Rates Of Anxiety Disorders Research Articles

Phenotypic psychiatric characterization of children with Williams syndrome and response of those with ADHD to methylphenidate treatment

Williams syndrome (WS) is associated with cognitive deficits, special behavioral phenotype, and high rates of psychiatric disorders. The aims of the present study were: (1) To compare the rates of psychiatric disorders and repetitive behaviors in children with WS to children with idiopathic developmental disability (DDs); (2) To longitudinally assess the change in psychiatric disorders during adolescence in WS; (3) To assess retrospectively the effectiveness and safety of methylphenidate (MPH) treatment in WS children with ADHD. The study consisted of a cohort of 38 children and adolescents (age 13.1 ± 5.2 years) with WS and a sample of age-matched DDs (age 15.0 ± 3.1 years). A current follow-up evaluation was conducted after 5.6 ± 1.6 years for 25 subjects (65.8%) of the WS cohort. The rate of most psychiatric disorders was found similar in children with WS and DD controls. Specific phobia, especially from noises, obsessive-compulsive symptoms (e.g., aggressive obsessions and repetitive questions), and stereotypic behaviors (e.g., glancing), were more common in WS than DDs. In a longitudinal follow-up of the WS children, we found a decrease in the rate of anxiety disorders. In addition, a clinically significant improvement was reported in 72.2% of WS children with ADHD following MPH treatment. Sadness/unhappiness was the most common side effect associated with MPH treatment in WS, occurring in 2/3 of treated individuals. The present study further elucidates the neuropsychiatric phenotype of WS. Our results also suggest that MPH treatment for ADHD in WS warrants future prospective controlled trials.

The validity of DSM symptoms for depression and anxiety disorders during pregnancy

The applicability of the symptom criteria for diagnostic mood and anxiety disorders has in recent times been questioned for women in the perinatal period, due to the overlap of diagnostic symptoms with normal symptoms due to the physical changes of pregnancy or postpartum, (e.g., sleep difficulties). 118 women in their second or early third trimester of pregnancy participated in a telephone interview that included the depression and anxiety modules of the MINI diagnostic interview, and an attributional probe question asking the woman whether endorsement of a symptom was due to the physical changes of her pregnancy or due to her mood or worries. 66% of pregnant women who met criteria for major depression reported that a sufficient number of their symptoms were due to the normal physical changes of their pregnancy, such that they would no longer meet criteria for a diagnosis of major depression. Attributional probing resulted in the rate of major depression falling from 6.8% to 1.7%. The impact on anxiety disorders appears to be less. An important issue is whether women's attributional perceptions are valid, though the face validity of some of their responses means that credence should be given to the findings. In addition, it would be useful from a validity perspective to undertake the same attributional probing with other populations where symptom presence is most likely due to mood, such as unemployed or recently separated adults without physical complaints. Rates of depressive disorders in pregnancy, using DSM symptom criteria, are significantly over-estimated due to the natural occurrence of many of the symptoms as a result of the pregnancy. Rates of anxiety disorders are also inflated, but to a lesser degree. This means that the validation of self-report mood measures, typically done against DSM diagnoses, is likely to have produced erroneous findings (e.g., optimum cut-off scores). It is probable that a similar finding would be obtained for the postpartum period. Thus future use of DSM symptom criteria for depression and anxiety in perinatal mental health work should use some form of attributional probing question to more accurately understand the applicability of symptoms to a diagnosis in this population.

