scholarly journals Broadening of Generalized Anxiety Disorders Definition Does not Affect the Response to Psychiatric Care: Findings from the Observational ADAN Study

2012 ◽  
Vol 8 (1) ◽  
pp. 158-168 ◽  
Author(s):  
Enrique Álvarez ◽  
Jose L Carrasco ◽  
José M Olivares ◽  
Vanessa López-Gómez ◽  
Inma Vilardaga ◽  
...  
Keyword(s):  
Psychiatric Care ◽  
Demographic Data ◽  
Anxiety Symptoms ◽  
Generalized Anxiety ◽  
Inclusion Criteria ◽  
Associated Symptoms ◽  
Generalized Anxiety Disorders ◽  
Dsm Iv ◽  
Functional Outcome Measures ◽  
Core Symptoms

Objective:To elucidate the consequences of broadening DSM-IV criteria for generalized anxiety disorder (GAD), we examined prospectively the evolution of GAD symptoms in two groups of patients; one group diagnosed according to DSM-IV criteria and the other, according to broader criteria.Method:Multicentre, prospective and observational study conducted on outpatient psychiatric clinics. Patients were selected from October 2007 to January 2009 and diagnosed with GAD according to DSM-IV criteria (DSM-IV group) or broader criteria. Broader criteria were considered 1-month of excessive or non-excessive worry and only 2 of the associated symptoms listed on DSM-IV for GAD diagnosis. Socio-demographic data, medical history and functional outcome measures were collected three times during a 6-month period.Results:3,549 patients were systematically recruited; 1,815 patients in DSM-IV group (DG) and 1,264 in broad group (BG); 453 patients did not fulfil inclusion criteria and were excluded. Most patients (87.9% in DG, 82.0% in BG) were currently following pharmacological therapies (mainly benzodiazepines) to manage their anxiety symptoms. The changes observed during the study were: 49.0% and 58.0%, respectively of patients without anxiety symptoms as per HAM-A scale at the 6 month visit (p=0.261) and 59.7% and 67.7%, respectively (p=0.103) of responder rates (> 50% reduction of baseline scoring).Conclusion:Broadening of GAD criteria does not seem to affect psychiatric care results in subjects with GAD, is able to identify the core symptoms of the disease according to the DSM-IV criteria and could lead to an earlier diagnosis.

Broadening diagnostic criteria of generalized anxiety disorders from DSM-IV: The impact on patient level of disability

2011 ◽  
Vol 26 (S2) ◽  
pp. 172-172
Author(s):  
E. Alvarez ◽  
J.L. Carrasco ◽  
J.M. Olivares ◽  
M. Pérez ◽  
V. López-Gómez ◽  
...  
Keyword(s):  
Demographic Data ◽  
Generalized Anxiety ◽  
Sociodemographic Characteristics ◽  
Disability Score ◽  
Patient Level ◽  
Associated Symptoms ◽  
Generalized Anxiety Disorders ◽  
Dsm Iv ◽  
Functional Outcome Measures ◽  
The Impact

PurposeTo explore the consequences of broadening DSM-IV criteria for Generalized Anxiety Disorder (GAD) on patient's disability.MethodsA multicentre and observational study was carried-out in outpatient psychiatric clinics in Spain between years 2007 and 2008. Naïve diagnosed patients with GAD according to DSM-IV criteria or with anxiety symptoms fulfilling broadened criteria were compared. At least 1-month of excessive or non-excessive worry along with only two of the associated symptoms listed on DSM-IV for GAD were considered as broadened GAD criteria. Socio-demographic data, medical history and functional outcome measures were recorded.ResultsA total of 3,549 patients were systematically recruited, 12.8% excluded because not found eligible for inclusion in analysis; 1,815 in the DSM-IV group (DG) and 1,264 in the broadening criteria group (BG). Both groups were similar on their sociodemographic characteristics. Total disability score in the WHO-DAS II scale was slightly, but statistically significant, higher in DG; 41.9 (17.1) versus 38.9 (16.0) points, p < 0.05. These weak differences were observed in all of the scale domains but mainly in domains “Getting around” [34.5 (23.6) versus 29.4 (22.8), p< 0.05] and “Life activities” [55.5 (27.1) versus 52.1 (26.2), p< 0.05], since differences in the other domains, even statistically significant, were negligible.ConclusionPatients with standard DSM-IV criteria for GAD appears to show slightly, but significant, worst level of disability than subjects with broadening diagnostic GAD criteria. Life-activities and participation in society domains seems to be the functional domains most impacted by symptoms of anxiety.

