Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Panic”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources
PubMed1995

Assessing the efficacy of treatments for panic disorder and agoraphobia. II. The Panic and Agoraphobia Scale.

Despite the plethora of rating scales for anxiety disorders and agoraphobia, a qualified scale for assessing the severity of panic disorder and agoraphobia (PDA) is still lacking. The new Panic and Agoraphobia Scale (P&A) is presented in this paper. It was developed to assess the degree of severity of these disorders after a diagnosis has been made according to the criteria of the DSM-III-R/IV or the ICD-10. The P&A was specially developed for use in clinical drug trials. Factors which impair the quality of life in panic disorder and agoraphobia patients (panic attacks, phobic avoidance, anticipatory anxiety, impairment in social relationships and work, assumption of somatic disease) were considered in the development of this scale so that the efficacy of a certain drug therapy on each of these factors can be assessed separately. Both an observer rating and a self-rating with matching items are available. The observer rating only takes about 10 minutes to complete. Translation into many European languages is planned so that it can be used in multicentre trials. Satisfactory results of item analysis, inter-rater reliability, objectivity, external validity and factor structure are presented. The P&A should be a useful tool for assessing the severity of PDA and may solve some of the methodological problems that have arisen in former PDA studies.

Adult↗
PubMed1994

Panic, agoraphobia, and panic disorder with agoraphobia. Data from a multicenter anxiety disorders study.

In a cross-sectional investigation of the properties of DSM-III-R panic disorder (PD), panic disorder with agoraphobia (PDA), and agoraphobia without history of panic disorder (AWOPD), we analyzed demographic, descriptive, comorbidity, treatment, and course data for 562 subjects with PD, PDA, or AWOPD in a multicenter anxiety-disorders study. In general, AWOPD subjects had the worst functioning and PD subjects the best, as measured by length of intake episodes, education attained, likelihood of receiving financial assistance, depressive comorbidity, and likelihood of having experienced 8 weeks symptom-free. Panic disorder with agoraphobia was the most common disorder and emerged as a condition intermediate in severity between the other two. Treatments received varied little by diagnosis. Most subjects received medication, usually benzodiazepines. Psychodynamic psychotherapy was the most frequently received psychosocial treatment; cognitive and behavioral approaches were less common. Subjects classified with AWOPD were the most likely to have received exposure therapies.

Adult↗
PubMed1991

The Panic-Associated Symptom Scale: measuring the severity of panic disorder.

The Panic-Associated Symptom Scale (PASS) is presented as a new measurement of the severity of the core symptoms of panic disorder. This first description addresses the rationale for its design and its scoring, score distributions, test-retest reliability, correlations within the PASS and with other scales, principal component structure, and response to drug therapy. Data are presented from a large study group of patients with panic disorder (n = 1168). Problems in measuring panic disorder are discussed.

Adult↗
PubMed1997

A comparison of paroxetine, clomipramine and placebo in the treatment of panic disorder. Collaborative Paroxetine Panic Study Investigators.

The aim of this 12-week, double-blind, parallel group, placebo-controlled study was to compare paroxetine with clomipramine in 367 patients with DSM-III-R defined panic disorder. Efficacy assessments included the daily panic attack diary, the Clinical Global Impression Scale, the Hamilton Anxiety Rating Scale, the Marks Sheehan Phobia Scale and the Sheehan Disability Scale. Paroxetine produced significant improvements compared with placebo in various measurements of panic attack frequency, and was as effective as clomipramine. However, paroxetine appeared to have a more rapid onset of action than clomipramine in reducing the number of panic attacks to zero. There was an equivalent improvement with both paroxetine and clomipramine in the supportive efficacy variables which assessed associated aspects of therapeutic improvement. Significantly more adverse effects were reported in the clomipramine group compared with the paroxetine group, while there was no difference between the paroxetine and placebo groups.

Adolescent↗
PubMed1989

Panic response to lactate administration in alcoholic and nonalcoholic patients with panic disorder.

