Higher Rates Of Anxiety Disorders Research Articles

Cardiac Syndrome X - A mystery to worry about.

Madam, Cardiac syndrome X, by definition means original pain without any evidence of significant CVD visualized on angiogram. Normal angiogram makes it difficult for medical practitioners to detect this syndrome. About 10-20% of persons who undergo coronarography suffers from cardiac syndrome X [1]. It has the highest prevalence in postmenopausal women [2]. Most common indication is symptoms of myocardial infarction in patients [3]. Recent study by Magdalena Piegza et al shows the cardiac syndrome patients suffer from anxiety disorders, depressive symptoms and sleep disturbances [4]. This syndrome brings a great concern to Pakistan as already we have a high rate of anxiety disorders, heart problems and higher ratio of deaths due to CVD. A study conducted on 423 persons in tertiary care hospital in Karachi showed the mean anxiety value to be 28.3% [5]. A complete diagnosis of the syndrome requires proper checkup and follow up, but inadequate procedural managements culminating due to lack of interest and awareness raise a high risk of cardiac syndrome X in Pakistan. A thorough online literary search on the PubMed did not find a single article about this issue pointing to the lack of interest and awareness among the medical practitioners of Pakistan. It has to be made sure by creating awareness driven by seminars and workshops to apprise doctors about this syndrome. A study by the Institute for Health Metrics and Evaluation found that 38% of deaths in Pakistan are due to ischemic heart diseases [6]. This increases the chances of cardiac syndrome X among the local population. Due diligence in medical care and follow up must be applied to patients reaching out with past history of anxietic disorders and ischemic heart problems. Common public awareness is also important and doctors should emphasize on ensuring proper lifestyle including diet, exercise, smoking cessation and weight reduction.

Clinical Features, Psychiatric Comorbidities and Treatments in Childhood OCD in terms of OCD Severity, Age and Gender

Objective: The aim of this study was to investigate the clinical features, psychiatric comorbidities, and treatments of childhood obsessive-compulsive disorder (OCD), with consideration given to OCD severity, gender and age. Method: The study included 104 children and adolescents between the ages of 6 and 17 who were diagnosed with OCD and followed up in Child and Adolescent Psychiatry outpatient clinics between 2016 and 2023. The study examined the sociodemographic characteristics, clinical features, comorbid psychiatric disorders, and treatment approaches of children and adolescents with OCD. Results: The sample had a mean age of 13.1 ± 2.7 years, and the mean age at onset of OCD was 11.9 ± 2.7 years (range: 5-17 years). Those with mild OCD had a significantly lower mean age at presentation and onset of OCD compared to those with moderate and severe OCD (p=0.012, p=0.02, respectively). Patients with severe OCD had longer illness duration (p=0.009) and outpatient follow-up (p=0.004) compared to those with moderate OCD. Boys had significantly higher rates of family history of psychiatric disorders (p=0.006), attention-deficit/hyperactivity disorder/oppositional defiant disorder (p=0.003), and tic disorder (p=0.035) comorbidity rates than girls, while girls had higher rates of anxiety disorders (p=0.022) comorbidity. The study found that repeating and counting compulsions were more common in adolescents than in preadolescents (p=0.003, all). Conclusion: These results suggest that clinical presentation and comorbidity may vary with disease severity, gender and age, in children and adolescents with OCD. Early intervention is crucial to prevent clinical progression, worsening, and mental health sequelae.

Evaluating the Cognitive Impact of Anxiolytics on Elderly Patients: A prospective observational study.

Background: The cognitive effects of anxiolytics in older adults are an important domain to research given the high rates of anxiety disorders and these medications commonly prescribed. Benzodiazepines, and some of the newer non-benzo" sedative anxiolytic agents have been associated with cognitive effects as a potential side effect. This study is going to be conducted in Lady Reading Hospital (LRH) Peshawar; thus the data will reflect upon population served by this particular hospital. Objectives: To assess the cognitive impact of anxiolytic medication in geriatric patients, specifically on short-term memory (STM), attention and executive functions. Design: A observational study. Place and Duration of Study: Department of Pharmacy, Lady Reading Hospital-Peshawar starting from January 05th 2021 to July 05th ,2022. Methods: This was an observational study conducted on 150 elderly patients at Lady Reading Hospital through non probability sampling, comparing cognitive domain of functioning between 75 users and rest controls. Cognitive function was evaluated by Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment before and after the medication. Results - This section will describe the cognitive score changes in relation to anxiolytic use. One-way ANOVA will be utilized to examine the differences in cognitive outcomes according drug type, dosage and duration of use. Conclusions: The use of anxiolytics in elderly patients is associated with deterioration cognitive function, which was confirmed by a decrease MMSE and MoCA scores during the course of treatment. The potential cognitive side effects when prescribing anxiolytics to the elderly requires a nuanced approach by healthcare providers. Keywords: Anxiolytics; older adult patients; cognitive performance, MMSE/MoCA.

