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Current Psychiatry Reports May 2017The review focused on associations between temperament dimensions and clinical features in different anxiety disorders, likewise in obsessive-compulsive disorder in... (Review)
Review
PURPOSE OF REVIEW
The review focused on associations between temperament dimensions and clinical features in different anxiety disorders, likewise in obsessive-compulsive disorder in clinical samples of adults. A literature search was conducted in the Medline and PsycINFO databases covering the years 2010-2016. A systematic review and grading of the level of evidence for an association between temperament dimension scores and clinical features in each disorder were performed.
RECENT FINDINGS
Twenty papers reporting 18 different studies were included. Five of the papers focused on panic disorder (PD), five on social anxiety disorder (SAD), three on post-traumatic stress disorder (PTSD), one on generalized anxiety disorder (GAD), three on obsessive-compulsive disorder (OCD), and an additional three papers on several anxiety disorders. The review consolidates the finding that trait anxiety, especially as assessed by Cloninger's model or the five-factor model, is a phenomenon common to all anxiety disorders and OCD. More follow-up studies including large samples are needed to differentiate the dimensional profiles of trait anxiety in specific disorders.
Topics: Adult; Anxiety Disorders; Humans; Psychiatric Status Rating Scales; Psychological Techniques; Stress Disorders, Post-Traumatic; Temperament
PubMed: 28417269
DOI: 10.1007/s11920-017-0779-5 -
FP Essentials Apr 2023Anxiety disorders are characterized by excessive fear and worry. Generalized anxiety disorder (GAD) and panic disorder (PD) are two of the most common anxiety disorders...
Anxiety disorders are characterized by excessive fear and worry. Generalized anxiety disorder (GAD) and panic disorder (PD) are two of the most common anxiety disorders in the United States. GAD is defined as excessive worry and anxiety that occur on most days for at least 6 months that affect daily functioning. PD is defined by recurrent unexpected panic attacks. Patients with symptoms of GAD or PD should be assessed for conditions such as hyperthyroidism, hyperparathyroidism, and cardiac arrhythmia before confirmation of an anxiety disorder diagnosis. A U.S. Preventive Services Task Force (USPSTF) draft statement recommends screening for anxiety in adults 64 years and younger, including pregnant and postpartum women. A final statement recommends screening for anxiety in children and adolescents ages 8 to 18 years. Multiple self-report tools have been validated for GAD and PD screening. The 7-item Generalized Anxiety Disorder (GAD-7) scale is an option for screening for GAD. The Panic Disorder Severity Scale (PDSS) is a 7-item tool with excellent sensitivity and specificity in screening for PD. Management with selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors in combination with psychotherapy has been shown to be effective for GAD and PD. Research on alternative treatments, such as psychedelic-assisted psychotherapy, is ongoing.
Topics: Adult; Pregnancy; Adolescent; Child; Humans; Female; Anxiety Disorders; Panic Disorder; Anxiety; Selective Serotonin Reuptake Inhibitors; Psychotherapy
PubMed: 37036769
DOI: No ID Found -
Bulletin of the Menninger Clinic 2023Although conditioning approaches have highlighted potential characteristics of disgust in anxiety disorders, obsessive-compulsive disorder (OCD), and posttraumatic... (Review)
Review
Although conditioning approaches have highlighted potential characteristics of disgust in anxiety disorders, obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD), these findings have yet to be translated into evidence-based treatments. Examination of the literature suggests various indicators of disgust that predict treatment outcome in these disorders. However, mechanisms remain unclear because studies examining disgust during the course of treatment are limited. Increasingly, the field has moved toward experimental investigation of strategies that reduce disgust. While cognitive reappraisal and imagery techniques appear promising, such techniques have yet to be examined as anxiety disorder treatments in large-scale randomized clinical trials. The literature also points to novel approaches to treating disgust, ranging from an inhibitory-informed approach to exposure therapy to transcranial direct current stimulation. However, the development of novel treatment approaches will require more rigorous experimental psychopathology approaches that can further elucidate processes that contribute to the etiology and/or maintenance of disorders of disgust.
Topics: Humans; Anxiety; Anxiety Disorders; Disgust; Emotions; Obsessive-Compulsive Disorder; Transcranial Direct Current Stimulation
PubMed: 37871191
DOI: 10.1521/bumc.2023.87.suppA.5 -
Current Opinion in Psychiatry Sep 2019To review recent studies which assess comorbidity, that is, prevalence of co-occurrence, relationships and treatment implications between anxiety disorders and various... (Review)
Review
PURPOSE OF REVIEW
To review recent studies which assess comorbidity, that is, prevalence of co-occurrence, relationships and treatment implications between anxiety disorders and various medical illnesses.
