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Mou S, Yan S, Shen S, Shuai Y, Li G, Shen Z, Shen P. Prolonged Disease Course Leads to Impaired Brain Function in Anxiety Disorder: A Resting State EEG Study. Neuropsychiatr Dis Treat 2024; 20:1409-1419. [PMID: 39049937 PMCID: PMC11268773 DOI: 10.2147/ndt.s458106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 07/03/2024] [Indexed: 07/27/2024] Open
Abstract
Objective Anxiety disorder (AD) is a common disabling disease. The prolonged disease course may lead to impaired cognitive performance, brain function, and a bad prognosis. Few studies have examined the effect of disease course on brain function by electroencephalogram (EEG). Methods Resting-state EEG analysis was performed in 34 AD patients. The 34 patients with AD were divided into two groups according to the duration of their illness: anxious state (AS) and generalized anxiety disorder (GAD). Then, EEG features, including univariate power spectral density (PSD), fuzzy entropy (FE), and multivariable functional connectivity (FC), were extracted and compared between AS and GAD. These features were evaluated by three previously validated machine learning methods to test the accuracy of classification in AS and GAD. Results Significant decreased PSD and FE in GAD were detected compared with AS, especially in the Alpha 2 band. In addition, FC analysis indicated that GAD patients' connection between the left and right hemispheres decreased. Based on machine learning, AS and GAD are classified on a six-month criterion with the highest classification accuracy of up to 0.99 ± 0.0015. Conclusion The brain function of patients is more severely impaired in AD patients with longer illness duration. Resting-state EEG demonstrated to be a promising examination in the classification in GAD and AS using machine learning methods with better classification accuracy.
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Affiliation(s)
- Shaoqi Mou
- Department of Psychiatry, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Shiyu Yan
- Department of Psychiatry, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Shanhong Shen
- Department of Sleep Medical Center, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, People’s Republic of China
| | - Yibin Shuai
- Department of Sleep Medical Center, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, People’s Republic of China
| | - Gang Li
- College of Engineering, Zhejiang Normal University, Jinhua, People’s Republic of China
| | - Zhongxia Shen
- Department of Sleep Medical Center, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, People’s Republic of China
| | - Ping Shen
- Department of Sleep Medical Center, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, People’s Republic of China
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Costa DLDC, Furlan Damiano R, Alcalá JÁ, Hatzinger M, Mesa F, Perna G, Purebl G, Torzsa P, Vobořilová V, Zwanzger P, Ho R, Bandelow B. How to treat subsyndromal anxiety disorder - practical recommendations for implementation in primary care. Int J Psychiatry Clin Pract 2024:1-10. [PMID: 38909282 DOI: 10.1080/13651501.2024.2362131] [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: 09/18/2023] [Accepted: 05/27/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND Anxiety is a common and disabling condition that significantly impacts quality of life. Subsyndromal anxiety (SSA) refers to anxiety symptoms that do not meet the full diagnostic criteria for an anxiety disorder but pose a risk for developing such disorders. We aimed to provide practical recommendations for the treatment of SSA in primary care settings. METHODS A narrative review was conducted to identify strategies for recognizing and treating patients with SSA. RESULTS The recommendations for treating SSA include lifestyle modifications such as exercise and stress reduction techniques, psychotherapy, and pharmacological treatments, including natural compounds like the lavender oil extract Silexan. Regular follow-up care is essential to monitor treatment response and address ongoing symptoms. Additionally, the use of the GAD-7 tool is recommended for accurately identifying patients with SSA. CONCLUSION Implementing these recommendations in primary care can lead to effective treatment of SSA, preventing the development of more severe anxiety disorders. An integrative approach, combining lifestyle modifications, psychotherapy, and pharmacotherapy, including natural compounds, offers significant benefits for managing anxiety.
