Panic Disorder Group Research Articles

Shared Neural Activity in Panic Disorder and Undifferentiated Somatoform Disorder Compared With Healthy Controls

In previous studies, some brain areas, including parahippocampal gyrus, were suggested to be associated with panic disorder. Both panic disorder and somatoform disorders are associated with anxiety. This study sought to determine if there are shared neural activity underlying panic disorder and undifferentiated somatoform disorder. Sixteen nonmedicated patients with panic disorder, 16 nonmedicated patients with undifferentiated somatoform disorder, and 10 healthy subjects were scanned between February 2005 and August 2006. Diagnoses were made according to the Korean version of the Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version, Patient/Non-Patient Edition. Regional cerebral perfusion was measured by 99 m-Tc-ethyl cysteinate dimer single photon emission computed tomography (SPECT). Using statistical parametric mapping analysis, we compared the SPECT images between the groups. Significant hyperperfusion was found at the left superior temporal gyrus and the left supramarginal gyrus in the panic disorder patients when compared to the controls (family-wise error [FWE], P < .001). The somatoform disorder patients showed hyperperfusion in the left hemisphere at the superior temporal gyrus, inferior parietal lobule, middle occipital gyrus, precentral gyrus, postcentral gyrus, and, in the right hemisphere, at the superior temporal gyrus when compared to the controls (false discovery rate [FDR], P < .001). In contrast, significant hypoperfusion was found at the right parahippocampal gyrus in each of panic disorder (FWE, P = .001) and somatoform disorder (FWE, P < .001) groups compared to healthy controls. However, no significant differences were found in regional cerebral perfusion between the 2 disorder groups. Both panic disorder and undifferentiated somatoform disorder showed hyperperfusion in the left superior temporal gyrus and hypoperfusion in the right parahippocampal gyrus, which suggests that the 2 disorders are likely to share neural activity.

Twenty-four hour skin conductance in panic disorder

Skin conductance, physical activity, ambient temperature and mood were recorded for 24 h in 22 panic disorder (PD) patients and 29 healthy controls. During the day, subjects performed standardized relaxation tests (ARTs). We hypothesized that tonically elevated anticipatory anxiety in PD during waking and sleeping would appear as elevated skin conductance level (SCL) and greater skin conductance (SC) variability. Mean SCL was higher during both usual waking activities and sleeping in PD, but not during the ARTs. Group SC variability differences did not reach significance, perhaps because of variance unrelated to anxiety. Analyses indicated that in the PD group, antidepressant medication reduced mean SCL whereas state anxiety had the opposite effect during the day. Depressive symptoms reported during the day were related to elevated mean SCL on the night of the recording. The rate and extent of SCL deactivation over the night was equal in the two groups. However, PD patients had more frequent interruptions of deactivation that could have arisen from conditioned arousal in response to threat cues during sleep.

Frontal Lobe Dysfunction in Panic Disorder: a Comparison of Multichannnel Near-infrared Spectroscopy in Monozygotic Twins Discordant for Panic Disorder

