-
Journal of Affective Disorders May 2019Symptoms of depressed mood and anxiety have been associated with immune dysregulation and atopic disorders, however it is unclear whether this relationship spans other...
BACKGROUND
Symptoms of depressed mood and anxiety have been associated with immune dysregulation and atopic disorders, however it is unclear whether this relationship spans other forms of psychopathology. The objective of this study was to use a large, population-based sample to examine the association between several common psychiatric conditions and two atopic disorders: seasonal allergies and asthma. This study also examined whether comorbidity between psychiatric disorders confounded the relationship between atopy and each psychiatric disorder.
METHODS
Data come from the Comprehensive Psychiatric Epidemiology Surveys, a nationally-representative sample of US adults (N = 10,309). Lifetime history of major depressive disorder (MDD), generalized anxiety disorder (GAD), panic disorder (PD), and post-traumatic stress disorder (PTSD) was assessed using the Composite International Diagnostic Inventory. History of seasonal allergies and asthma were assessed by self-report. Weighted logistic regression was used to evaluate the association between allergies and asthma and psychopathology. Psychiatric comorbidities were also examined as potential confounders.
RESULTS
Approximately 36.6% had a history of allergies and 11.5% a history of asthma. Seasonal allergies were positively associated with odds of MDD (Odds ratio (OR): 1.24, 95% Confidence Interval (CI): 1.06-1.46), GAD (OR: 1.54 (1.28-1.84)), PD (OR: 1.54 (1.24-1.91)), and PTSD (OR: 1.32 (1.09-1.59)). Asthma was not significantly associated with any psychiatric disorder. All significant associations persisted after adjustment for psychiatric comorbidities.
LIMITATIONS
Limitations include self-reporting of atopic disorder status and of all disorder ages of onset.
CONCLUSIONS
This study confirms the association between MDD and PD and seasonal allergies, and extends this relationship to GAD and PTSD.
Topics: Adolescent; Adult; Aged; Anxiety Disorders; Asthma; Depressive Disorder, Major; Female; Humans; Logistic Models; Male; Middle Aged; Odds Ratio; Panic Disorder; Psychopathology; Rhinitis, Allergic, Seasonal; Self Report; Stress Disorders, Post-Traumatic; United States; Young Adult
PubMed: 30921596
DOI: 10.1016/j.jad.2019.03.026 -
Effects of stressful life-events on DNA methylation in panic disorder and major depressive disorder.Clinical Epigenetics Apr 2022Panic disorder (PD) is characterized by recurrent panic attacks and higher affection of women as compared to men. The lifetime prevalence of PD is about 2-3% in the...
BACKGROUND
Panic disorder (PD) is characterized by recurrent panic attacks and higher affection of women as compared to men. The lifetime prevalence of PD is about 2-3% in the general population leading to tremendous distress and disability. Etiologically, genetic and environmental factors, such as stress, contribute to the onset and relapse of PD. In the present study, we investigated epigenome-wide DNA methylation (DNAm) in respond to a cumulative, stress-weighted life events score (wLE) in patients with PD and its boundary to major depressive disorder (MDD), frequently co-occurring with symptoms of PD.
METHODS
DNAm was assessed by the Illumina HumanMethylation450 BeadChip. In a meta-analytic approach, epigenome-wide DNAm changes in association with wLE were first analyzed in two PD cohorts (with a total sample size of 183 PD patients and 85 healthy controls) and lastly in 102 patients with MDD to identify possible overlapping and opposing effects of wLE on DNAm. Additionally, analysis of differentially methylated regions (DMRs) was conducted to identify regional clusters of association.
RESULTS
Two CpG-sites presented with p-values below 1 × 10 in PD: cg09738429 (p = 6.40 × 10, located in an intergenic shore region in next proximity of PYROXD1) and cg03341655 (p = 8.14 × 10, located in the exonic region of GFOD2). The association of DNAm at cg03341655 and wLE could be replicated in the independent MDD case sample indicating a diagnosis independent effect. Genes mapping to the top hits were significantly upregulated in brain and top hits have been implicated in the metabolic system. Additionally, two significant DMRs were identified for PD only on chromosome 10 and 18, including CpG-sites which have been reported to be associated with anxiety and other psychiatric phenotypes.
CONCLUSION
This first DNAm analysis in PD reveals first evidence of small but significant DNAm changes in PD in association with cumulative stress-weighted life events. Most of the top associated CpG-sites are located in genes implicated in metabolic processes supporting the hypothesis that environmental stress contributes to health damaging changes by affecting a broad spectrum of systems in the body.
