Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-26T12:27:06.670Z Has data issue: false hasContentIssue false

Social Adjustment in Panic-Agoraphobic Patients Reconsidered

Published online by Cambridge University Press:  02 January 2018

G. Perugi
Affiliation:
Chair II, Institute of Clinical Psychiatry, University of Pisa, Italy
H. S. Akiskal
Affiliation:
Department of Psychiatry, University of California at San Diego, USA
L. Musetti
Affiliation:
Chair II, Institute of Clinical Psychiatry, University of Pisa, Italy
E. Simonini
Affiliation:
Chair II, Institute of Clinical Psychiatry, University of Pisa, Italy
G. B. Cassano*
Affiliation:
Chair II, Institute of Clinical Psychiatry, University of Pisa, Italy
*
via Roma 67, 56100 Pisa, Italy

Abstract

Forty-eight depressed panic-agoraphobic patients - clinically matched for severity of depression with 35 primary chronic depressives - had significantly better adjustment in most areas of social functioning, especially those related to interpersonal contact, work, leisure activities, and sexual life. Even when depressed, panic-agoraphobic patients appear to possess sufficient interpersonal skills - that is, by leaning on significant others - to engage in a range of social activities, both at home and beyond. These data, which are open to different interpretations, nonetheless suggest that anxiety and mood disorders differently affect certain key areas of social adjustment.

