Abnormal Insula Network Characteristics in Panic Disorder.

BACKGROUND: Panic disorder (PD) is a common disabling condition characterized by recurrent panic attacks. Emotional and behavioral impairments are associated with functional connectivity (FC) and network abnormalities. We used the whole brain FC, modular networks, and graph-theory analysis to investigate extensive network profiles in PD. METHOD: The functional MRI data from 82 PD and 97 controls were included. Intrinsic FC between each pair of 160 regions, 6 intra-networks, and 15 inter-networks were analyzed. The topological properties were explored. RESULTS: PD patients showed altered FCs within the right insula, between frontal cortex-posterior cingulate cortex (PCC), frontal cortex-cerebellum, and PCC-occipital cortex (corrected P values < 0.001). Lower connections within the Sensorimotor Network (SMN) and SMN-Occipital Network (OCN) were detected (P values < 0.05). Various decreased global and local network features were found in PD (P values < 0.05). In addition, significant correlations were found between PD symptoms and nodal efficiency (Ne) in the insula (r = -0.273, P = 0.016), and the FC of the intra-insula (r = -0.226, P = 0.041). CONCLUSIONS: PD patients present with abnormal functional brain networks, especially the decreased FC and Ne within insula, suggesting that dysfunction of information integration plays an important role in PD.

Panicolytic-like effects of environment enrichment on male mice threatened by Bothrops jararaca lancehead pit vipers.

Environment enrichment (EE) is a well-known eustress model showing beneficial effects in different psychiatric diseases, but its positive properties in panic disorders are not yet established. The confrontation between prey and predator in complex arenas has been validated as a putative panic attack model. The principal aim of this work was to investigate the role of the EE on panic-like defensive responses elicited by mice threatened by venomous snakes. After 6 weeks of exposure either to an enriched or standard environments, 36 male mice were habituated in a complex polygonal arena for snakes containing an artificial burrow and elevated platforms for escape. The animals were confronted by Bothrops jararaca for 5 min, and the following antipredatory responses were recorded: defensive attention, stretched attend posture, flat back approach, prey versus predator interaction, oriented escape behavior, time spent in a safe place, and number of crossings. Mice threatened by snakes displayed several antipredatory reactions as compared to the exploratory behavior of those animals submitted to a nonthreatening situation (toy snake) in the same environment. Notably, EE causes anxiolytic- and panicolytic-like effects significantly decreasing the defensive attention and time spent in safe places and significantly increasing both prey versus predator interaction and exploratory behavior. In conclusion, our data demonstrate that EE can alter the processing of fear modulation regarding both anxiety- and panic-like responses in a dangerous condition, significantly modifying the decision-making defensive strategy.

Bradykinin actions in the central nervous system: historical overview and psychiatric implications.

Bradykinin (BK), a well-studied mediator of physiological and pathological processes in the peripheral system, has garnered less attention regarding its function in the central nervous system, particularly in behavioural regulation. This review delves into the historical progression of research focused on the behavioural effects of BK and other drugs that act via similar mechanisms to provide new insights into the pathophysiology and pharmacotherapy of psychiatric disorders. Evidence from experiments with animal models indicates that BK modulates defensive reactions associated with panic symptoms and the response to acute stressors. The mechanisms are not entirely understood but point to complex interactions with other neurotransmitter systems, such as opioids, and intracellular signalling cascades. By addressing the existing research gaps in this field, we present new proposals for future research endeavours to foster a new era of investigation regarding BK's role in emotional regulation. Implications for psychiatry, chiefly for panic and depressive disorders are also discussed.

Prediction of declarative memory profile in panic disorder patients: a machine learning-based approach

Objective: To develop a classification framework based on random forest (RF) modeling to outline the declarative memory profile of patients with panic disorder (PD) compared to a healthy control sample. Methods: We developed RF models to classify the declarative memory profile of PD patients in comparison to a healthy control sample using the Rey Auditory Verbal Learning Test (RAVLT). For this study, a total of 299 patients with PD living in the city of Rio de Janeiro (70.9% females, age 39.9 ± 7.3 years old) were recruited through clinician referrals or self/family referrals. Results: Our RF models successfully predicted declarative memory profiles in patients with PD based on RAVLT scores (lowest area under the curve [AUC] of 0.979, for classification; highest root mean squared percentage [RMSPE] of 17.2%, for regression) using relatively bias-free clinical data, such as sex, age, and body mass index (BMI). Conclusions: Our findings also suggested that BMI, used as a proxy for diet and exercises habits, plays an important role in declarative memory. Our framework can be extended and used as a prospective tool to classify and examine associations between clinical features and declarative memory in PD patients.

