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1.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 43(1): 6-11, Jan.-Feb. 2021. tab
Article in English | LILACS | ID: biblio-1153272

ABSTRACT

Objective: To investigate the course of panic disorder and its demographic and clinical correlates during the postpartum period. Methods: Data were collected from 38 consecutive postpartum women diagnosed with panic disorder. Psychiatric assessments were carried out on the first day after delivery and at 6-8 weeks postpartum. During the first assessment, the Panic and Agoraphobia Scale (PAS), Hospital Anxiety and Depression Scale (HADS), Coping Orientation to Problems Experienced (COPE), Multidimensional Scale of Perceived Social Support (MSPSS), and Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) were administered to the participants. PAS was also administered at the second assessment. Results: The mean PAS score reduced significantly from baseline to the second assessment. Logistic regression analysis indicated that a shorter duration of panic disorder independently predicted a ≥ 50-point decrease in the severity of panic symptoms during the postpartum period. Conclusion: These findings suggest that patients with a short duration of illness may experience significant alleviation in the severity of panic symptoms during the postpartum period.


Subject(s)
Humans , Female , Panic Disorder/epidemiology , Temperament , Agoraphobia , Postpartum Period
2.
Article in Chinese | WPRIM | ID: wpr-909564

ABSTRACT

The etiology and pathological mechanism of panic disorder (PD) are still unclear, which hinders the development of clinical diagnosis and treatment. In order to clarify the pathogenesis, biological diagnostic markers, curative effect prediction of PD, and ultimately provide a basis for individualized treatment, this article reviews the magnetic resonance imaging (MRI) research on PD in the past 5 years in conjunction with the hypothesis of the " fear network model" . It is found that the brain function and structural abnormalities of PD patients are not limited to the classic " fear network model" , but also a wider range of brain areas such as the cingulate gyrus, fronto-temporal cortex, insula, striatum, thalamus, sensorimotor related brain regions and cerebellum, together with classic brain regions such as the amygdala, form an expanded fear network. Among them, the amygdala, insula, medial prefrontal lobe, somato-motor network (SMN) and cerebellum are specific brain areas that differentiate PD from other anxiety disorders. The changes in the activity of the frontal lobe-limbic loop included in the fear network model can predict the treatment outcome of different methods for PD. This article improved the fear network hypothesis of PD, and more accurately identifies the biological indicators that can be used for accurate diagnosis and efficacy prediction of PD, which lays the foundation for the ultimate realization of personalized diagnosis and treatment of PD.

4.
Rev. Ciênc. Méd. Biol. (Impr.) ; 19(4): 560-564, dez 30, 2020. tab
Article in Portuguese | LILACS | ID: biblio-1355121

ABSTRACT

Introdução: crianças e adolescentes, não raro, apresentam sintomas de fobia social, transtorno do pânico e ansiedade de separação, que podem causar comprometimento nas habilidades sociais e dificultar as relações de forma incapacitante. Objetivo: Este estudo tem como objetivo verificar a presença de sintomas fóbicos sociais, transtorno de pânico e ansiedade de separação em adolescentes, com idade entre 11 e 17 anos, de uma escola pública da cidade de Salvador. Metodologia: este é um estudo observacional, transversal, que integra outro mais amplo, realizado em escola pública de Salvador, entre março e dezembro de 2015. A escala Revised Children's Anxiety and Depression foi aplicada em uma amostra de 674 alunos. Resultados: os alunos apresentaram sintomas de fobia social, transtorno do pânico e ansiedade de separação, em escala crescente, de acordo com a idade.


Introduction:children and adolescents often present symptoms of social phobia, panic disorder and separation anxiety disorder, which can cause social impairments and hinder relationships in a disabling way. Objective: this study aims to investigate the presence of social phobia, panic disorder and separation anxiety symptoms in adolescents aged between 11 and 17 years from a public school in the city of Salvador. Methodology: the present study is an observational cross-sectional research, which is part of a broader study conducted in a public school in Salvador, between March and December 2015. The Revised Children's Anxiety and Depression Scale (RCADS) was used in a sample of 674 students. Results: the students presented symptoms of social phobia, panic disorder and separation anxiety on an increasing scale proportional to age.


