (Drs Markowitz, Weissman, and Lish and Mr Ouellette), Department of Psychiatry and Public Health, College of Physicians and Surgeons of Columbia University (Drs Markowitz, Weissman, and Lish), and Cornell Medical School, Payne Whitney Clinic and New York Hospital (Dr Klerman), New York. Dr Markowitz is now with E. R. Squibb & Sons Inc, Princeton, NJ.

Footnotes
Accepted for publication April 20, 1989.

Reprint requests to New York State Psychiatric Institute, College of Physicians and Surgeons, Columbia University, 722 W 168th St, Box 14, New York, NY 10032 (Dr Weissman).

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