Age and Remission of Psychiatric Disorders

1997 ◽  
Vol 42 (7) ◽  
pp. 722-729 ◽  
Author(s):  
Roger C Bland ◽  
Stephen C Newman ◽  
Helene Orn
Keyword(s):  
Drug Abuse ◽  
Alcohol Abuse ◽  
Panic Disorder ◽  
Psychiatric Disorders ◽  
Remission Rate ◽  
Age Groups ◽  
Antisocial Personality ◽  
Compulsive Disorder ◽  
Remission Rates ◽  
One Year

Objective: To examine the relationship between remission of psychiatric disorders and age. Methods: We interviewed 3258 randomly selected adult residents of Edmonton using the Diagnostic Interview Schedule (DIS), which yielded DIS/DSM-III diagnoses. Remission was defined as being free of symptoms of the index lifetime disorder in the year preceding the interview, this being the difference between the lifetime and one-year prevalence. For each age group, the proportion of cases with and without symptoms in the preceding year was calculated. Numbers and proportions of cases were estimated after adjusting to the census population and weighting for household size. Only the more common disorders were examined; any comorbidities were ignored. Results: Drug abuse or dependence, antisocial personality disorder (in both sexes), and alcohol abuse or dependence (in men) all showed remission rates that increased with age. Panic disorder and obsessive–compulsive disorder (OCD) showed a decreased likelihood of remission with increasing age. Major depression and phobias showed little tendency to remission with age. Considering all disorders together, the one-year remission rate for all ages combined was only 33.2%, with a tendency for lower remission rates to be found in those aged 55 to 64. Conclusions: As may be expected, antisocial personality, drug abuse or dependence, and alcohol abuse or dependence tend to show increased remission rates with increasing age. In OCD and panic disorder, the low rates of remission found in all age groups indicate that these disorders produce significant long-term morbidity. For depression, which had an overall remission rate of less than 50%, the stable low rate of remission probably indicates not only the difficulties of treatment but also the low rates at which cases get treated.

scholarly journals Psychiatric epidemiology and disaster exposure in Australia

2017 ◽  
Vol 28 (03) ◽  
pp. 310-320 ◽  
Author(s):  
L. Reifels ◽  
K. Mills ◽  
M. L. A. Dückers ◽  
M. L. O'Donnell
Keyword(s):  
Alcohol Abuse ◽  
Panic Disorder ◽  
Psychiatric Disorder ◽  
Psychiatric Disorders ◽  
Natural Disaster ◽  
Lifetime Risk ◽  
Post Traumatic Stress ◽  
Compulsive Disorder ◽  
Disaster Exposure ◽  
Disorder Risk

Aims.To examine the lifetime prevalence and risk of psychiatric disorders associated with natural and man-made disaster exposure in Australia.Methods.We utilised data from a nationally representative population survey (N = 8841) which were analysed through univariate and multivariate logistic regression in order to examine the full spectrum of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) affective, anxiety and substance use disorders associated with exposure to natural and man-made disaster.Results.Man-made disaster exposure was primarily associated with an increased lifetime risk (odds ratio (95% CI)) of alcohol abuse disorder 2.29 (1.56–3.37), post-traumatic stress disorder (PTSD) 2.27 (1.36–3.79), obsessive–compulsive disorder (OCD) 1.95 (1.08–3.51) and major depressive disorder 1.69 (1.01–2.85). Multiple natural disaster exposure was associated with an increased lifetime risk of panic disorder 2.26 (1.11–4.61). Among the broader disorder spectrum examined, alcohol abuse disorder accounted for the single greatest increase in lifetime disorder prevalence associated with man-made disaster exposure, and the greatest number of natural or man-made disaster exposed individuals who had developed a lifetime psychiatric disorder. Despite the relatively greater disorder risk associated with man-made disaster, natural disaster exposure was associated with more cases of psychiatric disorder, likely due to the frequency with which these events occur in Australia.Conclusions.Notwithstanding the inability to draw causal inferences from cross-sectional survey data, population-based analyses provide a comprehensive and consistent method to ascertain the population imprint of psychiatric disorder and disaster exposure. Mental health policy and services should be targeting a range of psychiatric disorders in disaster contexts in addition to the usual focus on PTSD and depression, including alcohol abuse, panic disorder and OCD. Despite the relatively greater disorder risk associated with man-made disaster exposure, the national burden of psychiatric disorder in natural disaster contexts is particularly high.

Brain Hemispheric Organization, Anxiety, and Psychoses

CNS Spectrums ◽  
2000 ◽  
Vol 5 (9) ◽  
pp. 58-69 ◽  
Author(s):  
Silvana Galderisi ◽  
Armida Mucci ◽  
Mario Maj
Keyword(s):  
Panic Disorder ◽  
Anxiety Disorders ◽  
Psychiatric Disorders ◽  
Obsessive Compulsive Disorder ◽  
Theoretical Models ◽  
Developmental Perspective ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Hemispheric Functioning

AbstractAbnormalities of brain hemispheric organization have been found in a variety of psychiatric disorders. Despite the great amount of data collected and the number of theoretical models elaborated, the role of these abnormalities in the pathogenesis of these disorders remains controversial. This article briefly reviews current concepts of hemispheric functioning, discusses the role of abnormalities of brain hemispheric organization in schizophrenia and in two anxiety disorders (panic disorder and obsessive-compulsive disorder), and outlines a developmental perspective that accounts for the observed abnormalities.