Subject(s)
Humans , Male , Female , Child , Adolescent , Anxiety , Panic , Adolescent , Phobia, Social , Cross-Sectional Studies , Observational Study
5.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(4): 420-430, July-Aug. 2020. tab
Article in English | LILACS | ID: biblio-1132104

ABSTRACT

Panic disorder (PD) pathophysiology is very heterogeneous, and the discrimination of distinct subtypes could be very useful. A subtype based on respiratory symptoms is known to constitute a specific subgroup. However, evidence to support the respiratory subtype (RS) as a distinct subgroup of PD with a well-defined phenotype remains controversial. Studies have focused on characterization of the RS based on symptoms and response to CO2. In this line, we described clinical and biological aspects focused on symptomatology and CO2 challenge tests in PD RS. The main symptoms that characterize RS are dyspnea (shortness of breath) and a choking sensation. Moreover, patients with the RS tended to be more responsive to CO2 challenge tests, which triggered more panic attacks in this subgroup. Future studies should focus on discriminating respiratory-related clusters and exploring psychophysiological and neuroimaging outcomes in order to provide robust evidence to confirm RS as a distinct subtype of PD.


Subject(s)
Humans , Carbon Dioxide/blood , Panic Disorder/physiopathology , Pulmonary Ventilation/physiology , Hyperventilation/physiopathology , Psychopathology , Psychophysiology , Panic Disorder/diagnosis , Panic Disorder/psychology , Dyspnea/etiology , Hyperventilation/diagnosis , Hyperventilation/psychology
6.
Article in Chinese | WPRIM | ID: wpr-843242

ABSTRACT

Objective: To investigate the level of intolerance of uncertainty (IU) and possible related factors in the patients with anxiety disorders. Methods: The patients' diagnosis was made according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM- ). Thirty-five cases of generalized anxiety disorder (GAD), 15 cases of panic disorder (PD) and 31 healthy controls (HC group) were recruited at the same time. IU level was assessed by using the Chinese version of Intolerance of Uncertainty Scale (IUS). The characteristics of anxiety symptoms, depressive symptoms and body perception were assessed by Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and Body Perception Questionaire (BPQ), respectively. Results: The IU levels of both GAD group and PD group were significantly higher than those of HC group (P=0.000). There was no significant difference in IU levels between GAD group and PD group (P=0.491). The IU levels of GAD patients were positively correlated with HAMA-somatic anxiety (r=0.377, P=0.025) and BPQ-awareness (r=0.342, P=0.044). Conclusion: The patients with anxiety disorders have elevated IU levels, compared with healthy people. Possibly, somatic anxiety and body perception-awareness are related factors to IU in GAD patients.

7.
Kampo Medicine ; : 137-142, 2020.
Article in Japanese | WPRIM | ID: wpr-843008

ABSTRACT

We report a case of panic disorder treated with keishikyokeikabukuryobyakujutsuto. The patient was a 42-year-old woman who had one or two episodes of panic attacks every month for 1 year accompanied by dyspnea, fear, rigidity of hands, etc. The episodes were more frequent with physical exertion and menstruation and did not improve with kamishoyosan or kanbakutaisoto. Then, after a car accident, she had a panic attack with a stronger intensity. Blood and imaging examinations revealed no special findings, and we diagnosed her with panic disorder. We considered her complaint as Honton disease and administered ryokeikansoto. After 2 weeks, her mental condition improved, and dyspnea and fear of attacks relieved. After 2 months, office work became more strenuous, and attacks recurred once or twice a week. An abnormal sensation of the posterior cervix occurred as a prodrome of an attack, and simultaneously, she noticed neck stiffness. After switching to keishikyokeikabukuryobyakujutsuto, the cervical sensation disappeared, neck pain and neck stiffness were relieved, and the attacks did not reappear. This case suggested that keishikyokeikabukuryobyakujutsuto was useful for the prevention of panic attacks associated with neck stiffness.

