bluuebunny/crossref_metadata_2025 huggingface dataset:
Anxiety prevalence in coexisting alzheimer’s and thyroid pathology
Authors: Ioancio I. , Trascu R. , Turcu I. , Spiru L.
Published: May 2011

Background

Alzheimer disease (AD) is one of the most common neurodegenerative disorders (prevalence boosts from 0.2% in patients aged 55-65 up to 27% in patients aged 85+ years. Clinical manifestations of psychiatric disorders accompanying hypo- and hyper-thyroid function can mimic cognitive impairment.

Objectives

Our study aimed at studying the relationship between thyroid pathology, anxiety disorder and Alzheimer disease (AD).

Methods

Our longitudinal, prospective research followed 49 patients with thyroid disorders (aged 50-85 years, 93.5 females); 63.3% (n = 31) had coexisting dementia and thyroid disease while 36.7% (n = 18) were dementia-cleared (10 had mild cognitive impairment (MCI) and 8 - anxiety and/or depression); we cross/analyzed control (n = 18) and target (n = 31) groups.

Results

In the target group, 64.5% (n = 20) had hypothyroidism, 22.6% (n = 7) had euthyroid function and 12.9% (n = 4) had hyperthyroidism. The prevalence of anxiety and depression was higher in the hypothyroidism + dementia group (55.5%, n = 11) than in the hypothyroidism-only group (44.4%, n = 8). Most controls (77.8%, n = 14) had hypothyroidism while 22% (n = 4) had normal thyroid function.

Conclusions

Anxiety disorder had a greater prevalence both in the group with dementia + thyroid disease and in the MCI group. Hypothyroidism was the dominant thyroid disorder in both groups. The early diagnostic and treatment of thyroid disease is expected to improve prognosis and evolution of future cognitive disorders (MCI & AD).
Psychiatric evaluation of maladaptive male conscripts in a division of the republic of korean army: about the green camp participants
Authors: Kang S.-H.
Published: May 2011

Objectives

In this study, we aimed to elucidate the demographic and psychological characteristics of maladaptive soldiers in the Republic of Korea Army.

Methods

Study participants were 110 male conscripts who participated in the Green camp, a kind of group psychotherapy for maladaptive soldiers. All the participants were interviewed and diagnosed by a psychiatrist, and classified into two groups according to whether they left or rejoin the army. We analyzed the difference between these two groups in terms of demographic features, psychiatric diagnosis, and the Minnesota Multiphasic Personality Inventory (MMPI) subscores.

Results

Compared with soldiers who rejoined their units, those who left military service exhibited significantly lower educational level (p = 0.041) and higher rate in psychiatric treatment prior to enlistment (p = 0.011). Among the 106 study subjects, 63 (59.4%) and 23(21.7%) were diagnosed as personality disorder and adjustment disorder, respectively. Soldiers who left military service were diagnosed more frequently as mood disorder (p = 0.001) and schizophrenia (p = 0.014), respectively, than those who rejoined their units. The MMPI scores of soldiers who left military service were significantly higher on the psychasthenia (p = 0.028) and schizophrenia (p = 0.039) scales than those of soldiers who rejoined their units.

Conclusion

Most of the maladaptive soldiers were diagnosed as mental disorder. The results of this study suggest that systematic, consistent psychiatric evaluation and intervention for maladaptive male conscripts is crucial in the army.
Behavior psychoterapy in the treatment of agoraphobia
Authors: Kozarov T.
Published: May 2011

The origin of the word agoraphobia is greek word agora = squere and phobos = fear; fear of public places, streets and squares as well as separation of safety situations and people. Behaviour therapy belongs in “covering” psychoterapy which is primarly interested in actual behaviour of patient in the broadest sence of that word, from the very beginnings of the motoric and autonomous behaviour, along with private thoughts, feelings and events, till freely expressed behaviour which is available to external observation. The basis for neurosa is not entering in the situation of fear and passive avoide reaction which expresses agoraphobia.

