Lifetime Prevalence Of Anxiety Disorders Research Articles

Anxiety symptom severity is associated with increased arterial blood pressure and arterial blood pressure variability in apparently healthy young adults

Introduction: Lifetime prevalence of anxiety disorders is approximately 30%, and anxiety is associated with an increased susceptibility to develop cardiovascular disease. Anxiety disorders have been linked to hypertension, and autonomic dysfunction has been posited as a contributing factor. However, anxiety symptom severity exists on a continuum, and it is less clear how anxiety severity is associated with blood pressure or beat-to-beat blood pressure variability, a hemodynamic biomarker that reflects dynamic cardiovascular regulatory mechanisms. The objective of this study was to test the hypothesis that self-reported anxiety symptom severity is positively associated with resting blood pressure and beat-to-beat blood pressure variability among healthy young adults without cardiometabolic disease. Methods: Resting beat-to-beat blood pressure (mmHg; finger plethysmography) and anxiety scores from a self-report anxiety symptom questionnaire (Zung Self-Rated Anxiety Scale, ZSRA) were collected in 53 healthy young adults (40 males, 13 females, age = 25 ± 4 yr, BMI = 25 ± 6 kg/m2). Following 10 minutes of quiet rest, signals were recorded over a 10-minute period with participants in a supine position, and the middle 8 minutes were used for analyses. Multiple linear regression was used to examine the independent relations of ZSRA with systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), SAP standard deviation (SAPSD), DAP standard deviation (DAPSD), and MAP standard deviation (MAPSD) while controlling for age and sex. To further understand whether the observed relations between ZSRA and beat-to-beat blood pressure variability were explained by or independent of elevated absolute arterial pressure, partial correlations (rxy,z) were performed for ZSRA versus SAPSD, DAPSD, and MAPSD while partialling out the effect of SAP, DAP, and MAP, respectively. Results: ZSRA was significantly correlated with SAP (β = 0.34, p = 0.015), MAP (β = 0.32, p = 0.023), SAPSD (β = 0.36, p = 0.008), DAPSD (β = 0.35, p = 0.014), and MAPSD (β = 0.37, p = 0.008). When controlling for SAP, DAP, and MAP, ZSRA was independently associated with SAPSD (rxy,z = 0.34, p = 0.016), DAPSD (rxy,z = 0.35, p = 0.012), and MAPSD (rxy,z = 0.40, p = 0.005). Conclusion: Self-reported anxiety symptom severity is associated with increased blood pressure and beat-to-beat blood pressure variability, which indicates an important relationship between anxiety and blood pressure regulation across a continuum of symptom severity. This study is the first to show a relationship between anxiety and beat-to-beat blood pressure variability, independent of absolute mean blood pressure, among healthy young adults devoid of cardiometabolic disease. Our data build upon and align with previous findings that anxiety symptom severity is associated with increased muscle sympathetic nerve activity among healthy young adults and enhances our understanding of the relationship between anxiety and cardiovascular health, even among apparently healthy individuals. Funding provided by a grant from the Injury Prevention Research Center through the CDC (R49 CE003095; NDMJ). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Anxiety Disorders: Recent Global Approach to Neuro-pathogenesis, Drug Treatment, Cognitive Behavioral Therapy, and Their Implications

Anxiety is a group of mental disorders characterized by the sudden feeling of intense fear, panic, shortness of breath, chest pain, restlessness, GIT problems, insomnia, fatigue, muscle tension, sweating, loss of memory, blurred vision, and impaired learning. It occurs typically in response to a stressful situation that may become pathological when it is no longer controlled or occurs in the absence of real threat. This review aimed to appraise the literature on the prevalence, classification, neuro-pathogenesis, diagnoses, and treatment of anxiety disorders (AD). The search was made using PubMed, Embase, MEDLINE, and PsycINFO databases. Anxiety disorders are the most common mental disorders affecting humans, especially among developing nations. In general, the lifetime prevalence of AD is about 14%, with an annual prevalence of 31%. Unfortunately, AD, in general, is underdiagnosed and undertreated globally.
 Bangladesh Journal of Medical Science Vol.20(3) 2021 p.487-503

Variation rs6971 in the Translocator Protein Gene (TSPO) is Associated with Aggressiveness and Impulsivity but Not with Anxiety in a Population-Representative Sample of Young Adults