Sexual Orientation and its Relation to Mental Disorders and Suicide Attempts: Findings from a Nationally Representative Sample

To compare the rates of all Axis I and II mental disorders and suicide attempts in sexual orientation minorities with rates in heterosexuals using a nationally representative sample. Data used were from the National Epidemiologic Survey on Alcohol and Related Conditions Wave 2 (n = 34 653, response rate = 70.2%). Cross-tabulations and multivariate logistic regression analyses were performed to determine differences in rates of mental disorders and suicide attempts by sexual orientation. All analyses were stratified by sex. Compared with their heterosexual counterparts, lesbians and bisexual women demonstrated a 3-fold increased likelihood of substance use disorders, and gay and bisexual men showed twice the rate of anxiety disorders and schizophrenia and (or) psychotic illness, even after accounting for mental disorder comorbidity. Suicide attempts were independently associated with bisexuality, with odds 3 times higher than in heterosexuals. Findings from our study emphasize the fact that sexual orientation minorities are vulnerable to poor mental health outcomes, including suicide attempts. Clinicians need to be aware of these specific negative mental health consequences when assessing sexual orientation minorities.

Prevalence and Treatment of Mental Disorders Among US Children in the 2001–2004 NHANES

This article presents the 12-month prevalence estimates of specific mental disorders, their social and demographic correlates, and service use patterns in children and adolescents from the National Health and Nutrition Examination Survey, a nationally representative probability sample of noninstitutionalized US civilians. The sample includes 3042 participants 8 to 15 years of age from cross-sectional surveys conducted from 2001 to 2004. Data on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for mental disorders were derived from administration of selected modules of the National Institute of Mental Health Diagnostic Interview Schedule for Children, version IV, a structured diagnostic interview administered by lay interviewers to assess psychiatric diagnoses of children and adolescents. Twelve-month prevalence rates of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-defined disorders in this sample were 8.6% for attention-deficit/hyperactivity disorder, 3.7% for mood disorders, 2.1% for conduct disorder, 0.7% for panic disorder or generalized anxiety disorder, and 0.1% for eating disorders. Boys had 2.1 times greater prevalence of attention-deficit/hyperactivity disorder than girls, girls had twofold higher rates of mood disorders than boys, and there were no gender differences in the rates of anxiety disorders or conduct disorder. Only approximately one half of those with one of the disorders assessed had sought treatment with a mental health professional. These data constitute a first step in building a national database on mental health in children and adolescents.

Les troubles psychiatriques et psychocognitifs associés à la dyslexie de développement : un enjeu clinique et scientifique

Dyslexia is a complex neurodevelopemental disorder that affects 5 to 10% of school-age children. This condition consists in a specific learning disability with a neurological origin. These learning difficulties are unexpected in relation to other cognitive abilities and the provision of efficient classroom instruction. A range of neurobiological investigations suggests that disruption of the parieto-temporo-occipital systems underlies a failure of skilled reading to develop. The observation that dyslexia is both a familial and heritable problem was made early on and was confirmed by twin studies. They also suggested that both genetic and environmental factors are involved. Several loci have been implicated in dyslexia, notably on chromosomes 2, 3, 6, 15 and 18 and some candidate genes have been proposed, but no functional mutation has yet been identified. Dyslexia seldom appears isolated and dyslexic people are very likely to present other kinds of learning disabilities or psychiatric disorders. Specific language impairment, often with a mild outcome, is the most frequently associated with dyslexia. Indeed, late language development is often reported by dyslexic patients and also occurs more frequently among their siblings. Genetic linkage studies suggest some common genetic factor underlying this comorbidity. Dyscalculia is associated with dyslexia in 25% of cases, but most people with dyscalculia do not have any sign of dyslexia. The question of whether dyscalculia associated with dyslexia and dyscalculia itself rely on the same cognitive impairment is still controversial. Impaired motor development is also a common feature that affects nearly 50% of dyslexics and dyslexia is frequent among dyspraxic patients. This association raises the discussion on the role of motor impairment in dyslexia's physiopathology and the cerebellar theory of dyslexia. Beyond its link with other learning disorders, the study of dyslexia's comorbidity highlights psychopathological issues. ADHD is the most frequent psychiatric disorder associated with dyslexia. Underpinnings of this link between the two disorders seem to rely on common cognitive and genetic factors. Some authors have proposed a candidate gene ADRA2A to determine the condition including ADHD and dyslexia. In addition, dyslexics are exposed to a higher risk of anxiodepressive and behavioural disorders. Dyslexic children experience three times more behavioural disorders and one third of children with behavioural problems turn out to be affected by dyslexia. The literature study reveals inconsistent findings about depressed mood among dyslexics, but evidence of a persistent increase in the rate of anxiety disorders. The authors put forward the impact of environmental factors to explain these psychiatric comorbidities. This review emphasizes dyslexia's comorbidities because they represent an important issue, both from a scientific and clinical point of view. Indeed, for clinicians, children showing multiple learning disabilities have specific reeducation and educational needs and dyslexics have a higher risk of emotional and behavioural disorders. On the other hand, dyslexia's comorbidity study provides a powerful method for researchers to investigate the still unknown physiopathology of dyslexia.

