Panic Disorder Blood Test May Aid Treatment

Harriet Brown, 49, has struggled with panic disorder her entire life.

"I remember going out to lunch with colleagues," she said. "On one level I was fine. On another level, I was absolutely freaking out. I had sweaty palms. It was like play life. That's what it's been like for me, having to carry on when I feel horrible inside."

Although Brown began suffering from panic disorder at the age of 8, she was not diagnosed until she was in her early 20s.

"It was a huge relief to be diagnosed with something that had a name," she said. "Until my 20s, I thought I was crazy or that something was wrong with me. I went through a lot of it's all in your head stuff from doctors that really was not helpful."

Soon after her diagnosis, Brown relied mostly on therapy but now prefers medication.

"For me [panic disorder] is not about anything," Brown said."I spent time in therapy trying to figure out what it was. I understood a lot of things about my family, but it didn't stop the panic attacks. For example, you can have PD crossing a bridge. You can think crossing the bridge is the problem, but it's not. I think it's a biological mechanism that goes haywire," she said.

Testing Genes for Panic Disorder

Dr. Robert Philibert is developing a blood test that can help people like Brown who live with panic disorder.

The test, which measures the gene expression in lymphocytes in a person's blood, would enable doctors to determine whether a patient has the condition.

"Panic disorder will no longer be a purely descriptive diagnosis, but as with cystic fibrosis, Down syndrome and other conditions, a diagnosis based on genetic information," explained Philibert, a professor of psychiatry at the University of Iowa College of Medicine.

Philibert warned, however, that the test is only predictive and very costly.

"We're offering a test that won't be cheap by any standards -- anywhere between $200 to $1,000 to the patient or insurance companies," he said. "The ideal person for the test is someone for whom a difference in the course of treatment is worth the cost of the test."

For some patients, the test will allow a better diagnosis of the disorder.

"For example, if a patient has chest flutters, it could be panic disorder or ventricular tachycardia," he said. "Ventricular tachycardia is not panic disorder, and it can kill you. If in this case, the test came back negative, then [the patient] would need further testing."

Dr. Charles Glatt, assistant professor of psychiatry at Weil Cornell Medical College, agreed.

"A blood based test would be really valuable," Glatt said. "Although the DSM [Diagnostic and Statistical Manual of Mental Disorders] has helped a great deal in terms of standardizing diagnoses, they're still very subjective. That's why [we] want to get to the biology."

Changing Attitudes

Philibert insisted that panic disorder is grave and warrants greater attention from the medical community.

"A lot of these people develop agoraphobia and are holed up in their house, or drink to lower anxiety and develop alcoholism," he said. "People say, 'Panic disorder? Just get over it.' Yeah, right.

"People do the best they can, but we're just people. Not Greek deities -- who, by the way, had their own faults."

He is also convinced that the test could help improve the medical community's attitude toward panic disorder by giving it a biological basis.

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