1
|
Baussay A, Di Lodovico L, Poupon D, Doublet M, Ramoz N, Duriez P, Gorwood P. The capacity of cognitive tests to detect generalized anxiety disorder (GAD): A pilot study. J Psychiatr Res 2024; 174:94-100. [PMID: 38626566 DOI: 10.1016/j.jpsychires.2024.04.006] [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] [Received: 09/15/2023] [Revised: 03/25/2024] [Accepted: 04/03/2024] [Indexed: 04/18/2024]
Abstract
Cognitive impairment remains understudied in generalized anxiety disorder (GAD), despite the high prevalence and substantial burden associated with this disorder. We aimed to assess cognitive impairment in patients with GAD and evaluate the ability of cognitive tests to detect this disorder. Because of its high rate of comorbidity, we also examined how other anxiety disorders and current major depressive episodes affected our results. We tested 263 consecutive general practice outpatients. We used the GAD-7 and the Mini International Neuropsychiatric Interview (MINI) to detect anxiety and mood disorders. We assessed cognitive performance with the Stroop test, a facial emotion recognition test, and the trail-making test (TMT). Compared to patients without GAD, patients with GAD were significantly slower to complete the TMT(B-A) and faster to recognize emotions, especially negative ones such as disgust and anger. When controlling for other anxiety disorders and current major depressive episode, GAD retained a significant effect on the TMT(B-A), but not on the emotion recognition test. The TMT(B-A) could detect GAD with good accuracy (area under the curve (AUC) = 0.83, maximal Youden's index = 0.56), which was by no means comparable to the GAD-7 (AUC = 0.97, Youden's index = 0.81). While it is not efficient enough to replace the GAD-7 as a diagnostic tool, the capacity of the TMT(B-A) to detect GAD emphasizes the importance of cognitive flexibility impairment in GAD.
Collapse
Affiliation(s)
- Axel Baussay
- Université de Versailles Saint-Quentin-en-Yvelines. 2 Av. de La Source de La Bièvre, 78180, Montigny-le-Bretonneux, France
| | - Laura Di Lodovico
- CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, 100 Rue de La Santé, F-75014, Paris, France; Université Paris Cité, INSERM, UMR1266, F-75013, Paris, France
| | - Daphnee Poupon
- CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, 100 Rue de La Santé, F-75014, Paris, France
| | | | - Nicolas Ramoz
- Université Paris Cité, INSERM, UMR1266, F-75013, Paris, France
| | - Philibert Duriez
- CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, 100 Rue de La Santé, F-75014, Paris, France; Université Paris Cité, INSERM, UMR1266, F-75013, Paris, France
| | - Philip Gorwood
- CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, 100 Rue de La Santé, F-75014, Paris, France; Université Paris Cité, INSERM, UMR1266, F-75013, Paris, France.
| |
Collapse
|
2
|
Sacchet MD, Keshava P, Walsh SW, Potash RM, Li M, Liu H, Pizzagalli DA. Individualized Functional Brain System Topologies and Major Depression: Relationships Among Patch Sizes and Clinical Profiles and Behavior. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:616-625. [PMID: 38417786 PMCID: PMC11156548 DOI: 10.1016/j.bpsc.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 02/10/2024] [Accepted: 02/19/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Neuroimaging studies of major depression have typically been conducted using group-level approaches. However, given interindividual differences in brain systems, there is a need for individualized approaches to brain systems mapping and putative links toward diagnosis, symptoms, and behavior. METHODS We used an iterative parcellation approach to map individualized brain systems in 328 participants from a multisite, placebo-controlled clinical trial. We hypothesized that participants with depression would show abnormalities in salience, control, default, and affective systems, which would be associated with higher levels of self-reported anhedonia, anxious arousal, and worse cognitive performance. Within hypothesized brain systems, we compared patch sizes (number of vertices) between depressed and healthy control groups. Within depressed groups, abnormal patches were correlated with hypothesized clinical and behavioral measures. RESULTS Significant group differences emerged in hypothesized patches of 1) the lateral salience system (parietal operculum; t326 = -3.11, p = .002) and 2) the control system (left medial posterior prefrontal cortex region; z = -3.63, p < .001), with significantly smaller patches in these regions in participants with depression than in healthy control participants. Results suggest that participants with depression with significantly smaller patch sizes in the lateral salience system and control system regions experience greater anxious arousal and cognitive deficits. CONCLUSIONS The findings imply that neural features mapped at the individual level may relate meaningfully to diagnosis, symptoms, and behavior. There is strong clinical relevance in taking an individualized brain systems approach to mapping neural functional connectivity because these associated region patch sizes may help advance our understanding of neural features linked to psychopathology and foster future patient-specific clinical decision making.
Collapse
Affiliation(s)
- Matthew D Sacchet
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
| | - Poorvi Keshava
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Shane W Walsh
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts
| | - Ruby M Potash
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Meiling Li
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Hesheng Liu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts; Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; McLean Imaging Center, McLean Hospital, Belmont, Massachusetts
| |
Collapse
|
3
|
Erhardt A, Gelbrich G, Klinger-König J, Streit F, Kleineidam L, Riedel-Heller SG, Schmidt B, Schmiedek F, Wagner M, Grabe HJ, Rietschel M, Berger K, Deckert J. Generalised anxiety and panic symptoms in the German National Cohort (NAKO). World J Biol Psychiatry 2023; 24:881-896. [PMID: 34842503 DOI: 10.1080/15622975.2021.2011409] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 11/23/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Anxiety disorders (AD) are common in the general population, leading to high emotional distress and disability. The German National Cohort (NAKO) is a population-based mega-cohort study, examining participants in 16 German regions. The present study includes data of the first 101,667 participants and investigates the frequency and severity of generalised anxiety symptoms and panic attacks (PA). METHODS The Generalised Anxiety Disorder Symptoms Scale (GAD-7) and the first part of the Patient Health Questionnaire Panic Disorder (PHQ-PD) were filled out by NAKO participants (93,002). We examined the correlation of GAD-7 and PHQ-PD with demographic variables, stress (PHQ-Stress), depression (PHQ-9) and childhood trauma (CTS). RESULTS The total proportion of prior lifetime diagnoses of AD in the NAKO cohort reached 7.8%. Panic attacks were reported by 6.0% and possible/probable current GAD symptoms in 5.2% of the examined participants. Higher anxiety severity was associated with female sex, lower education level, German as a foreign language and younger age as well as high perceived stress and depression. CONCLUSIONS Clinically relevant GAD symptoms as well as panic attacks are frequent in the NAKO and are associated with sociodemographic factors, and high anxiety symptoms are accompanied by pronounced stress and depression levels.
Collapse
Affiliation(s)
- Angelika Erhardt
- Department of Psychiatry, Psychosomatics and Psychotherapy, Centre of Mental Health, Julius-Maximilians-University, Wuerzburg, Germany
- Max Planck Institute for Psychiatry, Munich, Germany
| | - Götz Gelbrich
- Institute for Clinical Epidemiology and Biometry, Julius-Maximilians-University, Wuerzburg, Germany
- Clinical Trial Centre Wuerzburg, University Hospital Würzburg, Wuerzburg, Germany
| | | | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Luca Kleineidam
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Germany
| | - Florian Schmiedek
- Leibniz-Institute for Research and Information in Education, University of Frankfurt, Germany
- Institute of Psychology, Goethe University, Frankfurt am Main, Germany
- Centre for Mind, Brain and Behaviour, University of Marburg and Justus Liebig University Giessen, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Centre for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE), Partner Site Rostock/Greifswald, Greifswald, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Klaus Berger
- Institute of Epidemiology & Social Medicine, University of Muenster, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, Centre of Mental Health, Julius-Maximilians-University, Wuerzburg, Germany
| |
Collapse
|
4
|
Trent ES, Viana AG, Raines EM, Busch HEC, Silva K, Storch EA, Zvolensky MJ. Childhood exposure to parental threatening behaviors and anxiety in emerging adulthood: Indirect effects of perceived stress. J Clin Psychol 2023; 79:1984-2008. [PMID: 36971223 PMCID: PMC10440255 DOI: 10.1002/jclp.23516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 03/03/2023] [Accepted: 03/14/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Although childhood exposure to parental threatening behaviors is associated with elevated anxiety in emerging adulthood, the underlying mechanisms remain unexplored. Perceived stress-a subjective experience comprised of feelings of helplessness (being unable to cope or exert control) and poor self-efficacy (confidence in one's ability to manage stressors)-is one candidate mechanism. The present investigation examined the underlying role of perceived stress in the association between childhood exposure to parental threatening behaviors and anxiety symptom severity in a sample of emerging adults. METHODS Participants (N = 855; Mage = 18.75 years, SD = 1.05, range 18-24; 70.8% female) were recruited from a large state university and administered a battery of self-report questionnaires assessing constructs of interest. RESULTS Structural equation modeling (SEM) analyses indicated that only greater childhood exposure to maternal threatening behaviors was directly associated with greater feelings of helplessness and lower self-efficacy. Furthermore, only childhood exposure to maternal threatening behaviors was indirectly associated with anxiety severity through greater feelings of helplessness and lower self-efficacy. In contrast, childhood exposure to paternal threatening behaviors was neither directly nor indirectly associated with anxiety severity. LIMITATIONS Limitations include a cross-sectional design, use of self-report measures, and a nonclinical sample. Replicating these findings in a clinical sample and testing the hypothesized model in a longitudinal design is necessary. CONCLUSIONS Findings underscore the need for intervention efforts that screen for and target perceived stress in emerging adults exposed to negative maternal parenting behaviors.
Collapse
Affiliation(s)
- Erika S. Trent
- Department of Psychology, University of Houston, Houston, TX
| | - Andres G. Viana
- Department of Psychology, University of Houston, Houston, TX
- Texas Institute of Measurement, Evaluation, & Statistics, University of Houston, Houston, TX
| | | | | | - Karina Silva
- Department of Psychology, University of Houston, Houston, TX
| | - Eric A. Storch
- Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
5
|
Kim YR, Jang KA. Differences in Oral Health and Generalized Anxiety Disorder According to Secondhand Smoke Exposure in Public Places. Behav Sci (Basel) 2023; 13:455. [PMID: 37366707 DOI: 10.3390/bs13060455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/22/2023] [Accepted: 05/29/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND This study aims to provide basic data for minimizing exposure to secondhand smoke (SHS) by confirming the relationship between exposure to SHS and generalized anxiety disorder (GAD). METHODS Using the third year data of the eighth National Health and Nutrition Examination Survey, 3874 people were selected as subjects. Complex sampling analysis was applied to all analyses, and 307 people were exposed to the SHS group (SHSG) and 3567 people were not exposed to the SHS group (NSHSG). Complex sample linear regression analysis was conducted to confirm the effect of exposure to SHS on oral health and GAD. RESULTS Among oral-health-related factors, exposure to SHS in Korean adults was related to the presence of implants. Additionally, exposure to SHS had a significant effect on GAD despite adjusting for sociodemographic characteristics and oral-health-related factors (p < 0.05). CONCLUSIONS In this study, the relationship between passive smoking and GAD was confirmed. Therefore, to reduce GAD, oral health management is necessary and exposure to SHS should be minimized.
Collapse
Affiliation(s)
- Yu-Rin Kim
- Department of Dental Hygiene, Silla University, 140 Baegyang-daero 700 Beon-gil, Sasang-gu, Busan 46958, Republic of Korea
| | - Kyeung-Ae Jang
- Department of Dental Hygiene, Silla University, 140 Baegyang-daero 700 Beon-gil, Sasang-gu, Busan 46958, Republic of Korea
| |
Collapse
|
6
|
Muziki JD, Uwera T, Niyonsenga J, Nshimiyimana A, Sebatukura SG, Mutabaruka J. Negative emotions and personal well-being among incarcerated filicide mothers in Rwanda. PLoS One 2022; 17:e0271255. [PMID: 35895737 PMCID: PMC9328529 DOI: 10.1371/journal.pone.0271255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/27/2022] [Indexed: 11/18/2022] Open
Abstract
Despite the tremendous evidence of the harmful effects of maternal filicide on the lives of offenders, there is a scarcity on studies of their negative emotions and personal wellbeing especially in sub-Saharan Africa. Thus, this study was primarily aimed at assessing the prevalence of negative emotions experienced by filicide mothers and how they were associated with personal wellbeing in Rwanda. With an institutional-based cross-sectional study design, we measured the symptoms of anxiety, anger, shame, guilt, depression and personal well-being in a convenient sample of 55 filicidal mothers (mean age = 26.69; SD = 6.88) who were incarcerated in Nyarugenge prison. SPSS (version 24) was used to compute descriptive, Pearson correlation, independent t-test and regression analyses. The results indicated that the rates of shame were (100%), guilt (98.2%), anxiety (92.7%), depression (92.7%), low happiness and satisfaction with life (81.8%), and anger was (76.4%) in the current sample. Based on age category, there was no significant difference in anger scores, depression, guilt, shame and personal well-being scores between young and adult filicide mothers (p>.05). Young filicide mothers (M = 14.55, SD = 4.03), on the other hand, had higher anxiety scores than adult filicide mothers (M = 11.57, SD = 4.72), t = 2.52, p = .015. Finally, anxiety (β = -.507, t = -3.478, p = .001) and age (β = -.335, t = -2.685, p < .001) were negatively associated with personal well-being. The results emerged from this study highlight that filicide mothers experience substantial negative emotions and poor personal wellbeing regardless of their age category. However, poor personal wellbeing was associated with anxiety and age. Based on these results, mental health professionals should examine their mental state with respect to negative emotions and initiate programs that decrease the emotions as well as increase personal well-being.
