A large study has found that patients with panic disorder may be more likely to report issues with alcohol and tobacco use compared with those without the condition, especially among men.
Investigators analyzed data from 10,953 adults without severe mental health issues. Among them, 342 screened positive for presumed panic disorder (pPD). These patients had significantly higher scores on alcohol and tobacco use screening tools compared with those without panic disorder.
The participants with pPD had an average alcohol use score of 1.26, vs 0.33 among those without. For tobacco use, the average score was 1.65 compared with 0.93. Both differences were statistically significant.
The patients with pPD had more alcohol and tobacco use issues.
Panic disorder affects about 2.7% of U.S. adults and is marked by sudden, intense fear accompanied by physical symptoms such as palpitations, shortness of breath, and dizziness. The condition is more common in women and typically begins in young adulthood.
In this sample, 58% of those with pPD were women. However, men with panic disorder had higher alcohol and tobacco use scores than women. “Among males with pPD, mean alcohol risk scores (2.10) were substantially higher than among males without pPD (0.53),” said Michael J. Chung, of the Department of Child & Adolescent Psychiatry at the New York University Langone Medical Center–Bellevue Hospital Center, and his colleagues. The association between panic disorder and alcohol use was stronger in men, with a significant interaction (beta = –0.97, P < .001).
The investigators also examined posttraumatic stress disorder (PTSD). Participants who screened positive for PTSD were more likely to report alcohol and tobacco use issues. However, PTSD didn't alter the relationship between panic disorder and substance use.
“We did not find any differences in alcohol or tobacco use [issues] when we looked at interactions with comorbid pPTSD,” the study authors wrote.
Ancestry was another focus. The participants identified as either African Ancestry or European Ancestry. Although past studies have found differences by race in panic and substance use disorders, this analysis didn't. “We did not find that ancestry/race had a moderating effect on alcohol and tobacco use [issues] among individuals with pPD,” the study authors added.
The investigators used a brief self-report screener rather than formal diagnostic interviews for panic disorder, alcohol use disorder, and tobacco use disorder. They acknowledged this limited diagnostic precision but allowed for faster identification of at-risk patients in clinical settings.
The investigators noted several limitations: the study was cross-sectional, so they couldn't determine causality, and the data were self-reported, which may have introduced recall bias.
Still, the findings could strengthen existing evidence linking panic disorder with substance use, particularly in men. These sex differences could help guide targeted treatment strategies.
“This study advances our understanding of the interplay between anxiety, SUD, and PD, particularly in the context of sex and ancestry/race differences, offering a foundation for future research and tailored clinical approaches,” the study authors concluded.
The authors declared no conflict of interest.
Source: Genomic Press