The Assessment of relationship between mitral valve prolapse and panic disorder

ABSTRACT THE ASSESSMENT OF RELATIONSHIP BETWEEN MITRAL VALVE PROLAPSE AND PANIC DISORDER During last 25 years, despite many studies searching for a causal relationship between mitral valve prolapse and panic disorder, no definite conclusion has been reached. The aim of this study was to evaluate the relationship between panic disorder and mitral valve prolapse from multiple aspects. For this reason; it was proposed to determine the psychopathologic features of patients with mitral valve prolapse, compare these features with cases in panic disorder and control groups, and find out mitral valve prolapse prevalence among panic disorder patients. The effect of prolapse level on psychopathology level of cases was also investigated. Depending upon these data, the relationship between mitral valve prolapse and panic disorder was studied, and a conclusion about the nature of this relationship was tried to be reached. 50 cases diagnosed as mitral valve prolapse in Cardiology outpatient service within age range of 15 to 51 years (mean 30.5±8.7) were included in this study. In order to compare with mitral valve prolapse patients, two study groups were composed. The panic disorder group included 50 patients diagnosed as panic disorder according to DSM-IV in our Psychiatry outpatient clinics between 16 to 55 years of age (mean 33.0+ 7.7) whereas control group included 50 healthy patients with no prominent complaint between 17 to 63 years of age. All patients were evaluated with echocardiography for mitral valve prolapse using standard echocardiographic techniques by cardiologists. After obtaining their consents, all patients were interviewed with a semi-structured interview scale and data regarding sociodemographic and their disease were obtained. Then all patients filled out self- report questionnaires including Symptom Check List (SCL-90-R), Beck Depression Inventory (BDI), State and Trait Anxiety Inventory (STAI 1 and STAI-2) and Toronto Alexithymia Scale (TAS). VIIThis study revealed that female/male ratio of mitral valve prolapse and panic disorder patients was approximately 2/1. 16% of mitral valve prolapse group and 2% of healthy control group had panic disorder as a first axis psychiatric diagnosis with statistically significant difference between groups. The mean scores in all psychometric scales were significantly higher in panic disorder group than the other two groups; and significantly higher in mitral valve prolapse group than the healthy control group. There were no significant difference between panic disorder and mitral valve prolapse group in terms of symptoms of panic attack except dyspnea, fear of death and paresthesias. Echocardiographic assessments revealed that 12% of panic disorder group and 5.7% of control group had mitral valve prolapse. No significant differences were found between panic disorder patients with and without mitral valve prolapse regarding psychometric instruments, clinical diagnosis and symptoms of panic attack. The data acquired from this study showed that patients with mitral valve prolapse and patients with panic disorder had similar age and gender distribution, mitral valve prolapse cases had higher panic disorder prevalence than normal healthy control groups. It was also found that mitral valve prolapse cases had clinical symptoms similar to panic disorder patients, had more psychopathology than healthy, control group, and that prolapse level of cases did not affect the psychopathology and clinical symptoms present in the patients. Taking the results of this study into account during follow-ups at Cardiology and Psychiatry clinics would be of great benefit to the patients and the physicians in many aspects. Key Words: Mitral valve prolapse, panic disorder, alexithymia, depression, anxiety VII