Collapse
Affiliation(s)
- Jean d’Amour Muziki
- Department of Clinical Psychology, College of Medicine and Health Sciences of University of Rwanda, Kigali, Rwanda
- * E-mail:
| | - Thaoussi Uwera
- Department of Health Informatics, College of Medicine and Health Sciences of University of Rwanda, Kigali, Rwanda
| | - Japhet Niyonsenga
- Department of Clinical Psychology, College of Medicine and Health Sciences of University of Rwanda, Kigali, Rwanda
- Mental Health & Behaviour Research Group, College of Medicine and Health Sciences of University of Rwanda, Kigali, Rwanda
| | - Augustin Nshimiyimana
- Department of Clinical Psychology, College of Medicine and Health Sciences of University of Rwanda, Kigali, Rwanda
| | - Siméon Gitimbwa Sebatukura
- Department of Clinical Psychology, College of Medicine and Health Sciences of University of Rwanda, Kigali, Rwanda
- * E-mail:
| | - Jean Mutabaruka
- Department of Clinical Psychology, College of Medicine and Health Sciences of University of Rwanda, Kigali, Rwanda
| |
Collapse
|
7
|
Burstein O, Shamir A, Abramovitz N, Doron R. Patients' attitudes toward conventional and herbal treatments for depression and anxiety: A cross-sectional Israeli survey. Int J Soc Psychiatry 2022; 68:589-599. [PMID: 33530827 PMCID: PMC8938990 DOI: 10.1177/0020764021992385] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND As many patients view conventional antidepressants and anxiolytics negatively, it is not surprising that the willingness to apply these treatments is far from ideal, thus posing a critical barrier in promoting an effective and durable treatment. AIM The present study aimed to explore patients' attitudes toward conventional and herbal treatments for depression and anxiety, while considering cultural and demographic factors, to further elucidate the antecedes that putatively determine the treatment's outcome. METHODS During June 2017, a cross-sectional survey was conducted using stratified sampling from a large-scale Israeli volunteer online panel. The final sample included 591 Jewish Israeli adults that reported they were suffering from depression or anxiety. RESULTS A heterogeneous range of attitudes toward treatment was found: for example, a large group of patients did not utilize prescription medications (39%), a professional consultation (12.9%), or any form of treatment (17.4%). Interestingly, these patients were significantly more likely to support naturally-derived treatments and were less concerned with scientific proof. Further, adverse effects were demonstrated as a prominent factor in the choice of treatment. A higher incidence of adverse effects was associated with an increased willingness to consider an alternative herbal treatment. Noteworthy attitudes were found in orthodox-Jewish individuals, who showed similar consultation rates, but utilized more psychological, rather than pharmacological treatments. CONCLUSIONS It is proposed that patients' perspectives and cultural backgrounds are needed to be taken into consideration during the clinical assessment and choice of treatment. The findings imply that a particular emphasis should be placed on patients that discard conventional pharmacological options and on distinct cultural aspects. Several recommendations for revising the current policy are advocated to promote more culturally-informed and patient-oriented care.
Collapse
Affiliation(s)
- Or Burstein
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel
| | - Alon Shamir
- Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.,Mazor Mental Health Center, Akko, Israel
| | | | - Ravid Doron
- School of Behavioral Science, The Academic College Tel-Aviv-Yaffo, Yaffo, Israel.,Department of Education and Psychology, The Open University, Raanana, Israel
| |
Collapse
|
8
|
Neurological and Mental Health Symptoms Associated with Post-COVID-19 Disability in a Sample of Patients Discharged from a COVID-19 Ward: A Secondary Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074242. [PMID: 35409924 PMCID: PMC8998950 DOI: 10.3390/ijerph19074242] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 12/04/2022]
Abstract
Recent studies suggest that COVID-19 survivors may experience long-term health consequences: in particular, neurological and mental health symptoms might be associated with long-term negative outcomes. This study is a secondary analysis of a larger cohort study and aims to determine the extent to which neurological and mental health sequelae are associated with survivors’ disability. Participants include COVID-19 survivors, with no pre-morbid brain conditions, who were discharged from the COVID-19 Unit of the ASST Spedali Civili Hospital between February and April 2020. At an average of 3.5 months after discharge, they were submitted to a neurological examination and completed the WHO Disability Assessment Schedule (WHODAS-12), the Hospital Anxiety and Depression Score, the Pittsburgh Sleep Quality Index and the Montreal Cognitive Assessment. Multivariable regression analysis was carried out to analyze variables that explain WHODAS-12 variation. In total, 83 patients (63 males, average age 66.9, 95% CI: 64.2–69.7) were enrolled; average WHODAS-12 was 13.2 (95% CI: 9.7–16.6). Cognitive dysfunction, anxiety, fatigue, and hyposmia/hypogeusia explained 28.8% of WHODAS-12 variation. These findings underline the importance and need for longitudinal follow-up assessments after recovery from COVID-19 and suggest the need for early rehabilitation of residual symptoms to enhance patients’ functioning.
Collapse
|
9
|
González-González AI, Brünn R, Nothacker J, Schwarz C, Nury E, Dinh TS, Brueckle MS, Dieckelmann M, Müller BS, van den Akker M. Everyday Lives of Middle-Aged Persons with Multimorbidity: A Mixed Methods Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:6. [PMID: 35010264 PMCID: PMC8751163 DOI: 10.3390/ijerph19010006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/06/2021] [Accepted: 12/15/2021] [Indexed: 01/01/2023]
Abstract
The healthcare burden of patients with multimorbidity may negatively affect their family lives, leisure time and professional activities. This mixed methods systematic review synthesizes studies to assess how multimorbidity affects the everyday lives of middle-aged persons, and identifies skills and resources that may help them overcome that burden. Two independent reviewers screened title/abstracts/full texts in seven databases, extracted data and used the Mixed Methods Appraisal Tool (MMAT) to assess risk of bias (RoB). We synthesized findings from 44 studies (49,519 patients) narratively and, where possible, quantitatively. Over half the studies provided insufficient information to assess representativeness or response bias. Two studies assessed global functioning, 15 examined physical functioning, 18 psychosocial functioning and 28 work functioning. Nineteen studies explored skills and resources that help people cope with multimorbidity. Middle-aged persons with multimorbidity have greater impairment in global, physical and psychosocial functioning, as well as lower employment rates and work productivity, than those without. Certain skills and resources help them cope with their everyday lives. To provide holistic and dynamic health care plans that meet the needs of middle-aged persons, health professionals need greater understanding of the experience of coping with multimorbidity and the associated healthcare burden.
Collapse
Affiliation(s)
- Ana Isabel González-González
- Institute of General Practice, Goethe University, 60590 Frankfurt am Main, Germany; (R.B.); (T.S.D.); (M.-S.B.); (M.D.); (B.S.M.); (M.v.d.A.)
- Health Services Research on Chronic Patients Network (REDISSEC), 28035 Madrid, Spain
| | - Robin Brünn
- Institute of General Practice, Goethe University, 60590 Frankfurt am Main, Germany; (R.B.); (T.S.D.); (M.-S.B.); (M.D.); (B.S.M.); (M.v.d.A.)
| | - Julia Nothacker
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (J.N.); (E.N.)
| | | | - Edris Nury
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (J.N.); (E.N.)
| | - Truc Sophia Dinh
- Institute of General Practice, Goethe University, 60590 Frankfurt am Main, Germany; (R.B.); (T.S.D.); (M.-S.B.); (M.D.); (B.S.M.); (M.v.d.A.)
| | - Maria-Sophie Brueckle
- Institute of General Practice, Goethe University, 60590 Frankfurt am Main, Germany; (R.B.); (T.S.D.); (M.-S.B.); (M.D.); (B.S.M.); (M.v.d.A.)
| | - Mirjam Dieckelmann
- Institute of General Practice, Goethe University, 60590 Frankfurt am Main, Germany; (R.B.); (T.S.D.); (M.-S.B.); (M.D.); (B.S.M.); (M.v.d.A.)
| | - Beate Sigrid Müller
- Institute of General Practice, Goethe University, 60590 Frankfurt am Main, Germany; (R.B.); (T.S.D.); (M.-S.B.); (M.D.); (B.S.M.); (M.v.d.A.)
| | - Marjan van den Akker
- Institute of General Practice, Goethe University, 60590 Frankfurt am Main, Germany; (R.B.); (T.S.D.); (M.-S.B.); (M.D.); (B.S.M.); (M.v.d.A.)
- Department of Family Medicine, School CAPHRI, Maastricht University, 6200 Maastricht, The Netherlands
- Academic Center for General Practice, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium
| |
Collapse
|
10
|
Liu C, Ying Z, Li Z, Zhang L, Li X, Gong W, Sun J, Fan X, Yang K, Wang X, Wei S, Dong N. Danzhi Xiaoyao Powder Promotes Neuronal Regeneration by Downregulating Notch Signaling Pathway in the Treatment of Generalized Anxiety Disorder. Front Pharmacol 2021; 12:772576. [PMID: 34912225 PMCID: PMC8666953 DOI: 10.3389/fphar.2021.772576] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/22/2021] [Indexed: 12/27/2022] Open
Abstract
Background: Generalized anxiety disorder (GAD) is one of the most common types of anxiety disorders with unclear pathogenesis. Our team's previous research found that extensive neuronal apoptosis and neuronal regeneration disorders occur in the hippocampus of GAD rats. Danzhi Xiaoyao (DZXYS) Powder can improve the anxiety behavior of rats, but its molecular mechanism is not well understood. Objective: This paper discusses whether the pathogenesis of GAD is related to the abnormal expression of Notch signal pathway, and whether the anti-anxiety effect of DZXYS promotes nerve regeneration in the hippocampus by regulating the Notch signaling pathway. Methods: The animal model of GAD was developed by the chronic restraint stress and uncertain empty bottle stimulation method. After the model was successfully established, the rats in the model preparation group were divided into the buspirone, DZXYS, DZXYS + DAPT, and model groups, and were administered the corresponding drug intervention. The changes in body weight and food intake of rats were continuously monitored throughout the process. The changes in anxiety behavior of rats were measured by open field experiment and elevated plus-maze test, and morphological changes and regeneration of neurons in the rat hippocampus were observed by HE staining and double immunofluorescence staining. Changes in the expression of key targets of the Notch signaling pathway in the hippocampus were monitored by real-time fluorescence quantitative PCR and western blotting. Results: In this study, we verified that the GAD model was stable and reliable, and found that the key targets of the Notch signaling pathway (Notch1, Hes1, Hes5, etc.) in the hippocampus of GAD rats were significantly upregulated, leading to the increased proliferation of neural stem cells in the hippocampus and increased differentiation into astrocytes, resulting in neuronal regeneration. DZXYS intervention in GAD rats can improve appetite, promote weight growth, and significantly reverse the anxiety behavior of GAD rats, which can inhibit the upregulation of key targets of the Notch signaling pathway, promote the differentiation of neural stem cells in the hippocampus into neurons, and inhibit their differentiation into astrocytes, thus alleviating anxiety behavior. Conclusion: The occurrence of GAD is closely related to the upregulation of the Notch signaling pathway, which hinders the regeneration of normal neurons in the hippocampus, while DZXYS can downregulate the Notch signaling pathway and promote neuronal regeneration in the hippocampus, thereby relieving anxiety behavior.
