• Korean Journal of Biological Psychiatry
• /
• v.14 no.3
• /
• pp.194-200
• /
• 2007

Objectives:This study was performed to investigate the differences of the clinical feature between panic disorder with agoraphobic patients and panic disorder without agoraphobic patients. Methods:Two hundred nine patients meeting the criteria of DSM-IV panic disorder were recruited. One group was panic disorder with agoraphobia(n=78, 42 male(53.8%), mean age $37.6{\pm}9.9$ years), another was panic disorder without agoraphobia(n=131, 81 male(61.8%), mean age $40.5{\pm}10.3$ years). The numbers and frequency of panic symptoms were compared between two groups with t-test, and the logistic regression analysis were used for predicting panic disorder with agoraphobia. Results:The number of panic symptoms during panic attack was significantly higher in the group of panic disorder with agoraphobia than the group of panic disorder without agoraphobia(p<0.05).'Sweating','nausea or abdominal distress','fear of losing control of going crazy','chills or hot flushes'were more frequent in the group of panic disorder with agoraphobia(p<0.05). Among panic symptoms on logistic regression analysis,'sweating',' nausea or abdominal distress','fear of losing control or going crazy'turned out to correlate significantly with risk of development of agoraphobia in panic disorder. Conclusion:These results suggest that the frequency of some symptoms during panic attack may be a predictor of agoraphobia in patients with panic disorder.

• Korean Journal of Biological Psychiatry
• /
• v.23 no.4
• /
• pp.166-172
• /
• 2016

Objectives We investigated whether the catechol-O-methyltransferase (COMT) and serotonin related gene polymorphisms may be associated with agoraphobia in patients with panic disorder in Korea. Methods The COMT gene (rs4680), 5-hydroxytryptamine (serotonin) transporter linked polymorphic region (5-HTTLPR) gene (rs25531), serotonin receptor 1A (HTR1A) gene (rs6295) genotypes were analyzed in 406 patients with panic disorder and age-sex matched 206 healthy controls. Patients with panic disorder were dichotomized by the presence of agoraphobia. The following instruments were applied : the Beck Depression Inventory, the Beck Anxiety Inventory, the Panic Disorder Severity Scale. Results There was a significant difference in the distribution of 5-HTTLPR genotype between panic patients with agoraphobia and without agoraphobia (p = 0.024). That is, the panic patients with agoraphobia had a significant excess of the less active 5-HTTLPR allele (S allele). (p = 0.039) Also, we replicated previous western reports which indicated a significant difference in the distribution of COMT genotype between the patients with panic disorder and the healthy controls (p = 0.040). However, no significant associations of agora-phobia or panic disorder with HTR1A gene polymorphisms were found. Conclusions This result supports that the COMT polymorphisms may be associated with panic disorder and suggests that the 5-HTTLPR polymorphisms may play a role in the pathogenesis of agoraphobia in the Korean patients with panic disorder.

• Journal of Oriental Neuropsychiatry
• /
• v.13 no.1
• /
• pp.133-141
• /
• 2002

This is a case report about agoraphobia patient treated with oriental medical psychotherapy. We treated with Kyungja-pyungji(Stabilization of anxiety) treatment, Ii- Jeung-Byun-Qi(movement of emotion and degeneration of Qi) treatment, Giungoroen-Focusing(wise saying and lofty opinion) method for 8 weeks. She could not go out herself without her mother for the first teatment time, but she improved step and she could go by herself to the public place at the last time. We found out that the application of systemic oriental medical psychotherapy is effective for the agoraphobia disorder. Therefore, we presented application of oriental medical psychotherapy with bibliological research.

• Journal of Oriental Neuropsychiatry
• /
• v.19 no.2
• /
• pp.251-263
• /
• 2008

Panic disorder with agoraphobia is an anxiety disorder in which there are repeated attacks of intense fear and anxiety, and a fear of being in places where escape might be difficult, or where help might not be available in case of a panic attack. We experienced a 39 year-old man who had Panic disorder with agoraphobia from recent onset and whose condition was improved through oriental medical treatment. We treated the patient with Herbal medications and Giungoroen (至言高論)-wise saying and lofty opinion) and Gyeongjapyeongji (驚者平之)-mental stress must be eased with tranquilizers) and Relaxation therapy. Giungoroen is psychological therapy that promotes patient's recognition of disease and will to cure it through conversation. Gyeongjapyeongji is desensitizing the unease. Relaxation therapy is the use of muscular relaxation techniques in treatment. This result suggests that oriental medical treatment has good effect on Panic disorder with agoraphobia.

