Subtyping of Panic Disorder by Symptom Profile

1993 ◽  
Vol 163 (2) ◽  
pp. 201-209 ◽  
Author(s):  
Andrew C. Briggs ◽  
David D. Stretch ◽  
Sydney Brandon
Keyword(s):  
Treatment Outcome ◽  
Statistical Analysis ◽  
Panic Disorder ◽  
Panic Attack ◽  
Respiratory Symptoms ◽  
Demographic Variables ◽  
Panic Attacks ◽  
Symptom Profile ◽  
Choice Of Treatment ◽  
Cross National

During Phase II of the Cross-National Panic Study, descriptions of the patient's last severe panic attack were collected for 1168 patients. Statistical analysis indicated that patients could be divided into two groups, characterised by the presence or absence of prominent respiratory symptoms. The two groups did not differ on demographic variables or coexisting diagnoses, but they did differ on psychopathology on entry to the study and treatment outcome. The group with prominent respiratory symptoms suffered more spontaneous panic attacks and responded to imipramine, whereas the group without prominent respiratory symptoms suffered more situational panic attacks and responded more to alprazolam. It is important to distinguish spontaneous and situational panic attacks, to aid choice of treatment.

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.

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.

Panic Disorder With and Without Agoraphobia

2009 ◽  
Author(s):  
Vladan Starcevic, MD, PhD
Keyword(s):  
Panic Disorder ◽  
Panic Attack ◽  
Empirical Support ◽  
Classification Systems ◽  
Panic Attacks ◽  
Anticipatory Anxiety ◽  
Symptom Profile ◽  
Intense Fear ◽  
History Of ◽  
The Relationship

Panic disorder is characterized by two components: recurrent panic attacks and anticipatory anxiety. Panic attacks within panic disorder are not caused by physical illness or certain substances and they are unexpected, at least initially; later in the course of the disorder, many attacks may be precipitated by certain situations or are more likely to occur in them. Anticipatory anxiety is an intense fear of having another panic attack, which is present between panic attacks. Some patients with panic disorder go on to develop agoraphobia, usually defined as fear and/or avoidance of the situations from which escape might be difficult or embarrassing or in which help might not be available in case of a panic attack; in such cases, patients are diagnosed with panic disorder with agoraphobia. Those who do not develop agoraphobia receive a diagnosis of panic disorder without agoraphobia. Components of panic disorder are presented in Figure 2—1. Patients with agoraphobia who have no history of panic disorder or whose agoraphobia is not related at least to panic attacks or symptoms of panic attacks are relatively rarely encountered in clinical practice. The diagnosis of agoraphobia without history of panic disorder has been a matter of some controversy, especially in view of the differences between American and European psychiatrists (and the DSM and ICD diagnostic and classification systems) in the conceptualization of the relationship between panic disorder and agoraphobia. The conceptualization adhered to here has for the most part been derived from the DSM system, as there is more empirical support for it. Although panic disorder (with and without agoraphobia) is a relatively well-defined psychopathological entity whose treatment is generally rewarding, there are important, unresolved issues. They are listed below and discussed throughout this chapter. …1. Are there different types of panic attacks based on the absence or presence of the context in which they appear (i.e., unexpected vs. situational attacks)? Should the ‘‘subtyping’’ of panic attacks be based on other criteria (e.g., symptom profile)? 2. Because panic attacks are not specific for panic disorder, should they continue to be the main feature of panic disorder? Can panic attacks occurring as part of panic disorder be reliably distinguished from panic attacks occurring as part of other disorders or in the absence of any psychopathology? 3. What is the relationship between panic attacks, panic disorder, and agoraphobia?

Recurrent episodes of intense fear, shortness of breath, racing heart, and sweating

2021 ◽  
pp. 111-118
Author(s):  
Christina L. Macenski
Keyword(s):  
Panic Disorder ◽  
Gold Standard ◽  
Panic Attack ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Behavioral Therapy ◽  
Panic Attacks ◽  
Shortness Of Breath ◽  
Intense Fear ◽  
Therapy Intervention ◽  
Norepinephrine Reuptake

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.

