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Patel TA, Cole SL, Cougle JR. Correlates of alcohol use and alcohol use disorder among individuals with DSM-5 social anxiety disorder: A population based study. J Affect Disord 2024; 360:55-61. [PMID: 38821365 DOI: 10.1016/j.jad.2024.05.163] [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: 09/09/2023] [Revised: 05/15/2024] [Accepted: 05/28/2024] [Indexed: 06/02/2024]
Abstract
Alcohol use disorder (AUD) commonly cooccurs with social anxiety disorder (SAD). With changes to diagnostic criteria of psychiatric disorders in the DSM-5, the present study sought to observe the associations between daily alcohol use, AUD, and social anxiety in a large sample of individuals with lifetime (N = 1255) and past-year (N = 908) SAD. The sample was derived from a large nationally representative study of adults in the United States. Of note, we found that at the symptom level, daily alcohol use and AUD were significantly related to panic attacks due to social anxiety, subjective distress, and impairment in relationships. Daily alcohol use and AUD were significantly associated with lifetime SAD severity; however, only past-year daily alcohol use was significantly related to past-year SAD severity. We also found that AUD was significantly related to greater treatment-seeking for SAD, and both AUD and daily alcohol use were significantly associated with lifetime history of suicide attempts even after covarying for SAD severity. The present study provides an updated investigation of alcohol use in individuals with DSM-5 SAD, and it underscores the significance of daily alcohol use as an important factor to consider in individuals with SAD.
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Affiliation(s)
- Tapan A Patel
- Department of Psychology, Florida State University, Tallahassee, FL, United States of America.
| | - Sally L Cole
- Department of Psychology, Florida State University, Tallahassee, FL, United States of America
| | - Jesse R Cougle
- Department of Psychology, Florida State University, Tallahassee, FL, United States of America.
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2
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Acuña AM, Park C, Leyrer-Jackson JM, Olive MF. Promising immunomodulators for management of substance and alcohol use disorders. Expert Opin Pharmacother 2024; 25:867-884. [PMID: 38803314 PMCID: PMC11216154 DOI: 10.1080/14656566.2024.2360653] [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: 03/26/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024]
Abstract
INTRODUCTION The neuroimmune system has emerged as a novel target for the treatment of substance use disorders (SUDs), with immunomodulation producing encouraging therapeutic benefits in both preclinical and clinical settings. AREAS COVERED In this review, we describe the mechanism of action and immune response to methamphetamine, opioids, cocaine, and alcohol. We then discuss off-label use of immunomodulators as adjunctive therapeutics in the treatment of neuropsychiatric disorders, demonstrating their potential efficacy in affective and behavioral disorders. We then discuss in detail the mechanism of action and recent findings regarding the use of ibudilast, minocycline, probenecid, dexmedetomidine, pioglitazone, and cannabidiol to treat (SUDs). These immunomodulators are currently being investigated in clinical trials described herein, specifically for their potential to decrease substance use, withdrawal severity, central and peripheral inflammation, comorbid neuropsychiatric disorder symptomology, as well as their ability to improve cognitive outcomes. EXPERT OPINION We argue that although mixed, findings from recent preclinical and clinical studies underscore the potential benefit of immunomodulation in the treatment of the behavioral, cognitive, and inflammatory processes that underlie compulsive substance use.
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Affiliation(s)
- Amanda M. Acuña
- Department of Psychology, Behavioral Neuroscience and Comparative Psychology Area, Arizona State University, Tempe, Arizona, USA
| | - Connor Park
- Department of Biomedical Sciences, Creighton University School of Medicine – Phoenix, Phoenix, Arizona, USA
| | - Jonna M. Leyrer-Jackson
- Department of Biomedical Sciences, Creighton University School of Medicine – Phoenix, Phoenix, Arizona, USA
| | - M. Foster Olive
- Department of Psychology, Behavioral Neuroscience and Comparative Psychology Area, Arizona State University, Tempe, Arizona, USA
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3
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Nguyen AW, Taylor HO, Taylor RJ, Ambroise AZ, Hamler T, Qin W, Chatters LM. The role of subjective, interpersonal, and structural social isolation in 12-month and lifetime anxiety disorders. BMC Public Health 2024; 24:760. [PMID: 38468204 DOI: 10.1186/s12889-024-18233-2] [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: 10/31/2023] [Accepted: 02/28/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Anxiety disorders are among the most prevalent psychiatric conditions worldwide, and the incidence of anxiety disorders among adults in the U.S. have increased over the last decade. Anxiety disorders can have debilitating effects on multiple areas of functioning and quality of life. Recently, social isolation has emerged as an important public health problem associated with worse health and well-being outcomes. Research on the connection between social isolation and mental health has found that multiple dimensions of social isolation may negatively impact mental health, but few inquiries have focused on the association between social isolation and anxiety. This study examined the relationships between multiple dimensions of social isolation and anxiety disorders in a nationally representative sample of adults aged 18 and older. METHODS The sample includes 6082 individuals from the National Survey of American Life. This study examined whether three different dimensions of social isolation-subjective, interpersonal, and structural-were associated with 12-month and lifetime anxiety disorders (any anxiety disorder, posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic disorder (PD), social anxiety disorder (SAD), and agoraphobia (AG). Logistic regressions were used to test the associations between the three social isolation variables and the anxiety outcomes. RESULTS This study found that of the three dimensions of social isolation, subjective isolation was most consistently related to both lifetime and 12-month anxiety disorders. Those who were subjectively isolated had increased odds of meeting criteria for any anxiety disorder, PTSD, GAD, PD, and AG over the past 12 months and throughout their lifetimes. Structural isolation was negatively associated with lifetime and 12-month AG. CONCLUSIONS Public health approaches should include mental health and primary care providers and need to target social isolation, especially subjective isolation, which may be key in preventing anxiety disorders and the worsening of anxiety disorders. Future public health research is needed on how and in what ways the differing dimensions of social isolation impact mental health.
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Affiliation(s)
- Ann W Nguyen
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave, 44106, Cleveland, OH, USA
| | - Harry Owen Taylor
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, M5S 1V4, Toronto, ON, Canada
| | - Robert Joseph Taylor
- School of Social Work, University of Michigan, 1080 S. University Ave, 48109, Ann Arbor, MI, USA.
| | - Alexis Z Ambroise
- College of Education and Human Development, University of Delaware, 19716, Newark, DE, USA
| | - Tyrone Hamler
- Graduate School of Social Work, University of Denver, 2148 S. High Street, 80210, Denver, CO, USA
| | - Weidi Qin
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, 1350 University Ave, Madison, WI, USA
| | - Linda M Chatters
- School of Social Work, University of Michigan, 1080 S. University Ave, 48109, Ann Arbor, MI, USA
- School of Public Health, University of Michigan, 1415 Washington Heights, 48109, Ann Arbor, MI, USA
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Patel TA, Schubert FT, Zech JM, Cougle JR. Prevalence and correlates of cannabis use among individuals with DSM-5 social anxiety disorder: Findings from a nationally representative sample. J Psychiatr Res 2023; 163:406-412. [PMID: 37276644 DOI: 10.1016/j.jpsychires.2023.05.079] [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: 03/21/2023] [Revised: 04/22/2023] [Accepted: 05/29/2023] [Indexed: 06/07/2023]
Abstract
Cannabis use disorder (CUD) and frequency of use are highly related to social anxiety disorder (SAD). With updates to diagnostic criteria of psychiatric disorders and recent changes in cannabis laws, the present study sought to explore the relationships between cannabis use, CUD, and social anxiety in a large nationally representative sample of individuals with lifetime (N = 1255) and past-year SAD (N = 980). Notably, we found that at the symptom level, at least weekly cannabis use was significantly related to fear or avoidance of social situations interfering with relationships in both samples. Weekly + cannabis use and CUD were significantly associated with lifetime SAD symptom severity, but only weekly + cannabis use was related to SAD severity in the past-year sample. We also found that weekly + cannabis use but not CUD was related to greater odds of seeking treatment for SAD and suicide attempt history. Overall, these data provide an updated examination of cannabis use and SAD using DSM-5 criteria and a large nationally representative sample and also highlight the importance of weekly + cannabis use as a marker of severity and suicide risk in individuals with SAD.
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Affiliation(s)
- Tapan A Patel
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | | | - James M Zech
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Jesse R Cougle
- Department of Psychology, Florida State University, Tallahassee, FL, USA.
