The effect of panic disorder in the managed care setting.

Panic disorder is significantly overrepresented in the primary care setting, compared with the general population. Patients with panic disorder are expensive to treat because they tend to be high utilizers of health care and are more likely to suffer recurrent psychiatric and physical disorders, present with unexplained somatic symptoms, and attempt suicide. Most primary care physicians receive little training in accurately recognizing and effectively treating panic disorder. The overutilization of primary care services by, and frequent misdiagnosis of, patients with panic disorder indicates a need for managed care systems to develop guidelines for diagnosing and managing panic disorder.