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A pragmatic, unblinded randomised controlled trial comparing an occupational therapy-led lifestyle approach and routine GP care for panic disorder treatment in primary care.

BACKGROUND: Treated anxiety increased in the UK by over 30% since 1994. Medication and psychological treatment is most common, but outcomes are sometimes poor, with high relapse rates. Lifestyle has a potential role in treatment, but is not considered in clinical guidelines. Panic disorder is potentially influenced by lifestyle factors. METHODS: 16 week unblinded pragmatic randomised controlled trial in 15 East of England primary care practices (2 Primary Care Trusts). Participants met DSM-IV criteria for panic disorder with/without agoraphobia. Follow-up at 20 weeks and 10 months. Control ar…

The epidemiology of blood-injection-injury phobia.

BACKGROUND: We report the prevalence, clinical characteristics, frequency of mental health treatment, demographic correlates, frequency of c … luding marijuana abuse/dependence, major depression, obsessive-compulsive disorder, panic disorder, agoraphobia, social phobia and other simple phobia. Cases and non-cases did not differ with regard to usual health-care settings, regular care for specific medical conditions, numbers of out-patient visits or hospitalizations, or previous general anaesthesia or …

Benzodiazepines versus placebo for panic disorder in adults.

BACKGROUND: Panic disorder is characterised by recurrent unexpected panic attacks consisting of a wave of intense fear that reaches a peak w … acceptability of benzodiazepines versus placebo in the treatment of panic disorder with or without agoraphobia in adults. SEARCH METHODS: We searched the Cochrane Common Mental Disorders Controlled Trials Register (CCMDCTR Studies and References), the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1950-), Embase (1974-), and PsycINFO (19 …

[Subjective memory complaints in young adults: the influence of the emotional state].

INTRODUCTION. Many young people today display memory complaints that are not linked to their real cognitive performance. A number of studies have sought to identify the factors involved in this problem, such as anxious-depressive symptoms, the variables of anxiety traditionally being measured as somatic or cognitive manifestations with an activation that is unspecific or not linked to any particular stimulus. AIMS. To perform an exploratory analysis to determine the role played by symptoms of depression and of various subtypes of specific and unspecific anxiety in memory complaints in young ad

A comparison of the effects of citalopram and moclobemide on resting brain perfusion in social anxiety disorder.

INTRODUCTION: The serotonin specific reuptake inhibitor (SSRI) citalopram and the reversible mono-amine oxidase-A inhibitor (RIMA) moclobemide have both been used successfully for the treatment of social anxiety disorder (SAD). In this study we investigate the effects of these compounds on resting brain function using single photon emission computed tomography (SPECT). METHODS: Subjects meeting DSM-IV criteria for SAD underwent regional cerebral blood flow (rCBF) SPECT using Tc-HMPAO at baseline and after 8 weeks of treatment with either citalopram or moclobemide. Using statistical parametric

Effect of short-term SSRI treatment on cognitive bias in generalised anxiety disorder.

RATIONALE: There is considerable evidence showing that individuals with generalised anxiety disorder (GAD) selectively process threat-related information, e.g. they have a bias to interpret ambiguous information in a threat-related manner. Cognitive theories of anxiety, which provide the basis of cognitive-behaviour therapy, propose that such processing biases play an important role in causing and maintaining anxiety. OBJECTIVES: Given that treatment with selective serotonin re-uptake inhibitors (SSRIs) appears to be effective for GAD, we examined whether it is successful in removing cognitiv

Heart rate variability as predictor of nonresponse to mirtazapine in panic disorder: a preliminary study.

Using spectral analysis of heart rate, several studies have shown that panic disorder patients are characterized by a reduced heart rate variability (HRV), indicative of abnormalities in autonomous nervous system (ANS) function. We recently reported that patients with panic disorder, who did not respond to pharmacotherapy, were characterized at baseline by a higher heart rate. In this study, ANS functioning is investigated as a possible predictor of nonresponse to pharmacotherapy. Twenty-eight medication-free panic disorder patients entered a 12-week open-label treatment study with mirtazapine

Fear, anxiety and perceived control in children of agoraphobic parents.

Sixteen children (M = 11 years) of agoraphobic parents were compared with 16 children of parents with no history of psychopathology, matched on age, gender and socioeconomic status. The majority (68%) of children of agoraphobic parents met DSM-III-R diagnostic criteria, anxiety disorders being most common. They reported more fear and anxiety and less control over various risks than did comparison children. Group's perceptions of the prevalence and their vulnerability to these risks did not differ. Agoraphobic mothers reported more separation anxiety than did comparison mothers, and maternal se

Validation of the spanish version of the Anxiety Sensitivity Index in a clinical sample.

In this study we validated the Spanish version of the Anxiety Sensitivity Index (ASI) in a sample of anxiety disordered patients. The results revealed that: (1) ASI scores were higher for anxiety disordered patients than for normal control subjects, and higher for patients with panic disorder (PD) than for patients with other anxiety disorders (OAD). In contrast, there were no differences among the groups on the Cognitive-Somatic Anxiety Questionnaire (CSAQ). (2) Using discriminant analysis, we were able to differentiate PD patients from patients with OAD on the ASI, but not on the CSAQ. (3) R

Expectations about arousal and nocturnal panic.

Expectations about arousal were examined in relation to nocturnal panic (NP). Eighteen panic disorder patients suffering from NP attacks and 18 control individuals were assigned randomly to conditions in which they were informed that audio feedback signals reflected heightened arousal that was either (a) expected and harmless or (b) unexpected. Participants relaxed and slept for 45 to 60 min, followed by presentation of periodic audio feedback signals. Physiological recording was continuous while subjective measures were collected at completion of the signals phase. NP patients in the unexpect

Social adjustment in panic-agoraphobic patients reconsidered.

