Panic States Research Articles

Long-Term Outcome of Panic States During Double-Blind Treatment and After Withdrawal of Alprazolam and Placebo

Long-Term Outcome of Panic States During Double-Blind Treatment and After Withdrawal of Alprazolam and Placebo

Literature update: A critical review

Abstract Have We Been Treating the Wrong Partner? KAPLAN, H.S.(1988) Intimacy disorders and sexual panic states, Journal of Sex and Marital Therapy, 14, pp. 3–12.

The evolution of freud's conceptualization of phobias

(1991). The evolution of freud's conceptualization of phobias. Psychoanalytic Inquiry: Vol. 11, Recent Developments in the Concept and Treatment of Phobias and Panic States, pp. 376-394.

The clinical and theoretical structures of adult phobias

(1991). The clinical and theoretical structures of adult phobias. Psychoanalytic Inquiry: Vol. 11, Recent Developments in the Concept and Treatment of Phobias and Panic States, pp. 333-350.

Syndrome of Diminished Vasodilator Reserve of the Coronary Microcirculation (Microvascular Angina or Syndrome X): Diagnosis by Combined Atrial Pacing and Thallium 201 Imaging—A Case Report

Patients with angina-like chest pain without evidence of epicardial coronary artery disease or coronary arterial vasospasm are becoming increasingly recognized. These are often related to noncardiac causes including esophageal, musculoskeletal, and hyperventilatory or panic states. However, recently a subgroup of such patients are being recognized as having true myocardial ischemia and chest pain on the basis of diminished coronary microvascular vasodilatory reserve (microvascular ischemia or Syndrome X). The authors describe such a patient who was found to have replication of anginal pain associated with a reversible ischemic defect on thallium 201 imaging during atrial pacing, suggesting ischemia in this myocardial segment. Resolution of angina and ST segment electrocardiographic changes of ischemia occurred with cessation of pacing. We believe this is the first report of a patient with this form of myocardial ischemia diagnosed by this method and should be considered in patients with anginal chest pain after significant coronary artery disease and coronary vasospasm have been excluded.

Panic states

Department of Psychiatry, Yale University School of Medicine and Unit, Ribicoff Research Facilities,Connecticut Mental Health Center, New Haven, Connecticut, USA

Five percent carbon dioxide challenge: Valid analogue and marker of panic disorder?

The administration of 5% carbon dioxide (CO 2) to patients with panic disorder (PD) induces a behavioral response similar to a naturally occurring panic attack. This article reviews the literature on the nature and incidence of this response. We conclude that the 5% CO 2 challenge test is a valid and useful laboratory analogue of naturally occurring panic attacks, and shows promise as a marker to identify a subset of PD patients. Though further research on reliability, validity, and dose-response effects must be conducted, the CO 2 challenge test provides important information regarding the phenomenology of panic states.

Panic symptoms in chest pain without coronary artery disease: A comparison with panic disorder

Recent reports have suggested similarities in symptom profiles between patients with persistent chest pain without coronary artery disease (CAD) and patients with panic disorder. However, comparison of chest pain patients with an independent sample of patients presenting with symptoms of panic disorder has been lacking to date. The present study examined three groups of patients for painic symptom presence and severity: a sample with recurrent chest pain (CP, n=22) recruited from cardiologists, screened for normal coronary arteries and not selected a priori for psychiatric diagnoses; a sample of patients with panic disorder (PD, n=26) recruit from psychotherapists; and a sample of normal controls (NC, n=39) recurited from the same community. Compared with normals, both CP and PD patients reported significantly more panic symptoms Both CP and PD patients reported significantly more severe sensations of chest pain, dyspnea, paresthesias, and fear of having a heart attack. The three groups were different on reports of palpitations and dizziness, with the PD group reporting the greatest severity of these symptoms, followed by the CP group. The PD sample alone reported significantly greater severity of all other panic symptomatology, relative to the CP and NC samples. A discriminant function analysis indicated that the three groups could be differentated on the basis of symptom severity. These results suggest that notable differences exist in the nature and severity of symptom reports in these two patient groups, despite similarities between panic states and persistent non-organic chest pain as indicated by prior research.

Response to sodium lactate infusion in alcoholics with panic attacks.

