The associations between childhood trauma and work functioning in adult workers with and without depressive and anxiety disorders

Abstract Background: To examine the association between childhood trauma and work functioning, and to elucidate to what extent this association can be accounted for by depression and/or anxiety. Methods: Data of 1,649 working participants were derived from the Netherlands Study of Depression and Anxiety (NESDA, n = 2,981). Childhood trauma (emotional neglect, psychological, physical, and sexual abuse before age 16) was assessed with a structured interview and work functioning, in terms of absenteeism and presenteeism, with the Health and Labor Questionnaire Short Form (SF-HLQ) and the World Health Organization Disability Assessment Schedule II (WHODAS-II), respectively. Depressive and/or anxiety disorders were assessed with the Composite Interview Diagnostic Instrument (CIDI). Mediation analyses were conducted. Results: At baseline, 44.8% reported to have experienced childhood trauma. Workers with the highest childhood trauma level showed significantly (p < 0.001) more absenteeism as well as more presenteeism. Mediation analyses revealed that indirect effects between the childhood trauma index and both work indices were significantly mediated by current depressive disorder (p = 0.023 and p < 0.001, respectively) and current comorbid depression-anxiety (p = 0.020 and p < 0.001, respectively), with the latter accounting for the largest effects (PM = 0.23 and PM = 0.29, respectively). No significant mediating role in this relationship was found for current anxiety disorder and remitted depressive and/or anxiety disorder. Conclusions: Persons with childhood trauma have significantly reduced work functioning in terms of absenteeism and presenteeism. This seems to be largely accounted for by current depressive disorders and current comorbid depression-anxiety.

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Dimensional anxiety scales for DSM-5: Sensitivity to clinical severity

European Psychiatry ◽

10.1016/j.eurpsy.2013.02.001 ◽

2013 ◽

Vol 28 (7) ◽

pp. 448-456 ◽

Cited By ~ 24

Author(s):

S. Knappe ◽

J. Klotsche ◽

A. Strobel ◽

R.T. LeBeau ◽

M.G. Craske ◽

...

Keyword(s):

Anxiety Disorder ◽

Anxiety Disorders ◽

Depressive Disorders ◽

Specific Phobia ◽

Panic Attacks ◽

Clinical Severity ◽

Global Functioning ◽

Clinical Sensitivity ◽

Dsm 5 ◽

Wide Range

AbstractPurposePsychometric properties and clinical sensitivity of brief self-rated dimensional scales to supplement categorical diagnoses of anxiety disorders in the DSM-5 were recently demonstrated in a German treatment seeking sample of adults. The present study aims to demonstrate sensitivity of these scales to clinical severity levels.MethodsThe dimensional scales were administered to 102 adults at a university outpatient clinic for psychotherapy. Diagnostic status was assessed using the Munich-Composite International Diagnostic Interview. To establish a wide range of clinical severity, we considered subthreshold (n= 83) and threshold anxiety disorders (n= 49, including Social Phobia, Specific Phobia, Agoraphobia, Panic Disorder, and Generalized Anxiety Disorder).ResultsIndividuals with either subthreshold or threshold anxiety disorder scored higher on all dimensional scales relative to individuals without anxiety. In addition, individuals with a threshold anxiety disorder scored higher on the dimensional scales than individuals with a subthreshold anxiety disorder (except for specific phobia). Disorder-related impairment ratings, global functioning assessments and number of panic attacks were associated with higher scores on dimensional scales. Findings were largely unaffected by the number of anxiety disorders and comorbid depressive disorders.ConclusionThe self-rated dimensional anxiety scales demonstrated sensitivity to clinical severity, and a cut-off based on additional assessment of impairment and distress may assist in the discrimination between subthreshold and threshold anxiety disorders. Findings suggest further research in various populations to test the utility of the scales for use in DSM-5.

