• Title/Summary/Keyword: Panic Disorder

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Frequency of Sodium Lactate Induced Panic Attacks and Blunted Growth Hormone Responses After Clonidine Infusions in Alochol Dependence Patients (주정의존 환자에서 Sodium Lactate 정주 후에 유발되는 공황 발작의 빈도 및 Clonidine에 의한 성장 호르몬 둔화 반응)

  • Choi, Ihn-Geun;Hyun, Dong-Hun;Yoo, Tae-Hyuk
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.1
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    • pp.13-20
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    • 1996
  • This study was performed to explore the frequency of panic attack induced by sodium lactate in alcohol dependence patients and to compare the extent of blunted growth hormone reponses after clonidine infusion with that of normal controls. The authors investigated 10 alcohol dependence patients receiving inpatient care in Hangang Sacred Heart Hospital from March 2, 1993 to August 31, 1993 and 10 normal controls. The disagnosis of alcohol dependence was based on DSM-III-R. Thirty minutes after the sodium lactate infusions clonidins were administrated. Venous bloods were sampled before the sodium lactate infusions, and 30, 45, 60, 90 minutes after the administrations of clonidine. Plasma growth hormone levels were measured by RIA method. The results were as follows : 1) In the questionaires of Hamilton Anxiety Rating Scale, Hamilton Depression Raing Scale, CAGE, Korean MAST, the scores of alcohol dependent patients were higher than those of normal controls. 2) Sixty percent of alcohol dependence patients and twenty percent of normal controls had panic attacks induced by sodium lactate. 3) All panic attacks induced by sodium lactate were relieved after clonidine infusions. 4) There were blunted growth hormone responses after clonidine infusions in alcohol dependence patients who had sodium lactate induced panic attacks like panic disorder patients. These results suggest that alcohol dependence patients may have noradrenergic abnormality same as panic disorder patients and two disorder may have high biological correlations each other.

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Implicit and Explicit Memory Bias in Panic Disorder (공황장애의 암묵 및 외현기억 편향)

  • Jung, Na-Young;Chae, Jeong-Ho;Lee, Kyoung-Uk
    • Anxiety and mood
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    • v.8 no.1
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    • pp.3-8
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    • 2012
  • Patients with panic disoder (PD) show recollection of their first panic attack, which resembles a trauma that is perceived as an unexpected frightening and subjectively life-threatening event. Information-processing models suggest that anxiety disorders may be characterized by a memory bias for threat-related information. This paper reviews the previous researches that investigated the implicit and/or explicit biases in patients with panic disorder. Among the 17 studies, which addressed the explicit memory bias in PD patients, 11 (64.7%) were found to be explicit memory bias in PD patients. In regards to the implicit memory bias, 4 out of 9 studies (44.4%) were found to support the memory bias. The result shows that evidence of explicit memory bias in PD patients was supported by a number of previous researches. However, evidence of implicit memory bias seems less robust, thus, needs further research for replication. Also, development of new paradigms and applications of various methods will be needed in further researches on memory bias in PD patients.

Personality Characteristics and Those Influences on the Outcome of Cognitive Behavioral Therapy in Patients with Panic Disorder (공황장애 환자의 성격 특성과 인지행동치료의 결과에 미치는 영향)