Expression of the 18-kDa translocator protein (TSPO), originally identified as a peripheral benzodiazepine receptor, has been found to be altered in several psychiatric disorders. A common single nucleotide polymorphism (rs6971) in the TSPO gene leads to an amino acid substitution, Ala147Thr, which dramatically alters the affinity with which TSPO binds drug ligands. As cholesterol also binds TSPO in the same transmembrane domain, it is suggested that this substitution may impair the ability of TSPO to bind or import cholesterol, and hence may affect steroid synthesis and hypothalamic-pituitary-adrenal function. The analysis was carried out on older birth cohort (n = 655) of the longitudinal Estonian Children Personality, Behavior and Health Study sample. Anxiety, aggressive behavior, impulsiveness, and history of stressful life events were self-reported in various data collection waves. Psychiatric assessment of lifetime prevalence of anxiety disorders was carried out at 25 years of age by experienced clinical psychologists. TSPO rs6971 was genotyped in all participants. TSPO rs6971 was not associated with self-reported levels of anxiety or lifetime prevalence of anxiety disorders. However, participants homozygous for the minor A allele displayed the highest aggressiveness and dysfunctional impulsivity scores. The positive, adaptive aspect of impulsivity was sensitive to stressful life events, as the AA genotype was associated with functional impulsivity only when the participants had experienced a low number of stressful life events during childhood. TSPO rs6971 polymorphism may be related to development of aggressiveness and impulsivity by adulthood, regardless of the participants’ gender.

Nutritional Factors, Physical Health and Immigrant Status Are Associated with Anxiety Disorders among Middle-Aged and Older Adults: Findings from Baseline Data of The Canadian Longitudinal Study on Aging (CLSA).

The main purpose of this study was to compare the lifetime prevalence of anxiety disorders among foreign-born and Canadian-born adults in middle and later life. Using baseline data of the Canadian Longitudinal Study on Aging (2010–2015), multivariable binary logistic regression was conducted to investigate anxiety diagnosis and immigrant status, while controlling for socio-economic, health-related, and nutrition covariates. Of 26,991 participants (49.3% men, 82.5% Canadian born, 58.5% aged 45–65 years), the overall prevalence of self-reported physician diagnosis of anxiety disorders was 8.5%, with immigrants being lower than Canadian-born respondents (6.4% vs. 9.3%, p < 0.001). After accounting for all covariates, the adjusted odds ratio (aOR) for anxiety disorders was lower among immigrants (aOR = 0.77, 95% CI: 0.67–0.88) compared to those who were Canadian born. Identified risk factors included: younger age (aORs = 1.79–3.52), being a woman (aOR = 1.25, 95% CI: 1.07–1.46), single status (aOR = 1.27, 95% CI: 1.09–1.48), lower income (aORs = 1.28–2.68), multi-morbidities (aORs = 2.73–5.13), chronic pain (aOR = 1.31, 95% CI: 1.18–1.44), lifetime smoking ≥ 100 cigarettes (aOR = 1.35, 95% CI: 1.23–1.48), BMI < 18.5 (aOR = 1.87, 95% CI: 1.20–2.92), body fat ≥ 26% (aORs = 1.28–1.79), fruit and vegetable intake (<3/day; aORs = 1.24–1.26), and pastry consumption (>1/day; aOR = 1.55, 95% CI: 1.12–1.15) (p < 0.05). Targeting socio-economic and nutritional risk factors may reduce the burden of anxiety disorders in middle and late adulthood.

Prevalence of anxiety disorder among older adults in Spain: A meta-analysis.

Anxiety disorders are recognized as one of the most prevalent mental disorders in late-life. However, the prevalence of anxiety disorders in older Spanish people has not yet been determined. The aim was to review epidemiological studies systematically to calculate the overall prevalence of anxiety in Spanish older adults by using meta-analytic techniques. We searched relevant published studies in electronic databases up to January 2018 providing data on the prevalence of anxiety among people aged 65+ years in Spain. Overall anxiety prevalence estimates were calculated using random-effects models. Sources of heterogeneity were explored by means of univariate meta-regressions. A total of 9 studies were included in the meta-analysis (N = 12,577). Pooled overall prevalence of anxiety was 11% (95% confidence interval (CI): 6%-18%) representing 1958,471 people aged 65+ (95%CI: 1068,257-3204,771). Point, 12-month and lifetime prevalence of anxiety disorders were 12%, 6% and 19%, respectively. We detected a small publication bias effect for life-time prevalence of anxiety. The use of different diagnostic methods across the studies would have required separate analyzes. Some heterogeneity was found across studies, probably due to different methodological issues. Overall, the pooled prevalence of anxiety disorders in Spanish older adults was lower than that observed in other countries. Due to the negative consequences of anxiety disorders in older adults, detection and treatment should be a priority in this population.

