Panic Attacks
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2021 ◽  
Umit Tural ◽  
Dan V. Iosifescu

Abstract Background Sodium lactate (NaL) infusion and carbon dioxide (CO2) inhalation are proven to provoke acute panic attacks (PAs) in patients with panic disorder (PD). A systematic literature search and meta-analysis were performed to compare the effect sizes of these methods. Methods Odds ratios were calculated for each of the original studies and were pooled using the random-effects model. Results Either NaL or CO2 provocations significantly increased the rates of PAs in individuals with PD compared to those in healthy controls. However, the effect size of NaL infusion (OR=25.13, 95% CI=15.48–40.80) was significantly greater than that of CO2 inhalation (OR=10.58, 95%CI=7.88–14.21). Conclusion The evidence for the efficacy of the two panic provocation tests is very strong. Yet, the results support the superiority of NaL infusion over CO2 inhalation challenge as a panic provocation test. Thus, lactate seems a much stronger stimulus than CO2 for the brain suffocation detector.

2021 ◽  
Vol 15 (3) ◽  
pp. 188-191
Lettycia Demczuk Thomas ◽  
Julyanna Demczuk Thomas ◽  
Luciana Wolfran ◽  
Fabiola Bono Fukushima

Behavioral disorders, including noise phobia, have a great impact on small animals internal medicine, impairing their quality of life as well as their life expectancy. The objective of this work is to report the case of a male dog who suffered from noise phobia and panic attacks triggered by thunderstorms and fireworks, and did not respond to previous training and treatment. After clinical and laboratory evaluations, he was treated with 2mg/kg clomipramine twice daily for 90 days associated with 0.06mg/kg alprazolam as needed on those days of intense fear. During the first week of treatment, a significant improvement could already be observed, with reduction in destructive behaviors, which lingered on for up to eight months of follow-up. The treatment stabilized the clinical condition and improved the patient’s quality of life.

Pravina Mohan ◽  
M. Anusree ◽  
B. Nikitha

Background: The outbreak of COVID-19 infection in humans first reported in Wuhan (China) which has spread around the world and having a significant impact on global health and mental health. It has caused widespread psychosocial and behavioural changes as a result of mass hysteria, economic burden, and financial losses, in addition to its high infectivity and the increased mortality rates. Method: Published articles regarding to mental health related to the COVID-19 outbreak and other previous global infections have been considered and reviewed. Comments: The pervasive fear of COVID-19, named as "coronaphobia," has resulted with a slew of psychiatric manifestations in people from all walks of life.  It has affected people from all the point of life, resulting in a variety of psychiatric issues such as anxiety, post-traumatic stress disorder (PTSD), fear and uncertainty, panic attacks, depression, obsessive compulsive disorder, xenophobia, and racism. Collective concerns have an impact on daily behaviours, the economy, prevention strategies, and decision-making by policymakers, health organisations, and medical centres, which can weaken COVID-19 control strategies and lead to increased morbidity and mental health needs on a global level.

F. DUYCK ◽  

TSH-secreting pituitary adenoma: a rare cause of hyperthyroidism Central hyperthyroidism is noted in a 35-year-old man with recurrent panic attacks. Thyroid-stimulating hormone-secreting pituitary adenoma (TSH-secreting adenoma) is found to be the underlying etiology. A pituitary adenomectomy is carried out, with regression of the symptoms and hyperthyroidism. TSH-secreting adenomas are rare and cause hyperthyroidism due to autonomous TSH secretion. In addition to hyperthyroidism, dysfunction of other pituitary axes and neurological problems due to local compression may also be present. Biochemically, TSH adenoma is characterized by elevated levels of thyroid hormones without suppression of the TSH concentration. After analytical interference has been ruled out, additional biochemical and radiological investigations are necessary in the differential diagnosis and to establish diagnostic certainty. Neurosurgical resection is the cornerstone of the treatment, although radiotherapy and somatostatin analogs may also be considered.

Molecules ◽  
2021 ◽  
Vol 26 (18) ◽  
pp. 5657
Jens F. Rehfeld

The classic gut hormone cholecystokinin (CCK) and its CCK2-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 CCK2-receptor antagonists.

