Thursday, 24 May 2012

The mystery behind panic disorder


By Brandon Chern 42710260

One might find it daunting to know that you might have Panic disorder. After all, the entire genetic complexity behind this disorder is still not revealed through modern technology. Some might say that “several neurotransmitter systems are the reason panic disorder”. But to simply state that the causation is some neuron receptors in our nervous system is just too simplistic! There are many genes associated to PD with other anxiety disorder and there are other phenotype factors to consider. Can we then come to a conclusion? Apparently, the only way we can truly shine light to this disabling problem is to conduct Genome-wide Association studies on a large scale. I will come to realise that perhaps this notion has some drawback. How can we balance out what could be the ethical and logical thing to do when studying patients that are emotionally and cognitively compromised? This is a grey area that I also wish to address. 




















Figure 1.  Know these Important Facts to Decide the Right Aid for You.


The second law of thermodynamics is a perfect illustration of how PD is linked to many other anxiety disorders. The genes are in a way tending to an increase of disorder. There could some specific chromosome that is causing this disorder. A specific chromosome 13q32e, has been linked to PD. This linkage shows the strong hereditary possibility with PD.

It has shown that PD has been linked to other psychiatric conditions. Major depressive disorders or bipolar disorders (BD) are just two of the many comorbid disorders! To give you a figure to ponder on, the “National Comorbidity Survey Replication (NCS-R) reported on a lifetime risk of BD of 14.4% appearing to be patients with PD.” Other family studies also did find shared genetic materials.
























Figure 2. Basic characteristics potentially relevant for genetic studies.

However as aforementioned, there are other shared or non-shared environmental factors we need to consider. Such risk factors include higher sensitivity of carbon dioxide which causes breathing problems or the dependence on cigarette smoking or cannabis that “can trigger PD in susceptible individuals.”































Figure 3. Clinical characteristics adopted from the Diagnostic and Statistical Manual of Mental Disorders.

There are many areas in genetic research that we can tap on to deepen our understanding of PD. There are two schools of thoughts when studying disorders; linkage studies and genome-wide association studies (GWASs). Since the discovery of new high risk genes with the latter, it is merely a statistical reasoning on the probability of getting a better result with a large sample size for GWASs. Panic disorder patients are a vulnerable group. Depending of the severity, they can exhibit extreme distress, disabling fear or avoidance. These emotions can take over the entire person’s conscious mind. Hence we need to consider that these patients give informed consent due to protect them and the researchers alike.



















Figure 4. Cheaper individual genome sequencing.

To conclude, the future should take sequencing of our chromosomes and DNA to the next level to get a better grasp of the risk variants. As the cost per Genome falls to affordable levels, research into PD can be enhanced and propagated to new heights. Perhaps we will soon have a cure to PD and someone will once again win a noble prize.

References

Johannes Schumacher, Ann Suhl Kristensen, Jens R Wendland (2011), 'The genetics of panic disorder.' ,
Journal of medical genetics, vol 48, issue 6, pp. 361-368.

Prithwish, 2010, Cheaper individual genome sequencing, http://www.omespeak.com/blog/?p=23.

Panichelp.org, 2011, Know these Important Facts to Decide the Right Aid for You.







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