The co-occurrence and correlates of anxiety disorders among adolescents with intermittent explosive disorder.

We examined the lifetime prevalence of anxiety disorders (ADs) among adolescents with lifetime intermittent explosive disorder (IED), as well as the impact of co-occurring ADs on anger attack frequency and persistence, additional comorbidity, impairment, and treatment utilization among adolescents with IED. IED was defined by the occurrence of at least three anger attacks that were disproportionate to the provocation within a single year. Data were drawn from the National Comorbidity Survey-Adolescent Supplement (N = 6,140), and diagnoses were based on structured lay-administered interviews. Over half (51.89%) of adolescents with IED had an AD, compared to only 22.88% of adolescents without IED. Compared to adolescents with IED alone, adolescents with IED and comorbid ADs: (a) were more likely to be female; (b) reported greater impairment in work/school, social, and overall functioning; (c) were more likely to receive an additional psychiatric diagnosis, a depressive or drug abuse diagnosis, or diagnoses of three or more additional disorders; and (d) had higher odds of receiving any mental/behavioral health treatment as well as treatment specifically focused on aggression. Adolescents with IED alone and those with comorbid ADs did not differ in the number of years experiencing anger attacks or the highest number of anger attacks in a given year. ADs frequently co-occur with IED and are associated with elevated comorbidity and greater impairment compared to IED alone. Gaining a better understanding of this comorbidity is essential for developing specialized and effective methods to screen and treat comorbid anxiety in adolescents with aggressive behavior problems.

Psychiatric Disorders and Function in Adolescents with Tetralogy of Fallot

To assess psychiatric disorders and function in adolescents with repaired tetralogy of Fallot (TOF) without and with a genetic diagnosis and to evaluate associations of functioning with medical factors, IQ, and demographics. Adolescents with TOF (n = 91) and 87 healthy referents completed a clinician-rated structured psychiatric interview, parent-/self-report measures of psychopathology, and brain magnetic resonance imaging. Twenty-three of the adolescents with TOF had a known genetic diagnosis. The prevalence of anxiety disorders did not differ significantly between adolescents with TOF without genetic diagnosis (n = 68) and referents. Adolescents with TOF and a genetic diagnosis showed an increased lifetime prevalence of anxiety disorder (43%) and lower global psychosocial functioning (median, 70; IQR, 63-75) compared with adolescents with TOF without genetic diagnosis (15% and 83; IQR, 79-87, respectively; P = .04 and <.001, respectively) and referents (6% and 85; IQR, 76-90, respectively; P = .001 and <.001, respectively). Adolescents with TOF without and with a genetic diagnosis had a higher lifetime prevalence of attention deficit-hyperactivity disorder (ADHD) than referents (19% and 39%, respectively, vs 5%; P = .04 and .002, respectively) and worse outcomes on parent-/self-report ratings of anxiety and disruptive behavior compared with referents. Risk factors for anxiety, ADHD, and lower psychosocial functioning for adolescents with TOF without a genetic diagnosis included older age, male sex, and low IQ. Medical variables were not predictive of psychiatric outcomes. Adolescents with TOF, particularly those with a genetic diagnosis, show increased rates of psychiatric disorder and dysfunction. Continued mental health screening and surveillance into young adulthood is warranted for adolescents with TOF.

