Psychiatry and Primary Care Recent epidemiologic studies have found that most patients with mental illness are seen exclusively in primary care medicine. These patients often present with medically unexplained somatic symptoms and utilize at least twice as many health care visits as controls. There has been an exponential growth in studies in this interface between primary care and psychiatry in the last 10 years. This special section, edited by Jürgen Unutzer, M.D., will publish informative research articles that address primary care-psychiatric issues. Prevalence and features of panic disorder and comparison to posttraumatic stress disorder in VA primary care ☆ Daniel F. Gros, Ph.D. a,b, ⁎ , B. Christopher Frueh, Ph.D. c,d , Kathryn M. Magruder, M.P.H., Ph.D. a,b a Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC 29401, USA b Medical University of South Carolina, Charleston, SC 29403, USA c Department of Psychology, University of Hawai'i, Hilo, HI 96720, USA d The Menninger Clinic, Houston, TX 77080, USA Received 22 February 2011; accepted 21 June 2011 Abstract Objective: Although panic disorder (PD) is a highly prevalent condition in both community and community primary care settings, little is known about PD in veteran populations, especially in comparison to posttraumatic stress disorder (PTSD). The present study investigated prevalence, comorbidity, physical and mental health impairment, and health care utilization of veterans with PD and PTSD. Method: A total of 884 veterans participated in a cross-sectional investigation in primary care clinics in four Veteran Affairs Medical Centers (VAMCs). Participants completed diagnostic interviews and self-report questionnaires, and a chart review was completed to assess their VAMC health care utilization. Results: A large number of veterans (8.3%) met the diagnostic criteria for PD and reported significantly more severe physical health impairment (pain, general health), mental health impairment (emotional well-being, role limitations) and social functioning than veterans without PD. Veterans with PD also had increased health care utilization for mental health. Further, PD was highly comorbid with PTSD, with similar symptoms across all measures. Conclusions: These findings demonstrate the high prevalence and severe impairment associated with PD in veterans and highlight the need for improved recognition, assessment and specialized treatments for PD in VAMCs and other care settings. Published by Elsevier Inc. Keywords: Panic disorder; Posttraumatic stress disorder; Veterans; Comorbidity; Health care utilization Although the prevalence of panic disorder (PD) is relatively low in community settings (2.7% 12-month prevalence), the prevalence in community primary care settings is considerably higher (6.8%) [1,2]. PD is associated with high levels of social, occupational and physical disability in addition to persistent general health complaints and poor perceived physical health [3]. Individuals with PD demonstrate high utilization of medical services, including being eight times more likely to use medical services than individuals without PD [3,4]. In addition, the majority of individuals with PD initially seek treatment from primary care (70%–85%) or emergency care (43%) settings [5]. Despite its high prevalence and associated medical services, Available online at www.sciencedirect.com General Hospital Psychiatry 33 (2011) 482 – 488 ☆ This work was partially supported by a grant from Veterans Affairs Health Services Research and Development (VCR-99-010-2). In addition, the authors are members of the Ralph H. Johnson VAMC Research Enhancement Award Program (REA08-261; principal investigator: Leonard Egede, M.D.). The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the US government. There are no conflicts of interest to disclose. ⁎ Corresponding author. Mental Health Service 116, Ralph H. Johnson VAMC, Charleston, SC 29401, USA. Tel.: +1 843 789 7311; fax: +1 843 805 5782. E-mail address: grosd@musc.edu (D.F. Gros). 0163-8343/$ – see front matter. Published by Elsevier Inc. doi:10.1016/j.genhosppsych.2011.06.005