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FP Essentials Apr 2023Anxiety disorders are characterized by excessive fear and worry. Generalized anxiety disorder (GAD) and panic disorder (PD) are two of the most common anxiety disorders...
Anxiety disorders are characterized by excessive fear and worry. Generalized anxiety disorder (GAD) and panic disorder (PD) are two of the most common anxiety disorders in the United States. GAD is defined as excessive worry and anxiety that occur on most days for at least 6 months that affect daily functioning. PD is defined by recurrent unexpected panic attacks. Patients with symptoms of GAD or PD should be assessed for conditions such as hyperthyroidism, hyperparathyroidism, and cardiac arrhythmia before confirmation of an anxiety disorder diagnosis. A U.S. Preventive Services Task Force (USPSTF) draft statement recommends screening for anxiety in adults 64 years and younger, including pregnant and postpartum women. A final statement recommends screening for anxiety in children and adolescents ages 8 to 18 years. Multiple self-report tools have been validated for GAD and PD screening. The 7-item Generalized Anxiety Disorder (GAD-7) scale is an option for screening for GAD. The Panic Disorder Severity Scale (PDSS) is a 7-item tool with excellent sensitivity and specificity in screening for PD. Management with selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors in combination with psychotherapy has been shown to be effective for GAD and PD. Research on alternative treatments, such as psychedelic-assisted psychotherapy, is ongoing.
Topics: Adult; Pregnancy; Adolescent; Child; Humans; Female; Anxiety Disorders; Panic Disorder; Anxiety; Selective Serotonin Reuptake Inhibitors; Psychotherapy
PubMed: 37036769
DOI: No ID Found -
Psychiatria Polska Apr 2021About 1/4 of the world's adult population suffers from hypertension. Due to the high prevalence of the disease, its impact on mortality and socio-economic costs, it is... (Review)
Review
About 1/4 of the world's adult population suffers from hypertension. Due to the high prevalence of the disease, its impact on mortality and socio-economic costs, it is important to search for modifiable causes of its development. This review analyses studies in order to answer the question: Is there a higher prevalence of panic disorder in adults (≥18 years of age) with hypertension, than in normotensive group? There have been found 10 cross-sectional studies describing correlation between hypertension and panic disorder. Odds ratio for this two clinical entities ranged from OR = 3.31 (2.99-3.67) to OR = 1.19 (0.87-1.62). Moreover, frequency of coincidence of those two clinical entities was found between 4.2% and 18.75%. In the prospective studies there have been found a positive association between panic disorder and subsequent life-long development of hypertension OR= 1.7 (1.4-2.0). On the other hand, association between hypertension and subsequent development of panic disorder in the 12-months observation was OR = 3.23 (1.51-6.93), but in 3 years of observation it was insignificant OR = 1.12 (0.80-1.57). Based on the literaturereview, dueto the differences in methodology and the small number of prospective studies, it can only be suggested to clinicians that in some cases they should search for panic disorder in patients with hypertension, especially paroxysmal one.
Topics: Adult; Cross-Sectional Studies; Humans; Hypertension; Panic Disorder; Prevalence; Prospective Studies
PubMed: 34365484
DOI: 10.12740/PP/116570 -
Australasian Psychiatry : Bulletin of... Dec 2020If the narrative of "coronavirus" has an underlying theme, it may perhaps for some be one of survival, whilst for others, the theme might be suffering. The recurring...
OBJECTIVE
If the narrative of "coronavirus" has an underlying theme, it may perhaps for some be one of survival, whilst for others, the theme might be suffering. The recurring motif of survival has continued throughout history, yet for the first time the sum of all fears has amounted to a run on the bare essentials. This paper seeks to offer an alternative formulation of "panic buying," with references to literature, philosophy, and contemporary neurobiology.
