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Zhang WX, Yang MB, Zhang KC, Xi M, Si SB. Characteristics of symptoms and development of psychological status in late Chinese adolescence. J Affect Disord 2024; 361:310-321. [PMID: 38851434 DOI: 10.1016/j.jad.2024.05.147] [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: 12/12/2023] [Revised: 05/04/2024] [Accepted: 05/27/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Many late adolescents experience a state of psychological sub-health, requiring early recognition and intervention. This study aims to assess the psychological state of late Chinese adolescents and uncover developmental trend of mental health through network analysis. METHOD We analyzed data from 9072 Chinese high school adolescents in Shandong Province surveyed in 2020-2021, and divided them into the normal, the suspected, and the abnormal groups based on Symptom Checklist 90 (SCL-90) scores. Network analysis was employed to identify the core symptoms and bridge symptoms across different states. RESULTS Anxiety and depression were the most central symptoms, without gender differences. Core symptoms, network structure, and network invulnerability varied across different psychological states. The abnormal group exhibited the highest value of natural connectivity, followed by the suspected and normal groups. This pattern extended to bridge networks. While not meeting diagnostic criteria, the suspected group demonstrated abnormalities in network edge invariance and global strength invariance. LIMITATIONS The cross-sectional design cannot establish causality, and biases in self-report measurements cannot be ignored. CONCLUSION Compared to traditional scale indicators, network structural characteristics may be a more sensitive assessment indicator.
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Affiliation(s)
- Wei-Xia Zhang
- Department of Physical Education, Northwestern Polytechnical University, Xi'an, China
| | - Meng-Bi Yang
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, China
| | - Ke-Chuang Zhang
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, China
| | - Min Xi
- Hospital of Northwestern Polytechnical University, Xi'an, China; The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi'an Jiaotong University, The Key Laboratory of Neuro-informatics and Rehabilitation Engineering of Ministry of Civil Affairs, Xi'an, China
| | - Shu-Bin Si
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, China; Key Laboratory of Industrial Engineering and Intelligent Manufacturing (Ministry of Industry and Information Technology), Xi'an, China.
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Rickelt J, Viechtbauer W, Marcelis M, van den Heuvel OA, van Oppen P, Eikelenboom M, Schruers K. Anxiety during the long-term course of obsessive-compulsive disorder. J Affect Disord 2024; 345:311-319. [PMID: 37838266 DOI: 10.1016/j.jad.2023.10.078] [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: 03/06/2023] [Revised: 09/22/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVE The study aimed to investigate anxiety and its relation with obsessive-compulsive symptoms during the long-term course of obsessive-compulsive disorder (OCD). METHODS We used data from the Netherlands OCD Association (NOCDA) study, which included 419 participants with OCD (aged 18-79 years). Severity of obsessive-compulsive symptoms and anxiety at baseline and after two, four, and six years were entered into three models, which were analyzed using structural equation modeling: 1) the cross-lagged model, which assumes that anxiety and obsessive-compulsive symptoms are two distinct groups of symptoms interacting directly on the long-term; 2) the stable traits model, which assumes that anxiety and obsessive-compulsive symptoms result from two distinct latent factors, which are stable over the time and interact with each other; and 3) the common factor model, which assumes that anxiety and obsessive-compulsive symptoms are presentations of the same latent factor. RESULTS The cross-lagged model and the stable traits model both were valid models with a good model fit. The common factor model had a poor model fit and was rejected. LIMITATIONS The duration of OCD varied widely between the participants (0-64 years). The majority experienced obsessive-compulsive symptoms since several years, which may have affected results on the course of anxiety and the interaction between anxiety and obsessive-compulsive symptoms. CONCLUSIONS Anxiety and obsessive-compulsive symptoms in OCD patients do not result from a shared underlying factor but are distinct, interacting symptom groups, probably interacting by distinct latent factors.
