Panic and bodily alarm

لَا يَحۡزُنُهُمُ ٱلۡفَزَعُ ٱلۡأَكۡبَرُ وَتَتَلَقَّىٰهُمُ ٱلۡمَلَٰٓئِكَةُ هَٰذَا يَوۡمُكُمُ ٱلَّذِي كُنتُمۡ تُوعَدُونَ

They will have no fear of the great Terror: the angels will receive them with the words, ‘This is the Day you were promised!’

إِذۡ يُوحِي رَبُّكَ إِلَى ٱلۡمَلَٰٓئِكَةِ أَنِّي مَعَكُمۡ فَثَبِّتُواْ ٱلَّذِينَ ءَامَنُواْۚ سَأُلۡقِي فِي قُلُوبِ ٱلَّذِينَ كَفَرُواْ ٱلرُّعۡبَ فَٱضۡرِبُواْ فَوۡقَ ٱلۡأَعۡنَاقِ وَٱضۡرِبُواْ مِنۡهُمۡ كُلَّ بَنَانࣲ‏

Your Lord revealed to the angels: ‘I am with you: give the believers firmness; I shall put terror into the hearts of the disbelievers- strike above their necks and strike all their fingertips.’

سَنُلۡقِي فِي قُلُوبِ ٱلَّذِينَ كَفَرُواْ ٱلرُّعۡبَ بِمَآ أَشۡرَكُواْ بِٱللَّهِ مَا لَمۡ يُنَزِّلۡ بِهِۦ سُلۡطَٰنࣰ اۖ وَمَأۡوَىٰهُمُ ٱلنَّارُۖ وَبِئۡسَ مَثۡوَى ٱلظَّٰلِمِينَ

We will strike panic into the disbelievers’ hearts because they attribute partners to God although He has sent no authority for this: their shelter will be the Fire- how miserable is the home of the evildoers

وَأَنزَلَ ٱلَّذِينَ ظَٰهَرُوهُم مِّنۡ أَهۡلِ ٱلۡكِتَٰبِ مِن صَيَاصِيهِمۡ وَقَذَفَ فِي قُلُوبِهِمُ ٱلرُّعۡبَ فَرِيقࣰ ا تَقۡتُلُونَ وَتَأۡسِرُونَ فَرِيقࣰ ا

He brought those People of the Book who supported them down from their strongholds and put panic into their hearts. Some of them you [believers] killed and some you took captive

هُوَ ٱلَّذِيٓ أَخۡرَجَ ٱلَّذِينَ كَفَرُواْ مِنۡ أَهۡلِ ٱلۡكِتَٰبِ مِن دِيَٰرِهِمۡ لِأَوَّلِ ٱلۡحَشۡرِۚ مَا ظَنَنتُمۡ أَن يَخۡرُجُواْۖ وَظَنُّوٓاْ أَنَّهُم مَّانِعَتُهُمۡ حُصُونُهُم مِّنَ ٱللَّهِ فَأَتَىٰهُمُ ٱللَّهُ مِنۡ حَيۡثُ لَمۡ يَحۡتَسِبُواْۖ وَقَذَفَ فِي قُلُوبِهِمُ ٱلرُّعۡبَۚ يُخۡرِبُونَ بُيُوتَهُم بِأَيۡدِيهِمۡ وَأَيۡدِي ٱلۡمُؤۡمِنِينَ فَٱعۡتَبِرُواْ يَٰٓأُوْلِي ٱلۡأَبۡصَٰرِ

It was He who drove those of the People of the Book who broke faith out from their homes at the first gathering of forces––you [believers] never thought they would go, and they themselves thought their fortifications would protect them against God. God came up on them from where they least expected and put panic into their hearts: their homes were destroyed by their own hands, and the hands of the believers. Learn from this, all of you with insight

مَن جَآءَ بِٱلۡحَسَنَةِ فَلَهُۥ خَيۡرࣱ مِّنۡهَا وَهُم مِّن فَزَعࣲ يَوۡمَئِذٍ ءَامِنُونَ

whoever comes with a good deed will be rewarded with something better, and be secure from the terrors of that Day

The greatest terror shall not make them sorrow, and the angels will receive them: “This is the day that you were promised.” On the Day of Resurrection in the greatest gathering place and most tremendous courtyard, they will not hear from the angels the call “no good news” [25:22], nor the address, “Stand apart today, O offenders!” [36:59], nor the harsh call, “Slink into it, and do not talk to Me!” [23:108]. They will not hear the call of separation's pain, nor will they despair of mercy. Rather the angels will keep on coming, company after company, and they will give the good news: “This is the day that you were promised,” that is, “This is the day in which you have the promised reward.” Among them are those who will be received by the angels, and among them are those who will be addressed and made known by the King. God will say, “My servants, have you been yearning for Me?” He will sa

The Supreme Terror — which is that a servant be ordered off to the Fire shall not grieve them and the angels shall receive them upon their exiting from their graves saying to them ‘This is your day the one which you were promised’ during the life of the world.

