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[PMID]:29357714
[Au] Autor:Quagliato LA; Freire RC; Nardi AE
[Ad] Endereço:a Laboratory of Panic & Respiration, Institute of Psychiatry , Federal University of Rio de Janeiro , Rio de Janeiro , Brazil.
[Ti] Título:Risks and benefits of medications for panic disorder: a comparison of SSRIs and benzodiazepines.
[So] Source:Expert Opin Drug Saf;17(3):315-324, 2018 Mar.
[Is] ISSN:1744-764X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Panic disorder (PD) is a prevalent and disabling anxiety disorder that can be treated effectively. Selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines are among the most frequently prescribed drugs for PD. In this article, the authors review the current evidence on efficacy, adverse events, and limitations of these two treatment options. Areas covered: MEDLINE/Pubmed and Web of Science databases were searched for open or placebo-controlled trials on SSRIs and/or benzodiazepines in PD treatment. Expert opinion: The literature search yielded 4,957 articles related to the theme. Of these, 24 articles were included in this review. Despite their usefulness in PD, SSRIs are associated with a delay of several weeks in onset of therapeutic effect and have the potential to exacerbate anxiety and panic early in the treatment course. Benzodiazepines present rapid onset of action, but can cause tolerance and dependence. Despite strong evidence of the effectiveness of SSRIs and benzodiazepines in the treatment of PD, few trials have performed head-to-head comparisons of these two drug classes. Future studies on the pharmacological treatment of PD should make direct comparisons of risks, benefits, and limitations of each group. This could help improve the evidence-based pharmacotherapy of PD.
[Mh] Termos MeSH primário: Benzodiazepinas/uso terapêutico
Transtorno de Pânico/tratamento farmacológico
Inibidores da Captação de Serotonina/uso terapêutico
[Mh] Termos MeSH secundário: Benzodiazepinas/administração & dosagem
Benzodiazepinas/efeitos adversos
Tolerância a Medicamentos
Seres Humanos
Transtorno de Pânico/fisiopatologia
Inibidores da Captação de Serotonina/administração & dosagem
Inibidores da Captação de Serotonina/efeitos adversos
Transtornos Relacionados ao Uso de Substâncias/epidemiologia
Fatores de Tempo
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Serotonin Uptake Inhibitors); 12794-10-4 (Benzodiazepines)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE
[do] DOI:10.1080/14740338.2018.1429403


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[PMID]:27775828
[Au] Autor:de Jonge P; Roest AM; Lim CC; Florescu SE; Bromet EJ; Stein DJ; Harris M; Nakov V; Caldas-de-Almeida JM; Levinson D; Al-Hamzawi AO; Haro JM; Viana MC; Borges G; O'Neill S; de Girolamo G; Demyttenaere K; Gureje O; Iwata N; Lee S; Hu C; Karam A; Moskalewicz J; Kovess-Masfety V; Navarro-Mateu F; Browne MO; Piazza M; Posada-Villa J; Torres Y; Ten Have ML; Kessler RC; Scott KM
[Ad] Endereço:Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
[Ti] Título:Cross-national epidemiology of panic disorder and panic attacks in the world mental health surveys.
[So] Source:Depress Anxiety;33(12):1155-1177, 2016 12.
[Is] ISSN:1520-6394
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CONTEXT: The scarcity of cross-national reports and the changes in Diagnostic and Statistical Manual version 5 (DSM-5) regarding panic disorder (PD) and panic attacks (PAs) call for new epidemiological data on PD and PAs and its subtypes in the general population. OBJECTIVE: To present representative data about the cross-national epidemiology of PD and PAs in accordance with DSM-5 definitions. DESIGN AND SETTING: Nationally representative cross-sectional surveys using the World Health Organization Composite International Diagnostic Interview version 3.0. PARTICIPANTS: Respondents (n = 142,949) from 25 high, middle, and lower-middle income countries across the world aged 18 years or older. MAIN OUTCOME MEASURES: PD and presence of single and recurrent PAs. RESULTS: Lifetime prevalence of PAs was 13.2% (SE 0.1%). Among persons that ever had a PA, the majority had recurrent PAs (66.5%; SE 0.5%), while only 12.8% fulfilled DSM-5 criteria for PD. Recurrent PAs were associated with a subsequent onset of a variety of mental disorders (OR 2.0; 95% CI 1.8-2.2) and their course (OR 1.3; 95% CI 1.2-2.4) whereas single PAs were not (OR 1.1; 95% CI 0.9-1.3 and OR 0.7; 95% CI 0.6-0.8). Cross-national lifetime prevalence estimates were 1.7% (SE 0.0%) for PD with a median age of onset of 32 (IQR 20-47). Some 80.4% of persons with lifetime PD had a lifetime comorbid mental disorder. CONCLUSIONS: We extended previous epidemiological data to a cross-national context. The presence of recurrent PAs in particular is associated with subsequent onset and course of mental disorders beyond agoraphobia and PD, and might serve as a generic risk marker for psychopathology.