Anxiety Disorders are Associated with Low Socioeconomic Status in Women but Not in Men

ObjectivesWe investigated to what extent the lifetime prevalence of anxiety disorders relates to negative economic changes, taking important lifestyle factors and unexpected life events into consideration. MethodsWe included 3,695 participants recruited in the city of Lausanne (Switzerland), from the population-based CoLaus/PsyCoLaus study. The association between anxiety disorders, lifestyle factors, and life events related to income was investigated using binary logistic regression analyses correcting for demographic and clinical confounders. ResultsCompared with men, women with anxiety disorders showed a significantly lower socioeconomic status (Mann-Whitney U = 56,318; p < .001) and reported a higher negative impact of substantial reduction of income (Mann-Whitney U = 68,531; p = .024). When performing adjusted analyses, low socioeconomic status (odd ratio, 0.87; p = .001) and negative impact of reduction of income (odd ratio, 1.01; p = .004) were associated significantly with anxiety disorders in women but not in men. ConclusionOur results suggest that anxiety disorders aggravate already existing gender differences in economic conditions, and that women with anxiety need additional support to attain socioeconomic security similar to that of men.

Use of Archived Neonatal Bloodspots for Examining Associations between Prenatal Exposure to Potentially Traumatic or Stressful Life Events, Maternal Herpesvirus Infection and Lifetime History of Generalized Anxiety Disorder in Offspring

Background: Lifetime prevalence of anxiety disorders is over 32% among U.S. adolescents, warranting further investigation into early life risk factors for such conditions. We conducted a pilot study to examine the role that maternal herpesvirus infection may play in the pathway between maternal trauma and stress during pregnancy and offspring generalized anxiety disorder (GAD). Methods: Participants included 69 women in the Detroit Neighborhood Health Study with data on past exposure to 19 potentially traumatic (PTEs) and 9 stressful life events (SLEs). Lifetime history of GAD in the youngest biologic child between 6-17 years old born in Michigan (i.e., index child) of each woman was ascertained via the Diagnostic Interview Schedule for Children, 4th edition, parent version. We obtained written informed consent from participants for retrieval of archived neonatal bloodspot samples corresponding to their index child from the Michigan Neonatal Biobank (MNB) and testing of these samples for markers of maternal herpes simplex virus (HSV)-1 and cytomegalovirus (CMV) seropositivity. Logistic regression was used to examine the association between maternal PTEs or SLEs during pregnancy and offspring GAD. Results: A total of 18.1% and 31.9% of women experienced ≥ 1 PTE or SLE during pregnancy, respectively, and 10.8% of offspring met the criteria for lifetime history of GAD. We obtained maternal consent for retrieval of and tested bloodspot samples corresponding to the index child of 22 women (38%), of which 4.5% and 40.9% were seropositive for HSV-1 and CMV, respectively. We observed positive, although not statistically significant associations between ≥ 1 PTE or SLE during pregnancy and offspring lifetime history of GAD. While a greater proportion of offspring with lifetime history of GAD were born to women seropositive for CMV and HSV-1, compared to those without lifetime history, these differences were not statistically significant and we did not further examine the mediating role of maternal herpesvirus seropositivity in this pathway. Conclusion: Findings from this study support the feasibility of utilizing neonatal bloodspots archived in the MNB to examine the role of herpesviruses as mediators between maternal traumatic or stressful life events during pregnancy and offspring anxiety disorders in larger Michigan cohorts.

Recovering from a stroke: A narrative review on post-stroke anxiety treatment and management

Recovering from a stroke: A narrative review on post-stroke anxiety treatment and management

A Lifetime Prevalence of Comorbidity Between Bipolar Affective Disorder and Anxiety Disorders: A Meta-analysis of 52 Interview-based Studies of Psychiatric Population

BackgroundBipolar affective disorder has a high rate of comorbidity with a multitude of psychiatric disorders and medical conditions. Among all the potential comorbidities, co-existing anxiety disorders stand out due to their high prevalence. AimsTo determine the lifetime prevalence of comorbid anxiety disorders in bipolar affective disorder under the care of psychiatric services through systematic review and meta-analysis. MethodRandom effects meta-analyses were used to calculate the lifetime prevalence of comorbid generalised anxiety disorder, panic disorder, social anxiety disorder, specific phobia, agoraphobia, obsessive compulsive disorder and posttraumatic stress disorder in bipolar affective disorder. Results52 studies were included in the meta-analysis. The rate of lifetime comorbidity was as follows: panic disorder 16.8% (95% CI 13.7–20.1), generalised anxiety disorder 14.4% (95% CI 10.8–18.3), social anxiety disorder13.3% (95% CI 10.1–16.9), post-traumatic stress disorder 10.8% (95% CI 7.3–14.9), specific phobia 10.8% (95% CI 8.2–13.7), obsessive compulsive disorder 10.7% (95% CI 8.7–13.0) and agoraphobia 7.8% (95% CI 5.2–11.0). The lifetime prevalence of any anxiety disorders in bipolar disorder was 42.7%. ConclusionsOur results suggest a high rate of lifetime concurrent anxiety disorders in bipolar disorder. The diagnostic issues at the interface are particularly difficult because of the substantial symptom overlap. The treatment of co-existing conditions has clinically remained challenging.