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Parental anxiety and offspring development: A systematic review. J Affect Disord 2023; 327:64-78. [PMID: 36740142 DOI: 10.1016/j.jad.2023.01.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Parental anxiety has been associated with increased risk of emotional and behavioural problems for offspring, yet the differing impact of each parent is unclear. As emotional disorders continue to present a significant challenge to the health system and with the role of mothers and fathers changing over the past two decades, we sought to systematically review the available literature for an association between parental anxiety and offspring suboptimal outcomes. METHODS A systematic review was conducted using the following databases: Ovid MEDLINE, Embase; PsycINFO and Google Scholar. Reference lists of the included papers were also searched. Data was analysed and grouped based on offspring age. RESULTS Eighteen studies were included in this review. Results suggest that both parents' mental health can impact negatively on the functioning of offspring, during infancy, childhood, and adolescence. This association is weak in infancy, with equivocal results, however the association in childhood appears robust for both mothers and fathers. In adolescence, the findings suggest that maternal anxiety may be more influential than paternal anxiety. LIMITATIONS As the methodology of the included studies was heterogenous, and the timing of assessment varied across the papers, drawing concrete conclusions from the existing research is somewhat impaired. CONCLUSIONS Both mothers' and fathers' anxiety have the propensity to negatively impact on their child's development. Implementing preventative interventions, which include both parents, as well as systemic interventions, which include the whole family, are essential in stemming the intergenerational transmission of mental health problems within families.
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Moon J, Lieber RJ, Bayazitli I, Mello ZR. An Examination of Multidimensional Time Perspective and Mental Health Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4688. [PMID: 36981597 PMCID: PMC10048536 DOI: 10.3390/ijerph20064688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/22/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
We examined the associations between time perspective and mental health outcomes (N = 337; Mage = 22.74, SDage = 5.59; 76% female). Time perspective included multiple dimensions (feelings, frequency, orientation, and relation) and time periods (past, present, and future). Mental health outcomes included depressive symptoms, anxiety, and rumination. To demonstrate the reliability of the time perspective scales, test-retest analyses were completed. Multivariate analyses showed that (a) positive feelings about time were associated with lower anxiety; (b) negative feelings about time were associated with greater anxiety; and (c) more frequent thoughts about the past were associated with greater depressive symptoms and anxiety. Associations remained when controlling for anxiety and depressive symptoms, respectively. Moreover, (a) positive feelings about time were associated with lower rumination; (b) negative feelings about time were associated with greater rumination; and (c) more frequent thoughts about the past were associated with greater rumination. Time perspective scales yielded scores that were moderate to high in test-retest reliability. Findings demonstrate the value of examining separate time perspective dimensions and time periods. Results highlight the role of time perspective in mental health interventions for adults.
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Childhood Adversity, Addiction Severity, and Comorbidity Among Patients Receiving Opioid Use Disorder Treatment: The Role of Emotion Regulation. J Nerv Ment Dis 2023; 211:150-156. [PMID: 36112518 DOI: 10.1097/nmd.0000000000001581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Patients in opioid use disorder (OUD) treatment report high rates of childhood adversity, and women experience greater exposure to certain types of childhood adversity ( e.g. , sexual abuse). Childhood adversity is associated with clinical severity, but the mechanisms explaining this association are not well understood. Participants ( N = 171) in opioid agonist treatment completed measures of childhood adversity, emotion regulation, and clinical severity ( i.e. , addictive behaviors, depression, and anxiety). Women endorsed greater childhood adversity and higher current psychopathology than men. The association between childhood adversity and clinical severity varied as a function of symptom type, although emotion regulation was a strong predictor in all models. Women reported higher levels of anxiety after controlling for covariates, childhood adversity, and emotion dysregulation. Future research should investigate treatment strategies to address emotion dysregulation among patients in OUD treatment, particularly women who may present with greater childhood adversity exposure and anxiety.
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Akosile W, Bor W, Tilse A, Hunt G, Rushton A, McDermott B, Lee E, McBride M. Predictors of completion of an adolescent residential alcohol and other drug withdrawal program. JOURNAL OF SUBSTANCE USE 2023. [DOI: 10.1080/14659891.2023.2166608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Wole Akosile
- New Farm Clinic, School of Medicine, University of Queensland, Brisbane, Australia
| | - William Bor
- Consultant Psychiatrist Queensland Children's Hospital, Children’s Health Queensland, Brisbane, Australia
- Centre for Children’s Health Research, South Brisbane, Australia
| | - Amanda Tilse
- Mater Young Adult Health Centre, South Brisbane, Australia
| | - Georgia Hunt
- Mater Young Adult Health Centre, South Brisbane, Australia
| | - Ann Rushton
- Former Residential Co-ordinator: Mater Alcohol and other Drugs Withdrawal Service, Former Residential Co-ordinator, Mater Alcohol and other Drugs Withdrawal Service, South Brisbane, Australia
| | - Brett McDermott
- Professor of Psychiatry, James Cook University, Townsville, Australia
| | - Erica Lee
- Mater Child and Youth Mental Health Service, South Brisbane, Australia
| | - Michelle McBride
- Psychologist Ahead Psychology, Former Manager Mater Alcohol and other Drugs Withdrawal Service, South Brisbane, Australia
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Milanak ME, Witcraft SM, Park JY, Hassell K, McMahon T, Wilkerson AK. A Transdiagnostic group therapy for sleep and anxiety among adults with substance use disorders: Protocol and pilot investigation. Front Psychiatry 2023; 14:1160001. [PMID: 37065898 PMCID: PMC10090550 DOI: 10.3389/fpsyt.2023.1160001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/09/2023] [Indexed: 04/18/2023] Open
Abstract
Introduction Treatment of substance use disorders (SUDs) is challenging with high rates of treatment dropout and relapse, particularly among individuals with comorbid psychiatric conditions. Anxiety and insomnia are prevalent among those with SUD and exacerbate poor treatment outcomes. Interventions that concurrently target anxiety and insomnia during the early stages of SUD treatment are lacking. To this end, we investigated the feasibility and preliminary effectiveness in a single-arm pilot trial of an empirically informed group transdiagnostic intervention, Transdiagnostic SUD Therapy, to concurrently reduce anxiety and improve sleep among adults receiving treatment for SUD. Specifically, we hypothesized that participants would evidence declines in anxiety and insomnia and improvements in sleep health, a holistic, multidimensional pattern of sleep-wakefulness that promotes wellbeing. A secondary aim was to describe the protocol for Transdiagnostic SUD Therapy and how it may be implemented into a real-world addiction treatment setting. Method Participants were 163 adults (Mage = 43.23; 95.1% White; 39.93% female) participating in an intensive outpatient program for SUD who attended at least three of four Transdiagnostic SUD Therapy sessions. Participants had diverse SUDs (58.3% alcohol use disorder, 19.0% opioid use disorder) and nearly a third of the sample met criteria for two SUDs and comorbid mental health diagnoses (28.9% anxiety disorder, 24.6% major depressive disorder). Results As anticipated, anxiety and insomnia reduced significantly across the 4-week intervention period from clinical to subclinical severity, and sleep health significantly improved (ps < 0.001). These statistically significant improvements following Transdiagnostic SUD Therapy demonstrated medium to large effects (ds > 0.5). Conclusion Transdiagnostic SUD Therapy is designed to be flexibly administered in "real-world" clinical settings and, preliminarily, appears to be effective in improving emotional and behavioral factors that increase risk for return to substance use and poor SUD treatment outcomes. Additional work is needed to replicate these findings, determine the feasibility of widespread uptake of Transdiagnostic SUD Therapy, and examine whether the treatment effects translate to improvement in substance use outcomes.
