Common Anxiety Disorders Research Articles

Treating the Anxious Teen: Research on the developing brain points to new approaches for helping young people with common anxiety disorders.

Treating the Anxious Teen: Research on the developing brain points to new approaches for helping young people with common anxiety disorders.

Association of sleep and generalized anxiety disorder in Korean adolescents

BackgroundGeneralized anxiety disorder (GAD) is a common anxiety disorder among adolescents, significantly impacting their concentration and learning capabilities. The connection between emotional well-being and sleep is well-established, and Korean adolescents are particularly prone to inadequate sleep. This study aimed to determine the association between sleep duration and GAD in Korean adolescents.MethodsThis study was conducted using data from 106,513 adolescents aged 12–18 years. Data from the 2020–2022 Korea Youth Risk Behavior Survey were used. Sleep duration was classified into five groups, based on an average sleep duration of 7–7.9 h in adolescents. Social jet lag was defined as a misalignment between an individual's biological and social clocks. Differences in sleep duration between weekdays and weekends, social jet lag, and bedtime were each classified into three categories. Multiple logistic regression analysis was performed to evaluate the association between sleep duration and GAD.ResultsComparing the five groups classified based on sleep duration, adolescents in the groups that slept less experienced a significant increase in the odds of developing GAD (adjusted odds ratio [aOR]: boys: 1.10 in the 6.0–6.9-h group, 1.14 in the 5.0–5.9-h group, and 1.23 in the ≤ 4.9-h group; girls: 1.05 in the 6.0–6.9-h group, 1.19 in the 5.0–5.9-h group, 1.22 in the ≤ 4.9-h group). Adolescents with poor sleep quality experienced more frequent instances of inadequate sleep (aOR: boys: 2.51; girls: 2.43).ConclusionsGAD is strongly associated with insufficient sleep. Consequently, it is imperative to assess and address GAD in adolescents with irregular sleep patterns.

Common Mental Disorders and Associated Factors During Pregnancy and the Postpartum Period in Indonesia: An Analysis of Data From the 2018 Basic Health Research.

A substantial proportion of women experience mental health challenges during pregnancy or the postpartum period. Common mental disorders (CMDs), including depression, anxiety, and obsessive-compulsive disorder, are prevalent. Identifying causes and associated risk factors is imperative for early intervention and the prevention of mental health issues. This study utilized data from the 2018 Basic Health Research, which was conducted nationwide in Indonesia, using a crosssectional approach. We focused on women aged 13-49 years who were currently or previously married, and had experienced pregnancy, including 8889 pregnant women and 77 012 women who had delivered between January 1, 2013 and August 31, 2018. The Self-Reporting Questionnaire-20 was employed to assess CMDs. Multivariate logistic regression was performed. The prevalence of CMDs in pregnant women was 12.6%, while postpartum mothers exhibited a prevalence of 10.1%. Poor health status displayed the strongest impact on CMDs during both pregnancy (adjusted odds ratio [aOR], 12.23; 95% confidence interval [CI], 9.01 to 16.60) and the postpartum period (aOR, 16.72; 95% CI, 14.85 to 18.82). Additional significant factors for both group include young maternal age, lack of education, unemployment, history of hypertension, and smoking status. Among pregnant women, CMDs was also associated with first-trimester pregnancy, previous pregnancy complications, and small upper arm circumference. For postpartum mothers, significant factors include living in rural areas, history of abortion, unwanted pregnancy, pregnancy complications, lack of antenatal care, spontaneous delivery, postpartum complications and contraceptive use. CMDs can impact in pregnant and postpartum women. Early diagnosis and management must be seamlessly integrated into primary healthcare practices.

Cortical and Subcortical Brain Alterations in Specific Phobia and Its Animal and Blood-Injection-Injury Subtypes: A Mega-Analysis From the ENIGMA Anxiety Working Group.