  • Choi, Young-Hee;Lee, Dong-Hyun;Park, Kee-Hwan;Yoon, Haye-Young;Woo, Jong-Min
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.2
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    • pp.142-153
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    • 2002
  • The authors intended to investigate personality characteristics and those influence on the outcome of cognitive behavioral therapy in patients with panic disorder. 167 patients who met DSM-IV criteria for panic disorder were assessed by the PDQ-R(Personality Disorder Questionnaire-Revision) and various self-report tools for assessing symptoms of panic disorder. The effect of therapy was measured by the changes of scores and the end state functioning before and after 12-sessions of CBT. The patients with panic disorder were more likely showed obsessive-compulsive, avoidant and paranoid personality disorder and also Cluster C. If is needed when patients were divided into two groups according to total scores of PDQ-R(high or low personality disorder groups), high personality disorder group showed many evidences for increased psychopathology at the start of treatments, this suggested the close linkage between panic disorder and personality disorder. Interestingly, there were no significant differences between both groups in scores of clinical variables and the end state functioning. In conclusion, although patients with high tendency of personality disorder had more generalized problems at the beginning of treatments, they could improve as much as the patients with low tendency of personality disorder. They can be helped by cognitive behavioral therapy for panic disorder and seem to profit as much as patients with low tendency of personality disorder. If is needed to seek other factors in poor responders for cognitive behavioral therapy.

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6-months Prospective Follow-up Study of Panic Disorder Treatment (공황장애 환자 치료 결과에 대한 6개월간의 전향적 추적조사)

  • Yu, Je-Chun;Lee, Chul
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.1
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    • pp.58-65
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    • 2001
  • Objectives : It is well known that pharmacologic and behavioral therapies of panic disorder show remarkable acute treatment outcome, however the course of panic disorder in clinical settings is often chronic and relapsing. The purpose of this study is to investigate the treatment outcome of panic disorder and the factors related to good treatment outcome by prospective follow-up study after 6 month in clinical settings. Methods : Twenty nine patients were diagnosed to have panic disorder by SCID(Structured Clinical Interview for DSM-III-R), among the patients who had visited the psychiatric out-patients clinic of the Asan Medical Center for the first time. We determined the initial clinical and demoraphic features of each patient and reevaluated them after 6 months, investigating the treatment outcome by anxiety, phobia, impairment scales. We looked into the rate of the patients who showed good treatment outcome and determined the factors that had relation with good treatment outcome among demographic and clinical features. Results : Nineteen out of 29 patients could be followed after 6 months. Among them, 10 patients 52.6%) on the impairment scale and phobia scale each, and 8 patients(42.1 %) on the anxiety scale showed good treatment outcome. 8 patients(42.1 %) showed good treatment outcome on the all three scales. High score in initial phobia scale had significant relation with good treatment outcome. Short duration of illness did not have significant relation with good treatment outcome however there was a trend(p=0.07). Conclusion : About half(42.1 %) of the panic disorder patients showed good treatment outcome on all three scales. Severe initial phobic symptom and short duration of illness were expected to have relation with good treatment outcome.

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The Stress Coping Strategies and Cognitive Characteristics of Somatic Symptom Perception in Patients with Panic Disorder (공황장애 환자의 스트레스 대처방식과 신체 증상 지각에 대한 인지적 특성)

  • Jung, Hae-Won;Lee, Moo-Suk;Park, Woo-Young;Yang, Jong-Chul;Lim, Eun-Sung;Park, Tae-Won;Chung, Yong-Chul;Chung, Sang-Keun;Hwang, Ik-Keun
    • Anxiety and mood
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    • v.3 no.2
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    • pp.116-122
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    • 2007
  • Objective : The purpose of this study was to investigate the strategies used to cope with stress and the cognitive characteristics of somatic symptom perception in patients with panic disorder. Methods : A total of 101 patients who met the DSM-IV criteria for panic disorder and 60 normal controls were recruited for participation in this study. We evaluated the subjects using The Way of Stress Coping Questionnaire (SCQ), Somato-Sensory Amplification Scale (SSAS), Symptom Interpretation Questionnaire (SIQ), and the Panic Disorder Severity Scale (PDSS). We analyzed the data using an independent t-test and Pearson correlation analysis (p<0.05). Results : The patients who used emotionally focused coping strategies scored significantly lower on the SCQ. The patients with panic disorder showed greater amplification of body sensations in the SSAS, a significantly higher score on the physical interpretation subset of the SIQ, and a lower score on the environmental interpretation subset of the SIQ than the normal controls. The PDSS scores were positively correlated with the SSAS score and physical interpretation score on the SIQ. Conclusion : These results show that patients with panic disorder have poor emotionally focused strategies for coping with stress, greater amplification of body sensations, and a tendency towards a physical interpretation of somatic symptoms.

