Author Keywords: anxiety; differential diagnosis; panic 相似文献
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1.
《The world journal of biological psychiatry》2013,14(2):124-125
Summary: The prevalence of mitral valve prolapse (MVP) and panic disorder (PD) has been reported to range from 0-50% depending on the respective diagnostic manuals and described selection criteria. We report the case of a 44-year-old patient suffering from both panic disorder and mitral valve prolapse. While antidepressants did not result in any improvement of panic symptoms, a fast remission was achieved by treating the patient with metoprolol. This case report suggests that betablockers might represent a useful tool in the treatment of panic disorder and mitral valve prolapse. 相似文献
2.
P Toren S Eldar D Cendorf L Wolmer R Weizman R Zubadi S Koren N Laor 《Journal of psychiatric research》1999,33(4):357-361
Studies in adults have suggested a comorbidity of mitral valve prolapse and anxiety disorders, especially panic disorder. The nature of the association between these disorders is yet unclear. In the last years, case studies have appeared, reporting on the comorbidity of anxiety disorders and mitral valve prolapse in children. The present study evaluated the prevalence of mitral valve prolapse in children with anxiety disorders as compared to normal controls. The study group consisted of 52 children, 6-18 years old, with a diagnosis of panic disorder (9.6%), separation anxiety disorder (65.4%) and/or overanxious disorder (61.5%). Fifty-one normal age- and gender-matched healthy children served as controls. All participants were evaluated for the presence of mitral valve prolapse by cardiac auscultation and echocardiography. None of the 52 children with anxiety disorder and one of the 51 control children (1.96%) had mitral valve prolapse. There appears to be no association between childhood anxiety disorders and mitral valve prolapse. Whether children with panic disorder proper show a greater prevalence of mitral valve prolapse remains an open question. Implications to the association of mitral valve prolapse and panic disorder are discussed. 相似文献
3.
Gulpek D Bayraktar E Akbay SP Capaci K Kayikcioglu M Aliyev E Soydas C 《Progress in neuro-psychopharmacology & biological psychiatry》2004,28(6):969-973
OBJECTIVE: The purpose of this study is to test the association between joint hypermobility syndrome (JHS) and panic disorder (PD) and to determine whether mitral valve prolapse (MVP) modifies or accounts in part for the association. METHOD: A total of 115 subjects are included in this study in three groups. Group I (n = 42): panic disorder patients with MVP. Group II (n = 35): panic disorder patients without mitral valve prolapse. Group III (n = 38): control subjects who had mitral valve prolapse without any psychiatric illness. Beighton criteria were used to assess joint hypermobility syndrome. Two-dimensional and M-mode echocardiography was performed on each subject to detect mitral valve prolapse. RESULTS: Joint hypermobility syndrome was found in 59.5% of panic disorder patients with mitral valve prolapse, in 42.9% of patients without mitral valve prolapse and in 52.6% of control subjects. Beighton scores was 4.93 +/- 2.97 in group I, 4.09 +/- 2.33 in group II, and 4.08 +/- 2.34 in group III. There was no significant difference between groups according to Beighton scores. CONCLUSION: We did not detect a statistically significant relationship between panic disorder and joint hypermobility syndrome. Mitral valve prolapse and joint hypermobility syndrome are known to be etiologically related and we suggest that mitral valve prolapse affects the prevalence of joint hypermobility syndrome in the panic disorder patients. 相似文献
4.
Filho AS Maciel BC Romano MM Lascala TF Trzesniak C Freitas-Ferrari MC Nardi AE Martín-Santos R Zuardi AW Crippa JA 《The British journal of psychiatry : the journal of mental science》2011,199(3):247-248
We investigated whether there is an association between anxiety disorders and mitral valve prolapse. We compared mitral valve prolapse prevalence in individuals with panic disorder (n = 41), social anxiety disorder (n = 89) and in healthy controls (n = 102) in an attempt to overcome the biases of previous studies. Our results show no associations between panic disorder or social anxiety disorder and mitral valve prolapse, regardless of the diagnostic criteria employed, and that the relationship between these conditions seems not to be clinically relevant. 相似文献
5.