Psychological distress and occupational asthma

To summarize recent findings on the psychological impact of occupational asthma, on the basis of a review of medical and psychological literature published between 1998 and 2008. For the purposes of this review, 'psychological impacts' are defined as the experience of psychological stress or distress, which refers to the experience of negative emotions (e.g., anxiety and sadness/depression). When severe and chronic, psychological distress may reach clinical levels and is referred to as a 'psychiatric disorder', which is a clinical diagnosis based on established diagnostic criteria. Only one original article assessing psychological impacts has been published in the past 10 years (in 2007). Levels of psychological distress (i.e., depression, anxiety, and cognitive dysfunction) were all in the clinical range, and rates of anxiety disorders and dysthymia (a chronic form of depression) affected approximately 35 and 23% of patients, respectively. The paucity of available literature indicates that the study of psychological factors associated with occupational asthma is still in its infancy. Though preliminary and in need of replication, the only published study to date suggests that patients with occupational asthma may be highly anxious and many are chronically depressed, a finding that is consistent with previous studies with nonoccupational asthmatics. The established link between psychological factors (e.g., depression and anxiety) and nonoccupational asthma suggests that future studies are desperately needed to more comprehensively assess the scope and severity of the psychological burden of this disease.

Disability Associated with Comorbid Anxiety Disorders in Women with Chronic Physical Illness in Ontario, Canada

ABSTRACT Anxiety disorders are more prevalent in individuals with chronic physical illness compared to individuals with no such illness, and about twice as prevalent in women as in men. This study used data collected in the 2005 Canadian Community Health Survey (21,198 women and 20,478 men) to examine factors associated with comorbid anxiety disorders and to assess the relation of these disorders on short-term disability and suicidal ideation. Comorbid anxiety disorders were more prevalent among women who were young, single, poor, and Canadian-born, and among women with chronic fatigue syndrome; fibromyalgia, bowel disorder or stomach or intestinal ulcers, or bronchitis had the highest rates of anxiety disorders. The presence of comorbid anxiety disorders was significantly associated with short-term disability, requiring help with instrumental daily activities, and suicidal ideation. Our findings underscore the importance of early detection and treatment of anxiety disorders in the physically ill, especially those who also suffer from mood disorders.

Prevalence of DSM-IV disorders in Chinese adolescents and the effects of an impairment criterion

