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Leo DG, Keller SS, Proietti R. "Close your eyes and relax": the role of hypnosis in reducing anxiety, and its implications for the prevention of cardiovascular diseases. Front Psychol 2024; 15:1411835. [PMID: 39035095 PMCID: PMC11258040 DOI: 10.3389/fpsyg.2024.1411835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/21/2024] [Indexed: 07/23/2024] Open
Abstract
Anxiety is the most common form of mental health disorder, affecting millions of people worldwide. Psychosocial interventions such as mindfulness and cognitive behavioral therapy (CBT) have been suggested as an effective treatment in the management of general anxiety and anxiety disorders, with emerging evidence also suggesting the effectiveness of hypnosis. Moreover, anxiety has shown to be linked to the onset and development of several cardiovascular diseases (CVD), which are the leading cause of global death. In this paper, we review the current literature to examine the role that anxiety has on the onset and development of CVD and summarize the current knowledge on the role that hypnosis and hypnotherapy have in reducing anxiety, also explaining how this can impact the cardiovascular system and the prevention of CVD. Review of the evidence suggests that hypnosis and hypnotherapy are effective in treating anxiety and may positively affect the heart and the cardiovascular system, reducing sympathetic activation and increasing parasympathetic tone, potentially preventing the onset of CVD related to increased sympathetic activation. However, further studies are required to further understand how hypnosis and hypnotherapy affect the cardiovascular system through investigation of the neurophysiological components of the hypnotic state and of the mind-body relationship. Healthcare systems should embed mental health screening in patients at risk of developing CVD as part of the clinical pathway and consider the role that hypnosis and hypnotherapy may play in the management of CVD.
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Affiliation(s)
- Donato Giuseppe Leo
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health and Life Science, University of Liverpool, Liverpool, United Kingdom
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - Simon S. Keller
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Riccardo Proietti
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health and Life Science, University of Liverpool, Liverpool, United Kingdom
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
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Harandi AA, Kimia N, Medghalchi A, Sharifipour E, Pakdaman H, Siavoshi F, Barough SS, Esfandani A, Hosseini MH. Cerebral hemodynamic response to generalized anxiety disorder. Psychiatry Res Neuroimaging 2023; 333:111654. [PMID: 37229961 DOI: 10.1016/j.pscychresns.2023.111654] [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: 12/06/2022] [Revised: 04/12/2023] [Accepted: 04/26/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is the least studied among anxiety disorders. Therefore, we aimed to compare the cervical blood flow velocities using doppler ultrasonography in untreated chronic GAD patients and healthy individuals. MATERIAL AND METHODS In this study, thirty-eight GAD patients were enrolled. And thirty-eight healthy volunteers were recruited as control participants. The common carotid artery (CCA), internal carotid artery (ICA), and vertebral artery (VA) of both sides were explored. Also, we trained machine learning models based on cervical arteries characteristics to diagnose GAD patients. RESULTS Patients with chronic untreated GAD showed a significant increase in peak systolic velocity (PSV) bilaterally in the CCA and the ICA (P value < 0.05). In GAD patients, the end-diastolic velocity (EDV) of bilateral CCA, VA, and left ICA was significantly decreased. The Resistive Index (RI) showed a significant increase in all patients with GAD. Moreover, the Support Vector Machine (SVM) model showed the best accuracy in identifying anxiety disorder. CONCLUSION GAD is associated with hemodynamic alterations of extracranial cervical arteries. With a larger sample size and more generalized data, it is possible to make a robust machine learning-based model for GAD diagnosis.
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Affiliation(s)
- Ali Amini Harandi
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Negin Kimia
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aida Medghalchi
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ehsan Sharifipour
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Pakdaman
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Siavoshi
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Akram Esfandani
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Kordi A, Sarabi-Jamab A, Shariat SV, Rezaee N, Shariati B, Faiz SHR, Mirfazeli FS. Higher anxiety and perceived trauma among COVID-19 patients: a prospective comparative study. BMC Psychiatry 2023; 23:100. [PMID: 36759783 PMCID: PMC9909645 DOI: 10.1186/s12888-023-04574-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 01/27/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND AND PURPOSE Psychiatric disorders such as anxiety, depression, and traumatic stress are not rare during infectious outbreaks, as the COVID-19 pandemic has posed a great concern to the general population. In this study, we aimed to investigate whether experiencing psychiatric symptoms during COVID-19 is the result of the burden of carrying an illness or the COVID-19 itself. METHOD Two hundred ten subjects and three different groups of participants (COVID-19 patients, university staff, and orthopedic patients) were recruited. They answered a demographic questionnaire, Yale-Brown Obsessive-Compulsive Scale (YBOCS) test for OCD symptoms, Impact of Event Scale-Revised (IES-R) for perceived trauma, Beck Anxiety Inventory (BAI) for anxiety, and Beck Depression Inventory (BDI) for depression assessments using phone or face-to-face interviews. RESULT At least one OCD symptom was observed in 85.7% of the subjects. However, there was no significant difference between the 3 groups (p = 0.2194). Perceived trauma was significantly higher among COVID-19 patients followed by university staff and orthopedic patients (23.73, 16.21, 11.51 mean IES-R scores respectively, p = 8.449e-14). COVID-19 patients also showed higher anxiety (mean BAI score: 17.00) than the university staff and orthopedic patients' group (9.22 and 5.56 respectively) (p = 6.175e-08). BDI score did not show much variation for depression, the mean score was 9.66, 9.49, and 6.7 for the COVID-19 patients, university staff, and orthopedic patients respectively, (p = 0.2735). CONCLUSION Perceived trauma and anxiety symptoms are significantly higher in COVID-19 patients and the symptoms of OCD and depression do not differ between COVID-19 and non-COVID-19 people, so the necessity of screening and following treatment of patients with COVID-19 should be kept in mind. TRIAL REGISTRATION IR.IUMS.FMD.REC.1399.761.
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Affiliation(s)
- Alireza Kordi
- grid.411746.10000 0004 4911 7066School of Medicine, Iran University of Medical Science, Tehran, Iran
| | - Atiyeh Sarabi-Jamab
- grid.411746.10000 0004 4911 7066Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Vahid Shariat
- grid.411746.10000 0004 4911 7066Mental Health Research Center,Psychosocial Health Research Institute, Department of psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Nastaran Rezaee
- grid.411463.50000 0001 0706 2472Department of Veterinary, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Behnam Shariati
- grid.411746.10000 0004 4911 7066Mental Health Research Center,Psychosocial Health Research Institute, Department of psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Hamid Reza Faiz
- grid.411746.10000 0004 4911 7066Minimally Invasive Surgery Research Center, Department of Anesthesiology and Pain Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sadat Mirfazeli
- Mental Health Research Center,Psychosocial Health Research Institute, Department of psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Abstract
Social anxiety disorder (SAD) is a common psychiatric disorder, often associated with avoidant temperament. Research studies have implicated a strong genetic architecture of SAD. We have conducted a systematic review on the genetics of SAD and yielded 66 articles. In general, prior research studies have focused on the serotonin transporter, oxytocin receptor, brain-derived neurotrophic factor and catechol-O-methyltransferase genes. Mixed and inconsistent results have been reported. Additional approaches and phenotypes have also been investigated, including pharmacogenetics of treatment response, imaging genetics and gene-environment interactions. Future directions warrant further international collaborative efforts, deep-phenotyping of clinical characteristics including consistent and reliable measurement-based symptom severity, and larger sample sizes to ensure sufficient power for stratification due to the heterogeneity of this chronic and often debilitating condition.
