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Biomedical subjects

E J Griez

Publications and source records attributed to E J Griez.

12 recordsLinked to original sources

[Panic disorder in patients with chest pain and palpitations: an often unrecognized relationship].

The prevalence of panic disorder in patients who present with chest pain or palpitations to a First Heart Aid setting varies in the literature between 0%-59%. In a high percentage of cases, panic disorder is not recognized by the cardiologist in patients who present initially with chest pain or palpitations. Patients with panic disorder have a large and ongoing medical consumption. A selective serotonin reuptake inhibitor and/or cognitive therapy appear to be good treatment of panic disorder in patients who present initially with chest pain or palpitations. A CO2 challenge test elicits the symptoms in patients with panic disorder with high sensitivity and specificity but this test has not been validated in patients who present initially with chest pain or palpitations and in whom the diagnosis 'panic disorder' is not yet established.

Arrhythmias, Cardiac↗

[Panic disorder, chest pain and palpitations: a pilot study of a Dutch First Heart Aid].

OBJECTIVE: To determine how many patients, presenting to a First Heart Aid (FHA) with chest pain or palpitations without a cardiac origin for their complaints, have a panic disorder and/or depression. DESIGN: Prospective and questionnaire investigation. METHOD: In 3 months (November 1st 1998-January 31st 1999) all patients presenting to the FHA of the University Hospital Maastricht, the Netherlands, and who were not admitted, were screened for the presence of psychopathology by means of a questionnaire, the 'Hospital anxiety and depression scale' (HADS). Patients scoring above 8 on the HADS with no cardiac cause for their initial complaint were interviewed using the 'Mini international neuropsychiatric interview' (MINI) to determine whether there was a panic disorder and/or a depressive episode. RESULTS: Of a total of 621 patients 251 met the inclusion criteria; 134 (53%) gave informed consent (72 (54%) men and 62 (46%) women, with a mean age of 55.9 (SD: 13.2; range: 23-84)). Of the 134, 77 had a HADS score > or = 8; in 59 (30 men; 29 women) the MINI was carried out; in 49 (83%) panic disorder (n = 45) or depression (n = 4) was diagnosed. In 7/45 the cardiologist had diagnosed a psychiatric disorder ('Hyperventilation'). CONCLUSION: In 83% of the patients who visited the Maastricht FHA with cardiac complaints but without a cardiac origin and who had a HADS score > or = 8, panic disorder and/or depression was diagnosed.

Adult↗

Panic disorder and idiopathic cardiomyopathy.

OBJECTIVE: This study investigated whether, among a population of cardiac patients, there is a preferential association between idiopathic cardiomyopathy (CMP) and Panic Disorder (PD). METHODS: A total of 93 patients with cardiac failure, 50 of them with CMP, 43 with other cardiac diseases, underwent a standard psychiatric examination using the MINI neuropsychiatric interview. RESULTS: While half of the subjects met the criteria for a psychiatric disorder, PD was no more prevalent in the CMP group compared to other patients. CONCLUSION: This study confirms the high prevalence of psychiatric pathology, particularly anxiety, mood, and alcohol-related disorders, in patients with cardiac failure. However, previous findings on the specific association between CMP and PD could not be replicated.

Adult↗

Fluvoxamine attenuates panic induced by 35% CO2 challenge.

BACKGROUND: The authors investigated whether 6 weeks of treatment with fluvoxamine would decrease the anxiogenic response to the 35% CO2 challenge in 11 patients with DSM-III-R panic disorder with agoraphobia. METHOD: The patients underwent a 35% CO2 challenge at baseline and again after 6 weeks of fluvoxamine treatment. RESULTS: The anxiogenic effect of CO2 was significantly (p < .05) reduced during fluvoxamine treatment. CONCLUSION: The results suggest a relationship between the anxiogenic effect of CO2 and the therapeutic effect of fluvoxamine.

Adult↗

Ventilatory response to CO2 in panic disorder.

The Read rebreathing technique was used to measure the ventilatory response to inhalation of carbon dioxide in 15 panic disorder patients, 15 obsessive-compulsive disorder patients, and 15 healthy control subjects. No significant differences in ventilatory response were found among the three groups. The tidal volume and frequency components of the ventilatory response also did not differ among the groups. The hypothetical pCO2 value corresponding with zero ventilation was significantly lower in the panic disorder patients than in normal control subjects.

Adult↗

Higher lifetime prevalence of respiratory diseases in panic disorder?

Current and past frequencies of respiratory diseases were assessed in 30 patients with panic disorder, 30 patients with obsessive-compulsive disorder, and 30 patients with eating disorders. Lifetime prevalence of respiratory disorders was significantly higher in patients with panic disorder (47%) than in patients with either obsessive-compulsive disorder (13%) or eating disorder (13%). Point prevalences showed no differences.

Adult↗

Hypercarbia versus hypocarbia in panic disorder.

In order to compare the panicogenic effects of hypercarbia and hypocarbia in panic disorder (PD), 12 PD patients and 11 healthy controls underwent a 35% CO2 challenge as well as a hyperventilation provocation test in a random cross-over design. Both anxiety and anxiety symptoms proved to be significantly higher during the 35% CO2 challenge in PD patients as compared to the response during 35% CO2 in normals and during hyperventilation in both patients and normals. The results suggest that PD patients are specifically hypersensitive to an increase in pCO2.

Adolescent↗

CO2 vulnerability in panic disorder.

The immediate effects of a single inhalation of a 35% CO2 mixture in oxygen were examined in 12 patients with panic disorders and 11 normal control subjects. Compared to a placebo air inhalation, the CO2 inhalation provoked short-lived autonomic panic symptoms in both patients and normals; it also elicited high subjective anxiety in patients with panic disorders. The latter rated the overall CO2-induced state as very similar to a real-life panic attack.

Adult↗

Breath-holding in panic disorder.

In earlier studies, it was found that exogenous carbon dioxide administration provoked high anxiety in panic disorder (PD) patients, whereas healthy normals and patients suffering from other anxiety disorders were hardly affected. Breath-holding provides a simple method to induce endogenous CO2 accumulation. Fourteen PD patients, 14 patients suffering from other anxiety disorders, and 14 healthy controls were asked to hold their breath as long as possible. Apnea times appeared to be longer in the normal control group than in the other two groups. Using a one-tailed t test, a trend for a difference was found between the PD subjects and other anxiety patients, the PD patients having slightly lower values. No differences were found with respect to increase in anxiety during breath-holding or the ratio of apnea times before and after hyperventilation.

Adult↗