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Diagnosis and Epidemiology of Anxiety, Obsessive-Compulsive, and Trauma and Stressor-Related Disorders

10.1093/med/9780190681425.003.0032 ◽

2017 ◽

Author(s):

Murray B. Stein ◽

Meghan E. Keough ◽

Peter P. Roy-Byrne

Keyword(s):

Systematic Review ◽

Anxiety Disorder ◽

Anxiety Disorders ◽

Depressive Disorders ◽

Obsessive Compulsive ◽

Prevalence Studies ◽

Current Prevalence ◽

The World ◽

Heavy Burden ◽

Dsm Iv

The anxiety, obsessive-compulsive, and trauma- and stressor-related disorders are, together, the most common class of mental disorders. From a systematic review of prevalence studies across 44 countries, the global current prevalence for the DSM IV anxiety disorders was estimated at 7.3% (95% CI 4.8%–10.9%), suggesting that one in 14 people around the world at any given time has an anxiety disorder. Women are approximately twice as likely as men to have an anxiety disorder. Anxiety disorders are a substantial contributor to the heavy burden of disease conveyed by mental and substance use disorders worldwide, where they are second only to depressive disorders in years-lost-to-disabilility.

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Systematic Review and Meta-Analysis of Anxiety and Depression in Youth With Epilepsy

Journal of Pediatric Psychology ◽

10.1093/jpepsy/jsz099 ◽

2020 ◽

Vol 45 (2) ◽

pp. 133-144 ◽

Cited By ~ 2

Author(s):

Amelia J Scott ◽

Louise Sharpe ◽

Max Loomes ◽

Milena Gandy

Keyword(s):

Systematic Review ◽

Anxiety Disorder ◽

Anxiety Disorders ◽

Depressive Disorders ◽

Meta Analysis ◽

Control Sample ◽

Separation Anxiety Disorder ◽

Anxiety And Depression ◽

Healthy Controls ◽

Pooled Prevalence

Abstract Objective The aim of this systematic review and meta-analysis was to provide an estimate of the prevalence of anxiety and depressive disorders in youth with epilepsy (YWE). It also aimed to calculate the overall magnitude of observed differences in anxiety and depressive symptoms reported by YWE compared with healthy controls and investigate whether any factors moderated anxiety and depression outcomes in YWE. Methods Following prospective registration, electronic databases were searched up until October 2018. Studies were included if they reported on the rate of anxiety or depression in samples of YWE, and/or if they used valid measures of anxious or depressive symptomatology in YWE compared with a healthy control sample. Results Twenty-three studies met inclusion criteria. The overall pooled prevalence of anxiety disorders in YWE was 18.9% (95% confidence interval [CI] 12.0%–28.5%), and for depression the pooled prevalence was 13.5% (95% CI 8.8%–20.2%). In samples of YWE compared with healthy controls, significantly higher anxiety (d = 0.57, 95% CI 0.32–0.83, p < .000) and depressive (d = 0.42, 95% CI 0.16–0.68, p < .000) symptomatology was reported. Conclusions YWE report anxiety and depressive disorders and symptoms to a significantly higher degree than youth without epilepsy. There is also evidence that certain anxiety disorders (e.g. generalized anxiety disorder, separation anxiety disorder) are particularly elevated, perhaps reflecting the unique impact of epilepsy on youth psychopathology. Research is needed to understand the risk factors associated with anxiety and depressive disorders in epilepsy, and better understand how these symptoms change across development.

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The Moderating Effects of Coping Strategies on Major Depression in the General Population

The Canadian Journal of Psychiatry ◽

10.1177/070674370204700207 ◽

2002 ◽

Vol 47 (2) ◽

pp. 167-173 ◽

Cited By ~ 19

Author(s):

JianLi Wang ◽

Scott B Pat ten

Keyword(s):