Lifetime prevalence of anxiety disorders in people with bipolar disorder: a systematic review and meta-analysis

Anxiety disorders are increasingly recognised as an important determinant of outcomes in patients with bipolar disorder. However, a reliable estimate of their prevalence is still missing, because the published prevalence of anxiety disorders in individuals with bipolar disorder varies widely. In this study, we aimed to quantify the lifetime prevalence of anxiety disorders in individuals with bipolar disorder and compare it with rates in people without the disorder. We searched the Web of Knowledge and Medline (through the PubMed interface) for articles published in any language from the database inception dates up until June 1, 2014, using a combination of the word "bipolar" and search terms for anxiety disorders. We included studies that reported original data about the lifetime prevalence of DSM-III and DSM-IV anxiety disorders in adults with bipolar disorder that recruited participants irrespective of comorbidities and that used a validated diagnostic interview to establish the diagnoses of bipolar disorder and at least one anxiety disorder. We excluded studies that reported only the current prevalence or if we were unable to establish whether they described current or lifetime prevalence, and those with discrepancies in the data that could not be resolved by contacting the authors. We did a random-effects meta-analysis of lifetime prevalence of DSM-III and DSM-IV anxiety disorders in adults with bipolar disorder, in which we quantified the lifetime prevalence of any anxiety disorder in people with bipolar disorder. We compared this prevalence in people with bipolar I disorder versus those with bipolar II disorder, and in people with bipolar disorder versus population controls. Data from 40 studies, including 14 914 individuals from North America, Europe, Australia, South America, and Asia, indicate that the lifetime prevalence of anxiety disorders in individuals with bipolar disorder is 45% (95% CI 40-51). Direct comparison in five samples with a total of 1378 individuals with bipolar disorder and 56 812 population controls without bipolar disorder indicates a three-fold increase (risk ratio [RR] 3·22 [95% CI 2·41-4·29]; p<0·0001) in the prevalence of anxiety disorders in those with bipolar disorder. 13 studies that included both individuals with bipolar I disorder (n=4270) and those with bipolar II disorder (n=1939) showed no difference in the lifetime prevalence of anxiety disorders between these subtypes (RR 1·07 [95% CI 0·96-1·20]; p=0·223). We noted significant heterogeneity among included studies that was not accounted for by reported differences in study characteristics. People with bipolar disorder are at increased risk of anxiety disorders compared with those without bipolar disorder; nearly one in two has an anxiety disorder in their lifetime. Anxiety disorders should therefore be assessed alongside the mood symptoms in patients with bipolar disorder. Capital Health Research Fund.

