-
Depression and Anxiety Mar 2021Prompt Mental Health Care (PMHC, Norwegian adaption of Improving Access to Psychological Therapies) has shown effects on symptoms of anxiety and depression compared to... (Randomized Controlled Trial)
Randomized Controlled Trial
Social anxiety and agoraphobia symptoms effectively treated by Prompt Mental Health Care versus TAU at 6- and 12-month follow-up: Secondary analysis from a randomized controlled trial.
BACKGROUND
Prompt Mental Health Care (PMHC, Norwegian adaption of Improving Access to Psychological Therapies) has shown effects on symptoms of anxiety and depression compared to treatment as usual (TAU). In this secondary analysis, we examine the effectiveness of PMHC among clients presenting with symptoms of social anxiety disorder (SAD) and/or agoraphobia on core symptoms at 6- and 12-month follow-up.
METHODS
Randomized controlled trial in two PMHC sites (70:30 ratio PMHC:TAU). Of participants, 61.3% (n = 472) scored at caseness for SAD and 47.7% (n = 367) for agoraphobia (40% both). Effects on SAD avoidance and physiological discomfort (SPIN-9), SAD cognitions (ATQ-SA), agoraphobic avoidance (MIA-8), and agoraphobic cognitions (ATQ-AP) were examined in piecewise growth models.
RESULTS
The PMHC group showed substantially greater symptom reduction than the TAU group for all outcomes: At 6-month follow-up, the between-group effect sizes were d -0.60 (95% CI: -0.94 to -0.26) for SPIN-9, -0.45 (95% CI: -0.70 to -0.20) for ATQ-SA, -0.50 (95% CI: -0.87 to -0.13) for MIA-8, and -0.61 (95% CI: -0.92 to -0.31) for ATQ-AP. All effects were sustained at similar level at a 12-month follow-up.
CONCLUSION
PMHC effectively alleviated SAD and agoraphobia symptoms, and individuals struggling with such symptoms constituted a large proportion of clients. Although results should be interpreted with caution due to risk of attrition bias, they lend further support for a scale-up of PMHC and similar initiatives. Individuals struggling with SAD and/or agoraphobia stood out as relatively high burdened, whereas only one of five had sought help the last 12 months, underscoring the need for the PMHC service.
Topics: Agoraphobia; Anxiety; Anxiety Disorders; Humans; Mental Health; Norway; Treatment Outcome
PubMed: 33393688
DOI: 10.1002/da.23132 -
Cureus Aug 2023YouTube, known as an online video platform, is one of the most popular and dynamic video platforms in the world. it provides access to videos with a variety of content,...
BACKGROUND
YouTube, known as an online video platform, is one of the most popular and dynamic video platforms in the world. it provides access to videos with a variety of content, both in health and many other areas. The fact that it is accessible to everyone and free of charge makes it frequently preferred by individuals. The effectiveness of social media platforms on the thoughts and behaviors of individuals has caused YouTube and other similar platforms to be the subject of health research in recent years. Agoraphobia is an anxiety disorder characterized by an intense fear of feeling trapped somewhere. Agoraphobia is a common type of anxiety disorder in society, and cognitive behavioral and psychopharmacological agents are used in its treatment. Our aim in this research is to examine YouTube videos on agoraphobia in terms of reliability and quality.
METHODS
The first 50 videos related to agoraphobia were included in the analysis, and the duration (minutes), video content, institutions/individuals who uploaded the video, the time elapsed since uploading, total views, and likes were recorded. In addition, all videos were evaluated on two different scales: Quality Criteria for Consumer Health Information (DISCERN) and the Global Quality Scale (GQS). The obtained data were analyzed statistically.
RESULTS
The mean video duration was 11.4±9.38 minutes, the mean views count was 113299.5±333091, and the mean like count was 8512.76±31429.37. Videos were evaluated in terms of content; 50% included general information, 28% agoraphobia experience, and 22% information about overcoming agoraphobia. The GQS and DISCERN scores were significantly higher in professional videos than in non-professionals (<0.005).
CONCLUSION
As a result of the evaluation of YouTube videos about agoraphobia in terms of quality and content, it has been determined that it is necessary to increase the rate of videos prepared by mental health professionals. Psychiatrists and other healthcare professionals working in the field of anxiety should be encouraged to provide videos with scientific and reliable content.