Major Depression ◽

General Population ◽

Coping Strategies ◽

Life Stress ◽

Depressive Disorders ◽

Short Form ◽

Composite International Diagnostic Interview ◽

Diagnostic Interview ◽

World Health ◽

Moderating Effects

Objectives: To evaluate the moderating effects of various coping strategies on the as sociation between stressors and the prevalence of major depression in the general population. Methods: Subjects from the Alberta buy- incomponent of the 1994 –1995 National Population Health Survey (NPHS) were included in the analysis ( n = 1039). Each subject was asked 8 questions about coping strategies that dealt with unexpected stress from family problems and personal crises. Major depression was measured using the World Health Organization's (WHO) Composite International Diagnostic Interview-Short Form (CIDI- SF) for major depression. The im pacts of coping strategies in relation to psychological stres sors on the prevalence of major depression were de ter mined by examining interactions between coping and life stress on major depression using logistic regression modelling. Results: No robust impact of coping strategies in relation to various categories of stress evaluated in the NPHS was observed. There was evidence that the use of “pray and seek religious help” and “talks to others about the situations” as coping strategies by women moderated the risk of major depression in the presence of financial stress and relation ship stress (with a partner). Using emotional expression as a coping strategy by women might de crease the risk of major depression in the presence of 1 or more re cent life events, personal stress, relationship stress (with a partner), and environmental stress. Conclusion: Different coping strategies may have a differential impact on the prevalence of major depression in specific circumstances. These findings may be important both to prevent and to treat depressive disorders.

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Anxiety disorders in an attention-deficit/hyperactivity disorder clinical sample

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2005000300008 ◽

2005 ◽

Vol 63 (2b) ◽

pp. 407-409 ◽

Cited By ~ 21

Author(s):

Isabella Souza ◽

Maria Antônia Pinheiro ◽

Paulo Mattos

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Anxiety Disorder ◽

Anxiety Disorders ◽

Children And Adolescents ◽

Attention Deficit ◽

Clinical Sample ◽

Structured Interview ◽

Separation Anxiety Disorder ◽

Clinical Samples ◽

Hyperactivity Disorder

OBJECTIVE: To evaluate the prevalence of anxiety disorders in a clinical referred sample of children and adolescents with attention deficit/hyperactivity disorder (ADHD). METHOD: 78 children and adolescents with ADHD according to DSM-IV criteria were investigated with a semi-structured interview (P-CHIPS), complemented by clinical interviews with the children or adolescents and their parents. Their IQ was calculated with neuropsychological testing. RESULTS: A high prevalence of anxiety disorders (23.05%) was found in the sample. Generalized anxiety disorder was the most prevalent disorder (12,8%), followed by social phobia (3,84%) and separation anxiety disorder (3,8%). Two children showed more than one anxiety disorder. CONCLUSION: Children and adolescents with ADHD seem to be more prone to have comorbid anxiety disorders, at least in clinical samples referred to specialized units.

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Systematic review of the outcome of anxiety and depressive disorders

The British Journal of Psychiatry ◽

10.1192/s0007125000293501 ◽

1998 ◽

Vol 173 (S34) ◽

pp. 35-41 ◽

Cited By ~ 31

Author(s):

J. Emmanuel ◽

S. Simmonds ◽

P. Tyrer

Keyword(s):

Systematic Review ◽

Anxiety Disorder ◽

Clinical Outcome ◽

Anxiety Disorders ◽

Strong Evidence ◽

Depressive Disorders ◽

Medline Search ◽

Diagnostic Categories ◽

The Past ◽

Standard Procedures

Background Although there have been many changes in the diagnosis of anxiety and depressive disorders in the past 20 years there have been few comparative enquiries into the clinical outcome of greater diagnostic categories. We therefore compared the outcome of all studies which compared the outcome of specific anxiety and depressive disorders using the standard procedures of systematic review.Method A Medline search was carried out of all studies comparing the outcome of anxiety and depressive disorders or mixed anxiety-depressive disorders in which information was available separately for each disorder.Results Eight studies satisfied the search criteria (all involving a period of observation of two years or greater); only one of these included randomisation of treatment and comparison between specific anxiety disorder outcome. There was a somewhat better outcome in patients with depressive disorders compared with anxiety ones, and strong evidence that both anxiety and depressive disorders singly had better outcomes than comorbid mixed disorders.Conclusion Comorbid anxiety-depressive disorders have a poor outcome compared with single anxiety and depressive disorders, and there is some evidence that anxiety disorders have a worse outcome than depressive ones.