To provide preliminary prevalence estimates of common DSM-IV (Diagnostic and Statistical Manual of Mental Disorders-4th Edition) disorders in a sample of Hong Kong Chinese adolescents. 541 Chinese adolescents were recruited from Grades 7, 8 and 9 of 28 mainstream high schools in Hong Kong (mean age=13.8 years; SD=1.2). The adolescents and their parents were separately administered the Youth and Parent versions of DISC-IV (Diagnostic Interview Schedule for Children-Version 4), respectively. Based upon both symptom and impairment criteria, as required by DSM-IV, the overall prevalence estimate of DSM-IV disorders in our sample of Chinese adolescents was 16.4%. Estimates for such individual disorders/diagnostic groupings as anxiety disorders, depressive disorders, attention deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), and substance use disorders were 6.9, 1.3, 3.9, 6.8, 1.7, and 1.1%, respectively. These rates were largely compatible with those reported in previous studies with perhaps lower rates of generalized anxiety disorder (GAD), depressive disorders, CD, and substance use disorders, but a higher rate of ODD. The rate of ADHD was somewhat higher, but this might reflect the current DSM-IV diagnostic practice. The rate of anxiety disorders was not as high as predicted from some previous questionnaire surveys. The application of an impairment criterion had discernible impacts on prevalence estimates, greater on anxiety and substance use disorders, but smaller on depressive and disruptive behavior disorders. There was a lack of gender difference in rates of ODD and CD. While the findings reported here are broadly compatible with those of other studies, there may be cross-cultural differences in rates of some individual disorders, e.g., GAD, depressive disorders, ODD, CD, and substance use disorders, as well as in gender difference regarding rates of ODD and CD. However, exact comparison between studies is confounded by methodological differences in sample characteristics, measures, and case definition. Standardization of methodology in epidemiological surveys should allow more precise identification of any within- or between-culture variations in prevalence estimation.

Prävalenz von Angst und Depression bei ambulanten Krebspatienten und deren Angehörigen

To assess prevalence rates of anxiety disorder and depression in patients and their spouses treated in a cancer outpatient clinic of a university hospital. Also the distress-thermometer (DT) was tested as a screening instrument for anxiety disorders and depression. 109 patients with different cancer types of different stages as well as their 109 spouses were assessed by questionnaires. In the patient sample anxiety levels were increased in 24.7% and in 20.2% for depression. In spouses anxiety levels were increased in 41.0% and in 21.6% for depression. Female spouses had higher anxiety levels than male spouses (p < 0.01); increased anxiety levels were found in 48% of the female spouses. In the patients sample the distress-thermometer has good values for sensitivity [0.93 (anxiety); 0.82 (depression)] and satisfying measures of specifity [0.68 (anxiety); 0.62 (depression)]. Female spouses of cancer patients are at increased risk for psychiatric morbidity, a fact that should be considered in future oncological care. The distress-thermometer is a simple, time saving and sensitive screening instrument to assess psychiatric morbidity in cancer patients, which can be recommended for clinical use.

Anxiety disorders among Nigerian women in late pregnancy: a controlled study

This study aimed to investigate the rate and type of anxiety disorders among Nigerian women in late pregnancy. Women in late pregnancy (n = 172) and a non-pregnant control group were assessed for DSM-IV anxiety disorders. The rate of any anxiety disorder in the pregnant women was 39.0% compared with 16.3% in the non-pregnant population (p < 0.001). Although all the anxiety disorders were more common, only the rate of social anxiety disorder was significantly higher among the pregnant than non-pregnant population. Correlates of anxiety disorder in the pregnant population include age less than 25 years (OR 4.62, 95% CI 2.39-8.92), primiparity (OR 3.90, 95% CI 2.00-7.59) and presence of medical conditions (OR 3.60, 95% CI 1.28-10.12). More research is needed in this field to ascertain the specific association between pregnancy and anxiety disorders.

Psychological Health of Men with Partners who have Post-Partum Depression

To compare the psychological health of men with partners who have post-partum depression (PPD; index group) with that of men with partners without PPD (comparison group). Using a cross-sectional survey, psychological symptoms and disturbances of index group men (n = 58) and comparison group men (n = 116) were compared. Validated self-report measures were used to assess five key areas of mental health: depression, anxiety, non-specific psychological impairment, aggression and alcohol use. Index group men had more symptoms of depression, aggression and non-specific psychological impairment, and had higher rates of depressive disorder, non-specific psychological problems and problem fatigue than comparison group men. Index group men were also more likely to have three or more comorbid psychological disturbances. There was no difference between the groups on measures of anxiety and alcohol use. Although many men in the postnatal period experience a variety of mental health problems, those who have a partner with PPD are themselves at increased risk for experiencing psychological symptoms and disturbances. Differentiation of psychological syndromes is important; higher rates of depressive disorder, non-specific psychological problems and problem fatigue were found, but rates of anxiety disorder and hazardous alcohol use did not differ between the groups. More attention from health professionals to men's mental health in the postnatal period may be beneficial to the entire family system.