Prevalence and Correlates of Self-Reported ADHD Symptoms in Bariatric Patients: Focus on Mood and Anxiety Comorbidity, Disordered Eating, and Temperamental Traits

PurposeAttention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by inattention, hyperactivity, and impulsivity. A positive association between ADHD and obesity has been observed, especially in adult samples. In this study, prevalence and correlates of self-reported symptoms indicative of a positive screening for ADHD were examined in patients seeking bariatric treatment.Material and MethodsThe study sample was composed of 260 adult patients with obesity referred for bariatric surgery to the Obesity Center of the Endocrinology Unit in Pisa University Hospital between January 2006 and November 2016 (BMI ≥ 30 kg/m2; mean ± standard deviation = 46.27 ± 7.45 kg/m2). ADHD symptoms were identified using ADHD Symptom Check‐List‐90‐R Screening Scale. Night-eating, binge-eating/purging behaviors, and temperamental and character traits were assessed in a subsample of 95 patients.ResultsThirty participants had a positive screening for ADHD (11.5%, 95% CI = 7.9–16.1%). Patients with a positive screening showed significantly higher rates of anxiety disorders (40% vs. 16.5%, χ2 = 7.97, p = 0.005) panic disorder (40% vs. 14.3%, χ2 = 10.48, p = 0.001), and a higher severity of psychopathological symptoms and sleep disturbances than those without. In subsample analyses, ADHD symptoms severity was associated with more bulimic behaviors (r = 0.31–0.46), greater harm avoidance (r = 0.45–0.66), less self-directedness (r = − 0.44–0.63), and cooperativeness (r = − 0.26–0.42).ConclusionADHD symptoms may be common in patients with obesity seeking bariatric treatment and are positively associated with disordered eating, internalizing features, and maladaptive character traits.Level of Evidence: V, cross sectional descriptive study.Graphical

Obstetric outcomes of nulliparous women with pelvic pain undergoing fertility treatment

Research QuestionTo evaluate the association between pelvic pain disorders and primary caesarean delivery for patients undergoing assisted reproductive technology treatment. DesignRetrospective cohort study of nulliparous patients with singleton pregnancies who underwent assisted reproductive technology treatment and achieved a live birth from 2012-2020. Cases included patients with prior diagnoses of pelvic pain disorders. A 3:1 ratio propensity score matched population of patients without pelvic pain was included as Controls. Comparative statistics were performed using chi-square and students t-test. A multivariate regression analysis was conducted to evaluate the association between pelvic pain patients and mode of delivery. Results174 pelvic pain patients were compared to 575 controls. Pelvic pain patients reported a significantly longer duration of infertility (18.9±20 months vs. 14.0±14 months, p=0.003) compared to controls. Pelvic pain patients had a significantly higher rate of anxiety disorders (115±21.9 vs. 55±31.6, p= 0.009) and use of anxiolytics at embryo transfer (17±3.2 vs. 12±6.9, p=0.03). Pelvic pain patients had a higher rate of primary caesarean delivery compared with controls (59.7% vs. 49.1%, p=0.01). After adjusting for multiple variables, there was a significant association between pelvic pain patients and increased odds of primary caesarean delivery (aOR = 1.48, CI 95%; 1.02-2.1). ConclusionPelvic pain patients have significantly greater odds of primary caesarean delivery when compared to patients without pelvic pain history. The infertility outpatient setting may be uniquely positioned to identify patients at risk for undergoing primary caesarean delivery and could facilitate earlier intervention for pelvic floor physical therapy during the preconception and antepartum periods.

From synaptic dysfunction to atypical emotional processing in autism.

