Objective Sleep in Pediatric Anxiety Disorders and Major Depressive Disorder

This chapter discusses the frequent comorbidity of major depressive disorder and anxiety disorders with specific sleep disorders as well as associated changes in sleep architecture and sleep quality. It includes a review of several of the most common mood and anxiety disorders that are known to be associated with abnormalities in sleep: major depressive disorder, post-traumatic stress disorder, obsessive–compulsive disorder, and panic disorder. Changes in objective and subjective sleep parameters, including sleep architecture, sleep quality, and sleep quantity, are addressed in association with each psychiatric condition. The effects on sleep of medications used in the treatment of mood and anxiety disorders are also outlined. Finally, the chapter discusses the over-representation in these psychiatric conditions of many common sleep disorders, including insomnia, obstructive sleep apnea, and delayed sleep phase disorder.

Download Full-text

Characterising anxiety in major depressive disorder and its use in predicting antidepressant treatment outcome: An iSPOT-D report

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867419835933 ◽

2019 ◽

Vol 53 (8) ◽

pp. 782-793 ◽

Cited By ~ 5

Author(s):

Taylor A Braund ◽

Donna M Palmer ◽

Leanne M Williams ◽

Anthony WF Harris

Keyword(s):

Major Depressive Disorder ◽

Treatment Outcome ◽

Depressive Disorder ◽

Anxiety Disorders ◽

Clinical Features ◽

Antidepressant Treatment ◽

Anxiety Symptoms ◽

Poor Agreement ◽

Major Depressive ◽

Anxious Depression

Objective: Major depressive disorder commonly co-occurs with one or more anxiety disorders or with clinically significant levels of anxiety symptoms. Although evidence suggests that anxious forms of depression are prognostic of poorer antidepressant outcomes, there is no clear definition of anxious depression, and inferences about clinical outcomes are thus limited. Our objective was to compare and evaluate definitions of anxious depression and anxiety-related scales according to clinical and antidepressant outcome criteria. Method: A total of 1008 adults with a current diagnosis of single-episode or recurrent, nonpsychotic, major depressive disorder were assessed at baseline on clinical features. Participants were then randomised to one of three antidepressants and reassessed at 8 weeks regarding remission and response of the 17-item Hamilton Rating Scale Depression (HRSD17) and the 16-item Quick Inventory of Depressive Symptomatology (QIDS-SR16). Anxious depression was defined as major depressive disorder with one or more anxiety disorders or major depressive disorder with a HRSD17 anxiety/somatisation factor score ⩾7. Anxiety-related scales included the HRSD17 anxiety/somatisation factor and the 42-item Depression Anxiety Stress Scales (DASS42) anxiety and stress subscales. Results: Anxious depression definitions showed poor agreement (κ = 0.15) and the HRSD17 anxiety/somatisation factor was weakly correlated with both DASS42 anxiety ( r = 0.24) and stress subscales ( r = 0.20). Anxious depression definitions were also associated with few impairments on clinical features and did not predict poorer antidepressant treatment outcome. However, higher DASS42 anxiety predicted poorer HRSD17 and QIDS-SR16 remission, and item-level analysis found higher scores on items 9 (situational anxiety) and 23 (somatic anxiety) of the DASS42 predicted poorer treatment outcome, even after adjusting for covariates and multiple comparisons. Conclusion: Common definitions of anxious depression show poor agreement and do not predict poorer treatment outcome. Anxiety symptoms may be better characterised dimensionally using DASS42 when predicting treatment outcome.

Download Full-text

Anxiety Disorders

10.1093/med/9780197512166.003.0040 ◽

2021 ◽

pp. 326-332

Author(s):

Ahmed T. Makhlouf

Keyword(s):

United States ◽

Major Depressive Disorder ◽

Anxiety Disorder ◽

Depressive Disorder ◽

Anxiety Disorders ◽

The United States ◽

Major Depressive ◽

Neurologic Disorders ◽

Disability Adjusted Life ◽

Life Years

Anxiety disorders are the most common psychiatric syndromes in the United States. About 29% of adults will receive a diagnosis of an anxiety disorder during their lifetime, and almost one-fifth of adults have symptoms of anxiety in any given year. Globally, anxiety disorders are responsible for 10% of the disability-adjusted life years for all psychiatric and neurologic disorders, second only to major depressive disorder.

Download Full-text