Diagnosis Of Panic Disorder Research Articles

A taxometric analysis of panic disorder.

Panic disorder is costly, and while evidence-based interventions for panic disorder are effective, obtaining a diagnosis often precludes access to such treatments. This is problematic because the categorical diagnosis of panic disorder (i.e. "you have it, or you don't") supported by modern diagnostic manuals contradicts empirically supported dimensional models of panic disorder. Taxometric analyses, which test the dimensional or categorical latent structure of constructs, have consistently revealed dimensional latent structures when applied to other anxiety disorders and panic-related processes, but taxometric analyses have never been applied to panic disorder. To address this gap in the literature, three nonredundant taxometric procedures were applied to seven theoretically-relevant indicators of panic disorder derived from Panic Disorder Severity Scale data collected from 663 participants recruited via Amazon Mechanical Turk. Simulated comparison plots and objective fit indices were also evaluated. The collective results provided consistent empirical support for a dimensional model of panic disorder, with an overall mean CCFI score of .39. The implications of the present findings for the measurement, assessment, diagnosis, and treatment of panic disorder are discussed.

Direct and rapid detection of serum amino acid and monoamine neurotransmitters to assist the diagnosis of panic disorder

Direct and rapid detection of serum amino acid and monoamine neurotransmitters to assist the diagnosis of panic disorder

Resting-state functional connectivity in anxiety disorders: a multicenter fMRI study.

Anxiety disorders (AD) are associated with altered connectivity in large-scale intrinsic brain networks. It remains uncertain how much these signatures overlap across different phenotypes due to a lack of well-powered cross-disorder comparisons. We used resting-state functional magnetic resonance imaging (rsfMRI) to investigate differences in functional connectivity (FC) in a cross-disorder sample of AD patients and healthy controls (HC). Before treatment, 439 patients from two German multicenter clinical trials at eight different sites fulfilling a primary diagnosis of panic disorder and/or agoraphobia (PD/AG, N = 154), social anxiety disorder (SAD, N = 95), or specific phobia (SP, N = 190) and 105 HC underwent an 8 min rsfMRI assessment. We performed categorical and dimensional regions of interest (ROI)-to-ROI analyses focusing on connectivity between regions of the defensive system and prefrontal regulation areas. AD patients showed increased connectivity between the insula and the thalamus compared to controls. This was mainly driven by PD/AG patients who showed increased (insula/hippocampus/amygdala-thalamus) and decreased (dorsomedial prefrontal cortex/periaqueductal gray-anterior cingulate cortex) positive connectivity between subcortical and cortical areas. In contrast, SAD patients showed decreased negative connectivity exclusively in cortical areas (insula-orbitofrontal cortex), whereas no differences were found in SP patients. State anxiety associated with the scanner environment did not explain the FC between these regions. Only PD/AG patients showed pronounced connectivity changes along a widespread subcortical-cortical network, including the midbrain. Dimensional analyses yielded no significant results. The results highlighting categorical differences between ADs at a systems neuroscience level are discussed within the context of personalized neuroscience-informed treatments. PROTECT-AD's registration at NIMH Protocol Registration System: 01EE1402A and German Register of Clinical Studies: DRKS00008743. SpiderVR's registration at ClinicalTrials.gov: NCT03208400.

Differential prevalence of psychiatric disorders and mental health characteristics associated with lifetime suicide attempts in the Asian American and Pacific Islander adult population