[Mh] Termos MeSH primário: Inquéritos Epidemiológicos/estatística & dados numéricos
Internacionalidade
Transtorno de Pânico/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Ásia/epidemiologia
Austrália/epidemiologia
Estudos Transversais
Europa (Continente)/epidemiologia
Feminino
Seres Humanos
Masculino
México/epidemiologia
Meia-Idade
Nova Zelândia/epidemiologia
Nigéria/epidemiologia
Transtorno de Pânico/psicologia
Prevalência
América do Sul/epidemiologia
Estados Unidos/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180201
[Lr] Data última revisão:
180201
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1002/da.22572


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[PMID]:29202148
[Au] Autor:Berko EH; Feier G
[Ad] Endereço:Case Western Reserve University School of Medicine, Cleveland, OH, USA. Email: eberko@metrohealth.org.
[Ti] Título:Behavioral Health Consult: Ensuring prompt recognition and treatment of panic disorder.
[So] Source:J Fam Pract;66(12):750-753, 2017 Dec.
[Is] ISSN:1533-7294
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Lorna D was seen by her primary care physician as follow-up to a visit she made to the emergency department (ED). The 37 year old had gone to the ED 4 times in the previous year. Each time she presented with tachycardia, dyspnea, nausea, numbness in her extremities, and a fear that she was having a heart attack. In spite of negative work-ups at each visit (electrocardiogram, cardiac enzymes, complete blood count, toxicology screen, Holter monitoring), Ms. D was terrified that the ED doctors were missing something. She was still "rattled" by the chest pain and shortness of breath she had experienced. Mild symptoms were persisting and she was worried that she would have a heart attack and die without the treatment she believed she needed. How would you proceed with this patient?
[Mh] Termos MeSH primário: Antidepressivos/uso terapêutico
Terapia Cognitiva
Transtorno de Pânico/diagnóstico
Transtorno de Pânico/terapia
Sertralina/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Algoritmos
Terapia Combinada
Diagnóstico Diferencial
Feminino
Seres Humanos
Prognóstico
[Pt] Tipo de publicação:CASE REPORTS
[Nm] Nome de substância:
0 (Antidepressive Agents); QUC7NX6WMB (Sertraline)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171208
[Lr] Data última revisão:
171208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE


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[PMID]:28926359
[Au] Autor:Zugliani MM; Martin-Santos R; Nardi AE; Freire RC
[Ad] Endereço:*Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; †Psychiatry Department, Hospital Clinic, IDIBAPS, CIBERSAM; and ‡Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Carrer de Villarroel, Barcelona, Spain.
[Ti] Título:Personality Traits in Panic Disorder Patients With and Without Comorbidities.
[So] Source:J Nerv Ment Dis;205(11):855-858, 2017 Nov.
[Is] ISSN:1539-736X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Panic disorder (PD) is often correlated with high neuroticism and low extraversion. This study aims to ascertain whether PD patients differ from healthy controls in regard to personality traits and determine if these traits are correlated with comorbid disorders, anxiety, and depression symptoms. Personality traits of 69 PD patients and 42 controls were compared using the Maudsley Personality Inventory. In PD patients, comorbidities, anxiety, and depression symptoms were also evaluated. PD patients showed higher neuroticism and lower extraversion compared with healthy controls. Patients without comorbidities presented similar results to controls, whereas those with comorbidities presented higher neuroticism and lower extraversion scores. PD per se may be unrelated to deviant personality traits, although comorbidities with major depressive disorder and agoraphobia are probably associated with high neuroticism and low extraversion. These traits show a strong correlation with the accumulation and severity of these disorders.
