• Korean Journal of Psychosomatic Medicine
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• v.14 no.1
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• pp.53-61
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• 2006

Objectives: This study was designed to evaluate difference of the alexithymia between panic patients and normal controls by examination of the relationships between different components of the alexithymia construct and level of anxiety and depression in panic patients and normal controls. Methods The subjects were 167 patients who met DSM-IV criteria for panic disorder and 110 normal controls. They drew up symptom checklists and self-rating scales, and were measured by Anxiety Disorders Interview Schedule-Panic attack & Agoraphobia(ADIS-P & A), Korean version of Toronto Alexithymia Scale (TAS-20K), Spielberger State-Trait Anxiety Inventory-State & Trait (STAI-S & T), Beck Depression Inventory (BDI), and Revised Anxiety Sensitivity Index (ASI-R). For statistical analysis, we performed t-test to compare the sociodemographic characteristics and the scores of self reported scales between panic patients and normal controls. Pearson correlation was performed between TAS-20K and it's subfactors, STAI-S & T, ASI-R and BDI in panic patients and normal controls. And stepwise multiple regression analysis was preformed to explain results of correlation analysis for alexithymia. Results: The panic patients reported more significant alexithymic (p<0.001), more difficulty identifying feeling (p<0.001) and describing feeling (p=0.001) than normal controls. Futhermore, panic patients were more significant anxious, sensitive to anxious feeling and depressive than normal controls. Moreover, the alexithymia of panic patients was explained by trait-anxiety $({\Delta}R^2=0.255)$ and anxiety sensitivity $({\Delta}R^2=0.062)$, that of normal controls was predicted by depression $({\Delta}R^2=0.144)$ and anxiety sensitivity $({\Delta}R^2=0.033)$ Conclusion: The panic patients reported more anxious and sensitive to anxious feeling, and these symptoms predict alexithymia in panic patients. However, the alexithymia of normal controls was explained by depression more than anxiety sensitivity, and such a result isn't consistent with previous studies and this may be mainly due to difference of the homogeneity in object of the studies.

• 건강소식
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• v.36 no.9
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• pp.26-27
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• 2012

아무런 징조도 없이 갑자기 닥쳐온 극심한 불안과 공포를 겪은 적이 있는가? 최근 TV 프로그램에서 차태현, 김하늘, 김혜수, 이경규, 양현석 등 인기스타들이 '공황장애'를 고백해 눈길을 끌었다. 극심한 스트레스와 우울증으로부터 발병한다는 공황장애는 이제 더 이상 낯설지 않은 병이 되었다.

• Korean Journal of Psychosomatic Medicine
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• v.3 no.2
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• pp.139-146
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• 1995

Forty patients meeting DSM-III-H criteria for panic disorder and 51 normal controls were assessed with the Personality Diagnostic Questionnaire-Revised(PDQ-R), a self-rating scale designed to assess Axis II personality disorders and traits. Results replicated previous findings of a preponderance of dependent, avoidant, and histrionic features. But our result showed other features such as paranoid, schizotypal, borderline, and antisocial traits also. Patients were divided into two groups according to the severity of their personality traits(high or low). These groups were compared in various panic symptomatology and SCL-90-R. None of the specific symptom dimensions in panic disorder, i.e. panic, anxiety, agoraphobia, social impairment, or chronicity was different between groups. Rather, high personality trait groups were found to have significantly more symptomatology in SCR-90-R than low personality groups. Result indicated that patients exhibiting a greater number of personality traits were also significantly more symptomatic. The results suggested a possible link beteween panic disorder and personality disorder. And, general factors such as depression, social or interpersonal sensitivity might provide a much better explanation of personality disorders in panic patients.

• Sleep Medicine and Psychophysiology
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• v.2 no.1
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• pp.65-72
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• 1995

The author compared indices of thyroid function in 76 patients with panic attack and 80 control subjects. And SCL-90-R was performed to evaluate the relationship between the psychiatric symptoms and thyroid indices in the patients with panic attack The results were as follows: 1). No siginificant differences in T3, T4 or TSH were found between the two groups. But T3 level was significantly lower in male panic patients than male controls(p<0.005). 2) The T3 level was significantly lower in male panic patients who had higher depression socre than average in SCL-90-R(p<0.025). 3) The TSH level was significantly lower in patients with higher anxiety(p<0.001) and phobia(p<0.05) score and in female panic patients(p<0.001) with higher anxiety and phobia score than average in SCL-90-R. 4) The phobic symptom(p<0.001) was siginificantly higher and the T3 level(p<0.005) was lower in the male than the female patients with panic attack.

