Med. Pro Praxi 2007; 4(9): 361-367

Panická porucha v somatické medicíně

doc. MUDr. Ján Praško CSc
Psychiatrické centrum Praha, 3. LF UK, Praha

Panická porucha se projevuje náhlými záchvaty úzkosti s četnými vegetativními příznaky. Většina postižených má strach z nebezpečné tělesné nemoci, a proto vyhledává zejména somatické lékaře. Některé somatické diagnózy bývají u pacientů s panickou poruchou častější. Jde zejména o kardiovaskulární onemocnění, vředovou chorobu, poruchy štítné žlázy, plicní choroby, epilepsii a vestibulární onemocnění, která mohou jednak panickou poruchu svými příznaky připomínat, jednak s ní být komorbidní. Panická porucha může být léčena léky nebo psychoterapií. SSRI, SNRI a kognitivně behaviorální terapie patří mezi léčby první volby. Účinná jsou také tricyklická antidepresiva, jejich podávání je však spojenou s řadou nežádoucích účinků. Léčba benzodiazepiny může být prováděna jen krátkodobě, jinak hrozí rozvoj závislosti.

Keywords: panická porucha, antidepresiva, benzodiazepiny, kognitivně behaviorální terapie

Published: October 20, 2007  Show citation

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Praško J. Panická porucha v somatické medicíně. Med. praxi. 2007;4(9):361-367.
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    References