BackgroundAsian American and Pacific Islander (AAPI) adults are an understudied group in terms of their mental health and mental healthcare needs. This has been complicated by the difficulty of recruiting adequate national samples of AAPI adults for research. ObjectiveThis study aimed to analyze national data to examine the lifetime prevalence of major psychiatric disorders among AAPI adults relative to non-AAPI adults, as well as to identify and compare sociodemographic and clinical characteristics associated with lifetime suicide attempts among AAPI and non-AAPI adults. MethodsCross-sectional data on 36,109 adults, including 1801 AAPI adults, from the National Epidemiological Survey of Alcohol and Related Conditions-III (NESARC-III), were analyzed with a series of chi-square and logistic regression analyses. ResultsWe found a significantly lower lifetime prevalence of mental health disorders in the AAPI versus the non-AAPI population nationally, including 2% of AAPI adults reporting lifetime suicide attempts as compared to about 5% of non-AAPI adults. Female sex and a history of major depressive disorder diagnosis were associated with lifetime suicide attempts in the AAPI and non-AAPI populations. Several unique factors were associated with having a history of suicide attempts in only the AAPI population, including a military service history and a diagnosis of panic disorder. DiscussionOur analysis demonstrated the significant sectors of the AAPI population that merit research, support, and intervention, including the AAPI veteran population. This study identifies several characteristics among AAPI adults that may make them particularly vulnerable to psychiatric problems and suicide risk, which may inform targeted prevention and efforts to provide culturally competent care to this population.

Sex talks-experiences with and barriers to communication about sexuality with healthcare staff among patients with anxiety disorder in Denmark.

Previous research among diverse patient populations suggests that healthcare staff routinely do not talk about sexuality with their patients even when such talks are highly indicated and relevant. In this study we sought to investigate how patients at outpatient anxiety clinics in Denmark experience sexual communication with healthcare staff and what barriers they encounter in this connection. We employed a survey design from January 1, 2018, to June 30, 2019. In collaboration with 11 outpatient anxiety clinics in Denmark, patients with a primary diagnosis of panic disorder, social phobia, generalized anxiety, or obsessive-compulsive disorder were invited to participate in the study. The final sample included 272 patients. Survey questions were related to sociodemographic characteristics, sexual activity and dysfunctions, pharmacological treatment adherence, anxiety and depression symptoms, and experience with and barriers to sexual communication. For each participant, clinicians at the clinics provided the International Classification of Diseases, 10th revision, diagnostic codes, medications, and dosage. Study inclusion criteria were not having an organic disorder that may cause anxiety, not having a previous diagnosis of bipolar affective disorder or schizophrenia, and the ability to speak and read Danish. Outcomes included patients' experiences with and barriers to sexual communication with healthcare staff. In total, 61% of the patients in this sample group found it relevant to talk to healthcare staff about sexuality but only 28% of the study patients had done so, of whom 83% reported this communication to be a positive experience. The most frequently reported patient barriers to communication with healthcare professionals regarding sexual concerns were a belief that if sexual matters were relevant, the healthcare staff would bring it up (94%), fear of transgressing their own boundaries (94%), embarrassment (92%), and lack of knowledge as to how to start a conversation about sex (91%). The study results indicated a need for healthcare staff to routinely map out and address sexual matters in their clinical work with anxiety patients while bearing in mind the common patient barriers for this topic. This study included a large clinical outpatient sample of anxiety patients and an extensive survey. However, the results may not be generalizable across all anxiety patients or patients in general. The results of this study strongly indicate that a majority of anxiety patients find it both relevant and beneficial to discuss sexual matters with healthcare staff in connection with their anxiety treatment, and therefore healthcare staff should be educated and equipped to routinely address these matters while bearing in mind the most common patient barriers for conversations about sexuality.

Intolerance of uncertainty on distress and impairment: The mediating role of repetitive negative thinking.