• Journal of Oriental Neuropsychiatry
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• v.21 no.4
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• pp.207-218
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• 2010

Objectives : This case report presents a 33-year-old male patient who complained chest pain and anxiety. diagnosed with panic disorder with agoraphobia improved by Herbal Extracts. SRP(Stress Reduction Program) and Acupuncture treatment. Methods : In early treatment period. we evaluated his general psychological state through interview and self-questionnaires(STAI, SCL-90-R, STAXI, BDI) for treatment planing. And then we had prescribed herbal extracts for 20 weeks with applying SRP and acupuncture treatment. After 20 weeks we assessed his psychological symptoms with same evaluation tools. Results : After 20 weeks. We found that patient's somatic and psychological symptoms(anxiety, depression, anger) were alleviated. Frequency and severity of panic attacks were reduced also. Conclusions : Herbal extracts. especially Gyejigayonggolmoryo-tang(桂枝加龍骨牡蠣湯) and Jakyakgamcho-tang(芍藥甘草湯), may be useful therapeutic tool for control of panic attack symptoms and anxiety.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.1
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• pp.58-65
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• 2001

Objectives : It is well known that pharmacologic and behavioral therapies of panic disorder show remarkable acute treatment outcome, however the course of panic disorder in clinical settings is often chronic and relapsing. The purpose of this study is to investigate the treatment outcome of panic disorder and the factors related to good treatment outcome by prospective follow-up study after 6 month in clinical settings. Methods : Twenty nine patients were diagnosed to have panic disorder by SCID(Structured Clinical Interview for DSM-III-R), among the patients who had visited the psychiatric out-patients clinic of the Asan Medical Center for the first time. We determined the initial clinical and demoraphic features of each patient and reevaluated them after 6 months, investigating the treatment outcome by anxiety, phobia, impairment scales. We looked into the rate of the patients who showed good treatment outcome and determined the factors that had relation with good treatment outcome among demographic and clinical features. Results : Nineteen out of 29 patients could be followed after 6 months. Among them, 10 patients 52.6%) on the impairment scale and phobia scale each, and 8 patients(42.1 %) on the anxiety scale showed good treatment outcome. 8 patients(42.1 %) showed good treatment outcome on the all three scales. High score in initial phobia scale had significant relation with good treatment outcome. Short duration of illness did not have significant relation with good treatment outcome however there was a trend(p=0.07). Conclusion : About half(42.1 %) of the panic disorder patients showed good treatment outcome on all three scales. Severe initial phobic symptom and short duration of illness were expected to have relation with good treatment outcome.

• Sleep Medicine and Psychophysiology
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• v.12 no.1
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• pp.50-57
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• 2005

Objectives: This study was designed to evaluate the differences in clinical characteristics and severity of symptoms between panic patients with and without comorbid major depressive disorder, and to ascertain the differences in the function of the autonomic nerve system measured by heart rate variability (HRV). Methods: The subjects were 60 patients who have panic disorder without major depressive disorder and 19 patients who met DSMIV criteria for both panic disorder and major depressive disorder. First, they drew up symptom checklists and self-rating scales, and were measured by Anxiety Disorder Inventory Schedule-Panic Attack & Agoraphobia (ADIS-P&A), Clinical Global Impression (CGI), Hamilton Rating Scale for Depression (HAM-D), Panic Disorder Severity Scale (PDSS) and Heart Rate Variability (HRV). For statistical analysis, we performed t-test to compare the scores of self reported scales and clinician’s rating scales in panic patients with comorbid major depressive disorder and those without major depressive disorder. ANCOVA was used to compare the variables of HRV, considering age as a covariate. Results: The subjective severities of depression and anxiety that comorbid patients complained of were higher than those of patients with only panic disorder. Futhermore, comorbid patients were more sensitive to anxiety and physical sensations, and they tend to be more negative in their thinking. The scores of clinician-rating scales such as CGI and PDSS were also higher in the comorbid patients. However, there were no significant differences in HRV variables between both groups, despite a tendency to low heart rate variability in the comorbid group. Conclusion: This study suggests that patients with panic disorder and comorbid major depressive disorder tend to complain of more symptoms and to be more sensitive to various symptoms than those with panic disorder without comorbid depression. However, in this study comorbid major depressive disorder did not have a significant impact on the HRV variables of patients with panic disorder.

