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Mundy J, Hübel C, Adey BN, Davies HL, Davies MR, Coleman JRI, Hotopf M, Kalsi G, Lee SH, McIntosh AM, Rogers HC, Eley TC, Murray RM, Vassos E, Breen G. Genetic examination of the Mood Disorder Questionnaire and its relationship with bipolar disorder. Am J Med Genet B Neuropsychiatr Genet 2023; 192:147-160. [PMID: 37178379 PMCID: PMC10952822 DOI: 10.1002/ajmg.b.32938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/18/2023] [Accepted: 04/15/2023] [Indexed: 05/15/2023]
Abstract
The Mood Disorder Questionnaire (MDQ) is a common screening tool for bipolar disorder that assesses manic symptoms. Its utility for genetic studies of mania or bipolar traits has not been fully examined. We psychometrically compared the MDQ to self-reported bipolar disorder in participants from the United Kingdom National Institute of Health and Care Research Mental Health BioResource. We conducted genome-wide association studies of manic symptom quantitative traits and symptom subgroups, derived from the MDQ items (N = 11,568-19,859). We calculated genetic correlations with bipolar disorder and other psychiatric and behavioral traits. The MDQ screener showed low positive predictive value (0.29) for self-reported bipolar disorder. Neither concurrent nor lifetime manic symptoms were genetically correlated with bipolar disorder. Lifetime manic symptoms had a highest genetic correlation (rg = 1.0) with posttraumatic stress disorder although this was not confirmed by within-cohort phenotypic correlations (rp = 0.41). Other significant genetic correlations included attention deficit hyperactivity disorder (rg = 0.69), insomnia (rg = 0.55), and major depressive disorder (rg = 0.42). Our study adds to existing literature questioning the MDQ's validity and suggests it may capture symptoms of general distress or psychopathology, rather than hypomania/mania specifically, in at-risk populations.
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Affiliation(s)
- Jessica Mundy
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Christopher Hübel
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
- National Centre for Register‐based Research, Aarhus Business and Social SciencesAarhus UniversityAarhusDenmark
| | - Brett N. Adey
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Helena L. Davies
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Molly R. Davies
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Jonathan R. I. Coleman
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
- South London and Maudsley NHS Foundation TrustBethlem Royal HospitalKentUK
| | - Gursharan Kalsi
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Sang Hyuck Lee
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Andrew M. McIntosh
- Division of Psychiatry, Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | - Henry C. Rogers
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Thalia C. Eley
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Robin M. Murray
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Evangelos Vassos
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Gerome Breen
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
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Renna ME, O'Toole MS, Fresco DM, Heimberg RG, Mennin DS. From psychological to physical health: Exploring temporal precedence throughout emotion regulation therapy. J Anxiety Disord 2021; 80:102403. [PMID: 33901929 PMCID: PMC8141041 DOI: 10.1016/j.janxdis.2021.102403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 03/18/2021] [Accepted: 04/13/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Generalized anxiety disorder (GAD) is characterized, in part, by physical symptoms such as muscle tension and gastrointestinal (GI) distress. To date, little research has examined how changes in psychological symptoms associated with GAD may impact physical symptoms. This study investigated if reductions in worry, anxiety, and depression precede changes in muscle tension and GI distress throughout psychotherapy. METHODS Participants with GAD (N = 85) completed 20 weeks of emotion regulation therapy (ERT) in addition to assessments pre, mid, and post treatment. They completed a physical symptom questionnaire, evaluating muscle tension and GI distress. Participants also completed psychological symptoms questionnaires, including the State Trait Anxiety Inventory (STAI-7), Penn State Worry Questionnaire (PSWQ), and Beck Depression Inventory (BDI-II). Control participants (N = 44) completed these measures at baseline. RESULTS Participants with GAD had significantly greater muscle tension (p < .001) and GI distress (p < .001) compared to control participants without GAD. Reductions in worry, depression, and trait anxiety did not precede changes in muscle tension (range of effect size (r): .05-.12). Reductions in both depression (p = 0.04) and trait anxiety (p < 0.01) preceded reductions in GI distress. Reductions in worry did not precede reductions in GI distress (p = 0.25). CONCLUSION These data provide preliminary evidence for the temporal effect of reductions in psychological symptoms on reductions in GI distress in GAD, highlighting the potential of psychotherapy to improve physical outcomes.
