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Neuro Endocrinology Letters Oct 2020Panic disorder and agoraphobia not only affect the patients themselves but also may have a detrimental effect on their intimate relationships. A problem arising in the... (Review)
Review
BACKGROUND
Panic disorder and agoraphobia not only affect the patients themselves but also may have a detrimental effect on their intimate relationships. A problem arising in the intimate sphere could be a trigger, a modulator, a maintenance factor, or the result of the panic disorder and agoraphobia. The consequences of panic disorder include increased demands on the non-affected partner to adapt, which may prove to be too challenging for some to manage. Panic disorder and agoraphobia can also change earlier relationship patterns which may result in partnership dysfunction. This review explores the effect of panic disorder and agoraphobia upon partnership problems and satisfaction.
METHOD
Relevant studies were identified via PubMed and Web of Science, published between January 1970 and April 2020. The search terms included "panic disorder", "agoraphobia", "marital problems", "marital conflicts" and "marital adjustment". Further references were found in reviews, books, and book chapters of the relevant papers. A total of 1154 articles were nominated by primary assortment using the keywords in different combinations. After selecting according to the inclusion and exclusion criteria, evaluating the complete texts and searching for secondary documents, 173 papers were finally chosen.
RESULTS
Problems in a relationship can act as a trigger for the development of the panic disorder and agoraphobia and could also function as modulating and maintenance factors. Panic disorder and agoraphobia often have a negative influence on the relationship and the non-affected partner. Partnership problems can be both a precursor and a consequence of panic disorder and agoraphobia.
Topics: Agoraphobia; Family Conflict; Humans; Marriage; Panic Disorder; Personal Satisfaction
PubMed: 33307653
DOI: No ID Found -
Journal of Behavior Therapy and... Dec 2022Although a great deal of research has focused on various aspects of control and their relations to psychopathology, new insights and therapeutic potential could be...
Although a great deal of research has focused on various aspects of control and their relations to psychopathology, new insights and therapeutic potential could be revealed through an examination and perhaps emphasis on fears of losing control. Although elements of control-related beliefs and phenomena have been highlighted in association with obsessive-compulsive disorder and social anxiety disorder, this paper will give a fresh perspective on fears and beliefs about losing control, with implications for understanding and perhaps treating a broad range of psychological problems including panic disorder, posttraumatic stress disorder (PTSD), and others. New research questions and hypotheses are proposed, along with potential implications for expanded research into this domain and for clinical applications within a cognitive-behavioural approach.
Topics: Fear; Humans; Obsessive-Compulsive Disorder; Panic Disorder; Phobia, Social; Stress Disorders, Post-Traumatic
PubMed: 36113905
DOI: 10.1016/j.jbtep.2022.101768 -
Molecules (Basel, Switzerland) Sep 2021The classic gut hormone cholecystokinin (CCK) and its CCK-receptor are expressed in almost all regions of the brain. This widespread expression makes CCK by far the most... (Review)
Review
The classic gut hormone cholecystokinin (CCK) and its CCK-receptor are expressed in almost all regions of the brain. This widespread expression makes CCK by far the most abundant peptidergic transmitter system in the brain. This CNS-ubiquity has, however, complicated the delineation of the roles of CCK peptides in normal brain functions and neuropsychiatric diseases. Nevertheless, the common panic disorder disease is apparently associated with CCK in the brain. Thus, the C-terminal tetrapeptide fragment of CCK (CCK-4) induces, by intravenous administration in a dose-related manner, panic attacks that are similar to the endogenous attacks in panic disorder patients. This review describes the history behind the discovery of the panicogenic effect of CCK-4. Subsequently, the review discusses three unsettled questions about the involvement of cerebral CCK in the pathogenesis of anxiety and panic disorder, including therapeutic attempts with CCK-receptor antagonists.
Topics: Adult; Cholecystokinin; Humans; Panic Disorder
PubMed: 34577128
DOI: 10.3390/molecules26185657 -
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 -
Journal of Clinical PsychopharmacologyAlthough alprazolam is approved only for use in panic disorder and generalized anxiety disorder, it is used for numerous other conditions, not only by psychiatrists but... (Review)
Review
BACKGROUND
Although alprazolam is approved only for use in panic disorder and generalized anxiety disorder, it is used for numerous other conditions, not only by psychiatrists but also by medical professionals in general. This commentary critically analyzes the use of alprazolam.
METHODS
A narrative review approach was adopted, using relevant articles and textbooks, to compile pertinent literature for the aforementioned topic.
RESULTS
Among all its adverse reactions, the most bothersome concern about the use of alprazolam is its potential for abuse and dependence. This can be attributed to certain unique pharmacokinetic and pharmacodynamic properties of this benzodiazepine. Also, the withdrawal triggered by use of alprazolam is challenging to treat. Alternate pharmacological and non-pharmacological strategies for use in anxiety and insomnia are available, which might be safer than alprazolam. Also, policy changes can serve as an answer to curb alprazolam abuse to some extent. Alprazolam might still be a good choice for individuals who do not have a history of abuse of other substances, with adequate psychoeducation and close monitoring of their usage pattern.