Avoidant restrictive eating disorder and panic attacks in an adult man: A case report / Trastorno evitativo restrictivo de la ingesta alimentaria y ataques de pánico en un hombre adulto: Reporte de caso

Abstract Avoidant or Restrictive Food Intake Disorder (ARFID) is an eating disorder (ED) not common in adults. In this article we present a clinical case of ARFID in a 37-year-old male patient treated in an ED center in Medellin, Colombia; displaying anxious symptoms that began a year earlier and concomitant weight loss, following a traumatic event causing an overall impairment with that patient. Several medical evaluations/examinations looking for organic causes, were excluded. Interventions were implemented by a psychiatry, a psychotherapist using cognitive-behavior therapy (CBT), and a nutritionist, all in face-to-face modality, which were carried out weekly for the first three months, then biweekly and subsequently quarterly. each lasting approximately 40-60 minutes. After the set of pharmacological interventions and psychotherapy, a great improvement in the functionality of the patient was observed. Improvement was found with respect to eating in public, food variation and panic attacks. In the absence of guidelines, it is important to use standardized and replicable treatments in this population.

Resumen El trastorno evitativo restrictivo de la ingesta (TERIA) es un trastorno alimentario (TCA) raro en adultos. Se presenta el caso de un hombre de 37 años con TERIA y trastorno de pánico atendido en un centro para TCA en Medellín, Colombia, quien presentó un año de síntomas ansiosos y pérdida de peso después de evento traumático, generando disfuncionalidad. Fue evaluada y excluida organicidad. Se realizaron intervenciones por parte de psiquiatría, psicoterapia con enfoque cognitivo conductual y nutrición, todas en modalidad presencial, las cuales se realizaron semanalmente los primeros tres meses, luego quincenalmente y posteriormente trimestralmente. Cada una con una duración de 40-60 minutos aproximadamente por sesión. Posterior al conjunto de intervenciones farmacológicas y psicoterapia, se observó una gran mejoría la funcionalidad del paciente, se encontró mejoría con respecto a comer en público, variación en los alimentos y ataques de panico. Ante la ausencia de guías de manejo de TERIA en adultos es relevante realizar tratamientos estandarizados que puedan ser replicados.

Prediction of declarative memory profile in panic disorder patients: a machine learning-based approach.

OBJECTIVE: To develop a classification framework based on random forest (RF) modeling to outline the declarative memory profile of patients with panic disorder (PD) compared to a healthy control sample. METHODS: We developed RF models to classify the declarative memory profile of PD patients in comparison to a healthy control sample using the Rey Auditory Verbal Learning Test (RAVLT). For this study, a total of 299 patients with PD living in the city of Rio de Janeiro (70.9% females, age 39.9 ± 7.3 years old) were recruited through clinician referrals or self/family referrals. RESULTS: Our RF models successfully predicted declarative memory profiles in patients with PD based on RAVLT scores (lowest area under the curve [AUC] of 0.979, for classification; highest root mean squared percentage [RMSPE] of 17.2%, for regression) using relatively bias-free clinical data, such as sex, age, and body mass index (BMI). CONCLUSIONS: Our findings also suggested that BMI, used as a proxy for diet and exercises habits, plays an important role in declarative memory. Our framework can be extended and used as a prospective tool to classify and examine associations between clinical features and declarative memory in PD patients.

Sex and estrous cycle-linked differences in the effect of cannabidiol on panic-like responding in rats and mice.

Clinical and preclinical studies point towards anxiolytic actions of cannabidiol (CBD), but its effect in panic disorder has been less explored and few studies consider effects in females. We here compared the effect of CBD on the response of male and female rats and mice to a panicogenic challenge; exposure to low O2 (rats) or high CO2 (mice) paying attention in females to possible effects of estrous cycle phase. Male and female Sprague-Dawley rats and C57BL/6 J mice were exposed to 7% O2 for 5 min (rats) or 20% CO2 (mice) and escape behaviour, which has been associated with panic attacks, was quantified as undirected jumps towards the gas chamber's ceiling. The effect of pretreatment with CBD (1-10 mg kg-1 i.p. in rats or 10-60 mg kg-1 i.p. in mice) was tested. The results showed that low O2 (rats) or high CO2 (mice) evoked escape in both sexes. In female rats the response was estrous cycle-sensitive: females in late diestrus made significantly more jumps than females in proestrus. In female mice escape was not influenced by estrous cycle phase and CBD was panicolytic. In female rats CBD attenuated escape behaviour in late diestrus phase but not in proestrus. In male rats and mice CBD had no effect on escape behaviour. Therefore, CBD is panicolytic in female rats and mice but not in males. In rats the effect is estrous cycle-sensitive: rats were most responsive to CBD in late diestrus. In mice higher doses were required to elicit effects and estrous cycle had no effect.

