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The World Journal of Biological... Dec 2023Anxiety disorders (AD) are common in the general population, leading to high emotional distress and disability. The German National Cohort (NAKO) is a population-based...
OBJECTIVES
Anxiety disorders (AD) are common in the general population, leading to high emotional distress and disability. The German National Cohort (NAKO) is a population-based mega-cohort study, examining participants in 16 German regions. The present study includes data of the first 101,667 participants and investigates the frequency and severity of generalised anxiety symptoms and panic attacks (PA).
METHODS
The Generalised Anxiety Disorder Symptoms Scale (GAD-7) and the first part of the Patient Health Questionnaire Panic Disorder (PHQ-PD) were filled out by NAKO participants (93,002). We examined the correlation of GAD-7 and PHQ-PD with demographic variables, stress (PHQ-Stress), depression (PHQ-9) and childhood trauma (CTS).
RESULTS
The total proportion of prior lifetime diagnoses of AD in the NAKO cohort reached 7.8%. Panic attacks were reported by 6.0% and possible/probable current GAD symptoms in 5.2% of the examined participants. Higher anxiety severity was associated with female sex, lower education level, German as a foreign language and younger age as well as high perceived stress and depression.
CONCLUSIONS
Clinically relevant GAD symptoms as well as panic attacks are frequent in the NAKO and are associated with sociodemographic factors, and high anxiety symptoms are accompanied by pronounced stress and depression levels.
Topics: Humans; Female; Cohort Studies; Anxiety Disorders; Panic Disorder; Anxiety
PubMed: 34842503
DOI: 10.1080/15622975.2021.2011409 -
European Neuropsychopharmacology : the... Apr 2020In the DSM-5, separation anxiety disorder (SAD) is newly classified in the chapter on anxiety, renewing research efforts into its etiology. In this narrative review, we... (Review)
Review
In the DSM-5, separation anxiety disorder (SAD) is newly classified in the chapter on anxiety, renewing research efforts into its etiology. In this narrative review, we summarize the current literature on the genetic, endocrine, physiological, neural and neuropsychological underpinnings of SAD per se, SAD in the context of panic disorder, separation anxiety symptoms, and related intermediate phenotypes. SAD aggregates in families and has a heritability of ~43%. Variants in the oxytocin receptor, serotonin transporter, opioid receptor µ1, dopamine D4 receptor and translocator protein genes have all been associated with SAD. Dysregulation of the hypothalamus-pituitary-adrenal axis, dysfunctional cortico-limbic interaction and biased cognitive processing seem to constitute further neurobiological markers of separation anxiety. Hypersensitivity to carbon dioxide appears to be an endophenotype shared by SAD, panic disorder and anxiety sensitivity. The identification of biological risk markers and its multi-level integration hold great promise regarding the prediction of SAD risk, maintenance and course, and in the future may allow for the selection of indicated preventive and innovative, personalized therapeutic interventions.
Topics: Anxiety, Separation; Carbon Dioxide; Diagnostic and Statistical Manual of Mental Disorders; Humans; Panic Disorder
PubMed: 32046934
DOI: 10.1016/j.euroneuro.2020.01.009 -
Psychiatry Research Sep 2020Panic and sleep disturbances are established risk factors for suicide. Nocturnal panic attacks, which occur out of sleep, represent an intersection of these risk...
Panic and sleep disturbances are established risk factors for suicide. Nocturnal panic attacks, which occur out of sleep, represent an intersection of these risk factors. Only one study to date has examined this relationship, but measured suicidality as a unitary construct. This represents a significant gap in the literature, considering most individuals who think about suicide do not make a plan and most who make a plan never make an attempt. We sought to expand upon existing research by examining how nocturnal panic relates to suicidal ideation, plans, and attempts separately. We predicted nocturnal panic would be associated with more suicidal ideation, plan, and attempt history than daytime only panic and no panic. Participants recruited from an online community sample were thoroughly screened for nocturnal and daytime panic history and completed questionnaires about past suicidal ideation, plans, and attempts. Nocturnal and daytime panic groups did not differ in past suicidal ideation or plans, but both groups exceeded the non-panic group. The nocturnal panic group reported more suicide attempts than the daytime and non-panic groups and judged themselves as more likely to make an attempt in the future. These results indicate a promising avenue for future research and suicide prevention efforts.
Topics: Adult; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Panic Disorder; Risk Factors; Sleep; Sleep Wake Disorders; Suicidal Ideation; Suicide, Attempted
PubMed: 32763542
DOI: 10.1016/j.psychres.2020.113280 -
Psychiatrike = Psychiatriki 2020Panic disorder (PD) is a common anxiety disorder with severe social and health consequences in the lives of individuals who suffer from it. General population studies...
