Demographic and clinical features of panic disorder comorbid with bipolar I disorder: A 3-year retrospective study

Nardi, Antônio Egídio; Nascimento, Isabella; Freire, Rafael C.; Veras, André Barciela; de-Melo-Neto, Valfrido L.; Valença, Alexandre Martins; Lopes, Fabiana L.; Soares-Filho, Gastão L.; Levitan, Michelle N.; Carvalho, Marcele Regine de; Costa, Robson; King, Anna Lucia Spear; Mezzasalma, Marco A.; Grivet, Leila O.; Rassi, Arabella; Versiani, Márcio

doi:10.1016/j.jad.2007.05.026

Cited by 5 publications

(12 citation statements)

References 12 publications

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“…In our study, patients with a bipolar tendency were more likely to be unmarried at the time of assessment. In previous investigations, bipolar patients had a higher risk of experiencing difficulties in marriages, which is also shown in this study[ 18 , 32 ].…”

Section: Discussionsupporting

confidence: 89%

“…In addition, an early onset of bipolar spectrum disorders is characterized as a severe form of bipolar disorder and tends to have a higher risk of having first-degree relatives with affective disorders[ 29 ]. In this study, the patients with bipolarity showed a younger age at onset, which has been found in previous studies[ 18 , 30 ]. Moreover, a previous study has already shown that the risk of anxiety disorder increases as the onset age of bipolar disorder decreases[ 31 ].…”

Section: Discussionsupporting

confidence: 86%

“…The lack of information regarding bipolar disorder comorbidity in patients with panic disorder can negatively impact the choice of treatment and management, which is the reason why an early diagnosis of bipolar disorder in patients with panic disorder is important in the treatment outcome of patients[ 7 , 11 ]. Previous studies have discussed the prognosis of bipolar disorder according to the presence of panic disorder[ 8 , 10 - 17 ], however, few studies have investigated bipolarity in patients with panic disorder[ 18 , 19 ]. The aim of this study was to compare clinical characteristics of panic disorder according to the bipolarity, and to investigate factors that predict the potential risk of bipolar disorder in patients with panic disorder.…”

Section: Introductionmentioning

confidence: 99%

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Psychological predictors of bipolarity in panic disorder

Oh¹,

Park²,

Ryu³

et al. 2021

WJP

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BACKGROUND Panic disorders frequently occur with affective disorders, particularly bipolar disorder. Patients with panic disorder and bipolar disorder are more likely to present with severe symptoms, such as high rates of suicidal behavior, poor symptomatic and functional recovery, and poor drug responses. AIM To investigate the psychological characteristics of panic disorder patients related to bipolarity. METHODS A total of 254 patients (136 men and 118 women, mean age = 33.48 ± 3.2 years) who were diagnosed with panic disorder were included in the study. Panic disorder with bipolarity (BP+) was defined as a score of ≥ 7 on the Korean version of the Mood Disorder Questionnaire (K-MDQ), and a score lower than 7 was considered as a panic disorder without bipolarity (BP-). Self-report questionnaires were analyzed to examine their association with bipolarity. Psychological tests used in the study were the Mood Disorder Questionnaire (MDQ), Panic Disorder Severity Scale, Beck Depression Inventory, State-Trait Anxiety Inventory (STAI), Temperament and Character Inventory (TCI), and Minnesota Multiphasic Personality Inventory (MMPI). Statistical analyses were performed to evaluate the correlation between bipolarity of panic disorder patients and various psychological test results indicative of psychological characteristics. RESULTS Patients with a K-MDQ score of 7 or more were considered to have a history of manic or hypomanic episodes (BP+ group, n = 128), while patients with K-MDQ scores below 7 were defined as those without bipolarity (BP- group, n = 126). The BP+ group were more likely to be unmarried (single 56.2% vs 44.4%, P = 0.008) and younger (30.78 ± 0.59 vs 37.11 ± 3.21, P < 0.001). Additionally, the BP+ group had significantly higher scores on psychological assessment scales, such as the hypochondriasis, psychopathic deviate, masculinity-femininity, psychasthenia, schizophrenia, and hypomania (Ma) in MMPI, and novelty seeking, harm avoidance and self-transcendence in TCI, and STAI (state and trait) compared to the BP- group. In logistic regression analysis, depression in MMPI, self-directedness in TCI, and age were negatively associated with MDQ score, meanwhile, Ma in MMPI and STAI (trait) were positively associated with MDQ score. CONCLUSION The result of this study suggests that almost 50% of patients with panic disorder are likely to have hypomanic or manic symptoms, and certain psychological factors are associated bipolarity in panic disorder.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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Psychological predictors of bipolarity in panic disorder

