scholarly journals Use of medication and psychological counselling among Canadians with mood and/or anxiety disorders

2017 ◽  
Vol 37 (5) ◽  
pp. 160-171 ◽  
Author(s):  
Siobhan O’Donnell ◽  
Maria Syoufi ◽  
Wayne Jones ◽  
Kathryn Bennett
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Treatment Options ◽  
Individual Characteristics ◽  
Perceived Barriers ◽  
Prescription Medications ◽  
Concurrent Disorders ◽  
Psychological Counselling ◽  
The Past ◽  
The Common

Introduction This study describes the use of prescription medications and psychological counselling in the past 12 months among Canadian adults with a self-reported mood and/or anxiety disorder diagnosis; the sociodemographic and clinical characteristics associated with their use; and reasons for not using them. Methods We used data from the 2014 Survey on Living with Chronic Diseases in Canada—Mood and Anxiety Disorders Component. The study sample (n = 2916) was divided into four treatment subgroups: (1) taking medication only; (2) having received counselling only; (3) both; or (4) neither. We combined the first three subgroups and carried out descriptive and multivariate logistic regression analyses comparing those who are taking medication and/or have received counselling in the past 12 months, versus those doing neither. Estimates were weighted to represent the Canadian adult household population living in the 10 provinces with diagnosed mood and/or anxiety disorders. Results The majority (81.8%) of Canadians with a mood and/or an anxiety disorder diagnosis reported they are taking medications and/or have received counselling (47.6% taking medications only; 6.9% received counselling only; and 27.3% taking/having received both). Upon controlling for individual characteristics, taking medications and/or having received counselling was significantly associated with older age; higher household income; living in the Atlantic region or Quebec versus Ontario; and having concurrent disorders or mood disorders only. Symptoms controlled without medication was the most common reason for not taking medications, while preferring to manage on their own and taking medications were among the common reasons for not having received counselling. Conclusion The majority of Canadian adults with a mood and/or an anxiety disorder diagnosis are taking medications, while few have received counselling. Insights gained regarding the factors associated with these treatments, and reasons for not using them, emphasize the importance of discussing treatment options and perceived barriers with patients to ensure they receive the best treatment according to their needs and preference.

Systematic review of the outcome of anxiety and depressive disorders

1998 ◽  
Vol 173 (S34) ◽  
pp. 35-41 ◽  
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.

scholarly journals Treatment of anxiety disorders

2017 ◽  
Vol 19 (2) ◽  
pp. 93-107 ◽  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Burden Of Illness ◽  
Behavioral Therapy ◽  
Treatment Plan ◽  
Treatment Options ◽  
Level Of Evidence ◽  
Randomized Controlled Studies ◽  
Meta Analyses

Anxiety disorders (generalized anxiety disorder, panic disorder/agoraphobia, social anxiety disorder, and others) are the most prevalent psychiatric disorders, and are associated with a high burden of illness. Anxiety disorders are often underrecognized and undertreated in primary care. Treatment is indicated when a patient shows marked distress or suffers from complications resulting from the disorder. The treatment recommendations given in this article are based on guidelines, meta-analyses, and systematic reviews of randomized controlled studies. Anxiety disorders should be treated with psychological therapy, pharmacotherapy, or a combination of both. Cognitive behavioral therapy can be regarded as the psychotherapy with the highest level of evidence. First-line drugs are the selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. Benzodiazepines are not recommended for routine use. Other treatment options include pregabalin, tricyclic antidepressants, buspirone, moclobemide, and others. After remission, medications should be continued for 6 to 12 months. When developing a treatment plan, efficacy, adverse effects, interactions, costs, and the preference of the patient should be considered.

scholarly journals Health status, activity limitations, work-related restrictions and level of disability among Canadians with mood and/or anxiety disorders

2016 ◽  
Vol 36 (12) ◽  
pp. 289-301 ◽  
Author(s):  
Lidia Loukine ◽  
Siobhan O’Donnell ◽  
E. M. Goldner ◽  
Louise McRae ◽  
H. Allen
Keyword(s):  
Mental Health ◽  
Anxiety Disorders ◽  
Population Based ◽  
Individual Characteristics ◽  
Severe Disability ◽  
Activity Limitations ◽  
Physical And Mental Health ◽  
Concurrent Disorders ◽  
Work Related ◽  
Mood And Anxiety Disorders

Introduction This study provides the first overview of the perceived general and mental health, activity limitations, work-related restrictions and level of disability, as well as factors associated with disability severity, among Canadian adults with mood and/or anxiety disorders, using a population-based household sample. Methods We used data from the 2014 Survey on Living with Chronic Diseases in Canada– Mood and Anxiety Disorders Component. The sample consists of Canadians aged 18 years and older with self-reported mood and/or anxiety disorders from the 10 provinces (n = 3361; response rate 68.9%). We conducted descriptive and multinomial multivariate logistic regression analyses. Results Among Canadian adults with mood and/or anxiety disorders, over one-quarter reported “fair/poor” general (25.3%) and mental (26.1%) health; more than one-third (36.4%) reported one or more activity limitations; half (50.3%) stated a job modification was required to continue working; and more than one-third (36.5%) had severe disability. Those with concurrent mood and anxiety disorders reported poorer outcomes: 56.4% had one or more activity limitations; 65.8% required a job modification and 49.6% were severely disabled. Upon adjusting for individual characteristics, those with mood and/or anxiety disorders who were older, who had a household income in the lowest or lower-middle adequacy quintile or who had concurrent disorders were more likely to have severe disability. Conclusion Findings from this study affirm that mood and/or anxiety disorders, especially concurrent disorders, are associated with negative physical and mental health outcomes. Results support the role of public health policy and programs aimed at improving the lives of people living with these disorders, in particular those with concurrent disorders.

