Treatment Of Anxiety Disorders Research Articles

Exploring the Relationship Between Attentional Bias and Symptoms of Adult Separation Anxiety Disorder

Purpose: Research has identified attentional bias towards threatening stimuli as a contributing factor to anxiety disorders, and treatment targeting this bias has been shown to reduce symptoms of anxiety (Azriel & Bar-Haim, 2020). Studies have found attentional bias to threats among children with separation anxiety disorder (SAD) when tested with dot-probe tasks, with a stronger bias seen when threats are disorder-congruent (Pergamin-Hight et al., 2015). No study has yet investigated this relationship among adults, despite growing recognition that separation anxiety is frequent in this population. Therefore, we investigated the relationship between SAD symptoms and attentional bias toward threatening stimuli (general and separation-specific) on a dot-probe task in a sample of adults, with the goal of informing targeted treatment for adult separation anxiety disorder (ASAD). Methods: Undergraduate participants (n = 57) completed a measure of ASAD symptom severity (ASA-27) and two versions of the dot-probe task, one with separation-specific threatening words and one with generally threatening words. Attentional bias was tested using detection latency. Results: Spearman’s rho correlations between ASA-27 and separation-specific threat trials (rs = -.07; p = .62) and general threat trials (rs = .07; p = .60) were not significant. However, ASAD symptoms were correlated with reduced accuracy on trials following ASAD-specific threat words (rs = -.38, p = .004), but not general threat words (rs = -.16, p = .22). Conclusions: We did not find that ASAD symptoms related to attentional bias. However, individuals with more ASAD symptoms were less accurate on trials that involved ASAD-threat words, suggesting an emotional interference effect of disorder-specific threats on task performance.

Effects of ayahuasca on fear and anxiety: cross-talk between 5HT1A and 5HT2A receptors

Ayahuasca is a hallucinogenic substance currently being investigated for the treatment of mood, anxiety, and trauma-related disorders. Evidence from animal and human studies suggest that the effects of ayahuasca involve modulation of neural substrates relevant for emotional processing, especially in regions rich in serotonergic receptors. Moreover, preclinical studies also show that ayahuasca has specific effects on fear-related memories. The serotonergic system has been classically associated to anxiety and fear responses, with selective serotonin reuptake inhibitors being first-class medication to treat mood, anxiety, and stress-related disorders. Here we review currently available data regarding ayahuasca (and its main components) behavioral and functional effects on anxiety and fear-related responses through its modulation of serotoninergic signaling.

Case Report: Case report : Mindfulness training led to catharsis and mindfulness-to-meaning in a patient with social anxiety disorder comorbid with persistent depressive disorder (Dysthymia)

Background The use of mindfulness in the treatment of anxiety and depression is becoming more and more widespread, but there are few reports that it has fundamentally changed patients’ sense of life. Case Presentation This report showed 9 year’s progress of treatment for Social Anxiety Disorder and Persistent Depressive Disorder in a 41-year-old female patient experiencing a long-term painful married life with a reckless husband and controlling mother-in-law. During the past 25 months, she received 180 sessions of mindfulness training, resulting in complete remission of the anxiety and depression symptoms. After the 30th session she experienced an episode of the catharsis during the mindfulness training and experienced what can be called Mindfulness-To-Meaning, which is characterized by durable eudaimonic well-being in the face of adversity. Conclusions The psychological mechanisms that supported arriving at Mindfulness-To-Meaning are delineated as: Heightened (1) awareness which promoted (2) verbalization of the primary theme of suppression, in which the stress was (3) appraised metacognitively. Then (4) decentering permitted integrating this painful theme into a new adaptive self and world view, which resulted in (5) emotional catharsis, or release. Furthermore (6) positive appraisal of this experience enhanced awareness and led to the experience of (7) Mindfulness-To-Meaning.

The regulative role and mechanism of BNST in anxiety disorder.

