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Ben Thabet J, Turki M, Mezghani M, Guermazi A, Mâalej M, Charfi N, Maalej M. Prevalence of the generalized anxiety disorder in Tunisia: A study of 707 primary care outpatients. Int J Psychiatry Med 2025; 60:187-202. [PMID: 38898013 DOI: 10.1177/00912174241263235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
OBJECTIVE This study examined the prevalence and correlates of generalized anxiety disorder (GAD) among primary care outpatients. METHOD A multicenter, cross-sectional study was conducted that included 707 primary care outpatients being seen at 20 primary healthcare centers in Tunis and Sfax, Tunisia. The Mini International Neuropsychiatric Interview was used to identify a diagnosis of GAD. The Beck Depression Inventory was used to assess depressive symptom severity, and the Sheehan Disability Scale (SDS) was used to measure functional impairment. RESULTS The prevalence of GAD was 11%. GAD was positively correlated with female gender (P = .005), family history of psychiatric disorder (P < .001), personal history of suicide attempt (P = .019), and depressive symptoms (P < .001). Based on the SDS, severe to very severe functional limitations were reported at work (56.4%), in social life (60.2%), and family life (73.1%) among GAD patients. CONCLUSION This study indicated a relatively high prevalence of GAD among primary care patients in Tunisia. Risk factors were also determined that may help to identify these patients. This information may help primary care physicians recognize this diagnosis and provide timely referrals to mental health professionals to prevent complications and maximize quality of life.
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Affiliation(s)
- Jihene Ben Thabet
- Psychiatry "C" Department, Hedi Chaker University Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Mariem Turki
- Psychiatry "B" Department, Hedi Chaker University Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Molka Mezghani
- Psychiatry Department, Razi Psychiatric Hospital, University of Tunis, Tunisia
| | - Asma Guermazi
- Psychiatry "C" Department, Hedi Chaker University Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Mohamed Mâalej
- Psychiatry "C" Department, Hedi Chaker University Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Nada Charfi
- Psychiatry "C" Department, Hedi Chaker University Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Manel Maalej
- Psychiatry "C" Department, Hedi Chaker University Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
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Chen SZ, Zainal NH, Newman MG. Elevated depression and anxiety predict future patterns of individualistic and collectivistic cultural values: A cross-lagged longitudinal network analysis. J Affect Disord 2024; 349:310-320. [PMID: 38181844 PMCID: PMC10950001 DOI: 10.1016/j.jad.2023.12.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/04/2023] [Accepted: 12/27/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND Specific components of independent and interdependent self-construal have been associated with psychopathology. However, most studies on this topic have been cross-sectional, precluding causal inferences. We used contemporaneous and temporal cross-lagged network analysis to establish weak causal effects in understanding the association between self-construal and psychopathology components. METHODS Middle-aged and older community-dwelling adults (n = 3294) participated in the Midlife Development in the United States study across two time-points, spaced nine years apart. Six self-construal (interdependence: connection to others, commitment to others, receptiveness to influence; independence: behavioral consistency, sense of difference from others, self-reliance) and three psychopathology nodes (major depressive disorder (MDD), generalized anxiety disorder (GAD), and panic disorder (PD) symptom severity) were examined. All network analyses controlled for age, sex, race, and number of chronic illnesses as covariates. RESULTS Contemporaneous and temporal networks yielded relations between elevated MDD and PD and increased receptiveness to influence. Heightened GAD symptom severity was associated with future increased difference from others and decreased connection to others, commitment to others, and receptiveness to influence. Higher MDD, GAD, and PD severity were associated with future lower self-reliance. Network comparison tests revealed no consistent network differences across sex and race. LIMITATIONS DSM-III-R measures of MDD, GAD, and PD were used. Results may not generalize to culturally diverse racial groups. CONCLUSIONS Changes in self-construal may result from increased MDD, GAD, and PD severity. Findings suggest the importance of targeting common mental health symptoms to positively influence how individuals view the self and others in various social contexts.
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Affiliation(s)
- Serena Z Chen
- The Pennsylvania State University, United States of America.
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Fujihara Y, Guo K, Liu CH. Relationship between types of anxiety and the ability to recognize facial expressions. Acta Psychol (Amst) 2023; 241:104100. [PMID: 38041913 DOI: 10.1016/j.actpsy.2023.104100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 11/16/2023] [Accepted: 11/28/2023] [Indexed: 12/04/2023] Open
Abstract
This study examined whether three subtypes of anxiety (trait anxiety, state anxiety, and social anxiety) have different effects on recognition of facial expressions. One hundred and thirty-eight participants matched facial expressions of three intensity levels (20 %, 40 %, 100 %) with one of the six emotion labels ("happy", "sad", "fear", "angry", "disgust", and "surprise"). While using a conventional method of analysis we were able to replicate some significant correlations between each anxiety type and recognition performance found in the literature. However, when we used partial correlation to isolate the effect of each anxiety type, most of these correlations were no longer significant, apart from the negative correlations between Beck Anxiety Inventory and reaction time to fearful faces displayed at 40 % intensity level, and the correlations between anxiety and categorisation errors. Specifically, social anxiety was positively correlated with misidentifying a happy face as a disgust face at 40 % intensity level, and state anxiety negatively correlated with misidentifying a happy face as a sad face at 20 % intensity level. However, these partial correlation analyses became non-significant after p value adjustment for multiple comparisons. Our eye tracking data also showed that state anxiety may be associated with reduced fixations on the eye regions of low-intensity sad or fearful faces. These analyses cast doubts on some effects reported in the previous studies because they are likely to reflect a mixture of influences from highly correlated anxiety subtypes.