CONCLUSION
The bare essentials disappeared perhaps as part of some self-fulfilling prophecy: the supermarkets became bare because others inadvertently lead us to believe they would become bare. The contagion model of emotional propagation provides a psychological model of how "panic buying" by an individual might lead to the replication of panic in an observer. The Polyvagal Theory further informs us of how the threat posed by the pandemic primes our limbic system to perceive danger, and explains how witnessing others engaging in fight-flight responses might evoke a fearful affect in an observer. In the end, it is perhaps through Nietzsche's study of classical tragedy that we may find some meaning to the pandemic, allowing our collective lived experience to serve as a template for growth.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Disaster Victims; Emotional Adjustment; Fear; Humans; Neurobiology; Pandemics; Panic; Pneumonia, Viral; Psychological Theory; Psychology, Social; SARS-CoV-2; Survival
PubMed: 32683892
DOI: 10.1177/1039856220936144 -
L'Encephale Feb 2021Although the "panic" word has been abundantly linked to the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic in the press, in the scientific... (Review)
Review
Although the "panic" word has been abundantly linked to the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic in the press, in the scientific literature very few studies have considered whether the current epidemic could predispose to the onset or the aggravation of panic attacks or panic disorder. Indeed, most studies thus far have focused on the risk of increase and aggravation of other psychiatric disorders as a consequence of the SARS-CoV-2 epidemic, such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and generalized anxiety disorder (GAD). Yet, risk of onset or aggravation of panic disorder, especially the subtype with prominent respiratory symptoms, which is characterized by a fear response conditioning to interoceptive sensations (e.g., respiratory), and hypervigilance to these interoceptive signals, could be expected in the current situation. Indeed, respiratory symptoms, such as coughs and dyspnea, are among the most commonly associated with the SARS-CoV-2 (59-82% and 31-55%, respectively), and respiratory symptoms are associated with a poor illness prognosis. Hence, given that some etiological and maintenance factors associated with panic disorder - i.e., fear conditioning to abnormal breathing patterns attributable or not to the COVID-19 (coronavirus disease 2019), as well as hypervigilance towards breathing abnormalities - are supposedly more prevalent, one could expect an increased risk of panic disorder onset or aggravation following the COVID-19 pandemic in people who were affected by the virus, but also those who were not. In people with the comorbidity (i.e., panic disorder or panic attacks and the COVID-19), it is particularly important to be aware of the risk of hypokalemia in specific at-risk situations or prescriptions. For instance, in the case of salbutamol prescription, which might be overly used in patients with anxiety disorders and COVID-19, or in patients presenting with diarrhea and vomiting. Hypokalemia is associated with an increased risk of torsade de pointe; thus, caution is required when prescribing specific psychotropic drugs, such as the antidepressants citalopram and escitalopram, which are first-line treatments for panic disorder, but also hydroxyzine, aiming at anxiety relief. The results reviewed here highlight the importance of considering and further investigating the impact of the current pandemic on the diagnosis and treatment of panic disorder (alone or comorbid with the COVID-19).
Topics: COVID-19; Humans; Pandemics; Panic Disorder
PubMed: 33221039
DOI: 10.1016/j.encep.2020.08.001 -
Iranian Journal of Public Health Dec 2021This study aimed to assess factors affecting panic buying and strategies to deal with them during COVID-19 with a scoping review. (Review)
Review
BACKGROUND
This study aimed to assess factors affecting panic buying and strategies to deal with them during COVID-19 with a scoping review.
METHOD
The review was performed based on Arksey and O'Malley. PubMed, Embase, Scopus, ProQuest, and Science Direct databases were selected to search. All English language full-text articles from Jan 2020 to May 2021 were included. Initially, the titles and abstracts of the retrieved articles were read and screening was accomplished based on the research question. After that, the full text of eligible studies was examined. A third reviewer was resolved disagreements at any stage by a consensus meeting. A self-assessment form was designed for data extraction. The causes of panic buying were assessed as a descriptive study.
RESULTS
The search process returned 23 articles after deletion for complete data extraction and analysis. Through thematic analysis, the factors influencing panic buying were divided into six categories including cognitive, emotional, behavioral, social, and economic factors as well as government action, and finally, the recommended strategies were categorized in two categories included psychosocial and economic.
CONCLUSION
A holistic view of panic buying's causes allows planners and decision-makers to design categorized strategies beyond the suggested strategies. Increasing customer awareness and monitoring the flow of information through social media and mass media, psychotherapy, counseling, and economic strategies are considered by planners to combat panic buying.
PubMed: 36317022
DOI: 10.18502/ijph.v50i12.7929 -
Journal of Clinical Psychology Jan 2021The present study examined the contribution of panic appraisal (PA) dimensions to the prediction of panic and agoraphobic symptoms, above and beyond anxiety sensitivity...
OBJECTIVE
The present study examined the contribution of panic appraisal (PA) dimensions to the prediction of panic and agoraphobic symptoms, above and beyond anxiety sensitivity (AS), among patients with panic disorder. PA dimensions consist of anticipated panic, perceived panic consequences, and panic coping efficacy.
METHOD
Panic disorder patients (N = 84, 60.7% female, M = 38 years) completed self-report measures of panic and agoraphobic symptoms, three dimensions of PA, AS, anxiety, and depression symptoms.
RESULTS
PA dimensions significantly contributed to the prediction of overall and all facets of panic and agoraphobic symptoms, as well as anxiety symptoms, but not depressive symptoms, above and beyond AS. Of the three PA dimensions, both anticipated panic and panic coping efficacy uniquely contributed to agoraphobic avoidance after controlling for AS and the other dimensions of PA.
CONCLUSION
PA dimensions may emerge as an important predictor of panic and agoraphobic or anxiety symptoms.
Topics: Adaptation, Psychological; Agoraphobia; Anxiety; Female; Humans; Male; Panic Disorder
PubMed: 32662523
DOI: 10.1002/jclp.23028 -
Journal of Clinical Neuroscience :... Nov 2020Anxiety is commonly observed together with skin diseases and can aggravate them, while skin diseases can increase anxiety. The relationship of skin diseases observed in...
OBJECTIVE
Anxiety is commonly observed together with skin diseases and can aggravate them, while skin diseases can increase anxiety. The relationship of skin diseases observed in panic disorder with quantitative electroencephalography (QEEG) findings has not been investigated yet. The aim of this study is to compare the absolute alpha and delta power of panic disorder patients with and without skin disease.
