DECLARATION UNDER SUBSECTION 196B(9)

OF THE VETERANS’ ENTITLEMENTS ACT 1986

The Repatriation Medical Authority (the Authority), under subsection 196B(9) of the Veterans’ Entitlements Act 1986 (the Act), makes the following declaration in respect of the review of the contents of the Statements of Principles in force under the Act concerning panic disorder, Instrument Nos. 68 and 69 of 2009. 

The investigation related to "a threatening, hostile, hazardous and/or menacing situation and/or environment". The Notice of Investigation was published in the Government Notices Gazette of 26 March 2014.

The Authority declares that it does not propose to amend Statements of Principles, Instrument Nos. 68 and 69 of 2009, concerning panic disorder for the reason that the new sound medical-scientific evidence available is not sufficient to justify an amendment to the Statements of Principles already determined in respect of panic disorder.

A cross-sectional Vietnam veteran study reported some significant associations between panic disorder and malevolent environment and perceived threat.  A cross-sectional Australian Gulf War Veterans' Health Study found that when compared with the control group, Australian Gulf War Veterans had an increased risk of presenting with a panic disorder/agoraphobia diagnosis after the Gulf War, however, these results were not significant.  A significant increased risk for panic disorder/agoraphobia in the previous 12-months was reported.  A retrospective database study of veterans of the recent Afghanistan and Iraq conflicts reported that greater perceived threat during deployment was significantly associated with anxiety disorders, but no findings for panic disorder specifically were reported.

Overall, the evidence was limited in quality and quantity and one study did not report specifically on panic disorder as an outcome. An association was demonstrated in some of the analyses, but the findings are limited by the cross-sectional design, retrospective data collection, lack of independent validation of some measures and possible confounding by other lifestyle factors and pre-deployment factors. Studies with prospective design and clinical measurement of psychiatric diagnoses are required to confirm if these associations are causal.

The Authority concluded that the sound medical-scientific evidence available is inadequate to raise a reasonable hypothesis concerning a causal relationship between exposure to a threatening, hostile, hazardous and/or menacing situation and/or environment and panic disorder.

The Common Seal of the  )

Repatriation Medical Authority  )

was affixed at the direction of:  )

PROFESSOR NICHOLAS SAUNDERS AO

CHAIRPERSON   17 / 10 /2014