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Transdiagnostic treatment using a unified protocol: application for patients with a range of comorbid mood and anxiety disorders

Trends in Psychiatry and Psychotherapy ◽

10.1590/s2237-60892013000200007 ◽

2013 ◽

Vol 35 (2) ◽

pp. 134-140 ◽

Cited By ~ 14

Author(s):

Ana Claudia C. de Ornelas Maia ◽

Arthur Azevedo Braga ◽

Cristiane Aparecida Nunes ◽

Antonio Egidio Nardi ◽

Adriana Cardoso Silva

Keyword(s):

Quality Of Life ◽

Anxiety Disorder ◽

Anxiety Disorders ◽

World Health ◽

Depression Symptoms ◽

Evaluation Instrument ◽

World Health Organization Quality ◽

Unified Protocol ◽

Mood And Anxiety Disorders

OBJECTIVE: To evaluate the effectiveness of a unified cognitive-behavioral therapy protocol for group treatment of patients with a range of comorbid mood and anxiety disorders. METHODS: In this open-trial study, the unified protocol was followed for the psychotherapeutic treatment of 16 patients with comorbid mood and anxiety disorders, confirmed by the Mini International Neuropsychiatric Interview. Beck Depression and Anxiety Inventories, the World Health Organization Quality of Life evaluation instrument, and the ARIZONA scale of sexual function were used to evaluate progress in patients throughout the therapeutic process. RESULTS: All patients showed unipolar depressive disorder. Comorbidity with anxiety disorders was distributed as follows: generalized anxiety disorder, 13 (81.3%); panic disorder, 3 (18.8%); social anxiety disorder, 1 (6.3%); and post-traumatic stress disorder, 1 (6.3%). Improvement was observed in the signs and symptoms of depression (F = 78.62, p < 0.001) and anxiety (F = 19.64, p < 0.001), overall quality of life (F = 39.72, p < 0.001), physical domain (F = 28.15, p < 0.001)), psychological variables (F = 9.90, p = 0.007), social functioning (F = 36.86, p < 0.001), environmental variables (F = 27.63, p < 0.001), and sexuality (F = 13.13; p < 0.005). All parameters showed highly significant correlations (p < 0.01). CONCLUSION: An effort to establish one unified treatment protocol for a whole family of emotional disorders (primarily mood and anxiety disorders) showed benefits in the field of clinical psychology and for the treatment of patients. No other data were found in the literature describing the implementation of the unified protocol in a transdiagnostic group. Our results revealed statistically significant improvement in all variables, suggesting that the protocol proposed can become an important tool to improve quality of life, sexuality, and anxiety/depression symptoms in patients with different diagnoses.

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The Association Between Generalized Anxiety Disorder and Resting-State Prefrontal Cortex Oxygenation Is Modified by Self-Reported Physical Activity: Results From The Irish Longitudinal Study on Ageing

The Journals of Gerontology Series A ◽

10.1093/gerona/glab090 ◽

2021 ◽

Author(s):

Cillian P McDowell ◽

Louise Newman ◽

Derek C Monroe ◽

John D O’Connor ◽

Silvin P Knight ◽

...

Keyword(s):

Physical Activity ◽

Prefrontal Cortex ◽

Longitudinal Study ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Resting State ◽

Short Form ◽

Saturation Index ◽

World Health ◽

Generalized Anxiety

Abstract Individuals with anxiety disorders exhibit lower intrinsic functional connectivity between prefrontal cortical areas and subcortical regions. The prefrontal cortex (PFC) is sensitive to the acute and chronic effects of physical activity (PA), while the anxiolytic effects of PA are well known. The current study examined the association of generalized anxiety disorder (GAD) and its interaction with PA, with resting-state, left PFC oxygenation. This cross-sectional study used data from participants (N = 2444) from The Irish Longitudinal Study on Ageing, a nationally representative prospective study of community-living adults aged 50 and older in Ireland. The Composite International Diagnostic Interview Short-Form determined fulfillment of criteria for GAD. The short-form International Physical Activity Questionnaire determined adherence to the World Health Organization PA guidelines. Resting-state, left PFC oxygenation was continuously measured via a Portalite. Tissue saturation index (TSI) was calculated as the ratio of oxygenated hemoglobin to total tissue hemoglobin (expressed as a percentage) for the final minute of a 5-minute supine-rest period. Multivariable linear regression quantified associations of GAD with TSI in the total population and population stratified by PA status. Participants with GAD had lower TSI (b = −1.416, p = .008) compared to those without GAD. However, this association was modified by PA. Among participants who met the PA guidelines, TSI did not differ according to GAD status (b = −0.800, p = .398). For participants who did not meet the guidelines, TSI was significantly lower among those with GAD (b = −1.758, p = .004). These findings suggest that PA may help to protect brain health among older adults with GAD.

