Panic disorder is an anxiety disorder characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms. The diagnosis frequently is associated to other comorbid axis-I psychiatric disorders, especially depressive disorders. Moreover panic disorder can also be comorbid with axis-II diagnosis of Personality Disorder¹(PDs).

The aim of this study was to evaluate the existing comorbidity between current DSM-IV axis I panic disorder with and without co-occurring depression and current DSM-IV axis II PDs.

We review all database from 1987 until January 2012 of all relevant cross-sectional and case-control studies which evaluate the comorbidity between panic disorders and PDs.

We found 97 possible papers, 20 entered in the review. Among patients with a current DSM-IV panic disorder 44.3% [34.6, 54.2] had any PDs; 6.3% [3.1, 10.4] had any cluster A-PDs; 17.9% [12.2, 24.2] any cluster B-PDs, and 34.9% [25.6, 44.7] had any cluster C-PDs. Among patients with a current DSM-IV panic disorder and co-occurring depression 61.8% [44.6, 77.7] had any personality disorder 7.2% [4.4, 10.5] had any cluster A-PDs; 24.0% [17.6, 30.9] any cluster B-PDs, and 38.6% [25.7, 52.2] had any cluster C-PDs.

The comorbidity between Panic disorder and Personality disorders is common. Cluster C-PDs was the most frequent PDs subtype related to panic disorder. Personality disorders were more prevalent among individuals with panic disorder and co-occurring depression. Further evaluations including dimensional and characterial dimensions are needed.Goodwin RD, Brook JS, Cohen P. Panic attacks and the risk of personality disorder. Psychol Med. 2005;35:227-35.