PubMed: 37577273
DOI: 10.7759/cureus.43318 -
Behavior Therapy Jun 2012Although cognitive-behavioral treatments for panic disorder have demonstrated efficacy, a considerable number of patients terminate treatment prematurely or remain... (Review)
Review
Although cognitive-behavioral treatments for panic disorder have demonstrated efficacy, a considerable number of patients terminate treatment prematurely or remain symtpomatic. Cognitive and biobehavioral coping skills are taught to improve exposure therapy outcomes but evidence for an additive effect is largely lacking. Current methodologies used to study the augmenting effects of coping skills test the degree to which the delivery of coping skills enhances outcomes. However, they do not assess the degree to which acquisition of coping skills and their application during exposure therapy augment outcomes. We examine the extant evidence on the role of traditional coping skills in augmenting exposure for panic disorder, discuss the limitations of existing research, and offer recommendations for methodological advances.
Topics: Adaptation, Psychological; Adult; Agoraphobia; Humans; Implosive Therapy; Panic Disorder; Treatment Outcome
PubMed: 22440065
DOI: 10.1016/j.beth.2011.08.002 -
Psychiatria Danubina Sep 2015We aimed to evaluate serum ghrelin (GHR) levels and lipid profile in panic disorder (PD), with and without agoraphobia, and to compare these parameters before and after...
BACKGROUND
We aimed to evaluate serum ghrelin (GHR) levels and lipid profile in panic disorder (PD), with and without agoraphobia, and to compare these parameters before and after treatment.
SUBJECTS AND METHODS
The GHR and lipid profiles were measured in blood samples taken from 31 PD patients with agoraphobia, 22 PD patients without agoraphobia, and 53 control group subjects. 23 of the 53 patients who were prescribed 20 to 40 mg/day paroxetine had continued treatment. The 23 patients who had continued treatment were measured again at the end of twelve weeks.
RESULTS
The GHR and triglyceride (TRG), total cholesterol (Total-C), low-density lipoproteins (LDL-C), and very low-density lipoproteins (VLDL-C) levels were higher in the PD with agoraphobia group than the PD without agoraphobia and control groups. The 23 patients that had continued their treatment were re-evaluated, and the serum GHR, Total-C levels, and BMI after treatment were significantly decreased, compared to the values before treatment.
CONCLUSIONS
There may be a pathophysiological relationship between the GHR and lipid profiles that interact with each other in PD. In fact, this relationship was more marked in PD with agoraphobia than in PD without agoraphobia.
Topics: Agoraphobia; Ghrelin; Humans; Lipids; Panic Disorder; Paroxetine
PubMed: 26400133
DOI: No ID Found -
Medicine Jul 2020Agoraphobia is frequently accompanied by panic disorder and causes considerable suffering. The aim of this study was to compare clinical features and treatment courses... (Observational Study)
Observational Study
Agoraphobia is frequently accompanied by panic disorder and causes considerable suffering. The aim of this study was to compare clinical features and treatment courses between patients with and without agoraphobia in panic disorder.In this retrospective study, 87 patients with panic disorder were divided into two groups depending on the presence of agoraphobia: patients with agoraphobia (PDA, n = 41) and patients without agoraphobia (PD, n = 46). Agoraphobia subscale score of the Albany Panic and Phobia Questionnaire was used to identify correlations between agoraphobia and panic and affective symptoms.The PDA group showed more severe panic and affective symptoms than the PD group. Patients with PDA were more likely to be younger at the age of onset, take benzodiazepines for longer durations, and be treated with antipsychotics augmentation. Agoraphobia subscale was associated with panic symptoms, depression, anxiety, and the duration of benzodiazepines use.The findings suggest that patients with PDA experienced more severe panic symptoms, more profound psychiatric comorbidity, and worse illness progression than those with PD.
Topics: Adult; Agoraphobia; Benzodiazepines; Female; Humans; Male; Middle Aged; Panic Disorder; Retrospective Studies; Young Adult
PubMed: 32791758
DOI: 10.1097/MD.0000000000021414 -
BMC Psychiatry Jun 2022During the COVID-19 pandemic, internet-delivered psychotherapeutic interventions (IPI) move increasingly into the focus of attention. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
During the COVID-19 pandemic, internet-delivered psychotherapeutic interventions (IPI) move increasingly into the focus of attention.