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Affiliation(s)
- Ami Baba
- Neurogenetics Section, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre
| | - Stefan Kloiber
- Campbell Family Mental Health Research Institute, General Adult Psychiatry and Health Systems Division, Centre for Addiction and Mental Health
- Department of Psychiatry, University of Toronto
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Gwyneth Zai
- Neurogenetics Section, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre
- Campbell Family Mental Health Research Institute, General Adult Psychiatry and Health Systems Division, Centre for Addiction and Mental Health
- Department of Psychiatry, University of Toronto
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Stein DJ, Craske MG, Rothbaum BO, Chamberlain SR, Fineberg NA, Choi KW, de Jonge P, Baldwin DS, Maj M. The clinical characterization of the adult patient with an anxiety or related disorder aimed at personalization of management. World Psychiatry 2021; 20:336-356. [PMID: 34505377 PMCID: PMC8429350 DOI: 10.1002/wps.20919] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The clinical construct of "anxiety neurosis" was broad and poorly defined, so that the delineation of specific anxiety disorders in the DSM-III was an important advance. However, anxiety and related disorders are not only frequently comorbid, but each is also quite heterogeneous; thus diagnostic manuals provide only a first step towards formulating a management plan, and the development of additional decision support tools for the treatment of anxiety conditions is needed. This paper aims to describe systematically important domains that are relevant to the personalization of management of anxiety and related disorders in adults. For each domain, we summarize the available research evidence and review the relevant assessment instruments, paying special attention to their suitability for use in routine clinical practice. We emphasize areas where the available evidence allows the clinician to personalize the management of anxiety conditions, and we point out key unmet needs. Overall, the evidence suggests that we are becoming able to move from simply recommending that anxiety and related disorders be treated with selective serotonin reuptake inhibitors, cognitive-behavioral therapy, or their combination, to a more complex approach which emphasizes that the clinician has a broadening array of management modalities available, and that the treatment of anxiety and related disorders can already be personalized in a number of important respects.
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Affiliation(s)
- Dan J Stein
- South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Michelle G Craske
- Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, (UCLA), Los Angeles, CA, USA
| | | | - Samuel R Chamberlain
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, and Southern Health NHS Foundation Trust, Southampton, UK
| | - Naomi A Fineberg
- School of Life and Medical Sciences, University of Hertfordshire, and Hertfordshire Partnership University NHS Foundation Trust, Hatfield, UK
- University of Cambridge Clinical Medical School, Cambridge, UK
| | - Karmel W Choi
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Peter de Jonge
- Developmental Psychology, Department of Psychology, Rijksuniversiteit Groningen, Groningen, The Netherlands
| | - David S Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, and Southern Health NHS Foundation Trust, Southampton, UK
| | - Mario Maj
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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Hou J, Chen Y, Ma D, Wang C, Jin H, An Y, Zhao H. [Effect of chronic emotional stress induced by empty bottle stimulation on inflammatory factors in rats with acute myocardial infarction: analysis of the CXCL12/CXCR4 axis]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2020; 40:624-631. [PMID: 32897206 DOI: 10.12122/j.issn.1673-4254.2020.05.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the effect of chronic emotional stimulation induced by empty bottle stimulation on CXCL12/CXCR4-mediated inflammatory response in rats with acute myocardial infarction (AMI). METHODS Rat models of anxiety were established by a 21-day stimulation with uncertain empty bottle drinking water, and myocardial infarction was induced by ligating the left anterior descending branch of the coronary artery; compound models were established by performing myocardial infarction operation on the 15th day of anxiety modeling. The rats were randomly divided into 4 groups: shamoperated group (n=6), myocardial infarction group (n=6), compound model group (with myocardial infarcted and anxiety; n= 6), and inhibitor group (compound models treated daily with 1 mg/kg AMD3100 for 6 days; n=7). Echocardiography was used to examine the LVEF and LVFS to evaluate the cardiac function of the rats. Elevated maze test and open field test were used to evaluate the behaviors of the rats. The expressions of CXCL12, CXCR4, IL-1β, IL-18 and neutrophil active protease (NE) in the myocardial tissues and blood samples were detected with ELISA and immunohistochemistry. RESULTS The LVEF and LVFS were lower in the compound model group than in the sham group and myocardial infarction group (P < 0.05), and were higher in inhibitor group than in the compound model group (P < 0.05). LVID; d and LVID; s were lower in the inhibitor group than in the compound model group (P < 0.05). Compared to those in the sham group and myocardial infarction group, the rats in the compound model group more obviously preferred to stay in the closed arm (P < 0.05) in EPM; the rats in the inhibitor group had more times of entering and staying in the open arm than the compound model rats (P < 0.05); the horizontal and vertical movements were less in the compound model rats than in those in the sham group and the myocardial infarction group (P < 0.05) in OFT, and the vertical movement of the rats in inhibitor group was higher than those in the compound model group (P < 0.05). The expression of CXCR4 in the marginal zone of myocardial infarction was significantly higher in the compound model group than in the sham-operated group, myocardial infarction group and inhibitor group (P < 0.05). The expressions of IL-1β, IL-18 and NE in the inhibitor group were significantly lower than those in the compound model group (P < 0.05). Compared with at in the sham-operated group, the number of Nissl bodies in the compound model group decreased significantly (P < 0.01). CONCLUSIONS Chronic emotional stress induced by empty bottle stimulation can lead to dysfunction of the CXCL12/CXCR4 axis, which causes inflammatory cascade after myocardial infarction to worsen myocardial cell necrosis, cardiac function and hippocampal neuronal damage after the infarction.
