Symptom Specificity in Patients with Panic

1990 ◽  
Vol 157 (4) ◽  
pp. 593-597 ◽  
Author(s):  
Paul Lelliott ◽  
Christopher Bass
Keyword(s):  
Panic Disorder ◽  
Respiratory Symptoms ◽  
Physical Symptoms ◽  
Panic Attacks ◽  
Major Focus ◽  
Experimental Procedure ◽  
Voluntary Hyperventilation ◽  
Panic Symptoms

Thirteen patients with panic disorder with predominantly cardiorespiratory (CR) symptoms were compared with seven patients with predominantly gastrointestinal (Gl) symptoms in an experimental procedure that involved exposure to phobia talk and voluntary hyperventilation (VHV). The CR patients had not only higher baseline anxiety, but also during phobia talk had a greater fall in pCO2 and reported more respiratory symptoms than the Gl patients. Moreover, the CR group found VHV more unpleasant and more like their panic attacks than the Gl panickers, and reported more physical symptoms after it. These findings suggest that patients with PD are not only heterogeneous with respect to the system to which panic symptoms refer (CR or Gl) but that provoking arousal in one system is more likely to produce distress if that system is the major focus of complaint. These findings, if replicated, would not support the suggestion that panic disorder is a uniform illness.

scholarly journals Coronavirus disease-19 Pandemic-Induced Panic Disorder

2021 ◽  
Vol 9 (T3) ◽  
pp. 237-239
Author(s):  
Muhammad Surya Husada ◽  
Mustafa M. Amin ◽  
Munawir Saragih
Keyword(s):  
Infectious Disease ◽  
Case Report ◽  
Panic Disorder ◽  
Panic Attack ◽  
Respiratory Symptoms ◽  
Panic Attacks ◽  
Psychosocial Burden ◽  
Her Family ◽  
Common Diagnosis ◽  
The Individual

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.

Fear of Autonomic Arousal and Use of Coping Strategies as Predictors of Agoraphobic Avoidance in Panic Disorder

1998 ◽  
Vol 15 (4) ◽  
pp. 228-236 ◽  
Author(s):  
Patricia Rayment ◽  
Jeff Richards
Keyword(s):  
Panic Disorder ◽  
Coping Strategies ◽  
Significant Proportion ◽  
Panic Attacks ◽  
Autonomic Arousal ◽  
Negative Cognitions ◽  
Considerable Controversy ◽  
Dsm Iv ◽  
Panic Symptoms ◽  
Behavioural Strategies

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.

Analysis of Posts on Social Network Service related to Panic Disorder using Text Mining (Preprint)

2021 ◽  
Author(s):  
Moon-Ju Jeon ◽  
Sung-Man Bae
Keyword(s):  
Panic Disorder ◽  
Clinical Characteristics ◽  
Physical Symptoms ◽  
Panic Attacks ◽  
Clinical Aspects ◽  
Term Frequency ◽  
Document Frequency ◽  
Word Clouds ◽  
N Gram ◽  
And Coping

BACKGROUND Panic attacks have different clinical characteristics among individuals and countries, characterizing time, place, and symptoms are not clearly predictable OBJECTIVE This study aimed to analyze crucial keywords related to panic disorder and identify various clinical characteristics of panic attacks METHODS We collected 8,728 Twitter posts related to panic disorder from January 1 to December 4, 2020. First, we analyzed crucial and simultaneous emergence keywords related to panic disorder. For this, Term frequency, Term Frequency-Inverse Document Frequency, degree centrality, and N-gram analyses were conducted using Rstudio and TEXTOM and visualized as word clouds. Also, we classfied results of Term frequency for panic disorder into physical symptoms, triggers, time, place, affect, pathology, person, and coping. RESULTS First, depression, drugs, respiration, and stress were keywords related to panic disorder. Next, hyperventilation, palpitations, and shaking were common physical symptoms. Stress, sound, trauma, and coffee were also ranked high in terms of triggering situations. Additionally, in terms of time, morning, night, and dawn accounted for most of the time. Meanwhile, homes, schools, subways, and companies were ranked high as places of occurrence. Regarding affect, fear, tears, and embarrassment were also common. Furthermore, anxiety and depression were ranked high in terms of pathology. Finally, drugs and hospitals were ranked high in terms of coping. CONCLUSIONS These results help to understand the main characteristics of panic disorder and various aspects of unexpected panic attacks and are expected to be a basis for identifying the characteristic clinical aspects of panic disorder among Koreans.

scholarly journals Panic attacks simulate presence of somatic illnesses

2009 ◽  
Vol 62 (3-4) ◽  
pp. 165-170 ◽  
Author(s):  
Milan Latas ◽  
Ivan Soldatovic ◽  
Marko Stamenovic ◽  
Vladan Starcevic
Keyword(s):  
Panic Disorder ◽  
Respiratory Symptoms ◽  
Somatic Symptoms ◽  
Primary Diagnosis ◽  
Panic Attacks ◽  
Study Results ◽  
Somatic Illness ◽  
Specific Association ◽  
Cardio Vascular ◽  
Relationship Of