Spa Therapy in Anxiety Disorder in a 8 Week Comparative and Randomized Multicentre Study on 237 Patients

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
O. Dubois
Keyword(s):  
Anxiety Disorder ◽  
Multicentre Study ◽  
Rating Scale ◽  
Therapy Group ◽  
Spa Therapy ◽  
Generalized Anxiety ◽  
Generalized Anxiety Disorders ◽  
Spa Treatment ◽  
Dsm Iv ◽  
Hamilton Rating Scale

We compared spa therapy-like balneotherapy treatment with Paroxetine by means of a multicentre, comparative, randomized 8-week study. At least 200 patients fitting the diagnosed criteria of generalized anxiety disorder (DSM IV) were to be recruited. They were carried out by an independent, fully-trained and specialized assessor.The total score on the HAM-A scale (Hamilton Rating Scale for Anxiety) was the main measure for efficiency.There were 237 patients altogether attending in ambulatory who were admitted into the 4 French centres and joined the protocol. 117 were divided up by drawing lots into the Spa Therapy group and 120 into the Paroxetine group.All 207 patients were able to be assessed at W8. The HAM-A scores at W8 showed significant improvement in the Spa Therapy group compared to the Paroxetine group (t = 3.04 p≤ 0.0001). Remission and the rate of improvement (superior or equal to 50%) were markedly higher in the Spa Therapy group.Other analyses stemming from this assessment enrich the results, with complemetary information on the importance of a spa treatment course prescribed in a psychiatric aim.In conclusion, the Spa Therapy-based Balneotherapy treatment is one that has shown specific efficiency in generalized anxiety disorders. Its profile of being well-tolerated and well-accepted by the patients may enable to introduce it regularly in GAD, particularly for people who are resistent to, dependent on or have difficulty in tolerating pharmacology or psychotherapy treatments.

scholarly journals Non-operative orthobiologic use for rotator cuff disorders and glenohumeral osteoarthritis: A systematic review

2020 ◽  
pp. 1-16
Author(s):  
David M. Robinson ◽  
Christine Eng ◽  
Steven Makovitch ◽  
Joshua B. Rothenberg ◽  
Stephanie DeLuca ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Cohort Studies ◽  
Randomized Clinical Trials ◽  
Platelet Rich Plasma ◽  
Inclusion Criteria ◽  
Serious Adverse Events ◽  
Bias Risk ◽  
Glenohumeral Osteoarthritis ◽  
Functional Outcome Measures

BACKGROUND: Shoulder pain from rotator cuff pathology and glenohumeral osteoarthritis is a common entity encountered in musculoskeletal practices. Orthobiologic agents are being increasingly used as a treatment option and understanding their safety and efficacy is necessary. OBJECTIVE: To systematically evaluate the available evidence for orthobiologic use in rotator cuff and glenohumeral pathology. METHODS: A systematic review was undertaken following PRISMA guidelines. Randomized clinical trials (RCTs) and prospective cohort studies evaluating non-operative treatment with prolotherapy, platelet-rich plasma (PRP), or medicinal signaling cells (MSCs) for rotator cuff pathology and glenohumeral osteoarthritis were included. Bias risk assessments used were the Cochrane tool and Newcastle-Ottawa score. RESULTS: The search yielded 852 potential articles, of which 20 met the inclusion criteria with a breakdown of 5 prolotherapy, 13 PRP, and 2 MSC. Sixteen studies were RCTs and 4 were cohort studies. Six studies were deemed “low risk of bias or good quality”. Efficacy results were mixed, and no serious adverse events were reported from orthobiologic treatment. CONCLUSIONS: Orthobiologics offer a relatively safe management option with inconclusive evidence for or against its use for rotator cuff pathology. No studies on glenohumeral osteoarthritis met the inclusion criteria. Adoption of standardized preparation reporting and consistent use of functional outcome measures is imperative for future studies to consider.

