Panic disorder among Cambodian refugees attending a psychiatric clinic

Abstract

This study surveys Khmer refugees attending two psychiatric clinics to determine both the prevalence of panic disorder as well as panic attack subtypes in those suffering panic disorder. A culturally valid adaptation of the SCID-panic module, the Cambodian Panic Disorder Survey (CPDS), was administered to 89 consecutive Cambodian refugees attending these psychiatric clinics. Utilizing culturally sensitive panic probes, the CPDS provides information regarding both the presence of panic disorder and panic-attack subtypes during the month prior to interview. Of 89 patients surveyed at two psychiatric clinics, 53 (60%) currently suffered panic disorder. Among the 53 patients suffering panic disorder, the most common panic attack subtypes during the previous month were the following: "sore neck" [51% of the 53 panic disorder patients (PDPs)], orthostatic dizziness (49% of PDPs), gastrointestinal distress (26% of PDPs), effort induced (21% of PDPs), olfactory induced (21% of PDPs), and "while-sitting dizziness" (16% of PDPs).

Panic disorder among Vietnamese refugees attending a psychiatric clinic: prevalence and subtypes

“…Of note, as in a survey of Khmer patients [23], during the panic attacks subtypes assessed by the special probes (e.g., headache and orthostatically induced dysphoria), almost all patients feared death and were highly distressed.…”

“…Furthermore, as a supplement, to provide comparative data to the survey of Cambodian refugees [23], four more probes were utilized, though from clinical experience the author doubted a positive reply would be found in the Vietnamese population: sore-neck dysphoria; hunger-induced distress; olfactory-triggered dysphoria; and head turning or seeing spinning objects as causing distress. In regard to this last query, in the Khmer survey [23], it was found that 16% of the panic disorder patients suffered "while-sitting dizziness."…”

“…In regard to this last query, in the Khmer survey [23], it was found that 16% of the panic disorder patients suffered "while-sitting dizziness." Upon further query, the investigator has now found that these panic attacks were caused either by turning the head rapidly-side-to-side or up-and-down-or else by looking at a spinning object.…”

“…Members of society will understand symptoms of somatic arousal in a specific way. If that society happens to have multiple cultural syndromes that lead to a great deal of catastrophic cognizing regarding certain symptoms of arousal, then trauma in that group may tend to result in panic disorder and panic disorder of certain subtypes, focusing on particular symptoms [23][24][25][26].…”

“…In regard to investigations of other Southeast Asian refugee groups (i.e., Cambodians, Laotians and Hmong), only one study examines rates of panic disorder. A survey of Khmer refugees attending a psychiatric clinic revealed that 60% of the patients surveyed suffered panic disorder [23]. Also, Khmer have several unusual panic subtypes such as orthostatically induced panic [23][24][25] and "sore neck" panic [23,26].…”