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panic disorder treatment

Sophie Bischoff, Gesine Wieder, Franziska Einsle, Moritz B Petzold, Christiane Janßen, Jennifer L M Mumm, Hans-Ulrich Wittchen, Thomas Fydrich, Jens Plag, Andreas Ströhle
Exposure-based Cognitive Behavioral Therapy (eb-CBT) represents the most evidence-based psychotherapeutic approach in anxiety disorders. However, its efficacy may be limited by a delay in onset of action and a substantial number of patients does not respond sufficiently to treatment. In this context, aerobic exercise was found to be effective in reducing clinical anxiety as well as to improve (elements of) disorder-specific CBT in some mental disorders. We therefore investigated the effect of aerobic exercise supplementary to an eb-CBT in panic disorder and agoraphobia (PD/AG)...
March 5, 2018: Journal of Psychiatric Research
Julia F Litzky, Maya A Deyssenroth, Todd M Everson, Barry M Lester, Luca Lambertini, Jia Chen, Carmen J Marsit
BACKGROUND: Depression and/or anxiety during pregnancy have been associated with impaired fetal growth and neurodevelopmental. Because placental imprinted genes play a central role in fetal development and respond to environmental stressors, we hypothesized that imprinted gene expression would be affected by prenatal depression and anxiety. METHODS: Placental gene expression was compared between mothers with prenatal depression and/or anxiety/obsessive compulsive disorder/panic and control mothers without psychiatric history (n=458) in the Rhode Island Child Health Study...
March 14, 2018: Pediatric Research
B Gulpers, A Lugtenburg, M Zuidersma, F R J Verhey, R C Oude Voshaar
BACKGROUND: Anxiety possibly interferes with executive functioning, although most studies rely on anxiety symptoms or lack control for comorbid depression. The objective of the present study is to examine the association between executive functioning and (individual) anxiety disorders with ak,ld without controlling for depression. METHOD: Generalized anxiety disorder (GAD), panic disorder with and without agoraphobia, agoraphobia, social phobia, as well as depressive disorder according to DSM-IV criteria were assessed with the Mini International Neuropsychiatric Interview in 82,360 community-dwelling people participating in the Lifelines cohort...
February 17, 2018: Journal of Affective Disorders
M Dold, L Bartova, J Mendlewicz, D Souery, A Serretti, S Porcelli, J Zohar, S Montgomery, S Kasper
OBJECTIVE: This multicenter, multinational, cross-sectional study aimed to investigate clinical characteristics and treatment outcomes associated with augmentation/combination treatment strategies in major depressive disorder (MDD). METHOD: Sociodemographic, clinical, and treatment features of 1410 adult MDD patients were compared between MDD patients treated with monotherapy and augmentation/combination medication using descriptive statistics, analyses of covariance (ancova), and Spearman's correlation analyses...
February 28, 2018: Acta Psychiatrica Scandinavica
Joseph A Hirsch
There is a high prevalence of anxiety disorders including specific phobias and panic disorder in the United States and Europe. A variety of therapeutic modalities including pharmacotherapy, cognitive behavioral therapy, systematic desensitization, hypnosis, in vivo exposure, and virtual reality exposure therapy have been applied. No one modality has been entirely successful. There has been only a limited attempt to combine psychological therapies in the treatment of specific phobias and panic disorder and what has been done has been primarily with systematic desensitization or cognitive behavioral therapy along with hypnotherapy...
April 2018: American Journal of Clinical Hypnosis
Luana D Laurito, Carla P Loureiro, Rafaela V Dias, Paula Vigne, Gabriela B de Menezes, Rafael C Freire, Ulrich Stangier, Leonardo F Fontenelle
We investigated the rates of current and past benzodiazepine (BZD) use in a sample of 102 subjects attending specialized anxiety disorder clinics, including panic disorder (PD; N = 36), social anxiety disorder (SAD; N = 28) and obsessive-compulsive disorder (OCD; N = 38) patients. Almost 56% of the entire sample was using BZDs at the moment of the assessment, and 74.5% described having used them at some point during their lifetimes. The duration of psychiatric treatment and a lifetime history of PD, but not any other "transdiagnostic" measure of severity (such as the Panic and Agoraphobia Scale, the Social Phobia Inventory, the Dimensional Obsessive-Compulsive Scale, the Anxiety Sensitivity Index-36, and the Beck Inventories) were independent risk factors for current prescription of BZDs...
February 9, 2018: Psychiatry Research
Joseph K Carpenter, Leigh A Andrews, Sara M Witcraft, Mark B Powers, Jasper A J Smits, Stefan G Hofmann
The purpose of this study was to examine the efficacy of cognitive behavioral therapy (CBT) for anxiety-related disorders based on randomized placebo-controlled trials. We included 41 studies that randomly assigned patients (N = 2,843) with acute stress disorder, generalized anxiety disorder (GAD), obsessive compulsive disorder (OCD), panic disorder (PD), posttraumatic stress disorder (PTSD), or social anxiety disorder (SAD) to CBT or a psychological or pill placebo condition. Findings demonstrated moderate placebo-controlled effects of CBT on target disorder symptoms (Hedges' g = 0...
