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Journal of Affective Disorders Jan 2023This study aimed to investigate the association between smartphone overdependence and generalized anxiety disorder among South Korean adolescents.
BACKGROUND
This study aimed to investigate the association between smartphone overdependence and generalized anxiety disorder among South Korean adolescents.
METHODS
Participants were selected from the Korean Youth Health Behavior Survey 2020. The primary dependent variable was the generalized anxiety disorder that was measured based on seven item instrument (GAD-7). The main exposure of interest was the smartphone overdependence using the integrated scale developed by the National Information Society Agency in Korea. Weighted chi-square test and multiple logistic regression were used to assess the association between smartphone overdependence and generalized anxiety disorder.
RESULTS
The final participants comprised of 54,948 middle and high school students. 13,775 students (25.1 %) were classified as the smartphone overdependence group. Of those who reported overly dependent on smartphones, 2803 students (20.3 %) had generalized anxiety disorder. The risk for generalized anxiety disorder were 2.15 folds (95 % CI 2.01-2.30) higher among the overdependence group in compared to their counterparts. Specifically, the risk for generalized anxiety disorder increased when smartphone has negatively affected relationships with friends and colleagues (OR: 2.35, 95 % CI 2.08-2.64). The sensitivity of smartphone overdependence scale was verified and the risk for generalized anxiety disorder increased in magnitude with the severity of smartphone overdependence.
CONCLUSION
The findings of the study showed significant association between smartphone overdependence and generalized anxiety disorder among South Korean adolescents. The negative changes in social relationships due to excessive smartphone use and the severity of overdependence accounted for the risk for generalized anxiety disorder.
Topics: Humans; Adolescent; Smartphone; Behavior, Addictive; Republic of Korea; Anxiety Disorders; Friends; Anxiety
PubMed: 36283537
DOI: 10.1016/j.jad.2022.10.018 -
Comprehensive Psychiatry Feb 2021Prior studies have reported that separation anxiety disorder (SEPAD) can continue into or may begin in adulthood. Association of SEPAD with other psychiatric disorders...
Prior studies have reported that separation anxiety disorder (SEPAD) can continue into or may begin in adulthood. Association of SEPAD with other psychiatric disorders has been frequently examined, and high rates of comorbidities have been found. The aim of this study was to investigate the prevalence and clinical correlation of SEPAD in adult patients undergoing treatment for major depressive disorder (MDD). The study sample was comprised of 100 outpatients. Participants underwent a DSM-5-based comprehensive assessment. Purposefully-designed semi-structured sociodemographic information and illness history forms were filled out by the researchers, and diagnoses of SEPAD were made using the Structured Clinical Interview for Separation Anxiety Symptoms, Separation Anxiety Symptom Inventory and Adult Separation Anxiety Survey. The frequency of SEPAD was 41% in patients with MDD, three-quarters of whom were adult onset. The use of new-generation antidepressants, adjunctive medications and comorbidity of other anxiety disorders were higher in patients with SEPAD (p < 0.05). SEPAD was highly prevalent, with a majority of cases starting in adulthood among patients with MDD, while SEPAD comorbidity was associated with high levels of anxiety and an increased likelihood of suboptimal response to usual depression treatment. Further studies are required to define the relevance and pathological basis for the comorbidity of SEPAD in people with MDD.
Topics: Adult; Anxiety Disorders; Anxiety, Separation; Comorbidity; Depressive Disorder, Major; Humans; Outpatients; Prevalence
PubMed: 33378709
DOI: 10.1016/j.comppsych.2020.152219 -
Psychotherapy (Chicago, Ill.) Sep 2022According to dynamic systems theory, initial symptom instability is necessary for long-term stable change to occur from psychotherapy. Such instability may be assessed... (Randomized Controlled Trial)
Randomized Controlled Trial
According to dynamic systems theory, initial symptom instability is necessary for long-term stable change to occur from psychotherapy. Such instability may be assessed using within-day sudden gains (SGs), sudden losses (SLs), and reversals. The present study examined these symptom change patterns and their association with treatment outcome using intensive diary assessment across three psychotherapies for generalized anxiety disorder (GAD). In a secondary analysis of Borkovec and Costello (1993), 59 clients diagnosed with GAD were randomly assigned to applied relaxation (AR; = 21), cognitive behavioral therapy (CBT; = 20), or nondirective (ND) therapy ( = 18). Clients completed thrice daily anxiety ratings while receiving psychotherapy. The occurrence of SGs, SLs, and reversals assessed for each individual was calculated using changes between each assessment. We examined the association between occurrence of SGs, SLs, and reversals and symptom change from pretreatment to posttreatment, and 6-month, and 1-year follow-up. Clients in ND (61.1%) were more likely to experience SGs than clients in CBT (20.0%) or AR (38.0%). 92.9% of SGs were followed by a reversal. Experiencing SGs was associated with less symptom change from pretreatment to follow-up in ND and not associated with outcome in CBT or AR. SLs and reversals were not associated with outcome. When measured at a within-day level, SGs are very likely to be reversed and may be associated with poorer long-term outcome in ND. Within-day SGs may have a fundamentally different meaning than session-to-session SGs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Topics: Anxiety; Anxiety Disorders; Cognitive Behavioral Therapy; Humans; Psychotherapy; Treatment Outcome
PubMed: 35666889
DOI: 10.1037/pst0000445 -
The Journal of Nervous and Mental... Oct 2022This study examined the relationship between eight measures of religious involvement and five anxiety disorders among a nationally representative sample of...
