Panic Disorder Health Article

Signs And Symptoms

Persons with PD have feelings of terror that strike suddenly and repeatedly with no warning. During a panic attack, a person may complain of palpitations, diaphoresis, weakness, faintness, and dizziness. A person's hands may become tingly or numb, and he or she might complain of feeling flushed or chilled. In addition, a person may complain of nausea, chest pain, smothering sensations, a sense of unreality, or fear of impending doom or loss of control. An attack generally peaks within 10 minutes, but some symptoms can last much longer.

PD can last from a few months to many years.

Updated - November 14, 2005.

During panic attacks, patients who have coronary artery disease (CAD) experience significant perfusion defects, according to an article published in the October 15, 2005, issue of The American Journal of Cardiology. The study was led by Dr Richard Fleet of the University of Montreal in Quebec.

The researchers studied 35 patients who had been diagnosed with panic disorder (PD) and CAD, and they compared these patients with 30 patients who had CAD but not PD (the control group). All study patients underwent a panic challenge test that was followed by cardiac evaluation. The well-established challenge test used in the study consisted of 1 vital capacity inhalation of a gas mixture containing 65% oxygen and 35% carbon dioxide. At the time of inhalation, the patients were injected with technetium-99m sestamibi. The cardiac evaluation consisted of the completion of single-photon emission computed tomography (to assess perfusion defects), 12-lead electrocardiography, and measurements of heart rate and blood pressure. All study patients maintained their regimens of cardiac medications.

The characteristics of both groups studied were similar with regard to baseline heart rate and blood pressure, nuclear exercise test results, cardiac medications, and gender. However, the patients who had PD were significantly younger than the patients who did not have PD.

At the point of inhalation, 74% of patients (26 of 35) who had PD had a panic attack as compared with only 6.7% of patients who did not have PD (2 of 30; P < .001). The patients who had PD and CAD and had a panic attack were more likely to develop a reversible myocardial perfusion defect than were the patients in the control group who did have a panic attack (80.9% vs 46.4%; P = .009).

The researchers concluded that having panic attacks preferentially provokes significant perfusion defects in patients who have both PD and CAD, and it is speculated that panic attacks could induce adverse cardiac effects.

In other news, it was reported that Internet-distributed self-help programs supplemented with minimal e-mail support by a therapist are as effective as traditional individual cognitive behavior therapy sessions for managing patients with PD. The findings of this study were published in the October 2005 issue of Behaviour Research and Therapy. .

In the study, Swedish researchers evaluated 49 patients who had PD with or without agoraphobia. The diagnosis of PD was confirmed through an in-person structured clinical interview that occurred before randomization. The patients were then randomly assigned to either receive 10 individual weekly sessions of cognitive behavior therapy or to participate in a 10-module self-help program on the Internet. The Internet program included interactive components such as essay questions, multiple choice quizzes, and an online discussion group.

In both groups, composite within-group effect sizes were high, whereas the between-group effect size was small (Cohen's d = 16). These results were confirmed after a 1-year follow-up period, with a within-group effect size of Cohen's d = 0.80 for the Internet group and d = 0.93 for the live group.

In conclusion, the researchers found supportive evidence that Internet-distributed self-help programs can be a viable and effective method of providing treatment to patients with PD.

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