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20 May 2002
Panic Disorder in Hong Kong
Panic disorder
is characterized by the recurrent sudden attacks of physical and emotional
anxiety symptoms, phobic avoidance behavior, and impairment of social function.
In order to understand its prevalence, symptom patterns, and help seeking
behavior, the Hong Kong Mood Disorders Center of the Faculty of Medicine,
The Chinese University of Hong Kong conducted a large-scale telephone survey
from April 16 to 25, 2002. 3,004 respondents aged 15 to 60 (1,446 males
and 1,558 females) were randomly selected and interviewed. The results
showed that about 4% respondents suffered from panic disorder. Based
on this finding, it is estimated that 120,000 people in the age range of
15-60 suffer from panic disorder but most of them did not receive effective
treatment.
In this survey, panic disorder is defined
as the presence of at least 3 somatic and/or emotional symptoms of anxiety
attacks in the previous one month, associated with persistent fear of the
further attacks, phobic avoidant behavior, and impairment of social function.
133 people (4.4%) were found to fit these diagnostic criteria. 44 (33%)
were males and 89 (67%) were females. The disorder was common among
the working population (age range 19-54) regardless of their social class
background.
Respondents with panic disorder would
avoide panic triggering situations such as height (37.1%), flying (34.4%),
driving (30.2%), going to cinema (17.8%), taking bus or MTR (12%).
42.2% of them had ever developed suicidal ideas.
Only 40 percent of sufferers of panic
disorder have sought medical consultation. Of which 49.5% consulted
general practitioners, 20% consulted non-psychiatric specialists, and 18%
consulted psychiatrists or psychologists. In order to find out the
cause of their disabling symptoms, two-fifth of them conducted various physical
examinations such as blood test (27.6%), electroencephalogram(26.4%), X-ray
(18.3%), and brain imaging/scanning (9.9%). Most were still worried
about their health even though the results of these investigations were normal.
Regarding health care spending, subjects with panic disorder spent a varying
amount of a few hundred to $100,000.
Panic disorder arises from a combination
of neurophysiological and psychosocial causes. Substantial research
has demonstrated that drug therapy and/or Cognitive Behavior Therapy (CBT)
are highly effective for the treatment of panic disorder. The former
consists of Specific Serotonin Reuptake Inhibitors (SSRIs) that act by regulating
serotonin neurotransmitters in the central nervous system. CBT alters
patient's problematic beliefs and avoidance behaviors in the setting of a
trusting therapist-client relationship. In order to improve the treatment
of panic and other mood disorders in Hong Kong, the Hong Kong Mood Disorders
Center has successfully trained 139 private general practitioners and it
also provides patients with CBT.
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