• Title/Summary/Keyword: Panic

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Clinical Characteristics in Panic Disorder Patients in Emergency Department (공황발작으로 응급실에 내원한 공황장애 환자들의 임상 특징)

  • Lee, Chang-Ju;Nam, Beom-Woo;Sohn, In-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.26-33
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    • 2021
  • Objectives : This study was designed to investigate datas related to panic attack and treatment in emergency room of panic disorder patients who visited emergency room for panic attack. Methods : A retrospective analysis of medical records was conducted on 92 patients with panic disorder who visited Chungju Konkuk university hospital emergency department due to panic attack and had bodily symptoms from 1st January 2010 to 31th December 2019. In addition to demographic characteristics and comorbid disorders, triggering stressors and alcohol consumption were corrected as pre-panic attack datas, bodily symptoms at the time of panic attack were corrected as datas during attack, electrocardiogram trial, consultation with psychiatrist, admission and information of used psychotropic drugs were corrected as post-attack data. Depending on size of data, Chi-square test or Fisher's exact test was used. Collected data was analyzed using R 4.03. Results : Cardiovascular disease was accompanied by 5.4% and depressive disorder was the most common coexisting mental disorder. Among triggering stressors, economic problem/work-related stress was significantly higher in men than women (𝛘2=4.322, p<0.005). The most common physical symptom during attack was circulatory (65.2%), followed by respiratory (57.6%), numbness-paralysis (33.7%), dizziness (19.6%), gastro-intestinal (14.1%) and autonomic symptom (12.0%). Electrocardiogram was taken at higher rate when patients complained circulatory symptom (𝛘2=8.46, p<0.005). The psychotropic drug most commonly used in emergency room was lorazepam, used in 92.1%. Conclusions : The most common bodily symptom during panic attack was circulatory symptom and the most common triggering stressor in men was economic problem/work-related stress. The most commonly used psychotropic for panic attack was lorazepam.

6-months Prospective Follow-up Study of Panic Disorder Treatment (공황장애 환자 치료 결과에 대한 6개월간의 전향적 추적조사)

  • Yu, Je-Chun;Lee, Chul
    • 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.

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The Stress Coping Strategies and Cognitive Characteristics of Somatic Symptom Perception in Patients with Panic Disorder (공황장애 환자의 스트레스 대처방식과 신체 증상 지각에 대한 인지적 특성)

  • Jung, Hae-Won;Lee, Moo-Suk;Park, Woo-Young;Yang, Jong-Chul;Lim, Eun-Sung;Park, Tae-Won;Chung, Yong-Chul;Chung, Sang-Keun;Hwang, Ik-Keun
    • Anxiety and mood
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    • v.3 no.2
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    • pp.116-122
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    • 2007
  • Objective : The purpose of this study was to investigate the strategies used to cope with stress and the cognitive characteristics of somatic symptom perception in patients with panic disorder. Methods : A total of 101 patients who met the DSM-IV criteria for panic disorder and 60 normal controls were recruited for participation in this study. We evaluated the subjects using The Way of Stress Coping Questionnaire (SCQ), Somato-Sensory Amplification Scale (SSAS), Symptom Interpretation Questionnaire (SIQ), and the Panic Disorder Severity Scale (PDSS). We analyzed the data using an independent t-test and Pearson correlation analysis (p<0.05). Results : The patients who used emotionally focused coping strategies scored significantly lower on the SCQ. The patients with panic disorder showed greater amplification of body sensations in the SSAS, a significantly higher score on the physical interpretation subset of the SIQ, and a lower score on the environmental interpretation subset of the SIQ than the normal controls. The PDSS scores were positively correlated with the SSAS score and physical interpretation score on the SIQ. Conclusion : These results show that patients with panic disorder have poor emotionally focused strategies for coping with stress, greater amplification of body sensations, and a tendency towards a physical interpretation of somatic symptoms.

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A Case Report on Panic Disorder Patient Using the 'MRM (Mentalizing the Rooms of Mind)' and Korean Medicine Therapy (한의치료와 '마음의 방 그리기'를 활용한 공황장애 치험 1례 보고)