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Affiliation(s)
- Daniel Lucas da Conceição Costa
- Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Rodolfo Furlan Damiano
- Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - José Ángel Alcalá
- Clinical Unit of Mental Health. Reina Sofia University Hospital, Cordoba, Spain
| | - Martin Hatzinger
- Psychiatric Services Solothurn, and Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Francisco Mesa
- Health Economy Unit, National Institute of Mental Health, Mexico City, Mexico
| | - Giampaolo Perna
- Department of Biological Sciences, Humanitas University, Milan, Italy
| | - György Purebl
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Péter Torzsa
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Věra Vobořilová
- Faculty of Health Care Studies, University of West Bohemia, Pilsen, The Czech Republic
| | - Peter Zwanzger
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany; kbo-Inn-Salzach-Klinikum, Clinical Center for Psychiatry, Psychotherapy, Psychosomatic Medicine, Geriatrics and Neurology, Wasserburg am Inn, Germany
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Borwin Bandelow
- Department of Psychiatry and Psychotherapy, University of Göttingen, Göttin-gen, Germany
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Rodriguez-Bailon M, Vidaña-Moya L, Fernández-Solano AJ, Grau-Carrion S, Merchán-Baeza JA. Effectiveness of an occupational self-analysis intervention through a mobile application ( OcupApp) in people with anxiety or depression: a randomised controlled trial protocol. Disabil Rehabil Assist Technol 2024:1-10. [PMID: 38571461 DOI: 10.1080/17483107.2024.2327520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 03/01/2024] [Indexed: 04/05/2024]
Abstract
The main objective of this protocol is to understand the effectiveness of the use of a mobile application (OcupApp) to generate a personal self-analysis about meaningful activities in a population of adults aged between 50 and 70 years with low or moderate depression/anxiety. A randomised study will be carried out comparing the effects of the use of the OcupApp application with a control intervention on health-related quality of life, mental health, frequency of participation on meaningful activities, and perceived occupational balance. This is the first study to use occupational self-analysis in m-health to improve occupational balance, mental health, frequency of participation in meaningful activities and health-related quality of life. The app was co-created with a population whose characteristics are similar to those of the target users, and it was tested in both the intervention itself and the presentation, thus it is expected to be effective. Trial Registration Number: Clinical Trial B1-2020_25.
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Affiliation(s)
- María Rodriguez-Bailon
- Department of Physiotherapy (Occupational Therapy). Faculty of Health Sciences, University of Málaga, Málaga, Spain
| | - Laura Vidaña-Moya
- Research Group Occare, Escola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa (EUIT), Universitat Autònoma de Barcelona, Terrassa, Spain
| | - Ana Judit Fernández-Solano
- Department of Occupational Therapy, Faculty of Physiotherapy, Podiatry and Occupational Therapy, UCAM Universidad Católica de Murcia, Spain
| | - Sergi Grau-Carrion
- Digital Care Research Group, Faculty of Science, Technology and Engineering, Centre of Health and Social care Research, University of Vic-Central University of Catalonia, (UVIC-UCC), Barcelona, Spain
| | - José Antonio Merchán-Baeza
- Department of Social Sciences and Welfare. Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Science and Welfare, University of Vic-Central University of Catalonia (UVIC-UCC), Barcelona, Spain
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Dold M, Möller HJ, Volz HP, Seifritz E, Schläfke S, Bartova L, Kasper S. Baseline symptom severity and efficacy of Silexan in patients with anxiety disorders: A symptom-based, patient-level analysis of randomized, placebo-controlled trials. Eur Psychiatry 2024; 67:e23. [PMID: 38425206 DOI: 10.1192/j.eurpsy.2024.16] [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] [Indexed: 03/02/2024] Open
Abstract
The influence of baseline severity on the efficacy of Silexan, a proprietary essential oil from Lavandula angustifolia, in anxiety disorders has not been investigated in a pooled dataset. We report on an individual patient data analysis of all five double-blind, randomized, placebo-controlled trials with Silexan in anxiety disorders. Eligible participants received Silexan 80 mg/d or placebo for 10 weeks. Analyses were based on the Hamilton Anxiety Rating Scale (HAMA), its psychic and somatic anxiety subscores, and the Clinical Global Impressions (CGI) scale. To correlate baseline severity with outcome, patients were segregated into mild, moderate, and severe cases. Altogether 1,172 patients (Silexan, n = 587; placebo, n = 585) were analyzed. For the HAMA total score, we found a significant association between the score at baseline and the treatment effect of Silexan versus placebo at week 10 (p < 0.001). HAMA items from the somatic domain scored lower at baseline and showed less improvement than items from the psychic domain, particularly in patients with mild or moderate baseline symptoms. For CGI item 2 (global improvement), significant efficacy favoring Silexan were observed in mild, moderate, and severe baseline symptom severity. Although significant improvements were found for all subsets, the more severe the initial symptoms, the greater the treatment effects documented by the HAMA. Overall this analysis confirms that Silexan is an effective treatment option in early or mild stages of anxiety disorder. Given its favorable safety profile, Silexan can thus fill a therapeutic gap in the treatment of (subsyndromal) anxiety disorders.
