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Panic attacks with psychotic features

I Galynker1, C Ieronimo, A Perez-Acquino

  • 1Beth Israel Medical Center and Albert Einstein College of Medicine, New York, NY 10003, USA.

The Journal of Clinical Psychiatry
|September 1, 1996
PubMed
Summary
This summary is machine-generated.

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Psychosis can occur during severe panic attacks in patients with panic disorder. These psychotic symptoms, including hallucinations and delusions, resolve with treatment or spontaneously, and do not require antipsychotics.

Area of Science:

  • Psychiatry
  • Anxiety Disorders
  • Psychotic Disorders

Background:

  • Anxiety disorders are common psychiatric conditions, frequently comorbid with depression and personality disorders.
  • Psychosis is a rare outcome of anxiety disorders.

Observation:

  • Researchers prospectively identified four patients experiencing panic attacks with co-occurring psychosis.
  • All patients met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for panic disorder.

Findings:

  • Psychosis, manifesting as auditory hallucinations or delusions, emerged during severe panic attacks in all four patients.
  • Psychotic symptoms were transient, resolving spontaneously or with benzodiazepine/SSRI treatment, without the need for neuroleptics.
  • One patient had a history of generalized anxiety disorder, while three had a history of panic disorder.

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Implications:

  • This suggests psychosis can manifest during severe panic attacks in panic disorder patients.
  • Differentiating these cases from other psychotic disorders is crucial for appropriate treatment, as antipsychotics are not indicated.
  • Further research is needed to understand the prevalence and pathophysiology of psychosis in anxiety disorders.