Cigarettes smoking may increase the likelihood to develop panic. A recent hypothesis suggests that a cognitive mechanism, triggered by nicotine withdrawal symptoms, would be the pathogenetic explanation of the co-occurrence between cigarette smoking and panic.

The literature on alcohol use disorders shows that alcohol withdrawal favors the onset of panic via a biological mechanism called kindling. Thus, nicotine withdrawal might be the possible biological explanation of the co-occurrence between cigarette smoking and panic.

To study the biological effects of nicotine withdrawal on a panic like response induced by the Breath Holding test (BH).

We run a cross-over design study on current smokers. Each subject received both nicotine and placebo in two different test days according to a randomized, double blind order. Thereafter, they underwent the BH. The panic-like response to the challenge was evaluated measuring blood pressure, heart rate, subjective (Visual Analogue Anxiety Scale - VAAS) and objective anxiety (Panic Symptom List - PSL).

28 subjects (13 females and 15 males) with a mean age of 31.0 ± 10.2 years were studied. At baseline the two conditions did not differ. At pre-test, subjects under nicotine had significantly higher blood pressure and heart rate than under placebo. No statistically significant results were found for the effects of nicotine on the BH response and subjects under nicotine had a longer breath holding time than under placebo.

Nicotine withdrawal symptoms seem not to affect the response to the BH in current smokers.

The monoamine oxidase A (MAO-A) gene has been suggested as a vulnerability gene in the pathogenesis of panic disorder.

Epigenetic processes such as methylation critically influencing gene regulation and mediating adaptation to environmental factors have so far not been investigated in panic disorder.

Thus, in the present study DNA methylation patterns in the MAO-A regulatory and exon1/intron1 region were investigated for association with panic disorder.

Sixty-five patients with panic disorder (m = 21, f = 44) and 65 healthy controls were analyzed for DNA methylation status at 42 MAO-A CpG sites via direct sequencing of sodium bisulfate treated DNA extracted from blood cells. The occurrence of positive and negative life events was ascertained. All subjects were genotyped for the MAO-A VNTR.

Male subjects showed no or only very minor methylation. In female patients, significantly lower methylation was observed at ten MAO-A CpG sites in the promoter and exon/intron 1 in comparison to healthy controls. Additionally, in female subjects the occurrence of negative life events was associated with a decreased methylation status, while positive life events were associated with relatively increased methylation. Age, smoking status or medication did not influence methylation status, the more active MAO-A VNTR alleles were associated with increased methylation in controls.

The present study suggests a potentially female-specific role of epigenetic alterations, i.e. MAO-A gene hypomethylation, in interaction with environmental factors in the pathogenesis of panic disorder. Future studies are warranted to replicate the present finding in independent samples, preferably in a longitudinal design.

The amygdala whis is part of limbic system is activated in case of fear and anxiety. This study evaluated the effects of oxytocin on the basolateral amygdala(BLA) in spontaneous EEG.

In this study 7 Sprague-Dawley adult male rats were used.Under anesthesia with the help of drill by opening a small hole,then by taking bregma as reference with the stereotaxic method(Anteroposterior:−2.8 mm, Lateral:+4.8 mm,Ventrodorsal:−8.5 mm), bipolar EEG electrode was placed to the BLA.Electrodes were fixed by using a dental restorations material.

Electrodes placed 3 days later, the animals are awake in their cages, spontaneous EEG recordings taken from the amygdala. Then, rats (n = 7) 0.9% isotonic NaCl intraperitoneally applied, the EEG was recorded amygdala their cages.

1 day later to the same rats(n = 7) oxytocin 10 IU/Kg were applied IP,5 minutes later of injection of oxytocin EEG records were taken in their own cage.

System records were taken 20 minutes by Biopac MP30 amplifier system in the range of 1–60 Hz band,with 10.000 amplification. We affirmed electrode location histologically following euthanisation.

There is significant(p < 0.05) diminution in delta frequency (&64.4 ± 10.9) of rats which is administred isotonic than spontan EEG records (%79.5 ± 12.8).

There is significant(p< 0.05) increasement in delta frequency (76.8±12.5)of rats which is administred oxytocin than isotonic injected rats (%64.4±10.9).