When your Lord inspired the angels with whom He reinforced the Muslims saying ‘I am with you with assistance and victorious help so make the believers stand firm by helping them and giving them good tidings. I shall cast terror fear into the hearts of the disbelievers; so smite above the necks that is the heads and smite of them every finger!’ that is smite the extremities of their hands and feet thus when one of them went to strike an disbeliever’s head it would roll off before his sword reached it. The Prophet s threw a handful of pebbles against them and every single idolater was struck in his eye and thus they were defeated.

(Remember) when He covered you with a slumber as a security from Him, and He caused water (rain) to descend on you from the sky, to clean you thereby and to remove from you the Rijz (whispering or dirt) of Shaytan, and to strengthen your hearts, and make your feet firm thereby (11)(Remember) when your Lord revealed to the angels, "Verily, I am with you, so keep firm those who have believed. I will cast terror into the hearts of those who have disbelieved, so strike them over the necks, and smite over all their fingers and toes. (12)This is because they defied and disobeyed Allah and His Messenger. And whoever defies and disobeys Allah and His Messenger, then verily, Allah is severe in punishment (13)This is (the torment), so taste it; and surely, for the disbelievers is the torment of the Fire (14) Slumber overcomes Muslims Allah reminds the believers of the slumber that He sent down o

(We shall cast terror into the hearts of those who disbelieve) [3:151]. Said al-Suddi: �After Uhud, Abu Sufyan and the idolaters headed toward Mecca. But after they traversed a certain distance, they felt regret, saying: �Evil is that which we have done! We massacred them such that none of them remained except those who fled from the battlefield and then we left them alone. Go back and exterminate them�. But when they decided to do so, Allah, exalted is He, cast terror in their hearts which made them decide against what they had resolved to do. Allah, exalted is He, then revealed this verse�.

(All that is in the heavens and all that is in the earth glorifieth Allah� Allah is Able to do all things) [59:1-6]. The commentators of the Qur'an said: �This verse was revealed about Banu'l-Nadir. When the Prophet, Allah bless him and give him peace, moved to Medina, they signed a treaty with him in which they agreed not fight against him or with him and the Messenger of Allah, Allah bless him and give him peace, consented. Then when the Messenger of Allah, Allah bless him and give him peace, defeated the idolaters at Badr, Banu'l-Nadir said: 'By Allah, he is the Prophet whose description we find in the Torah; he will not be defeated'. However, when the Muslims were defeated at Uhud, they broke their pledge and showed enmity toward the Messenger of Allah, Allah bless him and give him peace, and Muslims. The Messenger of Allah, Allah bless him and give him peace, surrounded them and the

أَخْبَرَنَا أَبُو عَبْدِ الرَّحْمَنِ، أَحْمَدُ بْنُ شُعَيْبٍ قَالَ أَنْبَأَنَا عَمْرُو بْنُ عَلِيٍّ، قَالَ حَدَّثَنَا أَبُو عَاصِمٍ، قَالَ حَدَّثَنَا ابْنُ أَبِي ذِئْبٍ، قَالَ حَدَّثَنِي أَسِيدُ بْنُ أَبِي أَسِيدٍ، عَنْ مُعَاذِ بْنِ عَبْدِ اللَّهِ، عَنْ أَبِيهِ، قَالَ أَصَابَنَا طَشٌّ وَظُلْمَةٌ فَانْتَظَرْنَا رَسُولَ اللَّهِ صلى الله عليه وسلم لِيُصَلِّيَ بِنَا ثُمَّ ذَكَرَ كَلاَمًا مَعْنَاهُ فَخَرَجَ رَسُولُ اللَّهِ صلى الله عليه وسلم لِيُصَلِّيَ بِنَا فَقَالَ ‏"‏ قُلْ ‏"‏ ‏.‏ فَقُلْتُ مَا أَقُولُ قَالَ ‏"‏ ‏{‏ قُلْ هُوَ اللَّهُ أَحَدٌ ‏}‏ وَالْمُعَوِّذَتَيْنِ حِينَ تُمْسِي وَحِينَ تُصْبِحُ ثَلاَثًا يَكْفِيكَ كُلَّ شَىْءٍ ‏"‏ ‏.‏

It was narrated from Mu'adh bin 'Abdullah that his father said:"It was raining and dark, and we were waiting for the Messenger of Allah [SAW] to lead us in prayer. Then the Messenger of Allah [SAW] came out to lead us in prayer and he said: 'Say.' I said: 'What should I say?' He said: 'Say: He is Allah, (the) One and Al-Mu'awwadhatain in the evening and in the morning, three times, and that will suffice you against everything