Repetitive negative thinking and intolerance of uncertainty are risk and maintenance factors for emotional disorders. Although emerging evidence suggests that intolerance of uncertainty predicts increases in distress through repetitive negative thinking, these relationships have yet to be investigated among veterans. The present study examines if repetitive negative thinking mediates the relationships of intolerance of uncertainty with stress, disordered symptoms and impairment among a mixed clinical sample of veterans. Two hundred and forty-four treatment-seeking veterans with diagnoses of major depressive disorder, panic disorder, or posttraumatic stress disorder completed measures of intolerance of uncertainty, repetitive negative thinking, stress, impairment, depression, panic, and posttraumatic stress prior to receiving treatment. Mediation models revealed indirect effects of intolerance of uncertainty through repetitive negative thinking on stress and impairment in the full sample, and on disordered symptoms in subsamples with major depressive disorder and posttraumatic stress disorder. Conversely, intolerance of uncertainty did not have direct or indirect effects on disordered symptoms in a panic disorder subsample. Findings suggest that repetitive negative thinking and intolerance of uncertainty uniquely contribute to stress, impairment, and disordered symptoms, but repetitive negative thinking, may, in part, drive intolerance of uncertainty's contribution to emotional disorders. Interventions for repetitive negative thinking might improve the efficacy of existing transdiagnostic treatment protocols. Cross-sectional data is a limitation of the present study. Prospective designs in civilian samples can better establish the temporality of these relationships and if they are generalizable to the larger population.

Incidence of Panic Disorder Diagnoses After Celebrity Disclosures of Panic Disorder in South Korea

The persistent stigma associated with mental health conditions is a major challenge worldwide. Celebrities may improve this by openly discussing their own mental health issues, potentially influencing public attitudes and encouraging individuals to seek treatment for these conditions. To evaluate the impact of celebrity mental health disclosures on the incidence and prevalence of panic disorder diagnosis in South Korea. This cohort study included the entire South Korean population from January 2004 to December 2021, as reflected in the National Health Insurance Service data. Analysis was conducted from May 2022 through January 2024. Time periods analyzed included the timeframe before (from January 2004 to December 2010) and after the public disclosures of panic disorder by 3 high-profile Korean celebrities between December 2010 and January 2012 (from January 2011 to December 2021). Monthly incidence and prevalence of panic disorder, defined by the presence of a clinical diagnosis of the condition. Trends were assessed using interrupted time series analysis with autoregressive integrated moving average models. To assess public interest in panic disorder, trends in search data were analyzed, examining the association between the timing of increased searches and changes in the incidence and prevalence of panic disorder. Data on obsessive-compulsive disorder (OCD) were included as a control. The study covered the entire population of South Korea, including 48 559 946 individuals in January 2004 and 52 593 886 individuals in December 2021. Before 2011, the mean (SD) annual prevalence of panic disorder was stable at 560 (140) persons per 100 000 persons per year. The celebrity disclosure in December 2010 was associated with higher monthly incidence rates of panic disorder, as measured by insurance claims data, changes that were observed in both the level (5.8 persons; 95% CI, 2.2-9.5 persons) and slope (0.78 persons per month; 95% CI, 0.19-1.40 persons per month) per 100 000 persons. By 2021, the observed annual prevalence per 100 000 persons reached 7530 persons, an increase of 775.6% compared with the 860 persons (95% CI, 330-1400 persons) estimated if the disclosures had not occurred. Internet searches anticipated changes in monthly prevalence with a lag of 2 or 3 months (F = 4.26, P = .02 and F = 3.11, P = .03, respectively). The celebrity disclosures had no significant association with the incidence or prevalence of OCD. In this observational cohort study, celebrity disclosure of mental health conditions was associated with a sustained reduction in stigma, as reflected in increased help-seeking behavior for the condition over more than a decade. This underscores the influential role celebrities can play in shaping public health perceptions and behaviors, offering valuable insights for the development of future mental health policies and public awareness campaigns.

