Past Anxiety Disorders Research Articles

Anxiety disorders and intravenous drug use in chemsex context

IntroductionSeveral studies have called atention to the mental health disorders associated with chemsex -the intentional use of drugs before or during sexual intercourse GBMSM (gay, bisexual and men who have sex with men) population-. Sexualized intravenous drug use is also known as slam or slamsex. There are few studies that analyze the mental health differences between intravenous drug users compared to non-intravenous drug users in chemsex context.ObjectivesWe aim to describe the mental health outcomes including current and past anxiety disorders diagnosis in a sample of users with sexualized drug use (chemsex) attended by the non-governmental organization Apoyo Positivo in the program “Sex, Drugs and You” and to compare the differences of current and previous diagnosis of anxiety disorders between intravenous drug users compared to non-intravenous drug users.MethodsA cross-sectional descriptive analysis of a sample of users attended by the non-governmental organization Apoyo Positivo in the program “Sex, Drugs and You” between 2016-2019 was performed.ResultsWe included 217 participants. Current or past diagnosis of anxiety disorders was found in 142 participants. Anxiety disorders were significantly higher in the intravenous drug use group compared to the non-intravenous drug use group (p<0.05).ConclusionsPrevious studies have reported that MSM who practiced chemsex were more likely to experience from anxiety. In our study, anxiety disorders where higher in participantes who engaged in intravenous drug use. A multidisciplinary team is necessary to address chemsex and provide care and treatment for mental health problems such as anxiety, depression, suicidal behaviour or drug-induced psychosis.Disclosure of InterestNone Declared

How current and past anxiety disorders affect daily life in adolescents and young adults from the general population-An epidemiological study with ecological momentary assessment.

Prior research indicated, based on retrospective assessments of symptomatology, that 25% of individuals with "remitted" anxiety disorders (AD) experience a relapse. The present study used ecological momentary assessment (EMA) to examine how ADs affect everyday life among community adolescents and young adults with current or remitted AD compared to healthy controls and to each other. Data come from the baseline assessment of the epidemiological Behavior and Mind Health study, conducted in Dresden (Germany) from 11/2015-12/2016. The sub-sample analyzed (n = 648, age 14-21) consisted of 65 participants with current DSM-5 AD-diagnosis, 52 participants with lifetime AD-diagnosis but not within the last 6 months (remitted), and 531 healthy controls (no psychopathology; healthy controls [HC]). EMA of various constructs took place 8 times a day for 4 days. The highest levels of symptoms were reported by those with current AD, followed by remitted AD and HC. Regression analyses revealed significantly worse mood, self-efficacy, quality of life and sleep-quality and more experiential avoidance, stress, negative thoughts and pessimism in remitted and current AD compared to HC. Current AD additional differed significantly from HC in optimism and positive thoughts. Furthermore, individuals with remitted AD without comorbidities differed significantly from HC on five out of 16 constructs. Not only current but also remitted AD is associated with diverse negative experiences in everyday life, which cannot merely be explained by comorbidities. As the remaining burden and impairment in individuals with remitted AD might contribute to relapse, interventions might be targeted to improve mental health.

The association of childhood maltreatment with depression and anxiety is not moderated by the oxytocin receptor gene

BackgroundThe oxytocin receptor (OXTR) gene may be involved in resilience or vulnerability towards stress, and hence in the development of stress-related disorders. There are indications that OXTR single nucleotide polymorphisms (SNPs) interact with early life stressors in predicting levels of depression and anxiety. To replicate and extend these findings, we examined whether three literature-based OXTR SNPs (rs2254298, rs53576, rs2268498) interact with childhood maltreatment in the development of clinically diagnosed depression and anxiety disorders.MethodsWe included 2567 individuals from the Netherlands Study of Depression and Anxiety. This sample consisted of 387 healthy controls, 428 people with a current or past depressive disorder, 243 people with a current or past anxiety disorder, and 1509 people with both lifetime depression and anxiety diagnoses. Childhood maltreatment was measured with both an interview and via self-report. Additional questionnaires measured depression and anxiety sensitivity.ResultsChildhood maltreatment was strongly associated with both lifetime depression and anxiety diagnoses, as well as with depression and anxiety sensitivity. However, the OXTR SNPs did not moderate these associations nor had main effects on outcomes.ConclusionsThe three OXTR gene SNPs did not interact with childhood maltreatment in predicting lifetime depression and anxiety diagnoses or sensitivity. This stresses the importance of replication studies with regard to OXTR gene variants in general populations as well as in clearly established clinical samples.

High Current Anxiety Symptoms, But Not a Past Anxiety Disorder Diagnosis, are Associated with Impaired Fear Extinction.

