Anxiety Disorders After Stroke: Results from the Perth Community Stroke Study

1995 ◽  
Vol 166 (3) ◽  
pp. 328-332 ◽  
Author(s):  
P. W. Burvill ◽  
G. A. Johnson ◽  
K. D. Jamrozik ◽  
C. S. Anderson ◽  
E. G. Stewart-Wynne ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Generalised Anxiety Disorder ◽  
Comorbid Depression ◽  
Post Stroke ◽  
Stroke Study ◽  
Community Controls

BackgroundThe prevalence of anxiety disorders in 294 patients who survived to four months in the Perth Community Stroke Study (Perth, Australia), and a follow-up of these patients at 12 months, are presented.MethodDiagnoses are described both in the usual DSM hierarchic format and by a non-hierarchic approach. Adoption of the hierarchic approach alone greatly underestimates the prevalence of anxiety disorders.ResultsMost cases were of agoraphobia, and the remainder were generalised anxiety disorder. The prevalence of anxiety disorders alone was 5% in men and 19% in women; in community controls, it was 5% in men and 8% in women. Adopting a non-hierarchic approach to diagnosis gave a prevalence of 12% in men and 28% in women. When those who showed evidence of anxiety disorder before stroke were subtracted, the latter prevalence was 9% in men and 20% in women.ConclusionOne-third of the men and half of the women with post-stroke anxiety disorders showed evidence of either depression or an anxiety disorder at the time of the stroke. At 12 month follow-up of 49 patients with agoraphobia by a non-hierarchic approach, 51 % had recovered, and equal proportions of the remainder had died or still had agoraphobia. The only major difference in outcome between those with anxiety disorder alone and those with comorbid depression was the greater mortality in the latter.

scholarly journals Role of caregiver factors in outpatient medical follow-up post-stroke: observational study in Singapore

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shilpa Tyagi ◽  
Gerald Choon-Huat Koh ◽  
Nan Luo ◽  
Kelvin Bryan Tan ◽  
Helen Hoenig ◽  
...  
Keyword(s):  
Observational Study ◽  
Management Strategies ◽  
Stroke Survivor ◽  
Stroke Survivors ◽  
Post Stroke ◽  
Memory Problems ◽  
Healthcare Needs ◽  
Stroke Study

Abstract Background Outpatient medical follow-up post-stroke is not only crucial for secondary prevention but is also associated with a reduced risk of rehospitalization. However, being voluntary and non-urgent, it is potentially determined by both healthcare needs and the socio-demographic context of stroke survivor-caregiver dyads. Therefore, we aimed to examine the role of caregiver factors in outpatient medical follow-up (primary care (PC) and specialist outpatient care (SOC)) post-stroke. Method Stroke survivors and caregivers from the Singapore Stroke Study, a prospective, yearlong, observational study, contributed to the study sample. Participants were interviewed 3-monthly for data collection. Counts of PC and SOC visits were extracted from the National Claims Database. Poisson modelling was used to explore the association of caregiver (and patient) factors with PC/SOC visits over 0–3 months (early) and 4–12 months (late) post-stroke. Results For the current analysis, 256 stroke survivors and caregivers were included. While caregiver-reported memory problems of a stroke survivor (IRR: 0.954; 95% CI: 0.919, 0.990) and caregiver burden (IRR: 0.976; 95% CI: 0.959, 0.993) were significantly associated with lower early post-stroke PC visits, co-residing caregiver (IRR: 1.576; 95% CI: 1.040, 2.389) and negative care management strategies (IRR: 1.033; 95% CI: 1.005, 1.061) were significantly associated with higher late post-stroke SOC visits. Conclusion We demonstrated that the association of caregiver factors with outpatient medical follow-up varied by the type of service (i.e., PC versus SOC) and temporally. Our results support family-centred care provision by family physicians viewing caregivers not only as facilitators of care in the community but also as active members of the care team and as clients requiring care and regular assessments.

