Anxiety Symptoms In People Research Articles

A cross-sectional study on the association of serum uric acid levels with depressive and anxiety symptoms in people with epilepsy

BackgroundHigh serum uric acid (SUA) levels may provide protection against depression and anxiety through its defensive role in oxidative damage. The aim of this study was to test the hypothesis of the independent associations of lower SUA levels with depressive and anxiety symptoms among patients with epilepsy (PWE).MethodsA cross-sectional study was performed among 320 PWE aged ≥18 years old in Northeast China. The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E; Chinese version) and the Generalized Anxiety Disorder-7 scale (GAD-7; Chinese version) were used as screening tools for depressive and anxiety symptoms for PWE. Serum uric acid levels were measured. The associations of SUA levels with depressive and anxiety symptoms were assessed by using binary logistic regression models, with adjustment for the related risk factors (P< 0.05).ResultsLower SUA tertiles were significantly associated with higher C-NDDI-E and GAD-7 scores compared with the higher two tertiles (p=0.001, and p= 0.002). Patients with depressive symptoms exhibited significantly lower SUA levels compared to those without depressive symptoms (p< 0.001). SUA levels of patients with anxiety symptoms were significantly lower than those of patients without anxiety symptoms (p< 0.001). The first and second SUA tertiles were associated with depressive symptoms, with the third tertile group as the reference group, after adjusting for confounders (first tertile: OR = 4.694, 95% CI = 1.643~ 13.413, P = 0.004; second tertile: OR = 3.440, 95% CI = 1.278~9.256, P = 0.014). However, The first and second SUA tertiles were not associated with the risk of anxiety symptoms compared with the third tertile in the adjusted logistic regression model (First tertile: OR = 1.556, 95% CI = 0.699~3.464, P = 0.279; second tertile: OR = 1.265, 95% CI = 0.607~2.635, P = 0.530).ConclusionWe found that lower SUA levels were independently associated with depressive symptoms but not with anxiety symptoms among PWE. Further well-designed prospective cohort studies are required to determine the causality of the associations and to further clarify the mechanisms of SUA in depressive symptoms.

Emotional dysregulation and uncertainty intolerance as transdiagnostic mediators of anxiety in adults with autism spectrum disorders and intellectual disability

BackgroundThere is extensive documentation supporting the comorbidity of anxiety and autistic spectrum disorder (ASD). Transdiagnostic factors such as executive functions, emotion regulation, and uncertainty intolerance are associated with anxiety in ASD. AimThe primary aim of this paper is to study anxiety symptoms in adults with ASD and ID and their relationship with transdiagnostic variables. Method121 adults (M = 35.46 years, SD = 9.46) with ASD and intellectual disabilities (ID) were evaluated to determine the predictive and mediating role of executive functioning, emotional regulation and intolerance to uncertainty. ResultsHierarchical linear regression showed uncertainty intolerance was a predictor of anxiety. A multiple mediation analysis supported the mediating role of uncertainty intolerance and emotional regulation between ASD and anxiety. Conclusions and implicationsThese findings suggest that interventions designed to reduce anxiety symptoms in people with ASD and ID should include among their goals emotional regulation and especially intolerance of uncertainty.

Biobehavioral utility of mindfulness-based art therapy: Neurobiological underpinnings and mental health impacts.

