Treatment of Comorbid Panic Disorder and Schizophrenia: Evidence for a Panic Psychosis

Kahn, Jeffrey P.; Meyers, John

doi:10.3928/0048-5713-20000101-08

Cited by 17 publications

(9 citation statements)

References 34 publications

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“…Despite clinical similarities to schizophrenia, it is likely that PDD is a diagnostically distinct psychotic form of SAD. Other reports have similarly suggested distinct psychotic forms of obsessive-compulsive disorder (Poyurovsky et al, 2004) and of panic anxiety (Savitz et al, 2011;Kahn and Meyers, 2000). These four cases support the idea that SAD is prodromal for later PDD, that PDD may respond much better when serotonin-specific reuptake inhibitors are used to treat the SAD component, and that careful diagnosis can lead to improved outcome (Pallanti et al, 2000).…”

Section: Discussionsupporting

confidence: 57%

Paranoid Delusional Disorder Follows Social Anxiety Disorder in a Long-Term Case Series

Veras¹,

Souza²,

Ricci³

et al. 2015

Journal of Nervous &Amp; Mental Disease

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Social anxiety disorder (SAD) patients may have self-referential ideas and share other cognitive processes with paranoid delusional disorder (PDD) patients. From an evolutionary perspective, SAD may derive from biologically instinctive social hierarchy ranking, thus causing an assumption of inferior social rank, and thus prompting concerns about mistreatment from those of perceived higher rank. This naturalistic longitudinal study followed four patients with initial SAD and later onset of PDD. These four patients show the same sequence of diagnosed SAD followed by diagnosed PDD, as is often retrospectively described by other PDD patients. Although antipsychotic medication improved psychotic symptoms in all patients, those who also had adjunctive serotonin-specific reuptake inhibitors for SAD had much more improvement in both psychosis and social functioning. From an evolutionary perspective, it can be conjectured that when conscious modulation of the SAD social rank instinct is diminished due to hypofrontality (common to many psychotic disorders), then unmodulated SAD can lead to paranoid delusional disorder, with prominent ideas of reference. Non-psychotic SAD may be prodromal or causal for PDD.

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Section: Discussionsupporting

confidence: 57%

Paranoid Delusional Disorder Follows Social Anxiety Disorder in a Long-Term Case Series

Veras¹,

Souza²,

Ricci³

et al. 2015

Journal of Nervous &Amp; Mental Disease

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“…Furthermore, these data show that panic subtypes, determined by age at onset and the presence of fear/anticipatory anxiety, may be associated with differences in severity as well as distinguishing specific types of vulnerabilities and patterns of symptomatology (i.e. depersonalization predicts psychosis and dyspnea is associated with an increased risk of agoraphobia [59,60]. Differences in the sequence of onset of panic and comorbid mental disorders and the differences in the sequence of onset between those with early-and late-onset panic attacks merit further, more in-depth investigation in future studies.…”

Section: Commentmentioning

confidence: 86%

Panic Attack as a Marker of Core Psychopathological Processes

Goodwin¹,

Hamilton²

2001

Psychopathology

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Objective: The goal of this study is to test the hypothesis that panic attacks are a marker of core psychopathological processes across mental disorders and that there are distinct syndromal patterns of psychopathology associated with specific subtypes of panic attack that can be distinguished by age and associated fear at onset. Methods: Data were drawn from the National Comorbidity Survey, a community-based household sample (n = 8,098) representative of the United States adult population. Four panic subtypes were identified based on findings from clinical studies and on our hypothesis. Multivariate logistic regression models were used to identify sociodemographic characteristics, panic symptoms and mental disorder correlates of each subtype. Results: Results of multivariate logistic regression analyses identified distinct sociodemographic characteristics, panic symptoms, psychiatric comorbidity, suicidal behavior and use of services associated with early-onset and late-onset panic with and without fear/anticipatory anxiety at the first attack. Conclusions: These findings provide support for the hypothesis that panic attacks are a marker of core underlying psychopathological processes and introduce new, preliminary evidence to support the possible existence of different panic subtypes in the general population. While these results need replication, these findings suggest that the specific type of comorbidity among those with panic attacks can be predicted to a large degree by the age and associated fear/anticipatory anxiety at the onset of the panic attacks.

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“…A novel finding relates to the high rate of panic disorder among adults (14% in mature adults). Some authors have suggested that panic disorder may be associated with the development of schizophrenia in the general population (54). This warrants further investigation in 22q11.2 deletion syndrome.…”

Section: Discussionmentioning

confidence: 99%

Psychiatric Disorders From Childhood to Adulthood in 22q11.2 Deletion Syndrome: Results From the International Consortium on Brain and Behavior in 22q11.2 Deletion Syndrome

Schneider

Debbané

Bassett

et al. 2014

AJP

700

740

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Objective Chromosome 22q11.2 deletion syndrome is a neurogenetic disorder associated with high rates of schizophrenia and other psychiatric conditions. The authors report what is to their knowledge the first large-scale collaborative study of rates and sex distributions of psychiatric disorders from childhood to adulthood in 22q11.2 deletion syndrome. The associations among psychopathology, intellect, and functioning were examined in a subgroup of participants. Method The 1,402 participants with 22q11.2 deletion syndrome, ages 6–68 years, were assessed for psychiatric disorders with validated diagnostic instruments. Data on intelligence and adaptive functioning were available for 183 participants ages 6 to 24 years. Results Attention deficit hyperactivity disorder (ADHD) was the most frequent disorder in children (37.10%) and was overrepresented in males. Anxiety disorders were more prevalent than mood disorders at all ages, but especially in children and adolescents. Anxiety and unipolar mood disorders were overrepresented in females. Psychotic disorders were present in 41% of adults over age 25. Males did not predominate in psychotic or autism spectrum disorders. Hierarchical regressions in the subgroup revealed that daily living skills were predicted by the presence of anxiety disorders. Psychopathology was not associated with communication or socialization skills. Conclusions To the authors' knowledge, this is the largest study of psychiatric morbidity in 22q11.2 deletion syndrome. It validates previous findings that this condition is one of the strongest risk factors for psychosis. Anxiety and developmental disorders were also prevalent. These results highlight the need to monitor and reduce the long-term burden of psychopathology in 22q11.2 deletion syndrome.

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Treatment of Comorbid Panic Disorder and Schizophrenia: Evidence for a Panic Psychosis

Cited by 17 publications

References 34 publications

Paranoid Delusional Disorder Follows Social Anxiety Disorder in a Long-Term Case Series

Paranoid Delusional Disorder Follows Social Anxiety Disorder in a Long-Term Case Series

Panic Attack as a Marker of Core Psychopathological Processes

Psychiatric Disorders From Childhood to Adulthood in 22q11.2 Deletion Syndrome: Results From the International Consortium on Brain and Behavior in 22q11.2 Deletion Syndrome

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