Panic disorder: from psychopathology to treatment
Disturbo di panico: dalla psicopatologia alla terapia
G. Perna* ** ***
* Hermanas Hospitalarias, FoRiPsi, Department of Clinical Neurosciences, Villa San Benedetto Menni, Albese con Cassano, Como; ** Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami (USA); *** Department of Psychiatry and Neuropsychology, Maastricht University (the Netherlands)
Summary
Panic disorder (PD) is a clinical entity which
complexity can be organized in a "march of panic" whose organizing
psychopathological principle is represented by the unexpected panic
attacks. Panic phenomenology is defined not only by full blown and limited
symptoms panic attacks but also by aborted panic attacks and shadows
of panic. All together these phenomena are the expression of the psychobiological
mechanisms abnormally activated in PD. The target of psychopharmacological
treatment should be focused on panic phenomenology while the only effective
psychotherapeutic intervention, cognitive behavioral therapy, should
correct the cognitive distortions and the avoidant and protective behaviors
that limit panic patient's freedom. A complete therapeutic approach
should include also regular aerobic exercise and evidence based breathing
therapy. Often the chronicization of PD is the results of mistakes in
the diagnostic and therapeutic processes rather than a true treatment
resistance.