8.
Trends psychiatry psychother. (Impr.) ; 41(4): 387-393, Oct.-Dez. 2019. tab
Article in English | LILACS | ID: biblio-1059178

ABSTRACT

Abstract Objective To identify which clinical features and personality traits are associated with quality of life (QoL) in panic disorder (PD) patients. Methods This was a cross-sectional study with PD patients. The brief version of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) and the Big Five Inventory (BFI) were used to assess QoL and personality traits respectively. The strength of correlations was measured with Pearson's, Spearman's, and point-biserial correlation coefficients. We also performed multiple linear regressions, considering sociodemographic data and scores from clinical scales as independent variables and QoL scores as dependent variables. Results A total of 98 patients were evaluated. Depressive symptoms had a strong negative correlation with QoL and, to a lesser extent, panic and anxiety symptoms were also negatively correlated with QoL. While consciousness, extraversion, and agreeableness had mild positive correlations with QoL, neuroticism had a strong negative correlation. Conclusion Symptoms of depression, anxiety, and panic seem to have a negative impact on the QoL of PD patients. Personality traits, especially neuroticism, may also influence QoL in these patients.


Resumo Objetivo Identificar quais características clínicas e traços de personalidade são mais associados à qualidade de vida (QdV) em pacientes com transtorno de pânico (TP). Métodos Este foi um estudo transversal, realizado em pacientes com TP. A versão breve do Questionário de Qualidade de Vida da Associação Mundial de Saúde (World Health Organization Quality of Life Questionnaire - WHOQOL-BREF) e o Inventário dos Cinco Grande Fatores (Big Five Inventory - BFI) foram utilizados para avaliar QdV e traços de personalidade, respectivamente. A força de associação foi medida através da correlação de Pearson, de Spearman ou ponto bisserial. Foram também realizadas regressões lineares múltiplas, considerando os dados sociodemográficos e escores obtidos nas escalas clínicas como variáveis independentes, e os escores de QdV como variáveis dependentes. Resultados Um total de 98 pacientes foram avaliados. Sintomas depressivos apresentaram uma forte relação negativa com QdV; em menor intensidade, sintomas de TP e ansiosos também se correlacionaram com QdV. Nos domínios de personalidade, enquanto conscienciosidade, extroversão e amabilidade apresentaram uma leve correlação positiva com QdV, neuroticismo apresentou forte correlação negativa. Conclusão Sintomas depressivos, ansiosos e de TP parecem ter forte impacto negativo na QdV dos pacientes com TP. Traços de personalidade, principalmente neuroticismo, podem influenciar QdV nesses pacientes.


Subject(s)
Humans , Male , Female , Adult , Personality , Quality of Life/psychology , Panic Disorder/psychology , Personality Inventory , Psychiatric Status Rating Scales , Cross-Sectional Studies , Surveys and Questionnaires
9.
Article in Chinese | WPRIM | ID: wpr-801378

ABSTRACT

Objective@#To identify potential relationship between single uncoding RNA-25-3p (miR-25-3p) expression level and the sertraline efficacy in patients with panic disorder.@*Methods@#Sixty cases of patients with panic disorder(case group) and sixty healthy-controls(control group) were collected with demographic data and peripheral venous blood before and after treatment.All the patients were evaluated using the 14-item Hamilton Anxiety Rating Scale (HAMA) and Panic Disorder Severity Scale (PDSS) at baseline, and then received sertraline treatment for 6 weeks.After six-week treatment, each patient was evaluated again with HAMA and PDSS.RT-PCR was used to detect the level of miR-25-3p expression.@*Results@#There was no significant difference in the miR-25-3p levels between control group (1.27±0.32) and case group (1.73±1.09) before treatment(t=1.53, P=0.14), but the levels in case group were much higher than that in control group after the treatment (5.72±4.13 vs 1.73±1.09, t=-2.15, P=0.04). Besides, the changes of the miR-25-3p levels were positively related with both the changes of PDSS3 and PDSS7 items before and after the treatment (r=0.60, P=0.02 for PDSS3 and r=0.61, P=0.02 for PDSS7).@*Conclusions@#miR-25-3p is associated with the drug efficacy and the outcome of some clinical symptoms of panic disorder.These findings might provide some evidence for the individualized treatment of patients with panic disorder according to regulation of gene expression in the future.

