Emotion-modulated startle in anxiety disorders is blunted by co-morbid depressive episodes

2010 ◽  
Vol 41 (1) ◽  
pp. 129-139 ◽  
Author(s):  
A. Taylor-Clift ◽  
B. H. Morris ◽  
J. Rottenberg ◽  
M. Kovacs
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Depressive Episode ◽  
Emotional Reactivity ◽  
Depressive Disorders ◽  
Late Onset ◽  
Response Patterns ◽  
Emotional Responding ◽  
Depressive Episodes ◽  
A Current

BackgroundWhile anxiety has been associated with exaggerated emotional reactivity, depression has been associated with blunted, or context insensitive, emotional responding. Although anxiety and depressive disorders are frequently co-morbid, surprisingly little is known about emotional reactivity when the two disorders co-occur.MethodWe utilized the emotion-modulated startle (EMS) paradigm to examine the effects of a concurrent depressive episode on emotional reactivity in young adults with anxiety disorders. Using an archival dataset from a multi-disciplinary project on risk factors in childhood-onset depression, we examined eye-blink startle reactions to late-onset auditory startle probes while participants viewed pictures with affectively pleasant, unpleasant and neutral content. EMS response patterns were analyzed in 33 individuals with a current anxiety (but no depressive) disorder, 24 individuals with a current anxiety disorder and co-morbid depressive episode and 96 healthy controls.ResultsControl participants and those with a current anxiety disorder (but no depression) displayed normative linearity in startle responses, including potentiation by unpleasant pictures. By contrast, individuals with concurrent anxiety and depression displayed blunted EMS.ConclusionsAn anxiety disorder concurrent with a depressive episode is associated with reactivity that more closely resembles the pattern of emotional responding that is typical of depression (i.e. context insensitive) rather than the pattern that is typical for anxiety (i.e. exaggerated).

Suicide Risk in Outpatients with Specific Mood and Anxiety Disorders

Crisis ◽  
2003 ◽  
Vol 24 (3) ◽  
pp. 105-112 ◽  
Author(s):  
Andrea P. Chioqueta ◽  
Tore C. Stiles
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Depressive Episode ◽  
Suicide Risk ◽  
Depressive Disorders ◽  
Major Depressive Episode ◽  
Suicide Ideation ◽  
Anxiety Symptoms ◽  
Major Depressive ◽  
Special Relevance

Summary: The present study examined the relationships between specific anxiety, mood disorders, levels of hopelessness, and suicide ideation. The sample consisted of 606 outpatients recruited from several psychiatric settings. It was found that dysthymia was significantly associated with hopelessness. Patients presenting major depressive episode with higher anxiety symptoms had significantly increased scores on the hopelessness scale. Major depressive episode and bipolar disorder, but not dysthymia, were significantly associated with higher levels of suicide ideation. Increased levels of anxiety symptoms in patients with dysthymia were associated with increased levels of suicide ideation, while increased depressive symptoms in patients with specific phobia and generalized anxiety disorder were associated with significantly lower levels of suicide ideation. The findings suggest that depressive disorders, but not anxiety disorders, constitute risk for suicide. Moreover, the differentiation between a depressive and an anxiety disorder as the principal diagnosis, as well as the assessment of anxiety-level symptoms in patients with major depressive episode and dysthymia, seems of special relevance when assessing suicide risk.

Rates of Depressive and Anxiety Disorders in a Residential Mother–Infant Unit for Unsettled Infants

2007 ◽  
Vol 41 (10) ◽  
pp. 836-842 ◽  
Author(s):  
Jane Phillips ◽  
Louise Sharpe ◽  
Stephen Matthey
Keyword(s):  
Anxiety Disorder ◽  
Major Depression ◽  
Anxiety Disorders ◽  
Psychiatric Morbidity ◽  
Depression Scale ◽  
Self Report ◽  
Not Otherwise Specified ◽  
History Of ◽  
A Current ◽  
Infant Behaviour

