Psychosomatic medicine
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Psychosomatic medicine · Dec 2007
Autonomic and respiratory characteristics of posttraumatic stress disorder and panic disorder.
Posttraumatic stress disorder (PTSD) and panic disorder (PD) are two anxiety disorders with prominent psychophysiological symptoms. The PTSD criterion of persistent hyperarousal suggests autonomic dysregulation, and the disorder has been associated with elevated heart rate. In contrast, PD has been associated with respiratory abnormalities such as low end-tidal Pco(2). An integrated analysis of automatic and respiratory function in a direct comparison of these anxiety disorders is currently lacking. ⋯ Persistent hyperarousal symptoms in PTSD seem to be due to high sympathetic activity coupled with low parasympathetic cardiac control. Respiratory abnormalities were also present in PTSD. Several psychophysiological measures exhibited group-comparison effect sizes in the order of 1.0, supporting their potential for enhancing differential diagnosis and possibly suggesting utility as endophenotypes in genetic studies of anxiety disorders.
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To review the potential for diagnostic difficulties and overlap in a number of symptoms of somatoform disorders and symptoms of withdrawal from alcohol and drugs, and to review epidemiologic, family, and clinical studies addressing comorbidity between somatoform and substance use disorders. The comorbidity between somatoform disorders and substance use disorders has rarely been studied. ⋯ More research on this type of comorbidity is warranted because the associations may be stronger than generally assumed. Such research should address methodological problems to produce studies with clearer findings.