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Affiliation(s)
- J Rickelt
- Maastricht University, Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Vijverdalseweg 1, 6226NB Maastricht, the Netherlands; Institute for Mental Health Eindhoven (GGzE), Dr. Poletlaan 39, 5626ND Eindhoven, the Netherlands.
| | - W Viechtbauer
- Maastricht University, Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Vijverdalseweg 1, 6226NB Maastricht, the Netherlands
| | - M Marcelis
- Maastricht University, Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Vijverdalseweg 1, 6226NB Maastricht, the Netherlands; Institute for Mental Health Eindhoven (GGzE), Dr. Poletlaan 39, 5626ND Eindhoven, the Netherlands
| | - O A van den Heuvel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy and Neuroscience, Amsterdam Neuroscience, de Boelelaan 1117, 1007MB Amsterdam, the Netherlands
| | - P van Oppen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy and Neuroscience, Amsterdam Neuroscience, de Boelelaan 1117, 1007MB Amsterdam, the Netherlands; GGZ inGeest, Research & Innovation, Oldenaller 1, 1081 HL Amsterdam, the Netherlands
| | - M Eikelenboom
- GGZ inGeest, Research & Innovation, Oldenaller 1, 1081 HL Amsterdam, the Netherlands
| | - K Schruers
- Maastricht University, Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Vijverdalseweg 1, 6226NB Maastricht, the Netherlands; Mondriaan Mental Health Center, Vijverdalseweg 1, 6226NB Maastricht, the Netherlands
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3
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Ouazzani Housni Touhami Y, Hlal H, Bout A, Najdi A, Aarab C, Rammouz I, Aalouane R. Clinical profile of schizophrenia comorbid with obsessive-compulsive symptoms: A comparative study. L'ENCEPHALE 2023; 49:549-556. [PMID: 36244835 DOI: 10.1016/j.encep.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 07/10/2022] [Accepted: 07/15/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Describe and compare the clinical profile of schizophrenic patients with and without obsessive-compulsive symptoms and obsessive-compulsive disorder (OCD) patients. METHODS A descriptive and analytical cross-sectional study was carried out at the psychiatry department of Hassan II University Hospital in Fez over 12 months to compare three groups of patients: "schizo-obsessive" (n=32), "schizophrenia" (n=34), and "OCD" (n=46). All participants (n=112) were assessed using the mini-international neuropsychiatric interview (MINI), the Yale-Brown obsessive-compulsive scale (Y-BOCS), the Brown assessment of beliefs scale (BABS), the Hamilton anxiety rating scale (HAM-A), the Beck's depression inventory (BDI-II), the positive and negative syndrome scale (PANSS), and the clinical global impressions-severity scale (CGI-S). RESULTS The "schizo-obsessive" group differed from the "schizophrenia" group in: more severe psychotic symptoms (mean=64.16±17.049, P<0.001), higher anxiety (mean=8.87±5,655, P<0.001) and depression (mean=7.50±5.989, P<0.001) scores, more prevalent suicide attempts (46.9%), higher illness severity score (mean=5.13±1.157, P=0.02), and more professional disinsertion (78.1%). The "schizo-obsessive" group (mean= 14.47±3.388) had significantly poor insight (P<0.001) compared to the "OCD" group (mean= 8.35±4.542). There were similarities in the obsessive and compulsive themes between the "schizo-obsessive" and the "OCD" groups, with no significant difference of severity (P=0.26). CONCLUSION A careful assessment of obsessive symptomatology is essential in schizophrenia for better patient management and prognosis.
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Affiliation(s)
- Y Ouazzani Housni Touhami
- Psychiatry Department, Hassan II University Hospital, Fez, Morocco; Clinical Neurosciences Laboratory, Faculty of Medicine, Pharmacy and Dental Medicine of Fez, Sidi Mohamed Ben Abdellah University (USMBA), Fez, Morocco.