Methimazole-Induced Remission Rates in Pediatric Graves’ Disease: a Systematic Review

2021 ◽  
Author(s):  
Jelmer M van Lieshout ◽  
Christiaan F Mooij ◽  
A. S Paul van Trotsenburg ◽  
Nitash Zwaveling-Soonawala
Keyword(s):  
Systematic Review ◽  
Treatment Duration ◽  
Remission Rate ◽  
Graves Disease ◽  
Treatment Protocols ◽  
Intention To Treat ◽  
Remission Rates ◽  
One Year ◽  
Treat Analysis

Objective: Comparison of studies on remission rates in pediatric Graves’ disease is complicated by lack of uniformity in treatment protocols, remission definition, and follow-up duration. We performed a systematic review on remission rates in pediatric Graves’ disease and attempted to create uniformity by recalculating remission rates based on an intention-to-treat analysis. Methods: PubMed and Embase were searched in August 2020 for studies on patients with Graves’ disease (i) 2 to 18 years of age, (ii) initially treated with methimazole or carbimazole for at least 18 months, (iii) with a follow-up duration of at least one year after cessation of methimazole or carbimazole. All reported remission rates were recalculated using an intention-to-treat analysis. Results: Of 1,890 articles, 29 articles consisting of 24 patient cohorts, were included with a total of 3,057 patients (82.6% female). Methimazole or carbimazole was initially prescribed in 2,864 patients (93.7%). Recalculation based on intention-to-treat analysis resulted in an overall remission rate of 28.8% (829/2,880). Pooled remission rates based on treatment duration were 23.7%, 31.0%, 43.7%, and 75% after respectively 1.5-2.5 years, 2.5-5 years, 5-6 years (two studies), and 9 years (single study) treatment duration. Occurrence of adverse events was 419 in 2,377 patients (17.6%), with major side effects in 25 patients (1.1%). Conclusions: Using a standardized calculation the overall remission rate in methimazole treated pediatric GD is 28.8%. A few small studies indicate that longer treatment increases the remission rate. However, evidence is limited and further research is necessary to investigate the efficacy of longer treatment durations.

Assessment of Co-occurring Psychiatric Disorders

2019 ◽  
pp. 143-160
Author(s):  
Dennis C. Daley ◽  
Antoine Douaihy
Keyword(s):  
Personality Disorder ◽  
Psychiatric Disorders ◽  
Antisocial Personality Disorder ◽  
Antisocial Personality ◽  
Obsessive Compulsive ◽  
Statistical Manual ◽  
Compulsive Disorder ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Concerned Significant Others

Co-occurring disorders (CODs) refers to the occurrence of both a substance use disorder (SUD) and a psychiatric disorder, such as mood disorder, anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, schizophrenia, eating disorder, antisocial personality disorder, and borderline personality disorder. This chapter reviews the prevalence, patterns, and effects of CODs. Next, the relationships between psychiatric disorders and SUDs, challenges for practitioners, and types and causes of psychiatric disorders are discussed. The chapter continues with the process of conducting a comprehensive and thorough assessment using the format of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The authors also discuss the importance of conveying assessment findings to the client and/or family and concerned significant others, as well as getting the client to accept help.

Comorbidity in obsessive-compulsive disorder: focus on depression

1995 ◽  
Vol 10 (8) ◽  
pp. 379-382 ◽  
Author(s):  
A Milanfranchi ◽  
D Marazziti ◽  
C Pfanner ◽  
S Presta ◽  
P Lensi ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Panic Disorder ◽  
Depressive Disorder ◽  
Psychiatric Disorders ◽  
Obsessive Compulsive Disorder ◽  
Generalized Anxiety ◽  
Obsessive Compulsive ◽  
Major Depressive ◽  
Compulsive Disorder

SummaryThe authors investigated the comorbidity between obsessive-compulsive disorder (OCD) and other psychiatric disorders in a group of 154 outpatients. The influence of an associate major depressive disorder (MDD) on the outcome of treatment with clomipramine was examined in a subgroup of 52 patients. The results showed that MDD was the most frequent disorder associated with OCD (almost 20% of the patients), followed by generalized anxiety and panic disorder. The co-presence of depression delayed the effect of clomipramine.

scholarly journals Efficacy and Acceptability Comparisons of Cognitive Behavior Therapy, Drugs, and Their Combination for Panic Disorder in Adults: a Network Meta-analysis

2020 ◽  
Author(s):  
Fengjie Gao ◽  
Hairong He ◽  
Bin Yan ◽  
Jian Yang ◽  
Yajuan Fan ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Remission Rate ◽  
Meta Analysis ◽  
The Other ◽  
Cognitive Behavior ◽  
Oral Drugs ◽  
Randomized Controlled ◽  
Remission Rates