[Mh] Termos MeSH primário: Transtorno de Pânico/psicologia
Personalidade
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Agorafobia/complicações
Agorafobia/psicologia
Ansiedade/complicações
Ansiedade/psicologia
Transtornos de Ansiedade/psicologia
Estudos de Casos e Controles
Estudos Transversais
Depressão/complicações
Depressão/psicologia
Transtorno Depressivo Maior/complicações
Transtorno Depressivo Maior/psicologia
Extroversão (Psicologia)
Feminino
Seres Humanos
Masculino
Meia-Idade
Neuroticismo
Transtorno de Pânico/complicações
Inventário de Personalidade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170920
[St] Status:MEDLINE
[do] DOI:10.1097/NMD.0000000000000745


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[PMID]:28903165
[Au] Autor:Yonkers KA; Gilstad-Hayden K; Forray A; Lipkind HS
[Ad] Endereço:Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
[Ti] Título:Association of Panic Disorder, Generalized Anxiety Disorder, and Benzodiazepine Treatment During Pregnancy With Risk of Adverse Birth Outcomes.
[So] Source:JAMA Psychiatry;74(11):1145-1152, 2017 Nov 01.
[Is] ISSN:2168-6238
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Registry data show that maternal panic disorder, or anxiety disorders in general, increase the risk for adverse pregnancy outcomes. However, diagnoses from registries may be imprecise and may not consider potential confounding factors, such as treatment with medication and maternal substance use. Objective: To determine whether panic disorder or generalized anxiety disorder (GAD) in pregnancy, or medications used to treat these conditions, are associated with adverse maternal or neonatal pregnancy outcomes. Design, Setting, and Participants: This cohort study conducted between July 1, 2005, and July 14, 2009, recruited women at 137 obstetric practices in Connecticut and Massachusetts before 17 weeks of pregnancy and reassessed them at 28 (±4) weeks of pregnancy and 8 (±4) weeks postpartum. Psychiatric diagnoses were determined by answers to the World Mental Health Composite International Diagnostic Interview. Assessments also gathered information on treatment with medications and confounding factors, such as substance use, previous adverse birth outcomes, and demographic factors. Exposure: Panic disorder, GAD, or use of benzodiazepines or serotonin reuptake inhibitors. Main Outcomes and Measures: Among mothers: preterm birth, cesarean delivery, and hypertensive diseases of pregnancy. Among neonates: low birth weight, use of minor respiratory interventions, and use of ventilatory support. Results: Of the 2654 women in the final analysis (mean [SD] age, 31.0 [5.7] years), most were non-Hispanic white (1957 [73.7%]), 98 had panic disorder, 252 had GAD, 67 were treated with a benzodiazepine, and 293 were treated with a serotonin reuptake inhibitor during pregnancy. In adjusted models, neither panic disorder nor GAD was associated with maternal or neonatal complications of interest. Most medication exposures occurred early in pregnancy. Maternal benzodiazepine use was associated with cesarean delivery (odds ratio [OR], 2.45; 95% CI, 1.36-4.40), low birth weight (OR, 3.41; 95% CI, 1.61-7.26), and use of ventilatory support for the newborn (OR, 2.85; 95% CI, 1.2-6.9). Maternal serotonin reuptake inhibitor use was associated with hypertensive diseases of pregnancy (OR, 2.82; 95% CI, 1.58-5.04), preterm birth (OR, 1.56; 95% CI, 1.02-2.38), and use of minor respiratory interventions (OR, 1.81; 95% CI, 1.39-2.37). With maternal benzodiazepine treatment, rates of ventilatory support increased by 61 of 1000 neonates and duration of gestation was shortened by 3.6 days; with maternal serotonin reuptake inhibitor use, gestation was shortened by 1.8 days, 152 of 1000 additional newborns required minor respiratory interventions, and 53 of 1000 additional women experienced hypertensive diseases of pregnancy. Conclusions and Relevance: Panic disorder and GAD do not contribute to adverse pregnancy complications. Women may require treatment with medications during pregnancy, which can shorten the duration of gestation slightly. Maternal treatment with a serotonin reuptake inhibitor is also associated with hypertensive disease of pregnancy and cesarean delivery.