Objective: Depression and anxiety are known to be common among women presenting to residential mother–infant programmes for unsettled infant behaviour but most studies have used self-report measures of psychological symptomatology rather than diagnostic interviews to determine psychiatric diagnoses. The aim of the present study was to determine rates of depressive and anxiety disorders and rates of comorbidity among clients of the Karitane residential mother–infant programme for unsettled infant behaviour. Method: One hundred and sixty women with infants aged 2 weeks–12 months completed the Edinburgh Postnatal Depression Scale and were interviewed for current and lifetime history of depressive and anxiety disorders using the Structured Clinical Interview for DSM-IV diagnosis (Research version). Results: A total of 25.1% of the sample met criteria for a current diagnosis of major depression, 31.7% had met criteria for major depression since the start of the pregnancy, and 30.5% of clients met criteria for a current anxiety disorder. Of note were the 21.6% who met criteria for generalized anxiety disorder or anxiety disorder not otherwise specified (worry confined to the topics of the baby or being a mother). High levels of comorbidity were confirmed in the finding that 60.8% of those with an anxiety disorder had experienced major or minor depression since the start of their pregnancy and 46.3% of those who had experienced depression since the start of their pregnancy also met criteria for a current anxiety disorder. Conclusions: There are high levels of psychiatric morbidity among clients attending residential mother–infant units for unsettled infant behaviour, highlighting the importance of providing multifaceted interventions in order to address both infant and maternal psychological issues.

scholarly journals A study on prevalence and co-morbidity of bipolar and anxiety disorders in chronic headache patients

2017 ◽  
Vol 5 (7) ◽  
pp. 3038 ◽  
Author(s):  
Sivaji M. ◽  
Manickavasagam J. ◽  
Indumathi Sundaramurthi ◽  
Gopinathan S.
Keyword(s):  
Anxiety Disorder ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Psychiatric Disorders ◽  
Depressive Episode ◽  
Chronic Headache ◽  
Rating Scale ◽  
Separation Anxiety Disorder ◽  
Co Morbidity ◽  
Headache Patients

Background: Co morbidity between headache and psychiatric disorders is more prevalent in chronic headache patients. The bipolar disorders and anxiety disorders are predominant in migraine and TTH respectively. This co morbidities have a poor reflection and impact on quality and outcome of chronic headache patients and results in worst prognosis and poor response to medical treatment.Methods: The chronic headache patients especially migraine and tension type of headache were analyzed with following materials such as the structured psychiatric clinical interview with ICD-10 mental and behavioural disorder, DSM-5 criteria. HAM-A, HAM-D, BDI-2, BPRS, young mania rating scale, Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and panic disorder scale.Results: Various subsets of bipolar disorder and anxiety disorder were found as follows: 74% of migraineurs are associated with psychiatric disorders in which bipolar affective disorder 6%, depressive episode 48%, dysthymia 30%, GAD 10% and Panic disorder 6%. 52% of TTH are associated with psychiatric disorders as follows: major depressive episode 52%, GAD 30%, separation anxiety disorder 6%, PTSD 7%, OCD 3% and panic disorder 2%.Conclusions: From previous and future studies the headache can be identified according to subsets of headache with psychiatric disorders make easier to provide appropriate pharmacological and psychological treatment which may reduce the chronicity and intractability of headache.

Dimensional anxiety scales for DSM-5: Sensitivity to clinical severity

2013 ◽  
Vol 28 (7) ◽  
pp. 448-456 ◽  
Author(s):  
S. Knappe ◽  
J. Klotsche ◽  
A. Strobel ◽  
R.T. LeBeau ◽  
M.G. Craske ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Depressive Disorders ◽  
Specific Phobia ◽  
Panic Attacks ◽  
Clinical Severity ◽  
Global Functioning ◽  
Clinical Sensitivity ◽  
Dsm 5 ◽  
Wide Range

AbstractPurposePsychometric properties and clinical sensitivity of brief self-rated dimensional scales to supplement categorical diagnoses of anxiety disorders in the DSM-5 were recently demonstrated in a German treatment seeking sample of adults. The present study aims to demonstrate sensitivity of these scales to clinical severity levels.MethodsThe dimensional scales were administered to 102 adults at a university outpatient clinic for psychotherapy. Diagnostic status was assessed using the Munich-Composite International Diagnostic Interview. To establish a wide range of clinical severity, we considered subthreshold (n= 83) and threshold anxiety disorders (n= 49, including Social Phobia, Specific Phobia, Agoraphobia, Panic Disorder, and Generalized Anxiety Disorder).ResultsIndividuals with either subthreshold or threshold anxiety disorder scored higher on all dimensional scales relative to individuals without anxiety. In addition, individuals with a threshold anxiety disorder scored higher on the dimensional scales than individuals with a subthreshold anxiety disorder (except for specific phobia). Disorder-related impairment ratings, global functioning assessments and number of panic attacks were associated with higher scores on dimensional scales. Findings were largely unaffected by the number of anxiety disorders and comorbid depressive disorders.ConclusionThe self-rated dimensional anxiety scales demonstrated sensitivity to clinical severity, and a cut-off based on additional assessment of impairment and distress may assist in the discrimination between subthreshold and threshold anxiety disorders. Findings suggest further research in various populations to test the utility of the scales for use in DSM-5.

scholarly journals What happens to anxiety disorders in later life?

