from Section III - Anxiety Disorders
Published online by Cambridge University Press: 10 January 2011
Panic disorder is a common and incapacitating mental disorder (primary as well as comorbid: PD lifetime prevalence 1.6–4.7% and 12-month prevalence in other mental disorders ~69%; Alonso and Lepine,2007; Kessler et al., 2005). It is characterized by the recurrent, unexpected attacks of multiple somatic (e.g. palpitations, sweating, paresthesias, feeling of shortness of breath or choking) and cognitive fear symptoms (e.g. derealization or depersonalization, fear of losing control or dying), which can occur with or without agoraphobia (fear of experiencing panic in situations from which escape might be difficult). The condition is diagnosed if such panic attacks are followed by persistent concerns about having additional attacks, worry about the implications of the attack or its consequences, and a significant change in the behavior related to the attacks (American Psychiatric Association, 2000).
Brain imaging in panic disorders
Structural and functional neuroimaging studies have contributed enormously to the understanding of the neural substrates of PD. To date, some 200 human neuroimaging studies have been performed using a wide variety of imaging techniques ranging from computed tomography (CT) and structural magnetic resonance imaging (MRI), to positron emission tomography (PET) and single photon emission computed tomography (SPECT), resting state cerebral blood flow (CBF) and receptor binding studies, to functional PET, SPECT and MRI studies using “panicogen” drug challenge (e.g. lactate, CO2, yohimbine) or cognitive activation paradigms (for reviews see Damsa et al., 2009; Engel et al., 2009; Graeff and Del-Ben, 2008; Rauch et al., 2003).
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