- Psychoactive substance abuse and dependence and its association with anxiety disorders: a population-based study of young adults in Brazil. [Journal Article]
- RBRev Bras Psiquiatr 2018 Feb 15; :0
- CONCLUSIONS: In this population-based sample, we found associations between GAD, PTSD, and increased prevalence of illicit substance abuse/dependence. In addition, individuals with agoraphobia seem to have increased tobacco abuse/dependence.
- Mental Health Problems Among Whistleblowers: A Comparative Study. [Journal Article]
- PRPsychol Rep 2018 Jan 01; :33294118757681
- Whistleblowers play a very important and indispensable role in society and health care sector, but their act may elicit retaliation and other negative effects, which may impact their mental health. T...
Whistleblowers play a very important and indispensable role in society and health care sector, but their act may elicit retaliation and other negative effects, which may impact their mental health. The main aim of the present comparative study is to assess to what extent whistleblowers ( N = 27) more often suffer from severe mental health problems than other population-based groups in the Netherlands, i.e., matched controls ( N = 135), cancer patients ( N = 130), persons with (partial) work disabilities ( N = 194), physically "healthy" persons ( N = 200), and general population ( N = 1026), using the 36-Item Short-Form Health Survey scales (for general mental health) and the Symptom Checklist-90-Revised scales (for specific mental health problems: depression, anxiety, agoraphobia, interpersonal sensitivity and distrust, and sleeping problems). Logistic regression analyses showed that the prevalence of general mental health problems was much higher than among matched controls and people with work disabilities but similar to cancer patient when controlling for demographics. About 85% suffered from severe to very severe anxiety, depression, interpersonal sensitivity and distrust, agoraphobia symptoms, and/or sleeping problems, and 48% reached clinical levels of these specific mental health problems. These specific mental health problems were much more prevalent than among the general population.
- Examining the short-term anxiolytic and antidepressant effect of Floatation-REST. [Journal Article]
- PlosPLoS One 2018; 13(2):e0190292
- Floatation-REST (Reduced Environmental Stimulation Therapy) reduces sensory input to the nervous system through the act of floating supine in a pool of water saturated with Epsom salt. The float expe...
Floatation-REST (Reduced Environmental Stimulation Therapy) reduces sensory input to the nervous system through the act of floating supine in a pool of water saturated with Epsom salt. The float experience is calibrated so that sensory signals from visual, auditory, olfactory, gustatory, thermal, tactile, vestibular, gravitational and proprioceptive channels are minimized, as is most movement and speech. This open-label study aimed to examine whether Floatation-REST would attenuate symptoms of anxiety, stress, and depression in a clinical sample. Fifty participants were recruited across a spectrum of anxiety and stress-related disorders (posttraumatic stress, generalized anxiety, panic, agoraphobia, and social anxiety), most (n = 46) with comorbid unipolar depression. Measures of self-reported affect were collected immediately before and after a 1-hour float session, with the primary outcome measure being the pre- to post-float change score on the Spielberger State Anxiety Inventory. Irrespective of diagnosis, Floatation-REST substantially reduced state anxiety (estimated Cohen's d > 2). Moreover, participants reported significant reductions in stress, muscle tension, pain, depression and negative affect, accompanied by a significant improvement in mood characterized by increases in serenity, relaxation, happiness and overall well-being (p < .0001 for all variables). In reference to a group of 30 non-anxious participants, the effects were found to be more robust in the anxious sample and approaching non-anxious levels during the post-float period. Further analysis revealed that the most severely anxious participants reported the largest effects. Overall, the procedure was well-tolerated, with no major safety concerns stemming from this single session. The findings from this initial study need to be replicated in larger controlled trials, but suggest that Floatation-REST may be a promising technique for transiently reducing the suffering in those with anxiety and depression.
- Stress hormone response to the DEX-CRH test and its relation to psychotherapy outcome in panic disorder patients with and without agoraphobia. [Journal Article]
- TPTransl Psychiatry 2018 Feb 02; 8(1):37
- This study tested whether the hormonal stress response to the DEX-CRH test may be predictive of the psychotherapy success for panic disorder (PD). Thirty-four patients diagnosed either with agoraphob...