Anxiety disorders, common yet impactful emotional disturbances, significantly affect physical and mental health globally. Many neuron circuits are associated with anxiety regulation like septo-hippocampal loop, amygdala(AMYG), bed nucleus of the stria terminalis (BNST), ventral hippocampus (vHPC), and brain regions like medial prefrontal cortex (mPFC). However, the concrete mechanism of anxiety disorder in BNST is relatively unknown. Recent research showed BNST plays a critical role in modulating anxiety owing to its anatomical location and special circuit characteristics, which are considered to be a hub in the limbic system regulating anxiety. BNST consists with multiple subregions, which can project separately into different brain regions and exert projecting independently to various brain regions with distinct regulatory effects. Moreover, multiple signal pathways in BNST are reported to play significant roles in regulating anxiety and stress behavior. This review briefly describes anxiety disorders and subdivisions and functions of BNST, focusing on the main neural circuits that serve as fundamental pathways in both the genesis and potential treatment of anxiety disorders and the molecular mechanism of BNST on anxiety. The complexity of structures and mechanisms has facilitated the development of imaging techniques. Innovative multimodal imaging techniques, such as functional magnetic resonance imaging (fMRI) and positron emission tomography (PET), have non-invasively illuminated BNST activities and their functional connections with other brain areas. These methodologies provide a deeper understanding of how BNST responds to anxiety-inducing stimuli, offering invaluable insights into its complex role in anxiety regulation. The continued exploration of BNST in anxiety research promises not only to elucidate fundamental neurobiological mechanisms but also to foster advancements in clinical treatments for anxiety disorders.

Uncovering the effects and mechanisms of tea and its components on depression, anxiety, and sleep disorders: A comprehensive review

Depression, anxiety and sleep disorders are prevalent psychiatric conditions worldwide, significantly impacting the physical and mental well-being of individuals. The treatment of these conditions poses various challenges, including limited efficacy and potential side effects. Tea, a globally recognized healthful beverage, contains a variety of active compounds. Studies have shown that consuming tea or ingesting its certain active ingredients have a beneficial impact on the mental health issues mentioned above. While the effects of tea on physical health are well-documented, there remains a gap in our systematic understanding of its impact on mental health. This article offers a thorough overview of animal, clinical, and epidemiological studies examining tea and its components in the treatment of depression, anxiety, and sleep disorders, and summarizes the associated molecular mechanisms. The active ingredients in tea, including L-theanine, γ-aminobutyric acid (GABA), arginine, catechins, theaflavins, caffeine, theacrine, and several volatile compounds, may help improve depression, anxiety, and sleep disorders. The underlying molecular mechanisms involve the regulation of neurotransmitters, including monoamines, GABA, and brain-derived neurotrophic factor (BDNF), as well as the suppression of oxidative stress and inflammation. Additionally, these ingredients may influence the microbiota-gut-brain (MGB) axis and the hypothalamic–pituitary–adrenal (HPA) axis. This review provides valuable insights into the effects and mechanisms by which tea and its components regulate depression, anxiety, and sleep disorders, laying the groundwork for further research into relevant mechanisms and the development of tea-based mental health products.

Effectiveness of acupuncture treatment in post-stroke depression and anxiety disorders: a prospective, randomized, controlled, single-blind study.

Our aim was to examine the effectiveness of acupuncture in post-stroke depression/anxiety disorders and to determine whether it reduces the need for anxiolytic and sedative drug use. This study included 54 stroke patients with depression and/or anxiety disorder. Patients were randomly assigned to the acupuncture treatment group (n = 27) or the control group (n = 27). A conventional rehabilitation program was applied to all patients and acupuncture was performed twice a week for 4 weeks. Patients were evaluated blindly by a psychiatrist at baseline (week 0), week 4 and week 8, using the Hamilton depression rating scale (HAM-D) and Hamilton anxiety rating scale (HAM-A), and drug doses were adjusted when necessary. The HAM-D and HAM-A scores at week 4 were pre-specified as the two primary outcome measures. Within each group, there was a significant decrease in the mean scores of HAM-D and HAM-A at weeks 4 and 8. No between-group differences in HAM-A or HAM-D scores were seen at 4 weeks but there was a significant decrease in HAM-D scores in favor of the acupuncture group at week 8 (p < 0.025). At week 4, the number of cases whose selective serotonin reuptake inhibitor (SSRI) dose was increased was found to be significantly higher in the control group. While the study was negative with respect to its primary outcomes, the findings with respect to certain secondary outcomes suggests further research is warranted to determine if acupuncture treatment is an effective/safe treatment to alleviate post-stroke depression/anxiety. NCT04283591 (ClinicalTrials.gov).

