Impaired abstraction and symbolization abilities in subjects with panic disorder

Abstract

Few studies were carried out, so far, on neuropsychological aspects of panic disorder (PD). Impairments involving memory, verbal learning, visuospatial abilities, divided attention and executive functioning have been reported; however, some studies found no difference between patients with PD and healthy subjects (HS). Discrepancies might be due to either the use of different tests for neuropsychological assessment or the inclusion of different patient populations (e.g. medicated, unmedicated).

In the present study general cognitive abilities, focused and sustained attention, incidental learning, secondary memory and the ability to suppress interference were evaluated in 28 drug-free patients with PD and 32 HS, matched for sex, age, educational level and handedness. In patients with PD frequency and intensity of panic attacks, anticipatory anxiety, main phobias and avoidance state, along with severity of anxiety and depressive symptoms, were also assessed.

Compared to HS, PD patients showed: 1) lower scores on tests assessing general cognitive abilities, 2) higher accuracy on the test exploring spatial incidental learning, 3) higher degree of interference on a test exploring secondary memory for non verbal materials. No correlation was observed between neuropsychological and psychopathological indices.

Our results suggest an impairment of abstraction and symbolization abilities in patients with PD. Differences in susceptibility to interference on the non verbal memory task may reflect an executive dysfunction involving orbito-frontal and cingulate cortices.