    1. Agle DP, Baum GL. Psychological aspects of chronic obstructive pulmonary disease. Med Clin North Am 1977; 61: 749-758. Go to original source... Go to PubMed...
    2. Allgulander C, Lavori PW. Excess mortality among 3302 patients with' pure' anxiety neurosis. Arch Gen Psychiatry 1991; 48: 599-602. Go to original source... Go to PubMed...
    3. Balaban CD, Porter JD. Neuroanatomical substrates for vestibuloautonomic interactions. J Vestib Res 1998; 8: 7-16. Go to original source... Go to PubMed...
    4. Ballenger, JC. Panic disorder and agoraphobia. In: Gelder MG, Lopez-Ibor JJ, Andreasen N (eds.): New Oxford Textbook of Psychiatry. Oxford University Press. Oxford 2000; 807-822.
    5. Bowen RC, Senthilselvan A, Barale A. Physical illness as an outcome of chronic anxiety disorders. Can J Psychiatry 2000; 45: 459-464. Go to original source... Go to PubMed...
    6. Brenes GA. Anxiety and chronic obstructive pulmonary disease: prevalence, impact and treatment. Psychosom Med 2003; 65: 963-970. Go to original source... Go to PubMed...
    7. Cameron OG. The differential diagnosis of anxiety: psychiatric and medical disorders. Psychiatr Clin North Am 1985; 8: 3-24. Go to original source... Go to PubMed...
    8. Carter C, Maddock R, Amsterdam E et al. Panic disorder and chest pain in the coronary care unit. Psychosomatics 1992; 33: 302-309. Go to original source... Go to PubMed...
    9. Carter CS, Servan-Schreiber D, Perlstein WM. Anxiety disorders and the syndrome of chest pain with normal coronary arteries: prevalence and pathophysiology. J Clin Psychiatry 1997; 58 (suppl 3): 70-73.
    10. Cormier LE, Katon WJ, Russo J et al. Chest pain with negative cardiac diagnostic studies: relationship to psychiatric illness. J Nerv Ment Dis 1988; 176: 351-358. Go to original source... Go to PubMed...
    11. Coryell W, Noyes R, Clancy J. Excess mortality in panic disorder: a comparison with primary unipolar depression. Arch Gen Psychiatry 1982; 39: 701-706. Go to original source... Go to PubMed...
    12. Craven J, Sutherland A. Buspirone for anxiety disorder in patients with severe lung disease. Lancet 1991; 338: 249. Go to original source... Go to PubMed...
    13. Crowe RR. Mitral valve prolapse and panic disorder. Psychiatr Clin North Am 1985; 8: 63-71. Go to original source... Go to PubMed...
    14. Dersh J, Polatin PB, Gatchel RJ. Chronic pain and psychopathology: research findings and theoretical considerations. Psychosom Med 2002; 64: 773-786. Go to original source... Go to PubMed...
    15. Eagger S, Luxon LM, Davies RA et al. Psychiatric morbidity in patients with peripheral vestibular disorder: a clinical neurootologic study. J Neurol Neurosurg Psychiatry 1992; 55: 363-387. Go to original source... Go to PubMed...
    16. Glassman AH, O'Connor CM, Califf RM et al. Sertraline treatment of major depression in patients with acute MI or unstable angina. JAMA 2002; 288: 701-709. Go to original source... Go to PubMed...
    17. Goldberg R, Morris P, Christian F et al. Panic disorder in cardiac outpatients. Psychosomatics 1990; 31: 168-173. Go to original source... Go to PubMed...
    18. Goodwin RD, Pine DS. Respiratory disease and panic attacks among adults in the United States. Chest 2002; 122: 645-650. Go to original source... Go to PubMed...
    19. Goodwin RD, Jacobi F, Thefeld W. Mental disorders and asthma in the community. Arch Gen Psychiatry 2003; 60: 1125-1130. Go to original source... Go to PubMed...
    20. Gorman JM, Fuer MR, Goetz R et al. Ventilatory physiology of subjects with panic disorder. Arch Gen Psychiatry 1988; 45: 31-39. Go to original source... Go to PubMed...
    21. Gorman JM, Sloan RP. Heart rate variability in depressive and anxiety disorders. Am Heart J 2000; 140: 577-583. Go to original source... Go to PubMed...
    22. Greenblatt DJ, von Moltke LL, Harmatz JS et al. Drug interactions with newer antidepressants: role of human cytochromes P450. J Clin Psychiatry 1998; 59 (suppl 15): 19-27. Go to original source... Go to PubMed...
    23. Haines AP, Imeson JR, Meade TW. Phobic anxiety and ischemic heart disease. Br Med J 1987; 295: 297-299. Go to original source... Go to PubMed...
