Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-23T15:57:29.382Z Has data issue: false hasContentIssue false
  • English
  • Français

Panic Disorder

An Overlapping or Independent Entity?

Published online by Cambridge University Press:  02 January 2018

A. Okasha ,
Z. Bishry ,
A. H. Khalil ,
T. A. Darwish ,
A. Seif El Dawla  and
A. Shohdy
A. Okasha*
Affiliation:
Department of Neuropsychiatry, Ain Shams University, 3 Shawarby Street, Kasr El Nil–Cairo, Egypt
Z. Bishry
Affiliation:
Department of Psychiatry, Ain Shams University, Cairo, Egypt
A. H. Khalil
Affiliation:
Department of Psychiatry, Ain Shams University, Cairo, Egypt
T. A. Darwish
Affiliation:
Kuwait Hospital for Psychological Medicine, Kuwait City, Kuwait
A. Seif El Dawla
Affiliation:
Department of Psychiatry, Ain Shams University, Cairo, Egypt
A. Shohdy
Affiliation:
Okasha Hospital for Psychological Medicine
*
∗Correspondence
Get access Rights & Permissions [Opens in a new window]

Abstract

We compared three groups of patients with panic disorder, generalised anxiety disorder and major depressive episode with a control group. Methods of comparison included a clinical profile of the patients, assessed by the Arabic version of the Present State Examination (PSE), a psychological battery of tests measuring personality traits and depressive and anxiety states, and the dexamethasone suppression test (DST) as a biological marker. Our data showed that psychological assessment and DST did not significantly differentiate between the three disorders. Despite a symptom overlap between the disorders, however, some symptoms were associated significantly more often with one disorder than another. Patients with panic disorder differed from patients with major depressive episode in showing more situational, avoidance and free floating anxiety, and more anxious foreboding. They showed less self-negligence, ideas of guilt, early awakening and social withdrawal. Compared with patients with generalised anxiety disorder, patients with panic disorder showed more loss of interest and muscle tension and less anxious foreboding, restlessness, inefficient thinking, social withdrawal and delayed sleep. Our conclusion is that the clinical course and the symptom profile of panic disorder justifies its existence as an independent diagnostic category.