Back to table of contents Previous article Next article LETTERFull AccessFrontal Lobe Dysfunction in Panic Disorder: a Comparison of Multichannnel Near-infrared Spectroscopy in Monozygotic Twins Discordant for Panic DisorderHisashi Tanii M.D., Ph.D.Yukika Nishimura M.S., Ph.D.,Ken Inoue M.D., Ph.D.,Naomi Hara M.S.,Atsushi Nishida M.S., Ph.D.,Motohiro Okada M.D., Ph.D.,Akira Imamura M.D., Ph.D.,Hisanobu Kaiya M.D., Ph.D.,Yuji Okazaki M.D.,Hisashi Tanii M.D., Ph.D.Search for more papers by this authorYukika Nishimura M.S., Ph.D.Search for more papers by this author,Ken Inoue M.D., Ph.D.Search for more papers by this author,Naomi Hara M.S.Search for more papers by this author,Atsushi Nishida M.S., Ph.D.Search for more papers by this author,Motohiro Okada M.D., Ph.D.Search for more papers by this author,Akira Imamura M.D., Ph.D.Search for more papers by this author,Hisanobu Kaiya M.D., Ph.D.Search for more papers by this author,Yuji Okazaki M.D.Search for more papers by this author,Published Online:1 Apr 2010https://doi.org/10.1176/jnp.2010.22.2.247.e3AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: Recent studies speculate that frontal lobe dysfunction in panic disorder plays a certain role to modulate anxiety responses. 1 This is the first case report about the use of near-infrared spectroscopy to investigate frontal lobe function in monozygotic twins discordant for panic disorder. Case ReportThe subjects were 30-year-old male monozygotic twins discordant for panic disorder as diagnosed by the DSM-IV. The affected twin (Twin A) was diagnosed with panic disorder without agoraphobia at age 25. The unaffected subject (Twin B) was healthy and works as a teacher of a high school and revealed no current or past psychiatric problems. The study participants included 24 right-handed male patients with panic disorder with or without agoraphobia (mean age ± SD=31.46±4.78, mean score of the Panic Disorder Severity Scale =10.21±5.80) diagnosed according to the criteria in the DSM-IV and 20 right-handed healthy male volunteers (mean age=29.95±5.44) without psychiatric disorder as the comparison group. The changes in the concentration of oxygenated hemoglobin in the panic disorder group were significantly smaller than in the healthy comparison group.The word fluency task used here consisted of a 30-second pretask baseline period, a 60-second task period consisting of three 20-second blocks, and a 70-second posttask baseline period. Relative oxygenated hemoglobin concentration changes were measured with a 52-channel near-infrared spectroscopy machine (Hitachi ETG-4000). Of 52 channels, the mean changes in oxygenated hemoglobin by three regions were calculated: 10 right lateral prefrontal anterior (PFC), 14 anterior PFC, and 10 left lateral PFC channels. The numbers of words generated during the word fluency task were nine words in Twin A and nearly the same number of words in Twin B (10 words). The twins generated words less than average on the comparison sample (mean words= 13.37±4.15). The oxygenated hemoglobin changes were small in the anterior PFC in Twin A as much as Twin B. It was approximately the same activation in the panic disorder group ( Figure 1 , panel B). On the other hand, in the bilateral PFC, the [oxy-Hb] changes were small in Twin A while the oxygenated hemoglobin changes were distributed at the midpoint of the comparison groups in Twin B ( Figure 1 , panels A and C). FIGURE 1. Mean [oxy-Hb] Changes During the Word Fluency TaskVertical bars represent the standard deviation.*p<0.001 by t-test, respectivelyNC=normal comparison subject; PD=panic disorder; twin A=affected by panic disorder; twin B=unaffected by panic disorderDiscussion Our presented results provide the possibility that the oxygenated hemoglobin changes in the frontal lobe reflect a pathophysiological feature of panic disorder. Previous research in a study of twins showed that the frontal cortex was markedly influenced by genetic factors. 2 In this present case, the findings suggest that the smaller activation in the anterior prefrontal cortex could possibly be associated with a genetic factor as an endophenotype for panic disorder. In contrast, the differences in the bilateral prefrontal cortex might correspond to a state marker. Further research of frontal lobe function will help elucidate the pathophysiology of panic disorder. Department of Psychiatry, Brain Science and Animal Model Research Center (BSAM), Mie University Graduate School of Medicine, Mie University, Tsu, MieDepartment of Public Health, Fujita Healthy University School of Medicine, Aichi, JapanDepartment of Psychiatry, Brain Science and Animal Model Research Center (BSAM), Mie University Graduate School of Medicine, Mie University, Tsu, MieSchizophrenia Research Team, Schizophrenia Project, Tokyo Institute of Psychiatry, TokyoDepartment of Psychiatry, Brain Science and Animal Model Research Center (BSAM), Mie University Graduate School of Medicine, Mie University, Tsu, MieDepartment of Psychiatry, Nagasaki University School of Medicine, Nagasaki, JapanResearch Center for Panic Disorder, Nagoya Mental Clinic, Aichi, JapanTokyo Metropolitan Matsuzawa Hospital, Tokyo

