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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 -
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 -
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 -
Frontiers in Psychiatry 2022Panic disorder (PD) is unique among anxiety disorders in that the emotional symptoms (e.g., fear and anxiety) associated with panic are strongly linked to body... (Review)
Review
Panic disorder (PD) is unique among anxiety disorders in that the emotional symptoms (e.g., fear and anxiety) associated with panic are strongly linked to body sensations indicative of threats to physiological homeostasis. For example, panic attacks often present with feelings of suffocation that evoke hyperventilation, breathlessness, or air hunger. Due to the somatic underpinnings of PD, a major focus has been placed on interoceptive signaling and it is recognized that dysfunctional body-to-brain communication pathways promote the initiation and maintenance of PD symptomatology. While body-to-brain signaling can occur several pathways, immune and humoral pathways play an important role in communicating bodily physiological state to the brain. Accumulating evidence suggests that neuroimmune mediators play a role in fear and panic-associated disorders, although this has not been systematically investigated. Currently, our understanding of the role of immune mechanisms in the etiology and maintenance of PD remains limited. In the current review, we attempt to summarize findings that support a role of immune dysregulation in PD symptomology. We compile evidence from human studies and panic-relevant rodent paradigms that indicate a role of systemic and brain immune signaling in the regulation of fear and panic-relevant behavior and physiology. Specifically, we discuss how immune signaling can contribute to maladaptive body-to-brain communication and conditioned fear that are relevant to spontaneous and conditioned symptoms of PD and identify putative avenues warranting future investigation.
PubMed: 36523875
DOI: 10.3389/fpsyt.2022.1015349 -
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 -
General Psychiatry 2020The Coronavirus Disease 2019 (COVID-19) epidemic emerged in Wuhan, China, spread nationwide and then onto half a dozen other countries between December 2019 and early...
The Coronavirus Disease 2019 (COVID-19) epidemic emerged in Wuhan, China, spread nationwide and then onto half a dozen other countries between December 2019 and early 2020. The implementation of unprecedented strict quarantine measures in China has kept a large number of people in isolation and affected many aspects of people's lives. It has also triggered a wide variety of psychological problems, such as panic disorder, anxiety and depression. This study is the first nationwide large-scale survey of psychological distress in the general population of China during the COVID-19 epidemic.
PubMed: 32215365
DOI: 10.1136/gpsych-2020-100213 -
BMC Psychiatry Nov 2022Bergen 4-day treatment (B4DT) is a concentrated exposure-based treatment (cET), where the patient receives concentrated, individually tailored cognitive behavioral... (Clinical Trial)
Clinical Trial
BACKGROUND
Bergen 4-day treatment (B4DT) is a concentrated exposure-based treatment (cET), where the patient receives concentrated, individually tailored cognitive behavioral therapy (CBT) during four consecutive days. Previous findings have indicated that B4DT could be a promising treatment for panic disorder (PD).
AIM
The aim of the present study was to evaluate the implementation of B4DT for panic disorder with- and without agoraphobia, at a new clinic. This is the first replication study for B4DT on panic disorder.
METHOD
Thirty consecutively recruited patients with PD were included in an open trial design. Assessment of symptoms of panic disorder were measured with Panic Disorder Severity Scale (PDSS), while symptoms of generalized anxiety were assessed by Generalized Anxiety Disorder-7 (GAD-7) and depressive symptoms by Patient Health Questionnaire (PHQ-9) pre-treatment, post-treatment and at 3-month follow-up. Treatment satisfaction was measured with Client Satisfaction Questionnaire (CSQ-8) post-treatment.
RESULTS
The results showed a significant reduction in symptom severity from pre-treatment to post-treatment (d = 4.32), and at 3-month follow-up (d = 4.91). The proportion of patients classified as fulfilling the criteria for remission was 80.0% at post-treatment and 86.7% at follow up. There was a significant reduction in symptoms of depression and generalized anxiety. Treatment satisfaction was high and none of the patients dropped out.
CONCLUSION
The current study replicated the results from the original study and indicate that the treatment can be successfully implemented at new clinics. B4DT may be a promising treatment for panic disorder and comorbid symptoms of generalized anxiety and depression. Larger and more controlled studies are needed to establish the efficacy of B4DT for panic disorder.
Topics: Humans; Agoraphobia; Ambulatory Care Facilities; Anxiety; Anxiety Disorders; Panic Disorder
PubMed: 36418989
DOI: 10.1186/s12888-022-04380-6 -
Frontiers in Psychiatry 2023The current narrative review summarizes and examines several theories of panic disorder (PD) including biological theories, encompassing neurochemical factors, metabolic... (Review)
Review
The current narrative review summarizes and examines several theories of panic disorder (PD) including biological theories, encompassing neurochemical factors, metabolic and genetic theories, respiratory and hyperventilation theories and cognitive theory. Biological theories have informed the development of psychopharmacological treatments; however, they may be limited in their utility given the efficacy of psychological treatments. In particular, behavioral and, more recently, cognitive models have garnered support due to the efficacy of cognitive-behavior therapy (CBT) in treating PD. The role of combination treatments has been found to be superior in the treatment of PD in particular cases, lending support for the need for an integrated approach and model for PD given that the etiology of PD is complex and multifactorial.
PubMed: 36793941
DOI: 10.3389/fpsyt.2023.957515