Panic disorder (PD) is a common anxiety disorder with severe social and health consequences in the lives of individuals who suffer from it. General population studies that attempt to measure the prevalence of this disorder across the world suggest that a 1.7% to 4.7 % of adults and adolescents suffer from Panic Disorder. In Greece, research analyzing the abovementioned matters is limited, and previous studies were put forward in small samples. The aim of the present study was to describe the prevalence and sociodemographic associations of panic disorder (PD) and related subthreshold panic symptoms in the general population of Greece and to appraise the comorbidity, use of services and impact on quality of life of these syndromes. This was a secondary analysis of the 2009-2010 psychiatric morbidity survey carried out in a representative sample of the Greek general population (4894 participants living in private households, 18-70 years, response rate 54%). Psychiatric disorders were assessed with the computerized version of the revised Clinical Interview Schedule (CIS-R). Quality of life was assessed with the EuroQoL EQ-5D generic instrument. The utilization of health services was examined by making relevant questions. Finally, direct questions were used to assess sociodemographic and socioeconomic factors According to our findings, 1.87% of the participants (95% confidence interval [CI]: 1.50-2.26%) met criteria for PD and 1.61% met criteria for subclinical PD (95% CI: 1.26-1.96%). There was a clear female preponderance for both PD (p=0.001) and Sub-PD (p=0.01). In addition, 3.48% of the participants reported having experienced panic attacks during the past week (95% confidence interval [CI]: 2.98-4.01%). PD or subclinical PD was independently associated with a limited number of sociodemographic and socioeconomic variables especially after the adjusted analysis. Both panic related conditions involved significant reductions in quality of life and elevated utilization of health services for both medical and psychological reasons in comparison to healthy participants. In conclusion, PD and subclinical panic symptoms were common in the general Greek population with substantial comorbidity and impaired quality of life. The observed use of the general and psychological health services among adults with panic symptoms and its temporal and economic consequences calls for more efficient diagnostic and treatment policies.
Topics: Comorbidity; Female; Greece; Humans; Male; Mental Health Services; Middle Aged; Panic Disorder; Patient Acceptance of Health Care; Prevalence; Quality of Life; Risk Factors; Socioeconomic Factors; Symptom Assessment
PubMed: 33099461
DOI: 10.22365/jpsych.2020.313.201 -
Annual International Conference of the... Jul 2023Panic attacks are an impairing mental health problem that impacts more than one out of every 10 adults in the United States (US). Clinical guidelines suggest panic...
Panic attacks are an impairing mental health problem that impacts more than one out of every 10 adults in the United States (US). Clinical guidelines suggest panic attacks occur without warning and their unexpected nature worsens their impact on quality of life. Individuals who experience panic attacks would benefit from advance warning of when an attack is likely to occur so that appropriate steps could be taken to manage or prevent it. Our recent work suggests that an individual's likelihood of experiencing a panic attack can be predicted by self-reported mood and community-level Twitter-derived mood the previous day. Prior work also suggests that physiological markers may indicate a pending panic attack. However, the ability of objective physiological, behavioral, and environmental measures collected via consumer wearable sensors (referred to as digital biomarkers) to predict next-day panic attacks has not yet been explored. To address this question, we consider data from 38 individuals who regularly experienced panic attacks recruited from across the US. Participants responded to daily questions about their panic attacks for 28 days and provided access to data from their Apple Watches. Mixed Regressions, with an autoregressive covariance structure were used to estimate the prevalence of a next-day panic attack Results indicate that digital biomarkers of ambient noise (louder) and resting heart rate (higher) are indicative of experiencing a panic attack the next day. These preliminary results suggest, for the first time, that panic attacks may be predictable from digital biomarkers, opening the door to improvements in how panic attacks are managed and to the development of new preventative interventions.Clinical Relevance- Objective data from consumer wearables may predict when an individual is at high risk for experiencing a next-day panic attack. This information could guide treatment decisions, help individuals manage their panic, and inform the development of new preventative interventions.
Topics: Adult; Humans; United States; Panic Disorder; Quality of Life; Self Report; Affect; Wearable Electronic Devices
PubMed: 38083448
DOI: 10.1109/EMBC40787.2023.10339982 -
Journal of the Academy of... 2024We present the case of a 67-year-old male with a history of major depressive disorder, panic disorder, treatment refractory hypertension, dyslipidemia, benign prostatic... (Review)
Review
We present the case of a 67-year-old male with a history of major depressive disorder, panic disorder, treatment refractory hypertension, dyslipidemia, benign prostatic hypertrophy, and environmental allergies who was initially brought to medical attention following an unwitnessed fall. He subsequently developed symptoms of insomnia disorder. Experts in consultation-liaison psychiatry and sleep medicine provide guidance for this clinical scenario based on their experience and a review of current literature, exploring the epidemiology of insomnia disorder and comorbidities in relation to this case. Furthermore, we offer a review of current treatment for insomnia disorder, including non-pharmacologic methods such as cognitive behavioral therapy for insomnia and pharmacotherapy.
Topics: Humans; Sleep Initiation and Maintenance Disorders; Male; Aged; Cognitive Behavioral Therapy; Depressive Disorder, Major; Panic Disorder; Comorbidity
PubMed: 38016579
DOI: 10.1016/j.jaclp.2023.11.684 -
BMC Psychiatry Jun 2022The aims of this study were to conduct a cross-cultural validation of the Panic Disorder Severity Scale - Self-Report (PDSS-SR) and to examine psychometric properties of...
