Background: In the present study, we evaluated whether patients with panic disorder (PD) in complete remission were more alexithymic than normal controls. Methods: Fifty-two PD patients (both during the acute phase of the disorder and after at least 2 months of complete remission) and 52 age- and sex-matched normal subjects completed the Toronto Alexithymia Scale-20 and the Hamilton Rating Scales for Anxiety (Ham-A) and for Depression. Results: A higher rate of alexithymia was found in PD patients than in controls (3.8%) both during the acute phase (44.2%; p < 0.001) and after remission of the disorder (21.2%; p = 0.008). During remission, PD patients showed: (1) Ham-A scores significantly higher than controls (p < 0.001); (2) only an elevation of the ‘difficulty in identifying feeling’ (DIF) dimension of alexithymia, and (3) a positive relationship between Ham-A scores and DIF levels (p < 0.001). Conclusion: After remission of panic attacks, phobic avoidance and anticipatory anxiety, PD patients are more alexithymic (even though the levels of alexithymia decreased after the resolution of the acute phase of PD) and anxious than controls. This finding might be explained by an overlap between cognitive aspects of PD and the DIF dimension of alexithymia, since alexithymic and anxious levels are positively related.

The aim of this open label trial was to evaluate mirtazapine tolerability and effectiveness in controlling symptomatology of patients with panic disorder. Forty-five patients with panic disorder, with or without agoraphobia, 11 of them with a comorbid diagnosis of major depression, were included. Patients were assessed with a structured psychiatric interview and their symptomatology evaluated with specific psychometric scales. Three study participants dropped out due to adverse events. Mirtazapine was administered at an established dose of 30 mg daily for 3 months. Patients were assessed at weeks 2 and 4, and then at monthly intervals. All psychometric measures showed statistically significant reductions in total scores at the rated time points, with a pronounced decline in number and intensity of panic attacks and anticipatory anxiety throughout the study. Mirtazapine was well tolerated as signified by the low discontinuation rate (6.3%), and all patients showed a significant symptomatic improvement. The improvement did not appear to be linked to the concurrent presence of a depressive illness.

Background: Human milk, unlike formula feeds, contains long-chain polyunsatured fatty acids, such as docosahexaenoic acid and arachidonic acid which are essential in the development of the central nervous system. If human milk is the optimal food for brain development, and if schizophrenia is a neurodevelopment disorder, might people who become schizophrenic in adult life be less likely to have been breast-fed? Aims: To compare the incidence and length of breast-feeding in patients, siblings and normal controls and to examine the relationship between the duration of breast-feeding and age at onset of schizophrenia. Method: 113 schizophrenic patients were recruited, as were 140 siblings of the patients and 113 nonschizophrenic controls. The breast-feeding history of the patients, their siblings and controls was obtained through interviews with the mothers of the patients and controls. Results: There were no significant differences between groups in the incidence of breast- feeding. The duration of breast-feeding was positively correlated with the age at onset of illness (r = +0.25, p < 0.02). Conclusion: Breast-feeding is no less common in those who develop schizophrenia in later life. However, breast milk might postpone the onset of the illness in schizophrenic patients.

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