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Clinical correlates and symptom patterns of anxious depression among patients with major depressive disorder in STAR*D.

BACKGROUND: Anxious depression, defined as Major Depressive Disorder (MDD) with high levels of anxiety symptoms, may represent a relatively … ndorse symptoms related to generalized anxiety, obsessive compulsive, panic, post-traumatic stress, agoraphobia, hypochondriasis, and somatoform disorders before and after adjustment for severity of depression. Anxious-depression individuals were also significantly less likely to endorse IDS-C30 items concerning atypical features, and were significantly more …

Anxiety disorders following miscarriage.

BACKGROUND: Several previous studies have established that miscarriage is a risk factor for depressive symptoms and disorder. By contrast, r … ant (95% CI = 0.8 to 17.2). There was no strong evidence for increased risk for phobic disorders or agoraphobia, combined or considered separately, in the 6 months following loss. Relative risk for all 3 disorders combined was 1.5 (95% CI = 0.9 to 2.3). CONCLUSION: In this first miscarriage cohort study using a concurrent frequency-matched comparison group, …

The longitudinal study of phobic disorder in a community sample from early to late adolescence.

PURPOSE: This study explored the development of phobic disorder as young subjects move into late adolescence. The objectives were to determi … imple phobias start early, have a higher prevalence, and are more frequent over time than social or agoraphobia. Further longitudinal studies are needed.

The side effects burden of extended imipramine treatment of panic disorder.

In a recent study, the authors gauged the net effectiveness of imipramine to be 53%; that is, of 110 patients having panic disorder with agoraphobia who started a course of imipramine at a fixed, targeted, weight-adjusted dose of 2.25 mg x kg(-1) x day(-1), 59 adhered to the regimen and showed a marked and stable response. The present study investigated in detail the side effects burden of imipramine treatment in the same sample using hierarchical linear modeling in a short-term perspective, based on data at baseline (N = 110) and at weeks 1, 2, 4, 6, and 8 (N = 77) of treatment, and a long-te…

Hyperventilation and chronic fatigue syndrome.

We studied the link between chronic fatigue syndrome (CFS) and hyperventilation in 31 consecutive attenders at a chronic fatigue clinic (19 … ociated with asthma and in three with panic. Only one patient with severe functional disability and agoraphobia had hyperventilation with no other obvious cause. A further five patients had borderline hyperventilation, in which PETCO2 was < 4 kPa (30 mmHg) for no more than 2 min, when we would have expected it to be normal. There was no association between le …

Double-blind, placebo-controlled study of a once-a-day, sustained-release preparation of alprazolam for the treatment of panic disorder.

OBJECTIVE: The goals of this study were to assess the antipanic efficacy of a new, sustained-release formulation of alprazolam and to assess the safety and tolerability of once-a-day administration of 1-10 mg of sustained-release alprazolam. METHOD: One hundred ninety-four patients with diagnosis of agoraphobia with panic attacks or panic disorder with limited phobic avoidance underwent a 1-week placebo washout before being randomly assigned to groups receiving 8 weeks of double-blind treatment with either sustained-release alprazolam or placebo. RESULTS: There was a significant treatment ef…

Epidemiology of panic disorder in African-Americans.

OBJECTIVE: The authors investigated the prevalence and clinical characteristics of panic disorder among African-Americans and whites in a co … es had similar rates of major depression, alcohol abuse, drug abuse, obsessive-compulsive disorder, agoraphobia, somatization disorder, and schizophrenia. Patterns of treatment seeking among African-American and white panic subjects were similar, with the exception that African-Americans were significantly less likely to seek help from a mental health profess …

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Compared With Diagnosis-Specific Protocols for Anxiety Disorders: A Randomized Clinical Trial.

IMPORTANCE: Transdiagnostic interventions have been developed to address barriers to the dissemination of evidence-based psychological treat … ents at an outpatient treatment center with a principal diagnosis of panic disorder with or without agoraphobia, generalized anxiety disorder, obsessive-compulsive disorder, or social anxiety disorder were randomly assigned by principal diagnosis to the UP, an SDP, or a waitlist control condition. Patients received up to 16 sessions of the UP or an SDP for 16 …

[Repetitive transcranial magnetic stimulation (rTMS) for anxiety disorders--a possible therapeutic option?].

Anxiety disorders rank among the most frequent psychiatric disorders. Effective psychotherapeutic and psychopharmacological interventions exist, although a considerable number of patients does not respond to standard interventions. Repetitive transcranial magnetic stimulation (rTMS) is capable of modulating cortical activity locally and non-invasively. Therefore, rTMS is discussed as a possible alternative treatment approach in psychiatric disorders. The present paper aims to provide a systematic review of randomised controlled studies, open studies, and case reports examining the potential th

Predictors of response among patients with panic disorder treated with medications in a naturalistic follow-up: the role of adult separation anxiety.