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition mainly characterized by social impairments and repetitive behaviors. Among these core symptoms, a notable aspect of ASD is the presence of emotional complexities, including high rates of anxiety disorders. The inherent heterogeneity of ASD poses a unique challenge in understanding its etiological origins, yet the utilization of diverse animal models replicating ASD traits has enabled researchers to dissect the intricate relationship between autism and atypical emotional processing. In this review, we delve into the general findings about the neural circuits underpinning one of the most extensively researched and evolutionarily conserved emotional states: fear and anxiety. Additionally, we explore how distinct ASD animal models exhibit various anxiety phenotypes, making them a crucial tool for dissecting ASD's multifaceted nature. Overall, to a proper display of fear response, it is crucial to properly process and integrate sensorial and visceral cues to the fear-induced stimuli. ASD individuals exhibit altered sensory processing, possibly contributing to the emergence of atypical phobias, a prevailing anxiety disorder manifested in this population. Moreover, these individuals display distinctive alterations in a pivotal fear and anxiety processing hub, the amygdala. By examining the neurobiological mechanisms underlying fear and anxiety regulation, we can gain insights into the factors contributing to the distinctive emotional profile observed in individuals with ASD. Such insights hold the potential to pave the way for more targeted interventions and therapies that address the emotional challenges faced by individuals within the autism spectrum.

A Prospective Comparison of Bipolar I and II Subjects with and without Comorbid Cannabis Use Disorders from the COGA Dataset.

The comorbidity of alcohol and substance use disorders among persons with bipolar disorder is elevated, as indicated by epidemiological and clinical studies. Following alcohol use, cannabis is the most frequently used and abused illicit substance among bipolar individuals, and such use may lead to comorbid cannabis use disorders (CUD). Previous research indicated that CUDs were related to a more severe course of bipolar disorder and higher rates of other comorbid alcohol and substance use disorders. Few studies, however, have conducted longitudinal research on this comorbidity. The aim of this study is to investigate the influence of CUD on the course of bipolar I and II individuals during a 5-year follow-up. The characteristics of bipolar disorder, cannabis use disorders, and other alcohol and substance use disorders, as well as comorbid mental disorders, were assessed using a standardized semi-structured interview (SSAGA) at both baseline and the 5-year follow-up. N = 180 bipolar I and II patients were subdivided into groups of with and without comorbid cannabis use disorders (CUD). Of the 77 bipolar I and 103 bipolar II patients, n = 65 (36.1%) had a comorbid diagnosis of any CUD (DSM-IV cannabis abuse or dependence). Comorbid bipolar patients with CUD had higher rates of other substance use disorders and posttraumatic stress disorders, more affective symptoms, and less psychosocial functioning at baseline and at 5-year follow-up. In contrast to previously reported findings, higher rates of anxiety disorders and bipolar disorder complications (e.g., mixed episodes, rapid cycling, and manic or hypomanic episodes) were not found. The effect of CUD on other substance use disorders was confirmed using moderation analyses. A 5-year prospective evaluation of bipolar patients with and without CUD confirmed previous investigations, suggesting that the risk of other substance use disorders is significantly increased in comorbid individuals. CUD has a moderation effect, while no effect was found for other mental disorders. Findings from this study and previous research may be due to the examination of different phenotypes (Cannabis use vs. CUD) and sample variation (family study vs. clinical and epidemiological populations).

A quantitative and qualitative examination of the impacts of the COVID-19 pandemic on U.S. veterans with self-reported anxiety and alcohol use disorder.

The COVID-19 pandemic generated concerns about rising stress and alcohol use, especially in U.S. veterans who experience high rates of anxiety disorders (ADs), alcohol use disorder (AUD), and dual AD+AUD diagnoses. This study investigated differences among these diagnostic groups in a veteran population related to their concern about COVID-19, impacts of COVID-19 on quality of life, and self-reported changes to urge to drink and drinking frequency. A nationally administered online survey was given to a sample of U.S. veterans reporting substance use issues during the pandemic. Differences in the level of concern about COVID-19, impacts of COVID-19 on quality of life, and drinking behaviors were examined in those self-reporting AD (n = 98), AUD (n = 46), or AD+AUD (n = 67). Consensual qualitative research was used to analyze an open-ended question about COVID-19's impact on substance use, health, and quality of life. Veterans with AD+AUD experienced significant increases in urge to drink and alcohol consumption compared to veterans with AD only. Greater urge and frequency of drinking were associated with greater negative impacts of COVID-19 on quality of life. There were no differences among groups in global negative impact on quality of life or level of COVID-19 concern. However, respondents described specific COVID-19 worries, with qualitative findings revealing that those with AD+AUD reported a disproportionate psychosocial burden due to the pandemic. Special attention in screening and treatment should be given to those with a dual AD+AUD diagnosis who may be experiencing both an increase in alcohol use and psychosocial burden as stress increases due to the pandemic.

