Burden and Distress in Caregivers of Patients With Panic Disorder and Agoraphobia.

We estimated the prevalence, severity, and correlates of burden and distress in caregivers of patients with panic disorder and agoraphobia. The instruments used in this cross-sectional study with 40 caregivers and 40 outpatients were Carer Burden Interview (CBI), Family Burden Interview Schedule (FBIS-BR), Self-Reporting Questionnaire (SRQ), Panic and Agoraphobia Scale (PAS), and Mini-international Neuropsychiatric Interview. Bivariate analyses were followed by regression analyses. The patients' mean PAS score was 29.6, and the mean scores in the caregivers' burden scales were 27 (CBI) and 1.64 (FBIS-BR). Distress (or common mental disorder [CMD]) occurred in 37.5% and was associated with higher burden. In the multivariate analysis, the SRQ score was predicted by female sex and worse self-evaluation of health, the CBI score by CMD and public service, the FBIS-BR score by CMD and not living with the patient, the FBIS-objective score by CMD and being employed, the FBIS-subjective score by CMD, and the level of worry by the severity of patients' avoidance and panic attacks.

Factors related to emotional responses in school-aged children who have asthma.

A systematic review of the literature was performed to answer the following questions (a) What factors contribute to the emotional responses of school-age children who have asthma? (b) What are the potential gaps in the literature regarding the emotional responses of school-age children (ages 6-12) who have asthma? (c) Are children with a lower socioeconomic status (SES) and those who are minorities represented in the literature proportionate to their prevalence? Two main focus areas regarding emotional responses were identified: (a) factors related to children who have asthma and (b) factors related to caregivers of children who have asthma. Internalizing disorders were reported consistently for children and caregivers of children who have asthma. Negative consequences of asthma for children included panic and asthma attacks, missed school days, and behavioral problems. Issues for caregivers included higher levels of anxiety and depressive symptoms, asthma management deficits, and lower caregiver warmth and involvement. Gaps in the literature included separated studies for children ages 6-12, a lack of a standardized method to define SES, studies that were of a more experimental nature, and a disparate number of studies of minority children and caregivers relative to their asthma prevalence.

Breast cancer, panic disorder, and CYP2D6: a case study.

When patients with breast cancer also present with mental health issues, the psychiatric-mental health advanced practice RN is an appropriate provider for treatment and medication management. Collaboration with the oncology advanced practice nurse and the rest of the healthcare team can provide personalized, comprehensive care to this patient population. This article describes one example.

COPD and anxiety: its impact on patients' lives.

BACKGROUND: Anxiety is a common comorbidity in people with chronic obstructive pulmonary disease (COPD) but its identification and management are often insufficient. AIM: To explore the experience of living with and managing comorbid anxiety and COPD from a patient's perspective. METHOD: The study followed a qualitative approach. In-depth interviews were carried out with 14 patients who had COPD. RESULTS: Participants believed anxiety had a significant impact on their quality of life. It made them feel isolated and caused them to avoid social occasions and daily activities. Identifying anxiety was a challenge because of the overlap in the symptoms of anxiety and those of COPD, and the side-effects of medication. CONCLUSION: Nurses can play a vital role in screening and managing anxiety, and educating people in strategies to prevent episodes of panic.

Searching for self: the layers and labels of panic disorder: a New Zealand study.

The diagnosis and management of panic symptoms are relatively neglected. If not treated, people can develop a panic disorder, a condition that has an adverse effect on the client's quality of life and psychological well-being. The aim of this New Zealand research is to understand the clients' perspective of panic disorder and how it impacts on their quality of life. Ten participants were interviewed and the data were analyzed using thematic analysis. The research findings indicate that recovery from panic disorder occurs in a process of the search for self that is made up of self-understanding and the reclaiming the self. The findings provide a psychosocial perspective of panic disorder that will assist nurses who work with these clients. Nurses are pivotal in teaching clients about their body's response to stress and health anxiety, the giving of supplementary health information, and timely referral for specialist treatment. The recommendations for nurse specialist input and biopsychosocial assessments are discussed.

Cognitive-behavioral treatment combined with asthma education for adults with asthma and coexisting panic disorder.

