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The Journal of Clinical Psychiatry Jul 2019To estimate the prevalence of anxiety disorders in pregnant and postpartum women and identify predictors accounting for variability across estimates. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To estimate the prevalence of anxiety disorders in pregnant and postpartum women and identify predictors accounting for variability across estimates.
DATA SOURCES
An electronic search of PsycINFO and PubMed was conducted from inception until July 2016, without date or language restrictions, and supplemented by articles referenced in the obtained sources. A Boolean search phrase utilized a combination of keywords related to pregnancy, postpartum, prevalence, and specific anxiety disorders.
STUDY SELECTION
Articles reporting the prevalence of 1 or more of 8 common anxiety disorders in pregnant or postpartum women were included. A total of 2,613 records were retrieved, with 26 studies ultimately included.
DATA EXTRACTION
Anxiety disorder prevalence and potential predictor variables (eg, parity) were extracted from each study. A Bayesian multivariate modeling approach estimated the prevalence and between-study heterogeneity of each disorder and the prevalence of having 1 or more anxiety disorder.
RESULTS
Individual disorder prevalence estimates ranged from 1.1% for posttraumatic stress disorder to 4.8% for specific phobia, with the prevalence of having at least 1 or more anxiety disorder estimated to be 20.7% (95% highest density interval [16.7% to 25.4%]). Substantial between-study heterogeneity was observed, suggesting that "true" prevalence varies broadly across samples. There was evidence of a small (3.1%) tendency for pregnant women to be more susceptible to anxiety disorders than postpartum women.
CONCLUSIONS
Peripartum anxiety disorders are more prevalent than previously thought, with 1 in 5 women in a typical sample meeting diagnostic criteria for at least 1 disorder. These findings highlight the need for anxiety screening, education, and referral in obstetrics and gynecology settings.
Topics: Anxiety Disorders; Bayes Theorem; Female; Humans; Pregnancy; Pregnancy Complications; Prevalence; Puerperal Disorders
PubMed: 31347796
DOI: 10.4088/JCP.18r12527 -
Health Promotion and Chronic Disease... May 2017We are pleased to bring you the second of two special issues on mood and anxiety disorders focussing on data from the 2014 Survey on Living with Chronic Diseases in...
We are pleased to bring you the second of two special issues on mood and anxiety disorders focussing on data from the 2014 Survey on Living with Chronic Diseases in Canada-Mood and Anxiety Disorder Component (SLCDC-MA). In December of 2016, we published the first issue, which included three articles describing various aspects of Canadian adults with a self-reported diagnosed mood and/or anxiety disorder including their sociodemographic characteristics, health status, activity limitations and level of disability and factors associated with well-being. The three articles in this (second) issue investigate topics related to the management of these disorders. Collectively, the articles explore key sociodemographic factors known to influence health-related outcomes and discuss strategies aimed at promoting the recovery and well-being of Canadian adults with a self-reported mood and/or anxiety disorder diagnosis.
Topics: Anxiety Disorders; Canada; Health Surveys; Humans; Mood Disorders; Periodicals as Topic
PubMed: 28493657
DOI: 10.24095/hpcdp.37.5.01 -
Journal of Anxiety Disorders Jan 2018Cognitive behavioral therapy (CBT) has demonstrated favorable long-term outcomes in youth with anxiety disorders in efficacy trials. However, long-term outcomes of CBT...
Cognitive behavioral therapy (CBT) has demonstrated favorable long-term outcomes in youth with anxiety disorders in efficacy trials. However, long-term outcomes of CBT delivered in a community setting are uncertain. This study examined the long-term outcomes of individual (ICBT) and group CBT (GCBT) in youth with anxiety disorders treated in community mental health clinics. A total of 139 youth (mean age at assessment 15.5 years, range 11-21 years) with a principal diagnosis of separation anxiety disorder (SAD), social anxiety disorder (SOP), and/or generalized anxiety disorder (GAD) were evaluated, on average, 3.9 years post-treatment (range 2.2-5.9 years). Outcomes included loss of all inclusion anxiety diagnoses, loss of the principal anxiety diagnosis and changes in youth- and parent-rated youth anxiety symptoms. At long-term follow-up, there was loss of all inclusion anxiety diagnoses in 53%, loss of the principal anxiety diagnosis in 63% of participants as well as significant reductions in all anxiety symptom measures. No statistical significant differences in outcome were obtained between ICBT and GCBT. Participants with a principal diagnosis of SOP had lower odds for recovery, compared to those with a principal diagnosis of SAD or GAD. In conclusion, outcomes of CBT for youth anxiety disorders delivered in community mental health clinics were improved at nearly 4 years post-treatment, and recovery rates at long-term follow-up were similar to efficacy trials.