Psychometric properties of the DSM-5 Panic Disorder Dimensional Scale in an Australian community sample

ABSTRACT Objective The Panic Disorder Dimensional Scale (PD-D) was developed to provide a dimensional rating of panic disorder (PD) symptom severity alongside the traditional categorical Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis. The aim of the present study was to evaluate the psychometric properties of the PD-D in an Australian community sample. Method Two-hundred and eighty-eight participants (72.9% female) aged 18–76 years (M = 28.28; SD = 12.08) completed the study. Results Confirmatory factor analysis indicated that PD-D demonstrates a unidimensional factor (comparative fit index [CFI] = 0.95; Tucker-Lewis index (TLI) = 0.94; standardised root mean square residual [SRMR] = 0.04). The scale also demonstrated excellent internal consistency [α = .96 (95% CI: .95–.97); ω = 0.96 (95% CI: .95–.97)], and evidence of convergent and divergent validity. A good test–retest reliability was evident for the total PD-D score (ICC = .76, p < .001). Conclusions The PD-D appears to be a reliable and valid measure which can be used to support diagnosis of PD in Australia. Limitations are discussed, including the use of a predominantly female sample and lack of clinician-informed data regarding current diagnoses.

Panic Disorder Versus Thyroid Medication Overuse: A Case Report

Introduction: Panic disorder is defined as the occurrence of spontaneous panic attacks that are not triggered by any specific stimulus. The symptoms of panic disorder include panic episodes that occur frequently and unexpectedly, as well as anxiety about the possibility of experiencing further panic attacks, the repercussions of panic attacks, or a change in behavior as a result of panic attacks. This study presented the diagnosis and treatment of panic disorder comorbid with thyroid medication overuse. Case presentation: A 36-year-old female patient presented to the emergency room with a primary concern and symptoms consistent with panic disorder, including experiencing a sense of losing control or impending death, chest pain, difficulty breathing, rapid heartbeat, excessive perspiration, trembling, and dizziness. The patient experienced significant periods of anxiety between episodes, preoccupied with the anticipation of the next occurrence. Each episode had a duration of roughly 15 minutes. The patient refutes any history of alcohol or drug misuse, and her sole medical condition is hypothyroidism. Subsequently, we perform a comprehensive analysis of the thyroid profile and make a referral to an internal medicine specialist for collaborative treatment. We treated the patient with a combination of a selective serotonin reuptake inhibitor (SSRI) fluoxetine 20 mg/day and a course of cognitive-behavioral therapy. Conclusion: Repeated episodes of intense panic attacks, accompanied by feelings of anxiety and observable alterations in behavior, distinguish panic disorder as a medical illness. The treatment involves the use of selective serotonin reuptake inhibitors, antidepressants, and cognitive behavioral therapy.

Smaller hypothalamic subregion with paraventricular nucleus in patients with panic disorder.

In panic disorder (PD), functional disturbance of the hypothalamus-pituitary-adrenal (HPA) axis has been considered. However, in neuroimaging studies of PD, the hypothalamus and pituitary gland are poorly studied.We investigated the volume of PD patients' hypothalamus and pituitary gland, enrolling 38 PD patients and 38 healthy controls. Severity of PD was mild to moderate according to the Panic Disorder Severity Scale, and the illness duration was relatively short (median = 2.8 years). The hypothalamus' gray matter was automatically extracted and segmented, whereas the pituitary gland was manually traced. Regarding the hypothalamus, the paraventricular nucleus (PVH), which produces the corticotropin-releasing hormone, was of interest.The volumes of the pituitary and the bilateral anterior-superior hypothalamic subunits, where the PVH would be located, were compared by the multiple regression analyses controlling for age and intracranial content volume. To compensate for limitation in the abovementioned segmentation and analyses, the voxel-based morphometry with small volume correction (VBM-SVC) targeting the whole hypothalamus was also performed.The multiple regression analyses did not find significant effect of PD diagnosis on the volumes. However, in the VBM-SVC analysis, volume reduction of the PVH was suggested in PD even when patients who experienced PD for ≥ 3 years were excluded [peak coordinate (x, y, z = -2, 3, -8), FWE-corrected P = .022 (cluster-level) and 0.003 (peak-level), voxel size = 63]. Our results suggested structural alteration of the PVH in PD patients for the first time, indicating importance of the HPA-axis in PD pathology.

