Psychological features in panic disorder: a comparison with major depression.

OBJECTIVE

We aim to evaluate the psychodynamic model for panic disorder (PD) formulated by Shear et al. (1993), comparing PD patients and major depression (MD) patients.

METHOD: We evaluated these parameters in open interviews in 10 PD patients and 10 patients with MD (DSM-IV). The data were recorded on videotape and were examined by 5 diagnostic blind appraisers.

RESULTS

The data allowed a comparative analysis that underscores the existence of a psychological model for PD vs MD: 1) the protracted symbiotic phase of development and the existence of problems with separation in PD patients; 2) patients with MD tended to have a particularly negative impression of relationship with the first objects; furthermore, they had remarkable experiences of loss; and 3) while the PD patients tended to be shy and inhibited in childhood, especially showing a clear difficulty in expressing aggressiveness, the depressed patients tended to disclose an impulsive aggressiveness from infancy to adulthood.

CONCLUSION

Exposure to parental behaviours that augment fearfulness may result in disturbances in object relations and persistence of conflicts between dependence and independence may predispose to anxiety symptoms and fears of PD.