[Mh] Termos MeSH primário: Transtornos de Ansiedade/complicações
Benzodiazepinas/efeitos adversos
Transtorno de Pânico/complicações
Complicações na Gravidez/epidemiologia
Inibidores da Captação de Serotonina/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Transtornos de Ansiedade/tratamento farmacológico
Cesárea/estatística & dados numéricos
Connecticut/epidemiologia
Feminino
Seres Humanos
Hipertensão Induzida pela Gravidez/induzido quimicamente
Hipertensão Induzida pela Gravidez/epidemiologia
Recém-Nascido de Baixo Peso
Massachusetts/epidemiologia
Transtorno de Pânico/tratamento farmacológico
Gravidez
Nascimento Prematuro/induzido quimicamente
Nascimento Prematuro/epidemiologia
Respiração Artificial/estatística & dados numéricos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Serotonin Uptake Inhibitors); 12794-10-4 (Benzodiazepines)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170914
[St] Status:MEDLINE
[do] DOI:10.1001/jamapsychiatry.2017.2733


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[PMID]:28768327
[Au] Autor:Barlow DH; Farchione TJ; Bullis JR; Gallagher MW; Murray-Latin H; Sauer-Zavala S; Bentley KH; Thompson-Hollands J; Conklin LR; Boswell JF; Ametaj A; Carl JR; Boettcher HT; Cassiello-Robbins C
[Ad] Endereço:Center for Anxiety and Related Disorders, Boston University, Boston, Massachusetts.
[Ti] Título:The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Compared With Diagnosis-Specific Protocols for Anxiety Disorders: A Randomized Clinical Trial.
[So] Source:JAMA Psychiatry;74(9):875-884, 2017 Sep 01.
[Is] ISSN:2168-6238
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Transdiagnostic interventions have been developed to address barriers to the dissemination of evidence-based psychological treatments, but only a few preliminary studies have compared these approaches with existing evidence-based psychological treatments. Objective: To determine whether the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) is at least as efficacious as single-disorder protocols (SDPs) in the treatment of anxiety disorders. Design, Setting, and Participants: From June 23, 2011, to March 5, 2015, a total of 223 patients at an outpatient treatment center with a principal diagnosis of panic disorder with or without agoraphobia, generalized anxiety disorder, obsessive-compulsive disorder, or social anxiety disorder were randomly assigned by principal diagnosis to the UP, an SDP, or a waitlist control condition. Patients received up to 16 sessions of the UP or an SDP for 16 to 21 weeks. Outcomes were assessed at baseline, after treatment, and at 6-month follow-up. Analysis in this equivalence trial was based on intention to treat. Interventions: The UP or SDPs. Main Outcomes and Measures: Blinded evaluations of principal diagnosis clinical severity rating were used to evaluate an a priori hypothesis of equivalence between the UP and SDPs. Results: Among the 223 patients (124 women and 99 men; mean [SD] age, 31.1 [11.0] years), 88 were randomized to receive the UP, 91 to receive an SDP, and 44 to the waitlist control condition. Patients were more likely to complete treatment with the UP than with SDPs (odds ratio, 3.11; 95% CI, 1.44-6.74). Both the UP (Cohen d, -0.93; 95% CI, -1.29 to -0.57) and SDPs (Cohen d, -1.08; 95% CI, -1.43 to -0.73) were superior to the waitlist control condition at acute outcome. Reductions in clinical severity rating from baseline to the end of treatment (ß, 0.25; 95% CI, -0.26 to 0.75) and from baseline to the 6-month follow-up (ß, 0.16; 95% CI, -0.39 to 0.70) indicated statistical equivalence between the UP and SDPs. Conclusions and Relevance: The UP produces symptom reduction equivalent to criterion standard evidence-based psychological treatments for anxiety disorders with less attrition. Thus, it may be possible to use 1 protocol instead of multiple SDPs to more efficiently treat the most commonly occurring anxiety and depressive disorders. Trial Registration: clinicaltrials.gov Identifier: NCT01243606.
[Mh] Termos MeSH primário: Agorafobia/terapia
Transtornos de Ansiedade/terapia
Terapia Cognitiva/métodos
Transtorno Obsessivo-Compulsivo/terapia
Transtorno de Pânico/terapia
Fobia Social/terapia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Método Simples-Cego
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE
[do] DOI:10.1001/jamapsychiatry.2017.2164


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[PMID]:28636577
[Au] Autor:Batinic B; Opacic G; Ignjatov T; Baldwin DS
[Ad] Endereço:Faculty of Philosophy, Department of Psychology, University of Belgrade, Clinic of Psychiatry, Clinical Center of Serbia, Pasterova 2, 11000, Belgrade, Serbia, doubleb@eunet.rs.
[Ti] Título:Comorbidity and Suicidality in Patients Diagnosed with Panic Disorder/Agoraphobia and Major Depression.
[So] Source:Psychiatr Danub;29(2):186-194, 2017 Jun.