Comorbidités chez 207 usagers de cannabis en consultation jeunes consommateurs

Health care seeking for a problematic use of cannabis is in progress in France. The aim is to assess the addictive and psychiatric comorbidity in cannabis users seen in the specific setting at the Lariboisière hospital. Two hundred and seven cannabis users were included from January 2004 to December 2009. Twelve-month and lifetime diagnosis of abuse and dependence (cannabis, alcohol, cocaine/crack) (DSM-IV), current and lifetime mood disorders, anxiety disorders, eating disorders and psychotic disorders were assessed (Mini-International Neuropsychiatric Interview). Logistic regression analyses identified adjusted odds ratios associated with the gender and the health care seeking (P=0.01). One hundred and forty-seven men (71%) and 60 women (29%), 29.3±8.6 years (15.2-51.6 years). Most of the outpatients ask for health care themselves (59.7%), whereas 19.4% are asked to seek health care by relatives (19.4%) or because of an academic, health or justice injunction (20.4%). In total, 49.3% of the outpatients are single, 35.7% are cohabitating, 9.3% are married and 6.3% are separated/divorced. About 20.4% of the outpatients are students, 35.7% have a professional activity, 19% are jobless, 2.4% are impaired, 0.5% are retired, at home and 12.1% do not have an official income. Twelve-month and lifetime prevalence of abuse/dependence are: cannabis (10.1/82.1% and 8.7/88.4%), alcohol (9.7/8.7% and 19.3/18.8%), cocaine/crack (2.4/3.4% and 4.8/11.6%). The mean duration of cannabis dependence for the current dependent users is 8.4±5.8 years. The mean number of "joints" during the last 6 months is 6±4.3, the mean amount of cannabis per week is 12.5±11.3g. About 51.3% of the dependent users report externalized and/or internalized disorders at school during childhood and adolescence. In total, 19.4% of the dependent users have a suicide attempt history and 18.9% have a psychiatric hospitalisation history, more frequently women (P<0.01 and P=0.02). About 73.8% have a psychologist or psychiatrist care history. In total, 38.1% of users have at least one current mood disorder, females more frequently than males (P<0.001). Current and lifetime prevalence of mood disorders are: major depressive disorder (MDD) (29.1% and 57.1%); current dysthymia (20.3%); hypomania (1.9 and 6.7%); mania (2.9 and 12.8%). Females have more frequently than males current and lifetime MDD (P<0.001). About 53.2% of users have at least one current anxiety disorder, females more frequently than males (P<0.001). Current and lifetime prevalence of anxiety disorders are: panic disorder (10 and 16.4%); agoraphobia (13.9 and 17.4%); social phobia (26.9 and 32.8%); obsessive-compulsive disorder (9.5 and 12.9%); post-traumatic stress disorder (PTSD) (6.5 and 16.4%); current generalized anxiety disorder (26.8%). Females have more frequently current and lifetime: agoraphobia (P=0.01 and P<0.001); PTSD (P<0.001); current social phobia (P=0.049). Current and lifetime eating disorders prevalence are: anorexia (0 and 1.5%); bulimia (4 and 8%); females more frequently have bulimia (P=0.02 and P<0.001). In total, 4.8% have a psychotic disorder. Adjusted odds ratios of associated variables to gender (women/men) are lifetime MDD OR=4.71 [2.1-10.61] (P<0.001) and later age of onset of cannabis abuse OR=1.1 [1.04-1.17] (P=0.002). Adjusted odds ratios associated with personal health care seeking compared to a non personal motivated health care seeking are the numbers of criteria of 12-month cannabis dependence OR=1.26 [1.06-1.51] (P=0.009) and age OR=1.07 [1.03-1.12] (P=0.002). Our survey confirms the high mood and anxiety disorders comorbidity in cannabis dependent users seen in a specific setting and underlines the need to evaluate those disorders.

The effects of ethnic, social and cultural factors on axis I comorbidity of bipolar disorder: Results from the clinical setting in Korea

ObjectiveEthnic, social and cultural factors contribute to axis I comorbid conditions in bipolar disorder (BPD). Korea has strict laws against illicit drugs and a relatively permissive prevailing attitude toward alcohol. The present study aimed to explore the lifetime axis I comorbidity rate in patients with BPD in Korea. MethodsClinically stable patients with bipolar I (n=222) and bipolar II (n=194) disorders were recruited from four tertiary medical centers in Korea. The subjects׳ diagnoses and axis I comorbid conditions were evaluated using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) and the Korean version of the Diagnostic Interview for Genetic Studies (K-DIGS). The lifetime prevalence of anxiety disorders, substance use disorders and eating disorders was explored. The prevalence of these axis I comorbid conditions was compared with data from prior studies in other countries and to data concerning the general Korean population. ResultsA total of 45.1% of all subjects had at least one axis I comorbid condition. Anxiety disorders (30.2%) were the most common comorbidity, followed by alcohol use disorders (16.8%). Males with BPD showed a higher rate of alcohol dependence compared to the general male population and females with BPD showed a greater risk of having alcohol use disorder compared to the general female population. The rate of drug use disorder was extremely low (1.7%), and only one subject had an illicit-drug-related problem. LimitationCross-sectional studies. ConclusionComorbid conditions of Korean patients with BPD showed a distinct pattern, which is associated with the ethnic, social and cultural characteristics in Korea.

