CHAPTER 7. The Neurobiology of Depression and Anxiety: How Do We Change from Models of Drug Efficacy to Understanding Mood and Anxiety Disorders?

The mood and behavior of individuals result from an orchestra of many factors. Among them steroids play an important role; however, only several common hormones have been investigated in this respect. It has been demonstrated that some steroid metabolites long considered merely the products of steroid hormone metabolism in fact possess considerable activity in the CNS. For this reason we studied the steroid metabolome including 50 analytes in 20 men with depression, 20 men with anxiety and 30 healthy controls. Significant differences were found not only between controls and men with either depression or anxiety, but also between men with depression and anxiety. Particularly striking were those steroids until now not generally associated with depression or anxiety, namely conjugated steroid forms, especially sulfates.

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New Psychotherapies for Mood and Anxiety Disorders

The Canadian Journal of Psychiatry ◽

10.1177/070674371005500402 ◽

2010 ◽

Vol 55 (4) ◽

pp. 193-201 ◽

Cited By ~ 8

Author(s):

Shannon Wiltsey Stirman ◽

Katherine Toder ◽

Paul Crits-Christoph

Keyword(s):

Anxiety Disorders ◽

Stress Disorder ◽

Empirical Support ◽

Current Level ◽

Depression And Anxiety ◽

The Past ◽

Efficacy Trials ◽

Mood And Anxiety Disorders ◽

Cognitive Behavioural ◽

Initial Results

Objective: To discuss psychotherapies for depression and anxiety that have emerged in recent years and to evaluate their current level of empirical support. Method: An electronic and a manual literature search of psychotherapies for mood and anxiety disorders were conducted. Results: Five new therapies for mood disorders and 3 interventions for posttraumatic stress disorder with co-occurring substance abuse met criteria for inclusion in this review. Fewer psychotherapies have been developed for other anxiety disorders. Although research for some of the psychotherapies has demonstrated superiority to usual care, none have firmly established efficacy or specific benefits over other established psychotherapies. Conclusions: A plurality of the new psychotherapies introduced and established in the past 5 years have been different assimilations of previously established cognitive-behavioural, interpersonal, or psychodynamic models. While initial results are promising for some, more rigorous efficacy trials and replications are necessary before conclusions can be drawn regarding their relative benefits.

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Critical review of available treatment options for treatment refractory depression and anxiety - clinical and ethical dilemmas

Medicinski pregled ◽

10.2298/mpns1606171k ◽

2016 ◽

Vol 69 (5-6) ◽

pp. 171-176 ◽

Cited By ~ 2

Author(s):

Dusan Kolar ◽

Michael Kolar

Keyword(s):

Anxiety Disorders ◽

Ethical Dilemmas ◽

Treatment Options ◽

Depression And Anxiety ◽

Treatment Resistant Depression ◽

Treatment Resistant ◽

Symptoms Of Depression ◽

Mood And Anxiety Disorders ◽

Resistant Depression ◽

Treatment Refractory

Treatment-resistant mood and anxiety disorders require an intensive therapeutic approach, and it should balance benefits and adverse effects or other potential detrimental effects of medications. The goal of treatment is to provide consistent and lasting improvement in symptoms of depression and anxiety. Benzodiazepines are effective for anxiety symptoms, but with no sustained treatment effects. Other medication treatment options for anxiety disorders are outlined. Ketamine is usually very effective in treating major depressive disorder but without sustained benefits. Long-term use may pose a significant risk of developing tolerance and dependence. Stimulant medication augmentation for treatment-resistant depression is effective for residual symptoms of depression, but effects are usually short-lasting and it sounds more as an artificial way of improving energy, alertness and cognitive functioning. Synthetic cannabinoids and medical marijuana are increasingly prescribed for various medical conditions, but more recently also for patients with mood and anxiety disorders. All of these treatments may raise ethical dilemmas about appropri?ateness of prescribing these medications and a number of questions regarding the optimal treatment for patients with treatment-resistant depression and treatment refractory anxiety disorders.

