БҰЗЫЛЫСТАРЫНЫҢ КЛИНИКАЛЫҚ ЕРЕКШЕЛІКТЕРІН САЛЫСТЫРУ
II- 2. Number of symptoms at the age of onset of first panic attacks in the three groups
TheNeg-FH group and PD-FH patientshad the same mean number of symptoms at the age of onset, as noted in Study I] in Results. In theDep- FH group, the mean number of symptoms at the age of onset was 7.3 (SD 3.6). The number of symptoms at the age of onset of panic attacks in these three groups was analyzed by family history using ANOVA, and significant differences in that number were noted (F(2, 139)=4.599, =0.012).
As in Study I] in Results, significant differences were found in Study 2] in Results between Neg- FH group and PD-FH patients. No significant differences between the Neg-FH and Dep-FH groups were noted (mean difference: -1.75,
>0.05).
Discussion
The present study yielded two findings. First, PD-FH patients had an early age of onset of the first panic attack, but our results suggest that the
family history of Other-FH (also only Dep-FH) patients did not affect age at onset. Second, PD- FH patients had a significantly greater number of symptoms during the first panic attack, but our results suggest that the family history of Other-FH (also only Dep-FH) patients did not affect the number of symptoms.
There was a report that a significantly higher proportion of patients who exhibited early-onset panic disorder had a family history of panic disorder among first-degree relatives than did patients with later-onset panic disorder in Barcelona of northeastern Spain [20]. Significant differences were not noted in the proportion of patients with early-onset and late-onset panic disorder with a family history of depression, schizophrenia, or alcohol dependence [20]. In other family study, Battaglia et al [2] found that the younger of two successive generations of 38 families with panic disorder experienced the onset of panic attacks at a significantly younger age.
Goodwin and Hamilton [6] showed that early- onset fearful panic attack may be a marker of increased vulnerability to severe and persistent psychopathology and that it may be related to high rates of suicidality. Pané-Farré et al [18]
showed that people who developed panic disorder reported more severe first panic attacks.
These studies also yielded results showing trends largely similar to the present findings [2,6,18].
However, for the most part, they did not examine in detail the number of symptoms at the age of onset of first panic attacks in patients with panic disorder and a family history of panic disorder among first-degree relatives [2,6,18]. In addition, there have been few reports which included other viewpoints about the onset and number of symptoms of the first panic attack in patients with a family history of psychiatric disorders including panic disorder.
One previous report showed that neuroticism, lifetime history of major depression, and recent stressful life events had direct effects on the risk for the first panic attack, but gender difference and overprotection did not have direct effects [22]. The report described that genetic variables were among the strong predictor variables, and suggested that it is necessary to discuss a new path model containing genetic variables including family history in order to predict the firstpanic attack [22].
Table.
Age at the onset of panic attacks and number of symptoms at the age of onset of first panic attacks in the three groups.
Conclusions
This study’s sample size was not large, and the study may contain recall bias and family history bias. This study was also performed exactly judgment as possible as so that psychiatrists reconfirmed the diagnosis of panic disorder patients and the family information obtained from them. The present study found that familial panic disorder appears earlier than the non-familial type. In addition, the present results indicate that this tendency is specific to those with a family history of panic disorder alone, suggesting a genetic basis for panic disorder. There are several limitations in this study, but it is a valuable report from multiple viewpoints on the first panic attack in patients with a family history of panic disorder. In future reports on this topic, the number of samples should be increased.
Acknowledgements
We would like to thank all of the participants in the present study and the staff of the Warakukai Incorporated Medical Institution Nagoya Mental Clinic, and the members of the Department of Psychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University. We wish to thank Yukika Nishimura, Ph.D (previously, Department of Psychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Mie, Japan) for her valuable comments and HisashiTanii, M.D, Ph.D (Department of Psychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Mie, Japan) for his valuable cooperation.
Conflict of interest: None
Author’s contributions: Ken Inoue, Hisanobu
Kaiya, Naomi Hara and Yuji Okazaki designed the study with comments from YN. Ken Inoueanalyzed the data with comments from YN.Ken Inoue, Hisanobu Kaiya, and Yuji Okazaki performed the sampling. Ken Inoue, Hisanobu Kaiya, Naomi Hara and Yuji Okazaki read and approved the report for submission.
Funding: This work was supported by KAKENHI (a Grant-in-Aid for Scientific Research) in the Priority Areas from the Ministry of Education, Culture, Sports, Science and Technology of Japan (2005-2009) awarded to YO.
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*Correspondence:
Ken Inoue - Health Service Center, Kochi University &Kochi Medical School, Kochi University, Kochi, Japan; previously, Department of Psychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Mie, Japan.
Address: Health Service Center, Kochi University, 2-5-1, Akebono-cho, Kochi-shi, Kochi 780-8520, Japan
E-mail: [email protected]
Phone:+81-88-844-8158, fax: +81-88-844-8089
Получена: 29 сентября 2017 / Принята: 25 октября 2017 / Опубликована online: 31 октября 2017
УДК 616.61 – 008.64