أَخْبَرَنَا مُحَمَّدُ بْنُ عَلِيٍّ، قَالَ حَدَّثَنِي الْقَعْنَبِيُّ، عَنْ عَبْدِ الْعَزِيزِ، عَنْ عَبْدِ اللَّهِ بْنِ سُلَيْمَانَ، عَنْ مُعَاذِ بْنِ عَبْدِ اللَّهِ بْنِ خُبَيْبٍ، عَنْ أَبِيهِ، عَنْ عُقْبَةَ بْنِ عَامِرٍ الْجُهَنِيِّ، قَالَ بَيْنَا أَنَا أَقُودُ، بِرَسُولِ اللَّهِ صلى الله عليه وسلم رَاحِلَتَهُ فِي غَزْوَةٍ إِذْ قَالَ ‏"‏ يَا عُقْبَةُ قُلْ ‏"‏ ‏.‏ فَاسْتَمَعْتُ ثُمَّ قَالَ ‏"‏ يَا عُقْبَةُ قُلْ ‏"‏ ‏.‏ فَاسْتَمَعْتُ فَقَالَهَا الثَّالِثَةَ فَقُلْتُ مَا أَقُولُ فَقَالَ ‏"‏ ‏{‏ قُلْ هُوَ اللَّهُ أَحَدٌ ‏}‏ ‏"‏ ‏.‏ فَقَرَأَ السُّورَةَ حَتَّى خَتَمَهَا ثُمَّ قَرَأَ ‏{‏ قُلْ أَعُوذُ بِرَبِّ الْفَلَقِ ‏}‏ وَقَرَأْتُ مَعَهُ حَتَّى خَتَمَهَا ثُمَّ قَرَأَ ‏{‏ قُلْ أَعُوذُ بِرَبِّ النَّاسِ ‏}‏ فَقَرَأْتُ مَعَهُ حَتَّى خَتَمَهَا ثُمَّ قَالَ ‏"‏ مَا تَعَوَّذَ بِمِثْلِهِنَّ أَحَدٌ ‏"‏ ‏.‏

It was narrated that 'Uqbah bin 'Amir Al-Juhani said:"While I was leading the Messenger of Allah [SAW] on his mount on a military campaign, he said: 'O 'Uqbah, say!' I listened, then he said: 'O 'Uqbah, say!' I listened, then he said it a third time. I said: 'What should I say?' He said: 'Say: He is Allah, (the) One...' and he recited the Surah to the end. Then he recited: 'Say: I seek refuge with (Allah) the Lord of the daybreak...' and I recited it with him until the end. Then he recited: 'Say: I seek refuge with (Allah) the Lord of mankind...' and I recited it with him until the end. Then he said: 'No one ever sought refuge (with Allah) by means of anything like them

فتوهم نفسك وقد وثبت متغيرا وجهك مغبرا بدنك من فرقك إلى قدمك من تراب قبرك مبهوتا من شدة الصعقة شاخص العين نحو النداء وقد ثار الخلق ثورة واحدة من القبور التى طال فيها بلاؤهم وقد أزعجهم الفزع والرعب مضافا إلى ما كان عندهم من الهموم والغموم وشدة الانتظار لعاقبة الأمر كما قال تعالى ونفخ فى الصور فصعق من فى السموات ومن فى الأرض إلا من شاء الله ثم نفخ فيه أخرى فإذا هم قيام ينظرون وقال تعالى @QB@ فإذا نقر في الناقور فذلك يومئذ يوم عسير على الكافرين غير يسير @QE@ وقال تعالى @QB@ ويقولون متى هذا الوعد إن كنتم صادقين ما ينظرون إلا صيحة واحدة تأخذهم وهم يخصمون فلا يستطيعون توصية ولا إلى أهلهم يرجعون ونفخ في الصور فإذا هم من الأجداث إلى ربهم ينسلون قالوا يا ويلنا من بعثنا من مرقدنا هذا ما وعد الرحمن وصدق المرسلون @QE@ فلو لم يكن بين يدي الموتى إلا هول تلك النفخة لكان ذلك جديرا بأن يتقى فإنها نفخة وصيحة يصعق بها من فى السموات والأرض يعنى يموتون بها إلا من شاء الله وهو بعض الملائكة

واما المنافق فانه عمي قلبه لم يجاوز بصره الظلمة ولم ير الا برقا يكاد يخطف البصر و رعدا عظيما وظلمة فاستوحش من ذلك وخاف منه فوضع اصابعه في اذنيه لئلا يسمع صوت الرعد وهاله ذلك البرق وشدة لمعانه وعظم نوره فهو خائف ان يختطف معه بصره لان بصره اضعف من ان يثبت معه فهو في ظلمة يسمع اصوات الرعد القاصف ويرى ذلك البرق الخاطف فان اضاء له ما بين يديه مشى في ضوئه وان فقد الضوء قام متحير ا لا يدري اين يذهب ولجهله لا يعلم ان ذلك من لوازم الصيب الذي به حياة الأرض والنبات وحياته هو نفسه بل لا يدرك الا رعدا وبرقا وظلمة ولا شعور له بما وراء ذلك فالوحشة لازمة له والرعب والفزع لا يفارقه واما من انس بالصيب وعلم انه لا بد فيه من رعد وبرق وظلمة بسبب الغيم استانس بذلك ولم يستوحش منه ولم يقطعه ذلك عن اخذه بنصيبه من الصيب فهذا مثل مطابق للصيب الذي نزل به جبريل صلى الله عليه وسلم من عند رب العالمين تبارك وتعالى على قلب رسول الله صلى الله عليه وسلم ليحيي به القلوب والوجود اجمع اقتضت حكمته ان يقارنه من الغيم والرعد وا

وجملة أدب المريض حسن الصبر وقلة الشكوى والضجر والفزع إلى الدعاء والتوكل بعد الدواء على خالق الدواء

