Psychological Defenses in Patients with Comorbid Panic Disorder and Alcoholism

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
D. Tsygankov ◽  
E. Agasaryan ◽  
D. Terekhova

The aim of this study was to examine psychological differences between various groups of patients with comorbid panic disorder and alcoholism (n = 214). We investigated the use of defense mechanisms by life style index of R. Plutchik. Patients of first group (who experienced there first panic attack during withdrawal of alcohol and then has stopped use of alcohol) significantly higher used projection, displacement and repression. Patients, who have originally suffered from panic attacks which they tried to release with the alcohol (second group), significantly higher used projection. Patients who experienced panic attacks only during ingestion of alcohol (third group), significantly higher used denial and repression. Patients with panic attacks during clinical remission of alcohol addiction, who used alcohol to weaken the panic symptoms, which resulted in the heavy alcoholism recurrence (fourth group), significantly higher used repression, projection and denial. So, there were differences between groups on preferred defense mechanisms. the results of the study can help in understanding the pathogenesis of comorbid panic disorder and alcoholism.The study is supported by the President's grant ÌÊ-2670.

2002 ◽  
Vol 19 (2) ◽  
pp. 102-111 ◽  
Author(s):  
Jeffrey C. Richards ◽  
Vanessa Richardson ◽  
Ciaran Pier

AbstractThe aim of this study was to determine the degree to which fearful and catastrophic cognitions, and self-efficacy for managing panic predicted various panic attack characteristics in panic disorder. The cognitive variables consisted of anxiety sensitivity, the frequency of fearful agoraphobic cognitions and measures of catastrophic misinterpretation of symptoms. The panic parameters were number and severity of panic symptoms, distress associated with panic attacks, worry about future panics, duration of panic disorder, and life interference due to panic disorder. These variables were measured in 40 people with panic disorder, 31 of whom also had significant agoraphobia. The frequency of fearful agoraphobic cognitions was the strongest predictor of panic attack symptomatology, predicting number of symptoms, symptom severity and degree of anticipatory fear of panic. Catastrophic misinterpretation of symptoms and anxiety sensitivity did not independently predict any panic parameters. Only self-efficacy for managing the rapid build-up of panic symptoms was specifically related to panic severity. The results therefore suggest that cognitive behaviour therapy for panic symptoms in panic disorder should reduce fearful cognitions rather than focus on panic coping strategies. The results offer little support for the contribution of the expectancy or catastrophic misinterpretation theories to the maintenance of panic disorder.


2021 ◽  
Vol 9 (T3) ◽  
pp. 237-239
Author(s):  
Muhammad Surya Husada ◽  
Mustafa M. Amin ◽  
Munawir Saragih

Background: COVID-19 is a newly emerging infectious disease which is found to be caused by SARS-2. COVID-19 pandemic has spread worldwide causing a rapidly increasing number of mental disorders cases, primarily anxiety disorder. Since majority of panic disorder patients are present with great anxiety in response to their physical or respiratory symptoms, support and encouragement from psychiatrist or therapist are fundamental to alleviate the severity of the symptoms. Case Report: We reported a case of COVID-19 induced panic disorder in a woman, 52 years old, batak tribe who started to experience multiple panic attacks since one of her family members was confirmed to be Covid-10 positive. Conclusion: In general, panic disorder is a common diagnosis, but this case appeared to be interesting as it is induced by COVID-19 pandemic. As in this case, the individual who experienced multiple panic attack is not even a COVID-19 patient but has one of her family member affected by the virus. A wide body of evidence has shown that this pandemic massively contributes to worsening of psychosocial burden in nationwide.


1998 ◽  
Vol 15 (4) ◽  
pp. 228-236 ◽  
Author(s):  
Patricia Rayment ◽  
Jeff Richards

Despite the very significant proportion of people with panic disorder who have accompanying agoraphobia, there is considerable controversy about the variables that influence the development of this avoidance behaviour. This study investigated whether degree of avoidance is a function of extent of fear and prevalence of negative cognitions about autonomic arousal symptoms and whether the use of, and confidence in, behavioural strategies to cope with panic sensations also influences agoraphobic avoidance. Thirty-nine people who met DSM-IV criteria for panic disorder completed questionnaires measuring fear and negative cognitions about autonomic arousal and panic sensations, and a questionnaire measuring their use of largely behavioural strategies to cope with panic attacks. Fear of autonomic arousal and negative cognitions in response to the occurrence of these arousal symptoms were jointly related to situational avoidance. There was little relationship between the use of, and confidence in, panic coping strategies and less agoraphobic avoidance, although simply allowing panic symptoms to develop and pass predicted less avoidance. The results were interpreted as providing an empirical basis for treatment that reduces fear of panic sensations and allows their experience to be tolerated while preventing escape and avoidance of situations in which panic occurs. There was little evidence that additional teaching of behavioural coping strategies would be useful in reducing agoraphobic avoidance.