Mindfulness-based art therapy (MBAT) combines mindfulness practices with art therapy to promote health, wellness, and adaptive responses to stress. Mindfulness-based stress reduction programs have been demonstrated to reduce anxiety symptoms in people with generalized anxiety disorder and serious medical conditions such as cancer. However, the benefits of MBAT specifically—not just in clinical anxiety disorders, but also for routine day-to-day anxiousness—have received little attention until recently. In this mini-review, we summarize how several established mindfulness-based interventions affect mental health with a specific focus on MBAT. We also describe and evaluate data indicating involvement of specific neural circuits and neuroendocrine markers of stress and/or anxiety. Lastly, we suggest areas of focus for future rigorous research on MBAT interventions and propose multiple biobehavioral and physiological mechanisms through which therapeutic benefits may be achieved.Impact statementRecent studies demonstrate the therapeutic potential of intensive MBAT and other mindfulness-based interventions for severe health conditions including cancer, heart disease, and anxiety, with effectiveness that rivals and sometimes even exceeds cognitive behavior therapy. MBAT-based approaches appear to be poised to mature into large-scale, cost-effective therapies for mental health disorders and symptoms comorbid with other serious health issues. However, the field currently suffers from inconsistent deployment protocols and needs additional validation data—at the behavioral, neuroendocrine, and neural levels—in order to establish best practices.

Self-concept, illness acceptance and depressive and anxiety symptoms in people with multiple sclerosis.

Little research has examined the relationship between self-concept and depressive and anxiety symptoms and whether this is moderated by illness acceptance in individuals with multiple sclerosis. Results of an online self-report survey completed by 515 individuals with multiple sclerosis revealed that self-concept was negatively associated with depressive and anxiety symptoms with illness acceptance moderating the association such that individuals with highest self-concept and illness acceptance had the lowest levels of depressive and anxiety symptoms. Findings lend support to psychological interventions that focus on increasing illness acceptance and fostering positive self-concept in individuals with multiple sclerosis.

The Analysis of Effects of Semantic Comprehension upon the Anxiety Indices in People with Autism Spectrum Disorder

Hypersensitivity to stimuli is one of main way of anxiety symptoms in people with Autism Spectrum Disorders (ASD) owing, within other factors, to deficit cognitive attribution performed on stimulating input. This research studies precisely the possible existence of relationships between the comprehensive elements of the information input and the anxiety increase in people with ASD.A total of 30 students with ASD have participated in the study, aged between 6 and 14 age years, divided into two groups, an experimental group (EG) consisting of 20 students and a control group (CG) formed by 10 other students. Study aims are to study the relationships between perception and information understanding, as well the consequent anxiety reactions in people with ASD and, finally, analyze the improvement of these data from application of a naturalistic systemic program. Results found along 3 successive measures along 12 months, performed throughout correlation analysis, ANOVA W test of 1-factor comparative measures and post- hoc analysis to age variable, allows to conclude the students who belong to EG significantly improved in aspects related to conceptual coding and in self-management of their own learning and, accordingly, they reduce anxiety level with regarding to their CG peers.

Obesity and anxiety symptoms: asystematic review and meta-analysis.

Obesity and anxiety are the two most common health problems and increased body mass index can be lead to anxiety. The aim of this meta-analysis was to investigate the frequency of anxiety symptoms in people who are obese/overweight. For this purpose the authors systematically searched keywords in the databases PubMed, Scopus, PsycINFO and Google scholar through August 2018. After acomprehensive review, 25studies were included into the meta-analysis. Results of the meta-analysis showed that the frequency of anxiety in obesity had a pooled odds ratio (OR) of 1.30 and a 95% confidence interval (CI) of 1.20-1.41 and in overweight had an OR of 1.10 and CI of 1.00-1.21. Comparison between obesity/overweight and normal weight showed high frequency of anxiety in obesity/overweight with respect to subgroups (sex, obesity and anxiety assessment, adjusted/unadjusted, anxiety duration and age). Evaluation of 25studies included in the meta-analysis showed publication bias. Overall, findings indicate anxiety occurs more frequently in obese/overweight people compared with normal weight people.

