| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
SPECIAL ISSUE: COMORBIDITY STUDIES |
From the Departments of Psychiatry (F.G., B.A., R.B., C.G., M.L.) and Cardiology (S.B., F.L.), Free University of Berlin, Berlin, Germany.
Address reprint request to: Dr. Frank Godemann, Hindenburgdamm 30, 12200 Berlin, Germany. Email: godemann{at}zedat fu-berlin.de
OBJECTIVE: A model for the development of anxiety disorders (panic disorder with or without agoraphobia) is needed. Patients with an implantable cardioverter/defibrillator (ICD) are exposed to repeated electric shocks. If the theory of anxiety development by aversive classic conditioning processes is valid, these repeated shocks should lead to an increased risk of anxiety disorders. To study this hypothesis, we retrospectively studied 72 patients after implantation of an automatic ICD.
METHODS: Patients were assessed with the semistructured Diagnostic Interview of Psychiatric Disease 1 to 6 years after implantation of an automatic ICD. Panic disorder and/or agoraphobia was diagnosed in patients who fulfilled all DSM-III-R criteria for those conditions.
RESULTS: Anxiety disorder developed in 15.9% of patients after ICD implantation. This was significantly related to the frequency of repeated defibrillation (shocks) to stop malignant ventricular arrhythmias. Dysfunctional cognitions are an additional vulnerability factor.
CONCLUSIONS: The data support both the conditioning hypothesis and the cognitive model of anxiety development. These findings suggest that ICD patients are an appropriate risk population for a prospective study of the development of anxiety disorders.
Key Words: implantable cardioverter/defibrillator • panic disorder • agoraphobia.
Abbreviations: DIPS = Diagnostic Interview of Psychiatric Disease; DSM-III-R = Diagnostic and Statistical Manual of Mental Disorders, third edition revised; ICD = implantable cardioverter/defibrillator; PTSD = posttraumatic stress disorder; SAD = subthreshold anxiety disorder; SCL-90-R = revised Symptom Checklist 90.
This article has been cited by other articles:
 |
|
 |
|
  R. Tung, P. Zimetbaum, and M. E. Josephson A Critical Appraisal of Implantable Cardioverter-Defibrillator Therapy for the Prevention of Sudden Cardiac Death J. Am. Coll. Cardiol., September 30, 2008; 52(14): 1111 - 1121. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Esler, M. Alvarenga, C. Pier, J. Richards, A. El-Osta, D. Barton, D. Haikerwal, D. Kaye, M. Schlaich, L. Guo, et al. The neuronal noradrenaline transporter, anxiety and cardiovascular disease. J Psychopharmacol, July 1, 2006; 20(4 Suppl): 60 - 66. [Abstract] [PDF]
|
|
|
|
 |
|
 M. E. Alvarenga, J. C. Richards, G. Lambert, and M. D. Esler Psychophysiological Mechanisms in Panic Disorder: A Correlative Analysis of Noradrenaline Spillover, Neuronal Noradrenaline Reuptake, Power Spectral Analysis of Heart Rate Variability, and Psychological Variables Psychosom Med, January 1, 2006; 68(1): 8 - 16. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. K. Schulman, P. R. Muskin, and P. A. Shapiro Psychiatry and Cardiovascular Disease Focus, April 1, 2005; 3(2): 208 - 224. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K.-H. Ladwig, B. Marten-Mittag, I. Deisenhofer, B. Hofmann, J. Schapperer, S. Weyerbrock, and C. Schmitt Exaggerated Electrodermal Startle Responses After Intracardiac Shock Discharges in Patients With Implanted Cardioverter Defibrillators Psychosom Med, March 1, 2003; 65(2): 222 - 228. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. E. Dimsdale Comorbidity Studies: A Core Area for Psychosomatic Research Psychosom Med, March 1, 2001; 63(2): 201 - 202. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