| | - H Hlal
- Department of Psychiatry, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed 1st University, Oujda, Morocco
| | - A Bout
- Psychiatry Department, Hassan II University Hospital, Fez, Morocco; Clinical Neurosciences Laboratory, Faculty of Medicine, Pharmacy and Dental Medicine of Fez, Sidi Mohamed Ben Abdellah University (USMBA), Fez, Morocco
| | - A Najdi
- Department of epidemiology, Public health and Social Sciences, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, Morocco
| | - C Aarab
- Psychiatry Department, Hassan II University Hospital, Fez, Morocco; Clinical Neurosciences Laboratory, Faculty of Medicine, Pharmacy and Dental Medicine of Fez, Sidi Mohamed Ben Abdellah University (USMBA), Fez, Morocco
| | - I Rammouz
- Psychiatry Department, Agadir University Hospital, Faculty of Medicine and Pharmacy of Agadir, Ibn Zohr University, Agadir, Morocco
| | - R Aalouane
- Psychiatry Department, Hassan II University Hospital, Fez, Morocco; Clinical Neurosciences Laboratory, Faculty of Medicine, Pharmacy and Dental Medicine of Fez, Sidi Mohamed Ben Abdellah University (USMBA), Fez, Morocco
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Olgiati P, Fanelli G, Serretti A. Obsessive-compulsive symptoms in major depressive disorder correlate with clinical severity and mixed features. Int Clin Psychopharmacol 2022; 37:166-172. [PMID: 35191860 DOI: 10.1097/yic.0000000000000396] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Obsessive-compulsive symptoms (OCS) are often reported in patients with bipolar disorder. The aim of this study was to investigate OCS and their related clinical features in major depressive disorder (MDD). The analysis involved 482 outpatients with MDD collected within the Combining Medications to Enhance Depression outcomes trial, who were assessed with scales for depression, suicidality, irritability, hypomanic symptomatology, and other comorbid psychiatric manifestations. OCS were reported in 27% of the sample. Patients with MDD experiencing OCS were found to differ from those not experiencing OCS by a greater severity of depression (d = 0.41, P = 0.0001), more hypomanic symptoms (d = 0.48, P < 0.0001) and mixed features (22% vs. 10%, P = 0.001), increased levels of suicidal thoughts (d = 0.40, P = 0.0001), a lower likelihood of achieving remission after antidepressant treatment (19% vs. 33%, P = 0.0109), as well as more comorbid anxiety disorders (i.e. panic disorder: d = 0.98, P < 0.0001; generalized anxiety disorder: d = 0.74, P < 0.0001; social phobia: d = 0.71, P < 0.0001), and post-traumatic stress disorder (d = 0.81, P < 0.0001). In light of these findings, clinicians should pay more attention to the occurrence of OCS in MDD, as these symptoms may reflect greater clinical severity, poorer treatment outcome, and increased risk for bipolarity.
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Affiliation(s)
- Paolo Olgiati
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Fanelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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Ambrosini F, Truzoli R, Vismara M, Vitella D, Biolcati R. The effect of cyberchondria on anxiety, depression and quality of life during COVID-19: the mediational role of obsessive-compulsive symptoms and Internet addiction. Heliyon 2022; 8:e09437. [PMID: 35600442 PMCID: PMC9107336 DOI: 10.1016/j.heliyon.2022.e09437] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/18/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
Since the global pandemic of the coronavirus disease 2019 (COVID-19), online health information-seeking behaviors have notably increased. Cyberchondria can be a vulnerability factor for the worsening of anxiety-depressive symptoms and quality of life. The current study aims to understand the predictive effect of cyberchondria on health anxiety, anxiety, depression and quality of life considering the mediating effect of obsessive-compulsive symptoms and Internet addiction and the moderating effect of COVID anxiety. 572 Italian participants (66% female; Mean age = 34; SD = 15) took part in a cross-sectional online survey involving CSS-12, MOCQ-R, IAT, SHAI, HADS, WHOQoL-BREF and CAS. Mediation and moderation analyses were conducted. Obsessive-compulsive symptoms and Internet addiction were found to partially mediate the cyberchondria-health anxiety and the cyberchondria-anxiety links and to totally mediate the cyberchondria-depression and the cyberchondria-quality of life links. COVID anxiety was found to moderate the relationship between cyberchondria and anxiety. The findings suggest that compulsivity may have a key role in the explanation of the underlying mechanisms of cyberchondria. Healthcare practitioners should provide additional support for individuals with cyberchondria. As such, cyberchondria is a contributing factor to the exacerbation of anxiety-depressive disorders and may impact on the quality of life.