The personality puzzle: a comprehensive analysis of its impact on three buying behaviors.

This study aimed at examining the role of personality traits in impulsive buying, compulsive buying, and panic buying simultaneously during the COVID-19 pandemic. At the beginning of the third confinement announced by the Portuguese government, 485 Portuguese answered in this study, mean age of 41.9 years (min = 18, max = 84; SD = 12.9), and 29.9% were men. Analyzes were carried out to investigate the association of Big Five's personality factors with impulsive buying, compulsive buying, and panic buying. Results showed that the three buying behaviors under study have significant and positive correlations between them, and they also correlate with different personality traits. The association of each Big Five factor on buying behaviors differed. While conscientiousness was negatively and openness was positively associated with impulsive buying, conscientiousness was negatively associated with compulsive buying, agreeableness was positively associated with panic buying, and neuroticism correlated positively with all consumer behaviors. Understanding the personality traits that contribute to the development of a disorder may provide valuable insight into preventive measures and effective treatment approaches for some debilitating disorders. This study opens ways for investigating impulsive buying and compulsive buying by relating them to panic buying. It discusses the three different buying behaviors during the COVID-19 pandemic and future consumer research directions involving other variables.

Deep brain stimulation of the dorsal raphe induces anxiolytic and panicolytic-like effects and alters serotonin immunoreactivity.

Previously we showed that Deep Brain Stimulation (DBS) of the dorsal region (DRD) and of the lateral wings of the dorsal raphe (lwDR) respectively decreases anxiety and panic-like responses in the elevated T-maze (ETM). This study investigates neurobiological alterations which might respond for these behavioral effects. Male Wistar rats were submitted to high-frequency stimulation (100 µA, 100 Hz) of the DRD or of the lwDR for 1 h, and subsequently tested in the avoidance or escape tasks of the ETM. Since serotonin (5-HT) reuptake inhibitors are first line pharmacological treatment for anxiety disorders, we also tested the effects of chronic fluoxetine administration (10 mg/kg, IP, 21 days) on a separate group of rats. An open field was used for locomotor activity assessment. Additionally, we evaluated c-Fos immunoreactivity (Fos-ir) in serotonergic cells of the dorsal raphe (DR). Results showed that DBS of the DRD decreases avoidance reactions, an anxiolytic-like effect, without altering escape or locomotor activity. Both fluoxetine and DBS of the lwDR decreased escape responses in the ETM, a panicolytic-like effect, without altering avoidance measurements or locomotor activity. While DBS of the DRD decreased double immunostaining in the DRD, DBS of the lwDR increased Fos-ir and double immunostaining in the DRD and lwDR. Fluoxetine also increased double immunostaining in the lwDR and in the DRV but decreased it in the DRD. These results suggest that both the anxiolytic and panicolytic-like effects of DBS and fluoxetine are related to 5-HT modulation in different subnuclei of the DR.

Defensive and Emotional Behavior Modulation by Serotonin in the Periaqueductal Gray.

Serotonin 5-hydroxytryptamine (5-HT) is a key neurotransmitter for the modulation and/or regulation of numerous physiological processes and psychiatric disorders (e.g., behaviors related to anxiety, pain, aggressiveness, etc.). The periaqueductal gray matter (PAG) is considered an integrating center for active and passive defensive behaviors, and electrical stimulation of this area has been shown to evoke behavioral responses of panic, fight-flight, freezing, among others. The serotonergic activity in PAG is influenced by the activation of other brain areas such as the medial hypothalamus, paraventricular nucleus of the hypothalamus, amygdala, dorsal raphe nucleus, and ventrolateral orbital cortex. In addition, activation of other receptors within PAG (i.e., CB1, Oxytocin, µ-opioid receptor (MOR), and γ-aminobutyric acid (GABAA)) promotes serotonin release. Therefore, this review aims to document evidence suggesting that the PAG-evoked behavioral responses of anxiety, panic, fear, analgesia, and aggression are influenced by the activation of 5-HT1A and 5-HT2A/C receptors and their participation in the treatment of various mental disorders.