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Effect of video-based movement therapy program on panic disorder symptom relief and brain wave on patients with panic disorder (공황장애 환자의 동영상 기반 동작치료 프로그램 수행이 공황장애 증상 완화 및 뇌파에 미치는 영향)

  • Jeong, Jin-Hyup
    • Journal of Digital Convergence
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    • v.17 no.10
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    • pp.453-459
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    • 2019
  • This study was conducted to investigate the effects of video - based movement therapy program on emotional variables (anxiety, depression, panic disorder) and EEG on panic disorder patients. The following conclusions were obtained. The results of the 12 - week video - based behavior therapy program showed that there were statistically significant differences (p <.05) in the anxiety scale of the exercise group. There were statistically significant differences (p <.05) between the left brain L-Beta region of the exercise group and the left brain H-Beta and the right brain L-Beta regions of the control group and no significant difference was found between the groups. The results of this study suggest that the performance of the video-based behavioral therapy program for panic disorder patients did not affect the emotional variables and EEG changes. However, in the case of emotional variables, It is considered that the longer the program execution period, the more result will be obtained. In addition, it is expected that more positive study results can be expected if the program is run after having had enough familiarity and adaptation time of the operation treatment program omitted in this study.

A Case Report of a Panic Disorder patient suffering from a Chronic Headache (만성두통을 호소하는 공황장애 환자의 두통 치험 1례)

  • Cha, Hye-Jin;Lee, Ji-Won;Chu, Ching-Nai;Kim, Hyo-Ju;Seo, Young-Min;Park, Se-Jin
    • Journal of Oriental Neuropsychiatry
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    • v.19 no.2
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    • pp.279-288
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    • 2008
  • In this case, a 33 year-old female patient had a chronic headache with Panic disorder, and accompanied gastroenteric troubles(vomiting, nausea, dyspepsia and abdominal discomfort), for fifteen years. It may be the symptoms of Phlegm-syncope headache, and we treated this disease with oriental medical treatment, including the Banhabaekchulcheonma-tang, Breathing retraining and Cognitive retructuring. The effects of treatment were measured by were using BPI(Brief Pain Inventory), VAS(Visual analog scale). In Conclusion, Chronic headache with panic disorder was improved by our treatment.

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Clinical Characteristics of Female Panic Disorder with Early Sexual Abuse History (초기 성 학대 경험이 있는 여성 공황장애 환자의 임상적 특성)

  • Kim, Kyung Min;Kim, Min-Kyoung;Lee, Kang Soo;Choi, Tai Kiu;Lee, Sang-Hyuk
    • Korean Journal of Biological Psychiatry
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    • v.23 no.4
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    • pp.130-139
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    • 2016
  • Objectives The objective of this study is to investigate differences of clinical characteristics between a healthy female control group and female panic disorder (PD) patients with early sexual abuse history (PD+S) and without early sexual abuse history (PD-S). Methods We examined data from 83 patients diagnosed with PD and 20 healthy control subjects. We divided the patients with PD into PD+S (32 patients) and PD-S (51 patients) to compare demographic and clinical characteristics. The following instruments were applied: the Stress coping strategies, the Beck Depression Inventory (BDI), the Panic Disorder Severity Scale, the Anxiety Sensitivity Index-Revised (ASI-R), the Albany Panic and Phobia Questionnaire (APPQ) and the NEO-neuroticism. Results Compared to the PD-S, the PD+S group showed higher scores in neuroticism and the APPQ. And, in the PD+S group, the scores of neuroticism were correlated with the ASI-R and APPQ subscale scores and the APPQ total scores were associated with the scores of BDI. Conclusions This study shows that female PD+S patients have higher scores in neuroticism and the APPQ than the PD-S group, and these factors are associated with the panic-related symptoms severity. It emphasizes the need of specific strategies considering the childhood abuse history such as early sexual abuse in clinical approach among patients with PD.

