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Introduction: PTSD and panic disorder have a bi-directional relationship. These exist as comorbidities and have cause-and-effect association. History of trauma figures prominently in a substantial proportion of patients with panic disorder. Survey on 8th October earthquake survivors have revealed high incidence of panic disorder, PTSD or both. Method: Team comprising of psychologists and psychiatrists conducted open-ended interviews of survivors to assess their mental state two months after the tragedy. Pre-earthquake culture was taken into account. Results: Data analyses of women (1056), men (281) and children (204) indicate high prevalence of Panic Disorder including PTSD (853 women, 153 men) and depression (73 women, 31 men). Victims suffered traumatic suffocation and sustained injuries including head injuries, peritraumatic dissociation, and near death experiences leading to PTSD, panic disorder or both. Sufferers were mostly females as they were inside their houses at the time of calamity. Pre-earthquake culture survey did not reveal extraordinary prevalence of pretraumatic variables in the population as compared to Pakistan except for absence of male members. 5O% of male population was out of the area for earning. In the subcontinent conversion is commonly used coping mechanism. Discussion PTSD and panic disorder are due to disturbance of central fear system. Panic in earthquake survivors may be inherent part of PTSD or be an independent phenomenon. In this population peritraumatic panic was very common. Panic Disorder can be explained on the basis of conditioned reflex to the cues. Hyperarousal during PTSD trigger panic attacks. Frequent panics were also due to high intensity after shocks.
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