The material: Patient J.D. 27 years old, second marriage, mother of one, sales menager, fear from independent moving lasts for 6 months. The origin of the fear is traumatic, and the basis are marriage conflicts-weather stay in marriage or to divorce for the second time (two undesirable goals).

Type of perssonality: Anxious.

The treatment: Behavioural therapy analysis, systematic desensivation in vivo, therapeutics was achieved; independently mobile in duration of 1 hour (depression as the second phenomenon has disappeared, anxiety as the leading one is reduced to minimum)
How do patients with social phobia manage interpersonal distance during social interactions ?
Authors: Lambrey S. , Voisin C. , Roucault F.-X. , Canet P. , Rauturau G. , Jouvent R. , Pelissolo A.
Published: May 2011

Personal space is the area individuals maintain around themselves into which others cannot intrude without arousing discomfort. This concept is potentially relevant in clinical psychiatry, especially in the context of disorders associated with social anxiety or social cognition disorders. Consistent with this idea, some rare studies have shown that personal space managing and interpersonal distance setting is disturbed in schizophrenic and bipolar patients. However, surprisingly, there is no data on personal space in social phobia. In this study, we aimed to investigate the characteristics of personal space in patients with social phobia using immersive and interactive virtual environments. Overall, the more the level of anxiety the more subjects leave space between themselves and others. The detailed results are discussed in the frame of cognitive models of social anxiety.
The effects of olanzapine in treatment of panic disorder with and without agoraphobia
Authors: Mokhber N. , Savadkoohi F.
Published: May 2011

Background

In this study, we have evaluated the effects of Olanzapine in treatment of panic disorder with and without agoraphobia.

Method and materials

Patients whit resistant panic disorder (resistant to tow SSRI agents) who came to psychiatric clinic of Ibn-e-Sina and Ghaem Hospitals-Mashhad during 2004–2005 were enrolled in this study. Low dose Olanzapine (2.5 milligram per day) was administered initially. ALL cases were evaluated by different psychiatric tests such as agoraphobic cognitions questionnaire panic attack and anticipatory anxiety scale, Hamilton depression test and general functional assessment.

Results

In this study, 30 patients were divided into two groups of panic disorder with agoraphobia (13 cases) and panic disorder without agrophobia (17 cases). Comparing these two groups, all indexes were improved significantly by time but The frequency of panic attacks in the last week minor panic attack duration of panic attacks agoraphobic cognition scale and Hamilton depression indexes were Improved significantly especially in those cases with panic disorder and agoraphobia Although the therapeutic response according to anxiety score, total panic attacks Hamilton depression test and general functional assessment was not showed any Difference.

Conclusion

Olanzapine augmentation has acceptable effects in the treatment of drug resistant panic disorder with agoraphobia and therapeutic effects were more significant among patients with panic disorder without agoraphobia.
Sports ballroom dances as a method of correction of anxiety at teenagers
Authors: Moskvin V.A.
Published: May 2011

Introduction

Ballrom dancing as a sport now has a great popularity in Russia, therefore it is necessary to determine features of its influence on dancer's personality.

Objectives

The hypothesis of this date has the following issue: regular employment of sports dances (under the European and Latin American program) are a method of correction of anxiety 13–14 years old teenagers.

Aims

At a preliminary investigation phase we selected ten teenagers (4 boys and 6 girls), which hadn’t been engaged in any kinds cognitive activity, except school classes and having high anxiety indicators. At the basic investigation phase teenagers became members of a dance sports club and the psychological monitoring was carried out.

Methods

During our research work we applied the test of R.Cattell (form HSPQ), the test of Ch. Spiellberger. Various methods of observation, interview, and also methods of mathematical statistics, particularly factor of correlation of K. Pearson, criterion of F. Wilcoxon were used.

Results

According to the R. Cattell test the tendency of anxiety decrease is fixed. Anxiety (scale O) was stably normalized at 80% of testees that positivly correlates with the results under the Ch. Spiellberger test results (r = 0,85). Two girls showed fluctuations of anxiety on the eve competitions.