Characteristics of Parent- and Child-Reported Anxiety in Psychostimulant Medication Naïve, Clinically Referred Children with Attention Deficit Hyperactivity Disorder, Combined Type (ADHD-CT)

2002 ◽  
Vol 36 (2) ◽  
pp. 234-239 ◽  
Author(s):  
Alasdair Vance ◽  
Jan Costin ◽  
Rebecca Barnett ◽  
Ernest Luk ◽  
Paul Maruff ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Child Anxiety ◽  
Parent Report ◽  
School Age Children ◽  
Systematic Research ◽  
Child Report ◽  
Hyperactivity Disorder ◽  
Primary School Age

Objective: Anxiety is a frequent comorbid condition in referred primary school-age children with attention deficit hyperactivity disorder, combined type (ADHD-CT), yet there has been relatively little systematic research of the nature of this comorbid anxiety. We describe the characteristics of parent-reported child anxiety disorders and child-reported anxiety disorders in primary school-age children with ADHD-CT. Method: A cross-sectional study of 75 clinically-referred psychostimulant medication naïve children with ADHD-CT examining separately parent and child reports of anxiety, defined categorically and dimensionally. A two-year follow up of 12 children with parent-reported child anxiety and 12 children with child-reported anxiety was also completed. Results: There was no significant association between the child and parent reports of anxiety. Generalized anxiety disorder (GAD), separation anxiety disorder (SAD), specific phobia (SpPh) and social phobia (SoPh) were the most common anxiety disorder diagnoses reported by parents and children. Two-year follow-up data revealed no decrease in the parent report but a significant decrease in the child report of anxiety disorders. Conclusions: The dissonance between the parent report of child anxiety and the child report of anxiety, emphasizes the importance of careful and thorough clinical assessment of the child's perspective. The nature of parent-reported child anxiety and children's self-report of anxiety requires further systematic research.

Comorbidity of Mood Disorders: A Longitudinal Prospective Study

1996 ◽  
Vol 168 (S30) ◽  
pp. 31-37 ◽  
Author(s):  
Jules Angst
Keyword(s):  
Anxiety Disorder ◽  
Major Depression ◽  
Panic Disorder ◽  
Generalised Anxiety Disorder ◽  
Major Depressive ◽  
Recurrent Brief Depression ◽  
Cannabis Consumption ◽  
Major Depressive Episodes ◽  
Depressive Episodes

From the Zurich cohort study (n=591), the association of major depressive episodes and recurrent brief depression (RBD) with other psychiatric disorders is presented cross-sectionally at age 28 and 30 years, and over ten years (age 20 to 30 years). Longitudinally, the odds ratios of major depression are highest with dysthymia (4.4), generalised anxiety disorder (4.4), panic disorder (2.7), hypomania and agoraphobia (2.6), and social phobia (2.4). There is a significant association with cannabis consumption and smoking. Follow-up data over nine years are available for 41 patients with a major depressive disorder (MDD) and 62 with RBD: approximately 20% of MDD patients did not receive a diagnosis during follow-up. Major depression reoccurred in 32%, became bipolar in 24%, or developed into RBD in 24%. RBD remitted in 41 %, reoccurred in 35%, turned into major depression in 22%, and became bipolar in only 7%. Longitudinally, MDD and RBD show a symmetrical diagnostic change in a quarter of the cases. There is no substantial development of MDD or RBD into minor depression or generalised anxiety disorder. Thirteen per cent of those with RBD later developed panic disorder.