Type
Papers
Information
The British Journal of Psychiatry , Volume 164 , Issue 6 , June 1994 , pp. 818 - 825
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alnaes, R. & Torgerson, S. (1989) Clinical differentiation between major depression only, major depression with panic disorder and panic disorder only. In Many Faces of Panic Disorder. Psychiatrica Fennica Supplement, pp. 58–64.CrossRefGoogle Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Anastasi, A. (1978) Psychological Testing (4th edn). New York: MacMillan.Google Scholar
Andrews, G. (1993) Panic and generalized anxiety disorder. Current Opinions in Psychiatry, 6, 191–194.Google Scholar
Arafa, M., Amine, Y. & Mousa, F. (1987) Cognitive components of anxiety: A comparison of panic disorder and a generalized anxiety disorder in an Arab culture. Egyptian Journal of Psychiatry, 10, 89–104.Google Scholar
Avery, D. H., Osgood, T. B., Ishiki, D. M., et al (1985) The DST in psychiatric outpatients with generalized anxiety disorder, panic disorder or primary affective disorder. American Journal of Psychiatry, 142, 844–848.Google ScholarPubMed
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. & Erbaugh, J. (1961) An inventory of measuring depression. Archives of General Psychiatry, 4, 561–571.Google Scholar
Bowen, R. C. & Kohout, J. (1979) The relationship between agoraphobia and primary affective disorders. Canadian Journal of Psychiatry, 24, 317–322.CrossRefGoogle ScholarPubMed
Breier, A., Charney, D. S. & Heninger, G. R. (1984) Major depression in patients with agoraphobia and panic disorder. Archives of General Psychiatry, 41, 1129–1135.Google Scholar
Breier, A., Charney, D. S. & Heninger, G. R. (1985) The diagnostic validity of anxiety disorders and their relationship to depressive illness. American Journal of Psychiatry, 142, 787–797.Google ScholarPubMed
Bridges, M., Yeragani, U. K., Rainey, J. M., et al (1986) Dexamethasone suppression test in patients with panic attacks. Biological Psychiatry, 21, 853–855.Google Scholar
Carroll, B. J. (1982) The dexamethasone suppression test for melancholia. British Journal of Psychiatry, 140, 292–304.Google Scholar
Carroll, B. J., Curtis, G. C. & Mendels, J. Neuroendocrine regulation in depression. Archives of General Psychiatry, 33, 1051–1058.Google Scholar
Coryell, W., Endicott, J., Andreasen, N. C., et al (1988) Depression and panic attacks: The significance of overlap as reflected in follow up and family study data. American Journal of Psychiatry, 145, 293–300.Google Scholar
El-Dawla, A., Okasha, A., Sadek, A., Hamed, A. & Lotaief, F. (1981) Anxiety: a concomitant of some psychiatric disorders (a psychophysiological approach). Egyptian Journal of Psychiatry, 6, 294–309.Google Scholar
Eriksson, E. (1988) Biological markers in depression and panic disorder. In Depression, Anxiety and Aggression: Factors that Influence the Course (eds Swinkels, J. A. & Blijleven, W.). Houten, The Netherlands: Mediact.Google Scholar
Eriksson, E. (1989) Neuroendocrine markers and CSF neurotransmitters and transmitter metabolites in patients with panic disorder. In Many Faces of Panic Disorder. Psychiatrica Fennica Supplement, pp. 35–40.Google Scholar
Eysenck, H. J. (1967) The Biological Basis of Personality. Springfield, IL: Charles C. Thomas.Google Scholar
Eysenck, H. J. & Eysenck, S. B. G. (1975) Manual of Eysenck Personality Questionnaire. London: Hodder and Stoughton.Google Scholar
Gorman, J. M., Askanazi, J., Liebowitz, M. R., et al (1984) Response to hyperventilation in a group of patients with panic disorder. American Journal of Psychiatry, 41, 857–861.Google Scholar
Greden, J. F., Gardner, R., King, D., et al (1983) Dexamethasone suppression test and antidepressant treatment of melancholia. Archives of General Psychiatry, 40, 493–500.CrossRefGoogle ScholarPubMed
Hamilton, M. (1959) The assessment of anxiety states by rating. British Journal of Medical Psychology, 32, 50–55.Google Scholar
Hibbert, G. & Pilsbury, D. (1989) Hyperventilation. Is it a cause of panic attacks? British Journal of Psychiatry, 155, 805–809.CrossRefGoogle ScholarPubMed
Johnston, E., Cunningham, D. G., Firth, C. D., et al (1980) Neurotic illness and its response to anxiolytic and antidepressant treatment. Psychological Medicine, 10, 321–328.Google Scholar
Kelly, D. (1980) (ed.) Anxiety and Emotions: Physiological Basis and Treatment. Springfield, IL: Charles C. Thomas.Google Scholar
Kelly, D., Brown, C. & Shaffer, J. W. (1970) A comparison of physiological and psychological measurements on anxious patients and normal controls. Psychophysiology, 6, 429–441.Google Scholar
Klein, D. F. (1964) Delineation of two drug responsive anxiety patterns. Psychopharmacology, 5, 397–408.CrossRefGoogle Scholar
Klein, D. F. & Fink, M. (1962) Psychiatric reaction patterns to imipramine. American Journal of Psychiatry, 119, 423–438.CrossRefGoogle ScholarPubMed
Klerman, G. L., Weissman, M. M. & Quellette, R. (1991) Panic attacks in the community. Journal of the American Medical Association, 265, 742–746.Google Scholar
Munjack, D. J. & Moss, H. B. (1981) Affective disorder and alcoholism in families of agoraphobics. Archives of General Psychiatry, 38, 869–871.Google Scholar
Okasha, A. (1966) A cultural psychiatric study of El Zar cult in the UAR. British Journal of Psychiatry, 112, 693.CrossRefGoogle Scholar
Okasha, A. & Ashour, A. (1981) Psychodemographic study of anxiety in Egypt (the First application of PSE in its Arabic version). British Journal of Psychiatry, 130, 70–73.Google Scholar
Prothro, E. T. (1955) Arab American differences in the judgement of written messages. Journal of Social Psychology, 42, 3.Google Scholar
Roth, M., Gurney, C., Garside, R. F., et al (1972) Studies in the classification of affective disorders. The relationship between anxiety states and depressive illness. British Journal of Psychiatry, 121, 147–161.Google Scholar
Roy-Byrne, P. P., Uhde, T. W., Post, R. M., et al (1985) Normal pain sensitivity in patients with panic disorder. Psychiatric Research, 14, 75–84.Google Scholar
Shouby, E. (1951) The influence of the Arab language on the psychology of the Arabs. Middle East Journal, 5, 284.Google Scholar
Targum, S. D. (1983) The application of serial neuroendocrine challenge studies in the management of depressive disorder. Biological Psychiatry, 18, 3–19.Google Scholar
Torgersen, S. (1985) Developmental differentiation of anxiety and affective neurosis. Acta Psychiatrica Scandinavica, 71, 304–310.CrossRefGoogle Scholar
Tyrer, P. (1985) Neurosis divisible? Lancet, ii, 685–688.Google Scholar
Vollrath, M. & Angst, J. (1989) Panic disorder in the Zurich cohort study: symptoms and course. In Many Faces of Panic Disorder. Psychiatrica Fennica Supplement, pp. 74–82.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1973) The Present State Examination (PSE) and Catego System. London: Institute of Psychiatry.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.