Respiratory Training Prior to Exposure in vivo in the Treatment of Panic Disorder with Agoraphobia: Efficacy and Predictors of Outcome

1995 ◽  
Vol 29 (1) ◽  
pp. 104-113 ◽  
Author(s):  
Edwin de Beurs ◽  
Alfred Lange ◽  
Pieter Koele ◽  
Richard van Dyck
Keyword(s):  
Treatment Outcome ◽  
Panic Disorder ◽  
Prognostic Value ◽  
Panic Attacks ◽  
Self Report ◽  
Number Of Patients ◽  
Exposure In Vivo ◽  
Respiratory Training

Thirty-two patients suffering from panic disorder with agoraphobia were treated with repeated hyperventilation provocations and respiratory training, followed by exposure in vivo. The treatment was evaluated with a comprehensive set of outcome measures, including self-report questionnaires, a multitask behavioural avoidance test and continuous monitoring of panic. The treatment was found effective for the majority of patients in diminishing the frequency of panic attacks and agoraphobic avoidance. The clinical relevance of the treatment effect was evidenced by the considerable number of patients that recovered. The effect of the treatment was sustained over a three and six month follow-up period. The prognostic value of a number of variables for treatment outcome was also investigated. Three variables accounted for the majority of the variance in treatment outcome: a higher pretreatment level of agoraphobic complaints, use of psychotropic medication and a longer duration of the disorder were associated with poorer outcome. Other variables, such as the therapeutic relationship and the quality of the marital bond, had no prognostic value.

scholarly journals Cross-national epidemiology of panic disorder and panic attacks in the world mental health surveys

2016 ◽  
Vol 33 (12) ◽  
pp. 1155-1177 ◽  
Author(s):  
Peter de Jonge ◽  
Annelieke M. Roest ◽  
Carmen C.W. Lim ◽  
Silvia E. Florescu ◽  
Evelyn J. Bromet ◽  
...  
Keyword(s):  
Mental Health ◽  
Panic Disorder ◽  
Health Surveys ◽  
Panic Attacks ◽  
World Mental Health ◽  
The World ◽  
Cross National

Childhood abuse and familial violence and the risk of panic attacks and panic disorder in young adulthood

2004 ◽  
Vol 35 (6) ◽  
pp. 881-890 ◽  
Author(s):  
RENEE D. GOODWIN ◽  
DAVID M. FERGUSSON ◽  
L. JOHN HORWOOD
Keyword(s):  
Sexual Abuse ◽  
Panic Disorder ◽  
Physical Abuse ◽  
Childhood Abuse ◽  
Young Adulthood ◽  
Panic Attack ◽  
Panic Attacks ◽  
Interparental Violence ◽  
Related Factors ◽  
Increased Risk

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.

scholarly journals Diurnal panic attacks with and without nocturnal panic attacks: are there some phenomenological differences?

2005 ◽  
Vol 27 (3) ◽  
pp. 216-221 ◽  
Author(s):  
Fabiana L Lopes ◽  
Antonio E Nardi ◽  
Isabella Nascimento ◽  
Alexandre M Valença ◽  
Marco A Mezzasalma ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Attention Deficit Disorder ◽  
Panic Attack ◽  
Age At Onset ◽  
Term Treatment ◽  
Panic Attacks ◽  
Short Term ◽  
Short Term Treatment ◽  
Term Outcome ◽  
Cross Sectional

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.

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.

scholarly journals A Case of Thyroid Storm Caused by Graves' Disease Misdiagnosed as Panic Attack Due to Panic Disorder

2021 ◽  
Author(s):  
Manabu Yasuda ◽  
Jun Kumakura ◽  
Oka Kiyonori ◽  
Kazuhito Fukuda
Keyword(s):  
Panic Disorder ◽  
Thyroid Function ◽  
Thyroid Disease ◽  
Panic Attack ◽  
Panic Attacks ◽  
Thyroid Storm ◽  
Graves Disease ◽  
Thyroid Function Tests ◽  
Sunday Morning ◽  
Initial Examination

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.

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