AbstractObjectiveTo compare 22 oral drugs, cognitive behavior therapy (CBT), and their combination treatments for the acute treatment of adults with panic disorder in terms of remission rate and acceptability.DesignSystematic review and network meta-analysisData sourcesPubMed, Web of Science, Cochrane Central Register of Controlled Trials, and Embase databases from their inception up to May 26, 2019.Study selectionRandomized controlled clinical trials (RCTs) of any oral drugs, CBT, CBT combined with any drug, or placebo in the acute treatment of adults with panic disorder diagnosed according to standard operationalized criteria. The primary outcomes were efficacy (remission rate) and acceptability (treatment discontinuations due to any cause).ResultsWe identified 6585 reports that included 68 full-text RCTs involving 11101 patients. In terms of efficacy, 13 (68%) of 19 interventions were associated with higher remission rates than those of for placebo, with ORs ranging from 2.1 (95% credible interval [CrI] = 1.1 to 4.0) for sertraline to 13 (CrI = 4.5 to 44) for CBT combined with any drug. Regarding acceptability, alprazolam, imipramine, and etizolam were associated with lower dropout rates, with ORs ranging from 0.23 (CrI = 0.15 to 0.33) for alprazolam to 0.076 (CrI = 0.0021 to 0.77) for etizolam. Most of the differences between the other interventions were unclear. In head-to-head analyses, CBT combined with any drug was more effective than the other interventions, but it was no associated with an improvement in acceptability (OR = 0.12 to 0.219).ConclusionsCBT combined with any drug was more effective than the other interventions analyzed in this study. CBT alone did not differ significantly from other drugs alone. We found that most drugs are effective against panic disorder, but they exhibit different acceptability and tolerability profiles.What is already known on this topicSome randomized controlled trials indicated that combined therapy are more effective than drug alone or cognitive behavior therapy alone. Nevertheless, drug monotherapy, cognitive behavior therapy, and combination therapy had never been compared in a comprehensive network meta-analysis. With this evidence gap remaining, the availability of reliable evidence of the relative merits of multiple interventions is essential to ensuring that clinicians choose the best option for each individual patient.What this study addsThis network meta-analysis is the first to evaluate the relative merits of cognitive behavior therapy, cognitive behavior therapy combined with any drug, and 22 oral drugs in the field of panic disorder. The results showed a significant higher remission rates for cognitive behavior therapy combined with any drug than those of the other interventions. Cognitive behavior therapy alone was superior to placebo but did not differ significantly from other active drugs. Additionally, paroxetine, venlafaxine, fluoxetine, sertraline, and clonazepam are more recommendable than the other drugs based on their remission rates, scores on panic-symptoms scales, and acceptability.

scholarly journals Outcomes of endoscopic transsphenoidal surgery for Cushing's disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zarina Brady ◽  
Aoife Garrahy ◽  
Claire Carthy ◽  
Michael W. O’Reilly ◽  
Christopher J. Thompson ◽  
...  
Keyword(s):  
Diabetes Insipidus ◽  
Cushing’S Disease ◽  
Transsphenoidal Surgery ◽  
Remission Rate ◽  
Cushing's Disease ◽  
Endoscopic Transsphenoidal Surgery ◽  
Endocrine Society ◽  
Csf Leakage ◽  
Remission Rates

Abstract Background Transsphenoidal surgery (TSS) to resect an adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma is the first-line treatment for Cushing’s disease (CD), with increasing usage of endoscopic transsphenoidal (ETSS) technique. The aim of this study was to assess remission rates and postoperative complications following ETSS for CD. Methods A retrospective analysis of a prospective single-surgeon database of consecutive patients with CD who underwent ETSS between January 2012–February 2020. Post-operative remission was defined, according to Endocrine Society Guidelines, as a morning serum cortisol < 138 nmol/L within 7 days of surgery, with improvement in clinical features of hypercortisolism. A strict cut-off of < 50 nmol/L at day 3 post-op was also applied, to allow early identification of remission. Results A single surgeon (MJ) performed 43 ETSS in 39 patients. Pre-operative MRI localised an adenoma in 22 (56%) patients; 18 microadenoma and 4 macroadenoma (2 with cavernous sinus invasion). IPSS was carried out in 33 (85%) patients. The remission rates for initial surgery were 87% using standard criteria, 58% using the strict criteria (day 3 cortisol < 50 nmol/L). Three patients had an early repeat ETSS for persistent disease (day 3 cortisol 306-555 nmol/L). When the outcome of repeat early ETSS was included, the remission rate was 92% (36/39) overall. Remission rate was 94% (33/35) when patients with macroadenomas were excluded. There were no cases of CSF leakage, meningitis, vascular injury or visual deterioration. Transient and permanent diabetes insipidus occurred in 33 and 23% following first ETSS, respectively. There was one case of recurrence of CD during the follow-up period of 24 (4–79) months. Conclusion Endoscopic transsphenoidal surgery produces satisfactory remission rates for the primary treatment of CD, with higher remission rates for microadenomas. A longer follow-up period is required to assess recurrence rates. Patients should be counselled regarding risk of postoperative diabetes insipidus.

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