Psychological health of men with partners who have post-partum depression

To compare the psychological health of men with partners who have post-partum depression (PPD; index group) with that of men with partners without PPD (comparison group).Using a cross-sectional survey, psychological symptoms and disturbances of index group men (n = 58) and comparison group men (n = 116) were compared. Validated self-report measures were used to assess five key areas of mental health: depression, anxiety, non-specific psychological impairment, aggression and alcohol use.Index group men had more symptoms of depression, aggression and non-specific psychological impairment, and had higher rates of depressive disorder, non-specific psychological problems and problem fatigue than comparison group men. Index group men were also more likely to have three or more comorbid psychological disturbances. There was no difference between the groups on measures of anxiety and alcohol use.Although many men in the postnatal period experience a variety of mental health problems, those who have a partner with PPD are themselves at increased risk for experiencing psychological symptoms and disturbances. Differentiation of psychological syndromes is important; higher rates of depressive disorder, non-specific psychological problems and problem fatigue were found, but rates of anxiety disorder and hazardous alcohol use did not differ between the groups. More attention from health professionals to men's mental health in the postnatal period may be beneficial to the entire family system.

Children of Depressed Parents Have More Health Problems

Back to table of contents Previous article Next article Clinical & Research NewsFull AccessChildren of Depressed Parents Have More Health ProblemsEve BenderEve BenderSearch for more papers by this authorPublished Online:2 Jun 2006https://doi.org/10.1176/pn.41.11.0018The adult offspring of depressed parents are far more likely than those of nondepressed parents to have a host of psychiatric and medical problems, such as cardiovascular disease, according to a study reported in the June American Journal of Psychiatry.The study found that the rates of anxiety disorders, major depression, and substance use disorders were about three times that of offspring from nondepressed parents 20 years after a baseline survey.In addition, adult children of depressed parents had about five times the rate of cardiovascular illness as children of nondepressed parents.“Based on these findings, the children of depressed parents have high rates of depression and anxiety disorders that are impairing and reoccur over the course of their lives,” lead author and study investigator Myrna Weissman, Ph.D., told Psychiatric News.Weissman is a professor of epidemiology in psychiatry at the College of Physicians and Surgeons and the School of Public Health at Columbia University.Weissman first began following her sample of 151 children from depressed and nondepressed parents in 1982 in their homes in New Haven, Conn.Some of her sample were drawn from the offspring of depressed adults receiving outpatient depression treatment at Yale University's depression research unit in the early 1980s. The adults who volunteered their children to be studied were moderately to severely depressed, Weissman said.She also recruited children of nondepressed parents who participated in the Epidemiologic Catchment Area study.She assessed 220 offspring aged 6 to 23 in both groups at baseline and then at two years, 10 years, and 20 years later.By the 20-year follow-up evaluation, there were 101 offspring with one or more parents with depression and 50 offspring with parents with no depression.To screen the offspring, researchers used the Schedule for Affective Disorders and Schizophrenia-Lifetime Version, the Global Assessment Scale, and the Social Adjustment Scale-Self Report. Researchers also used a standard medical checklist to gather information on nonpsychiatric medical conditions.Twenty years after she first studied them, Weissman found that the offspring of depressed parents had higher rates of major depression over the two decades (65 percent) compared with offspring of nondepressed parents (27 percent) in her sample.Compared with their peers, children of depressed parents had about three times the risk of developing depression by the time they were adults.In addition, while just 15 percent of offspring of nondepressed parents had a phobia, 43 percent of offspring of depressed parents did, which meant they had three times the risk for developing a phobia by the time they were adults.The study noted that “peak of first onset [of psychiatric disorders] was before the age of 20, with anxiety disorders before puberty and with major depression and substance dependence after puberty.”Twice as many of the offspring of depressed parents (19 percent) developed an addiction to drugs or alcohol, as did those of nondepressed parents (8 percent), putting them at more than twice the risk of developing a substance use disorder.Offspring of depressed parents also had more medical problems than their counterparts.Weissman found that by the 20-year evaluation, 11 percent of offspring of depressed parents had developed cardiovascular disease, compared with only 2 percent of children of nondepressed parents, making the former about five times as likely to develop heart problems as adults.Offspring of depressed parents were also more than twice as likely to develop a neuromuscular disorder.Weissman cited a number of studies that have found an association between depression and cardiovascular illness and said that an association between the two conditions could stem from altered immune, platelet, and hypothalamic-pituitary-adrenal axis functioning in depressed patients.She said that neither parents nor children with depression should be considered in isolation of one another.“If clinicians see a child with a psychiatric illness, they should examine the parents and see if one or both are depressed,” Weissman said, and do the same for depressed adult patients who have children.“ Parents and children should be considered a package.”Weissman is now evaluating a subsample of the children of the offspring she studied to determine the specific factors that may contribute to their mental health problems.An abstract of “Offspring of Depressed Parents: 20 Years Later” is posted at<http://ajp.psychiatryonline.org/> under the June issue. ▪ ISSUES NewArchived