Twenty panic disorder patients with mitral valve prolapse showed amelioration of prolapse on repeat echocardiogram after treatment for panic disorder. This effect was significant when compared to repeat echocardiograms in eight psychiatrically normal control subjects with mitral valve prolapse. 相似文献
6.
D L Mazza D Martin L Spacavento J Jacobsen H Gibbs 《The American journal of psychiatry》1986,143(3):349-352
Most previous research on mitral valve prolapse investigated its prevalence in patients whose primary diagnosis was one of the anxiety disorders. This study explored the inverse, i.e., the prevalence of anxiety disorders in patients manifesting mitral valve prolapse. There were no significant differences between patients (N = 48) and control subjects (N = 49) in panic disorder, phobic disorder, or generalized anxiety disorder or in the Zung depression score. The patient group scored significantly higher than control subjects on the Zung Anxiety Scale but significantly lower than Zung's patients with "anxiety neurosis". These results cast doubt on the hypothesis that mitral valve prolapse is etiologically related to the pathogenesis of the anxiety disorders. 相似文献
7.
The literature and clinical experience suggest a higher-than-normal incidence of mitral valve prolapse in patients with panic disorder, although the relationship between these two conditions is currently a matter of speculation. Patients with panic disorder are likely to first consult their family practitioner or internist, who may then refer them to a psychiatrist. Hence psychiatrists should be familiar with the signs, symptoms, and management of mitral valve prolapse. The authors describe mitral valve prolapse, panic disorder, and their association, then suggest a strategy for evaluation and treatment of these conditions. 相似文献
8.
R Liberthson D V Sheehan M E King A E Weyman 《The American journal of psychiatry》1986,143(4):511-515
Of 131 patients with panic disorder or agoraphobia, 44 (34%) had definite mitral valve prolapse on the basis of clinical findings of an apical mid- or late systolic click and a murmur and/or a two-dimensional echocardiogram showing prolapse of one leaflet in two views or of two leaflets in a single view. Seven other patients (5%) had a probable diagnosis of mitral prolapse on the basis of a typical murmur alone or an intermittent apical mid- or late systolic click and a prolapsing leaflet in a single echocardiographic view. This finding confirms previous reports of the association between panic disorder and mitral valve prolapse. 相似文献
9.
W Matuzas J Al-Sadir E H Uhlenhuth R M Glass 《The American journal of psychiatry》1987,144(4):493-496
Panic disorder has been associated with mitral valve prolapse and thyroid abnormalities. Mitral valve prolapse has also been associated with thyroid abnormalities. The authors studied a consecutive series of 65 patients self-referred for evaluation of panic attacks, who were examined for cardiac and thyroid abnormalities. Fifty percent of the patients had mitral valve prolapse according to both cardiac auscultation and echocardiography. Twenty-six percent of the women had some thyroid abnormality; 17% had thyroid microsomal antibodies. There was no apparent relationship between mitral valve prolapse and thyroid abnormalities. These observations suggest that panic attacks, mitral valve prolapse, and autoimmune thyroid disorders are associated. 相似文献
10.
Diagnosis of panic disorder in prepubertal children 总被引:2,自引:0,他引:2
B Vitiello D Behar S Wolfson S V McLeer 《Journal of the American Academy of Child and Adolescent Psychiatry》1990,29(5):782-784
Few reports on panic disorder in children are available, despite the retrospectively documented onset in childhood of about 20% of the cases of adult panic disorder. The authors report on six prepubertal children, aged 8 to 13 years, who met DSM-III-R criteria for adult-type panic disorder. Hyperthyroidism, cardiologic, and respiratory problems were excluded as well as abuse of caffeine or other drugs. The first panic attack occurred between 5 to 11 years of age, with an average interval of 3 years between onset of the disorder and diagnosis. Mitral valve prolapse was documented in two cases. Family history was always positive for panic disorder. Although not common, panic disorder should be considered in children with school phobia and positive family history. As it is in adults, mitral valve prolapse may be associated with panic disorder in children. 相似文献
11.