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Affiliation(s)
- Jiqiu Hou
- Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China
| | - Yali Chen
- Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China
| | - Di Ma
- Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China
| | - Chao Wang
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
| | - Huihui Jin
- Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China
| | - Ying An
- Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China
| | - Haibin Zhao
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
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Sheikh MA. Retrospectively reported childhood adversity is associated with asthma and chronic bronchitis, independent of mental health. J Psychosom Res 2018; 114:50-57. [PMID: 30314579 DOI: 10.1016/j.jpsychores.2018.09.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 09/09/2018] [Accepted: 09/09/2018] [Indexed: 02/08/2023]
Abstract
Several researchers have raised the concern that the cross-sectional association of retrospectively reported childhood adversity with self-reported onset of asthma and chronic bronchitis in adulthood may be confounded, as well as mediated by an individual's mental health. The aim of this study was to assess the effect of retrospectively reported childhood adversity on self-reported onset of asthma and chronic bronchitis in adulthood, independent of potential confounding and mediating variables (including respondent's mental health). We used data collected in 2007-2008 within the framework of the Tromsø Study (N = 12,981), a representative study of adult men and women in Norway. The associations of childhood adversity with asthma and chronic bronchitis were assessed with Poisson regression models. Relative risks (RR) and 95% confidence intervals (CI) were estimated with bias-corrected bootstrapping. Childhood adversity was associated with a 9% increased risk of asthma (RR = 1.09, 95% CI: 1.02, 1.16) and a 14% increased risk chronic bronchitis (RR = 1.14, 95% CI: 1.03, 1.26) in adulthood, independent of age, sex, parental history of psychiatric problems/asthma/dementia, education, smoking, social support, and respondent's mental health. Controlling for indicators of respondent's mental health reduced the strength of associations of childhood adversity with asthma and chronic bronchitis; however, the associations were still present in the same direction (p < .05). These findings suggest that the association of retrospectively reported childhood adversity with asthma and chronic bronchitis is independent of respondent's mental health. We recommend controlling for indicators of the respondent's mental health to assess an unbiased association of retrospectively measured childhood adversity with self-reported asthma and chronic bronchitis.
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Stein DJ, Scott KM, de Jonge P, Kessler RC. Epidemiology of anxiety disorders: from surveys to nosology and back. DIALOGUES IN CLINICAL NEUROSCIENCE 2018. [PMID: 28867937 PMCID: PMC5573557 DOI: 10.31887/dcns.2017.19.2/dstein] [Citation(s) in RCA: 127] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
On the basis of epidemiological survey findings, anxiety disorders are the most prevalent mental disorders around the world and are associated with significant comorbidity and morbidity. Such surveys rely on advances in psychiatric nosology and may also contribute usefully to revisions of the nosology. There are a number of questions at the intersection of psychiatric epidemiology and nosology. This review addresses the following: What is the prevalence of anxiety disorders and how do we best explain cross-national differences in prevalence estimates? What are the optimal diagnostic criteria for anxiety disorders, and how can epidemiological data shed light on this question? What are the comorbidities of anxiety disorders, and how do we best understand the high comorbidities seen in these conditions? What is the current treatment gap for anxiety disorders, and what are the implications of current understandings of psychiatric epidemiology and nosology for policy-making relevant to anxiety disorders? Here, we emphasize that anxiety disorders are the most prevalent of the psychiatric conditions, and that rather than merely contrasting cross-national prevalence in anxiety disorders, it is more productive to delineate cross-national themes that emerge about the epidemiology of these conditions. We discuss that optimizing diagnostic criteria for anxiety disorders is an iterative process to which epidemiological data can make a crucial contribution. Additionally, high comorbidity in anxiety disorders is not merely artefactual; it provides key opportunities to explore pathways to mental disorders and to intervene accordingly. Finally, work on the epidemiology and nosology of anxiety disorders has provided a number of important targets for mental health policy and for future integrative work to move between bench and bedside, as well as between clinic and community.
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Affiliation(s)
- Dan J Stein
- University of Cape Town and MRC Unit on Risk & Resilience in Mental Disorders, South Africa
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Curth NK, Brinck-Claussen UØ, Davidsen AS, Lau ME, Lundsteen M, Mikkelsen JH, Csillag C, Hjorthøj C, Nordentoft M, Eplov LF. Collaborative care for panic disorder, generalised anxiety disorder and social phobia in general practice: study protocol for three cluster-randomised, superiority trials. Trials 2017; 18:382. [PMID: 28814317 PMCID: PMC5559780 DOI: 10.1186/s13063-017-2120-3] [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: 12/26/2016] [Accepted: 07/26/2017] [Indexed: 01/17/2023] Open
Abstract
Background People with anxiety disorders represent a significant part of a general practitioner’s patient population. However, there are organisational obstacles for optimal treatment, such as a lack of coordination of illness management and limited access to evidence-based treatment such as cognitive behavioral therapy. A limited number of studies suggest that collaborative care has a positive effect on symptoms for people with anxiety disorders. However, most studies are carried out in the USA and none have reported results for social phobia or generalised anxiety disorder separately. Thus, there is a need for studies carried out in different settings for specific anxiety populations. A Danish model for collaborative care (the Collabri model) has been developed for people diagnosed with depression or anxiety disorders. The model is evaluated through four trials, of which three will be outlined in this protocol and focus on panic disorder, generalised anxiety disorder and social phobia. The aim is to investigate whether treatment according to the Collabri model has a better effect than usual treatment on symptoms when provided to people with anxiety disorders. Methods Three cluster-randomised, clinical superiority trials are set up to investigate treatment according to the Collabri model for collaborative care compared to treatment-as-usual for 364 patients diagnosed with panic disorder, generalised anxiety disorder and social phobia, respectively (total n = 1092). Patients are recruited from general practices located in the Capital Region of Denmark. For all trials, the primary outcome is anxiety symptoms (Beck Anxiety Inventory (BAI)) 6 months after baseline. Secondary outcomes include BAI after 15 months, depression symptoms (Beck Depression Inventory) after 6 months, level of psychosocial functioning (Global Assessment of Functioning) and general psychological symptoms (Symptom Checklist-90-R) after 6 and 15 months. Discussion Results will add to the limited pool of information about collaborative care for patients with anxiety disorders. To our knowledge, these will be the first carried out in a Danish context and the first to report results for generalised anxiety and social phobia separately. If the trials show positive results, they could contribute to the improvement of future treatment of anxiety disorders. Trial registration ClinicalTrials.gov, ID: NCT02678624. Retrospectively registered 7 February 2016; last updated 15 August 2016, Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2120-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nadja Kehler Curth
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Kildegårdsvej 28, 2900, Hellerup, Denmark
| | - Ursula Ødum Brinck-Claussen
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Kildegårdsvej 28, 2900, Hellerup, Denmark.