This study examined the relationship between eight measures of religious involvement and five anxiety disorders among a nationally representative sample of African-Americans ( N = 3403). The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition , World Mental Health Composite International Diagnostic Interview was used to assess 12-month and lifetime prevalence for each disorder. Logistic regression indicated weekly service attendance was inversely associated with 12-month and lifetime panic disorder, lifetime agoraphobia, and 12-month and lifetime posttraumatic stress disorder (PTSD). Prayer was inversely associated with 12-month agoraphobia, 12-month social phobia, and lifetime PTSD. Listening to religious radio and looking to God for strength were also inversely related to, respectively, 12-month and lifetime panic disorder. Conversely, reading religious materials was positively associated with 12-month panic disorder, 12-month agoraphobia, lifetime PTSD, and lifetime generalized anxiety disorder. The results are discussed in light of conceptual models that specify multiple and sometimes divergent pathways through which religion impacts health, and suggestions for clinicians addressing anxiety disorders are delineated.
Topics: Black or African American; Agoraphobia; Anxiety Disorders; Diagnostic and Statistical Manual of Mental Disorders; Health Surveys; Humans; Prevalence
PubMed: 35605210
DOI: 10.1097/NMD.0000000000001538 -
Journal of Affective Disorders Nov 2021Anxiety in pregnancy is one of the strongest risk factors for postpartum depression (PPD), and high worry is a hallmark of many anxiety disorders. We sought to determine...
BACKGROUND
Anxiety in pregnancy is one of the strongest risk factors for postpartum depression (PPD), and high worry is a hallmark of many anxiety disorders. We sought to determine whether the Penn State Worry Questionnaire (PSWQ), designed for the general population, could identify high worry in pregnancy and predict the development of PPD symptoms (PPDS).
METHODS
We followed women (N = 295) with and without mood and anxiety disorders across pregnancy and up to 6 months postpartum. Diagnoses were confirmed by SCID and by an experienced perinatal psychiatrist, and we administered the PSWQ and the Edinburgh Postnatal Depression Scale (EPDS) at up to 6 time points. We determined the trajectory of worry across time and its relationship to PPDS.
RESULTS
Women with a history or current diagnosis of major depressive disorder (MDD) or generalized anxiety disorder (GAD) were more likely to experience high antenatal worry (defined as PSWQ >60), p < .004 for MDD and <0.001 for all others. High antenatal worry was the only significant predictor of PPDS, with an OR of 3.91 (95% CI 1.44-10.65); neither psychiatric diagnosis nor elevated antenatal depressive symptoms was significantly associated with PPDS in a multivariate model.
LIMITATIONS
Our study used self-report measures in a largely homogeneous population, which may limit the generalizability of our results.
CONCLUSIONS
The PSWQ may be a useful clinical tool in pregnancy. High worry is a strong predictor of PPDS, and is a better predictor of PPDS than psychiatric diagnosis or elevated antenatal depressive symptoms in this population.
Topics: Anxiety; Anxiety Disorders; Depression; Depression, Postpartum; Depressive Disorder, Major; Female; Humans; Pregnancy; Psychiatric Status Rating Scales; Risk Factors
PubMed: 34343928
DOI: 10.1016/j.jad.2021.07.009 -
Depression and Anxiety Aug 2020Pediatric anxiety disorders such as generalized anxiety disorder (GAD) are common, impairing, and often undertreated. Moreover, many youth do not respond to standard,... (Review)
Review
BACKGROUND
Pediatric anxiety disorders such as generalized anxiety disorder (GAD) are common, impairing, and often undertreated. Moreover, many youth do not respond to standard, evidence-based psychosocial or psychopharmacologic treatment. An increased understanding of the gamma-aminobutyric acid (GABA) and glutamate neurotransmitter systems has created opportunities for novel intervention development for pediatric GAD.