Stresspac: A Controlled Trial of a Self-Help Package for the Anxiety Disorders

1995 ◽  
Vol 23 (2) ◽  
pp. 89-107 ◽  
Author(s):  
Jim White
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Controlled Trial ◽  
Individual Therapy ◽  
Anxiety Management ◽  
Ways Of Coping ◽  
Self Help ◽  
Management Advice ◽  
Post Therapy

In order to test the efficacy of a self-help anxiety management package, sixty-two individuals meeting DSM-III-R criteria for an anxiety disorder were randomly allocated to one of three conditions: Stresspac patients were given a self-help/information package. Advice only patients were offered verbal advice on ways of coping with anxiety. Patients in both conditions were seen on one occasion shortly after referral for assessment and management advice. They were then placed back on the waiting list for a three month period. Patients in the No intervention condition also completed measures during this time. They were not seen until the end of this period when formal assessment took place. All patients were then followed through individual therapy and to 12 month follow-up. Results clearly support the superiority of the Stresspac condition after the waiting period, at post therapy and at follow-up on a range of measures. Possible explanations for the results are discussed.

Anxiety disorders and the onset of depression among adults in the community

2002 ◽  
Vol 32 (6) ◽  
pp. 1121-1124 ◽  
Author(s):  
RENEE D. GOODWIN
Keyword(s):  
Anxiety Disorder ◽  
Major Depression ◽  
Anxiety Disorders ◽  
Panic Attack ◽  
Panic Attacks ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Sociodemographic Differences ◽  
Co Morbidity

Objective. To determine the association between anxiety disorders, panic attack and the risk of major depression among adults in the community.Method. Data were drawn from the Epidemiologic Catchment Area Program survey waves 1 (N = 20291) and 2 (N = 15849). Multivariate logistic regression analyses were used to determine the risk of incident major depression at 12-month follow-up (wave 2) associated with each anxiety disorder and panic attacks assessed at wave 1, adjusting for differences in sociodemographic characteristics, and then controlling simultaneously for all anxiety disorders, and other psychiatric co-morbidity.Results. Specific phobia (OR = 1.7 (1.6, 1.8)), agoraphobia (OR = 2.3 (2.2, 2.5)), obsessive–compulsive disorder (OR = 5.4 (5.0, 5.8)) and panic attack (OR = 1.9 (1.8, 2.1)) each made an independent contribution to the risk of major depression, which persisted after adjusting simultaneously for sociodemographic differences and other psychiatric co-morbidity. Conclusions. Each anxiety disorder and panic attacks appear to confer an independent risk for the onset of major depression within 12-months among adults in the community. Understanding the key role played by anxiety in depression onset is needed for prevention strategies.

Caffeine abstention in the management of anxiety disorders

1989 ◽  
Vol 19 (1) ◽  
pp. 211-214 ◽  
Author(s):  
M. S. Bruce ◽  
M. Lader
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Increased Sensitivity

SynopsisCaffeine toxicity remains a rarely reported condition, which may mimic anxiety disorders. Anxiety disorder patients do not consume toxic amounts of caffeine. However, increased sensitivity to caffeine in these patients has been suggested as contributing to their symptoms. Six cases of anxiety disorder are presented who improved with only caffeine abstention, and remained well for at least a six-month follow-up period.

scholarly journals The Prevalence of Generalised Anxiety Disorder Among Prisoners of the Penitentiary Institution in North-Eastern Poland

2021 ◽  
Vol 12 ◽  
Author(s):  
Barbara Stawinska-Witoszynska ◽  
Katarzyna Czechowska ◽  
Waclaw Moryson ◽  
Barbara Wieckowska
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Common Mental Disorders ◽  
Economic Status ◽  
Fisher Exact Test ◽  
Generalised Anxiety Disorder ◽  
Closed Type ◽  
North Eastern ◽  
The Impact