Muito além do trauma: uma investigação sobre o papel das reações peritraumáticas sobre o transtorno de estresse pós-traumático / Beyond the trauma: an investigation of the role of peritraumatic reactions on posttraumatic stress disorder

O Transtorno de Estresse Pós-Traumático (TEPT) é uma condição debilitante que impacta significativamente a qualidade de vida dos seus portadores. Dentre vários fatores de risco para o TEPT, as reações peritraumáticas (RP), como a imobilidade tônica peritraumática (ITP), dissociação (DP) e reações físicas de pânico (RFP), estão entre as mais investigadas. No entanto, a maioria dos estudos avaliou essas RP separadamente, e o elo entre elas e o TEPT ainda não foi bem compreendido. Portanto, essa tese teve como objetivos: (i) estimar simultaneamente o efeito das três RP sobre o TEPT utilizando um instrumento validado; e (ii) avaliar se há efeito indireto da ITP sobre o TEPT mediado pelo sentimento de culpa/vergonha. Utilizamos modelagem de equações estruturais para analisar dados de 3211 participantes do Rio de Janeiro e de São Paulo. Tratamos as RP como variáveis latentes, selecionando desconfundidores específicos para cada reação. Nossas exposições foram as RP, sendo TEPT o desfecho. Calculamos odds ratios e intervalos de confiança de 95%. Utilizamos o Bayesian Information Criterion para comparar o ajuste de modelos não aninhados. Quando analisadas separadamente, todas as RP alcançaram significância estatística. No entanto, apenas DP (ORDP=1,8; IC95%:1,3-2,4) e RFP (ORRFP=2,5; IC95%:1,8-3,4) permaneceram estatisticamente significativas quando incluímos as três reações em um modelo com seus respectivos desconfundidores e correlações entre elas. Os resultados sugeriram um possível efeito da ITP sobre o TEPT (ORITP=1,4; IC95%:1,0-1,9). As interações entre as RP não foram estatisticamente significativas. Ao investigarmos o sentimento de culpa/vergonha como mediador entre ITP e TEPT, o efeito indireto alcançou apenas significância estatística limítrofe (ORITP(TNIE)=1,1; IC95%:1,0-1,2). Os efeitos direto (ORITP(PNDE)=1,3; IC95%: 0,8-1,8) e total (ORITP(TE)=1,4; IC95%:0,9-1,9) para ITP perderam significância quando todas as RP, seus desconfundidores e correlações entre elas fizeram parte do mesmo modelo. As demais RP, no entanto, permaneceram estatisticamente significativas (ORDP=1,7; IC95%:1,3-2,3 e ORRFP=2,5; IC95%:1,8-3,4). Nossos resultados mostraram que a DP e as RFP aumentaram o risco de TEPT mesmo quando consideradas em conjunto. A ITP pode ter efeito sobre o risco de TEPT, mas esse achado deve ser interpretado com cautela devido a significância limítrofe dessa RP em nosso modelo final. Também não identificamos uma mediação significativa entre ITP e TEPT pelos sentimentos de culpa/vergonha. Contudo, a significância limítrofe encontrada para o efeito indireto demanda investigações adicionais. Nossos achados reforçam a ideia de que as reações peritraumáticas devem ser analisadas e compreendidas como ocorrências simultâneas. Também seria oportuno que estudos envolvendo culpa/vergonha, ITP e TEPT focalizassem traumas caracterizados por aprisionamento e impossibilidade de escapar, dado que estas experiências são apontadas como mais susceptíveis para desencadear a ITP. (AU)