Conclusions

Dancing sports develop ability to fruitful cooperation with adults and peer at teenagers, raise selfconfidence, form skills of self-organizing of their life. Reliable results on anxiety normalization are reached (p ≤ 0,005), hence, sports ballroom dances can be considered as a correction method for high by anxious teenagers.
The effects of CO2 inhalation in patients with chronic post-traumatic stress disorder (PTSD)
Authors: Muhtz C. , Daneshi J. , Braun M. , Kellner M.
Published: May 2011

Introduction

Panic disorder and post-traumatic stress disorder (PTSD), which is currently classified as an anxiety disorder in DSM-IV, share some clinical characteristics. Emerging evidence suggests that CO2-induced fear reactivity is associated with anxiety disorders, especially panic disorder. However, there are only very few data available about the sensitivity of patients with PTSD to carbon dioxide.

Aim

To examine the psychometric effects of CO2 on panic anxiety and PTSD symptoms in subjects with PTSD.

Methods

In 10 patients with PTSD, 10 sex- and age-matched healthy subjects and additional 8 patients with panic disorder we assessed anxiety, panic, dissociative and PTSD symptoms before and after a single vital capacity inhalation of 35% CO2.

Results

Inhalation of a single deep breath of 35% of carbon dioxide resulted in significant panicogenic and anxiogenic effects in PTSD patients versus healthy controls, which were similar to the well known responses of patients with panic disorder. Furthermore, significant pro-dissociative effects and significant provocation of post-traumatic flashbacks and PTSD symptoms were observed in PTSD patients.

Conclusions

These data provide novel evidence that panic disorder and PTSD share a common hypersensitivity to CO2 and thus might belong to the same spectrum of vulnerability.
Investigating the role of attentional disengagement bias in the tendency, ability and persistence of worry
Authors: Nelson D. , Lopian M. , Bratt N.
Published: May 2011

Introduction

Individuals with Generalised Anxiety Disorder (GAD) have an attentional bias towards threatening information. It is not known whether this results from facilitated engagement (faster orientation) or delayed disengagement (shifting attention away) from threat. Recent research has developed a new methodology designed to modify attentional disengagement from threat.

Objectives

Using this paradigm, the present study assessed the causal role of attentional disengagement from threat and its impact on worry.

Method

Twenty-four university students scoring below 56 on the Penn-State-Worry-Questionnaire were randomly assigned to either threat disengagement training, or non-threat disengagement training. Training was assessed using threat and non-threat test-trials. All participants then completed a novel worry task, assessing tendency, ability and persistency of worry. The hypothesis was that training to disengage from threat rather than non-threat stimuli would affect tendency, ability or persistence of worry.

Results

Accuracy and test-trial reaction-time data indicated disengagement training was successful; compared to the non-threat disengagement group, the threat disengagement group had faster reaction-times for non-threat valence test-trials, experienced marginally non-significantly more negative intrusions during active worry, and found it significantly more difficult to worry, when required to engage solely with worry without interruption in the worry task.

Conclusion

It is possible to manipulate attentional bias to disengage from threat information, leading to fewer negative thought intrusions during active worry and increased difficulty in engaging solely with worry, thus suggesting that impaired disengagement has a causal role in the ability to worry.
A systematic literature review of parenting behaviours exhibited by anxious people
Authors: Pape S.E. , Collins M.P.
Published: May 2011

Introduction

Research shows anxiety clustering within families: a greater proportion of children with anxious parents develop symptoms of anxiety than children with non-anxious parents. Anxious children often describe their parents as over-controlling and intrusive, lacking in affection and warmth, with reports of decreased parental support.

Objectives

(1)

to identify if parenting behaviors differ between anxious and non-anxious parents,

(2)

to discuss if these differences in behaviors can contribute to transgenerational transmission of anxiety.