[Is] ISSN:0353-5053
[Cp] País de publicação:Croatia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Comorbidity of anxiety and depression (both current and lifetime) is associated with greater chronicity and an increased risk of suicidality. We wished to ascertain which symptom clusters had the strongest association with suicidality. Our aims were (1) to examine the presence of current comorbidity and suicidality in patients diagnosed with panic disorder/agoraphobia (PD/A) and major depression (MD), and their relationship with duration of psychiatric treatment and frequency of hospital admission; and (2) to examine which coexisting symptoms were most strongly predictive of suicidality in sub-groups and the overall group. SUBJECTS AND METHODS: The study sample comprised 100 patients with PD/A and MD. The following assessment instruments were applied: the Panic and Agoraphobia Scale, the Beck Anxiety Inventory, the Beck Depression Inventory-II, the Beck Scale for Suicide Ideation, the Obsessive-Compulsive Inventory-Revised, the Liebowitz Social Anxiety Scale and the Whiteley Index of Hypochondriasis. RESULTS: High rates of current comorbidity were seen in both groups. Patients with MD had significantly higher suicidality scores, but were also older, with a longer duration of psychiatric treatment and more frequent hospitalizations. In the overall group, psychiatric comorbidity was correlated with duration of psychiatric treatment and frequency of hospitalizations (with the exception of hypochondriasis which was not correlated with frequency of hospitalization). In both sub-groups and the overall group, suicidality was correlated with scores for all examined comorbidity (with the exception of hypochondriasis in the PD/A group): however, after multiple regression only obsessive-compulsive symptomatology predicted suicidality in all sub-groups and the overall group, as well as depression in the overall group. Depression supposed as dependent variable and obsessive-compulsive symptomatology as a mediator explained around 37% of the variance in suicidal ideation. CONCLUSION: Patients with PD/A or MD show high rates of current comorbidity. The effect of depression on suicidality was significant, but a non-trivial impact was also mediated by obsessive-compulsive symptomatology.
[Mh] Termos MeSH primário: Agorafobia/psicologia
Transtorno Depressivo Maior/psicologia
Transtorno de Pânico/psicologia
Ideação Suicida
[Mh] Termos MeSH secundário: Adulto
Agorafobia/diagnóstico
Agorafobia/epidemiologia
Comorbidade
Estudos Transversais
Transtorno Depressivo Maior/diagnóstico
Transtorno Depressivo Maior/epidemiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Transtorno de Pânico/diagnóstico
Transtorno de Pânico/epidemiologia
Escalas de Graduação Psiquiátrica/estatística & dados numéricos
Psicometria
Fatores de Risco
Sérvia
Estatística como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170622
[St] Status:MEDLINE


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[PMID]:28609311
[Au] Autor:Kim JE; Song IH; Lee SH
[Ad] Endereço:*Graduate School of Social Welfare and the Institute of Convergence Science, Yonsei University, Seoul; and †Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
[Ti] Título:Gender Differences of Stressful Life Events, Coping Style, Symptom Severity, and Health-Related Quality of Life in Patients With Panic Disorder.
[So] Source:J Nerv Ment Dis;205(9):714-719, 2017 Sep.
[Is] ISSN:1539-736X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Although affective disorders have been known to have sex differences in the associated clinical characteristics and quality of life (QOL), sex differences among patients with panic disorder (PD) have remained relatively unexplored in Korea. We examined the sex differences in different types of stressful life events (SLEs), coping styles, symptom severity, and health-related QOL (HRQOL) in patients with PD. Data from 291 female and 254 male participants diagnosed with PD were analyzed using a structured clinical interview following the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria. Females with PD reported more SLEs including separation issues, physical illness or disability, and pregnancy-related problems than males. They also reported lower levels of confrontation and help-seeking coping strategies and higher levels of agoraphobia in symptom severity than males. The HRQOL of females with PD was significantly lower than male in physical functioning of HRQOL. This study suggests that the patient's sex is relevant to the assessment and treatment of PD.
[Mh] Termos MeSH primário: Adaptação Psicológica/fisiologia
Transtorno de Pânico
Qualidade de Vida
Estresse Psicológico
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Transtorno de Pânico/epidemiologia
Transtorno de Pânico/fisiopatologia
Transtorno de Pânico/psicologia
República da Coreia/epidemiologia
Índice de Gravidade de Doença
Fatores Sexuais
Estresse Psicológico/epidemiologia
Estresse Psicológico/fisiopatologia
Estresse Psicológico/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170614
[St] Status:MEDLINE
[do] DOI:10.1097/NMD.0000000000000696


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[PMID]:28575031
[Au] Autor:Bighelli I; Borghesani A; Barbui C
[Ad] Endereço:Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
[Ti] Título:Is the efficacy of antidepressants in panic disorder mediated by adverse events? A mediational analysis.