    24. Harter MC, Conway KP, Merikangas KR. Associations between anxiety disorders and physical illness. Eur Arch Psychiatry Clin Neurosci 2003; 253: 313-330.
    25. Holland JC, Morrow G, Schmale A et al. A randomized clinical trial of alprazolam versus progressive muscle relaxation in cancer patients with anxiety and depressive symptoms. J Clin Oncol 1991; 9: 1004-1011. Go to original source... Go to PubMed...
    26. Huppert JD, Rynn M. Generalized anxiety disorder. In: Stein DJ (ed): Clinical Manual of Anxiety Disorders. American Psychiatric Association, Washington 2004; 147-171.
    27. Jacob RG, Furman JM, Durrant JD et al. Panic, agoraphobia, and vestibular dysfunction. Am J Psychiatry 1996; 153: 503-512. Go to original source... Go to PubMed...
    28. Januzzi JL, Stern TA, Pasternak RC et al. The influence of anxiety and depression on outcomes of patients with coronary artery disease. Arch Intern Med 2000; 160: 1913-1921. Go to original source... Go to PubMed...
    29. Karajgi B, Rifkin A, Doddi S et al. The prevalence of anxiety disorders in patients with chronic pulmonary disease. Am J Psychiatry 1990; 147: 200-201. Go to original source... Go to PubMed...
    30. Kasper S, Zohar J, Stein DJ. Decision Making in Psychopharmacology. Martin Dunitz London 2002; 165 pp.
    31. Katon WJ, Richardson L, Lozano P et al. The relationship of asthma and anxiety disorders. Psychosom Med 2004; 66: 349-355. Go to original source... Go to PubMed...
    32. Kawachi I, Colditz GA, Ascherio A et al. Prospective study of phobic anxiety and risk of coronary heart disease in men. Circulation 1994; 89: 1992-1997. Go to original source... Go to PubMed...
    33. Kawachi I, Sparrow D, Vokonas PS et al. Symptoms of anxiety and risk of coronary heart disease: the normative aging study. Circulation 1994; 90: 2225-2229. Go to original source... Go to PubMed...
    34. Kinrys G a Pollack MH. Panic disorder and agoraphobia. In: Stein DJ (ed): Clinical Manual of Anxiety Disorders. American Psychiatric Publishing 2004; 13-41.
    35. Kubzansky LD, Kawashi I, Weiss ST et al. Anxiety and coronary heart disease: a synthesis of epidemiological evidence. Ann Behav Med 1998; 20: 47-58. Go to original source... Go to PubMed...
    36. Lavey ED, Winkle RA. Continuing disability of patients with chest pain and normal coronary arteriograms. J Chronic Dis 1979; 32: 191-196. Go to original source... Go to PubMed...
    37. Lepola U, Wade AG, Leihonen EV et al. A controlled one year trial with citalopram in the treatment of panic disorder. J. Clin. Psychiatry 1998: 59: 528-534. Go to original source... Go to PubMed...
    38. Mayou RA, Gill D, Thompson DR et al. Depression and anxiety as predictors of outcome after myocardial infarction. Psychosom Med 2000; 62: 212-219. Go to original source... Go to PubMed...
    39. McWilliams LA, Cox BJ, Enns MW. Mood and anxiety disorder associated with chronic pain: an examination in a nationally representative sample. Pain 2003; 106: 127-133. Go to original source... Go to PubMed...
    40. Mendels J, Chernoff RW, Blatt M. Alprazolam as an adjunct to propranolol in anxious outpatients with stable angina pectoris. J Clin Psychiatry 1986; 47: 8-11.
    41. Moser DK, Dracup K. Is anxiety after myocardial infarction associated with subsequent ischemic and arrhythmic events? Psychosom Med 1996; 58: 395-401. Go to original source... Go to PubMed...
    42. Ortega AN, Huertas SE, Canino G et al. Childhood asthma, chronic illness, and psychiatric disorders. J Nerv Ment Dis 2002; 190: 275-281. Go to original source... Go to PubMed...
    43. Papp LA, Weiss JR, Greenberg HE et al. Sertraline for chronic obstructive pulmonary disease and comorbid anxiety and mood disorders. Am J Psychiatry 1995; 152: 1531. Go to original source... Go to PubMed...
    44. Praško J, Ondráčková I, Šípek J. Panická porucha a její léčba. Psychiatrické centrum Praha 1997, Zprávy č. 146, 116 pp.
    45. Praško J. Agorafobie. In: Raboch J (ed): Psychiatrie: Doporučené postupy psychiatrické péče. Galén Praha 1999 a; 41 - 62.
    46. Praško J, Záleský R, Herman E et al. Panická porucha. In: Seifertová D, Praško J, Hőschl C (eds): Postupy v léčbě psychických poruch. Praha: Academia Medica Pragensis, 2004 a; 139-161.
