The Effects of Childhood Parental Death and Divorce on Six-Month History of Anxiety Disorders

1989 ◽  
Vol 154 (6) ◽  
pp. 823-828 ◽  
Author(s):  
J. Lindsey Tweed ◽  
Victor J. Schoenbach ◽  
Linda K. George ◽  
Dan G. Blazer
Keyword(s):  
Panic Disorder ◽  
Maternal Death ◽  
Parental Death ◽  
Panic Attacks ◽  
Parental Separation ◽  
Generalised Anxiety Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
History Of ◽  
Socio Demographic Factors

Duke Epidemiologic Catchment Area (ECA) data were used to examine the relationships between: (a) early childhood maternal death, paternal death, and parental separation/divorce, and (b) six-month DIS/DSM-III diagnoses of agoraphobia with and without panic attacks, simple phobia, social phobia, panic disorder, generalised anxiety disorder, and obsessive-compulsive disorder. Associations were found between: (a) maternal death and agoraphobia with panic attacks, and (b) parental separation/divorce and agoraphobia with panic attacks and panic disorder. The associations could not be explained by the effects of potentially confounding socio-demographic factors.

FEATURES OF THERAPY FOR PANIC DISORDER, ASSOCIATED WITH THE SARS-COV-2 PANDEMIC

Vestnik ◽  
2021 ◽  
pp. 313-318
Author(s):  
Л.Б. Куанова ◽  
Г.М. Жуламанова
Keyword(s):  
Panic Disorder ◽  
Rating Scale ◽  
Panic Attacks ◽  
Qtc Interval ◽  
Obsessive Compulsive ◽  
Significant Similarity ◽  
Therapy Regimen ◽  
Compulsive Disorder ◽  
History Of ◽  
First Time

Введение. В силу существенной схожести симптомов острого респираторного синдрома SARS-CoV-2 и панического расстройства (ПР), диагностика представляет значительные трудности. ПР имеют тенденцию развиваться хронически, с рецидивами на протяжении всей жизни. Цель работы: выявить особенности клинического проявления ПА/ПР на фоне COVID-19 и обосновать оптимальную схему терапии. Методы. Проведен анализ данных 86 пациентов, у которых диагностировано ПР при обращении на консультативный неврологический прием КФ UMC с мая 2020 г по май 2021 г. Скрининг панического расстройства проведен по Шкале тревоги Шихана (Sheehan Anxiety Rating Scale, ShARS). Результаты. Среди пациентов было 54 (62,8%) женщины и 32(37,2%) мужчины. По шкале ShARS тяжелым тревожное расстройство (80 баллов и выше) определено у 39 (45,3%), у остальных тревога (от 30 до 80 баллов) - клинически выраженная. Диагноз ПР у 21(24,4%) был диагностирован ранее заражения ковидной инфекцией. У остальных, выставлен впервые 26 (30,2%) пациентам, ранее не обращавшихся к неврологу и 39 (45,3%) пациентам, обращавшихся к неврологу с диагнозами соматоформная вегетативная дисфункция, сосудистая цефалгия, мигрень, обсессивно-компульсивное расстройство. Бронхиальная астма отмечалась в анамнезе в 13 (15,1%) случаях. Разновидности панических приступов были расценены как большие (развернутые) ПР (4 симптома и более) - у 55 (64%), в остальных случаях как симптоматически бедные. Особенность течения ПР на фоне SARS-CoV-2 определяется возникновением на фоне ипохондрических фобий. В то же время агорафобии и избегающего поведения, характерных для ПР, не отмечалось. Заключение. Использование бензодиазепинов для анксиолитических целей, противоастматических препаратов может быть контрпродуктивным в лечении тревожных расстройств. Ятрогенный риск наслаивается на возможную гипокалиемию, удлинение интервала QTc, артериальную гипертензию, вызванную COVID-19. Оценка результатов проведённого нейрофармакологического анализа и назначения препаратов анксиолитического действия Бифрен, в более тяжелых случаях ПР Прегабина показала клинический положительный эффект. Introduction. Due to the significant similarity between the symptoms of SARS-CoV-2 acute respiratory syndrome and panic disorder (PD), diagnosis presents significant difficulties. PD tend to develop chronically, with lifelong relapses. Purpose of the work: to identify the features of the clinical manifestation of PD in the presence of COVID-19 and to substantiate the optimal therapy regimen. Methods. We analyzed the data of 86 patients who were diagnosed with PD when they applied for a consultative neurological appointment CF UMC from May 2020 to May 2021. Panic disorder was screened according to the Sheehan Anxiety Rating Scale (ShARS). Results. Among the patients there were 54 (62.8%) women and 32 (37.2%) men. On the ShARS scale, severe anxiety disorder (80 points and higher) was identified in 39 (45.3%), in the rest anxiety (from 30 to 80 points) was clinically expressed. The diagnosis of PD in 21 (24.4%) was diagnosed earlier than contracting a covid infection. The rest were exposed for the first time to 26 (30.2%) patients who had not previously visited a neurologist and 39 (45.3%) patients who visited a neurologist with diagnoses of somatoform autonomic dysfunction, vascular cephalgia, migraine, obsessive-compulsive disorder. A history of bronchial asthma was observed in 13 (15.1%) cases. The types of panic attacks were regarded as large (extensive) PR (4 symptoms or more) - in 55 (64%), in other cases as symptomatically poor. The peculiarity of the course of PR against the background of SARS-CoV-2 is determined by the occurrence of hypochondriac phobias against the background. At the same time, agoraphobia and avoidant behavior characteristic of PD were not observed. Conclusion. The use of benzodiazepines for anxiolytic purposes, anti-asthma drugs may be counterproductive in the treatment of anxiety disorders. The iatrogenic risk is superimposed on possible hypokalemia, prolongation of the QTc interval, arterial hypertension caused by COVID-19. Evaluation of the results of the neuropharmacological analysis and the appointment of drugs with anxiolytic action Bifren, in more severe cases of Pregabin in PR showed a clinical positive effect.