The authors administered lactate to 12 abstinent alcoholics with panic disorder, 10 nonalcoholic patients with panic disorder, and eight control subjects. They found that the alcoholic patients had fewer panic attacks in response to lactate infusion than the nonalcoholic patients. This finding was not attributable to differences in baseline anxiety or the change in plasma chemical values brought about by sodium lactate administration. The authors suggest that there may be subgroups of patients with panic disorder who need further characterization to meaningfully elucidate the pathophysiology of the disorder.

Adult↗
PubMed2002

Responses to panic induction procedures in subjects with multiple chemical sensitivity/idiopathic environmental intolerance: understanding the relationship with panic disorder.

Idiopathic environmental intolerance (IEI), also known as multiple chemical sensitivity, is a clinical description for a cluster of symptoms of unknown etiology that have been attributed by patients to multiple environmental exposures when other medical explanations have been excluded. Because allergy has not been clearly demonstrated and current toxicological paradigms for exposure-symptom relationships do not readily accommodate IEI, psychogenic theories have been the focus of a number of investigations. A significantly higher lifetime prevalence of major depression, mood disorders, anxiety disorders, and somatization disorder has been reported among patients with environmental illness compared with that in controls. Symptoms often include anxiety, lightheadedness, impaired mentation, poor coordination, breathlessness (without wheezing), tremor, and abdominal discomfort. Responses to intravenous sodium lactate challenge or single-breath inhalation of 35% carbon dioxide versus a similar breath inhalation of clean air have shown a greater frequency of panic responses in subjects with IEI than in control subjects, although such responses did not occur in all subjects. Preliminary genetic findings suggest an increased frequency of a common genotype with panic disorder patients. The panic responses in a significant proportion of IEI patients opens a therapeutic window of opportunity. Patients in whom panic responses may at least be a contributing factor to their symptoms might be responsive to intervention with psychotherapy to enable their desensitization or deconditioning of responses to odors and other triggers, and/or may be helped by anxiolytic medications, relaxation training, and counseling for stress management.

Administration, Inhalation↗
PubMed2005

[Panic attacks and panic disorder: recognition and treatment].

To recognize and treat panic attacks or a panic disorder are still an important function of the family doctor. For a one-time panic attack, specific counseling is normally sufficient. A panic disorder should be treated early with drugs and/or with psychotherapy and, in particular, with behavioral therapy. It is also recommended that a psychiatric specialist or a neurologist be consulted and to coordinate the differential diagnostics and therapeutic procedure with the specialist.

Adult↗
PubMed1986

Effect of alprazolam and diazepam on anxiety and panic attacks in panic disorder: a controlled study.

Forty-eight patients currently experiencing panic attacks were randomly assigned to double-blind treatment with alprazolam, diazepam, or placebo. Efficacy was assessed using the Hamilton Rating Scale for Anxiety and a panic attack frequency rating scale. Results indicate that the two active treatments appeared equally effective in reducing both the frequency of panic attacks and the severity of generalized anxiety when compared with placebo. Overall, these data support the use of benzodiazepines in the treatment of panic disorder.

Adult↗
PubMed1988

Nortriptyline in the treatment of panic disorder and agoraphobia with panic attacks.

Thirty-four consecutive patients with panic disorder or agoraphobia with panic attacks were treated with nortriptyline at the LAC-USC Medical Center's Anxiety Disorders Clinic. Fourteen (67%) of the 21 completers totally lost their panic attacks, five (24%) showed partial improvement, and two (10%) showed no improvement. The relationship of treatment outcome to pretreatment and posttreatment measures of depression is discussed, in addition to the potential role of nortriptyline in treating panic attacks in clinical practice.

Adult↗
PubMedDate not supplied

Is panic attack a mask of psychogenic seizures?--a comparative analysis of phenomenology of psychogenic seizures and panic attacks.

The absence of clear clinical criteria for diagnosing psychogenic seizures and the abundance of vegetative symptoms in their structure raise the question of how to differentiate these states from panic attacks (PA). Clinical symptoms of paroxysm were compared in a group of 32 patients with PA and in a group of 15 patients with psychogenic seizures. It was found that the symptoms classified as panic ones according to DSM-III R criteria are equally observed in both groups. These states are differentiated only by the symptom "fear of dying", observed in 20% of patients with psychogenic seizures and in 90% of patients with PA, and by the number of conversion symptoms (5.9 in patients with psychogenic seizures and 2.2 in patients with PA). It is suggested that in both types of paroxysms panic associated symptoms are not specific and these symptoms only reflect affective distress. The latter is specifically expressed in the form of the symptom "fear of dying" during panic attacks and in the form of conversion symptoms during psychogenic seizures.