• 대한불안의학회:학술대회논문집
• /
• 2004.10a
• /
• pp.66-74
• /
• 2004

• The Journal of the Korean life insurance medical association
• /
• v.29 no.1
• /
• pp.7-11
• /
• 2010

Anxiety disorders Anxiety disorders are among the most prevalent mental disorders in the general population. Anxiety disorders can be viewed as a family of related but distinct mental disorders, which include following as classified in the text revision of fourth edition of Diagnostic and Statistical Manual Disorders(DSM-IV-TR): (1) panic disorder with or without agoraphobia; (2) agoraphobia with or without panic disorder; (3) specific phobia; (4) social phobia; (5) obsessive-compulsive disorder; (6) posttraumatic stress disorder; (7) acute stress disorder; (8) generalized anxiety disorder. An acute intense attack of anxiety accompanied by feeling of impending doom is known as panic disorder. The term phobia refer to an excessive fear of a specific object, circumstance, or situation. Obsessivecompulsive disorder is represented by a diverse group of symptoms that include intrusive thoughts, rituals, preoccupations, and compulsions. Posttraumatic stress disorder is a condition marked by development of symptoms after exposure to traumatic life events. Generalized anxiety disorder is defined as excessive anxiety and worry about several events or activities for most days during at least a 6-month period.

• Korean Journal of Biological Psychiatry
• /
• v.16 no.1
• /
• pp.37-45
• /
• 2009

Objectives : It is reported that panic disorder is frequently comorbid with other psychiatric illnesses. The aim of this study was to investigate differences of psychiatric comorbidity according to age of onset of panic disorder. Methods : Three hundred-two patients participated in the study. All the patients were evaluated by clinical instruments for the assessment the presence of other comorbid psychiatric disorders and various clinical features; Korean version of Mini International Neuropsychiatric Interview, Self-report questionnaires(Beck Anxiety Inventory, Beck Depression Inventory, Anxiety Sensitivity Index and State-Trait Anxiety Inventory) and clinical rating scale (Hamilton Anxiety Scale, Hamilton Depression Scale and Global Assessment of Functional score). Chi-square test was used to determine the difference between early onset and late onset panic disorder. Results : Forty percent of panic patients were found to have at least one comorbid psychiatric diagnosis. There were no differences among the groups divided by number of comorbidity in sex, agoraphobia comorbidity, duration of panic disorder, except onset age of panic disorder. Early onset group had more comorbidy with social phobia, agoraphobia, PTSD. We also found that Early onset panic disorder patients were more likely to experience derealization, nausea, parethesia than late onset panic disorder patients. Conclusion : The results of our study are in keeping with previous data from other parts of the world. Our finding suggest that earier onset of panic disorder related to more psychiatric comorbidity.

• Journal of Oriental Neuropsychiatry
• /
• v.21 no.4
• /
• pp.207-218
• /
• 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 Biological Psychiatry
• /
• v.1 no.1
• /
• pp.31-39
• /
• 1994

Anxiety and anxiety disorders are one of the most common and most serious psychiatric problems. Anti-anxiety drugs are one of the most effective treatment method for these problems. Benzodiazepines have various side-effects and the risk of overuse and abuse. Therefore, physicians should prescribe benzodiazepines carefully. However, they should not be discouraged from prescribing benzodiazepines when they have a knowledge of the pharmacological characteristics of these drugs and there is a clear indication for their use. Generally speaking, problems of benzodiazepine use such as dependence withdrawal symptoms, and cognitive impairment are more likely to occur with high dose, long-term use(more than 4 months), in geriatric patients and patients with a history of alcohol or other sustance abuse. But long-term or high-dose use can be jusified for patients with panic disorder of agoraphobia, and medically-ill patients with persistent anxiety that cannot be otherwise treated. In summary, there cannot be a general prescribing formulation for benzodiazepine use. Physician should always make their decision based on the individual patient's risk/benefit factors.

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