Pain syndrome in panic attack clinical presentation

Introduction. In modern medicine, great attention has been paid to the study of patients with panic attacks (PAs) for a long time. One of the areas of scientific research is the study of the patients′ personality traits, as well as social, genetic and physiological factors causing the development of panic disorder. But peculiarities of pain syndrome in patients with PAs remain understudied. As a result, treatment and rehabilitation of patients with PAs remain insufficiently effective.

The aim: to research the role of pain syndrome in the clinical presentation of panic attacks.

Materials and methods. The studies involved 197 participants aged 38,65±10,91 including 41 men (20,8 %) and 156 women (79,2 %). They were divided into two groups based on the presence or the absence of PAs with the first group representing 147 people with panic attacks and the second group — 50 people without panic attacks. In all patients, pain syndrome (headache, chest pain, neck pain, and pain in the lumbosacral region) was assessed according to a 10-point Visual Analogue Scale (VAS). To study the dependence of pain syndrome characteristics on the severity of the disease course, patients with PAs from the first group were divided into 3 groups according to PA frequency in a four-week period: group of 31 people with infrequent PAs (less than four panic attacks), group of 48 people with mid-frequent PAs (at least four panic attacks), and a group of 68 people with frequent PAs (at least four panic attacks per week).

Results. According to our research, pain syndrome of different localization and intensity is more common in patients with PAs than in those without PAs, and was detected in 93,2 % of patients with PAs. Patients with PAs more frequently reported multisite pain, differently from those without PAs predominantly presenting complaints of pain in one body region. The intensity of headache, chest or neck pain is significantly higher in patients with PAs than in patients without PAs (р<0,05). In the majority of patients with PAs (75,9 %), pain syndrome preceded developing of PAs.

Conclusion. Pain syndrome can serve as a predisposing factor for the development of panic attacks and be the reason for the aggravation of the disease course, which is why pain syndrome in patients with PAs should undoubtedly be corrected. Taking into consideration the fact that a medication burden on such patients is high, the correction should primarily be performed using non-drug treatment options, including osteopathic methods.

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