Panik bozukluk hastalarında cinsel işlev bozukluğu sıklığının cinsiyet açısından karşılaştırması

Purpose: The aim of this study is to evaluate the frequency of sexual dysfunction in male and female panic disorder (PD) patients and to make a comparison between genders.&#x0D; Materials and Methods: A total of 57 cases, including 33 females aged 36±6 years and 24 males aged 35±7 years, who were sexually active, did not use psychotropic drugs, with primary diagnosis of PD according to DSM-5, were included in the study. Individual information collection forms and the Arizona Sexual Experiences Scale (ASEX) were applied to all cases, and sexual dysfunctions (SD) were questioned.&#x0D; Results: According to the suggested cut-off score of the Turkish version of the Arizona Sexual Experiences Scale, 77.2% of all participants had SD. SD was detected in 81.8% of women and 70.8% of men. There was a significant difference between men and women in terms of ASEX total scores. There was no significant difference between men and women in terms of sexual desire and orgasm satisfaction. Sub-dimension scores of arousal, lubrication/erection, and reaching orgasm were significantly higher in females. Sexual reluctance was the most common in both genders, with 30.4% of women and 36.5% of men.&#x0D; Conclusion: Sexual dysfunction is common among PD patients. Sexual reluctance is the most common in male and female patients with PD. Arousal and orgasm problems are more common in female PD patients than in male PD patients.

Efficacy of an Internet-based intervention with self-applied exposure therapy in virtual reality for people with panic disorder: study protocol for a randomized controlled trial

BackgroundDue to several treatment barriers, many individuals with panic disorder do not receive evidence-based treatment. One promising option to narrow this treatment gap is Internet-based psychotherapy, which has been shown particularly effective in guided formats. Still, there remains room for improvement to make these digital therapies more accessible, cost-efficient, and aligned with best practices for in-person interventions (e.g., exposure). The smartphone app “Invirto – Treatment for Anxiety” offers digitally guided, evidence-based treatment of panic disorders including virtual reality (VR) for exposure therapy. The aim present study is to investigate the efficacy, safety, and acceptance of Invirto in comparison to a care-as-usual (CAU) control group.MethodsWe plan to conduct a randomized controlled trial with two conditions (intervention vs. CAU), three assessment times via online surveys (t0: baseline; t1: 3 months after baseline; t2: follow-up assessment 6 months after baseline), and a total of 128 participants with a clinical diagnosis of panic disorder (symptoms must be experienced ≥ 1 year). Recruitment will take place via email, phone, and the study website. The primary outcome will be the change in anxiety symptoms as measured by Beck’s Anxiety Inventory from t0 to t1. Secondary outcomes will be the change in anxiety symptoms (measured by the Panic and Agoraphobia Scale, PAS; Questionnaire on panic-related Anxieties, Cognitions and Avoidance, ACA), depressive symptoms (measured by the Beck-Depression-Inventory, BDI-II), treatment satisfaction (measured by the Client Satisfaction Questionnaire, CSQ-8; Treatment Adherence Perception Questionnaire, TAPQ-adapt; Positive and Negative Effects of Psychotherapy Scale, PANEPS-I), psychological flexibility (measured by the Acceptance and Action Questionnaire-II, AAQ-II), and dissociation during VR exposure (measured by an adapted version of the Peritraumatic Dissociative Experiences Questionnaire, PDEQ-adapt). Participants in the intervention group will receive access to the intervention (Invirto) right after t0, while the CAU group will receive access to Invirto after t1. We expect a larger change in both the primary and secondary outcomes from t0 to t1 in the intervention group in comparison to the CAU group.DiscussionThis study is one of the first to evaluate an Internet-based intervention for people with panic disorder that includes self-application of VR exposure therapy. The findings are expected to extend the body of knowledge about effective Internet-based treatment options for people with panic disorder. The empirical and clinical implications and the limitations of the study are discussed.Trial registrationDRKS00027585 (www.drks.de/drks_web/), date of registration: 13 January 2022.

Use of Insomnia Treatments and Discussions About Sleep with Health Professionals Among Australian Adults with Mental Health Conditions.