S. Yang T.-H. Tsai Z.-Y. Hou C.-Y. Chen C.-B. Sim 《Acta psychiatrica Scandinavica》1997,96(6):408-411
It has been reported that panic attacks might cause mitral valve prolapse (MVP) via haemodynamic or indirect effects. Such prolapse can be classified as being physiological (benign course) or pathological (poor course). It is therefore important to consider whether panic attacks, as a risk factor for MVP, are associated with its physiological or pathological type. Our study sample consisted of two groups of patients with panic disorder (PD), one having onset within 1 year (n=24) and the other with a history of more than 10 years (n=21). Demographic data, symptom presentations, auscultatory and echocardiographic findings of both groups were compared, but no significant difference was found except with regard to anticipatory anxiety. It is concluded that panic attack exerts no significant effect on mitral valve prolapse. 相似文献
12.
Joint hypermobility (JH) is considered a common benign, hereditary, overlap, connective tissue disorder with a prevalence
in the general population of about 10% in European populations and 25% in other ethnic groups. JH shows an association with
mitral valve prolapse and fibromyalgia. However, the most significant and important association between joint hypermobility
syndrome (JHS) and any other disorder from a clinical point of view is with panic disorder. This article summarizes all published
studies on JHS and anxiety, analyzing the main results and limitations. An overview of the etiologic explanation of the association
between JH and anxiety, with special focus on genetic findings, is also included. The most relevant conclusions are the following:
JHS is more prevalent in individuals with panic disorder/agoraphobia, and patients with JHS present with greater prevalence
of panic disorder/agoraphobia. In addition, there is an association between JHS severity and severity of anxiety, and mitral
valve prolapse plays a secondary role in the association between JHS and anxiety. New fields of research based on these data
are suggested. 相似文献
13.
Clomipramine (25-150 mg/day) was given in a 2-month open clinical trial to patients with DSM-III defined panic disorder (N = 8) or agoraphobia with panic attacks (N = 12); 6 of these patients were found to have MVP. Substantial improvement was seen in all of the patients with MVP and 11 of 14 without MVP. Response was not affected by age, sex, or agoraphobic vs panic disorder diagnosis. Thus, clomipramine appears effective in the treatment of spontaneous panic attacks with or without mitral valve prolapse. 相似文献
14.
R C Hall T P Beresford M K Popkin R S Hoffman B Wooley L Tice A K Hall 《Psychiatric medicine》1989,7(4):217-233
Much has been written about the occurrence of mitral valve prolapse among eating disordered patients. Despite this literature, a causal relationship between the two conditions has yet to be established. The present study evaluated 500 patients with eating disorders and demonstrated an association between a low median ideal body weight and the frequency of mitral valve prolapse (P less than 0.001). The physical signs and symptoms of mitral valve prolapse disappeared in eating disordered patients with the return of normal weight (P less than 0.001). Contrary to prior reports, there was no association between mitral valve prolapse and the occurrence of diagnosable panic or anxiety disorders. The results of this study suggest that the symptoms of anxiety and panic associated with mitral valve prolapse in eating disordered individuals may be due to physiologic change in cardiac status related to weight rather than central nervous system changes associated with classic anxiety disorders. 相似文献
15.
The authors report the prevalence of mitral valve prolapse in bipolar affective disorder. 22 bipolar patients (13 men and 9 women; age 17-75 years, mean 42.3) were selected at random from 41 bipolar patients for echocardiographic examination. Diagnosis of mitral valve prolapse was made if prolapsus of the anterior or posterior valve to the left atrium was seen in the two-dimensional echocardiography and if mid-to late-systolic posterior motion of the mitral valve was greater than 2 mm in M-mode echocardiography. Of the 22 bipolar patients, only two had mitral valve prolapse. This rate does not differ significantly from the 5% rate found in the general population. 相似文献
16.
Mitral valve prolapse and panic disorder 总被引:1,自引:0,他引:1
R R Crowe 《Psychiatric Clinics of North America》1985,8(1):63-71
Recently, there has been considerable interest in the association between panic attacks and mitral valve prolapse. This article reviews the syndrome of mitral valve prolapse, the data on its association with panic attacks, and possible reasons for such an association. Clinical implications are also discussed. 相似文献
17.
Rudradeo C. Bowen 《Progress in neuro-psychopharmacology & biological psychiatry》1983,7(4-6):605-609
1. 1. The literature comparing panic disorder with natural fear, hypoglycemia, hyperthyroidism, pheochromocytoma, the hyperventilation syndrome, the mitral valve prolapse syndrome and partial complex seizures is briefly reviewed.
