Nonfearful panic disorder in neurology patients validated by lactate challenge
Article Abstract:
In the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), subjective fear was the central criterion for a diagnosis of panic disorder. In the revised edition of the manual (DSM-III-R), the criteria changed to include either fear or intense discomfort (such as dizziness, heart palpitations, shortness of breath, or trembling), allowing for a new diagnostic syndrome of nonfearful panic disorder. To assess the validity of this panic disorder subtype, 48 neurology patients who suffered panic symptoms but had negative medical findings were evaluated. Eleven of the patients met the DSM-III-R criteria for nonfearful panic disorder and were infused at five-hour intervals, and in a randomly varied order, with either sodium lactate or a placebo. Previous studies have established that sodium lactate induces panic reactions in panic-disordered patients. All 11 patients experienced panic attacks in response to the lactate (but not to the placebo) infusion and required antipanic medication to end their induced episodes. Additionally, all 11 patients responded positively to antipanic medication over a six-month follow-up period. Case reports detail the histories and experiences of three of the 11 patients. Although only a small sample of subjects were studied, findings suggest that nonfearful panic disorder may be a valid subtype of panic disorder. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Psychiatry
Subject: Psychology and mental health
ISSN: 0002-953X
Year: 1991
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Higher lifetime prevalence of respiratory diseases in panic disorder?
Article Abstract:
Symptoms such as choking, shortness of breath, and anxiety are commonly seen in both those suffering from a respiratory disease and those suffering from a panic disorder. Some researchers have suggested there is an overlap in pathophysiology between panic disorder and certain respiratory diseases. This study examined whether persons suffering from panic disorder were more likely to suffer respiratory disease than other populations. The medical files of 30 panic disorder patients, 30 obsessive-compulsive patients, and 30 eating disorder patients were analyzed for lifetime prevalences of various respiratory diseases. The lifetime prevalence of respiratory disease was significantly higher for the panic disorder patients than for the other two groups of psychiatric patients. The lifetime prevalence rate differences resulted from extremely high prevalence rates of childhood respiratory disease for the panic disorder patients. Point prevalence rates were similar for the three groups and corresponded to findings from other studies on prevalence rates for the general population. The results indicated a relationship between high prevalence of childhood respiratory diseases and development of panic disorder. Further research is needed to clarify this relationship. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Psychiatry
Subject: Psychology and mental health
ISSN: 0002-953X
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
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