    47. Praško J, Prašková H. Agorafobie In: Seifertová D, Praško J, Hőschl C (eds): Postupy v léčbě psychických poruch. Praha: Academia Medica Pragensis, 2004 b; 163-173.
    48. Prašková H, Praško J. Úzkostné a fobické poruchy. Praha: Galén, 2000; 102 pp.
    49. Rickels K, Schweizer E. Clinical overview of serotonin reuptake inhibitors. J Clin Psychiatry 1990; 51 (suppl B): 9-12.
    50. Robertson MM ed. Epilepsy and Anxiety: Psychiatric Literature. Vol 6. New York, NY: Sanofi Winthrop Pharmaceuticals; 1996: 1-15.
    51. Rogers MP, White K, Warshaw MG et al. Prevalence of medical illness in patients with anxiety disorders. Int J Psychiatry Med 1994; 24: 83-96. Go to original source... Go to PubMed...
    52. Samet CM, Geller RD. Anxiety associated with cardiovascular disorders: a study using lorazepam. Psychosomatics 1979; 20: 707-713. Go to original source... Go to PubMed...
    53. Sartorius N, Ustun TB, Lecrubier Y et al. Depression comorbid with anxiety: results from the WHO study on psychological disorders in primary health care. Br J Psychiatry 1996; 168 (suppl 30): 38-43. Go to original source... Go to PubMed...
    54. Sauer WH, Berlin JA, Kimmel SE. Selective serotonin reuptake inhibitors and myocardial infarction. Circulation 2001; 104: 1894-1898. Go to original source... Go to PubMed...
    55. Shavitt RG, Gentil V, Mandetta R. The association of panic/agoraphobia and asthma: contributing factors and clinical implications. Gen Hosp Psychiatry 1992; 14: 420-423. Go to original source... Go to PubMed...
    56. Singh NP, Despars JA, Stansburg DW et al. Effects of buspirone on anxiety levels and exercise tolerance in patients with chronic airflow obstruction and mild anxiety. Chest 1993; 103: 800-804. Go to original source... Go to PubMed...
    57. Smoller JN, Pollack MH, Otto MN et al. Panic anxiety, dyspnea, and respiratory disease. Am J Respir Crit Care Med 1996; 154: 6-17. Go to original source... Go to PubMed...
    58. Stein DJ: Cognitive-affective neuroscience of depression and anxiety disorders. Martin Dunitz, London 2003. Go to original source...
    59. Stein MB, Asmundson GJG, Ireland D et al. Panic disorder in patients attending a clinic for vestibuilar disorders. Am J Psychiatry 1994; 151: 1697-1700. Go to original source... Go to PubMed...
    60. Tucker S, Adamson P, Miranda R et al. Paroxetine increases heart rate variability in panic disorder. J Clin Psychopharmacol 1997; 17: 370-376. Go to original source... Go to PubMed...
    61. Yardley L, Owen N, Nazareth I et al. Prevalence and presentation of dizziness in a general practice community sample of working age. Br J Gen Practice 1998; 48: 1131-1135.
    62. Yeragani JK, Pohl R, Berger R et al. Decreased heart rate variability in panic disorder patients: a study of power-spectral analysis of heart rate. Psychiatry Res 1993; 46: 89-103. Go to original source... Go to PubMed...
    63. Yingling KW, Wulsin LR, Arnold LM et al. Estimated prevalences of panic disorder and depression among consecutive patients seen in an emergency department with acute chest pain. J Gen Intern Med 1993; 8: 231-235. Go to original source... Go to PubMed...
    64. Weissman MM, Markowitz JS, Ouellette R et al. Panic disorder and cardiovascular/cerebrovascular problems: results from a community survey. Am J Psychiatry 1990; 147: 1504-1508. Go to original source... Go to PubMed...
    65. Wells KB, Golding JM, Burnam MA. Affective, substance use, and anxiety disorders in persons with arthritis, diabetes, heart disease, high blood pressure, or chronic lung conditions. Gen Hosp Psychiatry 1989; 11: 320-327. Go to original source... Go to PubMed...
    66. Wells KB, Golding JM, Burnam MA. Chronic medical conditions in a sample of the general population with anxiety, affective, substance use disorders. Am J Psychiatry 1989; 146: 1440-1446. Go to original source... Go to PubMed...
    67. Winters RW, Schneiderman N. Anxiety and coronary heart disease. In: Mostofsky DI, Barlow DH, eds. The Management of Stress and Anxiety in Medical Disorders. Boston, Mass: Allyn & Bacon; 2000: 206-219.

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