 |
|
Hypertension and Pheochromocytoma TestingThe Association With Anxiety Disorders
John Fogarty, MD;
MAJ Charles C. Engel, Jr, MC;
Joan Russo, PhD;
Greg Simon, MD, MPH;
Wayne Katon, MD
Arch Fam Med. 1994;3(1):55-60.
Abstract
Objective
To test the hypothesis that patients with hypertension who were screened for pheochromocytoma would have a higher prevalence of panic disorder, an increased prevalence of other anxiety and affective disorders, more psychological distress, a greater tendency to amplify somatic complaints, and increased functional disability compared with a control group. Our study also describes the clinical reasons for pheochromocytoma workups and the number of such workups with positive results in two large hospitals over a 1-year period based on a review of laboratory and chart data.
Design
Forty patients with hypertension who were screened for pheochromocytoma were compared with 30 group-matched controls with hypertension who were screened for cholesterol levels on a structured psychiatric interview as well as self-rating questionnaires measuring psychological distress, functional disability, and the tendency to amplify symptoms.
Main Results
The prevalence of current and lifetime panic disorder, agoraphobia, and multiple phobias was significantly higher in patients screened for pheochromocytoma compared with those screened for cholesterol levels. Moreover, the patients with hypertension who were screened for pheochromocytoma reported significantly higher levels of psychological distress, significantly lower levels of vocational and social role functioning and vitality, and a more adverse view of their physical and mental health. Current anxiety disorders in this group were especially associated with the primary care presentation of episodic physical symptoms (ie, palpitations and headache) and labile hypertension but not with severe or treatment-resistant hypertension.
Conclusion
Patients presenting with episodic somatic symptoms such as tachycardia, flushing, headache, and/or labile hypertension, who may normally be screened for pheochromocytoma, should be screened for anxiety disorders, especially panic disorder, by their primary care physicians.
Author Affiliations
USA
From the Department of Psychiatry and Behavioral Sciences, University of Washington Medical School (Drs Fogarty, Engel, Russo, and Katon), and the Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle (Dr Simon).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Phaeochromocytoma: diagnostic challenges for biochemical screening and diagnosis
Barron
J. Clin. Pathol. 2010;63:669-674.
ABSTRACT
| FULL TEXT
Medical Symptoms without Identified Pathology: Relationship to Psychiatric Disorders, Childhood and Adult Trauma, and Personality Traits
Katon et al.
ANN INTERN MED 2001;134:917-925.
ABSTRACT
| FULL TEXT
|
