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Results for “Phobic Disorders”

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PubMed1990

Administration of thymopentin to patients with phobic disorders improves depressed phagocytic functions.

Seven patients with phobic disorders were administered with a synthetic thymic extract, thymopentin (TP-5), in order to correct depressed polymorphonuclear cell (PMN) and monocyte phagocytosis and killing capacities. Subcutaneous administration (50 mg, three times weekly, for a period of 8 wks) of TP-5 resulted in a significant increase in phagocytic function with no change in the phagocytic capacity of PMN. These data support the concept that immunomodulators can achieve a correction of immune deficiencies associated with phobic disorders.

Adult↗

PubMed2001

[The anxiety-phobic disorder classification in children].

The study on development regularities and psychopathological structure of anxiety phobic disorders has been conducted in 92 patients, aged 5-15 years. The structure of anxiety-phobic complex is represented. A level of anxiety affect development (primary or secondary, presence and direction of affect cognitive component) and negative effectiveness were emerged in the children as common obligate anxiety-phobic characteristics, which contributed to complex structure stability. Three anxiety-phobic disorder types--situation-dependent, personality-dependent and vital--were distinguished. The first one is characterized by the combination of secondary anxiety with cognitive vector expression, the vector being outside directed, and emotionally unstable negative effectiveness variant (particular sensitivity to negative situations with disability for negative emotion control). The second type is distinguished by secondary anxiety manifestations, the anxiety vector being directed towards the self-ego. In these cases, personality component--rigid variant of negative effectiveness (higher sensitivity to negative events, along with disability for negative emotion modulation) dominates. The third type is defined by the combination of primary anxiety (with vital disturbance, diffusion, psychic activity disorganization in the absence of cognitive component) with rigid variant of negative effectiveness. The types of manifesting anxiety-phobic disorders described correspond to reactive (situation-dependent type), endoreactive (personality-dependent type) and autochthonous (vital type) variants of the disease course.

Adolescent↗

PubMed2005

Comorbid phobic disorders do not influence outcome of alcohol dependence treatment. Results of a naturalistic follow-up study.

AIMS: Despite claims that comorbid anxiety disorders tend to lead to a poor outcome in the treatment of alcohol dependence, the few studies on this topic show conflicting results. OBJECTIVE: To test whether the outcome of treatment-seeking alcohol-dependent patients with a comorbid phobic disorder is worse than that of similar patients without a comorbid phobic disorder. METHODS: The probabilities of starting to drink again and of relapsing into regular heavy drinking in (i) a group of 81 alcohol-dependent patients with comorbid social phobia or agoraphobia were compared with those in (ii) a group of 88 alcohol-dependent patients without anxiety disorders in a naturalistic follow-up using Cox regression analysis. RESULTS: Adjusted for initial group differences, the hazard ratio for the association of phobic disorders with resumption of drinking was 1.05 (95% CI, 0.85-1.30, P = 0.66) and the adjusted hazard ratio for the association of phobic disorders with a relapse into regular heavy drinking was 1.02 (95% CI, 0.78-1.33, P = 0.89). CONCLUSION: The findings of this study do not confirm the idea that alcohol-dependent patients who have undergone alcohol-dependence treatment are at greater risk of a relapse if they have a comorbid anxiety disorder. No differences were found in abstinence duration or time to relapse into regular heavy drinking between patients with and without comorbid phobic disorders.

Adult↗

PubMed1987

Treatment of panic and phobic disorders.

The clinical features, pathophysiology, and treatment of panic and phobic disorders are reviewed. Evidence from genetic, epidemiological, biological, and pharmacological studies suggests that phobic and panic disorders differ from other psychiatric illnesses. Dysfunction of the autonomic nervous system, causing excessive release of norepinephrine from the locus ceruleus, is implicated in the pathophysiology of these disorders. Overstimulation of the locus ceruleus by yohimbine, sodium lactate, and carbon dioxide can cause feelings of panic and anxiety in both patients with panic disorder and control subjects. Currently, excessive activity of the locus ceruleus is the only comprehensive neuroanatomic and physiological hypothesis for the etiology of panic disorder. Tricyclic antidepressant agents (TCAs), monoamine oxidase inhibitors (MAOIs), anxiolytic agents, and adrenergic agents all have been used to treat phobic and panic disorders. TCAs and the benzodiazepines, particularly alprazolam, are the drugs most commonly chosen for therapy. If these agents are ineffective, an MAOI or combination therapy can be tried. MAOIs are second-line agents for many patients because of toxicity and dietary limitations. Whether they are more effective than other agents requires further study. Panic and phobic disorders and depression have in common many properties of a dysregulated system; an improved understanding of the pathophysiology of panic and phobic disorders should lead to the development of more effective treatment strategies.