This study tested whether the hormonal stress response to the DEX-CRH test may be predictive of the psychotherapy success for panic disorder (PD). Thirty-four patients diagnosed either with agoraphobia with PD or PD without agoraphobia were subjected to cognitive behavioural therapy (CBT). Patients (pre-therapy) and healthy volunteers were exposed to the DEX-CRH test. Blood samples were taken for cortisol and adrenocorticotropic hormone (ACTH) assessment. Established panic-specific questionnaires were handed out for the pre-therapy and post-therapy evaluation of disease severity (with reference to panic beliefs and agoraphobic cognitions, fear of bodily sensations, agoraphobic avoidance behaviour). Repeated measures ANCOVA were conducted for the analysis of the pre-therapy hormonal response, and Pearson's correlation analysis to test for associations with the psychotherapy outcome. Data analyses revealed large effect sizes for CBT in the clinical measures (η2 ≥ 0.321), main effects of time for cortisol and ACTH with no differences between both groups, and significant associations between cortisol release and agoraphobic cognitions for the patients. PD diagnosis had no impact on the hormonal response. However, those patients with higher cortisol release showed less improvement after CBT (significantly for agoraphobic cognitions). Clinical implications of these findings are the prediction of the therapy success from a potential endocrine correlate whose persistency (if assessed repeatedly) during the treatment may predict (non-)response to the current treatment, possibly representing a decision support for a change in treatment to avoid the continuation of an inefficient treatment.
- [Anxiety disorders: which psychotherapy for whom?] [Review]
- NNervenarzt 2018 Jan 30
- According to the Federal Healthcare Survey (Bundesgesundheitssurvey), approximately 15% of the German population fulfil the diagnostic criteria for at least one anxiety disorder within (any) 1 year. ...
According to the Federal Healthcare Survey (Bundesgesundheitssurvey), approximately 15% of the German population fulfil the diagnostic criteria for at least one anxiety disorder within (any) 1 year. Women are affected approximately twice as often as men. The study by the Robert Koch Institute included the systematic assessment of panic disorder, agoraphobia, generalized anxiety disorder, social anxiety disorder and specific phobias; therefore, the question for both those affected and the treating therapist is "anxiety disorders: which psychotherapy for whom?" is of great clinical and healthcare political importance. We therefore review the available literature for answering three more specific questions: 1) what are the most suitable forms of psychotherapy, 2) which psychotherapy is most promising for an individual patient and diagnosis (differential evaluation of indications) and 3) what is the best approach to nonresponse or avoidance of the treatment offered? National and international guidelines agree that cognitive behavioral therapy is the psychotherapy of first choice in most patients with anxiety disorders. In cases of nonresponse or lack of availability of the appropriate therapy, psychodynamic therapy or pharmacotherapy can also be recommended. For individualized treatment recommendations we do not have empirical evidence. Also, no evidence-based (individual) recommendations are available for non-responders;however, there are some preferred strategies based on a clinical consensus.
- Anxiety disorders and CRP in a population cohort study with 54326 participants: The LifeLines study. [Journal Article]
- WJWorld J Biol Psychiatry 2018 Jan 29; :1-31
- Objectives - Growing evidence indicates that inflammatory processes may play a role in the pathogenesis of anxiety disorders. Nevertheless, much remains to be learned about the involvement of inflamm...