وجملة آداب المريض: حسن الصبر، وقلة الشكوى والتضجر، والفزع إلى #

أي لذلك الماء الذي غمر الأرض ومن عليها فصل وأما الوهل فهو بتحريك الهاء وأصله الفزع والروع يقال وهل يوهل وهو وهل ومستوهل قال القطامي يصف إبلا

وأما اللوعة فقال في الصحاح لوعة الحب حرقته وقد لاعه الحب يلوعه والتاع فؤاده أي احترق من الشوق ومنه قولهم أتان لاعة الفؤاد إلى جحشها قال الأصمعي أي لائعة الفؤاد وهي التي كأنها ولهى من الفزع فصل

A Lifetime Prevalence of Comorbidity Between Bipolar Affective Disorder and Anxiety Disorders: A Meta-analysis of 52 Interview-based Studies of Psychiatric Population.: Background: Bipolar affective disorder has a high rate of comorbidity with a multitude of psychiatric disorders and medical conditions. Among all the potential comorbidities, co-existing anxiety disorders stand out due to their high prevalence. Aims: To determine the lifetime prevalence of comorbid anxiety disorders in bipolar affective disorder under the care of psychiatric services through systematic review and meta-analysis. Method: Random effects meta-analyses were used to calculate the life

How prevalent are anxiety disorders in schizophrenia? A meta-analysis and critical review on a significant association.: Objective: The presence of anxiety disorders (AD) in schizophrenia (SZ) is attracting increasing interest. However, published studies have yielded very broad variations in prevalence rates across studies. The current meta-analysis sought to (1) investigate the prevalence of co-occurring AD in SZ by reporting pooled prevalence rates and (2) identify potential sources of variations in reported rates that could guide our efforts to identify and treat these co-occurring disorders in patients with SZ

Experience sampling and ecological momentary assessment for studying the daily lives of patients with anxiety disorders: a systematic review.: Anxiety disorders are highly prevalent. Symptoms may occur unpredictably (e.g., panic attacks) or predictably in specific situations (e.g., social phobia). Consequently, it may be difficult to assess anxiety and related constructs realistically in the laboratory or by traditional retrospective questionnaires. Experience sampling methods (ESM) and ecological momentary assessment (EMA) can deepen the understanding of the course of anxiety disorders by frequently assessing symptoms and other variab

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Compared With Diagnosis-Specific Protocols for Anxiety Disorders: A Randomized Clinical Trial.: Importance: Transdiagnostic interventions have been developed to address barriers to the dissemination of evidence-based psychological treatments, but only a few preliminary studies have compared these approaches with existing evidence-based psychological treatments. Objective: To determine whether the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) is at least as efficacious as single-disorder protocols (SDPs) in the treatment of anxiety disorders. Design, setting, an

Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials.: Trials of virtual reality exposure therapy (VRET) for anxiety-related disorders have proliferated in number and diversity since our previous meta-analysis that examined 13 total trials, most of which were for specific phobias (Powers & Emmelkamp, 2008). Since then, new trials have compared VRET to more diverse anxiety and related disorders including social anxiety disorder (SAD), posttraumatic stress disorder (PTSD), and panic disorder (PD) with and without agoraphobia. With the availability of

Comorbidity of personality disorders in anxiety disorders: a meta-analysis of 30 years of research.: Background: A comprehensive meta-analysis to identify the proportions of comorbid personality disorders (PD) across the major subtypes of anxiety disorders (AD) has not previously been published. Methods: A literature search identified 125 empirical papers from the period 1980-2010 on patients with panic disorders, social phobia, generalised anxiety, obsessive-compulsive (OCD) and post-traumatic stress disorder (PTSD). Several moderators were coded. Results: The rate of any comorbid PD was high

Differential alterations of resting-state functional connectivity in generalized anxiety disorder and panic disorder.

Generalized anxiety disorder (GAD) and panic disorder (PD) are most common anxiety disorders with high lifetime prevalence while the pathophysiology and disease-specific alterations still remain largely unclear. Few studies have taken a whole-brain perspective in the functional connectivity (FC) analysis of these two disorders in resting state. It limits the ability to identify regionally and psychopathologically specific network abnormalities with their subsequent use as diagnostic marker and novel treatment strategy. The whole brain FC using a novel FC metric was compared, that is, scaled correlation, which they demonstrated to be a reliable FC statistics, but have higher statistical power in two-sample t-test of whole brain FC analysis. About 21 GAD and 18 PD patients were compared with 22 matched control subjects during resting-state, respectively. It was found that GAD patients demo…

matched on Panic Disorder (mesh), panic disorder (text)

The Worry Behaviors Inventory: Assessing the behavioral avoidance associated with generalized anxiety disorder.