Specific phobia is a common anxiety disorder, but the literature on associated brain structure alterations exhibits substantial gaps. The ENIGMA Anxiety Working Group examined brain structure differences between individuals with specific phobias and healthy control subjects as well as between the animal and blood-injection-injury (BII) subtypes of specific phobia. Additionally, the authors investigated associations of brain structure with symptom severity and age (youths vs. adults). Data sets from 31 original studies were combined to create a final sample with 1,452 participants with phobia and 2,991 healthy participants (62.7% female; ages 5-90). Imaging processing and quality control were performed using established ENIGMA protocols. Subcortical volumes as well as cortical surface area and thickness were examined in a preregistered analysis. Compared with the healthy control group, the phobia group showed mostly smaller subcortical volumes, mixed surface differences, and larger cortical thickness across a substantial number of regions. The phobia subgroups also showed differences, including, as hypothesized, larger medial orbitofrontal cortex thickness in BII phobia (N=182) compared with animal phobia (N=739). All findings were driven by adult participants; no significant results were observed in children and adolescents. Brain alterations associated with specific phobia exceeded those of other anxiety disorders in comparable analyses in extent and effect size and were not limited to reductions in brain structure. Moreover, phenomenological differences between phobia subgroups were reflected in diverging neural underpinnings, including brain areas related to fear processing and higher cognitive processes. The findings implicate brain structure alterations in specific phobia, although subcortical alterations in particular may also relate to broader internalizing psychopathology.

Separation anxiety

Anxiety disorders are the most common mental disorders in children and are often under-recognized. Untreated anxiety disorders in children can significantly affect the quality of life. They can lead to comorbid psychiatric conditions and interfere with social, emotional and academic development, including in adulthood. Separation anxiety disorder is one of the most common childhood anxiety disorders. It involves an exaggeration of the anxiety typical for the developmental process and is manifested by excessive distress at separation from the attachment figure or family environment. The etiology of separation anxiety disorder points to the interaction of biological and environmental factors, particularly the family environment in early childhood. Diagnostic criteria for SAD are provided by DSM-V and are used in the comprehensive assessment of the disorder, in combination with other internationally validated assessment tools. The diagnosis provides essential information for the elaboration of the therapeutic approach by the clinical specialists. In this sense, there are conclusive data on the effectiveness of combining psychotherapy with pharmacotherapy to achieve lasting results. Furthermore, the importance of coordinating inter-professional efforts is essential for the effectiveness of the comprehensive approach to TAS.

Prevalence and comorbidity of anxiety disorder in school-attending children and adolescents aged 6–16 years in China

BackgroundThe reported prevalence rate of anxiety disorder in the paediatric population varies widely between different counties. Currently, there is no national epidemiological survey of childhood anxiety disorder in China. This...

VALIDITY AND RELIABILITY TESTS ON GENERALISED ANXIETY DISORDER DIAGNOSTIC SCALE

<span lang="EN-US">Generalized anxiety disorder is one of the most common anxiety disorders in society. The purpose of this study is to develop a diagnostic scale for generalized anxiety disorder because there is no self-report diagnostic tool for generalized anxiety disorder based on DSM-V and ICD-10 criteria in Indonesia. The items on the overall anxiety disorder scale have been tested use pre-tryout (readability test), content validity (S-CVI = 0.904) by a panel of judges, field tests on 210 adult participants aged 18-65 years which were then analyzed for validity (EFA and CFA) and reliability (alpha-cronbach = 0.911). This scale consists of 2 aspects, namely social-emotional symptoms and physiological symptoms with a total of 18 items that have satisfactory psychometric quality with construct model is unidimention. For further researchers, standardization and validation of criteria can be carried out by comparing this scale with the gold standard that is already available so that it can then be used in clinical practice</span>

Affect-Focused and Exposure-Focused Psychotherapies.

The authors discuss the two broad domains of affect-focused and exposure-focused psychotherapies, defining the characteristics and potential advantages and disadvantages of each. The two domains differ in their theoretical approaches, structures, and techniques. Exposure-focused therapies have come to dominate research and practice, leading to the relative neglect of affect-focused therapies. When the two approaches have been examined in well-conducted clinical trials, they generally appear to be equally beneficial for treating common mood, anxiety, and trauma disorders, although further research may better define differential therapeutics. The authors argue for better training in affect awareness and tolerance across psychotherapies and use a brief case vignette to illustrate several aspects of these different approaches.