Sociodemographic characteristics and comorbidity in panic disorder patients / Panik bozukluğu hastalarında sosyodemografik özellikler ve komorbidite

Aim: The aim of the present study is to investigate the sociodemographic characteristics and the frequency of comorbid Axis I diagnosis in panic disorder (PD) patients.Method: 77 patients who referrred to the psychiatry outpatient clinic of Vakif Gureba Training and Research Hospital and Sisli Etfal Training and Research Hospital and who were diagnosed with panic disorder according to DSM-IV diagnostic criteria were included in the study. Comorbid psychiatric diagnoses were evaluated by SCID-I (Structured Clinical Interview for DSM-IV Axis I Disorders). Results: Fifty six of the patients (72.7%) were female, and 21 (27.3%) were male. Mean age was 35.53±12.25. Among patients, 37.7% had Axis I psychiatric disorder diagnosis in their family histories. In 93% of the patients, a psychiatric comorbidity was diagnosed along with panic disorder. The most common Axis I comorbidity was major depression (47.2%). Discussion: Although the number of female patients was higher when compared to other studies, female/male ratio was determined to be lower. The rate of major depression was compatible with the literature, while comorbidity rates for generalized anxiety disorder and social anxiety disorder (SAD) were found to be lower than the groups in similar literature. SAD comorbidity rate in PD patients with agoraphobia was found to be significantly higher than the PD group without agoraphobia. Conclusion: Nearly half of the PD patients had major depression, while in patients with comorbid agoraphobia, prevalence of comorbid disorders, particularly of SAD, was shown to increase.

Impact of panic disorder upon self-management educational goals in chronic obstructive pulmonary disease?

The rationale for introducing self-management plans for the whole chronic obstructive pulmonary disease (COPD) population is uncertain. This study's aim was to investigate whether people with panic disorder (PD), compared to non-panic-disordered (NPD), derived additional educational or psychological benefits from having a self-management plan. The 24-week prospective study followed 76 participants hospitalized with an exacerbation of COPD. Participants completed mental health questionnaires including psychological measures of self-management plan impact. Subsequently, a nurse provided education for using a self-management plan. All participants were Plan naïve irrespective of their PD status. Self-management knowledge was assessed before introducing the Plan (baseline), 1 week post discharge and at 24 weeks. At baseline 28 (37%) of participants met the criteria for PD and this group had higher scores (better knowledge) for an impending (p < 0.05) and severe exacerbation (p < 0.05) and capacity to act during a severe exacerbation (p < 0.01). No interaction effect was found between PD and NPD scores over time, indicating that the PD's knowledge did not improve or deteriorate over time relative to the NPD. Evidence was mixed regarding the Plan's psychological impact. Self-management confidence improved in both groups. Amongst the PD group, perceived control of self-management tasks increased but so did body vigilance and distress about having COPD. There is mixed evidence regarding educational and psychological benefits of COPD self-management plans for people with PD. No additional educational advantages were found for the PD group. Plans may increase confidence and control over self-management but may also increase body vigilance and distress about having COPD.

Respiratory, autonomic, and experiential responses to repeated inhalations of 20% CO 2 enriched air in panic disorder, social phobia, and healthy controls

Inhalation of carbon dioxide (CO 2) enriched air triggers anxiety in panic disorder (PD) patients, which is often interpreted as a sign of biological vulnerability. However, most studies have not measured respiration in these tasks. We compared patients with PD ( n = 20) and social phobia (SP, n = 19) to healthy controls ( n = 18) during eight inhalations of 20% CO 2, preceded and followed by two inhalations of room air, while continuously measuring subjective anxiety and dyspnea as well as autonomic and respiratory variables. PD patients showed increased reactivity and delayed recovery during CO 2 inhalations for most measures. Unlike both other groups, the PD group's tidal volume responses did not habituate across CO 2 inhalations. However, PD patients did not differ from SP patients on most other measures, supporting a continuum model of CO 2 sensitivity across anxiety disorders. Both patient groups showed continued reactivity during the last air inhalations, which is unlikely to be due to a biological sensitivity.