Adolescent↗
PubMed1996

Panic attacks and panic disorder.

Panic disorder is a devastating condition with a higher prevalence in female patients and young adults. Panic disorders is frequently associated with major depression, agoraphobia, substance abuse, suicide attempts, and impaired quality of life. Only one half of the subjects with panic disorder seek care for their attacks, and those who do seek care tend to present to primary care and emergency department settings. If treated appropriately, panic disorder has a favorable prognosis.

Emergency Service, Hospital↗
PubMed2004

Feared consequences of panic attacks in panic disorder: a qualitative and quantitative analysis.

Cognitions are hypothesized to play a central role in panic disorder (PD). Previous studies have used questionnaires to assess cognitive content, focusing on prototypical cognitions associated with PD; however, few studies have qualitatively examined cognitions associated with the feared consequences of panic attacks. The purpose of this study was to conduct a qualitative and quantitative analysis of feared consequences of panic attacks. The initial, qualitative analysis resulted in the development of 32 categories of feared consequences. The categories were derived from participant responses to a standardized, semi-structured question (n = 207). Five expert-derived categories were then utilized to quantitatively examine the relationship between cognitions and indicators of PD severity. Cognitions did not predict PD severity; however, correlational analyses indicated some predictive validity to the expert-derived categories. The qualitative analysis identified additional areas of patient-reported concern not included in previous research that may be important in the assessment and treatment of PD.

Adolescent↗
PubMed1986

Abnormal regulation of noradrenergic function in panic disorders. Effects of clonidine in healthy subjects and patients with agoraphobia and panic disorder.

Clonidine hydrochloride, an alpha 2-adrenergic receptor agonist that decreases noradrenergic function, was administered to 21 healthy subjects and 26 drug-free patients with agoraphobia and panic attacks. Clonidine produced significantly greater decreases in plasma MHPG levels and sitting and standing diastolic blood pressure and significantly smaller increases in growth hormone levels and self-rated drowsiness in the patients. These findings indicate that the regulation of noradrenergic activity is aberrant in some patients with panic disorder, since a previous study demonstrated that patients with panic disorder exhibit increased plasma MHPG levels, blood pressure, and behavioral responses to the alpha 2-adrenergic receptor antagonist yohimbine. The increased dynamic range of noradrenergic activity observed as an increased sensitivity to both clonidine and yohimbine may reflect abnormalities in the regulatory inputs to noradrenergic neurons, or dysfunction in the alpha 2-adrenergic receptor effector coupling mechanism or the intracellular effector system.

Adult↗
PubMed1986

Serotonin function in panic disorders. The effect of intravenous tryptophan in healthy subjects and patients with panic disorder before and during alprazolam treatment.

Preclinical evidence suggests that alterations in serotonin function may relate to the development of anxiety and the therapeutic effectiveness of antianxiety treatments. Serotonin increases prolactin release, and intravenous administration of the serotonin precursor, tryptophan, produces reliable elevations in serum prolactin levels. To evaluate serotonergic function, the effects of intravenous tryptophan on prolactin secretion were determined in 23 drug-free patients meeting DSM-III criteria for agoraphobia with panic attacks or panic disorder and 21 age- and sex-matched healthy subjects. In nine of the patients the tryptophan infusion was repeated during long-term alprazolam treatment. The ability of tryptophan to increase prolactin levels was not different between the patients and healthy subjects and was not altered by alprazolam treatment. These findings suggest serotonin function may be normal in panic anxiety disorders and the antipanic mechanism of action of alprazolam may be unrelated to effects on serotonin activity.

Adult↗
PubMed2003

Panic disorder in public sector primary care: clinical characteristics and illness severity compared with "mainstream" primary care panic disorder.