Collapse
Affiliation(s)
- Chao Liu
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Ji'nan, China
| | - Zhenhao Ying
- School of Rehabilitation Science, Shandong University of Traditional Chinese Medicine, Ji'nan, China
| | - Zifa Li
- Experimental Center, Shandong University of Traditional Chinese Medicine, Ji'nan, China.,Key Laboratory of Traditional Chinese Medicine Classical Theory, Ministry of Education, Shandong University of Traditional Chinese Medicine, Ji'nan, China.,Shandong Provincial Key Laboratory of Traditional Chinese Medicine for Basic Research, Shandong University of Traditional Chinese Medicine, Ji'nan, China
| | - Long Zhang
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Ji'nan, China
| | - Xin Li
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Ji'nan, China
| | - Wenbo Gong
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Ji'nan, China
| | - Jiang Sun
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Ji'nan, China
| | - Xuejing Fan
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Ji'nan, China
| | - Ke Yang
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Ji'nan, China
| | - Xingchen Wang
- Department of Neurology, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Ji'nan, China.,The Second Clinical Medical College, Shandong University of Traditional Chinese Medicine, Ji'nan, China
| | - Sheng Wei
- Experimental Center, Shandong University of Traditional Chinese Medicine, Ji'nan, China.,Key Laboratory of Traditional Chinese Medicine Classical Theory, Ministry of Education, Shandong University of Traditional Chinese Medicine, Ji'nan, China.,Shandong Provincial Key Laboratory of Traditional Chinese Medicine for Basic Research, Shandong University of Traditional Chinese Medicine, Ji'nan, China
| | - Ning Dong
- Department of Neurology, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Ji'nan, China.,The Second Clinical Medical College, Shandong University of Traditional Chinese Medicine, Ji'nan, China
| |
Collapse
|
11
|
Okabe‐Miyamoto K, Durnell E, Howell RT, Zizi M. Did zoom bomb? Negative video conferencing meetings during
COVID
‐19 undermined worker subjective productivity. HUMAN BEHAVIOR AND EMERGING TECHNOLOGIES 2021. [DOI: 10.1002/hbe2.317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
| | - Eric Durnell
- Aerendir Social Research Mountain View California USA
| | - Ryan T. Howell
- Department of Psychology San Francisco State University San Francisco California USA
| | - Martin Zizi
- Aerendir Social Research Mountain View California USA
| |
Collapse
|
12
|
Méndez R, Balanzá-Martínez V, Luperdi SC, Estrada I, Latorre A, González-Jiménez P, Feced L, Bouzas L, Yépez K, Ferrando A, Hervás D, Zaldívar E, Reyes S, Berk M, Menéndez R. Short-term neuropsychiatric outcomes and quality of life in COVID-19 survivors. J Intern Med 2021; 290:621-631. [PMID: 33533521 PMCID: PMC8013333 DOI: 10.1111/joim.13262] [Citation(s) in RCA: 125] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/21/2020] [Accepted: 01/08/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND The general medical impacts of coronavirus (COVID-19) are increasingly appreciated. However, its impact on neurocognitive, psychiatric health and quality of life (QoL) in survivors after the acute phase is poorly understood. We aimed to evaluate neurocognitive function, psychiatric symptoms and QoL in COVID-19 survivors shortly after hospital discharge. METHODS This was a cross-sectional analysis of a prospective study of hospitalized COVID-19 survivors followed up for 2 months after discharge. A battery of standardized instruments evaluating neurocognitive function, psychiatric morbidity and QoL (mental and physical components) was administered by telephone. RESULTS Of the 229 screened patients, 179 were included in the final analysis. Amongst survivors, the prevalence of moderately impaired immediate verbal memory and learning was 38%, delayed verbal memory (11.8%), verbal fluency (34.6%) and working memory (executive function) (6.1%), respectively. Moreover, 58.7% of patients had neurocognitive impairment in at least one function. Rates of positive screening for anxiety, depression and post-traumatic stress disorder were 29.6%, 26.8% and 25.1%, respectively. In addition, 39.1% of the patients had psychiatric morbidity. Low QoL for physical and mental components was detected in 44.1% and 39.1% of patients respectively. Delirium and psychiatric morbidity were associated with neurocognitive impairment, and female gender was related with psychiatric morbidity. CONCLUSION Hospitalized COVID-19 survivors showed a considerable prevalence of neurocognitive impairment, psychiatric morbidity and poor QoL in the short term. It is uncertain if these impacts persist over the long term.
Collapse
Affiliation(s)
- R Méndez
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain.,University of Barcelona, Barcelona, Spain
| | - V Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
| | - S C Luperdi
- Psychiatry Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,University of Valencia, Valencia, Spain
| | - I Estrada
- University of Valencia, Valencia, Spain
| | - A Latorre
- Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - P González-Jiménez
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - L Feced
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - L Bouzas
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - K Yépez
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - A Ferrando
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - D Hervás
- Data Science, Biostatistics & Bioinformatics, Health Research Institute La Fe, Valencia, Spain
| | - E Zaldívar
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - S Reyes
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - M Berk
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - R Menéndez
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain.,University of Valencia, Valencia, Spain.,Center for Biomedical Research Network in Respiratory Diseases (CIBERES), Madrid, Spain
| |
Collapse
|
13
|
Nyongesa MK, Mwangi P, Koot HM, Cuijpers P, Newton CRJC, Abubakar A. The reliability, validity and factorial structure of the Swahili version of the 7-item generalized anxiety disorder scale (GAD-7) among adults living with HIV from Kilifi, Kenya. Ann Gen Psychiatry 2020; 19:62. [PMID: 33133222 PMCID: PMC7594456 DOI: 10.1186/s12991-020-00312-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 10/19/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Generalized Anxiety Disorder (GAD) is under-investigated in people living with HIV/AIDS from sub-Saharan Africa. In part, this is due to paucity of culturally appropriate measures for GAD which are psychometrically robust. This study aimed to evaluate the reliability, factorial structure, and validity of Swahili version of the 7-item GAD questionnaire (GAD-7) among adults living with HIV. STUDY DESIGN Descriptive cross-sectional study. METHODS 450 adults receiving comprehensive care from an HIV specialized clinic in Kilifi County, coastal Kenya, were consecutively recruited. Swahili versions of GAD-7, Patient Health Questionnaire (PHQ-9) and a 12-item HIV stigma scale were administered alongside measures of psychosocial and health-related characteristics. Internal consistency, test-retest reliability, factorial structure, convergent validity, and discriminant validity of Swahili GAD-7 were examined using Cronbach's alpha (α), intra-class correlation coefficient (ICC), Confirmatory Factor Analysis (CFA), Pearson's correlation, and analysis of covariance (ANCOVA), respectively. RESULTS Internal consistency of Swahili GAD-7 was good, α = 0.82 (95% CI 0.78, 0.85). Its test-retest reliability (2 weeks apart) was acceptable, ICC = 0.70 (95% CI 0.55, 0.81). A confirmatory analysis of a one-factor solution indicated an excellent fit to the hypothesized structure (RMSEA = 0.00 [95% confidence interval 0.00, 0.05], CFI = 1.00, TLI = 1.00). Multi-group CFA substantiated factorial invariance for sex and age for the one-factor structure of Swahili GAD-7. Scores of GAD-7, Swahili version, significantly correlated with those of PHQ-9 (r = 0.73; p < 0.001) and the HIV stigma scale (r = 0.36; p < 0.001) suggesting good convergent validity. Statistically significant differences were observed between participants on first-line antiretroviral therapy compared to those on second-line treatment (F [1, 441] = 5.55, p = 0.02) indicative of good discriminant validity of Swahili GAD-7. CONCLUSION GAD-7 Swahili version retained its original unidimensional latent structure with good psychometric properties among adults living with HIV from Kilifi, Kenya. It can be used to identify symptoms of GAD in similar research settings. However, to confidently identify those in need of mental health treatment or referral services in HIV primary care clinics, more research on the validity of Swahili GAD-7 is needed especially its discriminant validity and diagnostic accuracy at different cut-off scores.
Collapse
Affiliation(s)
- Moses K. Nyongesa
- Neuroassessment Group, KEMRI/Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), KEMRI, Box 230, Kilifi, Kenya
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Paul Mwangi
- Neuroassessment Group, KEMRI/Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), KEMRI, Box 230, Kilifi, Kenya
| | - Hans M. Koot
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Charles R. J. C. Newton
- Neuroassessment Group, KEMRI/Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), KEMRI, Box 230, Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Amina Abubakar
- Neuroassessment Group, KEMRI/Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), KEMRI, Box 230, Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, UK
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| |
Collapse
|
14
|
Wang SM, Woo YS, Kim NY, Na HR, Lim HK, Bahk WM. Agomelatine for the Treatment of Generalized Anxiety Disorder: A Meta-Analysis. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2020; 18:423-433. [PMID: 32702221 PMCID: PMC7383014 DOI: 10.9758/cpn.2020.18.3.423] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 12/17/2022]
Abstract
Objective Despite multiple drugs available, a large proportion of patients with generalized anxiety disorder (GAD) do not show adequate response and remission. Thus, additional novel pharmacological agents are needed to increase treatment option for GAD. We aimed to investigate efficacy and safety of agomelatine in the treatment of GAD by conducting a meta-analysis. Methods An extensive search of multiple databases and clinical trial registries were conducted. Mean change in total scores on Hamilton Anxiety Rating Scale (HAM-A) from baseline to endpoint was our primary outcome measure. Secondary efficacy measures included response and remission rates, as defined by a 50% or greater reduction in HAM-A total scores and a score of 7 or less in HAM-A total scores at study endpoint respectively. Results Four published double blinded, randomized, placebo-controlled trials were included in this meta-analysis. Agomelatine more significantly (standardized mean difference = −0.56, p = 0.004) improved HAM-A total scores than placebo. The odds ratios (ORs) of agomelatine over placebo for response and remission rates were 3.75 (p < 0.00001) and 2.74 (p < 0.00001), respectively. Agomelatine was generally well tolerated with insignificance in dropout rate, somnolence, headache, nasopharyngitis, and dizziness compared with placebo. However, agomelatine showed significantly higher incidence of liver function increment (OR = 3.13, p = 0.01) and nausea (OR = 3.27, p = 0.02). Conclusion We showed that agomelatine may be another treatment option in patients with GAD. However, the results should be interpreted and translated into clinical practice with caution because the meta-analysis was based on limited numbers of clinical trials.
Collapse
Affiliation(s)
- Sheng-Min Wang
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Nak-Young Kim
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hae-Ran Na
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Kook Lim
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
15
|
Khansa W, Haddad C, Hallit R, Akel M, Obeid S, Haddad G, Soufia M, Kheir N, Abi Elias Hallit C, Khoury R, Salameh P, Hallit S. Interaction between anxiety and depression on suicidal ideation, quality of life, and work productivity impairment: Results from a representative sample of the Lebanese population. Perspect Psychiatr Care 2020; 56:270-279. [PMID: 31321788 DOI: 10.1111/ppc.12423] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 06/26/2019] [Accepted: 07/05/2019] [Indexed: 12/01/2022] Open
Abstract
PURPOSE To assess the association between the interaction of anxiety and depression on the suicidal ideation, quality of life (QOL), and work productivity/impairment in Lebanon. DESIGN Cross-sectional. METHODS 1487 participants were enrolled between November 2017 and March 2018. RESULTS The interaction of anxiety and depression (β = .101), higher depression alone (β = .021), higher anxiety traits (STAI-B) (β = .007) were associated with higher suicidal ideation. Higher depression (β = 1.177), having more anxiety traits (STAI-B) (β = .485) and higher anxiety (STAI-A) (β = .298) were associated with higher activity impairment. Higher depression, higher anxiety traits and state, were associated with lower mental and physical QOL. PRACTICE IMPLICATIONS Screening for anxiety and depression can help clinicians improve patients' QOL and work productivity and decrease the suicidal ideation risk.
Collapse
Affiliation(s)
- Wael Khansa
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Chadia Haddad
- Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Rabih Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut, Lebanon.,INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Sahar Obeid
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,Faculty of Philosophy and Human Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,Faculty of Pedagogy, Lebanese University, Beirut, Lebanon
| | - Georges Haddad
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Michel Soufia
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Nelly Kheir
- Faculty of Pedagogy, Universite de la Sainte Famille, Batroun, Lebanon
| | | | - Rony Khoury
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Pascale Salameh
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,Faculty of Pharmacy, Lebanese University, Beirut, Lebanon.,Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| |
Collapse
|
16
|
Dalgleish T, Black M, Johnston D, Bevan A. Transdiagnostic approaches to mental health problems: Current status and future directions. J Consult Clin Psychol 2020; 88:179-195. [PMID: 32068421 PMCID: PMC7027356 DOI: 10.1037/ccp0000482] [Citation(s) in RCA: 265] [Impact Index Per Article: 66.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 11/25/2019] [Indexed: 12/19/2022]
Abstract
Despite a longstanding and widespread influence of the diagnostic approach to mental ill health, there is an emerging and growing consensus that such psychiatric nosologies may no longer be fit for purpose in research and clinical practice. In their place, there is gathering support for a "transdiagnostic" approach that cuts across traditional diagnostic boundaries or, more radically, sets them aside altogether, to provide novel insights into how we might understand mental health difficulties. Removing the distinctions between proposed psychiatric taxa at the level of classification opens up new ways of classifying mental health problems, suggests alternative conceptualizations of the processes implicated in mental health, and provides a platform for novel ways of thinking about onset, maintenance, and clinical treatment and recovery from experiences of disabling mental distress. In this Introduction to a Special Section on Transdiagnostic Approaches to Psychopathology, we provide a narrative review of the transdiagnostic literature in order to situate the Special Section articles in context. We begin with a brief history of the diagnostic approach and outline several challenges it currently faces that arguably limit its applicability in current mental health science and practice. We then review several recent transdiagnostic approaches to classification, biopsychosocial processes, and clinical interventions, highlighting promising novel developments. Finally, we present some key challenges facing transdiagnostic science and make suggestions for a way forward. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
- Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge
| | - Melissa Black
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge
| | - David Johnston
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge
| | - Anna Bevan
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge
| |
Collapse
|
17
|
Lai CH. Major Depressive Disorder in Neuroimaging: What is Beyond Fronto-limbic Model? CURRENT PSYCHIATRY RESEARCH AND REVIEWS 2019. [DOI: 10.2174/1573400515666181213155225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
The major depressive disorder (MDD) is a chronic illness with major manifestations
in cognitive, social and occupational functions. The pathophysiological model is an intrigue
issue for scientists to understand the origin of MDD.
Objective:
In the beginning, the cortico-limbic-striato-pallidal-thalamic model has been proposed to
link the clinical symptoms with the abnormalities in brain structure and function. However, the
model is still evolving due to recent advances in the neuroimaging techniques, especially for functional
magnetic resonance imaging (fMRI). The recent findings in the fMRI studies in MDD showed
the importance of fronto-limbic model for the modulations between cognitive function and primitive
and negative emotions.
Method:
This review will focus on the literature of fMRI studies in MDD with findings not in the
fronto-limbic structures.
