High Prevalence Of Anxiety Disorders Research Articles

Obstetrician-gynecologists' screening patterns for anxiety during pregnancy

As obstetrician-gynecologists (ob-gyns) take on a greater role in women's healthcare, it is important that they are aware of the high prevalence of anxiety disorders in their patient population. Anxiety disorders present during pregnancy can have detrimental effects on both mother and child. In this study, we queried 1,193 ob-gyns on their screening rates, practice patterns, training, and knowledge as they relate to anxiety disorders during pregnancy. We achieved a 44% response rate (n=397) after three mailings. Physicians reported a moderate interest in screening for and diagnosing anxiety, but less interest in treatment. Only 20% of respondents (n=79) screen for anxiety during pregnancy, and they typically refer anxiety-disordered patients to mental health professionals. Ob-gyns with comprehensive or adequate training were significantly more likely to screen than those who stated that their training was inadequate. Having a friend who has been diagnosed with an anxiety disorder also significantly increased both the likelihood that these physicians would screen and the reported level of interest in screening of anxiety disorders during pregnancy. At present, the majority of ob-gyns feel that their training in this area was barely adequate to inadequate. Specifically, generalized anxiety disorder may be the least understood. Increased training in this area would allow ob-gyns to overcome what they list as the primary barrier to anxiety screening during pregnancy--that is, inadequate training about anxiety disorders.

Prevalence of anxiety disorders in earthquake effected areas

Introduction:Earthquake disaster of Pakistan caused massive destruction. Survivors have experienced several recurrent aftershocks since then. Many of them measured above 5. Data was collected from various agencies including WHO, Turkish Red Crescent, Canadian team of relief and some other NGOs working with earth quake hit communities in NWFP and Azad Kashmir. Diagnosis was made using semi-structured interviews. The objective of this paper is to measure the impact of neurobiological and socio cultural underpinnings.Result:Data analyses of women (1056), men (281) and children (204) indicate high prevalence of anxiety disorders including PTSD (853 women, 153 men) and depression (73 women, 31 men). Results vary from the observations made from other disasters. Sex ratio shows huge difference in prevalence between males and females. The major factors responsible are loss of life and property and uncertainty regarding future, harsh weather and repeated tremors.Discussion:Patients with PTSD have dysregulation of HPA axis response. This alteration is more pronounced in case of women. Studies show that estrogen plays important role in the genesis of disease. Dexamethasone suppression test also indicates greater dysregulation of glucocorticoid receptor. Studies reveal predisposition in women for PTSD and depression.Women and children were affected most because most of them were at home and in schools. Hence, large number of women sustained more physical injuries and psychiatric consequences.In our study depression came out to be more prevalent in females. This can be explained as comorbidity of PTSD and because of its own dynamics.

Obesity and the risk for mental disorders in a representative German adult sample

A systematic approach to examining associations among obesity and socio-demographic determinants, psychological problems, and mental disorders in epidemiological samples is missing. Within the representative German Health Interview and Examination Survey and its Mental Health Supplement (GHS-MHS), 4181 subjects (age 18-65 years) took part in a physical examination (including measurement of body weight and height) and a standardized psychological interview (M-CIDI). Obesity (BMI > 30 kg/m(2)), somatic diseases, socio-economic variables, health-related quality of life (SF-36), and mental disorders (DSM-IV) were assessed. Data were analysed by logistic regression analyses. Prevalence of obesity was 18.5%. There was a strong association between obesity and somatic conditions, as well as to low socio-economic status (SES). No psychosocial disadvantages (e.g. regarding social relationships, impairment due to mental health problems, depressed feelings) for the obese individuals were found. With the exception of a higher prevalence of anxiety disorders in obese men (12.5 versus 8.5%, OR = 1.53, CI = 1.06-2.21, disappearing when controlled for number of somatic conditions), obese persons showed no elevated rates of mental disorders. Obesity is associated with a low SES and some somatic disadvantages but not with other social or emotional disadvantages that have been often assumed to be very prevalent in that group. From the population-based perspective, obesity per se seems not to be associated with a higher risk for suffering from mental disorders, whereas relations between specific aspects of obesity and specific types of psychopathology still need further study.