A qualitative study of the feasibility and acceptability of a smoking cessation program for people living with HIV and emotional dysregulation

ABSTRACTDespite high rates of co-occurring tobacco use and anxiety among persons living with HIV, evidence-based interventions for these individuals are limited. An existing cognitive–behavioral treatment protocol for smoking cessation and anxiety (Norton, P. J., & Barrera, T. L. (2012). Transdiagnostic versus diagnosis-specific CBT for anxiety disorders: A preliminary randomized controlled noninferiority trial. Depression and Anxiety, 29(10), 874–882. https://doi.org/10.1002/da.21974) was modified to address transdiagnostic constructs, such as anxiety sensitivity, distress tolerance, and depressive symptomatology (Labbe, A. K., Wilner, J. G., Kosiba, J. D., Gonzalez, A., Smits, J. A., Zvolensky, M. J., … O’Cleirigh, C. (2017). Demonstration of an Integrated Treatment for Smoking Cessation and Anxiety Symptoms in People with HIV: A Clinical Case Study. Cognitive and Behavioral Practice, 24(2), 200–214. https://doi.org/10.1016/j.cbpra.2016.03.009). This study examines the feasibility and acceptability of the intervention as determined from qualitative data from structured exit interviews from 10 participants who completed treatment. Results demonstrated that participants were very motivated to quit smoking and enrolled in the program for health-related reasons and to be able to quit. Participants found nearly all the treatment components to be useful for reaching their smoking cessation goal and in managing emotional dysregulation. Last, all participants stated that they would strongly recommend the treatment program. This qualitative study provides initial evidence for the feasibility and acceptability of a modified smoking cessation treatment protocol for HIV+ individuals with anxiety and emotional dysregulation. Future research will focus on evaluating the efficacy of the protocol in a full-scale randomized controlled trial, as well as working to collect qualitative data from participants who discontinue treatment to better understand reasons for treatment attrition.

Mindfulness-Based Baduanjin Exercise for Depression and Anxiety in People with Physical or Mental Illnesses: A Systematic Review and Meta-Analysis.

Objectives: we used a quantitative method to systematically synthesize the emerging literature and critically evaluate the effects of Baduanjin on depression and anxiety in people with physical or mental illnesses. Additionally, we determined if the number of total Baduanjin training sessions is associated with decreased anxiety and depression levels. Methods: both English and Chinese databases were searched for potential studies published between January 1982 and October 2017. The eligible randomized controlled trials were considered for meta-analysis. Effect size (Hedge’s g) was computed for the pooled effects while the random-effect model was set. For moderator analysis; Subgroup meta-analysis for categorical variables and meta-regression for continuous variables were performed. Results: the aggregated result has shown a significant benefit in favour of Baduanjin on anxiety (Hedge’s g = −0.99; CI −1.63 to −0.74) and depression (Hedge’s g = −1.07; CI −1.3 to −0.83). For continuous potential moderators; meta-regression indicated a significant effect for total hours in Baduanjin practice (β = −0.0053; 95% CI −0.009 to −0.0014; p = 0.008). With regard to depression; meta-regression indicated a significant effect for total sessions of Baduanjin practice (β = −0.0023; 95% CI −0.006 to −0.0004; p = 0.028). Conclusions: the encouraging findings indicate the efficacy of Baduanjin exercise in reducing depression and anxiety symptoms in people with physical or mental illnesses. However; the results should be interpreted with caution because of existing methodological limitations (e.g., high risk of bias; Baduanjin combined with other behavioral interventions; and heterogeneity of control groups).

Trajectories of anxiety symptoms and associations with incident cardiovascular disease in adults with type 2 diabetes