Disentangling the Neural Circuits of Arousal and Anxiety-Like Behavior.

Anxiety disorders are prevalent and debilitating conditions characterized by excessive concern and fear, affecting thoughts, behaviors, and sensations. A critical component of anxiety is arousal, a complex process involving alertness regulation and stimulus salience modulation. While arousal is adaptive in normal circumstances, dysregulation can lead to hypoarousal or hyperarousal, affecting response selection and threat perception. This chapter reviews challenges in studying arousal in preclinical anxiety models, emphasizing the need for multicomponent measurement and analysis. Novel methodologies integrating physiological measurement with activity tracking of neurons with single-cell resolution in awake animals are discussed, with emphasis in current challenges. Understanding these mechanisms is crucial for developing effective treatments for anxiety disorders.

Brief remote cognitive behaviour therapy for generalized anxiety disorder: An open trial.

Generalized anxiety disorder (GAD) is a persistent mental health condition that results in significant individual and economic burden. The uptake of evidence-based treatment is low, with many individuals with GAD citing cost as one of the key barriers. Brief treatments, which are typically more cost effective than standard length treatments, have the potential to make treatment more accessible to patients with GAD. Despite evidence demonstrating the efficacy of brief treatments for a range of anxiety disorders, there are currently no such studies examining brief Internet videoconferencing-delivered cognitive behavioural therapy (VCBT) interventions for patients with diagnosed GAD. The current study aims to examine the preliminary efficacy and acceptability of brief VCBT for GAD. The authors adopted an open trial design with 36 participants (77.8% female; Mage = 36.81 years; SD = 12.25) to examine the preliminary efficacy of a brief five-session VCBT intervention delivered remotely. Large pre-treatment to post-treatment effects were seen on the primary outcome measure, the Generalized Anxiety Disorder Questionnaire-7 item (GAD-7; d = 1.13; 95% CI: .62-1.61) and treatment effects increased at 3-month follow-up (d = 1.58; 95% CI: 1.04-2.10). Participants rated the intervention as highly acceptable with 92% reporting that they were satisfied with the treatment. These results provide preliminary support for the viability of brief remotely delivered CBT treatment in managing GAD symptoms.

AVALIAÇÃO NEUROPSICOLÓGICA NO TRANSTORNO DE ANSIEDADE GENERALIZADA NA INFÂNCIA E ADOLESCÊNCIA

This study aimed to explore the role of neuropsychological assessment in enhancing the efficacy of Generalized Anxiety Disorder (GAD) treatment in children and adolescents. Given the significant influence of emotional development during this life stage on the manifestation of fears and worries, a comprehensive understanding of each individual's psychological profile is essential. The high prevalence of GAD in childhood and adolescence underscores the critical need for early intervention to prevent chronic conditions and long-term consequences. A literature review reveals that psychological assessment in this population presents unique characteristics and is vital for identifying specific GAD symptoms, assessing symptom severity, and pinpointing preserved abilities. Additionally, neuropsychological assessment offers insights into how anxiety impacts the daily functioning of children and adolescents, aiding in the selection of tailored interventions. However, it is crucial to recognize that neuropsychological assessment is a complex process, and results must be interpreted cautiously considering the multifaceted nature of anxiety disorders and the influence of various factors. In conclusion, further research is imperative to deepen our understanding of the psychological dimensions of GAD in childhood and adolescence, thereby improving clinical practices and ensuring more effective treatment for this population.