Comorbidity and healthcare utilization in patients with treatment resistant depression: A large-scale retrospective cohort analysis using electronic health records

BackgroundMedical comorbidity and healthcare utilization in patients with treatment resistant depression (TRD) is usually reported in convenience samples, making estimates unreliable. There is only limited large-scale clinical research on comorbidities and healthcare utilization in TRD patients. MethodsElectronic Health Record data from over 3.3 million patients from the INSIGHT Clinical Research Network in New York City was used to define TRD as initiation of a third antidepressant regimen in a 12-month period among patients diagnosed with major depressive disorder (MDD). Age and sex matched TRD and non-TRD MDD patients were compared for anxiety disorder, 27 comorbid medical conditions, and healthcare utilization. ResultsOut of 30,218 individuals diagnosed with MDD, 15.2 % of patients met the criteria for TRD (n = 4605). Compared to MDD patients without TRD, the TRD patients had higher rates of anxiety disorder and physical comorbidities. They also had higher odds of ischemic heart disease (OR = 1.38), stroke/transient ischemic attack (OR = 1.57), chronic kidney diseases (OR = 1.53), arthritis (OR = 1.52), hip/pelvic fractures (OR = 2.14), and cancers (OR = 1.41). As compared to non-TRD MDD, TRD patients had higher rates of emergency room visits, and inpatient stays. In relation to patients without MDD, both TRD and non-TRD MDD patients had significantly higher levels of anxiety disorder and physical comorbidities. LimitationsThe INSIGHT-CRN data lack information on depression severity and medication adherence. ConclusionsTRD patients compared to non-TRD MDD patients have a substantially higher prevalence of various psychiatric and medical comorbidities and higher health care utilization. These findings highlight the challenges of developing interventions and care coordination strategies to meet the complex clinical needs of TRD patients.

Psychotropic Medication Usage in Individuals with Fetal Alcohol Spectrum Disorders (FASD) and Psychiatric Co-morbidities in Canada

Background and objective Individuals with Fetal Alcohol Spectrum Disorder (FASD) tend to be prescribed a high number of psycho-tropic medications to treat high rates of comorbid psychiatric disorders. A lack of guidance regarding best practices for prescribing psychotropic medications to individuals with FASD probably accounts for this reliance on polypharmacy. The objective of this study is to describe the types of medications prescribed to individuals with prenatal alcohol exposure, comparing rates between individuals diagnosed with FASD and individuals without FASD as well as how medications are prescribed based on age, sex, and comorbid psychiatric disorders. Material and methods Data were drawn from Canada's national FASD database. This database includes information collected during an FASD assessment related to diagnostic outcomes, secondary challenges, and medical and mental health information. Descriptive statistics were calculated for four diagnostic groups (FASD with sentinel facial features [FASD + SFF], FASD without sentinel facial features [FASD - SFF], at risk for FASD [“at risk”], and no FASD). Group demographics were compared using Chi-Square, Fisher's Exact Test, and ANOVA, as appropriate. Differences in the proportion of individuals between these four diagnostic groups were calculated using each of the following six classes of psychotropic medications—antipsychotics, antidepressants/anxiolytic, anticonvulsants/mood stabilizers, stimulants, melatonin, and others—using ANOVA. Considering just the individuals with FASD by combining the FASD + SFF and FASD - SFF groups, independent sample tests were used to compare differences in the proportion of males and females prescribed different medications. Chi-Square and Fisher's Exact Test were used to compare the proportion of individuals using psychotropic medications, according to category, within the FASD group based on the presence or absence of 13 comorbid psychiatric disorders. Results The overall sample included 2349 participants (mean value = 18.1 years, SD = 10.3). The sample included 1453 participants with an FASD diagnosis (n = 218, FASD + SFF, mean = 23.7 years, SD = 15.8, and n = 1235, FASD - SFF, mean = 19.5 years, SD = 10.0 years) and 896 participants who were assessed but did not receive an FASD diagnosis (n = 653, no FASD, mean = 16.1 years and n = 261, “at risk” for FASD, mean = 12.2 years). The FASD groups had a significantly higher rates of anxiety disorders, depressive disorders, and the presence of at least one comorbid psychiatric disorder compared to the no FASD and the “at risk” groups. Both FASD groups had a higher proportion of individuals taking antipsychotic and antidepressant/anxiolytic medications compared to the no FASD and “at risk” groups. Females with FASD were more often prescribed antidepressants/anxiolytics compared to males with FASD, while males with FASD were more often prescribed stimulants than females with FASD. The prevalence of antidepressants/anxiolytics, stimulants, and melatonin use by individuals with FASD differed across the lifespan. The prevalence of the prescription of six medication categories was found to differ according to psychiatric disorder. Conclusion Compared to individuals assessed as not fulfilling criteria for FASD, those with FASD had higher rates of psychiatric disorders and were prescribed significantly more antidepressants/anxiolytics and antipsychotics. The class and rate of prescriptions may support efforts in devising treatment guidelines for a complex disorder with known high comorbidity such as FASD.