Author(s):  
Christina L. Macenski

Panic disorder consists of recurrent, unexpected panic attacks accompanied by persistent worry about future attacks and/or a maladaptive change in behavior related to the attacks. A panic attack is defined as an abrupt surge of intense fear or discomfort that reaches a peak within minutes that occurs in conjunction with several other associated symptoms such as palpitations, sweating, trembling, shortness of breath, and chest pain. Features of panic disorder that are more common in adolescents than in adults include less worry about additional panic attacks and decreased willingness to openly discuss their symptoms. All patients with suspected panic disorder should undergo a medical history, physical examination, and laboratory workup to exclude medical causes of panic attacks. Cognitive behavioral therapy (CBT) including interoceptive exposures is the gold standard therapy intervention. Medications including selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) can also help reduce symptoms.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
D. Tsygankov ◽  
D. Terekhova ◽  
E. Agasaryan

The aim of this study was to examine clinicodynamical characteristics of clinical course of alcohol addiction and panic disorders. Patients (n = 214) with comorbidity of alcoholism and panic disorder were included in this study.Defined and described were 4 clinical variants of associated course of these diseases that differ in formation order, cause-effect relations between alcohol abuse and panic disorder, clinical features and course of alcoholism and panic attacks, further development of double pathology.The first group included patients with full abstinence from alcohol for no less than one year by reason of panic attacks during alcohol withdrawal syndrome. The second group consisted of patients whose panic attacks were followed by ingesting considerable doses of alcohol in order to release anxiety, which resulted in the bout of heavy drinking. Episodic paroxysmal alcohol ingestion was typical in patients from the third group. Ingestion of considerable doses of alcohol leaded to panic attacks, the following abstinence from alcohol (6 months in average) was based on fear of reiteration of panic disorder. The forth group included patients with panic attacks during clinical remission of alcohol addiction who used alcohol to ease the panic symptoms. This resulted in the heavy alcoholism recurrence.The results of the study can serve as a basis for working out programs of differential therapy for above-mentioned patients.The study is supported by the President's Grant Mκ-2670.2008.7.


2004 ◽  
Vol 35 (6) ◽  
pp. 881-890 ◽  
Author(s):  
RENEE D. GOODWIN ◽  
DAVID M. FERGUSSON ◽  
L. JOHN HORWOOD

Background. The objectives of the study were to examine linkages between exposure to childhood abuse and interparental violence and the subsequent development of panic attacks and panic disorder using data gathered on a birth cohort of 1265 New Zealand young people studied to the age of 21 years.Method. Data on: (a) exposure to child abuse and interparental violence; (b) the development of panic attacks and panic disorder; and (c) other childhood and related factors were gathered over the course of a 21-year longitudinal study.Results. After adjustment for childhood and related factors, exposure to childhood physical abuse was associated with a significantly increased risk of later panic attack (OR 2·3, 95% CI 1·1–4·9) and panic disorder (OR 3·0, 95% CI 1·1–7·9); childhood sexual abuse was associated with a significantly increased risk of panic attack (OR 4·1, 95% CI 2·3–7·2) and a marginally significant increase risk of panic disorder (OR 2·2; 95% CI 0·98–5·0). Exposure to interparental violence was unrelated to later panic attack or disorder after adjustment.Conclusions. Exposure to childhood sexual and physical abuse was associated with increased risks of later panic attack/disorder even after adjustment for prospectively assessed confounding factors. However, exposure to interparental violence during childhood was not related to increased risk of later panic attack/disorder after adjustment. These data suggest the need for clinicians to be aware that patients with histories of childhood physical and sexual abuse may be at increased risk for panic during young adulthood.


2005 ◽  
Vol 27 (3) ◽  
pp. 216-221 ◽  
Author(s):  
Fabiana L Lopes ◽  
Antonio E Nardi ◽  
Isabella Nascimento ◽  
Alexandre M Valença ◽  
Marco A Mezzasalma ◽  
...  

OBJECTIVE: To compare nocturnal and diurnal panic attacks in a cross-sectional study and in a longitudinal prospective short-term follow-up. METHODS: We selected 57 panic disorder (PD) subjects (DSM-IV) and rated them with the Panic Disorder Severity Scale (PDSS) at baseline and after 30 days of treatment with nortriptyline, and with the Eysenck Personality Inventory and the Brown Attention Deficit Disorder (ADD) Scale at baseline. RESULTS: The sample was divided into a nocturnal and diurnal panic attack (NDPA) group - 57.9% (n = 33) - and a diurnal panic attack (DPA) group - 42.1% (n = 24). The groups showed a similar mean age at onset of PD and a pattern of prominent respiratory symptoms. The PDSS did not differ between the groups following short-term treatment (p = 0.451). There were also neither significant differences in Neuroticism (p = 0.094) and Extroversion (p = 0.269) nor in the Brown ADD Scale (p = 0.527). CONCLUSION: In our study, patients with both nocturnal and diurnal panic attacks showed similar features in their phenomenology and short-term outcome when compared to pure diurnal panic attacks patients.