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Affiliation(s)
- Federica Ambrosini
- Department of Education Studies “Giovanni Maria Bertin”, University of Bologna, Italy
| | - Roberto Truzoli
- Department of Biomedical Sciences and Clinics Luigi Sacco, Faculty of Medicine and Surgery, University of Milan, Italy
| | - Matteo Vismara
- Department of Biomedical Sciences and Clinics Luigi Sacco, Faculty of Medicine and Surgery, University of Milan, Italy
- Aldo Ravelli Center for Neurotechnology and Brain Therapeutics, University of Milan, Italy
| | | | - Roberta Biolcati
- Department of Education Studies “Giovanni Maria Bertin”, University of Bologna, Italy
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6
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Malygin Y, Orlova A, Malygin V. Conceptualization of comorbid anxiety and depressive disorders and approaches to their managing. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:48-54. [DOI: 10.17116/jnevro202212206148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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7
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Orozco A, Cardoner N, Aragón CF, Ruiz-Murugarren S, Vicens M, Álvarez-Mon MÁ, Lahera G. Obsessive-compulsive symptoms in anxiety and depressive disorders: Influence of recent and/or traumatic life events. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2021; 14:218-226. [PMID: 34861930 DOI: 10.1016/j.rpsmen.2020.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/03/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION A high prevalence of obsessive-compulsive symptoms (OCSs) in anxiety-depressive disorders ranging from 30 to 67% has been described. OBJECTIVE This study aims to assess the presence and persistence of OCSs in an outpatient sample of subjects with anxiety and depressive disorders, as well as its relationship with recent life events (RLEs) and/or traumatic experiences (TEs). METHOD We conducted a prospective, observational, analytical study of 200 subjects with DSM-5 diagnoses of anxiety and/or depression. Participants were included by consecutive sampling and were evaluated at baseline and after 6-12 months (mean 8.5 months) of follow-up. The severity of the symptoms was assessed through the Hamilton Anxiety Scale (HARS) and Hamilton Scale for the evaluation of depression (HRSD-17), and comorbidity was assessed through the International Neuropsychiatric Interview (MINI). The Revised Inventory of Obsessions and Compulsions (OCI-R), the Recent Vital Changes Questionnaire (CVSV), and the Diagnostic Scale for Post-Traumatic Stress (PDS) were also administered. RESULTS 54% of the sample presented OCSs, and 30.5% presented one or more TEs throughout life. At the baseline visit, the presence of OCSs was associated with the severity of depressive symptoms (p=0.028), the presence of TEs (p<0.01), symptoms of post-traumatic stress disorder (p<0.01) and the number of RLEs (p<0.01). Response rate at follow-up was 38%, and persistence of OCSs was found in 60.5% of patients, independent of depressive or anxious symptoms, but was associated with the number of RLEs (p<0.01). CONCLUSION The presence of OCSs in patients with anxiety and depressive disorders is frequent and persistent. Anxious-depressive patients with a history of TEs and RLEs had higher OCS levels. These findings highlight the importance of early detection and the use of therapeutic strategies focused on resilience to stress and trauma.
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Affiliation(s)
- Arantxa Orozco
- Príncipe de Asturias University Hospital, Alcalá, Madrid, Spain
| | - Narcís Cardoner
- Hospital Universitario Parc Taulí Sabadell, Barcelone, Spain
| | | | | | - María Vicens
- Príncipe de Asturias University Hospital, Alcalá, Madrid, Spain
| | - Miguel Ángel Álvarez-Mon
- Faculty of Medicine, University of Alcalá, Madrid, Spain; Infanta Leonor Hospital, Madrid, Spain
| | - Guillermo Lahera
- Príncipe de Asturias University Hospital, Alcalá, Madrid, Spain; Faculty of Medicine, University of Alcalá, Madrid, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.
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8
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Hovenkamp-Hermelink JHM, Jeronimus BF, Myroniuk S, Riese H, Schoevers RA. Predictors of persistence of anxiety disorders across the lifespan: a systematic review. Lancet Psychiatry 2021; 8:428-443. [PMID: 33581052 DOI: 10.1016/s2215-0366(20)30433-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 01/10/2023]
Abstract
Despite the substantial disease burden of anxiety disorders, physicians have a poor understanding of factors that predict their typical persistent course. This systematic review of predictors of persistent anxiety disorders covered 48 studies with 29 690 patients diagnosed with an anxiety disorder that were published in PubMed, PsycINFO, and Web of Science between Jan 1, 1980 (introduction of DSM-III), and Dec 1, 2019. We also compared predictors between children, adolescents, adults, and older adults (ie, ≥55 years). A persistent course was primarily predicted by clinical and psychological characteristics, including having panic attacks, co-occurring personality disorders, treatment seeking, poor clinical status after treatment, higher severity and longer duration of avoidance behaviour, low extraversion, higher anxiety sensitivity, and higher behavioural inhibition. Unlike disorder onset, sociodemographic characteristics did not predict persistence. Our results outline a profile of patients with specific clinical and psychological characteristics who are particularly vulnerable to anxiety disorder persistence. Clinically, these patients probably deserve additional or more intensive treatment to prevent development of chronicity.