  • Kim, Jeesu;Cheong, Moon Joo;Lee, Ga-Won;Lyu, Yeoung-Su;Kang, Hyung Won
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.3
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    • pp.197-211
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    • 2020
  • Objectives: The purpose of this study was to introduce the progress of treatment and improve clinical use after conducting Mentalizing the Rooms of Mind, the main technique of Mindfulness & Loving Beingness psychotherapy, for a patient with panic disorder. Methods: We conducted a Mentalizing the Rooms of Mind for 10 sessions on an age 23 female diagnosed with panic disorder based on the DSM-5 diagnostic criteria. After receiving consent from the subject, through chart review, the progress of treatment was observed focusing on the MMPI-2 and CSEI-s (The Core Seven Emotions Inventory-short form) conducted pre- and post-treatment. This study was approved by the Institutional Review Board of Wonkwang University Sanbon Hospital (WMCSB202007-55). Results: 1. The MMPI-2 clinical scales of an age 23 female with panic disorder showed a 7 (Pt)-1 (Hs)-3 (Hy) profile pre-treatment, but for post-treatment, the scale showed 1 (Hs)-3 (Hy) profile, and the 7 (Pt) scale showed significant decline. In the MMPI-2 reconstructed clinical scales, RC7 (Dysfunctional Negative Emotions) and RC8 (Aberrant Experiences) showed significant decline. 2. In the pre- and post-treatment MMPI-2 content scales, Anxiety, Fears, Obsessiveness, Social Discomfort, and Work Interference scores decreased, showing overall positive stability. On the MMPI-2 supplementary scales, the Anxiety and Post-Traumatic Stress Disorder scores decreased, and the Ego Strength increased, resulting in improved overall psychological adaptation. 3. Pre- and post-treatment of an age 23 female with panic disorder, CSEI-s showed significant decline of 恐, 驚, 悲, and 思. So it seems that the emotions caused by Chiljeongsang (七情傷) were more stable than before treatment. Conclusions: As shown above, the treatment of panic disorder through Mentalizing the Rooms of Mind, a major technique of Mindfulness & Loving Beingness psychotherapy, showed positive changes in MMPI-2 as well as improvement of the subjective symptoms. Thus, Mentalizing the Rooms of Mind has high clinical use, and it seems that it is necessary to create a manual for this in the future.

Test turnaround Time for Complete Blood Cell Count using Delta and Panic Value Checks and the Q-flag Limit

  • Koo, Bon-Kyung;Ryu, Kwang-Hyun;Lim, Dae-Jin;Cho, Young-Kuk;Kim, Hee-Jin
    • Korean Journal of Clinical Laboratory Science
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    • v.44 no.2
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    • pp.66-74
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    • 2012
  • Test turnaround time (TAT) is the lead time from reception to reporting. In the complete blood cell count (CBC), 4 units of the XE-2100 (Sysmex Corp., Japan) processed around 80% of quantity, 1 unit of the LH-780 (Beckman-Coulter Incorp., USA) processed around 10% and 1 unit of ADVIA-2120 (Siemens AG, Munich, Germany) processed around 10%. We analyzed the change in the TAT for the CBC for over 7 years, from January of 2005 to December of 2011. The delta check made alterations of delta to WBC, hemoglobin, hematocrit, platelet and metamyelocyte, however, did not made them to band neutrophil, eosinophil, basophil and monocyte. The panic value check made alterations of panic value to hemoglobin, hematocrit, platelet and monocyte. In the criteria of currently slide review, LH-780 and ADVI-2120 analyzers prepared suspect flags of "Blast, Imm NE2, Immature granulocyte, Imm NE1, Left shift, Variant lymphocyte, Atypical lymphocyte, Platelet clumps and NRBC". The New slide review in the XE-2100 analyzer altered the preparations of a smear slide more than a "Platelet clumps flag(${\geq}200unit$), a single flag excluding the "Platelet clumps flag (${\geq}250unit$) and a multiple flag (${\geq}200unit$)". Also, below the 240 unit, medical technologists prepared manual slides selectively according to their evaluations. The automatic reporting rate was 33.4% without alterations, whereas it was 41.0% without alterations, and was thus improved by 7.6%. The slide review rate was 15.2% before using the Q-flag limit, whereas it was 12.1% for a reduce 3.1%. TAT was 45 minutes without the creation alterations of the delta and panic value checks, whereas it was 35 minutes after making alterations of the delta and panic value checks and thus was shortened by 10 minutes. We came to the conclusion that the establishment and operation of delta and panic value checks and slide review criteria suitable for laboratory environment can reduce unnecessary smear slides, re-checking, re-sampling, re-testing, telephone inquiries and concentrated workloads during specific times of the day.

