scholarly journals Impact of the COVID-19 pandemic on patients with pre-existing anxiety disorders attending secondary care

2020 ◽  
pp. 1-9 ◽  
Author(s):  
R. Plunkett ◽  
S. Costello ◽  
M. McGovern ◽  
C. McDonald ◽  
B Hallahan
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Social Impact ◽  
International Classification Of Diseases ◽  
Anxiety Symptoms ◽  
Social Impairment ◽  
Structured Interviews ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
The Impact

Objectives To examine the psychological and social impact of the COVID-19 pandemic on patients with established anxiety disorders during a period of stringent mandated social restrictions. Methods Semi-structured interviews were conducted with 30 individuals attending the Galway-Roscommon Mental Health Services with an International Classification of Diseases diagnosis of an anxiety disorder to determine the impact of the COVID-19 restrictions on anxiety and mood symptoms, social and occupational functioning and quality of life. Results Twelve (40.0%) participants described COVID-19 restrictions as having a deleterious impact on their anxiety symptoms. Likert scale measurements noted that the greatest impact of COVID-19 related to social functioning (mean = 4.5, SD = 2.9), with a modest deleterious effect on anxiety symptoms noted (mean = 3.8, SD = 2.9). Clinician rated data noted that 8 (26.7%) participants had disimproved and 14 (46.7%) participants had improved since their previous clinical review, prior to commencement of COVID-19 restrictions. Conditions associated with no ‘trigger’, such as generalised anxiety disorder, demonstrated a non-significant increase in anxiety symptoms compared to conditions with a ‘trigger’, such as obsessive compulsive disorder. Psychiatric or physical comorbidity did not substantially impact on symptomatology secondary to COVID-19 mandated restrictions. Conclusions The psychological and social impact of COVID-19 restrictions on individuals with pre-existing anxiety disorders has been modest with only minimal increases in symptomatology or social impairment noted.

Sex Differences in Anxiety Disorders

2019 ◽  
pp. 404-432
Author(s):  
Teresa A. Piggott ◽  
Alexandra N. Duran ◽  
Isha Jalnapurkar ◽  
Tyler Kimm ◽  
Stephanie Linscheid ◽  
...  
Keyword(s):  
Sex Differences ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Stress Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Considerable Research ◽  
Psychosocial Influences ◽  
Psychiatric Conditions ◽  
The Impact

Women are more likely than men to meet lifetime criteria for an anxiety disorder. Moreover, anxiety is a risk factor for the development of other psychiatric conditions, including major depression. Numerous studies have identified evidence of sex differences in anxiety disorders, and there is considerable research concerning factors that may contribute to vulnerability for anxiety in females. In addition to psychosocial influences, biological components such as the female reproductive hormone cycle have also been implicated. Although psychotropic medication is more likely to be prescribed to women, there is little controlled data available concerning sex differences in the efficacy and/or tolerability of pharmacotherapy in anxiety disorders. This chapter provides an overview of the impact of gender in the epidemiology, phenomenology, course, and treatment response in generalized anxiety disorder (GAD), social anxiety disorder (SAD), posttraumatic stress disorder (PTSD), panic disorder (PD), and obsessive-compulsive disorder (OCD).

scholarly journals The association of personality disorders with the prospective 7-year course of anxiety disorders

2010 ◽  
Vol 41 (5) ◽  
pp. 1019-1028 ◽  
Author(s):  
E. B. Ansell ◽  
A. Pinto ◽  
M. O. Edelen ◽  
J. C. Markowitz ◽  
C. A. Sanislow ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Personality Disorders ◽  
Prognostic Significance ◽  
Post Traumatic Stress ◽  
Structured Interviews ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

BackgroundThis study prospectively examined the natural clinical course of six anxiety disorders over 7 years of follow-up in individuals with personality disorders (PDs) and/or major depressive disorder. Rates of remission, relapse, new episode onset and chronicity of anxiety disorders were examined for specific associations with PDs.MethodParticipants were 499 patients with anxiety disorders in the Collaborative Longitudinal Personality Disorders Study, who were assessed with structured interviews for psychiatric disorders at yearly intervals throughout 7 years of follow-up. These data were used to determine probabilities of changes in disorder status for social phobia (SP), generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic disorder and panic disorder with agoraphobia.ResultsEstimated remission rates for anxiety disorders in this study group ranged from 73% to 94%. For those patients who remitted from an anxiety disorder, relapse rates ranged from 34% to 67%. Rates for new episode onsets of anxiety disorders ranged from 3% to 17%. Specific PDs demonstrated associations with remission, relapse, new episode onsets and chronicity of anxiety disorders. Associations were identified between schizotypal PD with course of SP, PTSD and GAD; avoidant PD with course of SP and OCD; obsessive-compulsive PD with course of GAD, OCD, and agoraphobia; and borderline PD with course of OCD, GAD and panic with agoraphobia.ConclusionsFindings suggest that specific PD diagnoses have negative prognostic significance for the course of anxiety disorders underscoring the importance of assessing and considering PD diagnoses in patients with anxiety disorders.

scholarly journals Service-user efforts to maintain their wellbeing during and after successful withdrawal from antipsychotic medication

