OBJECTIVES: I. Determine whether the prevalence of abnormalities on clinical vestibular
(balance) tests is higher in panic disorder with agoraphobia than in uncomplicated panic
disorder and nonpanic anxiety disorder.
II. Determine whether the prevalence of abnormalities on audiological tests of cochlear or
brainstem function is elevated in panic disorder without agoraphobia or nonpanic anxiety
III. Determine whether symptom patterns can be identified that are indicative of vestibular
abnormalities in panic disorder.
IV. Determine whether vestibular dysfunction can be induced by psychosomatic mechanisms.
PROTOCOL OUTLINE: Patients are stratified by otoneurological function (panic disorder
without agoraphobia, panic disorder with agoraphobia, anxiety disorder without panic or
agoraphobia-like avoidance, and normal controls).
Patients undergo a psychiatric interview and a structured interview focused on anxiety
disorders. Physical evaluation is completed.
A vestibular evaluation consisting of posturography, rotational testing, and ocular motor
screening battery, and positional and caloric testing is completed on all patients.
Patients then complete an audiological test battery consisting of basic audiological
analysis, speech recognition scores, immittance testing, brainstem evoked response, and
determination of binaural masking level differences.
Control patients also complete a hyperventilation-rotational test.
PROTOCOL ENTRY CRITERIA:
--Disease Characteristics-- Diagnostically proven panic disorders with or without moderate
or severe agoraphobia and anxiety disorders without panic or agoraphobia Panic disorder
may be accompanied by a secondary Axis 1 diagnosis of another disorder, such as
depression, generalized anxiety disorder, or dependent, histrionic, or compulsive
personality disorder --Prior/Concurrent Therapy-- Surgery: No prior ear surgery Other: No
concurrent medication for medical or psychiatric conditions At least 2 weeks since prior
medication No ototoxic drug intake --Patient Characteristics-- No medical disorders At
least 2 weeks since prior upper respiratory tract infection and recovered No history of
migraine No head trauma No scoliosis No alcoholism No drug abuse No family history of