Panic-agoraphobic spectrum symptoms in complicated grief

Bui, Éric; LeBlanc, Nicole J.; Morris, Laura K.; Marques, Luana; Shear, M. Katherine; Simon, Naomi M.

doi:10.1016/j.psychres.2013.03.033

Cited by 9 publications

(9 citation statements)

References 15 publications

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“…This pattern may be explained by a shared risk factor for these disorders (e.g., anxiety sensitivity). We have recently identified elevated rates of lifetime panic-spectrum symptoms in CG patients, [38] supporting the hypothesis that a shared diathesis contributes to the development of both PD and CG. Additional research is needed to understand the cause(s) of the high comorbidity between PTSD, PD, and CG.…”

Section: Discussionsupporting

confidence: 72%

Complicated Grief Symptoms in Anxiety Disorders: Prevalence and Associated Impairment

et al. 2013

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Background Previous research has identified high rates of comorbid anxiety disorders among individuals presenting with primary CG. In the present study, we examined the prevalence of comorbid CG in bereaved primary anxiety disorder (AD) patients compared to bereaved healthy controls. We also examined the impairment associated with comorbid CG in AD. Methods Participants were 242 bereaved adults (mean (SD) age = 41.5 (13.1), 44.2% women) with a primary AD diagnosis, including generalized anxiety disorder (GAD; n = 57), panic disorder (PD; n = 49), posttraumatic stress disorder (PTSD; n = 29), and generalized social anxiety disorder (GSAD; n = 107), as well as 155 bereaved healthy controls with no current DSM-IV Axis I diagnosis (mean (SD) age = 43.0 (13.6), 51.0% women). CG symptoms were measured using the 19-item inventory of complicated grief (ICG), with threshold CG defined as an ICG score of ≥30. Quality of life and functional impairment were assessed with the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and the Range of Impaired Functioning Tool (LIFE-RIFT), respectively. Results Participants with primary ADs had significantly higher rates of threshold CG symptoms than bereaved controls (12.0% vs. 0.65%; Fisher’s Exact P < 0.001). Rates of threshold CG were significantly elevated for each AD when compared to bereaved controls. After adjustment for age, sex, education, and comorbid major depressive disorder, threshold CG was associated with lower quality of life (β = −0.140, P = 0.023) and greater impairment (β = 0.141, P = 0.035) among individuals with AD. Conclusions Our findings suggest that threshold CG is of clinical relevance in bereaved individuals with a primary anxiety disorder. Screening for CG in patients with ADs may be warranted.

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Section: Discussionsupporting

confidence: 72%

Complicated Grief Symptoms in Anxiety Disorders: Prevalence and Associated Impairment

et al. 2013

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“…We previously reported elevated rates of panic spectrum symptoms among individuals with CG (Bui et al, 2013), however that study did not specifically explore GRP symptoms. The current study reveals that more than a third of treatment-seeking individuals with CG reported at least one full or limited symptom GRP attack over the past week, with twice that rate among people with current PD.…”

Section: Discussionmentioning

confidence: 96%

“…Simon et al (2007) found that among 206 treatment-seeking individuals with CG, 63% met diagnostic criteria for a comorbid anxiety disorder, including 14% for PD. We also reported that individuals with CG exhibited higher levels of lifetime panic-spectrum symptoms, than otherwise healthy bereaved individuals, even after controlling for current PD diagnosis (Bui et al, 2013). Correspondingly, we found in a recent study that 18% of individuals with a primary diagnosis of PD, who lost a loved one at least six months prior, screened positive for CG compared to less than 1% in individuals without any current DSM-IV psychiatric disorders (Marques et al, 2013), and approximately 7% prevalence in the general population (Kersting et al, 2011).…”

Section: Introductionmentioning

confidence: 85%

Grief-related panic symptoms in Complicated Grief

Bui

Horenstein

Shah

et al. 2015

Journal of Affective Disorders

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Background Although Complicated Grief (CG) has been associated with comorbid Panic Disorder (PD), little is known about panic attacks in CG, and whether panic symptoms may be grief-related. The present study examines the presence and impact of grief-related panic symptoms in CG. Methods Individuals with CG (n=146, 78% women, mean (SD) age =52.4(15.0)) were assessed for CG, DSM-IV diagnoses, work and social impairment, and with the Panic Disorder Severity Scale modified to assess symptoms “related to or triggered by reminders of your loss” and anticipatory worry. Results Overall, 39.7% reported at least one full or limited-symptom grief-related panic attack over the past week, and 32.2% reported some level of anticipatory worry about grief-related panic. Of interest, 17% met DSM criteria for PD. Among those without PD, 34.7% reported at least one full or limited-symptom grief-related panic attack over the past week, and this was associated with higher CG symptom severity (t=−2.23, p<0.05), and functional impairment (t=−3.31, p<0.01). Among the full sample, controlling for CG symptom severity and current PD, the presence of at least one full or limited-symptom grief-related panic attack was independently associated with increased functional impairment (B(SE)=4.86(1.7), p<0.01). Limitations Limitations include a lack of assessment of non grief-related panic symptoms and examination of a sample of individuals seeking treatment for CG. Conclusions Grief-related panic symptoms may be prevalent among individuals with CG and independently contribute to distress and functional impairment.

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“…Patients who describe symptoms of bereavement may have higher susceptibility to stress or may have difficulty coping with stress. Comorbidity of disorders related to anxiety is observed frequently, particularly in individuals with complicated grief (38,39). However, separation anxiety and avoidant personality traits, which are closely associated with stress, were found to be higher in these individuals (40).…”

Section: Discussionmentioning

confidence: 99%