Panic disorder is characterised by the presence of recurrent, unexpected panic attacks followed by at least one month of persistent concern about having an attack (APA, 2000). In a comparison of agitated versus nonagitated patients following traumatic brain injury, Levin and Grossman (1978) noted that patients who experienced screaming, combativeness, and other signs of sympathetic arousal in the acute confusional phase following the brain injury tended to display significantly higher levels of anxiety, depression, and thought disturbance after stabilization or improvement in orientation. The symptoms did not appear to be related to the side of the injury but correlated with acute aphasic symptoms and the appearance of auditory or visual hallucinations (Epstein & Ursano, 1994). Schuetznow and Wiercisiewski (1999) report a single case of panic disorder featuring anxiety symptoms regarding health, and fear of suffering a heart attack following TBI. Again, panic is a relatively uncommon presentation following TBI in most of the published literature, but can occur comorbidly with PTSD (McMillan et al., 2003).
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