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Affiliation(s)
- Melissa E. Milanak
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Sara M. Witcraft
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Jie Young Park
- Edward Via College of Osteopathic Medicine–Carolinas, Spartanburg, SC, United States
| | | | - Tierney McMahon
- Department of Psychology, Northwestern University, Evanston, IL, United States
| | - Allison K. Wilkerson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- *Correspondence: Allison K. Wilkerson,
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Sex differences in addiction-relevant behavioral outcomes in rodents following early life stress. ADDICTION NEUROSCIENCE 2023; 6. [PMID: 37101684 PMCID: PMC10124992 DOI: 10.1016/j.addicn.2023.100067] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
In humans, exposure to early life stress (ELS) is an established risk factor for the development of substance use disorders (SUDs) during later life. Similarly, rodents exposed to ELS involving disrupted mother-infant interactions, such as maternal separation (MS) or adverse caregiving due to scarcity-adversity induced by limited bedding and nesting (LBN) conditions, also exhibit long-term alterations in alcohol and drug consumption. In both humans and rodents, there is a range of addiction-related behaviors that are associated with drug use and even predictive of subsequent SUDs. In rodents, these include increased anxiety-like behavior, impulsivity, and novelty-seeking, altered alcohol and drug intake patterns, as well as disrupted reward-related processes involving consummatory and social behaviors. Importantly, the expression of these behaviors often varies throughout the lifespan. Moreover, preclinical studies suggest that sex differences play a role in how exposure to ELS impacts reward and addiction-related phenotypes as well as underlying brain reward circuitry. Here, addiction-relevant behavioral outcomes and mesolimbic dopamine (DA) dysfunction resulting from ELS in the form of MS and LBN are discussed with a focus on age- and sex-dependent effects. Overall, these findings suggest that ELS may increase susceptibility for later life drug use and SUDs by interfering with the normal maturation of reward-related brain and behavioral function.
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Tran DD, Fitzke RE, Wang J, Davis JP, Pedersen ER. Substance Use, Financial Stress, Employment Disruptions, and Anxiety among Veterans during the COVID-19 Pandemic. Psychol Rep 2022:332941221080413. [PMID: 35324356 PMCID: PMC8958310 DOI: 10.1177/00332941221080413] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
The COVID-19 pandemic has resulted in financial, employment, and mental health challenges. In general, American veterans report high rates of substance use, which may be influenced by the COVID-19 pandemic. Those with pre-existing mental health problems, employment disruptions, or financial stress may be particularly vulnerable. We examined the relationships between pre-existing self-report screens for a probable anxiety disorder, COVID-19-related financial stress, employment disruption (e.g., lost job, reduced hours), and alcohol, cannabis, and cigarette use during the pandemic among 1230 veterans (Mage = 34.5; 89% male). Participants were recruited through various social media sites and completed an online survey 1 month prior to implementation of the nationwide physical distancing guidelines in the United States (February 2020). Six months later (August 2020), they completed a follow-up survey. Compared to veterans who screened negative for anxiety prior to the pandemic, veterans who screened positive reported consuming more drinks per week (b = 3.05), were more likely to use cannabis (OR = 6.53), and smoked more cigarettes (b = 2.06) during the first 6 months of the pandemic. Financial stress was positively associated with alcohol (b = 1.09) and cannabis use (OR = 1.90). Alcohol use was heaviest among veterans with a positive pre-existing anxiety screen and high financial stress. Moreover, veterans who experienced employment disruption due to the pandemic consumed less alcohol but were more likely to use cannabis during the pandemic. Veterans with pre-pandemic anxiety and pandemic-related financial stress may be using substances at higher rates and may benefit from intervention to mitigate negative substance use-related outcomes. Findings also enhance our understanding of veteran substance use behaviors following disruptions in employment due to the pandemic.
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Affiliation(s)
- Denise D Tran
- Department of Psychiatry and Behavioral Sciences, 12223University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Reagan E Fitzke
- Department of Psychiatry and Behavioral Sciences, 12223University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Jennifer Wang
- 12223University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Jordan P Davis
- USC Center for Artificial Intelligence in Society. USC Center for Mindfulness Science. USC Institute for Addiction Science, 115162University of Southern California, Suzanne Dworak-Peck School of Social Work, Los Angeles, CA, USA
| | - Eric R Pedersen
- Department of Psychiatry and Behavioral Sciences, 12223University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
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Fuller-Thomson E, Carrique L, MacNeil A. Generalized anxiety disorder among adults with attention deficit hyperactivity disorder. J Affect Disord 2022; 299:707-714. [PMID: 34799150 DOI: 10.1016/j.jad.2021.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Research has identified a link between Attention-Deficit Hyperactivity Disorder (ADHD) and Generalized Anxiety Disorder (GAD). The aims of this study were to investigate the relationship between ADHD and GAD, and to identify significant correlates of GAD among those with ADHD. METHODS Data were derived from the nationally representative 2012 Canadian Community Health Survey-Mental Health. The sample included 6,989 respondents aged 20-39, of whom 682 had GAD. Bivariate and logistic regression analyses were conducted to determine the degree to which the association between ADHD and GAD was attenuated by demographics, socioeconomic status, social support, spirituality, childhood adversities, depression, and substance abuse/dependence. Additional analyses were conducted using the subsample of those diagnosed with ADHD (n = 272) to determine factors associated with GAD. RESULTS 1 in 9 respondents with GAD had ADHD, in comparison to 1 in 33 of those without GAD. The age-sex-race adjusted odds of GAD were four-fold for those with ADHD in comparison to those without ADHD. After adjusting for all covariates, the odds of GAD were still more than double for those with ADHD. Factors associated with GAD among those with ADHD include being female, having an income <$40,000, having fewer close relationships, and having a lifetime history of depression. LIMITATIONS Cross-sectional design prohibits causal inferences. CONCLUSION The high co-morbidity between ADHD and GAD emphasizes the need for targeted intervention to support these often overlapping disorders.
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Affiliation(s)
- Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada; Institute for Life Course and Aging, University of Toronto, Toronto, ON, Canada; Department of Family and Community Medicine & Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
| | - Lauren Carrique
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada; Institute for Life Course and Aging, University of Toronto, Toronto, ON, Canada
| | - Andie MacNeil
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada; Institute for Life Course and Aging, University of Toronto, Toronto, ON, Canada
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Okuno H, Rezeppa T, Raskin T, De Los Reyes A. Adolescent Safety Behaviors and Social Anxiety: Links to Psychosocial Impairments and Functioning with Unfamiliar Peer Confederates. Behav Modif 2021; 46:1314-1345. [PMID: 34763552 DOI: 10.1177/01454455211054019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Socially anxious adolescents often endure anxiety-provoking situations using safety behaviors: strategies for minimizing in-the-moment distress (e.g., avoiding eye contact, rehearsing statements before entering a conversation). Studies linking safety behaviors to impaired functioning have largely focused on adults. In a sample of one hundred thirty-four 14 to 15 year-old adolescents, we tested whether levels of safety behaviors among socially anxious adolescents relate to multiple domains of impaired functioning. Adolescents, parents, and research personnel completed survey measures of safety behaviors and social anxiety, adolescents and parents reported about adolescents' evaluative fears and psychosocial impairments, and adolescents participated in a set of tasks designed to simulate social interactions with same-age, unfamiliar peers. Relative to other adolescents in the sample, adolescents high on both safety behaviors and social anxiety displayed greater psychosocial impairments, evaluative fears, and observed social skills deficits within social interactions. These findings have important implications for assessing and treating adolescent social anxiety.
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Affiliation(s)
- Hide Okuno
- University of Maryland at College Park, USA
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Clark AE, Goodwin SR, Marks RM, Belcher AM, Heinlein E, Bennett ME, Roche DJO. A Narrative Literature Review of the Epidemiology, Etiology, and Treatment of Co-Occurring Panic Disorder and Opioid Use Disorder. J Dual Diagn 2021; 17:313-332. [PMID: 34582313 PMCID: PMC9487392 DOI: 10.1080/15504263.2021.1965407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Panic disorder is a debilitating psychiatric disorder that often co-occurs with substance use disorders. Given the current opioid epidemic, the high reported rates of comorbid panic disorder and opioid use disorder are particularly concerning. In this narrative review, we describe the literature on panic disorder and opioid use disorder co-occurrence. METHODS 86 studies, 26 reviews, 2 commentaries, and 5 guidelines pertaining to opioid use disorder, panic disorder, and their comorbidity were identified using all EBSCO databases, PubMed, and Google Scholar. RESULTS First, we review epidemiological literature on the prevalence of the comorbid condition above and beyond each disorder on its own. Additionally, we discuss the challenges that complicate the differential diagnosis of panic disorder and opioid use disorder and contribute to difficulties establishing rates of comorbidity. Second, we review three theoretical models that have been proposed to explain high rates of co-occurring panic disorder and opioid use disorder: the precipitation hypothesis, the self-medication hypothesis, and the shared vulnerability hypothesis. Third, we outline how co-occurring panic and opioid use disorder may impact treatment for each condition. CONCLUSION Based on findings in the field, we provide recommendations for future research as well as treatment considerations for co-occurring panic and opioid use disorders.