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Prevalence, symptom patterns and comorbidity of anxiety and depressive disorders in primary care in qatar

European Psychiatry ◽

10.1016/s0924-9338(11)71849-1 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 138-138

Author(s):

A. Bener

Keyword(s):

Health Care ◽

Primary Health Care ◽

Anxiety Disorder ◽

Anxiety Disorders ◽

Depressive Disorders ◽

Common Symptom ◽

Age Group ◽

Depression And Anxiety ◽

Primary Health ◽

Co Morbidity

AimTo determine the prevalence of anxiety and depressive disorders in Qatari population who attend the primary health care settings and examine their symptoms patterns and co-morbidity.DesignA cross sectional.SettingPrimary health care center, QatarSubjectsA total of 2080 Qatari subjects aged 18 to 65 years were approached and 1660 (79.8%) patients participated in this study.MethodsThe study was based on a face to face interview with a designed diagnostic screening questionnaire which consists of 17 questions about symptoms and signs of anxiety and depression disorders. Physicians determined the definitive diagnosis for depression and anxiety disorders by further checking and screening their symptoms.ResultsThe overall prevalence of depression and anxiety disorder was 13.5% and 10.3% respectively. Qatari women were at higher risk for depression (53.1% vs 46.9%) and anxiety disorder (56.7% vs 43.3%) compared to men. More than half of the sufferers with anxiety (56.7%) and depression (53.1%) were Qatari women with a higher frequency in the age group 1834 years. There were significant differences between men and women with depression in terms of age group (p = 0.004), marital status (p = 0.04), occupation (p < 0.001) and household income (p = 0.002). Nervousness was the most common symptom in subjects with anxiety disorders (68.4%), whereas sleep difficulty was the most common symptom in subjects with depressive disorder (59.4%).ConclusionThe depression was more prevalent in Qatari than anxiety disorders. The high risk groups of depression and anxiety disorders were being female, married, middle aged and highly educated.

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Emotion-modulated startle in anxiety disorders is blunted by co-morbid depressive episodes

Psychological Medicine ◽

10.1017/s003329171000036x ◽

2010 ◽

Vol 41 (1) ◽

pp. 129-139 ◽

Cited By ~ 31

Author(s):

A. Taylor-Clift ◽

B. H. Morris ◽

J. Rottenberg ◽

M. Kovacs

Keyword(s):

Anxiety Disorder ◽

Anxiety Disorders ◽

Depressive Episode ◽

Emotional Reactivity ◽

Depressive Disorders ◽

Late Onset ◽

Response Patterns ◽

Emotional Responding ◽

Depressive Episodes ◽

A Current

BackgroundWhile anxiety has been associated with exaggerated emotional reactivity, depression has been associated with blunted, or context insensitive, emotional responding. Although anxiety and depressive disorders are frequently co-morbid, surprisingly little is known about emotional reactivity when the two disorders co-occur.MethodWe utilized the emotion-modulated startle (EMS) paradigm to examine the effects of a concurrent depressive episode on emotional reactivity in young adults with anxiety disorders. Using an archival dataset from a multi-disciplinary project on risk factors in childhood-onset depression, we examined eye-blink startle reactions to late-onset auditory startle probes while participants viewed pictures with affectively pleasant, unpleasant and neutral content. EMS response patterns were analyzed in 33 individuals with a current anxiety (but no depressive) disorder, 24 individuals with a current anxiety disorder and co-morbid depressive episode and 96 healthy controls.ResultsControl participants and those with a current anxiety disorder (but no depression) displayed normative linearity in startle responses, including potentiation by unpleasant pictures. By contrast, individuals with concurrent anxiety and depression displayed blunted EMS.ConclusionsAn anxiety disorder concurrent with a depressive episode is associated with reactivity that more closely resembles the pattern of emotional responding that is typical of depression (i.e. context insensitive) rather than the pattern that is typical for anxiety (i.e. exaggerated).

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