Sporun Fiziksel Aktivite Boyutunun Psiko-Eğitimle Desteklenmesinin Sonuçlarının İncelenmesi

Today, especially after the pandemic, the importance of physical activity, in which individuals remember its value once again, stands out even more. During this period, it has become indisputable to what extent physical activity provides benefits to the social, emotional, physical and psychological development of individuals. So much so that physical activity applications have also found a place among the contents added to the distance education activities. Dec. However, the problem of overweight and obesity, which is rapidly becoming one of the most important health problems in the world, is also effective in spreading physical activity practices Decently. Considering the benefits of regular physical activity in general, it contributes to healthy growth and development, helps to protect against unwanted habits, prevents socialization and the formation of certain long-term diseases that may be encountered during adulthood, as well as treating and supporting the treatment of disorders that may occur, ensuring that they last an active old age, in other words, it can make important contributions to improving the quality of life throughout life. In this context, psycho-education as a complementary element of physical activity is also defined as empowering education aimed at promoting individual's awareness and entrepreneurship. Psycho-education is not only to inform the individual and his family about the problematic situation or to offer them solutions, but also the process of providing education and training about the factors that cause this situation. In this way, the person understands the situation better and develops a sense of control, so that the problem can gradually decrease. The human body, which was created in order to be able to do physical activity, can encounter various problems every day due to inactivity. Besides the well-known health benefits of physical activity, it should not be overlooked that along with its cognitive effects, it may also contribute to increasing academic achievement in the sense of its positive role on mental processes at different age levels depending on these effects, and ultimately as a result of these processes. At the same time, it is known in past and recent studies that physical activity has a direct or indirect effect on many topics, from the use of individuals experiencing mental or mental problems in treatment processes, to coping with stress, anxiety, and post-traumatic stress disorder treatments, in addition to conditions such as self-confidence, self-esteem, and well-being. Key Words: Special Ability, Special Ability Students, Physical Activity

Effect of meditation or escitalopram on work performance in patients with anxiety disorders.

This study aimed to 1) examine how psychopharmacotherapy and mindfulness-based stress reduction (MBSR) influence absenteeism and job performance among individuals with anxiety disorders and 2) compare the effectiveness of these treatments in improving work performance. Adults (N=67) with a primary anxiety disorder were recruited to participate in the study. Participants were randomized to escitalopram, a common treatment for anxiety disorders, or MBSR. Absenteeism and job performance were measured with the Health and Work Performance (HPQ) questionnaire prior to treatment and at the week 24 follow up. At week 24, individuals in the escitalopram arm and the MBSR arm showed significant improvements in partial days of missed work due to mental/physical health problems from baseline (1.00 [0.00-2.50] to 0.00 [0.00=1.00], p=.034 and 0.00 [0.00-2.00] to 0.00 [0.00=1.00], p=.001, respectively). In the MBSR arm only, job performance increased from baseline to week 24 (65.00 [50.00-80.00] to 75.00 [67.50-82.50], p=.017). None of the outcome variables significantly varied by group at baseline or week 24. Our study finds evidence that MBSR improves work performance equivalently to SSRI medication among individuals with anxiety disorders. Given the limitations of SSRIs, MBSR should be considered as an alternative to individuals who desire improved anxiety symptoms and work outcomes. ClinicalTrials.gov Identifier: NCT03522844.

Pharmacodynamics of Drugs Adaptation to Activity in Extreme Conditions

A decrease in a person’s physical and mental performance, which occurs during activity in complicated conditions, under extreme influences, determines the advisability of using drugs aimed at pathogenetically significant mechanisms and targets for the development of distress as means of pharmacological support for adaptation processes. V.V. Zakusov Research Institute of pharmacology, over the course of many years, has accumulated significant experience in performing research and applied developments in order to improve the arsenal of medicines necessary for adaptation that are superior in effectiveness to existing ones. The review presents the developments of the original anxiolytic Afobazole, the nootropic drug Noopept, the antiasthenic drug Ladasten, and the drug Loxidan, an emergency means of increasing physical performance. Information is provided on the results of new exploratory pharmacological studies for the treatment of anxiety disorders, depression, post-traumatic stress disorders, aimed at regulating the central mechanisms that determine the development of distress and emerging pathologies.

