ویژگی خلق و خوی در بیماران مبتلا به اختلال پانیک و بستگان درجه اول آنها

Aim Panic disorder is one of the highly heritable anxiety disorders; and temperament characteristics are considered predicting liability to panic disorder. Accumulating evidence suggests temperament characteristics are intermediate phenotypes for clinical conditions. Given this background, we aimed to investigate temperament characteristics in patients with panic disorder, their first-degree relatives, and healthy controls. Method Study sample was consisted 60 patients with panic disorder, 37 first-degree relatives of these patients, and 37 age, gender, and education level matched healthy controls (HC). SCID-I, the Panic Agoraphobia Scale, and the State and Trait Anxiety Inventory were applied to assess clinical characteristics of the patient group. Temperament characteristics were assessed using the Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire (TEMPS-A). Results Anxious, depressive, cyclothymic, and irritable temperament scores of patients were higher than those of HC. There was no difference between the patients and the relatives, with the exception of higher anxious temperament scores in patients. Conclusion Overall, our findings suggest that anxious temperament characteristic might be a trait marker for liability to panic disorder. Further research with a prospective design in a larger sample is required to confirm our findings.

Life time prevalence of panic disorder was reported to be 3–21 times higher in the first degree relatives of patients with panic disorder in comparison to general population [1] and [2]. Twin studies indicate that panic disorder is heritable [3]; there exists an increased genetic liability in patients with early-onset panic disorder [4]. On molecular level, panic disorder was associated with serotonin transporter gene polymorphism, and dysfunctioning in the cholecystokinin system [5], [6] and [7]. However, genetics of panic disorder has a complex and multifactorial nature like many of the other neuropsychiatric disorders. Genetic studies indicate that many genes with small effect sizes play a role in etiopathogenesis of panic disorders, while exposure to several other environmental factors increases susceptibility [8]. A growing body of evidence shows that temperament is a heritable phenomenon [9]. In particular, anxious temperament is characterized as a phenotype of increased psychological and behavioral responses to the emergent stimuli that has been shaped during the early childhood period [10] and [11]. Moreover, research suggests that anxious temperament and anxiety proneness are likely predictors for future panic disorders [12], thereby indicating that particular temperamental features are sub-threshold forms of clinical conditions. Studies showing an increased risk, particularly for anxiety disorders, depression and comorbid substance use disorders in children with anxious temperament [13], and an association between anxious temperament and serotonin transporter gene further support this notion [14]. In the light of the current evidence, we aimed to investigate the temperamental characteristics of patients with panic disorder, and their first generation relatives. We think that temperamental characteristics are essential elements to understand the heritability of panic disorder, and therefore we hypothesized anxious temperamental characteristics would be comparable in patients with panic disorder, and in their first generation relatives, but less prominent in the control group.