Overview of Diagnosis and Drug Treatments of Anxiety Disorders

CNS Spectrums ◽  
2005 ◽  
Vol 10 (1) ◽  
pp. 49-56 ◽  
Author(s):  
David J. Nutt
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Drug Treatments ◽  
The Common

AbstractAnxiety disorders are common and often disabling. They fall into five main categories: panic disorder, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder and posttraumatic stress disorder, each of which have characteristic symptoms and cognitions. All anxiety disorders respond to drugs and psychological treatments. This review will focus on drug treatments. Recent research has emphasized the value of antidepressants especially the selective serotonin reuptake inhibitors, benzodiazepines, and related sedative-like compounds. The common co-existence of depression with all of the anxiety disorders means that the selective serotonin reuptake inhibitors are now generally considered to be the first-line treatments but the benzodiazepines have some utility especiaRy in promoting sleep and working acutely to reduce extreme distress.

scholarly journals Factors associated with delayed diagnosis of mood and/or anxiety disorders

2017 ◽  
Vol 37 (5) ◽  
pp. 137-148 ◽  
Author(s):  
Ricky Cheung ◽  
Siobhan O’Donnell ◽  
Nawaf Madi ◽  
Elliot M Goldner
Keyword(s):  
Mental Health ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Symptom Onset ◽  
Delayed Diagnosis ◽  
Individual Characteristics ◽  
Physical And Mental Health ◽  
Early Symptom ◽  
Delay In Diagnosis ◽  
Time To Diagnosis

Introduction This study examined the association between time to diagnosis and sociodemographic and clinical characteristics as well as time to diagnosis and physical and mental health status, among Canadian adults with a self-reported mood and/or anxiety disorder diagnosis. Methods We used data from the 2014 Survey on Living with Chronic Diseases in Canada—Mood and Anxiety Disorders Component. The study sample (n=3212) was divided into three time to diagnosis subgroups: long (> 5 years), moderate (1–5 years) and short ($lt; 1 year). We performed descriptive and multinomial multivariate logistic regression analyses. Estimates were weighted to represent the Canadian adult household population living in the 10 provinces with diagnosed mood and/or anxiety disorders. Results The majority (61.6%) of Canadians with a mood and/or anxiety disorder diagnosis reported having received their diagnosis more than one year after symptom onset (30.0% reported a moderate delay and 31.6% a long delay). Upon controlling for individual characteristics, we found significant associations between a moderate delay and having no or few physical comorbidities; a long delay and older age; and both moderate and long delays and early age of symptom onset. In addition, a long delay was significantly associated with “poor” or “fair” perceived mental health and the greatest number of activity limitations. Conclusion These findings affirm that a long delay in diagnosis is associated with negative health outcomes among Canadian adults with mood and/or anxiety disorders. Time to diagnosis is particularly suboptimal among older adults and people with early symptom onset. Tailored strategies to facilitate an early diagnosis for those at greatest risk of a delayed diagnosis, especially for those with early symptom onset, are needed.

scholarly journals To clot, or not to clot – Antithrombotic therapy is the question

2019 ◽  
Vol 61 (3) ◽  
pp. 32-40
Author(s):  
E. Osuch ◽  
A. Marais
Keyword(s):  
Blood Platelets ◽  
Vitamin K Antagonists ◽  
Treatment Options ◽  
Factor Xa ◽  
Individual Characteristics ◽  
Coagulation Cascade ◽  
Clot Lysis ◽  
Vascular Endothelial ◽  
Pharmacological Management ◽  
The Past

Haemostasis and thrombosis rely on three components namely the vascular endothelial wall, blood platelets and the coagulation cascade. Non-physiologic excessive thrombosis occurs when haemostatic processes are dysfunctional, causing undue clot formation or reduced clot lysis. Antithrombotic agents including antiplatelet, anticoagulation and fibrinolytic agents are essential for the prophylaxis and pharmacological management of venous thromboembolism and arterial thrombosis. Anticoagulation treatment options have expanded steadily over the past few decades, providing a greater number of agents. Anticoagulants that directly target the enzymatic activity of thrombin and factor Xa have recently been developed to address the inadequacies of traditional vitamin K antagonists. Appropriate use of these agents requires knowledge of their individual characteristics, risks, and benefits.

