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Research on Child and Adolescent... Feb 2023Altered sensory processing has been linked to symptoms of obsessive-compulsive disorder (OCD) and anxiety disorders (ADs) in youth, but few studies have examined...
Altered sensory processing has been linked to symptoms of obsessive-compulsive disorder (OCD) and anxiety disorders (ADs) in youth, but few studies have examined sensory processing in clinical samples and no study has analyzed self-report data from youth meeting diagnostic criteria for OCD or ADs. This study included 86 youth with OCD, 82 youth with ADs, and 46 youth without psychiatric disorders. Participants completed the adolescent version of the Sensory Profile and scales measuring three symptom dimensions of OCD, four symptom dimensions of anxiety, and symptoms of major depression. Results showed that different forms of sensory processing difficulties (sensitivity, avoidance, low registration) were adequately captured by one broad sensory processing factor. Youth with OCD and ADs reported statistically significantly more sensory difficulties than youth without psychiatric disorders, but the two clinical groups did not differ from each other. Altered sensory processing in the clinical groups was not explained by the presence of neurodevelopmental disorders. Sensory difficulties were moderately to strongly related to all self-reported symptom dimensions, and uniquely related to the OCD dimension of symmetry/ordering and the anxiety dimensions of panic and social anxiety. Most youth in the clinical groups were classified as having difficulties with sensory processing. The present study shows that sensory processing difficulties are common in youth with OCD and ADs, not explained by co-occurring neurodevelopmental disorders, and linked to a host of internalizing symptoms. More research is needed to identify whether sensory processing difficulties precede, follow, or mutually reinforce the development of OCD and ADs in youth.
Topics: Humans; Adolescent; Child; Anxiety Disorders; Obsessive-Compulsive Disorder; Anxiety; Depressive Disorder, Major; Perception
PubMed: 36149521
DOI: 10.1007/s10802-022-00962-w -
Clinical Psychology & Psychotherapy May 2021In recent years the development of new virtual environments has been qualitatively high and fast at the same time, but the dissemination of virtual reality (VR) in... (Review)
Review
In recent years the development of new virtual environments has been qualitatively high and fast at the same time, but the dissemination of virtual reality (VR) in clinical practice is still scarce. The aim of this review is to give an insight into the state of the art of the use of VR as an assessment tool and treatment intervention in anxiety and related disorders as posttraumatic stress disorder and obsessive-compulsive disorders. Besides an overview into the efficacy of VR, a summary will be given on assumed working mechanisms in virtual reality exposure therapy and how this aligns with current theoretical models. Further, it will be discussed how VR is accepted by patients and research into the reluctance of therapist to use this technology during treatment with focus on the therapeutic alliance and how it may be influenced by the use of VR. Finally, we discuss clinical and future issues as, for example, dissemination into clinical practice and what VR has to offer therapists in future. This not only in adult population but as well in younger patients, as young adolescents VR has a great potential as it connects easily with its playful elements to this population and might be a low threshold step to offer treatment or preventive interventions.