Evaluation of Therapeutic Effects of Cognitive-Behavioral Therapy in Patients with Panic Disorder using Serial $^{99m}Tc-ECD$ Brain Perfusion (공황장애 환자에서 $^{99m}Tc-ECD$ 뇌관류 SPECT를 이용한 인지행동치료 효과 평가)

  • Kim, Jung-Hee;Song, Ho-Chun;Yang, Jong-Chul;Lee, Byeong-Il;Heo, Young-Jun;Bom, Hee-Seung;Park, Tae-Jin;Min, Jung-Joon
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.6
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    • pp.302-308
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    • 2006
  • Purpose: Although several neuroanatomical models of panic disorder have been proposed, little is known regarding the neurological mechanisms underlying cognitive-behavioral therapy (CBT) in patients with panic disorder. This study was performed to identify the brain structures that show changes of regnioal cerebral blood flow (rCBF) after CBT in patients with panic disorder. Materials and Methods: Seven patients who were diagnosed as panic disorder by DSM-IV were treated with CBT for 8 weeks and twelve healthy volunteers joined in this study. Serial $^{99m}Tc-ECD$ brain perfusion SPECT images were acquisited and PDSS-SR (Self-Report version of Panic Disorder Severity Scale) and ACQ (Agoraphobic Cognitive Question) scores were measured just before and after CBT in all patients. Data were analyzed using SPM2. Results: Subjective symptoms were improved, and PDSS-SR and ACQ scores were significantly reduced ($14.9{\pm}3.9\;vs.\;7.0{\pm}1.8$, p<0.05; $30.3{\pm}8.5\;vs.\;21.6{\pm}3.4$, p<0.05, respectively) after CBT in panic patients. Before CBT, a significant increase of rCBF was found in the cingulate gylus, thalamus, midbrain, both medial frontal and temporal lobes of the panic patients compared to the normal volunteers. After CBT, we observed a significant rCBF decrease in the left parahippocamus, right insula and cingulate gyrus, both frontal and temporal lobes, and a significant rCBF increase in both the occipital lobes, left insula, both frontal and left parietal lobes. Conclusion: These data suggested that CBT is effective for panic disorder and diminish the activity of the brain areas associated with fear in panic disorder.

Recent Advances in Cognitive Behavioral Therapy for Panic Disorder (공황장애 인지행동치료의 최신 지견)

  • Seo, Ho-Jun;Lee, Kang-Soo;Lee, Sang-Hyuk;Suh, Ho-Suk
    • Anxiety and mood
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    • v.12 no.1
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    • pp.47-55
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    • 2016
  • 30% of patients with panic disorder (PD) show treatment-resistant and chronic waxing and waning course. Therefore, adequate treatment strategies for PD by evidence based pharmacotherapy and combined cognitive behavioral therapy (CBT) are recommended. Regarding how and why CBT for PD works, three hypotheses include the cognitive theory, anxiety control theory, and behavioral theory were discussed. The recent findings that the altered activation in frontal lobe is normalized after CBT, suggest a reduction of an altered top-down fear processing in the neural correlates of CBT in PD. In order to improve accessibility to CBT, brief CBT and internet based CBT for PD were suggested. Despite limitations of sample sizes and study design, most of studies suggest that brief CBT is more effective than control conditions, and even as equally effective as standard CBT. The evidences suggest that internet based CBT may not be significantly different from face-to-face CBT in reducing anxiety. Several advances within the field of third-wave CBT for PD have led to the development of new techniques based on mindfulness, such as mindfulness-based cognitive therapy and acceptance and commitment therapy. Based on Korean algorithm project for panic disorder, especially the psychological education and cognitive reconstruction components were recommended in CBT with PD.

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