Katschnig4 review the history of neurotic anxiety and panic disorder. Westphal on the reports of the years 1871-1872. To present a third of patients who can not go wrong with themselves. Or, if you walk through the street, it will cause tremendous anxiety over the situation that Westphal's Agro beer float. (Agoraphobia).
In a similar period later in the year is 1871 Da Costa5 reported anxiety, stress, which occurs later in the Journal of the American Journal of Medical Sciences, by the soldiers, one of which had me shaking. Chest pain and dizziness. Occurring after the fight in the Civil War, Da Costa thought that this disorder is caused by psychological and neurological expressed by a sim Hunter did take a lot of work and the variability of heart abnormalities and more. He named this disease as "irritable heart syndrome", which was later called this condition is different from a soldier's heart, effort syndrome, Da Costa's syndrome, and neurocirculatory asthenia (NCA) 5 and so on.
Later in the year 1880 Beard (referred to in Article Katschnig3) has published a book called A Practical Treatise on Nervous Exhaustion (Neurasthenia), and the nervous fatigue. (Neurasthenia) as a disease of civilization of the American people. He assumed that the disease is increasing. It is the civilized way of life was changed. Especially those living in urban and industrialized countries.
In the year 1894 Freud7 separate anxiety neurosis from neurotic fatigue. And the anxiety neurosis as a pathological anxiety. (Pathological anxiety) was a common (generalized) or without knowing the cause, floating back and forth freely. (Free-floating) with chronic And may be associated with for anxiety attack anxiety attack or not it Freud who said he is concerned about your mental consciousness immediately. Without any idea that the first two of Freud's concept of anxiety neurosis were divided into 2 types of chronic (chronic anxiety) and acute (anxiety attack).
Later in the year 1959 West and Dally8 noted that a group of neurotic patients have fear (phobia), and anxiety is severe. To respond to treatment with monoamine oxidase inhibitors (MAOI) MAOI drugs because the drugs are classified as West and Dally, depression, these patients are referred to as "atypical depression".
In the same year Klein has studied the clinical effects of imipramine, a drug that has not been released. The drug was synthesized by changing the structure of the drug. phenothiazine. It is hoped that an effective drug to treat schizophrenia as well as phenothiazine. The study found no effect of treatment of psychiatric patients with schizophrenia. (Schizophrenia), but to make it. Depression in patients with schizophrenia, the better. And when the trials for patients with severe depression was found to be great.
At the time, Klein was educated at Hillside Hospital, with patients, he found that a group of patients with severe anxiety. No ear hear, or any other psychedelic. And are often treated with long-term psychotherapy as an outpatient. The intensity of psychotherapy (intensive psychotherapy) on a patient in it. It does not help to improve symptoms. It is often diagnosed as schizophrenia. This is because the symptoms are severe and have a social life very much. But when the drug chlorpromazine. Patients with these symptoms were worse than ever. Patients are resistant to impact. The side of medicine is not. And finally refused to take the medicine.
Klein has reviewed the history of these patients very well. Until one day while he was living as normal as walking along the street or dining. They are faced with a most startling one. Shake it like a tight uncomfortable symptoms of suffocation. I stood in the areas of unstable or wobbly. And feel that they were going to die. Patients who would have thought that these symptoms are symptoms of heart disease. Or about the vessel in the brain. This enables him to see a doctor. The medical examination did not find any abnormality. Doctors tend to appease patients that symptoms may occur due to something he ingested. Some doctors say is caused by a virus. And tell patients not to worry. After the patient's life as usual. Until several days or several weeks later. He experienced the same symptoms again. Occur instantaneously. This is a group of symptoms that occur all that. Symptoms of panic attacks (panic attack) or as a brief panic. When a new patient to the doctor. Doctors could not detect the fault as well. This time the patient will begin to not trust doctors. Many patients are asking doctors and other specimens for which, of course, that these results will not have the disorder as well. At this point, your doctor may give you the confidence. (Reassurance) to the patient again. It would not exist. Until the cause panic in the third. This time, the patient will believe that. I have a really unusual. But it may be because doctors are not interested in the resolution or not they are good enough.
The patient will have a panic occur again. And symptoms during each session. Patients, which was originally conceived as normal. This time, it turns out that during the panic symptoms each time. He will always have fear, anxiety, tension. Concern that expected in advance that will cause panic again. (Interepisodic anticipatory anxiety) and to avoid situations such as driving a car can not go it alone. The bus can not go alone. Refused to eat the restaurants are crowded. And to call upon any one family member to follow him everywhere. This condition is known as the Four A's in Arabia (agoraphobia) in the Klein referred patients with these symptoms as "phobic anxiety syndrome" by the criteria for diagnosis.
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