Association Between Joint Hypermobility Syndrome and Panic Disorder: A Case-Control Study

A significant association between joint hypermobility syndrome (JHS) and panic disorder was observed in a sample of rheumatology outpatients. The aim of this study was to assess whether JHS is more frequent in panic-disorder than in control subjects. The authors conducted a case-control study comparing 55 untreated patients with panic disorder and three matched-control groups: psychiatric patients, fibromyalgia patients, and healthy persons. JHS was more frequent among panic-disorder than among psychiatric patients, the healthy group, or the fibromyalgia group. In the panic-disorder group, there was a significant correlation between severity of JHS and anxiety. The strong association between JHS and panic disorder points to a genetic association. There is also a possibility that JHS and mitral valve prolapse, another condition frequently associated with panic disorder, share a common pathophysiological mechanism.

Cognitive–affective characteristics of smokers with and without posttraumatic stress disorder and panic psychopathology

The present study evaluated differences among daily smokers with posttraumatic stress disorder (PTSD), panic disorder (PD), panic attacks (PA), and no axis I psychopathology (past 6 months) in terms of several cognitive–affective variables implicated in both the onset and maintenance of anxiety psychopathology and cigarette smoking. The sample consisted of 123 daily smokers (62% women: M age = 29.7, SD = 11.9). Compared to the PA and no psychopathology groups, the PTSD group reported significantly higher levels of anxiety sensitivity, discomfort intolerance, negative affectivity, anxious arousal, and anhedonic depression; and, the PTSD group reported significantly lower levels of perceived control over anxiety-related events than the PA group. The PD group, compared to those in the PA and no psychopathology groups, reported significantly higher levels of anxiety sensitivity, negative affectivity, and anxious arousal; and significantly lower levels of perceived control over anxiety-related events. No significant differences were evident between the PTSD and PD groups. Theoretical and clinical implications of the present findings are discussed in terms of smoking and emotional vulnerability.

Evaluation of personality traits in panic disorder using Swedish universities Scales of Personality

Personality factors may interact with development and expressions of panic disorder (PD). This study sought to identify differences in personality traits between patients with PD and healthy individuals and explore the relationships between personality domains and various demographic and clinical variables of PD. Personality traits were evaluated in 193 patients and 314 matched healthy subjects using the Swedish universities Scales of Personality (SSP). All SSP traits, except for detachment and physical trait aggression, were significantly deviated in PD group, as compared to healthy subjects. The SSP factors of neuroticism and aggressiveness, but not extraversion, were significantly higher in PD group than in controls. More pronounced aberrations in personality traits were observed in PD with affective comorbidity. Only few demographic and clinical variables were associated with SSP scores in PD group. These results add to the evidence of maladaptive personality disposition in patients with PD, particularly high neuroticism and manifest somatic trait anxiety. Use of SSP proved to add clinically relevant information on personality traits in patients with PD.