Aims

Identifying whether behaviour modification could reduce familial transmission rates of anxiety.

Method

A search of OvidSP Medline, Google Scholar, and PubMed was performed, covering 1999 to 2010. Search terms used were: parenting, parents, maternal, paternal, or parental; and anxiety, PTSD, OCD, panic disorder, or phobia. 14 Papers were identified.

Results

While most papers identified differences in parenting between anxious and control parents, the conclusions were variable. Two observed increased amounts of controlling behaviour, 5 a decrease in sensitivity, 1 witnessed exageration of behaviours, and 5 a decrease in granting of autonomy or increased protectiveness.

Conclusion

The most supported differences in anxious parenting are less granting of autonomy, and lower levels of sensitivity. Whilst in isolation they cannot explain how anxiety is transmitted, and appear to be reciprocally related to child anxiety and temperament, they give grounds for further research. In particular this review identifies the need to study the above behavioral components in longitudinal studies, to observe causal effects between parent behavior and child anxiety.
Correlates of insomnia in patients with social phobia: Role of depression and anxiety
Authors: Raffray T. , Pelissolo A.
Published: May 2011

Introduction

Most of the literature examining sleep in anxiety disorders has focused on post-traumatic stress disorder and generalized anxiety disorder. Few studies have examined sleep disturbances in social phobia. Yet, social phobia has a lifetime prevalence of 12%. Previous studies assessed sleep disturbances in small samples of individuals with social phobia. Most studies reported bivariate analysis, the only multivariate analysis being in non treatment-seeking individuals.

Objectives

To assess insomnia severity in a population of treatment-seeking patients with social phobia and investigate correlations between insomnia, depression, general anxiety, and social anxiety.

Aims

To demonstrate that positive associations exist between anxiety, depression, and insomnia in patients with social phobia, depression contributing the most to insomnia severity.

Methods

One hundred and seventy-nine treatment-seeking individuals with a DSM-IV diagnosis of social phobia completed the Insomnia Severity Index (ISI), the Hospital Anxiety and Depression Scale (HAD-A and HAD-D) and the Liebowitz Social Anxiety Scale (LSAS).

Results

Two-thirds of our sample had insomnia. Depression, anxiety, social anxiety, and insomnia were positively correlated. Sex, HAD-A and LSAS significantly contributed in explaining the ISI total score after accounting for age, medication use, and depression, whereas HAD-D was not a significant contributor. The model explained 33.5% of the overall variance.

Conclusion

Assessing sleep quality and quantity, and understanding the interactions between insomnia, anxiety and depression, is needed to improve treatment in patients with social phobia and could allow adapting cognitive and behavioral therapy for insomnia programs to social anxiety.
Broadening diagnostic criteria of generalized anxiety disorders from DSM-IV: The impact on patient level of disability
Authors: Alvarez E. , Carrasco J.L. , Olivares J.M. , Pérez M. , López-Gómez V. , Vilardaga I. , Rejas J.
Published: May 2011

Purpose

To explore the consequences of broadening DSM-IV criteria for Generalized Anxiety Disorder (GAD) on patient's disability.

Methods

A multicentre and observational study was carried-out in outpatient psychiatric clinics in Spain between years 2007 and 2008. Naïve diagnosed patients with GAD according to DSM-IV criteria or with anxiety symptoms fulfilling broadened criteria were compared. At least 1-month of excessive or non-excessive worry along with only two of the associated symptoms listed on DSM-IV for GAD were considered as broadened GAD criteria. Socio-demographic data, medical history and functional outcome measures were recorded.

Results

A total of 3,549 patients were systematically recruited, 12.8% excluded because not found eligible for inclusion in analysis; 1,815 in the DSM-IV group (DG) and 1,264 in the broadening criteria group (BG). Both groups were similar on their sociodemographic characteristics. Total disability score in the WHO-DAS II scale was slightly, but statistically significant, higher in DG; 41.9 (17.1) versus 38.9 (16.0) points, p < 0.05. These weak differences were observed in all of the scale domains but mainly in domains “Getting around” [34.5 (23.6) versus 29.4 (22.8), p< 0.05] and “Life activities” [55.5 (27.1) versus 52.1 (26.2), p< 0.05], since differences in the other domains, even statistically significant, were negligible.

