Primary care companion to the Journal of clinical psychiatry
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Prim Care Companion J Clin Psychiatry · Apr 2002
Panic Disorder and Chest Pain: Mechanisms, Morbidity, and Management.
Approximately one quarter of patients who present to physicians for treatment of chest pain have panic disorder. Panic disorder frequently goes unrecognized and untreated among patients with chest pain, leading to frequent return visits and substantial morbidity. Panic attacks may lead to chest pain through a variety of mechanisms, both cardiac and noncardiac in nature, and multiple processes may cause chest pain in the same patient. ⋯ Furthermore, patients with panic disorder and chest pain have high rates of functional disability and medical service utilization. Fortunately, panic disorder is treatable; selective serotonin reuptake inhibitors, benzodiazepines, and cognitive-behavioral psychotherapy all effectively reduce symptoms. Preliminary studies have also found that treatment of patients who have panic disorder and chest pain with benzodiazepines results in reduction of chest pain as well as relief of anxiety.
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Prim Care Companion J Clin Psychiatry · Feb 2002
The Mood Disorder Questionnaire: A Simple, Patient-Rated Screening Instrument for Bipolar Disorder.
Bipolar disorder is frequently encountered in primary care settings, often in the form of poor response to treatment for depression. Although lifetime prevalence of bipolar I disorder is 1%, the prevalence of bipolar spectrum disorders (e.g., bipolar I, bipolar II, and cyclothymia) is much higher, especially among patients with depression. ⋯ The Mood Disorder Questionnaire is a brief, self-report screening instrument that can be used to identify patients most likely to have bipolar disorder. Once identified, and subsequently appropriately diagnosed, the lives of those with bipolar disorder may be considerably improved.