Serum cholesterol levels and panic symptoms in patients with panic disorder: a preliminary study

Background: Although some previous research has focused on the relationship between panic disorder (PD) and a high total cholesterol (TC) level, it is still controversial. Recently, researchers have reported the heterogeneity of clinical symptoms in PD and the complexity of the correlations found among them. Therefore, the controversy on the TC level in PD may be due to the existence of clinical subgroups in PD. It is important to ascertain whether or not an elevated TC level in patients with PD is associated with specific panic symptoms. Methods: In 104 drug-free patients with PD, we examined the relationship between TC level and each of several panic symptoms occurring at the time of panic attacks (PAs), which included anticipatory anxiety, agoraphobia, and 13 panic symptoms based on the DSM-III-R. Results: Stepwise regression analysis revealed a significant effect of the presence of the symptom ‘fear of dying’ on TC levels. Patients with a fear of dying had a significantly higher TC level than those without it. Limitations: The relatively small sample size may limit the generalizability of our findings. Discussion: These data suggest that TC level may be associated with panic symptoms in patients with PD.