Posttraumatic stress disorder (PTSD) is a debilitating condition that greatly impacts quality of life. Among several PTSD risk factors, peritraumatic reactions (PR) such as peritraumatic tonic immobility (PTI), dissociation (PD) and physical panic reactions (PPR) are some of the most investigated. However, several studies have assessed these PR separately, and the pathway connecting them to PTSD is not well understood. Therefore, this thesis aimed to: (i) simultaneously estimate the effect of the three PR on PTSD using a validated instrument; and (ii) assess if there is an indirect effect of PTI on PTSD mediated by feelings of guilt/shame. We used structural equation modelling to analyse data from 3211 participants from Rio de Janeiro and São Paulo. We treated the PR as latent variables and selected specific confounders for each reaction. Our exposures were the PR, and PTSD was the outcome. We calculated odds ratios and 95% confidence intervals for each analysis. We also employed the Bayesian Information Criterion to compare the goodness of fit between non-nested models. Separately, all PR achieved statistically significant results. However, only PD (ORPD=1.8; 95%CI:1.3-2.4) and PPR (ORPPR=2.5; 95%CI:1.8-3.4) remained statistically significant when all three were included in a model with their respective confounders and correlations among all PR. Our findings suggested a possible effect of PTI on PTSD (ORPTI=1.4; 95%CI:1.0-1.9). Interactions between the PR were not statistically significant. When we investigated feelings of guilt/shame as the mediator between PTI and PTSD, the indirect effect achieved a borderline statistical significance (ORPTI(TNIE)=1.1; 95%CI:1.0-1.2). Direct (ORPTI(PNDE)=1.3; 95%CI:0.8-1.8) and total (ORPTI(TE)=1.4; 95%CI:0.9-1.9) effects lost their significance when all PR, their confounders and correlations were included in the same model. The other PR remained statistically significant (ORPD=1.7; 95%CI:1.3-2.3 and ORPPR=2.5; 95%CI:1.8-3.4). Our findings showed PD and PPR to increase the risk of PTSD even when considered in tandem. PTI could have an effect on PTSD, but this must be considered cautiously, as this PR only reached borderline significance in our final model. Feelings of guilt/shame did not significantly mediate PTI's effect on PTSD. However, a borderline statistical significance in the indirect effects warrants further investigation. Our findings reinforce the hypothesis that peritraumatic reactions should be analysed and understood as simultaneous occurrences, not as separate entities. It would also be appropriate for studies concerning guilt/shame, PTI and PTSD to focus on traumas characterized by imprisonment and feelings of inescapability, given that these experiences are allegedly more likely to trigger PTI. (AU)

Mutually exclusive disorder-dependent hearing discomfort in first-episode psychosis and panic disorder: two experiments using the same auditory stimulus set and two similar musical sequences.

We investigated the level of hearing tolerance in patients with first-episode psychosis (FEP) and panic disorder (PD) as compared to two different groups of healthy controls (HC, HC2), one for each experiment, because we used two distinct psychophysical paradigms. We evaluated auditory discomfort of 28 volunteers (14 with FEP and 14 HC) in the first study and of 42 volunteers (21 with PD and 21 HC2) in the second study. We presented 20 sounds: 16 pure-tone frequency sweeps (specially designed for use with FEP) and 11 s or 13 s musical sequences from the very beginning of the music "Play the Game" (PLAY) from Queen and its reverses. The first procedure used a Likert-like 0-10 scale ranging from "nothing bad" to "too bad" where volunteers made vertical marks along a horizontal line according to their discomfort. The second procedure involved subjective magnitude estimation online due to the SARS-COV-19 pandemic. Sounds were placed online and played by PD and HC2 volunteers themselves after having listened to the standard (the first 8 s from RADIO, "Radio Ga Ga" by Queen). Then, PD and HC2 volunteers were asked to assign values equal to, or multiples of 10 that felt like, or proportional to, their hearing "discomfort" in comparison with Sound 00 (RADIO). Our findings showed that FEP volunteers assign more discomfort to the 16 specially designed frequency sweep stimuli that appear not to affect HC, HC2, and PD. On the other hand, musical sequences from PLAY caused strong discomfort to PD in the reverse mode, but did not seem to affect HC, HC2, and FEP. Further experiments using the exact same paradigm with FEP and PD are needed to explore these findings.