BackgroundTrajectories of anxiety symptoms in people with type 2 diabetes (T2D) and their associations with diabetes health outcomes have not been investigated. This study examined latent longitudinal trajectories of anxiety symptoms in adults with T2D and their associations with incident cardiovascular disease (CVD). MethodsData were from the Evaluation of Diabetes Treatment Study, a community-based cohort study of adults aged 40–76years with T2D. Anxiety and CVD were assessed by self-report at baseline and at four annual follow-up assessments. N=832 participants without cardiovascular disease at baseline and 12-month follow-up were included in the present study. Group-based trajectories of anxiety at baseline, 12-month follow-up, and 24-month follow-up were modelled using latent class growth modeling. Associations between anxiety trajectories and CVD reported at 24-, 36-, or 48-month follow-ups were examined with logistic regression analysis adjusted for sociodemographic and lifestyle characteristics. ResultsFour distinct anxiety trajectories were identified, reflecting chronically low (39.4%), chronically moderate-low (47.4%), chronically moderate-high (11.1%), and chronically high (2.2%) anxiety. The likelihood of CVD was greater for the chronically moderate-low (OR=2.23, 95% CI=1.36–3.66), chronically moderate-high (OR=3.05, 95% CI=1.54–6.02), and chronically high (OR=3.61, 95% CI=1.09–12.00) anxiety trajectory groups compared to the chronically low anxiety group. ConclusionThe identified latent trajectories reflected three groups with chronic courses of anxiety symptoms at different levels of severity and one group with chronically low levels of anxiety. Chronic anxiety, even at subthreshold levels, was associated with an increased risk of CVD among people with T2D.

Pilot of a randomised controlled trial of the selective serotonin reuptake inhibitor sertraline versus cognitive behavioural therapy for anxiety symptoms in people with generalised anxiety disorder who have failed to respond to low-intensity psychological treatments as defined by the National Institute for Health and Care Excellence guidelines.

Generalised anxiety disorder (GAD) is common, causing unpleasant symptoms and impaired functioning. The National Institute for Health and Care Excellence (NICE) guidelines have established good evidence for low-intensity psychological interventions, but a significant number of patients will not respond and require more intensive step 3 interventions, recommended as either high-intensity cognitive behavioural therapy (CBT) or a pharmacological treatment such as sertraline. However, there are no head-to-head comparisons evaluating which is more clinically effective and cost-effective, and current guidelines suggest that treatment choice at step 3 is based mainly on patient preference. To assess clinical effectiveness and cost-effectiveness at 12 months of treatment with the selective serotonin reuptake inhibitor (SSRI) sertraline compared with CBT for patients with persistent GAD not improved with NICE-defined low-intensity psychological interventions. Participant randomised trial comparing treatment with sertraline with high-intensity CBT for patients with GAD who had not responded to low-intensity psychological interventions. Community-based recruitment from local Improving Access to Psychological Therapies (IAPT) services. Four pilot services located in urban, suburban and semirural settings. People considered likely to have GAD and not responding to low-intensity psychological interventions identified at review by IAPT psychological well-being practitioners (PWPs). Those scoring ≥ 10 on the Generalised Anxiety Disorder-7 (GAD-7) anxiety measure were asked to consider involvement in the trial. Aged ≥ 18 years, a score of ≥ 10 on the GAD-7, a primary diagnosis of GAD diagnosed on the Mini International Neuropsychiatric Interview questionnaire and failure to respond to NICE-defined low-intensity interventions. Inability to participate because of insufficient English or cognitive impairment, current major depression, comorbid anxiety disorder(s) causing greater distress than GAD, significant dependence on alcohol or illicit drugs, comorbid psychotic disorder, received antidepressants in past 8 weeks or high-intensity psychological therapy in previous 6 months and any contraindications to treatment with sertraline. Consenting eligible participants randomised via an independent, web-based, computerised system. (1) The SSRI sertraline prescribed in therapeutic doses by the patient's general practitioner for 12 months and (2) 14 (± 2) CBT sessions delivered by high-intensity IAPT psychological therapists in accordance with a standardised manual designed for GAD. The primary outcome was the Hospital Anxiety and Depression Scale - Anxiety component at 12 months. Secondary outcomes included measures of depression, social functioning, comorbid anxiety disorders, patient satisfaction and economic evaluation, collected by postal self-completion questionnaires. Only seven internal pilot participants were recruited against a target of 40 participants at 7 months. Far fewer potential participants were identified than anticipated from IAPT services, probably because PWPs rarely considered GAD the main treatment priority. Of those identified, three-quarters declined participation; the majority (30/45) were reluctant to consider the possibility of randomisation to medication. Poor recruitment was the main limiting factor, and the trial closed prematurely. It is unclear how much of the recruitment difficulty was a result of conducting the trial within a psychological therapy service and how much was possibly a result of difficulty identifying participants with primary GAD. It may be easier to answer this important question by recruiting people from primary care rather than from those already engaged in a psychological treatment service. Current Controlled Trials ISCRTN14845583. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 45. See the NIHR Journals Library website for further project information.

