Panic attacks and other problems

There is an increasing amount of evidence to suggest that people who suffer from panic attacks are also more likely to suffer from other physical and mental-health problems. Researchers from the University of Manitoba in Winnipeg, Canada used information from the huge U.S. National Epidemioligic Survey on Alcohol and Related Conditions. They studied 34,653 people who were asked about their health in 2001-2 and 2004-5. The study found that those people who had panic attacks in 2001-2 were more likely to have generalised anxiety disorder, panic disorder, social phobia, depression and mania in 2004-5.

Kinley, D. Jolene ... [et al] - Panic attacks as a risk for later psychopathology: results from a nationally representative survey Depression and Anxiety DOI 10.1002/da.20809

'Don't panic!' works for mild panickers

Mild panic disorder can affect quite a sizeable proportion of people, is associated with a large burden of disease and generates considerable economic costs to society yet little research has been done into early interventions designed to nip the problem in the bud before it gets worse. Peter Meulenbeek from the Vrije Universiteit in Amsterdam led a team of researchers studying the effectiveness of a group-therapy programme called 'Don't Panic!' based on cognitive-behavioural principles that have been shown to be effective in the treatment of full-blown panic disorder. 217 people participated in the study, 109 went on the 'Don't Panic!' course and 108 were placed on a waiting list as part of a control group. 39% of people on the 'Don't Panic!' course showed a clinically-significant improvement compared to only 16% on the control group and the benefits of the treatment lasted at least six months.

Meulenbeek, Peter ... [et al] - Early intervention in panic: pragmatic randomised controlled trial British Journal of Psychiatry April 2010, 167(4), 326-331

Don't panic, go surfing

Cognitive-behavioural therapy is a well-established treatment for panic disorder but dropout rates of 25% are common and those offered treatment only around a half might respond. As part of CBT people are often taught panic-control strategies, such as breathing exercises and relaxation but a more recent approach called 'panic surfing' encourages people to 'ride out' the wave of anxiety in an accepting manner instead of trying to control their symptoms. An Australian study of 18 participants used the 'panic surfing' technique to treat panic disorder. Significant improvements occurred over the course of the treatment and were maintained at a 1-month follow-up.

Lamplugh, Claire ... [et al] - A pilot study of cognitive behaviour therapy for panic disorder augmented by panic surfing Clinical Psychology and Psychotherapy November-December 2008, 15(6), 440-445

Panic disorder and heart disease

A study of 405,000 people by researchers from University College London looked into the links between panic disorder and heart problems. The study found that people who were younger than 50 when first diagnosed with panic disorder were 38% more likely to have a heart attack and 44% more likely to develop heart disease than those in the general population. People who were over 50 when first diagnosed had an 11% greater risk. However, people with panic disorder had a lower risk of dying from heart disease than the rest of the population. The researchers who wrote the study weren't sure whether the symptoms of heart disease were being misdiagnosed as panic disorder or whether panic disorder actually led to an increased risk of developing heart problems.

You can find out more about this research at

http://www.mentalhelp.net/poc/view_doc.php?type=news&id=115361&cn=1

Sudden improvements, lasting gains

People going through psychotherapy often demonstrate sudden, dramatic improvements suggesting that they have had some kind of epiphany that has dramatically altered their outlook on life and way of thinking. These sudden changes represent genuine improvement in people's condition and those who show sudden improvements from one session to the next are more likely to show a greater and longer-lasting improvement after the end of therapy. A team of researchers at the University of Virginia in the U.S. looked into sudden improvement in 30 people going through a 12-week course of cognitive behaviour therapy (CBT) for panic disorder. 43% of the clients showed at least one dramatic burst of improvement during the course of therapy. Half of those who had had a dramatic improvement had had it between the first and second sessions, while the other half had experienced it later on. However, only the later improvers had better symptoms at the end of the study compared to people who had shown no dramatic improvement. The later improvers showed a greater improvement in their fear of anxiety-related symptoms at the end of their course of therapy, and at a six-month follow-up.

Clerkin, E., Teachman, B. and Janik, S. Smith - Sudden gains in group cognitive-behavioural therapy for panic disorder Behaviour Research and Therapy 2008

Panic and pregnancy

Female reproductive hormones can have a significant influence on anxiety disorders throughout a woman's life but little is known about the interactions between pregnancy and panic disorder (PD) which can affect between 1-3.8% of women over the course of their lives and is twice as frequent in women. Researchers in Turkey assessed 512 women in the third trimester of pregnancy for panic disorder and also compared 13 pregnant women with panic disorder to 19 non-pregnant controls. Among all the pregnant women the prevalence rate for PD was 2.5%. Among the 13 pregnant women with PD 7 had developed it during their pregnancy while the other 6 were suffering from it before they became pregnant. There was no difference between the pregnant and non-pregnant women as far as the severity of PD symptoms was concerned.

Guler, Ozkan ... [et al] - The prevalence of panic disorder in pregnant women during the third trimester of pregnancy Comprehensive Psychiatry 2008, 49, 154-158

Threat interpretation bias, and anxiety

The tendency to selectively process events as threatening is a central feature of cognitive models of anxiety. A number of studies with adults demonstrate an association between threat interpretation biases and panic disorder, social phobia and generalized anxiety disorder. Although investigations of cognitive factors in childhood anxiety disorders have lagged behind research with adults research has shown similar threat interpretation biases in relation to childhood anxiety disorders. A U.S. study of 45 7-12 year-olds presented them with three ambiguous situations and asked them how they would think, feel about and respond to them. 15 of the children suffered from anxiety disorders, 16 weren't anxious but were considered at risk because they had anxious parents and 14 were non-anxious with non-anxious parents. Compared to the other children the anxious children reported stronger negative emotions in response to the situations and felt that they had less ability to influence them. Children with anxious and non-anxious parents had similar results on the tests.

Waters, Allison M. ... [et al] - Threat interpretation bias as a vulnerability factor in childhood anxiety disorders Behaviour Research and Therapy January 2008, 46(1), 39-47