By Mark H. Pollack, Jerrold F. Rosenbaum
Sensible in strategy and recent in content material, Panic disease and Its therapy presents a transparent and clinically correct precis of the present wisdom in this tough affliction, protecting indicators, care, fee, comorbidities, and caliber of existence. includes algorithms and tables supplying at-a-glance drug treatment plans and an appendix with measures for assessing symptom severity and healing reaction! Written by way of prime professionals at the etiology, path, and administration of this , Panic affliction and Its remedy ·promotes enhanced reputation of indicators in pychiatric and nonpsychiatric settings, together with the first care physician's place of work or the emergency room ·reviews facts from a variety of assets at the diagnosis of panic ailment, emphasizing the possibility of chronicity and recurrence ·examines the newest advances implicating neurochemical, neurophysiological, and useful neuroanatomical abnormalities within the pathogenesis of panic sickness ·analyzes hazard components for the disease, together with genetics, temperment, developmental reviews, and existence occasions ·explores on hand pharmacotherapies for panic problems, together with selective serotonin-reuptake inhibitors ·investigates panic assaults and panic sickness from a cognitive-behavioral viewpoint, detailing particular remedies detailed to manage actual sensations ·presents medical recommendations for treatment-refractory sufferers, assuring optimum diagnostic and healing efforts for nonresponders ·and extra! Panic sickness and Its therapy serves as insightful analyzing for psychiatrists and behavioral scientists, medical psychopharmacologists, neuropsychiatrists, scientific psychologists, scientific social staff, and scientific scholars, citizens, and fellows in those disciplines. it's also worthwhile for basic care physicians, together with internists, relatives medical professionals, and generalists, in addition to emergency room employees, who're usually the 1st future health care execs to judge the sufferer.
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Additional resources for Panic Disorder & Its Treatment (Medical Psychiatry Series)
They were referred by different types of specialists to whom the patients had gone because they were most concerned about a particular symptom in that specialist's area of expertise. Forty-four percent had been to see a neurologist, 39% had seen a cardiologist, and 33% a gastroenterologist. If PCPs raise their index of suspicion and address the screening question to the patients described below, a much higher percentage of PD patients could be effectively recognized and easily diagnosed, even within the constraints of a busy PCP setting.
1% of cases of hypertension (93), but urinary studies are routinely performed in the work-up of hypertension to rule out a potential pheochromocytoma. These tests are costly and find a pheochromocytoma only one or two times out of 1000. However, almost two-thirds of the patients screened for pheochromocytomas have PD. Thus, when pheochromocytoma is considered in the differential of a patient displaying episodic symptoms of labile hypertension, PD should be the principal condition considered. Certainly screening questions and history would be far more cost-effective than extensive urinary testing to make the appropriate diagnosis in most cases.
In one study, 3845% of patients with uncertain diagnoses (vs. 15% for whom the diagnoses were clear) had a psychiatric diagnosis (6); 12% had PD diagnoses. Simon and Von Korff (33) have demonstrated that patients with multiple unexplained symptoms are over 200 times more likely to have PD, an increased risk 10 times that of any other syndrome. Panic attacks are reported in over one-quarter of patients who experience five or more problems or symptoms, 18% meet full criteria for PD (33). In an early classic study, Katon (29) described PD patients from primary care who were seen in consultation by a psychiatrist.