Results:
Additional regions beyond the fronto-limbic model have been observed in some literature of
MDD. Some regions in the parietal, temporal and occipital lobes have been shown with the alterations
in gray matter, white matter and brain function. The importance of sensory detection, visuospatial function,
language reception, motor response and emotional memories in these regions might provide the
clues to understand the cognitive misinterpretations related to altered reception of outside information,
behavioral responses related to biased cognition and emotional memories and clinical symptoms related
to the significant alterations of interactions between different brain regions.
Conclusion:
Future studies to establish a more comprehensive model for MDD will be warranted,
especially for the model beyond the fronto-limbic structures.
Collapse
Affiliation(s)
- Chien-Han Lai
- Institute of Biophotonics, National Yang-Ming University, Taipei City, Taiwan
| |
Collapse
|
18
|
Abstract
BACKGROUND Vortioxetine is an approved antidepressant that has also demonstrated positive effects on anxiety symptoms in subjects with generalized anxiety disorder (GAD). This post-hoc analysis evaluates the efficacy of vortioxetine in GAD subjects who are working and/or pursuing an education. METHODS In study NCT00744627, 301 GAD subjects were randomized to vortioxetine 5 mg or placebo for 8 weeks. Efficacy measures included the Hamilton Anxiety Rating Scale (HAM-A) total score, response/remission, global functioning (Sheehan Disability Scale [SDS]), and quality of life (Short Form-36 Health Survey). In study NCT00788034, 687 GAD subjects were treated open-label with vortioxetine 5 or 10 mg for 20 weeks, after which subjects in remission were randomized to fixed-dose of vortioxetine (5 or 10 mg) or placebo for at least 24 weeks. The primary endpoint was time to relapse. Analyses were completed in subjects working and/or pursuing an education at study entry and the full analysis set. RESULTS In study NCT00744627, the effect of vortioxetine versus placebo on HAM-A total score was -4.3 (p=0.0005) in working subjects (60% of total), while the effect in the total population was -3.8 (p=0.0001). The effect was greatest in subjects in professional (-4.5, p=0.0130) and associate professional positions (-7.6, p=0.0086). Greater effects in terms of response, remission, and the SDS and SF-36 were also observed. In NCT00788034, working subjects (69% of total) randomized to placebo were significantly more likely to relapse than subjects treated with vortioxetine (hazard ratio=2.9; p<0.001), while the hazard ratio in the total population was 2.7 (p<0.0001). CONCLUSIONS The beneficial effects of vortioxetine on anxiety symptoms, functioning, and quality of life are greater in adults with GAD who are working and/or pursuing an education versus the full GAD study population.
Collapse
|
19
|
Smith KE, Bunting AM, Golder S, Hall MT, Higgins GE, Logan TK. Prevalence and Correlates of Disability Among a Sample of Victimized Women on Probation and Parole. JOURNAL OF CORRECTIONAL HEALTH CARE 2019; 25:143-161. [PMID: 30866703 DOI: 10.1177/1078345819833387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this exploratory study was to establish the prevalence of disability as measured by self-reported Social Security Disability Insurance (SSDI) receipt among a sample of women on probation and parole who have experienced interpersonal victimization in childhood and/or adulthood. Women receiving SSDI were more likely to be older, White, to live alone, and to score lower on measures of social support compared to women not receiving SSDI. SSDI recipients were also more likely to report poorer health, chronic pain, and more frequent health care service utilization. High rates of adverse childhood experiences, rape, adult victimization, and an overall greater severity of post-traumatic stress disorder symptomatology were observed for women receiving SSDI. Groups had similar overall mental health profiles and diverged primarily on trauma variables. Findings support the need for trauma-informed care and highlight the possibility that some criminal justice system-involved women likely qualify for SSDI, yet are not receiving it.
Collapse
Affiliation(s)
- Kirsten E Smith
- 1 Kent School of Social Work, University of Louisville, Louisville, KY, USA
| | - Amanda M Bunting
- 2 Department of Sociology, University of Kentucky, Lexington, KY, USA
| | - Seana Golder
- 1 Kent School of Social Work, University of Louisville, Louisville, KY, USA
| | - Martin T Hall
- 1 Kent School of Social Work, University of Louisville, Louisville, KY, USA
| | - George E Higgins
- 3 Department of Criminal Justice, University of Louisville, Louisville, KY, USA
| | - T K Logan
- 4 Department of Behavioral Science, University of Kentucky, Lexington, KY, USA.,5 Center on Drug and Alcohol and Research, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
20
|
Tiirikainen K, Haravuori H, Ranta K, Kaltiala-Heino R, Marttunen M. Psychometric properties of the 7-item Generalized Anxiety Disorder Scale (GAD-7) in a large representative sample of Finnish adolescents. Psychiatry Res 2019; 272:30-35. [PMID: 30579178 DOI: 10.1016/j.psychres.2018.12.004] [Citation(s) in RCA: 165] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 11/06/2018] [Accepted: 12/02/2018] [Indexed: 02/02/2023]
Abstract
Symptoms of generalized anxiety disorder (GAD) are common among adolescents and can lead to severe psychosocial impairment, yet there is a lack of a good quality scale to measure symptoms of generalized anxiety in young people. The 7-item Generalized Anxiety Disorder Scale (GAD-7) is a self-report scale used to measure GAD symptoms and has been validated in adult populations, but the measure's psychometric properties regarding adolescents are unknown. The aim of this study was to investigate the reliability, factorial validity, and construct validity of the GAD-7 in adolescents in a nationally representative sample from a general population. Our study was based on Finnish survey data on 111,171 adolescents aged 14-18 years. Our results show that the GAD-7 demonstrates good psychometric properties in adolescents. The internal consistency of the GAD-7 was good (Cronbach's α = 0.91) and the instrument's unidimensional factor structure was supported. The associations of GAD-7 sum scores with self-report measures of depression and social anxiety supported construct validity. The psychometric properties of the GAD-7 in this sample of adolescents were similar to those reported among adults. However, studies in which diagnostic interviews are performed are needed to demonstrate the diagnostic efficacy of the measure in this age group.
Collapse
Affiliation(s)
- Kati Tiirikainen
- Mental Health Unit, National Institute for Health and Welfare, Box 30, 00271 Helsinki, Finland.
| | - Henna Haravuori
- Mental Health Unit, National Institute for Health and Welfare, Box 30, 00271 Helsinki, Finland; Helsinki University Central Hospital, Department of Adolescent Psychiatry, PO Box 590,00029 HUS, Finland
| | - Klaus Ranta
- Helsinki University Central Hospital, Department of Adolescent Psychiatry, PO Box 590,00029 HUS, Finland
| | - Riittakerttu Kaltiala-Heino
- Department of Adolescent Psychiatry, Tampere University Hospital, Box 2000, 33521 Tampere, Finland; Faculty of Medicine and Life Sciences, University of Tampere, PB 100, FI-33014, Finland
| | - Mauri Marttunen
- Mental Health Unit, National Institute for Health and Welfare, Box 30, 00271 Helsinki, Finland; Helsinki University Central Hospital, Department of Adolescent Psychiatry, PO Box 590,00029 HUS, Finland
| |
Collapse
|
21
|
Kasper S, Müller WE, Volz HP, Möller HJ, Koch E, Dienel A. Silexan in anxiety disorders: Clinical data and pharmacological background. World J Biol Psychiatry 2018; 19:412-420. [PMID: 28511598 DOI: 10.1080/15622975.2017.1331046] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Silexan is a lavender oil preparation available in 80-mg capsules. Here we review clinical trials investigating its anxiolytic efficacy, safety and tolerability in humans, as well as preclinical investigations supporting this therapeutic use. METHODS Besides three selected publications reporting preclinical investigations, seven clinical trials are included, of which five had a treatment duration of 6 or 10 weeks. Primary outcome measure was the HAM-A total score reduction, while single items were assessed with regard to effects on concomitant depressive symptoms and on quality of sleep. RESULTS In patients with subthreshold (subsyndromal) anxiety or generalised anxiety disorder (GAD), an anxiolytic effect of Silexan was evident after 2 weeks. HAM-A total score reductions between baseline and end of treatment were significantly superior to placebo in patients with subthreshold anxiety and comparable with those achieved under lorazepam or paroxetine in patients with GAD. In addition, Silexan had beneficial effects on typical concomitant symptoms of anxiety disorders, such as impaired sleep, somatic complaints, co-morbid depression or decreased quality of life. Except for mild gastrointestinal symptoms, Silexan did not induce any adverse effects and did not cause drug interactions, sedation or withdrawal symptoms at daily doses of 80 or 160 mg. CONCLUSIONS Silexan is a safe and effective treatment in anxiety disorders.
Collapse
Affiliation(s)
- Siegfried Kasper
- a Department of Psychiatry and Psychotherapy , Medical University of Vienna , Vienna , Austria
| | - Walter E Müller
- b Department of Pharmacology Biocenter , Goethe-University , Frankfurt , Germany
| | - Hans-Peter Volz
- c Psychotherapy and Psychosomatic Medicine , Hospital for Psychiatry , Werneck , Germany
| | - Hans-Jürgen Möller
- d Clinic for Psychiatry and Psychotherapy , Ludwig Maximilians University , Munich , Germany
| | - Egon Koch
- e Research and Development Department, Dr. Willmar-Schwabe GmbH & Co. KG , Karlsruhe , Germany
| | - Angelika Dienel
- e Research and Development Department, Dr. Willmar-Schwabe GmbH & Co. KG , Karlsruhe , Germany
| |
Collapse
|
22
|
Taillieu TL, Afifi TO, Turner S, Cheung K, Fortier J, Zamorski M, Sareen J. Risk Factors, Clinical Presentations, and Functional Impairments for Generalized Anxiety Disorder in Military Personnel and the General Population in Canada. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63:610-619. [PMID: 29304289 PMCID: PMC6109886 DOI: 10.1177/0706743717752878] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
OBJECTIVE This study sought to examine differences in sociodemographic risk factors, comorbid mental conditions, clinical presentations, and functional impairments associated with past-year generalized anxiety disorder (GAD) between Canadian Armed Forces (CAF) Regular Force personnel and the Canadian general population (CGP). METHOD Data were from 2 nationally representative surveys collected by Statistics Canada: 1) the Canadian Community Health Survey on Mental Health, collected in 2012 ( N = 25,113; response rate = 68.9%); and 2) the Canadian Forces Mental Health Survey, collected in 2013 ( N = 8,161; response rate = 79.8%). RESULTS The prevalence of lifetime and past-year GAD was significantly higher in the CAF (12.1% and 4.7%) than in the CGP (9.5% and 3.0%). Comorbid mental disorders were strongly associated with GAD in both populations. Although the content area of worry and the GAD symptoms endorsed were similar, CAF personnel were significantly more likely to endorse specific types of worries (i.e., success at school/work, social life, mental health, being away from home or loved ones, and war or revolution) and specific symptoms of GAD (i.e., restless, keyed up, or on edge and more irritable than usual) than civilians, after adjusting for sociodemographic covariates and comorbid mental disorders. CAF personnel with past-year GAD reported significantly higher functional impairment at home than civilians with past-year GAD. CONCLUSION GAD is a substantial public health concern associated with significant impairment and disability in both military and civilian populations. GAD in military and civilian populations shows similarities and differences: Key similarities include its extensive comorbidity and significant functional impairment, whereas key differences include the focus of worries and symptom profile.
Collapse
Affiliation(s)
- Tamara L. Taillieu
- Applied Health Sciences Program, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tracie O. Afifi
- Departments of Community Health Sciences and Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sarah Turner
- Departments of Community Health Sciences and Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kristene Cheung
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Janique Fortier
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mark Zamorski
- Directorate of Mental Health, Canadian Forces Health Services Group Headquarters, Ottawa, Ontario, Canada
| | - Jitender Sareen
- Departments of Psychiatry, Psychology, and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| |
Collapse
|
23
|
Dogra S, Good J, Buman MP, Gardiner PA, Copeland JL, Stickland MK. Physical activity and sedentary time are related to clinically relevant health outcomes among adults with obstructive lung disease. BMC Pulm Med 2018; 18:98. [PMID: 29879930 PMCID: PMC5992845 DOI: 10.1186/s12890-018-0659-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 05/23/2018] [Indexed: 12/22/2022] Open
Abstract
Background The purpose of the current study was to determine the association between sedentary time and physical activity with clinically relevant health outcomes among adults with impaired spirometry and those with or without self-reported obstructive lung disease (asthma or COPD). Methods Data from participants of the Canadian Longitudinal Study on Aging were used for analysis (n = 4156). Lung function was assessed using spirometry. Adults were said to have impaired spirometry if their Forced Expiratory Volume in 1 s was <5th percentile lower limit of normal (LLN). A modified version of the Physical Activity Scale for the Elderly was used to assess sitting time and physical activity levels. Healthcare use and quality of life outcomes were assessed using self report. Results Among those with asthma, participating in strengthening activities was associated with lower odds of reporting poor perceived health (OR = 0.65, CI: 0.53, 0.79), poor perceived mental-health (OR = 0.73, CI: 0.60, 0.88), unhealthy aging (OR = 0.68, CI: 0.56, 0.83), and reporting an emergency department visit in the past 12 months (OR = 0.76, CI: 0.60, 0.95). Among those with COPD, those who reported highest weekly sedentary time had higher odds of reporting poor perceived health (OR = 2.70, CI: 1.72, 4.24), poor perceived mental-health (OR = 1.99, CI: 1.29, 3.06), and unhealthy aging (OR = 3.04, CI: 1.96, 4.72). Among those below the LLN, sitting time (OR = 2.57, CI: 1.40, 4.72) and moderate intensity physical activity (OR = 0.23, CI: 0.09, 0.63) were associated with overnight hospital stays. Conclusions Higher physical activity levels and lower sedentary time may be associated with lower healthcare use and better quality of life. This research may have implications related to the use of physical activity for improving health outcomes and quality of life among adults with obstructive lung disease or impaired spirometry. Electronic supplementary material The online version of this article (10.1186/s12890-018-0659-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Shilpa Dogra
- Faculty of Health Sciences (Kinesiology), University of Ontario Institute of Technology, 2000 Simcoe St N, Oshawa, ON, L1H-7K4, Canada.
