No abstract

To the best of our knowledge, we here report the fi rst case of a panic attack based on Spice consumption in a 21-year-old male patient with attention defi cit hyperactivity disorder (ADHD). The condition had been treated over several years with methylphenidate, but which had been taken irregularly. Within minutes after a third-ever consumption of Spice, the patient developed both blurred vision and an unsteady gait as well as an acute onset of an agonal state with the fear of ignorance of his friends. This panic attack was accompanied by a vegetative hyperirritability that lasted for more than two hours. After admission to the emergency department, acute cardiac disease was ruled out and the patient was transferred to our Department of Psychiatry where fi xation became necessary. After intravenous application of 2 mg lorazepam and isotonic fl uid substitution, the patient recovered over night. In light of the previously presumed association of panic attacks and consumption of cannabinoids, we here discuss the potential de-masking of panic attacks after Spice consumption (as a synthetic cannabinoid) by ADHD-based imbalances of the dopaminergic and norepiphrenic receptor profi les.

A single bolus of propofol administered after the end of the seizure reduced the incidence of post-ECT PIA. The PACU staff and patients rated the emergence period significantly better when propofol was administered.

ObjectiveAlexithymia is considered to be a personality trait with a tendency to express psychological distress in somatic rather than emotional form and, therefore, may play a vital role in somatization. Although, such a propensity can be found in patients suffering from tinnitus, the relationship between alexithymic characteristics and the subjective experience of tinnitus severity remains yet unclear. Our aim was to evaluate which alexithymic characteristics are linked to the subjective experience of tinnitus symptomatology.MethodsWe evaluated tinnitus severity (Tinnitus Handicap Inventory, THI), alexithymia (20-item Toronto Alexithymia Scale, TAS-20), and depression (Beck Depression Inventory, BDI) in 207 outpatients with tinnitus. Correlation analyses and multiple regression analyses were calculated in order to investigate the relationship between alexithymic characteristics, tinnitus severity, and depression.ResultsHighly significant positive correlations were found between THI total score and TAS-20 total score as well as BDI score. Regarding the TAS-20 subscales, multiple regression analyses showed that only the TAS-20 subscale “difficulty in identifying feelings” (DIF) and the BDI significantly predicted the subjective experience of tinnitus severity. Regarding the THI subscales, only higher scores of the THI subscale “functional” demonstrated an independent moderate association with higher scores for DIF.ConclusionWe found an independent association between the subjective experience of tinnitus severity and alexithymic characteristics, particularly with regard to limitations in the fields of mental, social, and physical functioning because of tinnitus and the difficulty of identifying feelings facet of alexithymia. These findings are conducive to a better understanding of affect regulation that may be important for the psychological adaptation of patients suffering from tinnitus.