Respiratory Pathophysiology of Panic Disorder: An Ambulatory Monitoring Study

To assess the external validity of laboratory baselines in panic disorder (PD), frequently associated with respiratory pattern abnormalities like increased respiratory variability and sighing, implying a stable pathophysiologic trait characteristic. Physical activity and a variety of breath-by-breath volumetric, timing, and variability measures of respiration were recorded in the daily life of 26 patients with PD and 26 healthy controls (HC), using a novel ambulatory monitoring system optimized for reliable assessment of respiratory pattern. Data were stratified for physical activity to eliminate its confounding effects. Groups showed strong and consistent diurnal patterns in almost all respiratory variables. However, patients with PD did not differ from HC regarding any of the respiratory timing, volumetric and variability measures, with negligible group effect sizes for all measures. Patients with fewer self-reported respiratory symptoms of anxiety exhibited more pronounced rapid shallow breathing as well as diminished total breath time and its variability. Despite state-of-the-art ambulatory assessment and sufficient statistical power to detect respiratory alterations previously observed in the laboratory, we found no evidence for such alterations in PD patients' daily life. Neither the total PD group nor patients with particularly pronounced respiratory symptomatology displayed increased respiratory variability. These results caution against interpreting results from laboratory baselines in PD as reflecting a stable trait characteristic. Rather, they likely represent a state-trait interaction due to enhanced reactivity of PD patients to novel environments. These results challenge aspects of respiratory theories of PD that were based on laboratory findings.

Smaller amygdala is associated with anxiety in patients with panic disorder

Anxiety a core feature of panic disorder, is linked to function of the amygdala. Volume alterations in the brain of patients with panic disorder have previously been reported, but there has been no report of amygdala volume association with anxiety. Volumes of hippocampus and amygdala were manually measured using magnetic resonance imaging obtained from 27 patients with panic disorder and 30 healthy comparison subjects. In addition the amygdala was focused on, applying small volume correction to optimized voxel-based morphometry (VBM). State-Trait Anxiety Inventory and the NEO Personality Inventory Revised were also used to evaluate anxiety. Amygdala volumes in both hemispheres were significantly smaller in patients with panic disorder compared with control subjects (left: t = -2.248, d.f. = 55, P = 0.029; right: t = -2.892, d.f. = 55, P = 0.005). VBM showed that structural alteration in the panic disorder group occurred on the corticomedial nuclear group within the right amygdala (coordinates [x,y,z (mm)]: [26,-6,-16], Z score = 3.92, family-wise error-corrected P = 0.002). The state anxiety was negatively correlated with the left amygdala volume in patients with panic disorder (r = -0.545, P = 0.016). These findings suggested that the smaller volume of the amygdala may be associated with anxiety in panic disorder. Of note, the smaller subregion in the amygdala estimated on VBM could correspond to the corticomedial nuclear group including the central nucleus, which may play a crucial role in panic attack.

`I'm Cured But….'

The current qualitative research studied representations of illness posttreatment from a heart transplant group, a panic disorder group, and a tic disorder group. All three groups were preoccupied with perceptions about the impact of the illness, perception of self and the perception of how others view the ill person. The heart transplant group seem to adopt an active style of coping compared to the panic disorder group who presented a more passive, anticipatory mode of coping, and the tic group who were preoccupied with control over the perceptions of others. This qualitative information could help optimize adaptation strategies.

Adult Attachment Styles in Panic Disorder with and Without Comorbid Adult Separation Anxiety Disorder

Attachment theory suggests that anxious attachment styles are associated with risk to psychiatric disorder, especially anxiety disorders. Separation anxiety would appear to be a core form of anxiety that is associated with anxious attachment. Nevertheless, as yet no research has examined the relationship of attachment styles to adult separation anxiety disorder, a condition that has only recently been fully recognized. The Attachment Style Questionnaire was used to examine attachment styles among 83 consecutive anxiety clinic patients diagnosed with panic disorder with agoraphobia and those re-assigned from that category to adult separation anxiety disorder. Dimensional associations showed strong correlations with scales measuring anxious attachment and separation anxiety. Patients assigned to the separation anxiety group scored significantly higher than those in the panic disorder group on the scales of Need for Approval and Preoccupation with Relationships. The findings finally dispel the notion that separation anxiety and anxious attachment are relevant to panic disorder with agoraphobia, suggesting instead that that constellation is confined to a separate group, namely that of adult separation anxiety disorder. Possible implications for treatment are considered.