The impact of telephone-delivered cognitive behaviour therapy and befriending on mood disorders in people with chronic obstructive pulmonary disease: A randomized controlled trial.

The main objectives of this pragmatic randomized controlled trial were to investigate the impact of cognitive behaviour therapy (CBT) and an active social control (befriending) on depression and anxiety symptoms in people with chronic obstructive pulmonary disease (COPD). Eligible participants were randomly allocated to receive eight weekly telephone interventions of CBT (n=54) or befriending (n=56). Repeated-measures ANOVA was used to assess changes in scores and Cohen's d was used to assess effect sizes. Significant improvement was observed in anxiety symptoms for the befriending group from baseline (T1) to post-intervention assessment (T2) and to 8-week follow-up assessment (T3), with a small to medium effect size (Cohen's d=0.3). Significant improvement was noted in depression symptoms from T1 to T2 for both groups, but only the CBT group had a significant difference at T3, with a small to medium effect size (Cohen's d=0.4). For secondary outcomes, there was a significant change in COPD symptoms from T1 to T2 for the befriending group; however, at T3 this change was no longer significant. Finally, there was a significant change in general self-efficacy for both groups between T1 and T2, and T1 and T3. Cognitive behaviour therapy reduced depression symptoms but not anxiety. Befriending reduced depression symptoms in the short term and anxiety symptoms in both the short term and long term. Further research is needed to demonstrate non-inferiority of telephone delivery compared with other formats, and to understand the impact of befriending which has the potential to be a cost-effective support for people with COPD. Statement of contribution What is already known on this subject? Depression and anxiety are common comorbidities in people with chronic obstructive pulmonary disease. Mood disorders are not commonly routinely treated in people with chronic obstructive pulmonary disease. Telephone-administered CBT has been shown to be as effective as face-to-face CBT in reducing depression and anxiety. What does this study add? Telephone-administered CBT can reduce depression symptoms in people with COPD. Telephone-administered befriending can reduce anxiety and depression symptoms in people with COPD. People with COPD who have mood disorders would prefer to have CBT than befriending.

Demonstration of an Integrated Treatment for Smoking Cessation and Anxiety Symptoms in People With HIV: A Clinical Case Study

Despite high rates of co-occurring tobacco use and anxiety symptoms and disorders among persons with HIV, evidence-based interventions for these individuals are not yet available. The present study sought to evaluate an integrated treatment model addressing smoking cessation and anxiety sypmtoms among HIV-positive smokers. Treatment was an 8-week intervention integrating a standard smoking cessation protocol (i.e., cognitive-behavioral therapy [CBT], nicotine replacement therapy) with CBT for anxiety. Inclusion criteria were 18–65years of age, ≥10 cigarettes/day, State–Trait Anxiety Inventory [STAI-T] score of >39, and moderate motivation (i.e., ≥5 out of 10 on a 10-point Likert scale) to quit smoking. Primary outcomes included scores on the Anxiety Sensitivity Index (ASI) and cigarettes smoked per day. Self-reported abstinence was biochemically verified by carbon monoxide breath analysis. Three male participants (mean age 49.3, SD=9.1) completed through 2-month follow-up. At baseline all participants reported smoking an average of 20 cigarettes per day. Two participants quit smoking and maintained abstinence by the 2-month follow-up, and demonstrated a reduction in ASI scores. Participant 3 continued to smoke but at a reduced rate. Participants’ response to cognitive and behavioral strategies (e.g., creating balanced thoughts, interoceptive exposures) will be discussed. Clinical lessons learned include use of a flexible approach to cognitive restructuring, use of imaginal and in vivo exposures in session to better prepare patients for homework practice, and flexibility in delivering the treatment in an individual or group format. This clinical presentation provides preliminary support for the feasibility and initial effectiveness of an integrated treatment to reduce anxiety symptoms and aid in smoking cessation in anxious, HIV-positive smokers.