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Affiliation(s)
- Ashton E Clark
- Department of Psychiatry, University of Maryland, Baltimore, Maryland, USA
| | - Shelby R Goodwin
- Department of Psychiatry, University of Maryland, Baltimore, Maryland, USA
| | | | | | - Emily Heinlein
- Department of Psychiatry, University of Maryland, Baltimore, Maryland, USA
| | - Melanie E Bennett
- Department of Psychiatry, University of Maryland, Baltimore, Maryland, USA.,Baltimore VA Medical Center, Baltimore, Maryland, USA
| | - Daniel J O Roche
- Department of Psychiatry, University of Maryland, Baltimore, Maryland, USA
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Ebrahimi Z, Kahvandi N, Komaki A, Karimi SA, Naderishahab M, Sarihi A. The role of mGlu4 receptors within the nucleus accumbens in acquisition and expression of morphine-induced conditioned place preference in male rats. BMC Neurosci 2021; 22:17. [PMID: 33743609 PMCID: PMC7981834 DOI: 10.1186/s12868-021-00627-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 03/12/2021] [Indexed: 11/26/2022] Open
Abstract
Background Several studies have shown that glutamate neurotransmission in the nucleus accumbens (NAc) is required for the development of morphine-induced conditional place preference (CPP). In addition, metabotropic glutamate receptors (mGluRs) in NAc play important roles in the reward pathways. However, the precise role of mGluR4 in different steps of the morphine-induced CPP is less well known. In the present study the effect of bilateral intra-accumbal infusion of VU0155041, as a specific mGluR4 agonist on the acquisition and expression of morphine induced CPP in male Wistar rats was investigated. The animals were bilaterally implanted with guide cannulae above the NAc. In the first step of the study, the VU0155041 was administered at doses of 10, 30 and 50 μg/0.5 μL saline per side into the NAc during the 3 days of morphine (5 mg/kg) conditioning (acquisition) phase of morphine-induced CPP. In the second step of the study, the rats bilaterally received VU0155041 at the dose of 50 μg/0.5 μL, 5 min before the post-conditioning test in order to check the effect of VU0155041 on the expression of morphine-induced CPP. Results The results showed that the intra-accumbal injection of VU0155041 inhibits the acquisition of morphine-induced CPP in a dose dependent manner, but had no effect on expression. Conclusions The data indicated that intra-NAc administration of VU0155041 dose dependently blocks the establishment of morphine-induced CPP and reduces the rewarding properties of morphine. These effects may be related to changes in glutamate activity in the NAC and/or learning dependent mechanism of glutamate neurotransmission in reward pathway(s).
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Affiliation(s)
- Zahra Ebrahimi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nazanin Kahvandi
- Department of Physiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Alireza Komaki
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.,Department of Neuroscience, School of Sciences and Advanced Technology in Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Asaad Karimi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.,Department of Neuroscience, School of Sciences and Advanced Technology in Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Marzieh Naderishahab
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abdolrahman Sarihi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran. .,Department of Neuroscience, School of Sciences and Advanced Technology in Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
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16
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Abdu Z, Hajure M. Correlation of Alcohol Use Disorders with Common Mental Disorders and Its Association with Socio-demographic Characteristics Among Community in Ethiopia: A Cross-sectional Study. Risk Manag Healthc Policy 2020; 13:2909-2917. [PMID: 33324125 PMCID: PMC7733413 DOI: 10.2147/rmhp.s279590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/11/2020] [Indexed: 12/04/2022] Open
Abstract
Background Alcohol use disorders occurring together with common mental disorders are common and have been recognized worldwide as a crucial public health concern. However, there is a scarcity of data about the correlation of alcohol use disorders with common mental disorders and its association with socio-demographic characteristics among community in Ethiopia, especially in the study area. The aim of the study is to assess the correlation of alcohol use disordesr with common mental disorders and its association with socio-demographic characteristics among adults of selected woredas of the Ilu Aba Bor zone. Methods Community-based cross-sectional study was employed on 690 participants selected by using the multistage sampling technique. Data were collected by using the alcohol use disorder identification test (AUDIT) and self-reporting questionnaire (SRQ-20) scale. Data analysis were done using SPSS version 20. Pearson correlation was used to see the relation of two variables. The strength of the association was determined at p-value <0.005. Results 14.1% of the study sample positive for alcohol use disorders and 27.2% for common mental disorders. There is a significant positive relationship between alcohol use disorders and common mental disorders, r(688)=0.314, p=0.001. From socio-demographic characteristics, multivariable logistic regression analysis revealed marital status being single, orthodox religion followers, and living in urban had a significant association with alcohol use disorders. Conclusion In the Ilu Aba Bor zone, 14.1% of participants reported alcohol use disorders, and 27.2% have a common mental disorders. There is a significant positive relationship between alcohol use disorders and common mental disorders. Being single, orthodox religion, and living in urban had a significant association with alcohol use disorders. Detection and treatment of people with alcohol use disorders and common mental disorders in the community have been recommended at the same time through integrated treatment.
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Affiliation(s)
- Zakir Abdu
- Department of Psychiatry, Faculty of Health and Medical Sciences, Mettu University, Mettu, Ethiopia
| | - Mohammedamin Hajure
- Department of Psychiatry, Faculty of Health and Medical Sciences, Mettu University, Mettu, Ethiopia
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17
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Obeid S, Lahoud N, Haddad C, Sacre H, Fares K, Akel M, Salameh P, Hallit S. Factors associated with anxiety among the Lebanese population: the role of alexithymia, self-esteem, alcohol use disorders, emotional intelligence and stress and burnout. Int J Psychiatry Clin Pract 2020; 24:151-162. [PMID: 32031427 DOI: 10.1080/13651501.2020.1723641] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Objective: To assess factors associated with anxiety among a sample of the Lebanese population.Methods: A cross-sectional, conducted between November 2017 and March 2018, enrolled 789 participants. Anxiety was measured using the Hamilton Anxiety Scale. A cluster analysis was then performed with the identified factor scores to identify the different profiles of the participants.Results: A cluster analysis based on the three factors derived three mutually exclusive clusters, which form 29.62%, 34.54%, and 35.84% of all participants, respectively. The first cluster represented people in distress (low emotional intelligence, high depersonalisation, alcohol use disorder, burnout, stress, alexithymia and low self-esteem); the second one represented people with wellbeing (High emotional intelligence, low depersonalisation, low alcohol use disorder, low burnout, low stress, low alexithymia and high self-esteem), whereas cluster 3 represented people in between. Higher age (Beta = 0.065) was significantly associated with higher anxiety, whereas being in cluster 2 (people with wellbeing) (Beta = -12.37) and cluster 3 (people in between) (Beta = -5.426) were significantly associated with lower anxiety compared to being in cluster 1 (people in distress).Conclusions: The findings of this study are overall consistent with those of epidemiologic community-based surveys and may help inform structural models of classification and prediction of anxiety disorders (ADs).
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Affiliation(s)
- Sahar Obeid
- Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,INSPECT-LB: Institut National de Santé Publique, d'Epidémiologie Clinique et de Toxicologie - Liban, Beirut, Lebanon
| | - Nathalie Lahoud
- INSPECT-LB: Institut National de Santé Publique, d'Epidémiologie Clinique et de Toxicologie - Liban, Beirut, Lebanon.,Faculty of Pharmacy, Lebanese University, Beirut, Lebanon.,Faculty of Public Health, CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Lebanese University, Fanar, Lebanon.,School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Chadia Haddad
- Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, University Limoges, Limoges, France.,Department of psychiatry, CH Esquirol, Limoges, France
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, d'Epidémiologie Clinique et de Toxicologie - Liban, Beirut, Lebanon.,Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Kassandra Fares
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Marwan Akel
- INSPECT-LB: Institut National de Santé Publique, d'Epidémiologie Clinique et de Toxicologie - Liban, Beirut, Lebanon.,School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, d'Epidémiologie Clinique et de Toxicologie - Liban, Beirut, Lebanon.,Faculty of Pharmacy, Lebanese University, Beirut, Lebanon.,Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT-LB: Institut National de Santé Publique, d'Epidémiologie Clinique et de Toxicologie - Liban, Beirut, Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
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18
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19
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Xing W, Lü W, Wang Z. Resting respiratory sinus arrhythmia moderates the association between social phobia symptoms and self-reported physical symptoms. Stress Health 2019; 35:525-531. [PMID: 31276300 DOI: 10.1002/smi.2885] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 05/12/2019] [Accepted: 06/23/2019] [Indexed: 11/08/2022]
Abstract
The present study sought to investigate the association between social phobia symptoms and self-reported physical symptoms and the moderation effect of resting respiratory sinus arrhythmia (RSA) on this link. Data of 5-min resting RSA, social phobia symptoms assessed by the Social Phobia Scale, and physical symptoms assessed by the Cohen-Hoberman Inventory of Physical Symptoms were collected from 167 undergraduate students. Results indicated that higher levels of social phobia symptoms were associated with higher levels of self-reported physical symptoms. Resting RSA played the moderating role in the link between social phobia symptoms and self-reported physical symptoms, such that social phobia symptoms were positively associated with self-reported physical symptoms among individuals with low resting RSA, whereas this association was nonsignificant among individuals with high resting RSA. These findings suggest that high resting RSA as a physiological marker of better self-regulation capacity might buffer the effect of social phobia symptoms on physical health.
