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Journal of Affective Disorders Dec 2016There is a lack of clarity regarding specific risk factors discriminating generalized anxiety disorder (GAD) from panic disorder (PD).
BACKGROUND
There is a lack of clarity regarding specific risk factors discriminating generalized anxiety disorder (GAD) from panic disorder (PD).
GOAL
This study investigated whether GAD and PD could be discriminated through differences in developmental etiological factors including childhood parental loss/separation, psychological disorders, and maternal and paternal attachment.
METHOD
Twenty people with adult generalized anxiety disorder (GAD), 20 with adult panic disorder (PD), 11 with adult comorbid GAD and PD, and 21 adult non-anxious controls completed diagnostic interviews to assess symptoms of mental disorders in adulthood and childhood. Participants also reported on parental attachment, loss and separation.
RESULTS
Childhood diagnoses of GAD and PD differentiated clinical groups from controls as well as from each other, suggesting greater likelihood for homotypic over heterotypic continuity. Compared to controls, specific phobia was associated with all three clinical groups, and childhood depression, social phobia, and PTSD were uniquely associated with adult GAD. Both maternal and paternal attachment also differentiated clinical groups from controls. However, higher levels of subscales reflecting maternal insecure avoidant attachment (e.g., no memory of early childhood experiences and balancing/forgiving current state of mind) emerged as more predictive of GAD relative to PD. There were no group differences in parental loss or separation.
CONCLUSIONS
These results support differentiation of GAD and PD based on developmental risk factors. Recommendations for future research and implications of the findings for understanding the etiology and symptomatology of GAD and PD are discussed.
Topics: Adolescent; Adult; Anxiety Disorders; Comorbidity; Female; Humans; Male; Panic Disorder; Parenting; Phobia, Social; Phobic Disorders; Risk Factors; Young Adult
PubMed: 27466747
DOI: 10.1016/j.jad.2016.07.008 -
Endocrinology and Metabolism Clinics of... Dec 2019Pseudopheochromocytoma manifests as severe, symptomatic paroxysmal hypertension without significant elevation in catecholamine and metanephrine levels and lack of... (Review)
Review
Pseudopheochromocytoma manifests as severe, symptomatic paroxysmal hypertension without significant elevation in catecholamine and metanephrine levels and lack of evidence of tumor in the adrenal gland. The clinical manifestations are similar but not identical to those in excess circulating catecholamines. The underlying symptomatic mechanism includes augmented cardiovascular responsiveness to catecholamines alongside heightened sympathetic nervous stimulation. The psychological characteristics are probably attributed to the component of repressed emotions related to a past traumatic episode or repressive coping style. Successful management can be achieved by strong collaboration between a hypertension specialist and a psychiatrist or psychologist with expertise in cognitive-behavioral panic management.
Topics: Adrenal Gland Neoplasms; Humans; Hypertension; Panic Disorder; Pheochromocytoma; Somatoform Disorders
PubMed: 31655774
DOI: 10.1016/j.ecl.2019.08.004 -
Neuroscience Bulletin Jun 2024Panic disorder is a psychiatric disorder characterized by recurrent panic attacks, with a prevalence of ~ 4% in the general population, causing heavy personal and... (Review)
Review
Panic disorder is a psychiatric disorder characterized by recurrent panic attacks, with a prevalence of ~ 4% in the general population, causing heavy personal and socioeconomic burdens. The similarities of animal defense responses to clinical panic attack symptoms in humans make it possible to translate neuroanatomical pathways identified in animal studies to panic disorder in humans. Therefore, in this review we first present a basic overview of panic disorder in humans including the main subtypes, models commonly used to trigger panic attacks, related hypotheses, the neurotransmitter systems that may be involved, and the current clinical treatments to give the reader a comprehensive understanding of panic disorder. The animal section introduces the models that trigger panic-like behavior in animals and the brain regions that may be involved, providing insights for future elucidation of the neural circuit mechanisms behind panic attacks.
Topics: Panic Disorder; Humans; Brain; Animals; Disease Models, Animal
PubMed: 37477800
DOI: 10.1007/s12264-023-01088-9 -
Neuro Endocrinology Letters Apr 2023Both panic disorder (PD) and obstructive sleep apnea (OSA) are frequent conditions that can be comorbid. This article reviews the current state of knowledge about the... (Review)
Review
OBJECTIVE
Both panic disorder (PD) and obstructive sleep apnea (OSA) are frequent conditions that can be comorbid. This article reviews the current state of knowledge about the comorbidity of PD and OSA and the effectiveness of therapy in patients with this comorbidity.