Introduction. Panic attacks are characterized with sudden attacks of anxiety with numerous somatic symptoms, such as palpitations, tachycardia, tachypnea, nausea, vertigo. The objective of this study was to analyze symptoms of panic attacks in patients with panic disorder, especially, to determine the specific relationship of somatic and neurological symptoms of panic attacks in boundaries of somatic systems. Material and methods. The study sample consisted of 97 patients with primary diagnosis of panic disorder, without any acute, severe and unstable somatic illness. The presence and frequency of symptoms of panic attacks were estimated by the Panic Disorder Questionnaire. Results. The study results indicate that the most frequent symptoms of panic attacks were cardiological signs (heart pounding or racing) and trembling, followed by unsteady and fainting feeling symptoms, sweating, respiratory symptoms and gastroenterological symptoms. The results of correlation analyses indicate that symptoms of panic attacks classified into cardio-vascular, gastro-enterological, respiratory and neuro-otological systems show statistically significant correlations. Conclusion. The results of analyses of symptoms of panic attacks point to their intercorrelation. This specific association of the symptoms, if they are examined on their own in the patients, could lead to false clinical manifestation of some somatic illness. Therefore, it is necessary to analyze adequately and make the proper differential diagnosis of patients with panic disorder.

The Indirect Effect of Anxiety Sensitivity in the Relationship Between Panic Symptoms and Panic Severity

2015 ◽  
Vol 29 (2) ◽  
pp. 123-133 ◽  
Author(s):  
Alexander M. Talkovsky ◽  
Peter J. Norton
Keyword(s):  
Panic Disorder ◽  
Anxiety Sensitivity ◽  
Indirect Effect ◽  
Cognitive Model ◽  
Primary Diagnosis ◽  
Panic Attacks ◽  
Symptom Intensity ◽  
Bodily Sensations ◽  
Panic Symptoms ◽  
The Relationship

The cognitive model of panic (Clark, 1988) suggests that panic attacks result from the catastrophic misinterpretation of bodily sensations rather than the sensations themselves. Anxiety sensitivity (AS) is fear of anxious bodily sensations (Reiss, 1991) and has implications in panic development, maintenance, and severity. Although previous work has demonstrated that AS amplifies symptoms in response to provocations, few have analyzed the role of AS in the relationship between panic symptoms and panic disorder severity. The purpose of this investigation was to determine if AS, a cognitive risk for panic, has an indirect effect on the association between self-reported panic symptoms and panic severity, both self-reported and clinician-assessed, among 67 treatment-seeking individuals with a primary diagnosis of panic disorder with or without agoraphobia. Data were analyzed using the bootstrapped conditional process indirect effects model. Results indicated that the overall total mediational effect on Panic Disorder Severity Scale (PDSS) was significant with evidence of partial mediation. The direct effect of Beck Anxiety Inventory (BAI) on PDSS remained significant although there was also a significant indirect effect of BAI via AS. Results showed a similar relationship when Clinician Severity Rating was the outcome. Moderation analyses were not significant. Therefore, AS was a significant partial mediator of the relationship between symptom intensity and panic severity, whether clinician-rated or self-reported. This investigation provides support for the importance of AS in panic, highlighting its importance but suggesting that it is not sufficient to explain panic disorder.

scholarly journals Nocturnal panic attacks

2002 ◽  
Vol 60 (3B) ◽  
pp. 717-720 ◽  
Author(s):  
Fabiana L. Lopes ◽  
Antonio E. Nardi ◽  
Isabella Nascimento ◽  
Alexandre M. Valença ◽  
Walter A Zin
Keyword(s):  
Sleep Apnea ◽  
Panic Disorder ◽  
Sleep Disorders ◽  
Respiratory Symptoms ◽  
Sleep Apnea Syndrome ◽  
Specific Treatment ◽  
Panic Attacks ◽  
Apnea Syndrome

The panic-respiration connection has been presented with increasing evidences in the literature. We report three panic disorder patients with nocturnal panic attacks with prominent respiratory symptoms, the overlapping of the symptoms with the sleep apnea syndrome and a change of the diurnal panic attacks, from spontaneous to situational pattern. The implication of these findings and awareness to the distinct core of the nocturnal panic attacks symptoms may help to differentiate them from sleep disorders and the search for specific treatment.

scholarly journals Respiratory manifestations of panic disorder: causes, consequences and therapeutic implications

2009 ◽  
Vol 35 (7) ◽  
pp. 698-708 ◽  
Author(s):  
Aline Sardinha ◽  
Rafael Christophe da Rocha Freire ◽  
Walter Araújo Zin ◽  
Antonio Egidio Nardi
Keyword(s):  
Panic Disorder ◽  
Respiratory Symptoms ◽  
Behavioral Therapy ◽  
Respiratory Physiology ◽  
Panic Attacks ◽  
Hyperventilation Syndrome ◽  
Therapeutic Implications ◽  
Challenge Tests ◽  
Respiratory Challenge ◽  
The Relationship

