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Panic disorder refers to the frequent and recurring acute attacks of anxiety. Objective: This study describes the routine use of mobiles phones (MPs) and investigates the appearance of possible emotional alterations or symptoms related to their use in patients with panic disorder (PD). Background: We compared patients with PD and agoraphobia being treated at the Panic and Respiration Laboratory of The Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil, to a control group of healthy volunteers. Methods: An MP-use questionnaire was administered to a consecutive sample of 50 patients and 70 controls. Results: People with PD showed significant increases in anxiety, tachycardia, respiratory alterations, trembling, perspiration, panic, fear and depression related to the lack of an MP compared to the control group. Conclusions: Both groups exhibited dependence on and were comforted by having an MP; however, people with PD and agoraphobia showed significantly more emotional alterations as well as intense physical and psychological symptoms when they were apart from or unable to use an MP compared to healthy volunteers.

The case presented here illustrates the dependence of an individual with panic disorder on his MP. A specific approach for this dependence should be used in some panic disorder patients.

Facebook is notably the most widely known and used social network worldwide. It has been described as a valuable tool for leisure and communication between people all over the world. However, healthy and conscience Facebook use is contrasted by excessive use and lack of control, creating an addiction with severely impacts the everyday life of many users, mainly youths. If Facebook use seems to be related to the need to belong, affiliate with others and for self-presentation, the beginning of excessive Facebook use and addiction could be associated to reward and gratification mechanisms as well as some personality traits. Studies from several countries indicate different Facebook addiction prevalence rates, mainly due to the use of a wide-range of evaluation instruments and to the lack of a clear and valid definition of this construct. Further investigations are needed to establish if excessive Facebook use can be considered as a specific online addiction disorder or an Internet addiction subtype.

This long-term extension of an 8-week randomized, naturalistic study in patients with panic disorder with or without agoraphobia compared the efficacy and safety of clonazepam (n = 47) and paroxetine (n = 37) over a 3-year total treatment duration. Target doses for all patients were 2 mg/d clonazepam and 40 mg/d paroxetine (both taken at bedtime). This study reports data from the long-term period (34 months), following the initial 8-week treatment phase. Thus, total treatment duration was 36 months. Patients with a good primary outcome during acute treatment continued monotherapy with clonazepam or paroxetine, but patients with partial primary treatment success were switched to the combination therapy. At initiation of the long-term study, the mean doses of clonazepam and paroxetine were 1.9 (SD, 0.30) and 38.4 (SD, 3.74) mg/d, respectively. These doses were maintained until month 36 (clonazepam 1.9 [SD, 0.29] mg/d and paroxetine 38.2 [SD, 3.87] mg/d). Long-term treatment with clonazepam led to a small but significantly better Clinical Global Impression (CGI)-Improvement rating than treatment with paroxetine (mean difference: CGI-Severity scale -3.48 vs -3.24, respectively, P = 0.02; CGI-Improvement scale 1.06 vs 1.11, respectively, P = 0.04). Both treatments similarly reduced the number of panic attacks and severity of anxiety. Patients treated with clonazepam had significantly fewer adverse events than those treated with paroxetine (28.9% vs 70.6%, P < 0.001). The efficacy of clonazepam and paroxetine for the treatment of panic disorder was maintained over the long-term course. There was a significant advantage with clonazepam over paroxetine with respect to the frequency and nature of adverse events.

BackgroundThe growth of the Internet has led to significant change and has become an integral part of modern life. It has made life easier and provided innumerous benefits; however, excessive use has brought about the potential for addiction, leading to severe impairments in social, academic, financial, psychological, and work domains. Individuals addicted to the Internet usually have comorbid psychiatric disorders. Panic disorder (PD) and generalized anxiety disorder (GAD) are prevalent mental disorders, involving a great deal of damage in the patient’s life.ObjectiveThis open trial study describes a treatment protocol among 39 patients with anxiety disorders and Internet addiction (IA) involving pharmacotherapy and modified cognitive behavioral therapy (CBT).MethodsOf the 39 patients, 25 were diagnosed with PD and 14 with GAD, in addition to Internet addiction. At screening, patients responded to the MINI 5.0, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Clinical Global Impressions Scale, and the Young Internet Addiction Scale. At that time, IA was observed taking into consideration the IAT scale (cutoff score above 50), while anxiety disorders were diagnosed by a psychiatrist. Patients were forwarded for pharmacotherapy and a modified CBT protocol. Psychotherapy was conducted individually, once a week, over a period of 10 weeks, and results suggest that the treatment was effective for anxiety and Internet addiction.ResultsBefore treatment, anxiety levels suggested severe anxiety, with an average score of 34.26 (SD 6.13); however, after treatment the mean score was 15.03 (SD 3.88) (P<.001). A significant improvement in mean Internet addiction scores was observed, from 67.67 (SD 7.69) before treatment, showing problematic internet use, to 37.56 (SD 9.32) after treatment (P<.001), indicating medium Internet use. With respect to the relationship between IA and anxiety, the correlation between scores was .724.ConclusionsThis study is the first research into IA treatment of a Brazilian population. The improvement was remarkable due to the complete engagement of patients in therapy, which contributed to the success of the treatment from a behavioral perspective, and gave patients the confidence to continue to manage Internet use in their lives.

INTRODUCTION: Facebook is the world's most widely accessed social network, where millions of people intercommunicate. Behavioral and psychological changes relate to abusive and uncontrolled use creating severe impacts on users' life. METHOD: A critical revision was performed through MedLine, Lilacs, SciELO and Cochrane databases using the terms: "Facebook Addiction, " "Social Network Sites, " "Facebook Abuse. " The search covered the past 5 years up to January 2015. Articles that examine dependence on Facebook in the general population were included; we analyzed how this concept evolved over the last five years, and hope to contribute to the better understanding of the issue and its impacts. RESULTS: Although controversial, published reports correlate Facebook addiction to mechanisms of reward and gratification. Some users developed an abusive relationship stimulated by the false feeling of satisfaction or as a way to feel better or more self-assured (increased level of excitement or escape). Studies from several countries indicate different prevalence, probably due to lack of consensus, and the use of different denominations, giving rise to the adoption of different diagnostic criteria. CONCLUSION: Social Networks are modern communication tools; however, not only benefits, but also subsequent damage caused by its abusive use must be monitored. Many users with abusive usage and dependence recognize significant losses in their personal, professional, academic, social and family lives. Further investigation is needed to determine if abusive Facebook usage is a new psychiatric classification or merely the substrate of other disorders.

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