METHOD
We reviewed 39 randomized controlled studies of IPIs with 97 study arms (n = 4122 patients) for anxiety disorders (panic disorder/agoraphobia, generalized anxiety disorder, and social anxiety disorder) and performed a meta-analysis. Most studies were conducted with cognitive behavioural approaches (iCBT). Results were compared with a previous meta-analysis examining medications and face-to-face (F2F) psychotherapy.
RESULTS
In direct comparisons, IPIs were as effective as F2F-CBT and superior to waitlist controls. Programs with more intensive therapist contact yielded higher effect sizes (ES). We compared the obtained ES with a previous comprehensive meta-analysis of 234 studies. In this comparison, iCBT was less effective than individual F2F-CBT and medications, not different from pill placebos, and more effective than psychological placebo and waitlist (p > .0001 for all comparisons). ES of IPIs may be overestimated. Treatments were only compared to waitlist, which is not a sufficient control condition. 97% of the studies were not blinded with regard to the main outcome measure. 32% of the participants received antianxiety drugs during the trials. In 89%, participants were recruited by advertisements rather than from clinical settings, and 63% of the participants had an academic background (students or university employees) which might affect the generalizability of the findings. Remote diagnoses were often made by students without completed training in psychotherapy. In only 15% of the studies, diagnoses were made in personal contact with a psychiatrist or psychologist. In 44% of the studies, the 'therapists' maintaining remote contact with the participants were mostly students without completed psychotherapy education.
CONCLUSIONS
IPIs may be a useful tool when face-to-face psychotherapy is not easily available, or as an add-on to standard psychotherapeutic or psychopharmacological treatments but should perhaps not be used as monotherapy. We have suggested standards for future research and the practical use of IPIs.
Topics: Agoraphobia; Anxiety Disorders; COVID-19; Humans; Internet; Pandemics; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 35768807
DOI: 10.1186/s12888-022-04002-1 -
British Medical Journal Nov 1974
Topics: Agoraphobia; Anti-Anxiety Agents; Benzodiazepines; Desensitization, Immunologic; Humans; Phobic Disorders; Psychosurgery; Psychotherapy
PubMed: 4154125
DOI: No ID Found -
British Medical Journal Jan 1975
Topics: Agoraphobia; Behavior Therapy; Humans; Life Style; Phobic Disorders; Psychoanalytic Therapy; Psychosurgery
PubMed: 1120241
DOI: 10.1136/bmj.1.5948.40-a -
Turk Psikiyatri Dergisi = Turkish... 2004Current diagnostic classification systems have provided reliable, objective and valid diagnoses of mental disorders. They present both categorical and dichotomous... (Review)
Review
Current diagnostic classification systems have provided reliable, objective and valid diagnoses of mental disorders. They present both categorical and dichotomous approaches to mental disorders. However, rigid usage of diagnostic criteria may cause high comorbidity rates. Moreover, these classification systems fail to identify subthreshold conditions, atypical signs and symptoms, and personality traits associated with the core symptoms of a given mental disorder. These subclinical manifestations are clinically meaningful in terms of disability and effects on quality of life. For these reasons, many researchers have begun to develop dimensional or spectral approaches for a number of mental disorders. Studies on panic disorder with or without agoraphobia have revealed a substantial clinical heterogeneity. The panic-agoraphobic spectrum concept was defined to overcome these difficulties. This concept includes DSM-IV and ICD-10 diagnostic criteria together with atypical and subthreshold symptoms of panic disorder, and constitutes a broader band of panic and agoraphobia symptoms. The panic-agoraphobic spectrum incorporates eight domains of clinical features: 1) separation sensitivity, 2) panic-like symptoms, 3) stress sensitivity, 4) medication and substance sensitivity, 5) anxious expectation, 6) agoraphobia, 7) illness phobia and hypochondriasis, 8) reassurance orientation. In this article, we reviewed the spectrum conceptualization of panic disorder and agoraphobia, particularly focusing on the domains of the panic-agoraphobic spectrum and their assessment.
Topics: Agoraphobia; Diagnostic and Statistical Manual of Mental Disorders; Humans; International Classification of Diseases; Panic Disorder; Psychiatric Status Rating Scales
PubMed: 15362006
DOI: No ID Found -
Buffalo Medical and Surgical Journal Sep 1885
PubMed: 36665728
DOI: No ID Found