Evidence from Cochrane systematic reviews on pharmacological treatment compared to placebo for panic disorder / Evidências das revisões sistemáticas cochrane sobre o tratamento farmacológico comparado ao placebo para transtorno de pânico

ABSTRACT. Panic disorder is an anxiety condition characterized by recurrent and unexpected panic attacks. The comparison between active treatment and placebo is essential to analyze an intervention's efficacy and safety. It is important to identify and summarize the studies with higher evidence to assist health professionals and public policy managers in clinical decision-making. Objective: The aim of this study was to identify and summarize all Cochrane systematic reviews (SRs) that compared the efficacy and safety of any drug treatment compared to placebo for panic disorder patients. Methods: SRs published in the Cochrane Library were included without date restriction. All outcomes presented were analyzed. The methodological quality of the SRs was evaluated using the AMSTAR-2 tool. Results: We included three Cochrane SRs of high methodological quality on the effects of antidepressants, benzodiazepines, and azapirones for panic disorder. All medications showed benefits in response to treatment, symptom improvement, and reduced panic attacks. Dropouts were lower with tricyclic antidepressants and benzodiazepines and higher with azapirones. The occurrence of adverse events was higher for drug groups. Conclusions: Very low to moderate certainty evidence (GRADE) showed that antidepressants and benzodiazepines seem to improve clinical symptoms in individuals with short-term panic disorder compared to placebo. In addition, the use of azapirones seems to have greater adherence by patients than placebo. However, there is insufficient evidence to support its clinical efficacy.

RESUMO. O transtorno de pânico é uma condição de ansiedade caracterizada por ataques de pânico recorrentes e inesperados. A comparação entre tratamento ativo e placebo é essencial para analisar a eficácia e a segurança de uma intervenção. É importante identificar os estudos com maiores evidências para auxiliar os profissionais de saúde e gestores de políticas públicas nas decisões clínicas. Objetivo: Identificar e sumarizar todas as revisões sistemáticas (RS) publicadas na Cochrane que relatam a eficácia e a segurança de qualquer tratamento medicamentoso comparado ao placebo para pacientes com transtorno de pânico. Métodos: Foram selecionadas e analisadas todas as RS publicadas na base de dados Cochrane, sem restrição de data. A qualidade metodológica das RS foi avaliada utilizando a ferramenta AMSTAR-2. Resultados: Foram incluídas três RS Cochrane com alta qualidade metodológica que avaliaram os efeitos de antidepressivos, benzodiazepínicos e azapironas para transtorno de pânico. Todos os medicamentos mostraram benefícios na resposta ao tratamento, melhora dos sintomas e redução das crises de pânico. O número de desistências do tratamento foi baixo com antidepressivos tricíclicos e benzodiazepínicos e alto com azapironas. A ocorrência de eventos adversos foi elevada para os grupos das medicações analisadas Conclusões: Evidências de certeza muito baixa a moderada (pela Classificação de Recomendações, Avaliação, Desenvolvimento e Análises - GRADE) mostraram que antidepressivos e benzodiazepínicos parecem melhorar os sintomas clínicos em indivíduos com transtorno de pânico em menor prazo, em comparação ao placebo. Além disso, o uso de azapironas parece ter maior adesão por parte dos pacientes do que o placebo. No entanto, não há evidências suficientes para comprovar sua eficácia clínica.

Moral Panics, Viral Subjects: Black Women's Bodies on the Line during Cuba's 2020 Pandemic Lockdowns.

While Cuba was in a COVID-19-induced lockdown, coleras, women who wait in hours-long colas (lines) to purchase scarce goods to resell, emerged in online state media as "folk devils" responsible for the acute shortages of basic goods. Using an intersection lens, we combine fieldwork in lines and content analysis of online media to examine the creation and policing of the colera threat during the summer of 2020. Coleras were framed as immoral subjects, gendered and racialized, and often depicted as a virus that threatened the nation's health. The colera moral panic attempted to obscure class, race, and gender inequalities and structures that have made certain citizens vulnerable in the aftermath of successive waves of Cuban economic reforms. Understanding this moral panic allows us to appreciate the material scarcities and indignities to which poor Black women have been subjected, and widespread concerns about the state's failure to protect society's most vulnerable.

Durante el encierro inducido por el COVID­19 en Cuba, las coleras, mujeres que esperan horas en colas (filas) para comprar bienes escasos para revenderlos, surgieron en los medios estatales en línea como "diablas populares", responsables de la aguda escasez de bienes básicos. Usando una lente interseccional, combinamos trabajo de campo en líneas y análisis de contenido de medios en línea para examinar la creación y vigilancia de la amenaza colera durante el verano de 2020. Las coleras fueron enmarcadas como sujetas inmorales, generizadas y racializadas, y a menudo representadas como un virus que amenazaba la salud de la nación. El pánico moral sobre la colera intentó oscurecer la clase, la raza y las desigualdades y estructuras de género que han hecho vulnerables a determinados ciudadanos tras las sucesivas oleadas de reformas económicas en Cuba. Entender este pánico moral nos permite apreciar las carencias materiales y las indignidades a las que las mujeres pobres negras han sido sometidas, así como las preocupaciones generalizadas sobre la falta de protección del Estado hacia los más vulnerables de la sociedad.