METHODS
This narrative review examines potential candidates for pediatric GAD: eszopiclone, riluzole, eglumegad (LY354740), pimavanserin, agomelatine.
RESULTS
The pharmacology, preclinical data, clinical trial findings and known side effects of eszopiclone, riluzole, eglumegad (LY354740), pimavanserin, agomelatine, are reviewed, particularly with regard to their potential therapeutic relevance to pediatric GAD.
CONCLUSION
Notwithstanding numerous challenges, some of these agents represent potential candidate drugs for pediatric GAD. Further treatment development studies of agomelatine, eszopiclone, pimavanserin and riluzole for pediatric GAD also have the prospect of informing the understanding of GABAergic and glutamatergic function across development.
Topics: Adolescent; Anxiety Disorders; Child; Humans; Treatment Outcome
PubMed: 32419335
DOI: 10.1002/da.23038 -
JAMA Network Open Nov 2023Anxiety disorders are associated with poor maternal and neonatal outcomes. Women in low- and middle-income countries (LMICs) are thought to be disproportionally burdened... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Anxiety disorders are associated with poor maternal and neonatal outcomes. Women in low- and middle-income countries (LMICs) are thought to be disproportionally burdened by these disorders, yet their prevalence is unclear.
OBJECTIVE
To conduct a systematic review and meta-analysis to determine the prevalence of 6 anxiety and related disorders among perinatal women in LMICs.
DATA SOURCES
Embase, MEDLINE, PsycINFO, Cochrane Library, CINAHL, and Web of Science databases were searched from inception until September 7, 2023.
STUDY SELECTION
Studies conducted in World Bank-defined LMICs and reporting prevalence of generalized anxiety disorder, obsessive-compulsive disorder, social anxiety disorder, posttraumatic stress disorder, panic disorder, or adjustment disorder during the perinatal period (conception to 12 months post partum) using a validated method were included.
DATA EXTRACTION AND SYNTHESIS
This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. Study eligibility, extracted data, and risk of bias of included studies were assessed by 2 independent reviewers. Random-effects meta-analysis was used to estimate pooled point prevalence. Subgroup analyses were performed by specific anxiety disorder.
MAIN OUTCOMES AND MEASURES
Main outcomes were prevalence estimates of each anxiety disorder, measured as percentage point estimates and corresponding 95% CIs.
RESULTS
At total of 10 617 studies were identified, 203 of which met the inclusion criteria and reported the outcomes of 212 318 women from 33 LMICs. Generalized anxiety disorder was the most reported (184 studies [90.6%]) and most prevalent disorder at 22.2% (95% CI, 19.4%-25.0%; n = 173 553). Posttraumatic stress disorder was the second most prevalent (8.3%; 95% CI, 5.0%-12.2%; 33 studies; n = 22 452). Adjustment disorder was least prevalent (2.9%; 95% CI, 0.0%-14.1%; 2 studies; n = 475). The prevalence of generalized anxiety varied by country income status, with the highest prevalence among lower-middle-income countries (27.6%; 95% CI, 21.6%-33.9%; 59 studies; n = 25 109), followed by low-income (24.0%; 95% CI, 15.3%-33.8%; 11 studies; n = 4961) and upper-middle-income (19.1%; 95% CI, 16.0%-22.4%; 110 studies; n = 138 496) countries.
CONCLUSIONS AND RELEVANCE
These findings suggest that 1 in 5 women living in LMICs experience anxiety disorders during pregnancy and post partum. Targeted action is needed to reduce this high burden.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Developing Countries; Prevalence; Anxiety Disorders; Anxiety; Stress Disorders, Post-Traumatic
PubMed: 37976063
DOI: 10.1001/jamanetworkopen.2023.43711 -
Journal of Child Psychology and... Feb 2021Anxiety disorders first emerge during the critical developmental periods of childhood and adolescence. This review synthesizes recent findings on the prevalence, risk... (Review)
Review
BACKGROUND
Anxiety disorders first emerge during the critical developmental periods of childhood and adolescence. This review synthesizes recent findings on the prevalence, risk factors, and course of the anxiety disorders; and their neurobiology and treatment.
METHODS
For this review, searches were conducted using PubMed, PsycINFO, and clinicaltrials.gov. Findings related to the epidemiology, neurobiology, risk factors, and treatment of pediatric anxiety disorders were then summarized.