Conclusion

Patients with standard DSM-IV criteria for GAD appears to show slightly, but significant, worst level of disability than subjects with broadening diagnostic GAD criteria. Life-activities and participation in society domains seems to be the functional domains most impacted by symptoms of anxiety.
Effect of pregabalin on generalized anxiety disorder patients with severe symptoms of anxiety and depression refractory to duloxetin
Authors: Olivares J.M. , Carrasco J.L. , Alvarez E. , Pérez M. , López-Gómez V. , Vilardaga I. , Rejas J.
Published: May 2011

Purpose

The purpose of this research was to analyse the effect of adding Pregabalin (PGB) on severe symptoms of anxiety and depression in patients with Generalized Anxiety Disorder refractory to duloxetin in daily medical practice in Spain.

Methods

This is a post-hoc analysis of a 6-month multicentre, prospective and observational study carried out in outpatient psychiatric clinics in Spain. Men and women, above 18 years, with a diagnosis of GAD according with DSM-IV-TR criteria, pregabalin naïve and refractory to a previous course of duloxetin (3 months or more) and severe symptoms of anxiety (HAM-A ≥ 24) and depression (MADRS ≥ 35) were considered eligible for analysis.

Results

A total of twenty-five patients [76% women, mean age; 49.3 (11.8) years, 82% with a comorbid depressive disorder] fulfilled criteria for analysis, and were previously exposed to duloxetin [mean dose: 71.7 (26.7) mg/day] for an average of 6.7 (3.7) months. Adding pregabalin [mean dose: 172.8 (75.5) mg/day], during 5.2 (1.8) months, reduced both anxiety and depressive symptoms by a mean of, respectively in HAM-A and MADRS scales, 54.1% (from 36.5 ± 4.3 pts to 16.6 ± 9.1 pts; p < 0.001, effect size: 4.63) and 52.8% (from 40.4 ± 4.6 pts to 19.0 ± 11.0 pts; p < 0.001, effect size: 4.65). As a result, the percentages of patients without symptoms of either anxiety or depression were 30% and 24%, respectively.

Conclusion

Despite small sample, adding pregabalin had a meaningful and significant effect on severe symptoms of anxiety and depressive symptoms in patients with severe GAD and concomitant depressive disorder resistant to duloxetin.
Quantifying contributions for anxiety variability in adolescence: “Missing parts” of the phenotype definition
Authors: Salum G.A. , Manfro G.G.
Published: May 2011

Introduction

Although several risk factors for anxiety-related phenotypes have been identified, few studies have quantified the weight of each one of these factors.

Objective/aim

The aim of this study is to quantify contributions for anxiety variance in adolescents.

Methods

Ninety-seven adolescents from a community cross-sectional study and their parents were assessed with a structured DSM-IV diagnostic interview, several psychiatric and environmental rating scales and with a nutritional evaluation. The whole evaluation protocol generates 31 constructs previously associated with anxiety-related phenotypes in the literature. These constructs were organized in a hierarchical block analysis as follows:

(1)

socio-demographic and early life environment;

(2)

family environment and maternal psychiatric symptomatology and temperament;

(3)

stressfull life-events and maltreatment;

(4)

physical health and nutrition. The Screen for Children and Adolescent Related Anxiety Disorders (SCARED) was used as outcome.

Results

The results of our hierarchical model accounts for only 24% of the total SCARED score. Hierarchically, block one and two did not explain significantly the SCARED variability (r2 = 0.078; p = 0.011 and r2=0.106; p = 0.064/pincremental = 0.090). After the inclusion of block 3, the hierarchical model achieved statistical significance (r2 = 0.231; p = 0.001/pincremental = 0.001), with little additional explanation after the inclusion of block 4 (r2 = 0.243; p = 0.001/pincremental = 0.242).