Social anxiety disorder in 300 patients hospitalized for alcoholism in Brazil: high prevalence and undertreatment

Background Although the frequency of social phobia is high among alcoholic patients, this anxiety disorder is often neglected because treatment tends to be focused exclusively on alcohol dependence. Methods A total of 300 hospitalized alcoholic patients were interviewed using Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition and Liebowitz Social Anxiety Scale as well a questionnaire to check the use of medication for social phobia among alcoholics and the relationship between social phobia and alcohol use. Results A prevalence of 30.6% was found for specific phobia, 24.7% for social phobia, 22.2% for anxiety disorder induced by alcohol, 19.3% for generalized anxiety disorder, 5% for obsessive-compulsive disorder, 4.6% for posttraumatic stress disorder, and 2% for panic disorder with agoraphobia. Social phobia preceded alcohol dependence in 90.2% of the patients. The frequency of the use of medication for social phobia among social phobic alcoholics was 20.3%. Conclusions The study confirms the high prevalence of anxiety disorders among alcoholics, particularly of social phobia. It also suggests that social phobia precedes alcohol dependence but shows that the use of medication for social phobia is still infrequent. Further studies are required to check if the failure to identify this comorbidity can make the recovery of alcoholics even more difficult.

Clinical Manual of Anxiety Disorders

Back to table of contents Previous article Next article Book ReviewsFull AccessClinical Manual of Anxiety DisordersRuthAnn Rizzi M.D.RuthAnn Rizzi M.D.Search for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ps.2006.57.4.582aAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail For those of us looking for a clear, concise primer on anxiety disorders, Clinical Manual of Anxiety Disorders, edited by Dan J. Stein, director of the MRC research unit on anxiety and stress disorders at the University of Stellenbosch in Cape Town, South Africa, is a well-organized place to start. It refers often to the two most comprehensive sources of psychiatric epidemiologic information: the Epidemiologic Catchment Area study and the National Comorbidity Survey. Given their importance in the evolution of the concept of anxiety and anxiety disorders, this introductory explanation is a welcome review. Readers will likely find it a useful companion as they begin to digest information from the current National Comorbidity Survey-Replication (NCS-R). Disorder-based chapters follow the overview chapter, with most contributors seeking to further the explanation of the epidemiology of each major disorder, with some variable results. In fact, if there is a flaw in the manual, it is in the variability in the content and presentation among the various chapters. That being said, each chapter is consistently laid out around DSM-IV-TR criteria. Panic disorder and agoraphobia have concise epidemiologic and treatment sections and a slightly overinclusive section on neuroanatomy; this section would have been more helpful if subsequent chapters had followed a similar format for comparison. The various pharmacologic and psychotherapeutic treatment options are well referenced, a consistent feature throughout the manual. The chapter on specific phobia is thorough, although less so in the treatment review. Social phobia is given a more extensive review of ratings instruments and a broader review of treatment options than disorders in the preceding chapters.Ratings scales are surprisingly much less thorough in the section on obsessive-compulsive disorder, although there is an excellent narrative review of the various psychotherapies applicable for this disorder (the algorithm pales next to it) followed by a concise table of available pharmacotherapies. Posttraumatic stress disorder (PTSD) receives a useful discussion of nomenclature, a subject often fraught with semantic confusion in this disorder.Perhaps the most useful concept is the allowance for major depression following trauma, taking the burden off PTSD as the sole clinical category of response to trauma. Again, various available psychotherapies are excellently explained. The strength of the chapter on generalized anxiety disorder lies in its real-life examples of the most common differential diagnoses.Practicing clinicians are most likely to benefit from this manual, because its depth exceeds that of a general overview and can be further supplemented by its extensive references. It is a timely addition to clinical manuals, because the NCS-R highlights the high prevalence of anxiety disorders in society.Dr. Rizzi is affiliated with department of psychiatry at the University of Massachusetts Medical School in Worchester. FiguresReferencesCited byDetailsCited byNone Volume 57Issue 4 April, 2006Pages 582-583PSYCHIATRIC SERVICES April 2006 Volume 57 Number 4 Metrics PDF download History Published online 1 April 2006 Published in print 1 April 2006