Psychological and Psychiatric Events Following Immunization with Five Different Vaccines against SARS-CoV-2.

BACKGROUND: Despite the high number of vaccines administered against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) worldwide, the information on the psychological/psychiatric adverse events following immunization (AEFI) with these newly developed vaccines remains scarce. OBJECTIVE: To describe the frequency of psychological/psychiatric symptoms among recipients of five different anti-SARS-CoV-2 vaccines and to explore the factors associated with their development reported in the nationwide Mexican registry of AEFI against SARS-CoV-2. METHODS: Descriptive study of all the psychological/psychiatric symptoms, including anxiety, panic attacks, insomnia, and agitation reported to the Mexican Epidemiological Surveillance System from 21 December 2020 to 27 April 2021, among adult (≥18 years old) recipients of 7,812,845 doses of BNT162b2, ChAdOx1 nCov-19, rAd26-rAd5, Ad5-nCoV, or CoronaVac. The factors associated with their development are determined by multivariate regression analysis. RESULTS: There were 19,163 AEFI reports during the study period; amongst them, 191 (1%) patients had psychological/psychiatric symptoms (median age of 41 years, interquartile range of 32-54; 149 [78%] women) for an observed incidence of 2.44 cases per 100,000 administered doses (95% confidence interval [CI] 2.12-2.82), 72.8% of psychiatric AEFIs were reported among recipients of BNT162b2. The median time from vaccination to symptom onset was 35 min (interquartile range: 10-720). Overall, the most common psychological/psychiatric symptoms were anxiety in 129 (67.5%) patients, panic attacks in 30 (15.7%), insomnia in 25 (13%), and agitation in 11 (5.7%). After adjusting for the confounding factors, the odds for developing psychological/psychiatric symptoms were higher for those concurrently reporting syncope (odds ratio [OR]: 4.73, 95% CI: 1.68-13.33); palpitations (OR: 2.47, 95% CI: 1.65-3.70), and dizziness (OR: 1.59, 95% CI: 1.10-2.28). CONCLUSION: In our population, psychological/psychiatric symptoms were extremely infrequent AEFIs. No severe psychiatric AEFIs were reported. Immunization stress-related responses might explain most of the detected cases.

Neonatal maternal deprivation facilitates the expression of a panic-like escape behavior in adult rats.

A wealth of evidence associates disruptions of the parent-infant relationship (e.g. childhood parental loss or parental neglect) with the later appearance of panic disorder. In rodents, neonatal maternal separation and maternal deprivation (MD) are reported to increase the expression of anxiety-related defensive responses in adult animals. However, little is known about the long-term consequences of these early-life stressors in animal models of panic. We here investigated the effects of a single 24 h-episode of MD on post-natal day 11 (PND 11) in adult male Wistar rats submitted to two animal models that associate escape expression with panic attacks: the elevated T-maze and exposure to severe hypoxia (7% O2). We also investigated the involvement of serotonin (5-HT) in the observed changes. Although neonatal MD did not affect the behavioral responses measured in the elevated T-maze, it facilitated the expression of escape during hypoxia exposure, indicating a panicogenic-like effect. Pre-test administration of the 5-HT synthesis inhibitor, para-chlorophenylalanine (PCPA; 4 daily injections of 100 mg/kg) facilitated escape attempts in non-deprived animals during the hypoxia challenge, but did not interfere with the expression of this behavior in maternally-deprived rats. The levels of 5-HT1A receptors in key panic- and anxiety-associated areas, the dorsal periaqueductal gray and amygdala, respectively, were not different between previously deprived and non-deprived animals. Plasma corticosterone levels were significantly increased by hypoxia exposure, independently of the animals' previous stress condition or PCPA administration. Therefore, MD on PND 11 predisposes the adult animal to the panic-evoking effects of severe hypoxia, a stimulus also reported to induce panic attacks in humans. The lack of PCPA effect on the pro-escape consequence of MD may be indicative that 5-HT signaling is impaired in the stressed animal.

Symbolic reading of panic disorder: experience of imminent death and self alerts.