10.
Article in Chinese | WPRIM | ID: wpr-843409

ABSTRACT

As a common mental disorder, panic disorder (PD) repeats unpredictably and negatively, influencing social function and life quality of patients. With the increasingly fierce social environment, the incidence of PD has been increasing year by year which accounts for an increasing proportion of the global burden of disease. In recent years, research on the relationship between childhood trauma and PD has been increasing, which included the impact of multiple aspects of physical or emotional abuse, physical or emotional neglect, sexual abuse, and family dysfunction on PD. And as a predictor of PD, separation anxiety in childhood is closely related to PD. This paper reviews the research progress of childhood physical abuse, emotional abuse, sexual abuse and separation from parents of PD patients.

11.
Article in Chinese | WPRIM | ID: wpr-824254

ABSTRACT

Objective To identify potential relationship between single uncoding RNA-25-3p (miR-25-3p) expression level and the sertraline efficacy in patients with panic disorder.Methods Sixty cases of patients with panic disorder(case group) and sixty healthy-controls(control group) were collected with demographic data and peripheral venous blood before and after treatment.All the patients were evaluated using the 14-item Hamilton Anxiety Rating Scale (HAMA) and Panic Disorder Severity Scale (PDSS) at baseline,and then received sertraline treatment for 6 weeks.After six-week treatment,each patient was evaluated again with HAMA and PDSS.RT-PCR was used to detect the level of miR-25-3p expression.Results There was no significant difference in the miR-25-3p levels between control group (1.27±0.32) and case group (1.73±1.09) before treatment(t=1.53,P=0.14),but the levels in case group were much higher than that in control group after the treatment (5.72±4.13 vs 1.73±1.09,t=-2.15,P=0.04).Besides,the changes of the miR-25-3p levels were positively related with both the changes of PDSS3 and PDSS7 items before and after the treatment (r=0.60,P=0.02 for PDSS3 and r=0.61,P=0.02 for PDSS7).Conclusions miR-25-3p is associated with the drug efficacy and the outcome of some clinical symptoms of panic disorder.These findings might provide some evidence for the individualized treatment of patients with panic disorder according to regulation of gene expression in the future.

12.
Article in Chinese | WPRIM | ID: wpr-754174

ABSTRACT

Objective To explore the characteristics of alexithymia and interoception in patients with panic disorder(PD) and its relationship. Methods Thirty-seven patients with PD and 45 healthy con-trols who met the diagnostic criteria of DSM-Ⅳ were selected. Toronto Alexithymia Scale ( TAS) and state-trait anxiety inventory ( STAI) were used to assess the characteristics of alexithymia and anxiety symptoms respectively. The heartbeat perception levels were tested by the Mental Tracking Paradigm. Results The de-tection rate of alexithymia in patients with panic disorder was 37. 83% (14/37),but the rate in the normal control group was only 4. 44%(2/45),and the difference was statistically significant (χ2=14. 42,P<0. 05). The total score of TAS (55. 11±10. 99),factor Ⅰ (20. 62±6. 78) and factor Ⅱ (14. 68±3. 70) in the PD group were higher than those in the control group (42. 93± 9. 25,12. 82± 4. 99,11. 42±3. 04; F=20. 72, 31. 08,15. 31,P<0. 01). The levels of the heartbeat perception were higher in the PD group than that in the control group (0. 75±0. 15,0. 58±0. 19;t=4. 13,P<0. 05). In PD group,the score of STAI were positively correlated with TAS total score and factor Ⅰ and Ⅱ scores( r=0. 57,0. 61,0. 47;r=0. 54,0. 62,0. 39,P<0. 05). There was no significant correlation between the scores of STAI and the level of interoception. The mediating effect of interoception level on alexithymia and state anxiety was not significant while the mediating effect on alexithymia and trait anxiety was also not significant. Conclusions The alexithymia detection rate and interoception sensitivity in patients with panic disorder were higher than those of healthy people. There may be interaction between alexithymia and anxiety symptoms. Interoception may be a clinical feature of panic disorder.