What should a nation do to prevent common mental disorders? Meet seven conditions for effective prevention

The global burden of Common Mental Disorders (CMDs), including depressive, anxiety and substance use disorders, is substantial. Since increased treatment has not reduced CMD prevalence, prevention is a logical approach to reduce CMD burden. However, CMD prevention as currently delivered has not reduced prevalence. Seven conditions need to be met to maximize the long-term effectiveness of CMD prevention: 1. Target young persons early in life and families. 2. Modify major CMD risk and protective factors. 3. Embed in social institutions and culture. 4. Implement via synergistic programs of proven effectiveness in multiple community settings (pre-school and kindergarten, elementary and secondary schools, child and health care, social welfare/family support). 5. Secure long-term funding with permanent, structural integration into community organizations. 6. Address socio-economic disadvantage and attendant risk factors. 7. Use the power of policy. We consider how these conditions might be achieved in large populations. A dilemma is that compelling evidence regarding the benefits of CMD prevention may be needed to motivate large, long-term investments, but until society has made and sustained these investments for 10 to 20 years, full benefits of CMD prevention may not be realized. Therefore, we propose regional implementation and evaluation focused initially on proximal benefits for child development. Developmental determinants important to educators, parents and other stakeholders should be evaluated initially to establish short-term pay-offs for educational and behavioral outcomes. Long-term CMD prevention initiatives may not only prevent CMDs, but also develop resourceful, resilient, and well-educated children and adults.

Prevalence and sociodemographic determinants of common mental disorders (CMDs) symptoms in a rural adult population of Haryana, North India.

Common mental disorders (CMDs), including depression, anxiety, and somatoform disorders, affect all stages of life and impact individuals, families, and communities. This study aimed to determine the magnitude of CMDs and their sociodemographic determinants in the adult population of a rural block in North India. A cross-sectional, quantitative, community-based study was conducted among adult residents of a rural block in Haryana, North India, using a multistage random sampling technique. The Hindi version of the General Health Questionnaire (GHQ-12), a well-validated tool, was used to screen participants for CMDs. Scores of 4 or above denoted the presence of CMDs. Bivariate analyses were performed to determine the associations between CMDs and sociodemographic characteristics. Of the 180 residents selected for the study, most were women (60.0%) and aged between 31 and 50 years (52.3%). The prevalence of CMDs symptoms in the study population was 20.0%. The presence of CMDs symptoms was significantly higher among those who were aged 60 years or older [OR=12.33, 95% CI 3.21-47.38], widowed, divorced or separated [OR=7.50, 95% CI 1.09-51.52], illiterate [OR= 6.25, 95% CI 2.84-13.77], had monthly family income below 10,000 INR [OR=3.33, 95% CI 1.54-7.20], had any chronic physical illness [OR=8.28, 95% CI 3.70-18.56] and had a family history of any psychiatric illness [OR=5.56, 95% CI 1.52-19.42]. The burden of CMDs was quite high among adults in rural North India. The presence of CMDs was closely associated with sociodemographic characteristics. Primary care and community-based settings need to screen for, diagnose, and manage CMDs to address this growing problem.

Current prevalence and determinants of generalized anxiety disorder from a nationally representative, population-based survey of India.

Generalized anxiety disorder (GAD) is one of the common anxiety disorders leading to impairment and burden. However, GAD remains the least studied anxiety disorder. There is a need for nationally representative epidemiological data of GAD to understand the current burden and plan the mental health policies and programs to attain their unmet needs. Hence, this study focuses on epidemiology, socio-demographic correlates, disability, and treatment gap of GAD from India's National Mental Health Survey (NMHS) 2016. NMHS 2016 was a nationally representative epidemiological survey of adult respondents from 12 states of India. NMHS is a multi-stage, stratified, random cluster sampling with random selection based on probability proportional to size at each stage. The Mini-International Neuropsychiatric Interview 6.0.0 used to diagnose psychiatric disorders. Sheehan disability scale was used to assess the disability. The current weighted prevalence of GAD was estimated. Association between GAD and socio-demographic factors was done using Firth's penalized logistic regression. The treatment gap and disability in GAD also calculated. The current weighted prevalence of GAD is 0.57%. The male gender and higher education groups have significantly lesser odds with current GAD. Urban metro and the married group have significantly higher odds with current GAD. The most common comorbid psychiatric disorders are depression (15.8%) followed by agoraphobia (9.4%). Among respondents with current GAD in the past 6 months across three domains, around 2/5th has mild and moderate disability, 1/10th has a severe disability, and 1/20th has an extreme disability. The overall treatment gap of current GAD is 75.7%. NMHS 2016 has provided valuable insights into the epidemiology and burden of GAD among the general population. The available findings provide a glimpse of the current scenario in GAD to aid policymakers in targeting interventions.