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Affiliation(s)
- Johanna H M Hovenkamp-Hermelink
- Interdisciplinary Center Psychopathology and Emotional regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
| | - Bertus F Jeronimus
- Interdisciplinary Center Psychopathology and Emotional regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands; Department of Developmental Psychology, University of Groningen, Groningen, Netherlands
| | - Solomiia Myroniuk
- Department of Developmental Psychology, University of Groningen, Groningen, Netherlands
| | - Harriëtte Riese
- Interdisciplinary Center Psychopathology and Emotional regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Robert A Schoevers
- Interdisciplinary Center Psychopathology and Emotional regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Ter Meulen WG, Draisma S, van Hemert AM, Schoevers RA, Kupka RW, Beekman ATF, Penninx BWJH. Depressive and anxiety disorders in concert-A synthesis of findings on comorbidity in the NESDA study. J Affect Disord 2021; 284:85-97. [PMID: 33588240 DOI: 10.1016/j.jad.2021.02.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Comorbidity of depressive and anxiety disorders is common and remains incompletely comprehended. This paper summarizes findings from the Netherlands Study of Depression and Anxiety (NESDA) regarding prevalence, temporal sequence, course and longitudinal patterns; sociodemographic, vulnerability and neurobiological indicators; and functional, somatic and mental health indicators of comorbidity. METHODS Narrative synthesis of earlier NESDA based papers on comorbidity (n=76). RESULTS Comorbidity was the rule in over three-quarter of subjects with depressive and/or anxiety disorders, most often preceded by an anxiety disorder. Higher severity and chronicity characterized a poorer comorbidity course. Over time, transitions between depressive and anxiety disorders were common. Consistent comorbidity risk indicators in subjects with depressive and anxiety disorders were childhood trauma, neuroticism and early age of onset. Psychological vulnerabilities, such as trait avoidance tendencies, were more pronounced in comorbid than in single disorders. In general, there were few differences in biological markers and neuroimaging findings between persons with comorbid versus single disorders. Most functional, somatic, and other mental health indicators, ranging from disability to cardiovascular and psychiatric multimorbidity, were highest in comorbid disorders. LIMITATIONS The observational design of NESDA limits causal inference. Attrition was higher in comorbid relative to single disorders. CONCLUSIONS As compared to single disorders, persons with comorbid depressive and anxiety disorders were characterized by more psychosocial risk determinants, more somatic and other psychiatric morbidities, more functional impairments, and poorer outcome. These results justify specific attention for comorbidity of depressive and anxiety disorders, particularly in treatment settings.
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Affiliation(s)
- Wendela G Ter Meulen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
| | - Stasja Draisma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
| | - Albert M van Hemert
- Leiden University, Leiden University Medical Centre, Department of Psychiatry, Leiden, the Netherlands.
| | - Robert A Schoevers
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Research School of Behavioral and Cognitive Neurosciences (BCN), Groningen, the Netherlands.
