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Subclasificación de los pacientes con trastorno de angustia con bradicardia

Published online by Cambridge University Press:  12 May 2020

J. Massana ,
J. A. López Risueño ,
G. Masana ,
T. Marcos ,
L. González  and
A. Otero
J. Massana
Affiliation:
Hospital Clínic i Provincial de Barcelona, Universitat de Barcelona, Barcelona
J. A. López Risueño
Affiliation:
Hospital Clínic i Provincial de Barcelona, Universitat de Barcelona, Barcelona
G. Masana
Affiliation:
Hospital Clínic i Provincial de Barcelona, Universitat de Barcelona, Barcelona
T. Marcos
Affiliation:
Hospital Clínic i Provincial de Barcelona, Universitat de Barcelona, Barcelona
L. González
Affiliation:
Hospital Clínic i Provincial de Barcelona, Universitat de Barcelona, Barcelona
A. Otero
Affiliation:
Hospital Clínic i Provincial de Barcelona, Universitat de Barcelona, Barcelona
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Resumen

Propósito

Ya que la práctica clínica indica que el trastorno de angustia puede no ser una afección homogénea, se llevó a cabo un estudio para examinar la posible existencia de grupos o subgrupos diferentes de pacientes con angustia.

Sujetos y métodos

Treinta y dos pacientes con trastorno de angustia (DSM-III-R) sufrieron la prueba de provocación con lactato en nuestro laboratorio y fueron evaluados en cuanto a su frecuencia cardíaca, presión arterial, sudación y el Inventario de Angustia Aguda.

Resultados

Durante la provocación con lactato, los pacientes que se quejaban sobre todo de síntomas "cardiorrespiratorios" (N = 12) mostraron taquicardia y sudación localizada. A la inversa, los pacientes que se quejaban sobre todo de síntomas "pseudoneurológicos" (N = 16) mostraron bradicardia y sudación generalizada. En ambos grupos, las puntuaciones del Inventario de Angustia Aguda fueron significativamente más altas durante la crisis de angustia que antes, pero la distribución de las puntuaciones fue notablemente diferente.

Discusión y conclusión

Los resultados indican que el trastorno de pánico puede ser una afección heterogénea. Se debaten las implicaciones de estos resultados para otros trastornos fóbicos, para la teoría de la falsa alarma de asfixia de Klein o para el "modelo de la amígdala ampliada".

Keywords

bradicardiamodelo de la amígdala ampliadafalsa alarma de asfixiamecanismos de la angustiatrastorno de angustiataquicardia
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 8 , Issue 5 , June 2001 , pp. 294 - 300
Copyright
Copyright © European Psychiatric Association 2001