Background: Understanding behavioral avoidance associated with generalized anxiety disorder (GAD) has implications for the classification, theoretical conceptualization, and clinical management of the disorder. This study describes the development and preliminary psychometric evaluation of a self-report measure of avoidant behaviors associated with GAD: the Worry Behaviors Inventory (WBI). Methods: The WBI was administered to treatment-seeking patients (N=1201). Convergent validity was assessed by correlating the WBI with measures of GAD symptom severity. Divergent validity was assessed by correlating the WBI with measures of general disability and measures of depression, social anxiety and panic disorder symptom severity. Results: Exploratory and confirmatory factor analyses supported a two-factor structure (Safety Behaviors and Avoidance). Internal reliability was acceptable for the 10…

matched on Panic (mesh), panic disorder (text)

Fears, Coping Styles, and Health Behaviors: A Comparison of Patients With Hypochondriasis, Panic Disorder, and Depression.

Research into correlates of illness anxiety disorder (formerly hypochondriasis) rarely applies comprehensive assessments of health behavior. Moreover, studies on phenomenological varieties of clinical health anxiety are scarce. We examined health behavior, fear, and acceptance of death and dying, and coping with a hypothetical bodily disease in patients with hypochondriasis, panic disorder, depression, and healthy controls (all groups n = 30) using self-rated questionnaires. ANOVA with Dunnett-T3 post hoc tests revealed no group differences in health behavior. The hypochondriasis and panic disorder groups showed more fear and less acceptance of death and dying than patients with depression and controls. Groups did not differ concerning coping strategies. Patients with hypochondriasis ruminated more when confronted with their most feared rather than another disease. Patients apparently ov…

matched on Panic Disorder (mesh), panic disorder (text)

Oral contraceptive use and psychiatric disorders in a nationally representative sample of women.

The purpose of this study is to examine the association between oral contraceptive use (any current use, duration, and type) and major depressive disorder (MDD), generalized anxiety disorder (GAD), and panic disorder (PD) in a nationally representative sample of women in the USA. Data were drawn from 1,105 women aged 20-39 in the National Health and Nutrition Examination Surveys from 1999 to 2004. The associations between self-reported use of oral contraceptives in the past year and DSM-IV diagnosed and subthreshold MDD, GAD, and PD in the past year were assessed comparing oral contraceptive users to all non-users, former users, and former long-term users. Women using oral contraceptives had a lower past-year prevalence of all disorders assessed, other than subthreshold MDD. When adjusted for confounders, women using oral contraceptives in the past year had significantly lower odds of su…

matched on Panic Disorder (mesh), panic disorder (text)

The mental health of Australian elite athletes.

Objectives: Currently, little is known about the prevalence of mental disorders in athletes. This study aims to investigate Australian elite athletes' symptoms of general psychological distress and common mental disorders. Design: A cross-sectional survey design was employed to assess self-reported symptom prevalence. Methods: A total of 224 elite athletes (118 female, 106 male) from national sporting organisations in Australia were administered a self-report internet-based survey comprising measures of demographic status and mental health symptoms. Results: Overall, 46.4% of athletes were experiencing symptoms of at least one of the mental health problems assessed. Percentages meeting criteria for mental disorders were similar to previous epidemiological studies of both international athlete and community samples: depression (27.2%), eating disorder (22.8%), general psychological distre…

matched on Panic Disorder (mesh), panic disorder (text)

Common and disorder-specific neural responses to emotional faces in generalised anxiety, social anxiety and panic disorders.

Background: Although evidence exists for abnormal brain function across various anxiety disorders, direct comparison of neural function across diagnoses is needed to elicit abnormalities common across disorders and those distinct to a particular diagnosis. Aims: To delineate common and distinct abnormalities within generalised anxiety (GAD), panic and social anxiety disorder (SAD) during affective processing. Method: Fifty-nine adults (15 with GAD, 15 with panic disorder, 14 with SAD, and 15 healthy controls) underwent functional magnetic resonance imaging while completing a facial emotion matching task with fearful, angry and happy faces. Results: Greater differential right amygdala activation to matching fearful v. happy facial expressions related to greater negative affectivity (i.e. trait anxiety) and was heightened across all anxiety disorder groups compared with controls. Collapsin…

matched on Panic Disorder (mesh), panic disorder (text)

Single-subject anxiety treatment outcome prediction using functional neuroimaging.

The possibility of individualized treatment prediction has profound implications for the development of personalized interventions for patients with anxiety disorders. Here we utilize random forest classification and pre-treatment functional magnetic resonance imaging (fMRI) data from individuals with generalized anxiety disorder (GAD) and panic disorder (PD) to generate individual subject treatment outcome predictions. Before cognitive behavioral therapy (CBT), 48 adults (25 GAD and 23 PD) reduced (via cognitive reappraisal) or maintained their emotional responses to negative images during fMRI scanning. CBT responder status was predicted using activations from 70 anatomically defined regions. The final random forest model included 10 predictors contributing most to classification accuracy. A similar analysis was conducted using the clinical and demographic variables. Activations in the…

matched on Panic Disorder (mesh), panic disorder (text)

Predicting rapid response to cognitive-behavioural treatment for panic disorder: the role of hippocampus, insula, and dorsolateral prefrontal cortex.

