by Genomic Press

Credit: CC0 Public Domain

In a research article, researchers have revealed compelling evidence that biological sex significantly influences substance use patterns among individuals with panic disorder, with implications for both clinical assessment and treatment strategies.

The study, published in the journal Genomic Psychiatry, examined associations between panic disorder and both alcohol and tobacco use disorders in a demographically diverse sample of nearly 11, 000 individuals.

The research team, led by Dr. Michele Pato, from Rutgers University, found that while panic disorder generally increased the risk of problematic substance use, men with panic disorder showed dramatically higher alcohol risk scores than women with the same condition.

"Our findings demonstrate that sex plays a crucial moderating role in how panic disorder relates to alcohol use problems, " said Professor Pato. "While females are generally more likely to experience panic disorder, males with the condition appear particularly more vulnerable to developing problematic drinking behaviors, potentially as a form of self-medication."

The study utilized data from the Genomic Psychiatry Cohort, a large-scale collection of individuals screened against severe mental illness. The sample's demographic diversity—56% female, with a balanced representation of European (55%) and African (45%) ancestry—provided researchers with a unique opportunity to examine how these demographic factors might influence comorbidity patterns.

Contrary to some previous research, the study found no significant ancestry-based differences in substance use patterns among those with panic disorder. This suggests that the relationship between panic and substance use disorders remains consistent across these ancestral groups, despite known differences in overall prevalence rates.

Questions for future research

What specific neurobiological mechanisms might make males with panic disorder more susceptible to alcohol problems? Could hormonal factors be influencing these sex-based vulnerability patterns? These questions represent important directions for future research.

Implications for comorbid conditions

The study also found that individuals with both panic disorder and posttraumatic stress disorder (PTSD) faced significantly higher risks for both alcohol and tobacco use disorders. This highlights the compounding effect of multiple anxiety conditions on substance use risk.

Clinical significance

How might these findings reshape clinical approaches to treating panic disorder? Should clinicians implement more targeted screening for substance use problems, particularly among male patients with panic symptoms? The research suggests that sex-specific assessment and intervention strategies may be warranted.

"Understanding these sex-based vulnerability patterns has direct implications for how we screen for and treat comorbid conditions, " noted Dr. Michael Chung, lead author and researcher at New York University Langone Medical Center. "Our work highlights the importance of considering biological sex when developing treatment plans for patients with panic disorder."

The researchers employed a unique methodology, using screening items to identify "presumed" conditions rather than formal diagnostic assessments. This approach allowed them to examine relationships across a larger and more diverse sample than many previous studies.

What role might societal expectations around masculinity play in driving these sex differences? Are men with panic disorder less likely to seek professional help and more likely to self-medicate with substances? These sociocultural factors require further investigation to fully understand the observed patterns.

This research adds to a growing body of evidence suggesting that anxiety and substance use disorders share complex, bidirectional relationships that vary across demographic groups. The findings underscore the need for integrated treatment approaches that address both anxiety symptoms and substance use behaviors simultaneously.

More information: Sex differences in alcohol and tobacco use disorders among individuals with panic disorder: A cross-sectional analysis from the genomic psychiatry cohort, Genomic Psychiatry (2025). DOI: 10.61373/gp025a.0020