Psychiatric Diagnoses in Patients with Williams Syndrome and Their Families

Williams Syndrome (WS) is a genetic disorder associated with mental retardation (MR) and a distinct behavioral phenotype including a friendly and outgoing personality. This population, like others with MR, has been reported to have an increased rate of symptoms of mental illness; however, few studies have used DSM-IV criteria to quantify specific psychiatric diagnoses in WS and the prevalence of psychiatric illness in relatives of individuals with WS and the possible relationship between family and patient diagnoses is currently unknown. Methods: Twenty-one families participated; the patients’ average age was 16 years. DSM-IV diagnoses were applied by using the Anxiety Disorders Interview Schedule (ADIS, Parent and Child Versions) and the Family History Screen. Results: A diagnosis from the ADIS was applicable to 13 patients (62%), and in 16 patients (76%) a diagnosis was applicable in their first-degree family members. Ten patients (48%) had some form of anxiety, specific phobia being the most common. Three patients (14%) had major depressive disorder and 9 patients (43%) had attention-deficit/hyperactivity disorder (ADHD). The presence of anxiety or mood disorders in patients with WS and the presence of these disorders in their family members were unrelated. Conclusions: Patients with WS have a high prevalence of anxiety disorders and of ADHD. The presence of psychiatric disorders in WS did not appear to have a significant relationship to family history of psychiatric disorders, consistent with the hypothesis that the specific genetic alteration in WS causes, or contributes to causing, the anxiety disorders and the ADHD that are so common in the disorder. Populations with mental retardation (MR), especially those with known genetic alterations, offer a window into the effects of genes on determining cognition and behavior. Populations with MR are known to have increased rates of emotional distress and mental illness (1, 2). While estimates vary, the prevalence of

Anxiety disorders in an attention-deficit/hyperactivity disorder clinical sample

To evaluate the prevalence of anxiety disorders in a clinical referred sample of children and adolescents with attention deficit/hyperactivity disorder (ADHD). 78 children and adolescents with ADHD according to DSM-IV criteria were investigated with a semi-structured interview (P-CHIPS), complemented by clinical interviews with the children or adolescents and their parents. Their IQ was calculated with neuropsychological testing. A high prevalence of anxiety disorders (23.05%) was found in the sample. Generalized anxiety disorder was the most prevalent disorder (12,8%), followed by social phobia (3,84%) and separation anxiety disorder (3,8%). Two children showed more than one anxiety disorder. Children and adolescents with ADHD seem to be more prone to have comorbid anxiety disorders, at least in clinical samples referred to specialized units.

Behaviorial inhibition and history of childhood anxiety disorders in Brazilian adult patients with panic disorder and social anxiety disorder

To evaluate the presence of behavioral inhibition and anxiety disorders during childhood in Brazilian adult patients with panic disorder and social anxiety disorder compared to a control group. Fifty patients with panic disorder, 50 patients with social anxiety disorder, and 50 control subjects were included in the study. To assess the history of childhood anxiety, the Schedule for Affective Disorders and Schizophrenia for School Age Children, Epidemiologic Version (K-SADS-E), and the Diagnostic Interview for Children and Adolescents-Parent Version (DICA-P) were used. The presence of behavioral inhibition in childhood was assessed by the self-reported scale of Behavioral Inhibition Retrospective Version (RSRI-30). Patients showed significantly higher prevalence of anxiety disorders and behavioral inhibition in childhood compared to the control group. Patients with social anxiety disorder also showed significantly higher rates of avoidance disorder (46% vs. 18%, p = 0.005), social anxiety disorder (60% vs. 26%, p = 0.001), presence of at least one anxiety disorder (82% vs. 56%, p = 0.009) and global behavioral inhibition (2.89 +/- 0.61 vs. 2.46 +/- 0.61, p < 0.05) and school/social behavioral inhibition (3.56 +/- 0.91 vs. 2.67 +/- 0.82, p < 0.05) in childhood compared to patients with panic disorder. Our data are in accordance to the literature and corroborates the theory of an anxiety diathesis, suggesting that a history of anxiety disorders in childhood is associated with an anxiety disorder diagnosis, mainly social anxiety disorder, in adulthood.

The effects of sex and neonatal maternal separation on fear-potentiated and light-enhanced startle

This study was based on the higher prevalence of anxiety disorders in women than in men, and on the finding that early adverse experiences are a major risk factor for the development of anxiety disorders later in life. The object of this study was to investigate in rats, the sensitivities of the light-enhanced startle (LES) and fear-potentiated startle (FPS) paradigms to sex differences and to determine the effects of maternal separation (MS) on the baseline startle magnitude and potentiated startle response in these paradigms. Pups in the MS group were separated daily from their mother for 180 min/day from postnatal day 2 (PND2) to PND14. Control litters remained undisturbed. The adult male and female progeny were tested in the FPS and LES. As predicted, females showed a significantly greater potentiation of startle than males in the FPS, and a strong trend towards greater startle potentiation in the LES. Contrary to predictions, MS had no effect on startle potentiation in the FPS and severely disrupted LES in female, but not male rats. The observed sex differences add to the validity of the FPS and LES as animal paradigms of fear and anxiety. The findings indicate that these paradigms can be used to study the biological basis of sex differences in fear and anxiety. In contrast, the effects of MS on startle potentiation argue against the idea that MS provides a robust model for the predicted influences of early adverse effects on these startle potentiation measures of fear and anxiety.