Although cognitive-behavioural therapy (CBT) is an effective first-line intervention for anxiety disorders, treatments remain long and cost-intensive, difficult to access, and a subgroup of patients fails to show any benefits at all. This study aimed to identify functional and structural brain markers that predict a rapid response to CBT. Such knowledge will be important to establish the mechanisms underlying successful treatment and to develop more effective, shorter interventions. Fourteen unmedicated patients with panic disorder underwent 3 T functional and structural magnetic resonance imaging (MRI) before receiving four sessions of exposure-based CBT. Symptom severity was measured before and after treatment. During functional MRI, patients performed an emotion regulation task, either viewing negative images naturally, or intentionally down-regulating negative affect by using previou…

matched on Panic Disorder (mesh), panic disorder (text)

Effectiveness of internet-based cognitive behaviour therapy for panic disorder in routine psychiatric care.

Objective: Guided Internet-based cognitive behaviour therapy (ICBT) for panic disorder has been shown to be efficacious in several randomized controlled trials. However, the effectiveness of the treatment when delivered within routine psychiatric care has not been studied. The aim of this study was to investigate the effectiveness of ICBT for panic disorder within the context of routine psychiatric care. Method: We conducted a cohort study investigating all patients (n = 570) who had received guided ICBT for panic disorder between 2007 and 2012 in a routine care setting at an out-patient psychiatric clinic providing Internet-based treatment. The primary outcome measure was the Panic Disorder Severity Scale-Self-report (PDSS-SR). Results: Participants made large improvements from screening and pretreatment assessments to posttreatment (Cohen's d range on the PDSS-SR = 1.07-1.55). Improvem…

matched on Panic Disorder (mesh), panic disorder (text)

Prefrontal dysfunction during emotion regulation in generalized anxiety and panic disorders.

Background: The mechanisms that contribute to emotion dysregulation in anxiety disorders are not well understood. Two common disorders, generalized anxiety disorder (GAD) and panic disorder (PD), were examined to test the hypothesis that both disorders are characterized by hypo-activation in prefrontal cortex (PFC) during emotion regulation. A competing hypothesis that GAD in particular is characterized by PFC hyper-activation during emotion regulation (reflecting overactive top-down control) was also evaluated. Method Twenty-two medication-free healthy control (HC), 23 GAD, and 18 PD participants underwent functional magnetic resonance imaging (fMRI) during a task that required them to reappraise (i.e. reduce) or maintain emotional responses to negative images. Results: GAD participants reported the least reappraisal use in daily life, and reappraisal use was inversely associated with a…

matched on Panic Disorder (mesh), panic disorder (text)

Evaluation of perseveration in relation to panic-relevant responding: an initial test.

Background: Perseveration reflects the tendency to engage in a behavior even when it is no longer rewarding nor produces the expected consequences. Method: The current study explored whether (1) individuals endorsing a recent (past 2 years) history of nonclinical panic attacks would report greater levels of perseveration compared to individuals without such a history; (2) whether individuals endorsing higher levels of perseveration would evidence greater panic-relevant responding to a 4-minute 10% carbon dioxide-enriched air challenge. Results: Results indicated that individuals with, compared to without, a positive panic attack history endorsed significantly greater levels of perseveration. Additionally, greater pre-challenge levels of perseveration significantly predicted greater panic attack symptom severity as well as self-reported anxiety; these significant effects were evident abov…

matched on Panic Disorder (mesh), panic attack (text)

Sleep disturbance, personality and the onset of depression and anxiety: prospective cohort study.

Objective: Previous studies have shown associations between sleep disturbance and the onset of depression and anxiety. However, this relationship may reflect an underlying vulnerability, such as temperament or cognitive style, which accounts for an association between the two. This study aimed to evaluate the relationship between sleep disturbance and the onset of a mental disorder after a 4-year follow-up, and whether this was accounted for by ruminative style and neuroticism. Method: The nine-item Patient Health Questionnaire was used to assess the criteria for major depression, generalized anxiety disorder (GAD) and panic disorder (PD) in a community cohort of 3636 young and middle-aged Australian adults, free of any disorder at baseline, over a 4-year period. Sleep disturbance was based on a factor derived from the sleep items of the Goldberg Depression and Anxiety Scales. The associ…

matched on Panic Disorder (mesh), panic disorder (text)

Persistence of multiple illnesses in World Trade Center rescue and recovery workers: a cohort study.

Background: More than 50,000 people participated in the rescue and recovery work that followed the Sept 11, 2001 (9/11) attacks on the World Trade Center (WTC). Multiple health problems in these workers were reported in the early years after the disaster. We report incidence and prevalence rates of physical and mental health disorders during the 9 years since the attacks, examine their associations with occupational exposures, and quantify physical and mental health comorbidities. Methods: In this longitudinal study of a large cohort of WTC rescue and recovery workers, we gathered data from 27,449 participants in the WTC Screening, Monitoring, and Treatment Program. The study population included police officers, firefighters, construction workers, and municipal workers. We used the Kaplan-Meier procedure to estimate cumulative and annual incidence of physical disorders (asthma, sinusitis…

matched on Panic Disorder (mesh), panic disorder (text)

Worry, worry attacks, and PTSD among Cambodian refugees: a path analysis investigation.