13.
Article in English | WPRIM | ID: wpr-742646

ABSTRACT

@#The objective of this article is to provide an update on the diagnosis, assessment, and management of anxiety disorders in adults. This article covers the following disorders: panic disorder, panic attacks, specific phobia, social anxiety disorder and generalized anxiety disorder. Selective mutism and separation anxiety disorder, being childhood anxiety disorders, will not be covered. Obsessive compulsive disorder and post-traumatic stress disorder, which are not categorized as anxiety disorders in DSM-5, will not be covered. Anxiety and related disorders are common mental health disorders but are under-diagnosed and undertreated. Most cases of anxiety disorders present first to the primary care physician and can be managed in primary care.It is important to take a detailed history of the patient’s symptoms and their severity and duration, enquire about psychosocial stressors, as well as symptoms that may be suggestive of a medical condition and also to assess suicidality. A combined approach of psycho-education, relaxation training, and medications give the best results. SSRIs are first line pharmacologic treatment for most anxiety disorders. There is a need to stress that benzodiazepines have no role in the long-term treatment of anxiety disorders. They should not be given for more than 2 to 4 weeks. Treatment for generalized anxiety disorder should be for at least 32 weeks as high relapse rates are reported after discontinuing medications.

14.
Article in English | WPRIM | ID: wpr-741923

ABSTRACT

To conceptualize a novel bio-psychosocial-behavioral treatment model of panic disorder (PD), it is necessary to completely integrate behavioral, psychophysiological, neurobiological, and genetic data. Molecular genetic research on PD is specifically focused on neurotransmitters, including serotonin, neuropeptides, glucocorticoids, and neurotrophins. Although pharmacological interventions for PD are currently available, the need for more effective, faster-acting, and more tolerable pharmacological interventions is unmet. Thus, glutamatergic receptor modulators, orexin receptor antagonists, corticotrophin-releasing factor 1 receptor antagonists, and other novel mechanism-based anti-panic therapeutics have been proposed. Research on the neural correlates of PD is focused on the dysfunctional “cross-talk” between emotional drive (limbic structure) and cognitive inhibition (prefrontal cortex) and the fear circuit, which includes the amygdala-hippocampus-prefrontal axis. The neural perspective regarding PD supports the idea that cognitive-behavioral therapy normalizes alterations in top-down cognitive processing, including increased threat expectancy and attention to threat. Consistent with the concept of “personalized medicine,” it is speculated that Research Domain Criteria can enlighten further treatments targeting dysfunctions underlying PD more precisely and provide us with better definitions of moderators used to identify subgroups according to different responses to treatment. Structuring of the “negative valence systems” domain, which includes fear/anxiety, is required to define PD. Therefore, targeting glutamate- and orexin-related molecular mechanisms associated with the fear circuit, which includes the amygdala-hippocampus-prefrontal cortex axis, is required to define a novel bio-psychosocial-behavioral treatment model of PD.


Subject(s)
Glucocorticoids , Molecular Biology , Nerve Growth Factors , Neuropeptides , Neurotransmitter Agents , Orexin Receptor Antagonists , Panic Disorder , Panic , Serotonin
15.
Article in English | WPRIM | ID: wpr-741922

ABSTRACT

The core concept for pathophysiology in panic disorder (PD) is the fear network model (FNM). The alterations in FNM might be linked with disturbances in the autonomic nervous system (ANS), which is a common phenomenon in PD. The traditional FNM included the frontal and limbic regions, which were dysregulated in the feedback mechanism for cognitive control of frontal lobe over the primitive response of limbic system. The exaggerated responses of limbic system are also associated with dysregulation in the neurotransmitter system. The neuroimaging studies also corresponded to FNM concept. However, more extended areas of FNM have been discovered in recent imaging studies, such as sensory regions of occipital, parietal cortex and temporal cortex and insula. The insula might integrate the filtered sensory information via thalamus from the visuospatial and other sensory modalities related to occipital, parietal and temporal lobes. In this review article, the traditional and advanced FNM would be discussed. I would also focus on the current evidences of insula, temporal, parietal and occipital lobes in the pathophysiology. In addition, the white matter and functional connectome studies would be reviewed to support the concept of advanced FNM. An emerging dysregulation model of fronto-limbic-insula and temporooccipito-parietal areas might be revealed according to the combined results of recent neuroimaging studies. The future delineation of advanced FNM model can be beneficial from more extensive and advanced studies focusing on the additional sensory regions of occipital, parietal and temporal cortex to confirm the role of advanced FNM in the pathophysiology of PD.


