Medical Express

ISSN (print): 2318-8111

ISSN (online): 2358-0429

Author's Articles

4 result(s) for: Antonio E Nardi

Treatment effect on temperament and character in panic disorder: a prospective randomized double-blind study

Marina Dyskant Mochcovitch; Tathiana P. Baczynski; Adriana Cardoso de Oliveira e Silva; Antonio E. Nardi


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OBJECTIVE: The present study aims to analyze the effect of pharmacological treatment for panic disorder on temperament and character dimensions and to compare the effect of imipramine and fluoxetine on this outcome.
METHOD: Temperament and character dimensions were evaluated in panic disorder patients before and after six months of pharmacological treatment with imipramine and fluoxetine, using the Temperament and Character Inventory-Revised. Patients were randomized between groups and both (patient and investigators) were blinded to the intervention drug. Furthermore, 34 non-panic controls answered the revised Temperament and Character Inventory through an Internet survey.
RESULTS: Panic disorder patients showed higher scores for Harm Avoidance and lower scores for Persistence, Self-Directedness, and Cooperativeness than controls at baseline, but only the low Persistence value remained different from controls after treatment. Responder patients presented significant reduction in Harm Avoidance scores and a significant increase in Self-Directedness scores, whereas non-responders showed a significant increase of Harm Avoidance levels. Fluoxetine and Imipramine showed similar effects on the revised Temperament and Character Inventory dimensions.
CONCLUSION: High Harm Avoidance and low Self-Directedness, Persistence, and Cooperativeness are associated with panic disorder. Treatment of acute panic disorder symptoms lead to the reduction of Harm Avoidance and to an increase in Self-Directedness scores. However, there was no difference between treatment with fluoxetine and imipramine for the effect on the revised Temperament and Character Inventory dimensions.

Keywords: Panic disorder; Temperament; Character; Imipramine, Fluoxetine.

Aerobic exercise reduces anxiety symptoms and improves fitness in patients with panic disorder

Murilo Khede Lamego; Eduardo Lattari; Alberto Souza de Sá Filho; Flávia Paes; Jarbas Mascarenhas Jr.; Geraldo Maranhão Neto; Aldair José de Oliveira; Carlos Campos; Nuno Barbosa F. Rocha; Antonio E. Nardi; Sergio Machado


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OBJECTIVE: To investigate the effects of a regularly repeated aerobic exercise series on anxiety and maximum oxygen consumption (VO2max) in Panic Disorder patients.
METHODS: Ten previously sedentary female subjects diagnosed with Panic Disorder performed 36 sessions of aerobic exercise (at 70 to 75% of VO2max), 3 times per week during 12 weeks. A cardiopulmonary evaluation (ergospirometry test) was used to set the intensity of training as well as to establish baseline and post-training VO2max parameters. The assessment of anxiety symptoms was performed at baseline, at the end of the 6th and 12th weeks, using the Trait Anxiety Inventory (STAI-T) and State Anxiety Inventory (STAI-S), and the Subjective Units of Distress Scale (SUDS) questionnaires. One-way ANOVA for repeated measurements (at 3 moments: Baseline, 6th week (mid-training) and 12th week (post-training) was used to compare the evolution of the questionnaires; the Bonferroni post hoc test was applied to identify differences between moments. A dependent t-test was performed for measures of VO2max.
RESULTS: Compared to baseline, (a) STAI-T showed significant anxiety reductions at mid- and post-training moments; (b) STAI-S and SUDS recorded anxiety reductions only at Post-training; (c) VO2max showed a significant improvement at Post-training.
CONCLUSION: This protocol promoted beneficial effects on cardiorespiratory fitness and anxiety levels of Panic Disorder patients.

Keywords: Panic disorder, aerobic exercise, maximum oxygen consumption.

Genetic Polymorphisms and Generalized Anxiety Disorder: a systematic review

Verônica de Medeiros Alves; Edilson Leite de Moura; Larissa Tenório Andrade Correia; Antonio E. Nardi


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OBJECTIVE: Generalized Anxiety Disorder is a disease characterized by feelings of anxiety, fear, excessive worrying and tension in the face of life experiences. This study aims to identify genetic polymorphisms associated with Generalized Anxiety Disorder described in scientific literature.
METHOD: This review was set up by searching PubMed/Medline, Web of Science and Scopus database using the following key words: "gene and generalized anxiety disorder", "SNP and generalized anxiety disorder" and "polymorphism and generalized anxiety disorder".
RESULTS: We found ten polymorphic varieties of nine genes that showed association and seven polymorphic varieties of three genes that showed no association with Generalized Anxiety disorder: genes NPY, BDNF, BLC2, DED2, RGS2, HTR1A, MAOA, ERS2 and 5-HTT showed association, whereas BDNF, ERS1 and TPH showed no association with the Disorder. Conflicting results regarding BDNF come from different studies.
CONCLUSION: This review identified a variety of genetic polymorphisms, that have been studied in relation to Generalized Anxiety Disorder. Taken jointly, their results are inconclusive, showing that more genetic studies focused on this mental disorder are necessary.

Keywords: Polymorphisms, Generalized anxiety disorder, Gene.

Unveiling the specific role of psychological and cardiorespiratory variables in the therapeutic effect of an aerobic exercise training protocol for panic disorder

Aline Sardinha; Raphael Marques Gomes; Claudio Gil Soares de Araújo; Rafael C Freire; Marina Dyskant Mochcovitch; Andrea Camaz Deslandes; Antonio E Nardi


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BACKGROUND: There is limited evidence regarding the use of exercise training in the treatment of panic disorder.
OBJECTIVE: To describe the role of psychological and cardiorespiratory variables in the therapeutic effect of a 12-week exercise training in panic disorder patients.
METHODS: Eleven symptomatic panic disorder patients completed 24 sessions, 2 sessions/week, 70%VO2max) aerobic exercise training in addition to regular pharmacological treatment. Assessment was performed at baseline, six and 12-week periods. Exercise training intensity was individualized according to maximal cardiopulmonary exercise testing data.
RESULTS: Patients who exercised in conjunction with pharmacotherapy obtained significant improvements in several variables. Exercise training produced a selective, rather than a general anxiolytic impact. An early (6-week) effect was observed in fear of physiological arousal, interoceptive conditioning and in the frequency and intensity of panic attacks. Smaller additional 12-week effects were found in health concerns and agoraphobic cognitions, with no significant impact in agoraphobia.
CONCLUSION: A 12-week aerobic exercise training protocol was well-tolerated and able to improve several psychological and cardiovascular indicators in most patients with panic disorders. Further studies are needed to identify the best training protocols and long-term effects of exercise, as well as interactions between cardiorespiratory and psychological variables in this context.

Keywords: Mental health, Anxiety sensitivity, Interoceptive exposure, Exercise, Cardiovascular risk.