2002 ◽  
Vol 24 (suppl 1) ◽  
pp. 74-80 ◽  
Author(s):  
Gerard JA Byrne
Keyword(s):  
Anxiety Disorders ◽  
Older People ◽  
Older Patients ◽  
Depressive Disorders ◽  
Late Onset ◽  
Reliability And Validity ◽  
Later Life ◽  
Pharmacological Interventions ◽  
Measuring Change ◽  
Pathological Anxiety

Anxiety disorders decline in prevalence with advancing age but remain more common than depressive disorders. They are often of late-onset and there is frequent comorbidity with depressive disorders and physical illness. While anxiety disorders in older people are likely to respond to the same non-pharmacological interventions that have been shown to work in younger people, there is currently little formal evidence of this. Although there is some evidence that the non-benzodiazepine anxiolytic medication, buspirone, is effective against late life anxiety symptoms, clinical trials in older people with rigorously diagnosed anxiety disorders are needed. An anxiety scale with demonstrated reliability and validity in older people is needed for screening for pathological anxiety and for measuring change in older patients undergoing treatment for anxiety disorders.

Diagnosis and Epidemiology of Anxiety, Obsessive-Compulsive, and Trauma and Stressor-Related Disorders

2017 ◽  
Author(s):  
Murray B. Stein ◽  
Meghan E. Keough ◽  
Peter P. Roy-Byrne
Keyword(s):  
Systematic Review ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Depressive Disorders ◽  
Obsessive Compulsive ◽  
Prevalence Studies ◽  
Current Prevalence ◽  
The World ◽  
Heavy Burden ◽  
Dsm Iv

The anxiety, obsessive-compulsive, and trauma- and stressor-related disorders are, together, the most common class of mental disorders. From a systematic review of prevalence studies across 44 countries, the global current prevalence for the DSM IV anxiety disorders was estimated at 7.3% (95% CI 4.8%–10.9%), suggesting that one in 14 people around the world at any given time has an anxiety disorder. Women are approximately twice as likely as men to have an anxiety disorder. Anxiety disorders are a substantial contributor to the heavy burden of disease conveyed by mental and substance use disorders worldwide, where they are second only to depressive disorders in years-lost-to-disabilility.

Systematic Review and Meta-Analysis of Anxiety and Depression in Youth With Epilepsy

2020 ◽  
Vol 45 (2) ◽  
pp. 133-144 ◽  
Author(s):  
Amelia J Scott ◽  
Louise Sharpe ◽  
Max Loomes ◽  
Milena Gandy
Keyword(s):  
Systematic Review ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Control Sample ◽  
Separation Anxiety Disorder ◽  
Anxiety And Depression ◽  
Healthy Controls ◽  
Pooled Prevalence

Abstract Objective The aim of this systematic review and meta-analysis was to provide an estimate of the prevalence of anxiety and depressive disorders in youth with epilepsy (YWE). It also aimed to calculate the overall magnitude of observed differences in anxiety and depressive symptoms reported by YWE compared with healthy controls and investigate whether any factors moderated anxiety and depression outcomes in YWE. Methods Following prospective registration, electronic databases were searched up until October 2018. Studies were included if they reported on the rate of anxiety or depression in samples of YWE, and/or if they used valid measures of anxious or depressive symptomatology in YWE compared with a healthy control sample. Results Twenty-three studies met inclusion criteria. The overall pooled prevalence of anxiety disorders in YWE was 18.9% (95% confidence interval [CI] 12.0%–28.5%), and for depression the pooled prevalence was 13.5% (95% CI 8.8%–20.2%). In samples of YWE compared with healthy controls, significantly higher anxiety (d = 0.57, 95% CI 0.32–0.83, p < .000) and depressive (d = 0.42, 95% CI 0.16–0.68, p < .000) symptomatology was reported. Conclusions YWE report anxiety and depressive disorders and symptoms to a significantly higher degree than youth without epilepsy. There is also evidence that certain anxiety disorders (e.g. generalized anxiety disorder, separation anxiety disorder) are particularly elevated, perhaps reflecting the unique impact of epilepsy on youth psychopathology. Research is needed to understand the risk factors associated with anxiety and depressive disorders in epilepsy, and better understand how these symptoms change across development.

scholarly journals Affect fluctuations examined with ecological momentary assessment in patients with current or remitted depression and anxiety disorders

2020 ◽  
pp. 1-10 ◽  
Author(s):  
R. A. Schoevers ◽  
C. D. van Borkulo ◽  
F. Lamers ◽  
M.N. Servaas ◽  
J. A. Bastiaansen ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Ecological Momentary Assessment ◽  
Affect Regulation ◽  
Depression And Anxiety ◽  
Remitted Depression ◽  
Ecological Momentary ◽  
Ema Data ◽  
Momentary Assessment ◽  
A Current