| | - Annette Sofie Davidsen
- Research Unit for General Practice and Section of General Practice, University of Copenhagen, Øster Farimagsgade 5, PO Box 2099, 1014, Copenhagen K, Denmark
| | - Marianne Engelbrecht Lau
- Stolpegård Psychotherapy Centre, Mental Health Services, Capital Region of Denmark, Stolpegårdsvej 20, 2820, Gentofte, Denmark
| | | | - John Hagel Mikkelsen
- Mental Health Center Frederiksberg, Mental Health Services, Capital Region of Denmark, Nordre Fasanvej 57-59, 2000, Frederiksberg, Denmark
| | - Claudio Csillag
- Mental Health Center North Zealand, Mental Health Services, Capital Region of Denmark, Dyrehavevej 48, 3400, Hillerød, Denmark
| | - Carsten Hjorthøj
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Kildegårdsvej 28, 2900, Hellerup, Denmark
| | - Merete Nordentoft
- Institute for Clinical Medicine, University of Copenhagen, Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Kildegårdsvej 28, 2900, Hellerup, Denmark
| | - Lene Falgaard Eplov
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Kildegårdsvej 28, 2900, Hellerup, Denmark
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Mohammed H, Ghosh S, Vuvor F, Mensah-Armah S, Steiner-Asiedu M. Dietary intake and the dynamics of stress, hypertension and obesity in a peri-urban community in Accra. Ghana Med J 2017; 50:16-21. [PMID: 27605720 DOI: 10.4314/gmj.v50i1.3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES This study intends to investigate the association between dietary intake, stress and prevalence of chronic diseases. DESIGN AND SETTING The study was a cross-sectional design conducted in two poor peri-urban communities in Accra. PARTICIPANTS AND OUTCOME MEASURES A total of 90 households each with a male and female between the ages of 18 and 45 years were sampled, and their socio-demographic status, anthropometric measurement and fasting blood sugar were assessed. Blood pressure was measured and chronic stress/anxiety was determined using the trait and state inventory (T-stai) questionnaire. Three days repeated 24-hour dietary recall was also done. Analysis of variance and linear regression analysis were used in data analysis. RESULTS About 28% of the subjects were hypertensive and 55.5% had high chronic stress. Hypertension was higher in males (32.2%) than females (24.4%) (p=.023) whiles stress was higher in females (60.9%) than males (50.0%) (p=.017). Hypertensive subjects recorded higher stress (51.02%) and hypertension was more prevalent in subjects with high stress (32.89%) especially in females (57.14%, p=.036). Hypertension increased with mean age whiles stress decreased with mean age. Hypertensive subjects recorded a significantly higher BMI and sodium intake whiles high stress individuals recorded a lower animal protein but a higher cereal protein intake (p<.05). Chronic stress was associated with intake of low animal protein and high cereal protein. Increased dietary diversity score was associated with decreased obesity prevalence (p<.05). CONCLUSION Hypertension, chronic stress, and obesity were linked, and affected by dietary sodium, animal protein, and dietary diversity of subjects respectively.
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Affiliation(s)
- Husein Mohammed
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana; Friedman School of Nutrition Science and Policy, Tufts University, Boston, USA
| | - Shibani Ghosh
- Nevin Scrimshaw International Nutrition Foundation, Boston, USA; Friedman School of Nutrition Science and Policy, Tufts University, Boston, USA
| | - Fred Vuvor
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana
| | - Seth Mensah-Armah
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana; Department of Food and Nutrition, Iowa State University, Iowa, USA
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Bayer-Topilsky T, Suri RM, Topilsky Y, Marmor YN, Trenerry MR, Antiel RM, Mahoney DW, Schaff HV, Enriquez-Sarano M. Mitral Valve Prolapse, Psychoemotional Status, and Quality of Life: Prospective Investigation in the Current Era. Am J Med 2016; 129:1100-9. [PMID: 27235006 DOI: 10.1016/j.amjmed.2016.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 04/29/2016] [Accepted: 05/02/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The purpose of this study is to investigate whether mitral valve prolapse is associated with the patient's psychoemotional status and health-related quality of life. METHODS Mitral valve prolapse and mitral regurgitation were prospectively and comprehensively assessed in 281 patients (age 61 ± 13 years; 63% men); 216 patients with mitral valve prolapse were compared with 65 without mitral valve prolapse (of similar age and sex). Simultaneously, we assessed the patient's psychoemotional status (anxiety, depression, posttraumatic stress symptoms), health-related quality of life, and perceived severity of illness using validated questionnaires. RESULTS Twenty-nine percent of the patients had either no or mild mitral regurgitation (area of effective regurgitant orifice ≤0.2), and 71% had clinically significant mitral regurgitation (moderate/severe). Stratifying patients into no/mild vs moderate/severe mitral regurgitation revealed no differences in psychoemotional status or mental health-related quality of life between patients with mitral valve prolapse vs those without mitral valve prolapse within each subgroup; no/mild mitral regurgitation and moderate/severe mitral regurgitation (all P ≥ .5). In multivariate analysis, mitral valve prolapse was not independently associated with psychoemotional status or health-related quality of life (all P ≥ .4). In addition, while objective severity of the illness was not related to psychoemotional status or health-related quality of life (all P ≥ .2), the patient's perceived severity of illness predicted in and of itself all psychoemotional (all P < .03) and quality-of-life outcomes (all P < .003). CONCLUSION Mitral valve prolapse is not a determinant of the patient's psychoemotional status or quality of life. Psychoemotional status and health-related quality of life are determined by the patient's perception of the severity of the mitral valve disease, rather than by the presence of mitral valve prolapse.
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Affiliation(s)
- Tali Bayer-Topilsky
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn; The Engelberg Center for Children and Youth, JDC-Myers-Brookdale Institution, Jerusalem, Israel
| | - Rakesh M Suri
- Thoracic & Cardiovascular Surgery at Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - Yan Topilsky
- Department of Cardiology, Sourasky Medical Center, Tel Aviv, Israel
| | - Yariv N Marmor
- Department of Industrial Engineering and Management, ORT Braude College of Engineering, Karmiel, Israel
| | - Max R Trenerry
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minn
| | - Ryan M Antiel
- Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn
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Chien IC, Lin CH. Increased risk of diabetes in patients with anxiety disorders: A population-based study. J Psychosom Res 2016; 86:47-52. [PMID: 27302546 DOI: 10.1016/j.jpsychores.2016.05.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 05/03/2016] [Accepted: 05/07/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Few known studies have investigated the epidemiology of diabetes in patients with anxiety disorders. Therefore, the study aimed to determine the prevalence and incidence of diabetes in patients with anxiety disorders. METHODS The National Health Research Institute provided a database of 1,000,000 random subjects for study. We obtained a random sample aged 18years and over 766,427 subjects in 2005. Those study subjects who had at least two primary or secondary diagnoses of anxiety disorders were identified. We compared the prevalence of diabetes in anxiety patients with the general population in 2005. Furthermore, we investigated this cohort from 2006 to 2010 to detect the incident cases of diabetes in anxiety patients compared with the general population. RESULTS The prevalence of diabetes in patients with anxiety disorders was higher than that in the general population (11.89% vs. 5.92%, odds ratio, 1.23; 95% confidence interval, 1.17-1.28) in 2005. The average annual incidence of diabetes in patients with anxiety disorders was also higher than that in the general population (2.25% vs. 1.11%, risk ratio 1.34; 95% confidence interval, 1.28-1.41) from 2006 to 2010. Compared with the general population, patients with anxiety disorders revealed a higher incidence of diabetes in all age groups among both females and males. CONCLUSIONS Patients with anxiety disorders had a much higher prevalence and incidence of diabetes in the younger adult age group than in the general population. The higher incidence of diabetes among anxiety patients was related to increased age, antipsychotic use, hypertension, and hyperlipidemia.