| | - Ralph W Kupka
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
| | - Aartjan T F Beekman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
| | - Brenda W J H Penninx
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
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10
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Orozco A, Cardoner N, Aragón CF, Ruiz-Murugarren S, Vicens M, Álvarez-Mon MÁ, Lahera G. Obsessive-compulsive symptoms in anxiety and depressive disorders: Influence of recent and/or traumatic life events. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2020; 14:S1888-9891(20)30129-4. [PMID: 33359119 DOI: 10.1016/j.rpsm.2020.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION A high prevalence of obsessive-compulsive symptoms (OCSs) in anxiety-depressive disorders ranging from 30 to 67% has been described. OBJECTIVE This study aims to assess the presence and persistence of OCSs in an outpatient sample of subjects with anxiety and depressive disorders, as well as its relationship with recent life events (RLEs) and/or traumatic experiences (TEs). METHOD We conducted a prospective, observational, analytical study of 200 subjects with DSM-5 diagnoses of anxiety and/or depression. Participants were included by consecutive sampling and were evaluated at baseline and after 6-12 months (mean 8.5 months) of follow-up. The severity of the symptoms was assessed through the Hamilton Anxiety Scale (HARS) and Hamilton Scale for the evaluation of depression (HRSD-17), and comorbidity was assessed through the International Neuropsychiatric Interview (MINI). The Revised Inventory of Obsessions and Compulsions (OCI-R), the Recent Vital Changes Questionnaire (CVSV), and the Diagnostic Scale for Post-Traumatic Stress (PDS) were also administered. RESULTS 54% of the sample presented OCSs, and 30.5% presented one or more TEs throughout life. At the baseline visit, the presence of OCSs was associated with the severity of depressive symptoms (p=0.028), the presence of TEs (p<0.01), symptoms of post-traumatic stress disorder (p<0.01) and the number of RLEs (p<0.01). Response rate at follow-up was 38%, and persistence of OCSs was found in 60.5% of patients, independent of depressive or anxious symptoms, but was associated with the number of RLEs (p<0.01). CONCLUSION The presence of OCSs in patients with anxiety and depressive disorders is frequent and persistent. Anxious-depressive patients with a history of TEs and RLEs had higher OCS levels. These findings highlight the importance of early detection and the use of therapeutic strategies focused on resilience to stress and trauma.
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Affiliation(s)
- Arantxa Orozco
- Príncipe de Asturias University Hospital, Alcalá, Madrid, Spain
| | - Narcís Cardoner
- Hospital Universitario Parc Taulí Sabadell, Barcelone, Spain
| | | | | | - María Vicens
- Príncipe de Asturias University Hospital, Alcalá, Madrid, Spain
| | - Miguel Ángel Álvarez-Mon
- Faculty of Medicine, University of Alcalá, Madrid, Spain; Infanta Leonor Hospital, Madrid, Spain
| | - Guillermo Lahera
- Príncipe de Asturias University Hospital, Alcalá, Madrid, Spain; Faculty of Medicine, University of Alcalá, Madrid, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.
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11
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Liu W, Li J, Huang Y, Yu B, Qin R, Cao X. The relationship between left-behind experience and obsessive-compulsive symptoms in college students in China: the mediation effect of self-esteem. PSYCHOL HEALTH MED 2020; 26:644-655. [PMID: 32274935 DOI: 10.1080/13548506.2020.1748667] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Abstract
The number of left-behind children in China is gradually increasing, and college students with left-behind experience (LBE) have more severe mental health problems. The aim of this study was to evaluate the association of LBE and the obsessive-compulsive (OC) symptoms of college students, explore the mediation role of self-esteem in the relationship between them. A total of 4145 college students were recruited in Anhui province, China. The Chinese Obsessive-Compulsive Inventory-Revised (OCI-R) and Rosenberg Self-Esteem Scale (RSES) were used to measure OC symptoms and self-esteem. Bootstrap program was used to test the mediation effect. The results showed that the detection rate of OC symptoms was 24.1%. Multiple linear regression analyses found that LBE was positively associated with OC symptoms (t = 2.928, p = 0.003). High self-esteem scores in college students were significantly associated with a lower probability of OC symptoms (t = -17.023, p < 0.001). Furthermore, the test of Bootstrap showed that the indirect effect of self-esteem between LBE and OC symptoms was significant for 95% CI (LLCI = 0.3586, ULCL = 0.7264) and the mediation effect was 0.5396. The ratio of the indirect effect to the total effect was 0.408. OC symptoms were common mental health problems among college students. LBE had a positive predictive effect for OC symptomsand self-esteem plays a mediating role between them. Improving self-esteem will be beneficial to prevent and control the OC symptoms of college students.