Topics: DNA Methylation; Depressive Disorder, Major; Epigenesis, Genetic; Epigenome; Female; Humans; Panic Disorder
PubMed: 35477560
DOI: 10.1186/s13148-022-01274-y -
High Altitude Medicine & Biology Sep 2019Psychiatric disorders have a high lifetime prevalence affecting about 30% of the global population. Not much is known about high altitude (HA) sojourns in individuals... (Review)
Review
Psychiatric disorders have a high lifetime prevalence affecting about 30% of the global population. Not much is known about high altitude (HA) sojourns in individuals living with a psychiatric condition. This lack of scientific evidence contrasts with the anticipated increase in numbers of individuals with preexisting psychiatric conditions seeking medical advice on HA exposure. Not only are there risks associated with a HA climb, but physical activity in general is known to improve symptoms of many psychiatric disorder and enhance measures of mental well-being like quality of life and resilience. There are additional positive effects of alpine environments on mental health beyond those of physical activity. All individuals going to HA with a preexisting psychiatric condition should be in a state of stable disease with no recent change in medication. Specific considerations and recommendations apply to individual psychiatric disorders. During the HA sojourn the challenge is to separate altitude-related symptoms such as insomnia from prodromal symptoms of the underlying disorder (e.g., depressive episode) or altitude-related hyperventilation from panic attacks. In case an individual with preexisting anxiety disorder decides to go to HA there might be a predisposition toward acute mountain sickness (AMS), but it should always be considered that many symptoms of anxiety and AMS overlap. Any medication that is anticipated to be taken during ascent or at HA should be tested for compatibility with the psychiatric condition and medication before the trip.
Topics: Affect; Altitude; Altitude Sickness; Contraindications; Drug Interactions; Exercise; Humans; Hydrocortisone; Hyperventilation; Hypnotics and Sedatives; Mental Disorders; Mountaineering; Panic Disorder; Psychotropic Drugs; Serotonin; Sleep Wake Disorders
PubMed: 31343257
DOI: 10.1089/ham.2019.0020 -
Biological Psychology Apr 2022Over the past six years, a rapidly growing number of studies have shown that respiration exerts a significant influence on sensory, affective, and cognitive processes.... (Review)
Review
Over the past six years, a rapidly growing number of studies have shown that respiration exerts a significant influence on sensory, affective, and cognitive processes. At the same time, an increasing amount of experimental evidence indicates that this influence occurs via modulation of neural oscillations and their synchronization between brain areas. In this article, we review the relevant findings and discuss whether they might inform our understanding of a variety of disorders that have been associated with abnormal patterns of respiration. We review literature on the role of respiration in chronic obstructive pulmonary disease (COPD), anxiety (panic attacks), and autism spectrum disorder (ASD), and we conclude that the new insights into respiratory modulation of neuronal activity may help understand the relationship between respiratory abnormalities and cognitive and affective deficits.
Topics: Autism Spectrum Disorder; Brain; Cognition; Emotions; Humans; Panic Disorder
PubMed: 35292337
DOI: 10.1016/j.biopsycho.2022.108316 -
Cognitive Behaviour Therapy Jul 2023Individuals with Panic Disorder (PD) often have impaired insight, which can impede their willingness to seek treatment. Cognitive processes, including metacognitive...
Individuals with Panic Disorder (PD) often have impaired insight, which can impede their willingness to seek treatment. Cognitive processes, including metacognitive beliefs, cognitive flexibility, and jumping to conclusions (JTC) may influence the degree of insight. By understanding the relationship between insight and these cognitive factors in PD, we can better identify individuals with such vulnerabilities to improve their insight. The aim of this study is to examine the relationships between metacognition, cognitive flexibility, and JTC with clinical and cognitive insight at pretreatment. We investigate the association among those factors' changes and changes in insight over treatment. Eighty-three patients diagnosed with PD received internet-based cognitive behavior therapy. Analyses revealed that metacognition was related to both clinical and cognitive insight, and cognitive flexibility was related to clinical insight at pre-treatment. Greater changes in metacognition were correlated with greater changes in clinical insight. Also, greater changes in cognitive flexibility were related to greater changes in cognitive insight. The current study extends previous studies suggesting potential relationships among insight, metacognition, and cognitive flexibility in PD. Determining the role of cognitive concepts in relation to insight may lead to new avenues for improving insight and can have implications for engagement and treatment-seeking behaviors.