Although impaired fear extinction has repeatedly been demonstrated in patients with anxiety disorders, little is known about whether these impairments persist after treatment. The current comparative exploratory study investigated fear extinction in 26 patients treated for their anxiety disorder in the years preceding the study as compared to 17 healthy control subjects. Fear-potentiated startle and subjective fear were measured in a cue and context fear conditioning paradigm within a virtual reality environment. Results indicated no differences in fear extinction between treated anxiety patients and control subjects. However, scores on the Beck Anxiety Inventory across all participants revealed impaired extinction of fear potentiated startle in subjects with high compared to low anxiety symptoms over the past week. Taken together, this exploratory study found no support for impaired fear extinction in treated anxiety patients, and implies that current anxiety symptoms rather than previous patient status determine the success of extinction.

Anxiety and Depressed Mood Decline Following Smoking Abstinence in Adult Smokers with Attention Deficit Hyperactivity Disorder

IntroductionA preponderance of relevant research has indicated reduction in anxiety and depressive symptoms following smoking abstinence. This secondary analysis investigated whether the phenomenon extends to smokers with attention deficit hyperactivity disorder (ADHD). MethodsThe study setting was an 11-Week double-blind placebo-controlled randomized trial of osmotic release oral system methylphenidate (OROS-MPH) as a cessation aid when added to nicotine patch and counseling. Participants were 255 adult smokers with ADHD. The study outcomes are: anxiety (Beck Anxiety Inventory (BAI)) and depressed mood (Beck Depression Inventory II (BDI)) measured one Week and six Weeks after a target quit day (TQD). The main predictor is point-prevalence abstinence measured at Weeks 1 and 6 after TQD. Covariates are treatment (OROS-MPH vs placebo), past major depression, past anxiety disorder, number of cigarettes smoked daily, demographics (age, gender, education, marital status) and baseline scores on the BAI, BDI, and the DSM-IV ADHD Rating Scale. ResultsAbstinence was significantly associated with lower anxiety ratings throughout the post-quit period (p<0.001). Depressed mood was lower for abstainers than non-abstainers at Week 1 (p<0.05), but no longer at Week 6 (p=0.83). Treatment with OROS-MPH relative to placebo showed significant reductions at Week 6 after TQD for both anxiety (p<0.05) and depressed mood (p<0.001), but not at Week 1. Differential abstinence effects of gender were observed. Anxiety and depression ratings at baseline predicted increased ratings of corresponding measures during the post-quit period. ConclusionStopping smoking yielded reductions in anxiety and depressed mood in smokers with ADHD treated with nicotine patch and counseling. Treatment with OROS-MPH yielded mood reductions in delayed manner.

Psychiatric Predictors of Surgery Non-completion Following Suitability Assessment for Bariatric Surgery

Bariatric surgery is recognized as a treatment for severe obesity; however, little is known about factors influencing patient surgery non-completion. This study explored the relationship between psychiatric factors and patient non-completion during the pre-bariatric surgery suitability assessment. A total of 367 individuals underwent a structured psychiatric interview and were classified as either surgery completers (SC) or surgery non-completers (SNC) if they attended at least one pre-surgery assessment appointment but did not receive surgery. The results showed that in comparison to the SC group, the SNC group had significantly higher rates of overall past Axis I psychiatric disorders (58.1 vs. 46.6%, p = 0.035), past anxiety disorders (17.4 vs. 9.4%, p = 0.03), and past substance use disorders (8.7 vs. 3.7%, p = 0.03). For specific past psychiatric disorders, the SNC group exhibited significantly higher rates of a past post-traumatic stress disorder (PTSD) (5 vs. 1%, p = 0.029) and past substance dependence disorder (7 vs. 1%, p = 0.005). Although overall current psychiatric disorders did not significantly differ between groups, the SNC group had significantly higher rates of current PTSD (2 vs. 0%, p = 0.049) and current generalized anxiety disorder (4 vs. 0%, p = 0.005). A past history of an anxiety or substance use disorder may play a role in patients not completing the assessment component of the bariatric surgery process. Additional psychosocial support, such as cognitive behavioral therapy or targeted psychoeducation, may help improve patient completion of the pre-surgery assessment phase.

S.10.02 Current major depression and its role in tobacco dependence: state effects on craving, dopamine release, and smoking cessation