Evaluation of smoking characteristics among community-recruited daily smokers with and without posttraumatic stress disorder and panic psychopathology

The present investigation compared 123 community-recruited daily smokers with posttraumatic stress disorder (PTSD), panic disorder (PD), nonclinical panic attacks (PA), or no current Axis I psychopathology (controls; C) in terms of nicotine dependence, smoking rate, quit history, severity of symptoms during past quit attempts, and motivation for and expectancies about smoking. No differences were observed between groups in regard to smoking rate or nicotine dependence. The PTSD group reported making more lifetime quit attempts than the other groups, and the PTSD and PD groups perceived more severe symptoms during past quit attempts. The PD and PTSD groups reported greater motivation to smoke to reduce negative affect. Individuals with PTSD endorsed a stronger expectation that smoking would alleviate negative mood states and would produce negative consequences. Overall, results suggest that smokers with PD or PTSD differ from other smoking groups in a number of clinically significant ways.

Demographic and clinical features of panic disorder comorbid with bipolar I disorder: A 3-year retrospective study

Background Mood disorders are considered related to anxiety disorders and their association may determine clinical course and prognosis. We aimed to describe with retrospective methodology the demographic, clinical, and treatment features in a group of panic disorder comorbid with bipolar I disorder (PD–BI) patients who were been treated for at least 3 year-period and compare them with bipolar I (BI) patients who were treated during the same period. Method We compared the demographic and clinical data of 26 PD–BI, 28 BI, and 25 panic disorder (PD) outpatients without history of comorbidity with mood disorder were diagnosed and treated for at least 3 years in the Federal University of Rio de Janeiro. Results PD group have a higher educational level, are more married, and are more economically active. In the PD–BI and BI patients the disorders started earlier. They also turn out to have an equivalent pattern in the presence of drug abuse episodes, moderate or severe depressive episodes, psychotic episodes, suicide attempts, maniac episodes, mixed episodes, use of fewer days of antidepressants and benzodiazepines, and use of more days of antipsychotics and mood stabilizers. The PD–BI and the BI groups had a higher frequency of depressive episodes and psychotic episodes. Limitations It is a retrospective data description based on a naturalistic treatment. The sample has a small size and the some data could be different in a large sample. Conclusion PD–BI patients have demographic, clinical and therapeutic features similar to BI and the data support its validation as a special severe bipolar I disorder subgroup.

P-Wave Dispersion in Panic Disorder

P-wave dispersion (PWD) is defined as the difference between the maximum and the minimum P-wave (Pmax and Pmin, respectively) duration. Significant variation in cardiac atrial PWD has been correlated with changes in systemic autonomic tone such as during periods of anxiety. It is also known that the degree of PWD seen on 12-lead electrocardiogram (ECG) may be a predictor of susceptibility of the atrial myocardium to future atrial fibrillation (AF). Therefore, we firstly aimed to show an association between PWD and panic disorder, a state of high sympathetic tone. PWD was measured in 40 outpatients with panic disorder and in 40 physically and mentally healthy age- and gender-matched controls. In addition, the Panic Agoraphobia Scale (PAS) and the Hamilton Depression Rating Scale (HDRS) were scored concomitantly. Both Pmax and Pmin were significantly higher than those of healthy controls. PWD was significantly greater in the panic disorder group than in the controls. As expected, the mean score on PAS was significantly higher for the panic disorder group than for the controls and correlated significantly with PWD. Heart rate (measured as RR intervals in milliseconds on electrocardiogram) did not differ significantly between the groups. The findings of the present study suggest that the disorder may be associated with an increase in PWD. This association may result from prolonged anxiety and increase in sympathetic modulation, which are main characteristics of panic disorder.

Personality traits spectrum in panic disorder and major depression

Our aim was to identify the personality traits in patients with panics disorder, major depression and with both disorders (comorbidity). Diagnoses were made with the Structured Clinical Interview for DSM-IV before the treatment, and the personality evaluation with the Maudsley Personality Inventory was made during the follow-up. Four groups were analyzed: a control group (n = 30), a major depression without panic disorder group (n = 45); a panic disorder without major depression group (n = 56) and a comorbidity group (n = 21), with major depression and panic disorder, simultaneously. All disorder groups had significantly higher neuroticism means when compared to the control group. The highest mean was in the comorbidity group, followed by the major depression group and the panic disorder group. The difference of neuroticism means between the comorbidity group and the panic disorder group also reached statistical significance. The lowest extraversion mean was in the comorbidity group, followed by the major depression group, the panic disorder group, and the control group. Compared to normal controls, extraversion was significantly low in the comorbidity and major depression groups. In our sample, there was a continuum of personality traits between panic disorder and major depression and, the co-occurrence of these disorders was associated with accentuated personality traits.