Objectives - Growing evidence indicates that inflammatory processes may play a role in the pathogenesis of anxiety disorders. Nevertheless, much remains to be learned about the involvement of inflammation, including C-reactive protein (CRP), in specific anxiety disorders. This study examines the relation between anxiety disorders and CRP. Methods - Associations of serum CRP with anxiety disorders were determined in a large population study (n = 54,326 participants, mean age = 47 years; 59% female), the LifeLines cohort. Depressive and anxiety disorders (generalized anxiety disorder, social anxiety phobia, panic disorder with or without agoraphobia and agoraphobia without panic disorder) were assessed using the Mini-International Neuropsychiatric Interview. Results - Anxiety disorders, with the exception of social anxiety disorder, were significantly associated with increased CRP. After adjusting for demographics, life-style factors, health factors, medication use, depression, and psychological stressors, CRP remained significantly associated with panic disorder with agoraphobia (beta = 0.01, p = 0.013). Moreover, CRP levels were significantly higher in people with panic disorder with agoraphobia compared to other anxiety disorders, independent of all covariates (F = 3.00, df = 4, p = 0.021). Conclusions - Panic disorder with agoraphobia is associated with increased CRP, although the effect size of this association is small. This indicates that neuroinflammatory mechanisms may play a potential role in its pathophysiology.
- Frequency of psychological alterations in primary antiphospholipid syndrome: preliminary study. [Journal Article]
- LLupus 2018 Jan 01; :961203317751063
- Objectives To detect the frequency of psychological alterations in primary antiphospholipid syndrome patients. Methods Thirty-six primary antiphospholipid syndrome patients were analyzed by a psychol...
Objectives To detect the frequency of psychological alterations in primary antiphospholipid syndrome patients. Methods Thirty-six primary antiphospholipid syndrome patients were analyzed by a psychological interview using a standard protocol and review of medical charts. Clinical manifestations, associated comorbidities, antiphospholipid antibodies, and treatment were also evaluated. Results The mean age was 44.2 ± 10.8 years, 29 (80%) were women and 29 (80%) were of Caucasian race. The mean duration of disease was 7.3 ± 5.2 years. The frequency of the presence of psychological alterations was 97.1%. Family dependence was observed in 14 (40%), memory loss in 12 (34.3%), social losses in 12 (34.3%), sexual limitations in seven (20%), sadness in six (17.1%), severe speech limitation in four (11.4%), anxiety in three (8.6%), learning difficulty in two (5.7%), generalized phobia in two (5.7%), suicide ideation in one (2.6%), agoraphobia in one (2.6%), and obsessive-compulsive disorder in one (2.6%). Conclusion This study demonstrated that almost all primary antiphospholipid syndrome patients have psychological alterations. These data reinforce the need for psychological evaluation in primary antiphospholipid syndrome patients.
- [Psychopathology of anxiety-phobic disorders that led to hospitalization in a psychiatric hospital]. [Journal Article]
- ZNZh Nevrol Psikhiatr Im S S Korsakova 2017; 117(11):18-23
- CONCLUSIONS: Patients with hospital anxiety-phobic disorders had agoraphobia with panic disorder, social phobias, hypochondriacal phobias, specific phobias and multiple phobias. The main reasons for hospitalization were: the intensity of anxiety-phobic disorders, contrast content of phobias, multiplicity of anxiety-phobic disorders, ambulance calls, personality accentuations and rental aims.
- Fear of Fear and Broad Dimensions of Psychopathology over the Course of Cognitive Behavioural Therapy for Panic Disorder with Agoraphobia in Japan. [Journal Article]
- EAEast Asian Arch Psychiatry 2017; 27(4):150-5
- CONCLUSIONS: Changes in fear of fear, especially maladaptive cognitions, may predict broad dimensions of psychopathology reductions in patients of panic disorder with agoraphobia over the course of cognitive behavioural therapy. For the sake of improving a broader range of psychiatric symptoms in patients of panic disorder with agoraphobia, more attention to maladaptive cognition changes during cognitive behavioural therapy is warranted.
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- The bidirectional relationship between anxiety disorders and circulating levels of inflammatory markers: Results from a large longitudinal population-based study. [Journal Article]
- DADepress Anxiety 2017 Dec 15
- CONCLUSIONS: The prospective association between agoraphobia at baseline and hsCRP levels over the follow-up period suggests that chronic low-grade inflammation may be a consequence of this condition. The decrease in IL-6 in PTSD also requires further investigation. No evidence was found for chronic low-grade inflammation as a predictor of future anxiety disorders.