Characteristics of patients with panic disorder attended in primary care during the COVID-19 pandemic: A cross-sectional multicenter study. — CFSMEATLAS
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Characteristics of patients with panic disorder attended in primary care during the COVID-19 pandemic: A cross-sectional multicenter study.
Roca, Miquel, Villamor, Antonio Torres, Molinera, Vicente Gasull et al. · Atencion primaria · 2023 · DOI
Quick Summary
This study looked at how often panic disorder occurs in people visiting primary care clinics during the COVID-19 pandemic. Researchers found that about 5.3% of patients had panic disorder, with more cases in women. People with panic disorder were more likely to have money problems, high stress, and other conditions like chronic fatigue syndrome or irritable bowel syndrome.
Why It Matters
This study is relevant to ME/CFS populations because it documents a strong association between panic disorder and chronic fatigue syndrome during the pandemic, suggesting that mental health and post-viral fatigue conditions frequently co-occur. Understanding shared risk factors—particularly socioeconomic stress and high stress levels—may inform integrated treatment approaches for patients with overlapping fatigue and anxiety disorders.
Observed Findings
Panic disorder prevalence was 5.3% (36 of 678 patients) in primary care during COVID-19 waves 2–3.
63.9% of panic disorder cases occurred in women; mean age 46.7±17.1 years.
Socioeconomic hardship (low income, unemployment, housing payment difficulties) was significantly more common in patients with panic disorder.
High stress (Holmes-Rahe scale >300), concomitant chronic fatigue syndrome, and irritable bowel disease were associated with panic disorder.
Financial difficulties in the past 6 months were an associated risk factor for panic disorder.
Inferred Conclusions
Panic disorder is a clinically significant condition in primary care during the pandemic, affecting approximately 1 in 19 attendees and showing female predominance.
Socioeconomic stress and high psychosocial stress are key correlates of panic disorder in real-world primary care.
Comorbidity between panic disorder, chronic fatigue syndrome, and irritable bowel disease suggests shared underlying mechanisms or overlapping vulnerability.
Primary care mental health resources need strengthening during and beyond the pandemic to meet population needs.
Remaining Questions
Does the COVID-19 pandemic directly cause or exacerbate panic disorder, or are observed patterns driven primarily by pre-existing socioeconomic vulnerability?
What This Study Does Not Prove
This cross-sectional study cannot establish whether panic disorder causes chronic fatigue syndrome, whether chronic fatigue causes panic disorder, or whether the pandemic itself directly triggered these conditions. The study does not prove that socioeconomic factors directly cause panic disorder; it only shows they are more common in people with panic disorder. Temporal relationships and causal mechanisms remain unclear.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
What is the causal direction between panic disorder and chronic fatigue syndrome—does one condition predispose to the other, or do they share a common etiology?
How do treatment outcomes differ for patients with panic disorder alone versus those with comorbid chronic fatigue syndrome?
Are the risk factors identified (socioeconomic stress, high stress scores) modifiable targets for prevention or intervention?