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Affiliation(s)
- Markus Dold
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Hans-Jürgen Möller
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Hans-Peter Volz
- Hospital for Psychiatry, Psychotherapy and Psychosomatic Medicine Schloss Werneck, Werneck, Germany
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Switzerland
| | | | - Lucie Bartova
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Siegfried Kasper
- Center for Brain Research, Medical University of Vienna, Vienna, Austria
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Chong TWH, Kootar S, Wilding H, Berriman S, Curran E, Cox KL, Bahar-Fuchs A, Peters R, Anstey KJ, Bryant C, Lautenschlager NT. Exercise interventions to reduce anxiety in mid-life and late-life anxiety disorders and subthreshold anxiety disorder: a systematic review. Ther Adv Psychopharmacol 2022; 12:20451253221104958. [PMID: 35833057 PMCID: PMC9272174 DOI: 10.1177/20451253221104958] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 05/16/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Anxiety disorders are highly prevalent and cause significant distress, disability, and cost. Medication adverse effects and interactions increase in mid-life and late-life, highlighting the need for effective non-pharmacological interventions. OBJECTIVES We aimed to evaluate the extent of evidence supporting exercise interventions for anxiety and subthreshold anxiety disorders in mid-life and late-life. DESIGN Systematic review. DATA SOURCES AND METHODS We searched MEDLINE, PsycINFO, Embase, Emcare, Ovid Nursing, CINAHL Plus, Cochrane Library, Health Collection, Humanities & Social Sciences Collection, and https://clinicaltrials.gov databases for trials published January 1994-May 2019. Randomised controlled trials of exercise interventions involving aerobic exercise or resistance training for adults aged 40 years and above with anxiety or subthreshold anxiety disorders in residential or health settings were identified. The primary outcome was change in anxiety. We excluded trials including participants aged below 40 years, participants with diagnosis of separation anxiety, selective mutism, obsessive-compulsive disorder, acute stress disorder and post-traumatic stress disorder, and head-to-head comparisons of interventions. Trial quality was assessed using the Cochrane Risk of Bias Tool and evidence synthesised in narrative form. RESULTS Four trials totalling 132 participants met inclusion criteria, although some had methodological limitations. Interventions included a home-based resistance training intervention, supervised group-based aerobic intervention, Tai Chi intervention, and supervised group-based aerobic and strength intervention. Three trials included late-life participants and the fourth mid-life. Three trials demonstrated greater reductions in anxiety in the intervention group compared with control. The fourth trial showed pre-post reductions in anxiety in both groups, with between-group difference not reaching statistical significance. CONCLUSION There is limited supportive evidence suggesting that exercise interventions have potential to be effective, feasible and safe non-pharmacological interventions for anxiety and subthreshold anxiety disorders in mid-life and late-life. The heterogeneity, limited number and high risk of bias of some trials meant that we were not able to conduct a meta-analysis. Tailoring of interventions may improve uptake and reduce dropout. The paucity of research in this area with only four included trials demonstrates the urgent need for future and larger trials to provide proof of concept, data about effective types and doses of exercise interventions, and guidance to community, clinical, and public health services.
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Affiliation(s)
- Terence W H Chong
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne and St Vincent's Hospital Melbourne, St George's Campus, 283 Cotham Road, Kew, VIC 3101, Australia
| | - Scherazad Kootar
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Helen Wilding
- St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Sarah Berriman
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Eleanor Curran
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Kay L Cox
- Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA, Australia
| | - Alex Bahar-Fuchs
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Ruth Peters
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Kaarin J Anstey
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Christina Bryant
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Nicola T Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
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Feldborg M, Lee NA, Hung K, Peng K, Sui J. Perceiving the Self and Emotions with an Anxious Mind: Evidence from an Implicit Perceptual Task. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212096. [PMID: 34831851 PMCID: PMC8622160 DOI: 10.3390/ijerph182212096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/11/2021] [Accepted: 11/16/2021] [Indexed: 12/19/2022]
Abstract
Anxiety disorders cause mental distress and low wellbeing in many people worldwide. Theories of anxiety describe negative worldviews and self-views as maintaining factors of the disorders. Recent research in social cognition has found a link between depression and altered perceptual biases to emotions, but the same research on anxiety is still missing. In this study, we measured perceptual biases to emotional and self-related stimuli in sub-clinically anxious participants and healthy controls using a self-emotional shape-label matching task. Results demonstrate that anxious participants had a diminished perceptual self-bias compared with healthy controls. Furthermore, the severity of anxiety was related to an emotional bias towards valanced other-related stimuli. The findings confirm the hypothesis that anxious individuals display an altered self-prioritisation effect in comparison with healthy individuals and that anxiety severity is linked to altered responses to emotionally valanced others. These findings have potential implications for early diagnosis and treatment of anxiety disorders.
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Affiliation(s)
- Michella Feldborg
- School of Psychology, University of Aberdeen, Aberdeen AB24 3FX, UK; (M.F.); (N.A.L.); (J.S.)
| | - Naomi A. Lee
- School of Psychology, University of Aberdeen, Aberdeen AB24 3FX, UK; (M.F.); (N.A.L.); (J.S.)
| | - Kalai Hung
- Department of Psychology, Tsinghua University, Beijing 100084, China;
- Correspondence:
| | - Kaiping Peng
- Department of Psychology, Tsinghua University, Beijing 100084, China;
| | - Jie Sui
- School of Psychology, University of Aberdeen, Aberdeen AB24 3FX, UK; (M.F.); (N.A.L.); (J.S.)
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