Among traumatized Cambodian refugees, this article investigates worry (e.g., the types of current life concerns) and how worry worsens posttraumatic stress disorder (PTSD). To explore how worry worsens PTSD, we examine a path model of worry to see whether certain key variables (e.g., worry-induced somatic arousal and worry-induced trauma recall) mediate the relationship between worry and PTSD. Survey data were collected from March 2010 until May 2010 in a convenience sample of 201 adult Cambodian refugees attending a psychiatric clinic in Massachusetts, USA. We found that worry was common in this group (65%), that worry was often about current life concerns (e.g., lacking financial resources, children not attending school, health concerns, concerns about relatives in Cambodia), and that worry often induced panic attacks: in the entire sample, 41% (83/201) of the patients had "worry attac…

matched on Panic Disorder (mesh), panic attack (text)

Routine outcome monitoring in the Netherlands: practical experiences with a web-based strategy for the assessment of treatment outcome in clinical practice.

Routine outcome monitoring (ROM) is a method devised to systematically collect data on the effectiveness of treatments in everyday clinical practice. ROM involves documenting the outcome of treatments through repeated assessments. Assistants are employed who perform a baseline assessment comprising a standardized diagnostic interview, administration of rating scales and completion of several self-report measures by the patient. At fixed time intervals, assessments are repeated. Dedicated Web-based software has been developed to assist in this task. ROM informs therapists and patients on the severity of the complaints at intake, and the waxing and waning of symptoms over the course of treatment. Researchers can use ROM for effectiveness research, and managers can use it for benchmarking. The use of ROM for research is illustrated by presenting data on the diagnostic status of patients par…

matched on Panic Disorder (mesh), panic disorder (text)

The impact of panic disorder on interoception and dyspnea reports in chronic obstructive pulmonary disease.

The prevalence of panic disorder (PD) in patients with chronic obstructive pulmonary disease (COPD) is significantly higher than that in the general population. Comorbid anxiety disorders in COPD are associated with a number of worse outcomes, however little is known about the mechanisms by which PD affects patients with COPD. We hypothesized that patients with COPD and PD would have greater dyspnea severity, but not greater somatosensory sensitivity, to dyspneic stimuli. We studied 10 patients with COPD and PD, 9 patients with COPD without PD, and 9 healthy, matched controls. Participants were administered the Anxiety Sensitivity Index-3. We tested interoceptive sensitivity using a respiratory load detection protocol and dyspnea ratings in response to inspiratory resistive loads. Participants with COPD and PD had higher anxiety sensitivity scores and reported greater dyspnea in response…

matched on Panic Disorder (mesh), panic disorder (text)

Depressive disorders during pregnancy: prevalence and risk factors in a large urban sample.

Objective: To estimate the prevalence of major and minor depression, panic disorder, and suicidal ideation during pregnancy while also identifying factors independently associated with antenatal depressive disorders. Methods: In this prospective study, participants were 1,888 women receiving ongoing prenatal care at a university obstetric clinic from January 2004 through January 2009. Prevalence of psychiatric disorders was measured using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria based on the Patient Health Questionnaire. Multiple logistic regression identified factors associated with probable major depressive disorder and any depressive disorder. Results: Antenatal depressive disorders were present in 9.9% with 5.1% (97) meeting criteria for probable major depression and 4.8% (90) meeting criteria for probable minor depression. Panic dis…

matched on Panic Disorder (mesh), panic disorder (text)

Panic disorder as a risk factor for post-partum depression: Results from the Perinatal Depression-Research & Screening Unit (PND-ReScU) study.

Background: Although the role of anxiety disorders on the development of Post-partum Depression (PPD) have already been studied in literature, that of individual anxiety disorders has not received specific attention. The aim of this study is to investigate the role of Panic Disorder (PD) and family history for PD as risk factors for PPD. Methods: Six hundred women were recruited in a prospective, observational study at the 3rd month of pregnancy and followed up until the 6th month after delivery. At baseline, risk factors for PPD, Axis-I disorders and family history for psychiatric disorders were assessed. We investigated minor and major depression (mMD) occurred at 1st, 3rd and 6th months post-partum. Logistic regression models were used to estimate the association between PD, family history for PD and PPD. Results: Forty women had mMD in the post-partum. PD during pregnancy (RR=4.25; 9…

matched on Panic Disorder (mesh), panic disorder (text)

Prevalence of anxiety disorders among adults seeking speech therapy for stuttering.

The present study explored the prevalence of anxiety disorders among adults seeking speech therapy for stuttering. Employing a matched case-control design, participants included 92 adults seeking treatment for stuttering, and 920 age- and gender-matched controls from the Australian National Survey of Mental Health and Well-being. A conditional logistic regression model was used to estimate odds ratios for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and International Classification of Diseases (ICD-10) anxiety disorders. Compared with matched controls, the stuttering group had six- to seven-fold increased odds of meeting a 12-month diagnosis of any DSM-IV or ICD-10 anxiety disorder. In terms of 12-month prevalence, they also had 16- to 34-fold increased odds of meeting criteria for DSM-IV or ICD-10 social phobia, four-fold increased odds of meeting crite…

matched on Panic Disorder (mesh), panic disorder (text)

Enduring mental health morbidity and social function impairment in world trade center rescue, recovery, and cleanup workers: the psychological dimension of an environmental health disaster.

