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Subclasificación de los pacientes con trastorno de angustia con bradicardia

Published online by Cambridge University Press:  12 May 2020

J. Massana
Affiliation:
Hospital Clínic i Provincial de Barcelona, Universitat de Barcelona, Barcelona
J. A. López Risueño
Affiliation:
Hospital Clínic i Provincial de Barcelona, Universitat de Barcelona, Barcelona
G. Masana
Affiliation:
Hospital Clínic i Provincial de Barcelona, Universitat de Barcelona, Barcelona
T. Marcos
Affiliation:
Hospital Clínic i Provincial de Barcelona, Universitat de Barcelona, Barcelona
L. González
Affiliation:
Hospital Clínic i Provincial de Barcelona, Universitat de Barcelona, Barcelona
A. Otero
Affiliation:
Hospital Clínic i Provincial de Barcelona, Universitat de Barcelona, Barcelona
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Resumen

Propósito

Ya que la práctica clínica indica que el trastorno de angustia puede no ser una afección homogénea, se llevó a cabo un estudio para examinar la posible existencia de grupos o subgrupos diferentes de pacientes con angustia.

Sujetos y métodos

Treinta y dos pacientes con trastorno de angustia (DSM-III-R) sufrieron la prueba de provocación con lactato en nuestro laboratorio y fueron evaluados en cuanto a su frecuencia cardíaca, presión arterial, sudación y el Inventario de Angustia Aguda.

Resultados

Durante la provocación con lactato, los pacientes que se quejaban sobre todo de síntomas "cardiorrespiratorios" (N = 12) mostraron taquicardia y sudación localizada. A la inversa, los pacientes que se quejaban sobre todo de síntomas "pseudoneurológicos" (N = 16) mostraron bradicardia y sudación generalizada. En ambos grupos, las puntuaciones del Inventario de Angustia Aguda fueron significativamente más altas durante la crisis de angustia que antes, pero la distribución de las puntuaciones fue notablemente diferente.

Discusión y conclusión

Los resultados indican que el trastorno de pánico puede ser una afección heterogénea. Se debaten las implicaciones de estos resultados para otros trastornos fóbicos, para la teoría de la falsa alarma de asfixia de Klein o para el "modelo de la amígdala ampliada".

Type
Artículo original
Copyright
Copyright © European Psychiatric Association 2001

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