Anxiety caused by injection of isotonic,is augmented EEG frequency if we compare with resting EEG records.Oxytocin,diminue the EEG frequency of rats which has injection anxiety.This results show electrophyiologicly that oxytocin is an powerfull anxiolytic.

Some studies have demonstrated high cognitive deficits in patients with post-traumatic stress disorder (PTSD).

Considering the limited available information about this issue, we decided to assess the cognitive deficits and memory disturbances in these patients.

The present study is a case control research conducted on 50 patients with post-traumatic stress disorder who were admitted to Ibn-e-Sina psychiatric hospital in Mashhad, in north-eastern part of Iran in 2008. The control group included 50 people of first degree relatives of these patients who met the inclusion criteria of the study. Case and control groups were selected by simple sampling method; and for all of them, a questionnaire of demographic information, Wechsler memory scale, and mini mental status examination (MMSE) were completed. The gathered data were analyzed using SPSS 14th edition by chi square, T test, and analyze of variance.

The mean score of Wechsler memory scale in patients with PTSD (80.78 ± 18.39) was signifantly higher than control group (67.92 ± 7.38) (P = 0.000). The mean score of MMSE was significantly lower in patients with PTSD compared to control group (P = 0.000). The determined disability level assessed by Iranian veterans’ organization and also comorbidity of other psychiatric disorders with PTSD did not have a significant relationship with cognitive deficits, but the duration of PTSD and age of patients were signifantly related to the level of cognitive deficits.

Cognitive deficits and memory disturbances are higher in patients with PTSD than general population.

Social anxiety disorder (SAD) is a common anxiety disorder with a life-time prevalence around 7–10%. Perfectionism is a personality construct defined as the setting of high standards paired with overly critical self-evaluation in pursuit of those standards. Although perfectionism has generally been associated with several forms of psychopathology, research in social anxiety has received less attention.

To explore the relationship between perfectionism and SAD.

A cross-sectional survey of 571 university students was designed. We analysed the association between perfectionism components (concern over mistakes, personal standards, parental expectations, parental criticism, doubt about actions and organisation) and SAD with the Frost Multidimensional Perfectionism Scale (FMPS) and the Liebowitz Social Anxiety Scale (LSAS). SAD diagnostic was confirmed using the Structured Clinical Interview for DSM-IV-Axis-I.

Twelve percent of the sample had SAD, with no gender differences. For both sex, the prevalence of high-perfectionism (FMPS total) was higher in SAD than in control group (p < 0.001). Specifically, high-concern over mistakes and high-doubt about actions was associated to SAD in both gender whereas high-parental criticism was associated to SAD only in women. After controlling for age and personal psychiatric history, only high-concern over mistakes was associated with an increased risk of SAD (OR = 3.41;95%CI = 1.56–7.46) in women.

This study supports the association between SAD and perfectionism specifically with the high-concern over mistakes component in women.

The Schema Therapy model proposes that early maladaptive schemas (EMS) play a key role in the development and maintenance of many psychological disorders. Although the identification of these schemas has received much attention in disorders such as depression and personality disorders, the studies focused on social anxiety are scarce. Therefore, a primary aim of this study was to evaluate the relationships between early maladaptive schemas and social anxiety. On the other hand, according to the Schema Therapy, once developed, the role of schemas in the development of psychological disorders depends largely on how the individual copes with those schemas. Therefore, a second aim was to evaluate the moderating role of coping styles (overcompensation and avoidance) in the relationships between the schemas and social anxiety.

539 students of Bizkaia (Basque Country) aged between 18 and 25 years (M = 20.44, SD = 3.90) completed measures of social anxiety (Caso-A30; Caballo et al., 2010), Early Maladaptative Schemas (YSQ-3; Young, 2005) and coping styles (YRAI-1 and YCI-1 -1; Young, 2003).

Results showed that social anxiety is associated with several schemas: Subjugation, Pessimism, Emotional Inhibition, Grandiosity (negative relationship), Abandonment, Enmeshment, and Self-Sacrifice. Moreover, the relationship between the schema of emotional deprivation and social anxiety is moderated by the coping style of overcompensation, whereas the relationship between enmeshment and sacrifice schemas and social anxiety is moderated by avoidance. Finally, we discuss the implications of these results for understanding social anxiety and its treatment.