Emotional Intelligence Partially Mediates the Association between Anxiety Sensitivity and Anxiety Symptoms1,2.

Anxiety Sensitivity (AS), the propensity to fear the somatic, mental, and social consequences of anxiety, is associated with an elevated risk of developing anxiety disorders. It was hypothesized that Emotional Intelligence (EI) might serve as a mediating variable between AS and anxiety symptom expression. Sixty-one healthy adults (30 men, 31 women; M age = 30.4 yr., SD = 8.0), recruited through posted advertisements, completed the Anxiety Sensitivity Index (ASI) and the ANX subscale of the Personality Assessment Inventory (PAI), as well as three assessments of EI, including two indices of the Ability model of EI (MSCEIT; SREIS), and one index of the Trait model of EI (i.e., Bar-On EQ-i). Partial mediation between AS and ANX was found for the EQ-i but not for the MSCEIT or SREIS, as determined by the bootstrap method of mediation analysis. The association between AS and anxiety symptoms was partly explained through its effects on the intervening variable of Trait EI, and points to the possibility that interventions improving Trait EI may be useful in reducing the expression of anxiety symptoms in people with high AS.

The association between mindfulness and emotional distress in adults with diabetes: could mindfulness serve as a buffer? Results from Diabetes MILES: The Netherlands.

People with diabetes have a higher risk of emotional distress (anxiety, depression) than non-diabetic or healthy controls. Therefore, identification of factors that can decrease emotional distress is relevant. The aim of the present study was to examine (1) the association between facets of mindfulness and emotional distress; and (2) whether mindfulness might moderate the association between potential adverse conditions (stressful life events and comorbidity) and emotional distress. Analyses were conducted using cross-sectional data (Management and Impact for Long-term Empowerment and Success--Netherlands): 666 participants with diabetes (type 1 or type 2) completed measures of mindfulness (Five Facet Mindfulness Questionnaire-Short Form; FFMQ-SF), depressive symptoms (Patient Health Questionnaire; PHQ-9), and anxiety symptoms (General Anxiety Disorder assessment; GAD-7). Hierarchical multiple regression analyses showed significant associations between mindfulness facets (acting with awareness, non-judging, and non-reacting) and symptoms of anxiety and depression (β = -0.20 to -0.33, all p < 0.001). These mindfulness facets appeared to have a moderating effect on the association between stressful life events and depression and anxiety (all p < 0.01). However, the association between co-morbidity and emotional distress was largely not moderated by mindfulness. In conclusion, mindfulness is negatively related to both depression and anxiety symptoms in people with diabetes and shows promise as a potentially protective characteristic against the influence of stressful events on emotional well-being.

The prevalence of anxiety and depression in people with age-related macular degeneration: a systematic review of observational study data.

BackgroundComorbid mental health problems have been shown to have an adverse effect on the quality of life of people with common eye disorders. This study aims to assess whether symptoms of anxiety and/or depression are more prevalent in people with age-related macular degeneration (AMD) than in people without this condition.MethodsA systematic search of electronic databases (Medline, CINAHL, EMBASE, PsycINFO) from inception to February 2012 was conducted to identify studies of AMD populations which measured symptoms of anxiety and/or depression. Reference checking of relevant articles was also performed. Data on the study setting, prevalence and how anxiety and depression were measured were extracted from the papers. Critical appraisal was performed using the Critical Appraisal Skills Programme (CASP) tools.ResultsA total of 16 papers were included in the review, from an original search result of 597. The prevalence estimates, taken from nine cross-sectional and cohort studies, ranged from 15.7%-44% for depressive symptoms and 9.6%-30.1% for anxiety symptoms in people with AMD. The seven case–control studies found that people with AMD were more likely to experience symptoms of depression compared with those without AMD, but not more likely to experience symptoms of anxiety.ConclusionsOverall, the evidence suggests that symptoms of depression are more prevalent amongst AMD populations than anxiety symptoms. The heterogeneity of the studies included in this review means that it is difficult to draw strong conclusions as to the true estimates of depression and anxiety symptoms in AMD populations and prevented formal meta-analysis. Further research which specifies clinical anxiety and gives clear definitions as to the type of AMD being investigated is required.