| | - Joshua Good
- Faculty of Health Sciences (Kinesiology), University of Ontario Institute of Technology, 2000 Simcoe St N, Oshawa, ON, L1H-7K4, Canada
| | - Matthew P Buman
- College of Health Solutions, Arizona State University, 550 N 3rd Street, Phoenix, AZ, 85004, USA
| | - Paul A Gardiner
- Faculty of Medicine, The University of Queensland, Level 2, Building 33, Princess Alexandra Hospital, Woolloongabba, QLD, 4102, Australia
| | - Jennifer L Copeland
- Department of Kinesiology and Physical Education, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada
| | - Michael K Stickland
- Faculty of Medicine and Dentistry, University of Alberta, and G.F. Macdonald Centre for Lung Health, 3-135 Clinical Sciences Building, 11304 - 83 Avenue, Edmonton, Alberta, T6G 2J3, Canada
| |
Collapse
|
24
|
Visted E, Vøllestad J, Nielsen MB, Schanche E. Emotion Regulation in Current and Remitted Depression: A Systematic Review and Meta-Analysis. Front Psychol 2018; 9:756. [PMID: 29867700 PMCID: PMC5968125 DOI: 10.3389/fpsyg.2018.00756] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 04/30/2018] [Indexed: 01/19/2023] Open
Abstract
Background: Major Depressive Disorder (MDD) is a highly prevalent, recurrent, and potentially chronic disorder. Identifying risk factors and underlying mechanisms to inform preventive and therapeutic interventions is therefore imperative. Emotion regulation is a proposed factor in the development and maintenance of MDD. The aim of the present review was to summarize and synthesize research on self-reported emotion regulation strategy use and emotion regulation abilities in adults diagnosed with current and remitted MDD. Methods: Seventy-two eligible studies were retrieved from databases through a systematic literature search. Group differences between individuals with current MDD, remitted MDD, and healthy controls were calculated using meta-analytic procedures. Meta-regression analyses investigated potential moderator effects on emotion regulation difficulties. Results: Results indicated that individuals with current MDD report higher maladaptive emotion regulation strategy use for avoidance (Hedges' g = 1.3), rumination (g = 2.1), and suppression (g = 1.1) compared to healthy controls. Also, they reported lower adaptive emotion regulation strategy use for acceptance (g = −1.0), problem solving (g = −1.0), and reappraisal (g = −0.7). Individuals with current MDD reported limited general emotion regulation abilities, indicated by higher alexithymia (g = 1.45), lower emotional awareness (g = −0.95), emotional clarity (g = −1.50) and emotional tolerance (g = −1.89). Similar results were found in individuals with remitted MDD for avoidance (g = 1.0), rumination (g = 1.1), suppression (g = 0.6), and general emotion regulation abilities. However, no difference was found between individuals with remitted MDD and healthy controls for adaptive emotion regulation strategies. Meta-regression analyses suggest that age of illness onset, comorbid anxiety and duration of remission influence emotion regulation. Conclusion: The present review and meta-analysis indicates that individuals with current and remitted MDD have difficulties with emotion regulation compared to individuals who have never been depressed. Although depressive symptoms improve, emotion regulation difficulties may continue, and could be a contributing factor to relapse. Our findings inform future research on emotion regulation and psychotherapeutic interventions.
Collapse
Affiliation(s)
- Endre Visted
- Department of Clinical Psychology, University of Bergen, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Jon Vøllestad
- Department of Clinical Psychology, University of Bergen, Bergen, Norway.,Solli District Psychiatric Centre (DPS), Bergen, Norway
| | - Morten Birkeland Nielsen
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway.,Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | | |
Collapse
|
25
|
Fındıklı E, Camkurt MA, İzci F, Karaaslan MF, Fındıklı HA, Sümer P, Kurutaş EB. The Diagnostic Value of Malondialdehyde, Superoxide Dismutase and Catalase Activity in Drug Naïve, First Episode, Non-Smoker Generalized Anxiety Disorder Patients. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2018; 16:88-94. [PMID: 29397670 PMCID: PMC5810442 DOI: 10.9758/cpn.2018.16.1.88] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 04/03/2016] [Accepted: 04/25/2016] [Indexed: 12/31/2022]
Abstract
Objective Generalized anxiety disorder (GAD) is a common anxiety disorder. Although lots of research done to reveal neurobiological basis of GAD, it is still unclear. Diagnosis of GAD depends on subjective complaints of patients, thus the need for a biological marker is constantly emerging. In this study, we aimed to investigate diagnostic value of malondialdehyde (MDA), superoxide dismutase (SOD) and catalase (CAT) in GAD. Methods We evaluated MDA, SOD, and CAT levels in peripheral blood of 46 patients and 45 controls. MDA was measured with Ohkawa’s methods, SOD was measured with Fridovich method, and CAT was measured with Beutler’s method. Results MDA was significantly increased in patients than controls, medians 4.05 nmol/mg and 1.71 nmol/mg respectively, p<0.001; SOD and CAT activity was significantly decreased in patients than controls, medians of SOD were 159.07 U/mg and 301.87 U/mg, p<0.001 respectively, medians for CAT were 138.47 U/mg and 160.60 U/mg respectively. We found high correlation between Hamilton Anxiety Rating Scale and SOD, MDA r values were 0.723 and 0.715 respectively, p<0.001 for both. Receiver operator characteristic (ROC) curve analysis showed high diagnostic performance for MDA and SOD, low diagnostic performance for CAT, areas under curve were 1.0, 1.0, and 0.648 respectively. Conclusion Our results reveal possible diagnostic value of MDA, less likely of SOD but not CAT. Future studies should investigate diagnostic value of oxidants and antioxidantn enzymes in larger samples and include diagnostic value of these parameters.
Collapse
Affiliation(s)
- Ebru Fındıklı
- Department of Psychiatry, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Mehmet Akif Camkurt
- Department of Psychiatry, Afşin State Hospital, Afşin, Kahramanmaraş, Turkey
| | - Filiz İzci
- Department of Psychiatry, İstanbul Bilgi University, İstanbul, Turkey
| | | | - Hüseyin Avni Fındıklı
- Department of Internal Medicine, School of Medicine, Adıyaman University, Adıyaman, Turkey
| | - Perihan Sümer
- Department of Biochemistry, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Ergül Belge Kurutaş
- Department of Biochemistry, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| |
Collapse
|
26
|
Latas M, Trajković G, Bonevski D, Naumovska A, Vučinić Latas D, Bukumirić Z, Starčević V. Psychiatrists' treatment preferences for generalized anxiety disorder. Hum Psychopharmacol 2018; 33. [PMID: 29266492 DOI: 10.1002/hup.2643] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 10/07/2017] [Accepted: 11/14/2017] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The objective of this study is to ascertain psychiatrists' treatment preferences for generalized anxiety disorder (GAD) and compare them to the same psychiatrists' treatment preferences in the hypothetical scenario that treatment is to be administered to themselves as patients. METHODS A questionnaire was completed by 221 psychiatrists from 3 Balkan countries. They were asked to indicate their treatment preferences for patients with GAD and for themselves as patients. RESULTS A large majority of psychiatrists chose selective serotonin reuptake inhibitors/serotonin and norepinephrine reuptake inhibitors as preferred treatment option for GAD patients. Fewer psychiatrists selected benzodiazepines and pregabalin and about one third chose psychotherapy. The majority of psychiatrists chose the same treatments for their patients and for themselves, with main differences being in terms of pharmacotherapy (especially benzodiazepines) being less frequently recommended and psychotherapy being more frequently recommended as preferred treatment option for psychiatrists as patients. CONCLUSIONS Treatment preferences for GAD by psychiatrists in the 3 West Balkan countries were mostly in accordance with treatment guidelines and treatment preferences for patients and for psychiatrists as patients were mostly concordant. However, some psychiatrists were more likely to choose pharmacotherapy for patients and psychotherapy for themselves as patients. These findings have implications for education of psychiatrists and for efforts to improve treatment guidelines and mental health services.
Collapse
Affiliation(s)
- Milan Latas
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic of Psychiatry, Clinical Centre of Serbia, Belgrade, Serbia
| | - Goran Trajković
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Dimitar Bonevski
- Psychiatric Hospital "Skopje", Centre for Mental Health "Centar", Skopje, Macedonia
| | - Andromahi Naumovska
- Psychiatric Hospital "Skopje", Centre for Mental Health "Centar", Skopje, Macedonia
| | - Dušanka Vučinić Latas
- Psychiatric Hospital, Clinical Centre "Dr Dragisa Misovic - Dedinje" and Department of Psychology, University Singidunum, Belgrade, Serbia
| | - Zoran Bukumirić
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vladan Starčević
- Sydney Medical School - Nepean, Discipline of Psychiatry, University of Sydney, Sydney, Australia
| |
Collapse
|
27
|
Lee SH, Park Y, Jin MJ, Lee YJ, Hahn SW. Childhood Trauma Associated with Enhanced High Frequency Band Powers and Induced Subjective Inattention of Adults. Front Behav Neurosci 2017; 11:148. [PMID: 28860979 PMCID: PMC5559431 DOI: 10.3389/fnbeh.2017.00148] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 07/25/2017] [Indexed: 12/21/2022] Open
Abstract
Childhood trauma can lead to various psychological and cognitive symptoms. It has been demonstrated that high frequency electroencephalogram (EEG) powers could be closely correlated with inattention. In this study, we explored the relationship between high frequency EEG powers, inattention, symptoms of adult attention deficit hyperactivity disorder (ADHD), and childhood traumatic experiences. A total of 157 healthy Korean adult volunteers were included and divided into two groups using the Childhood Trauma Questionnaire (CTQ) score. The subjective inattention scores, ADHD scale, and anxiety and depression symptom were evaluated. EEG was recorded and quantitative band powers were analyzed. The results were as follows: (1) the high CTQ group showed significantly increased delta, beta1, beta2, beta3 and gamma, and significantly decreased low alpha power compared to the low CTQ group; (2) the high CTQ group had higher inattention score compared to the low CTQ group; (3) the high CTQ group had higher adult ADHD scores; (4) CTQ scores showed significant positive correlations with inattention scores, and adult ADHD scores; (5) unexpectedly, the inattention scores showed significant positive correlations with beta powers and a negative correlation with low alpha power; and (6) the moderated mediation model was confirmed: the depression fully mediated the path from state anxiety to inattention, and the CTQ significantly moderated the pathway between anxiety and depression. Our results show the possibility that childhood adversity may cause subjective inattention and adult ADHD symptoms. Depressive symptoms fully mediated the path from anxiety to inattention, especially in those who report severe childhood traumatic experiences.