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Affiliation(s)
- Wanying Xing
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, Shaanxi Key Research Center for Children Mental and Behavioral Health, School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Wei Lü
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, Shaanxi Key Research Center for Children Mental and Behavioral Health, School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Zhenhong Wang
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, Shaanxi Key Research Center for Children Mental and Behavioral Health, School of Psychology, Shaanxi Normal University, Xi'an, China
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20
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Torvik FA, Rosenström TH, Gustavson K, Ystrom E E, Kendler KS, Bramness JG, Czajkowski N, Reichborn-Kjennerud T. Explaining the association between anxiety disorders and alcohol use disorder: A twin study. Depress Anxiety 2019; 36:522-532. [PMID: 30838764 PMCID: PMC6548587 DOI: 10.1002/da.22886] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 01/23/2019] [Accepted: 02/02/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND It is unknown whether social anxiety disorder (SAD) has a unique association with alcohol use disorder (AUD) over and beyond that of other anxiety disorders, how the associations develop over time, and whether the associations are likely to be causal. METHODS Diagnoses of AUD, SAD, generalized anxiety disorder, panic disorder, agoraphobia, and specific phobias were assessed twice using the Composite International Diagnostic Interview among 2,801 adult Norwegian twins. The data were analyzed using logistic regression analyses and multivariate biometric structural equation modeling. RESULTS SAD had the strongest association with AUD, and SAD predicted AUD over and above the effect of other anxiety disorders. In addition, SAD was prospectively associated with AUD, whereas other anxiety disorders were not. AUD was associated with a slightly elevated risk of later anxiety disorders other than SAD. Biometric modeling favored a model where SAD influenced AUD compared to models where the relationship was reversed or due to correlated risk factors. Positive associations between AUD and other anxiety disorders were fully explained by shared genetic risk factors. CONCLUSIONS Unlike other anxiety disorders, SAD plausibly has a direct effect on AUD. Interventions aimed at prevention or treatment of SAD may have an additional beneficial effect of preventing AUD, whereas interventions aimed at other anxiety disorders are unlikely to have a similar sequential effect on AUD.
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Affiliation(s)
- Fartein Ask Torvik
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway;,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway;,Department of Psychology, University of Oslo, Norway
| | | | - Kristin Gustavson
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway;,Department of Psychology, University of Oslo, Norway
| | - Eivind Ystrom E
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway;,Department of Psychology, University of Oslo, Norway;,PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, University of Oslo, Norway
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA;,Department of Human and Molecular Genetics and Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Jørgen G. Bramness
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Brumunddal, Norway;,Institute of Clinical Medicine, UiT - The Arctic University of Norway
| | - Nikolai Czajkowski
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway;,Department of Psychology, University of Oslo, Norway
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway;,Institute of Clinical Medicine, University of Oslo, Norway
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21
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Esmaeelzadeh S, Moraros J, Thorpe L, Bird Y. Examining the Association and Directionality between Mental Health Disorders and Substance Use among Adolescents and Young Adults in the U.S. and Canada-A Systematic Review and Meta-Analysis. J Clin Med 2018; 7:jcm7120543. [PMID: 30551577 PMCID: PMC6306768 DOI: 10.3390/jcm7120543] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 12/05/2018] [Accepted: 12/11/2018] [Indexed: 12/17/2022] Open
Abstract
Background: The purpose of this systematic review was to examine the association and directionality between mental health disorders and substance use among adolescents and young adults in the U.S. and Canada. Methods: The following databases were used: Medline, PubMed, Embase, PsycINFO, and Cochrane Library. Meta-analysis used odds ratios as the pooled measure of effect. Results: A total of 3656 studies were screened and 36 were selected. Pooled results showed a positive association between depression and use of alcohol (odds ratio (OR) = 1.50, 95% confidence interval (CI): 1.24–1.83), cannabis (OR = 1.29, 95% CI: 1.10–1.51), and tobacco (OR = 1.65, 95% CI: 1.43–1.92). Significant associations were also found between anxiety and use of alcohol (OR = 1.54, 95% CI: 1.19–2.00), cannabis (OR = 1.36, 95% CI: 1.02–1.81), and tobacco (OR = 2.21, 95% CI: 1.54–3.17). A bidirectional relationship was observed with tobacco use at baseline leading to depression at follow-up (OR = 1.87, CI = 1.23–2.85) and depression at baseline leading to tobacco use at follow-up (OR = 1.22, CI = 1.09–1.37). A unidirectional relationship was also observed with cannabis use leading to depression (OR = 1.33, CI = 1.19–1.49). Conclusion: This study offers insights into the association and directionality between mental health disorders and substance use among adolescents and young adults. Our findings can help guide key stakeholders in making recommendations for interventions, policy and programming.
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Affiliation(s)
| | - John Moraros
- School of Public Health, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada.
| | - Lilian Thorpe
- FRCP, Faculty, Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada.
| | - Yelena Bird
- School of Public Health, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada.
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22
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Andretta I, Limberger J, Schneider JA, Mello LTND. Sintomas de Depressão, Ansiedade e Estresse em Usuários de Drogas em Tratamento em Comunidades Terapêuticas. PSICO-USF 2018. [DOI: 10.1590/1413-82712018230214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Sintomas de depressão, ansiedade e estresse podem interferir negativamente no progresso do tratamento de usuários de substâncias. Este estudo objetivou avaliar os níveis de depressão, ansiedade e estresse em homens e mulheres em tratamento em Comunidades Terapêuticas, relacionando tais níveis com o tipo de substância utilizada e dados sociodemográficos. Utilizou-se um Questionário de Dados Sociodemográficos e de Uso de Drogas e a escala DASS-21. Participaram 115 homens e 53 mulheres, em tratamento, totalizando 168 indivíduos, com idade média de 32 anos (DP = 8,7). A maioria eram usuários de tabaco e crack, este último associado às mulheres. Identificou-se que os usuários de tabaco e os usuários de drogas que não tinham emprego se associaram a níveis mais altos dos sintomas de depressão, ansiedade e estresse. Conclui-se que tais estratégias podem auxiliar na diminuição dos sintomas avaliados pelo DASS-21, melhorando as condições de vida para o enfrentamento do transtorno por uso de substâncias.