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Affiliation(s)
- Wei Liu
- Department of Maternal and Child Heath Care, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Juan Li
- Department of Maternal and Child Heath Care, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yixuan Huang
- Department of Clinical Medicine, the First School of Clinical Medicine, Anhui Medical University, Hefei, Anhui, China.,Faculty of Science, McGill University, Montreal, Québec, Canada
| | - Banglin Yu
- Department of Maternal and Child Heath Care, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Ruofang Qin
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Xiujing Cao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.,Douglas Mental Health University Institute, Montreal, Québec, Canada
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Examining the effects of punishment schedule density on the development and maintenance of avoidance and safety behaviours: Implications for exposure therapies. J Behav Ther Exp Psychiatry 2018; 61:172-179. [PMID: 30103104 DOI: 10.1016/j.jbtep.2018.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 07/31/2018] [Accepted: 08/03/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Engaging in safety behaviors in the absence of actual threat is a key feature of many psychological disorders, including OCD and depression. Failure to discriminate between threatening and safe environments may make these behaviors resistant to change. The purpose of the current study is to investigate the conditions under which avoidance and safety behaviors are developed and maintained. METHODS In experiment 1, sixty-seven participants who were initially screened for low obsessive-compulsive behavior were invited to play a computerized game to gain points and avoid their potential loss. In Phase 1, they were exposed to a lean punishment schedule (relatively frequent point losses) and a dense schedule (highly frequent point losses). In Phase 2, they were tested on engagement in safety behaviors, where no punishment had been programmed. In experiment 2, twenty-two new participants were exposed to the lean punishment schedule followed immediately by the no point loss condition (Phase 2), one and two weeks after their initial exposure to the punishment conditions to test for the maintenance of safety behavior over time. RESULTS Findings demonstrated that participants developed avoidance immediately, but safety behavior was developed and maintained only for those who were exposed to the lean punishment schedule. LIMITATIONS Prolonged exposure to dense punishment schedules may yield different results because the contrast between safe and aversive environments may be less discernible. CONCLUSIONS These findings are important because they provide experimental evidence on the conditions that render safety behaviors difficult to amend, and offer important recommendations for clinical practice.
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Hofer PD, Wahl K, Meyer AH, Miché M, Beesdo-Baum K, Wong SF, Grisham JR, Wittchen HU, Lieb R. Obsessive-compulsive disorder and the risk of subsequent mental disorders: A community study of adolescents and young adults. Depress Anxiety 2018; 35:339-345. [PMID: 29489041 DOI: 10.1002/da.22733] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 01/25/2018] [Accepted: 01/29/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Comorbidity of obsessive-compulsive disorder (OCD) with other mental disorders has been demonstrated repeatedly. Few longitudinal studies, however, have evaluated the temporal association of prior OCD and subsequent mental disorders across the age period of highest risk for first onset of mental disorders. We examined associations between prior OCD and a broad range of subsequent mental disorders and simulated proportions of new onsets of mental disorders that could potentially be attributed to prior OCD, assuming a causal relationship. METHODS Data from 3,021 14- to 24-year-old community subjects were prospectively collected for up to 10 years. DSM-IV OCD and other DSM-IV mental disorders were assessed with the Munich-Composite International Diagnostic Interview. We used adjusted time-dependent proportional hazard models to estimate the temporal associations of prior OCD with subsequent mental disorders. RESULTS Prior OCD was associated with an increased risk of bipolar disorders (BIP; [hazard ratio, HR = 6.9, 95% confidence interval, CI, (2.8,17.3)], bulimia nervosa [HR = 6.8 (1.3,36.6)], dysthymia [HR = 4.4 (2.1,9.0)], generalized anxiety disorder (GAD; [HR = 3.4 (1.1,10.9)], and social phobia [HR = 2.9 (1.1,7.7)]). Of these outcome disorders, between 65 and 85% could be attributed to OCD in the exposed group, whereas between 1.5 and 7.7% could be attributed to OCD in the total sample. CONCLUSIONS This study provides strong evidence that prior OCD is associated with an increased risk of subsequent onset of BIP, bulimia nervosa, dysthymia, GAD, and social phobia among adolescents and young adults. Future studies should evaluate if early treatment of OCD can prevent the onset of these subsequent mental disorders.
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Affiliation(s)
- Patrizia D Hofer
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Karina Wahl
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Andrea H Meyer
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Marcel Miché
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Shiu F Wong
- School of Psychology, The University of New South Wales, Kensington, NSW, Australia
| | - Jessica R Grisham
- School of Psychology, The University of New South Wales, Kensington, NSW, Australia
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Clinical Psychology & Psychotherapy RG, Department of Psychiatry & Psychotherapy, Ludwig Maximilians Universitaet Munich, Munich, Germany
| | - Roselind Lieb
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland.,Max Planck Institute of Psychiatry, Munich, Germany
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