Background: The World Trade Center (WTC) attacks exposed thousands of workers to hazardous environmental conditions and psychological trauma. In 2002, to assess the health of these workers, Congress directed the National Institute for Occupational Safety and Health to establish the WTC Medical Monitoring and Treatment Program. This program has established a large cohort of WTC rescue, recovery, and cleanup workers. We previously documented extensive pulmonary dysfunction in this cohort related to toxic environmental exposures. Objectives: Our objective in this study was to describe mental health outcomes, social function impairment, and psychiatric comorbidity in the WTC worker cohort, as well as perceived symptomatology in workers' children. Methods: Ten to 61 months after the WTC attack, 10,132 WTC workers completed a self-administered mental health questionnaire. Results: Of the worke…

matched on Panic Disorder (mesh), panic disorder (text)

Sympathetic activity in major depressive disorder: identifying those at increased cardiac risk?

Background: Evidence exists linking major depressive disorder (MDD) with clinical cardiovascular events. The importance of the sympathetic nervous system in the generation of cardiac risk in other contexts is established. Objective: To examine the importance of the sympathetic nervous system in the generation of cardiac risk in patients with major depressive disorder (MDD). Methods: Studies were performed in 39 patients meeting the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria for MDD and in 76 healthy subjects. Treatment for patients consisted of selective serotonin reuptake inhibition (SSRI) for 12 weeks. Whole body and cardiac sympathetic activity were examined using noradrenaline isotope dilution methodology and sympathetic nerve recording techniques. Measurement of the extraction of infused tritiated noradrenaline by the heart, and estimation of cardiac …

matched on Panic Disorder (mesh), panic disorder (text)

Fear conditioning in panic disorder: Enhanced resistance to extinction.

Enhanced conditionability has been proposed as a crucial factor in the etiology and maintenance of panic disorder (PD). To test this assumption, the authors of the current study examined the acquisition and extinction of conditioned responses to aversive stimuli in PD. Thirty-nine PD patients and 33 healthy control participants took part in a differential aversive conditioning experiment. A highly annoying but not painful electrical stimulus served as the unconditioned stimulus (US), and two neutral pictures were used as either the paired conditioned stimulus (CS+) or the unpaired conditioned stimulus (CS-). Results indicate that PD patients do not show larger conditioned responses during acquisition than control participants. However, in contrast to control participants, PD patients exhibited larger skin conductance responses to CS+ stimuli during extinction and maintained a more negati…

matched on Panic Disorder (mesh), panic disorder (text)

Comorbid depression, chronic pain, and disability in primary care.

Objectives: The objectives of this study were to provide estimates of the prevalence and strength of association between major depression and chronic pain in a primary care population and to examine the clinical burden associated with the two conditions, singly and together. Methods: A random sample of Kaiser Permanente patients who visited a primary care clinic was mailed a questionnaire assessing major depressive disorder (MDD), chronic pain, pain-related disability, somatic symptom severity, panic disorder, other anxiety, probable alcohol abuse, and health-related quality of life (HRQL). Instruments included the Patient Health Questionnaire, SF-8, and Graded Chronic Pain Questionnaire. A total of 5808 patients responded (54% of those eligible to participate). Results: Among those with MDD, a significantly higher proportion reported chronic (i.e., nondisabling or disabling) pain than t…

matched on Panic Disorder (mesh), panic disorder (text)

Psychopathology in women arrested for domestic violence.

This study examined the prevalence of psychopathology among women arrested for violence and whether the experience of intimate partner violence (IPV) was associated with Axis I psychopathology. Women who were arrested for domestic violence perpetration and court referred to violence intervention programs (N= 103) completed measures of IPV victimization, perpetration, and psychopathology. Results revealed high rates of posttraumatic stress disorder (PTSD), depression, generalized anxiety disorder (GAD), panic disorder, substance use disorders, borderline personality disorder, and antisocial personality disorder. Violence victimization was significantly associated with symptoms of psychopathology. Logistic regression analyses showed that sexual and psychological abuse by partners were associated with the presence of PTSD, depression, and GAD diagnoses. Results highlight the potential impor…

matched on Panic Disorder (mesh), panic disorder (text)

Psychiatric disorders following first breast cancer recurrence: prevalence, associated factors and relationship to quality of life.

Objective: The purpose of this study was to investigate the prevalence of and factors associated with psychiatric disorders and the impact on quality of life (QOL) in patients with first breast cancer recurrence. Methods: We analyzed the baseline data on 50 consecutively enrolled recurrent breast cancer patients, participating in a feasibility study of multifaceted psychosocial intervention. Psychiatric disorders, including major depressive disorder (MDD), dysthymic disorder, panic disorder, post-traumatic stress disorder (PTSD), generalized anxiety disorder and adjustment disorders (AD), were evaluated according to the Structured Clinical Interview for the DSM-III-R and IV. The patients' demographic data, biomedical factors, social support, mental adjustment to cancer, personality traits and QOL were also evaluated. Results: Eleven (22%) met the DSM-III-R and IV criteria for MDD, PTSD o…

matched on Panic Disorder (mesh), panic disorder (text)