Anxiety disorders in primary care

2017 ◽  
Author(s):  
Markus Dold ◽  
Siegfried Kasper
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Generalized Anxiety Disorder ◽  
Social Anxiety Disorder ◽  
Pharmacological Treatment ◽  
Treatment Options ◽  
Specific Phobia ◽  
Generalized Anxiety

Chapter 7 summarizes the epidemiology, clinical characteristics, and evidence for pharmacological treatment options of generalized anxiety disorder, panic disorder, agoraphobia, specific phobia, and social anxiety disorder. With regard to the pharmacological management, serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) represent the well-established first-line medication for generalized anxiety disorder (GAD), panic disorder, agoraphobia, and social anxiety disorder. In GAD, also the calcium channel modulator pregabalin can be regarded as evidence-based treatment option. In simple cases of specific phobia, however, the initiation of a pharmacotherapy is not recognized as standard treatment according to international treatment guidelines and psychotherapeutic interventions should be preferred. Besides illustrating the pharmacological treatment options, we described the actualized diagnostic criteria for anxiety disorders established in the newly introduced fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V).

An Overview of Dementias

2012 ◽  
Vol 21 (3) ◽  
pp. 75-84
Author(s):  
Venkata Vijaya K. Dalai ◽  
Jason E. Childress ◽  
Paul E Schulz
Keyword(s):  
Clinical Presentation ◽  
Treatment Options ◽  
Current Treatment ◽  
Great Variability ◽  
Health Concern ◽  
Public Health Concern ◽  
Life Threatening ◽  
The Common ◽  
Neurodegenerative Dementias ◽  
Made In

Dementia is a major public health concern that afflicts an estimated 24.3 million people worldwide. Great strides are being made in order to better diagnose, prevent, and treat these disorders. Dementia is associated with multiple complications, some of which can be life-threatening, such as dysphagia. There is great variability between dementias in terms of when dysphagia and other swallowing disorders occur. In order to prepare the reader for the other articles in this publication discussing swallowing issues in depth, the authors of this article will provide a brief overview of the prevalence, risk factors, pathogenesis, clinical presentation, diagnosis, current treatment options, and implications for eating for the common forms of neurodegenerative dementias.

Endovenous procedures in varicose veins

Phlebologie ◽  
2008 ◽  
Vol 37 (05) ◽  
pp. 229-236
Author(s):  
N. Cayne ◽  
G. Jacobowitz ◽  
P. Lamparello ◽  
T. Maldonado ◽  
C. Rockman ◽  
...  
Keyword(s):  
Varicose Veins ◽  
Treatment Options ◽  
Postoperative Recovery ◽  
Comparable Efficacy ◽  
Intense Pulse Light ◽  
Efficacy And Safety ◽  
Endovenous Laser Ablation ◽  
The Past ◽  
Early Evidence ◽  
Endovenous Treatment

SummaryOver the past ten years endoveous treatment options for varicose veins have evovled considerably, offering clinicians a multitude of options to meet the needs of their patients. The endothermal ablation procedures have moved to the forefront as the choice modality for treating truncal reflux. Both radiofrequency ablation and endovenous laser ablation are widely accepted and interchangeable, showing comparable efficacy and safety. Although numerous endovenous laser wavelengths exist, the data indicates that the differences do not affect the efficacy or postoperative recovery of the procedure. The endovenous laser innovation that has shown early evidence of improved patient outcome is the jacket-tip fiber. The versatility of sclerotherapy makes it a critical component in the endovenous treatment of varicosities. Although not approved by the Food and Drug Administration (USA), the use of a foamed sclerosing agent is the fastest growing segment of sclerotherapy and an important treatment modality in the future of varicose vein treatment. Cutaneous lasers and intense pulse light devices contribute a crucial element, enabling clinicians to treat minute veins that may be impossible to treat with other therapies.

Beyond Promoter: The Role of Macrophage in Invasion and Progression of Renal Cell Carcinoma

2020 ◽  
Vol 15 (7) ◽  
pp. 588-596
Author(s):  
Haibao Zhang ◽  
Guodong Zhu
Keyword(s):  
Renal Cell Carcinoma ◽  
Tumor Microenvironment ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Cell Formation ◽  
Biological Behavior ◽  
Tumor Stem Cell ◽  
The Past ◽  
The Common

Renal cell carcinoma (RCC) is one of the common urologic neoplasms, and its incidence has been increasing over the past several decades; however, its pathogenesis is still unknown up to now. Recent studies have found that in addition to tumor cells, other cells in the tumor microenvironment also affect the biological behavior of the tumor. Among them, macrophages exist in a large amount in tumor microenvironment, and they are generally considered to play a key role in promoting tumorigenesis. Therefore, we summarized the recent researches on macrophage in the invasiveness and progression of RCC in latest years, and we also introduced and discussed many studies about macrophage in RCC to promote angiogenesis by changing tumor microenvironment and inhibit immune response in order to activate tumor progression. Moreover, macrophage interactes with various cytokines to promote tumor proliferation, invasion and metastasis, and it also promotes tumor stem cell formation and induces drug resistance in the progression of RCC. The highlight of this review is to make a summary of the roles of macrophage in the invasion and progression of RCC; at the same time to raise some potential and possible targets for future RCC therapy.

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