To determine the association of anxiety related to Index of religious moral beliefs (IRMB) and quality of life (QoL) of war veterans in Bosnia and Herzegovina.

The sample consists of 59 male war veterans’ inpatients with clinically presented anxiety disorder and 45 controls that were observed as healthy regarding results of previous psychological testing. We applied the Bosnia-Herzegovina versions of Hopkins Symptom Checklist (HSCL-25), Harvard Trauma Questionnaire (HTQ), Manchester Short Assessment of Quality of Life (MANSA) and Religious moral beliefs questionnaire (RMBQ).

Anxious war veterans were older (mean ± standard deviation = 42.5 ± 7.2) years than not anxious (37.6 ± 3.6) (F = 61.605, P < 0.001, ANOVA). The trauma experiences' mean score of war veterans was (mean ± standard deviation) 33.5 ± 12.5 with significant statistical differences between anxious (38.3 ± 12.9) and not anxious war veterans (27.3 ± 8.7) (F = 24.734, P < 0.001, ANOVA). Among anxious war veterans IRMB was significantly lower 39.9 ± 4.8 than among not anxious war veterans (42.6 ± 3.9) (F = 7.788, P = 0.006, ANOVA). QoL was significantly lower amongst anxious 38.8 ± 11.1 than among not anxious war veterans (65.4 ± 8.4) (F = 180.333, P < 0.001, ANOVA).

IRMB negatively associated with trauma experiencesaverage number, with severity of anxiety and positively correlated with level of QoL (Pearson's “r” = − 252, P = 0.015; Pearson's “r” = − 223, P = 0.031; Pearson's “r” = 337, P = 0.001, respectively).

Anxiety disorder of war veterans significantly decreased their quality of life. The religious moral beliefs may help protection of the mental health stability of war veterans' who are suffering because of anxiety disorder after surviving multiple war traumas and may help in prevention of decreasing of their QoL.

Short-term clinical trials have demonstrated the efficacy and safety of pregabalin for the treatment of generalized anxiety disorder (GAD).

This study examines the long-term safety and efficacy of pregabalin (150–600 mg/day) in patients diagnosed with GAD.

Patients completing two short-term, double-blind efficacy trials of pregabalin for the treatment of GAD (n = 329) were enrolled in this 1-year, non-randomized, open-label safety extension study. Disease severity was assessed at baseline, week 27, and week 52 using the Clinical Global Impression of Severity (CGI-S) score (7-point scale). Patients were characterized as “responders” or “non-responders” based on CGI-S scores of ≤2 an >2, respectively. Safety and tolerability were also assessed.

Patients were predominately white (98.5%), female, (67.8%) and had a mean (SD) age of 55 (17) years. Mean (SD) CGI-S scores at baseline (n = 329) and endpoint (n = 319) were 3.55 (1.07) and 2.58 (1.18), respectively, for all patients. One hundred fifty-four (46.8%) patients were characterized as CGI-S responders at endpoint compared to 50 (15.2%) patients at baseline. The number of patients shifting from a non-responder to a responder was 122 (37.1%). Conversely, the number of patients shifting from a responder to a non-responder was 14 (4.3%).

Pregabalin's anxiolytic efficacy was maintained over the 1 year study period. The severity of anxiety symptoms decreased with extended pregabalin treatment, evident by decreased CGI-S score and an increased number of CGI-S responders at endpoint compared to baseline.This study was funded by Pfizer Inc.

Anxiety is associated with decreased functioning and quality of life. Accurate and quick diagnosis of anxiety disorders can help their treatment.

This cross-sectional, analytical descriptive study deals with 344 in Schooler children (10–14 years old childen) in gorgan, selected through cluster sampling. Spence child anxiety scales (SCAS) was completed by their Parents. The collected data were analyzed using descriptive procedures and chi-squar statistical measure.

The results showed that prevalence for all anxiety disorders was 10.8% (females = 3.5%; males = 7.3%) (10.5% social phobia, 12.2% panic disorder, 12.8% generalized Anxiety disorder, 11.9% obsessive-compulsive disorder, 15.7% separation anxiety disorder, and 18% fear of physical injury). There were significant gender differences in the prevalence of separation anxiety disorder (P = 0.000, x2 = 29.21) and fear of physical injury disorder (P = 0.000, x2 = 13.24).

