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.

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.

scholarly journals Cognitive behavioral therapy in anxiety disorders: current state of the evidence

2011 ◽  
Vol 13 (4) ◽  
pp. 413-421 ◽  
Keyword(s):  
Anxiety Disorder ◽  
Cognitive Behavioral Therapy ◽  
Anxiety Disorders ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Current State ◽  
Meta Analyses

A plethora of studies have examined the efficacy and effectiveness of cognitive-behavioral therapy (CBT) for adult anxiety disorders. In recent years, several meta-analyses have been conducted to quantitatively review the evidence of CBT for anxiety disorders, each using different inclusion criteria for studies, such as use of control conditions or type of study environment. This review aims to summarize and to discuss the current state of the evidence regarding CBT treatment for panic disorder, generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. Overall, CBT demonstrates both efficacy in randomized controlled trials and effectiveness in naturalistic settings in the treatment of adult anxiety disorders. However, due to methodological issues, the magnitude of effect is currently difficult to estimate. In conclusion, CBT appears to be both efficacious and effective in the treatment of anxiety disorders, but more high-quality studies are needed to better estimate the magnitude of the effect.

scholarly journals Likely Exacerbation of Psychological Disorders from Covid-19 Response

2021 ◽  
Vol 12 ◽  
pp. 215013272110167
Author(s):  
Tara Rava Zolnikov ◽  
Tanya Clark ◽  
Tessa Zolnikov
Keyword(s):  
Psychological Disorders ◽  
Emotional Reactions ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Current State ◽  
The Face ◽  
Adults And Children ◽  
Post Traumatic ◽  
Anxiety Depression

Anxiety and fear felt by people around the world regarding the coronavirus pandemic is real and can be overwhelming, resulting in strong emotional reactions in adults and children. With depressive and anxiety disorders already highly prevalent in the general population (300 million worldwide), depression and/or anxiety specifically because of the pandemic response is likely. Moreover, the current state of panic in the face of uncertainty is apt to produce significant amounts of stress. While this situation has the potential to cause psychological disorders in previously unaffected populations, perhaps more impactful is the exacerbation of symptoms of many existing disorders including anxiety, depression, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and hoarding disorder.

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.

Prevalence of current anxiety disorders in people with bipolar disorder during euthymia: a meta-analysis

2016 ◽  
Vol 47 (6) ◽  
pp. 1107-1115 ◽  
Author(s):  
B. Pavlova ◽  
R. H. Perlis ◽  
O. Mantere ◽  
C. M. Sellgren ◽  
E. Isometsä ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Diagnostic Criteria ◽  
Meta Analysis ◽  
Fold Increase ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Increase Risk

BackgroundAnxiety disorders are highly prevalent in people with bipolar disorder, but it is not clear how many have anxiety disorders even at times when they are free of major mood episodes. We aimed to establish what proportion of euthymic individuals with bipolar disorder meet diagnostic criteria for anxiety disorders.MethodWe performed a random-effects meta-analysis of prevalence rates of current DSM-III- and DSM-IV-defined anxiety disorders (panic disorder, agoraphobia, social anxiety disorder, generalized anxiety disorder, specific phobia, obsessive–compulsive disorder, post-traumatic stress disorder, and anxiety disorder not otherwise specified) in euthymic adults with bipolar disorder in studies published by 31 December 2015.ResultsAcross 10 samples with 2120 individuals with bipolar disorder, 34.7% met diagnostic criteria for one or more anxiety disorders during euthymia [95% confidence interval (CI) 23.9–45.5%]. Direct comparison of 189 euthymic individuals with bipolar disorder and 17 109 population controls across three studies showed a 4.6-fold increase (risk ratio 4.60, 95% CI 2.37–8.92, p < 0.001) in prevalence of anxiety disorders in those with bipolar disorder.ConclusionsThese findings suggest that anxiety disorders are common in people with bipolar disorder even when their mood is adequately controlled. Euthymic people with bipolar disorder should be routinely assessed for anxiety disorders and anxiety-focused treatment should be initiated if indicated.

scholarly journals Anxiety and DSM-5

2015 ◽  
Vol 17 (3) ◽  
pp. 245-246 ◽  
Keyword(s):  
Anxiety Disorders ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Clinical Neuroscience ◽  
Developmental Approach ◽  
Compulsive Disorder ◽  
Dsm 5 ◽  
Considerable Impact ◽  
Post Traumatic

