Seasonal panic disorder: a possible variant of seasonal affective disorder.
The present communication concerns a 30 year-old female patient with panic disorder in whom panic attacks appeared to be seasonally-related. Characteristically, attacks were more frequent and severe during the months of October to May with spontaneous remissions during the months of June to September. Since 70% of patients with seasonal affective disorder (SAD), a variant of affective illness characterized by recurrent winter depressions with remissions in summer, suffer from anxiety disorders, we propose that seasonal panic disorder may be a variant of SAD. Since SAD is associated with phase delay of circadian rhythms, some forms of panic disorder may be related to phase instability of circadian rhythms. Moreover, since administration of artificial bright light therapy is currently the most effective treatment for SAD, it is suggested that patients with panic disorder should be questioned as to whether their symptoms are seasonally related. If a positive association is established, these patients should be offered treatment with light therapy prior to or coincident with the institution of pharmacotherapy.
Sandyk
R
R
Department of Psychiatry, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10461.
Dann
L C
LC
D000328:Adult; D000525:Alprazolam / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000150:complications / Q000628:therapy; D002940:Circadian Rhythm; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000150:complications / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008550:Melatonin / Q000097:blood; D016584:Panic Disorder / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D010789:Phototherapy; D011613:Psychotherapy; D016574:Seasonal Affective Disorder / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D012621:Seasons
D008550:Melatonin; D000525:Alprazolam