Insomnia is a common issue among individuals with mental health conditions, yet the frequency of insomnia treatment remains unclear. The purpose of this study was to investigate the prevalence of probable insomnia, discussions regarding sleep with health professionals, and the utilisation of commonly delivered insomnia treatments in Australian adults diagnosed with mental health conditions. This study represents a secondary analysis of data collected through a cross-sectional, national online survey conducted in 2019. A subset included participants (n = 624, age 18-85y) who self-reported a diagnosis of depression, bipolar disorder, anxiety, panic disorder, or post-traumatic stress disorder. Participants were classed as having probable insomnia based on self-reported symptoms and a minimum availability of 7.5 hours in bed. Among individuals with probable insomnia (n = 296, 47.4%), 64.5% (n = 191) reported discussing sleep with one or more health professionals, predominantly with general practitioners (n = 160, 83.8%). However, 35.4% (n = 105) of people with probable insomnia had not discussed their sleep with a health professional. Additionally, 35.1% (n = 104) used prescribed medication for sleep, while only 15.9% (n = 47) had used the first line recommended treatment of cognitive-behavioral therapy for insomnia in the last 12 months. Although most participants who met the criteria for probable insomnia had engaged in discussions about sleep with health professionals, utilisation of first line recommended treatment was low. Interventions that promote routine assessment of sleep and first line treatment for insomnia by health professionals would likely benefit people with mental health conditions.

Two-channel EEG based diagnosis of panic disorder and major depressive disorder using machine learning and non-linear dynamical methods

The current study aimed to investigate the possibility of rapid and accurate diagnoses of Panic disorder (PD) and Major depressive disorder (MDD) using machine learning. The support vector machine method was applied to 2-channel EEG signals from the frontal lobes (Fp1 and Fp2) of 149 participants to classify PD and MDD patients from healthy individuals using non-linear measures as features. We found significantly lower correlation dimension and Lempel-Ziv complexity in PD patients and MDD patients in the left hemisphere compared to healthy subjects at rest. Most importantly, we obtained a 90% accuracy in classifying MDD patients vs. healthy individuals, a 68% accuracy in classifying PD patients vs. controls, and a 59% classification accuracy between PD and MDD patients. In addition to demonstrating classification performance in a simplified setting, the observed differences in EEG complexity between subject groups suggest altered cortical processing present in the frontal lobes of PD patients that can be captured through non-linear measures. Overall, this study suggests that machine learning and non-linear measures using only 2-channel frontal EEGs are useful for aiding the rapid diagnosis of panic disorder and major depressive disorder.