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23
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Trained Observers’ Ratings of Adolescents’ Social Anxiety and Social Skills within Controlled, Cross-Contextual Social Interactions with Unfamiliar Peer Confederates. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2018. [DOI: 10.1007/s10862-018-9676-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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24
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Çökmüş FP, Özmen E, Alkin T, Batir MB, Çam FS. Evaluation of serum MicroRNA expression profiles in patients with panic disorder. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1429844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
| | - Erol Özmen
- Department of Psychiatry, Manisa Celal Bayar University Hospital, Manisa, Turkey
| | - Tunç Alkin
- Department of Psychiatry, 9 Eylül University Hospital, İzmir, Turkey
| | - Muhammet Burak Batir
- Department of Medical Genetic, Manisa Celal Bayar University Hospital, Manisa, Turkey
| | - Fethi Sırrı Çam
- Department of Medical Genetic, Manisa Celal Bayar University Hospital, Manisa, Turkey
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25
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Karp JN, Makol BA, Keeley LM, Qasmieh N, Deros DE, Weeks JW, Racz SJ, Lipton MF, Augenstein TM, De Los Reyes A. Convergent, incremental, and criterion-related validity of multi-informant assessments of adolescents' fears of negative and positive evaluation. Clin Psychol Psychother 2017; 25:217-230. [DOI: 10.1002/cpp.2156] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 10/10/2017] [Accepted: 10/11/2017] [Indexed: 01/04/2023]
Affiliation(s)
- Jeremy N. Karp
- Department of Psychology; University of Maryland at College Park; College Park Maryland USA
| | - Bridget A. Makol
- Department of Psychology; University of Maryland at College Park; College Park Maryland USA
| | - Lauren M. Keeley
- Department of Psychology; University of Maryland at College Park; College Park Maryland USA
| | - Noor Qasmieh
- Department of Psychology; University of Maryland at College Park; College Park Maryland USA
| | - Danielle E. Deros
- Department of Psychology; University of Maryland at College Park; College Park Maryland USA
| | - Justin W. Weeks
- University of Nebraska Medical Center College of Medicine; Omaha Nebraska USA
| | - Sarah J. Racz
- Department of Psychology; University of Maryland at College Park; College Park Maryland USA
| | - Melanie F. Lipton
- Department of Psychology; University of Maryland at College Park; College Park Maryland USA
| | - Tara M. Augenstein
- Department of Psychology; University of Maryland at College Park; College Park Maryland USA
| | - Andres De Los Reyes
- Department of Psychology; University of Maryland at College Park; College Park Maryland USA
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26
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Fuller-Thomson E, Jayanthikumar J, Agbeyaka SK. Untangling the Association Between Migraine, Pain, and Anxiety: Examining Migraine and Generalized Anxiety Disorders in a Canadian Population Based Study. Headache 2016; 57:375-390. [PMID: 27991658 DOI: 10.1111/head.13010] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 10/29/2016] [Accepted: 10/30/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aims of this study were to investigate: (1) the prevalence and unadjusted and adjusted odds of 12-month generalized anxiety disorder (GAD) among adults with migraine in comparison to those without migraine; (2) If debilitating pain and/or limitations in instrumental activities of daily living (IADLs) are mediators of the migraine-GAD association; and (3) Factors associated with past year GAD among adults with migraine. METHODS Secondary data analysis of the nationally representative 2012 Canadian Community Health Survey-Mental Health (CCHS-MS), a population-based survey of community dwellers with a response rate of 68.9%. The first subsample included those with (n = 2232) and without migraine (n = 19,270), and the second subsample was restricted to those with migraine (n = 2232). GAD was based on the WHO-CIDI scale. RESULTS Fully, 6% of those with migraines had past year GAD in comparison of 2.1% of those without migraine (P < .001). The socio-demographically adjusted odds of past year GAD were two and a half times higher among those with migraine than those without (OR= 2.46; 95% CI = 2.00, 3.02). A path analysis indicated that debilitating pain and limitations in IADLs were mediators in the relationship between migraine and GAD. In the sample restricted to migraineurs, the factors associated with higher odds of 12-month GAD included having a university degree, having low income, being without a confidant, and being male. CONCLUSIONS Generalized anxiety disorder is robustly associated with migraine and targeted outreach and interventions are warranted.
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Affiliation(s)
- Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Janany Jayanthikumar
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Senyo K Agbeyaka
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
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27
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Fleury MJ, Grenier G, Bamvita JM, Perreault M, Caron J. Typology of individuals with substance dependence based on a Montreal longitudinal catchment area study. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2016; 42:405-19. [PMID: 25124748 DOI: 10.1007/s10488-014-0581-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This study sought to develop a typology of individuals with substance dependence (ISD) based on a longitudinal survey (n = 2,434) and 121 ISD. The latter were divided into three groups: newly abstinent individuals, chronic dependents and acute dependents. Individuals' typology was developed by cluster analysis. Newly abstinent individuals had fewer emotional problems and mental disorders in the previous 12 months. Four classes of ISD were identified, labelled respectively "chronic multi-substance consumption and mental disorders comorbidities," "multi-substance consumption," "alcohol and marijuana consumption" and "alcohol consumption only." Strategies adapted to each of these profiles could be promoted for more effective treatment.
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Affiliation(s)
- Marie-Josée Fleury
- Department of Psychiatry, McGill University, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada,
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28
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Marmorstein NR. Interactions Between Internalizing Symptoms and Urgency in the Prediction of Alcohol Use and Expectancies Among Low-Income, Minority Early Adolescents. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2016; 9:59-68. [PMID: 27512337 PMCID: PMC4975247 DOI: 10.4137/sart.s31438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 05/26/2016] [Accepted: 05/27/2016] [Indexed: 11/09/2022]
Abstract
This study examined whether urgency, a disposition to rash action under conditions of strong emotion, moderates associations between internalizing symptoms and alcohol use and related expectancies. Data from the Camden Youth Development Study, a longitudinal, community-based study of early adolescents (N = 144, mean age at intake = 11.9 years; 65% Hispanic, 30% African-American; 50% male), were used. Self-report questionnaire measures of depressive symptoms, social and generalized anxiety symptoms, urgency, alcohol use, and alcohol expectancies were used. Mixed models were used to examine the effects of internalizing symptoms, urgency, and their interaction on alcohol use and expectancy trajectories over time. Depressive symptoms interacted with urgency such that youth with high levels of both tended to have elevated levels of global positive alcohol expectancies. Social anxiety symptoms interacted with urgency to be associated with increasing levels of social behavior alcohol expectancies such that youth with high levels of both tended to experience particular increases in these expectancies over time. Generalized anxiety was not found to be associated with alcohol-related constructs. Therefore, high levels of urgency combine with depressive and social anxiety symptoms to be associated with particularly increased risk for alcohol expectancies that are associated with later alcohol use and problems, indicating particular risk for youth with these combinations of personality traits and psychopathology symptoms.
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29
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Yoshimi NT, Campos LM, Simão MO, Torresan RC, Torres AR. Social anxiety symptoms in alcohol-dependent outpatients: prevalence, severity and predictors. JORNAL BRASILEIRO DE PSIQUIATRIA 2016. [DOI: 10.1590/0047-2085000000112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Objectives High rates of comorbidity between social anxiety disorder (SAD) and alcohol use disorders have been reported, but the predictors of this comorbidity are poorly known and most studies involve primary SAD samples. The aims were to estimate the prevalence and severity of SAD symptoms among alcohol-dependent patients and to investigate sociodemographic and clinical factors associated with SAD comorbidity, including suicidal behaviors. Methods A cross-sectional study with 53 adults who were in treatment for alcohol dependence at a Brazilian public university outpatient service. Assessment instruments Social Phobia Inventory (SPIN), Short Alcohol Dependence Data and Beck Depression Inventory. Bivariate analyses between the categorical outcome (Probable SAD: SPIN ≥ 19) and explanatory variables were conducted. Correlates of SPIN total and subscales scores (dimensional outcomes) were also investigated. Results The diagnosis and treatment of alcohol dependence occurred, on average, 30 years after the onset of alcohol use and 39.6% of the 53 patients (37 men and 16 women) reported alleviation of social anxiety symptoms with alcohol use. Twenty-four (45.3%) patients presented probable SAD. These patients differed from non-SAD alcohol-dependent individuals by having lower income and higher frequency of depression, suicidal ideation, suicide plans and attempts. The SPIN subscales mostly associated with suicidal behaviors were social inadequacy and social inferiority. Conclusions SAD symptoms are common among help-seeking alcohol-dependent individuals and should be directly investigated and treated, since depression and suicidality are associated with this comorbidity. Prospective studies are needed to assess the impact of SAD treatment on the clinical course of alcohol dependence.
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Thomas SA, Weeks JW, Dougherty LR, Lipton MF, Daruwala SE, Kline K, De Los Reyes A. Allelic Variation of Risk for Anxiety Symptoms Moderates the Relation Between Adolescent Safety Behaviors and Social Anxiety Symptoms. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2015; 37:597-610. [PMID: 26692635 PMCID: PMC4675354 DOI: 10.1007/s10862-015-9488-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Social anxiety often develops in adolescence, and precedes the onset of depression and substance use disorders. The link between social anxiety and use of behaviors to minimize distress in social situations (i.e., safety behaviors) is strong and for some patients, this link poses difficulty for engaging in, and benefiting from, exposure-based treatment. Yet, little is known about whether individual differences may moderate links between social anxiety and safety behaviors, namely variations in genetic alleles germane to anxiety. We examined the relation between adolescent social anxiety and expressions of safety behaviors, and whether allelic variation for anxiety moderates this relation. Adolescents (n=75; ages 14-17) were recruited from two larger studies investigating measurement of family relationships or adolescent social anxiety. Adolescents completed self-report measures about social anxiety symptoms and use of safety behaviors. They also provided saliva samples to assess allelic variations for anxiety from two genetic polymorphisms (BDNF rs6265; TAQ1A rs1800497). Controlling for adolescent age and gender, we observed a significant interaction between social anxiety symptoms and allelic variation (β=0.37, t=2.41, p=.02). Specifically, adolescents carrying allelic variations for anxiety evidenced a statistically significant and relatively strong positive relation between social anxiety symptoms and safety behaviors (β=0.73), whereas adolescents not carrying allelic variation evidenced a statistically non-significant and relatively weak relation (β=0.22). These findings have important implications for treating adolescent social anxiety, in that we identified an individual difference variable that can be used to identify people who evidence a particularly strong link between use of safety behaviors and expressing social anxiety.
