Panic disorder and medical comorbidity: a review of the medical and psychiatric literature.

University of Washington School of Medicine, Seattle 98195, USA.
Bulletin of the Menninger Clinic (Impact Factor: 0.72). 02/1996; 60(2 Suppl A):A12-38.
Source: PubMed

ABSTRACT Epidemiological studies have found significant comorbidity between panic disorder and many medical illnesses. The authors discuss the accumulating psychiatric and medical literature addressing comorbidity between panic disorder and cardiac, respiratory, gastrointestinal, and neurological illnesses. Cardiac symptoms such as chest pain and palpitations, as well as certain disorders such as mitral valve prolapse, hypertension, and cardiomyopathy, share significant comorbidity with panic disorder. Researchers have also shown significant comorbidity between panic disorder and chronic obstructive pulmonary disease, irritable bowel syndrome, and migraine headache. Pathophysiological mechanisms that may explain the association between panic disorder and comorbid medical illnesses, such as autonomic dysregulation of cardiac activity and smooth muscle tone and dynamic abnormalities of the coronary microvasculature, are discussed as well.

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    ABSTRACT: Introduction: Cerebrovascular disease is a major public health problem and common cause of neuropsychiatric disorders in the medically ill. Vascular lesions in the Central Nervous System cause signifi cant morbidity, usually followed by severe cognitive dysfunctions which become an important risk factor for developing psychopathology during the course of cerebrovascular disorders. Objective: To describe neuropsychiatric disorders affecting people with stroke other than post-stroke depression, as this will be reviewed extensively elsewhere. Method: Review of medical literature. Conclusions: Research on the neurobiology of mental disorders based on vascular theories to explain the etiology and physiopathology of some mental disorders has not come up with consistent results linking structural and functional studies with clinical correlates of neuropsychiatric syndromes. Implicit mechanisms responsible for the blend between systemic disease, neurological disorders and psychiatry are still poorly understood by the scientifi c community responsible for the treatment of cerebrovascular patients. Most studies are limited to case reports and series in severely ill patients leaving out those patients with mild to moderate stroke. These subjects are known to be at risk for neuropsychiatric disorders involving movement and cognitive symptoms such as Parkinson’s, dementia and delirium.
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