Increased Prevalence of Functional Gastrointestinal Disorders in Panic Disorder: Clinical and Theoretical Implications

CNS Spectrums ◽  
2005 ◽  
Vol 10 (11) ◽  
pp. 899-908 ◽  
Author(s):  
R. Bruce Lydiard
Keyword(s):  
United States ◽  
Panic Disorder ◽  
Diagnostic Criteria ◽  
Community Sample ◽  
Functional Gastrointestinal Disorders ◽  
Significant Proportion ◽  
The United States ◽  
Gastrointestinal Disorders ◽  
Convenience Sample ◽  
Dsm Iv

ABSTRACTBackground:Functional gastrointestinal disorders (FGID) are a group of disorders characterized by recurrent gastrointestinal distress for which no structural or biochemical cause can be discerned. Irritable bowel syndrome (IBS) is an FGID estimated to affect 10% to 25% of the United States population. IBS occurs in over 40% of individuals with panic disorder, and in patients with IBS, 25% to 30% have panic disorder, which has led to speculation about possible shared pathophysiology between the two. Less is known about the prevalence of other FGID in individuals with panic disorder.Objective:The purpose of this study was to examine the prevalence of IBS and all the other FGID in patients with current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) panic disorder.Introduction:We assessed FGIDs in 73 treatment-seeking DSM-IV panic disorder patients via the Diagnostic Interview Questions for Functional Gastrointestinal Disorders and made descriptive comparisons with a large convenience sample from an already-completed United States Household Survey (USHS), which employed the same diagnostic criteria.Results:The prevalence of IBS and other FGIDs in both men and women with panic disorder were substantially higher than in the USHS respondents. Women with panic disorder had significantly more functional chest pain than men, but there was no gender difference in IBS. With the exception of functional anorectal and biliary disorders, the FGID prevalences were comparatively higher in panic disorder versus the USHS respondents.Discussion:This survey supports earlier reports of a high prevalence of IBS in individuals with panic disorder and also suggests that the prevalence of several other FGIDs were comparatively high as well. Methodological limitations precluded direct statistical analysis. It may be that commonly overlapping psychiatric and often-painful FGIDs, and extra-intestinal disorders increase the risk for comorbidity in already-affected individuals via shared pathophysiology. One potential model for which there is some evidence for a role in stress, panic disorder, FGIDs and several extra-intestinal functional conditions is dysregulation of corticotropin-releasing factor function.Conclusion:The prevalence of FGIDs in DSM-IV panic disorder was comparatively higher than in USHS respondent community sample, which used similar FGID diagnostic criteria. The cause for the apparent close association of panic disorder with FGID may represent shared pathophysiology. Increased understanding of the mechanism of the overlap may allow for improved treatment of the significant proportion of the population suffering from comorbid psychiatric and functional medical conditions.

scholarly journals Characterizing nicotine exposure among a community sample of non-daily smokers in the United States

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andréa L. Hobkirk ◽  
Vishal Midya ◽  
Nicolle M. Krebs ◽  
Sophia I. Allen ◽  
Lisa Reinhart ◽  
...  
Keyword(s):  
United States ◽  
Community Sample ◽  
Social Activity ◽  
Area Under The Curve ◽  
The United States ◽  
Intraindividual Variability ◽  
Nicotine Exposure ◽  
Individual Values ◽  
Convenience Sample ◽  
Ecological Momentary

Abstract Background Over one-quarter of all smokers in the United States identify as non-daily smokers and this number is projected to rise. Unlike daily smokers who typically maintain consistent levels of nicotine exposure with regular smoking, non-daily smokers have variable patterns of smoking that likely result in high intraindividual variability in nicotine intake. The current study aimed to characterize the weekly intraindividual variability in cotinine and identify smoking-related predictors in nondaily smokers. Methods An ecological momentary assessment of 60 non-daily smokers ages 24–57 years was conducted over a consecutive 7-day at-home protocol to log each smoking session, assessments of mood and social activity during smoking, and collection of daily saliva samples in a convenience sample from Pennsylvania, USA. Hierarchical linear regression analyses were conducted to determine the effects of smoking characteristics on total cotinine exposure measured by pharmacokinetic area under the curve and the range, maximum, and minimum cotinine values during the week controlling for demographic variables. Results The mean daily cotinine level was 119.2 ng/ml (SD = 168.9) with individual values that ranged from nondetectable to 949.6 ng/ml. Menthol predicted increased total cotinine levels (P < 0.05). Shorter time to the first cigarette of the day predicted significantly higher minimum (P < 0.05), maximum (P < 0.05), and total cotinine values (P < 0.05) after controlling for covariates. Negative emotions and social interactions with others were also significantly associated with higher cotinine metrics. There was no significant effect of the nicotine metabolite ratio. Conclusions Our findings highlight the variability in nicotine exposure across days among non-daily smokers and point to the role of smoking context in nicotine exposure. The findings suggest the need to develop better assessment methods to determine health and dependence risk and personalized cessation interventions for this heterogeneous and growing group of smokers.