Introduction: Generalised anxiety disorder (GAD) is one of the most common mental disorders. The psychosocial factors that may lead to generalised anxiety disorders include stress, traumatic events, conscious and unconscious internal conflicts, and low social and economic status. Imprisonment and forced isolation may favour the development of depression or anxiety disorders in inmates. Thus, this study aimed to analyse the prevalence of generalised anxiety disorder (GAD) in the population of inmates detained in one of the largest penitentiary units in north-eastern Poland.Materials and Methods: The data comes from 2017 and includes information on 635 male inmates incarcerated at the Czerwony Bór Prison. The information comes from the health records of individual inmates, kept by the prison outpatient clinician, and documented consultations with doctors of units outside the prison. The classification of generalised anxiety disorders (F41.1) was made in accordance with the 10th Revision of the International Statistical Classification of Diseases and Health Problems and the clinical diagnosis made by a psychiatrist. The Mann-Whitney test was used to compare quantitative data without normal distribution, chi-squared test or Fisher exact test for comparing qualitative data. A one-dimensional and multi-dimensional logistic regression model was used to examine the impact of the prison type on the prevalence of generalised anxiety disorder.Results: Generalised anxiety disorder was observed among 44 prisoners (6.9%), most often in the age range 30–39 years and among men younger than 30 years, respectively 40.9 and 31.8% of all diagnosed. The average age of patients was 34.6 years. The least number of prisoners with GAD was in the age group 50–59 (2.3%). Nearly 66% of patients were prisoners detained in a closed type prison; the chance of generalised anxiety disorder was three times higher than among the prisoners in a half-open and open type facility. Generalised anxiety disorder was diagnosed significantly more often with those currently serving a prison sentence than those before incarceration.Conclusions: In Polish conditions, the importance of the problem associated with GAD is evidenced by a significant increase in its prevalence in the prison environment and a three times higher chance of developing generalised anxiety disorder among prisoners in a closed type institution, which calls for highly organised psychiatric care and increased availability of psychological assistance for prisoners.

scholarly journals Prevalence and identification of anxiety disorders in pregnancy: the diagnostic accuracy of the two-item Generalised Anxiety Disorder scale (GAD-2)

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e023766 ◽  
Author(s):  
Selina Nath ◽  
Elizabeth G Ryan ◽  
Kylee Trevillion ◽  
Debra Bick ◽  
Jill Demilew ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Positive Predictive Value ◽  
Anxiety Disorders ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Stratified Sampling ◽  
Generalised Anxiety Disorder ◽  
Population Prevalence

ObjectiveTo estimate the population prevalence of anxiety disorders during pregnancy and investigate the diagnostic accuracy of the two-item Generalised Anxiety Disorder scale (GAD-2) for a) GAD and b) any anxiety disorder.DesignCross-sectional survey using a stratified sampling design. Sampling weights were used in the analysis to adjust for the bias introduced by the stratified sampling.SettingInner-city maternity service, South London.Participants545 pregnant women were interviewed after their first antenatal appointment; 528 provided answers on the GAD-2 questions.Main outcome measuresDiagnosis generated by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (SCID).ResultsPopulation prevalence of anxiety disorders was 17% (95% CI 12% to 21%): 5% (95% CI 3% to 6%) for GAD, 4% (95% CI 2% to 6%) for social phobia, 8% (95% CI 5% to 11%) for specific phobia and 2% (95% CI 1% to 4%) for obsessive-compulsive disorder. Post-traumatic stress disorder (PTSD) prevalence was unclear due to higher levels of reluctance to respond to PTSD interview questions but sensitivity analyses suggest population prevalence maybe up to 4% (95% CI 2% to 6%). Weighted sensitivity of GAD-2 for GAD (cut-off ≥3) was 69%, specificity 91%, positive predictive value 26%, negative predictive value 98% and likelihood ratio 7.35. For any anxiety disorder the weighted sensitivity was 26%, specificity 91%, positive predictive value 36%, negative predictive value 87% and likelihood ratio 2.92.ConclusionsAnxiety disorders are common but GAD-2 generates many false positives and may therefore be unhelpful in maternity services.

scholarly journals The efficacy and safety of 'Antianxiety Granule' for anxiety disorder: A multicentre, randomized, double-blind, placebo-controlled, parallel-group trial

2019 ◽  
Author(s):  
Zhongwei Sha ◽  
Yiping Hou ◽  
Chunchun Xue ◽  
Ou Li ◽  
Zhimin Li ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Anxiety Disorders ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Parallel Group ◽  
Parallel Group Trial ◽  
Group Trial