CANNABIDIOL AS A FORM OF TREATMENT FOR PATIENTS WITH POST-TRAUMATIC STRESS DISORDER FROM VICTIMS OF VIOLENCE – INTEGRATIVE REVIEW

Introduction. Violence as a social and public health problem, with a particular focus on its consequences, such as Post-Traumatic Stress Disorder (PTSD). According to the World Health Organization, violence encompasses the intentional use of physical force or power, threatening or harming individuals, groups or communities. Objective: To describe the effects of Cannabidiol on patients with Post-Traumatic Stress due to physical and psychological violence. Methodology: This is an observational and retrospective integrative systematic review, with the exclusion criteria: non-empirical articles, non-indexed publications. A total of 545 articles related to post-traumatic stress and cannabidiol were found and only 13 articles were selected to present the results of this study. Results and discussion: The endogenous endocannabinoid system plays a significant role in the processing and extinction of fear memory. Cannabidiol (CBD), a non-psychoactive component of Cannabis sativa, has shown potential in the treatment of anxiety disorders, including PTSD. CBD interacts with the endocannabinoid system indirectly by increasing the availability of endocannabinoids such as anandamide, which act on CB1 receptors in the brain. This activation of the endocannabinoid system may help reduce the behavioral response to aversive memories and improve fear extinction. Final Thoughts: While early research on the effects of CBD on PTSD is promising, more studies are needed to determine its efficacy and safety, particularly in victims of violence. Sources also emphasize the need for greater awareness and accessibility of cannabinoid-based treatments for those who may benefit from them.

Raül Andero Galí: Bridging animal and human studies to understand stress and memory

From pianist to pioneering neuroscientist, Dr. Raül Andero Galí brings a unique perspective to his role as ICREA (Institució Catalana de Recerca i Estudis Avançats) Research Professor at the Autonomous University of Barcelona (Universitat Autònoma de Barcelona). Following his PhD in Neuroscience, earning the Extraordinary Doctoral Prize, he worked alongside Dr. Kerry Ressler at Emory University's Howard Hughes Medical Institute, pioneering innovative approaches that bridge mouse and human studies in fear research. After a productive tenure as an Instructor in Psychiatry at McLean Hospital-Harvard Medical School, he established his laboratory at UAB in 2016, where he continues to break new ground in understanding how stress shapes fear memory formation. His laboratory uniquely combines sophisticated techniques, from in vivo calcium imaging in mice to human fear response studies, focusing on how sex differences and hormonal cycles influence fear processing. Through this work, his team is uncovering new possibilities for treating anxiety disorders and PTSD, offering hope for more targeted therapeutic approaches. Beyond the bench, Professor Andero has cultivated an intellectually stimulating laboratory environment that reflects his broader vision for advancing neuroscience through comparative studies. We are pleased that he completed the Genomic Press Interview, offering our readers valuable insights into both his scientific journey and personal philosophy that drives his innovative research forward.

Acceptability of Digital Mental Health Interventions for Depression and Anxiety: Systematic Review.

Depression and anxiety disorders are common, and treatment often includes psychological interventions. Digital health interventions, delivered through technologies such as web-based programs and mobile apps, are increasingly used in mental health treatment. Acceptability, the extent to which an intervention is viewed positively, has been identified as contributing to patient adherence and engagement with digital health interventions. Acceptability, therefore, impacts the benefit derived from using digital health interventions in treatment. Understanding the acceptability of digital mental health interventions among patients with depression or anxiety disorders is essential to maximize the effectiveness of their treatment. This review investigated the acceptability of technology-based interventions among patients with depression or anxiety disorders. A systematic review was performed based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and PROSPERO (International Prospective Register of Systematic Reviews) guidelines. We searched PubMed, Web of Science, and Ovid in May 2022. Studies were included if they evaluated digital interventions for the treatment of depression or anxiety disorders and investigated their acceptability among adult patients. Studies were excluded if they targeted only specific populations (eg, those with specific physical health conditions), investigated acceptability in healthy individuals or patients under the age of 18 years, involved no direct interaction between patients and technologies, used technology only as a platform for traditional care (eg, videoconferencing), had patients using technologies only in clinical or laboratory settings, or involved virtual reality technologies. Acceptability outcome data were narratively synthesized by the direction of acceptability using vote counting. Included studies were evaluated using levels of evidence from the Oxford Centre for Evidence-Based Medicine. The risk of bias was assessed using a tool designed for this review and GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). A total of 143 articles met the inclusion criteria, comprising 67 (47%) articles on interventions for depression, 65 (45%) articles on interventions for anxiety disorders, and 11 (8%) articles on interventions for both. Overall, 90 (63%) were randomized controlled trials, 50 (35%) were other quantitative studies, and 3 (2%) were qualitative studies. Interventions used web-based programs, mobile apps, and computer programs. Cognitive behavioral therapy was the basis of 71% (102/143) of the interventions. Digital mental health interventions were generally acceptable among patients with depression or anxiety disorders, with 88% (126/143) indicating positive acceptability, 8% (11/143) mixed results, and 4% (6/143) insufficient information to categorize the direction of acceptability. The available research evidence was of moderate quality. Digital mental health interventions seem to be acceptable to patients with depression or anxiety disorders. Consistent use of validated measures for acceptability would enhance the quality of evidence. Careful design of acceptability as an evaluation outcome can further improve the quality of evidence and reduce the risk of bias. Open Science Framework Y7MJ4; https://doi.org/10.17605/OSF.IO/SPR8M.