The Relationship of Asthma and Anxiety Disorders

Objective: This article reviewed the child and adult medical literature on the prevalence of comorbid anxiety disorders in patients with asthma. Theoretical ideas regarding the relatively high comorbidity rates are presented along with a model describing putative interactions between anxiety disorders and asthma. Method: A search of the literature from the last 2 decades using MEDLINE by pairing the word, “asthma,” with the following words: “anxiety,” “depression,” “panic,” and “psychological disorders.” We located additional research by screening the bibliographies of articles retrieved in the MEDLINE search. Results: Both adult and child/adolescent populations with asthma appear to have a high prevalence of anxiety disorders. In child/adolescent populations with asthma, up to one third may meet criteria for comorbid anxiety disorders. In adult populations with asthma, the estimated rate of panic disorder ranges from 6.5% to 24%. However, most studies are limited by small samples, nonrepresentative populations, self-reported asthma status, and lack of controlling for important potential confounders such as smoking and asthma medications. There are also limited data on the impact of anxiety comorbidity in patients with asthma on symptom burden, self-care regimens (such as monitoring peak expiratory flow, taking medication, and quitting smoking), functional status, and medical costs. Conclusions: There appears to be a high comorbidity of anxiety disorders in patients with asthma. The prevalence and longitudinal impact of anxiety comorbidity needs to be examined in a large population-based sample of children, adolescents, and adults with asthma. If a high prevalence of comorbid anxiety disorder is documented and if this comorbidity adversely affects the self-efficacy and self-care, symptom burden, and functioning in persons with asthma, then it will be important to develop treatment trials.

High prevalence of anxiety symptoms in hospitalized geriatric patients.

To examine the prevalence of anxiety symptoms in hospitalized geriatric patients. Controlled cross-sectional study. Ninety-eight geriatric in-patients and 68 healthy home-dwelling controls of similar age recruited from senior citizen centres. Anxiety measured as a current emotional state by Spielberger's State-Trait Anxiety Inventory (STAI). The geriatric patients scored significantly higher than the controls. Applying Spielberger's recommended cut-off of 39/40 on the STAI sumscore, 41% of the female and 47% of the male geriatric patients might be suspected of suffering from significant anxiety symptoms. Patients with chronic obstructive pulmonary disease tended to score higher; otherwise no relationship was found between the STAI sumscore and type of chronic somatic disease, nor between the STAI sumscore and number of drugs in regular use. STAI proved feasible for use in the elderly. The scoring on the STAI is high in geriatric in-patients. Further studies are needed to clarify to what extent this relates to a high prevalence of anxiety disorders.

Quelques réflexions sur l'anxiété et ses troubles associés : un débat entre l'approche cognitivocomportementale et psychodynamique

Reflections on anxiety and associated disturbances. A debate between the cognitive-behavioral and psychodynamic approaches. Epidemiological studies in psychopathology have underscored the high prevalence of anxiety disorders, depression and alcohol dependence, as well as a strong association between these disorders that increases the severity of each syndrome. Although several different explanations are currently applied to understand the problem of co-morbidity, investigations that have specifically examined the possibility of a causal relationship note that anxiety disorders often precede the other two syndromes. This knowledge serves as the basis for a debate between cognitive-behavioral and psychodynamic approaches in the goal of improving therapeutic interventions.

Anxiety in ethnic minority youth. Methodological and conceptual issues and review of the literature.

Although current research has documented a relatively high prevalence of anxiety disorders in American youth, this research has been conducted mainly with nonminority samples. Fair treatment and increasing numbers of ethnic minority persons in the United States require that more should be known about minority youth. However, research with majority youth cannot be safely generalized to minority youth for several reasons, such as potential differences in the manifestation of anxiety, differences in style of response to assessment devices, and different life circumstances. This review is presented in two major sections. First, the authors address definition of terms and fully examine the significance of studying anxiety in ethnic minority youth. Also considered are methodological issues such as sampling and participation biases. Second, the authors review anxiety in ethnic minority children and adolescents in the United States including studies addressing fears, worries, trait anxiety, test anxiety, and anxiety disorders.