Efficacy of Cognitive Behaviour Therapy in Generalized Anxiety Disorders

2004 ◽  
Vol 74 (1) ◽  
pp. 36-42 ◽  
Author(s):  
M. Linden ◽  
D. Zubraegel ◽  
T. Baer ◽  
U. Franke ◽  
P. Schlattmann
Keyword(s):  
Anxiety Disorders ◽  
Cognitive Behaviour Therapy ◽  
Generalized Anxiety ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Generalized Anxiety Disorders

Self-monitoring in patients with schizophrenia

2004 ◽  
Vol 34 (8) ◽  
pp. 1561-1569 ◽  
Author(s):  
GÜNTHER KNOBLICH ◽  
FRANK STOTTMEISTER ◽  
TILO KIRCHER
Keyword(s):  
Hand Movements ◽  
Control Group ◽  
Formal Thought Disorder ◽  
Self Monitoring ◽  
The Core ◽  
Matched Healthy Control ◽  
Healthy Control ◽  
Dsm Iv ◽  
Core Symptoms ◽  
The Relationship

Background. The present study investigated whether a failure of self-monitoring contributes to core syndromes of schizophrenia.Method. Three groups of patients with a DSM-IV diagnosis of schizophrenia (n=27), with either prominent paranoid hallucinatory or disorganization syndrome, or without these symptoms, and a matched healthy control group (n=23) drew circles on a writing pad connected to a PC monitor. Subjects were instructed to continuously monitor the relationship between their hand movements and their visual consequences. They were asked to detect gain changes in the mapping. Self-monitoring ability and the ability to automatically correct movements were assessed.Results. Patients with either paranoid-hallucinatory syndrome or formal thought disorder were selectively impaired in their ability to detect a mismatch between a self-generated movement and its consequences, but not impaired in their ability to automatically compensate for the gain change.Conclusions. These results support the claim that a failure of self-monitoring may underlie the core symptoms of schizophrenia.

Depression and Generalized Anxiety Symptoms in Panic Disorder Implications for Comorbidity

1995 ◽  
Vol 183 (5) ◽  
pp. 304-308 ◽  
Author(s):  
SUSAN G. BALL ◽  
ALEXANDER M. BUCHWALD ◽  
MARIA T. WADDELL ◽  
ANANTHA SHEKHAR
Keyword(s):  
Panic Disorder ◽  
Anxiety Symptoms ◽  
Generalized Anxiety

Cement-in-cement femoral component revision

2021 ◽  
Vol 103-B (7) ◽  
pp. 1215-1221
Author(s):  
John W. Kennedy ◽  
Nigel Y. B. Ng ◽  
David Young ◽  
Nicholas Kane ◽  
Andrew G. Marsh ◽  
...  
Keyword(s):  
Femoral Component ◽  
Short Form ◽  
Demographic Data ◽  
Senior Author ◽  
Inclusion Criteria ◽  
Reliable Technique ◽  
Patient Demographic Data ◽  
Oxford Hip Score ◽  
Component Revision

Aims Cement-in-cement revision of the femoral component represents a widely practised technique for a variety of indications in revision total hip arthroplasty. In this study, we compare the clinical and radiological outcomes of two polished tapered femoral components. Methods From our prospectively collated database, we identified all patients undergoing cement-in-cement revision from January 2005 to January 2013 who had a minimum of two years' follow-up. All cases were performed by the senior author using either an Exeter short revision stem or the C-Stem AMT high offset No. 1 prosthesis. Patients were followed-up annually with clinical and radiological assessment. Results A total of 97 patients matched the inclusion criteria (50 Exeter and 47 C-Stem AMT components). There were no significant differences between the patient demographic data in either group. Mean follow-up was 9.7 years. A significant improvement in Oxford Hip Score (OHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and 12-item Short-Form Survey (SF-12) scores was observed in both cohorts. Leg lengths were significantly shorter in the Exeter group, with a mean of -4 mm in this cohort compared with 0 mm in the C-Stem AMT group. One patient in the Exeter group had early evidence of radiological loosening. In total, 16 patients (15%) underwent further revision of the femoral component (seven in the C-Stem AMT group and nine in the Exeter group). No femoral components were revised for aseptic loosening. There were two cases of femoral component fracture in the Exeter group. Conclusion Our series shows promising mid-term outcomes for the cement-in-cement revision technique using either the Exeter or C-Stem AMT components. These results demonstrate that cement-in-cement revision using a double or triple taper-slip design is a safe and reliable technique when used for the correct indications. Cite this article: Bone Joint J 2021;103-B(7):1215–1221.

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