How to help the one-third of patients with panic disorder who have chronic, persistent symptoms?
DSM-5 must emphasize that physical symptoms deserve the respect of a thorough work-up before assuming their cause is psychiatric. And people with defined medical illnesses should not be casually mislabeled as also mentally ill just because they are upset about being sick.
According to the CDC's latest published report, there were 38,364 suicides in the US in 2010—an average of 105 each day. Globally, an estimated 1 million suicides occur annually.
The goal of this article is to improve recognition of comorbid psychiatric and movement disorders and to help the reader formulate a management strategy using a multidisciplinary approach.
Panic attacks are nearly always pathological and disordered states, even when they occur in an understandable context.
This tale involves a “clever” inmate. He enjoyed the respectable rung of bank robber, but found he had suddenly descended to approximately the level of a sex offender. The reason for his slippage was the inmate code, which demands allegiance to other inmates under virtually all circumstances. “Ratting out” a fellow inmate may cost one his life, or at the very least, result in a decidedly anxious, paranoid existence.
After scoring high on the Panic Disorder Severity Scale, this patient sought panic-focused psychodynamic therapy.
Exposure-based therapies are highly effective for patients with anxiety disorders, to the extent that exposure should be considered a first-line, evidence-based treatment for such patients. In clinical practice, however, these treatments are underutilized, which highlights the need for additional dissemination and training.
Mixed states constitute a wondrously variegated universe of psychopathology. These states are characterized by the intrusion of features characteristic of depression into states of hypomania or mania and the converse. Mixed states assume a myriad of forms that as a family may be among the most commonly encountered states of affective illness.
Research emerging from the field of emotion science suggests that individuals who have anxiety and mood disorders tend to experience negative affect more frequently and more intensely than do healthy individuals, and they tend to view these experiences as more aversive, representing a common diathesis across anxiety and mood disorders.1-5 Deficits in the ability to regulate emotional experiences, resulting from unsuccessful efforts to avoid or dampen the intensity of uncomfortable emotions, have also been found across the emotional disorders and are a key target for therapeutic change.