2003 ◽  
Vol 33 (5) ◽  
pp. 879-885 ◽  
Author(s):  
RENEE D. GOODWIN ◽  
WILLIAM W. EATON

Objective. The study was designed to determine the association between self-reported asthma and the risk, persistence and severity of panic attacks among adults in the community.Method. Data were drawn from waves 1 and 2 of the Baltimore site of the Epidemiologic Catchment Area (ECA) Study (N=2768), which included self-report information on asthma, treatment for asthma and panic attacks in 1981 and 1982. Multiple logistic regression analyses were used to calculate odds ratios comparing the prevalence of panic attack at baseline and follow-up by asthma status at baseline. Linear regression analyses were used to examine the relationship between self-reported asthma status and the number of panic symptoms during a panic attack.Results. Self-report asthma was associated with significantly increased likelihood of having panic attacks at baseline (1981) (12·1% v. 7·3%, P<0·05) and of having panic attacks at both baseline and follow-up (15·9% v. 7·3%, P<0·05), compared to those without asthma at baseline. Adults receiving treatment for asthma at baseline had an increased risk of incident panic attacks at follow-up (OR=2·65 (1·11, 6·34)) and at baseline and follow-up (OR=5.88 (2·21, 15.62)), though untreated asthma did not appear to increase risk of incident panic at follow-up. Similarly, the risk of panic at follow-up was not increased among those with asthma at baseline who did not report asthma at follow-up, compared with those without asthma at baseline. Treated asthma was associated with having more panic symptoms during panic attacks, compared to those without asthma (P<0·001).Conclusion. These findings are consistent with and extend previous results suggesting that self-reported asthma is associated with an increased risk of panic attacks among adults in the general population, and that there is a consistent relation between severity and persistence of asthma and panic attacks. The lack of association between remitted asthma and panic attack may reveal a need for further research to determine whether asthma may be a causal risk factor for panic attacks, or whether a third factor (genetic or environmental) may be associated with increased risk of the co-occurrence of asthma and panic attacks. Replication of these results using alternative methodology with corroborative data on asthma and panic attacks is needed next.


Cephalalgia ◽  
1999 ◽  
Vol 19 (8) ◽  
pp. 728-731 ◽  
Author(s):  
W Ossipova ◽  
OA Kolosova ◽  
AM Vein

Migraine headache and panic disorder are two conditions that have a number of underlying physiological and psychological abnormalities in common. The temporal relationship between the occurrence of migraine headache and panic attacks could be different, however. According to our observations, some migraine subjects develop panic attacks with the typical symptoms (palpitation, dyspnea, anxiety/fear, shiver, sweating, polyuria) on the “peak” of their attacks. This variant of migraine without aura was conditionally defined as “panic migraine”. Here we describe two patients suffering from migraine without aura in whom migraine was associated with the typical panic attack. It is suggested that a pronounced autonomic dysregulation along with marked psychological abnormalities could be responsible for the constellation of migraine and panic symptoms during one episode. Taking into account the previously obtained results, it is concluded that compared to “pure” migraine, “migraine associated with panic attacks” is characterized by a severe course, marked autonomic and emotional disturbances during pain-free intervals, seriously impaired quality of life, and requires a specific therapeutic approach.


2021 ◽  
Author(s):  
Manabu Yasuda ◽  
Jun Kumakura ◽  
Oka Kiyonori ◽  
Kazuhito Fukuda

Abstract BackgroundGraves' disease is characterized by hyperthyroidism and the symptoms of Graves' disease often overlap with those of panic disorder, which may make it difficult to distinguish between the two conditions. In this report, we describe how proper diagnosis of thyroid disease in patients with mental illness can lead to appropriate treatment.Case presentationWe encountered a 34-year-old woman in whom thyroid crisis from Graves’ disease was misdiagnosed as panic attack. The patient was being managed as a case of panic disorder and bipolar disorder in a psychiatric outpatient setting. About 6 months before presentation, she had lost about 16 kg in weight, and a month before presentation, she developed several unpleasant symptoms as her condition worsened. Several weeks before, she had severe palpitations, tachycardia, and discomfort in her throat. She became unable to eat solids and ate only yogurt and gelatin and felt difficult to take psychiatric drugs.A day on the Sunday morning, she visited our department of emergency outpatient with severe nausea. Examination revealed proptosis, and so thyroid function tests were requested in addition to routine blood tests. There was no improvement in her condition, and she returned to hospital in the early hours of the next morning. Based on her symptoms, she was diagnosed as having panic attacks due to panic disorder and was given diazepam injection and allowed to go home. There was no suspicion of Graves' disease.Later that day, the thyroid function test results became available and thyroid storm was suspected. The endocrinology department was consulted immediately and she was referred and hospitalized the next day. During hospitalization, she was treated with steroid and radioisotope therapy, and was discharged from hospital in three weeks. ConclusionPsychiatrists and doctors engaged in psychosomatic medicine need to consider the possibility of thyroid disease as a differential diagnosis of panic disorder. It is necessary to check thyroid function at the initial examination when a patient presents with symptoms of severe panic attack.


Sign in / Sign up

Export Citation Format

Share Document