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Biomedical subjects

L DeRosear

Publications and source records attributed to L DeRosear.

7 recordsLinked to original sources
PubMed1989

Panic disorder in patients with chest pain and angiographically normal coronary arteries.

Although patients with angiographically normal or near normal coronary arteries are at low risk for cardiac disease, several follow-up studies have shown that many continue to report recurrent chest pain associated with social and work dysfunction. Three diagnostic entities have been proposed to explain the morbidity of this group: microvascular angina, esophageal motility disorders and panic disorder. The purpose of this study was to test the hypothesis that panic disorder is found frequently in patients with chest pain who have normal epicardial vessels. Ninety-four subjects with angiographically normal coronary arteries were interviewed according to a structured psychiatric protocol within 24 hours of their catheterizations. Thirty-two (34%) fit Diagnostic and Statistical Manual of Mental Disorders (third edition, revised) criteria for current panic disorder. Because panic disorder can be effectively treated, physicians should consider this diagnosis in this group of patients. Current research findings suggest that panic disorder, microvascular angina and esophageal disorders may each form the basis for chest pain in approximately 25% of these patients. Miscellaneous problems account for the other 25%.

Adult↗
PubMed1989

Self-mutilation and eating disorders.

Patients with eating disorders are at high risk for self-mutilation (e.g., skin cutting and burning), and vice versa. Evidence for this linkage comes from a literature review, from patient interviews, from responses to an instrument we have developed (the Self-Harm Behavior Survey), and from three instructive case reports. Even if the self-mutilation in these patients is regarded as a Borderline Personality Disorder symptom, DSM-IV should list it as an associated feature or a complication of Anorexia Nervosa/Bulimia Nervosa. In lieu of a dual diagnosis, we postulate that the combination of self-mutilation, anorexia, bulimia, and other symptoms (such as episodic alcohol abuse and swallowing foreign objects) may be manifestations of an impulse control disorder known as the "deliberate self-harm syndrome."

Adult↗
PubMed1987

Panic disorder: a frequent occurrence in patients with chest pain and normal coronary arteries.

From 10% to 20% of patients undergoing coronary arteriography for chest pain are subsequently found to have normal coronary arteries. We investigated the prevalence of panic disorder in these patients in a two-stage study. Our results indicate that approximately one third of patients with chest pain and angiographically normal coronary arteries have panic disorder. Proper diagnosis and treatment of these patients with panic disorder may be expected to substantially reduce their psychosocial morbidity.

Adult↗
PubMed1987

Atypical or nonanginal chest pain. Panic disorder or coronary artery disease?

Of 195 patients with atypical or nonanginal chest pain presenting in a cardiology clinic, 104 consented to be evaluated for anxiety disorders using a structured psychiatric interview. Thirty patients had histories of coronary artery disease (CAD). Fifty-nine patients in the sample (16 of those with CAD and 43 of those without CAD) fit diagnostic criteria for panic disorder (PD). Those without CAD and with PD were primarily women (mean age, 43 years) with predominantly nonanginal chest pain. Those patients with both CAD and PD were primarily men (mean age, 54 years) with predominantly atypical angina. Since PD has been shown to be readily responsive to pharmacologic intervention, this diagnosis should be considered in patients with atypical or nonanginal chest pain.

Adolescent↗
PubMedDate not supplied

Major depression in cardiology chest pain patients without coronary artery disease and with panic disorder.

104 patients in a cardiology clinic with atypical or non-anginal chest pain were studied through a structured clinical interview. 43 without coronary artery disease fit diagnostic criteria for panic disorder. 19 (44%) of this group reported a lifetime prevalence of major depression, nine (21%) current and ten (23%) past only. Nine reported that their major depressive episodes had preceded the onset of their panic disorder. On many self-report questionnaire scales the group with a lifetime history of major depression (n = 19) differed significantly from the group with no lifetime history of major depression (n = 24). These differences, however, could be attributed primarily to the group with current major depression. There appears to be a subgroup of panic disorder patients who have current major depression who are more symptomatic than those with panic disorder and past major depression and panic disorder alone. These findings also suggest that the association between panic disorder and depression may remain high outside of psychiatric settings.

Adult↗