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Affiliation(s)
- Yuya Fujihara
- Department of Psychology, Yasuda Women's University, Japan.
| | - Kun Guo
- School of Psychology, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire LN6 7TS, United Kingdom.
| | - Chang Hong Liu
- Department of Psychology, Bournemouth University, United Kingdom.
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Bayrakçeken E, Alkan Ö, Abar H. Psychological Help-Seeking Status for Living with Mental Health Conditions in Türkiye: Using a Multivariate Probit Model. Healthcare (Basel) 2023; 11:2837. [PMID: 37957982 PMCID: PMC10649634 DOI: 10.3390/healthcare11212837] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND/AIM Mental disorders constitute a significant public health concern, contributing significantly to the overall disease burden. Individuals experiencing mental distress often delay or avoid seeking psychological help or do not seek help due to varying factors. This study examines the factors affecting individuals' preferences, particularly young people, in seeking psychological help in Türkiye. METHODS This study utilized microdata from the Türkiye Health Survey conducted by TURKSTAT in 2016 and 2019. The factors influencing decisions to consult with a psychologist, psychotherapist, or psychiatrist were determined by multivariate probit regression analysis. The Türkiye Health Survey employed a stratified two-stage cluster sampling method, surveying 17,242 individuals over the age of 15 in 9470 households in 2016 and 17,084 individuals over the age of 15 in 9470 households in 2019. RESULTS The analysis findings indicated that, in the entire sample, women are more likely to seek psychological help, while younger women are less likely to do so. In the entire sample, as the education level increased, the probability of individuals receiving psychological help increased, while it decreased for young people. It was determined that people who use tobacco and alcohol are more likely to receive psychological help than others. It was also determined that individuals who perceive their health status as good, especially those who are both young and perceive their health status as good, are less likely to seek psychological help. CONCLUSIONS The significance and impact of the variables on the probability of individuals seeking psychological help vary for both the entire sample and young people. There may be various restrictions in getting psychological help, and people may resort to informal methods instead of professionals to cope with their existing problems. In developing preventive strategies to safeguard mental health, factors related to young people's and individuals' psychological help-seeking status should be prioritized, and more attention should be paid to them.
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Affiliation(s)
- Esra Bayrakçeken
- Department of Medical Services and Techniques, Vocational School of Health Services, Ataturk University, Erzurum 25030, Türkiye;
| | - Ömer Alkan
- Department of Econometrics, Faculty of Economics and Administrative Sciences, 2nd Floor, Number 222, Ataturk University, Erzurum 25030, Türkiye
- Master Araştırma Eğitim ve Danışmanlık Hizmetleri Ltd., Şti., Ata Teknokent, Erzurum 25240, Türkiye
| | - Hayri Abar
- Department of Economics, Faculty of Business and Economics, Gaziantep University, 1st Floor, Number 132, Gaziantep 27310, Türkiye;
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REZAEIFARD A, MAZRAEH N, KHODARAHIMI S, GISKI MM, RASTI A. The Effect of Group-Based Emotional Schema Therapy on Anxiety Sensitivity and Anxiety Severity in Outpatient Females with Generalized Anxiety Disorder. JOURNAL OF EVIDENCE-BASED PSYCHOTHERAPIES 2022. [DOI: 10.24193/jebp.2022.1.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
"Purpose: The aim of the present study was to examine the effectiveness of Group-Based Emotional Schema Therapy (GBEST) on anxiety sensitivity and anxiety severity decrease in females with Generalized Anxiety Disorder (GAD). Methods: This was a double-blind randomized experimental study that was carried out with three pretest, posttest, and follow-up stages within an experimental group and the control group. The participants were 50 outpatient females with GAD that they recruited by a random sampling method in each group. The Anxiety Sensitivity Index (ASI) and the Generalized Anxiety Disorder 7-Item Scale (GAD-7) were used in this study. The experimental group was imposed on the GBEST in 10 sessions which were held weekly for 90 minutes; finally, the post-test was applied to both experimental and control groups and three months later, they were followed up. Results: Findings showed that the experimental group had a significant decrease in anxiety sensitivity and anxiety severity compared with the control group during the post-test and the follow-up stages. Conclusions: The GBEST is recommended for the treatment of anxiety sensitivity and anxiety severity in females with GAD."
