At least 120,000 people in Hong Kong suffer from panic attacks but only one in four has sought medical help for their condition, a Chinese University study has found.
People in their 30s and 40s, especially women, are most at risk of suffering from the attacks, which tend not to be recognised by most doctors, researchers said.
The study by the university's Mood Disorders Centre found that those who did seek help spent sums ranging from a few hundred dollars to $100,000 on treatment, but two-thirds said the treatment was ineffective.
The study was based on a telephone survey last month of 3,004 people aged between 15 and 60.
Centre director Professor Lee Sing said four per cent of those surveyed - 133 people - were found to fit the diagnosis for a panic disorder. Of those, 67 per cent were women and 28 per cent of sufferers of both sexes were aged between 35 and 44.
Professor Lee said panic attacks were caused by a combination of stress and physiological vulnerability.
'People experience spontaneous attacks of acute anxiety. The attack lasts five or 10 minutes and the level of anxiety is extreme, much higher than in general society,' he said.
'The person, in anticipation of another attack, becomes very anxious. Because of that, he avoids [panic-triggering] situations.'
Based on the findings, people who panic avoid heights (37 per cent), flying (34.4 per cent), driving (30 per cent), going to the cinema (17.8 per cent) and taking the bus or the MTR (12 per cent).
The danger in untreated panic disorder is it can lead to severe mental illnesses, such as depression, with 42 per cent of those surveyed saying they had 'suicidal ideas'.
'Panic is much under-recognised,' said the professor.
Patients would go to a doctor complaining about severe heart palpitations, inability to breathe, dizziness and extreme fear, he said. Most general practitioners, however, would treat each of the symptoms, which would not help.
The survey showed only 40 per cent of sufferers of panic disorder had sought medical help, half of them with GPs, because of fear of being stigmatised if they sought psychiatric or psychological help, Professor Lee said.
He said it was important that GPs were trained to diagnose mood disorders to prevent tragedies such as suicides.
'Experience overseas has shown that most people suffering from mood disorders can be treated by private doctors,' he said.
The president of the Practising Estate Doctors' Association, Dr Gabriel Choi Kin, said medical students were given a few weeks of training in severe psychiatric illnesses, but not mood disorders.
'Family doctors are the first line of defence in a health-care system. We can then pick out warning signs,' he said.