Prevalence of mental disorders after catastrophic financial loss

Article Abstract:

The relationship between undergoing stressful life events and subsequent major depression has been a focus of research in recent years, and this was explored by evaluating the risk of major mental illness among people who had lost their retirement savings as a result of bank fraud. Seventy-two people (55 investors and the spouses of 17) living in Oregon who had invested large sums in the First Colonial Bank of the Marshall Islands, and 58 age- and gender-matched control subjects, were interviewed using the Diagnostic Interview Schedule (a psychiatric evaluation instrument). Other questionnaires were also administered. Almost 30 percent of the fraud victims experienced a major depressive episode during the first 16 to 20 months after their financial loss; only 1.5 percent of control subjects experienced such an episode. For 10 victims, the episode lasted longer than six months, and five had contemplated suicide. Generalized anxiety disorder was more prevalent for victims than controls. No differences were noted between the two groups in yearly income or alcohol abuse or dependence before or after the loss, or mental health visits to professionals afterwards. However, after the loss, victims had lower subjective physical health ratings and higher tranquilizer usage than controls. They also had more somatic complaints, such as heart palpitations, headaches, abdominal pain, and a sensation of a lump in the throat. Many felt they had caused their own bad fortune. The results indicate that catastrophic financial loss is associated with the development of a major depressive disorder and generalized anxiety disorder. Although free psychiatric services were offered to all the victims, only two accepted this offer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Stress (Psychology), Bank fraud

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Vestibular dysfunction followed by panic disorder with agoraphobia

Article Abstract:

It has recently been reported that vestibular dysfunction, a disorder of the inner ear, may be linked to anxiety disorders such as panic attacks. The basis of this theory is that these patients experience unexplained physiological symptoms (for example, dizziness), which a vulnerable person may feel are caused by anxiety, and this triggers a panic attack. A cycle of 'fear of fear' develops, involving escalating anxiety that leads to panic attacks. A case is discussed in which a 39-year-old married man had vestibular dysfunction leading to panic disorder with agoraphobia; the case illustrates the theory described above. The man's first symptoms were disequilibrium and weakness in the legs while walking, as well as dizziness when leaning back in his office chair. It appears that a viral infection preceded these experiences. His first panic attack occurred after an episode of dizziness and four more panic attacks followed in the next six months. Symptoms of ringing, fullness, and pain in the ears continued. The patient then developed a fear of situations such as crowds and heavy traffic, in which he felt trapped. Testing of vestibular function showed moderately severe vestibulo-ocular dysfunction. He was evaluated for anxiety disorders, and diagnosed with panic disorder with agoraphobia, but the anxiety was greatly reduced when he was told that the dizziness was of physical origin. While the dizziness did not resolve, the panic attacks ceased and his agoraphobia became minimal. The situations in which the man experienced anxiety were analyzed and were found to involve abrupt movements of the head or of his surroundings, which is consistent with vestibular dysfunction as the cause of his anxiety. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Vertigo, Panic attacks

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Relationship and chronology of depression, agoraphobia, and panic disorder in the general population

Article Abstract:

The coincidence and timetable of the appearance of symptoms of depression, agoraphobia (irrational fear of public spaces), and panic disorder were studied in 3,300 people. These disorders often coincided. However, the coincidence of agoraphobia with panic disorder appears to be simply due to the coincidence of both these disorders with depression. The average age at first symptoms was lowest for agoraphobia (low teens); for depression and panic disorder the average age was 20. These results do not support the view that panic disorder is an integral part of agoraphobia, but suggest rather that it is more closely associated with depression. The fact that agoraphobia precedes depression makes it doubtful that depression is the primary illness underlying anxiety disorders. These data should be interpreted with care since they were collected after the fact of the illnesses studied.

Depression (Mood disorder)

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