BACKGROUND
The aims of this study were to conduct a cross-cultural validation of the Panic Disorder Severity Scale - Self-Report (PDSS-SR) and to examine psychometric properties of the French-Canadian version.
METHODS
A sample of 256 adults were included in the validation study based on data from the baseline interview of a clinical trial on transdiagnostic cognitive-behavioral therapy for mixed anxiety disorders. Participants completed the Anxiety and Related Disorders Interview Schedule (ADIS-5), and self-report instruments including the PDSS-SR, Beck Anxiety Inventory (BAI), Mobility Inventory for Agoraphobia (MIA), Sheehan Disability Scale (SDS), Patient Health Questionnaire (PHQ-9), Social Phobia Inventory (SPIN), Insomnia Severity Index (ISI) and Penn State Worry Questionnaire (PSWQ). The cross-cultural adaptation in French of the PDSS-SR included a rigorous back-translation process, with an expert committee review. Sensitivity to change was also examined with a subgroup of patients (n = 72) enrolled in the trial.
RESULTS
The French version of the PDSS-SR demonstrated good psychometric properties. The exploratory factor analysis supported a one factor structure with an eigenvalue > 1 that explained 64.9% of the total variability. The confirmatory factor analysis (CFA) corroborated a one-factor model with a good model fit. Internal consistency analysis showed a .91 Cronbach's alpha. The convergent validity was adequate with the ADIS-5 clinical severity ratings for panic disorder (r = .56) and agoraphobia (r = .39), as well as for self-report instruments [BAI (r = .63), MIA (accompanied: r = .50; alone: r = .47) and SDS (r = .37)]. With respect to discriminant validity, lower correlations were found with the SPIN (r = .17), PSWQ (r = .11), ISI (r = .19) and PHQ-9 (r = .28). The optimal threshold for probable diagnosis was 9 for the PDSS-SR and 4 for the very brief 2-item version. The French version showed good sensitivity to change.
CONCLUSIONS
The French version of the PDSS-SR has psychometric properties consistent with the original version and constitutes a valid brief scale to assess the severity of panic disorder and change in severity over time, both in research and clinical practice.
Topics: Adult; Canada; Humans; Panic Disorder; Reproducibility of Results; Self Report; Severity of Illness Index
PubMed: 35761266
DOI: 10.1186/s12888-022-03989-x -
American Family Physician Apr 2020
Review
Topics: Adult; Anti-Anxiety Agents; Arousal; Benzodiazepines; Humans; Panic; Panic Disorder; Treatment Outcome
PubMed: 32227829
DOI: No ID Found -
Journal of Health Psychology Jun 2021This study documented the 6-month incidence of panic disorder and its predictors in emergency department patients with panic attacks and non-cardiac chest pain. The...
This study documented the 6-month incidence of panic disorder and its predictors in emergency department patients with panic attacks and non-cardiac chest pain. The assessment included a validated structured interview to identify panic attacks and questionnaires measuring the potential predictors of panic disorder. Presence of panic disorder was assessed 6 months later. The incidence of panic disorder was 10.1 percent ( = 14/138). Anxiety sensitivity was the only significant predictor of the incidence of panic disorder (odds ratio = 1.06; 95% confidence interval = 1.01-1.12). Patients with panic attacks and non-cardiac chest pain are at an elevated risk for panic disorder. This vulnerability appears to increase with anxiety sensitivity.
Topics: Anxiety; Anxiety Disorders; Chest Pain; Humans; Incidence; Panic Disorder
PubMed: 31250658
DOI: 10.1177/1359105319859062 -
The Journal of Nervous and Mental... Jun 2021The objective of this study was to investigate potential correlates of dispositional optimism and quality of life in patients with depression and panic disorder. The...
The objective of this study was to investigate potential correlates of dispositional optimism and quality of life in patients with depression and panic disorder. The study used a cross-sectional design. The analyzed sample consisted of 77 participants with panic disorder and 75 participants with depression attending two outpatient clinics at the Psychiatry Institute of the Federal University of Rio de Janeiro. Both groups presented similar impairments in optimism and quality of life. In the panic disorder group, optimism scores were significantly correlated with a decrease in anxiety and depression scores (r = 0.26 and r = 0.37, respectively); in the depression group, increases in optimism scores were significantly correlated with decreases in anxiety and depression scores (r = 0.23 and r = 0.3, respectively). The present study showed that high anxiety and depression are correlated with poor optimism and quality of life scores in panic disorder and depression groups. Thus, psychological treatments that can address these topics, besides acute symptoms, are crucial to the absolute recovery of patients.
Topics: Adolescent; Adult; Aged; Anxiety; Cross-Sectional Studies; Depression; Depressive Disorder; Female; Humans; Male; Middle Aged; Optimism; Outcome Assessment, Health Care; Panic Disorder; Pessimism; Quality of Life; Young Adult
PubMed: 34037554
DOI: 10.1097/NMD.0000000000001317