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References

Bibliografía

American, Psychiatry AssociationDiagnostic and statistical manual of mental disorders, 3rd ed, rev. Washington, DC: APA; 1987.Google Scholar
American, Psychiatric AssociationDiagnostic and statistical manual of mental disorders, 4th ed. Washington, DC: APA; 1994.Google Scholar
Asmundson, GJ, Stein, MB, Ireland, DA factor analytic study of the dizziness handicap inventory: does it assess phobic avoidance in vestibular referrals? J Vestib Res 1999, 9: 63–8.Google ScholarPubMed
Bienvenu, OJ, Eaton, WWThe epidemiology of blood-injection-injury phobia. Psychol Med 1998; 28: 1129–36.CrossRefGoogle ScholarPubMed
Briggs, AC, Stretch, DD, Brandon, SSubtyping of panic disorder by symptom profile. Br J Psychiatry 1993 163: 201–9.CrossRefGoogle ScholarPubMed
Buller, R, Meier, W, Benhert, OClinicai subtypes of panic-disorder: their descriptive and prospective validity. J Affect Disord 1986; 11: 105–14.CrossRefGoogle Scholar
Charney, DS, Woodsm, SW, Pricem, LHNoradrenergic dys-regulation in panic disorder. In: Ballanger, J Ed. Neurobiology of panic disorder. New York: Alan R Liss Inc; 1990. p. 91-106.Google Scholar
Charney, DS, Dentch, AA functional neuroanatomy of anxiety and fear: implications for the pathophysiology and treatment of anxiety disorders. Crit Rev Neurobiol 1996; 10: 419–4G.Google ScholarPubMed
Connolly, J, Hallam, RS, Marks, IMSelective association of fainting with blood-injury phobias. Behav Res Ther 1976; 7:8–13.CrossRefGoogle Scholar
Copian, JD, Lydiard, RBThe neurobiology of anxiety disorders: brain circuits in panic disorder. Biol Psychiatry 1998; 44:1264–76.Google Scholar
Davis, MThe role of the amygdala in emotional learning. Int Rev Neurobiol 1994, 36: 225–66.CrossRefGoogle ScholarPubMed
Davis, MAre different parts of the extended amygdala involved in fear versus anxiety? Biol Psychiatry 1998; 44: 1239–47.CrossRefGoogle ScholarPubMed
Davis, AFunctional neuroanatomy of anxiety and fear: a focus on the amygdala. In: Charney, DS, Nestler, EJ, Bunney, BS Eds. Neurobiology of mentai illness. New York: Oxford University Press, Inc; 1999. p- 463-74.Google Scholar
De, Jongh A, Bongaarts, G, Vermeule, I, Visser, K, De, Vos P, Makkes, PBlood-injury-injection phobia and dental phobia. Behav Res Ther 1998; 36: 971–82.Google Scholar
Dillon, DJ, Gorman, JM, LieLowitz, MR, Fyer, AJ, Klein, DFMeasurement of lactate-induced panic and anxiety. Psychiatry Res 1987; 20: 97–105.CrossRefGoogle ScholarPubMed
Friedman, BH, Thayer, JFAnxiety and autonomic fleximi-lity: a cardiovascular approach. Biol Psychol 1998; 49: 303–23.Google ScholarPubMed
George, DT, Lindquist, T, Nutt, DJ, Ragan, PW, Alim, T, McFarlane, Vet al. Effect of chloride or glucosa on the incidence of lactate-induced panic attacks. Am J Psychiatry 1995; 152: 692–7.Google ScholarPubMed
Kellner, M, Knandt, KAtrial natriuretic hormona in lactate-induced panic attacks: mode of ralease and endocrine and pathophysiological consequences. J Psychiatr Res 1998; 32:3437–48.CrossRefGoogle Scholar
Klein, DFFalse suffocation alarms spontaneous panics, and relatad conditions. Arch Gen Psychiatry 1993; 50: 306–17.CrossRefGoogle ScholarPubMed
Krafczyk, S, Schlamp, V, Dieterich, M, HaberLauer, PBrandt Increased body sway at 3 5-8 Hz in patients with phobic postural vertiga. Neurosci Lett 1999; 259: 149–52.CrossRefGoogle Scholar
LeDoux, JE, Farb, CF, Ruggiero, DATopographic organization of neurons in the acoustic thalamus that project to the amygdala. J Neurosci 1990; 10: 1043–54.CrossRefGoogle ScholarPubMed
LeDoux, JEThe neural circuits flnderlying anxiety and fear: fear and the brain: where have we been, and where are we going. Biol Psychiatry 1998; 44: 1229–38.CrossRefGoogle Scholar
Liebowitz, MR, Fyer, AJ, Gorman, JMLactate provocation of panic attacks: I. Clinical and behavioral findings. Arch GenPsychiatry 1984; 41: 764–70.Google Scholar
LieLowitz, MR, Gorman, JR, Fyer, AJLactate provocation of panic attacks: II. Biochemical and physiological findings. Arch Gen Psychiatry 1985; 42: 709–19.CrossRefGoogle Scholar
Marks, I, Matthews, AMBrief standard self-rating for phobic patients. BeLav Res Ther 1979; 17: 263–7.CrossRefGoogle ScholarPubMed
Martinsen, EW, Raglin, JSTolerance to intensive exercise and high levels of lactate in panic disorder. J Anxiety Disord 1998; 12: 333–42.CrossRefGoogle ScholarPubMed
Nutt, DJThe pharmacology of human anxiety. Pharmacol Ther 1990; 47: 233–66.CrossRefGoogle ScholarPubMed
Peskind, ER, Jensen, CFSodium lactate and hypertonic sodium chloride induce equivalent panic incidence, panic symptoms and hypernatremia in panic disorder. Biol Psychiatry 1998; 44: 1007–16.CrossRefGoogle ScholarPubMed
Pyke, RE, Greenberg, HSNorepinephrine challenges in panic patients. J Clin Psychopharmacol 1986; 6: 279–85.CrossRefGoogle ScholarPubMed
Sawchuck, CN, Lohr, JM, Lee, TC, Tolin, DFExposure to disgust-evoking imagery and information processing bie-ses in blood-injection-injury phobia. Behav Res Ther 1999; 37: 249–57.CrossRefGoogle Scholar
Segui, J, Slavador-Carulla, L, García, L, Canet, J, Ortiz, M, Farre, JMSemiology and subtyping of panic disorders. Acta Psychiatr Stand 1998; 97: 272–7.CrossRefGoogle ScholarPubMed
Sheehan, DV, BallengerJ, Jacobsen GTreatment of endogenous anxiety with phobic, hysterical and hypochondriacal symptoms. Arch Geni Psychiatry 1980; 37: 51–9.CrossRefGoogle ScholarPubMed
Sheehan, DV, Carr, DB, Fishman, SM, Walsh, MM, Peltier, Saxe DLactate intusion in anxiety research: its evolution and practice. J Clin Psychiatry 1985; 46: 158–65.Google Scholar
Weissman, MMPanic and generalizad anxiety: are they sepárate disorders? J Psychiatr Res 1990; 24 (Suppl 2): 157–62.CrossRefGoogle Scholar