Topics: Adolescent; Adult; Anxiety; Anxiety Disorders; Humans; Obsessive-Compulsive Disorder; Virtual Reality; Virtual Reality Exposure Therapy
PubMed: 34097318
DOI: 10.1002/cpp.2623 -
Clinical Child and Family Psychology... Dec 2021Anxiety disorders are common in adolescence but outcomes for adolescents are unclear and we do not know what factors moderate treatment outcome for this age group. We... (Meta-Analysis)
Meta-Analysis Review
Anxiety disorders are common in adolescence but outcomes for adolescents are unclear and we do not know what factors moderate treatment outcome for this age group. We conducted meta-analyses to establish the effectiveness of psychological therapies for adolescent anxiety disorders in (i) reducing anxiety disorder symptoms, and (ii) remission from the primary anxiety disorder, compared with controls, and examine potential moderators of treatment effects. The protocol was registered with PROSPERO (CRD42018091744). Electronic databases (Web of Science, MEDLINE, Psycinfo, EMBASE) were searched from January 1990 to December 2019. 2511 articles were reviewed, those meeting strict criteria were included. Random effects meta-analyses were conducted. Analyses of symptom severity outcomes comprised sixteen studies (CBT k = 15, non-CBT k = 1; n = 766 adolescents), and analyses of diagnostic remission outcomes comprised nine (CBT k = 9; n = 563 adolescents). Post-treatment, those receiving treatment were significantly more likely to experience reduced symptom severity (SMD = 0.454, 95% CI 0.22-0.69) and remission from the primary anxiety disorder than controls (RR = 7.94, 95% CI 3.19-12.7) (36% treatment vs. 9% controls in remission). None of the moderators analysed were statistically significant. Psychological therapies targeting anxiety disorders in adolescents are more effective than controls. However, with only just over a third in remission post-treatment, there is a clear need to develop more effective treatments for adolescents, evaluated through high-quality randomised controlled trials incorporating active controls and follow-up data.
Topics: Adolescent; Anxiety; Anxiety Disorders; Cognitive Behavioral Therapy; Humans; Psychotherapy; Treatment Outcome
PubMed: 34471966
DOI: 10.1007/s10567-021-00364-2 -
Journal of Affective Disorders Feb 2021The phenomenology and neurobiology of depressive symptoms in anxious youth is poorly understood.
BACKGROUND
The phenomenology and neurobiology of depressive symptoms in anxious youth is poorly understood.
METHODS
Association networks of anxiety and depressive symptoms were developed in adolescents with generalized anxiety disorder (GAD; N=52, mean age: 15.4±1.6 years) who had not yet developed major depressive disorder. Community analyses were used to create consensus clusters of depressive and anxiety symptoms and to identify "bridge" symptoms between the clusters. In a subset of this sample (n=39), correlations between cortical thickness and depressive symptom severity was examined.
RESULTS
Ten symptoms clustered into an anxious community, 5 clustered into a depressive community and 5 bridged the two communities: impaired schoolwork, excessive weeping, low self-esteem, disturbed appetite, and physical symptoms of depression. Patients with more depressive cluster burden had altered cortical thickness in prefrontal, inferior and medial parietal (e.g., precuneus, supramarginal) regions and had decreases in cortical thickness-age relationships in prefrontal, temporal and parietal cortices.
LIMITATIONS
Data are cross-sectional and observational. Limited sample size precluded secondary analysis of comorbidities and demographics.
CONCLUSIONS
In youth with GAD, a sub-set of symptoms not directly related to anxiety bridge anxiety and depression. Youth with greater depressive cluster burden had altered cortical thickness in cortical structures within the default mode and central executive networks. These alternations in cortical thickness may represent a distinct neurostructural fingerprint in anxious youth with early depressive symptoms. Finally, youth with GAD and high depressive symptoms had reduced age-cortical thickness correlations. The emergence of depressive symptoms in early GAD and cortical development may have bidirectional, neurobiological relationships.
Topics: Adolescent; Anxiety; Anxiety Disorders; Cross-Sectional Studies; Depression; Depressive Disorder, Major; Humans
PubMed: 33221716
DOI: 10.1016/j.jad.2020.11.027 -
BMC Medicine Aug 2023Comorbidity is the rule rather than the exception for childhood and adolescent onset mental disorders, but we cannot predict its occurrence and do not know the neural...
Neurodevelopmental risk and adaptation as a model for comorbidity among internalizing and externalizing disorders: genomics and cell-specific expression enriched morphometric study.
BACKGROUND
Comorbidity is the rule rather than the exception for childhood and adolescent onset mental disorders, but we cannot predict its occurrence and do not know the neural mechanisms underlying comorbidity. We investigate if the effects of comorbid internalizing and externalizing disorders on anatomical differences represent a simple aggregate of the effects on each disorder and if these comorbidity-associated cortical surface differences relate to a distinct genetic underpinning.