Study of Childhood Abuse and Anxiety: An Application of Logistic Regression

Introduction: Disorders can often lead to physical illness and suffering along with associated functional disability which hampers the overall well-being of a person. Consequently, it can lead to loss of productivity at the workplace, absenteeism, and social isolation which eventually affects the individual and the society. Researchers have found a crucial association between childhood traumatic experiences with developing anxiety or panic disorder.&#x0D; Methods: The purpose of this study is to do a logistic regression on Add health survey data to examine whether a history of childhood abuse tends to lead to a diagnosis of anxiety or panic disorder in later life. Additionally, medical conditions such as ADHD, PTSD or socio-economic conditions, and addiction were also investigated for their possible contribution to developing anxiety or panic disorder.&#x0D; Results: 49.4 % of respondents reported having faced either physical, emotional, or sexual abuse before the age of 18. Among the total respondents, 12.5 % reported having been diagnosed with anxiety disorder and among these individuals, 25.9 % reported having experienced physical abuse, 64.6 % faced emotional abuse, and 10.3 % said they faced sexual abuse earlier in their life. Results from logistic regression indicated gender (OR=2.069; 95% CI 1.627-2.7), race (OR=0.513; 95% CI 1.442-2.634), PTSD (OR=2.087; 95% CI 1.811-4.35), depression (OR 9.857; 95% CI 7.752-12.535) had a significant effect on developing anxiety. Additionally, an individual who experienced any kind of abuse in their childhood is 0.7 times (95% CI 0.527-0.841) more likely to develop the panic disorder later in their life. Results from the unadjusted logistic regression model indicated that individuals who reported a history of childhood abuse have 1.799 times (95% CI 1.473-2.197) higher odds of being diagnosed with anxiety disorder. Interestingly, women have higher odds (OR= 2.039; 95% CI 1.624-2.560) of having anxiety disorder than men if they were a victim of childhood abuse. Respondents who reported to have faced at least one type of abuse have approximately 1.886 (95% CI 1.512-2.354) times’ greater odds of having anxiety than those who didn’t. Consecutively, experiencing the two types of abuse increased the odds to 2.502 (95% CI 1.930-3.244) finally undergoing all three types of abuse increased the odds by more than double in comparison to those who faced a single kind.&#x0D; Conclusion: Childhood emotional abuse was found to be a more significant contributor to anxiety or panic disorder than other types of abuse. Any kind of childhood abuse experience seemed to have a greater effect on the female portion of the respondents in comparison to the males. Hence, to treat anxiety and panic disorders, childhood maltreatment and other mental illnesses like PTSD and depression should be considered by healthcare professionals to ensure optimal care. Furthermore, interventions targeting those issues need to be developed.

Serum BDNF levels are involved in the diagnosis and treatment response in patients with PD

BackgroundThe study aimed to explore whether brain-derived neurotrophic factor (BDNF) could be predictive for the diagnosis of panic disorder (PD) and to explore the association between serum BDNF levels and the treatment response to escitalopram in PD patients. MethodsNinety PD patients and 99 healthy controls (HCs) were finally recruited. PD patients were treated only by escitalopram for 8 weeks. All patients were administered the Short-Form Health Survey-36 (SF-36), Hamilton Anxiety Rating Scale (HAMA-14), and State-Trait Anxiety Inventory (STAI) to assess life quality, anxiety symptoms and trait, respectively. Neuropsychological tests were assessed at baseline in all participants. Besides, peripheral venous blood was drawn from all participants for BDNF serum levels detection both at baseline and after 8 weeks of treatment. ResultsIn PD patients, the baseline serum BDNF levels were lower than HCs. The area under the ROC curve (AUC) of baseline serum BDNF levels predicting PD from HCs was 0.947 (94.9 % for sensitivity, 77.8 % for specificity). The baseline serum BDNF levels (beta = 0.276, p = 0.007), the current duration (beta = −0.301, p = 0.004), and trait anxiety (TAI) (beta = 0.201, p = 0.045) were predictors for reduction rates of HAMA-14 after 8 weeks' escitalopram treatment. LimitationsA long-term observation and high homogeneity of sample may make the results more convincing. ConclusionThis preliminary finding highlighted the value of serum BDNF levels for the diagnosis of PD. In addition, the higher baseline serum BDNF levels may predict the better escitalopram treatment response in PD patients.

The psychological diagnosis of panic disorder

Psychological disorders are common among society individuals because of life stresses’ accumulations, which differ in terms of diagnosis,categorization and the reasons behind them. This makes them difficult in terms of diagnosis and understanding. Therefore, psychologists have to examine them for the sake of identifying their types, according to psychological and social examinations. The disorders interfere with anxiety and the concerns of panic disorder, which is categorized as an independent pathological category characterized with frequent seizures with subsequent physical signs. This is what we shall explain through this article.