Conclusion

Even after an extensive exploratory analysis we were able to explain only about one fourth of anxiety symptoms variability in adolescents. Our findings support the notion that we still have a distant comprehension of the factors that lead to anxiety in adolescents and that the major determinants of anxiety disorders in adolescence are still missing.
Domains of disgust sensitivity in a spanish nonclinical sample
Authors: Sandín B. , Olmedo M. , Chorot P. , Valiente R.M. , Santed M.A. , Campagne D. , Callejas B.
Published: May 2011

Introduction and aims

Disgust has been characterized as a basic emotion, with unique physiological, behavioral and cognitive features. Although emotions have been a main subject of psychopathology over the last decades, disgust has recently been labelled as a “forgotten emotion” in psychiatry. In their original work, Haidt et al. (1994) outlined 8 domains of disgust elicitors: food, animals, body products, body envelope violation, death, sex, and hygiene, and a domain of sympathetic magic. While there is some variability in people's disgust sensitivity, this emotion has a fairly recognizable set of elicitors within a given culture. The aim of this work was to examine the kinds of domains in which Spanish experience disgust.

Method

We asked participants (students of psychology at the UNED) to describe:

(a)

the five most disgusting experiences of their lives,

(b)

the distress reactions experienced during these experiences,

(c)

and to list all things that provoke reactions of disgust to him/her or to other people.

Results

Descriptions of disgusting stimuli, objects and behaviors were conceptually classified in the following 11 domains: body products, animals, foods, envelope violations, hygiene/dirt, putrefaction, socio-moral, sex, death, disease, and marginalization/poverty. The largest of these domains were body products, animals and foods, which accounted for 64% of all descriptions. The more distressing reactions were related to body products, foods and hygiene.

Conclusions

We replicated the domains previously found by Haidt et al. (1994), except the area of sympathetic magic. Our data also provide support for new kinds of disgust elicitors, named socio-moral, death, and marginalization/poverty.
Relationship between social support and social support in favorable interactions with the general depression,feel anxiety and lack of arousal
Authors: Shabani S. , Ahmadi Gatab T. , Delavar A. , Saleh Ahangar K.
Published: May 2011

Introduction

The theory of social support can influence the overall broad range of social networks on people to create positive experiences that people bring, the experience can feel the predictability and stability in situations of life and enhance self-worth is effective.

Objectives

This study reviews the relationship between social support and social support optimal interactions with general depression, lack of arousal and anxiety felt among the students was fun.

Methods

The study sample of 293 students are Tabatabai University.

Results

The status of students in the social protection component interactions in daily emotional support, emotional support and protect significant issue oriented issue is above average and good social support in daily emotional support component, useful daily support and protection issue higher orbit are average. Pearson correlation results show that social support and favorable interactions with the general depression, anxiety and lack of arousal feel in 0 / 05 and 0 / 01 is significant and negative relationship with one another are significant. Regression analysis showed that the spatial step feel and lack of arousal component of anxiety in social support interactions to predict depression and components of general social support will predict the optimum.

Conclusions

The results of this study also shows that the highest correlation between social support and lack of interaction feel is the highest correlation between social support and depression in general is good.
The relationship between social support in interactions, favorable social support and general depression, anxiety arousal and lack of feeling of pleasure
Authors: Shabani S. , Ahmadi Gatab T.
Published: May 2011

Introduction

The theory of social support can affect the extensive networks of social communications on people generally and causes the positive experiences for people, these experiences can be effective on feeling of predictability and stability in situations of life and enhancement of self-worth.

Objective

The purpose of this study is the investigation of relationship between social support in interactions, favorable social support and general depression, anxiety arousal and lack of feeling of pleasure among students.

Method

The statistical sample of study includes 293 students of Allame Tabatabaee University.

