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Subtyping of Panic Disorder by Symptom Profile

Published online by Cambridge University Press:  02 January 2018

Andrew C. Briggs*
Affiliation:
The Department of Psychiatry
David D. Stretch
Affiliation:
The Department of Psychiatry
Sydney Brandon
Affiliation:
Department of Psychiatry, University of Leicester, Clinical Sciences Building, Leicester Royal Infirmary, PO Box 65, Leicester LE2 7LX
*
Correspondence

Abstract

During Phase II of the Cross-National Panic Study, descriptions of the patient's last severe panic attack were collected for 1168 patients. Statistical analysis indicated that patients could be divided into two groups, characterised by the presence or absence of prominent respiratory symptoms. The two groups did not differ on demographic variables or coexisting diagnoses, but they did differ on psychopathology on entry to the study and treatment outcome. The group with prominent respiratory symptoms suffered more spontaneous panic attacks and responded to imipramine, whereas the group without prominent respiratory symptoms suffered more situational panic attacks and responded more to alprazolam. It is important to distinguish spontaneous and situational panic attacks, to aid choice of treatment.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1993 

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References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders, (3rd edn) (DSM-III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). Washington, DC: APA.Google Scholar
Aronson, T. A. & Logue, C. M. (1988) Phenomenology of panic attacks: a descriptive study of panic disorder patient's selfreports. Journal of Clinical Psychiatry, 49, 813.Google ScholarPubMed
Baker, R. J. & Nelder, J. A. (1985) The GLIM System Release 3.77 Manual. Oxford: Numerical Algorithms Group.Google Scholar
Bass, C., Kartsounis, L. & Lelliott, P. (1987) Hyperventilation and its relationship to anxiety and panic. Integrative Psychiatry, 5, 274291.Google Scholar
Cameron, O. G., Thyer, B. A., Nesse, R. M., et al (1986) Symptom profiles of patients with DSM-III anxiety disorders. American Journal of Psychiatry, 143, 11321137.Google Scholar
Carr, D. B. & Sheehan, D. V. (1984) Panic anxiety: a new biological model. Journal of Clinical Psychiatry, 45, 323330.Google Scholar
Cattell, R. B. (1966) The scree test for the number of factors. Multivariate Behavioral Research, 1, 245276.CrossRefGoogle ScholarPubMed
Clark, D. M. (1986) A cognitive approach to panic. Behaviour Research and Therapy, 24, 461470.Google Scholar
Costello, C. G. (1992) Research on symptoms versus research on syndromes. Arguments in favour of allocating more research time to the study of symptoms. British Journal of Psychiatry, 160, 304308.Google Scholar
Cross-National Collaborative Panic Study Second Phase Investigators (1992) Drug treatment of panic disorder: comparative efficacy of alprazolam, imipramine and placebo. British Journal of Psychiatry, 160, 191202.CrossRefGoogle Scholar
Fienberg, S. E. (1977) The Analysis of Cross-Classified Categorical Data. Cambridge, MA: MIT Press.Google Scholar
Hibbert, G. A. (1984) Hyperventilation as a cause of panic attacks. British Medical Journal, 288, 263264.Google Scholar
Hoes, M. J. A. J. M., Colla, P., Van Doorn, P., et al (1987) Hyperventilation and panic attacks. Journal of Clinical Psychiatry, 48, 435437.Google Scholar
Katerndahl, D. A. (1988) The sequence of panic symptoms. Journal of Family Practice, 26, 4952.Google ScholarPubMed
Katon, W. (1984) Panic disorder and somatization. American Journal of Medicine, 77, 101106.Google Scholar
Katschnig, H. & Amering, M. (1990) Panic attacks and panic disorder in cross-cultural perspective. In Clinical Aspects of Panic Disorder (ed. Ballenger, J. C.). New York: Wiley Liss.Google Scholar
Klein, D. F. (1973) Drug therapy as a means of syndromal identification and nosological revision. In Psychopathology and Psychopharmacology (eds Cole, J. O., Freedman, A. M. & Friedhoff, A. J.). Baltimore: Johns Hopkins University Press.Google Scholar
Klein, D. F. (1987) Anxiety reconceptualized. Gleaning from pharmacological dissection - early experience with imipramine and anxiety. In Anxiety (ed. Klein, D. F.). Basel: Karger Press.Google Scholar
Lancet (1988) Treatment of syndromes or symptoms in psychiatry (editorial). Lancet, ii, 373374.Google Scholar
Ley, R. (1987) Panic disorder and agoraphobia: fear of fear or fear of the symptoms produced by hyperventilation? Journal of Behavior Therapy and Experimental Psychiatry, 18, 305316.Google Scholar
Lydiard, R. B., Laraia, M. T., Howell, E. F., et al (1986) Can panic disorder present as irritable bowel syndrome? Journal of Clinical Psychiatry, 47, 470473.Google Scholar
Marks, I. M. (1987) Clinical syndromes (chaps 9–11) In Fears Phobias and Rituals. New York: Oxford University Press.Google Scholar
Priest, R. G. & Montgomery, S. A. (1988) Benzodiazepines and dependence: a College statement. Bulletin of the Royal College of Psychiatrists, 12, 107108.Google Scholar
SAS Institute Inc (1985) SAS User's Guide: Statistics, Version 5 Edition. Cary, NC: SAS Institute Inc.Google Scholar
Skerritt, P. W. (1983) Anxiety and the heart - a historical review. Psychological Medicine, 13, 1725.CrossRefGoogle Scholar
Snaith, P. (1992) Anhedonia: exclusion from the pleasure dome. British Medical Journal, 305, 134.Google Scholar
Spitzer, R. L. & Williams, J. B. W. (1983) Structured Clinical Interview for DSM-III-Upjohn Version (SCID-UP12/15/83). Biometrics Research Department, New York State Psychiatric Institute.Google Scholar
Tyrer, P. (1985) Neurosis divisible? Lancet, i, 685688.Google Scholar
Tyrer, P. Murphy, S., Kingdon, D., et al (1988) The Nottingham study of neurotic disorder: comparison of drug and psychological treatments. Lancet, ii, 235240.CrossRefGoogle Scholar
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