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Affiliation(s)
- I-Chia Chien
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan; Department of Public Health & Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
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Copeland LA, Sako EY, Zeber JE, Pugh MJ, Wang CP, MacCarthy AA, Restrepo MI, Mortensen EM, Lawrence VA. Mortality after cardiac or vascular operations by preexisting serious mental illness status in the Veterans Health Administration. Gen Hosp Psychiatry 2014; 36:502-8. [PMID: 24957928 DOI: 10.1016/j.genhosppsych.2014.04.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 04/16/2014] [Accepted: 04/17/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To estimate 1-year mortality risk associated with preoperative serious mental illness (SMI) as defined by the Veterans Health Administration (schizophrenia, bipolar disorder, posttraumatic stress disorder [PTSD], major depression) following nonambulatory cardiac or vascular surgical procedures compared to patients without SMI. Cardiac/vascular operations were selected because patients with SMI are known to be at elevated risk of cardiovascular disease. METHOD Retrospective analysis of system-wide data from electronic medical records of patients undergoing nonambulatory surgery (inpatient or day-of-surgery admission) October 2005-September 2009 with 1-year follow-up (N=55,864; 99% male; <30 days of postoperative hospitalization). Death was hypothesized to be more common among patients with preoperative SMI. RESULTS One in nine patients had SMI, mostly PTSD (6%). One-year mortality varied by procedure type and SMI status. Patients had vascular operations (64%; 23% died), coronary artery bypass graft (26%; 10% died) or other cardiac operations (11%; 15%-18% died). Fourteen percent of patients with PTSD died, 20% without SMI and 24% with schizophrenia, with other groups intermediate. In multivariable stratified models, SMI was associated with increased mortality only for patients with bipolar disorder following cardiac operations. Bipolar disorder and PTSD were negatively associated with death following vascular operations. CONCLUSIONS SMI is not consistently associated with postoperative mortality in covariate-adjusted analyses.
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Affiliation(s)
- Laurel A Copeland
- Center for Applied Health Research, Central Texas Veterans Health Care System, with Baylor Scott & White Health, Temple, TX, USA; Department of Medicine, Texas A&M Health Science Center, and School of Rural Public Health, Bryan/College Station, TX, USA.
| | - Edward Y Sako
- South Texas Veterans Health Care System, San Antonio, TX, USA; UT Health Science Center at San Antonio, San Antonio, TX, USA
| | - John E Zeber
- Center for Applied Health Research, Central Texas Veterans Health Care System, with Baylor Scott & White Health, Temple, TX, USA; Department of Medicine, Texas A&M Health Science Center, and School of Rural Public Health, Bryan/College Station, TX, USA
| | - Mary Jo Pugh
- South Texas Veterans Health Care System, San Antonio, TX, USA; UT Health Science Center at San Antonio, San Antonio, TX, USA
| | - Chen-Pin Wang
- South Texas Veterans Health Care System, San Antonio, TX, USA; UT Health Science Center at San Antonio, San Antonio, TX, USA
| | | | - Marcos I Restrepo
- South Texas Veterans Health Care System, San Antonio, TX, USA; UT Health Science Center at San Antonio, San Antonio, TX, USA
| | - Eric M Mortensen
- VA North Texas Health Care System, Dallas, TX, USA; University of Texas Southwestern Medical Center, Dallas, TX, USA
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Levitan MN, Chagas MH, Linares IM, Crippa JA, Terra MB, Giglio AT, Cordeiro JL, Garcia GJ, Hasan R, Andrada NC, Nardi AE. Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder. BRAZILIAN JOURNAL OF PSYCHIATRY 2013; 35:406-15. [DOI: 10.1590/1516-4446-2012-0860] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 01/30/2013] [Indexed: 11/22/2022]
Affiliation(s)
- Michelle Nigri Levitan
- Universidade Federal do Rio de Janeiro (UFRJ), Brazil; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Marcos H. Chagas
- Universidade de São Paulo (USP), Brazil; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Ila M. Linares
- Universidade de São Paulo (USP), Brazil; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - José A. Crippa
- Universidade de São Paulo (USP), Brazil; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Mauro B. Terra
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil; Centro de Estudos Jose de Barros Falcão, Brazil
| | | | - Joana L.C. Cordeiro
- Universidade de São Paulo (USP), Brazil; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Giovana J. Garcia
- Universidade de São Paulo (USP), Brazil; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Rosa Hasan
- Associação Brasileira de Neurologia, Brazil
| | | | - Antonio E. Nardi
- Universidade Federal do Rio de Janeiro (UFRJ), Brazil; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
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Parmentier H, García-Campayo J, Prieto R. Comprehensive review of generalized anxiety disorder in primary care in Europe. Curr Med Res Opin 2013; 29:355-67. [PMID: 23356728 DOI: 10.1185/03007995.2013.770731] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This review aims to summarize meta-analyses and other relevant data relating to the efficacy and safety of the various treatment options for generalized anxiety disorder (GAD) in Europe. In addition, it will provide an overview of the prevalence, burden, and recognition of the disorder, with a view to raise awareness of GAD and inform primary care practitioners. RESEARCH DESIGN AND METHODS Relevant research or review articles on psychological or pharmacological treatments for GAD published in the English language between March 2006 and March 2012 were identified via a literature search in PubMed and ISI Web of Knowledge and from the Cochrane Library. Other relevant references/clinical guidelines were individually selected by the authors. RESULTS Prevalence rates of GAD vary across Europe but its economic and social burden is increasing. A large proportion of patients with GAD present with symptoms in primary care. However, due to the disorder's complexity and the incidence of comorbid diseases, some primary care physicians may lack the knowledge or confidence to effectively recognize, manage, and/or treat the disorder. This is despite psychological and pharmacological treatments being available for the effective management of GAD. CONCLUSIONS GAD remains a difficult disorder to detect and comorbid complications add to its economic and social burden. Early detection and intervention reduces the societal burden and improves GAD patients' quality of life and functional ability. Primary care practitioners play a key role in identifying and treating patients with GAD.
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Affiliation(s)
- H Parmentier
- 53 Smitham Bottom Lane, Purley, Surrey, CR8 3DF, UK.