Collapse
Affiliation(s)
- Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje UniversityGoyang, South Korea.,Department of Psychiatry, Inje University, Ilsan-Paik HospitalGoyang, South Korea
| | - Yeonsoo Park
- Clinical Emotion and Cognition Research Laboratory, Inje UniversityGoyang, South Korea.,Department of Psychology, Sogang UniversitySeoul, South Korea
| | - Min Jin Jin
- Clinical Emotion and Cognition Research Laboratory, Inje UniversityGoyang, South Korea.,Department of Psychology, Chung-Ang UniversitySeoul, South Korea
| | - Yeon Jeong Lee
- Clinical Emotion and Cognition Research Laboratory, Inje UniversityGoyang, South Korea.,Department of Psychiatry, Soonchunhyang University Seoul HospitalSeoul, South Korea
| | - Sang Woo Hahn
- Department of Psychiatry, Soonchunhyang University Seoul HospitalSeoul, South Korea
| |
Collapse
|
28
|
Salk RH, Hyde JS, Abramson LY. Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms. Psychol Bull 2017; 143:783-822. [PMID: 28447828 PMCID: PMC5532074 DOI: 10.1037/bul0000102] [Citation(s) in RCA: 1113] [Impact Index Per Article: 159.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In 2 meta-analyses on gender differences in depression in nationally representative samples, we advance previous work by including studies of depression diagnoses and symptoms to (a) estimate the magnitude of the gender difference in depression across a wide array of nations and ages; (b) use a developmental perspective to elucidate patterns of gender differences across the life span; and (c) incorporate additional theory-driven moderators (e.g., gender equity). For major depression diagnoses and depression symptoms, respectively, we meta-analyzed data from 65 and 95 articles and their corresponding national data sets, representing data from 1,716,195 and 1,922,064 people in over 90 different nations. Overall, odds ratio (OR) = 1.95, 95% confidence interval (CI) [1.88, 2.03], and d = 0.27 [0.26, 0.29]. Age was the strongest predictor of effect size. The gender difference for diagnoses emerged earlier than previously thought, with OR = 2.37 at age 12. For both meta-analyses, the gender difference peaked in adolescence (OR = 3.02 for ages 13-15, and d = 0.47 for age 16) but then declined and remained stable in adulthood. Cross-national analyses indicated that larger gender differences were found in nations with greater gender equity, for major depression, but not depression symptoms. The gender difference in depression represents a health disparity, especially in adolescence, yet the magnitude of the difference indicates that depression in men should not be overlooked. (PsycINFO Database Record
Collapse
Affiliation(s)
- Rachel H. Salk
- Department of Psychology, University of Wisconsin –
Madison
- Department of Psychiatry, University of Pittsburgh School of
Medicine
| | - Janet S. Hyde
- Department of Psychology, University of Wisconsin –
Madison
| | | |
Collapse
|
29
|
Salk RH, Hyde JS, Abramson LY. Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms. Psychol Bull 2017. [PMID: 28447828 DOI: 10.1037/bu10000102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
In 2 meta-analyses on gender differences in depression in nationally representative samples, we advance previous work by including studies of depression diagnoses and symptoms to (a) estimate the magnitude of the gender difference in depression across a wide array of nations and ages; (b) use a developmental perspective to elucidate patterns of gender differences across the life span; and (c) incorporate additional theory-driven moderators (e.g., gender equity). For major depression diagnoses and depression symptoms, respectively, we meta-analyzed data from 65 and 95 articles and their corresponding national data sets, representing data from 1,716,195 and 1,922,064 people in over 90 different nations. Overall, odds ratio (OR) = 1.95, 95% confidence interval (CI) [1.88, 2.03], and d = 0.27 [0.26, 0.29]. Age was the strongest predictor of effect size. The gender difference for diagnoses emerged earlier than previously thought, with OR = 2.37 at age 12. For both meta-analyses, the gender difference peaked in adolescence (OR = 3.02 for ages 13-15, and d = 0.47 for age 16) but then declined and remained stable in adulthood. Cross-national analyses indicated that larger gender differences were found in nations with greater gender equity, for major depression, but not depression symptoms. The gender difference in depression represents a health disparity, especially in adolescence, yet the magnitude of the difference indicates that depression in men should not be overlooked. (PsycINFO Database Record
Collapse
Affiliation(s)
- Rachel H Salk
- Department of Psychology, University of Wisconsin-Madison
| | - Janet S Hyde
- Department of Psychology, University of Wisconsin-Madison
| | - Lyn Y Abramson
- Department of Psychology, University of Wisconsin-Madison
| |
Collapse
|
30
|
Hope MO, Assari S, Cole-Lewis YC, Caldwell CH. Religious Social Support, Discrimination, and Psychiatric Disorders among Black Adolescents. RACE AND SOCIAL PROBLEMS 2017; 9:102-114. [PMID: 32089748 PMCID: PMC7034935 DOI: 10.1007/s12552-016-9192-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Discrimination is a common experience for Black youth that can jeopardize their mental health. However, research suggests that various dimensions of religion have positive effects on youths' mental health and well-being. Additionally, exposure to discrimination may vary by youths' socio-demographic factors, such as gender and ethnicity. Numerous studies identify the protective effects of emotional and tangible religious social support on the mental health of Black adults reporting discrimination. Conversely, fewer studies address the influence of emotional and tangible religious social support on mental health for Black adolescents experiencing discrimination, while also accounting for socio-demographic heterogeneity among Black adolescents. Historically, religion has played an instrumental role in the diverse narratives of the Black Diaspora in the United States. It is important to account for its potential protective effects for Black youth. Examining these factors using a compensatory risk and resilience model, our study finds that Black adolescents who experience discrimination are also more likely to meet criteria for a psychiatric disorder. Additionally, those who report experiencing religious social support are less likely to meet criteria for a psychiatric disorder. These findings were not moderated by the sociodemographic factors of race or ethnicity. To date, this investigation is one of the first to examine the effect of different types of religious social support in the presence of discrimination on psychiatric illness among African American and Caribbean Black adolescents.
Collapse
Affiliation(s)
| | - Shervin Assari
- Department of Psychiatry, University of Michigan-Ann Arbor
- Center for Research on Ethnicity, Culture, and Health, University of Michigan School of Public Health
| | - Yasmin C. Cole-Lewis
- Department of Psychiatry, University of Michigan-Ann Arbor
- Department of Psychology, University of Michigan-Ann Arbor
| | - Cleopatra Howard Caldwell
- Center for Research on Ethnicity, Culture, and Health, University of Michigan School of Public Health
- Department of Health Behavior and Health Education, University of Michigan School of Public Health
| |
Collapse
|
31
|
Ruscio AM, Hallion LS, Lim CCW, Aguilar-Gaxiola S, Al-Hamzawi A, Alonso J, Andrade LH, Borges G, Bromet EJ, Bunting B, Caldas de Almeida JM, Demyttenaere K, Florescu S, de Girolamo G, Gureje O, Haro JM, He Y, Hinkov H, Hu C, de Jonge P, Karam EG, Lee S, Lepine JP, Levinson D, Mneimneh Z, Navarro-Mateu F, Posada-Villa J, Slade T, Stein DJ, Torres Y, Uda H, Wojtyniak B, Kessler RC, Chatterji S, Scott KM. Cross-sectional Comparison of the Epidemiology of DSM-5 Generalized Anxiety Disorder Across the Globe. JAMA Psychiatry 2017; 74:465-475. [PMID: 28297020 PMCID: PMC5594751 DOI: 10.1001/jamapsychiatry.2017.0056] [Citation(s) in RCA: 215] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
IMPORTANCE Generalized anxiety disorder (GAD) is poorly understood compared with other anxiety disorders, and debates persist about the seriousness of this disorder. Few data exist on GAD outside a small number of affluent, industrialized nations. No population-based data exist on GAD as it is currently defined in DSM-5. OBJECTIVE To provide the first epidemiologic data on DSM-5 GAD and explore cross-national differences in its prevalence, course, correlates, and impact. DESIGN, SETTING, AND PARTICIPANTS Data come from the World Health Organization World Mental Health Survey Initiative. Cross-sectional general population surveys were carried out in 26 countries using a consistent research protocol and assessment instrument. A total of 147 261 adults from representative household samples were interviewed face-to-face in the community. The surveys were conducted between 2001 and 2012. Data analysis was performed from July 22, 2015, to December 12, 2016. MAIN OUTCOMES AND MEASURES The Composite International Diagnostic Interview was used to assess GAD along with comorbid disorders, role impairment, and help seeking. RESULTS Respondents were 147 261 adults aged 18 to 99 years. The surveys had a weighted mean response rate of 69.5%. Across surveys, DSM-5 GAD had a combined lifetime prevalence (SE) of 3.7% (0.1%), 12-month prevalence of 1.8% (0.1%), and 30-day prevalence of 0.8% (0). Prevalence estimates varied widely across countries, with lifetime prevalence highest in high-income countries (5.0% [0.1%]), lower in middle-income countries (2.8% [0.1%]), and lowest in low-income countries (1.6% [0.1%]). Generalized anxiety disorder typically begins in adulthood and persists over time, although onset is later and clinical course is more persistent in lower-income countries. Lifetime comorbidity is high (81.9% [0.7%]), particularly with mood (63.0% [0.9%]) and other anxiety (51.7% [0.9%]) disorders. Severe role impairment is common across life domains (50.6% [1.2%]), particularly in high-income countries. Treatment is sought by approximately half of affected individuals (49.2% [1.2%]), especially those with severe role impairment (59.4% [1.8%]) or comorbid disorders (55.8% [1.4%]) and those living in high-income countries (59.0% [1.3%]). CONCLUSIONS AND RELEVANCE The findings of this study show that DSM-5 GAD is more prevalent than DSM-IV GAD and is associated with substantial role impairment. The disorder is especially common and impairing in high-income countries despite a negative association between GAD and socioeconomic status within countries. These results underscore the public health significance of GAD across the globe while uncovering cross-national differences in prevalence, course, and impairment that require further investigation.
Collapse
Affiliation(s)
| | - Lauren S. Hallion
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Carmen C. W. Lim
- Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Sergio Aguilar-Gaxiola
- Center for Reducing Health Disparities, University of California Davis Health System, Sacramento
| | - Ali Al-Hamzawi
- College of Medicine, Al-Qadisiya University, Diwania Governorate, Iraq
| | - Jordi Alonso
- Health Services Research Unit, Institut Municipal d'Investigació Médica–Hospital del Mar Medical Research Institute, Barcelona, Spain7Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain 8CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Laura Helena Andrade
- Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Guilherme Borges
- Calzada México Xochimilco No. 101 Delegación Tlalpan, Distrito Federal, Mexico
| | - Evelyn J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York
| | - Brendan Bunting
- School of Psychology, Ulster University, Londonderry, United Kingdom
| | - José Miguel Caldas de Almeida
- Chronic Diseases Research Center and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Koen Demyttenaere
- Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Silvia Florescu
- National School of Public Health, Management and Professional Development, Bucharest, Romania
| | - Giovanni de Girolamo
- Istituto Di Ricovero e Cura a Carattere Scientifico, St John of God Clinical Research Centre, Brescia, Italy
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica en Red Salud Mental, Universitat de Barcelona, Barcelona, Spain
| | - Yanling He
- Shanghai Mental Health Center, Shanghai, China
| | - Hristo Hinkov
- National Center for Public Health and Analyses, Sofia, Bulgaria
| | - Chiyi Hu
- Shenzhen Institute of Mental Health & Shenzhen Kanging Hospital, Shenzhen, China
| | - Peter de Jonge
- Developmental Psychology, Department of Psychology, Rijksuniversiteit Groningen, Groningen, the Netherlands23Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands
| | - Elie G. Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon25Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon26Institute for Development Research Advocacy and Applied Care, Beirut, Lebanon
| | - Sing Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | - Jean-Pierre Lepine
- Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes, Paris, France
| | - Daphna Levinson
- Ministry of Health Israel, Mental Health Services, Jerusalem, Israel
| | - Zeina Mneimneh
- Institute for Development Research Advocacy and Applied Care, Beirut, Lebanon30Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor
| | - Fernando Navarro-Mateu
- Unidad de Docencia, Investigación y Formación en Salud Mental, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud, Instituto Murciano de Investigación Biosanitaria–Arrixaca, Centro de Investigación Biomédica en Red Epidemiología y Salud Pública–Murcia, Murcia, Spain
| | | | - Tim Slade
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Republic of South Africa
| | - Yolanda Torres
- Center for Excellence on Research in Mental Health, CES University, Medellín, Colombia
| | - Hidenori Uda
- Health, Social Welfare, and Environmental Department, Kagoshima Regional Promotion Bureau, Kagoshima Prefecture, Japan
| | - Bogdan Wojtyniak
- Centre of Monitoring and Analyses of Population Health, National Institute of Public Health–National Institute of Hygiene, Warsaw, Poland
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Somnath Chatterji
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Kate M. Scott
- Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand
| |
Collapse
|
32
|
Kinney KL, Boffa JW, Amir N. Gender Difference in Attentional Bias Toward Negative and Positive Stimuli in Generalized Anxiety Disorder. Behav Ther 2017; 48:277-284. [PMID: 28390492 DOI: 10.1016/j.beth.2016.06.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 06/02/2016] [Accepted: 06/03/2016] [Indexed: 11/24/2022]
Abstract
Females are two times as likely as males to develop generalized anxiety disorder (GAD; Steiner et al., 2005; Vesga-López et al., 2008). Moreover, the clinical presentation of GAD is different across genders. One explanation for these differences may be the role of cognitive biases involved in GAD between genders. In the present study, we used an exogenous spatial cueing task to examine gender differences in attentional bias for negative and positive information in 118 individuals with a primary diagnosis of GAD. Males and females did not differ in their attentional bias for idiographically selected negative or neutral words. However, women showed a significantly larger attentional bias for positive words than did men. Results suggest that developing gender-specific treatments for GAD could improve treatment response rates.
Collapse
Affiliation(s)
| | | | - Nader Amir
- San Diego State University; University of California San Diego.
| |
Collapse
|
33
|
Examining the Psychometric Properties of the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire in Two Samples of Youth with OCD. Child Psychiatry Hum Dev 2017; 48:180-188. [PMID: 27329368 DOI: 10.1007/s10578-016-0662-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Researchers have demonstrated that quality of life (QOL) is an important construct to measure in individuals with mental health disorders, yet only a small amount of research has been dedicated to examining QOL and its response to treatment in children and adolescents with obsessive-compulsive disorder (OCD). The current study explored the psychometric properties of a measure of QOL, the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q), by examining the reliability, validity, and treatment sensitivity of this measure delivered in two separate RCTs for OCD (total N = 251 across both studies). Our results provide evidence for the reliability and validity of the PQ-LES-Q in adolescents with OCD (all Cronbach's alphas >.89, convergent validity correlations significant at the p < .05 level), but that an adaptation of the measure many be necessary for valid use in younger children with OCD.
