[Panic disorders in the emergency room].
Patients with panic disorder perceive physical symptoms which they interpret as dangerous phenomena; therefore, they normally seek help from physicians in somatic medicine and do not consult with a psychotherapist or psychiatrist. The combination of physical symptoms and catastrophic thinking induces such an intense feeling of anxiety that patients often visit an emergency unit. Thus, the prevalence of panic disorder is high among patients who seek help for heart symptoms within the setting of an emergency department (18%); in other clinical populations it may even be higher (patients with negative coronary angiography 33 to 59%, with irritable bowel syndrome 29 to 38%, with migraine headache 5 to 15%). Already in the emergency department it is possible to establish with the patient an understanding of the impact such catastrophic interpretations of basically benign physical changes have on the development of panic. This helps to avoid long-standing and expensive patient careers that have often been described in the literature. The present review includes a description of the cognitive model of the origin and the treatment of panic disorder as well as an overview of drug treatments with benzodiazepines and antidepressive drugs.
Langewitz
W
W
Abteilung Psychosomatik, Kantonsspital Basel, Universitätskliniken.
Kiss
A
A
Saner
R
R
D000928:Antidepressive Agents / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D006331:Heart Diseases / Q000523:psychology; D006801:Humans; D008881:Migraine Disorders / Q000523:psychology; D016584:Panic Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D011602:Psychophysiologic Disorders / Q000523:psychology*; D014717:Vertigo / Q000523:psychology
D000928:Antidepressive Agents; D001569:Benzodiazepines
Panikstörungen auf der Notfallstation.