Abstract Abstract Background: Anxiety disorders are the most prevalent class of lifetime disorders in China, and generalized anxiety disorder (GAD) is one of the most common but frequently overlooked anxiety disorders. Conventional pharmacological treatments for GAD have varying degrees of side effects, dependency, and/or withdrawal syndromes. Traditional Chinese Medicine (TCM) therapy is considered a valuable therapeutic option for anxiety disorders and a potentially effective technique to reduce the side effects associated with antipsychotic drugs. This trial aimed to evaluate the clinical efficacy and safety of Antianxiety Granule, a granular Chinese medicine compound, for GAD. Methods/Design: The current work is a multicentre, randomized, double-blind, placebo-controlled, parallel-group clinical trial with a 6-week treatment schedule. The study consists of three periods: a 1- to 7-day screening period, a 6-week primary treatment period, and a 1-week follow-up period. Follow-up assessments will be conducted one week after the last visit with a face-to-face interview or by telephone. The clinical efficacy of Antianxiety Granule for the treatment of GAD will be evaluated by examining the change in the Hamilton anxiety scale (HAMA) score, state-trait anxiety inventory (STAI) score, and TCM symptom scale in GAD patients who receive the daily TCM treatment. Moreover, an intention-to-treat (ITT) analysis will also be used in this randomized controlled trial (RCT). Discussion: Our study is a multicentre, randomized, double-blind, placebo-controlled, parallel-group trial to evaluate the safety and efficacy of Antianxiety Granule for the treatment of GAD. The results of this trial will provide valuable clinical evidence for the treatment of GAD. Trial registration: The trial was registered with Chinese Clinical Trial Registry (http://www.chictr.org.cn/showproj.aspx?proj=27210) under the registration number ChiCTR1800016039 on 8 May 2018. The study was approved by the Ethics Committee of the Shanghai Municipal Hospital of Traditional Chinese Medicine (2017SHL-KY-14). Keywords: Generalized anxiety disorder (GAD), Traditional Chinese Medicine (TCM), RCT, Efficacy, Safety

scholarly journals A Randomised Controlled Trial of Acceptance and Commitment Therapy and Cognitive-Behaviour Therapy for Generalised Anxiety Disorder

2014 ◽  
Vol 31 (2) ◽  
pp. 110-130 ◽  
Author(s):  
Elbina Avdagic ◽  
Shirley A. Morrissey ◽  
Mark J. Boschen
Keyword(s):  
Anxiety Disorder ◽  
Acceptance And Commitment Therapy ◽  
Treatment Completion ◽  
Generalised Anxiety Disorder ◽  
Reliable Change ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Treatment Gains ◽  
Post Assessment

The study examined the relative efficacy of group acceptance and commitment therapy (ACT) for generalised anxiety disorder (GAD) compared to group cognitive-behavioural therapy (CBT). Fifty-one individuals with GAD were randomly allocated to a 6-week intervention, either ACT or CBT. Participants were assessed at pre-treatment, post-treatment, and 3-month follow-up on symptom measures, quality of life, and process measures. Data from 38 participants (19 in each group) were available at post-assessment, indicating significant improvements on all measures for both treatment conditions. Treatment gains were maintained at follow-up, with significant further improvements in anxiety, depression and stress symptoms for both groups. While no between-group differences were found at treatment completion, a significant interaction indicating steeper reduction in worrying symptoms (d = .79) from pre- to post-assessment was found for the ACT group compared to the CBT group. Furthermore, in relation to worrying, at treatment completion 78.9% of participants in the ACT group achieved reliable change compared to 47.4% of participants in the CBT group. However, both groups showed equivalent reliable change rates of 60% at the follow-up assessment. The results suggest that group ACT was as efficacious as group CBT. While participants in the ACT group maintained treatment gains at follow-up, participants in the CBT group continued to improve between post-assessment and follow-up.

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