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Non-Fearful Panic Disorder in Gastroenterology

Received May 6, 2007; revised July 21, 2007; accepted August 1, 2007. From the Psychosomatic Unit; Department of Gastroenterology, IRCCS De Bellis Hospital, Castellana Grotte, Italy. Send correspondence and reprint requests to Dr. Piero Porcelli, Unità di Psicosomatica, IRCCS Ospedale De Bellis, Via della Resistenza, 70013 Castellana Grotte, Bari, Italy. e-mail: porcellip{at}media.it
© 2008 The Academy of Psychosomatic Medicine

BACKGROUND: Nonfearful panic disorder (NFPD) is a panic condition masked under the appearance of somatic symptoms only, without the component of fear, and it represents a challenging diagnostic task. METHOD: This is the first case report of NFPD in a male patient with acute gastric pain and gastrointestinal disease (atrophic gastritis and H. pylori infection). RESULTS: The patient showed atypical panic symptoms and demoralization on the Diagnostic Criteria for Psychosomatic Research screening. He was successfully treated with anti-panic medication and cognitive–behavioral therapy. DISCUSSION: The case report shows that accurate psychosomatic assessment may help clinicians avoid diagnostic delay, prevent the administration of unnecessary medications, and give patients more appropriate treatment.

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