Abstract
Fatigue is a criterion for the diagnosis of major depressive disorder and general anxiety disorder but not panic disorder. Our objective was to explore the nature of fatigue in patients with panic disorder who did not have primary depressive disorder. In a sample of 51 patients who had agreed to participate in a prospective, double-blind medication trial, most patients reported lack of energy on the day of evaluation (65%). Below normal physical endurance was reported by 397c. Although patients with major depressive disorder were excluded, 31% of patients had moderate to severe scores on the Beck Depression Inventory (BDI). Those who had less energy had higher BDI scores, more anxiety, more irritability, less ability to concentrate on simple tasks, and less interest in things normally of interest. Below normal endurance also significantly correlated with hopelessness. Patients fell into three subgroups: patients with panic disorder not dysphoric, not fatiguecf (29%); (2) fatigued but not dysphoric (43%); and (3) fatigued and dysphoric (24%). Fatigue occurred in the absence of depression, but the severity of fatigue correlated with severity of both anxious and depressive symptoms. Fatigue may be a significant marker of an intermediate stage or a failing adaptive process, a stage between panic disorder and secondary depression.
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