METHODS
We studied the cortical surface area (SA) and thickness (CT) of 11,878 preadolescents (9-10 years) from the Adolescent Brain and Cognitive Development Study. Linear mixed models were implemented in comparative and association analyses among internalizing (dysthymia, major depressive disorder, disruptive mood dysregulation disorder, agoraphobia, panic disorder, specific phobia, separation anxiety disorder, social anxiety disorder, generalized anxiety disorder, post-traumatic stress disorder), externalizing (attention-deficit/hyperactivity disorder, oppositional defiant disorder, conduct disorder) diagnostic groups, a group with comorbidity of the two and a healthy control group. Genome-wide association analysis (GWAS) and cell type specificity analysis were performed on 4468 unrelated European participants from this cohort.
RESULTS
Smaller cortical surface area but higher thickness was noted across patient groups when compared to controls. Children with comorbid internalizing and externalizing disorders had more pronounced areal reduction than those without comorbidity, indicating an additive burden. In contrast, cortical thickness had a non-linear effect with comorbidity: the comorbid group had no significant CT differences, while those patient groups without comorbidity had significantly higher thickness compare to healthy controls. Distinct biological pathways were implicated in regional SA and CT differences. Specifically, CT differences were associated with immune-related processes implicating astrocytes and oligodendrocytes, while SA-related differences related mainly to inhibitory neurons.
CONCLUSION
The emergence of comorbidity across distinct clusters of psychopathology is unlikely to be due to a simple additive neurobiological effect alone. Distinct developmental risk moderated by immune-related adaptation processes, with unique genetic and cell-specific factors, may contribute to underlying SA and CT differences. Children with the highest risk but lowest resilience, both captured in their developmental morphometry, may develop a comorbid illness pattern.
Topics: Humans; Depressive Disorder, Major; Genome-Wide Association Study; Anxiety Disorders; Attention Deficit Disorder with Hyperactivity; Comorbidity; Genomics
PubMed: 37542243
DOI: 10.1186/s12916-023-02920-9 -
Comprehensive Psychiatry May 2022We assessed the heterogeneous development of self-reported social anxiety symptoms across childhood and adolescence (ages 10 to 18; N = 701) and examined whether these...
AIM
We assessed the heterogeneous development of self-reported social anxiety symptoms across childhood and adolescence (ages 10 to 18; N = 701) and examined whether these groups predicted clinically derived diagnoses of social anxiety disorder (SAD), generalized anxiety disorder (GAD), depressive episodes, panic disorder (PD), agoraphobia, obsessive compulsive disorder (OCD), and substance use in adulthood (ages 19 to 22).
RESULTS
Three distinct social anxiety symptom trajectories were found: a high increasing group (15.5%), a moderate group (37.3%), and a low group (47.2%). The high increasing and moderate trajectory groups were differentiated from the low trajectory group on the adult mental disorders examined: SAD (high OR = 15.74; moderate OR = 11.72), GAD (high OR = 13.08; moderate OR = 8.98), depressive episode (high OR = 19.75), PD (high OR = 8.43; moderate OR = 5.90), agoraphobia (high OR = 16.39; moderate OR = 9.68), and OCD (high OR = 3.49; moderate OR = 2.98). The high and moderate groups were not differentiated on SAD, GAD, PD, or OCD but were differentiated on depressive episodes (OR = 3.24). Relative to the low and moderate trajectory groups, the high increasing social anxiety symptoms trajectory group also predicted cannabis use, but not alcohol use in adulthood. Gender, ethnicity, household income, and parental education were accounted for when predicting adult outcomes.
CONCLUSION
These results highlight the importance of early treatment of symptoms of childhood social anxiety in the prevention of mental health problems in adulthood.
