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Thatcher C. Whys and What Ifs: Writing and Anxiety Reduction in Individuals Bereaved by Addiction. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2021. [DOI: 10.1080/15401383.2021.1924097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Eersel JHW, Taris TW, Boelen PA. Reciprocal relations between symptoms of complicated grief, depression, and anxiety following job loss: A cross‐lagged analysis. CLIN PSYCHOL-UK 2021. [DOI: 10.1111/cp.12212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Janske H. W. Eersel
- Utrecht University, Department of Clinical Psychology, Utrecht, The Netherlands,
| | - Toon W. Taris
- Utrecht University, Department of Social, Health and Organizational Psychology, Utrecht, The Netherlands,
| | - Paul A. Boelen
- Utrecht University, Department of Clinical Psychology, Utrecht, The Netherlands,
- ARQ National Psychotrauma Centre, Diemen, The Netherlands,
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Besteher B, Squarcina L, Spalthoff R, Bellani M, Gaser C, Nenadić I, Brambilla P. Subclinical Agoraphobia Symptoms and Regional Brain Volumes in Non-clinical Subjects: Between Compensation and Resilience? Front Psychiatry 2018; 9:541. [PMID: 30546323 PMCID: PMC6279873 DOI: 10.3389/fpsyt.2018.00541] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/11/2018] [Indexed: 01/22/2023] Open
Abstract
Background: Symptoms of anxiety are present not only in panic disorder or other anxiety disorders, but are highly prevalent in the general population. Despite increasing biological research on anxiety disorders, there is little research on understanding subclinical or sub-threshold symptoms relating to anxiety in non-clinical community samples, which could give clues to factors relating to resilience or compensatory changes. Aims:This study focused on brain structural correlates of subclinical anxiety/agoraphobia symptoms from a multi-center imaging study. Methods: We obtained high-resolution structural T1 MRI scans of 409 healthy young participants and used the CAT12 toolbox for voxel-based morphometry (VBM) analysis. Subjects provided self-ratings of anxiety using the SCL-90-R, from which we used the phobia subscale, covering anxiety symptoms related to those of panic and agoraphobia spectrum. Results: We found significant (p < 0.05, FDR-corrected) correlations (mostly positive) of cortical volume with symptom severity, including the right lingual gyrus and calcarine sulcus, as well as left calcarine sulcus, superior, middle, and inferior temporal gyri. Uncorrected exploratory analysis also revealed positive correlations with GMV in orbitofrontal cortex, precuneus, and insula. Conclusions: Our findings show brain structural associations of subclinical symptoms of anxiety, which overlap with those seen in panic disorder or agoraphobia. This is consistent with a dimensional model of anxiety, which is reflected not only functionally but also on the structural level.
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Affiliation(s)
- Bianca Besteher
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | | | - Robert Spalthoff
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Marcella Bellani
- Department of Psychiatry, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Christian Gaser
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.,Department of Neurology, Jena University Hospital, Jena, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Marburg, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Giessen and Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior (CMMB), Marburg, Germany
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.,Department of Psychiatry and Behavioural Neurosciences, UT Houston Medical School, Houston, TX, United States
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Taymur İ, Özdel K, Aypak C, Duyan V, Türedi Ö, Güngör BB, Selvi Y. Evaluation of the Relationship between Major Depressive Disorder and Bereavement Symptoms in Elderly Patients Who Present Either to Psychiatry or Family Medicine. Noro Psikiyatr Ars 2017; 53:108-114. [PMID: 28360781 DOI: 10.5152/npa.2015.10095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 03/21/2015] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION We aimed to determine the level of bereavement and depression symptoms among elderly patients who experience the loss of a significant other and the relationship between depressive symptoms and bereavement symptoms. METHODS The study sample consisted of elderly adults who lost a significant other at least 6 months prior to the submission time. Participants were recruited from patients who presented to either the psychiatry or family medicine outpatient unit of a Training and Research Hospital. Cognitive functions were assessed using Standardized Mini Mental Examinations for Educated and Uneducated People (SMME/SMME-U). Participants were excluded from the study if their SMME or SMME-U scores were lower than 23 points. To assess the severity of depressive and bereavement symptoms, the Geriatric Depression Scale (GDS) and Core Bereavement Items (CBI) scales were used, respectively. RESULTS Overall, 33 out of 67 individuals (49.2%) who presented to the psychiatry unit and 7 out of the 43 individuals (16.3%) who presented to the family medicine unit were diagnosed with major depressive disorder (MDD). CBI scale score means were higher in the MDD groups than in the non-depressive groups (p=0.012 and p=0.001, respectively). CBI scores were significantly correlated to acute (p=0.047) and chronic stress (p=0.007) in the psychiatry group and to chronic stress in the family medicine group (p=0.001). CONCLUSION Probing loss experiences and reactions to them can be important to understand depression, to evaluate its symptoms, and to help manage the relevant symptoms. Considering the significant contributions of bereavement to depressive symptom severity in elders, interventions specific to bereavement symptoms should not be ignored.
