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Diurnal Rhythms and Symptom Severity in Panic Disorder

A Preliminary Study of 24–Hour Changes in Panic Attacks, Generalised Anxiety, and Avoidance Behaviour

Published online by Cambridge University Press:  02 January 2018

Marilla F. Geraci  and
Thomas W. Uhde
Marilla F. Geraci
Affiliation:
Mental Health Clinic, MHAN & A Nursing Service, Clinical Center Nursing Department, National Institutes of Health, Bethesda, Maryland
Thomas W. Uhde*
Affiliation:
Section on Anxiety and Affective Disorders, Biological Psychiatry Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland, USA
*
∗Correspondence
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Abstract

Diurnal changes in the frequency of panic attacks and symptoms of generalised anxiety, phobic anxiety and phobic avoidance in 34 panic-disorder patients and 40 normal controls were evaluated. The panic-disorder patients had significant diurnal changes in generalised and phobic anxiety, but not phobic avoidance. Increased severity of symptoms and prominent diurnal changes were most evident in the panic-disorder patients with a history of depression. Although panic attacks were distributed throughout the 24–hour period, patients with a current episode or history of depression tended to have more frequent panic attacks in the morning or early afternoon. These observations challenge the traditional belief that ‘anxious neurotic’ patients are relatively asymptomatic upon awakening in the morning and then develop more severe symptoms of anxiety later in the day.

Type
Papers
Information
The British Journal of Psychiatry , Volume 161 , Issue 4 , October 1992 , pp. 512 - 516
Copyright
Copyright © 1992 The Royal College of Psychiatrists 

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