RECENT FINDINGS
The prevalence rates of anxiety disorders in patients with medical illnesses are high, with percentage up to 29% in patients with epilepsy, 48.9% in patients with multiple sclerosis, 30.1% in patients with Parkinson's disease, 30% in patients with cardiovascular disease, 47.0% in patients with diabetes mellitus, and so on. The most prevalent anxiety disorders among individuals with somatic illnesses are generalized anxiety disorder and panic disorder. In addition, various medical illnesses are highly prevalent in samples of patients with anxiety disorders. Anxiety disorders co-occurring with medical illnesses have a number of clinical implications, including a greater severity and negative impact on treatment outcome of both medical illnesses and anxiety disorders.
SUMMARY
It is important for clinicians to look for possible anxiety disorders among patients with medical illnesses. Further studies need to ascertain how to best treat individuals suffering from both anxiety disorders and medical illnesses, and focus on the issue of causality when these conditions co-occur.
Topics: Anxiety Disorders; Chronic Disease; Comorbidity; Humans; Patient Care Management; Prevalence
PubMed: 31116127
DOI: 10.1097/YCO.0000000000000527 -
Canadian Journal of Psychiatry. Revue... Apr 2017The objective was to estimate the age of onset (AOO) for all anxiety disorders and for specific subtypes. Gender differences in the AOO of anxiety disorders were... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The objective was to estimate the age of onset (AOO) for all anxiety disorders and for specific subtypes. Gender differences in the AOO of anxiety disorders were examined, as were the influence of study characteristics on reported AOOs.
METHODS
Seven electronic databases were searched up to October 2014, with keywords representing anxiety disorder subtypes, AOO, and study design. The inclusion criteria were studies using a general population sample that provided data on the AOO for all anxiety disorders, or specific anxiety disorders, according to DSM-III-R, DSM-IV, or ICD-10 criteria.
RESULTS
There were 1028 titles examined, which yielded 24 studies meeting the inclusion criteria. Eight studies reported the AOO and gender. Meta-analysis found a mean AOO of all anxiety disorders of 21.3 years (95% CI 17.46 to 25.07). Separation anxiety disorder, specific phobia, and social phobia had their mean onset before the age of 15 years, whereas the AOO of agoraphobia, obsessive-compulsive disorder, posttraumatic stress disorder, panic disorder, and generalized anxiety disorder began, on average, between 21.1 and 34.9 years. Meta-analysis revealed no difference in the AOO between genders. A prospective study design and higher developmental level of the study country were associated with an earlier AOO.
CONCLUSIONS
Results from this meta-analysis indicate that anxiety disorder subtypes differ in the mean AOO, with onsets ranging from early adolescence to young adulthood. These findings suggest that prevention strategies of anxiety disorders should be directed towards factors associated with the development of anxiety disorder subtypes in the age groups with the greatest vulnerability for developing those disorders.
Topics: Age of Onset; Anxiety Disorders; Humans
PubMed: 27310233
DOI: 10.1177/0706743716640757 -
Hearing Research Mar 2016The most common form of tinnitus is a subjective, auditory, and distressing phantom phenomenon. Comorbidity with depression is high but other important psychiatric... (Review)
Review
BACKGROUND
The most common form of tinnitus is a subjective, auditory, and distressing phantom phenomenon. Comorbidity with depression is high but other important psychiatric disorders such as anxiety disorders have received less attention. The current paper reviews the literature on the associations between tinnitus and anxiety disorders and the underlying pathophysiology, and discusses the clinical implications.
METHODOLOGY
PubMed and Web of Science were searched for all articles published up until October 2014 using combinations of the following search strings "Tinnitus", "Anxiety disorder", "Panic Disorder", "Generalized Anxiety Disorder", "Post traumatic stress disorder", "PTSD" "Social Phobia", "Phobia Disorder", "Obsessive Compulsive Disorder", "Agoraphobia".
RESULTS
A total of 117 relevant papers were included. A 45% lifetime prevalence of anxiety disorders is reported in tinnitus populations, while an important overlap in associated (sub)cortical brain areas and cortico-subcortical networks involved in attention, distress, and memory functions is suggested. A disturbed hypothalamic-pituitary-adrenal axis function can be found in tinnitus and in anxiety disorders but, in comorbidity, the direction of the dysfunction is unclear.
CONCLUSION
Comorbidity is high and screening for and treatment of anxiety disorders is recommended in moderate to severe tinnitus, as, given the overlap in the structural and functional brain circuitries involved, theoretically, their management could improve (subjective) levels of tinnitus although further empirical research on this topic is required.