BACKGROUND: Efficacy of treatments for panic disorder is well established, but not all patients respond. Adult separation anxiety has been found to predict poorer response to CBT, but its effect on response to medication has not been previously explored. STUDY AIM: The aim of this study is to investigate if panic-agoraphobic spectrum factors, including 'separation anxiety' factor predict treatment outcome in patients with panic disorder. STUDY SAMPLE: Participants who met criteria for PD (n=57) completed baseline assessment and 12 months follow-up. Patients were administered the Panic Agorap

Mood and anxiety psychopathology and temporomandibular disorder: a spectrum approach.

Psychological factors play an important role in the aetiopathogenesis of temporomandibular disorders (TMD), as demonstrated by an increase in stress, anxiety, depression and somatization in TMD patients. The aim of this work was to investigate the presence of mood and panic-agoraphobic symptoms in different groups of TMD patients by means of a spectrum approach to psychopathology. A total of 131 subjects were included in this study and TMD signs and symptoms were investigated by means of a standardized clinical examination. Two self-report questionnaires were used to evaluate mood (MOODS-SR) a

Changes in appetite and weight during the pharmacological treatment of patients with panic disorder.

Antidepressants reportedly increase appetite, carbohydrate craving and weight in some patients with depression and panic disorder. This paper presents the results of changes in appetite and weight in patients with panic disorder treated with imipramine, diazepam or placebo in a double-blind prospective study. Forty-four patients with panic disorder were randomly assigned imipramine, diazepam and placebo. The investigators monitored weight and the patients rated their appetite and cravings during the eight week study. No significant increases in weight or appetite were found in the patients wit

Further investigation on benzodiazepine binding inhibitory activity in patients with major depression or panic disorder and in healthy volunteers.

Preliminary findings regarding the presence of plasmatic benzodiazepine binding inhibitory activity (BBIA) in 14 psychiatric patients prompted us to investigate it further in larger samples of psychiatric patients (n = 44) and in healthy controls (n = 14). The results have shown that BBIA is present in all the subjects included with statistically significant differences between the patients and controls. The highest concentrations were found in the patients with no difference between anxious or depressed patients, and the lowest in the healthy controls. These findings indicate that BBIA might

Influence of husbands on the outcome of their agoraphobic wives' therapy.

Of 30 agoraphobic married women undertaking home-based behaviour therapy, 15 each had a female friend as co-therapist and 15 had their own husband as co-therapist. At 12 months follow-up, women spent a mean of approximately 40 minutes a day more outside the home alone than at baseline. Women assisted by female friends made somewhat more behavioural gains than those assisted by husbands. Women in both groups whose husbands had been more depressed 2 months after the beginning of therapy did less well at 6 months. Husbands who become more depressed may retard their wives' progress in therapy, but

Posttraumatic stress disorder.

The authors review posttraumatic stress disorder in terms of clinical features, historical development and phenomenology, and relationship to other psychiatric disorders. Treatment modalities are detailed.

Endogenous anxiety: implications for nosology and treatment.

Clinical and research findings are reviewed in relation to the distinction between endogenous and exogenous anxiety. The single most potent discriminating symptom between the two subtypes is the presence or absence of spontaneous (anxiety) symptom attacks. This concept avoids the diagnostic difficulties that can arise under current systems when patients present with symptoms that fulfill the criteria for multiple anxiety-related diagnosis. Patients in the endogenous category differ from those whose anxiety is reactive in age of onset, clinical course, and response to psychotherapy and medicati

A rare coincidence of different types of driver mutations among uterine leiomyomas (UL).

BACKGROUND: Alcohol is a major risk factor for preventable illness, with huge cost to healthcare economies. There is a role for alcohol-specific digital health interventions (DHI), but there have been few randomised controlled trials (RCT) comparing DHI with face-to-face treatment. Such trials are complex and face obstacles in recruitment and retention. METHODS: Mixed-methods feasibility RCT of an alcohol DHI, testing recruitment, online data-collection and randomisation processes, with an embedded process evaluation. Recruitment ran from October 2014 for 9 months. Participants were adults dr

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… Additionally, Beard et al. [ 7 ] reported that panic disorder patients with agoraphobia had lower physical and mental component scores in the Short-Form 36 compared to panic disorder patients without agoraphobia. … However, only one study from the Netherlands analysed the economic burden of panic disorder with a special view on agoraphobia [ 11 ]. The authors of this study differentiated between full-blown and subthreshold panic disorder with or without agoraphobia. …