Topics: Adolescent; Adult; Agoraphobia; Anxiety; Anxiety Disorders; Cannabis; Child; Humans; Panic Disorder; Young Adult
PubMed: 35245889
DOI: 10.1016/j.comppsych.2022.152302 -
Annals of Medicine Dec 2024Anxiety and depression are common comorbidities in idiopathic pulmonary fibrosis (IPF) that impair health-related quality of life. However, there is a lack of studies... (Observational Study)
Observational Study
BACKGROUND
Anxiety and depression are common comorbidities in idiopathic pulmonary fibrosis (IPF) that impair health-related quality of life. However, there is a lack of studies focusing on the mental disorder of IPF after antifibrotic treatment and their related predictive factors.
METHODS
Patients with an initial diagnosis of IPF were enrolled. Data on demographics, lung function, Generalized Anxiety Disorder-7 (GAD-7) Scale, Patient Health Questionnaire 9 (PHQ-9), Patient Health Questionnaire-15 (PHQ-15), and St. George's Respiratory Questionnaire total score(SGRQ-T) were collected. Changes in anxiety, depression, somatic symptoms, and quality of life scores before and after nintedanib treatment were compared, and the related predictive factors were analyzed.
RESULTS
A total of 56 patients with a first diagnosis of IPF were enrolled, with 42 and 35 patients suffering from anxiety and depression, respectively. The GAD-7, PHQ-9, PHQ-15, and SGRQ scores were higher in the anxiety and depression groups. SGRQ total score (SGRQ-T) [OR = 1.075, 95%CI= (1.011, 1.142)] was an independent predictor of IPF combined with anxiety ( < 0.05); SGRQ-T [OR = 1.080, 95%CI= (1.001, 1.167)] was also an independent predictor of IPF combined with depression ( < 0.05). After treatment, GAD-7, PHQ-9, PHQ-15, and SGRQ scores decreased ( < 0.05). ΔSGRQ-T significantly affected ΔGAD-7 (β = 0.376, = 0.009) and ΔPHQ-9 (β = 0.329, = 0.022).
CONCLUSION
Anxiety and depression in IPF patients are closely related to somatic symptoms, pulmonary function, and quality of life. The SGRQ-T score is of great value for assessing anxiety and depression in patients with IPF. Short-term treatment with nintedanib antifibrotic therapy can alleviate anxiety and depression in IPF patients.
Topics: Humans; Quality of Life; Depression; Medically Unexplained Symptoms; Anxiety; Anxiety Disorders; Idiopathic Pulmonary Fibrosis; Indoles
PubMed: 38581666
DOI: 10.1080/07853890.2024.2323097 -
The American Journal of Geriatric... Apr 2021Studies on the course of depression often ignore comorbid anxiety disorders or anxiety symptoms. We explored predictors of complete remission (no depression nor anxiety...
OBJECTIVE
Studies on the course of depression often ignore comorbid anxiety disorders or anxiety symptoms. We explored predictors of complete remission (no depression nor anxiety diagnoses at follow-up) and of the course of comorbid anxiety symptoms. We additionally tested the hypothesis that the course of anxiety disorders and symptoms in depressed patients is explained by negative life-events in the presence of high neuroticism or a low sense of mastery.
METHODS
An observational study of 270 patients (≥60 years) diagnosed with major depressive disorder and 2-year follow-up data, who participated in the Netherlands Study of Depression in Older persons (NESDO). Sociodemographic, somatic, psychiatric, and treatment variables were first explored as possible predictors. A multiple logistic regression analysis was used to examine their predictive value concerning complete remission. Subsequently, negative life-events, personality and their interaction were tested as potential predictors. Linear Mixed Models were used to assess whether the personality traits modified the effect of early and recent life-events, and time and their interactions on the course of the anxiety symptoms.
RESULTS
A total of 135 of 270 patients achieved complete remission. Depressed patients with a comorbid anxiety disorder at baseline less often achieved complete remission: 38 of 103 (37.0%) versus 97 of 167 (58.1%). The severity of depressive and anxiety symptomatology, the presence of a comorbid anxiety disorder, and a poorer physical health at baseline predicted nonremission. In line with our hypothesis, a less favorable course of self-reported anxiety symptoms was associated with more recent negative life-events, but only among patients with a high level of neuroticism or a low level of mastery.