Multiple respiratory abnormalities can be found in anxiety disorders, especially in panic disorder (PD). Individuals with PD experience unexpected panic attacks, characterized by anxiety and fear, resulting in a number of autonomic and respiratory symptoms. Respiratory stimulation is a common event during panic attacks. The respiratory abnormality most often reported in PD patients is increased CO2 sensitivity, which has given rise to the hypothesis of fundamental abnormalities in the physiological mechanisms that control breathing in PD. There is evidence that PD patients with dominant respiratory symptoms are more sensitive to respiratory tests than are those who do not manifest such symptoms, and that the former group constitutes a distinct subtype. Patients with PD tend to hyperventilate and to panic in response to respiratory stimulants such as CO2, triggering the activation of a hypersensitive fear network. Although respiratory physiology seems to remain normal in these subjects, recent evidence supports the idea that they present subclinical abnormalities in respiration and in other functions related to body homeostasis. The fear network, composed of the hippocampus, the medial prefrontal cortex, the amygdala and its brain stem projections, might be oversensitive in PD patients. This theory might explain why medication and cognitive-behavioral therapy are both clearly effective. Our aim was to review the relationship between respiration and PD, addressing the respiratory subtype of PD and the hyperventilation syndrome, with a focus on respiratory challenge tests, as well as on the current mechanistic concepts and the pharmacological implications of this relationship.

scholarly journals Cardio-respiratory symptoms in panic disorder: a contribution from cognitive-behaviour therapy

2011 ◽  
Vol 60 (4) ◽  
pp. 301-308
Author(s):  
Anna Lucia Spear King ◽  
Adriana Cardoso de Oliveira e Silva ◽  
Alexandre Martins Valencça ◽  
Antonio Egidio Nardi
Keyword(s):  
Panic Disorder ◽  
Respiratory Symptoms ◽  
Behavioural Therapy ◽  
Panic Attacks ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Group 2 ◽  
Fear Of Bodily Sensations ◽  
Group 1

Objective: To compare patients with panic disorder with agoraphobia treated with cognitive-behavioural therapy (CBT) associated with the medication with patients treated only with medication and verify the behaviour of the cardio-respiratory symptoms of both groups. Methods: Randomized sample in the Psychiatry Institute of the Federal University of Rio de Janeiro, divided in two groups of 25 participants each. Group 1 undertook 10 weekly sessions of CBT with one hour of duration each together with medication. Group 2, Control, were administered medication that only consisted of tricyclic anti-depressants and selective inhibitors of the re-uptake of serotonin. Evaluation instruments were applied at the beginning and to the end of the interventions. Results: According to the applied scales, group 1 showed statistically more significant results than group 2, with: reduction of panic attacks, cardio-respiratory symptoms, anticipatory anxiety, agoraphobia avoidance and fear of bodily sensations. Conclusion: Exposures (in vivo and interoceptive), especially for induction symptom exercises and relaxation, were considered essential to prepare patients with panic disorder to handle future cardio-respiratory symptoms and panic attacks with agoraphobia.

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
Keyword(s):  
Panic Disorder ◽  
Life Style ◽  
Defense Mechanisms ◽  
Panic Attack ◽  
Alcohol Addiction ◽  
Panic Attacks ◽  
Fourth Group ◽  
Psychological Differences ◽  
Panic Symptoms ◽  
Psychological Defenses

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.

Panic Disorder With Nocturnal Panic Attacks: Symptoms and Comorbidities

2007 ◽  
Vol 23 (3) ◽  
pp. 195-200 ◽  
Author(s):  
Gökhan Sarísoy ◽  
Ömer Böke ◽  
Ali C. Arík ◽  
Ahmet R. Şahin
Keyword(s):  
Panic Disorder ◽  
Beck Depression Inventory ◽  
Panic Attack ◽  
Respiratory Symptoms ◽  
Psychiatric Symptoms ◽  
Panic Attacks ◽  
Symptom Checklist ◽  
Scale Scores ◽  
Dsm Iv ◽  
The Relationship

AbstractThe aim of this study was to determine the relationship between nocturnal panic attacks and comorbidities, clinical variables and panic attack symptoms. One hundred and six consecutive patients with DSM-IV panic disorder were enrolled in the study. The patients were divided into two groups depending on the presence of nocturnal panic attacks. Comorbidities were diagnosed with the help of SCID-I and SCID-II. The groups were compared using the Beck Depression Inventory, State-Trait Anxiety Inventory and Symptom Checklist. Nocturnal panic attacks were not related to comorbidities or age at the onset of the disease. The scores from the Beck Depression Inventory, general scores from the Symptom Checklist, somatization, obsession-compulsion, interpersonal sensitivity and anger-hostility sub-scale scores were higher in the nocturnal panic attack group. Patients with nocturnal panic attacks experience more frequent respiratory symptoms, suggesting that nocturnal panic attacks may be related to respiratory symptoms. Our findings demonstrate that patients with nocturnal panic attacks have more respiratory symptoms of panic, depressive and other psychiatric symptoms than the no nocturnal panic group.

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