Oh¹,

Park²,

Ryu³

et al. 2021

WJP

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“…Indeed, patients who were firstly administered BZDs presented more often anxious symptoms at onset (22.3% vs. 10.5%), whereas depressive, psychotic, or other onset symptoms did not differ between groups. Nardi and colleagues previously confirmed the aforementioned association between anxious symptoms and use of BZDs in patients with mood spectrum disorders (Nardi et al, ). Nonetheless, considering the international guidelines, the presence of anxious symptoms should rather be considered a reason to start a second‐generation antidepressant, rather than a BZD (Baldwin et al, ).…”

Section: Discussionmentioning

confidence: 62%

Exploring characteristics associated with first benzodiazepine prescription in patients with affective disorders and related diagnoses

Carlo

Grancini

Vismara

et al. 2019

Human Psychopharmacology

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Objective: In patients with affective disorders, benzodiazepines (BZDs) are frequently administered at the onset, sometimes inappropriately. We sought to identify clinical variables associated with first BZD prescription in a large sample of patients with affective disorders.Methods: Four hundred sixty patients with mood or anxiety disorders attending different psychiatric services were assessed comparing those who received BZD as first treatment (BZD w/) and those who did not (BZD w/o).Results: More than one third (35.7%) of the total sample had received BZDs as first prescription. In relation to mood disorders, BZD w/ subjects more frequently (a) had not a psychiatrist as first therapist, (b) had anxious symptoms at onset, (c) had adjustment disorder as first diagnosis, (d) were treated as outpatients. In relation to specific diagnoses, (a) personal decision of treatment for major depressive disorder, (b) outpatient status for bipolar disorder and (c) longer duration of untreated illness for adjustment disorder were more frequently associated with first BZD prescription. For anxiety disorders, the presence of stressful life events and the diagnoses of panic disorder or specific phobias were more frequently observed in BZD w/ patients. Conclusion:Patients with affective disorders frequently received BZDs as first prescription with significant differences between and within mood and anxiety disorders.

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“…At times, present experiences and emotional states may generate anxious or impulsive responses because of an emotional experience stored in the amygdala. 16 In a similar study about emotional memory 4 related to bipolar disorder, 17 the results suggested abnormalities in the amygdala circuit in the case of bipolar disorder. Another review study 18 on neuroanatomy in panic disorder patients also indicated the existence of a ''fear network'', which has as its main point the central nucleus of the amygdala.…”

Section: ' Discussionmentioning

confidence: 89%

Analysis of velocity and direction of trunk movement in wheelchair basketball athletes

Santos¹,

Monteiro²,

Cantelli³

et al. 2014

Medical Express

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Rational minds make logical connections between cause and effect, whereas emotional minds make no such distinctions, following instinctive logic. This paper investigates episodic emotional memory in patients with panic disorder with agoraphobia in comparison to a control group. METHOD: Sixty volunteers, 30 patients with panic disorder with agoraphobia and 30 healthy controls were exposed to the same slideshow of 11 slides, but randomly exposed to two different narrated versions, namely one emotional and one neutral. Each group of 30 participants was randomly subdivided into two subgroups of 15; each subgroup of patients and controls was exposed either to the emotional or to the neutral narrative. One week later patients and controls returned to answer questionnaires about the slides and respective narrated stories. RESULTS: Panic disorder patients exposed to the emotional content of the story showed a significantly enhanced emotional memory, evidenced by a better recollection of the emotional narration when compared to patients exposed to the neutral version. Compared to controls, panic disorder patients exhibited greater discrepancy between the emotional versus the neutral narrative. CONCLUSION: Results showed that the panic disorder patients were significantly impacted by the content of the emotional version of the story, with respect to their emotional memory; the same was not observed for the control group exposed to the same emotional version of the story. We conclude that the characteristics of the panic disorder condition had an influence on emotional memory.

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Demographic and clinical features of panic disorder comorbid with bipolar I disorder: A 3-year retrospective study

Cited by 5 publications

References 12 publications

Psychological predictors of bipolarity in panic disorder

Psychological predictors of bipolarity in panic disorder

Exploring characteristics associated with first benzodiazepine prescription in patients with affective disorders and related diagnoses

Analysis of velocity and direction of trunk movement in wheelchair basketball athletes

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