RESUMO
We investigated the relative importance of "fear of arousal symptoms" (i.e., anxiety sensitivity) and "dissociation tendency" in generating ataque de nervios. Puerto Rican patients attending an outpatient psychiatric clinic were assessed for ataque de nervios frequency in the previous month, and they completed the Anxiety Sensitivity Index (ASI) and the Dissociation Experiences Scale (DES). ASI scores were especially high in the ataque-positive group (M=41.6, SD=12.8) as compared with the ataque-negative group (M=27.2, SD=11.7), t(2, 68)=4.6, P<.001. Among the whole sample (N=70), in a logistic regression analysis, the ASI significantly predicted (odds ratio=2.6) the presence of ataque de nervios, but the DES did not. In a linear regression analysis, ataque severity was significantly predicted by both the ASI (beta=.46) and the DES (beta=.29). The theoretical and clinical implications of the strong relationship of the ASI to ataque severity are discussed.
Assuntos
Transtornos de Ansiedade/etnologia , Nível de Alerta , Características Culturais , Transtornos Dissociativos/etnologia , Medo , Hispânico ou Latino/psicologia , Transtorno de Pânico/etnologia , Transtornos Somatoformes/etnologia , Adulto , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Estudos Transversais , Transtornos Dissociativos/diagnóstico , Transtornos Dissociativos/psicologia , Feminino , Humanos , Masculino , Massachusetts , Pessoa de Meia-Idade , Transtorno de Pânico/diagnóstico , Transtorno de Pânico/psicologia , Inventário de Personalidade , Porto Rico/etnologia , Papel do Doente , Transtornos Somatoformes/diagnóstico , Transtornos Somatoformes/psicologiaRESUMO
OBJECTIVE: The aim of this study was to evaluate the prevalence of traumas and the presence of childhood anxiety disorders in adult patients with social phobia and investigate their influence on the presentation of the disorder. METHODS: Twenty-four adult patients with social phobia were asked about the presence of trauma before the age of 16. The K-SADS-E and the DICA-P interviews were used to assess these patients regarding childhood anxiety disorders. RESULTS: Twelve (50%) patients reported a history of trauma before the age of 16. The presence of trauma did not influence the presentation of the disorder. Seventy-five percent of patients had a history of anxiety disorders in childhood. Patients with a history of at least 2 childhood anxiety disorders had an increased lifetime prevalence of major depression (10 vs. 3; p=.04) and family history of psychiatric disorders (13 vs. 6; p=.02). CONCLUSION: Anxiety disorder in childhood is associated with family history of psychiatric disorders. The presence of more than one diagnosis of anxiety disorder in childhood can be considered a risk factor for the development of depression in adult patients with social phobia.
Assuntos
Ansiedade/complicações , Transtornos Fóbicos/etiologia , Adulto , Fatores Etários , Ansiedade/epidemiologia , Criança , Feminino , Humanos , Masculino , Prevalência , Estresse Psicológico/complicações , Estresse Psicológico/epidemiologiaRESUMO
OBJECTIVE: The aim of this study was to evaluate the prevalence of traumas and the presence of childhood anxiety disorders in adult patients with social phobia and investigate their influence on the presentation of the disorder. METHODS: Twenty-four adult patients with social phobia were asked about the presence of trauma before the age of 16. The K-SADS-E and the DICA-P interviews were used to assess these patients regarding childhood anxiety disorders. RESULTS: Twelve (50 percent) patients reported a history of trauma before the age of 16. The presence of trauma did not influence the presentation of the disorder. Seventy-five percent of patients had a history of anxiety disorders in childhood. Patients with a history of at least 2 childhood anxiety disorders had an increased lifetime prevalence of major depression (10 vs. 3; p=.04) and family history of psychiatric disorders (13 vs. 6; p=.02). CONCLUSION: Anxiety disorder in childhood is associated with family history of psychiatric disorders. The presence of more than one diagnosis of anxiety disorder in childhood can be considered a risk factor for the development of depression in adult patients with social phobia
Assuntos
Humanos , Masculino , Feminino , Criança , Adulto , Ansiedade/complicações , Transtornos Fóbicos/etiologia , Ansiedade/epidemiologia , Estresse Psicológico/complicações , Estresse Psicológico/epidemiologia , Fatores Etários , PrevalênciaRESUMO
Based on a previous study showing that panic disorder patients had increased expression of na ve phenotype lymphocytes (CD45RA+ and CD62L+), increased plasma cortisol, as well as decreased interleukin-2 (IL-2) producion, we hypothesized that changes in the percentage of expression of these lymphocyte surface molecules could be related to the substances released by the hypothalamic-pituitary-adrenal (HPA) axis and possibly associated to panic disorder (cortisol, IL-2, serotonin and epinephrine). In order to study the altered expression, blood mononuclear cells of normal volunteers were stimulated with mitogen, in the presence of dexamethasone, IL-2, serotonin and epinephrin. CD62L is decreased by IL-2 in vitro. Serotonin and epinephrine did not promote changes in the expression of these surface molecules. The results of the ex vivo study are in agreement with a previous clinical study with panic patients. It could be suggested that stress is responsible for certain immunologic dysfunctions and new studies should be conducted.