The author proposes a symbolic reading of panic disorder as a psychopathological emergency that currently overwhelms our society, relating to an explicit process of transformation. She understands this phenomenon as resulting from the lack of the creative feminine in people's lives, which contributes to the emergence of symptoms that are understood as alerts from the Self, which decry the danger under which the person lives. She amplifies the proposition with a symbolic reading of two great mythical moments: Oedipus' encounter with the Sphinx, and the institution of the first jury court, dramatized in the tragic play The Eumenides, by Aeschylus (Ésquilo).

L'autrice propose une lecture symbolique du trouble panique comme une urgence psychopathologique qui submerge notre société actuelle, dans un franc processus de transformation. Elle comprend ce phénomène comme une réalité qui résulte du manque de féminin créatif dans la vie des personnes. Ceci contribue à l'émergence de symptômes qui sont compris comme des alertes venant du Soi parce qu'ils dénoncent le danger dans lequel la personne vit. L'autrice amplifie la proposition avec une lecture symbolique de deux grands moments mythiques: Œdipe et sa rencontre avec le Sphinx et l'institution du premier tribunal avec jury, exprimé dans la tragédie d'Eschyle, Les Euménides.

La autora propone una lectura simbólica del trastorno de pánico como una emergencia psicopatológica que abruma a nuestra sociedad actual, en franco proceso de transformación. Ella comprende este fenómeno como una realidad que es resultado de la falta de lo femenino creativo en la vida de las personas, lo cual contribuye a la emergencia de síntomas que son comprendidos como alertas del Self, debido a que denuncian el peligro en el cual la persona vive. La autora amplifica esta propuesta a partir de la lectura simbólica de dos importantes momentos míticos: Edipo: su encuentro con la Esfinge, y la institución de la primera corte de justicia, expresada en la obra trágica, Las Euménides de Esquilo.

O autor propõe a leitura simbólica do transtorno de pânico como uma emergência psicopatológica que sobrecarrega nossa sociedade atual, em um processo franco de transformação. Ela entende esse fenômeno como uma realidade resultante da falta do criativo feminino na vida das pessoas, o que contribui para o surgimento de sintomas que são entendidos como alertas do Si Mesmo, porque denunciam o perigo sob o qual a pessoa vive. Ela amplifica a proposição com uma leitura simbólica de dois grandes momentos míticos: Édipo: seu encontro com a Esfinge e a instituição da primeira corte do júri, expressa na trágica peça: Os Eumênides de Ésquilo.

Dynamic factor structure of team performances in Liga MX.

Team performance of the Mexican Football League (Liga MX), measured as the percentage of the total points obtained during each short tournament, is analyzed using Dynamic Factor Models (DFMs). The estimation of the common components is carried out with Principal Components and the stochastic nature of the DFM is studied through Panel Analysis of Non-stationarity in Idiosyncratic and Common Components. The results reveal that there are two common factors, one being possibly non-stationary. These factors show an interesting dynamic behavior in the league and allow to split the teams into two groups, namely, top competitors and emerging or relegated teams. Some discussion is given in this direction.

Augmented anandamide signalling in the substantia nigra pars reticulata mediates panicolytic-like effects in mice confronted by Crotalus durissus terrificus pit vipers.

RATIONALE: The endocannabinoid modulation of fear and anxiety due to the on-demand synthesis and degradation is supported by a large body of research. Although it has been proposed that anandamide (AEA) in the substantia nigra pars reticulata (SNpr) seems to be important for the organisation of innate fear-related behaviours, a role for endogenous AEA has yet to be clarified. METHODS: Mice were treated with the fatty acid amide hydrolase (FAAH) selective inhibitor URB597 at different concentrations (0.01, 0.1, 1 nmol/0.1 µL) in the SNpr and confronted by rattlesnakes (Crotalus durissus terrificus). The most effective dose of URB597 (1 nmol) was also preceded by microinjections of the CB1 receptor antagonist AM251 (0.1 nmol) into the SNpr, and mice were then confronted by the venomous snake. RESULTS: URB597 (0.1 and 1 nmol) in the SNpr decreased the expression of defensive behaviours such as defensive attention, escape, and time spent inside the burrow of mice confronted by rattlesnakes. Moreover, pretreatment of SNpr with AM251 suppressed these antiaversive effects of URB597 in this midbrain structure. CONCLUSION: Overall, these data clearly indicate that the panicolytic consequences of endogenous AEA enhancement in the SNpr are mediated by CB1 receptor signalling.