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Affiliation(s)
- Sarah A. Thomas
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland, Biology/Psychology Building, Room 3123H, College Park, MD 20742, USA
| | | | - Lea R. Dougherty
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Melanie F. Lipton
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland, Biology/Psychology Building, Room 3123H, College Park, MD 20742, USA
| | - Samantha E. Daruwala
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland, Biology/Psychology Building, Room 3123H, College Park, MD 20742, USA
| | - Kathryn Kline
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland, Biology/Psychology Building, Room 3123H, College Park, MD 20742, USA
| | - Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland, Biology/Psychology Building, Room 3123H, College Park, MD 20742, USA
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Black JJ, Clark DB, Martin CS, Kim KH, Blaze TJ, Creswell KG, Chung T. Course of alcohol symptoms and social anxiety disorder from adolescence to young adulthood. Alcohol Clin Exp Res 2015; 39:1008-15. [PMID: 25864451 DOI: 10.1111/acer.12711] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 02/24/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is limited knowledge of the course of social anxiety disorder (SAD) from adolescence into adulthood, and how SAD and alcohol use disorder (AUD) symptoms change together over time. The current study examined how persistent and adolescent-limited SAD relate to alcohol symptom trajectories across adolescence and into adulthood, as well as gender differences in the course of SAD and AUD symptoms. METHODS Participants were 788 youth (ages 12 to 18 at the baseline assessment; 46.2% female; 80.5% White) recruited from the community (n = 220) and from clinical programs (n = 568). Youth completed clinical interviews on their lifetime history of AUD symptoms and SAD at baseline and were followed through age 25. Multivariate polynomial growth mixture modeling was used to estimate developmental trajectories for SAD and AUD symptoms separately, then together in a dual trajectory model. Gender differences were examined using a classify-analyze approach. RESULTS Three SAD trajectory classes were identified: adolescent-limited (15%), persistent (6%), and no SAD (79%). For AUD symptoms, 5 trajectories were identified: severe (10%), moderate (22%), remitting (18%), young adult onset (22%), and stable low (28%). Those with a history of SAD were about twice as likely to be in the severe AUD symptom class compared to those without a history of SAD. Compared to those with persisting SAD, those in the adolescent-limited SAD class were more likely to belong to the stable low AUD trajectory. Compared to males with SAD, females with SAD were less likely to be in the moderate AUD symptom class and were more likely to be in stable low and young adult onset AUD symptom classes. CONCLUSIONS A history of SAD was associated with membership in the severe AUD trajectory group. The association of gender with SAD and AUD differed depending on developmental period. Future research should examine whether treating SAD in early adolescence may prevent subsequent AUD symptoms.
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Affiliation(s)
- Jessica J Black
- Pittsburgh Adolescent Alcohol Research Center, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania
| | - Duncan B Clark
- Pittsburgh Adolescent Alcohol Research Center, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania
| | - Christopher S Martin
- Pittsburgh Adolescent Alcohol Research Center, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania
| | - Kevin H Kim
- Department of Education, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Thomas J Blaze
- Department of Education, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kasey G Creswell
- Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - Tammy Chung
- Pittsburgh Adolescent Alcohol Research Center, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania
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Ruglass LM, Lopez-Castro T, Cheref S, Papini S, Hien DA. At the crossroads: the intersection of substance use disorders, anxiety disorders, and posttraumatic stress disorder. Curr Psychiatry Rep 2014; 16:505. [PMID: 25224608 DOI: 10.1007/s11920-014-0505-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The co-occurrence of substance use disorders with anxiety disorders and/or posttraumatic stress disorder has been widely documented and when compared to each disorder alone, consistently linked to increased risk for a host of negative outcomes including greater impairment, poorer treatment response, and higher rates of symptom relapse. This article focuses on recent advances in the understanding and effective treatment of this common and highly complex comorbidity. Prevalence and epidemiological data are introduced, followed by a review of contemporary models of etiology and associative pathways. Conceptualizations of effective treatment approaches are discussed alongside evidence from the past decade of clinical research trials. Highlighted are ongoing questions regarding the benefit of sequential, parallel, and integrated approaches and the necessity of further investigation into the mechanisms underlying treatment efficacy. Lastly, recent contributions from neuroscience research are offered as a promising bridge for the development and testing of novel, interdisciplinary treatment approaches.
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Affiliation(s)
- Lesia M Ruglass
- Department of Psychology, The City College of New York, 160 Convent Avenue, NAC Building, Rm 7/120, New York, NY, 10031, USA,
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Blanco C, Rubio J, Wall M, Wang S, Jiu CJ, Kendler KS. Risk factors for anxiety disorders: common and specific effects in a national sample. Depress Anxiety 2014; 31:756-64. [PMID: 24577934 PMCID: PMC4147018 DOI: 10.1002/da.22247] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 11/12/2013] [Accepted: 01/18/2014] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Anxiety disorders and major depressive disorder (MDD) often co-occur and share a broad range of risk factors. The goal of this study was to examine whether the co-occurrence of anxiety disorders and MDD could be explained by an underlying latent factor and whether the risk factors exert their effect exclusively through this factor, directly on each disorder, or through a combination of effects at both levels. METHODS Data were drawn from a large, nationally representative sample. Confirmatory factor analysis was used to identify the latent structure of anxiety disorders. A multiple indicators multiple causes (MIMIC) approach was used to assess the common and specific effects of risk factors for anxiety disorders. RESULTS A one-factor model provided a good fit to the co-occurrence of anxiety disorders. Low self-esteem, family history of depression, female sex, childhood sexual abuse, White race, years of education, number of traumatic experiences, and disturbed family environment increased the risk of anxiety disorders and MDD through their effect on the latent factor. There were also several direct effects of the covariates on the disorders, indicating that the effect of the covariates differed across disorders. CONCLUSIONS Risk for anxiety disorders and MDD appears to be mediated partially by a latent variable underlying anxiety disorders and MDD, and partially by disorder-specific effects. These findings may contribute to account for the high rates of comorbidity among disorders, identify commonalities in the etiologies of these disorders, and provide clues for the development of unified preventive interventions.
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Affiliation(s)
- Carlos Blanco
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, New York
| | - José Rubio
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, New York
| | - Melanie Wall
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, New York
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
| | - Shuai Wang
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, New York
| | - Chelsea J. Jiu
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, New York
| | - Kenneth S. Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia
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Pires AJ, Casanova CC, Quevedo LDA, Jansen K, Silva RAD. Panic disorder and psychoactive substance use in primary care. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2014; 36:113-8. [PMID: 27000711 DOI: 10.1590/2237-6089-2013-0042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To identify the association between panic disorder and licit and illicit substance use in the population provided with primary care in the southern Brazil. METHODS This is a cross-sectional study with patients from three primary care centers. We used the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) to evaluate substance use and the Mini International Neuropsychiatric Interview (MINI) to diagnose panic disorder. RESULTS A total of 1,081 subjects were evaluated. The prevalence of panic disorder was 5.6%. Panic disorder was associated with using marijuana (p = 0.001), tobacco (p = 0.001), cocaine (p < 0.001), and other illicit substances (p < 0.001). CONCLUSION A significant association is noticed between panic disorder and licit and illicit substance use, thus, it is interesting to rethink the approach to treatment/intervention in patients with dual diagnosis.