Forty-eight depressed panic-agoraphobic patients--clinically matched for severity of depression with 35 primary chronic depressives--had significantly better adjustment in most areas of social functioning, especially those related to interpersonal contact, work, leisure activities, and sexual life. Even when depressed, panic-agoraphobic patients appear to possess sufficient interpersonal skills--that is, by learning on significant others--to engage in a range of social activities, both at home and beyond. These data, which are open to different interpretations, nonetheless suggest that anxiety

Childhood history of anxiety in adults with panic disorder: association with anxiety sensitivity and comorbidity.

Converging lines of evidence indicate a nonspecific link between childhood anxiety disorders and adult panic disorder. Anxiety sensitivity, defined as the fear of anxiety symptoms, was hypothesized to be a potential mediating variable in this link. This study examined the association among childhood history of anxiety disorders, current anxiety symptoms, and anxiety sensitivity in a sample of 100 patients with panic disorder undergoing treatment. Fifty-five percent of the patients had histories of one or more childhood anxiety disorders. Despite the heterogeneity of symptoms and treatment inte

[The "anxiety" ambulatory clinic: development and outlook].

The study herewith represents the conception of the Bonn "anxiety"-ambulance, which was established in the University of Bonn, Department of Psychiatry, in January 1991. Besides we report our experiences from the first four months after opening of our ambulance and present first results.

Serotonin-influencing drugs in the treatment of panic disorder.

Clinical and preclinical data suggest a link between serotonin [5-hydroxytryptamine (5-HT)] function and certain psychopathologic dimensions of anxiety disorders. Antidepressants consistently have been found to exert a favorable effect in anxiety disorders, particularly panic disorders. Clinical studies with 5-HT-selective drugs have shown that 5-HT neurons may comprise the site at which anxiolytic drugs exert a significant proportion of their action. Thus, fluvoxamine, a selective 5-HT uptake inhibitor, but not maprotiline, a selective noradrenaline uptake inhibitor, was found to be efficacio

An Operationalized Multisymptomatic Model of Neuroses (OMMON): toward a reintegration of diagnosis and treatment in behaviour therapy.

Experimental results from a sample of 216 patients with four different "symptom-neuroses" show that 65% to 90% of these patients have different combinations of multiple symptomatology. With a background of these data, we present an Operationalized Multisymptomatic Model of Neuroses (OMMON), based on self-rating assessment of these patients on 4 symptom scales. Individual ratings on each scale are dichotomized into (+) or (-) results with regard to defined cut-off points and the model is derived from their 16 mathematically possible combinations. Subsequent analysis of these data (from a single

Increased plasma catecholamine levels in patients with symptomatic mitral valve prolapse.

Total plasma catecholamine levels, plasma norepinephrine levels, heart rate, and systolic and diastolic pressures were measured in 15 symptomatic patients with mitral valve prolapse and in 19 normal subjects in supine baseline conditions and in a standing position. In the 15 symptomatic patients, total plasma catecholamine levels and plasma norepinephrine levels were significantly elevated in both positions, and heart rate was lower than in normal subjects in the supine position but returned to normal in the upright position. Thus, symptomatic patients with mitral valve prolapse demonstrate in

The classification of anxiety and hysterical states. Part I. Historical review and empirical delineation.

The history of the classification of anxiety, hysterical, and hypochondriacal disorders is reviewed. Problems in the ability of current classification schemes to predict, control, and describe the relationship between the symptoms and other phenomena are outlined. Existing classification schemes failed the first test of a good classification model--that of providing categories that are mutually exclusive. The independence of these diagnostic categories from each other does not appear to hold up on empirical testing. In the absence of inherently mutually exclusive categories, further empirical

Anxiety in the Medically Ill: A Systematic Review of the Literature.

BackgroundAlthough anxiety is highly represented in the medically ill and its occurrence has relevant clinical implications, it often remains undetected and not properly treated. This systematic review aimed to report on anxiety, either symptom or disorder, in patients who suffer from a medical illness.MethodsEnglish-language papers reporting on anxiety in medically ill adults were evaluated. PubMed, PsycINFO, Web of Science, and Cochrane databases were systematically searched from inception to June 2021. Search term was "anxiety" combined using the Boolean "AND" operator with "medically ill/c

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… Among patients with systemic arterial hypertension, 36% had a DSM-IV anxiety disorder: 22.4% GAD, 4% specific phobia, 3.2% agoraphobia, 2.4% PD, 1.6% PD with agoraphobia, 1.6% social phobia (Rafanelli et al., 2012 * ). … The combined prevalence rate for PD with or without agoraphobia was 8% (Karajgi et al., 1990 * ) while the prevalence of GAD and PD was 5.9% (Chan et al., 2009 * ), of GAD 7.3%, of PD 12.7%, of agoraphobia 7.3%, and of social anxiety 1.8% (Cheung et al., 2012 * ). …

Severity of panic disorder, adverse events in childhood, dissociation, self-stigma and comorbid personality disorders Part 2: Therapeutic effectiveness of a combined cognitive behavioural therapy and pharmacotherapy in treatment-resistant inpatients.

OBJECTIVES: A combination of antidepressants with the cognitive-behavioural therapy showed effectiveness in treatment-resistant patients wit … egree of general anxiety and depression and the severity of specific symptoms of panic disorder and agoraphobia. The rate of improvement was negatively related to sexual abuse in childhood, presence of comorbid personality disorder, and positively with the severity of the disorder at the beginning, and the level of self-stigma at the beginning of treatment. I …