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Schuurmans J, van Balkom AJ, van Megen HJ, Smit JH, Eikelenboom M, Cath DC, Kaarsemaker M, Oosterbaan D, Hendriks G, Schruers KR, van der Wee NJ, Glas G, van Oppen P. The Netherlands Obsessive Compulsive Disorder Association (NOCDA) study: design and rationale of a longitudinal naturalistic study of the course of OCD and clinical characteristics of the sample at baseline. Int J Methods Psychiatr Res 2012; 21:273-85. [PMID: 23148029 PMCID: PMC6878579 DOI: 10.1002/mpr.1372] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Revised: 12/16/2011] [Accepted: 01/10/2012] [Indexed: 11/10/2022] Open
Abstract
In half of Obsessive Compulsive Disorder (OCD) patients the disorder runs a chronic course despite treatment. The factors determining this unfavourable outcome remain unknown. The Netherlands Obsessive Compulsive Disorder Association (NOCDA) study is a multicentre naturalistic cohort study of the biological, psychological and social determinants of chronicity in a clinical sample. Recruitment of OCD patients took place in mental health organizations. Its design is a six-year longitudinal cohort study among a representative clinical sample of 419 OCD patients. All five measurements within this six-year period involved validated semi-structured interviews and self-report questionnaires which gathered information on the severity of OCD and its co-morbidity as well as information on general wellbeing, quality of life, daily activities, medical consumption and key psychological and social factors. The baseline measurements also include DNA and blood sampling and data on demographic and personality variables. The current paper presents the design and rationale of the study, as well as data on baseline sample characteristics. Demographic characteristics and co-morbidity ratings in the NOCDA sample closely resemble other OCD study samples. Lifetime co-morbid Axis I disorders are present in the majority of OCD patients, with high current and lifetime co-morbidity ratings for affective disorders (23.4% and 63.7%, respectively) and anxiety disorders other than OCD (36% current and 46.5% lifetime).
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Affiliation(s)
- Josien Schuurmans
- Department of Clinical Psychology and EMGO + InstituteVU University AmsterdamAmsterdamThe Netherlands
| | - Anton J.L.M. van Balkom
- Department of PsychiatryVU University Medical Centre/GGZ inGeest and EMGO + InstituteAmsterdamThe Netherlands
| | | | - Johannes H. Smit
- Department of PsychiatryVU University Medical Centre/GGZ inGeest and EMGO + InstituteAmsterdamThe Netherlands
| | - Merijn Eikelenboom
- Department of PsychiatryVU University Medical Centre/GGZ inGeest and EMGO + InstituteAmsterdamThe Netherlands
| | - Danielle C. Cath
- Department of Clinical and Health PsychologyUtrecht UniversityUtrechtThe Netherlands
| | | | - Desiree Oosterbaan
- Department of PsychiatryUniversity Medical Centre NijmegenNijmegenThe Netherlands
| | | | - Koen R.J. Schruers
- Academic Anxiety Centre, PsyQ Maastricht, Maastricht UniversityDivision of Mental Health and NeuroscienceMaastrichtThe Netherlands
| | | | | | - Patricia van Oppen
- Department of PsychiatryVU University Medical Centre/GGZ inGeest and EMGO + InstituteAmsterdamThe Netherlands
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Dunlop BW, Davis PG. Combination treatment with benzodiazepines and SSRIs for comorbid anxiety and depression: a review. PRIMARY CARE COMPANION TO THE JOURNAL OF CLINICAL PSYCHIATRY 2012; 10:222-8. [PMID: 18615162 DOI: 10.4088/pcc.v10n0307] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 05/02/2007] [Accepted: 11/13/2007] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To review the literature on the co-occurrence of anxiety with depressive disorders and the rationale for and use of combination treatment with benzodiazepines and selective serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors (SSRIs/SNRIs) for treating comorbid anxiety and depression. DATA SOURCES PubMed and PsycINFO were searched using terms identified as relevant based on existing practice guidelines. The primary search terms were anxiety, anxiety disorders, depression, depressive disorders, comorbidity, epidemiology, benzodiazepines, antidepressants, pharmacology, clinical trials, and pharmacotherapy. Reference lists of identified articles were also reviewed to ensure capture of relevant literature. STUDY SELECTION Publications were selected for inclusion in the review if they applied to adult populations and specifically addressed the comorbidity of anxiety and depression, their epidemiology, or their management. Case reports and case series were not considered for inclusion. DATA EXTRACTION Each author assessed the publications independently for content related to the review topics. Findings considered relevant to the clinical understanding and management of comorbid anxiety and depression were incorporated into the review. DATA SYNTHESIS Comorbidity is very common among patients with anxiety and depressive disorders, and, even when full criteria for 2 separate disorders are not met, subsyndromal symptoms are often present. Little controlled research has explored how benzodiazepines and SSRIs/SNRIs may be usefully combined, yet their combination is frequently employed in clinical practice. Patients with comorbidities are likely to have poorer treatment outcomes and have greater utilization of health care resources. Currently SSRIs/SNRIs are considered first-line therapy and are effective in both anxiety and depressive states. Nevertheless, many patients have only a partial response or have difficulty tolerating efficacious doses of antidepressant monotherapy. Benzodiazepines appear to improve treatment outcomes when an anxiety disorder co-occurs with depression or for depression characterized by anxious features. Specifically, they may provide benefits both in terms of speed of response and overall response. CONCLUSIONS Long-term management plans for anxiety disorder with or without comorbid depression should include strategies for acute or short-term care, long-term maintenance, and episodic or breakthrough symptoms. Combination therapy with benzodiazepines and antide-pressants in appropriate clinical settings may improve outcomes over monotherapy in some patients.
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Affiliation(s)
- Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University, School of Medicine, Atlanta, Ga, USA.
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Panic disorder. ACTA ACUST UNITED AC 2012; 106:363-74. [DOI: 10.1016/b978-0-444-52002-9.00020-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
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Sensitivity and specificity of the Geriatric Anxiety Inventory and the Hospital Anxiety and Depression Scale in the detection of anxiety disorders in older people with chronic obstructive pulmonary disease. Int Psychogeriatr 2012; 24:128-36. [PMID: 21794199 DOI: 10.1017/s1041610211001426] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Anxiety and depression are prevalent in patients with chronic obstructive pulmonary disease (COPD). This study evaluates the sensitivity and specificity of two self-administered anxiety rating scales in older people with COPD. The Geriatric Anxiety Inventory (GAI) and the Hospital Anxiety and Depression Scale (HADS) are established useful screening tools but they have not been previously validated in this population. METHODS Older people with COPD completed the GAI and the HADS along with a structured diagnostic psychiatric interview, the Mini International Neuropsychiatric Interview (MINI). The outcomes of both rating scales were compared against the diagnosis of anxiety disorders based on the MINI. Receiver operating characteristic (ROC) curves were used to identify the optimal diagnostic cut points for each scale. RESULTS Fourteen (25.5%) of the 55 participants, were diagnosed with an anxiety disorder. Mean GAI and HADS-anxiety subscale scores were significantly higher in subjects with an anxiety disorder than those without the diagnosis (p = 0.002 and 0.005 respectively). Both scales demonstrated moderate diagnostic value (area under the ROC curve was 0.83 for GAI and 0.79 for HADS). Optimal cut points were ≥3 (GAI) and ≥4 (HADS-anxiety subscale). At these cut-points, the GAI had a sensitivity of 85.7%, specificity of 78.0% and the HADS had a sensitivity of 78.6%, specificity 70.7%. CONCLUSION Our results support the use of the GAI and HADS as screening instruments for anxiety disorders in older people with COPD. The optimal cut points in this population were lower than previously recommended for both rating scales. The results of this study should be replicated before these cut points can be recommended for general use in older people with COPD.