Topics: Adolescent; Anxiety; Anxiety Disorders; Anxiety, Separation; Child; Cognitive Behavioral Therapy; Data Collection; Female; Follow-Up Studies; Humans; Male; Phobia, Social; Psychotherapy, Group; Treatment Outcome; Young Adult
PubMed: 29195188
DOI: 10.1016/j.janxdis.2017.11.003 -
Child and Adolescent Psychiatric... Jul 2023This review summarizes the developmental epidemiology of childhood and adolescent anxiety disorders. It discusses the coronavirus disease of 2019 (COVID-19) pandemic,... (Review)
Review
This review summarizes the developmental epidemiology of childhood and adolescent anxiety disorders. It discusses the coronavirus disease of 2019 (COVID-19) pandemic, sex differences, longitudinal course, and stability of anxiety disorders in addition to recurrence and remission. The trajectory of anxiety disorders-whether homotypic (ie, the same anxiety disorder persists over time) or heterotypic (ie, an anxiety disorder shifts to a different diagnosis over time) is discussed with regard to social, generalized, and separation anxiety disorders as well as specific phobia, and panic disorder. Finally, strategies for early recognition, prevention, and treatment of disorders are discussed.
Topics: Adolescent; Humans; Female; Male; Child; COVID-19; Anxiety Disorders; Phobic Disorders; Panic Disorder; Anxiety, Separation
PubMed: 37201964
DOI: 10.1016/j.chc.2023.02.001 -
Current Topics in Behavioral... 2018In the present chapter, we review the literature focusing on oxytocin (OT)-centered research in anxiety spectrum conditions, comprising separation anxiety disorder,... (Review)
Review
In the present chapter, we review the literature focusing on oxytocin (OT)-centered research in anxiety spectrum conditions, comprising separation anxiety disorder, specific phobias, social anxiety disorder (SAD), panic disorder, generalized anxiety disorder, and anxiety-related endophenotypes (e.g., trust behavior, behavioral inhibition, neuroticism, and state/trait anxiety). OT receptor gene (OXTR) polymorphisms have been implicated in gene-environment interactions with attachment style and childhood maltreatment and to influence clinical outcomes, including SAD intensity and limbic responsiveness. Epigenetic OXTR DNA methylation patterns have emerged as a link between categorical, dimensional, neuroendocrinological, and neuroimaging SAD correlates, highlighting them as potential peripheral surrogates of the central oxytocinergic tone. A pathophysiological framework of OT integrating the dynamic nature of epigenetic biomarkers and the summarized genetic and peripheral evidence is proposed. Finally, we emphasize opportunities and challenges of OT as a key network node of social interaction and fear learning in social contexts. In conjunction with multi-level investigations incorporating a dimensional understanding of social affiliation and avoidance in anxiety spectrum disorders, these concepts will help to promote research for diagnostic, state, and treatment response biomarkers of the OT system, advancing towards indicated preventive interventions and personalized treatment approaches.
Topics: Anxiety Disorders; DNA Methylation; Fear; Gene-Environment Interaction; Humans; Interpersonal Relations; Oxytocin; Receptors, Oxytocin; Social Environment
PubMed: 28812274
DOI: 10.1007/7854_2017_25 -
Modern Trends in Pharmacopsychiatry 2015In this article, the co-occurrence of anxiety disorders (in particular generalized anxiety disorder) and pain conditions is described, characteristics of chronic pain... (Review)
Review
In this article, the co-occurrence of anxiety disorders (in particular generalized anxiety disorder) and pain conditions is described, characteristics of chronic pain are explained, and data on the prevalence of co-comorbidity of both conditions are reviewed. Further, hypotheses on the possible psychosocial and neurobiological backgrounds of the high rate of co-occurrence are discussed. This review will also focus on the role of 'unexplained' pain syndromes (e.g. somatic symptom disorder and fibromyalgia) and anxiety. Finally, we address possible treatment strategies for patients with both conditions. There is a need for a rigorous assessment of pain syndromes in generalized anxiety disorder and anxiety in chronic pain conditions in order to prevent subsequent mortality by early treatment of both conditions.
