Biomedical subjects

A J Fyer

Publications and source records attributed to A J Fyer.

95 records · Page 6Linked to original sources

PubMed1982

The treatment of sexual phobias: the combined use of antipanic medication and sex therapy.

During the past 20 years, there has been described a group of profoundly anxious and phobic patients, who are not amenable to psychological forms of treatment or to the major and the minor tranquilizers, but who respond dramatically to tricyclic and MAO inhibitor medication. The separation of this drug-responsive syndrome from other anxiety disorders constitutes a major advance in psychiatry. This paper discusses the implications of these findings for the treatment of psychosexual disorders. To illustrate the hypotheses and discussion, the case histories of three patients with sexual phobias are described. All had been treatment failures with sex therapy and psychotherapy but responded to a combination of tricyclic medication and sex therapy which was modified to accommodate the special needs of sexually phobic patients.

Adult↗

PubMed1981

Treatment of panic disorder.

In this article we present a 2-yr treatment experience of 14 patients with panic disorder. An approach that utilizes both psychopharmacological and psychodynamically oriented psychotherapy is described. Specific methods of using medication, types and structure of psychotherapeutic interventions, typical response patterns, and reasons for treatment successes and failures are discussed. Our intent is to provide a basis upon which other clinicians may formulate their own treatment approach.

Adult↗

PubMedDate not supplied

Familial transmission of panic disorder: effect of major depression comorbidity.

This study assesses the effect of major depressive disorder (MDD) comorbidity on familial transmission of panic disorder (PD). The following questions are addressed: (1) is PD familial, i.e., do relatives of patients with PD show an increased risk for PD? (2) do PD and MDD share a common diathesis, i.e., do relatives of patients with PD without MDD show an increased risk for MDD? (3) is lifetime comorbid PD with MDD conjointly familial, i.e., do relatives of patients with PD and MDD show an increased risk for the combined syndrome? Subjects were: (1) 152 relatives of 54 anxiety clinic patients with PD and MDD; (2) 193 relatives of 72 patients with PD without MDD; (3) 231 relatives of 77 not ill controls. Relatives were interviewed by clinicians, and best estimate DSM-III-R diagnoses were formulated by senior staff. Relatives of PD with MDD (13%) and PD without MDD probands (9%) showed significantly higher rates of PD than relatives of controls (3%). Relatives of PD with MDD probands (37%) showed significantly higher rates of MDD than relatives of PD without MDD (24%) and controls (21%), with no difference between the latter two groups. Relatives of PD with MDD probands (9%) showed significantly higher rates of PD with MDD than relatives of PD without MDD (3%) and controls (1%). We conclude that: (1) PD is familial; (2) PD in the absence of MDD does not incur increased risk of MDD to relatives; and (3) PD with MDD may represent a distinct, complex syndrome.

Adolescent↗

PubMedDate not supplied

The relationship of social phobia subtypes and avoidant personality disorder.

The diagnoses of social phobia (SP) and avoidant personality disorder (APD) have evolved from different historical sources, but their criteria appear to converge in DSM-III-R. Fifty anxiety disorder clinic patients with DSM-III-R SP were evaluated for presence of DSM-III-R APD. APD was present in 89% of those with the generalized subtype of SP (GSP) and 21% of those with the discrete subtype of SP (DSP). The findings are discussed in conjunction with other recent reports showing substantial overlap between GSP and APD.

Adult↗

PubMedDate not supplied

The mitral valve prolapse--panic disorder connection.

Whether mitral valve prolapse (MVP) is more common in patients with panic disorder (PD) and agoraphobia with panic attacks (AgP) than in the normal population is controversial. A related issue is whether the presence of MVP in such patients has any clinical or biological significance. Echocardiograms were performed on 36 patients with PD/AgP and 22 normal controls. MVP was found to be more common in PD/AgP patients than in normal controls. However, MVP in the patients was mild and not associated with thickened mitral leaflets or small left ventricular size. Moderate or severe prolapse was uncommon in both groups. Patients with MVP had trends to higher heart rate and prolonged QTc interval on EKG, and reported more respiratory difficulty during panic attacks compared to patients without MVP. Lactate infusion did not affect patients with MVP differently than patients without MVP. The authors conclude that MVP is more common in patients with PD or AgP than in normal controls, but is of doubtful clinical significance.

Adult↗