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Korean Guidelines for the Treatment of Panic Disorder 2018 : Initial and Maintenance Treatment Strategies for the Pharmacological Treatment of Panic Disorder (2018 한국형 공황장애 치료지침서 : 초기 및 유지 약물치료 전략)

  • Kim, Min-Kyoung;Lee, Jae-Hon;Gim, Minsook;Kim, Won;Moon, Eunsoo;Seo, Ho-Jun;Koo, Bon-Hoon;Yang, Jong-Chul;Lee, Kang Soo;Lee, Sang-Hyuk;Kim, Chan-Hyung;Yu, Bum-Hee;Suh, Ho-Suk
    • Anxiety and mood
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    • v.14 no.2
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    • pp.53-62
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    • 2018
  • Objective : The Korean Association of Anxiety Disorders developed Korean guidelines for treatment of panic disorder (PD) 2018. In this paper, we discussed the consensus among psychiatrists, regarding initial and maintenance treatment strategies for pharmacological treatment of PD in Korea. Methods : Based on current treatment guidelines published by the American Psychiatric Association, the National Institute for Clinical Excellence, and the Canadian Psychiatric Association, we developed questionnaires pertinent to initial and maintenance treatment strategies for pharmacological treatment of PD. Seventy-two experts in PD answered questionnaires. We classified expert opinions into three categories, first, second, and third-line treatment strategies, by analyzing the 95% confidence interval. Results : Antidepressants, benzodiazepine anxiolytics, and cognitive-behavioral therapy (CBT) were recommended as treatments of choice (ToC), and first-line strategies for initial treatment of PD. Escitalopram, paroxetine, sertraline, and venlafaxine were preferred from among many anti-panic drugs. Mean starting dose of anti-panic drugs for initial treatment of PD was relatively lower, than that for other psychiatric illnesses such as major depressive disorder. In the case of maintenance treatment of PD, antidepressants and CBT were selected as ToC and first-line strategies. Patients were typically examined every four weeks during treatment, to review effectiveness and side effects of the drug. Pharmacotherapy was generally continued for one year or more. Conclusion : This study provides information about consensus among Korean experts regarding pharmacological treatment strategies for patients with panic disorder.

Effect of video-based movement therapy program on panic disorder symptom relief and brain wave on patients with panic disorder (공황장애 환자의 동영상 기반 동작치료 프로그램 수행이 공황장애 증상 완화 및 뇌파에 미치는 영향)

  • Jeong, Jin-Hyup
    • Journal of Digital Convergence
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    • v.17 no.10
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    • pp.453-459
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    • 2019
  • This study was conducted to investigate the effects of video - based movement therapy program on emotional variables (anxiety, depression, panic disorder) and EEG on panic disorder patients. The following conclusions were obtained. The results of the 12 - week video - based behavior therapy program showed that there were statistically significant differences (p <.05) in the anxiety scale of the exercise group. There were statistically significant differences (p <.05) between the left brain L-Beta region of the exercise group and the left brain H-Beta and the right brain L-Beta regions of the control group and no significant difference was found between the groups. The results of this study suggest that the performance of the video-based behavioral therapy program for panic disorder patients did not affect the emotional variables and EEG changes. However, in the case of emotional variables, It is considered that the longer the program execution period, the more result will be obtained. In addition, it is expected that more positive study results can be expected if the program is run after having had enough familiarity and adaptation time of the operation treatment program omitted in this study.

An Analysis of Disaster Mythology (재난 신화에 관한 분석)

  • Kim, Man-Jae
    • Journal of the Korean Society of Hazard Mitigation
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    • v.7 no.4
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    • pp.31-39
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    • 2007
  • Disaster mythology is "beliefs about human behavior in disaster that have been proven to be wrong through scientifically conducted research studies." Disaster researchers have discovered a series of disaster myths. The results of research survey based on 491 individuals confirm prior research representing widespread belief in disaster mythology such as panic, looting, crime, evacuation and lethargy. This study also indicates that, while high, the percentage of local government officials demonstrating belief in disaster myths was lower than the public except for looting. The probability of believing disaster myths was greater for individuals who were female (panic and evacuation), old (evacuation and lethargy), in their twenties and thirties (looting), and officials with disaster related work experience (panic, looting and crime). The results indicate the importance of understanding public belief to make effective emergency plans.

A Case Report of a Panic Disorder patient suffering from a Chronic Headache (만성두통을 호소하는 공황장애 환자의 두통 치험 1례)

  • Cha, Hye-Jin;Lee, Ji-Won;Chu, Ching-Nai;Kim, Hyo-Ju;Seo, Young-Min;Park, Se-Jin
    • Journal of Oriental Neuropsychiatry
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    • v.19 no.2
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    • pp.279-288
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    • 2008
  • In this case, a 33 year-old female patient had a chronic headache with Panic disorder, and accompanied gastroenteric troubles(vomiting, nausea, dyspepsia and abdominal discomfort), for fifteen years. It may be the symptoms of Phlegm-syncope headache, and we treated this disease with oriental medical treatment, including the Banhabaekchulcheonma-tang, Breathing retraining and Cognitive retructuring. The effects of treatment were measured by were using BPI(Brief Pain Inventory), VAS(Visual analog scale). In Conclusion, Chronic headache with panic disorder was improved by our treatment.

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