Anxiety disorders, depression and incontinence in preschool children-A population-based study.

The aim was to examine associations of specific anxiety disorders, depressive symptoms, and incontinence in a representative, population-based sample of preschool children. All preschool children of a defined geographical area examined before school-entry were included. Parents completed a questionnaire including the Preschool Feelings Checklist (PFC), eight questions referring to nocturnal enuresis (NE), daytime urinary incontinence (DUI), fecal incontinence (FI) and constipation, and 30 items regarding Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) diagnostic criteria of separation anxiety disorder (SAD), social phobia (SOC), specific phobia (PHOB), and generalized anxiety disorder (GAD). Data of 1206 children (mean age = 5.7 years; 53.5% boys) are presented. 34.6% of incontinent children had an anxiety disorder based on DSM-5 criteria and 13.3% had clinically relevant depressive symptoms (measured by the PFC). Rates of incontinence overall were 14.1% (11.9% NE, 3.1% DUI, and 1.8% FI) and 6.3% for constipation. Rates of SOC and PHOB were increased in NE (20.8% and 25.4%), DUI (39.3% and 34.5%) and FI (35.3% and 50.0%) compared to continent children (13.5% and 17.2%). Children with constipation had higher rates of SOC, PHOB, and GAD than those without. Compared to continent children (9.7%), depressive symptoms were more frequent in children with NE (26.8%), DUI (50.0%), and FI (61.9%). Anxiety disorders and depressive symptoms are common in children with incontinence. The most specific DSM-5 disorders associated with incontinence are SOC and PHOB, which can be incapacitating and may require treatment. Due to the high rates of anxiety disorders, it is important to screen all children with incontinence, for example, with specific questionnaires.

Is there a 'bipolar iceberg' in UK primary care psychological therapy services?

Improving Access to Psychological Therapies (IAPT) is a primary care therapy service commissioned by England's National Health Service (NHS) for people with unipolar depression and anxiety-related disorders. Its scope does not extend to 'severe mental illness', including bipolar disorders (BD), but evidence suggests there is a high BD prevalence in ostensibly unipolar major depressive disorder (uMDD) samples. This study aimed to indicate the prevalence and characteristics of people with BD in a naturalistic cohort of IAPT patients. 371 participants were assessed before initiating therapy. Participants were categorised by indicated diagnoses: BD type-I (BD-I) or type-II (BD-II) as defined using a DSM diagnostic interview, bipolar spectrum (BSp, not meeting diagnostic criteria but exceeding BD screening thresholds), lifetime uMDD or other. Information about psychiatric history and co-morbidities was examined, along with symptoms before and after therapy. 368 patients provided sufficient data to enable classification. 10% of participants were grouped as having BD-I, 20% BD-II, 40% BSp, 25% uMDD and 5% other. BD and uMDD participants had similar demographic characteristics, but patients meeting criteria for BD-I/BD-II had more complex psychiatric presentations. All three 'bipolar' groups had particularly high rates of anxiety disorders. IAPT therapy receipt was comparable between groups, as was therapy response (F9704 = 1.113, p = 0.351). Notwithstanding the possibility that bipolar diathesis was overestimated, findings illustrate a high prevalence of BD in groups of people notionally with uMDD or anxiety. As well as improving the detection of BD, further substantive investigation is required to establish whether individuals affected by BD should be eligible for primary care psychological intervention.

Nurses suffering in silence: Addressing the stigma of mental health in nursing and healthcare.

Nurses suffering in silence: Addressing the stigma of mental health in nursing and healthcare.