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Study protocol of Diabetes LEAP: a longitudinal study examining emotional problems in adolescents with type 1 diabetes and their parents/caregivers

BMC Pediatrics ◽

10.1186/s12887-019-1743-9 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Giesje Nefs ◽

Linh Nguyen ◽

Per Winterdijk ◽

Esther Hartman ◽

Theo Sas ◽

...

Keyword(s):

Type 1 Diabetes ◽

Longitudinal Study ◽

Anxiety Disorders ◽

Self Care ◽

Emotional Problems ◽

Small Sample ◽

Depression And Anxiety ◽

Mood And Anxiety Disorders ◽

Course Of Depression

Abstract Background Type 1 diabetes (T1D) is a chronic metabolic condition requiring intensive daily self-care to avoid both high and low blood glucose levels. Self-care and glycemic outcomes are particularly problematic in adolescence, a period known for its increased risk of emotional problems. However, the true scope of mood and anxiety disorders in adolescents with T1D is unknown. Earlier studies are limited by a small sample size, lack of diagnostic interview data, a focus on depression only, non-adolescent specific estimates, lack of information about parental emotional problems and/or a cross-sectional design. Diabetes LEAP is a two-year prospective observational cohort study examining (a) the prevalence and course of depression and anxiety in adolescents with T1D and their parents/caregivers, (b) the risk factors predicting the presence of these emotional problems, (c) their longitudinal relation with diabetes outcomes, and (d) the psychosocial care currently in place. Methods Adolescents (12–18 years) from 8 Dutch pediatric diabetes clinics are interviewed using the DISC-IV to establish the presence of mood and anxiety disorders in the previous 4 weeks, the previous 12 months, and lifetime. They also complete questionnaires, including CDI-2, GAD-7, and PAID-T. Parents/caregivers complete PHQ-9, GAD-7, and PAID-PR. Follow-up assessments take place after 1 and 2 years. Discussion This longitudinal study with diagnostic interviews in a large cohort of adolescents with T1D in the Netherlands will provide much needed information regarding the prevalence and course of depression and anxiety in this group, thereby opening avenues for proper recognition, prevention and timely treatment.

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Introduction Advances in the Treatment of Mood and Anxiety Disorders

CNS Spectrums ◽

10.1017/s109285290002544x ◽

2004 ◽

Vol 9 (S4) ◽

pp. 5-5

Author(s):

Charles B. Nemeroff ◽

Mark H.B. Radford ◽

Robert N. Golden

Keyword(s):

Anxiety Disorder ◽

Anxiety Disorders ◽

Work Productivity ◽

The United States ◽

Depression And Anxiety ◽

Major Depressive ◽

Epidemiologic Research ◽

Mood And Anxiety Disorders ◽

Adult Lives ◽

Evaluation Techniques

Mood and anxiety disorders are prevalent in all countries and cultures, which becomes obvious when standardized diagnostic and evaluation techniques are utilized. It is estimated that ~450 million people worldwide suffer from psychiatric illness. In the United States alone, epidemiologic research has identified that tens of millions of Americans suffer from major depressive disorder (MDD) annually, with many of them being in the prime of their adult lives. In addition to medical, personal, and social costs, depression is also believed to have a significant impact on work productivity. Further epidemiologic research indicates that nearly half of all individuals meeting lifetime criteria for MDD also have met criteria for a comorbid anxiety disorder. With an average age of 16 years for the onset of any lifetime anxiety disorder, anxiety disorders appear to predispose affected individuals to a substantial lifetime risk for MDD. In order to improve outcomes in depression and anxiety disorders, clinicians must enhance the entire process of recognition, diagnosis, and treatment.

