Axis I and II comorbidities in subjects with and without nocturnal panic

Abstract

Our purpose in this study was to compare the prevalence and pattern of Axis I and II comorbidities between patients with and without nocturnal panic (NP) attacks. One hundred and sixteen subjects with panic disorder (PD; according to DSM-IV criteria) were included: We assessed Axis I and II comorbidities using the Structured Clinical Interview for DSM-IV Axis I and II disorders, respectively. Of the sample, 27.6% of subjects had recurrent nocturnal panic attacks (NP group). Subjects with NP did not differ from those without in any sociodemographic or clinical characteristics. In the sample (94 subjects), 81% had at least one lifetime comorbid Axis I disorder, without significant differences between subjects with and without nocturnal panic even when considering comorbidity rates for single disorders; a trend toward significance was found for anorexia nervosa and somatization disorder, which both were more frequent among subjects with NP. Concerning Axis II disorders, 49.1% of the sample (57 subjects) met the criteria for at least one personality disorder, without significant differences between patients with and without NP. No significant differences were detected in comorbidity rates for any single Axis II personality disorder. Personality might play a relevant role in influencing treatment approaches to PD, but it does not appear to be a differential focus of concern in patients with compared to those without NP.

Personalidad y Trastorno de Pánico: Un estudio de revisión

“…Desde mitad de los 90 y a principios del 2000 se amplía el porcentaje de prevalencia de los TPe en pacientes con TP/TPA del 20 al 95% (Ampollini et al, 1999;Barzega, et al, 2001;Berger et al 2004;Langs et al, 1998;Massion et al 2002). Los estudios más recientes arrojan cifras que oscilan entre el 33.3 y el 76.8% (Albert, Maina, Bergesio y Bogetto, 2006;Marchesi, Cantón, Fonito, Giannelli y Maggini, 2005;Marchesi et al, 2006;Ozkan y Altindag, 2005). Como podemos observar existe unanimidad en relacionar los TPe con el TP.…”

“…Los resultados obtenidos por nuestra revisión (Tabla 1) indican, al igual que otros autores, que la prevalencia de los TPe en pacientes con TP/TPA es elevada (Albert et al, 2006;Iketani et al, 2002;Iketani et al, 2004;Latas et al, 2000;Marchesi et al, 2005;Marchesi et al, 2006;Ozkan y Altindag, 2005;Venturello et al, 2002). Los resultados obtenidos respecto a la identificación de Clusters y TPe específi-cos coindiden en parte con el estudio de metanálisis recientemente publicado de Friborg, Martinussen, Kaiser, Overgard y Rosenvinge (2013).…”

Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder

“…Similarly, another study indicated that patients with prominent respiratory symptoms are more sensitive to CO 2 inhalation and have higher rates of nocturnal panic attacks, which is related to a more severe subtype of panic, a longer duration of the disease, and more intense phobic symptoms 68 (B). Patients with nocturnal panic attacks are more often depressed or have other psychiatric symptoms 69 (B) and tend to be more prone to developing anorexia nervosa and somatization disorder 70 (B). Thus, diurnal and nocturnal panic attacks seem to develop in different ways.…”

Can psychopharmacological treatment change personality traits in patients with panic disorder?

“…4 The reported prevalence of this comorbidity ranges from 30% to 69%, this considerable variation likely being attributable to the different methodologies employed, especially the type of instrument used to assess personality, as well as to differences among the patient samples evaluated. [5][6][7][8][9] Grant et al studied panic disorder patients with agoraphobia who sought treatment and found that the prevalence of at least one personality disorder was as high as 75%. 10 Considering the high frequency of comorbidity of panic disorder and personality disorder, together with the fact that both tend to have a chronic course, the possible clinical impact of this association becomes important.…”