The DSM-5 process, and the publication of DSM-5 in 2013, have had a considerable impact on the classification of anxiety disorders. Major changes included the reorganization of the chapter structure, individual groupings of disorders within each chapter from a life span viewpoint, and the use of specifiers. The DSM-5 chapter on anxiety disorders does not include obsessive-compulsive disorder or post-traumatic stress disorder. The chapter itself now reflects a developmental approach. The text of each disorder has been enhanced with short sections on development and course, risk and prognostic factors, etc. It is expected that the reformulation of anxiety disorders in DSM-5 will lead to greater precision in a variety of ways, as illustrated in the papers in this issue of Dialogues in Clinical Neuroscience. In summary, these changes in the way we classify anxiety disorders reflect our best view on the clinical empirical data and should prove useful in the assessment of specific anxiety disorders.

Anxiety Disorders

Depression ◽  
2019 ◽  
pp. 89-101
Author(s):  
Carly Yasinski ◽  
Bonnie Seifert ◽  
Callan M. Coghlan ◽  
Barbara O. Rothbaum
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Theoretical Models ◽  
Response To Treatment ◽  
Anxiety And Depression ◽  
Negative Consequences ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Post Traumatic ◽  
High Level

This chapter discusses the similarities, differences, and comorbidities between depression and anxiety disorders broadly defined, including generalized anxiety disorder, social anxiety disorder, specific phobias, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. The high level of comorbidity between anxiety disorders and depression is explicated, and the negative consequences of this comorbidity, including higher severity, functional impairment, and worse response to treatment, are discussed. Major theoretical models for differentiating anxiety and depression, including the tripartite model, the integrative hierarchical model, and the quadripartite model, are explained. Translational research, including neurological, psychophysiological, and genetic underpinnings of the similarities and differences between anxiety and depression, is reviewed. The chapter concludes with broad treatment implications and recommendations.

Anxiety and Related Disorders in People with Intellectual Disability

2020 ◽  
pp. 129-140
Author(s):  
Sherva Cooray ◽  
Avinash Hiremath
Keyword(s):  
Anxiety Disorder ◽  
Separation Anxiety ◽  
Separation Anxiety Disorder ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Cognitive Limitations ◽  
Treatment Models ◽  
Post Traumatic ◽  
People With Intellectual Disabilities

This chapter provides an overview of anxiety and related disorders including, generalized anxiety disorder, panic disorder, agoraphobia, specific phobia, social anxiety disorder, separation anxiety disorder, hypochondriasis, obsessive compulsive disorder (OCD) and post traumatic stress disorder (PTSD). It covers the diagnosis, clinical features, epidemiology, aetiology, pathophysiology, risk factors, treatment, and prognosis. Due to the cognitive limitations and needs profile of people with intellectual disabilities (ID), the diagnosis of these conditions is particularly challenging, due to which they are under-recognized and poorly treated. The approaches to management are largely modelled on treatment models used in the mainstream populations without ID, although these models have to be adapted appropriately to the needs of the individual’s psychological, biological, and social circumstances.

Adult Hippocampal Neurogenesis, Pattern Separation, and Generalization

2016 ◽  
Author(s):  
Kristen C. Klemenhagen ◽  
Franklin R. Schneier ◽  
Abby J. Fyer ◽  
H. Blair Simpson ◽  
René Hen
Keyword(s):  
Anxiety Disorder ◽  
Hippocampal Neurogenesis ◽  
Adult Hippocampal Neurogenesis ◽  
Pattern Separation ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Evidence Based Treatments ◽  
Post Traumatic ◽  
Pathological Anxiety

Almost one-third of adult Americans will have an anxiety disorder in their lifetime, with enormous personal, societal, and financial costs. Among the most disabling of these disorders are post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), social anxiety disorder, generalized anxiety disorder, and panic disorder. Although there are evidence-based treatments for these disorders, as many as 50% of patients do not respond, and there is a considerable need for new therapies. This chapter proposes that the excessive generalization seen in patients with pathological anxiety is due to impaired hippocampal functioning, specifically a deficit in the neural process of pattern separation, which relies upon the dentate gyrus and is sensitive to neurogenesis. Preclinical findings indicate that stimulating DG neurogenesis improves pattern separation and reduces anxiety behaviors in mice. As a result the authors hypothesize that pharmacological or environmental manipulations aimed at stimulating neurogenesis will be beneficial for the treatment of anxiety disorders.

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