Integrated genome-wide methylation and expression analyses provide predictors of diagnosis and early response to antidepressant in panic disorder

BackgroundWe investigated differentially methylated and expressed genes between panic disorder (PD) and healthy controls (HCs) to determine whether DNA methylation and expression level of candidate genes can be used as biomarkers for diagnosis and early response. MethodsIllumina infiniun Methylation EPIC (850 k) Beadchip for genome-wide methylation screening and mRNA sequencing was conducted in a discovery set (30 patients with PD and 30 matched HCs). The candidate gene loci methylation and expression were verified in an independent validation sample (101 PD patients and 107 HCs). ResultsIn the discovery set, there were 3613 differentially methylated cytosine phosphate guanosine sites and these differential methylation positions were located within 1938 unique genes, including 1758 hypermethylated genes, 150 hypomethylated genes, and the coexistence of hypermethylation and hypomethylation sites were found in 30 genes. There were 1111 differential transcripts in PD compared to normal controls (850 down-regulated and 261 up-regulated). Further, 212 differentially expressed genes were screened (40 up-regulated and 172 down-regulated). In the validation set, compared with HCs, there was no significant difference in DNA methylation level of Casitas B-lineage lymphoma (CBL) gene loci (cg07123846). The expression level of CBL gene in PD patients was lower (vs. HCs). After four weeks' treatment, the baseline expression level of CBL gene in the responders was higher than nonresponders. LimitationsThe sample size was limited. We only chose CBL as a candidate gene. Follow-up periods were short. ConclusionsThere are differences in genome-wide DNA methylation and mRNA expression between PD patients and HCs. The changes in expression level of CBL gene may be an important molecular marker for PD diagnosis and early response.

Psycho-social and psychiatric co-morbidity among children with poisoning

Background: The poisoning in children results from exposures to toxic agents that may lead to harmful effects based on the reaction of the body to these agents. Poisoning can be accidental or suicidal in intent. To assess any psycho-social factor that leads to poisoning and to determine any underlying psychiatric co-morbidity among children with acute poisoning.Methods: A hospital-based prospective observational study conducted in postgraduate department of pediatrics, G. B. Pant children’s hospital an associated hospital of government medical college Srinagar Jammu and Kashmir India. This study was conducted over 2 years with effect from November 2019 to November 2021. Psychiatric co-morbidity was determined by using the MINI- KID scale. Results: In our study, 572 cases with poisoning were studied over two years; the mean age of childhood poisoning was 3.8 years. The majority of the poisoning cases were accidental, with male to female ratio of 1.6:1. Most of the cases were seen in lower-middle-class families (65.7%). Organophosphorus was the most common agent involved. Oral ingestion was the predominant route of poisoning. A total of 46 subjects had a psychiatric diagnosis as assessed by MINI-KID. Among which, 34.7% of the subjects had the diagnosis of panic disorder, followed by depressive episodes (MDD) amounting to 26%, and ADHD in 13%. A total of 53 were having underlying psychosocial factors. Adolescent self-poisoning is commonly associated with underlying psychiatric illness.Conclusions: The underlying psychosocial and psychiatric disorders need proper identification and management.

Electroencephalographic changes of panic disorder patients in west Uttar Pradesh

80 panic disorder patients were diagnosed with electroencephalography (EEG). The study was electroencephalographic (EEG) changes of Panic Disorder patients in West Uttar Pradesh,India. The objectives 1) To examine the EEG of Panic Disorder patients. 2)To explore the clinical features for the diagnosis of panic disorder and their association with EEG. A large group of patients having panic disorder showed abnormal EEG associated with their clinical features. The pathophysiology behind is not clarified. The study was interpreted with 14 (17.5%) panic disorder patients and EEG abnormalities of 80 patients conflict with 13 symptoms in DSM-IV. The patients were assessed with Logistic regression analysis.EEG was selected as the dependent variable and age, sex, and with or without 13 symptoms as independent variables. The panic disorder patients showed abnormal EEG alpha frequency with repeatedly slow theta frequency. Nausea or abdominal distress (43.4% vs 67.7%, p = 0.01); derealization or depersonalization (37.7 %vs82.4%, p = 0.005); or paresthesias (7.5%vs47.1%, p = 0.001) were extracted by multivariate analysis as factors related to EEG abnormalities. The study indicated that physiological predispositions are closely related to panic disorder.