scholarly journals Correlates of COVID-19 Vaccine Hesitancy among a Community Sample of African Americans Living in the Southern United States

Vaccines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 879
Author(s):  
Justin Xavier Moore ◽  
Keon L. Gilbert ◽  
Katie L. Lively ◽  
Christian Laurent ◽  
Rishab Chawla ◽  
...  
Keyword(s):  
United States ◽  
African Americans ◽  
Community Sample ◽  
The United States ◽  
Community Dwelling ◽  
Vaccine Hesitancy ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Logistic Regression Models ◽  
Sectional Analysis

In the United States, African Americans (AAs) have been disproportionately affected by COVID-19 mortality. However, AAs are more likely to be hesitant in receiving COVID-19 vaccinations when compared to non-Hispanic Whites. We examined factors associated with vaccine hesitancy among a predominant AA community sample. We performed a cross-sectional analysis on data collected from a convenience sample of 257 community-dwelling participants in the Central Savannah River Area from 5 December 2020, through 17 April 2021. Vaccine hesitancy was categorized as resistant, hesitant, and acceptant. We estimated relative odds of vaccine resistance and vaccine hesitancy using polytomous logistic regression models. Nearly one-third of the participants were either hesitant (n = 40, 15.6%) or resistant (n = 42, 16.3%) to receiving a COVID-19 vaccination. Vaccine-resistant participants were more likely to be younger and were more likely to have experienced housing insecurity due to COVID-19 when compared to both acceptant and hesitant participants, respectively. Age accounted for nearly 25% of the variation in vaccine resistance, with 21-fold increased odds (OR: 21.93, 95% CI: 8.97–5.26–91.43) of vaccine resistance in participants aged 18 to 29 compared to 50 and older adults. Housing insecurity accounted for 8% of the variation in vaccine resistance and was associated with 7-fold increased odds of vaccine resistance (AOR: 7.35, 95% CI: 1.99–27.10). In this sample, AAs under the age of 30 and those experiencing housing insecurity because of the COVID-19 pandemic were more likely to be resistant to receiving a free COVID-19 vaccination.

The Epidemiology of DSM-IV Panic Disorder and Agoraphobia in the United States

2006 ◽  
Vol 67 (03) ◽  
pp. 363-374 ◽  
Author(s):  
Bridget F. Grant ◽  
Deborah S. Hasin ◽  
Frederick S. Stinson ◽  
Deborah A. Dawson ◽  
Rise B. Goldstein ◽  
...  
Keyword(s):  
United States ◽  
Panic Disorder ◽  
The United States ◽  
Dsm Iv

Prevalence of Rome IV Functional Gastrointestinal Disorders in Children and Adolescents in the United States

2017 ◽  
Vol 152 (5) ◽  
pp. S649
Author(s):  
Russell Zwiener ◽  
Catherine Keller ◽  
Samantha Robin ◽  
Paul E. Hyman ◽  
Olafur S. Palsson ◽  
...  
Keyword(s):  
United States ◽  
Children And Adolescents ◽  
Functional Gastrointestinal Disorders ◽  
The United States ◽  
Gastrointestinal Disorders ◽  
Rome Iv

scholarly journals Functional gastrointestinal disorders in children: agreement between Rome III and Rome IV diagnoses