Subject(s)
Autonomic Nervous System , Connectome , Frontal Lobe , Limbic System , Neuroimaging , Neurotransmitter Agents , Occipital Lobe , Panic Disorder , Panic , Parietal Lobe , Rabeprazole , Temporal Lobe , Thalamus , White Matter
16.
Article in English | WPRIM | ID: wpr-741920

ABSTRACT

BACKGROUND: Internet-delivered psychological treatments have been suggested as a chance to expand the access to professional help. However, little is known about the usefulness of different support formats and approaches of digital treatments for panic disorder among clinicians. OBJECTIVE: This narrative review aimed to explore the recent evidence base on the efficacy and acceptability of different internet-delivered treatments for adults with panic disorder. METHODS: A systematic search in electronic databases (Pubmed/Medline, PSYNDEX) and a hand search were performed to identify articles on randomized controlled trials published within the past five years (2012/12/10–2017/12/12) in English peer-reviewed journals. RESULTS: Eight studies (1,013 participants) involving 10 interventions met the inclusion criteria. Nine interventions were primarly based on Cognitive Behavioral Therapy principles. Most interventions were effective, when compared to a control condition (6 of 8 comparisons). Minimal guidance was associated with improved outcomes in one study and adherence in two studies (3 comparisons). Furthermore, no differences were found based on treatment approach (2 comparisons). Regarding acceptability, the attrition rates were moderate to high, ranging from 9.8% to 42.1% of randomized participants. Adherence rates also varied largely (7.8–75%), whereas participant satisfaction of program completers was assessed overall high (5 studies). CONCLUSION: Diverse effective internet-delivered treatments are available for the self-management of panic symptoms. Especially selfguided and transdiagnostic Cognitive Behavioral Therapy approaches appear being efficient options for the dissemination in routine care. However, due to the limited evidence base, further efforts are required to improve the actual uptake of internet-delivered treatments and identify moderators of outcomes.


Subject(s)
Adult , Anxiety Disorders , Cognitive Behavioral Therapy , Hand , Humans , Internet , Panic Disorder , Panic , Self Care , Telemedicine
17.
Article in English | WPRIM | ID: wpr-741919

ABSTRACT

OBJECTIVE: Treatment for panic disorder (PD) have evolved, although there is still a strong unmet need for more effective and tolerable options. The present study summarizes and discusses recent evidence regarding the pharmacological and neuromodulatory treatment of PD. METHODS: MEDLINE, Cochrane Library, PsycINFO and Thomson Reuters’s Web of Science were searched for clinical trials published between 2010 and 2018. We included all prospective experimental studies including randomized controlled trials (RCT) and other clinical trials with more than 10 patients. RESULTS: Only 11 articles met the inclusion criteria, including 4 RCT, 3 open clinical trials and 5 comparative clinical trials. RCT demonstrated efficacy of transcranial magnetic stimulation (TMS) in only one of two trials. Neither pindolol nor d-fenfluramine were effective in blocking flumazenil-induced panic attacks. Augmentation with quetiapine was not superior to placebo. Open trials indicated that escitalopram, vortioxetine and TMS may be effective. Comparative trials did not demonstrate superiority from any drug, but confirmed tranylcypromine, paroxetine, clonazepam and alprazolam as effective options. CONCLUSION: The current study confirmed the efficacy of tranylcypromine, paroxetine, clonazepam, alprazolam and escitalopram. Vortioxetine and TMS, with duration of 4 or more weeks, also seems to be effective. Quetiapine, pindolol and d-fenfluramine were not considered effective compounds.


