Stressful Life Events’ Effect on Panic Attacks

Panic disorder is a common psychiatric disorder diagnosed in clinical practice. It significantly decreases the quality of life. In the present study, the researchers examined the relationship between panic disorders and stressful life events. These events include situations such as an impending divorce, getting fired, hospitalization for physical illness, arrest by police, a serious family argument, the death of a spouse, etc. The participants had worsened panic symptoms over the course of 12 weeks after a stressful life event related to family, friends, household or work.

At present, about 3.7 percent of people suffer from panic disorder. About 1.1 percent of people have a panic attack with irrational fear to situations, at least once in their lifetime. Such psychiatric problems lead to reduction in productivity at the workplace and excessive use of healthcare. It is therefore important to identify the risk factors that predispose people to develop panic attacks. Some studies have shown an association between panic disorder and stressful life events. However, so far no study has continuously followed up on the participants. This study aimed to estimate the duration after a stressful life event during which panic disorder is observed. The researchers also evaluated the factors that determine the severity of panic disorder.

* The participants of this study were subjects enrolled in the “Harvard/Brown Anxiety Research Program”. In this study, 711 people suffering from anxiety disorder were being followed up on to identify situations that intensified the anxiety disorder. Out of these, the present study included 418 participants who were suffering from panic disorder. As the first step, the demographic data about the participants was collected.
* The anxiety level of the participants was continuously measured throughout the study by using a questionnaire.
* Information regarding impending stressful event (such as divorce) or stressful events that occurred during the course of the study was noted by interviews.
* All the participants were followed up for 12 weeks to record the occurrence of panic attacks.

* Almost 98 percent of the participants in the present study were Caucasians. Of these, 67 percent were women, 57 percent were unemployed and 53 percent were married. Most of them were suffering from depression also.
* Common stressful life events included the loss of a job and hospitalization for physical illness.
* No panic disorders were observed before and immediately after the occurrence of the stressful life event.
* The symptoms of panic disorder gradually worsened over the period of 12 weeks after the occurrence of the stressful life event.

Shortcomings/Next steps
The participants included in this study were patients who were seeking medical care for their anxiety disorder problem. Therefore, the findings of this study cannot be generalized to the general population. Moreover, this study has only identified that a stressful life event is followed by panic attacks, without establishing causality. Further studies are necessary to confirm the role of stressful life events in causing panic disorder.

This study has shown that a stressful life event is a risk factor for developing panic attacks. According to researchers, a stressful event makes the body systems, especially the autonomic nervous system, hyperresponsive to minor disturbances of life. This finally leads to a panic attack for even a trivial problem. This study has also shown that rather than anticipation of a stressful event, the actual occurrence of the event produces panic attack. The researchers also found that panic disorder develops slowly over a period after a stressful life event. These findings have important implications in the prevention of panic disorder. If a person suffering from anxiety encounters a stressful life event, clinicians must anticipate a panic attack and must treat the patient accordingly.

For More Information:
Impact of Stressful Life Events on the Course of Panic Disorder in Adults
Publication Journal: Journal of Affective Disorders, 2011
By Ethan Moitra; Ingrid Dyck; Alpert Medical School of Brown University, Providence, Rhode Island

* FYI Living Lab Reports are a summary of the original report.

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