Our aim was to observe the induction of anxiety symptoms and panic attacks by a caffeine challenge test in panic disorder (PD) patients (DSM-IV) and their healthy first-degree relatives. We randomly selected 25 PD patients, 27 healthy first-degree relatives of probands with PD, and 22 healthy volunteers with no family history of PD. In a randomized double-blind experiment performed over two occasions 7 days apart, 480 mg caffeine and a caffeine-free solution were administered in a coffee form. Using specific panic attack criteria, 52.0% (n=13) PD patients, 40.7% (n=11) first-degree relatives (chi2=1.81, df=1, P=0.179), and none of the control subjects had a panic attack after the test (chi2=51.7, df=2, P<0.001). In this caffeine challenge test, PD patients and their first-degree relatives were more sensitive than healthy volunteers to the panic attack symptoms but less sensitive to headache, increase in blood pressure, and insomnia. Our data suggest that there is an association between panic attacks after the intake of 480 mg of caffeine in PD patients and their first-degree relatives. There is a clear differentiation of PD patients and their first-degree relatives by a caffeine test from the healthy group.

Accessible summary  Some people with intellectual impairments have a stammer It can be different from the ways other people stammer Speech and language therapy might help people with intellectual impairments who stammer Speech and language therapy is fun Summary Adults with intellectual impairments have a high prevalence of stammering. Characteristic speech and associated behaviours are also different in quality and more variable between individuals than those of the typical adult population. This paper describes a speech and language therapy group with two adults with intellectual impairments and atypical stammering. Sessions took place over 10 weeks, with a standard format using discussion about communication, speech modification and relaxation. Sessions were videotaped with participants’ permission, and Talking Mats™ supported participants in explaining their responses to their stammering. The evidence suggests that both participants gained socially from attending the group. Analysis of video material and photographs of the mats demonstrated positive change in fluency for one participant immediately following the therapy block, but no change for the second participant. Clinical interventions for these clients need to incorporate theoretical and therapeutic approaches to intellectual impairment and consider adult and paediatric aspects of stammering.