METHOD
Articles obtained via PubMed and Web of Science search were selected; the publishing date was between January 1990 and December 2022. The applied search terms were: obstructive sleep apnea; panic disorder; CPAP; antidepressants; anxiolytics; antipsychotics. Eighty-one articles were chosen by primary search via keywords. After a complete assessment of the full texts, 60 papers were chosen. Secondary papers from the references of the primary documents were investigated, evaluated for suitability, and included in the list of documents (n = 18). Thus, seventy-eight papers were incorporated into the review article.
RESULTS
Studies describe a greater prevalence of panic disorder in OSA patients. So far, there is no data on the prevalence of OSA in PD patients. Limited evidence is found regarding the influence of CPAP treatment on PD, and this evidence suggests that CPAP can partially alleviate PD symptoms. Medication used in PD treatment can significantly impact comorbid OSA, as explored in several studies.
CONCLUSIONS
The relationship between the two conditions seems bidirectional, and it is necessary to assess OSA patients for comorbid panic disorder and vice versa. Both disorders can worsen the other and must be treated with a complex approach to ensure improvement in patients' physical health and psychological well-being.
Topics: Humans; Panic Disorder; Sleep Apnea, Obstructive; Comorbidity; Continuous Positive Airway Pressure; Anti-Anxiety Agents
PubMed: 37182230
DOI: No ID Found -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2020Panic attack is a separate episode of fear or anxiety with the simultaneous development of typical autonomic and mental symptoms. Attack is a widespread phenomenon that... (Review)
Review
Panic attack is a separate episode of fear or anxiety with the simultaneous development of typical autonomic and mental symptoms. Attack is a widespread phenomenon that makes up the central core of panic disorder and affects about 5% of the population. Up to 71% of patients suffering from attacks report panic episodes not only in wakefulness, but also during sleep. This review focuses on the distinctions of night panic attacks, the particular qualities of sleep disturbances associated with them, and methods of treating these conditions.
Topics: Anxiety Disorders; Humans; Panic; Panic Disorder; Sleep; Sleep Wake Disorders
PubMed: 33459551
DOI: 10.17116/jnevro2020120121118 -
Drug and Alcohol Dependence Feb 2017Little is known about panic attacks and puffing topography, a behavioral index of the value of smoking reinforcement. This study examined smoking style during the course...
BACKGROUND
Little is known about panic attacks and puffing topography, a behavioral index of the value of smoking reinforcement. This study examined smoking style during the course of smoking of a single cigarette among adult daily smokers with and without a history of panic attacks.
METHOD
Participants (n=124, M=43.9, SD=9.7; 44.4% female) were non-treatment seeking daily smokers. Lifetime panic attack history was assessed via diagnostic assessment; 28.2% (n=35) of the sample had a panic attack history. Participants smoked one cigarette during an ad libitum smoking trial. Puff volume, duration, and inter-puff interval were measured using the Clinical Research Support System (CReSS) pocket device.
RESULTS
Regression analyses revealed that panic attack status was not associated with significant differences in average puff volume, duration, or inter-puff interval. Multi-level modeling was used to examine puffing trajectories. Puff-level data revealed that there was a significant quadratic time x panic effect for puff volume and duration. Those with a panic attack history demonstrated relatively sustained levels of both puff volume and duration over time, whereas those without a history of panic attacks demonstrated an increase followed by a decrease in volume and duration over time. These effects were not accounted for by the presence of general psychopathology.
DISCUSSION
Smokers with a panic attack history demonstrate more persistent efforts to self-regulate the delivery of nicotine, and thus may be at risk for continued smoking and dependence. Tailored treatment may be needed to address unique vulnerabilities among this group.
Topics: Adult; Female; Humans; Male; Middle Aged; Panic Disorder; Reinforcement, Psychology; Smoking; Surveys and Questionnaires; Tobacco Products
PubMed: 28033542
DOI: 10.1016/j.drugalcdep.2016.11.023 -
Paediatric Respiratory Reviews Dec 2023The COVID-19 pandemic has created diagnostic difficulties with the increase in mental health illnesses that often present with nonspecific symptoms, like...