2021 ◽  
Vol 11 ◽  
pp. 204512532198913
Author(s):  
Miriam Larsen-Barr ◽  
Fred Seymour
Keyword(s):  
Antipsychotic Medication ◽  
Online Survey ◽  
Structured Interviews ◽  
Obsessive Compulsive ◽  
Convenience Sample ◽  
Internal Resources ◽  
Compulsive Disorder ◽  
What Works ◽  
Systemic Factors ◽  
The Impact

Background: It is well-known that attempting antipsychotic withdrawal can be a fraught process, with a high risk of relapse that often leads people to resume the medication. Nonetheless, there is a group of people who appear to be able to discontinue successfully. Relatively little is known about how people do this. Methods: A convenience sample of adults who had stopped taking antipsychotic medication for more than a year were recruited to participate in semi-structured interviews through an anonymous online survey that investigated antipsychotic medication experiences in New Zealand. Thematic analysis explored participant descriptions of their efforts to maintain their wellbeing during and after the withdrawal process. Results: Of the seven women who volunteered to participate, six reported bipolar disorder diagnoses and one reported diagnoses of obsessive compulsive disorder and depression. The women reported successfully discontinuing antipsychotics for 1.25–25 years; six followed a gradual withdrawal method and had support to prepare for and manage this. Participants defined wellbeing in terms of their ability to manage the impact of any difficulties faced rather than their ability to prevent them entirely, and saw this as something that evolved over time. They described managing the process and maintaining their wellbeing afterwards by ‘understanding myself and my needs’, ‘finding what works for me’ and ‘connecting with support’. Sub-themes expand on the way in which they did this. For example, ‘finding what works for me’ included using a tool-box of strategies to flexibly meet their needs, practicing acceptance, drawing on persistence and curiosity and creating positive life experiences. Conclusion: This is a small, qualitative study and results should be interpreted with caution. This sample shows it is possible for people who experience mania and psychosis to successfully discontinue antipsychotics and safely manage the impact of any symptoms that emerge as a result of the withdrawal process or other life stressors that arise afterwards. Findings suggest internal resources and systemic factors play a role in the outcomes observed among people who attempt to stop taking antipsychotics and a preoccupation with avoiding relapse may be counterproductive to these efforts. Professionals can play a valuable role in facilitating change.

TMS in the study and treatment of anxiety disorders

2012 ◽  
Author(s):  
Benjamin Greenberg ◽  
Sarah H. Lisanby
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Therapeutic Effects ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Systematic Testing ◽  
Compulsive Disorder ◽  
Current State ◽  
Post Traumatic ◽  
Disorder Treatment

A few studies of transcranial magnetic stimulation (TMS) as an anxiety disorder treatment have been reported. In treatment studies, the focal application of TMS in the treatment of anxiety disorders has been guided by the present understanding of the neurocircuitry underlying these disorders. This article reviews the current state of the literature on the uses of TMS in the study and treatment of anxiety disorders, and discusses the implications for understanding their patho-etiology. Investigation of the possible therapeutic effects of repetitive TMS in obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), or any anxiety disorder remains at a preliminary stage. There have been promising initial observations in OCD, which require systematic testing in controlled studies. As far as PTSD is concerned, the available data suggest that additional TMS work is required. The observations need to be replicated in controlled settings to determine whether this approach will have value in treating anxiety disorders.

scholarly journals Comparative Prevalence of Eating Disorders in Obsessive-Compulsive Disorder and Other Anxiety Disorders

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Himanshu Tyagi ◽  
Rupal Patel ◽  
Fabienne Rughooputh ◽  
Hannah Abrahams ◽  
Andrew J. Watson ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Geographical Area ◽  
Primary Diagnosis ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Significant Difference

Objective. The purpose of this study was to compare the prevalence of comorbid eating disorders in Obsessive-Compulsive Disorder (OCD) and other common anxiety disorders.Method. 179 patients from the same geographical area with a diagnosis of OCD or an anxiety disorder were divided into two groups based on their primary diagnosis. The prevalence of a comorbid eating disorder was calculated in both groups.Results. There was no statistically significant difference in the prevalence of comorbid eating disorders between the OCD and other anxiety disorders group.Conclusions. These results suggest that the prevalence of comorbid eating disorders does not differ in anxiety disorders when compared with OCD. However, in both groups, it remains statistically higher than that of the general population.

