Genetics of Fear and Anxiety Disorders

1986 ◽  
Vol 149 (4) ◽  
pp. 406-418 ◽  
Author(s):  
I. M. Marks
Keyword(s):  
Panic Disorder ◽  
Anxiety Disorders ◽  
Defensive Behaviour ◽  
Biological Functions ◽  
Obsessive Compulsive ◽  
Familial Influences ◽  
History Of ◽  
Normal Human ◽  
Fear And Anxiety ◽  
Genetically Determined

From protozoa to mammals, organisms have been selectively bred for genetic differences in defensive behaviour which are accompanied by differences in brain and other biological functions. Studies of twins indicate some genetic control of normal human fear from infancy onwards, of anxiety as a symptom and as a syndrome, and of phobic and obsessive- compulsive phenomena. Anxiety disorders are more common among the relatives of affected probands than of controls, especially among female and first-degree relatives; alcoholism and secondary depression may also be over-represented. Familial influences have been found for panic disorder, agoraphobia, and obsessive-compulsive problems. Panic disorder in depressed probands increases the risk to their relatives of phobia as well as of panic disorder, major depression, and alcoholism. The strongest family history of all anxiety disorders is seen in blood-injury phobia; even though it can be successfully treated by exposure, its roots may lie in a genetically determined specific autonomic susceptibility. Some genetic effects can be modified by environmental means.

The Effects of Childhood Parental Death and Divorce on Six-Month History of Anxiety Disorders

1989 ◽  
Vol 154 (6) ◽  
pp. 823-828 ◽  
Author(s):  
J. Lindsey Tweed ◽  
Victor J. Schoenbach ◽  
Linda K. George ◽  
Dan G. Blazer
Keyword(s):  
Panic Disorder ◽  
Maternal Death ◽  
Parental Death ◽  
Panic Attacks ◽  
Parental Separation ◽  
Generalised Anxiety Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
History Of ◽  
Socio Demographic Factors

Duke Epidemiologic Catchment Area (ECA) data were used to examine the relationships between: (a) early childhood maternal death, paternal death, and parental separation/divorce, and (b) six-month DIS/DSM-III diagnoses of agoraphobia with and without panic attacks, simple phobia, social phobia, panic disorder, generalised anxiety disorder, and obsessive-compulsive disorder. Associations were found between: (a) maternal death and agoraphobia with panic attacks, and (b) parental separation/divorce and agoraphobia with panic attacks and panic disorder. The associations could not be explained by the effects of potentially confounding socio-demographic factors.

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.

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.

Patterns of Reassurance Seeking and Reassurance-Related Behaviours in OCD and Anxiety Disorders

2012 ◽  
Vol 41 (1) ◽  
pp. 1-23 ◽  
Author(s):  
Osamu Kobori ◽  
Paul M. Salkovskis
Keyword(s):  
Panic Disorder ◽  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Reliability And Validity ◽  
The Other ◽  
Self Report ◽  
Healthy Controls ◽  
Obsessive Compulsive ◽  
Reassurance Seeking ◽  
Compulsive Disorder

Background: Reassurance seeking is particularly prominent in obsessive-compulsive disorder (OCD) and may be important in OCD maintenance. Aims: This study used a new self-report questionnaire to measure the range of manifestations of reassurance-seeking behaviours, describing their sources from which they seek, frequency, process (how they seek), and consequences (as opposed to triggers and motivations). This study also attempts to identify the degree to which reassurance is specific to OCD as opposed to panic disorder. Method: Reassurance Seeking Questionnaire (ReSQ) was administered to 153 individuals with OCD, 50 individuals with panic disorder with/without agoraphobia, and 52 healthy controls. The reliability and validity of the measure was evaluated and found to be satisfactory. Results: Reassurance seeking was found to be more frequent in both anxiety disorders relative to healthy controls. Individuals diagnosed with OCD were found to seek reassurance more intensely and carefully, and were more likely to employ “self-reassurance” than the other two groups. Conclusions: Further investigation of reassurance will enable better understanding of its role in the maintenance of anxiety disorders in general and OCD in particular.