Topics: Humans; Panic Disorder; Metacognition; Cognitive Behavioral Therapy; Surveys and Questionnaires
PubMed: 36880358
DOI: 10.1080/16506073.2023.2179539 -
Neuropsychobiology 2019Laboratory measures have played an integral role in diagnosing pathology; however, compared to traditional medicine, psychiatric medicine has lagged behind in using such... (Review)
Review
Laboratory measures have played an integral role in diagnosing pathology; however, compared to traditional medicine, psychiatric medicine has lagged behind in using such measures. A growing body of literature has begun to examine the viability and development of different laboratory measures in order to diagnose psychopathologies. The present review examines the current state of development of both sodium lactate infusion and CO2-35% inhalation as potential ancillary measures to diagnose panic disorder (PD). A previously established 3-step approach to identifying laboratory-based diagnostic tests was applied to available literature assessing the ability of both sodium lactate infusion or CO2-35% inhalation to induce panic attacks in PD patients, healthy controls, and individuals with other psychiatric conditions. Results suggest that across the literature reviewed, individuals with PD were more likely to exhibit panic attacks following administration of sodium lactate or CO2-35% compared to control participants. The majority of the studies examined only compared individuals with PD to healthy controls, suggesting that these ancillary measures are underdeveloped. In order to further determine the utility of these ancillary measures, research is needed to determine if panic attacks following administration of these chemical agents are unique to PD, or if individuals with related pathologies also respond, which may be indicative of transdiagnostic characteristics found across disorders.
Topics: Administration, Inhalation; Carbon Dioxide; Humans; Infusions, Intravenous; Panic Disorder; Predictive Value of Tests; Sodium Lactate
PubMed: 30982042
DOI: 10.1159/000499136 -
Deutsches Arzteblatt International Mar 2019We evaluated a team-based program of exercises for patients with panic disorder with or without agoraphobia (PDA) in primary care. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
We evaluated a team-based program of exercises for patients with panic disorder with or without agoraphobia (PDA) in primary care.
METHODS
419 patients with PDA (mean age 46.2 years, standard deviation 14.4 years; 74% female) were included in this cluster-randomized, controlled intervention trial. The patients were blinded with respect to their group assignment at baseline. Patients in the intervention group (36 primary-care practices, 230 patients) underwent a 23-week exercise program combined with case management, while patients in the control group (37 practices, 189 patients) received standard care. Symptoms of anxiety (according to the Beck Anxiety Inventory, BAI) at six months were the primary endpoint. Patients were followed up at six months (n = 338, 81%) and at twelve months (n = 318, 76%). The analysis was by intention to treat.
RESULTS
Symptoms of anxiety improved to a significantly greater extent in the intervention group (p = 0.008). The intergroup dif- ference in the reduction of the BAI score (range: 0-63) was 3.0 points (95% confidence interval [-5.8; -0.2]) at six months and 4.0 points [-6.9; -1.2] at twelve months. In the intervention group, there was a significantly greater reduction in the frequency of panic attacks (p = 0.019), in avoidant behavior (p = 0.016), and in depressiveness (p<0.001), as well as a greater improvement of the quality of treatment (p<0.001).
CONCLUSION
In primary-care patients who have panic disorder with or without agoraphobia, a team-based exercise program combined with case management can improve symptoms to a greater extent than standard primary-care treatment.
Topics: Agoraphobia; Case Management; Exercise Therapy; Female; Humans; Male; Middle Aged; Panic Disorder; Primary Health Care; Psychotherapy, Group; Treatment Outcome
PubMed: 30995952
DOI: 10.3238/arztebl.2019.0159 -
Journal of Medical Case Reports Jul 2023Panic disorder and panic attacks are two of the most common problems in psychiatry. A psychoimmunological correlation between allergic diseases and panic disorder has...
BACKGROUND
Panic disorder and panic attacks are two of the most common problems in psychiatry. A psychoimmunological correlation between allergic diseases and panic disorder has been strongly suggested. Histamine H1 receptor antagonists have been suggested as alternative drugs for the treatment of panic disorder. Chronic spontaneous urticaria (CSU) and panic disorder improved simultaneously with selective serotonin reuptake inhibitor antidepressants. Panic disorder has also been treated with the antihistamine chlorpheniramine. The immunoglobulin/histamine complex is a histamine-fixed immunoglobulin preparation that was reported to be effective in treating CSU. This case report describes the successful treatment of a patient with concomitant panic disorder and CSU for 23 years using immunoglobulin/histamine complex therapy.
CASE PRESENTATION
This report describes a 52-year-old female Korean patient who suffered from CSU with panic disorder for 23 years. Basic allergy tests (blood tests and skin prick tests) were conducted before and after treatment for the evaluation of allergic conditions. A multiple allergosorbent test (MAST) for the detection of allergen-specific IgE levels was also performed. The clinical severity of CSU was evaluated using the urticaria severity score system. Diagnostic interviews systematically assessed the diagnostic criteria outlined by the DSM-V, and the patient was evaluated before, during and after treatment using the Beck Depression Inventory (BDI-2) for depression, the State-Trait Anxiety Inventory (STAI) for anxiety and the Beck Hopelessness Score (BHS) for hopelessness. The patient received 2 ml of Histobulin™ (12 mg human immunoglobulin/0.15 µg histamine complex) once a week by subcutaneous injection for the treatment of CSU. Initial improvement of CSU was achieved after the third injection. After the twenty-seventh injection of Histobulin™, she showed no symptoms or signs and ceased allergic medication use. With the remission of CSU, allergic rhinitis was also completely resolved. The frequency of the common cold was significantly decreased during and after treatment. The medication frequency and development of clinical manifestations of panic disorder changed in parallel with the clinical severity of CSU. Moreover, the patient exhibited no clinical manifestations and ceased medication for panic disorder and sleeping pills for insomnia simultaneously with the remission of CSU. In the psychological evaluation, the BDI, STAI and BHS scores improved accordingly.
