Quality of life in panic disorder
Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia, University NY 10032. Archives of General Psychiatry
(Impact Factor: 14.48).
Data from the Epidemiologic Catchment Area study showed that a lifetime Diagnostic Interview Schedule/DSM-III diagnosis of panic disorder was associated with pervasive social and health consequences similar to or greater than those associated with major depression. These consequences included subjective feelings of poor physical and emotional health, alcohol and other drug abuse, increased likelihood of suicide attempts, impaired social and marital functioning, financial dependency, and increased use of psychoactive medications, health services, and the hospital emergency department for emotional problems. Comorbidity of panic disorder with major depression, agoraphobia, and alcohol or other drug abuse did not explain these findings. The social and health consequences of panic disorder (quality of life) should be considered, as risks and benefits of currently available acute and maintenance treatments are evaluated. Clinical trials of panic disorder, whether of drugs or behavioral treatment, should include quality of life assessments as outcome measures. Long-term prospective studies based on clinical samples of patients with panic disorder are indicated to relate the illness more precisely to social morbidity.
Available from: Michael Schatman
- "When complicated by agoraphobia, which occurs in 21.6% of cases of panic disorder (Kessler et al. 2006) and 32.6% of all individuals experiencing panic attacks (Goodwin et al. 2002), the malady becomes even more disabling (Kessler et al. 2006). While minimally investigated , the available literature supports a relationship between panic disorder and marital discord (Markowitz et al. 1989; McLeod 1994), although a thorough review of the literature fails to yield any investigations of the relationship between panic disorder and relationships with one's children. However, numerous studies have indicated that panic disorder predisposes sufferers to substance abuse (e.g., Arch et al. 2006; Martins et al. 2009; Robinson et al. 2009), with reviews (Allan 1995; Kushner et al. 2000) suggesting that such substance abuse represents an effort at self-medication. "
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ABSTRACT: Approximately half of the state legislatures in the USA have enacted tort reform, generally focused on reducing noneconomic
damages such as those awarded for pain and suffering of traumatically injured parties. Traumatic injury has been empirically
associated with the development of chronic pain, which in turn has been associated with the concept of human suffering. This
analysis examines the meaning of suffering within the context of traumatically induced chronic pain, recognizing that this
population is at heightened risk of experiencing long-term emotional as well as physical pain. Factors contributing to profound
suffering include the potential development of post-traumatic stress disorder, depression and anxiety, role/identity loss,
maltreatment by a medical system generally inept in its management of chronic pain, and the negative manner in which personal
injury victims are often treated by the legal system. While the American medical system struggles to identify suffering, the
legal system—through tort reform—has chosen to simply ignore it, demonstrating little concern for the integrity of the vulnerable
chronic pain sufferer. In doing so, the “destructed” chronic painient is further “deconstructed”. We argue that by limiting
the size of settlements and jury awards, tort reform serves to potentially deny personal injury victims of a critical vehicle
for finding meaning in their suffering, and accordingly limits their likelihood of achieving relief.
KeywordsTraumatic injury chronic pain-Suffering-Tort reform-PTSD-Depression-Anxiety
Available from: Mariko Makino
- "Katon and colleagues reconfirmed that 6.7% of primary care patients meet the diagnostic criteria for panic disorder (PD) . It is also reported that 28% of PD patients consult emergency rooms (ER) . The lifetime prevalence of PD is 0.4% in Taiwan . "
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ABSTRACT: Since the 1980s, a high EEG abnormality rate has been reported for patients with panic disorder. However, how the EEG abnormalities of panic disorder patients are related to the clinical features and pathology of these patients has yet to be clarified. In this study we investigated whether or not EEG abnormalities are related to the 13 symptoms in the DSM-IV criteria for a diagnosis of panic attacks.
Subjects were 70 patients diagnosed with panic disorder.Logistic regression analysis was performed with EEG findings as dependent variables and age, sex and with or without the 13 symptoms as independent variables.
(1)EEG findings for panic disorder patients with EEG abnormalities: Of the 17 patients, 13 had repeated slow waves in the θ-band; the most prevalent EEG abnormality found in this study. Paroxysmal abnormality interpreted as epileptiform was found in only two cases. (2)Nausea or abdominal distress (37.7% vs 82.45%, OR-12.5), derealization or depersonalization (7.5% vs 47.1%, OR = 13.9,) and paresthesias (43.4% vs 64.7%, OR = 7.9,) were extracted by multivariate analysis as factors related to EEG abnormalities.
Of the 70 patients studied, 17 had EEG abnormalities. Among these 17 cases, "repeated slow waves in the θ-band" was the most common abnormality. The factors identified as being related to EEG abnormalities are nausea or abdominal distress, derealization or depersonalization, and paresthesias. The study indicated that physiological predispositions are closely related to panic attacks.
Available from: uthscsa.edu
- "These rates of anxiety disorder are quite elevated compared to general epidemiologic studies which estimate about 28.8% lifetime prevalence [Kessler and Wang, 2008]. As anxiety disorders can be quite disabling and can prevent adaptation to school, work, and relationships [Markowitz et al., 1989; Kessler and Frank, 1997], it therefore behooves physicians treating persons with these chromosomal "
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ABSTRACT: Chromosome 18 abnormalities are associated with a range of physical abnormalities such as short stature and hearing impairments. Psychiatric manifestations have also been observed. This study focuses on the presentations of psychiatric syndromes as they relate to specific chromosomal abnormalities of chromosome 18. Twenty-five subjects (13 with an 18q deletion, 9 with 18p tetrasomy, and 3 with an 18p deletion), were interviewed by psychiatrists (blind to specific chromosomal abnormality) using the DIGS (subjects 18 and older) or KSADS-PL (subjects under 18). A consensus best estimation diagnostic process was employed to determine psychiatric syndromes. Oligonucleotide Array Comparative Genomic Hybridization (Agilent Technologies) was utilized to define specific regions of chromosome 18 that were deleted or duplicated. These data were further analyzed to determine critical regions of the chromosome as they relate to phenotypic manifestations in these subjects. 58.3% of the chromosome 18q- deletion subjects had depressive symptoms, 58.3% had anxiety symptoms, 25% had manic symptoms, and 25% had psychotic symptoms. 66.6% of the chromosome 18p- deletion subjects had anxiety symptoms, and none had depressive, manic, or psychotic symptoms. Fifty percent of the chromosome 18p tetrasomy subjects had anxiety symptoms, 12.5% had psychotic symptoms, and 12.5% had a mood disorder. All three chromosomal disorders were associated with high anxiety rates. Psychotic, manic and depressive disorders were seen mostly in 18q- subjects and this may be helpful in narrowing regions for candidate genes for these psychiatric conditions.
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