Type
Papers
Copyright
Copyright © The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Akiskal, H. S. (1990) Toward a clinical understanding of the relationship of anxiety of depressive disorders. In Comorbidity in Anxiety and Mood Disorders (eds J. Maser & R. Cloninger). Washington, DC: American Psychiatric Press.Google Scholar
Akiskal, H. S. & McKinney, W. T. (1973) Toward a unified hypothesis. Science, 182, 2028.Google Scholar
Akiskal, H. S., Bitar, B. & Puzantian, V. (1978) The nosological status of neurotic depression. Archives of General Psychiatry, 35, 7179.Google Scholar
Akiskal, H. S., Lemmi, H., Dickson, H., et al (1984) Chronic depression: part 2. Sleep EEG differentiation of primary dysthymic disorders from anxious depressions. Journal of Affective Disorders, 6, 287295.Google Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Andrews, G., Stewart, G., Morris-Tates, A., et al (1990) Evidence for a general neurotic syndrome. British Journal of Psychiatry, 157, 612.CrossRefGoogle ScholarPubMed
Angst, J. & Dobler-Mikola, A. (1985) The Zurich Study: a prospective epidemiological study of depressive, neurotic, and psychosomatic syndromes. IV. Recurrent and nonrecurrent brief depression. European Archives of Psychiatry and Neurological Sciences, 234, 408416.Google Scholar
Arrindell, W. A. & Emmelkamp, P. M. G. (1986) Marital adjustment, intimacy and needs in female agoraphobics and their partners: a controlled study. British Journal of Psychiatry, 149, 592602.CrossRefGoogle ScholarPubMed
Bowen, R. & Kohout, J. (1979) The relationship between agoraphobia and primary affective disorders. Canadian Journal of Psychiatry, 24, 317322.Google Scholar
Breier, A., Charney, D. & Heninger, G. (1984) Major depression in patients with agoraphobia and panic disorder. Archives of General Psychiatry, 41, 11291135.Google Scholar
Bronisch, T. & Hecht, H. (1989) Validity of adjustment disorder, comparison with major depression. Journal of Affective Disorders, 17, 229236.Google Scholar
Buglass, D., Clarke, J., Henderson, A. S., et al (1977) A study of agoraphobic housewives. Psychological Medicine, 7, 7386.Google Scholar
Buller, R., Maier, W. & Benkert, O. (1986) Clinical subtypes in panic disorder: their descriptive and prospective validity. Journal of Affective Disorders, 11, 105114.Google Scholar
Bullock, R. C., Siegel, R., Weissman, M., et al (1972) The weeping wife: marital relations of depressed women. Journal of Marriage and Family, 34, 488495.Google Scholar
Cassano, G., Perugi, G. & McNair, D. (1988) Panic disorder: review of empirical and rational basis of pharmacological treatment. Pharmacopsychiatry, 21, 157165.Google Scholar
Cassano, G., Perugi, G., Musetti, L., et al (1989) The nature of depression presenting concomitantly with panic disorder. Comprehensive Psychiatry, 30, 473482.Google Scholar
Cassano, G., Perugi, G., Maremmani, I., et al (1990) Social adjustment in dysthymia. In Dysthmic Disorder (eds Burton, S. W. & Akiskal, H. S.). London: Gaskell, Royal College of Psychiatrists.Google Scholar
Clancy, J., Noyes, R., Hoenk, P., et al (1978) Secondary depression in anxiety neurosis. Journal of Nervous and Mental Disease, 166, 846850.CrossRefGoogle ScholarPubMed
Cloninger, C., Martin, R., Clayton, P., et al (1981) A blind follow-up and family study of anxiety neurosis: preliminary analysis of the St Louis 500. In Anxiety: New Research and Changing Concepts (eds Klein, D. & Rabkin, J.). New York: Raven Press.Google Scholar
Coryell, W., Noyes, R. & Clancy, J. (1983) Panic disorder and primary unipolar depression: a comparison of background and outcome. Journal of Affective Disorders, 5, 311317.Google Scholar
Dealy, R., Ishiki, D., Avery, D., et al (1981) Secondary depression in anxiety disorders. Comprehensive Psychiatry, 22, 612618.CrossRefGoogle ScholarPubMed
DeLisio, G., Maremmani, I., Perugi, G., et al (1986) Impairment of work and leisure in depressed outpatients: a preliminary communication. Journal of Affective Disorders, 10, 7984.Google Scholar
Guy, W. (1976) ECDEU Assessment Manual for Psychopharmacology. Washington, DC: US Department of Health, Education and Welfare.Google Scholar
Hecht, H. & Wittchen, H.-U. (1988) The frequency of social dysfunction in a general population sample and in patients with mental disorders: a comparison using the Social Interview Schedule (SIS). Social Psychiatry, Psychiatrical Epidemiology, 23, 1729.Google Scholar
Hecht, H., von Zerssen, D. & Wittchen, H.-U. (1990) Anxiety and depression in a community sample: the influence of comorbidity on social functioning. Journal of Affective Disorders, 18, 137144.CrossRefGoogle Scholar
Hurry, J. & Sturt, E. (1981) Social performance in a population sample: relation to psychiatric symptoms. In What Is a Case? (eds Wing, J. K., Bebbington, P. & Robbins, L. N.). London: Grant McIntyre.Google Scholar
Klein, D. (1974) Endogenomorphic depressions: toward a terminologic revision. Archives of General Psychiatry, 31, 447454.CrossRefGoogle Scholar
Leckman, J., Weissman, M., Merikangas, K., et al (1983) Panic disorder and major depression. Archives of General Psychiatry, 40, 10551060.Google Scholar
Lesser, I., Rubin, R., Pecknold, J., et al (1988) Secondary depression in panic disorder and agoraphobia. Archives of General Psychiatry, 45, 437443.Google Scholar
Markowitz, J. S., Weissman, M. M., Quellette, R., et al (1989) Quality of life in panic disorder. Archives of General Psychiatry, 46, 984992.Google Scholar
Maser, J. D. & Cloninger, C. R., (eds) (1990) Comorbidity of Mood and Anxiety Disorders. Washington, DC: American Psychiatric Press.Google Scholar
Munjack, D. & Moss, H. (1981) Affective disorder and alcoholism in families of agoraphobics. Archives of General Psychiatry, 38, 869871.CrossRefGoogle ScholarPubMed
Murphy, J. M., Olivier, D. C., Sobol, A. M., et al (1986) Diagnosis and outcome: depression and anxiety in a general population. Psychological Medicine, 16, 117126.CrossRefGoogle ScholarPubMed
Noyes, R. Jr, Reich, J., Christiansen, J., et al (1990) Outcome of panic disorder: relationship to diagnostic subtypes and comorbidity. Archives of General Psychiatry, 47, 809818.CrossRefGoogle ScholarPubMed
Perugi, G., Maremmani, I., Deltito, J., et al (1986) Social adjustment in agoraphobia with panic attacks and major depression. New Trends in Experimental and Clinical Psychiatry, 2, 4551.Google Scholar
Perugi, G., Maremmani, I., McNair, D., et al (1988) Differential changes in areas of social adjustment from depressive episodes through recovery. Journal of Affective Disorders, 15, 3943.Google Scholar
Raskin, M., Peeke, H., Dickmann, W., et al (1982) Panic and generalized anxiety disorders: developmental antecedents and precipitants. Archives of General Psychiatry, 39, 687689.CrossRefGoogle ScholarPubMed
Roth, M. (1990) Categorical and unitary classification of neurotic disorder. Journal of the Royal Society of Medicine, 83, 609614.Google Scholar
Roth, M., Gurney, C., Garside, R., et al (1972) Studies in the classification of affective disorders - the relationship between anxiety states and depressive illnesses. British Journal of Psychiatry, 121, 147161.Google Scholar
Sargant, W. (1962) The treatment of anxiety states and atypical depression by the monoamine oxidase inhibitor drugs. Journal of Neuropsychiatry, 3, 96103.Google Scholar
Sargant, W. & Dally, P. J. (1962) Treatment of anxiety states by antidepressant drugs. British Medical Journal, i, 69.Google Scholar
Schapira, K., Roth, M. & Kerr, T. (1972) The prognosis of affective disorder: the differentiation of anxiety states from depressive illness. British Journal of Psychiatry, 22, 175181.Google Scholar
Schooler, N., Hogarty, G. & Weissman, M. (1979) Social Adjustment Scale II. In Resource Material for Community Mental Health Program Evaluators, publication ADM 79-328 (eds Argreaves, W. A. et al), pp. 290330. Washington, DC: US Department of Health, Education and Welfare.Google Scholar
Sturt, E. (1981) Hierarchical patterns in the distribution of psychiatric symptoms. Psychological Medicine, 11, 783794.Google Scholar
Tyer, P. J. (1990) The division of neurosis: a failed classification. Journal of the Royal Society of Medicine, 83, 614616.CrossRefGoogle Scholar
VanValkenburg, C., Akiskal, H. S., Puzantian, V., et al (1984) Anxious depression: clinical, family history, and naturalistic outcome comparison with panic and major depressive disorders. Journal of Affective Disorders, 6, 6782.Google ScholarPubMed
Vaughn, C. E. & Leff, J. P. (1976) The influence of family and social factors on the course of psychiatric illness: a comparison of schizophrenic and depressed neurotic patients. British Journal of Psychiatry, 129, 125137.Google Scholar
Weissman, M. & Paykel, E. (1974) The Depressed Woman: a Study of Social Relationships. Chicago: University of Chicago Press.Google Scholar
Weissman, M., Leckman, J., Merikangas, K., et al (1984) Depression and anxiety disorders in parents and children: results from the Yale family study. Archives of General Psychiatry, 41, 845852.Google Scholar
West, E. D. & Dally, P. J. (1959) Effects of iproniazid in depressive syndromes. British Medical Journal, i, 14911494.Google Scholar
Young, M. A. & Lewinsohn, P. M. (1980) The functional relation between depression and problematic interpersonal behavior. Journal of Abnormal Psychology, 89, 333341.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.