A randomized, controlled clinical trial: the effect of mindfulness-based cognitive therapy on generalized anxiety disorder among Chinese community patients: protocol for a randomized trial

BackgroundResearch suggests that an eight-week Mindfulness-Based Cognitive Therapy (MBCT) program may be effective in the treatment of generalized anxiety disorders. Our objective is to compare the clinical effectiveness of the MBCT program with a psycho-education programme and usual care in reducing anxiety symptoms in people suffering from generalized anxiety disorder.MethodsA three armed randomized, controlled clinical trial including 9-month post-treatment follow-up is proposed. Participants screened positive using the Structure Clinical Interview for DSM-IV (SCID) for general anxiety disorder will be recruited from community-based clinics. 228 participants will be randomly allocated to the MBCT program plus usual care, psycho-education program plus usual care or the usual care group. Validated Chinese version of instruments measuring anxiety and worry symptoms, depression, quality of life and health service utilization will be used. Our primary end point is the change of anxiety and worry score (Beck Anxiety Inventory and Penn State Worry Scale) from baseline to the end of intervention. For primary analyses, treatment outcomes will be assessed by ANCOVA, with change in anxiety score as the baseline variable, while the baseline anxiety score and other baseline characteristics that significantly differ between groups will serve as covariates.ConclusionsThis is a first randomized controlled trial that compare the effectiveness of MBCT with an active control, findings will advance current knowledge in the management of GAD and the way that group intervention can be delivered and inform future research.Unique Trail Number (assigned by Centre for Clinical Trails, Clinical Trials registry, The Chinese University of Hong Kong): CUHK_CCT00267

Ginkgo biloba special extract EGb 761 ® in generalized anxiety disorder and adjustment disorder with anxious mood: A randomized, double-blind, placebo-controlled trial

Ginkgo biloba special extract EGb 761 ®, an anti-dementia drug, enhances cognitive functioning and stabilizes mood in cognitively impaired elderly subjects. Moreover, EGb 761 ® had been found to alleviate symptoms of anxiety in people with mental decline, therefore it was now tested for clinical efficacy in younger patients suffering from anxiety. One hundred and seven patients with generalized anxiety disorder (GAD, n = 82) or adjustment disorder with anxious mood (ADWAM, n = 25) according to the diagnostic and statistical manual of mental disorders, third edition – revised (DSM-III-R) were randomized to daily doses of 480 mg EGb 761 ®, 240 mg EGb 761 ® or placebo for 4 weeks. Intention-to-treat (ITT) analyses were performed on the primary outcome measure, the Hamilton rating scale for anxiety (HAMA), and the secondary variables, the clinical global impression of change (CGI-C), the Erlangen anxiety tension and aggression scale (EAAS), the list of complaints (B-L′), and the patient’s global rating of change. The HAMA total scores decreased by −14.3 (±8.1), −12.1 (±9.0) and −7.8 (±9.2) in the high-dose EGb 761 ®, the low-dose EGb 761 ® and the placebo group, respectively. Changes were significantly different from placebo for both treatment groups with p = 0.0003 (high-dose group) and p = 0.01 (low-dose). Regression analyses revealed a dose–response trend ( p = 0.003). EGb 761 ® was significantly superior to placebo on all secondary outcome measures. It was safe and well tolerated and may thus be of particular value in elderly patients with anxiety related to cognitive decline.