CONCLUSION
Comorbid anxiety in depression as a negative impact on complete remission at 2-year follow-up. The course of anxiety severity seems dependent on the interaction of personality traits and life-events.
Topics: Aged; Aged, 80 and over; Anxiety; Anxiety Disorders; Comorbidity; Depressive Disorder, Major; Female; Humans; Life Change Events; Male; Middle Aged; Netherlands; Neuroticism; Personality; Prognosis; Remission Induction; Self Report
PubMed: 33414001
DOI: 10.1016/j.jagp.2020.12.023 -
PeerJ 2022Nursing students are at risk of anxiety during their university education.
BACKGROUND
Nursing students are at risk of anxiety during their university education.
OBJECTIVE
To determine the psychometric characteristics of the General Anxiety Disorder (GAD-7) questionnaire in a population of university nursing students.
METHODS
A cross-sectional study was carried out with 170 students at the University of Jaen (Spain) in 2022. An online questionnaire was administered that included sociodemographic and student profile variables, the GAD-7 questionnaire, and the Goldberg anxiety subscale. An exploratory factor analysis (EFA), validation with convergence, and reliability analysis using Cronbach's were performed.
RESULTS
The EFA identified a single component that explained 63.50% of the variance. It was positively correlated with the Goldberg anxiety subscale ( = 0.653; < 0.001). A statistically significant association was observed with academic year, gender, and having experienced an anxiety crisis ( < 0.005). Internal consistency with Cronbach's was 0.903.
CONCLUSION
The GAD-7 presents appropriate psychometric characteristics for use in a university population of nursing students. It is capable of detecting symptoms and generalized anxiety disorder, making it a useful and simple tool for detecting anxiety-related problems in this population.
Topics: Humans; Patient Health Questionnaire; Students, Nursing; Cross-Sectional Studies; Reproducibility of Results; Anxiety Disorders; Surveys and Questionnaires
PubMed: 36340193
DOI: 10.7717/peerj.14296 -
The 5-HT7 receptor system as a treatment target for mood and anxiety disorders: A systematic review.Journal of Psychopharmacology (Oxford,... Dec 2023Preclinical animal and preliminary human studies indicate that 5-HT7 antagonists have the potential as a new treatment approach for mood and anxiety disorders. In this... (Review)
Review
BACKGROUND
Preclinical animal and preliminary human studies indicate that 5-HT7 antagonists have the potential as a new treatment approach for mood and anxiety disorders. In this systematic review, we aimed to review the relationship between the 5-HT7 receptor system and mood and anxiety disorders, and to explore the pharmacology and therapeutic potential of medications that target the 5-HT7 receptor for their treatment.
METHODS
Medline, Cochrane Library, EMBASE, PsycINFO databases, the National Institute of Health website Clinicaltrials.gov, controlled-trials.com, and relevant grey literature were used to search for original research articles, and reference lists of included articles were then hand searched.
RESULTS
Sixty-four studies were included in the review: 52 animal studies and 12 human studies. Studies used a variety of preclinical paradigms and questionnaires to assess change in mood, and few studies examined sleep or cognition. Forty-four out of 47 (44/47) preclinical 5-HT7 modulation studies identified potential antidepressant effects and 20/23 studies identified potential anxiolytic effects. In clinical studies, 5/7 identified potential antidepressant effects in major depressive disorder, 1/2 identified potential anxiolytic effects in generalized anxiety disorder, and 3/3 identified potential antidepressant effects in bipolar disorders.
CONCLUSION
While there is some evidence that the 5-HT7 receptor system may be a potential target for treating mood and anxiety disorders, many agents included in the review also bind to other receptors. Further research is needed using drugs that bind specifically to 5-HT7 receptors to examine treatment proof of concept further.
Topics: Animals; Humans; Anti-Anxiety Agents; Antidepressive Agents; Anxiety Disorders; Depressive Disorder, Major
PubMed: 37994803
DOI: 10.1177/02698811231211228