Subject(s)
Alprazolam , Citalopram , Clonazepam , Humans , Panic Disorder , Panic , Paroxetine , Pindolol , Prospective Studies , Quetiapine Fumarate , Transcranial Magnetic Stimulation , Tranylcypromine
18.
Article in English | WPRIM | ID: wpr-765014

ABSTRACT

BACKGROUND: Panic disorder (PD) and major depressive disorder (MDD) can occur concurrently, despite different clinical manifestations. Because MDD and PD patients tend to have more complicated conditions, understanding the co-occurrence and pattern of these conditions is important. Here, we investigated the influence of PD and MDD on each other, with respect to time interval. METHODS: Data from three national representative surveys were pooled (total 18,807 respondents), and the age of onset (AOO) of PD and MDD was analyzed. We performed Kaplan-Meier analysis to estimate separate survival functions, using the AOO of MDD and PD as the outcome. To understand the temporal effect of other disorders, we used a Cox proportional hazard model to estimate the hazard ratios for the onset of MDD/PD with other comorbidities as time-dependent covariates. RESULTS: PD elevated the risk of subsequent MDD by 1.5-fold, whereas MDD elevated the risk of subsequent PD by 3.8-fold. The effect of such an elevation risk was significant for up to 2 years. CONCLUSION: The results revealed a bidirectional relationship between MDD and PD. Each disease represents a risk of a subsequent occurrence of the other, which lasts for a considerable duration.


Subject(s)
Age of Onset , Comorbidity , Depressive Disorder, Major , Humans , Kaplan-Meier Estimate , Korea , Panic Disorder , Panic , Proportional Hazards Models
19.
Frontiers of Medicine ; (4): 602-609, 2019.
Article in English | WPRIM | ID: wpr-771245

ABSTRACT

Panic disorder (PD) is an acute paroxysmal anxiety disorder with poorly understood pathophysiology. The dorsal periaqueductal gray (dPAG) is involved in the genesis of PD. However, the downstream neurofunctional changes of the dPAG during panic attacks have yet to be evaluated in vivo. In this study, optogenetic stimulation to the dPAG was performed to induce panic-like behaviors, and in vivo positron emission tomography (PET) imaging with F-flurodeoxyglucose (F-FDG) was conducted to evaluate neurofunctional changes before and after the optogenetic stimulation. Compared with the baseline, post-optogenetic stimulation PET imaging demonstrated that the glucose metabolism significantly increased (P < 0.001) in dPAG, the cuneiform nucleus, the cerebellar lobule, the cingulate cortex, the alveus of the hippocampus, the primary visual cortex, the septohypothalamic nucleus, and the retrosplenial granular cortex but significantly decreased (P < 0.001) in the basal ganglia, the frontal cortex, the forceps minor corpus callosum, the primary somatosensory cortex, the primary motor cortex, the secondary visual cortex, and the dorsal lateral geniculate nucleus. Taken together, these data indicated that in vivo PET imaging can successfully detect downstream neurofunctional changes involved in the panic attacks after optogenetic stimulation to the dPAG.

20.
Article in Korean | WPRIM | ID: wpr-786251

ABSTRACT

OBJECTIVES: The objective of this study is to investigate differences in clinical characteristics between female panic disorder (PD) patients with abortion history (PD+A) and without abortion history (PD−A).METHODS: We examined data from 341 female patients diagnosed with PD. We divided the patients with PD into PD+A (82 patients) and PD−A (259 patients) to compare demographic and clinical characteristics. The following instruments were applied : stress coping strategies, NEO-neuroticism, the Anxiety Sensitivity Index-Revised (ASI-R), the Albany Panic and Phobia Questionnaire (APPQ), the Beck Depression Inventory, the Beck Anxiety Inventory (BAI) and the Sheehan Disability Scale.RESULTS: Compared to the PD−A, the PD+A group showed no significant difference in coping strategies. However, significantly higher scores in neuroticism, the ASI-R, the APPQ and the BAI were observed. In terms of health-related disability, the PD+A group did not show significant difference.CONCLUSIONS: Our results suggest that the PD+A group may differ from the PD−A group in trait markers such as neuroticism and anxiety sensitivity, and abortion history may be associated with panic-related symptom severity. Our study suggests that further consideration is needed on such clinical characteristics in PD patients with abortion history.


Subject(s)
Abortion, Induced , Anxiety , Depression , Female , Humans , Panic Disorder , Panic , Phobic Disorders
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