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Affiliation(s)
- Megan E Renna
- The Ohio State University College of Medicine, Comprehensive Cancer Center & Institute for Behavioral Medicine Research, Columbus, OH, USA.
| | - Mia S O'Toole
- Aarhus University, Department of Psychology and Behavioral Sciences, Aarhus, Denmark
| | - David M Fresco
- University of Michigan, Department of Psychiatry & Institute for Social Research, Ann Arbor, MI, USA
| | | | - Douglas S Mennin
- Teachers College, Columbia University, Department of Clinical and Counseling Psychology, New York, NY, USA
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Preti A, Demontis R, Cossu G, Kalcev G, Cabras F, Moro MF, Romano F, Balestrieri M, Caraci F, Dell'Osso L, Di Sciascio G, Drago F, Hardoy MC, Roncone R, Faravelli C, Gonzalez CIA, Angermayer M, Carta MG. The lifetime prevalence and impact of generalized anxiety disorders in an epidemiologic Italian National Survey carried out by clinicians by means of semi-structured interviews. BMC Psychiatry 2021; 21:48. [PMID: 33472585 PMCID: PMC7816458 DOI: 10.1186/s12888-021-03042-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 01/05/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is one of the most reported diagnoses in psychiatry, but there is some discrepancy between the cases identified in community studies and those identified in tertiary care. This study set out to evaluate whether the use of clinicians as interviewers may provide estimates in a community survey close to those observed in primary or specialized care. METHODS This is a community survey on a randomly selected sample of 2338 adult subjects. The Advanced Neuropsychiatric Tools and Assessment Schedule (ANTAS) was administered by clinicians, providing lifetime diagnosis based on the DSM-IV-TR. Health-related quality of life (HR-QoL) was measured with the Short-Form Health Survey (SF-12). RESULTS Overall, 55 (2.3%) subjects met the criteria for GAD, with greater prevalence in women (3.6%) than in men (0.9%): OR = 4.02; 95%CI: 1.96-8.26. Up to 40% of those with GAD had at least another diagnosis of mood, anxiety, or eating disorders. The mean score of SF-12 in people with GAD was 32.33 ± 6.8, with a higher attributable burden than in other conditions except for major depressive disorder. CONCLUSIONS We found a relatively lower lifetime prevalence of GAD than in community surveys based on lay interviewers and a structured interview. The identified cases of GAD showed a strong impact on the quality of life regardless of co-morbidity and high risk in women, suggesting a profile similar to the one identified from studies in primary and specialized care.
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Affiliation(s)
- Antonio Preti
- University of Cagliari, Cagliari, Italy.
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, via Cherasco 15, 10126, Turin, Italy.
| | | | | | - Goce Kalcev
- Department of Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | | | | | | | | | - Filippo Caraci
- Department of Drug Sciences, University of Catania, Catania, Italy
- Oasi Research Institute-IRCCS, Troina, Italy
| | | | | | - Filippo Drago
- Department of Drug Sciences, University of Catania, Catania, Italy
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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: 7] [Impact Index Per Article: 1.2] [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.
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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
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Karp JF, DiNapoli EA, Wetherell J, Bolon C, Rodriguez E, Shega J, Weiner DK. Deconstructing Chronic Low Back Pain in the Older Adult—Step by Step Evidence and Expert-Based Recommendations for Evaluation and Treatment: Part IX: Anxiety. PAIN MEDICINE 2016; 17:1423-35. [DOI: 10.1093/pm/pnw135] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Linden M, Rath K. The impact of the intensity of single symptoms on the diagnosis and prevalence of major depression. Compr Psychiatry 2014; 55:1567-71. [PMID: 25085572 DOI: 10.1016/j.comppsych.2014.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 06/07/2014] [Accepted: 06/09/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE Diagnoses are based on algorithms which count symptoms. The question is whether all or only sufficiently severe complaints of patients should qualify as diagnostic criteria and how prevalence rates of mental disorders change when all or only moderate or severe complaints are counted as symptoms in diagnostic algorithms. METHOD One hundred thirty-nine general practice patients were diagnosed as suffering from major depression according to DSM-IV on the basis of the standardized clinical International Neuropsychiatric Diagnostic Interview (MINI). They additionally filled in the self-rating SCL-90, which allows patients to rate the intensity of each symptom on a five-point Likert scale. The diagnostic algorithm for major depression was modeled on the basis of the SCL-90 self-rating. MINI-diagnoses were compared with SCL-diagnoses when symptoms with different intensity were taken into account. RESULTS The prevalence of "SCL-90-major depression" is 77.2% if all symptoms are counted, and 38.7% if only at least moderately severe symptoms, or 5.0% if only extremely severe symptoms are included in the diagnostic algorithm. Sensitivity rates vary from 10.8%, if only extremely severe symptoms are counted, to 94.2% if all complaints were included. Specificity rates vary from 37.4% for all complaints and 100% for extremely severe items. Accuracy is best when "a little bit" of complaint is omitted (78.1%) and lowest if only extremely severe symptoms are counted (58.9%). CONCLUSION The data demonstrate the importance of the severity of single symptoms for the diagnosis of mental disorders. Symptom definition, recognition, and evaluation must find greater attention in research, clinical practice, and training of physicians.
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Affiliation(s)
- Michael Linden
- Research Group Psychosomatic Rehabilitation at the Charité University Medicine Berlin, Berlin, Germany; Department of Behavioral Medicine at the Rehabilitation Center Seehof, Teltow/Berlin, Germany.
| | - Katharina Rath
- Research Group Psychosomatic Rehabilitation at the Charité University Medicine Berlin, Berlin, Germany; Department of Behavioral Medicine at the Rehabilitation Center Seehof, Teltow/Berlin, Germany
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