Panic disorder and quality of life: variables predictive of functional impairment

Hollifield, Michael; Katon, Wayne; Skipper, Betty J.; Chapman, Tim F.; Ballenger, James C.; Mannuzza, Salvatore; Fyer, Abby J.

doi:10.1176/ajp.154.6.766

Cited by 111 publications

(11 citation statements)

References 30 publications

(23 reference statements)

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“…Reduced quality of life has been associated with various psychiatric disorders in children and adolescents (Bastiaansen, Koot, Bongers, Varni, & Verhulst, 2004). Studies with adults have shown that individuals with anxiety disorders, including social phobia and specific phobia, report lower levels of life satisfaction than their normal counterparts (see Bech & Angst, 1996; Hollifield et al, 1997; Mogotsi et al, 2000). …”

Section: Methodsmentioning

confidence: 99%

Specific Phobia in Youth: Phenomenology and Psychological Characteristics

et al. 2010

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Sociodemographic and psychological characteristics of 62 youth with animal and natural environment types of specific phobia were examined in a treatment-seeking sample. Differences due to age, sex, ethnicity, family structure, and family socioeconomic status were not found between youth with the two types of specific phobia. Moreover, differences were not obtained between the two groups in the clinical severity of their phobias, the perceived dangerousness of the feared outcomes associated with their phobias, the perceived levels of coping with their phobias, or overall fearfulness. However, differences between youth with the two types of specific phobias were found on somatic/anxious symptoms, depressive symptoms, and life satisfaction. In addition, differences were noted on withdrawn, somatic complaints, anxious/depressed symptoms, and social problems as reported by the mothers of these youngsters. Finally, differences in the percent of co-occurring anxiety disorders between youth with the two types of specific phobia were found. On all of the domains in which differences were found, youth with the natural environment type fared more poorly than those with the animal type. These findings converge with those obtained in treatment studies which indicate that youth with the natural environment type are more difficult to treat than youth with the animal type.According to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994), a specific phobia is defined as a persistent fear that is excessive or unreasonable and that is cued by the presence of a specific object or situation. Specific phobias are classified into five major types: animal (e.g., insects, snakes, dogs), natural environment (e.g., darkness, storms, heights), situational (e.g., enclosed spaces, elevators, flying), blood-injection-injury (BII) (e.g., seeing blood, receiving Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Brown, and Barlow (1997) indicated that BII phobias are associated with reduced physiological arousal whereas other phobia types are characterized by heightened physiological arousal. However, the clinical features of specific phobia types in children have not been examined heretofore. The primary purpose of the present study was to examine such differences in two major types of phobia in children and adolescents: animal and natural environment types. NIH Public AccessTo date, only a few investigations have reported on sociodemographic characteristics of children with specific phobias in community and clinical sampl...

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Section: Methodsmentioning

confidence: 99%

Specific Phobia in Youth: Phenomenology and Psychological Characteristics

et al. 2010

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“…Recent estimates suggest that 3.7% of people will meet criteria for PD and 1.1% for PDA in their lifetime (Kessler et al, 2006). PD/PDA is associated with significant impairment in quality of life and role functioning (Hollifield et al, 1997; Stein, et al, 2005). Moreover, PD/PDA is associated with increased healthcare utilization (Rief, Martin, Klaiberg, & Brähler, 2005), decreased productivity in the form of increased disability (Kouzis & Eaton, 1994), and missed work days (Stein et al, 2005).…”

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confidence: 99%

Impact of stressful life events on the course of panic disorder in adults

Moitra

Dyck

Beard

et al. 2011

Journal of Affective Disorders

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Background Panic Disorder with/without Agoraphobia (PD/PDA) is a prevalent anxiety disorder, associated with impairment in quality of life and functionality, as well as increased healthcare utilization. Extant research shows a relationship between stressful life events (SLEs) and the onset of panic attacks in adults who ultimately develop PD/PDA. However, limited attention has been paid to how SLEs might affect the severity of panic symptoms in individuals with PD/PDA. In this study, we examined the relationship between SLEs and panic symptom severity in adults with PD/PDA. Methods Four hundred-eighteen adults with PD/PDA from the Harvard/Brown Anxiety Research Program (HARP), a long-term prospective longitudinal observational multicenter study of adults with a current or past history of anxiety disorders were included in this study. We examined occurrence of SLEs and their impact on panic symptom severity 12-weeks pre- and post-SLE. Results A time-slope effect showed that participants had worsened panic symptoms over the course of the 12-weeks after family/friends/household and work SLEs. That is, their symptoms worsened progressively after the event, rather than immediately thereafter (i.e., significant symptom change within the same week of the event). Limitations The sample may not be representative of the general population. Conclusions These findings provide new insights into how SLEs affect panic symptoms in adults with PD/PDA in that household-related SLEs, such as serious family arguments, and work-related SLEs, such as being fired, put some adults at risk for worsened panic symptoms within 12-weeks of the event.

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“…And a smaller clinical study with 61 patients demonstrated that the presence of depression is a risk factor for worse quality of life amongst patients with panic disorder [7]. …”

Section: Introductionmentioning

confidence: 99%

Disability and Comorbidity: Diagnoses and Symptoms Associated with Disability in a Clinical Population with Panic Disorder

Bonham

Uhlenhuth

2014

Psychiatry Journal

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Background. Anxiety disorders are associated with considerable disability in the domains of (1) work, (2) social, and (3) family and home interactions. Psychiatric comorbidity is also known to be associated with disability. Methods. Data from the Cross-National Collaborative Panic Study was used to identify rates of comorbid diagnoses, anxiety and depression symptom ratings, and Sheehan disability scale ratings from a clinical sample of 1165 adults with panic disorder. Results. Comorbid diagnoses of agoraphobia, major depression, and social phobia were associated with disability across the three domains of work, social, and family and home interactions. The symptom of agoraphobic avoidance makes the largest contribution to disability but there is no single symptom cluster that entirely predicts impairment and disability. Limitations. The findings about the relative contributions that comorbid diagnoses make to disability only apply to a population with panic disorder. Conclusions. Although panic disorder is not generally considered to be among the serious and persistent mental illnesses, when it is comorbid with other diagnoses, it is associated with considerable impairment. In particular, the presence of agoraphobic avoidance should alert the clinician to the likelihood of important functional impairment. When measuring the functional impact of comorbid anxiety disorders, both the categorical and the dimensional approaches to diagnosis make valuable contributions.

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Panic disorder and quality of life: variables predictive of functional impairment

Cited by 111 publications

References 30 publications

Specific Phobia in Youth: Phenomenology and Psychological Characteristics

Specific Phobia in Youth: Phenomenology and Psychological Characteristics

Impact of stressful life events on the course of panic disorder in adults

Disability and Comorbidity: Diagnoses and Symptoms Associated with Disability in a Clinical Population with Panic Disorder

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