Fear↗

PubMed2004

Temporal relationship between the age of onset of phobic disorders and development of substance dependence in adolescent psychiatric patients.

AIMS: To investigate the age of onset of phobic disorders in relation to later development of substance dependence in a sample of adolescent psychiatric patients. DESIGN, SETTING AND PARTICIPANTS: Clinical sample of 238 adolescents (age 12-17) admitted to psychiatric inpatient hospitalization between April 2001 and July 2003. MEASUREMENTS: Psychiatric diagnoses and onset ages obtained from the schedule for affective disorders and schizophrenia for school aged children-present and lifetime (K-SADS-PL). FINDINGS: Logistic regression analyses revealed that adolescents with phobic disorders had a 4.9-fold risk for comorbid substance dependence compared to those without phobia. The mean onset age was 11.4 and 14.4 years for phobias and comorbid substance dependence, respectively. Boys (13.7 years) had a statistically significantly lower onset age for substance dependence than girls (15.4 years). Over one-half of the adolescents with phobic disorders had developed substance dependence within three years after the onset of phobia. CONCLUSIONS: We found that phobias might influence the development of secondary substance dependence within a few years from the onset of phobia already in adolescence.

Adolescent↗

PubMed1998

Phobic disorder, psychotherapy, and risk-taking: an economic perspective.

Phobic disorders are receiving much attention in psychiatric practice today. Agoraphobia, the most common of the phobic disorders, involves the risk of experiencing a panic attack in public places, thus discouraging the worker from fully participating in the labor market. This paper applies the economic tools of rational choice under uncertainty to the analysis of agoraphobia, with the purpose of gaining more insight as regards the extent of deviation from normal work behavior (which presumably responds to incentives) and the effectiveness of psychotherapy in treating work-avoidance, challenging the popular claim that the cost of psychotherapy helps ensure its success.

Absenteeism↗

PubMed1996

Phobic disorders are associated with temperament in alcoholic men.

OBJECTIVE: To investigate whether in a sample of men with alcohol dependence those with comorbid phobic disorders had higher persistence scores than those without. METHOD: Ninety-nine men with moderate-severe alcohol dependence recruited from an alcohol treatment programme were interviewed using the Structured Clinical Interview (SCID) and completed a Tridimensional Personality Questionnaire (TPQ). RESULTS: Subjects with a comorbid phobic disorder had significantly higher persistence scores compared to those without. CONCLUSIONS: The temperament dimension, persistence, is associated with phobic disorder.

Adult↗

PubMed1998

[Differential diagnosis and prognosis of phobic disorders].

The paper presents differential-diagnostic signs of phobic disorders of different etiology. Acute episodes of depersonalization preceding phobias and fears arising during the first age crisis are considered as some diagnostic signs of endogenous phobias. The significant criteria for diagnosis of psychogenic phobias are anxious suspiciousness, affective instability, susceptibility, spontaneity of reactivity and the presence of personally important psychic trauma. An autonomic paroxysm caused by alcoholic situation in exogenic organic pathology (alcoholism) was transformed quite fast into some senestopathias, which themselves maintained the of fear. The relationships of phobias and depressions in endogenous disorders was different: in slow-progredient variations of the disease depression resulted in a decrease of the manifestations of the phobias, and vice versa; in shift-like variations depression is an independent syndrome in the depressive-phobic complex. Depressions and phobias are closely connected in psychogenic phobias, they complicated and developed in parallel. In exogenic-organic phobias both affective disorders and phobias had a paroxysmal character and transformed into dysphorias.

Depressive Disorder↗

PubMed1983

A rating scale of phobic disorders.