Pilot study of a parent-based intervention for functional somatic symptoms in children.

Functional somatic symptoms are associated with significant distress and impairment for children and their families. Despite the central role that families play in their children's care, there is little clinical research to guide how parents can support their children with functional somatic symptoms and promote better functioning. To address this gap, we developed a parent-based intervention for functional somatic symptoms in children and obtained preliminary data on acceptability, feasibility, treatment satisfaction, and clinical outcomes. The intervention was adapted from SPACE (Supportive Parenting for Anxious Childhood Emotions), an evidence-based treatment for anxiety and related disorders in children. The intervention, SPACE-Somatic, was delivered to parents of 16 children (Mage = 14.50 years; 75% girls) with a range of functional somatic symptoms. Parents participated in seven weekly group sessions conducted via telehealth. We found that SPACE-Somatic was acceptable, feasible, and satisfactory to parents. There were significant improvements in several clinical outcomes from baseline to posttreatment, including children's level of functional impairment, with some gains maintained at 3-month follow-up. Parents also reported improvements in their own stress and their accommodation of children's symptoms. This pilot study provides preliminary evidence that a parent-based intervention is viable and beneficial to children with functional somatic symptoms and their parents.

Cost-effectiveness analysis of mindfulness-based cognitive therapy in patients with anxiety disorders in secondary mental health care settings alongside a randomized controlled trial.

Anxiety disorder is one of the most prevalent mental disorders. Mindfulness-based cognitive therapy (MBCT) is effective for treating anxiety disorders. However, no studies have investigated the cost-effectiveness of MBCT for anxiety disorders. We aimed to conduct a cost-effectiveness analysis alongside a randomized controlled trial (RCT) to clarify the cost-effectiveness of MBCT for anxiety disorders. A cost-effectiveness analysis alongside an RCT was conducted for 8 weeks in 40 patients with anxiety disorders at a university hospital. Patients (1) aged 20-75 years; (2) who were diagnosed with panic disorder/agoraphobia or social anxiety disorder based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria; and (3) who provided written consent were analyzed. The participants were allocated randomly (1:1 ratio) to the augmented MBCT group (i.e., MBCT plus treatment as usual [TAU]) or TAU (waitlist control) group. The cost-effectiveness was assessed using the incremental cost-effectiveness ratio (ICER), which is the ratio of the incremental costs divided by the incremental state-trait anxiety inventory- state (STAI-S), state-trait anxiety inventory- trait (STAI-T), and quality-adjusted life years (QALYs). The QALYs were estimated using The Japanese version of EuroQoL five-dimensional 3-level questionnaire. The unit cost data were derived from the government-regulated fees. This study was conducted from a public healthcare insurance perspective. No discount rates were considered. A total of 38 participants with complete data were included in the analysis. The MBCT was JPY 13,885 more than the cost of TAU and was associated with a STAI-S, STAI-T, and QALY increase of 10.13, 12.00, 0.009 respectively. The ICER were JPY 1,371 (USD13) per STAI-S, JPY 1,157 (USD 11) per STAI-T, and JPY 1,566,357 (USD 14,940) per QALY respectively. MBCT had an 77.5% probability of being cost-effective at a willingness to pay threshold in Japan (JPY 5,000,000 per QALY). The results of the four one-way sensitivity analyses supported the robustness of the base-case analysis findings. Augmented MBCT for anxiety disorders is cost-effective compared with TAU post-treatment from a public healthcare insurance perspective. Future studies should include long-term observations, and analysis from a societal perspective.

