• 심성연구
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• 제37권1호
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• pp.1-30
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• 2022

이 글은 음악을 하는 20대 초반 청년들에게 발생한 공황발작의 의미를 분석 심리학적으로 이해해보고자 하는 시도이다. 공황발작은 주로 20대에 발생한다고 알려진 불안신경증의 일종으로 다양한 자율신경계 증상에 동반되는 극심한 공포와 두려움이 특징이다. 공황발작과 감정기복, 자살사고나 자해행동이 동반된 세 사례에서 공황발작이 나타났던 상황을 살펴보고, 각 사례에서 공황발작의 심리적 의미를 살펴보았다. 첫 번째 사례의 공황발작은 무의식적인 상태로 남아 있고자 하는 이에게 의식성을 가지고 생각하거나 사고하게끔 한다. 두 번째 사례에서 미래를 향한 삶으로의 전진을 망설이며 갈등하는 이에게 내면의 문을 열어 자신의 깊은 마음과 접촉할 수 있게 하여 갈등을 초월할 가능성을 열어주기도 한다. 세 번째 사례에서는 무의식의 실현되고자 하는 본능과 충동을 공황발작으로 경험하고, 그 충동을 의식적으로 실현해간다. 각각 다른 의미가 있는 것처럼 보이는 그들의 공황발작은 청년기 이전 시기의 의식 수준으로부터 새로워질 것을 촉구하는 무의식의 강력한 접근일 것이다.

• 수면정신생리
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• 제4권1호
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• pp.49-56
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• 1997

Nocturnal panic involves sudden awakening from sleep in a state of panic characterized by various somatic sensation of sympathetic arousal and intense fear. Many(18-71%) of the spontaneous panic attacks tend to occur from a sleeping state unrelated to the situational and cognitive context. Nocturnal panickers experienced daytime panics and general somatic sensation more frequently than other panickers. Despite frequent distressing symptoms, these patients tend to exhibit little social or occupational impairment and minimal agoraphobia and have a high lifetime incidence of major depression and a good response to tricyclic antidepressants. Sleep panic attacks arise from non-REM sleep, late stage 2 or early stage 3. The pathophysiology and the similarity of nocturnal panic to sleep apnea, dream-induced anxiety attacks, night terrors, sleep paralysis, and temporal lobe epilepsy are discussed.

• 정신신체의학
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• 제4권1호
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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.

• 정신신체의학
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• 제6권2호
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• pp.104-119
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• 1998

This study was conducted to determine the important factors in the illness behavior of panic disorder patients. And then, find the best ways to lead the patients who have recurrent panic attacks to the adequate therapeutic situations. We studied 53 patients diagnosed as panic disorder according to DSM-IV among the outpatients who had been followed up at Bong Seng Memorial Hospital for 6 Ms, from May 1997 to October 1997. To evaluate the illness behaviors, we designed a checklist including socio-demographic data, degree of subjective distress from medical and psychiatric treatment, panic symptoms, life events, places of help-seeking, Anxiety Sensitivity Index. Using the checklist, we had semistructured interviews with the panic disorder patients to elucidate their help-seeking behaviors from first panic attack to diagnosing as panic disorder. The results were as follows ; 1) After first panic attack, the patients initially sought help at 1) Emergency room 40%, 2) Rest &/or Personal emergency care 35%, 3) Pharmacy 10%, 4) Outpatient care at hospital 10%, 5) Oriental medicine 5%. 2) Considering the panic symptoms, derealization, paresthesia and the severity of panic symptoms were the most important factors affecting the patient's help-seeking behaviors who had experienced the first panic attack. 3) Most of all the patients (80%) were apt to visit the hospitals within 15 days after experiencing about 3 panic attacks. 4) Before diagnosed as panic disorder, the patients had visited 3-5 health care centers during about 1 year. 5) Primary care physicaians(for example, emergency care physicians, family doctors and internists) had the most important roles in treating or guiding the patients to the adequate therapeutic situations. From the above results, the authors propose that non-psychiatric physicians have to know the panic disorder or attacks exactly. When patients complaint sudden onset physical symptoms e.g. palpitation, dyspnea, dizziness or the cognitive symptoms like the fear of death or insanity, physicians should consider the possibility of panic attack and encourage the patients to be evaluated for psychiatric illness.

• 대한한의진단학회지
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• 제16권3호
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• pp.59-68
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• 2012

The purpose of this study is to report the effects of oriental demonstration treatment for Panic Disorder. Panic Disorder is an anxiety disorder, characterized by panic attacks which are recurring episodes of fear accompanied by somatic symptoms such as shortness of breath, palpitations, chest pain, choking, dizziness, trembling and/or faintness. Objectives: We experienced one case of Panic Disorder treated with Asian medical treatment, acupuncture and herbal medication. 20-year-old female patient suffered from Panic Disorder with nausea and insomnia. Methods: Shihosogantang-gami had been applied to the patient. Results: After treatment her Panic Disorder was improved. Conclusions: Shihosogantang -gami of Asian medical treatment could be safe and effective.