Collapse
|
34
|
Möller HJ, Bandelow B, Volz HP, Barnikol UB, Seifritz E, Kasper S. The relevance of 'mixed anxiety and depression' as a diagnostic category in clinical practice. Eur Arch Psychiatry Clin Neurosci 2016; 266:725-736. [PMID: 27002521 PMCID: PMC5097109 DOI: 10.1007/s00406-016-0684-7] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 02/17/2016] [Indexed: 01/04/2023]
Abstract
According to ICD-10 criteria, mixed anxiety and depressive disorder (MADD) is characterized by co-occurring, subsyndromal symptoms of anxiety and depression, severe enough to justify a psychiatric diagnosis, but neither of which are clearly predominant. MADD appears to be very common, particularly in primary care, although prevalence estimates vary, often depending on the diagnostic criteria applied. It has been associated with similarly pronounced distress, impairment of daily living skills, and reduced health-related quality of life as fully syndromal depression and anxiety. Although about half of the patients affected remit within a year, non-remitting patients are at a high risk of transition to a fully syndromal psychiatric disorder. The validity and clinical usefulness of MADD as a diagnostic category are under debate. It has not been included in the recently released DSM-5 since the proposed diagnostic criteria turned out to be not sufficiently reliable. Moreover, reviewers have disputed the justification of MADD based on divergent results regarding its prevalence and course, diagnostic stability over time, and nosological inconsistencies between subthreshold and threshold presentations of anxiety and depressive disorders. We review the evidence in favor and against MADD and argue that it should be included into classification systems as a diagnostic category because it may enable patients to gain access to appropriate treatment early. This may help to reduce patients' distress, prevent exacerbation to a more serious psychiatric disorder, and ultimately reduce the societal costs of this very common condition.
Collapse
Affiliation(s)
- Hans-Jürgen Möller
- Clinic and Polyclinic for Psychiatry and Psychotherapy, Ludwig Maximilian University, Nußbaumstrasse 7, 80336, Munich, Germany
| | - Borwin Bandelow
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, von-Siebold-Strasse 5, 37075, Göttingen, Germany
| | - Hans-Peter Volz
- Hospital for Psychiatry, Psychotherapy and Psychosomatic Medicine Schloss Werneck, Balthasar-Neumann-Platz 1, 97440, Werneck, Germany
| | - Utako Birgit Barnikol
- Research Unit Ethics, Institute for the History of Medicine and Medical Ethics, University Medical Center Cologne, Cologne, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Albertus Magnus University of Cologne, Joseph Stelzmann Strasse 20, 50937, Cologne, Germany
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, Lenggstrasse 31, 8032, Zurich, Switzerland
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
| |
Collapse
|
35
|
Prevalence, correlates, comorbidity and severity of generalized anxiety disorder in Singapore. Asian J Psychiatr 2016; 23:32-38. [PMID: 27969075 DOI: 10.1016/j.ajp.2015.06.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 05/14/2015] [Accepted: 06/22/2015] [Indexed: 11/22/2022]
Abstract
Despite its pervasiveness and associated impairment, generalized anxiety disorder (GAD) remains a poorly recognized disorder. Furthermore, given that GAD has been relatively understudied in Asia, the current study examined the prevalence, correlates and co-morbid conditions of this disorder in a multi-ethnic population of Singapore. Data was utilized from the Singapore Mental Health Study (SMHS), a cross-sectional epidemiological survey conducted among the adult population (n=6616) aged 18 years and above. The Composite International Diagnostic Interview version 3.0 (CIDI v3.0) was used to assess co-morbidity as well as the life-time and 12-month prevalence of disorders. Functional impairment and treatment-seeking behavior were also assessed. The life-time (0.9%) and 12-month (0.4%) prevalence estimates in the current study were found to be lower than those reported in Western populations but comparable to the prevalence estimates found in Asian countries. The relatively lower prevalence rate of GAD in this study suggests the possible role of culture in reporting and manifestation of anxiety symptomatology. The failure of a substantial proportion of individuals to seek treatment despite self-reported impairment was also identified as an area of concern.
Collapse
|
36
|
Labrecque J, Dugas MJ, Marchand A, Letarte A. Cognitive-Behavioral Therapy for Comorbid Generalized Anxiety Disorder and Panic Disorder With Agoraphobia. Behav Modif 2016; 30:383-410. [PMID: 16723421 DOI: 10.1177/0145445504265277] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The goal of this study was to evaluate the efficacy of a cognitive-behavioral treatment package for comorbid generalized anxiety disorder (GAD) and panic disorder with agoraphobia (PDA). A single-case, multiple-baseline, across-subjects design was used with 3 primary GAD patients with secondary PDA. The efficacy of the treatment was evaluated with a structured interview, a battery of self-report questionnaires, and daily self-monitoring booklets. Results are promising: At posttreatment, 2 out of 3 participants achieved high endstate functioning and maintained this level at 3-, 6-, and 12-month follow-ups. The 3rd participant also improved but achieved moderate endstate functioning. The strengths and limitations of the treatment are discussed.
Collapse
Affiliation(s)
- Joane Labrecque
- Département de Psychologie, Université du Québec à Montréal and Hôpital Louis-H. Lafontaine, Montréal, Canada.
| | | | | | | |
Collapse
|
37
|
Interactions Between Reappraisal and Emotional Nonacceptance in Psychopathology: Examining Disability and Depression Symptoms in Generalized Anxiety Disorder. COGNITIVE THERAPY AND RESEARCH 2016. [DOI: 10.1007/s10608-016-9793-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
38
|
Lee SP, Vaingankar JA, Chong SA, Subramaniam M. Modifying Duration Criterion in Generalized Anxiety Disorder: Effects on Prevalence and Disability in an Asian Community Sample. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2016. [DOI: 10.1080/00207411.2016.1189755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
39
|
Jacobson NC. Current evolutionary adaptiveness of psychiatric disorders: Fertility rates, parent-child relationship quality, and psychiatric disorders across the lifespan. JOURNAL OF ABNORMAL PSYCHOLOGY 2016; 125:824-39. [PMID: 27362490 DOI: 10.1037/abn0000185] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study sought to evaluate the current evolutionary adaptiveness of psychopathology by examining whether these disorders impact the quantity of offspring or the quality of the parent-child relationship across the life span. Using the National Comorbidity Survey, this study examined whether DSM-III-R anxiety, posttraumatic stress, depressive, bipolar, substance use, antisocial, and psychosis disorders predicted later fertility and the quality of parent-child relationships across the life span in a national sample (N = 8,098). Using latent variable and varying coefficient models, the results suggested that anxiety in males and bipolar pathology in males and females were associated with increased fertility at younger ages. The results suggested almost all other psychopathology was associated with decreased fertility in middle to late adulthood. The results further suggested that all types of psychopathology had negative impacts on the parent-child relationship quality (except for antisocial pathology in males). Nevertheless, for all disorders, the impact of psychopathology on both fertility and the parent-child relationship quality was affected by the age of the participant. The results also showed that anxiety pathology is associated with a high-quantity, low-quality parenting strategy followed by a low-quantity, low-quality parenting strategy. Further, the results suggest that bipolar pathology is associated with an early high-quantity and a continued low-quality parenting strategy. Posttraumatic stress, depression, substance use, antisocial personality, and psychosis pathology are each associated with a low-quantity, low-quality parenting strategy, particularly in mid to late adulthood. These findings suggest that the evolutionary impact of psychopathology depends on the developmental context. (PsycINFO Database Record
Collapse
|
40
|
Medeiros GC, Sampaio DG, Leppink EW, Chamberlain SR, Grant JE. Anxiety, Gambling Activity, and Neurocognition: A Dimensional Approach to a Non-Treatment-Seeking Sample. J Behav Addict 2016; 5:261-70. [PMID: 27363461 PMCID: PMC5387777 DOI: 10.1556/2006.5.2016.044] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 04/25/2016] [Accepted: 05/15/2016] [Indexed: 11/19/2022] Open
Abstract
Background and aims Previous analyses have highlighted significant associations between gambling disorder (GD)/subsyndromal GD and increased rates of anxiety symptoms and anxiety disorders relative to the general population. However, less is known about how anxiety symptoms influence the clinical presentation of gambling problems. The objective of this study was to evaluate the association between anxiety symptoms, gambling activity, and neurocognition across the spectrum of gambling behavior. Methods The sample consisted of 143 non-treatment-seeking young adults (aged 18-29 years), in which 63 individuals (44.1%) were classified as recreational gamblers, 47 (32.9%) as having subsyndromal GD, and 33 (23.1%) met criteria for GD. Results The main findings were: (a) there was a positive correlation between anxiety severity and gambling severity measured by the number of DSM-5 GD criteria met; (b) there was a positive correlation between anxiety severity and attentional impulsiveness; (c) subjects with suicidality presented higher levels of anxiety; and (d) the severity of anxiety symptoms was negatively correlated with the quality of life. Discussion and conclusions This study suggests that anxiety may be associated with relevant clinical variables in the broad spectrum of gambling activity. Therefore, proper management of anxiety symptoms might improve the clinical presentation of gamblers in different areas.
Collapse
Affiliation(s)
- Gustavo C. Medeiros
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Daniela G. Sampaio
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Eric W. Leppink
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | | | - Jon E. Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| |
Collapse
|
41
|
Sjonnesen K, Bulloch AGM, Williams J, Lavorato D, B Patten S. Characterization of Disability in Canadians with Mental Disorders Using an Abbreviated Version of a DSM-5 Emerging Measure: The 12-Item WHO Disability Assessment Schedule (WHODAS) 2.0. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2016; 61:227-35. [PMID: 27254415 PMCID: PMC4794955 DOI: 10.1177/0706743716632514] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a disability scale included in Section 3 of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a possible replacement for the Global Assessment of Functioning Scale (GAF). To assist Canadian psychiatrists with interpretation of the scale, we have conducted a descriptive analysis using data from the 2012 Canadian Community Health Survey-Mental Health component (CCHS-MH). METHODS The 2012 CCHS-MH was a cross-sectional survey of the Canadian community (n = 23,757). The survey included an abbreviated 12-item version of the WHODAS 2.0. Mental disorder diagnoses were assessed for schizophrenia, other psychosis, major depressive episode (MDE), generalized anxiety disorder (GAD), bipolar I disorder, substance abuse/dependence, and alcohol abuse/dependence. RESULTS Mean scores ranged from 14.2 (95% CI, 14.1 to 14.3) for the overall community population to 23.1 (95% CI, 19.5 to 26.7) for those with schizophrenia, with higher scores indicating greater disability. Furthermore, the difference in scores between those with lifetime and past-month episodes suggests that the scale is sensitive to changes occurring during the course of these disorders; for example, scores varied from 23.6 (95% CI, 22.2 to 25.1) for past-month MDE to 14.4 (95% CI, 14.2 to 14.7) in the lifetime MDE group without a past-year episode. CONCLUSION This analysis suggests that the WHODAS 2.0 may be a suitable replacement for the GAF. As a disability measure, even though it is not a mental health-specific instrument, the 12-item WHODAS 2.0 appears to be sensitive to the impact of mental disorders and to changes over the time course of a mental disorder. However, the clinical utility of this measure requires additional assessment.
Collapse
|
42
|
Aberrant Parasympathetic Stress Responsivity in Pure and Co-Occurring Major Depressive Disorder and Generalized Anxiety Disorder. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2016. [DOI: 10.1007/s10862-015-9493-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
43
|
Kasper S, Volz HP, Dienel A, Schläfke S. Efficacy of Silexan in mixed anxiety-depression--A randomized, placebo-controlled trial. Eur Neuropsychopharmacol 2016; 26:331-340. [PMID: 26718792 DOI: 10.1016/j.euroneuro.2015.12.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 11/18/2015] [Accepted: 12/01/2015] [Indexed: 01/04/2023]
Abstract
Mixed anxiety and depressive disorder (MADD; ICD-10 F41.2) is a condition characterized by subsyndromal symptoms of anxiety and depression, neither of which are clearly predominant. Silexan has been demonstrated to be efficacious in subsyndromal and syndromal anxiety disorders and co-morbid depressive symptoms. In this study 318 adult out-patients with MADD according to ICD-10 criteria, a total score ≥18 points on the Hamilton Anxiety Rating Scale (HAMA), and at least moderately severe anxious and depressed mood were randomized and received 1×80mg Silexan or placebo in double-blind fashion for a scheduled period of 70 days. Primary outcome measures were the HAMA and Montgomery Åsberg Depression Rating Scale (MADRS) total score changes between baseline and treatment end. The HAMA total score decreased by 10.8±9.6 points for Silexan and by 8.4±8.9 points for placebo (treatment group difference: p<0.01, one-sided; ANCOVA with factors for treatment and centre and the baseline value as covariate), and total score decreases of 9.2±9.9 and 6.1±7.6 points, respectively, were observed for the MADRS (p<0.001). Compared to placebo, the patients treated with Silexan had a better over-all clinical outcome and showed more pronounced improvements of impaired daily living skills and health related quality of life. Eructation was the only adverse event with a substantially higher incidence under Silexan. The study thus demonstrates that Silexan is efficacious and safe in the treatment of MADD.