Examining the hikikomori syndrome in a French sample of hospitalized adolescents with severe social withdrawal and school refusal behavior.

While the term hikikomori (HKM) has spread internationally to describe a chronic and severe form of social withdrawal, its place in current nosography and its transposition into non-Asian cultures are still debated. A retrospective chart review was conducted to determine the rate and the clinical profiles of HKM among a French sample of adolescent inpatients. Data were obtained from 191 adolescents aged 12-18 years (M = 15.0, 44% boys) consecutively admitted in two inpatient units from January 2017 to December 2019. Using a retrospective diagnosis of HKM based on Teo and Gaw's criteria, we compared socio-demographic characteristics, clinical features, and treatment outcomes between HKM patients and those with other forms of social withdrawal and/or school refusal (SW/SR). At admission, 7% of participants met HKM criteria (n = 14, M = 14.3, 64% boys), one out of six adolescents with SW/SR. Among those with SW/SR, HKM + vs. HKM- participants had higher rates of anxiety disorder (Odd Ratio, OR = 35.2) and lower disruptive behavioral disorder (OR = 0.03). A minority of the participants with anxiety and depressive disorders met the HKM criteria (respectively, 15% and 9%), but those with HKM had a longer duration of symptoms, longer hospitalization, and required more daily care facilities at discharge compared to HKM-. While HKM syndrome could not be delimitated from anxiety disorder, it was associated with specific clinical features and treatment outcomes. The clinical characteristics observed were consistent with the features reported in Asian HKM adults, supporting face validity of this clinical concept in adolescent inpatients with different cultural contexts.

Management of Psychiatric Disorders in Patients with Hepatic and Gastrointestinal Diseases.

Management of Psychiatric Disorders in Patients with Hepatic and Gastrointestinal Diseases.

Mental health conditions in Lesbian, Gay, Bisexual, Transgender, Queer and Asexual youth in Brazil: A call for action

BackgroundLesbian, Gay, Bisexual, Transgender, Queer, and Asexual (LGBTQA+) youth have a greater chance of experiencing stressful life events when compared to cisgender heterosexual peers, which can lead to mental health problems. We aimed to estimate the prevalence of mental disorders among LGBTQA+ youths from two large cities in Brazil. MethodsParticipants were 13–22 years old youths from the 3rd wave of the Brazilian High-Risk Cohort for Psychiatric Disorders (n = 1475). Mental disorders were assessed using the Development and Well-Being Behavior Assessment. Sexual orientation and gender identity were assessed using a self-report confidential questionnaire. Data were analyzed through logistic regressions (adjusting for sociodemographic) using sampling weights to account for attrition and our oversampling high-risk design. Results15.18% of the sample described themselves as LGBTQA+. The LGBTQA+ group presented higher rates of anxiety disorders (30.14% vs. 13.37%; OR = 3.37; 95%CI:2.51–4.50), depressive disorders (27.75% vs. 15.34%; OR = 2.17; 95%CI:1.60–2.93) and post-traumatic stress disorder (4.98% vs. 2.25%; OR = 4.20; 95%CI:2.24–7.82), if compared with the cisgender heterosexual group. No difference was found for conduct disorders (2.97% vs. 5.21%; OR = 0.82; 95%CI:0.35–1.65) or attention deficit hyperactivity disorder (5.92% vs. 3.28%; OR = 1.56; 95%CI:0.83–2.79). LimitationsAlthough recruitment was performed at 57 schools in the two cities, sampling was non-probabilistic and included only urban areas, which might bias prevalence estimates and group comparisons. ConclusionsOur results elucidate the mental health disparities between LGBTQA+ people and cisgender heterosexuals in Brazil. It highlights the need to promote the inclusion of this population in policy formulation and support actions to mitigate the suffering related to sexual orientation and gender identity.

Characteristics and associated morbidities of young adults with misconceived food allergy: A cross-sectional study.