Anxiety disorders and the onset of depression among adults in the community

2002 ◽  
Vol 32 (6) ◽  
pp. 1121-1124 ◽  
Author(s):  
RENEE D. GOODWIN
Keyword(s):  
Anxiety Disorder ◽  
Major Depression ◽  
Anxiety Disorders ◽  
Panic Attack ◽  
Panic Attacks ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Sociodemographic Differences ◽  
Co Morbidity

Objective. To determine the association between anxiety disorders, panic attack and the risk of major depression among adults in the community.Method. Data were drawn from the Epidemiologic Catchment Area Program survey waves 1 (N = 20291) and 2 (N = 15849). Multivariate logistic regression analyses were used to determine the risk of incident major depression at 12-month follow-up (wave 2) associated with each anxiety disorder and panic attacks assessed at wave 1, adjusting for differences in sociodemographic characteristics, and then controlling simultaneously for all anxiety disorders, and other psychiatric co-morbidity.Results. Specific phobia (OR = 1.7 (1.6, 1.8)), agoraphobia (OR = 2.3 (2.2, 2.5)), obsessive–compulsive disorder (OR = 5.4 (5.0, 5.8)) and panic attack (OR = 1.9 (1.8, 2.1)) each made an independent contribution to the risk of major depression, which persisted after adjusting simultaneously for sociodemographic differences and other psychiatric co-morbidity. Conclusions. Each anxiety disorder and panic attacks appear to confer an independent risk for the onset of major depression within 12-months among adults in the community. Understanding the key role played by anxiety in depression onset is needed for prevention strategies.

Anxiety Disorders

2017 ◽  
Author(s):  
Ambreen Ghori ◽  
Aarti Gupta
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Body Dysmorphic Disorder ◽  
Stress Disorder ◽  
Acute Stress ◽  
Medical Condition ◽  
Generalized Anxiety ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
General Medical Condition

This chapter reviews topics on anxiety disorders including panic disorder, specific phobia, social anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, acute stress disorder, generalized anxiety disorder, anxiety disorder due to a general medical condition, Substance/medication-induced anxiety disorder and body dysmorphic disorder

Procedural validity of the computerized version of the Composite International Diagnostic Interview (CIDI-Auto) in the anxiety disorders

1995 ◽  
Vol 25 (6) ◽  
pp. 1269-1280 ◽  
Author(s):  
Lorna Peters ◽  
Gavin Andrews
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Major Depressive Episode ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Obsessive Compulsive ◽  
Major Depressive ◽  
Lower Range ◽  
Compulsive Disorder ◽  
Level Of Agreement

SynopsisThe procedural validity of the computerized version of the Composite International Diagnostic Interview (CIDI-Auto) was examined against the consensus diagnoses of two clinicians for six anxiety disorders (agoraphobia, panic disorder (±agoraphobia), social phobia, simple phobia, obsessive compulsive disorder (OCD), generalized anxiety disorder (GAD) and major depressive episode (MDE)). Clinicians had available to them all data obtained over a 2- to 10-month period. Subjects were 98 patients accepted for treatment at an Anxiety Disorders Clinic, thus, all subjects had at least one of the diagnoses being examined. While the CIDI-Auto detected 88·2% of the clinician diagnoses, it identified twice as many diagnoses as did the clinicians. The sensitivity of the CIDI-Auto was above 0·85 except for GAD, which had a sensitivity of 0·29. The specificity of the CIDI-Auto was lower (range: 0·47–0·99). The agreement between the CIDI-Auto and the clinician diagnoses, as measured by intraclass kappas, ranged from poor (k = 0·02; GAD) to excellent (k = 0·81; OCD), with a fair level of agreement overall (k = 0·40). Canonical correlation analysis suggested that the discrepancies between the CIDI-Auto and clinicians were not due to different diagnostic distinctions being made. It is suggested that the CIDI-Auto may have a lower threshold for diagnosing anxiety disorders than do experienced clinicians. It is concluded that, in a sample where all subjects have at least one anxiety disorder diagnosis, the CIDI-Auto has acceptable validity.

Ketamine’s dose-related effects on anxiety symptoms in patients with treatment refractory anxiety disorders

2017 ◽  
Vol 31 (10) ◽  
pp. 1302-1305 ◽  
Author(s):  
Paul Glue ◽  
Natalie J Medlicott ◽  
Sarah Harland ◽  
Shona Neehoff ◽  
Bridie Anderson-Fahey ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Post Traumatic Stress ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Post Traumatic ◽  
Resistant Depression

The N-methyl-D-aspartate receptor antagonist ketamine has rapid onset activity in treatment-resistant depression, post-traumatic stress disorder and obsessive compulsive disorder. Due to similarities in brain network activity in depression and anxiety disorders, we hypothesized that ketamine might also be active in other refractory anxiety disorders. We evaluated the efficacy and safety of ketamine in 12 patients with refractory generalized anxiety disorder and/or social anxiety disorder who were not currently depressed, using an ascending single dose study design (0.25, 0.5, 1 mg/kg administered subcutaneously) at weekly intervals. Within 1 h of dosing, patients reported reduced anxiety, which persisted for up to seven days. A dose-response profile was noted for anxiolytic effects, dissociative side effects, and changes in blood pressure and heart rate, with minor changes at 0.25 mg/kg, and progressively greater and more durable changes at the higher doses. Ten of 12 patients were treatment responders at 0.5–1 mg/kg. Ketamine was safe and well tolerated in this population. Ketamine may be a potential therapeutic alternative for patients with refractory generalized anxiety disorder/social anxiety disorder. Along with its demonstrated effectiveness in patients with treatment-resistant depression, obsessive compulsive disorder and post-traumatic stress disorder, these data raise the intriguing possibility that ketamine may have broad efficacy in disorders characterized by negative emotional states, and that these disorders may share a common precipitating neurobiology.

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