The development of agoraphobia in panic disorder: a predictable process?

Langs, Gernot; Quehenberger, Franz; Fabisch, Karin; Klug, Günter; Fabisch, Hans; Zapotoczky, H. G.

doi:10.1016/s0165-0327(99)00097-x

Cited by 32 publications

(23 citation statements)

References 30 publications

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“…Similarly, epidermiologic catchment area (ECA) data indicate a significantly smaller sex ratio for PD compared to agoraphobia [Myers et al, 1984]. Patients with PDA, compared to those with PD, also show a more pernicious course with an earlier onset [Langs et al, 2000] plus lower rates of remission and higher rates of relapse [Carpiniello et al, 2002;Keller et al, 1994]. Those with PDA are also more likely to have comorbid psychiatric conditions [Andrews and Slade, 2002].…”

Section: Introductionmentioning

confidence: 99%

Assessing the clinical utility of agoraphobia in the context of panic disorder

Schmidt

Cromer

2008

Depress. Anxiety

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In the DSM-IV, a panic disorder (PD) diagnosis includes specification of agoraphobia, which is primarily an index of situational avoidance due to fear of panic. No other anxiety diagnosis requires specification of level of avoidance. This raises the question as to whether agoraphobia provides unique information beyond the core features of PD (i.e., panic attacks and panic-related worry). The incremental validity of agoraphobia, defined using DSM-IV specifiers versus level of situational avoidance, was examined in relation to the expression and treatment of PD (N=146). Analyses indicate that agoraphobia status adds uniquely to the prediction of PD symptoms, impairment, and response to treatment. However, level of situational avoidance, defined either as a continuous or dichotomous variable, appears to have greater utility compared to the DSM-IV method of classifying agoraphobia. In summary, the agoraphobia specifier seems to have clinical utility but this could be improved by focusing on a dimensional assessment of situational avoidance.

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Section: Introductionmentioning

confidence: 99%

Assessing the clinical utility of agoraphobia in the context of panic disorder

Schmidt

Cromer

2008

Depress. Anxiety

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“…Agoraphobic patients as compared with those having uncomplicated panic disorders commonly report cognitive symptoms such as fear of loss of control [13], depersonalization, and vestibular symptoms [14][15][16]. Panic patients with prominent depersonalization and derealization experience a higher degree of agoraphobic avoidance [8].…”

Section: Introductionmentioning

confidence: 99%

A Study of the Phenomenology of Panic Attacks in Patients from India

Neerakal

Srinivasan²

2003

Psychopathology

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We studied the symptom structure of panic attacks in 94 patients attending an outpatient psychiatric clinic. Autonomic symptoms of anxiety were reported by the majority of the panic patients. As compared with studies from the West, certain cognitive symptoms, such as fear of loss of control and depersonalization, and vestibular symptoms were endorsed by fewer panic patients. The majority of our panic patients tended to seek help initially from physicians and medical specialists. The majority of the patients also did not experience some DSM-IV symptoms as part of their panic attacks. Comorbid psychiatric conditions influenced the symptom structure of panic attacks. A higher number of agoraphobics as compared with patients with uncomplicated panic disorders had the symptoms of fear of loss of control and fainting. Our findings support the notion that the experience of panic attacks is variable and differs across cultures.

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“…Da mesma forma, as sensações subjetivas de ansiedade presentes no transtorno de pâni-co e que levam o indivíduo a temer um novo ataque de pânico apresentam certo grau de similaridade à sensação difusa de ansiedade experimentada por um indivíduo diante de sinais vagos, mas potencialmente perigosos. Esse tipo de ansiedade recorrente e constante é tão marcante no transtorno de pânico que cerca de 2/3 destes pacientes desenvolvem agorafobia e passam a evitar lugares onde é difícil sair ou encontrar ajuda (Langs et al, 2000;Van Balkon et al, 1997).…”

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Percepção de dor aguda em pacientes com transtorno de pânico

Miranda¹,

Crepaldi²,

Almeida³

et al. 2011

Psicol. Reflex. Crit.

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ResumoO presente trabalho investigou experimentalmente os limiares nociceptivos e a percepção subjetiva de dor no transtorno de pânico (TP). Trinta e sete pacientes com TP foram voluntariamente submetidos a um Teste Pressor ao Frio (TPF), em que uma de suas mãos era mergulhada em um banho termostatizado de água fria (7ºC) por um período máximo de três minutos. A latência de retirada da mão da água foi utilizada como um índice de dor aguda, enquanto a experiência subjetiva de dor foi avaliada por meio do Questionário McGill de Dor e de uma escala visual analógica. Os resultados indicaram latências similares de retirada da mão em comparação a 37 sujeitos-controle sadios, mas uma experiência subjetiva de dor significantemente maior nos pacientes com TP. Esse padrão de resultados não apenas confirma a utilidade do teste de pressor ao frio para a indução e estudo experimental da dor aguda em laboratório, mas também sugere uma importante associação entre dor e ansiedade. Palavras-chave: Dor, Teste de Pressor ao Frio, Transtorno de Pânico, Questionário McGill de Dor. AbstractThe present study experimentally investigated the nociceptive threshold and the subjective pain perception in panic disorder (PD). Thirty seven PD patients were voluntarily submitted to a cold pressor test (CPT) in which one of their hands was dipped into a thermostatized cold water bath (7ºC) for a maximum period of three minutes. Acute pain experience was assessed by measuring the hand retrieval latency, whereas the subjective pain experience was evaluated through McGill Pain Questionnaire and a pain visual analog scale. As compared to 37 healthy control-subjects, results indicated similar hand retrieval latencies but a significantly higher subjective pain experience in PD patients. Such pattern of results not only indicates the usefulness of the cold pressor test to induce and experimentally study pain in laboratory settings, but also suggests an important anxiety-pain association.

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The development of agoraphobia in panic disorder: a predictable process?

Cited by 32 publications

References 30 publications

Assessing the clinical utility of agoraphobia in the context of panic disorder

Assessing the clinical utility of agoraphobia in the context of panic disorder

A Study of the Phenomenology of Panic Attacks in Patients from India

Percepção de dor aguda em pacientes com transtorno de pânico

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