A preponderance of relevant research has indicated reduction in anxiety and depressive symptoms following smoking abstinence. This secondary analysis investigated whether the phenomenon extends to smokers with attention deficit hyperactivity disorder (ADHD).The study setting was an 11-Week double-blind placebo-controlled randomized trial of osmotic release oral system methylphenidate (OROS-MPH) as a cessation aid when added to nicotine patch and counseling. Participants were 255 adult smokers with ADHD. The study outcomes are: anxiety (Beck Anxiety Inventory (BAI)) and depressed mood (Beck Depression Inventory II (BDI)) measured one Week and six Weeks after a target quit day (TQD). The main predictor is point-prevalence abstinence measured at Weeks 1 and 6 after TQD. Covariates are treatment (OROS-MPH vs placebo), past major depression, past anxiety disorder, number of cigarettes smoked daily, demographics (age, gender, education, marital status) and baseline scores on the BAI, BDI, and the DSM-IV ADHD Rating Scale.Abstinence was significantly associated with lower anxiety ratings throughout the post-quit period (p < 0.001). Depressed mood was lower for abstainers than non-abstainers at Week 1 (p < 0.05), but no longer at Week 6 (p = 0.83). Treatment with OROS-MPH relative to placebo showed significant reductions at Week 6 after TQD for both anxiety (p < 0.05) and depressed mood (p < 0.001), but not at Week 1. Differential abstinence effects of gender were observed. Anxiety and depression ratings at baseline predicted increased ratings of corresponding measures during the post-quit period.Stopping smoking yielded reductions in anxiety and depressed mood in smokers with ADHD treated with nicotine patch and counseling. Treatment with OROS-MPH yielded mood reductions in delayed manner.

The Northwestern-UCLA youth emotion project: Associations of cognitive vulnerabilities, neuroticism and gender with past diagnoses of emotional disorders in adolescents

Neuroticism has been hypothesized to be a non-specific risk factor for both anxiety and unipolar mood disorders whereas some cognitive and personality-cognitive vulnerabilities have been hypothesized to be more specific to depression. Using a retrospective design with a sample of 575 high school juniors, we tested three competing models of the associations among these variables. Both neuroticism and the cognitive and personality-cognitive vulnerabilities had significant zero-order associations with rates of past diagnoses of both anxiety and unipolar mood disorders. Neuroticism had significant unique associations with past anxiety disorders and comorbid anxiety and unipolar mood disorders whereas the other vulnerabilities did not. In addition, gender interacted with neuroticism but not with the other vulnerabilities in associating with past diagnoses of mood disorders, showing that neuroticism is more highly associated with past unipolar mood diagnoses in males than in females. Finally, the cognitive and personality-cognitive vulnerabilities overlapped with substantial portions of the variance that neuroticism shared with diagnoses. These results suggest that, at least for retrospective associations with past anxiety and unipolar mood disorders, the cognitive and other personality-cognitive vulnerabilities are non-specific facets of neuroticism.

Intermittent explosive disorder and other psychiatric co-morbidity among court-referred and self-referred aggressive drivers

We assessed possible Axis I and Axis II disorders in two groups of aggressive drivers ( n=20, court-referred; n=10, self-referred) and 30 non-aggressive driver controls, using the SCID and SCID-II. Aggressive drivers were more likely than controls to be positive for any Axis I and Axis II disorders. They were also more likely to meet the criteria for Intermittent Explosive Disorder (IED), current or past alcohol or substance abuse or dependence and Antisocial PD and Borderline PD. The self-referred aggressive drivers were more likely than court-referred aggressive drivers to meet the criteria for a current or past Anxiety Disorder. Re-analysis of aggressive driver data on the basis of presence or absence of IED revealed differences only in Axis II disorders: those with IED were more likely to meet the criteria for any Axis II disorder and Antisocial PD.

Phobias, panic, and pain in 55 survivors of road vehicle accidents

We examined 55 survivors of road vehicle accidents (RVA) with minimal injury and chronic pain physically, by structured clinical interview, by panic, phobia, anxiety sensitivity, and pain scales. Twenty-one (38.2%) of the 55 RVA survivors met DSM-III-R criteria for simple phobia with onset after RVA, and eight (38.1%) of the 21 met full criteria for current PTSD. Five (23.8%) of the 21 phobics and none of the nonphobics gave a past history of other phobia. Gender, pain location, and pain severity were similar in phobics and nonphobics. Fears were predominantly specific for RVA and, with the exception of three RVA survivors, panic occured exclusively in cars. Results on prevalence of phobias and PTSD after RVA are similar to earlier findings. The results also suggest that “accident phobia” is not similar to agoraphobia, that past anxiety disorder may predispose towards fear aquisition, but that it may not necessarily predetermine fear content.

Epidemiology of childhood anxiety disorders

SummaryThis review studies the epidemiology of anxiety disorders of childhood and adolescence, including prevalence rates, comorbidity patterns, risk factors and course. Comorbidity is very important: most children with anxiety disorders also have one or several other anomalies, usually anxiety or mood disorders. The authors point out the main evidence suggesting that a number of risk factors are associated with childhood anxiety disorders: age, sex, low socioeconomic setting; child's personality, and lastly, familial risk factors which have a very strong influence: children of parents with current or past anxiety disorders are more at risk of having anxiety disorders. Concerning the course of disorders, we have tentatively defined subsets of children or adolescents with anxiety disorders, and tried to clarify the recovery rate of these subsets. Future directions for research are suggested.