CONCLUSIONS
The immunoglobulin/histamine complex was effective in treating CSU and concomitant panic disorder in this patient and could be effective in treating some types of panic disorder. Considering the mechanisms of action of histamine and the immunoglobulin/histamine complex together with the patient's clinical progress, histamine seemed to be related to panic disorder in this case. The concept of histamine-mediated syndromes, including allergies and psychiatric disorders, shows that a wider disease identity may be needed. Further studies on the immunopathogenesis of panic disorder and the mechanisms of action of the immunoglobulin/histamine complex are necessary.
Topics: Female; Humans; Middle Aged; Histamine; Panic Disorder; Chronic Disease; Chronic Urticaria; Urticaria; Histamine H1 Antagonists
PubMed: 37501211
DOI: 10.1186/s13256-023-03937-7 -
Comprehensive Psychiatry Aug 2015Panic attacks (PAs) are highly prevalent among trauma exposed individuals and have been associated with a number of adverse outcomes. Despite high suicide rates among...
Panic attacks (PAs) are highly prevalent among trauma exposed individuals and have been associated with a number of adverse outcomes. Despite high suicide rates among trauma exposed individuals, research to date has not examined the potential relation between panic symptoms and suicidal ideation and behaviors among this high risk population. The current study tested the association of panic with suicidal ideation and behaviors among a large sample of trauma exposed smokers. Community participants (N=421) who reported a lifetime history of trauma exposure were assessed concurrently for current panic, suicidal ideation and behaviors, and psychiatric diagnoses. Those who met criteria for a current panic disorder diagnosis were removed from analyses to allow for the assessment of non-PD related panic in line with the recent addition of the PA specifier applicable to all DSM-5 disorders. Findings indicated that panic symptoms were significantly associated with suicidal ideation and behaviors beyond the effects of depression and number of trauma types experienced. Further, post-traumatic stress disorder (PTSD) diagnostic status significantly moderated this relationship, indicating that the relationship between panic and suicidal ideation and behaviors is potentiated among individuals with a current PTSD diagnosis. This investigation suggests that panic symptoms may be a valuable clinical target for the assessment and treatment of suicidal ideation and behaviors among trauma exposed individuals.
Topics: Adolescent; Adult; Aged; Depression; Female; Humans; Male; Middle Aged; Panic Disorder; Stress Disorders, Post-Traumatic; Suicidal Ideation; Suicide, Attempted; Young Adult
PubMed: 26050924
DOI: 10.1016/j.comppsych.2015.05.006 -
Acta Psychologica Jun 2023In Pakistan, the fourth wave of COVID-19 is causing an increasing number of positive cases. This fourth wave may be a risky aspect of mental health issues for COVID-19...
BACKGROUND
In Pakistan, the fourth wave of COVID-19 is causing an increasing number of positive cases. This fourth wave may be a risky aspect of mental health issues for COVID-19 patients. This quantitative study is designed to understand the stigmatization, and panic disorder and to explore the mediating role of death anxiety among patients of COVID-19 during the fourth wave of novel coronavirus.
METHODS
The study was conducted using a correlational research design. The survey was carried out by utilizing a questionnaire with a convenient sample technique. The sample of the study was comprised of 139 patients with COVID-19. Data were collected through Stigma Scale for Chronic Illnesses (SSCI), The Panic Disorder Severity Scale (PDSS), and Death Anxiety Inventory.
RESULTS
Results show that stigma is significantly positively related to panic disorder and death anxiety. Furthermore, panic disorder is also significantly positively related to death anxiety. Results also indicate that stigmatization is a significant positive predictor for death anxiety and panic disorder. Moreover, results indicate that death anxiety has a mediating role in the relationship between stigmatization and panic disorder with age and gender as covariates.
CONCLUSION
This study would be helpful for people around the world to understand this threatening contagious virus so they wouldn't stigmatize infected ones. Additional research is required for the sustainable improvement of anxiety over time.
Topics: Humans; Panic Disorder; COVID-19; Stereotyping; Pandemics; Pakistan; Anxiety
PubMed: 37100020
DOI: 10.1016/j.actpsy.2023.103924