February 16, 2018: Depression and Anxiety
Danielle A Lopes, Thaissa M O Souza, José S de Andrade, Mariana F S Silva, Hanna K M Antunes, Luciana Le Seur Maluf, Isabel C Céspedes, Milena B Viana
Environmental enrichment (EE) is an animal management technique, which seems to improve adaptation to the experimental conditions of housing in laboratory animals. Previous studies have pointed to different beneficial effects of the procedure in the treatment of several disorders, including psychiatric conditions such as depression. The anxiolytic effects induced by EE, on the other hand, are not as clear. In fact, it has been proposed that EE acts as a mild stressor agent. To better understand the relationship of EE with anxiety-related responses, the present study exposed rats to one week of EE and subsequently tested these animals in the inhibitory avoidance and escape tasks of the elevated T-maze (ETM)...
February 12, 2018: Behavioural Brain Research
Antonia Kotianova, Michal Kotian, Milos Slepecky, Michaela Chupacova, Jan Prasko, Ingrid Tonhajzerova
Background: Alarming somatic symptoms, in particular, cardiovascular symptoms, are the characteristic feature of panic attacks. Increased cardiac mortality and morbidity have been found in these patients. Power spectral analysis of electrocardiogram R-R intervals is known to be a particularly successful tool in the detection of autonomic instabilities in various clinical disorders. Our study aimed to compare patients with panic disorder and healthy controls in heart rate variation (HRV) parameters (very-low-frequency [VLF], low-frequency [LF], and high-frequency [HF] band components of R-R interval) in baseline and during the response to the mental task...
2018: Neuropsychiatric Disease and Treatment
G Andrews, A Basu, P Cuijpers, M G Craske, P McEvoy, C L English, J M Newby
BACKGROUND: A 2010 meta-analysis of internet-delivered CBT (iCBT) RCTs argued 'computer therapy for the anxiety and depressive disorders was effective, acceptable and practical health care' without data on effectiveness or practicality in routine practice. METHODS: Databases, reviews and meta-analyses were searched for randomised controlled trials of cCBT or iCBT versus a control group (care as usual, waitlist, information control, psychological placebo, pill placebo, etc...
February 1, 2018: Journal of Anxiety Disorders
Susann Wichmann, Stefan R Bornstein, Thomas Lorenz, Katja Petrowski
This study tested whether the hormonal stress response to the DEX-CRH test may be predictive of the psychotherapy success for panic disorder (PD). Thirty-four patients diagnosed either with agoraphobia with PD or PD without agoraphobia were subjected to cognitive behavioural therapy (CBT). Patients (pre-therapy) and healthy volunteers were exposed to the DEX-CRH test. Blood samples were taken for cortisol and adrenocorticotropic hormone (ACTH) assessment. Established panic-specific questionnaires were handed out for the pre-therapy and post-therapy evaluation of disease severity (with reference to panic beliefs and agoraphobic cognitions, fear of bodily sensations, agoraphobic avoidance behaviour)...
February 2, 2018: Translational Psychiatry
A Ströhle, T Fydrich
According to the Federal Healthcare Survey (Bundesgesundheitssurvey), approximately 15% of the German population fulfil the diagnostic criteria for at least one anxiety disorder within (any) 1 year. Women are affected approximately twice as often as men. The study by the Robert Koch Institute included the systematic assessment of panic disorder, agoraphobia, generalized anxiety disorder, social anxiety disorder and specific phobias; therefore, the question for both those affected and the treating therapist is "anxiety disorders: which psychotherapy for whom?" is of great clinical and healthcare political importance...
January 30, 2018: Der Nervenarzt
Maria Avramidou, Felix Angst, Jules Angst, André Aeschlimann, Wulf Rössler, Ulrich Schnyder
BACKGROUND: Although subacute and chronic gastrointestinal symptoms are very common in primary care, epidemiological date are sparse. The aim of the study was to examine and quantify the prevalence of subacute and chronic gastrointestinal symptoms and their associations with somatic and mental disorders in the general population. METHODS: Data were collected prospectively between 1981 (age m = 22, f = 23) and 2008 (age 49/50) from the Zurich Cohort Study (n = 292 men, 299 women), a representative general population survey...
January 27, 2018: BMC Gastroenterology
Angelo G I Maremmani, Denise Gazzarrini, Amelia Fiorin, Valeria Cingano, Graziano Bellio, Giulio Perugi, Icro Maremmani
Background: In the Gambling Disorder (GD), there is no exogenous drug administration that acts as the central core of the traditional meaning of addiction. A specific psychopathology of Substance Use Disorders has been proposed recently. In a sample of Heroin Use Disorder (HUD) patients entering opioid agonist treatment, it became possible to identify a group of 5 mutually exclusive psychiatric dimensions: Worthlessness-Being trapped (W-BT), Somatic Symptoms (SS), Sensitivity-Psychoticism (SP), Panic Anxiety (PA) and Violence-Suicide (VS)...