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Lesch E, de Bruin K, Anderson C. A Pilot Implementation of the Emotionally Focused Couple Therapy Group Psychoeducation Program in a South African Setting. JOURNAL OF COUPLE & RELATIONSHIP THERAPY 2018. [DOI: 10.1080/15332691.2017.1417940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Elmien Lesch
- Psychology Department, Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | - Kathryn de Bruin
- Marital and Family Therapist, Private Practice, San Diego, California, USA
| | - Colleen Anderson
- Clinical Psychologist, Private Practice, Cape Town, South Africa
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Hammett JF, Castaneda DM, Ulloa EC. Predicting Mental Health Based on Partners' Marital Distress: A Latent Profile Analysis. FAMILY JOURNAL (ALEXANDRIA, VA.) 2016; 24:205-215. [PMID: 37719235 PMCID: PMC10503696 DOI: 10.1177/1066480716648685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Since marital distress is a multidimensional phenomenon, research efforts directed at identifying meaningful groups of individuals with common characteristics based on their dissatisfaction in various relationship domains are important. In addition, it is important to examine this association not only among White majority-group couples but also among other ethnic groups, such as Mexican American couples, who may differ in terms of cultural values and customs. A latent class analysis (LPA) of Caucasian and Mexican American newlyweds' (N = 278) self-reported marital distress identified four such groups. These groups showed a continuum of dissatisfaction as well as varying degrees of differences in partners' views of traditional versus non-traditional gender roles. The classes resulting from the LPA were related to individuals' mental health. Those individuals who found themselves in groups with higher distress also experienced higher levels of anxiety and depression than those individuals who found themselves in groups with lower distress. Although more research is clearly needed among larger and more diverse samples, the present findings may be useful to the field of marriage and family therapy in that they may guide prevention and intervention efforts in the field of marital distress and mental health.
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Lesch E, Engelbrecht SK. The Reliability of the Dyadic Satisfaction (DS) Subscale in a Low-income Semi-rural South African Community. JOURNAL OF PSYCHOLOGY IN AFRICA 2014. [DOI: 10.1080/14330237.2008.10820192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Pankiewicz P, Majkowicz M, Krzykowski G. Anxiety disorders in intimate partners and the quality of their relationship. J Affect Disord 2012; 140:176-80. [PMID: 22381954 DOI: 10.1016/j.jad.2012.02.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 02/01/2012] [Accepted: 02/02/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND The aim of this study was to explain whether anxiety disorders presenting in one or both partners of a relationship can influence the latter and to what extent. METHODS This study included 85 couples, where: 1) the male partner suffered from an anxiety disorder and female partner was free from this type of disorder (F((-))M((+)), n=20); 2) the female partner suffered from an anxiety disorder and the male partner was free from this type of disorder (F((+))M((-)); n=40); and 3) both partners were affected with anxiety disorders (F((+))M((+)), n=25). The quality of the relationship was assessed by both partners using three different scales: 1) Dyadic Adjustment Scale (DAS), 2) Family Attitude Scale (FAS), and 3) Marriage Success Scale (SPM). RESULTS In case of the SPM scale, women from F((-))M((+)) group evaluated their marriages significantly compared to other groups. In case of males, the self-evaluated quality of marriage was the lowest in the case of individuals from F((+))M((+)) group. In case of the DAS scale, women and men being free from anxiety disorders assessed the quality of their relationships significantly higher than other participants. The analyzed groups did not differ significantly in terms of mean values scored in the FAS scale. LIMITATIONS The lack of a multifactorial analysis taking into account the effects of a variety of anxiety disorders. CONCLUSION The presence of anxiety disorders in at least one partner negatively affects the quality of partner relationship. The couples where the female partners are affected are particularly fragile.
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Affiliation(s)
- Piotr Pankiewicz
- Clinic of Psychiatric Diseases and Neurotic Disorders, Medical University of Gdansk, ul. Dębinki 7, Gdansk, Poland.
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Wymbs BT, Pelham WE, Molina BSG, Gnagy EM, Wilson TK, Greenhouse JB. Rate and predictors of divorce among parents of youths with ADHD. J Consult Clin Psychol 2008; 76:735-44. [PMID: 18837591 PMCID: PMC2631569 DOI: 10.1037/a0012719] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Numerous studies have asserted the prevalence of marital conflict among families of children with attention-deficit/hyperactivity disorder (ADHD), but evidence is surprisingly less convincing regarding whether parents of youths with ADHD are more at risk for divorce than are parents of children without ADHD. Using survival analyses, the authors compared the rate of marital dissolution between parents of adolescents and young adults with and without ADHD. Results indicated that parents of youths diagnosed with ADHD in childhood (n = 282) were more likely to divorce and had a shorter latency to divorce compared with parents of children without ADHD (n = 206). Among a subset of those families of youths with ADHD, prospective analyses indicated that maternal and paternal education level; paternal antisocial behavior; and child age, race/ethnicity, and oppositional-defiant/conduct problems each uniquely predicted the timing of divorce between parents of youths with ADHD. These data underscore how parent and child variables likely interact to exacerbate marital discord and, ultimately, dissolution among families of children diagnosed with ADHD.
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Affiliation(s)
- Brian T Wymbs
- Center for Children and Families, University at Buffalo, State University of New York, NY, USA.
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