This study tested the efficacy of a nurse-administered 8-week group treatment program for adults with asthma suffering from coexisting panic disorder. The program consisted of cognitive behavioral treatment (CBT) for panic disorder combined with asthma education (AE). Forty-eight women with a confirmed diagnosis of asthma and panic disorder were randomly allocated to a treatment condition (n=25) and a wait-list control condition (n=23). Twenty-five participants--15 in the treatment group and 10 in the wait-list control group--completed treatment. Repeated measures ANOVA procedures were used to compare the groups on panic and asthma outcomes at posttreatment and 6-month follow-up. The results demonstrate that the CBT-AE program is capable of producing substantial and durable antipanic and antianxiety treatment effects and led to substantial but nonsustained improvement in morning peak-flow expiratory rate and asthma-related quality of life. Implications of these findings for this clinical population are addressed.

Postpartum onset of panic disorder.

PURPOSE: To describe the experience of panic disorder in mothers during the postpartum period. The onset of panic disorder during the postpartum period has recently been reported. Clinicians are urged to differentiate between the more widely known presentation of postpartum depression and the newly reported postpartum panic disorder. DESIGN: Phenomenology. The purposive sample consisted of six women with panic disorder during the postpartum period. METHODS: In 1995, mothers were interviewed regarding their experiences with panic. The verbatim transcripts of these interviews were analyzed using Colaizzi's phenomenological method. In all, 214 statements regarding mothers' experiences of panic were extracted and clustered into six themes. FINDINGS: Panic during the postpartum period seriously complicated mothers' lives as they struggled to maintain their composure during panic attacks. As a result of recurring panic attacks, negative changes in women's lifestyles ensued stripping them of their self-esteem and leaving them to bear the burden of disappointing not only themselves, but also their families. CLINICAL IMPLICATIONS: Implications for nursing practice with mothers suffering from postpartum onset of panic disorder can be derived from each one of the six themes. Nurses can help women identify panic triggers to help prevent further panic attacks. Also, nursing interventions can target the guilt mothers experience over repeatedly disappointing themselves and their families.

New hope for a disabling condition. Cognitive-behavioral approaches to panic disorder.

1. Panic disorder, which encompasses both biological and psychological dimensions, is a common anxiety-related problem that can result in significant disability. 2. Cognitive-behavioral approaches to panic disorder are effective in 70% to 80% of patients treated, and generally involve a combination of patient education, relaxation training, exposure, and cognitive restructuring. 3. Mental health nurses can benefit their panic disorder patients by becoming aware of cognitive-behavioral treatment options, and should consider adding these methods to their repertoire of therapeutic skills.

An assessment tool to identify panic disorder.

Panic disorder is a psychiatric condition that is infrequently diagnosed correctly. People with untreated panic are most often seen in primary care settings. Panic is a debilitating condition that affects approximately 10% of the population and is eminently treatable when identified. Without treatment, clients are at risk for complications such as phobias, substance abuse, and depression. The purpose of this research study was to develop a valid, reliable tool to assist health care practitioners in identifying and assessing persons who have panic disorder. With the use of the Anxiety Inventory, information can be elicited to identify these people. In addition, data regarding the presence of phobias and depression and self-medication for any of the aforementioned behaviors can be collected. The tool also addresses any familial history of anxiety, panic attacks, depression, and drug and alcohol abuse. With the use of the Anxiety Inventory, practitioners can diagnose panic disorder in their clients and refer them for appropriate treatment.

Panic disorder: the overlooked problem.

The anxiety syndrome of Panic Disorder shares symptoms of numerous physical conditions and may aggravate existing physical conditions. Because many clients experiencing this disorder become isolated and homebound, the home care nurse is in a position to see patients with this disorder. This article provides assessment criteria guidelines that help the nurse identify patients with this problem.

Panic disorder: a personal and nursing perspective.

Fortunately, the symptoms of PD and agoraphobia now can be managed effectively with medication or with a combination of medication and behavioral treatments. It is certain that these new treatments will give many patients who were once disabled by this disorder the chance to lead normal lives.

Recognizing panic in cardiac patients.

Patients presenting with apparent myocardial infarctions may in fact be suffering from panic attacks; many symptoms of the latter mimic those of the former. Cardiovascular nurses who know what to listen for in patients' descriptions can recognize indications that panic may be occurring. This article describes panic attacks, panic disorder, and the long-term consequences that often accrue when this highly treatable problem is not recognized. Particularly when no evidence of myocardial damage is found, a cardiovascular nurse's recognition of panic can lead to a referral for appropriate psychological treatment, preventing years of needless suffering and unnecessary health care costs.