2021 ◽  
Author(s):  
Desiree F. Baaleman ◽  
Carlos A. Velasco-Benítez ◽  
Laura M. Méndez-Guzmán ◽  
Marc A. Benninga ◽  
Miguel Saps
Keyword(s):  
Diagnostic Criteria ◽  
Functional Dyspepsia ◽  
Functional Gastrointestinal Disorders ◽  
Functional Constipation ◽  
Final Analysis ◽  
Gastrointestinal Disorders ◽  
Rome Iii ◽  
Sample Characteristics ◽  
Irritable Bowel ◽  
Rome Iv

AbstractTo evaluate the agreement between the Rome III and Rome IV criteria in diagnosing pediatric functional gastrointestinal disorders (FGIDs), we conducted a prospective cohort study in a public school in Cali, Colombia. Children and adolescents between 11 and 18 years of age were given the Spanish version of the Questionnaire on Pediatric Functional Gastrointestinal Disorders Rome III version on day 0 and Rome IV version on day 2 (48 h later). The study protocol was completed by 135 children. Thirty-nine (28.9%) children were excluded because of not following the instructions of the questionnaire. The final analysis included data of 96 children (mean 15.2 years old, SD ± 1.7, 54% girls). Less children fulfilled the criteria for an FGID according to Rome IV compared to Rome III (40.6% vs 29.2%, p=0.063) resulting in a minimal agreement between the two criteria in diagnosing an FGID (kappa 0.34, agreement of 70%). The prevalence of functional constipation according to Rome IV was significantly lower compared to Rome III (13.5% vs 31.3%, p<0.001), whereas functional dyspepsia had a higher prevalence according to Rome IV than Rome III (11.5% vs 0%).Conclusion: We found an overall minimal agreement in diagnosing FGIDs according to Rome III and Rome IV criteria. This may be partly explained by the differences in diagnostic criteria. However, limitations with the use of questionnaires to measure prevalence have to be taken into account. What is Known:• The Rome IV criteria replaced the previous Rome III criteria providing updated criteria to diagnose functional gastrointestinal disorders (FGIDs).• Differences found between Rome IV and historic Rome III FGID prevalence may have been affected by changes in prevalence over time or differences in sample characteristics. What is New:• We found a minimal agreement between Rome III and Rome IV FGID diagnosis, especially in the diagnoses of functional constipation, irritable bowel syndrome, and functional dyspepsia.• The minimal agreement may be partly explained by changes in diagnostic criteria, but limitations with the use of questionnaires to measure prevalence have to be taken into account.

Professional values, job satisfaction, career development, and intent to stay

2016 ◽  
Vol 24 (6) ◽  
pp. 675-685 ◽  
Author(s):  
Susan Yarbrough ◽  
Pam Martin ◽  
Danita Alfred ◽  
Charleen McNeill
Keyword(s):  
United States ◽  
Job Satisfaction ◽  
Career Development ◽  
Intent To Stay ◽  
The United States ◽  
Early Career ◽  
Professional Values ◽  
Convenience Sample ◽  
Hospital System ◽  
The Future

Background: Hospitals are experiencing an estimated 16.5% turnover rate of registered nurses costing from $44,380 - $63,400 per nurse—an estimated $4.21 to $6.02 million financial loss annually for hospitals in the United States of America. Attrition of all nurses is costly. Most past research has focused on the new graduate nurse with little focus on the mid-career nurse. Attrition of mid-career nurses is a loss for the profession now and into the future. Research objective: The purpose of the study was to explore relationships of professional values orientation, career development, job satisfaction, and intent to stay in recently hired mid-career and early-career nurses in a large hospital system. Research design: A descriptive correlational study of personal and professional factors on job satisfaction and retention was conducted. Participants and research context: A convenience sample of nurses from a mid-sized hospital in a metropolitan area in the Southwestern United States was recruited via in-house email. Sixty-seven nurses met the eligibility criteria and completed survey documents. Ethical considerations: Institutional Review Board approval was obtained from both the university and hospital system. Findings: Findings indicated a strong correlation between professional values and career development and that both job satisfaction and career development correlated positively with retention. Discussion: Newly hired mid-career nurses scored higher on job satisfaction and planned to remain in their jobs. This is important because their expertise and leadership are necessary to sustain the profession into the future. Conclusion: Nurse managers should be aware that when nurses perceive value conflicts, retention might be adversely affected. The practice environment stimulates nurses to consider whether to remain on the job or look for other opportunities.