Childhood history of anxiety disorders among adults with social phobia: Rates, correlates, and comparisons with patients with panic disorder

2001 ◽  
Vol 14 (4) ◽  
pp. 209-213 ◽  
Author(s):  
Michael W. Otto ◽  
Mark H. Pollack ◽  
Kristin M. Maki ◽  
Robert A. Gould ◽  
John J. Worthington ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Anxiety Disorders ◽  
Social Phobia ◽  
History Of

Panic Attacks and Anxiety Disorders

2020 ◽  
Author(s):  
Curtis Wittmann
Keyword(s):  
Emergency Department ◽  
Anxiety Disorder ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Stress Disorder ◽  
Acute Stress ◽  
Panic Attacks ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

This review discusses the acute diagnosis and management of panic and anxiety disorders. Anxiety disorders are among the most common psychiatric disorders in the country and are a relatively common cause of presentation to the emergency department. Most anxiety disorders can be conceptualized as fear- or phobia-based disorders, including panic disorder, specific phobia, social phobia, acute stress disorder, posttraumatic stress disorder, and obsessive-compulsive disorder. Each of these disorders is discussed, including prevalence and common clinical presentations. The initial evaluation of patients with a suspected or diagnosed anxiety disorder will be based on their current symptoms. Some patients may be highly agitated and may require deescalation or sedation to perform a reasonable history and physical examination. To achieve this, providers should ensure their own safety first, with attention to the physical layout of the emergency department, ensuring that they are closer to the room exit than the patient (so that they cannot be trapped). The presence of police or security may be necessary to provide optimal care and an appropriate evaluation. Typical treatment of acute exacerbations of anxiety disorders includes medical management, most often benzodiazepines, which can provide immediate relief. Psychiatric consultation may be necessary in certain cases. For most patients, outpatient management rather than inpatient admission will lead to the most effective management of their anxiety.   Key words: anxiety disorder, obsessive-compulsive disorder, panic disorder, phobia, stress disorder This review contains 1 highly rendered figure, 17 tables, and 29 references.

scholarly journals The Social Costs of Anxiety Disorders

1995 ◽  
Vol 166 (S27) ◽  
pp. 19-22 ◽  
Author(s):  
Andrew C. Leon ◽  
Laura Portera ◽  
Myrna M. Weissman
Keyword(s):  
Mental Health ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Indirect Costs ◽  
The United States ◽  
Social Costs ◽  
Emergency Rooms ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
The Social

Background. The social costs of anxiety disorders, which afflict a substantial proportion of the general population in the United States, are considered.Method. Data from the National Institute of Mental Health (NIMH) Epidemiological Catchment Area Program were analysed.Results. Over 6% of men and 13% of women in the sample of 18 571 had suffered from a DSM–III anxiety disorder in the past six months. Nearly 30% of those with panic disorder had used the general medical system for emotional, alcohol or drug-related problems in the six months prior to the interview. Those with anxiety disorders were also more likely to seek help from emergency rooms and from the specialised mental health system. Men with panic disorder, phobias or obsessive–compulsive disorder in the previous six months are more likely to be chronically unemployed and to receive disability or welfare.Discussion. Once correctly diagnosed there are safe and effective psychopharmacologic and behavioural treatments for the anxiety disorders. Nevertheless the burden of anxiety disorders extends beyond the direct costs of treatment to the indirect costs of impaired social functioning.

Improving the Recognition of Anxiety Disorders in Depressed Patients

CNS Spectrums ◽  
2006 ◽  
Vol 11 (S1) ◽  
pp. 2-4
Author(s):  
Iwona Chelminski
Keyword(s):  
Primary Care ◽  
Anxiety Disorder ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Panic Attacks ◽  
Depressed Patients ◽  
Increased Risk ◽  
History Of ◽  
Primary Care Patients