The lifetime prevalence of anxiety disorders among patients with irritable bowel syndrome.

The prevalence of irritable bowel syndrome (IBS), the most common functional gastrointestinal disorder, ranges from 10% to 20% in the general population. It is estimated that from 40% to 90% of persons with a diagnosis of IBS suffer from mental disorders, mainly anxiety and depressive disorders. The aim of the study was to assess the lifetime prevalence of anxiety disorders in IBS patients and to compare it with the prevalence of these disorders in a control group of patients with gastroesophageal reflux disease (GERD). The study included 106 patients with IBS and 53 patients with GERD. IBS was diagnosed according to the Rome II criteria after a basic evaluation to exclude an organic disease. Anxiety disorders were diagnosed using the Composite International Diagnostic Interview (CIDI) in accordance with ICD-10 diagnostic criteria. Anxiety disorders during the patient's lifetime were diagnosed in 50 IBS patients (47%). Specific phobias occurred in 23.5% of them, social phobias in 10.4%, generalized anxiety disorder in 10.4%, panic disorder in 3.8% and agoraphobia in 8.5%. In the control group with GERD, anxiety disorders during the subject's lifetime were diagnosed in 30% of the group. The difference in the prevalence of anxiety disorders between patients with IBS and GERD was statistically significant (p<0.05). The lifetime prevalence of anxiety disorders in IBS patients was higher than in the control group with GERD (47% vs. 30%). The prevalence rate of anxiety disorders in the control group with GERD was similar to the prevalence rate in the general population.

P.2.d.003 Fractional anisotropy in patients with first episode mania in late life

Background: The present analyses were designed to compare the clinical characteristics and long-term episode course of Bipolar-I and Bipolar-II patients in order to help clarify the relationship between these disorders and to test the bipolar spectrum hypothesis. Methods: The patient sample consisted of 135 definite RDC Bipolar-I (BP-I) and 71 definite RDC Bipolar-II patients who entered the NIMH Collaborative Depression Study (CDS) between 1978 and 1981; and were followed systematically for up to 20 years. Groups were compared on demographic and clinical characteristics at intake, and lifetime comorbidity of anxiety and substance use disorders. Subsets of patients were compared on the number and type of affective episodes and the duration of inter-episode well intervals observed during a 10-year period following their resolution of the intake affective episode. Results: BP-I and BP-II had similar demographic characteristics and ages of onset of their first affective episode. Both disorders had more lifetime comorbid substance abuse disorders than the general population. BP-II had a significantly higher lifetime prevalence of anxiety disorders in general, and social and simple phobias in particular, compared to BP-I. Intake episodes of BP-I were significantly more acutely severe. BP-II patietns had a substantially more chronic course, with significantly more major and minor depressive episodes and shorter inter-episode well intervals. BP-II patients were prescribed somatic treatment a substantially lower percentage of time during and between affective episodes. Limitations: BP-I patients with severe manic course are less likely to be retained in long-term follow-up, whereas the reverse might be true for BP-II patients who are significantly more prone to depression (i.e., patients with less inclination to depression and with good prognosis may have dropped out in greater proportions); this could increase the gap in long term course characteristics between the two samples. The greater chronicity of BP-II may be due, in part, to the fact that the patients were prescribed somatic treatments substantially less often both during and between affective episodes. Conclusions: The variety in severity of the affective episodes shows that bipolar disorders, similar to unipolar disorders, are expressed longitudinally during their course as a dimensional illness. The similarities of the clinical phenotypes of BP-I and BP-II, suggest that BP-I and BP-II are likely to exist in a disease spectrum. They are, however, sufficiently distinct in terms of long-term course (i.e., BP-I with more severe episodes, and BP-II more chronic with a predominantly depressive course), that they are best classified as two separate subtypes in the official classification systems.