METHODS
246 panic disorder patients, 19 of whom had skin disease and 227 of whom did not have skin disease, were included in the study. Panic disorder severity scale (PDSS) scores of patients were recorded, and QEEG recording was performed. Absolute alpha and delta power and PDSS scores were compared between the two groups.
RESULTS
It was found that the absolute delta power in the left hemisphere was lower and PDSS scores were higher in the patients with skin diseases compared to the control group. In the patients with skin disease, decreased delta power in the left hemisphere may cause impairment in the processing of positive emotions and may cause trait anxiety.
CONCLUSION
Trait anxiety may increase susceptibility to skin diseases by disrupting cutaneous homeostasis resulting from the prolonged sympathetic nervous system activation.
Topics: Adult; Brain Waves; Case-Control Studies; Dominance, Cerebral; Electroencephalography; Female; Humans; Male; Panic Disorder; Psychiatric Status Rating Scales; Severity of Illness Index; Skin Diseases
PubMed: 33222937
DOI: 10.1016/j.jocn.2020.09.071 -
Australasian Emergency Care Dec 2019Anxiety and panic symptoms are widespread in the general population. The physical manifestations of anxiety and panic commonly account for people presenting to Emergency...
Anxiety and panic symptoms are widespread in the general population. The physical manifestations of anxiety and panic commonly account for people presenting to Emergency Departments (EDs). It is therefore important for ED clinicians to be informed of the numerous causes of anxiety and panic and equipped to respond effectively. This paper describes the underlying pathophysiology of the physical symptoms of anxiety and panic and differential diagnoses to consider. Organic conditions that are associated with symptoms of anxiety and panic are highlighted. Brief interventions are tabled for ED clinicians to use when explaining symptoms, and to promote individual self-management.
Topics: Anxiety; Breathing Exercises; Diagnosis, Differential; Emergency Service, Hospital; Escape Reaction; Humans; Hyperventilation; Life Style; Medical History Taking; Panic; Patient Education as Topic; Physical Examination; Relaxation Therapy; Self Care; Stress, Psychological
PubMed: 31530499
DOI: 10.1016/j.auec.2019.08.002 -
Journal of Affective Disorders Sep 2023It has been suggested that gender differences in anxiety and depressive symptoms characterize panic disorder (PD) in terms of vulnerability to stressful life events,...
BACKGROUND
It has been suggested that gender differences in anxiety and depressive symptoms characterize panic disorder (PD) in terms of vulnerability to stressful life events, anxiety, depressive symptom patterns, and brain structure. However, few studies have investigated the gender differences in PD using a network approach.
METHODS
This study included 619 participants with PD (313 men). The Panic Disorder Severity Scale, Albany Panic and Phobia Questionnaire, and Beck Depression Inventory-II were used to evaluate symptomatology. To investigate the PD-related white matter (WM) neural correlates, tract-based spatial statistics were used. The PD-related clinical scales and WM neural correlates were included in the network analysis to identify associations between variables. To evaluate network differences between genders, network comparison tests were conducted.
RESULTS
Our findings revealed that agoraphobia in men was the strongest central symptom. In addition, loss of pleasure, and not anxiety or panic symptoms, was the strongest central symptom in women with PD. The network comparison test revealed that the bridge strength score was higher in agoraphobia and tiredness in men and in self-criticalness in women. Furthermore, in the network that includes neural correlates of WM, the bridge strength score was higher in the cingulate gyrus WM in men and the cingulum hippocampus in women.
LIMITATIONS
Since this is a cross-sectional network study of PD patients, the causal relationship between interactions in this network analysis for both genders may not be accurately determined.
CONCLUSION
Network structures of anxiety and depressive symptomatology and related WM neural correlates can differ according to gender in PD patients.
Topics: Humans; Female; Male; Panic Disorder; Sex Factors; Cross-Sectional Studies; Anxiety; Anxiety Disorders; Agoraphobia
PubMed: 37247787
DOI: 10.1016/j.jad.2023.05.087 -
Indian Journal of Psychiatry 2021Dissociative experiences and health anxiety are frequently encountered in anxiety disorders and contribute to the burden of illness.
BACKGROUND
Dissociative experiences and health anxiety are frequently encountered in anxiety disorders and contribute to the burden of illness.
AIM
The aim was to assess and compare dissociative experiences and level of health anxiety in patients with panic disorder and normal individuals.
MATERIALS AND METHODS
We recruited forty eligible patients with panic disorder and forty healthy volunteers without any psychiatric diagnoses. Health anxiety was evaluated by the Short Health Anxiety Inventory and dissociative symptoms were assessed by the Dissociative Experiences Scale (DES).
RESULTS
Dissociative experiences were more frequently reported by patients with panic disorder compared to normal controls, but overall mean DES scores were lower in both groups compared to previous literature. A high level of health anxiety was also seen in panic disorder compared to normal individuals.
CONCLUSION
Health anxiety and dissociative experiences, especially depersonalization-derealization, are commonly encountered in panic disorder and should be actively explored to understand how they influence psychopathology and treatment outcome.
PubMed: 34083823
DOI: 10.4103/psychiatry.IndianJPsychiatry_896_20