Psychiatric Comorbidities of Female Inpatients With Eating Disorders

We analyze 27 point-prevalent DSM-IV Axis I comorbidities for eating disorder inpatients. The sample included 2436 female inpatients treated between January 1, 1995, and December 31, 2000, for primary DSM-IV diagnoses of anorexia, bulimia, and eating disorder not otherwise specified. Analyses were multivariate analysis of variance and multinomial logistic regression; sociodemographics and severity-of-illness measures were controlled. Ninety-seven percent of patients evidenced > or = 1 comorbid diagnoses; 94% evidenced comorbid mood disorders, largely unipolar depression, with no differences across eating disorders; 56% evidenced anxiety disorders, with no differences across eating disorders; and 22% evidenced substance use disorders, with significant differences across eating disorders (p < .0001). Five specific diagnoses differed across eating disorders. Alcohol abuse/dependence was twice as likely with bulimia (p < .0001); polysubstance abuse/dependence three times as likely with bulimia (p < .0001); obsessive-compulsive disorder twice as likely with restricting and binge/purge anorexia (p < .01); posttraumatic stress disorder twice as likely with binge-purge anorexia (p < .05); schizophrenia/other psychoses three times more likely with restricting anorexia (p < .05) and two times with binge-purge anorexia (p < .05). New findings emerged: extremely high comorbidity regardless of eating disorder, ubiquitous depression across all eating disorders, no difference in overall rate of anxiety disorders across eating disorders, greater posttraumatic stress disorder in binge-purge anorexia, more psychotic diagnoses in anorexia. Certain previous findings were confirmed: more obsessive-compulsive disorder in anorexia; more substance use in bulimia; and a replicated comorbidity rank-ordering for eating disorder patients: mood, anxiety, and substance use disorders, respectively.

Comorbid Anxiety Disorders Worsen Outcome of Treatment for Alcohol Dependence

Patients with alcohol dependence have an elevated rate of anxiety disorders. These researchers examined how comorbid anxiety disorders affect the risk

Symptoms and personality traits of East and West German psychotherapy patients with anxiety and depressive disorders

The aim of this study is to explore symptoms and personality traits of patients from two Psychosomatic University Departments, one in Düsseldorf (West Germany) and the other in Magdeburg (East Germany), suffering from anxiety disorders and depression. 560 unselected outpatients with anxiety disorders and depression were examined with the Symptom-Checklist (SCL-90-R) and the Inventory of Interpersonal Problems (IIP-D). The ratio of these two diagnostic groups in relation to the total number of outpatients in both clinics was analysed. The results show a higher rate of Anxiety disorders in the East German group and a higher rate of depressed patients in the West German group. Both diagnostic groups differ in certain scales of SCL-90-R and IIP-D. These profiles are mainly stable against cultural (East-West) influences. The SCL-90-R and IIP-D should be used to develop diagnostic profiles of the discussed syndromes. Social and cultural influences of patients' self ratings should be taken into account.