Assuntos
Epinefrina/sangue , Selectina L/sangue , Transtorno de Pânico/imunologia , Estresse Psicológico/imunologia , Linfócitos T/imunologia , Análise de Variância , Anti-Inflamatórios/sangue , Anti-Inflamatórios/farmacologia , Biomarcadores , Estudos de Casos e Controles , Moléculas de Adesão Celular/imunologia , Células Cultivadas/efeitos dos fármacos , Dexametasona/sangue , Dexametasona/farmacologia , Regulação da Expressão Gênica , Humanos , Interleucina-2/farmacologia , Contagem de Linfócitos , Transtorno de Pânico/sangue , Transtorno de Pânico/psicologia , Serotonina/sangue , Estresse Psicológico/sangueRESUMO
Based on a previous study showing that panic disorder patients had increased expression of naïve phenotype lymphocytes (CD45RA+ and CD62L+), increased plasma cortisol, as well as decreased interleukin-2 (IL-2) producion, we hypothesized that changes in the percentage of expression of these lymphocyte surface molecules could be related to the substances released by the hypothalamic-pituitary-adrenal (HPA) axis and possibly associated to panic disorder (cortisol, IL-2, serotonin and epinephrine). In order to study the altered expression, blood mononuclear cells of normal volunteers were stimulated with mitogen, in the presence of dexamethasone, IL-2, serotonin and epinephrin. CD62L is decreased by IL-2 in vitro. Serotonin and epinephrine did not promote changes in the expression of these surface molecules. The results of the ex vivo study are in agreement with a previous clinical study with panic patients. It could be suggested that stress is responsible for certain immunologic dysfunctions and new studies should be conducted
Assuntos
Humanos , Dexametasona , Epinefrina , Técnicas In Vitro , Selectina L , Transtorno de Pânico , Estresse Psicológico , Linfócitos T , Análise de Variância , Estudos de Casos e Controles , Moléculas de Adesão Celular , Células Cultivadas , Regulação da Expressão Gênica , Contagem de Linfócitos , Transtorno de Pânico , Serotonina , Estresse PsicológicoRESUMO
Os autores examinaram a frequência de eventos vitais significativos durante o ano que antecedeu o transtorno do pânico e sua relação com história de ansiedade na infância, história familiar de ansiedade, comorbidades e curso da doença. Foram acompanhados 223 pacientes em estudo naturalístico, longitudinal do transtorno do pânico. Embora 80 por cento dos pacientes com transtorno do pânico referisse a ocorrência de fator estressante no ano anterior ao início da doença, sua frequência é mais elevada em pacientes com história de ansiedade na infância e comorbidade com depressão na vida adulta. A presença de eventos vitais significativos não está associada com a presença de outros transtornos de ansiedade na vida adulta e nem com história familiar de ansiedade. Apesarde sua associação com história de ansiedade na infância e depressão, a presença de um fator estressor identificável não está associado a severidade ou ao curso do transtorno do pânico