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Disfunción Fisiológica y Cognitiva en Pacientes con Crisis de Angustia en el Período Entre Crisis

Published online by Cambridge University Press:  12 May 2020

L. Dratcu  and
A. Bond
L. Dratcu
Affiliation:
Guy's Hospital, Escuelas Médicay Dental, Clínica de York, 47 Weston Street, LondresSE1 3RR
A. Bond
Affiliation:
Sección de Psicofarmacología Clínica, Instituto de Psiquiatría, King's College, Londres, Reino Unido
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Resumen

Se afirma que las crisis de angustia [panic attacks] y el efecto contra la angustia de los antidepresivos distinguen el trastorno de angustia (TA, panic disorder) del trastorno de ansiedad generalizada (TAG). Sin embargo, la mayoría de estudios que muestran perturbaciones neuroquímicas en el TA pasan por alto el período entre crisis. Comparamos a pacientes con trastorno de angustia en el período entre crisis con controles en medidas bioquímicas, psicológicas y fisiológicas. No hubo diferencias en las pruebas neuroendocrinas. Los pacientes realizaron autoevaluaciones de los síntomas corporales y psicológicos de ansiedad significativamente más altas y puntuaron peor en el recuerdo de palabras. Los pacientes tenían significativamente más fluctuaciones de la conductancia de la piel y más actividad de ondas lentas en el electroencefalograma, un signo de hiperventilación que puede tener implicaciones para la actividad cerebral. Las discrepancias entre las autoevaluaciones de los pacientes y las medidas objetivas de la tasa de pulso y el rendimiento psicomotor indicaron que los pacientes con TA tienen percepciones distorsionadas tanto del funcionamiento físico como del mental. La hiperventilación y las distorsiones cognitivas en los períodos entre crisis pueden facilitar las crisis de angustia y son parte de la patofisiología del trastorno.

Keywords

trastorno de angustiadistorsión cognitivahiperventilaciónelectroencefalogramatrastornos de ansiedad
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 5 , Issue 5 , June 1998 , pp. 319 - 329
Copyright
Copyright © European Psychiatric Association 1998

