Clinical and psychophysiological analysis of panic attacksin patients with various mental diseases

Abstract

The fact that the unilateral approach to studying panic attacks (PA) is unsound has presently become evident in the context of one specialty - neurology or psychiatry. Subjects and methods . One hundred and ninety-three patients with PA, among whom 80 (30 men and 50 women; mean age 31.5±9.66 years) fully met the inclusion-exclusion criteria, were examined. A control group comprised 36 healthy individuals (16 men and 20 women; mean age 25.9±6.73 years). The interdisciplinary approach integrating two (neurological and psychiatric) paradigms was applied to investigate PA. Clinical, psychological, and neurophysiological studies were employed. Results and discussion . The clinical picture of PA and an interattack interval was shown to encompass similar autonomic and different psychopathological manifestations caused by varying pathogenic mechanisms. The clinical manifestations of the latter most frequently correspond to neurotic, specific personality, and schizotypal disorders. It was ascertained that each group of patients with PA, which was identified by the nosological principle, was characterized by the pattern of clinical and psychophysiological characteristics and the trend in PA in addition to general manifestations. The neurophysiological signs of mental disease, in whose picture PA developed, corresponded to the progression of psychopathological and personality manifestations of PA in each consecutive group. The determinant of the pathogenesis and clinical presentation of PA in various mental diseases is psychodynamic processes, the specific features of which need to be taken into account when making diagnostic, therapeutic, prognostic, and expert decisions.