2018: Annals of General Psychiatry
Alessandro Pompoli, Toshi A Furukawa, Orestis Efthimiou, Hissei Imai, Aran Tajika, Georgia Salanti
Cognitive-behaviour therapy (CBT) for panic disorder may consist of different combinations of several therapeutic components such as relaxation, breathing retraining, cognitive restructuring, interoceptive exposure and/or in vivo exposure. It is therefore important both theoretically and clinically to examine whether specific components of CBT or their combinations are superior to others in the treatment of panic disorder. Component network meta-analysis (NMA) is an extension of standard NMA that can be used to disentangle the treatment effects of different components included in composite interventions...
January 25, 2018: Psychological Medicine
Laiana A Quagliato, Rafael C Freire, Antonio E Nardi
Panic disorder (PD) is a prevalent and disabling anxiety disorder that can be treated effectively. Selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines are among the most frequently prescribed drugs for PD. In this article, the authors review the current evidence on efficacy, adverse events, and limitations of these two treatment options. Areas covered: MEDLINE/Pubmed and Web of Science databases were searched for open or placebo-controlled trials on SSRIs and/or benzodiazepines in PD treatment...
January 22, 2018: Expert Opinion on Drug Safety
Zahra Fatahi, Zahra Reisi, Gregor Rainer, Abbas Haghparast, Abbas Khani
Despite evidence from psychiatry and psychology clinics pointing to altered cognition and decision making following the consumption of cannabis, the effects of cannabis derivatives are still under dispute and the mechanisms of cannabinoid effects on cognition are not known. In this study, we used effort-based and delay-based decision tasks and showed that ACEA, a potent cannabinoid agonist induced apathetic and impulsive patterns of choice in rats in a dose-dependent manner when locally injected into the anterior cingulate cortex (ACC) and orbitofrontal cortex (OFC), respectively...
January 17, 2018: Neuropharmacology
Geoff McCombe, Frank Fogarty, Davina Swan, Ailish Hannigan, Gerard M Fealy, Lorraine Kyne, David Meagher, Walter Cullen
INTRODUCTION: Identifying and managing mental disorders among older adults is an important challenge for primary care in Europe. Electronic medical records (EMRs) offer considerable potential in this regard, although there is a paucity of data on their use for this purpose. OBJECTIVES: To examine the prevalence/treatment of identified mental disorders among older adults (over 55 years) by using data derived from EMRs in general practice. METHODS: We utilized data from a cross-sectional study of mental disorders in primary care, which identified patients with mental disorders based on diagnostic coding and prescribed medicines...
December 2018: European Journal of General Practice
Shinobu Nagata, Yoichi Seki, Takayuki Shibuya, Mizue Yokoo, Tomokazu Murata, Yoichi Hiramatsu, Fuminori Yamada, Hanae Ibuki, Noriko Minamitani, Naoki Yoshinaga, Muga Kusunoki, Yasushi Inada, Nobuko Kawasoe, Soichiro Adachi, Keiko Oshiro, Daisuke Matsuzawa, Yoshiyuki Hirano, Kensuke Yoshimura, Michiko Nakazato, Masaomi Iyo, Akiko Nakagawa, Eiji Shimizu
OBJECTIVE: Mental defeat and cognitive flexibility have been studied as explanatory factors for depression and posttraumatic stress disorder. This study examined mental defeat and cognitive flexibility scores in patients with panic disorder (PD) before and after cognitive behavioral therapy (CBT), and compared them to those of a gender- and age-matched healthy control group. RESULTS: Patients with PD (n = 15) received 16 weekly individual CBT sessions, and the control group (n = 35) received no treatment...
January 12, 2018: BMC Research Notes
Joseph M Trombello, Michael O Killian, Allen Liao, Katherine Sanchez, Tracy L Greer, Robrina Walker, Bruce Grannemann, Chad D Rethorst, Thomas Carmody, Madhukar H Trivedi
OBJECTIVE: The self-report Concise Associated Symptoms Tracking Scale (CAST-SR) was developed to track mania, irritability, anxiety, panic, and insomnia symptoms among depressed outpatients receiving antidepressant medication. Given the overlap between these domains, depression, and stimulant use disorders, we reexamined CAST-SR psychometrics in a novel sample: individuals with stimulant use disorder receiving aerobic exercise or health education interventions. METHODS: Using the subsample of stimulant-dependent (following DSM-IV criteria) individuals prescribed antidepressants (N = 124) from the multisite Stimulant Reduction Intervention Using Dosed Exercise (CTN-0037) trial (total sample N = 302), conducted July 2010 to February 2013, we analyzed CAST-SR data collected at the first assessment after participant's discharge from residential treatment...
January 9, 2018: Journal of Clinical Psychiatry
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