[So] Source:PLoS One;12(6):e0178617, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:It has been hypothesised that the perception of adverse events in placebo-controlled antidepressant clinical trials may induce patients to conclude that they have been randomized to the active arm of the trial, leading to the breaking of blind. This may enhance the expectancies for improvement and the therapeutic response. The main objective of this study is to test the hypothesis that the efficacy of antidepressants in panic disorder is mediated by the perception of adverse events. The present analysis is based on a systematic review of published and unpublished randomised trials comparing antidepressants with placebo for panic disorder. The Baron and Kenny approach was applied to investigate the mediational role of adverse events in the relationship between antidepressants treatment and efficacy. Fourteen placebo-controlled antidepressants trials were included in the analysis. We found that: (a) antidepressants treatment was significantly associated with better treatment response (ß = 0.127, 95% CI 0.04 to 0.21, p = 0.003); (b) antidepressants treatment was not associated with adverse events (ß = 0.094, 95% CI -0.05 to 0.24, p = 0.221); (c) adverse events were negatively associated with treatment response (ß = 0.035, 95% CI -0.06 to -0.05, p = 0.022). Finally, after adjustment for adverse events, the relationship between antidepressants treatment and treatment response remained statistically significant (ß = 0.122, 95% CI 0.01 to 0.23, p = 0.039). These findings do not support the hypothesis that the perception of adverse events in placebo-controlled antidepressant clinical trials may lead to the breaking of blind and to an artificial inflation of the efficacy measures. Based on these results, we argue that the moderate therapeutic effect of antidepressants in individuals with panic disorder is not an artefact, therefore reflecting a genuine effect that doctors can expect to replicate under real-world conditions.
[Mh] Termos MeSH primário: Antidepressivos/uso terapêutico
Transtorno de Pânico/tratamento farmacológico
[Mh] Termos MeSH secundário: Antidepressivos/efeitos adversos
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antidepressive Agents)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170603
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0178617


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[PMID]:28562148
[Au] Autor:Loprinzi PD; Addoh O; Wong Sarver N; Espinoza I; Mann JR
[Ad] Endereço:a Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management , University of Mississippi , University, MS , USA.
[Ti] Título:Cross-sectional association of exercise, strengthening activities, and cardiorespiratory fitness on generalized anxiety, panic and depressive symptoms.
[So] Source:Postgrad Med;129(7):676-685, 2017 Sep.
[Is] ISSN:1941-9260
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Limited research has evaluated the individual and combined associations of physical activity (PA), cardiorespiratory fitness (CRF) and muscle strengthening activities (MSA) on generalized anxiety, panic and depressive symptoms. We evaluated this topic in a representative sample of young (20-39 years) adults, with considerations by sex. METHODS: Data from the 1999-2004 National Health and Nutrition Examination Survey (N = 2088) were used. Generalized anxiety, panic and depressive symptoms were assessed via self-report as well as using the Generalized Anxiety Disorder, Panic Disorder, and Depressive Disorders modules of the automated version of the World Health Organization Composite International Diagnostic Interview (CIDI-Auto 2.1). PA and MSA were assessed via validated self-report questionnaires and CRF was determined via a submaximal treadmill-based test. An index variable was created summing the number (range = 0-3) of these parameters for each participant. For example, those meeting PA guidelines, MSA guidelines and having moderate-to-high CRF were classified as having an index score of 3. RESULTS: MSA was not independently associated with generalized anxiety, panic and depressive symptoms, but those with higher levels of PA and CRF had a reduced odds of these symptoms (ranging from 40 to 46% reduced odds). Compared to those with an index score of 0, those with an index score of 1, 2, and 3, respectively, had a 39%, 54% and 71% reduced odds of having generalized anxiety, panic and depressive symptoms. Results were consistent across both sexes. CONCLUSION: PA and CRF, but not MSA, were independently associated with generalized anxiety, panic and depressive symptoms. There was evidence of an additive association between PA, CRF, and MSA on these symptoms.
[Mh] Termos MeSH primário: Aptidão Cardiorrespiratória
Transtorno Depressivo/terapia
Exercício
Transtorno de Pânico/terapia
Treinamento de Resistência
[Mh] Termos MeSH secundário: Adulto
Estudos Transversais
Feminino
Seres Humanos
Masculino
Fatores Sexuais
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170601
[St] Status:MEDLINE
[do] DOI:10.1080/00325481.2017.1336054



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