Evaluating the Effectiveness of Cognitive Behaviour Therapy for General Anxiety Disorder

Generalized Anxiety Disorder (GAD) is a common and challenging anxiety disorder with origins in DSM-III and later DSM-III-R. It involves persistent, uncontrollable worry and various symptoms affecting people of various ages. While GAD has received less research attention compared to other anxiety disorders, this essay examines Cognitive Behavioral Therapy (CBT) as an effective GAD treatment. It introduces two theoretical models, compares CBT to control groups, and highlights its partial effectiveness and potential long-term benefits. CBT is applicable across age groups, with limitations in older adults. It may also impact cognitive function. In conclusion, evidence supports CBT as a useful GAD treatment, acknowledging potential bias and the need for research into cultural influences.

Dietary counselling plus omega-3 supplementation in the treatment of generalized anxiety disorder: protocol for a randomized wait-list controlled pilot trial (the “EASe-GAD Trial”)

BackgroundAnxiety disorders are prevalent and disabling conditions involving excessive worry and tension. Generalized anxiety disorder (GAD), the most common anxiety disorder, affects 5% of individuals from high-income countries and many individuals report that treatment options are not accessible, effective, or tolerable. Clinical evidence suggests that nutrition interventions, based on the Mediterranean diet and supplementation of omega-3 fatty acids, can significantly improve symptoms of depression; however, the effect of nutrition interventions on anxiety symptoms has not been studied in a clinical population. The primary objective of the present study is to assess the feasibility and acceptability of a dietary counselling and omega-3 fatty acid supplementation intervention delivered to adult women with GAD. The secondary objectives include assessing changes in anxiety symptom severity, assessing changes in quality of life, assessing changes in biomarkers, and evaluating the components of the program.MethodsThis study is a randomized, wait-list controlled pilot trial delivering a 12-week, dietary counselling intervention and omega-3 supplementation to 50 adult women with GAD. Participants will complete seven individual counselling sessions which include education, personalized recommendations, mindful eating techniques, motivational interviewing, and goal setting. They will be provided with recipes, instructional videos, and food items. The intervention is designed based on the Social Cognitive Theory and previous research that has been done by the author team to identify dietary constituents with the most evidence to support their use in the treatment of anxiety disorders. Questionnaires and blood work will be completed at baseline, after the waiting period (for those in the waitlist group), and after the intervention.DiscussionResults from this study will lay the foundation for future large-scale studies in this area and may provide preliminary evidence of the role of diet counselling and omega-3 supplementation in the management of GAD. Research on the role of nutrition in psychiatric care has been identified as a priority by a number of international organizations. The present trial directly addresses the call for the research that is most needed to advance the field.Trial registrationThis protocol was registered at ClinicalTrials.gov on October 10, 2022; NCT05573672.Trial sponsor: The Canadian College of Naturopathic Medicine, 1255 Sheppard Ave E, Toronto, ON M2K 1E2, 416–498-1255.Steering committee: Composed of MA, LL, KC, IvdW, SM, UN, AJ. The committee meets monthly to oversee the trial.Protocol identifier: CCNM_EASe-GADCT_2201v4.

Review of Therapy for GAD

Generalized anxiety disorder (GAD), a chronic anxiety disorder characterized by persistent significant nervousness, autonomic nervous function excitement and excessive vigilance, is the most common anxiety disorder. With the deepening of research, people have a profound understanding of the causes and mechanisms of GAD and for patients with GAD, and there are systematic treatments based on series of clinical evidence and meta-analysis. This article will start with some mainstream treatment methods including CBT, DBT and medication therapy, commonly used in clinical practice, compare their feedback, and discuss their advantages and disadvantages.