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Positive impact of the β-blocker celiprolol on panic, anxiety, and cardiovascular parameters in patients with mitral valve prolapse syndrome. J Clin Psychopharmacol 2011; 31:783-5. [PMID: 22051923 DOI: 10.1097/jcp.0b013e318236bfa6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Psychosocial and behavioral correlates of anxiety symptoms in a sample of HIV-positive, methamphetamine-using men who have sex with men. AIDS Care 2011; 23:628-37. [PMID: 21293993 DOI: 10.1080/09540121.2010.525608] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Studies show high rates of psychiatric symptoms among methamphetamine users; however, little information exists regarding methamphetamine use and anxiety. This study investigated psychosocial and behavioral correlates of anxiety symptoms in a sample of 245 HIV-positive men having sex with men (MSM) who were enrolled in a sexual risk-reduction intervention. In a multiple regression analysis, anxiety symptoms were associated with homelessness, recent experience of HIV symptoms, injection drug use, lifetime sexual abuse, engaging in risky sexual behaviors, and seeking out partners at risky sexual venues when "high" on methamphetamine. These findings can be used to inform and refine sexual risk-reduction interventions and substance-use treatment programs for HIV-positive methamphetamine-using MSM.
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Logue MW, Bauver SR, Kremen WS, Franz CE, Eisen SA, Tsuang MT, Grant MD, Lyons MJ. Evidence of overlapping genetic diathesis of panic attacks and gastrointestinal disorders in a sample of male twin pairs. Twin Res Hum Genet 2011; 14:16-24. [PMID: 21314252 DOI: 10.1375/twin.14.1.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
We explored the comorbidity between panic attacks (PA), whose symptoms can include gastrointestinal discomfort, and gastrointestinal disorders (GD). Structural equation modeling was used to analyze data from 1,874 MZ and 1,498 DZ male-male twin pairs from the Vietnam Era Twin Registry. PA and GD were associated (relative risk for GD = 2). The percentage of liability due to genetic factors was estimated to be 37% for PA and 31% for GD. There was significant correlation between the genetic risk factors for PA and GD (estimated r = .55, 95% CI of 34% to 82%) and no evidence of correlation between the environmental causes of PA and GD. Therefore, PA and GD comorbidity can be explained by overlapping genetic factors and not overlapping environmental factors. Although these data cannot identify a biological pathway for such a shared liability, it suggests the presence of GD may be informative for genetic studies of panic.
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Affiliation(s)
- Mark W Logue
- Genetics Program, Boston University School of Medicine, Boston, United States of America
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Lewis KE, Annandale JA, Sykes RN, Hurlin C, Owen C, Harrison NK. Prevalence of Anxiety and Depression in Patients with Severe COPD: Similar High Levels with and without LTOT. COPD 2009; 4:305-12. [DOI: 10.1080/15412550701595716] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Manzoni GM, Pagnini F, Castelnuovo G, Molinari E. Relaxation training for anxiety: a ten-years systematic review with meta-analysis. BMC Psychiatry 2008. [PMID: 18518981 DOI: 10.11.86/1471-244x-8-41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Relaxation training is a common treatment for anxiety problems. Lacking is a recent quantitative meta-analysis that enhances understanding of the variability and clinical significance of anxiety reduction outcomes after relaxation treatment. METHODS All studies (1997-2007), both RCT, observational and without control group, evaluating the efficacy of relaxation training (Jacobson's progressive relaxation, autogenic training, applied relaxation and meditation) for anxiety problems and disorders were identified by comprehensive electronic searches with Pubmed, Psychinfo and Cochrane Registers, by checking references of relevant studies and of other reviews. Our primary outcome was anxiety measured with psychometric questionnaires. Meta-analysis was undertaken synthesizing the data from all trials, distinguishing within and between effect sizes. RESULTS 27 studies qualified for the inclusion in the meta-analysis. As hypothesized, relaxation training showed a medium-large effect size in the treatment of anxiety. Cohen's d was .57 (95% CI: .52 to .68) in the within analysis and .51 (95% CI: .46 to .634) in the between group analysis. Efficacy was higher for meditation, among volunteers and for longer treatments. Implications and limitations are discussed. CONCLUSION The results show consistent and significant efficacy of relaxation training in reducing anxiety. This meta-analysis extends the existing literature through facilitation of a better understanding of the variability and clinical significance of anxiety improvement subsequent to relaxation training.
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Affiliation(s)
- Gian Mauro Manzoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.
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Manzoni GM, Pagnini F, Castelnuovo G, Molinari E. Relaxation training for anxiety: a ten-years systematic review with meta-analysis. BMC Psychiatry 2008; 8:41. [PMID: 18518981 PMCID: PMC2427027 DOI: 10.1186/1471-244x-8-41] [Citation(s) in RCA: 194] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2008] [Accepted: 06/02/2008] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Relaxation training is a common treatment for anxiety problems. Lacking is a recent quantitative meta-analysis that enhances understanding of the variability and clinical significance of anxiety reduction outcomes after relaxation treatment. METHODS All studies (1997-2007), both RCT, observational and without control group, evaluating the efficacy of relaxation training (Jacobson's progressive relaxation, autogenic training, applied relaxation and meditation) for anxiety problems and disorders were identified by comprehensive electronic searches with Pubmed, Psychinfo and Cochrane Registers, by checking references of relevant studies and of other reviews. Our primary outcome was anxiety measured with psychometric questionnaires. Meta-analysis was undertaken synthesizing the data from all trials, distinguishing within and between effect sizes. RESULTS 27 studies qualified for the inclusion in the meta-analysis. As hypothesized, relaxation training showed a medium-large effect size in the treatment of anxiety. Cohen's d was .57 (95% CI: .52 to .68) in the within analysis and .51 (95% CI: .46 to .634) in the between group analysis. Efficacy was higher for meditation, among volunteers and for longer treatments. Implications and limitations are discussed. CONCLUSION The results show consistent and significant efficacy of relaxation training in reducing anxiety. This meta-analysis extends the existing literature through facilitation of a better understanding of the variability and clinical significance of anxiety improvement subsequent to relaxation training.
