Panic disorder respiratory subtype: a comparison between responses to hyperventilation and CO2 challenge tests.

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Panic disorder respiratory subtype: a comparison between responses to hyperventilation and CO2 challenge tests.

Freire RC, Lopes FL, Valença AM, Nascimento I, Veras AB, Mezzasalma MA, de-Melo-Neto VL, Zin WA, Nardi AE.

Laboratory of Panic & Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rua Visconde de Pirajá, 407/702, 22410-003, Rio de Janeiro, Brazil. rafaelcrfreire@terra.com.br

In this study 117 panic disorder patients were divided into a respiratory subtype group and a non-respiratory subtype group. The respiratory subtype patients were observed to be more sensitive to the 35% CO(2) inhalation challenge test and the hyperventilation test than the non-respiratory subtype patients.

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PMID: 17964660 [PubMed – indexed for MEDLINE]

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New-onset anxiety disorders at high altitude.

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New-onset anxiety disorders at high altitude.

Fagenholz PJ, Murray AF, Gutman JA, Findley JK, Harris NS.

Departments of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02140, USA.

OBJECTIVE: Studies on the neurologic effects of high-altitude travel have focused on psychometric and cognitive testing and the long-term effects of hypoxia on memory and cognition. Few authors have discussed overt clinical psychiatric illness during high-altitude travel, and those few have focused on patients with preexisting psychiatric diagnoses. We describe a series of patients with new-onset anxiety disorders at high altitude treated at the Himalayan Rescue Association (HRA) clinic in Pheriche, Nepal (4240 m) in the spring season of 2006. METHODS: We report on all 6 cases of anxiety-related illness diagnosed at the HRA Pheriche Clinic during the spring season, 2006. Three cases, representing the 3 discrete types of illness we encountered, are described in detail. RESULTS: Six of 76 foreign patients and none of the 224 Nepalis seen during the season had anxiety-related primary diagnoses. None of the 6 patients had a history of psychiatric disorders or anxiety-related problems at low altitude. Three of the 6 patients were seen after hours, and all 6 required multiple visits. We describe 3 types of anxiety-related disorders: limited-symptom panic attacks induced by nocturnal periodic breathing, excessive health-related anxiety, and excessive emotionality. CONCLUSIONS: Anxiety-related illness requires significant use of medical resources by high-altitude travelers. Further research is needed to define the epidemiology of anxiety-related disorders at high altitude, to quantify the contributions of various etiologic factors, and to identify safe, effective treatments.

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PMID: 18076297 [PubMed – indexed for MEDLINE]

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Reducing anxiety sensitivity with exercise.

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Reducing anxiety sensitivity with exercise.

Smits JA, Berry AC, Rosenfield D, Powers MB, Behar E, Otto MW.

Department of Psychology, Southern Methodist University, Dallas, Texas 75275, USA. jsmits@smu.edu

BACKGROUND: Exercise interventions repeatedly have been shown to be efficacious for the treatment of depression, and initial studies indicate similar efficacy for the treatment of anxiety conditions. To further study the potential beneficial role of prescriptive exercise for anxiety-related conditions, we examined the role of exercise in reducing fears of anxiety-related sensations (anxiety sensitivity). METHODS: We randomly assigned 60 participants with elevated levels of anxiety sensitivity to a 2-week exercise intervention, a 2-week exercise plus cognitive restructuring intervention, or a waitlist control condition. Assessment of outcome was completed at pretreatment, midtreatment, 1-week posttreatment, and 3-week follow-up. RESULTS: We found that both exercise conditions led to clinically significant changes in anxiety sensitivity that were superior to the waitlist condition, representing a large controlled effect size (d=2.15). Adding a cognitive component did not facilitate the effects of the exercise intervention. Consistent with hypotheses, changes in anxiety sensitivity mediated the beneficial effects of exercise on anxious and depressed mood. CONCLUSIONS: We discuss these findings in terms of the potential role of exercise as an additional psychosocial intervention for conditions such as panic disorder, where anxiety sensitivity is a prominent component of pathology. Copyright 2008 Wiley-Liss, Inc.

PMID: 18729145 [PubMed – in process]

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Frequency and severity of the symptoms of irritable bowel syndrome across the anxiety disorders and depression.

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Frequency and severity of the symptoms of irritable bowel syndrome across the anxiety disorders and depression.

Gros DF, Antony MM, McCabe RE, Swinson RP.

Mental Health Service, Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, United States; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States; Anxiety Treatment and Research Centre, St. Joseph’s Healthcare, Hamilton, ON, Canada.

High rates of irritable bowel syndrome (IBS) symptoms have been reported in individuals diagnosed with anxiety and depressive disorders. However, most studies have investigated these relations in a single disorder, rather than a heterogeneous group of patients, thereby not allowing for comparisons across anxiety disorders and depression, or for considering the effects of comorbidity. Thus, the present study investigated the symptoms of IBS in a diverse group of patients (N=357) by administering questionnaires and a diagnostic interview. A high frequency of IBS symptoms was found in patients with panic disorder, generalized anxiety disorder, and major depressive disorder. However, the frequency of IBS symptoms in patients with social anxiety disorder, specific phobia, and obsessive-compulsive disorder was comparable to rates found in community samples. In addition, anxiety sensitivity and illness attitudes and intrusiveness were predictive of elevated IBS symptomatology. Together, these findings emphasize the role physiological symptoms of anxiety and worry in the co-occurrence of the anxiety disorders and IBS.

PMID: 18819774 [PubMed – as supplied by publisher]

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Psychiatric disturbances in CADASIL: a brief review.

Acta Neurol Scand. 2008 Mar 31 [Epub ahead of print]
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Psychiatric disturbances in CADASIL: a brief review.
Valenti R, Poggesi A, Pescini F, Inzitari D, Pantoni L.
Department of Neurological and Psychiatric Sciences, University of Florence, Italy.
Background – Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited cerebrovascular disease, clinically characterized by a variable combination of migraine, recurrent transient ischemic attack (TIA) or lacunar strokes, cognitive decline, and mood disturbances. However, the assessment of psychiatric disturbances in this disease has never been carried out systematically. Methods – This paper presents a brief review of the literature regarding the occurrence of psychiatric disorders in CADASIL patients. Results – The prevalence of psychiatric disorders in CADASIL patients is reported to range from 20% to 41%. The psychiatric disturbances reported with the highest frequency are mood disturbances (9-41%). Pooling together the studies and considering a total of 454 CADASIL patients reported in the literature, 106 of these were affected by mood disturbances (24%). The majority of studies however did not use any defined criteria to assess the presence of psychiatric disorders and diagnoses were mainly based on history or review of clinical records. Conclusions – The review of CADASIL literature suggests the need for a more structured approach to the investigation of these disturbances that are highly prevalent and may greatly impact quality of life in these patients.
PMID: 18384453 [PubMed – as supplied by publisher]
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