Panic Disorder and Risk of Stroke: A Population-Based Study

Objective: An estimate of the risk of stroke among patients with panic disorder was sought. Method: A retrospective cohort study was conducted using data from the National Health Insurance Research Database in Taiwan. A total of 1725 patients who were newly diagnosed with panic disorder between 2001 and 2007 and had no other psychiatric disorders or history of stroke were included. We then selected our control group by excluding patients with past history of stroke or other mental disorder (n = 388,584). Each patient was tracked from his/her index ambulatory care visit until the end of 2009 to identify whether a stroke was diagnosed during the follow-up periods. The hazard ratios of strokes in panic disorder patients and control group during the observation periods were analyzed with multivariable Cox proportional-hazards models adjusted for age, sex, concur-rent medical conditions, and medications. Results: In the control group, 19,060 patients (4.9%) had new-onset stroke whereas there were 88 patients (5.1%) in the panic disorder group during the follow-up periods. The risk of stroke was 1.38 times greater for patients with panic disorder than for patients in the control group; (hazard ratio [HR] = 1.38; 95% confidence interval [CI], 1.12-1.71, p = 0.0025). Conclusions: Our findings demonstrated that patients with panic disorder had an increased risk of stroke in Taiwan. Further experimental studies are needed to identify the underlying mechanisms that could lead to early interventions. For panic disorder patients, treatment of their symptoms may be warranted to prevent possible stroke. (Psychosomatics 2012; 53:463-469)