Results

The status of students is above the average in social support in interactions in components of daily emotional support, problem-centered emotional support and problem -centered support and it is above the average in favorable social support in components of daily emotional support,useful daily supports and problem-centered support.the results of Pearson correlation show that: social support in favorable interactions with general depression, anxiety arousal and lack of feeling of pleasure is significant in level of 0 / 05 and 0 / 01 and have negative significant relationship together. Regression analysis indicated that the components of lack of feeling of pleasure and anxiety arousal predict social support in interactions and component of general depression predicts the favorable social support.

Discussion

Also, the results of present study show that: there is the highest correlation between social support in interactions and lack of feeling of pleasure and there is the highest correlation between favorable social support and general depression.
Dysfunction of Ca2+/ CaM kinase IIA cascades in basolateral amygdala of posttraumatic stress disorder rats
Authors: Shi Y. , Han F.
Published: May 2011

Objective

To explore changes of Ca2+-CaM-CaMKIIα in basolateral amygdala of PTSD rats may reveal part of the pathogensis.

Methods

The SPS-method was used to set up the rat PTSD models. A total of 90 male Wistar rats were randomly divided into1d, 4d, 7d, 14d groups of SPS and normal control groups. The intracellular free calcium level in basolateral amygdala was examined by fluorescence spectrophotometer. CaM and CaMKIIα expression in basolateral amygdala were examined by immunohistochemistry, western blotting and reverse transcription-polymerase chain reaction (RT-PCR).

Results

The intracellular free calcium level reached the peak 1 day after SPS stimulation, then gradually decreased to normal level. The expression of CaM 1day after SPS is also the most and then decreased to normal level. In contrast, CaMKIIα expression showed a significant down-regulation 1day after SPS throughout and then gradually increased to normal level. This findings suggest dysfunction of Ca2+-CaM-CaMKIIα in basolateral amygdala of PTSD rats.

Conclusion

Thus, the trauma-induced enhanced anxiety appear to be associated with, and possibly caused by, changes of Ca2+-CaM-CaMKIIα in basolateral amygdala.
Orbitofrontal hyperactivity in social anxiety disorder patients: An fmri study
Authors: Sladky R. , Kraus C. , Tröstl J. , Kasper S. , Lanzenberger R. , Moser E. , Windischberger C.
Published: May 2011

Introduction

Social anxiety disorder (SAD) refers to persistent fear of social situations in which the person is exposed to possible scrutiny by others. Anxiety disorders are associated with dysbalanced inhibition within the limbic system towards threatening stimuli (Phillips 2003). It has been shown SAD patients are particularly sensitive towards faces displaying harsh emotions (Phan 2006).

Objectives

In this study we used fMRI to investigate activation differences between 14 SAD patients and 15 matched healthy controls. The subjects performed a facial emotion discrimination paradigm including a control condition using shape discrimination (modified version of Hariri 2002).

Aims

The aim of this study was to investigate emotion task-specific differences in brain activation of patients and healthy controls.

Methods

After clinical assessment, 225 whole-brain volumes (TR = 1.8s) were acquired on a Siemens TRIO 3T MR scanner and analyzed using SPM8.

Results

The paradigm activated the amygdalae, the fusiform gyri, the posterior cingulate cortex and the orbitofrontal cortex (OFC) (A). There was a hyperactivation of the OFC in patients compared to healthy controls (B). We found no significant difference in the amygdalae or fusiforme gyrus.

Conclusion

Although not in a social threat situation, SAD patients showed more activity in the orbitofrontal cortex. In contrast to other studies we found no differences in other brain areas indicating an optimized control condition. According to the functional coupling between prefrontal areas and the amygdalae, these data are consistent with an increased effort in down-regulating amygdalar activation by the orbitofrontal cortex.
From secondary gain to permanent disability
Authors: Softic R.
Published: May 2011

Introduction

Secondary gain was defined in terms of interpersonal, and social advantage achieved by patient as outcome of the illness. It helps the Ego to incorporate the symptom(s). Secundary gain is unconcious mechanism. It shouldn’t be mixed up with malingering or factitious disorder.