• 동의신경정신과학회지
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• 제26권1호
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• pp.1-10
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• 2015

Objectives: The purpose of this study was to evaluate the effect of breath-counting meditation on anxiety disorder patients with panic attack. Methods: Two anxiety disorder patients with panic attack were treated with Breath-counting Meditation, acupunctures, and herb-medications. The patients have been predicted for anxiety disorder with panic attack through Dignosis and Statistical Manual (DSM-IV), Panic Disorder Severity Scale (PDSS), BDI (Beck Depression Inventory), and BAI (Beck Anxiety Inventory) on their 1st and 6th treatments. Results: After the treatments, both the physical and psychological symptoms have decreased. Conclusions: This study suggests that the breath-counting meditation is an effective way for treating patients who are suffering from anxiety disorder with panic attack.

• 정신신체의학
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• 제4권2호
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• pp.245-253
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• 1996

In spite of its prominent effects on reduction of panic attacks and preveniton of relapse, cognitive-behavioral therapy(CBT) for panic disorder is seldomly utilized and studied in this country. for the past year, authors have modified CBT program for panic disorder that was based on PCT(panic control program) designed by Dr. Barlow and Dr. Craske. Our program is composed of informational component, somatic management skills, cognitive restructuring, interoceptive exposure and in vivo exposure. One patient has significantly improved by this program and satisfied with the treatment result. The aim of this article is to present our experience of treating a panic patient with CBT.

• 대한불안의학회지
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• 제7권1호
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• pp.3-8
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• 2011

Cognitive models of panic disorder have emphasized cognitive distortions' roles in the maintenance and treatment of panic disorder (PD). However, the patient's difficulty with identifying and managing emotional experiences might contribute to an enduring vulnerability to panic attacks. Numerous researchers, employing emotion processing paradigms and neuroimaging techniques, have investigated the empirical evidence for poor emotion processing in PD. For years, researchers considered that abnormal emotion processing in PD might reflect a dysfunction of the frontal-temporal-limbic circuits. Although neuropsychological studies have not provided consistent results regarding this model, a few studies have tried to find the biological basis of dysfunctional emotion processing in PD. In this article, we examine the possibility of dysregulation of emotion processing in PD. Specifically we discuss the neural basis of emotion processing and the manner in which such neurocognitive impairments may help clarify PD's core symptoms.

• 대한불안의학회지
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• 제3권2호
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• pp.91-96
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• 2007

Panic disorder is a common psychiatric illness that causes considerable morbidity. However, the biological basis of panic disorder remains unclear. In this report, we present and summarize the current literature on functional neuroimaging studies related to the neurobiology of panic disorder. The findings were summarized and divided into six groups : (1) known brain structures related to anxiety, especially panic disorder ; (2) structural results ; (3) functional imaging studies at rest ; (4) functional imaging studies with challenge testing ; (5) neuroreceptor studies ; and (6) changes in the treatment of panic disorder. Based on the findings of these neuroimaging studies, it seems as though panic disorder involves the hippocampal and parahippocampal areas, including the amygdala, as well as some cortical regions, such as the temporal and prefrontal cortices. Panic disorder is known to be associated with an imbalance between the right and left hemispheres of the brain at rest or during panic attacks. During a panic attack, patients with panic disorder are likely to experience an increase in local activity in the cingulate, insula, midbrain, and so on. On the other hand, a widespread reduction in the cortical areas has also been reported in most provocation studies. Thus, panic disorder may be related to the excess activation of the fear networks in response to subtle environmental cues and insufficient inhibition from higher cortical control areas ; however ; further studies are recommended in order to fully understand the neurobiology of panic disorder.

• 동의신경정신과학회지
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• 제18권3호
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• pp.193-207
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• 2007

Panic disorder is one of the anxiety disorder, characterized by panic attacks which are discrete episodes of fear accompanied by somatic symptoms such as shortness of breath, palpitations, chest pain, choking, dizziness, trembling and/or faintness. We experienced a 41 year-old male who complained of sudden enervation, unstable blood pressure and anxiety about self's symptoms. We bad given herbal medicines aoh cognitive & behavioral therapy. Results from studies to date suggest the cognitive behavioral therapy(CBTl are useful for depression, anxiety disorder, phobia. He understood his symptom's meaning and tried to overcome fear related to symptoms through exposure training. We concluded that cognitive behavioral therapy can be very effective methods to treat panic disorder, because patient with panic disorder has maladaptive automatic thoughts, based on dysfunctional beliefs like "I'm too weak, I have some problem."