• Korean Journal of Psychosomatic Medicine
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• v.6 no.2
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• pp.147-154
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• 1998

Objective : This study was designed to find the characteristics of MMPI that could influence the outcome of cognitive behavioral therapy(CBT) for panic disorder. Methods : 34 patients who met DSM-IV criteria for panic disorder with or without agoraphobia had completed 11 weekly sessions of cognitive behavioral therapy. All the patients were assessed with MMPI before the initiation of treatment. Five self-report measures including Beck Depression Inventory(BDI), Spielberger State-Trait Anxiety Inventory(STAI), Agoraphobic Cognition Questionnarie(ACQ), Body Sensation Questionnaire(BSQ), and Daily Anxiety Selfrating (0 - 8 scales) were also assessed as a pre- and post-treatment assessment. After the completion of treatment, patients were classified by the High End-State(HES) functioning group and the Low End-State(LES) functioning group for the data analysis. Results : 1) The LES group showed significantly higher scores in Hypochondriasis Scale(HS), Depression Scale(D), Hysterical Scale(Hy), Obsessive Scale(Pt), Schizophrenia Scale(Sc) and Validity Scale(F) of MMPI than the HES group. However, these differences gave impressions that the LES group had more severe symptoms rather than that they could be the factors influencing the outcome of CBT. 2) Though, the severity of symptoms of the LES group in the 5 measures of pre-assessment was basically higher than that of the HES group. The fact that both group showed the similar improvement between pre- and post-assessment supported the above interpretation. Conclusion : In regarding the above results, MMPI was not a proper tool that could provide the factors influencing the outcome of CBT. In the future study, the authors need to use a different tool that can find the personality characteristics more directly.

• Korean Journal of Psychosomatic Medicine
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• v.12 no.1
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• pp.76-85
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• 2004

Objectives: The purpose of the present study was to investigate the emotional state and personality characteristics of patient with panic disorder. Methods: Twenty patients with panic disorder, 21 patients with somatoform disorder, and 20 normal healthy controls were studied. Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI) and Korean standardized edition of Cattell's 16 Personality Factors Questionnaire(16-PF) were used for assessment. Statistically, One-way ANOVA with Scheffe test were used by SPSS/PC for windows. Results: 1) Total score of BDI was higher in the panic group than the somatoform group and normal control group(p<0.001). 2) Total score of state anxiety and trait anxiety in the panic group was higher than the somatoform group and normal control group(p<0.001). 3) In 16 PF, there were no definitely abnormal range of scores. But in first-stratum source traits of 16PF, the panic group was higher than the somatoform group and normal healthy group in O-factor (p<0.01) and Q4-factor(p<0.001). In second-stratum source traits of 16PF, the panic group was higher than the somatoform group in ANX-factor(p<0.05), but lower than normal control group in TOUfactor(p<0.05). 4) There were no differences in the panic subgroup according to sex and cutoff points of BDI score 16 and STAI-T score 54. 5) According to cutoff point of STAI-S score 52, the panic subgroup above 52 was higher than the panic subgroup under 52 in G-factor(p<0.001), Q3-factor(p<0.05) and SUP-factor(p<0.001), but lower in L-factor(p<0.05). Conclusion: These results suggest that emotional state of patients with panic disorder are depressive and anxious as compared with patients with somatoform disorder and normal controls. Patients with panic disorder did not show any abnormal personality characteristics but were more guilt-prone, anxious, emotionally sensitive. We propose that the understanding of panic patients' emotional state and personality characteristics will helpful to treat and manage in patient with panic disorder.

• Sleep Medicine and Psychophysiology
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• v.4 no.1
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• pp.49-56
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• 1997

Nocturnal panic involves sudden awakening from sleep in a state of panic characterized by various somatic sensation of sympathetic arousal and intense fear. Many(18-71%) of the spontaneous panic attacks tend to occur from a sleeping state unrelated to the situational and cognitive context. Nocturnal panickers experienced daytime panics and general somatic sensation more frequently than other panickers. Despite frequent distressing symptoms, these patients tend to exhibit little social or occupational impairment and minimal agoraphobia and have a high lifetime incidence of major depression and a good response to tricyclic antidepressants. Sleep panic attacks arise from non-REM sleep, late stage 2 or early stage 3. The pathophysiology and the similarity of nocturnal panic to sleep apnea, dream-induced anxiety attacks, night terrors, sleep paralysis, and temporal lobe epilepsy are discussed.