Abstract Background There is increasing interest in day-to-day affect fluctuations of patients with depressive and anxiety disorders. Few studies have compared repeated assessments of positive affect (PA) and negative affect (NA) across diagnostic groups, and fluctuation patterns were not uniformly defined. The aim of this study is to compare affect fluctuations in patients with a current episode of depressive or anxiety disorder, in remitted patients and in controls, using affect instability as a core concept but also describing other measures of variability and adjusting for possible confounders. Methods Ecological momentary assessment (EMA) data were obtained from 365 participants of the Netherlands Study of Depression and Anxiety with current (n = 95), remitted (n = 178) or no (n = 92) DSM-IV defined depression/anxiety disorder. For 2 weeks, five times per day, participants filled-out items on PA and NA. Affect instability was calculated as the root mean square of successive differences (RMSSD). Tests on group differences in RMSSD, within-person variance, and autocorrelation were performed, controlling for mean affect levels. Results Current depression/anxiety patients had the highest affect instability in both PA and NA, followed by remitters and then controls. Instability differences between groups remained significant when controlling for mean affect levels, but differences between current and remitted were no longer significant. Conclusions Patients with a current disorder have higher instability of NA and PA than remitted patients and controls. Especially with regard to NA, this could be interpreted as patients with a current disorder being more sensitive to internal and external stressors and having suboptimal affect regulation.

Systematic review of the outcome of anxiety and depressive disorders

1998 ◽  
Vol 173 (S34) ◽  
pp. 35-41 ◽  
Author(s):  
J. Emmanuel ◽  
S. Simmonds ◽  
P. Tyrer
Keyword(s):  
Systematic Review ◽  
Anxiety Disorder ◽  
Clinical Outcome ◽  
Anxiety Disorders ◽  
Strong Evidence ◽  
Depressive Disorders ◽  
Medline Search ◽  
Diagnostic Categories ◽  
The Past ◽  
Standard Procedures

Background Although there have been many changes in the diagnosis of anxiety and depressive disorders in the past 20 years there have been few comparative enquiries into the clinical outcome of greater diagnostic categories. We therefore compared the outcome of all studies which compared the outcome of specific anxiety and depressive disorders using the standard procedures of systematic review.Method A Medline search was carried out of all studies comparing the outcome of anxiety and depressive disorders or mixed anxiety-depressive disorders in which information was available separately for each disorder.Results Eight studies satisfied the search criteria (all involving a period of observation of two years or greater); only one of these included randomisation of treatment and comparison between specific anxiety disorder outcome. There was a somewhat better outcome in patients with depressive disorders compared with anxiety ones, and strong evidence that both anxiety and depressive disorders singly had better outcomes than comorbid mixed disorders.Conclusion Comorbid anxiety-depressive disorders have a poor outcome compared with single anxiety and depressive disorders, and there is some evidence that anxiety disorders have a worse outcome than depressive ones.

Disorders of the anxiety-depressive spectrum in patients with rheumatic diseases

2021 ◽  
Vol 6 (4) ◽  
pp. 18-22
Author(s):  
A. Fleyshman
Keyword(s):  
Chronic Pain ◽  
Anxiety Disorder ◽  
Rheumatic Diseases ◽  
Depressive Disorders ◽  
Anxiety And Depression ◽  
Clinical Psychologist ◽  
Generalized Anxiety ◽  
Autoimmune Rheumatic Diseases ◽  
Somatic Diseases ◽  
Depressive Episodes

Anxiety and depressive disorders play an important role not only as independent diseases, but also as conditions that occur against the background of other somatic diseases. In the practice of a rheumatologist, patients with anxiety and depression are a frequent occurrence. In patients with autoimmune rheumatic diseases, anxiety and depressive disorders are 7-15 times more common than in the general population. The main cause of depression in rheumatology is the presence of severe and chronic pain. Studies show that in patients with rheumatic diseases, as a rule, the following disorders of the anxiety-depressive spectrum of RTDS are detected: depressive episodes of various severity with concomitant anxiety, dysthymia, generalized anxiety disorder. Taking into account the peculiarities of diseases, the supervision of patients with anxiety and depressive disorders should be carried out by several specialists, namely a rheumatologist, a psychiatrist, a clinical psychologist. Therapy of anxiety and depressive disorders, in addition to drugs aimed at the main rheumatic disease, must also include drugs with antidepressant and anxiolytic properties (neuroleptics, antidepressants).

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