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Affiliation(s)
| | | | | | - Karen Jansen
- Universidade Católica de Pelotas, Pelotas, RS, Brazil
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Fleury MJ, Grenier G, Bamvita JM, Perreault M, Caron J. Predictors of alcohol and drug dependence. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2014; 59:203-12. [PMID: 25007113 PMCID: PMC4079128 DOI: 10.1177/070674371405900405] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 10/01/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Our study sought to identify sociodemographic, clinical, life perception, and service use characteristics that distinguish new cases of people dependent on substances from the general population; and to determine predictors of substance dependence over a 2-year period. Variables that differentiate people dependent on substances according to sex and age were also assessed. METHODS Among 2434 people who took part in an epidemiologic catchment area health survey at baseline, 2.2% were identified with substance dependence at the second measurement time only. Using a comprehensive framework, various aspects were considered as predictors for multivariate statistics. RESULTS Participants with substance dependence at time 2 only showed worse clinical conditions, life events, life and health perception, and neighbourhood characteristics than other participants, but only 2.5% used health care services. Male sex, younger age, stigmatization, and impulsiveness were predictors of substance dependence. Regarding sex, females with dependence were only more likely to suffer from social phobia than males. In terms of age categories, participants over 50 with substance dependence were more likely to have a lower household income and less social support than younger people. CONCLUSION Stigmatization was the strongest predictor of substance dependence. Our study also confirmed that males and younger people were more likely to have substance dependence. Anti-stigmatization, prevention, and outreach programs are needed to overcome the reluctance of this clientele to use health care services. Health professionals should also pay more attention to life and health perception and neighbourhood characteristics of newly identified drug users.
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Affiliation(s)
- Marie-Josée Fleury
- Associate Professor, Department of Psychiatry, McGill University, Montreal, Quebec; Researcher, Douglas Mental Health University Institute, Montreal, Quebec; Scientific Director, Montreal Addiction Rehabilitation Centre-University Institute, Montreal, Quebec
| | - Guy Grenier
- Research Associate, Douglas Mental Health University Institute, Montreal, Quebec
| | - Jean-Marie Bamvita
- Research Agent, Douglas Mental Health University Institute, Montreal, Quebec
| | - Michel Perreault
- Associate Professor, Department of Psychiatry, McGill University, Montreal, Quebec; Researcher, Douglas Mental Health University Institute, Montreal, Quebec
| | - Jean Caron
- Associate Professor, Department of Psychiatry, McGill University, Montreal, Quebec; Researcher, Douglas Mental Health University Institute, Montreal, Quebec
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Torres AR, Ferrão YA, Shavitt RG, Diniz JB, Costa DLC, do Rosário MC, Miguel EC, Fontenelle LF. Panic Disorder and Agoraphobia in OCD patients: clinical profile and possible treatment implications. Compr Psychiatry 2014; 55:588-97. [PMID: 24374170 DOI: 10.1016/j.comppsych.2013.11.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Revised: 11/18/2013] [Accepted: 11/20/2013] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Panic Disorder (PD) and agoraphobia (AG) are frequently comorbid with obsessive-compulsive disorder (OCD), but the correlates of these comorbidities in OCD are fairly unknown. The study aims were to: 1) estimate the prevalence of PD with or without AG (PD), AG without panic (AG) and PD and/or AG (PD/AG) in a large clinical sample of OCD patients and 2) compare the characteristics of individuals with and without these comorbid conditions. METHOD A cross-sectional study with 1001 patients of the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders using several assessment instruments, including the Dimensional Yale-Brown Obsessive-Compulsive Scale and the Structured Clinical Interview for DSM-IV-TR Axis I Disorders. Bivariate analyses were followed by logistic regression models. RESULTS The lifetime prevalence of PD was 15.3% (N=153), of AG 4.9% (N=49), and of PD/AG 20.2% (N=202). After logistic regression, hypochondriasis and specific phobia were common correlates of the three study groups. PD comorbidity was also associated with higher levels of anxiety, having children, major depression, bipolar I, generalized anxiety and posttraumatic stress disorders. Other independent correlates of AG were: dysthymia, bipolar II disorder, social phobia, impulsive-compulsive internet use, bulimia nervosa and binge eating disorder. Patients with PD/AG were also more likely to be married and to present high anxiety, separation anxiety disorder, major depression, impulsive-compulsive internet use, generalized anxiety, posttraumatic stress and binge eating disorders. CONCLUSIONS Some distinct correlates were obtained for PD and AG in OCD patients, indicating the need for more specific and tailored treatment strategies for individuals with each of these clinical profiles.
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Affiliation(s)
- Albina R Torres
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Univ Estadual Paulista, Brazil.
| | - Ygor A Ferrão
- Department of Psychiatry, Health Sciences Federal University of Porto Alegre, Brazil
| | - Roseli G Shavitt
- Department of Psychiatry, University of São Paulo Medical School, Brazil
| | - Juliana B Diniz
- Department of Psychiatry, University of São Paulo Medical School, Brazil
| | - Daniel L C Costa
- Department of Psychiatry, University of São Paulo Medical School, Brazil
| | | | - Euripedes C Miguel
- Department of Psychiatry, University of São Paulo Medical School, Brazil
| | - Leonardo F Fontenelle
- Anxiety and Depression Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro & D'Or Institute for Research and Education, Brazil
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Wojcik SM, Tantra M, Stepniak B, Man KNM, Müller-Ribbe K, Begemann M, Ju A, Papiol S, Ronnenberg A, Gurvich A, Shin Y, Augustin I, Brose N, Ehrenreich H. Genetic markers of a Munc13 protein family member, BAIAP3, are gender specifically associated with anxiety and benzodiazepine abuse in mice and humans. Mol Med 2013; 19:135-48. [PMID: 23698091 DOI: 10.2119/molmed.2013.00033] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 05/14/2013] [Indexed: 01/02/2023] Open
Abstract
Anxiety disorders and substance abuse, including benzodiazepine use disorder, frequently occur together. Unfortunately, treatment of anxiety disorders still includes benzodiazepines, and patients with an existing comorbid benzodiazepine use disorder or a genetic susceptibility for benzodiazepine use disorder may be at risk of adverse treatment outcomes. The identification of genetic predictors for anxiety disorders, and especially for benzodiazepine use disorder, could aid the selection of the best treatment option and improve clinical outcomes. The brain-specific angiogenesis inhibitor I-associated protein 3 (Baiap3) is a member of the mammalian uncoordinated 13 (Munc13) protein family of synaptic regulators of neurotransmitter exocytosis, with a striking expression pattern in amygdalae, hypothalamus and periaqueductal gray. Deletion of Baiap3 in mice leads to enhanced seizure propensity and increased anxiety, with the latter being more pronounced in female than in male animals. We hypothesized that genetic variation in human BAIAP3 may also be associated with anxiety. By using a phenotype-based genetic association study, we identified two human BAIAP3 single-nucleotide polymorphism risk genotypes (AA for rs2235632, TT for rs1132358) that show a significant association with anxiety in women and, surprisingly, with benzodiazepine abuse in men. Returning to mice, we found that male, but not female, Baiap3 knockout (KO) mice develop tolerance to diazepam more quickly than control animals. Analysis of cultured Baiap3 KO hypothalamus slices revealed an increase in basal network activity and an altered response to diazepam withdrawal. Thus, Baiap3/BAIAP3 is gender specifically associated with anxiety and benzodiazepine use disorder, and the analysis of Baiap3/BAIAP3-related functions may help elucidate mechanisms underlying the development of both disorders.
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Affiliation(s)
- Sonja M Wojcik
- Max Planck Institute of Experimental Medicine, Department of Molecular Neurobiology, Göttingen, Germany.
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Abstract
Anxiety disorders and substance use disorders are highly comorbid, and such comorbidity complicates treatment and worsens prognosis. The mechanisms underlying the relationship between anxiety and substance use disorders are poorly understood. This paper reviews recent research attempting to explain these associations. Cognitive factors, such as attentional bias, expectancies, and anxiety sensitivity, appear to impact on the relation between anxiety and substance misuse. Temporality of the anxiety and substance use disorder may also indicate whether the substance use disorder is primary (anxiety may be a result of use) or secondary (substances may be used to self-medicate). Social phobia has been predominantly identified as a primary disorder preceding substance use, while the temporality of other anxiety and substance use disorders is less clear. The efficacy of concurrent treatment compared with separate treatment of either anxiety or substance use disorder is unclear and requires further research.
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Affiliation(s)
- Sonja Pasche
- Department of Psychiatry and Mental Health, University of Cape Town, Groote Schuur Hospital, Rondebosch, South Africa.
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