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Affiliation(s)
- Gian Mauro Manzoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.
| | | | - Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy,Department of Psychology, Catholic University of Milan, Italy
| | - Enrico Molinari
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy,Department of Psychology, Catholic University of Milan, Italy
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Carlos Pascual J, Castaño J, Espluga N, Díaz B, García-Ribera C, Bulbena A. Enfermedades somáticas en pacientes con trastornos de ansiedad. Med Clin (Barc) 2008; 130:281-5. [DOI: 10.1157/13116589] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Abstract
Panic disorder seems to be mediated by the neuronal circuitry and neurochemical systems that have evolved to respond to external threatening stimuli. Distant threats activate prefrontal cortex (involved in complex planning of avoidance strategies), while immediate threats activate midbrain structures (involved in fast reflexive behaviors). Panic disorder may, however, also involve more specific interoceptive mechanisms. For example, the association between respiratory dysfunction and panic disorder has bolstered a false suffocation alarm hypothesis. Genetic and environmental contributors to panic disorder are beginning to be delineated. Effective pharmacotherapy and psychotherapy are able to normalize the relevant psychobiology.
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Kapfhammer HP. Depressive und Angststörungen bei somatischen Krankheiten. PSYCHIATRIE UND PSYCHOTHERAPIE 2008. [PMCID: PMC7122024 DOI: 10.1007/978-3-540-33129-2_57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Depressiv-ängstliche Störungen sind bei den unterschiedlichen somatischen Erkrankungen häufig. Sie sind nicht nur als Reaktion auf die Situation der Erkrankung zu verstehen, sondern in ein komplexes Bedingungsgefüge eingebettet. Sie sind besonders häufig bei Erkrankungen, die das Zentralnervensystem oder endokrine Regulationssysteme direkt betreffen. Es besteht ein enger Zusammenhang zur Chronizität, Schwere und Prognose der Erkrankung. Eigenständige Effekte von diversen pharmakologischen Substanzgruppen sind wahrscheinlich.
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Abstract
Physiatrists frequently see patients who have chronic pain, and the physiatric approach is highly relevant to pain management. This article is directed toward physiatrists who do not specialize in pain management. It discusses the epidemiology of pain in patient groups often treated by physiatrists, pathophysiologic processes underlying chronic pain, the assessment of chronic pain patients, and selected treatments for chronic pain.
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Affiliation(s)
- James P Robinson
- Department of Rehabilitation Medicine, Box 356490, University of Washington, Seattle, WA 98195, USA.
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30
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Youngstedt SD, Kripke DF. Does bright light have an anxiolytic effect? - an open trial. BMC Psychiatry 2007; 7:62. [PMID: 17971237 PMCID: PMC2194679 DOI: 10.1186/1471-244x-7-62] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2007] [Accepted: 10/30/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this open trial was to examine the influence of acute bright light exposure on anxiety in older and young adults. METHODS This study was ancillary to a complex 5-day laboratory experiment testing phase-responses to light at all times of the day. On 3 consecutive days, participants were exposed to bright light (3,000 lux) for 3 hours. The Spielberger State-Trait Anxiety Inventory (Form Y1) was administered 5 minutes before and 20 minutes after each treatment. Mean state anxiety before and after treatment were analyzed by age, sex, and time ANOVA. To avoid floor effects, only participants with baseline STAI levels of > or = 25 were included. RESULTS A significant anxiolytic effect of bright light was found for the mean data, as well as for each of the three days. No significant main effect of age, sex, or interaction of these factors with STAI change were found. CONCLUSION The results show consistent and significant (albeit modest) anxiolytic effects following acute bright light exposure in low anxiety adults. Further randomized, controlled trials in clinically anxious individuals are needed.
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Affiliation(s)
- Shawn D Youngstedt
- Department of Exercise Science, Norman J, Arnold School of Public Health University of South Carolina, Columbia, SC 29208 USA.
| | - Daniel F Kripke
- Department of Psychiatry and Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, La Jolla, CA 92093-0667, USA
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31
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Abstract
PURPOSE OF REVIEW Pain is a common reason for seeking healthcare. Chronic pain is commonly comorbid with psychiatric disorders. New evidence provides fresh insights into the nature of the link between pain and mental disorders and offers opportunity to refine treatment approaches. RECENT FINDINGS Even though depression is the most commonly studied comorbid psychiatric disorder, new studies show that other mental disorder, especially anxiety disorders, are also common. Comorbid conditions, including other chronic physical conditions, account for a substantial proportion of the disability associated with chronic pain conditions. The causal link between chronic pain and mental disorders may vary depending on the specific mental disorder, but the link may be mediated by biological, psychological, and social factors. Recent findings also suggest that the evolution of the comorbidity may differ between the sexes. Promising interventions for chronic pain that also target contextual psychosocial problems have been recently described. SUMMARY The frequent occurrence of mental disorders among patients with pain, especially those whose pain is chronic, has implications for the management of such patients. Current understanding of the complexity of this link not only provides opportunities for designing appropriate interventions but also raises new questions for further research.
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Affiliation(s)
- Oye Gureje
- Department of Psychiatry, University of Ibadan, University College Hospital, Ibadan, Nigeria.
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32
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Smriga M, Ando T, Akutsu M, Furukawa Y, Miwa K, Morinaga Y. Oral treatment with L-lysine and L-arginine reduces anxiety and basal cortisol levels in healthy humans. Biomed Res 2007; 28:85-90. [PMID: 17510493 DOI: 10.2220/biomedres.28.85] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Dietary supplementation with an essential amino acid L-lysine has been shown to reduce chronic anxiety in humans with low dietary intake of L-lysine. A combination of L-lysine and L-arginine has been documented to normalize hormonal stress responses in humans with high trait anxiety. The present study was carried out in one hundred eight healthy Japanese adults. The aim of study was to find out whether a week-long oral treatment with L-lysine (2.64 g per day) and L-arginine (2.64 g per day) reduces trait and stress-induced state anxiety and basal levels of stress hormones. We confirmed that, without regard to gender, the amino acid treatment significantly reduced both trait anxiety and state anxiety induced by cognitive stress battery. In addition, we found that the treatment with L-lysine and L-arginine decreased the basal levels of salivary cortisol and chromogranin-A (a salivary marker of the sympatho-adrenal system) in male subjects. These results of this double-blind, placebo controlled and randomized study confirm the previous findings in humans and animals and point to a combination of L-lysine and L-arginine as a potentially useful dietary intervention in otherwise healthy humans with high subjective levels of mental stress and anxiety.
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Affiliation(s)
- Miro Smriga
- Institute of Life Sciences, Ajimoto Co. Inc, 1-1 Suzuki-cho, 210-8681 Kawasaki-ku, Kawasaki-shi, Japan.
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