Short communication Panic disorder in patients with chronic heart failure Thomas Müller-Tasch a, ⁎ , Lutz Frankenstein b , Nicole Holzapfel a , Dieter Schellberg a , Bernd Löwe c , Manfred Nelles b , Christian Zugck b , Hugo Katus b , Bernhard Rauch d , Markus Haass e , Jana Jünger a , Andrew Remppis b , Wolfgang Herzog a a Department of Psychosomatic and General Internal Medicine, University of Heidelberg, Heidelberg, Germany b Department of Cardiology, Angiology, and Pneumology, University of Heidelberg, Heidelberg, Germany c Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Hamburg-Eilbek (Schön Clinics), Hamburg, Germany d Heart Center Ludwigshafen, Ludwigshafen, Germany e Department of Cardiology, Theresien-Hospital Mannheim, Mannheim, Germany Received 9 July 2007; received in revised form 10 September 2007; accepted 11 September 2007 Abstract Objective: Our objective was to assess the prevalence of panic disorder, its influence on quality of life (QoL), and the presence of further anxiety and depressive comorbid disorders in outpatients with chronic heart failure (CHF). Methods: In a cross-sectional study, anxiety and depressive disorders were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic criteria in patients with CHF who were aged ≥18 years and had New York Heart Association (NYHA) Functional Classes I–IV, using the Patient Health Questionnaire. Health-related QoL was evaluated using the Short-Form 36 Health Survey (SF-36). Results: Of the 258 participating patients, 24 (9.3%) fulfilled diagnostic criteria for panic disorder. Seven of these (29.2%) were diagnosed with comorbid anxiety disorders, 11 (47.3%) were diagnosed with comorbid depressive disorder, and 5 (20.8%) were diagnosed with other anxiety disorders and any depressive disorder. Female gender [odds ratio (OR)=3.1; 95% confidence interval (95% CI)=1.2–7.8; P=.02] and a lower level of education (OR=0.3; 95% CI=0.1–0.9; P=.04) were associated with the presence of panic disorder. In patients with panic disorder, QoL was significantly more restricted on all subscales of the SF-36 as compared to those without panic disorder, even when age, gender, and NYHA functional class were controlled for (P=.05 to b.01). Conclusion: Approximately 1 of 10 patients with CHF suffers from panic disorder, many of whom also have additional anxiety or depressive comorbid disorders. Female gender and a low level of education are positively associated with the presence of panic disorder. QoL is severely limited by the presence of panic disorder. Diagnosis of mental disorders and treatment offers for affected patients should be available in patient care. © 2008 Elsevier Inc. All rights reserved. Keywords: Heart failure; Panic disorder; Prevalence; Psychiatric comorbidities; Quality of life Introduction Chronic heart failure (CHF) is a debilitating disease with high rates of prevalence [1] and mortality [2]. Affected individuals suffer from shortness of breath, limited physical capacity, and leg edema. Quality of life (QoL) is severely restricted [3]. In patients with CHF, comorbid depression has recently become a focus of research. Approximately 20% of CHF patients suffer from clinically significant depression [4], which is associated with restrictions in patients' QoL [3,5] and is a predictor of mortality [4,6]. Panic disorder is more frequently found in people with medical conditions (3–8%) than in those without medical conditions (1 –3%), is associated with a severely Journal of Psychosomatic Research 64 (2008) 299 – 303 ⁎ Corresponding author. Department of Psychosomatic and General Internal Medicine, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. Tel.: +49 6221 568654; fax: +49 6221 565749. E-mail address: Thomas.Mueller-Tasch@med.uni-heidelberg.de (T. Müller-Tasch). 0022-3999/08/$ – see front matter © 2008 Elsevier Inc. All rights reserved. doi:10.1016/j.jpsychores.2007.09.002