In conclusion, anxiety disorders are frequent in Schooler children. Further studies are needed to evaluate the factors associated with anxiety disorders amongst children in this region. Also Additional epidemiological studies are needed to determine the Prevalence of Anxiety in the broader population of schoolers in Iran country.

Worry is a repetitive cognitive process in which a person anticipates and elaborates on possible undesirable future events and their consequences. On the other hand, mindfulness is nonelaborative, nonjudgmental, present-centered awareness in which experiences that arise in the attentional field are acknowledged and accepted. In previous research, worry and mindfulness have been proposed, respectively, as risk and protective factors for psychopathology, including depression and anxiety. However, so far, the roles of worry and mindfulness were studied separately.

To estimate both specific and common contribution of worry and mindfulness to severity of anxiety and depressive symptoms in a sample of adults from the general population.

One-hundred fifty-six adults recruited from the community took part in the study. They completed self-report questionnaires measuring anxiety symptoms (State-Trait Anxiety Inventory), depressive symptoms (Beck Depression Inventory), worry (Penn State Worry Questionnaire) and mindfulness (Cognitive and Affective Mindfulness Scale Revised). A series of hierarchical stepwise regression analyses were performed on the collected data.

Mindfulness and worry were found to be related to severity of both depressive and anxiety symptoms, with worry being a risk factor and mindfulness being a protective factor. However, the relative contribution of worry and mindfulness was different for the two types of symptoms: worry was a stronger predictor of variance in anxiety symptoms than mindfulness, mindfulness was on the other hand a better predictor of variance in depressive symptoms.

Worry and mindfulness introduce both unique and common contribution to severity of anxiety and depressive symptoms.

Numerous of clinical, epidemiological international studies shows high prevalence and the importance of the panic disorder and its co morbidity.

The aim of this study is to analyze prevalence of panic disorders and its co morbidity in subjects at the Psychiatric Clinic KCUS, and examine the demographic profile of patients.

Randomly selected subjects (aged between 18 and 64 years, N=3679, who were hospitalized at the Psychiatric Clinic from 01/01/2010–31.12.2010.) were interviewed by the Structural Clinical Interview (SCID) which generated DSM-IV diagnoses and to assess co morbidity. Depressive symptoms were assessed by Hamilton Depression Scale (HDRS) with items. Anxiety symptoms were assessed with Beck Anxiety Inventory scale with 21 items. Study is retrospective, clinical-epidemiological.

Of the total number of patients, (3679) 424 (35.3%) was found with panic disorder. Panic Disorder is the most common among male population 45–64 age group. Majority (74%) gained high school education. The most of them, 206 (60%) were unemployed and married 274 (80%). Co morbidity was the most frequent among subjects 26–45 yrs with 2,6%. As co morbid disorder the highest prevalence was PTSD (11.8%); anxiety disorder with 57 (4.7%) and Depression 10 (0.8%) cases. Other demographic characteristics and frequency of Panic Disorders was analyzed as well.

The wider effective assessment, evaluation, diagnosis and treatment can lead to better treatment outcomes and improved quality of life in primary care patients.

Several studies have highlighted a poor emotional processing in patients with Panic Disorder (PD). Difficulty to identify and manage emotional experience might contribute to the enduring vulnerability to panic attacks.

We describe our implementation of a group psychotherapy program, the Emotional Training (ET), aimed at relapse prevention in patients with PD.

The ET group incorporates some elements of the so-called “emotion-focused therapies” in a cognitive-behavioral framework. In particular, it introduces elements of skills training to increase awareness of emotional states (including psychophysical reactions), their acceptance and adaptive modulation. The present study was designed to assess the feasibility and efficacy of ET group in healthy subjects.

Nine participants completed this pilot study, which lasted 6 months, with weekly 2.5 hour sessions. General cognitive abilities, selective attention, cognitive flexibility, management of emotions, emotional expressivity, empathy, inhibition of interference from emotional stimuli (emotional Stroop test) and Theory of Mind were assessed before and at the end of the study. Significant differences at 6 months were found for the emotional Stroop test and the Emphaty Quotient, compared to baseline.

These results suggest that ET intervention increases the ability to perceive the emotional states in social contexts and to inhibit the interference from emotional stimuli. This pilot study provided encouraging results; a further step will be to verify, in patients with PD, the effectiveness of ET and its usefulness in relapse prevention.