CONCLUSION
There is a need to reconsider the need for long-term use of benzodiazepines in general, and alprazolam in particular. However, they still might be an appropriate choice in individuals where abuse and dependence are less likely.
Topics: Humans; Alprazolam; Benzodiazepines; Panic Disorder; Anxiety Disorders; Antisocial Personality Disorder; Anti-Anxiety Agents
PubMed: 37040158
DOI: 10.1097/JCP.0000000000001669 -
American Family Physician Aug 2022
Topics: Anxiety; Anxiety Disorders; Humans; Panic Disorder; Phobic Disorders
PubMed: 35977133
DOI: No ID Found -
The Primary Care Companion For CNS... Feb 2021
Topics: Anxiety; COVID-19; Humans; Panic; Panic Disorder; SARS-CoV-2
PubMed: 34000140
DOI: 10.4088/PCC.20l02826 -
Psychiatry Research. Neuroimaging Aug 2022Optical coherence tomography (OCT) is a novel method that allows high resolution cross-sectional imaging of biological tissues. It was suggested that changes in the...
AIM
Optical coherence tomography (OCT) is a novel method that allows high resolution cross-sectional imaging of biological tissues. It was suggested that changes in the cranial structure or functions would be reflected in the retina. OCT has been an important method in the diagnosis and follow-up of diseases via morphometric or quantitative retinal measurements. Panic disorder (PD) is an anxiety disorder, where free radicals, inflammatory processes and neurotransmitter transmission disorders play a role in the etiology. The present study aimed to demonstrate neurodegeneration in PD by the comparison of PD patient and control OCT data.
MATERIAL AND METHOD
The study group included 21 PD patients who met the study criteria. The control group included 21 healthy individuals without any known psychiatric or organic disease, including eye disease, and gender-matched to the patient group. All participants underwent detailed psychiatric and eye examinations. Central macular thickness (CMT), macular volume (MV), mean and retinal nerve fiber layer thickness (RNFL), ganglion cell layer thickness (GCLT), and central choroidal thickness (CCT) were measured in both eyes of all participants with OCT. A sociodemographic data form, Clinical Global Impression Scale (CGIS), and Panic Disorder Severity Scale (PDSS) were administered to the participants.
RESULTS
In the study, it was determined that the CMT values of the PD patients were lower when compared to the controls in the OCT examination. There was a statistically significant difference between the CMT of the PD patient group and the control group; the CMT was lower in the patient group. There were no significant differences between the groups based on GCLT, RNFL superior, RNFL inferior, RNFL nasal, RNFL temporal, and CCT. There was no significant correlation between CGIS, PDSS scores and OCT measurements.
CONCLUSION
This is the first study in the literature where patients with a PD diagnosis were analyzed based on the OCT method. OCT, which is a simple, noninvasive and relatively inexpensive method that the patient could easily adapt to during imaging, could be employed as a supplementary method in the diagnosis and follow-up of PD patients.
Topics: Humans; Panic Disorder; Parkinson Disease; Retina; Tomography, Optical Coherence
PubMed: 35690017
DOI: 10.1016/j.pscychresns.2022.111496 -
Psychiatry 2023
Topics: Humans; Panic; Psychology, Social; Panic Disorder
PubMed: 38149710
DOI: 10.1080/00332747.2023.2289817 -
Journal of Affective Disorders Mar 2020Computer simulations (CS) and virtual reality exposure are promising techniques for research and treatment of panic disorder with agoraphobia (PDA). The objective of...
BACKGROUND
Computer simulations (CS) and virtual reality exposure are promising techniques for research and treatment of panic disorder with agoraphobia (PDA). The objective of this study was to ascertain whether a given CS was a stimulus capable of producing panic attacks (PAs), anxiety and psychophysiological changes in patients with PDA.
METHODS
Thirty PDA patients and 30 healthy subjects were recruited for this study. Subjects were exposed to a 3-min CS of a situation relevant to agoraphobic patients. Anxiety, panic symptoms, PAs, heart rate, skin conductance and respiration were recorded before, during and after the CS exposure.
RESULTS
The CS effectively induced anxiety, hyperventilation and electrodermal responses in PDA patients but not in healthy subjects. Forty percent of PDA patients had a PA while none of the control subjects had a PA. A subgroup of patients who were less sensitive to the CS than the other subgroup of PDA patients and did not present full-blown PAs still had more panic symptoms, higher anxiety levels and more respiratory irregularities than the controls.
LIMITATIONS
Low immersion and low sense of presence, lack of interaction with the environment.
CONCLUSIONS
Exposure to the CS produced effects similar to in vivo exposure, respiratory and caffeine challenges. Subsequent studies should: make direct comparisons between CS and other challenges for PDA; investigate if CS can be a tool for predicting effects of medication; determine the potential of CS as a desensitization technique for situational PAs.
Topics: Agoraphobia; Anxiety Disorders; Computer Simulation; Humans; Panic; Panic Disorder
PubMed: 31786029
DOI: 10.1016/j.jad.2019.11.081