Diagnostic relevance of sleep complaints in anxiety and mood disorders

1995 ◽  
Vol 10 (8) ◽  
pp. 386-390 ◽  
Author(s):  
F Arriaga ◽  
E Lara ◽  
A Matos-Pires ◽  
F Cavaglia ◽  
L Bastos
Keyword(s):  
Major Depression ◽  
Panic Disorder ◽  
Generalised Anxiety Disorder ◽  
Obsessive Compulsive ◽  
Sleep Complaints ◽  
Compulsive Disorder ◽  
Clinical Assessments ◽  
Obsessive Compulsive Disorders ◽  
Compulsive Disorders ◽  
Normal Controls

SummaryClinical assessments of sleep and subjective state upon waking were performed in normal controls and patients with generalised anxiety disorder, panic disorder, obsessive-compulsive disorder, primary dysthymia and major depression. Subjects were selected according to DSM-III-R criteria. As compared to normal controls, patients with generalised anxiety, dysthymia and major depression exhibit pervasive and intense complaints of insomnia, and no clear distinctions can be drawn among these groups. Patients with panic disorder do not differ from normal controls, whereas obsessive compulsive patients present limited sleep symptoms. These findings suggest that subjective sleep variables are relevant for the diagnostic discrimination of panic and obsessive-compulsive disorders.

Is Hypochondriasis Related to Obsessive-Compulsive Disorder, Panic Disorder, or Both? An Empirical Evaluation

2008 ◽  
Vol 22 (2) ◽  
pp. 115-127 ◽  
Author(s):  
Brett Deacon ◽  
Jonathan S. Abramowitz
Keyword(s):  
Panic Disorder ◽  
Obsessive Compulsive Disorder ◽  
Cognitive Biases ◽  
Function Analysis ◽  
Intolerance Of Uncertainty ◽  
Panic Attacks ◽  
Self Report ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Body Vigilance

Although hypochondriasis (HC) is considered a somatoform disorder in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision), some authors have pointed out that the symptoms of HC overlap with certain anxiety disorders, namely, panic disorder (PD) and obsessive-compulsive disorder (OCD). Few studies have empirically addressed this overlap. In the present investigation, we used discriminant function analysis to explore how patients with a principal diagnosis of HC, OCD, or PD varied with respect to cardinal symptoms of these disorders (i.e., health anxiety, obsessions and compulsions, and panic-related anxiety and avoidance) and key cognitive biases (i.e., intolerance of uncertainty, anxiety sensitivity, and body vigilance). Fifty treatment-seeking individuals with PD, 21 with OCD, and 23 with HC completed self-report measures of symptoms and cognitions during their clinic visit. Results indicated that whereas individuals with HC experience panic attacks, obsessions, and compulsions, these symptoms are markedly less pronounced than among those with PD and OCD. Conversely, overlaps were found in terms of cognitive biases, with HC patients demonstrating elevated levels of intolerance of uncertainty, body vigilance, and fear of cardiovascular symptoms. Implications for the conceptualization and treatment of HC are discussed.

