Original Research An Increased Risk of Stroke Among Panic Disorder Patients: A 3-Year Follow-up Study

Objective: To explore whether panic disorder (PD) increases the risk for stroke, using a nationwide, population-based dataset. Methods: Our study used data from Taiwan’s National Health Insurance Research Database. The study cohort included patients who received ambulatory psychiatric care for PD between 2002 and 2003, inclusive (n = 3891). We selected our comparison cohort by randomly recruiting enrollees (n = 19 455) matched with the study group by sex and age. Each patient was tracked for 3 years, from their index ambulatory care visit until the end of 2006, to identify whether or not a patient had a stroke during the follow-up period. Cox proportional hazard regressions were performed as a means of computing the 3-year survival rate, adjusting for potential confounding factors. Results: Among the total sample, 2029 patients (8.7%) experienced a stroke during the 3-year follow-up period, including 647 from the study cohort (16.6 % of the PD patients) and 1382 (7.1%) from the comparison cohort. After adjusting for the patients ’ sex, age, monthly income, level of urbanization, and comorbid medical disorders, the hazard of stroke occurring during the 3-year follow-up period was 2.37 (P < 0.001) times greater for patients with PD than for patients in the comparison cohort. In further analyses, stratified by medical diseases and age, the significant risk of PD on subsequent stroke persisted. Conclusions: We conclude that PD is an independent risk factor for stroke. For patients with PD, aggressive treatment of PD may be considered as part of stroke prevention. Can J Psychiatry. 2010;55(1):43–49. Clinical Implication