Effect of cross-cultural education combined with music therapy on anxiety disorders

BackgroundAnxiety disorder usually refers to anxiety disorder. Common anxiety disorders include social phobia and separation anxiety disorder. Different anxiety disorders have different incidence rates. At present, the pathogenesis of anxiety disorder is not yet clear, but its common causes include genetic and psychological factors. Music therapy treats diseases from both physiological and psychological perspectives.Subjects and MethodsIn order to analyze the relief effect of cross-cultural education combined with music therapy on academic anxiety disorder in university students, the study selected 80 students with anxiety disorder. They were randomly divided into two groups, the observation group and the control group, with 40 students in each group. Among them, the control group only received cross-cultural education, while the observation group received music therapy based on cross-cultural education. Both groups were treated three times a week for a total of 8 weeks. After the treatment, the study evaluated the treatment results using the Self Rating Anxiety Scale, Self Rating Depression Scale, and SPSS23.0.ResultsThe results showed that there was a significant decrease in anxiety and depression scores between the observation group and the control group students after treatment, and there was a significant difference compared to before treatment (P<0.05). In addition, after treatment, the anxiety and depression scores of the observation group students decreased more than those of the control group, and the difference between the two was significant (P<0.05).ConclusionsIn summary, the combination of cross-cultural education and music therapy in universities has a certain alleviating effect on students’ academic anxiety disorder.

A comparison of schema modes and self-beliefs related to social anxiety in individuals with subclinical social anxiety disorder and without social anxiety disorder: a preliminary finding

ABSTRACT Social anxiety disorder (SAD) is the most common anxiety disorder and has serious negative effects on multiple areas of life. The possibility of comorbidity with other disorders and malfunction in different domains of life exists in both full-blown and subclinical social anxiety. This study aimed to compare the schema modes and self-beliefs related to social anxiety in individuals with subclinical social anxiety disorder and without social anxiety disorder. Multistage cluster random and purposive sampling methods were used to select 100 students, 50 with and 50 without symptoms of social anxiety disorder. Participants were evaluated in regard to schema modes, self-beliefs related to social anxiety, social anxiety, depression, and generalized anxiety disorder. They were then evaluated clinically through Structured Clinical Interview for DSM-5 (SCID-5). Data analysis was performed by Multivariate Analysis of Variance (MANOVA) which showed that there was a significant difference between the groups of individuals with and without symptoms of social anxiety in schema modes and self-beliefs related to social anxiety (p < 0.001). The obtained results can contribute to a deeper understanding of the dimensions of vulnerability underlying subclinical social anxiety disorder in the relationship between symptoms of subclinical social anxiety disorder and schema modes.

Digital Application of Clinical Staging to Support Stratification in Youth Mental Health Services: Validity and Reliability Study.

As the demand for youth mental health care continues to rise, managing wait times and reducing treatment delays are key challenges to delivering timely and quality care. Clinical staging is a heuristic model for youth mental health that can stratify care allocation according to individuals' risk of illness progression. The application of staging has been traditionally limited to trained clinicians yet leveraging digital technologies to apply clinical staging could increase the scalability and usability of this model in services. The aim of this study was to validate a digital algorithm to accurately differentiate young people at lower and higher risk of developing mental disorders. We conducted a study with a cohort comprising 131 young people, aged between 16 and 25 years, who presented to youth mental health services in Australia between November 2018 and March 2021. Expert psychiatrists independently assigned clinical stages (either stage 1a or stage 1b+), which were then compared to the digital algorithm's allocation based on a multidimensional self-report questionnaire. Of the 131 participants, the mean age was 20.3 (SD 2.4) years, and 72% (94/131) of them were female. Ninety-one percent of clinical stage ratings were concordant between the digital algorithm and the experts' ratings, with a substantial interrater agreement (κ=0.67; P<.001). The algorithm demonstrated an accuracy of 91% (95% CI 86%-95%; P=.03), a sensitivity of 80%, a specificity of 93%, and an F1-score of 73%. Of the concordant ratings, 16 young people were allocated to stage 1a, while 103 were assigned to stage 1b+. Among the 12 discordant cases, the digital algorithm allocated a lower stage (stage 1a) to 8 participants compared to the experts. These individuals had significantly milder symptoms of depression (P<.001) and anxiety (P<.001) compared to those with concordant stage 1b+ ratings. This novel digital algorithm is sufficiently robust to be used as an adjunctive decision support tool to stratify care and assist with demand management in youth mental health services. This work could transform care pathways and expedite care allocation for those in the early stages of common anxiety and depressive disorders. Between 11% and 27% of young people seeking care may benefit from low-intensity, self-directed, or brief interventions. Findings from this study suggest the possibility of redirecting clinical capacity to focus on individuals in stage 1b+ for further assessment and intervention.

