Correlates Of Anxiety Disorders Research Articles

Prevalence and its correlates of anxiety disorders from India's National Mental Health Survey 2016.

Introduction:Anxiety disorders (ADs) impact the quality of life and productivity at an individual level and result in substantial loss of national income. Representative epidemiological studies estimating the burden of ADs are limited in India. National Mental Health Survey (NMHS) 2016 of India aimed to strengthen mental health services across India assessed the prevalence and pattern of public health priority mental disorders for mental health-care policy and implementation. This article focuses on the current prevalence, sociodemographic correlates, disability, and treatment gap in ADs in the adult population of NMHS 2016.Materials and Methods:NMHS 2016 was a nationally representative, multicentered study across 12 Indian states during 2014–2016. Diagnosis of ADs (generalized AD, panic disorder, agoraphobia, and social AD) was based on Mini-International Neuropsychiatric Interview 6.0.0. Disability was by Sheehan’s Disability Scale.Results:The current weighted prevalence of ADs was 2.57% (95% confidence interval: 2.54–2.60). Risk factors identified were female gender, 40–59 age group, and urban metro dwellers. Around 60% suffered from the disability of varying severity. The overall treatment gap for ADs was 82.9%.Conclusions:The burden of AD is similar to Depressive disorders, and this article calls for the immediate attention of policymakers to institute effective management plans in existing public health programs.

Emotional Reactivity and Regulation in Panic Disorder: Insights from a Functional Magnetic Resonance Imaging Study of Cognitive Behavioral Therapy

l i r t a P H p n U s p t s e c i t F or more than a century, psychologists and psychiatrists have sought to understand the biological bases of mental disorders, with a view to fashioning more effective treatments. Advances in functional neuroimaging have made it possible for clinical researchers to make significant strides towards realizing this long-held goal, allowing them to do the following: 1) characterize differences in neural responses between patients with various psychiatric conditions and healthy subjects (HS), and 2) examine the neural correlates of psychosocial and biologic treatments. One particular target of investigation has been the anxiety disorders, which constitute the most common family of psychiatric disorders, with a lifetime prevalence of 28.8% (1). Compared with HS, patients with anxiety disorders demonstrate hyperactivity in the insula and amygdala, key regions in the fear network (2,3). In addition to shared features, there are important differences among anxiety disorders. For example, hypoactivation in the rostral anterior cingulate cortex (ACC), dorsal ACC, ventromedial prefrontal cortex (PFC), and thalamus is more characteristic of posttraumatic stress disorder than social anxiety disorder (SAD) or specific phobias (2). In contrast, hyperactivation in the amygdalae and insular cortex is found more frequently in SAD and specific phobias than in posttraumatic stress disorder (2). Related research examining the neural correlates of psychosocial treatments for anxiety disorders has found that cognitive behavioral therapy (CBT) decreases blood flow to the amygdala and the medial temporal lobe in patients with SAD during an anxiety-inducing task (4). Research in patients with specific phobias has demonstrated that CBT leads to reduced activation in the anterior insula and increased activation in the dorsolateral PFC (4). These findings suggest that the neural mechanisms underlying anxiety may be specific to each disorder and that the mechanisms associated with change during CBT may be disorder specific as well. Despite the wealth of research examining the neural correlates of anxiety disorders, surprisingly little is known about the neurobiology of panic disorder (PD). Panic disorder is marked by internally generated threat, vegetative symptoms, and sudden extreme anxiety (3). Maladaptive associative learning is thought to play a role in the etiology of PD, and research has shown that patients with PD extrapolate learned fears to related stimuli (5). Agoraphobia (the avoidance of situations in which escape or assistance may not be possible) commonly co-occurs with panic disorder (PD/A) (6). The neural correlates of PD/A are not well described, but one positron emission tomography study found that, compared with HS, PD/A patients displayed higher levels of glucose uptake in the bilateral amygdala, hippocampus, and thalamus (among other regions) (7), providing evidence for the role of the fear network in PD/A. Only two studies have investigated the neural correlates of CBT for PD/A,

Trauma and resulting sensitization effects are modulated by psychological factors

Traumas have both immediate consequences and proactive consequences. Examples include learned helplessness, HPA-axis responsivity, gastrointestinal vulnerability to ulcer, and other correlates of anxiety disorders. Both immediate and proactive consequences may be modulated by behavioral and cognitive evolutionary evolved adaption processes, among which are forms of learning that enable 'coping'. Examples of associative and non-associative forms of coping and effects on learned helplessness, HPA-axis responsivity, and gastrointestinal vulnerability are presented. The importance of attention to behavioral contingencies in situations in which potentially traumatic events occur is emphasized as critical to understanding that it is not the physical event(s) per se that determine the immediate and long term consequences.

Social outcomes related to age of onset among psychiatric disorders.

Analyses are presented that examine the impact of a diagnosis of affective disorder, anxiety disorder, and substance abuse before and after age 20 on multiple measures of education, socioeconomic and employment status, childbearing, marital status, and instability in a random sample (N = 3,000) of community respondents from the Piedmont Health Survey. Results indicate that all categories are associated with social outcomes regardless of age of onset, particularly for marital and family outcomes. For socioeconomic outcomes, the correlates of anxiety disorder are more pervasive, and the effects of a substance abuse diagnosis are stronger for early onset.