Transport phobias is the actual and common problem for megalopolises and large cities of Russia. Subjective severity of transport phobia frequently causes significant functional impairment and lower quality of life.

To determine clinical subtypes, diagnostic categories and levels of transport phobia.

86 hospitalized patients (residents of Moscow) aged 18 to 60 with the leading pathological fear of riding in transport were included in the study. All subjects underwent psychopathological evaluation, psychological testing and follow-up.

3 subtypes of transport phobia were described: 1) mono-phobia (8,1%) - fear of one kind of transport with favorable prognostic value, 2) poly-phobia (50%)- fear of 2 or 3 kinds of transport with other psychopathological syndromes and different prognosis, 3) total transport phobia (41,9%) with unfavorable prognosis.

Fear of going by underground was common initial stage and mentioned as the most anxiogenous situation. The safest mean of transport was an automobile. The course of transport phobia tends to be progressive with the transformation from mono-phobia to pan-phobia.

Transport phobias developed on the basis of previous panic attaks or vegetative paroxysm with hypochondriac fears (cardio-, maniaphobia and etc.).

According to ICD-10 85,5% of patients had agoraphobia with panic disorder, 14,5% - agoraphobia without panic disorder.

Comorbid disorders included post-traumatic stress disorder, specific phobias, MDD and schizotypal disorder.

The level of transport phobia changed from possessing fears into obsessional and overvalued.

The poly-phobia occured more frequently in hospitalized patients.

The purpose of this research is comparisional investigation of intelligence quotient and anxiety level of high school boys living in up and down area of the city in this research. Up area of the city means area of a city that has good and sufficient equipments and schools with skilled teachers for teaching and instruction, and down area of the city means area of a city that has not good and sufficient equipments and schools with skilled teachers for teaching and instruction that residents of this area live in edging of city.

Research method is causative - and comparative. The sample of research were 100 high school boys (50 people from the up of the city and 50 people from the down of the city) that randomly selected and responded to Cattle's intelligence test “form A” and Zang's anxiety questionnaire. For analyzing the data, “T” independent test were used.

The findings showed that there is meaningful difference in intelligence quotient between two groups. It means that the high school boys who live in up area of the city have more intelligence quotient rather than high school boys who live in the down area of the city. But there is not meaningful difference between two groups anxiety level.

Symptoms of Alcohol-Induced Disorders may resemble characteristic features of Panic Attacks. It is also known that individuals with fears occasionally use alcohol as an anti-anxious agent.

The objective of the study was to investigate the relationship between some common fears and Alcohol-Related Disorders. We have sorted out 61 inpatients with the diagnosis of “Panic Disorder (PD) with Agoraphobia” according to the DSM-IV criteria.

The rate of Alcohol Dependence among first-degree relatives of the patients was quite high (24, 6%). Approximately 10% had Alcohol Abuse within 5 years prior to PD onset.

Alcohol-Induced Panic Attacks (13,1%) were accompanied by predominance of somatic symptoms and fear of a life-threatening illness. Most individuals (95,1%) have completely abandoned any experience with alcohol in the first 3 months after manifestation of PD. Some months later, the repeated Panic Attacks could lead to avoidance of a variety of situations. About one-third occasionally used alcohol when they were travelling by public transport. Some patients (9,8%) took alcohol every time they intended being alone out of home which eventually led to Alcohol Dependence (6,5%). When agoraphobia occurred soon after special treatment (so-called “coding from alcohol”) just only the smell and view of alcohol beverages could provoke panic-like symptoms (8,2%).

Both alcohol consumption and anti-alcohol treatment may immediately precede the onset of Panic Attacks. PD alone is associated with low risk of Alcohol Use Disorders. In contrast, agoraphobic symptoms are very likely to be accompanied with the frequent use of alcohol in fearful situations.

The purpose of the present study is to examine the effectiveness of CBT on a sample of no selected, pharmacologically treatment-resistant OCD patients and to find the predictors of successful treatment in these conditions. The therapy was conducted in a naturalistic setting and systematic CBT steps were adapted to each patient. Pharmacologic treatment underwent no or minimal changes during the trial period. Outcome measures included the Y-BOCS, CGI, BDI, BAI, Somatoform Dissociation Questionaire, and Dissociative Experience Scale. The primary outcome measure for response was a rating of 25% improvement in Y-BOCS. There was border for remission -12 points or less on the same scale, and 1-2 points in CGI-S.

