Factors associated with panic attacks in nonclinical subjects
ABSTRACT The purpose of this study was to (a) compare people who experienced recent panic attacks (panickers) with nonpanickers and (b) determine, the factors associated with panic attacks in nonclinical subjects. Two hundred and fifty-six students completed the Panic Attack Questionnaire (PAQ), the State-Trait Anxiety Inventory (STAI), the Beck Depression, Inventory (BDI), the Profile of Mood States (POMS), and two measures of fear/avoidance. Over 22% of the subjects reported one or more panic attacks in the 3 weeks, prior to testing. Comparisons of panickers and nonpanickers showed that panickers (a) scored higher on measures of anxiety, depression, etc., and (b) reported more first-order relatives who have panic attacks. The panic attacks were characterized by (a) having a sudden onset, (b) an average of eight DSM-III symptoms, and (c) occurring in a wide variety of situations (especially social situations). Subjects who experienced unpredictable panic attacks differed, on several measures from subjects with only predictable attacks. Finally, panickers reported experiencing several symptoms not included in DSM-III. Similarities, between panickers and patients with Panic Disorder and Agoraphobia and the assessment of panic-related, disorders are discussed.
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ABSTRACT: The frequency of symptoms during panic attacks and anticipation of the panic consequences were compared in patients with the subtypes of panic disorder (PD). Patients with moderate and severe agoraphobic avoidance reported that they had experienced more symptoms than patients with an uncomplicated PD (without agoraphobia [AG]); they also experienced almost all of the symptoms more frequently, with the difference being significant for a quarter of the examined panic symptoms. Panic patients with moderate and severe AG were also significantly more concerned about the loss of control and social and physical consequences of panic attacks. Taken together, these findings suggest that the severity of panic attacks, defined as the number of panic symptoms, along with a variety of anticipatory fears about the consequences of the attacks may contribute to the development of AG in panic patients.Comprehensive Psychiatry.
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ABSTRACT: Nocturnal panic (NP), waking from sleep in a state of panic, is a common occurrence among patients with panic disorder, with 44-71% reporting at least one such attack. NP is a non-REM event that is distinct from sleep terrors, sleep apnea, nightmares or dream-induced arousals. This review outlines recent advances in the characterization of NP, as well as current approaches to the assessment and treatment of NP. In contrast to earlier work, more recent studies suggest that patients with NP do not differ from patients without NP on sleep architecture, sleep physiology, self-reported sleep quality and severity of panic disorder. However, more precise measurement of physiological precipitants and features is warranted. Assessment of NP focuses on ruling out other explanations for NP, with differential diagnosis based on interviews, sleep polysomnography and ambulatory recording of sleep. Psychological treatment (cognitive-behavioral therapy) targets misappraisals of anxiety sensations, hyperventilatory response, and conditioned reactions to internal, physical cues. Recent evidence supports the efficacy of this approach, however, controlled studies on pharmacological agents in the treatment of NP are lacking. Research is needed to examine the effects of combined cognitive-behavioral therapy and medications, compared to medication alone in the treatment of NP.Sleep Medicine Reviews 07/2005; 9(3):173-84. · 6.93 Impact Factor
Article: Prevalence and presentation of dizziness in a general practice community sample of working age people.[show abstract] [hide abstract]
ABSTRACT: Dizziness is known to be a common, handicapping condition in the elderly, and a strong association between dizziness and anxiety disorders has been observed in hospital samples. However, little is known about the prevalence of dizziness among people of working age in the community and its implications for psychosocial functioning and general practice consultation and treatment. To determine the prevalence of dizziness, giddiness, vertigo, and unsteadiness, and associations with disability and handicap, symptoms of panic and agoraphobia, and general practice consultation and treatment. Postal questionnaires were completed by 2064 people aged 18-64 years randomly sampled from the patient lists of four London practices. Validated survey items were used to assess symptoms, panic and agoraphobia, levels of occupational disability and handicap, and general practice consultation and treatment. More than one in five responders (n = 480) had experienced dizziness during the past month; nearly half of these (n = 225) reported some degree of handicap and 30% had been dizzy for more than five years. Almost half (n = 221) of those with dizziness also reported anxiety and/or avoidance behaviour. Multiple physical and psychological symptoms were associated with higher levels of handicap. Only one in four of the 225 dizzy responders reporting some degree of handicap had received any form of treatment. Dizziness is a common, chronic, and often untreated symptom in people aged 18-65 years, associated with extensive handicap and psychological morbidity.British Journal of General Practice 05/1998; 48(429):1131-5. · 1.83 Impact Factor