BackgroundMany patients with self-reported food allergy are not allergic but suffer from similar burdens. We aimed to characterize young adults with misconceived food allergy.MethodsA cross-sectional study of individuals (n = 12,592) aged 17–18 years, recruited to the Israel Defense Forces (IDF) at a single urban-area recruitment center over a six month-period. All participants underwent a comprehensive medical and psychological evaluation. Cognitive tests were performed and a Combined Intellectual-Education score assigned. Participants who reported food elimination due to allergy were skin-tested and underwent oral food challenges, when indicated. The characteristics, psychological evaluation and cognitive tests of individuals with no reported food allergy (n = 12,444), misconceived food allergy (n = 64) and true food allergy (n = 84) were compared.FindingsThe prevalence of atopic co-morbidities was higher in recruits reporting compared to those not reporting food allergy while the rate of other co-morbidities was comparable. Anxiety disorder was diagnosed significantly more in individuals who reported food allergy (4·1%) compared to those who did not (1·7%) (p = 0·04). Further analysis revealed that this diagnosis was concentrated in individuals with misconceived (8/64, 12·5%) compared to true food allergy (2/84, 2·4%), (p = 0·02). Patients with misconceived food allergy were mostly of female sex, had lower Combined Intellectual-Education scores compared to patients with true (p = 0·001) and no reported food allergy (p = 0·01), and required the longest mean evaluation time (147·6 ± 109·4 days).InterpretationPatients with misconceived food allergy have higher rates of anxiety disorder and are often from a lower educational level and of female sex. Medical and educational attention is required to improve care of this specific population.FundingThe research reported in this publication was supported by the Israel Defense Forces (IDF) Medical Corps and Directorate of Defense Research & Development, Israeli Ministry of Defense (IMOD DDR&D).

Wellbeing differences in children with synaesthesia: anxiety and mood regulation.

Synaesthesia is a neurodevelopmental trait that causes unusual sensory experiences (e.g., perceiving colours when reading letters and numbers). Our paper represents the first evidence that synaesthesia can impact negatively on children's well-being, and that there are likely to be important mental health co-morbidities for children with synaesthesia. We recruited 76 synaesthetes aged 6-10 years who had one of two types of synaesthesia (grapheme-colour synaesthesia and sequence-personality synaesthesia), and compared them to almost one thousand matched non-synaesthete controls. We tested children's wellbeing with two different measures, and found a significant relationship between synaesthesia and affect (i.e., mood), and also between synaesthesia and anxiety. Children with synaesthesia showed evidence suggesting significantly higher rates of Anxiety Disorder, and also displayed a type of mood-moderation in demonstrating fewer extremes of emotion (i.e., significantly fewer negative feelings such as fear, but also significantly fewer positive feelings such as joy). We discuss our results with reference to the emotional moderation of alexithymia (the inability to recognize or describe one's own emotions), and to a set of known links between alexithymia, anxiety, autism and synaesthesia.

Warr;or21: A 21-Day Program to Enhance First Responder Resilience and Mental Health.

First responders face multiple stressors on a daily basis. They have experienced higher rates of anxiety disorders, depression, burnout, post-traumatic stress disorder (PTSD), suicide (Asmundson and Stapleton, 2008), alcohol and substance abuse (Ballenger et al., 2010), and deficient sleep hygiene (Pearsall, 2012) compared to the general population. Existing resilience research can be utilized and adapted to help first responders cope in a positive manner as a form of prevention and also as part of their recovery. New resiliency programs continue to emerge and this paper details one – warr;or21. The warr;or21 program is explained and based on an evaluation of the program’s preliminary data, the results are promising with how the program can assist first responders (and the general public) increase their resiliency and mental health.

Comorbidities Between Specific Learning Disorders and Psychopathology in Elementary School Children in Germany.

Children with reading and/or spelling disorders have increased rates of behavioral and emotional problems and combinations of these. Some studies also find increased rates of attention-deficit/hyperactivity disorder (ADHD), conduct disorder, anxiety disorder, and depression. However, the comorbidities of, e.g., arithmetic disorders with ADHD, anxiety disorder, and depression have been addressed only rarely. The current study explored the probability of children with specific learning disorders (SLD) in reading, spelling, and/or arithmetic to also have anxiety disorder, depression, ADHD, and/or conduct disorder. The sample consisted of 3,014 German children from grades 3 and 4 (mean age 9;9 years) who completed tests assessing reading, spelling as well as arithmetic achievement and intelligence via a web-based application. Psychopathology was assessed using questionnaires filled in by the parents. In children with a SLD we found high rates of anxiety disorder (21%), depression (28%), ADHD (28%), and conduct disorder (22%). Children with SLD in multiple learning domains had a higher risk for psychopathology and had a broader spectrum of psychopathology than children with an isolated SLD. The results highlight the importance of screening for and diagnosing psychiatric comorbidities in children with SLD.