Panic disorder is characterized by recurrent anxiety attacks in the absence of a frightening stimulus. It is a common disorder, affecting 2-5% of the general population and 10-14% of patients seen in cardiology practice. Infusion of sodium (DL)lactate precipitates an anxiety attack in most persons with this disorder but rarely does so in normal controls, suggesting a neurobiological basis for the problem. Despite this observation, the pathophysiology of panic disorder remains unknown. We have now used positron emission tomography to measure cerebral blood flow (CBF) in patients with panic disorder in the absence of a panic attack. Analysis of CBF in regions thought to mediate symptoms of panic, anxiety and vigilance reveals a significant (P less than 0.005) abnormal asymmetry of CBF (left less than right) located in a region of the parahippocampal gyrus. This asymmetry was present in seven patients with panic disorder and a positive response to lactate infusion but was absent in six normal controls and in three patients with panic disorder associated with a negative response to lactate. We believe this to be the first study to identify a discrete brain abnormality in patients with this severe form of anxiety.

Anxiety Disorders↗

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Enhancing the educational benefits of collaborative research.

Careful planning for student involvement in collaborative research will greatly enhance the potential for teaching and learning. Active participation by students as contributing members of the research team results in an increased understanding of the research process and of content related to the research question. Students also profit from the teamwork involved. The authors offer practical suggestions for maximizing student involvement at each stage of the research project.

Education, Nursing, Baccalaureate↗

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[Diagnostic criteria for psychiatric research: RDC (Research Diagnostic Criteria). French translation and adaptation by M. Ansseau].

This article represents the French translation of the Research Diagnostic Criteria, a set of operational criteria for 24 psychiatric disorders developed by researchers at the New York State Psychiatric Institute and Columbia University (New York) to permit the selection of homogeneous samples of patients presenting with a defined psychiatric illness. The Research Diagnostic Criteria are especially focussed on depressive disorders, defining the major depressive disorder, which comprises 10 non exclusive subtypes. These criteria currently represent the most widely used nosologic system for clinical research in psychiatry, allowing for comparison of results and facilitation of replication by different research teams.

Affective Disorders, Psychotic↗