Download Panic Disorders in Primary Care: Prevalence, Comorbidities, and Treatment and more Slides Psychology in PDF only on Docsity! Panic Disorders In Primary Care Docsity.com Mental Health and Primary Care Mental Health Primary Care Docsity.com 70,000,000 people in the US have a Diagnosable Mental/Addictive Disorder Mental/ Addictive Disorder 28% No Mental/ Addictive Disorder 72% Reiger et al. 1993 Docsity.com 40,000,000 people in the US receive services for Mental/Addictive Disorders Reiger et al. 1993 No Treatment 85% Treatment 15% Docsity.com Sectors Where Mental Health Services are Provided • Specialty Mental /Addictive Sector – Inpatient and Outpatient Psychiatric/Addictive • General Medical Sector – Nursing Home and Hospitals – Outpatient (Primary Care Setting) • Other – Human Service Professionals (Clergy, Counselors) – Voluntary support Network (Family, Friends, AA) Docsity.com Organizing Principles DSM-IV Affective Disorders Anxiety Disorders Psychotic Disorders Substance Abuse Other Docsity.com Organizing Principles DSM-IV Affective Disorders Major Depression, Bipolar Disorder, Dysthymia Anxiety Disorders Psychotic Disorders Substance Abuse Other Docsity.com Organizing Principles DSM-IV Affective Disorders Major Depression, Bipolar Disorder, Dysthymia Anxiety Disorders GAD, Panic Disorder, PTSD, OCD, Phobias Psychotic Disorders Substance Abuse Other Docsity.com Organizing Principles DSM-IV Affective Disorders Major Depression, Bipolar Disorder, Dysthymia Anxiety Disorders GAD, Panic Disorder, PTSD, OCD, Phobias Psychotic Disorders Schizophrenia, Schizoaffective Substance Abuse Alcohol, Cocaine, Nicotine, Other Other Psychiatric Aspects of Medical Disease: Stroke, Dementia, HIV, CAD Other Psych: Personality Disorders, Eating Disorders, Somatization Docsity.com Psychiatric Disorders in the Primary Care Setting • Any Diagnosis 30-50% • Major Depression 7-19% • Substance Abuse/Dependence 3-7% • Any Anxiety Disorder 10-25% • Panic Disorder 1-6% JAMA Dec. 14,1994 Docsity.com Panic Attacks: General • Panic Disorder 1.5-4.0% General Population • “Panic Attacks” (no disorder) 15% • 2-3x Females: Males • Develops in Young Adulthood and Adolescence Docsity.com Panic Attacks: Comorbidity • Substance Abuse • Major Depression • Post Traumatic Stress Disorder • Obsessive Compulsive Disorder • Generalized Anxiety Disorder • Personality Disorder Docsity.com Panic-Depression Comorbidity • 30-40% MDD have recurrent panic attacks • 10-20% MDD have panic disorder • 50-55% PD (or panic attacks) have MDD • Patients with MDD and PD – Earlier onset MDD – More severe MDD Docsity.com Medical Presentations • Cardiac Panic • Pulmonary Panic • GI Panic • “Vertigo” Panic • Panic exacerbating pre-existing disease Docsity.com “GI” Panic • 6-25%Unexplained GI symptoms in general pop • Significant concurrence between IBS and PD • Lifetime prevalence of PD – In IBD: ~3% – In IBS: 28% Docsity.com “Vertigo” Panic • Dizziness second most common symptom in PD • 50-85% of PD patients report dizziness • Some studies find a high rate of vestibular dysfunction in patients with PD – (especially if agoraphobia is present) • Headache third most common PD symptom – 12-15% of headache patients have PD Docsity.com “Personalities” • Alexithymia • Somatothymia • Diminished ego strength • Medicalized distress • Resists diagnosis • Personality Disorder Docsity.com