The COVID-19 pandemic has created diagnostic difficulties with the increase in mental health illnesses that often present with nonspecific symptoms, like hypersensitivity pneumonitis. Hypersensitivity pneumonitis is a complex syndrome of varying triggers, onset, severity, and clinical manifestations that can be challenging to diagnose in many cases. Typical symptoms are nonspecific and can be attributed to other entities. There are no pediatric guidelines, which contributes to diagnostic difficulties and delays in treatment. It is particularly important to avoid diagnostic biases, have an index of suspicion for hypersensitivity pneumonitis, and to develop pediatric guidelines as outcomes are excellent when diagnosed and treated promptly. This article discusses hypersensitivity pneumonitis with a focus on the causes, pathogenesis, diagnostic approach, outcomes, and prognosis while using a case to illustrate the diagnostic difficulties worsened by the COVID-19 pandemic.
Topics: Humans; Child; Panic Disorder; Pandemics; Alveolitis, Extrinsic Allergic; COVID-19; Prognosis
PubMed: 37225541
DOI: 10.1016/j.prrv.2023.05.002 -
Psychiatric Services (Washington, D.C.) Dec 2021Psychoanalytic approaches, although still extensively used by practitioners, have been marginalized in treatment guidelines partly because of limited efficacy research....
Psychoanalytic approaches, although still extensively used by practitioners, have been marginalized in treatment guidelines partly because of limited efficacy research. In recent years, several manualized psychodynamic approaches have been developed that target specific problems or disorders, which can be referred to generally as problem-focused psychodynamic psychotherapies. These treatments offer modified psychodynamic techniques to address dynamics associated with particular disorders and can be used for systematic outcome studies. For example, one of these, panic-focused psychodynamic psychotherapy, has demonstrated efficacy in the treatment of panic disorder. The manuals for these psychotherapies emphasize comprehensibility for training purposes and are more readily transportable to the public health sector. Extensive research will be needed to ascertain which psychotherapies are most effective for various patients and conditions over the short and long term.
Topics: Humans; Panic Disorder; Psychoanalytic Therapy; Psychotherapy, Psychodynamic
PubMed: 33926196
DOI: 10.1176/appi.ps.202000887 -
Expert Opinion on Pharmacotherapy 2016The prevalence of panic disorder (PD) in the population is high and these patients have work impairment, high unemployment rates, seek medical treatment more frequently... (Review)
Review
INTRODUCTION
The prevalence of panic disorder (PD) in the population is high and these patients have work impairment, high unemployment rates, seek medical treatment more frequently and have more hospitalizations than people without panic symptoms. Despite the availability of pharmacological, psychological and combined treatments, approximately one-third of all PD patients have persistent panic attacks and other PD symptoms after treatment.
AREAS COVERED
MEDLINE/Pubmed, CENTRAL, PsycINFO and Web of Science databases were searched for clinical trials in treatment-resistant PD. Only studies published between 1980 and 2015, in English, with human subjects, considered "journal articles" and clinical trial were included. We included trials recruiting only adult subjects with treatment-resistant PD, consistent with criteria from DSM-III to DSM5. We included all prospective experimental studies. Case, case series, retrospective studies or studies with <10 PD subjects were not included.
EXPERT OPINION
Only 11 articles were included in this review. There were few quality studies, only two were randomized, controlled and double blind. Augmentation of the pharmacological treatment with cognitive-behavioral therapy demonstrated some short-term efficacy in treatment-resistant PD. There were also preliminary evidences of efficacy for monotherapy with reboxetine and olanzapine, and augmentation with pindolol, divalproex sodium, aripiprazole and olanzapine in short-term treatment.
Topics: Antidepressive Agents; Antipsychotic Agents; Cognitive Behavioral Therapy; Combined Modality Therapy; Humans; Panic Disorder; Prospective Studies; Randomized Controlled Trials as Topic; Treatment Failure
PubMed: 26635099
DOI: 10.1517/14656566.2016.1109628 -
Psychophysiology Aug 2019The present article aims to illustrate and review evidence on how associative learning involving interoceptive stimuli (interoceptive conditioning) can lead to changes... (Review)
Review
The present article aims to illustrate and review evidence on how associative learning involving interoceptive stimuli (interoceptive conditioning) can lead to changes in physiological, emotional, and perceptual outcomes. We first outline a functional perspective on Pavlovian conditioning and provide a general introduction and historical background on interoceptive conditioning as a special instance of Pavlovian conditioning. Next, biological and learning accounts of panic disorder are discussed, followed by an analysis of which stimuli and responses may be most promising to model learning that is relevant to panic disorder. Finally, studies on interoceptive fear conditioning with respiratory stimuli are reviewed and discussed, and future directions are outlined.
Topics: Animals; Anxiety; Association Learning; Conditioning, Classical; Fear; Humans; Interoception; Panic Disorder
PubMed: 31228272
DOI: 10.1111/psyp.13421