Panic Attacks and Anxiety Disorders

2020 ◽  
Author(s):  
Curtis Wittmann
Keyword(s):  
Emergency Department ◽  
Anxiety Disorder ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Stress Disorder ◽  
Acute Stress ◽  
Panic Attacks ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

This review discusses the acute diagnosis and management of panic and anxiety disorders. Anxiety disorders are among the most common psychiatric disorders in the country and are a relatively common cause of presentation to the emergency department. Most anxiety disorders can be conceptualized as fear- or phobia-based disorders, including panic disorder, specific phobia, social phobia, acute stress disorder, posttraumatic stress disorder, and obsessive-compulsive disorder. Each of these disorders is discussed, including prevalence and common clinical presentations. The initial evaluation of patients with a suspected or diagnosed anxiety disorder will be based on their current symptoms. Some patients may be highly agitated and may require deescalation or sedation to perform a reasonable history and physical examination. To achieve this, providers should ensure their own safety first, with attention to the physical layout of the emergency department, ensuring that they are closer to the room exit than the patient (so that they cannot be trapped). The presence of police or security may be necessary to provide optimal care and an appropriate evaluation. Typical treatment of acute exacerbations of anxiety disorders includes medical management, most often benzodiazepines, which can provide immediate relief. Psychiatric consultation may be necessary in certain cases. For most patients, outpatient management rather than inpatient admission will lead to the most effective management of their anxiety.   Key words: anxiety disorder, obsessive-compulsive disorder, panic disorder, phobia, stress disorder This review contains 1 highly rendered figure, 17 tables, and 29 references.

Obsessive–Compulsive Disorder

1996 ◽  
Vol 169 (1) ◽  
pp. 101-107 ◽  
Author(s):  
P. Lensi ◽  
G. B. Cassano ◽  
G. Correddu ◽  
S. Ravagli ◽  
J. L. Kunovac ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Close Association ◽  
Demographic Data ◽  
Bipolar Disorders ◽  
Panic Attacks ◽  
Obsessive Compulsive ◽  
Axis Ii ◽  
Compulsive Disorder ◽  
History Of ◽  
Axis I

BackgroundDemographic data, family history, psychopathological features, comorbidity and course of obsessive–compulsive disorder (OCD) are investigated and data generated to support the possible existence of two subgroups with gender-related differences of a broader nature.MethodTwo hundred and sixty-three OCD patients, consecutive admissions to the Institute of Psychiatry, University of Pisa over a period of 5 years, not excluding those with comorbid Axis I and Axis II conditions, were studied. Patients were evaluated with a specifically designed semi-structured OCD interview.ResultsWe found a significantly greater history of perinatal trauma in men who also had an earlier onset, greater likelihood of never having been married and a higher frequency of such symptoms as sexual, exactness and symmetry obsessions and odd rituals; by contrast, women suffered a later onset of the disorder, were more likely to be married, had higher rates of associated panic attacks after the onset of OCD and a higher frequency of aggressive obsessions at the onset of their illness, and were less frequently associated with bipolar disorders.ConclusionsPathophysiological mechanisms in OCD seem to differ by gender. Perinatal trauma might predispose to earlier onset in men, whereas in women there is a close association between OCD and panic disorder.

How athletes coped with COVID-19 restrictions: differences between Switzerland and Italy

2020 ◽  
Keyword(s):  
Psychological Symptoms ◽  
Training Session ◽  
Coping Resources ◽  
Government Officials ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Aggressive Action ◽  
History Of ◽  
Global Threat ◽  
Sport Facilities

The ongoing COVID-19 pandemic is a global crisis of unprecedented scale in modern times. The initial outbreak of COVID-19 in Wuhan spread rapidly, affecting other parts of China and soon other countries becoming a global threat. [1] On 11 March 2020, the WHO has declared the ‘Pandemic state’ calling the governments to take ‘urgent and aggressive action’ to delay and mitigate the peak of infection. To respond to COVID-19 public health experts and government officials are taking several measures, including social distancing, self-isolation, or quarantine; strengthening health facilities to control the disease; and asking people to work at home. To safeguard the health of athletes and others involved all forms of organized sport have been either cancelled or postponed. These range from mass participation events such as marathon races to football league and even to the Olympics and Paralympics that for the first time in the history of the modern games, have been postponed, and will be held in 2021. All sport in Italy had been suspended from early March and from April the lockdown measures had been extended to the training session for professional and non-professional athletes within all sport facilities. Unlike Italy, the Swiss government has not imposed a general curfew so athletes continued to train outdoor although training in a group was forbidden. [2,3] Some athletes in this situation will be able to build on existing coping resources while others athletes may experience psychological symptoms including fear of being infected, anxiety of physical recovery if infected, disturbed sleep, eating disorders, obsessive-compulsive disorder, and family conflicts.