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Affiliation(s)
- İbrahim Taymur
- Clinic of Psychiatry, Şevket Yılmaz Training and Research Hospital, Bursa, Turkey
| | - Kadir Özdel
- Clinic of Psychiatry, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Cenk Aypak
- Clinic of Family Practice, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Veli Duyan
- Ankara University Scholl of Health Sciences, Social Service Specialist, Ankara, Turkey
| | - Özlem Türedi
- Clinic of Family Practice, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Buket Belkız Güngör
- Clinic of Psychiatry, Şevket Yılmaz Training and Research Hospital, Bursa, Turkey
| | - Yavuz Selvi
- Department of Psychiatry, Selçuk University School of Medicine, Konya, Turkey
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Bui E, Horenstein A, Shah R, Skritskaya NA, Mauro C, Wang Y, Duan N, Reynolds CF, Zisook S, Shear MK, Simon NM. Grief-related panic symptoms in Complicated Grief. J Affect Disord 2015; 170:213-6. [PMID: 25254619 PMCID: PMC4252915 DOI: 10.1016/j.jad.2014.08.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 08/19/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although Complicated Grief (CG) has been associated with comorbid Panic Disorder (PD), little is known about panic attacks in CG, and whether panic symptoms may be grief-related. The present study examines the presence and impact of grief-related panic symptoms in CG. METHODS Individuals with CG (n=146, 78% women, mean (SD) age=52.4(15.0)) were assessed for CG, DSM-IV diagnoses, work and social impairment, and with the Panic Disorder Severity Scale modified to assess symptoms "related to or triggered by reminders of your loss" and anticipatory worry. RESULTS Overall, 39.7% reported at least one full or limited-symptom grief-related panic attack over the past week, and 32.2% reported some level of anticipatory worry about grief-related panic. Of interest, 17% met DSM criteria for PD. Among those without PD, 34.7% reported at least one full or limited-symptom grief-related panic attack over the past week, and this was associated with higher CG symptom severity (t=-2.23, p<0.05), and functional impairment (t=-3.31, p<0.01). Among the full sample, controlling for CG symptom severity and current PD, the presence of at least one full or limited-symptom grief-related panic attack was independently associated with increased functional impairment (B(SE)=4.86(1.7), p<0.01). LIMITATIONS Limitations include a lack of assessment of non-grief-related panic symptoms and examination of a sample of individuals seeking treatment for CG. CONCLUSIONS Grief-related panic symptoms may be prevalent among individuals with CG and independently contribute to distress and functional impairment.
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Affiliation(s)
- Eric Bui
- Department of Psychiatry, Massachusetts General Hospital, One Bowdoin square, Boston, MA 02114, United States; Harvard Medical School, Boston, MA, United States.
| | - Arielle Horenstein
- Department of Psychiatry, Massachusetts General Hospital, One Bowdoin square, Boston, MA 02114, United States
| | - Riva Shah
- Department of Psychiatry, Massachusetts General Hospital, One Bowdoin square, Boston, MA 02114, United States
| | | | - Christine Mauro
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Yuanjia Wang
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Naihua Duan
- Division of Biostatistics, Department of Psychiatry, Columbia University, New York, NY, United States
| | | | - Sidney Zisook
- University of California, San Diego, CA, United States; VA San Diego Healthcare System, San Diego, CA, United States
| | - M Katherine Shear
- Columbia School of Social Work, New York, NY, United States; Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, United States
| | - Naomi M Simon
- Department of Psychiatry, Massachusetts General Hospital, One Bowdoin square, Boston, MA 02114, United States; Harvard Medical School, Boston, MA, United States
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Marques L, Bui E, LeBlanc N, Porter E, Robinaugh D, Dryman T, Nadal-Vicens M, Worthington J, Simon N. Complicated grief symptoms in anxiety disorders: prevalence and associated impairment. Depress Anxiety 2013; 30:1211-6. [PMID: 23495105 PMCID: PMC4038035 DOI: 10.1002/da.22093] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 01/10/2013] [Accepted: 02/13/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous research has identified high rates of comorbid anxiety disorders among individuals presenting with primary CG. In the present study, we examined the prevalence of comorbid CG in bereaved primary anxiety disorder (AD) patients compared to bereaved healthy controls. We also examined the impairment associated with comorbid CG in AD. METHODS Participants were 242 bereaved adults (mean (SD) age = 41.5 (13.1), 44.2% women) with a primary AD diagnosis, including generalized anxiety disorder (GAD; n = 57), panic disorder (PD; n = 49), posttraumatic stress disorder (PTSD; n = 29), and generalized social anxiety disorder (GSAD; n = 107), as well as 155 bereaved healthy controls with no current DSM-IV Axis I diagnosis (mean (SD) age = 43.0 (13.6), 51.0% women). CG symptoms were measured using the 19-item inventory of complicated grief (ICG), with threshold CG defined as an ICG score of ≥30. Quality of life and functional impairment were assessed with the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and the Range of Impaired Functioning Tool (LIFE-RIFT), respectively. RESULTS Participants with primary ADs had significantly higher rates of threshold CG symptoms than bereaved controls (12.0% vs. 0.65%; Fisher's Exact P < 0.001). Rates of threshold CG were significantly elevated for each AD when compared to bereaved controls. After adjustment for age, sex, education, and comorbid major depressive disorder, threshold CG was associated with lower quality of life (β = -0.140, P = 0.023) and greater impairment (β = 0.141, P = 0.035) among individuals with AD. CONCLUSIONS Our findings suggest that threshold CG is of clinical relevance in bereaved individuals with a primary anxiety disorder. Screening for CG in patients with ADs may be warranted.
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Affiliation(s)
- Luana Marques
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, Massachusetts,Correspondence to: Luana Marques, Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, One Bowdoin Square, Boston, MA 02114.
| | - Eric Bui
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, Massachusetts
| | - Nicole LeBlanc
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, Massachusetts
| | - Eliora Porter
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, Massachusetts
| | - Donald Robinaugh
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, Massachusetts,Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Taylor Dryman
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, Massachusetts
| | - Mireya Nadal-Vicens
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, Massachusetts
| | - John Worthington
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, Massachusetts
| | - Naomi Simon
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, Massachusetts
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