ABSTRACT
Desde a síndrome do coração irritável, passando pelas diversas síndromes do fin de siècle e chegando ao triunfo das teorias neurocientíficas sobre a hipersensibilidade dos centros cerebrais de resposta ao alarme e sufocação, a Medicina buscou teorias para explicar a experiência de pavor. Investiga-se o modo como ocorreram, ao longo da história, as transformações da atenção médica sobre o medo e os estados mórbidos que o acompanham. Ao se buscar na literatura médica vestígios de análises científicas sobre o mal-estar intenso, do meio do século XIX ao fim do XX, não se pretendeu construir uma história triunfalista, de modo que as teorias atuais pudessem ganhar status de superioridade em relação às do passado. Evidenciou-se, sim, a importância cultural e a força histórica de cada uma delas, salientando as possíveis continuidades e rupturas de sentido que elas assumiram.
Subject(s)
Humans , History, 19th Century , History, 20th Century , Fear , Narration/history , Panic Disorder/history , Phobic Disorders/history , Stress Disorders, Post-Traumatic/psychologyABSTRACT
This article aims to describe important points in the history of panic disorder concept, as well as to highlight the importance of its diagnosis for clinical and research developments. Panic disorder has been described in several literary reports and folklore. One of the oldest examples lies in Greek mythology - the god Pan, responsable for the term panic. The first half of the 19th century witnessed the culmination of medical approach. During the second half of the 19th century came the psychological approach of anxiety. The 20th century associated panic disorder to hereditary, organic and psychological factors, dividing anxiety into simple and phobic anxious states. Therapeutic development was also observed in psychopharmacological and psychotherapeutic fields. Official classification began to include panic disorder as a category since the third edition of the American Classification Manual (1980). Some biological theories dealing with etiology were widely discussed during the last decades of the 20th century. They were based on laboratory studies of physiological, cognitive and biochemical tests, as the false suffocation alarm theory and the fear network. Such theories were important in creating new diagnostic paradigms to modern psychiatry. That suggests the need to consider a wide range of historical variables to understand how particular features for panic disorder diagnosis have been developed and how treatment has emerged.
Subject(s)
Agoraphobia/history , Panic Disorder/history , Anxiety Disorders/historyABSTRACT
The author examined Freud's chest pains and arrythmia beginning in late 1893 according to the new available data and modern psychiatry. Published studies and recent findings were reviewed. The major works of Freud were also considered. Among the issues examined are clinical features, comorbidity, bounderies with other disorders. The findings of this review provided support for the dual diagnosis of panic disorder without agoraphobia and nicotine dependence. Freud's scientific learning was wide-ranging and his scientific ambition vast. During this period (1893-1897) Freud laid the foundations for the theory of anxiety. He referred to the conditions caused by the damned-up libido as the actual neuroses. Although the work of Freud has the same aim as the modern DSM-IV, the classification of the Austrian author reflects a different tradition. A discrepancy exists between anxiety neuroses (Freud) and anxiety disorders (DSM-IV)