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References

BIBLIOGRAFIA

Abelson, JLNesse, RMVinik, AI, Pentagastrin infusions in patients with panic disorder. II. Neuroendocrinology Biol Psychiatry 1994; 36; 84–96.CrossRefGoogle ScholarPubMed
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Washington, DC; American Psychiatric Association; 1987.Google Scholar
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association; 1994.Google Scholar
Angst, JVollrath, M. The natural history of anxiety disorders. Acta Psychiatr Scand 1991; 84: 446-52.CrossRefGoogle ScholarPubMed
Barlow, DHVermilyea, JBlanchard, EBVermilyea, BB et al. The phenomenon of panic. J Abnorm Psychol 1985; 94: 320-8.CrossRefGoogle Scholar
Bass, C. Panic attacks and hyperventilation. Br J Psychiatry 1987; 150: 563-4.Google ScholarPubMed
Bond, AJLader, M. The use of analogue scales in rating subjective feelings. Br J Clin Pharmacol 1974; 47: 211-18.Google Scholar
Breier, AChamey, DSHeninger, GR, Agoraphobia with panic attacks: development, diagnostic stability, and course of illness. Ardi Gen Psychiatry 1986; 43: 1029-36.Google ScholarPubMed
Casano, GBPerugi, GMusetti, L, Co-morbidity in panic disorder. Psychiatr Ann 1990; 20: 517-21.CrossRefGoogle Scholar
Clark, DM. A cognitive approach to panic. Behav Res Ther 1986; 24: 461-70.CrossRefGoogle ScholarPubMed
Clark, DMSalkovskis, PMHackmann, AMiddleton, H et al. A comparison of cognitive therapy, applied relaxation and imipramine in the treatment of panic disorder. Br J Psychiatry 1994; 164: 75969.Google Scholar
De Beurs, EVan Balkom, AJLMLange, AKoele, PVan Dick, R.Treatment of panic disorder with agoraphobia: comparison of fluvoxamine, placebo and psychological panic management combined with exposure, and of exposure in vivo alone. Am J Psychiatry 1995; 152: 683-91.Google ScholarPubMed
Dratcu, LBond, A. Referrals for panic disorder to a clinical psychopharmacology research unit. Psychiatr Bull 1993; 17: 416-17.CrossRefGoogle Scholar
Dratcu, LKeating, JWSherwood, RLader, M, A comparison of augmenting central serotonin and noradrenaline function in healthy subjects: implications for studies on the neurochemistry of anxiety. J Psychophannacol 1995; 9: 127-35.CrossRefGoogle ScholarPubMed
Edelman, RJ. Anxiety. Theory, Research and Intervention in Clinical and Health Psychology. Chichester: John Wiley and Sons; 1992.Google Scholar
Jolkkonen, JLepola, UBissette, GNemeroff, CRiekkinen, P, CSF Corticotropin-releasing factor is not affected in panic disorder. Biol Psychiatry 1993; 33: 136-8.CrossRefGoogle Scholar
Kiloh, LGMcComas, AJOsselton, JW, Upton ARM. Clinical Electroencephalography, Fourth Edition. London: Butterworth; 1981, p. 64–87.Google Scholar
Klein, DF. False suffocation alarms, spontaneous panics, and related conditions. An integrative hypothesis. Arch Gen Psychiatry 1993; 50: 306-17.CrossRefGoogle ScholarPubMed
Lader, MHWing, L. Physiological Measures, Sedative Drugs, and Morbid Anxiety, Maudsley Monograph 14. Oxford: Oxford University Press; 1966.Google Scholar
Lader, MHBruce, MS. States of anxiety and their induction by drugs. Br J Clin Pharmacol 1986; 22: 251-61.CrossRefGoogle ScholarPubMed
Lishman, WA. Organic psychiatry. The psychological consequences of cerebral disorder, Second Edition. London: Blackwell; 1987, p. 428-85.Google Scholar
Lum, LC. Hyperventilation syndromes in medicine and psychiatry: a review. J Roy Soc Med 1987; 80: 229-31.CrossRefGoogle ScholarPubMed
McPherson, FM. Psychology in relation to psychiatry. In: Kendell, REZealley, AK, eds. Companion to Psychiatric Studies, Fifth Edition. Edinburg: Churchill Livingstone; 1993, p. 23–42.Google Scholar
Nesse, RMCameron, OGCurtis, GCMcCann, DSHuber-Smith, MJ, Adrenergic function in patients with panic anxiety. Arch Gen Psychiatry 1984; 41: 771-6.CrossRefGoogle ScholarPubMed
Nutt, DJLawson, C. Panic attacks: a neurochemical overview of models and mechanisms. Br J Psychiatry 1992; 160: 165-78.CrossRefGoogle ScholarPubMed
O’Sullivan, GHarvey, IBass, CSheehy, M et al. Psychophysiological investigations of patients with unilateral symptoms in the hyperventilation syndrome. Br J Psychiatry 1992; 160: 664-7.CrossRefGoogle ScholarPubMed
Rainey, JMEttedgui, EPohl, RBalon, R et al. The B-receptor: isoproterenol anxiety States. Psychopathology 1984; 17 suppl 3: 40–51.CrossRefGoogle Scholar
Rosenbaum, AHSchatzberg, AFJost, FACross, PD et al. Urinary free cortisol levels in anxiety. Psychosomatics 1983; 24: 835-7.CrossRefGoogle ScholarPubMed
Roth, WTEhlers, ATaylor, CBMargraf, JAgras, WS, Skin conductance habituation in panic disorder patients. Biol Psychiatry 1990; 27: 1231-43.CrossRefGoogle ScholarPubMed
Roy-Byme, PPUhde, TWSack, DLinnoila, MPost, RM, Plasma HVA and anxiety in patients with panic disorder. Biol Psychiatry 1986; 21: 849-53.Google Scholar
Roy-Byrne, PPCowley, DS. Course and outcome in panic disorder: a review of recent follow-up studies. Anxiety 1994/1995; 1: 151-60.CrossRefGoogle ScholarPubMed
Schachter, SSinger, JE. Cognitive, social and physiological determinants of emotional State. Psychol Review 1962; 69: 379-99.CrossRefGoogle ScholarPubMed
Spielberger, CDGorsuch, RLLushene, RE. The State- Trait Anxiety Inventory. Palo Alto: Consulting Psycnologists Press; 1970.Google Scholar
Stokes, PE. The neuroendocrinology of anxiety. In: Turna, AHMaser, J, eds. Anxiety and the Anxiety Disorders. Hillsdale: Lawrence Erlbaum; 198, p. 5376.Google Scholar
Uhde, TWJoffe, RTJimerson, DCPost, RM, Normal urinary free cortisol and plasma MHPG in panic disorder: clinical and theoretical implications. Biol Psychiatry 1988; 23: 565-85.CrossRefGoogle ScholarPubMed
Vachon, L. Respiratory disorders. In: Kaplan, HISadock, BJ, eds. Comprehensive Texbook of Psychiatry, Fifth Edition. Baltimore: Williams & Wilkins; 1989, p. 1198-209.Google Scholar
Wittchen, HUEssau, CAKrieg, JC, Anxiety disorders: similarities and differences of comorbidity in treated and untreated groups. Br J Psychiatry 1991; 159 suppl 12: 23–33.Google Scholar
Zahn, TP. Psychophysiological approaches to psychopathology. In: Coles, GHDonchin, EPorges, SW, eds. Psychophysiology. Systems, Processes, and Applications. Oxford: Elsevier; 1986. p. 508–610.Google Scholar