By Spilios Argyropolous;Adrian Feeney;David Nutt
In scientific perform, complicated sufferers with comorbidity of temper and nervousness problems are arguably the norm. those volumes specialize in this sector, offering updated stories of the conceptual matters that confront the clinician while comparing those sufferers Concise and easy-to-read, in addition they current a pragmatic method of the administration and therapy of sufferers with comorbid temper and anxiousness problems.
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Extra info for Anxiety Disorders Comorbid with Depression: Pocketbook: Panic Disorder and Agoraphobia
Thus, in individuals with identical genetic material the concordance rates are relatively low. This would suggest that, although some of the risk of developing panic disorder is heritable, not all of it is. Environmental factors are also an important role in triggering this panic disorder in individuals with a genetically predetermined diathesis (Fyer 2000). Linkage studies Linkage studies have attempted to identify which portion of the chromosome is responsible for the heritability of panic disorder.
Symptoms of both disorders can be present during the same episode of illness. In this case, the patient may fulfil the diagnostic criteria for both conditions at the same time, or either of the two may present at a subthreshold level (Angst et al 1997). Subthreshold symptoms of panic disorder that may appear during a depressive episode include panic attacks, increased vasomotor responses, emotional lability, perceptual distortions, depersonalization and derealization. On the other hand, panic patients may experience persistent low mood, worsening of their symptoms in the morning, early morning wakening, suicidal ideation and psychomotor retardation (Hamilton 1983).
The SSRIs may serve to damp down this autonomic arousal and benzodiazepines may modulate the impaired appraisal of threat, which leads to these characteristic cognitions (Middleton 1991) (Figure 9). Cognitive Benzodiazepine effect Misinterpretation Impaired appraisal of threat Reflex avoidance Behavioural Aversive arousal SSRI effect Panic attack Physiological Figure 9 Proposed sites of action of SSRIs and benzodiazepines in relation to cognitive, physiological and behavioural components of panic disorder.
Anxiety Disorders Comorbid with Depression: Pocketbook: Panic Disorder and Agoraphobia by Spilios Argyropolous;Adrian Feeney;David Nutt