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Characteristics of African-American and White Patients With Panic Disorder and Agoraphobia
Steven Friedman; Marjorie Hatch; Cheryl M. Paradis
Psychiatric Services 1994; doi:
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This work was partly supported by grant MH-42545 from the National Institute of Mental Health and by funds generated through the department of psychiatry practice plan of the State University of New York Health Sciences Center at Brooklyn. The authors thank Reuben Margolis for assistance in data analysis.

State University of New York Health Science Center at Brooklyn, Box 1203, 450 Clarkson Ayenue, Brooldyn, New York 11203

State University of New York Health Science Center at Brooklyn, Box 1203, 450 Clarkson Ayenue, Brooldyn, New York 11203; Kings County Hospital Center in Brooklyn

1994 by the American Psychiatric Association

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Objective: The authors explored the clinical characteristics and treatment response of African-American and white patients with panic disorder and agoraphobia who presented for treatment at an anxiety disorders clinic.Methods: One hundred white and 43 African-American patients were evaluated using a structured interview and completed a variety of standardized rating scales. In addition, data regarding clinical characteristics, psychiatric history, childhood history, life stressors, and treatment outcome were obtained by chart review. The incidence of isolated sleep paralysis was also assessed in a subsample of patients.Results: The two groups had no significant differences in psychiatric symptoms. African-American patients were more likely to use a medical emergency room, to have had childhood separations, and to have bad parents who abused substances. They also reported less separation anxiety, school phobia, and affective illness in family members. In addition, African Americans, both patients and nonclinical control subjects, were more likely to report that they experienced repetitive episodes of isolated sleep paralysis. Treatment outcome was moderately successful among both African-American patients and white patients.Conclusions: Although African-American and white patients show similar symptoms of panic disorder, African-American patients had more unnecessary psychiatric hospitalizations, a higher rate of medical emergency room visits, a higher incidence of isolated sleep paralysis, greater likelihood of childhood trauma, and a greater number of life stressors. Addressing these issues in treatment is critical in reducing the dropout rate and maintaining successful treatment.

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