Chapter 9 Anxiety and stress-related disorders
Abstracts and keywords to be supplied.
- Introduction 320
- Historical perspective 322
- Hyperventilation syndrome (HVS) 324
- Panic disorder 1: clinical features 326
- Panic disorder 2: aetiological models 328
- Panic disorder 3: management guidelines 330
- Agoraphobia 332
- Simple or specific phobias 334
- Social phobia 336
- Generalized anxiety disorder (GAD) 338
- Obsessive–compulsive disorder (OCD) 340
- Exceptional stressors and traumatic events 342
- Acute stress reaction 344
- Acute stress disorder 345
- Adjustment disorders 346
- Normal and abnormal grief reactions 348
- Post-traumatic stress disorder 1: diagnosis 350
- Post-traumatic stress disorder 2: management 352
- Depersonalization (derealization) syndrome 354
* Formerly known as Da Costa syndrome. Other archaic terms include: cardiac neurasthenia, cardiac neurosis, circulatory neurasthenia, disordered action of the heart (DAH), effort syndrome, hyperdynamic–adrenergic circulatory state, hyperkinetic heart syndrome, irritable heart, neurocirculatory asthenia, soldier’s heart, vasoregulatory asthenia.
1 ‘Panic’ derives from the Greek god Pan, who was in the habit of frightening humans and animals ‘out of the blue’.
2 ICD-10 and DSM-IV disagree on the nature of panic disorder. ICD-10 regards true panic attacks as not being situational, and DSM-IV allows for both spontaneous and situational. Hence DSM-IV includes agoraphobia within panic disorder, seeing it as a special case of situational panic disorder (panic disorder with agoraphobia), whereas ICD-10 separates agoraphobia (under the rubric ‘phobic anxiety disorders’) from panic disorder (under the rubric ‘other anxiety disorders’). ‘Agoraphobia with panic disorder’ is allowed in ICD-10 when there is avoidance of places or situations where to have a spontaneous panic attack would be difficult or embarrassing.
3 Katon W (1984) Panic disorder and somatization. Review of 55 cases. American Journal of Medicine, 77, 101–8.[CrossRef][Web of Science][Medline]
4 Simon GE and Van Korff M (1991) Somatization and psychiatric disorder in the NIMH Epidemiologic Catchment Area study. AJP, 148, 1494–500.
5 Eaton WW, Kessler RC, Wittchen HU and Magee WJ (1994) Panic and panic disorder in the United States. AJP, 151, 413–20.
1 Gratacos M, Nadal M, Martin-Santos R et al. (2001) A polymorphic genomic duplication on human chromosome 15 is a susceptibility factor for panic and phobic disorders. Cell, 106, 367–79.[CrossRef][Web of Science][Medline]
1 Ballenger JC et al. (1997) Panic disorder and agoraphobia. In Treatments of psychiatric disorders, Vol. 2, 2nd edn, pp. 1421–52. Washington, DC, American Psychiatric Press.
2 Barlow DH and Craske MG (1988) Mastery of your anxiety and panic. State University for New York at Albany, Center for Stress and Anxiety Disorders.
1 Literally ‘fear of the market place’ (Greek).
2 Lelliott P, Marks I, McNamee G and Tobena A (1989) Onset of panic disorder with agoraphobia. Toward an integrated model. Archives of General Psychiatry, 46, 1000–4.[Abstract/Full Text]
1 Kendler KS, Neale MC, Kessler RC et al. (1992) The genetic epidemiology of phobias in women. The interrelationship of agoraphobia, social phobia, situational phobia, and simple phobia. Archives of General Psychiatry, 49, 273–81.[Abstract/Full Text]
1 Kendler KS, Neale MC, Kessler RC et al. (1992) The genetic epidemiology of phobias in women. The interrelationship of agoraphobia, social phobia, situational phobia, and simple phobia. Archives of General Psychiatry, 49, 273–81.[Abstract/Full Text]
2 Rapee RM and Heimberg RG (1997) A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy, 35, 741–56.[CrossRef][Web of Science][Medline]
3 Schneier FR, Johnson J, Hornig CD et al. (1992) Social phobia. Comorbidity and morbidity in an epidemiologic sample. Archives of General Psychiatry, 49, 282–8.[Abstract/Full Text]
1 Buspirone should be considered as an alternative to BDZs when sedative effects are unwanted (e.g. drivers of vehicles, pilots, machine operators), in patients with a personal/family history of drug misuse, or for those already taking other CNS depressants.
1 Stein MB, Walker JR, Hazen AL and Forde DR (1997) Full and partial posttraumatic stress disorder: findings from a community survey. AJP, 154, 1114–19.
1 Stroebe M, van Son M, Stroebe W et al. (2000) On the classification and diagnosis of pathological grief. Clinical Psychology Review, 20, 57–75.[CrossRef][Web of Science][Medline]
2 The results from studies vary. A study by Zisook et al., looked at the rate of depression in late-life widows. The results showed that 16% of them had depression 13 mths after bereavement. Zisook S, Paulus M, Shuchter SR and Judd LL (1997) The many faces of depression following spousal bereavement. J Affect Disord, 45, 85–95.[CrossRef][Web of Science][Medline]
3 Parkes CM (1986) Bereavement: studies of grief in adult life, 2nd edn. International Universities Press.
1 Kessler RC, Sonnega A, Bromet E et al (1995) Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048–60.[Abstract/Full Text]
1 The dangers of attributing present psychopathology to childhood events cannot be overstated—recently illustrated by high-profile cases of alleged ‘recovered memories’. Unsubstantiated claims of childhood (or other) abuse should be regarded with extreme caution. The psychodynamic notion of ‘repression’ is at best intellectually dubious, and the significance of childhood trauma even in empirical studies finds little consistent support. See Pope HG (1997) Psychology astray: fallacies in studies of ‘repressed memory’ and childhood trauma. Upton, Boca Raton, FL.