Collapse
Affiliation(s)
- Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
| | - Hans-Peter Volz
- Hospital for Psychiatry, Psychotherapy and Psychosomatic Medicine Schloss Werneck, Werneck, Germany
| | | | | |
Collapse
|
44
|
Prevalence and correlates of DSM-IV-TR major depressive disorder, self-reported diagnosed depression and current depressive symptoms among adults in Germany. J Affect Disord 2016; 190:167-177. [PMID: 26519637 DOI: 10.1016/j.jad.2015.10.006] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 09/30/2015] [Accepted: 10/02/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND While standardized diagnostic interviews using established criteria are the gold standard for assessing depression, less time consuming measures of depression and depressive symptoms are commonly used in large population health surveys. We examine the prevalence and health-related correlates of three depression measures among adults aged 18-79 years in Germany. METHODS Using cross-sectional data from the national German Health Interview and Examination Survey for Adults (DEGS1) (n=7987) and its mental health module (DEGS1-MH) (n=4483), we analysed prevalence and socio-demographic and health-related correlates of (a) major depressive disorder (MDD) established by Composite International Diagnostic Interview (CIDI) using DSM-IV-TR criteria (CIDI-MDD) in the last 12 months, (b) self-reported physician or psychotherapist diagnosed depression in the last 12 months, and (c) current depressive symptoms in the last two weeks (PHQ-9, score ≥10). RESULTS Prevalence of 12-month CIDI-MDD was 4.2% in men and 9.9% in women. Prevalence of 12-month self-reported health professional-diagnosed depression was 3.8% and 8.1% and of current depressive symptoms 6.1% and 10.2% in men and women, respectively. Case-overlap between measures was only moderate (32-45%). In adjusted multivariable analyses, depression according to all three measures was associated with lower self-rated health, lower physical and social functioning, higher somatic comorbidity (except for women with 12-month CIDI-MDD), more sick leave and higher health service utilization. LIMITATIONS Persons with severe depression may be underrepresented. Associations between CIDI-MDD and correlates and overlap with other measures may be underestimated due to time lag between DEGS1 and DEGS1-MH. CONCLUSIONS Prevalence and identified cases varied between these three depression measures, but all measures were consistently associated with a wide range of adverse health outcomes.
Collapse
|
45
|
Roberge P, Normand-Lauzière F, Raymond I, Luc M, Tanguay-Bernard MM, Duhoux A, Bocti C, Fournier L. Generalized anxiety disorder in primary care: mental health services use and treatment adequacy. BMC FAMILY PRACTICE 2015; 16:146. [PMID: 26492867 PMCID: PMC4618956 DOI: 10.1186/s12875-015-0358-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 10/06/2015] [Indexed: 11/10/2022]
Abstract
PURPOSE Generalized Anxiety Disorder (GAD) is a common mental disorder in the primary care setting, marked by persistent anxiety and worries. The aims of this study were to: 1) examine mental health services utilisation in a large sample of primary care patients; 2) explore detection of GAD and minimal standards for pharmacological and psychological treatment adequacy based on recommendation from clinical practice guidelines; 3) examine correlates of treatment adequacy, i.e. predisposing, enabling and needs factors according to the Behavioural Model of Health Care Use. METHODS A sample of 373 adults meeting DSM-IV criteria for Generalized Anxiety Disorder in the past 12 months took part in this study. Data were drawn from the "Dialogue" project, a large primary care study conducted in 67 primary care clinics in Quebec, Canada. Following a mental health screening in medical clinics (n = 14833), patients at risk of anxiety or depression completed the Composite International Diagnostic Interview-Simplified (CIDIS). Multilevel logistic regression models were developed to examine correlates of treatment adequacy for pharmacological and psychological treatments. RESULTS Results indicate that 52.5 % of participants were recognized as having GAD by a healthcare professional in the past 12 months, and 36.2 % of the sample received a pharmacological (24.4 %) and/or psychological treatment (19.2 %) meeting indicators based on clinical practice guidelines recommendations. The detection of GAD by a health professional and the presence of comorbid depression were associated with overall treatment adequacy. CONCLUSIONS This study suggests that further efforts towards GAD detection could lead to an increase in the delivery of evidence-based treatments. Key targets for improvement in treatment adequacy include regular follow up of patients with a GAD medication and access to psychotherapy from the primary care setting.
Collapse
Affiliation(s)
- Pasquale Roberge
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001,12th Avenue North, Sherbrooke, QC, J1H 5 N4, Canada.
| | - François Normand-Lauzière
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001,12th Avenue North, Sherbrooke, QC, J1H 5 N4, Canada.
| | - Isabelle Raymond
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001,12th Avenue North, Sherbrooke, QC, J1H 5 N4, Canada.
| | - Mireille Luc
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001,12th Avenue North, Sherbrooke, QC, J1H 5 N4, Canada.
| | - Marie-Michèle Tanguay-Bernard
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001,12th Avenue North, Sherbrooke, QC, J1H 5 N4, Canada.
| | - Arnaud Duhoux
- Division of Neurology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001,12th Avenue North, Sherbrooke, QC, J1H 5 N4, Canada.
| | - Christian Bocti
- Faculty of Nursing, Université de Montréal, Pavillon Marguerite-d'Youville, C.P. 6128 succ. Centre-ville, Montreal, QC, H3C 3 J7, Canada.
| | - Louise Fournier
- CRCHUM (Centre de recherche du Centre Hospitalier de l'Université de Montréal), Université de Montréal, Pavillon Édouard-Asselin, 264, boul. René-Lévesque Est, Montréal, QC, H2X 1P1, Canada.
| |
Collapse
|
46
|
Silva Júnior EAD, Gomes CADB. Psychiatric comorbidities among adolescents with and without anxiety disorders: a community study. JORNAL BRASILEIRO DE PSIQUIATRIA 2015. [DOI: 10.1590/0047-2085000000076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To evaluate, in a community sample of adolescents, the presence of comorbidities in different anxiety disorders. Methods This is a cross-sectional study, initially composed of 2,457 adolescents, aged between 10-17 years old, from public schools of the area covered by the Basic Health Unit of a university hospital. We applied the Screen for Child Anxiety Related Emotional Disorders (SCARED) to assess for anxiety disorders. Then, 138 positive cases in the screening were assessed for mental disorders through the Schedule for Affective Disorder and Schizophrenia for School-Age Children – Present and Lifetime Version (K-SADS-PL). Results Patients with anxiety disorders had more association with other anxiety disorders, as well as depression, and enuresis. The most common comorbidity described in our study was between generalized anxiety disorder and separation anxiety disorder (OR = 4.21, 95% CI 1.88, 9.58). Significant association was observed between other disorders such as enuresis and separation anxiety disorder (OR = 3.81, 95% CI 1.16, 12.49), as well as depression and generalized anxiety disorder (OR = 3.40; 95% CI 1.52, 7.61). Conclusion Our study showed a relevant presence of comorbidities adolescents with anxiety disorders, selected from a community sample, especially regarding other anxiety disorders. Nevertheless, further studies are needed to confirm our findings.
Collapse
|
47
|
Buelow MT, Barnhart WR. The Influence of Math Anxiety, Math Performance, Worry, and Test Anxiety on the Iowa Gambling Task and Balloon Analogue Risk Task. Assessment 2015; 24:127-137. [PMID: 26310960 DOI: 10.1177/1073191115602554] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Multiple studies have shown that performance on behavioral decision-making tasks, such as the Iowa Gambling Task (IGT) and Balloon Analogue Risk Task (BART), is influenced by external factors, such as mood. However, the research regarding the influence of worry is mixed, and no research has examined the effect of math or test anxiety on these tasks. The present study investigated the effects of anxiety (including math anxiety) and math performance on the IGT and BART in a sample of 137 undergraduate students. Math performance and worry were not correlated with performance on the IGT, and no variables were correlated with BART performance. Linear regressions indicated math anxiety, physiological anxiety, social concerns/stress, and test anxiety significantly predicted disadvantageous selections on the IGT during the transition from decision making under ambiguity to decision making under risk. Implications for clinical evaluation of decision making are discussed.
Collapse
|
48
|
Mennin DS, Fresco DM, Ritter M, Heimberg RG. AN OPEN TRIAL OF EMOTION REGULATION THERAPY FOR GENERALIZED ANXIETY DISORDER AND COOCCURRING DEPRESSION. Depress Anxiety 2015; 32:614-23. [PMID: 25945946 PMCID: PMC4515189 DOI: 10.1002/da.22377] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 04/07/2015] [Accepted: 04/09/2015] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Although CBT is efficacious for a wide variety of psychiatric conditions, relatively fewer GAD patients achieve high endstate functioning as compared to patients receiving CBTs for other disorders. Moreover, GAD trials that utilized patient samples without prominent depression have tended to report that effect sizes for depressive outcomes were small or diminished to pretreatment levels in the follow-up period. Emotion regulation therapy (ERT) integrates principles from traditional and contemporary cognitive behavioral treatments with basic and translational findings from affect science to offer a blueprint for improving intervention by focusing on motivational, regulatory, and contextual learning mechanisms. METHOD The purpose of this investigation was to provide initial support for the efficacy of ERT in an open trial of patients with GAD and cooccurring depressive symptoms. Twenty-one patients received a 20-session version of ERT delivered in weekly individual sessions. Standardized clinician ratings and self-report measures were assessed at pre-, mid-, and posttreatment as well as at three- and nine-month follow-ups. Intent-to-treat analyzes were utilized. RESULTS GAD patients, half with comorbid major depression, evidenced statistically, and clinically meaningful improvements in symptom severity, impairment, quality of life, and in model-related outcomes including emotional/motivational intensity, mindful attending/acceptance, decentering, and cognitive reappraisal. Patients maintained gains across the three and nine month follow-up periods. CONCLUSIONS These findings, although preliminary, provide additional evidence for the role of emotion dysregulation in the onset, maintenance, and now treatment of conditions such as GAD and cooccurring depressive symptoms.
Collapse
Affiliation(s)
- Douglas S Mennin
- Department of Psychology, Hunter College, City University of New York, New York
| | - David M Fresco
- Department of Psychological Sciences, Kent State University, Kent, Ohio
| | - Michael Ritter
- Department of Psychiatry G.V. (Sonny) Montgomery VA Medical Center, Jackson, Mississippi
| | | |
Collapse
|
49
|
Green SM, Haber E, Frey BN, McCabe RE. Cognitive-behavioral group treatment for perinatal anxiety: a pilot study. Arch Womens Ment Health 2015; 18:631-8. [PMID: 25652951 DOI: 10.1007/s00737-015-0498-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 01/04/2015] [Indexed: 01/17/2023]
Abstract
Along with physical and biological changes, a tremendous amount of upheaval and adjustment accompany the pregnancy and postpartum period of a woman's life that together can often result in what is commonly known as postpartum depression. However, anxiety disorders have been found to be more frequent than depression during pregnancy and at least as common, if not more so, during the postpartum period, e.g., Brockington et al., (Archieves Women's Ment Health 9:253-263, 2006; Wenzel et al. (J Anxiety Disord, 19:295-311, 2005). Cognitive-behavioral therapy (CBT) is a well-established psychological treatment of choice for anxiety; however, few studies have specifically examined a cognitive-behavioral intervention targeting perinatal anxiety. This pilot study examined the effectiveness of a cognitive-behavioral group treatment (CBGT) program specifically tailored to address perinatal anxiety in 10 women who were either pregnant or within 12 months postpartum. Participants were recruited from a women's clinic at an academic hospital setting, with anxiety identified as their principal focus of distress. Following a diagnostic interview confirming a primary anxiety disorder and completion of assessment measures, participants completed a 6-week CBGT program. There was a statistically significant reduction in anxiety and depressive symptoms following the CBGT program (all p < 0.05). Participants also reported high acceptability and satisfaction with this treatment for addressing their perinatal anxiety. These findings suggest that CBGT for perinatal anxiety is a promising treatment for both anxiety and depressive symptoms experienced during the perinatal period. Further studies are needed to evaluate the treatment efficacy through larger controlled trials.
Collapse
Affiliation(s)
- Sheryl M Green
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada,
| | | | | | | |
Collapse
|
50
|
Functional disability and quality of life decrements in mental disorders: Results from the Mental Health Module of the German Health Interview and Examination Survey for Adults (DEGS1-MH). Eur Psychiatry 2015; 30:793-800. [PMID: 26169476 DOI: 10.1016/j.eurpsy.2015.06.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 06/05/2015] [Accepted: 06/14/2015] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND This paper provides nationally representative data on how current and past mental disorders are related to functional disability and health-related quality of life (QoL). METHODS Results are based on a nationally representative sample (DEGS1-MH; n=4483 aged 18-79). Respondents were examined by clinical interviewers with the DSM-IV Composite International Diagnostic Interview (DIA-X/M-CIDI). Functional disability, i.e. number of disability days in the past 4weeks, and QoL, i.e. mental (MCS) and physical (PCS) component scale of the SF-36V2, were examined in subjects with 12-month mental disorders (=active cases [AC]) and compared to (a) subjects who never met diagnostic criteria (=unaffected individuals [UAI]), and (b) those with a history of mental disorders but not meeting the diagnostic criteria in the past 12months (=non-active cases [NAC]; partially or fully remitted). RESULTS In comparison to UAI (mean: 1.9), AC reveals a 2-3 fold disability days/month (5.4, P<.001) and a substantially reduced MCS (UAI: 52.1; AC: 43.3, P<.001). NAC had a similar number of disability days as UAI, but significantly reduced MCS scores (49.9; P<.001). Disability days and QoL decrements were highest in internalizing disorders including somatoform disorders and most pronounced in comorbid cases. CONCLUSIONS By and large, findings of a previous study were confirmed and extended for this nationally representative German sample. 12-month mental disorders, particularly internalizing, including somatoform disorders, are associated with high levels of disability and increased health-related QoL decrements. Partial or complete remission of the mental disorders is associated with a normalization of the numbers of disability days.
Collapse
|