An Internet-based investigation of the catastrophic misinterpretation model of panic disorder

The catastrophic misinterpretation (CM) model of panic disorder proposes that spontaneous panic attacks are the result of interpretation of harmless autonomic arousal as precursors to physical (e.g., heart attack) or psychological (e.g., insanity) emergency. Mixed research findings to date have provided equivocal support. The body sensations interpretation questionnaire-modified was administered via Internet to investigate core assumptions of the model among 30 people with panic disorder (PD), 28 with social anxiety disorder (SAD), and 30 non-anxious controls. The PD group gave more harm-related interpretations of ambiguous internal stimuli than both other groups, and this tendency to interpret ambiguous stimuli catastrophically was not also apparent for external/general events. Furthermore, people with PD rated harm and anxiety outcomes as more catastrophic than non-anxious controls. Results substantially support the CM model although a modification is proposed.

Recognition of happy facial affect in panic disorder: An fMRI study

Background This study investigated activation of the anterior cingulate cortex (ACC) and amygdala during the presentation of happy facial affect images in patients with panic disorder (PD) as measured by blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI). Methods Eight patients with PD and eight sex-matched controls were recruited for the study. Scanning was performed on a general electric (GE) Signa 1.5 T scanner retrofitted with a whole body echo planar coil. Using a quadrature head coil, echo planar images and high-resolution MR images were acquired. Results After covarying for age, examination of group differences revealed greater ACC activation bilaterally in patients with PD compared to controls in response to happy faces. However, there were no differences in amygdala activation between the groups. These findings contrasted with regional brain activation in response to neutral faces where there were was also greater bilateral ACC activation in the PD group, but only 44 ACC voxels showed significant increases as opposed to 509 voxels for the happy condition. There were no between group differences in activation in the amygdala. Conclusion This is the first fMRI study to our knowledge that demonstrates ACC abnormalities in response to happy facial affect recognition in PD.

Magical Thinking in Obsessive-Compulsive Disorder, Panic Disorder and the General Community

Magical Ideation was examined in 71 individuals across four groups matched, where possible, for gender and age. These groups were: (1) Obsessive Compulsive Disorder (OCD) patients with cleaning compulsions (n = 11); (2) OCD patients with checking compulsions (n = 20); (3) panic disorder patients with minimal obsessive compulsive symptoms (n = 19); (4) a “normal” control group with minimal obsessive compulsive symptoms (n = 21). The Magical Ideation Scale (MI, Eckblad and Chapman, 1983), the Obsessive Compulsive Inventory- Short Version (OCI-SV; Foa et al., 2002) and the Maudsley Obsessional-Compulsive Inventory (MOCI, Hodgson and Rachman, 1977) were administered to all participants. A one-way Anova was conducted with four planned contrasts. As expected, the OCD groups obtained magical ideation scores higher than the normal subjects. This suggests that OCD patients engage in more magical thinking tendencies than non-anxious controls. Similarly, OCD participants obtained a mean magical ideation score significantly higher than the panic disorder group, suggesting that obsessional compulsive patients are more likely to exhibit magical thinking than individuals with panic disorder. Of note, panic disorder and control group means on MI did not differ significantly. Finally, individuals with obsessive cleaning compulsions displayed higher levels of magical thinking compared to individuals with obsessive checking compulsions, despite no difference in severity of their obsessive compulsive symptoms. This observation was counter to previous findings (Einstein and Menzies, 2004a; Einstein and Menzies, 2004b).