2. 2. Some features of each of these syndromes may clinically resemble panic disorder.
3. 3. It is concluded that: a) patients with panic disorder should be medically evaluated. b) the diagnosis of panic disorder should be based on a broad system, rather than on symptoms alone, c) diagnostic systems should include a category for “organic anxiety syndromes”.
18.
S R Dager K A Comess A K Saal E J Sisk K W Beach D L Dunner 《Comprehensive psychiatry》1989,30(5):369-375
Fifty consecutive panic patients had M-mode echocardiographs read independently by two cardiologists with expertise in echocardiography. In this prospective study, there was poor interrater reliability (22 of 50; K = 0.11) for diagnosis of mitral valve prolapse (MVP). On repeat evaluation 10 months later there was also unacceptable intrarater reliability for each reader: 22 of 35 (K = 0.41) and 22 of 35 (K = 0.45). We conclude that M-mode echocardiography is clinically unreliable for establishing the diagnosis of mitral valve prolapse. These findings suggest that the variable reporting of M-mode-determined mitral valve prolapse in psychiatric populations may reflect differences among echocardiologists rather than differences in cardiac pathology. The clinical implications of these findings are discussed. 相似文献
19.
Filho AS Maciel BC Martín-Santos R Romano MM Crippa JA 《Primary care companion to the Journal of clinical psychiatry》2008,10(1):38-47
Objective: Although the possible relationship between panic disorder and mitral valve prolapse (MVP) attracted considerable research interest in the 1980s and 1990s, the reported prevalence of MVP in these patients has been inconsistent and widely variable. Clinical and epidemiologic studies have produced controversial data on possible association or definite causal relationship between these 2 entities. The primary objective of the present review was to summarize the current state of knowledge on the association between panic disorder and MVP, including the influence of diagnostic criteria for MVP on the controversial results.Data Sources: We searched MEDLINE, LILACS, and EMBASE databases using the keywords panic and mitral. Inclusion criteria were articles concerning the reciprocal association of MVP and panic disorder, published from the earliest dates available through December 2006.Study Selection: All relevant articles published in English, Spanish, or Portuguese and reporting original data related to the association of MVP and panic disorder were included. Forty articles fulfilling the criteria for inclusion in this review were identified.Data Synthesis: Even though the reported prevalence of MVP in panic disorder varied from 0% to 57%, a significant association between the 2 disorders was documented in 17 of the 40 studies. Such inconsistent results were due to sampling biases in case or control groups, widely different diagnostic criteria for MVP, and lack of reliability of MVP diagnosis. None of the reviewed studies used the current state-of-the-art diagnostic criteria for MVP to evaluate the volunteers. Apparently, the more elaborate the study methodology, the lower the chance to observe a significant relationship between these 2 conditions.Conclusions: Published results are insufficient to definitely establish or to exclude an association between MVP and panic disorder. If any relationship does actually exist, it could be said to be infrequent and mainly occur in subjects with minor variants of MVP. To clarify this intriguing issue, future studies should mainly focus on the observed methodological biases and particularly should use the current criteria for MVP as the standard for evaluation. 相似文献
20.
Brain-derived neurotrophic factor (BDNF), a member of the neurotrophic factor family, plays an important role in the development, maintenance and function of several neuronal systems. Recent studies have demonstrated that antidepressants, commonly used for panic disorder treatment, can increase central BDNF. In addition, animals with BDNF deficits have higher levels of anxiety when exposed to stressors in comparison to normal controls. The present study tested the hypothesis that the BDNF gene Val66Met polymorphism is associated with panic disorder. In this study, therefore, the incidence of this polymorphism was compared in 103 panic disorder patients and 180 normal controls. The genotype and allele frequencies for the BDNF gene Val66Met polymorphism did not differ comparing the two groups. Furthermore, no association was demonstrated between this BDNF polymorphism and either mitral valve prolapse or agoraphobia in panic disorder patients. These findings suggest that the investigated BDNF polymorphism does not play a major role in the pathogenesis of panic disorder in this Chinese population. Further studies exploring the relationship between genetic variations of BDNF and the cerebral atrophy associated with, and antidepressant treatment response in, panic disorder may be appropriate. 相似文献