• 수면정신생리
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• 제18권2호
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• pp.57-62
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• 2011

Sleep disturbance is a one of common complaints among patients with panic disorder. However, clinicians and researchers did not give much attention to the sleep symptoms of panic disorder yet. Several previous studies suggested that the sleep disturbance in panic disorder is mediated by nocturnal panic attack. In terms of the pathophysiology of panic disorder, nocturnal panic attack seems to be closely associated with the sleep problems in panic disorder. In this article, the authors reviewed various previous studies about sleep of panic disorder and intended to give importance of evaluating sleep disturbances and nocturnal panic attack in panic disorder for both clinical and research purpose.

• 생물정신의학
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• 제14권3호
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• pp.194-200
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• 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.

• 대한불안의학회지
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• 제2권1호
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• pp.56-60
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• 2006

Panic disorder is a relatively common psychiatric illness (life time prevalence 3.5%), and it is known that 91% of patients with panic disorder have at least one other psychiatric disorder. And patients with panic disorder, who have coexisting generalized anxiety disorder, tend to have more severe symptoms and less favorable outcome and respond less well to psychological and pharmacologic treatment. The authors report a 51-year old male who was previously diagnosed as panic disorder in the out-patient clinic, showed poor response to antipanic treatment. However, he showed great improvement after he was treated for panic disorder and comorbid generalized anxiety disorder. This case report showed that more effort to identify comorbid conditions is needed in panic disorder patients and the effectiveness of venlafaxine in the treatment of panic disorder with generalized anxiety disorder.

• 대한불안의학회지
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• 제3권2호
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• pp.91-96
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• 2007

Panic disorder is a common psychiatric illness that causes considerable morbidity. However, the biological basis of panic disorder remains unclear. In this report, we present and summarize the current literature on functional neuroimaging studies related to the neurobiology of panic disorder. The findings were summarized and divided into six groups : (1) known brain structures related to anxiety, especially panic disorder ; (2) structural results ; (3) functional imaging studies at rest ; (4) functional imaging studies with challenge testing ; (5) neuroreceptor studies ; and (6) changes in the treatment of panic disorder. Based on the findings of these neuroimaging studies, it seems as though panic disorder involves the hippocampal and parahippocampal areas, including the amygdala, as well as some cortical regions, such as the temporal and prefrontal cortices. Panic disorder is known to be associated with an imbalance between the right and left hemispheres of the brain at rest or during panic attacks. During a panic attack, patients with panic disorder are likely to experience an increase in local activity in the cingulate, insula, midbrain, and so on. On the other hand, a widespread reduction in the cortical areas has also been reported in most provocation studies. Thus, panic disorder may be related to the excess activation of the fear networks in response to subtle environmental cues and insufficient inhibition from higher cortical control areas ; however ; further studies are recommended in order to fully understand the neurobiology of panic disorder.

• 한국엔터테인먼트산업학회논문지
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• 제13권4호
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• pp.63-70
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• 2019

상황 인식 환경에서 공황장애의 증상을 추출하고자 일상생활을 통해 자연스런 음직임에서 발생하는 신체 상황정보를 추출하여 공황장애의 구성요소를 찾아내고 온톨로지 이론을 적용하여 의미를 추론 과정을 거쳐 공황장애에 증상의 정도에 대해 정보를 제공할 수 있다. 온톨로지 기반의 정보 처리를 위해 공황장애의 구성요소는 클래스로 정의하고 공황장애의 상태를 이해할 수 있도록 온톨로지 모델링을 통해 공황장애지수를 도출하였다. 공황장애 구성요소와 공황장애 지수의 도출은 공황장애에 대한 상황 인식 기반의 정보 서비스를 가능할 것이며, 상황인식 기반 디바이스와 결합되어 상황정보는 주기적으로 동기화된다. 공황장애 지수의 결과를 관찰할 수 있으며 공황장애의 요인이 되는 생활습관을 개선하는데 적용할 수 있을 것이다.

• 대한불안의학회지
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• 제2권1호
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• pp.17-21
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• 2006

SSRIs have been considered as the first line of treatment for patients with panic disorder since 1990s along with cognitive behavioral treatments. High potency benzodiazepines (e.g. alprazolam, clonazepam) have had advantages in anti-panic effects. However, these drugs have limitations of treating panic disorder because of their dependency, tolerance and withdrawal. Serotonin and noradrenaline reuptake inhibitors (SNRIs) such as venlafaxine were introduced as antidepressants since 1990s. Recently, it is confirmed that SNRIs have the remarkable anti-panic effects although some concerns about its cost, tolerance, withdrawal, side effects such as dry mouth, constipation, and hypertension have emerged. In this regard, further study is required to confirm the efficacy of long term treatment of panic disorder. Despite these concerns, venla-faxine extended-release is an effective treatment in patients with panic disorder.

• 수면정신생리
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• 제2권1호
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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.

• 대한한의진단학회지
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• 제16권3호
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• pp.59-68
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• 2012

The purpose of this study is to report the effects of oriental demonstration treatment for Panic Disorder. Panic Disorder is an anxiety disorder, characterized by panic attacks which are recurring episodes of fear accompanied by somatic symptoms such as shortness of breath, palpitations, chest pain, choking, dizziness, trembling and/or faintness. Objectives: We experienced one case of Panic Disorder treated with Asian medical treatment, acupuncture and herbal medication. 20-year-old female patient suffered from Panic Disorder with nausea and insomnia. Methods: Shihosogantang-gami had been applied to the patient. Results: After treatment her Panic Disorder was improved. Conclusions: Shihosogantang -gami of Asian medical treatment could be safe and effective.

• 정신신체의학
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• 제6권2호
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• pp.104-119
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• 1998

This study was conducted to determine the important factors in the illness behavior of panic disorder patients. And then, find the best ways to lead the patients who have recurrent panic attacks to the adequate therapeutic situations. We studied 53 patients diagnosed as panic disorder according to DSM-IV among the outpatients who had been followed up at Bong Seng Memorial Hospital for 6 Ms, from May 1997 to October 1997. To evaluate the illness behaviors, we designed a checklist including socio-demographic data, degree of subjective distress from medical and psychiatric treatment, panic symptoms, life events, places of help-seeking, Anxiety Sensitivity Index. Using the checklist, we had semistructured interviews with the panic disorder patients to elucidate their help-seeking behaviors from first panic attack to diagnosing as panic disorder. The results were as follows ; 1) After first panic attack, the patients initially sought help at 1) Emergency room 40%, 2) Rest &/or Personal emergency care 35%, 3) Pharmacy 10%, 4) Outpatient care at hospital 10%, 5) Oriental medicine 5%. 2) Considering the panic symptoms, derealization, paresthesia and the severity of panic symptoms were the most important factors affecting the patient's help-seeking behaviors who had experienced the first panic attack. 3) Most of all the patients (80%) were apt to visit the hospitals within 15 days after experiencing about 3 panic attacks. 4) Before diagnosed as panic disorder, the patients had visited 3-5 health care centers during about 1 year. 5) Primary care physicaians(for example, emergency care physicians, family doctors and internists) had the most important roles in treating or guiding the patients to the adequate therapeutic situations. From the above results, the authors propose that non-psychiatric physicians have to know the panic disorder or attacks exactly. When patients complaint sudden onset physical symptoms e.g. palpitation, dyspnea, dizziness or the cognitive symptoms like the fear of death or insanity, physicians should consider the possibility of panic attack and encourage the patients to be evaluated for psychiatric illness.

• 생물정신의학
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• 제23권4호
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• pp.166-172
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• 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.