Depressive and anxiety disorders in women with HIV infection.

This study examined whether there were differences in the rate of depressive and anxiety disorders between HIV-infected women (N=93) and a comparison group of uninfected women (N=62). Secondary objectives were to examine correlates of depression in HIV-infected women-including HIV disease stage and protease inhibitor use-and the associations between symptoms of depression or anxiety and other potential predictor variables. Subjects underwent extensive semiannual clinical, psychiatric, neuropsychological, and immunological evaluations. Depressive and anxiety disorder diagnoses were assessed by using the Structured Clinical Interview for DSM-IV. Symptoms of depression and anxiety were evaluated with the Hamilton Depression Rating Scale (the 17-item version and a modified 11-item version) and the Hamilton Anxiety Rating Scale, respectively. The rate of current major depressive disorder was four times higher in HIV-seropositive women (19.4%) than in HIV-seronegative women (4.8%). Mean depressive symptom scores on the 17-item Hamilton depression scale also were significantly higher, overall, in the HIV-infected women (mean=8.7, SD=8.0) relative to comparison subjects (mean=3.3, SD=5.8). There was no significant between-group difference in the rate of anxiety disorders. However, HIV-seropositive women had significantly higher anxiety symptom scores (mean=8.8, SD=8.9) than did HIV-seronegative women (mean=3.6, SD=5.5). Both groups had similar substance abuse/dependence histories, but adjusting for this factor had little impact on the relationship of HIV status to current major depressive disorder. HIV-seropositive women without current substance abuse exhibited a significantly higher rate of major depressive disorder and more symptoms of depression and anxiety than did a group of HIV-seronegative women with similar demographic characteristics. These controlled, clinical findings extend recent epidemiologic findings and underscore the importance of adequate assessment and treatment of depression and anxiety in HIV-infected women.

Panic, dyspnea, and asthma.

Dyspnea, a cardinal symptom of asthma, is also a common feature of panic attacks. Patients with asthma have high rates of anxiety disorders, and respiratory illness may be a risk factor in the development of panic disorder. The diagnosis of anxiety disorders in patients with asthma can be challenging, but successful identification and treatment of anxiety can reduce morbidity and improve quality of life in these patients. Serotonergic anxiolytic medications and cognitive-behavioral therapy appear to be the treatments of choice for pathologic anxiety in patients with asthma.

Psychiatric Family History in Adolescents with Severe Asthma

To examine the hypothesis that an association exists between severe asthma and familial affective and anxiety disorders. A parent, usually the mother, of 62 adolescents admitted to a tertiary care asthma center was administered the Family History-Research Diagnostic Criteria Interview. Lifetime prevalence rates of psychiatric disorders in first-degree relatives were compared with previously reported rates. In relatives of asthmatic adolescents, rates for depression, mania (females only), substance abuse (males only), and antisocial personality disorder were significantly higher than the rates in the non-ill comparison sample. Rates for substance abuse (males only) and antisocial personality disorder were higher than the rates for relatives of the depressed comparison sample. Rates for anxiety disorders were not higher than rates in epidemiological samples. Rates of attention-deficit hyperactivity disorder (females only) and posttraumatic stress disorder in relatives were higher than in community samples. These results support the presence of a link between severe asthma and familial affective disorders, posttraumatic stress disorder, antisocial personality disorder, and substance abuse. Whether these disorders are genetically associated with asthma or represent an association with severe asthma because of environmental effects on the growing child is discussed.

Panic Disorder in Women

Selected anxiety disorders, particularly panic disorder with agoraphobia, occur much more frequently in women. Researchers have few explanations for this phenomenon. This paper presents epidemiologic data on the rates of anxiety disorders in men and women and discusses hypothetical contributions to these differences in rates.