Topics: Anxiety Disorders; Chronic Pain; Fibromyalgia; Humans; Pain Management; Somatoform Disorders
PubMed: 26437036
DOI: 10.1159/000435939 -
Advances in Experimental Medicine and... 2020In almost all treatments for prevalent psychiatric conditions, particular attention has been devoted to stress and its consequences; this has led to an involuntary and... (Review)
Review
In almost all treatments for prevalent psychiatric conditions, particular attention has been devoted to stress and its consequences; this has led to an involuntary and unavoidable reinforcement of negative aspects of life. Because of the important influence of individual and cultural influences on positive health, well-being is a challenge from a clinical and scientific perspective and interventions aimed at enhancing it represent an area of growing interest for the future of clinical practice and research. Well-being therapy (WBT) is a short-term psychotherapeutic strategy aimed at enhancing well-being based on the model originally developed in 1958 by Marie Jahoda. It emphasizes self-observation, with the use of a structured diary, interaction between patients and therapists, and homework. WBT may be used as the only therapeutic strategy or in sequential combination with other psychotherapeutic strategies, mainly cognitive behavioral therapy. WBT can be differentiated from positive interventions based on several features which are described in detail in the present chapter. We also report the clinical use of WBT in the treatment of anxiety disorders, mainly generalized anxiety disorder, panic disorder, and agoraphobia. Potential further clinical application of WBT is withdrawal after antidepressants discontinuation and side effects during long-term antidepressant treatment.
Topics: Agoraphobia; Antidepressive Agents; Anxiety Disorders; Cognitive Behavioral Therapy; Humans; Panic Disorder; Psychotherapy
PubMed: 32002942
DOI: 10.1007/978-981-32-9705-0_24 -
Current Opinion in Psychiatry Jan 2020The alternative model for personality disorders in DSM-5 and the upcoming ICD-11 stimulated an increased interest in the concept of personality functioning for the... (Review)
Review
PURPOSE OF REVIEW
The alternative model for personality disorders in DSM-5 and the upcoming ICD-11 stimulated an increased interest in the concept of personality functioning for the diagnosis of personality disorders. Furthermore, the impact of personality functioning on other mental disorders has become the focus of recent research efforts. The purpose of this review is to provide a comprehensive and critical study of the empirical literature on the relationship between personality functioning and anxiety disorders.
RECENT FINDINGS
Recent studies predominantly show a positive association of anxiety symptoms and disorders with an impairment in personality functioning. However, no evidence was found for different levels of personality functioning according to the type of anxiety disorder. Anxiety disorders can occur at all levels of personality organization.
SUMMARY
Anxiety disorders are associated with significant impairment in personality functioning. As the underlying personality structure is known to play a crucial role for treatment outcome, the evaluation of personality functioning should be a central part of a comprehensive diagnostic process and treatment planning in patients with anxiety disorders.
Topics: Adult; Anxiety Disorders; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Male; Personality Disorders
PubMed: 31790374
DOI: 10.1097/YCO.0000000000000556 -
Current Psychiatry Reports Nov 2016Anxiety and its associated disorders are common in patients with cardiovascular disease and may significantly influence cardiac health. Anxiety disorders are associated... (Review)
Review
Anxiety and its associated disorders are common in patients with cardiovascular disease and may significantly influence cardiac health. Anxiety disorders are associated with the onset and progression of cardiac disease, and in many instances have been linked to adverse cardiovascular outcomes, including mortality. Both physiologic (autonomic dysfunction, inflammation, endothelial dysfunction, changes in platelet aggregation) and health behavior mechanisms may help to explain the relationships between anxiety disorders and cardiovascular disease. Given the associations between anxiety disorders and poor cardiac health, the timely and accurate identification and treatment of these conditions is of the utmost importance. Fortunately, pharmacologic and psychotherapeutic interventions for the management of anxiety disorders are generally safe and effective. Further study is needed to determine whether interventions to treat anxiety disorders ultimately impact both psychiatric and cardiovascular health.
Topics: Antidepressive Agents; Anxiety Disorders; Benzodiazepines; Cardiovascular Diseases; Humans; Psychotherapy
PubMed: 27671918
DOI: 10.1007/s11920-016-0739-5 -
Primary Care Jun 2016Investigation for a possible anxiety disorder should be considered in patients with multiple or persistent anxiety symptoms or multiple somatic complaints without a... (Review)
Review
Investigation for a possible anxiety disorder should be considered in patients with multiple or persistent anxiety symptoms or multiple somatic complaints without a clear somatic etiology. The ideal treatment for anxiety disorders is a combination of pharmacologic and behavioral strategies. As primary care health care evolves, it is expected that the management of mental health disorders (including anxiety disorders) will largely occur in the context of collaborative care models in which patients and primary care clinicians are assisted by trained case managers who help facilitate a more comprehensive, holistic treatment plan between primary care and mental health providers.
Topics: Anxiety Disorders; Complementary Therapies; Humans; Primary Health Care; Psychotherapy; Selective Serotonin Reuptake Inhibitors; Surveys and Questionnaires
PubMed: 27262005
DOI: 10.1016/j.pop.2016.02.002