The prevalence of anxiety disorders is increased among low-income individuals, who are more likely to seek mental health care in medical as opposed to specialty settings because of limited insurance access and restricted availability of public sector mental health resources. However, little is known about the clinical characteristics and illness severity of anxiety disorders in this setting. We studied the clinical characteristics of low-income compared with middle-income primary care panic patients. Clinical, functional, and service use measures obtained at baseline interview in 39 panic disorder patients seen in one public sector medical clinic were compared with 76 patients seen in two middle-income clinics. All patients were participants in a randomized effectiveness pharmacotherapy trial [Roy Byrne et al., Arch Gen Psychiatry 2001;58:869-876]. Public sector patients were more often older, male, single, unemployed, of lower income, and non-Caucasian ethnicity. They had more severe clinical symptoms, more medical comorbidity, worse physical and role health status, and more emergency room visits. Low income and unemployment accounted for most of the differences in non-anxiety-related measures. However, type of clinic still contributed independently to the greater severity of specific measures of panic/anxiety (Panic Disorder Severity Scale and Marks Fear Scale scores), suggesting that the increased stress and limited social resources associated with low-income and disadvantaged status may have more specific effects on anxiety than other aspects of psychopathology.

Adolescent↗
PubMed1992

Center differences and cross-national invariance in help-seeking for panic disorder. A report from the cross-national collaborative panic study.

Help-seeking behaviour for treatment of panic disorder was investigated in the sample of the Cross-National Collaborative Panic Study Second Phase. A total of 1168 patients were entered into this trial in 14 countries. Although there were significant center differences in prior treatment and utilization of health services there were also similarities. Treatment had been provided mainly by general practitioners. Drug treatment consisted mostly of prescription of classical tranquilizers and had a longer duration than treatment by psychotherapy. Patients with agoraphobic avoidance, past major depression and longer duration of illness used medical and psychiatric treatment facilities more intensely. Older and more severely disabled subjects were more frequently treated by medical health care providers and were more likely to receive psychotropic drugs. The results indicate that general practitioners carry an important load in the treatment of panic disorders but may need more information about recent development in pharmacotherapy for this condition.

Adult↗
PubMed1992

The Galway Study of Panic Disorder. II: Changes in some peripheral markers of noradrenergic and serotonergic function in DSM III-R panic disorder.

Sixty six patients with panic disorders, fulfilling the DSM III criteria for panic attack, together with a group of age and sex matched controls, were studied for changes in their peripheral noradrenergic and serotonergic status before treatment and during six months treatment with either clomipramine or lofepramine. The results of this study suggest that, despite clinical improvement, the peripheral markers of both adrenergic (platelet aggregation to noradrenaline, platelet alpha 2 receptor density and lymphocyte beta receptor density) and serotonergic (platelet aggregation to serotonin, 3H-ketanserin binding to platelet 5HT2 receptors and 3H-5HT uptake into platelets) function largely remained abnormal. It is concluded that such abnormalities are trait markers of biogenic amine function in patients with panic attack. Further studies are needed to determine whether or not these parameters eventually normalize in those patients showing prolonged remission of symptoms.

Adult↗
PubMed1992

The Galway Study of Panic Disorder. I: Clomipramine and lofepramine in DSM III-R panic disorder: a placebo controlled trial.

Among 79 volunteer, unpaid, family doctor-referred psychiatric out patients with DSM III-R panic disorder, with and without agoraphobia, 66 completed a six week placebo-controlled trial of lofepramine versus clomipramine and 57 survivors were followed up for 6 months. All subjects received one hour per week concurrent behavioural counselling in the acute phase. Of 13 dropouts in the first 3 weeks, 9 (of 27) were on clomipramine, 2 (of 26) were on lofepramine and 2 (of 26) were on placebo. The high (30%) early dropout from the clomipramine group was largely due to medication intolerance. Both drugs were superior to placebo by the end of week 6 on several standard rating scales but not on panic attack frequency. No significant differences in efficacy were found between the two drugs tested to the end of 6 months. No tendency for relapse was noted in the three months following taper-off of medication from week 12 to week 24. The study provides evidence that both drugs, in the dosages used, are superior to placebo in the acute phase of panic disorder in treatment-naive subjects concurrently receiving appropriate psychotherapy.

Adult↗