The authors studied the response to sodium lactate infusion of 12 alcoholics with a history of panic attacks, 10 alcoholics without a history of panic attacks, and 16 nonalcoholic patients with panic disorder. The rate of lactate-induced panic was significantly higher in alcoholics with panic attacks than in alcoholics without panic attacks. Alcoholics with panic attacks were similar to nonalcoholic patients with panic disorder in their response to lactate. These findings support the specificity of lactate-induced panic for panic states and suggest that panic attacks in alcoholics resemble those in nonalcoholics. Lactate infusion may prove useful in the diagnosis of panic disorder in alcoholics.

Prevalence, onset, and clinical recognition of panic states in hospitalized male alcoholics.

Alcoholism has been associated with a high prevalence of anxiety and phobic disorders. The authors ascertained the current prevalence of panic disorder and the lifetime prevalence of infrequent panic attacks in 154 male alcoholics in an inpatient alcohol treatment program. Thirteen percent (N = 20) gave a lifetime history of panic attacks and 45% (N = 9) of these had current panic disorder. Panic attacks preceded or coincided with the onset of problem drinking in 50% (N = 9) of the 18 patients with both diagnoses. Only two patients with histories of panic had been previously diagnosed, and none had been treated. Clinical implications of these findings are discussed.

Literature Update: A critical review

Abstract Have We Been Treating the Wrong Partner? KAPLAN, H.S.(1988) Intimacy disorders and sexual panic states, Journal of Sex and Marital Therapy, 14, pp. 3–12.

Intimacy disorders and sexual panic states.

This paper explores the question: Is sexual avoidance a manifestation of intrapsychic barriers to emotional closeness? In some cases it clearly is, but in other cases it is the result of other determinants such as a partner's excessive demands for intimacy and communication and his or her intolerance for even normal emotional distance. Our finding that couples with this dynamic and with sexual aversions have an unusually high prevalence of panic disorder is considered in the light of its clinical implications.

Clinical characteristics and response to sodium lactate of patients with infrequent panic attacks.

Nine patients with panic attacks too infrequent to meet DSM-III criteria for panic disorder were compared to 20 panic disorder patients with respect to clinical characteristics and response to sodium lactate infusion. The two groups showed similar clinical characteristics and response to lactate. The authors conclude that patients with infrequent panic attacks are clinically and biologically similar to those with panic disorder and discuss implications for the diagnosis of panic states.

Mitral Valve Prolapse, Panic States, and Anxiety: A Dilemma in Perspective

The inter-relationship of mitral valve prolapse and psychiatric symptoms as a model for the approach to illness for psychiatrists is considered. The clinical usefulness of the concept of mitral valve prolapse is discussed and placed in perspective to consultation-liaison psychiatry. The special role of an integrative, multidimensional model of all illness is emphasized.

Biological markers in panic states: Lactate-induced panic and mitral valve prolapse

Anxious patients, and more specifically, patients experiencing panic attacks, are thought to have a significant biological component to their illness. This study looks at two promising biological markers associated with this patient population—mitral valve prolapse and lactate-induced panic. We present our findings, which further characterize clinical and biological aspects of these two markers.

Behavioural and combined therapy in panic states

1. 1. This review will focus only on those paradigms for treatment of panic states with agoraphobia. Until recently the behaviour therapy literature has completely ignored panic disorder and has focused exclusively on the agoraphobic aspect of this syndrome. 2. 2. To summarize the behavioural therapy of panic disorder and agoraphobia, it appears that exposure is in the short run the most effective behavioural paradigm in agoraphobia. However, when contrasted with cognitive approaches it does not appear to be as effective in the treatment of panic disorder. 3. 3. In conclusion, it is unclear whether we can speak of antiphobic medications. Certainly studies of imipramine, chlomipramine, monoamine oxidase inhibitors, and alprazolam have demonstrated an anti-panic affect of medications and a subsequent improvement in phobic avoidance. However, when exposure is not made a part of the treatment, there is a much poorer resolution and a tendancy for the patient to relapse.

Psychoanalytic psychotherapy with panic states: A case presentation.

Psychoanalytic psychotherapy with panic states: A case presentation.

Psychoanalytic psychotherapy with panic states: A case presentation.

Psychoanalytic psychotherapy with panic states: A case presentation.

Clinical and biological correlates of panic states

1. 1. Panic states may be a presenting symptom in medical or psychiatric conditions. 2. 2. It is also a discrete diagnostic entity with distinct genetic, clinical and biological profiles. 3. 3. This paper reviews the salient features of the condition and its clinical presentation including its biological characteristics.

Psychoanalytic psychotherapy with panic states: A case presentation.

Psychoanalytic psychotherapy with panic states: A case presentation.