Research Team Proposes New Spectrum Syndrome


As though the world weren't already complicated enough, researchers have established yet another spectrum syndrome.

Jeremy D. Coplan, MD, professor of psychiatry at SUNY Downstate Medical Center, and colleagues reported in the Journal of Neuropsychiatry and Clinical Neurosciences a high rate of association between panic disorder and four domains of physical illness. This research could alter how physicians and psychiatrists view the boundaries within and between psychiatric and medical disorders.

"Patients who appear to have certain somatic disorders - illnesses for which there is no detectable medical cause and which physicians may consider to be imagined by the patient," says Dr. Coplan, "may instead have a genetic propensity to develop a series of real, related illnesses."

They uncovered a correlation between panic disorder, bipolar disorder, and physical illness, with a much higher prevalence of some physical illnesses among patients with panic disorder when set against the general population.

This research team therefore proposed a spectrum syndrome comprising a core anxiety disorder and four related domains, for which they have coined the term ALPIM:

  • A = Anxiety disorder (mostly panic disorder);
  • L = Ligamentous laxity (joint hypermobility syndrome, scoliosis, double-jointedness, mitral valve prolapse, easy bruising);
  • P = Pain (fibromyalgia, migraine and chronic daily headache, irritable bowel syndrome, prostatitis/cystitis);
  • I = Immune disorders (hypothyroidism, asthma, nasal allergies, chronic fatigue syndrome)
  • M = Mood disorders (major depression, Bipolar II and Bipolar III disorder, tachyphylaxis. Two thirds of patients in the study with mood disorder had diagnosable bipolar disorder and most of those patients had lost response to antidepressants).

"Panic disorder itself may be a predictor for a number of physical conditions previously considered unrelated to mental conditions, and for which there may be no or few biological markers," adds Coplan.

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