2021 ◽  
Vol 14 (3) ◽  
pp. 1-9
Amaan Javed ◽  
Ritwika Roy

  Background: This study focuses on the direct and indirect implications of the COVID-19 pandemic on adults with Autism in India. This study took into account the social isolation during the global pandemic in 2020 and its effect on the emotional well-being of the community. Methods: We designed a survey involving Indian residents. Part I involved questionnaires for different cohorts: 1) educated, 2) employed and 3) unemployed. The questions were based on proposed life models to maintain the heterogeneity according to the preferences of the target group. Part II of  involved online interviews conducted in English. Qualitative and quantitative analyses were performed. Findings: The analyses of participants’ responses (N=10) stipulated that the impact of the COVID-19 pandemic on autistic people's mental health has been variable. Participants encountered both positive and negative emotions. Factors such as disrupted schedules, fear of job loss, poor domestic support system and inconsistency in transition were important. These were associated with development of new or worsening of pre-existing psychological as well as behavioural conditions including depression, anxiety, panic attacks and high-stress levels. At the same time, reduced interactions with decreased social insistence led to an improvement for some participants. Interpretation: Our results illustrate the deterioration of mental health and well-being for Autistic adults due to the impact of the COVID-19 pandemic. These findings emphasise the need for the development of innovative approaches and investment in the creation of support systems to address mental distress in this population.

2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 95-95
Oana Maria Isailă ◽  
Sorin Hostiuc ◽  
George Cristian Curcă ◽  

"Animal-assisted therapy is a complementary therapy in which an animal that meets certain well-defined criteria is an integral part of the therapeutic process. It has proven its positive contribution in treating disorders such as ADHD, autism spectrum disorders, depression, anxiety, panic attacks, PTSD, phobias, suicidal ideation. Human-animal interaction lowers stress, anxiety and increases quality of life. The therapy animal, in order to have the expected motivating role, must have a balanced personality and want to interact with people. In this sense, it goes through training programs based on obedience and desensitization to certain stimuli. This peculiar context raises ethical issues for the patient and the animal co-therapist, which requires setting boundaries. Although the legal framework sets out the elements on animal welfare, ethical issues that arise for animals are: the animal species that may be involved, limiting their freedom, endangering their welfare, the risk of exploitation (which can lead to their fatigue and burn-out), the type of interaction -which must be voluntary, bidirectional. Regarding the patient, in addition to the aspects related to beneficence and nonmaleficence, there are issues in obtaining an adequate informed consent (targeting possible allergies, some religious / cultural beliefs incompatible with this type of therapy). Thus, animal-assisted therapy must take into account the benefits of both parties involved, without instrumentalizing the animals. "

2021 ◽  
Nader Abazari ◽  
Leila Heydarinasab ◽  
Hamid Yaghubi ◽  
Hojjatollah Farahani

Abstract Background: Premenstrual dysphoric disorder PMDD is a health difficulty that is so similar to premenstrual syndrome PMS but is more serious Many women with PMDD may also have anxiety or depression, in this way, lasting irritability or anger that may affect other people, feelings of sadness or despair, or even thoughts of suicide, feelings of tension or anxiety, panic attacks, mood swings or crying often, lack of interest in daily activities and relationships, trouble thinking or focusing, tiredness or low energy, food cravings or binge eating, trouble sleeping, feeling out of control, physical symptoms such as cramps, bloating, breast tenderness, headaches, and joint or muscle pain are some of prevalent symptoms suffer women with PMDDMethods: The present research was a randomized controlled trial. In order to control variables pain intensity and psychological distress among patients with PMDD, the participants were selected accidently from female students of Shahed University of Tehran who consulted to psychology in order to assess their premenstrual symptoms and randomly divided into two groups. Each of groups encompassed 30 women between 20 up to 35-year-old whom diagnosed by PMDD via PSST from winter 2019 to spring 2020. In this study, one group received hypnotherapy and the other group received no intervention. Results: There are significant differences between the two groups. The efficacy of the procedure of hypnotherapy in the experimental group was more than that in the control group, (sig = 0.05).Conclusion The present study findings revealed that hypnotherapy with suggestions focused on cognitive flexibility and ego strength affected pain intensity and psychological distress among females with PMDD significantly. (sig=0.05)

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