Understanding the presentation and treatment of anxiety disorders.

Anxiety disorders are the most prevalent mental health issues worldwide and can have significant detrimental effects on people's quality of life and daily functioning. Nurses in a range of healthcare settings are likely to encounter people with various anxiety disorders, so it is essential that they have adequate knowledge and understanding of these conditions. This article explores the development of anxiety, before outlining the aetiologies and symptoms of common anxiety disorders. The author also provides an overview of some of the treatments available for anxiety disorders and explains the nurse's role in supporting those affected by these conditions.

Efficacy of culturally adapted interventions for common mental disorders in people of Chinese descent: a systematic review and meta-analysis

Evidence suggests that culturally adapted psychological interventions have some benefits in treating diverse ethnic groups. However, the effect of such cultural adaptions specifically in Chinese ethnic groups has not been thoroughly reviewed. We aimed to systematically assess the evidence for the efficacy of different cultural adaptations in treating common mental disorders in people of Chinese descent (ie, ethnic Chinese populations). In this systematic review and meta-analysis, we searched MEDLINE, Embase, PsycINFO, CNKI, and WANFANG to identify randomised controlled trials published in English and Chinese from database inception to March 10, 2023. We included trials of culturally adapted psychological interventions in people of Chinese descent (with at least 80% of Han Chinese descent) aged 15 years or older with a diagnosis or subthreshold symptoms of common mental disorders, including depression, anxiety disorders, and post-traumatic stress disorder. We excluded studies that included participants with severe mental disorders (eg, schizophrenia, bipolar disorder), neurodevelopmental disorders, or dementia. Study selection and data extraction were done by two independent reviewers, who extracted data for study characteristics, cultural adaptations, and summary efficacy. The primary outcome was post-intervention change in symptoms (both self-reported and clinician-rated). We used random-effects models to calculate standardised mean differences. Quality was assessed using the Cochrane risk of bias tool. The study is registered with PROSPERO (CRD42021239607). We identified 32 791 records, 67 of which were included in our meta-analysis (60 done in mainland China, four in Hong Kong, and one each in Taiwan, Australia, and the USA). We included 6199 participants (mean age 39·32 years [range 16-84]), of whom 2605 (42%) were male and 3247 (52%) were female. Culturally adapted interventions had medium effect sizes in terms of reducing both self-reported (Hedges' g 0·77 [95% CI 0·61-0·94]; I2 84%) and clinician-rated (0·75 [0·54-0·96]; 86%) symptom severity across all disorders at end of treatment, irrespective of adaptation types. We noted no difference in efficacy between culturally modified interventions and culturally specific interventions. Subgroup analyses showed considerable heterogeneity. Inadequate reporting in included studies largely restricted risk-of-bias appraisals across all domains. Psychological interventions can be transported across cultures with appropriate modifications. Adaptations to interventions can be made by modifying evidence-based interventions, or in culturally specific ways that are rooted in the sociocultural context. However, findings are limited by the insufficient reporting of interventions and cultural adaptations. None. For the Chinese translation of the abstract see Supplementary Materials section.

Attackenangst bei Migräne: Diagnostik und Behandlung

In the field of headache disorders, the term "fear of attacks" refers to the fear of aheadache attack occurring. Excessive fear of attacks may worsen the course of amigraine and lead to an increase in migraine activity. In the assessment of attack-related fear, acategorical (fear of attacks as aspecific phobia) and adimensional approach (measuring the extent of fear using aquestionnaire) are available. The 29-item Fear of Attacks in Migraine Inventory (FAMI) is an economic self-report questionnaire for the assessment of attack-related fear, and it has good psychometric properties. The treatment of attack-related fear includes behavioral interventions as well as pharmacological therapy. Behavioral interventions have few side effects and are based on the treatment of common anxiety disorders (e.g., agoraphobia). Although the evidence of existing treatments is sparse, attack-related fear should be considered in routine care.