DEPRESSION AND ANXIETY 24:545–552 (2007) Research Article ARE THERE GENDER DIFFERENCES IN CATASTROPHIC APPRAISALS IN PANIC DISORDER WITH AGORAPHOBIA? Vladan Starcevic, M.D., Ph.D., F.R.A.N.Z.C.P., 1Ã Milan Latas, M.D., Ph.D., 2 Dusan Kolar, M.D., Ph.D., 3 and David Berle, B.A. (Hons.), M.Psychol. 4 Our aim in this study was to compare panic-related catastrophic appraisals between women and men with panic disorder with agoraphobia (PDA). One hundred two outpatients with PDA (75 women and 27 men) participated. Two instruments for the assessment of catastrophic appraisals, Agoraphobic Cogni- tions Questionnaire and Panic Appraisal Inventory, were administered before and after cognitive-behavioral therapy (CBT) that also included pharmacother- apy in three-fourths of the patients. Female and male patients did not differ significantly in terms of their tendency to anticipate catastrophic consequences of panic, before or after CBT-based treatment. For both females and males, the tendency to make catastrophic appraisals decreased significantly with treatment. We conclude that among patients with PDA there are no gender differences in catastrophic appraisals of panic sensations and symptoms. The apparently higher risk of panic recurrence in women does not seem to be related to their panic- related catastrophic appraisals. These findings also support a notion that there is no gender difference in response to CBT-based treatment of PDA. Depression and Anxiety 24:545–552, 2007. & 2006 Wiley-Liss, Inc. Key words: panic disorder; agoraphobia; gender; risk factors; panic-related cognitions; catastrophizing; cognitive-behavioral therapy INTRODUCTION The research on gender differences in panic disorder (PD) and panic disorder with agoraphobia (PDA) has not produced consistent findings. Whereas women have a significantly increased risk of PD, and especially of PDA, studies showed relatively few differences between women and men with PD/PDA. For example, several studies in clinical samples [Oei et al., 1990; Starcevic et al., 1998; Yonkers et al., 1998] reported no differences in panic symptoms between women and men, whereas one study based on a community sample of people with panic attacks and PD [Sheikh et al., 2002] reported that women were more likely to have respiratory symptoms (shortness of breath, feeling smothered, choking/difficulty swallowing) and faint- ness during panic attacks. There is some agreement that women with PDA have a more severe condition and more functional impairment in comparison with men [Starcevic et al., 1998; Turgeon et al., 1998]. As for Published online 27 November 2006 in Wiley InterScience (www. interscience.wiley.com). DOI 10.1002/da.20245 Received for publication 7 March 2006; Revised 3 June 2006; Accepted 27 June 2006 Ã Correspondence to: Vladan Starcevic, Department of Psycholo- gical Medicine, Nepean Hospital, P.O. Box 63, Penrith, New South Wales 2751, Australia. E-mail: starcev@wahs.nsw.gov.au; vstar@tpg.com.au 1 University of Sydney, Discipline of Psychological Medicine, and Nepean Hospital, Penrith, New South Wales, Australia 2 Institute of Psychiatry, Clinical Center of Serbia, Belgrade, Serbia and Montenegro 3 Institute of Neurology and Psychiatry for Children and Adolescents, University of Belgrade School of Medicine, Belgrade, Serbia and Montenegro 4 Nepean Anxiety Disorders Clinic, Sydney West Area Health Service, Penrith, New South Wales, Australia r r 2006 Wiley-Liss, Inc.