EXAMINATION OF PANIC IN 12,087 RECREATIONAL SCUBA DIVERS

1. EXAMINATION OF PANIC IN 12,087 RECREATIONAL SCUBADIVERS DF Colvard and LY Colvard, 3725 National Dr #228, Raleigh, NC 27612 Results: 12,087 certified recreational scuba divers (76% males and 24% females) completed the survey. Introduction: Panic while diving is thought to be a major factor contributing to recreational scuba diver injuries and deaths. Morgan has reported that 64% of female and 50% of male divers reported “panic or near-panic” episodes on one or more occasions. Physicians have been advised not to approve diving for individuals with a history of panic disorder or recent panic. This study sought to examine the incidence of panic while diving, the relationship to a history of panic prior to diving, and the results of panic during a dive. • Among the 499 with a panic dive and rapid or uncontrolled ascent, 14 males and 9 females reported having signs or symptoms of decompression illness, and 7 males and 2 females underwent hyperbaric treatment, an insufficient number of cases for meaningful statistical analysis. One diver reported long term residual effects: numbness in the left toes after 5 years. Methods: This retrospective study examined responses to an Internet survey of recreational scuba divers at a website provided and promoted by Rodale’s Scuba Diving magazine in the Fall of 2000. PADI provided a hot link to the survey from their electronic newsletter, which was directly sent to over 200,000 PADI certified recreational divers. The survey included questions about demographics, diver certification, diving history, and any history of panic while diving or at other times. The first survey question about panic defined a panic experience as “an intense fear of losing control or dying”, consistent with the definition of a panic attack in DSM-IV. Respondents with a panic experience while diving were directed to additional questions. The data were sorted according to history of panic prior to diving and panic during diving, and were compared while controlling for gender and whether the first panic during diving occurred during or after initial training. The relative risks and 95% confidence intervals were computed from the incidence rates of first panic using the computer program “Confidence Interval Analysis” from Statistics With Confidence, 2nd edition, Altman, et al, BMJ Books 2000. (Relative risk is the ratio of the incidence of some outcome in two groups of individuals defined by the presence or absence of some characteristic.) Conclusions: A history of panic prior to diving corresponded to about a two-fold relative risk of panic while diving, (2.3 for males and 1.7 for females). However, a history of panic prior to diving made little difference in the incidence of rapid or uncontrolled ascent with panic, either during or after initial training. A follow up study of the divers from this survey is currently underway. A prospective study of new dive students is needed to better determine the incidence of panic, the relative risk with a history of panic prior to diving, the incidence of rapid ascent, and the morbidity and mortality from the same, so that physicians can better advise potential dive students. References: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Washington, DC, American Psychiatric Association, 1994, p. 394-396. Bachrach AJ and Egstrom GH. Stress and Performance in Diving. San Pedro, California, Best Publishing, 1987, p. 1. Bove AA. Medical Examination of Sport Scuba Divers, 3rd edition. San Antonio, Texas, Medical Seminars, 1998, p. 20-25. Guidelines for Recreational Scuba Diver’s Physical Examination, Recreational Scuba Training Council, Inc., 1998. Morgan WP. Anxiety and Panic in Recreational Scuba Divers. Int J Sports Med 1995; 20: 398-421. Parker J. The Sports Diving Medical: A Guide to Medical Conditions Relevant to Scuba Diving. Melbourne, Australia, JL Publications, 1994, p. 103-107.