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Transcultural Issues in Mood and Anxiety Disorders: A Focus on Japan

CNS Spectrums ◽

10.1017/s1092852900025451 ◽

2004 ◽

Vol 9 (S4) ◽

pp. 6-13 ◽

Cited By ~ 5

Author(s):

Mark H.B. Radford

Keyword(s):

Anxiety Disorders ◽

Japanese Patients ◽

Depression And Anxiety ◽

Economic Changes ◽

Symptoms Of Depression ◽

The Past ◽

Mood And Anxiety Disorders ◽

Appropriate Treatment ◽

Methodological Problems ◽

Evaluation Techniques

AbstractAccurate comparisons of the prevalence of psychiatric disorders across Eastern and Western cultures are difficult and limited by methodological problems. Nevertheless, using standardized diagnostic and evaluation techniques, recent surveys have suggested that depression and anxiety disorders exist in all countries and cultures examined thus far, although variations in the prevalence rates and symptomatology may exist. This article discusses the influence and impact that culture can have on recognizing and treating mood and anxiety disorders, with a particular focus on Japan. Over the last 20 years, studies have consistently reported an increase in mental illness in Japan, especially symptoms of depression and anxiety. While such symptoms have had an adaptive cultural role in the past, current social and economic changes in Japan have turned any adaptive advantage into a potentially significant disadvantage, with a major impact on the capacity of individuals to function adequately. The situation is compounded by the fact that Japanese patients are reluctant to openly discuss disturbances of mood, since these are considered to be indicative of personal weakness rather than treatable medical conditions. Reluctance to discuss personal mental health hinders timely recognition and appropriate treatment.

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The gut-brain axis and microbial therapeutics

Health Science Inquiry ◽

10.29173/hsi295 ◽

2020 ◽

Vol 11 (1) ◽

pp. 127-130

Author(s):

Arthi Chinna Meyyappan

Keyword(s):

Anxiety Disorders ◽

Psychiatric Disorders ◽

Treatment Method ◽

Fecal Microbiota ◽

Personalized Treatment ◽

Depression And Anxiety ◽

Compelling Evidence ◽

Fecal Microbiota Transplant ◽

Treatment Methods ◽

Mood And Anxiety Disorders

Given the vast personal and economic burdens of psychiatric disorders, specifically mood and anxiety disorders, finding appropriate treatments for all those affected is critical. Due to the various presentations of psychiatric indications, no one treatment method is efficacious in all patients. Thus, a more personalized, but feasible treatment method is necessary for properly treating and preventing these disorders from becoming refractory and more burdensome. In recent years, there has been a growing appreciation for research in the field of the “gut-brain axis” (GBA), specifically as a target for psychiatric disorders. Researchers have found the gut to be influenced not only by similar determinants to that of psychiatric indications, but also highly modifiable using GBA treatments such as probiotics and fecal microbiota transplant (FMT). This is compelling evidence for the use of the GBA as a target for disorders such as depression and anxiety and for development of personalized treatment methods.

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Irritability in Mood and Anxiety Disorders

Irritability in Pediatric Psychopathology ◽

10.1093/med-psych/9780190846800.003.0012 ◽

2019 ◽

pp. 233-252

Author(s):

Pablo Vidal-Ribas Belil ◽

Argyris Stringaris

Keyword(s):

Bipolar Disorder ◽

Mental Disorders ◽

Anxiety Disorders ◽

Diagnostic Category ◽

Depression And Anxiety ◽

Statistical Manual ◽

Diagnostic And Statistical Manual ◽

Disruptive Mood Dysregulation Disorder ◽

Dsm 5 ◽

Mood And Anxiety Disorders

Irritability is common in children and adolescents presenting with mood and anxiety disorders and was recently introduced in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a diagnostic category under the name of disruptive mood dysregulation disorder (DMDD). The aim of this chapter is to describe the distinct phenomenology, epidemiology, and correlates of irritability in the context of bipolar disorder, DMDD, depression, and anxiety disorders. The course of irritability is episodic in bipolar disorder and depression and is commonly accompanied by elated and depressed mood, respectively. In contrast, the irritability seen in DMDD is chronic and recurrent. In anxiety disorders, the experience of irritability is usually related to the presence of the feared situation. Regardless of these differences, irritability seems to be associated with higher rates of comorbidity and greater functional impairment and may need attention in its own right.

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