Scales were constructed for the rating of phobic disorders, taking into account both behaviour therapeutic and psychodynamic aspects. The scales rate phobic behaviour with regard to anxiety (situational and anticipatory) and coping (avoidance and escape). The target phobia as well as seven common phobias are rated, the former being divided into: fairly easy, moderately difficult, and very difficult situations. The scales also include free anxiety (10 items), ego-restriction (11 items), and social function (six items with regard to interpersonal relations, and one each for capacity to work and leisure activities), and finally, a global rating. The inter-rater reliability was good (mostly around 0.90). Construct validity was supported by the result in effect studies of short-term psychotherapy.

Anxiety↗

PubMed2005

[Time-organization of EEG patterns' structure in anxiety and phobic disorders].

Thirty-five patients, aged 19-48 years (mean age 38 years) with anxiety and phobic disorders were examined. According to ICD-10 criteria--social phobia (F40.1), panic disorder (F41.0), somatoform autonomic dysfunction (F45.3) were diagnosed. Using electroencephalography data, qualitative and quantitative characteristics of the time- and spatial-organization of brain EEG activity in anxiety and phobic disorders of different severity were established. It were determined 4 types of wave interactions between EEG components, which reflected a different extent of the regulatory mechanisms lesions: 2 structures with one core component (alpha or beta), a structure with two core components and a non-organized structure.

Adult↗

PubMed1984

Delineation of anxiety and phobic disorders responsive to monoamine oxidase inhibitors: implications for classification.

Studies of the treatment of panic anxiety and various other states with monoamine oxidase (MAO) inhibitors are critically reviewed. It is concluded that MAOIs have differential effects on several dimensions of pathologic anxiety. The association between depression and anxiety states is also reviewed; it is observed that MAOIs effectively treat severe anxiety and phobic disorders without operating strictly via their antidepressant mechanism. In addition, it is proposed that biologic depression and biologic anxiety should be considered to have some independence from one another. Guidelines for the clinical delineation of anxiety disorders are provided, and the clinical and research implications of the proposal for revision of DSM-III anxiety and phobic disorders section, are outlined in detail. It is suggested that anxiety and phobic disorders be classified into endogenous (disease) and exogenous (nondisease) types.

Alprazolam↗

PubMed2001

[Obsessive-phobic disorders with the phenomena of mysophobia in slowly progressing schizophrenia].

54 patients, 24 men and 30 women, (mean age 27 years) were examined. Two types of obsessive-phobic disorders with the phenomena of mysophobia were distinguished: obsession of the external (extracorporal) threat and obsession of contamination. Disorders of the first type (25 cases) were observed in psychopathic-like schizophrenia. They were characterized by a fear of possible contacts with different pathogenic agents--toxic substances, sharp small subjects, bacteria. Obsessions presented with a system of actions preventing phobic situations (rituals). With progression of the disease there was a decrease of both the degree and affective saturation of phobic disorders together with preserving rituals. Negative disorders presented with rough psychopathic-like changes with features of the "verschroben" defect. The disorders of the second type (29 patients) were observed in neurosis-like schizophrenia. Mysophobia manifested with both the repeated control and the fear of contamination accomplished. Ritual behavior presented with repeated actions and repeated control of the "sterility" of the own body and the surrounding subjects. Dynamics of these disorders was characterized by a tendency to more severe rituals of the control and persisting anxiety. Deficit disorders manifested with mental infantilism with psychopathic-like disorders of schizo-anancastic sphere. The above types of the obsessive-phobic disorders have a differential-diagnostic significance in respect of clinical variations of schizophrenia and determination of the state acuity with possible reversibility of the disorders (in neurosis-like schizophrenia).

Adolescent↗

PubMed1977

Clinical experience in the treatment of phobic disorders.

The author describes his experience in treating phobic disorders with both parenteral and oral clomipramine. Other techniques are mentioned and it is suggested that it is not only possible, but also desirable, to incorporate some of these in a regime of parenteral therapy for hospital in-patients. It is recommended that oral administration of clomipramine be used in the case of out-patients.

Administration, Oral↗

PubMed1991

Phobic disorders in the elderly.

