scholarly journals Structure of genetic and environmental risk factors for dimensional representations of DSM–IV anxiety disorders

2009 ◽  
Vol 195 (4) ◽  
pp. 301-307 ◽  
Author(s):  
Kristian Tambs ◽  
Nikolai Czajkowsky ◽  
Espen R⊘ysamb ◽  
Michael C. Neale ◽  
Ted Reichborn-Kjennerud ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Environmental Risk ◽  
Common Factor ◽  
Genetic Effect ◽  
Composite International Diagnostic Interview ◽  
Environmental Risk Factors ◽  
Post Traumatic Stress ◽  
Compulsive Disorder

BackgroundTwin data permit decomposition of comorbidity into genetically and environmentally derived correlations. No previous twin study includes all major forms of anxiety disorder.AimsTo estimate the degree to which genetic and environmental risk factors are shared rather than unique to dimensionally scored panic disorder, generalised anxiety disorder, phobias, obsessive–compulsive disorder and post-traumatic stress disorder.MethodData obtained from 2801 young-adult Norwegian twins by means of the Composite International Diagnostic Interview were analysed with the Mx program.ResultsA multivariate common factor model fitted best. The latent liability to all anxiety disorders was substantially more heritable (54%) than the individual disorders (23% to 40%). Most of the genetic effect was common to the disorders. Genes contributed just over 50% to the covariance between liabilities.ConclusionsThe five anxiety disorders all share genetic and environmental risk factors. This has implications for the revision of the anxiety disorder section in DSM–V.

Major Depression and Generalised Anxiety Disorder

1996 ◽  
Vol 168 (S30) ◽  
pp. 68-75 ◽  
Author(s):  
Kenneth S. Kendler
Keyword(s):  
Risk Factors ◽  
Anxiety Disorder ◽  
Major Depression ◽  
Environmental Risk ◽  
Genetic Factors ◽  
Environmental Risk Factors ◽  
Generalised Anxiety Disorder ◽  
Increase Risk ◽  
Twin Models ◽  
One Year

In both clinical and epidemiological samples, major depression (MD) and generalised anxiety disorder (GAD) display substantial comorbidity. In a prior analysis of lifetime MD and GAD in female twins, the same genetic factors were shown to influence the liability to MD and to GAD. A follow-up interview in the same twin cohort examined one-year prevalence for MD and GAD (diagnosed using a one-month minimum duration of illness). Bivariate twin models were fitted using the program Mx. High levels of comorbidity were observed between MD and GAD. The best-fitting twin models, when GAD was diagnosed with or without a diagnostic hierarchy, found a genetic correlation of unity between the two disorders. The correlation in environmental risk factors was +0.70 when GAD was diagnosed non-hierarchically, but zero when hierarchical diagnoses were used. Our findings provide further support for the hypothesis that in women, MD and GAD are the result of the same genetic factors. Environmental risk factors that predispose to ‘pure’ GAD episodes may be relatively distinct from those that increase risk for MD.

scholarly journals Spectrum of Anxiety Disorders Among Medical Students in a Nigerian Medical School: A Cross-Sectional Study With Standardized Screening Tools

2018 ◽  
Vol 8 (2) ◽  
pp. 132
Author(s):  
A. T. Chinawa ◽  
J. M. Chinawa ◽  
E. Aniwada ◽  
Oge Amadi ◽  
A. C. Ndukuba ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Medical Students ◽  
Anxiety Disorders ◽  
Marital Status ◽  
Simple Random Sampling ◽  
Screening Tools ◽  
P Value ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Compulsive Disorder

BACKGROUND: Anxiety disorders among medical students constitute a global problem, and also reflect the mental state of the general population. There is paucity of data on the spectrum of such disorders among medical students in Nigeria.AIM: The study aims to determine the prevalence of anxiety disorders among medical students, and the effect of socio-demographic characteristics.METHODS: A total of 217 medical students from the second to the final years of study at Enugu State University of Science and Technology in south-east Nigeria were enrolled by simple random sampling. Five pretested, self- administered standardized questionnaires were used as screening tools for anxiety disorders. Data were analyzed using the Statistical Package for Social Sciences program (SPSS version 20). A p-value less than 0.05 was taken as statistically significant.RESULTS: Thirty one (14.3%) of the enrolled medical students fulfilled the screening criteria for anxiety disorders. Specifically, generalized anxiety disorder (GAD) was significantly related to gender (p =0.017) and the year of study (p =0.017). Post-traumatic stress disorder (PTSD) was significantly related to the year of study (p =0.037), and social anxiety disorder (SAD) to the year of study (p =0.003) and gender (p =0.04). Similarly, panic disorder was significantly related to the year of study (p =0.025) while specific phobia was significantly associated with marital status (p =0.003), parental monthly income (p =0.022) and student’s monthly allowance (p =0.002). Finally, obsessive-compulsive disorder was significantly related to marital status (p =0.034) and year of study (p =0.028).CONCLUSION: Medical students in Nigeria are prone to a spectrum of anxiety disorders. This susceptibility is influenced by socio-demographic characteristics.

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.

Procedural validity of the computerized version of the Composite International Diagnostic Interview (CIDI-Auto) in the anxiety disorders

1995 ◽  
Vol 25 (6) ◽  
pp. 1269-1280 ◽  
Author(s):  
Lorna Peters ◽  
Gavin Andrews
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Major Depressive Episode ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Obsessive Compulsive ◽  
Major Depressive ◽  
Lower Range ◽  
Compulsive Disorder ◽  
Level Of Agreement

SynopsisThe procedural validity of the computerized version of the Composite International Diagnostic Interview (CIDI-Auto) was examined against the consensus diagnoses of two clinicians for six anxiety disorders (agoraphobia, panic disorder (±agoraphobia), social phobia, simple phobia, obsessive compulsive disorder (OCD), generalized anxiety disorder (GAD) and major depressive episode (MDE)). Clinicians had available to them all data obtained over a 2- to 10-month period. Subjects were 98 patients accepted for treatment at an Anxiety Disorders Clinic, thus, all subjects had at least one of the diagnoses being examined. While the CIDI-Auto detected 88·2% of the clinician diagnoses, it identified twice as many diagnoses as did the clinicians. The sensitivity of the CIDI-Auto was above 0·85 except for GAD, which had a sensitivity of 0·29. The specificity of the CIDI-Auto was lower (range: 0·47–0·99). The agreement between the CIDI-Auto and the clinician diagnoses, as measured by intraclass kappas, ranged from poor (k = 0·02; GAD) to excellent (k = 0·81; OCD), with a fair level of agreement overall (k = 0·40). Canonical correlation analysis suggested that the discrepancies between the CIDI-Auto and clinicians were not due to different diagnostic distinctions being made. It is suggested that the CIDI-Auto may have a lower threshold for diagnosing anxiety disorders than do experienced clinicians. It is concluded that, in a sample where all subjects have at least one anxiety disorder diagnosis, the CIDI-Auto has acceptable validity.

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.

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.

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 The Structure of Genetic and Environmental Risk Factors for Anxiety Disorders in Men and Women

2005 ◽  
Vol 62 (2) ◽  
pp. 182 ◽  
Author(s):  
John M. Hettema ◽  
Carol A. Prescott ◽  
John M. Myers ◽  
Michael C. Neale ◽  
Kenneth S. Kendler
Keyword(s):  
Risk Factors ◽  
Anxiety Disorders ◽  
Environmental Risk ◽  
Environmental Risk Factors ◽  
Men And Women

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.

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