There is considerable symptom overlap and high levels of comorbidity between anxiety disorders and depression. The recognition of this comorbidity has both academic interest and clinical significance. Epidemiological studies have demonstrated that depressed individuals with a history of anxiety disorders are at increased risk for hospitalization, suicide attempt, and greater impairment from the depression. These individuals also tend to have a more chronic course of depression, as observed in psychiatric patients, primary care patients, and epidemiological samples. Van Valkenberg and colleagues reported that depressed patients with anxiety had poorer outcome and greater psychosocial impairment than those without an anxiety disorder. In the National Institute of Mental Health Collaborative Depression Study, the presence of panic attacks predicted a lower rate of recovery during the first 2 years of the follow-up interval. Similarly, Grunhaus found poorer outcome in depressed patients with comorbid panic disorder than in depressed patients without panic. In an 8-month follow-up study, depressed primary care patients with a history of generalized anxiety disorder (GAD) or panic disorder were less likely to have recovered from their depressive episode.Gaynes and colleagues prospectively followed primary care patients with major depressive disorder (MDD) every 3 months for 1 year after their initial diagnostic evaluation. At baseline, half of the original 85 patients had a coexisting anxiety disorder, the most frequent being social phobia (n=38). Twelve months after intake, 68 of the patients were available for the final interview. Those with a comorbid anxiety disorder were significantly more likely to still be in an episode of depression (82% vs 57%; risk ratio=1.44; 95% CI 1.02-2.04), and they experienced more disability days during the course of the 12 months than the depressed patients without an anxiety disorder (67.1 days vs 27.5 days).

scholarly journals Neuroimaging in anxiety disorders

2011 ◽  
Vol 13 (4) ◽  
pp. 453-461 ◽  
Keyword(s):  
Anxiety Disorders ◽  
Treatment Options ◽  
Panic Attacks ◽  
Functional Neuroanatomy ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Post Traumatic ◽  
Fear And Anxiety ◽  
Neuroimaging Techniques

Over the last few years, neuroimaging techniques have contributed greatly to the identification of the structural and functional neuroanatomy of anxiety disorders. The amygdala seems to be a crucial structure for fear and anxiety, and has consistently been found to be activated in anxiety-provoking situations. Apart from the amygdala, the insula and anterior cinguiate cortex seem to be critical, and ail three have been referred to as the "fear network." In the present article, we review the main findings from three major lines of research. First, we examine human models of anxiety disorders, including fear conditioning studies and investigations of experimentally induced panic attacks. Then we turn to research in patients with anxiety disorders and take a dose look at post-traumatic stress disorder and obsessive-compulsive disorder. Finally, we review neuroimaging studies investigating neural correlates of successful treatment of anxiety, focusing on exposure-based therapy and several pharmacological treatment options, as well as combinations of both.

scholarly journals Serum Cholesterol Level Comparison: Control Subjects, Anxiety Disorder Patients, and Obsessive-Compulsive Disorder Patients

2002 ◽  
Vol 47 (6) ◽  
pp. 557-561 ◽  
Author(s):  
Helmut Peter ◽  
Iver Hand ◽  
Fritz Hohagen ◽  
Anne Koenig ◽  
Olaf Mindermann ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Cholesterol Level ◽  
Normal Control ◽  
Serum Cholesterol ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Control Subjects ◽  
Cholesterol Levels

Objective: To determine whether panic disorder is associated with elevated serum cholesterol levels. Serum cholesterol levels of panic disorder patients are reported to be elevated. This could explain the higher-than-expected cardiovascular mortality in this population. Some evidence exists wherein cholesterol levels are also increased in patients with general anxiety disorder and phobias. To date, there are only 2 reports on cholesterol levels of obsessive-compulsive disorder (OCD) patients, giving controversial results. Method: We compared serum cholesterol levels of anxiety disorder patients, OCD patients, and normal control subjects with each other ( n = 60 in each group). Serum cholesterol was measured in each subject before treatment. Subjects of the 3 groups were matched by age and sex. Results: Patients with anxiety disorders and OCD had elevated cholesterol levels, compared with normal control subjects. Cholesterol levels in OCD patients were comparable with those in patients with phobia. Conclusions: Our data support the assumption that elevation in cholesterol level is not a specific feature of panic disorder (as most assumed), but more generally associated with anxiety disorders. Increased cholesterol levels in patients with anxiety disorders and OCD may be of clinical relevance.

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