Comorbidity and Global Functioning (DSM-III-R Axis V) in a Brazilian Sample of Cocaine Users

We assessed the mental disorders rate in treatment-seeking, non-intravenous cocaine users in a Brazilian outpatient clinic, and evaluated how comorbidity affects global functioning. Fifty male nonintraveneous cocaine users from an outpatient clinic were interviewed with semistructured instruments based on DSM-III-R criteria. All subjects met the DSM-III-R criteria for “cocaine abuse” or “dependence” during the last 6 months. The lifetime Axis I or Axis II disorders rate was 69%, with a higher prevalence of anxiety disorders (31%) and depressive disorders (20%). By using a multivariate analysis, the number of personality disorders, the number of psychiatric diagnoses, and the presence of depressive and anxiety disorders were found as significant factors associated with poor global functioning among nonintraveneous cocaine addicts.

Gender Difference in the Prevalence of Clinical Depression: The Role Played by Depression Associated With Somatic Symptoms

This study tested the hypothesis that female subjects may exhibit a higher prevalence than male subjects of depression associated with somatic symptoms but not a higher prevalence of depression not associated with these other symptoms. The author reanalyzed research interview data on major depression from the National Comorbidity Survey, dividing respondents into those who met overall criteria for major depression and exhibited fatigue and appetite and sleep disturbance ("somatic depression") and those who met overall criteria but did not exhibit these somatic criteria ("pure depression"). Female subjects exhibited a higher prevalence than male subjects of somatic depression but not a higher prevalence of pure depression. Somatic depression was associated with a high prevalence of anxiety disorder and, among female subjects, with body aches and onset of depression during early adolescence. The gender difference in depression may result from a difference in a specific subtype of anxious somatic depression.

The relationship between anxiety disorders and age.

To review the major community-based epidemiological studies that have reported data on anxiety disorders in individuals aged 65 and over and to examine age-related changes in their prevalence and incidence. All English language entries relating to anxiety in the BIDS, EMBASE, Medline and PsychLit computerized databases, together with a search of relevant citations. The prevalence of phobic disorders in the population aged 65 or over lies between 0.7% and 12% over a 1-6-month period. As the rates for social phobia, 1%, and simple phobia, 4%, are fairly consistent, much of this variation is due to agoraphobia, whose prevalence lies between 1.4% and 7.9%. The prevalence of obsessive-compulsive disorder is 0.1-0.8%, panic disorder 0.1% and generalized anxiety 4%. Women do have a higher prevalence of anxiety disorders than men but this difference diminishes with increasing age, as does the apparent prevalence of all anxiety disorders apart from generalized anxiety, measured without hierarchical rules, which appears to be maintained or increase. The relative importance of various explanations for this apparent reduction is discussed, including the three that are of greatest public health and clinical importance: cohort effects, anxiety-related mortality and comorbidity between anxiety and cognitive impairment. A tri-dimensional approach (psychic, somatic and behavioural) to anxiety measurement is advocated in order to facilitate future studies of age-related changes which may lead to a reappraisal of the status of generalized anxiety as a 'residual category'.

HOW COMMON ARE THE ANXIETY DISORDERS IN OLD AGE?

This community study of the anxiety disorders in people aged 65 and over finds a relatively high prevalence of anxiety disorders (15%), with phobic disorders being the most prevalent subclassification (12%). While generalized anxiety was usually seen with other psychiatric syndromes, phobic disorder was usually observed in the absence of either depression or anxiety. These results suggest that while generalized anxiety should be placed below depression in a diagnostic hierarchy, phobic disorder does not fit with this diagnostic model.

A survey of anxiety disorders clinics in Canadian hospitals.

A questionnaire on anxiety disorder services was sent to 240 Canadian hospitals, of which 117 responded. Eighteen of the responding hospitals had anxiety disorder clinics and saw an average of 208 patients a year. These clinics appear to be scarce although, according to epidemiological studies, there is a high prevalence of anxiety disorders in the community. The specific diagnoses of the patients seen in the specialty clinics and the treatments offered generally followed international patterns.