FINDINGS
Anxiety disorders are high prevalence, and early-onset conditions associated with multiple risk factors including early inhibited temperament, environment stress, and structural and functional abnormalities in the prefrontal-amygdala circuitry as well as the default mode and salience networks. The anxiety disorders are effectively treated with cognitive behavioral therapy (CBT), selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs).
CONCLUSIONS
Anxiety disorders are high prevalence, early-onset conditions associated with a distinct neurobiological fingerprint, and are consistently responsive to treatment. Questions remain regarding who is at risk of developing anxiety disorders as well as the way in which neurobiology predicts treatment response.
Topics: Adolescent; Anxiety Disorders; Child; Cognitive Behavioral Therapy; Humans; Serotonin; Selective Serotonin Reuptake Inhibitors; Temperament
PubMed: 32500537
DOI: 10.1111/jcpp.13262 -
Human Brain Mapping Jan 2022Anxiety disorders are highly prevalent and disabling but seem particularly tractable to investigation with translational neuroscience methodologies. Neuroimaging has... (Review)
Review
Anxiety disorders are highly prevalent and disabling but seem particularly tractable to investigation with translational neuroscience methodologies. Neuroimaging has informed our understanding of the neurobiology of anxiety disorders, but research has been limited by small sample sizes and low statistical power, as well as heterogenous imaging methodology. The ENIGMA-Anxiety Working Group has brought together researchers from around the world, in a harmonized and coordinated effort to address these challenges and generate more robust and reproducible findings. This paper elaborates on the concepts and methods informing the work of the working group to date, and describes the initial approach of the four subgroups studying generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobia. At present, the ENIGMA-Anxiety database contains information about more than 100 unique samples, from 16 countries and 59 institutes. Future directions include examining additional imaging modalities, integrating imaging and genetic data, and collaborating with other ENIGMA working groups. The ENIGMA consortium creates synergy at the intersection of global mental health and clinical neuroscience, and the ENIGMA-Anxiety Working Group extends the promise of this approach to neuroimaging research on anxiety disorders.
Topics: Anxiety Disorders; Humans; Limbic System; Multicenter Studies as Topic; Neuroimaging; Prefrontal Cortex
PubMed: 32618421
DOI: 10.1002/hbm.25100 -
BMJ Open Oct 2023Depression and anxiety afflict millions worldwide causing considerable disability. MULTI-PSYCH is a longitudinal cohort of genotyped and phenotyped individuals with...
PURPOSE
Depression and anxiety afflict millions worldwide causing considerable disability. MULTI-PSYCH is a longitudinal cohort of genotyped and phenotyped individuals with depression or anxiety disorders who have undergone highly structured internet-based cognitive-behaviour therapy (ICBT). The overarching purpose of MULTI-PSYCH is to improve risk stratification, outcome prediction and secondary preventive interventions. MULTI-PSYCH is a precision medicine initiative that combines clinical, genetic and nationwide register data.
PARTICIPANTS
MULTI-PSYCH includes 2668 clinically well-characterised adults with major depressive disorder (MDD) (n=1300), social anxiety disorder (n=640) or panic disorder (n=728) assessed before, during and after 12 weeks of ICBT at the internet psychiatry clinic in Stockholm, Sweden. All patients have been blood sampled and genotyped. Clinical and genetic data have been linked to several Swedish registers containing a wide range of variables from patient birth up to 10 years after the end of ICBT. These variable types include perinatal complications, school grades, psychiatric and somatic comorbidity, dispensed medications, medical interventions and diagnoses, healthcare and social benefits, demographics, income and more. Long-term follow-up data will be collected through 2029.
FINDINGS TO DATE
Initial uses of MULTI-PSYCH include the discovery of an association between PRS for autism spectrum disorder and response to ICBT, the development of a machine learning model for baseline prediction of remission status after ICBT in MDD and data contributions to genome wide association studies for ICBT outcome. Other projects have been launched or are in the planning phase.
FUTURE PLANS
The MULTI-PSYCH cohort provides a unique infrastructure to study not only predictors or short-term treatment outcomes, but also longer term medical and socioeconomic outcomes in patients treated with ICBT for depression or anxiety. MULTI-PSYCH is well positioned for research collaboration.
Topics: Adult; Pregnancy; Female; Humans; Sweden; Depression; Depressive Disorder, Major; Autism Spectrum Disorder; Genome-Wide Association Study; Anxiety Disorders; Anxiety; Psychotherapy; Treatment Outcome; Internet
PubMed: 37793927
DOI: 10.1136/bmjopen-2022-069427