The biopsychosocial assessment for NCCP
Elizabeth Marks, Myra Hunter, John Chambers in CBT for Managing Non-cardiac Chest Pain, 2017
The symptoms of a panic attack share similarities with NCCP, and for many patients the anxiety associated with chest pain can cause panic attacks. A panic attack is an abrupt surge of intense fear or discomfort occurring from a calm or an anxious state, peaking in minutes, during which four or more of the following symptoms occur: Palpitations, pounding heart, or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath or smothering; feeling of choking; chest pain or discomfort; nausea or abdominal distress; feeling dizzy, unsteady, lightheaded, or faint; chills or heat sensations; numbness or tingling sensations; feelings of unreality; feelings of being detached from oneself; fear of losing control or going crazy; fear of dying.The Diagnositic and Statistical Manual of Mental Diseases, 5th Edition Panic disorder is diagnosed when attacks are frequent, there is signifi-cant worry about the consequences of the attacks and there are major behavioural changes. If the patient reports panic attacks occurring outside of NCCP episodes, it is more appropriate to refer them on for further assessment and care.
Psychological Disorders
Mohamed Ahmed Abd El-Hay in Understanding Psychology for Medicine and Nursing, 2019
A panic attack is a sudden episode of extreme anxiety that rapidly escalates in intensity. About 28 percent of adults have occasional panic attacks, especially during times of stress (Kessler et al., 2006). These feelings are usually accompanied by feeling dizzy or faint, or having a pounding heart, shortness of breath, a choking sensation, or chest pain. The person may also experience nausea, perspiration, shaking, light-headedness, faintness, chills, or hot flashes. These symptoms are interpreted as indicating a terrible consequence, e.g., I am going to have a heart attack, I am about to die, go crazy, or lose control. This leads to hypervigilance about body sensations, increased arousal of the sympathetic nervous system, more physical sensations, and heightened anxiety, which spirals into a panic attack (Clark, 1986). A panic attack typically peaks within 10 minutes of onset and then gradually subsides. Panic disorder refers to recurrent panic attacks in which the individual is worrying about having further attacks. Panic disorder usually appears between late adolescence and the mid-thirties. The first panic attack may occur after a stressful experience, such as an injury or illness, or during a stressful period of life, such as while changing jobs or during a period of marital conflict (Watanabe, Kazuhisa, & Madoka, 2005). In other cases, the first panic attack cannot be related to life events.
Services for depression, anxiety and post-traumatic stress disorder
Charles Kaye, Michael Howlett in Mental Health Services Today and Tomorrow, 2018
The main difference between phobic anxiety disorders and other anxiety disorders is that in the former, the anxiety is evoked only or predominantly by certain well-defined situations or objects. For example, in agoraphobia the anxiety is provoked by leaving home. Sufferers of agoraphobia commonly complain of becoming acutely anxious if they enter shops, are in crowds or travel alone. Specific phobias include a specific fear of heights, spiders or flying. With a specific phobia, fear is caused by the presence or anticipation of a specific object or situation and hence that situation is avoided, or endured with intense anxiety or distress. Conversely, panic disorder is characterised by recurrent attacks of severe anxiety (panic) that are not restricted to any particular situation or set of circumstances and are therefore unpredictable. In generalised anxiety disorder, the anxiety is generalised and persistent. Characteristic symptoms of anxiety include intense fear or discomfort, often accompanied by symptoms characteristic of a panic attack, i.e. palpitations, sweating, shaking, shortness of breath, feeling of choking, chest pain, nausea, dizziness, and a fear of losing control.
The experience of return to work in individuals with traumatic brain injury (TBI): A qualitative study
Published in Neuropsychological Rehabilitation, 2020
Lauren Libeson, Marina Downing, Pamela Ross, Jennie Ponsford
Injury-related factors such as anxiety and depression were also prevalent and hindered work performance: I’ve gone through depression. I’ve had anxiety – I had an anxiety attack. That was quite something. I’ve never – [experienced that before] … So I’m in a low mood … that affects my expectations of myself and how I can actually perform it and it’s a circle that’s just compounding because you’re not achieving the results but you know you should be putting the work in (P11).Another participant developed anxiety and compulsive checking as she did not trust her own memory, even six years post-injury, It’s a big issue at the-moment for me, because if I’m doing a particular job at work, I’ll do it but I’ll check and re-check and re-check. It’s becoming an obsession … Which I never had before … . Anxiety, stress, worry. I can’t have a good sleep at night (P13).
Adrenal disorders in pregnancy, labour and postpartum – an overview
Published in Journal of Obstetrics and Gynaecology, 2020
Madhavi Manoharan, Prabha Sinha, Shabnum Sibtain
The signs and symptoms of pheochromocytoma mimic those of severe pregnancy-induced hypertension. This can be associated with other sympathetic symptoms and signs such as palpitations, tachycardia, sweating, seizure disorders, anxiety attacks, chest pain, dyspnoea, nausea and vomiting, pallor, and flushing. Pheochromocytoma should be considered in cases of refractory hypertension in pregnancy and appropriate investigations should be carried out to differentiate from pre-eclampsia. The presence of paroxysmal hypertension after 20 weeks of pregnancy with orthostasis and absence of proteinuria and oedema helps in differentiating from other causes of hypertension in pregnancy. It is also necessary to distinguish from hyperthyroidism, where significant diastolic hypertension is not seen.
A Narrative Literature Review of the Epidemiology, Etiology, and Treatment of Co-Occurring Panic Disorder and Opioid Use Disorder
Published in Journal of Dual Diagnosis, 2021
Ashton E. Clark, Shelby R. Goodwin, Russell M. Marks, Annabelle M. Belcher, Emily Heinlein, Melanie E. Bennett, Daniel J. O. Roche
Panic disorder is a debilitating psychiatric disorder characterized by unexpected panic attacks that have rapid onset and are short in duration (American Psychiatric Association, 2013). To meet criteria for panic disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), individuals are required to have 4 of 13 symptoms, which can include fast heartbeat, shaking, shortness of breath, chest pain, nausea, and fear of dying. After experiencing a panic attack, an individual may worry about its re-occurrence or avoid situations they feel may result in another panic attack (American Psychiatric Association, 2013). Findings from national epidemiological studies indicate 2.1% of American adults endorse past 12-month panic disorder and 5.1% endorse lifetime panic disorder (Hasin & Grant, 2015). Although these rates of panic disorder may appear modest, they translate into a significant economic and societal burden. Panic and other anxiety disorders cost the United States as much as $46.6 billion per year (Devane et al., 2005; Greenberg et al., 1999) with panic disorder ranking as one of the costliest psychiatric conditions (Batelaan et al., 2007). Panic disorder also confers significant costs in terms of annual emergency room visits, as those with panic attacks commonly seek general medical care as opposed to psychiatric care due to the disorder being undiagnosed and symptoms mistaken for heart-related issues (Lynch & Galbraith, 2003).
Related Knowledge Centers
- Chest Pain
- Diagnostic & Statistical Manual of Mental Disorders
- Hypoesthesia
- Palpitations
- Panic Disorder
- Shortness of Breath
- Fear
- Shortness of Breath
- Diagnostic & Statistical Manual of Mental Disorders
- Social Anxiety Disorder
- Post-Traumatic Stress Disorder
- Substance Use Disorder