Recent Progress in Synthetic and Natural Catechol-O-methyltransferase Inhibitors for Neurological Disorders.

Catechol-O-methyltransferase (COMT) inhibitors have played a crucial role in the development of potent and selective drugs for the treatment of Parkinson's disease, depression, and anxiety disorders. This review provides a comprehensive analysis of the structure-activity relationship (SAR) of COMT inhibitors, highlighting key structural features and pharmacophoric elements that govern their potency, selectivity, and pharmacokinetic properties. This review also discusses the application of SAR principles in the design and optimization of COMT inhibitors. Our analysis reveals the emergence of novel chemical scaffolds and the potential for COMT inhibitors to address unmet medical needs in neurology and psychiatry. This Perspective serves as a valuable resource for clinicians and researchers, providing insights into the rational design of COMT inhibitors and the development of next-generation therapeutics.

THE KEY CHARACTERISTICS OF THE COGNITIVE-BEHAVIORAL THERAPY AS A PERFORMANCE FACTOR IN THE PSYCHOLOGICAL PRACTICE

Cognitive Behavioral Therapy (CBT) is a modern, pragmatic, evidence-based psychotherapeutic approach. Numerous studies have proven the effectiveness of CBT in the treatment of depression, anxiety disorders, eating disorders and personality disorders. CBT is used along with the pharmacological treatment of schizophrenia, bipolar disorder, and other mental disorders. The research focuses on the main characteristics of cognitive-behavioral therapy, such as therapeutic relationship, conceptualization, psychoeducation, and relapse prevention, which are essential for therapeutic performance. The ways of reflection development are outlined, the difficulties encountered by a CBT therapist are identified. An evaluation form of the implementation of key components of CBT in practice is proposed, which includes a list of questions for sessions planning and the therapeutic plan development. Keywords: fundamentals of cognitive-behavior therapy (CBT), principles, conceptualization, therapeutic relationships, psychoeducation, reflection, relapse prevention

A review on the efficacy of artificial intelligence for managing anxiety disorders.

Anxiety disorders are psychiatric conditions characterized by prolonged and generalized anxiety experienced by individuals in response to various events or situations. At present, anxiety disorders are regarded as the most widespread psychiatric disorders globally. Medication and different types of psychotherapies are employed as the primary therapeutic modalities in clinical practice for the treatment of anxiety disorders. However, combining these two approaches is known to yield more significant benefits than medication alone. Nevertheless, there is a lack of resources and a limited availability of psychotherapy options in underdeveloped areas. Psychotherapy methods encompass relaxation techniques, controlled breathing exercises, visualization exercises, controlled exposure exercises, and cognitive interventions such as challenging negative thoughts. These methods are vital in the treatment of anxiety disorders, but executing them proficiently can be demanding. Moreover, individuals with distinct anxiety disorders are prescribed medications that may cause withdrawal symptoms in some instances. Additionally, there is inadequate availability of face-to-face psychotherapy and a restricted capacity to predict and monitor the health, behavioral, and environmental aspects of individuals with anxiety disorders during the initial phases. In recent years, there has been notable progress in developing and utilizing artificial intelligence (AI) based applications and environments to improve the precision and sensitivity of diagnosing and treating various categories of anxiety disorders. As a result, this study aims to establish the efficacy of AI-enabled environments in addressing the existing challenges in managing anxiety disorders, reducing reliance on medication, and investigating the potential advantages, issues, and opportunities of integrating AI-assisted healthcare for anxiety disorders and enabling personalized therapy.