Overview of Anxiety Disorders

2018 ◽  
Author(s):  
Jon E Grant
Keyword(s):  
United States ◽  
Anxiety Disorder ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Separation Anxiety ◽  
The United States ◽  
Specific Phobia ◽  
Separation Anxiety Disorder ◽  
Generalized Anxiety ◽  
Psychosocial Impairment

Anxiety disorders are the most common psychiatric disorders among adults in the United States. Although anxiety disorders generally result in significant psychosocial impairment, most adults do not seek treatment until many years after the onset of the anxiety disorder. The treatment literature for anxiety disorder has grown tremendously since the 1980s, and both psychotherapy and medications may prove beneficial for people with anxiety disorders. This review presents a general overview of the anxiety disorders. This review contains 7 tables, and 33 references. Key words: agoraphobia, anxiety disorder, generalized anxiety disorder, panic disorder, separation anxiety disorder, social anxiety disorder, specific phobia, treatment of anxiety

Investigation and Review of Unexpected Infant and Child Deaths

PEDIATRICS ◽  
1993 ◽  
Vol 92 (5) ◽  
pp. 734-735
Author(s):  
Keyword(s):  
Public Health ◽  
United States ◽  
Child Abuse ◽  
Child Death ◽  
Significant Proportion ◽  
The United States ◽  
Medical Examiner ◽  
Sudden Infant ◽  
Child Deaths ◽  
Death Investigation

A significant proportion of infant and child deaths are preventable. Of the 55 861 deaths of children aged 14 and younger in the United States in 1989, more than three fourths occurred in children under the age of 2 years.1 Approximately one third of the latter were unexpected, including those due to sudden infant death syndrome (SIDS) or trauma, or deaths that were otherwise unexplained. Child abuse deaths occur in greatest numbers among infants, followed by those in toddlers and preschool children.2 Children younger than 6 years of age are most vulnerable to abuse because of their small size, incomplete verbal skills, and often limited contact with adults other than their primary caretakers.3 With few exceptions, throughout the United States there is no uniform system for the investigation of infant and child deaths. Many jurisdictions lack appropriately trained pathologists, interagency collaboration hat would facilitate sharing of information about the family, and a surveillance system to evaluate data regarding infant deaths. As a result, progress in the understanding of SIDS is inhibited, cases of child abuse and neglect may be missed, familial genetic diseases go undiagnosed, public health threats may be unrecognized, and inadequate medical care may be undetected. Lack of adequate infant and child death investigation is an impediment to preventing illness, injury and death of other children at risk. Adequate death investigation requires the participation of numerous individuals including medical examiner/coroner, public health officials, the patient's physician, the pathologist, and personnel from agencies involved with child welfare and social services and law enforcement.

“Why can’t I Have the Office Jobs?”: Immigrant Latinx Transgender Peoples’ Experiences with Seeking Employment

2021 ◽  
pp. 089484532110629
Author(s):  
Roberto L. Abreu ◽  
Kirsten A. Gonzalez ◽  
Louis Lindley ◽  
Cristalís Capielo Rosario ◽  
Gabriel M. Lockett ◽  
...  
Keyword(s):  
United States ◽  
Thematic Analysis ◽  
Community Sample ◽  
The United States ◽  
Disability Benefits ◽  
Structured Interviews ◽  
Future Directions ◽  
Transgender People ◽  
Job Opportunities ◽  
Positive Experiences

Research has documented the experiences of transgender people in seeking employment. To date, no scholarship has explored the experiences of immigrant Latinx transgender people seeking employment in the United States. Using an intersectionality framework, the present study aimed to uncover the experiences of immigrant Latinx transgender people as they sought employment in the United States. A community sample of 18 immigrant Latinx transgender people from a large metropolitan city in Florida engaged in semi-structured interviews. Thematic analysis revealed five themes related to participants’ experiences seeking employment, including: (1) discrimination, (2) limited options, (3) positive experiences, (4) momentary de-transition, and (5) disability benefits as financial relief. Future directions such as exploring ways in which immigrant Latinx transgender people resist discrimination while seeking job opportunities are discussed. Implications for practice and advocacy such as advocating for equitable employment policies that acknowledge the intersectional experiences of this community are presented.

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