Topics: Anxiety Disorders; Auditory Perception; Comorbidity; Humans; Prevalence; Prognosis; Risk Factors; Tinnitus
PubMed: 26342399
DOI: 10.1016/j.heares.2015.08.014 -
JAAPA : Official Journal of the... Feb 2019Generalized anxiety disorder (GAD), characterized by excessive worry or apprehension, can lead to significant distress or impairment in patients' social or occupational... (Review)
Review
Generalized anxiety disorder (GAD), characterized by excessive worry or apprehension, can lead to significant distress or impairment in patients' social or occupational function but commonly is overlooked by primary care providers. GAD and other anxiety disorders are among the most common mental health disorders affecting children. Without treatment, children with GAD are at higher risk for academic underperformance, substance abuse, other mental health disorders, and poor outcomes in adulthood. This article reviews screening and assessment for GAD in children and pharmacologic and nonpharmacologic recommendations for management.
Topics: Anxiety Disorders; Child; Disease Management; Female; Humans; Male; Patient Health Questionnaire; Primary Health Care
PubMed: 30699096
DOI: 10.1097/01.JAA.0000552719.98489.75 -
The Medical Clinics of North America Sep 2014Anxiety disorders are the most common psychiatric condition presenting to primary care practitioners. Yet they can be easily overlooked or misdiagnosed. Patients that... (Review)
Review
Anxiety disorders are the most common psychiatric condition presenting to primary care practitioners. Yet they can be easily overlooked or misdiagnosed. Patients that struggle with anxiety disorders are more likely to seek treatment from primary care providers than mental health specialists. Given the costs in terms of debilitation and associated financial burden, and increased risk of suicide, the identification and successful treatment of anxiety is imperative. By means of clinical acumen and the use of screening tools, the provider can develop expertise in recognition and effective treatment of anxiety disorders.
Topics: Anti-Anxiety Agents; Anxiety Disorders; Behavior Therapy; Combined Modality Therapy; Comorbidity; Complementary Therapies; Cost of Illness; Diagnostic and Statistical Manual of Mental Disorders; Humans; Mass Screening; Mental Disorders; Primary Health Care; Prognosis; Psychotherapy; Quality of Life; Selective Serotonin Reuptake Inhibitors; Sick Leave; Suicidal Ideation; Surveys and Questionnaires
PubMed: 25134870
DOI: 10.1016/j.mcna.2014.06.003 -
The Nursing Clinics of North America Jun 2016Anxiety disorders are among the most prevalent and disabling psychiatric disorders. Patients and their families have a plethora of evidence-based treatment options to... (Review)
Review
Anxiety disorders are among the most prevalent and disabling psychiatric disorders. Patients and their families have a plethora of evidence-based treatment options to manage these potentially incapacitating and costly disorders. Nurses in various settings can assess symptoms of anxiety disorder and initiate or refer patients for treatment. Families play a critical role in treatment planning and must be part of the health care team. Primary nursing interventions must be person centered and recovery based to ensure accurate diagnosis, initiation of appropriate person-centered treatment, and facilitate an optimal level of functioning and quality of life.
Topics: Anxiety Disorders; Depressive Disorder; Evidence-Based Nursing; Female; Humans; Male; Nurse's Role; Nurse-Patient Relations; Quality of Life
PubMed: 27229274
DOI: 10.1016/j.cnur.2016.01.003 -
Advances in Experimental Medicine and... 2020Many pharmacological treatments were proved effective in the treatment of panic disorder (PD), generalized anxiety disorder (GAD), social anxiety disorder (SAD),... (Review)
Review
Many pharmacological treatments were proved effective in the treatment of panic disorder (PD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD); still many patients do not achieve remission with these treatments. Neurostimulation techniques have been studied as promising alternatives or augmentation treatments to pharmacological and psychological therapies. The most studied neurostimulation method for anxiety disorders, PTSD, and OCD was repetitive transcranial magnetic stimulation (rTMS). This neurostimulation technique had the highest level of evidence for GAD. There were also randomized sham-controlled trials indicating that rTMS may be effective in the treatment of PTSD and OCD, but there were conflicting findings regarding these two disorders. There is indication that rTMS may be effective in the treatment of panic disorder, but the level of evidence is low. Deep brain stimulation (DBS) was most studied for treatment of OCD, but the randomized sham-controlled trials had mixed findings. Preliminary findings indicate that DBS could be affective for PTSD. There is weak evidence indicating that electroconvulsive therapy, transcranial direct current stimulation, vagus nerve stimulation, and trigeminal nerve stimulation could be effective in the treatment of anxiety disorders, PTSD, and OCD. Regarding these disorders, there is no support in the current literature for the use of neurostimulation in clinical practice. Large high-quality studies are warranted.
Topics: Anxiety Disorders; Electric Stimulation Therapy; Electroconvulsive Therapy; Humans; Obsessive-Compulsive Disorder; Randomized Controlled Trials as Topic; Stress Disorders, Post-Traumatic; Transcranial Direct Current Stimulation; Transcranial Magnetic Stimulation
PubMed: 32002936
DOI: 10.1007/978-981-32-9705-0_18