The inner world of overactive monitoring: neural markers of interoception in obsessive–compulsive disorder

2017 ◽  
Vol 47 (11) ◽  
pp. 1957-1970 ◽  
Author(s):  
A. Yoris ◽  
A. M. García ◽  
L. Traiber ◽  
H. Santamaría-García ◽  
M. Martorell ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Obsessive Compulsive Disorder ◽  
Evoked Potential ◽  
Cognitive Profile ◽  
Healthy Controls ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Inner World ◽  
External Stimuli ◽  
Internal Body

BackgroundObsessive–compulsive disorder (OCD) patients typically overmonitor their own behavior, as shown by symptoms of excessive doubt and checking. Although this is well established for the patients’ relationship with external stimuli in the environment, no study has explored their monitoring of internal body signals, a process known to be affected in anxiety-related syndromes. Here, we explored this issue through a cardiac interoception task that measures sensing of heartbeats. Our aim was to explore key behavioral and electrophysiological aspects of internal-cue monitoring in OCD, while examining their potential distinctiveness in this condition.MethodWe administered a heartbeat detection (HBD) task (with related interoceptive confidence and awareness measures) to three matched groups (OCD patients, panic disorder patients, healthy controls) and recorded ongoing modulations of two task-relevant electrophysiological markers: the heart evoked potential (HEP) and the motor potential (MP).ResultsBehaviorally, OCD patients outperformed controls and panic patients in the HBD task. Moreover, they exhibited greater amplitude modulation of both the HEP and the MP during cardiac interoception. However, they evinced poorer confidence and awareness of their interoceptive skills.ConclusionsConvergent behavioral and electrophysiological data showed that overactive monitoring in OCD extends to the sensing of internal bodily signals. Moreover, this pattern discriminated OCD from panic patients, suggesting a condition-distinctive alteration. Our results highlight the potential of exploring interoceptive processes in the OCD spectrum to better characterize the population's cognitive profile. Finally, these findings may lay new bridges between somatic theories of emotion and cognitive models of OCD.

Pindolol augmentation in treatment-resistant panic disorder and obsessive-compulsive disorder

1998 ◽  
Vol 8 ◽  
pp. S99 ◽  
Author(s):  
J. Zohar ◽  
P.N. Dannon ◽  
Y. Sasson ◽  
S. Hirschmann ◽  
I. Iancu ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Obsessive Compulsive Disorder ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

scholarly journals Fear of body symptoms and sensations in patients with panic disorders and patients with somatic diseases

2009 ◽  
Vol 137 (11-12) ◽  
pp. 659-663 ◽  
Author(s):  
Milan Latas ◽  
Danilo Obradovic ◽  
Marina Pantic
Keyword(s):  
Myocardial Infarction ◽  
General Population ◽  
Panic Disorder ◽  
Somatic Symptoms ◽  
The Body ◽  
Panic Attacks ◽  
Somatic Illness ◽  
History Of ◽  
Body Sensations ◽  
High Level

Introduction. A cognitive model of aetiology of panic disorder assumes that people who experience frequent panic attacks have tendencies to catastrophically interpret normal and benign somatic sensations - as signs of serious illness. This arise the question: is this cognition specific for patients with panic disorder and in what intensity it is present in patients with serious somatic illness and in healthy subjects. Objective. The aim of the study was to ascertain the differences in the frequency and intensity of 'catastrophic' cognitions related to body sensations, and to ascertain the differences in the frequency and intensity of anxiety caused by different body sensations all related to three groups of subjects: a sample of patients with panic disorder, a sample of patients with history of myocardial infarction and a sample of healthy control subjects from general population. Methods. Three samples are observed in the study: A) 53 patients with the diagnosis of panic disorder; B) 25 patients with history of myocardial infarction; and C) 47 healthy controls from general population. The catastrophic cognitions were assessed by the Agoraphobic Cognitions Questionnaire (ACQ) and the Body Sensations Questionnaire (BSQ). These questionnaires assess the catastrophic thoughts associated with panic and agoraphobia (ACQ) and the fear of body sensations (BSQ). All study subjects answered questionnaires items, and the scores of the answers were compared among the groups. Results. The results of the study suggest that: 1) There is no statistical difference in the tendency to catastrophically interpret body sensations and therefore to induce anxiety in the samples of healthy general population and patients with history of myocardial infarction; 2) The patients with panic disorder have a statistically significantly more intensive tendency to catastrophically interpret benign somatic symptoms and therefore to induce a high level of anxiety in comparison to the sample of patients with the history of serious somatic illness (myocardial infarction) and the sample of healthy general population. Conclusion. The tendency to catastrophically interpret benign somatic symptoms and therefore to induce a high level of anxiety in patients with panic disorder, confirms the cognitive aetiology model of panic disorder and suggests that it should be the focus of prophylactic and therapeutic management of patients with panic disorder.

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