Panic disorder linked to difficulty expressing emotions
June 3, 2008

In patients with panic disorder (PD), difficulty in identifying and managing emotional experience might contribute to the enduring vulnerability to panic attacks according to a study by University of Naples researchers published in the journal Psychotherapy and Psychosomatics.

The study was designed to test the hypothesis that panic disorder patients show a higher prevalence of alexithymia stimuli processing and poorer performance on neuropsychological tests exploring the activity of fronto-temporo-limbic circuits.

Alexithymia, general cognitive abilities, focused and sustained attention, working memory, secondary memory, incidental learning, susceptibility to interference from both cognitive and emotional stimuli, and ability to recognize facial emotional expressions were assessed in 32 drug-free patients with panic disorder and 32 controls.

Alexithymia was more frequent in patients with panic disorder than in the control group. The patients with panic disorder had lower verbal cognitive abilities and more difficulty to inhibit interference from nonverbal stimuli and from panic-related words; they performed better than the controls on the test assessing spatial incidental learning. Anxiety, panic symptomatology and verbal cognitive abilities were associated with alexithymia.

The findings are compatible with a dysfunction of fronto-limbic circuits, in particular orbitofrontal and cingulate cortices. A reduction in verbal cognitive abilities was also observed, which might suggest reduced abstraction and symbolization in these patients.

Source: Galderisi S, Mancuso F, Mucci A, et al. Alexithymia and Cognitive Dysfunctions in Patients with Panic Disorder. Psychother Psychosom. 2008;77(3):182-8. [Abstract]