Epidemiology of Anxiety Disorders in the Australian General Population: Findings of the 2007 Australian National Survey of Mental Health and Wellbeing

The aims of this study were to report 12-month and lifetime prevalence for anxiety disorders in the Australian general population, identify sociodemographic and clinical correlates of anxiety disorders, and report the rates of comorbidity among anxiety, affective, and substance use disorders across the lifespan. The 2007 National Survey of Mental Health and Wellbeing was a nationally representative, face-to-face household survey of 8841 (60% response rate) community residents aged between 16 and 85 years. Diagnoses for anxiety, affective and substance use disorders were made according to the DSM-IV using the World Mental Health Survey Initiative version of the Composite International Diagnostic Interview. 12-month and lifetime prevalence of anxiety disorders were 11.8% and 20.0%, respectively. Anxiety disorders had a similar median age of onset (19 years) compared to substance use disorders (20 years), but earlier than affective disorders (34 years). Social phobia was the earliest onset anxiety disorder (median 13 years), with generalized anxiety disorder the latest (median 33 years). Significant correlates of the presence of anxiety disorders included being female, single, not in the labour force, in the middle age groups, not having post-graduate qualifications, having a comorbid physical condition, and having a family history of mental disorders. Being in the oldest age ranges and being born in another non-English speaking country were associated with lower odds of having an anxiety disorder. Body mass index was not associated with the presence of an anxiety disorder. Anxiety disorders were highly comorbid, particularly with major depression, dysthymia, and alcohol dependence. Comorbidity with substance use disorders reduced with age. Comorbidity with affective disorders was high across the lifespan. Anxiety disorders are common, can have an early onset, and are highly comorbid. Prevention, early detection, and treatment of anxiety disorders should be a priority.

Prevalence of anxiety disorders among elderly people

The objectives of this study are to determine current and lifetime prevalence of anxiety disorders and also to explore the relationship, if any, between possible risk factors and anxiety disorders, amongst elderly people living in the Sivas province of Turkey. The research sample consisted of 462 persons. A Socio-demographic Data Form was given to the participants and the Anxiety Module of SCID-I was applied. Chi-square and Fischer's exact tests were used to evaluate the data obtained. The current prevalence for all types of anxiety disorder was found to be 17.1% overall and the lifetime prevalence was found to be 18.6%. The current prevalence rates for particular disorders were found to be 0.4% for panic disorder, 3.2% for obsessive-compulsive disorder, 1.9% for post-traumatic stress disorder, 2.8% for social phobia, 11.5% for specific phobia, 6.9% for generalized anxiety disorder (GAD). Lifetime prevalence rates for these disorders (except GAD) were 1.1%, 3.2%, 3.0%, 2.85%, 11.5% respectively. Anxiety disorders are more common among elderly people than was previously thought. The lifetime prevalence of specific phobia amongst the elderly is higher than that of general population; the lifetime prevalence ratios of obsessive-compulsive disorder and social phobia are similar to that of the general population in Sivas. In order to improve the delivery of health services, it is recommended that further studies should be conducted among elderly people, both by applying standardized diagnostic tools, but also taking into account socio-economic factors and using convenient therapy methods developed specifically for this group.

The association of anxiety disorders and obsessive compulsive personality disorder with anorexia nervosa: Evidence from a family study with discussion of nosological and neurodevelopmental implications

To investigate the association of anorexia nervosa with anxiety disorders through use of a case-control family study design. Lifetime prevalence of anxiety disorders and obsessive compulsive personality disorder was determined among 574 first-degree relatives of 152 probands with anorexia nervosa and compared to rates observed among 647 first-degree relatives of 181 never-ill control probands. Adjusting for comorbidity of the same illness in the proband, relatives of probands with anorexia nervosa, had a significantly higher prevalence of generalized anxiety, obsessive compulsive disorder, separation anxiety disorder, social phobia, panic disorder, and obsessive compulsive personality disorder compared to relatives of never-ill control probands. Anorexia nervosa may share familial liability factors in common with various anxiety phenotypes. In suggesting that a transmitted propensity for anxiety is a key aspect of vulnerability in anorexia nervosa, the findings point to research developments in the affective neurosciences, specifically the neurocircuitry of fear and anxiety, as a heuristic framework in which to interpret aspects of premorbid temperamental anxieties and clinical symptoms.

Review: worldwide lifetime prevalence of anxiety disorders is 16.6%, with considerable heterogeneity between studies

These include: Data supplement http://ebmh.bmjjournals.com/cgi/content/full/9/4/115/DC1 web only table References http://ebmh.bmjjournals.com/cgi/content/full/9/4/115#BIBL This article cites 3 articles, 2 of which can be accessed free at: Rapid responses http://ebmh.bmjjournals.com/cgi/eletter-submit/9/4/115 You can respond to...