Sixty confirmed cases of phobic disorder identified in an urban elderly community sample were compared with 60 controls matched pairwise for age and sex. Cases reported higher rates of specific and non-specific neurotic symptoms, and all were assigned to a diagnostic CATEGO class, compared with seven of the controls. A past history of chronic psychiatric disorder other than phobia was commoner in the cases. Most cases had more than one fear; agoraphobic main fears were predominantly of late onset and associated with moderate to severe social impairment, whereas specific main fears were associated with early onset and minimal social impairment. The onset of agoraphobic fears in old age was attributed by most cases to an episode of physical illness or other traumatic event. Increased rates of palpitations, dyspnoea, giddiness and tinnitus not attributable to anxiety were identified in the cases. Cases did not differ from the controls in socio-economic status, or in the number or quality of current intimate confiding relationships, but they reported higher rates than controls of parental loss before the age of 18 years. Cases reported higher rates of contact with general practitioners, but only one was in contact with psychiatric services at the time of interview. Cases also reported receiving more help in personal care from family members.

Aged↗

PubMedDate not supplied

Reliability and validity of the work and social adjustment scale in phobic disorders.

The Work and Social Adjustment Scale (WSAS) is a simple widely used 5-item measure of disability whose psychometric properties need more analysis in phobic disorders. The reliability, factor structure, validity, and sensitivity to change of the WSAS were studied in 205 phobic patients (73 agoraphobia, 62 social phobia, and 70 specific phobia) who participated in various open and randomized trials of self-exposure therapy. Internal consistency of the WSAS was excellent in all phobics pooled and in agoraphobics and social phobics separately. Principal components analysis extracted a single general factor of disability. Specific phobics gave less consistent ratings across WSAS items, suggesting that some items were less relevant to their problem. Internal consistency was marginally higher for self-ratings than clinician ratings of the WSAS. Self-ratings and clinician ratings correlated highly though patients tended to rate themselves as more disabled than clinicians did. WSAS total scores reflected differences in phobic severity and improvement with treatment. The WSAS is a valid, reliable, and change-sensitive measure of work/social and other adjustment in phobic disorders, especially in agoraphobia and social phobia.

Adult↗

PubMed2001

A polymorphic genomic duplication on human chromosome 15 is a susceptibility factor for panic and phobic disorders.

Anxiety disorders are complex and common psychiatric illnesses associated with considerable morbidity and social cost. We have studied the molecular basis of the cooccurrence of panic and phobic disorders with joint laxity. We have identified an interstitial duplication of human chromosome 15q24-26 (named DUP25), which is significantly associated with panic/agoraphobia/social phobia/joint laxity in families, and with panic disorder in nonfamilial cases. Mosaicism, different forms of DUP25 within the same family, and absence of segregation of 15q24-26 markers with DUP25 and the psychiatric phenotypes suggest a non-Mendelian mechanism of disease-causing mutation. We propose that DUP25, which is present in 7% control subjects, is a susceptibility factor for a clinical phenotype that includes panic and phobic disorders and joint laxity.

Adult↗

PubMed1996

Individual response patterns and treatment matching in the phobic disorders: a review.

Studies using response profile treatment matching in the phobic disorders are reviewed. It is argued that the research effort to date is plagued by a multitude of methodological problems which bring into question the validity of the major findings. While there have clearly been some encouraging data, too many inconsistent results exist to offer unqualified endorsement of the procedure. At this point, the optimum strategy for clinicians would appear to involve the inclusion of a treatment component consistent with the dominant response system of the individual patient, but not at the expense of well-established procedures (e.g. graduated in vivo exposure).

Follow-Up Studies↗

PubMed1989

Phobic disorders and anxiety states: how do they differ?

A review of the clinical literature to date has shown that the nature of the relationship between phobic disorders and anxiety states is still unclear. As a wide range of symptoms are shared by patients with all DSM-III anxiety disorder diagnoses, at this stage there is still a need to investigate the latent dimensions which distinguish the anxiety disorder subtypes. In the present study 176 patients with the DSM-III diagnoses of agoraphobia with panic attacks, social phobia, panic disorder and generalized anxiety disorder completed the Fear Survey Schedule, Fear Questionnaire, Hostility and Direction of Hostility Questionnaire, Maudsley Personality Inventory, and the Hamilton Anxiety and Depression Scales. Group membership was significantly predicted by a discriminant analysis which yielded a Fear Questionnaire agoraphobia function and a social phobia function. The results from discriminant analysis suggests that agoraphobia and anxiety states may be closely related. Classification errors were also determined, providing further evidence with which to refute the claim that agoraphobia has "all or none" characteristics.

Anxiety Disorders↗