As far 47 patients completed the trial. All patients finished minimum of 5 weeks of CBT and showed statistically significant improvement on all outcome measures. At the end of therapy 64.1% of patients were improved. 50% of patients reach remission according Y-BOCS and 40.4% according CGI. The main predictors of good therapeutic outcome were lower scores in Y-BOCS, good insight, high resistance against symptoms, low level of dissociation, and aggressive character of obsessions. The negative predictors were control/symmetry obsession and compulsions, and obsessive slowness and ambivalence.

CBT could be effectively used for medication-resistant OCD patients. There are some factors, like intensity of OCD symptoms, level of insight, resistance against symptoms, and level of dissociation, which could predict outcome of the therapy.

We compare the efficacy of 6weeks therapeutic program and 6weeks follow up in patients suffering with panic disorder and/or agoraphobia and comorbid personality disorder (29 patients) and panic disorder and/or agoraphobia without comorbid personality disorder (31 patients). Patients were treated with CBT and psychopharmacs. They were regularly assessed in week 0, 2, 4, 6 and 12 on the CGI, PDSS, HAMA, SDS, HDRS, BAI and BDI.

A combination of CBT and pharmacotherapy proved to be the effective treatment of patients suffering with panic disorder and/or agoraphobia with or without comorbid personality disorder. The 12th week treatment efficacy in the patients with panic disorder without personality disorder had been showed significantly better compared with the group with panic disorder comorbid with personality disorder in CGI and specific inventory for panic disorder - PDSS. Also the scores in depression inventories HDRS and BDI showed significantly higher decrease during the treatment comparing with group without personality disorder. But the treatment effect between groups did not differ in objective anxiety scale HAMA, and subjective anxiety scale BAI.

We measured HRV in 31 panic disorder patients and 20 healthy controls. Patients were treated with psychotropics. Autonomic nervous system has been evaluated during orthostatic change in three positions (1st - supine 5 minutes, 2nd - standing 5 minutes, 3rd - supine 5 minutes). Intensity of symptoms was assessed using CGI (Clinical Global Impression), BAI (Beck Anxiety Inventory) and BDI (Beck Depression Inventory), DES (Dissociative Experience Scale). The functioning of the ANS has been measured by the microcomputer diagnostic system that is using power spectral analysis which quantifies the heart rate variability. HRV was assessed using time domain, frequency domain, and nonlinear analyses.

There were highly statistically significant differences between panic patients and control group in all components of power spectral analysis in 2nd and 3rd VLF components and in HF components of 2nd of experiment. We have found highly statistically significant negative correlations between level of dissociation measured by DES and some parameters of ANS.

Autonomic dysregulation is associated with panic disorder and has the relation with the level of dissociation, the age of patiens and age of onset of disorder.

The aim of study was to establish the efficacy of CBT or short psychodynamic psychotherapy on non-selected and medication-resistant patients with anxiety disorders and to search for predictors of response.

Short psychodynamic psychotherapy or systematic CBT was tailored according the needs of each patient. Pharmacology treatment remained mainly unchanged during the trial period. Outcome measures were: Clinical Global Impression - Severity of Illness scale (CGI), Dissociative Experience Scale (DES), Somatoform Dissociation Questionnaire (SDQ-20), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI). The primary outcome measures were clinical response defined as 30% decrease in BAI and remission defined as a 1 or 2 points in CGI.

190 patients were included into the study and 15 dropped out. Altogether 175 patients completed at least 5 of 6 weeks of intensive psychotherapy program. Patients of all diagnostic groups showed significant improvement in CGI, BAI, BDI. At the end of the treatment 51.1% of the patients achieved clinical response and 42.3% clinical remission. The main characteristics present at the beginning of the trial increasing probability of achieving response or remission during the treatment were BAI score lower than 25, BDI score lower than 20, no comorbidity with personality disorder, no comorbid depression, no being divorced or widowed.

Therapeutic efficacy of the intensive psychotherapeutics programs for anxiety disorders was predicted with level of anxiety and depression, comorbidity with depression and personality disorders and marital status.