Case report

45 years old male patient was hospitalized at a Clinic of Psychiatry in Tuzla complaining the memory inpairment, confusion, and weakness of right arm and leg. The patient had been hospitalized at the Clinic of Neurology few months prior to actual hospitalisation. Diagnostic procedures, including MRI of the brain were done. Despite of negative tests results the diagnosis of ischemic stroke was made. During clicical observation the diagnosis of Dissociative motor disorder was postulated.

Conclusion

The dissociative disorders is common in clinical practice. Existence of strong secondary gain may lead to chronicity and working and social dysfunction.
Long-term treatment with agomelatine: prevention of relapse in patients with generalised anxiety disorder over 6 months
Authors: Stein D. , Ahokas A. , Allgulander C. , Soegaard J. , Bitter I. , Lehtmets A. , Wahlstedt K. , Van Amerigen M.
Published: May 2011

Aim

This study assessed the efficacy of agomelatine (1,2,3), in the prevention of relapse in non-depressed out-patients with DSM-IV-TR defined Generalized Anxiety Disorder (GAD) and the tolerability.

Methods

GAD patients received open label agomelatine (25–50 mg/day). At week 4 the dose was increased for patients with insufficient improvement (blinded criteria). At week 16, responders were randomised to maintenance treatment with either agomelatine, or placebo for a 26 week period. Then, agomelatine treated-patients were re-randomised to an agomelatine arm or to a placebo arm, to confirm the lack of discontinuation symptoms (on the DESS check-list).

The primary outcome was the time to relapse (days) during the 26 week double-blind treatment period, as estimated using the Kaplan-Meier method. Relapse was defined as HAMA total score > = 15 or withdrawal for lack of efficacy (in the investigator's opinion, based on both HAM-A and CGI scores).

Results

477 patients entered the open-label phase and 329 completed this period. 228 patients were randomly assigned to receive agomelatine (114 patients) or placebo (114 patients).

The incidence over time of relapse was significantly lower with agomelatine compared to placebo (19.7% versus 31.7% log rank test p = 0.046) during the double-blind treatment period.

During the double-blind treatment period 12.4% patients with agomelatine and 9.6% with placebo reported at least one emergent adverse event related to the study treatment. There was no discontinuation syndrome in agomelatine treated patients.

Conclusion

Agomelatine was efficacious in preventing relapse in GAD, with maintenance of efficacy over 6 months, and good tolerability.
Reduced connectivity in the uncinate fiber tract between the frontal cortex and limbic subcortical areas in social phobia
Authors: Tröstl J. , Sladky R. , Hummer A. , Kraus C. , Moser E. , Kasper S. , Lanzenberger R. , Windischberger C.
Published: May 2011

Introduction

Several fMRI and resting-state connectivity studies have demonstrated alterations in the limbic system and frontal areas in social anxiety disorder (SAD).

Aims

Here we used high-resolution whole-brain diffusion tensor imaging (DTI) to examine differences in anatomical connectivity between patients and controls in the white matter.

Methods

We examined 14 SAD patients (age 26.3 ± 9.0y) and 15 healthy controls (age 25.6 ± 3.3y) using DTI on a 3T Trio MRI scanner (Siemens, Germany). DTI acquisition with 1.6 mm isotropic resolution was performed in 30 directions and a maximum b-value of 800. Fractional anisotropy (FA) maps were obtained using FSL. Group analysis was performed in SPM8 (two sample t-test).

Results

The figure shows a coronal slice through the uncinate fasciculus. Arrows point to areas where SAD patients show decreased FA-values compared to controls (p < 0.05). Note that these areas are limited to the uncinate fasciculus and are found bilaterally.

Conclusion

Reduced FA-values indicate a reduction in anatomical connectivity strength. Our study thus clearly shows reduced connectivity strength in the uncinate fasciculus connecting frontal regions with limbic areas as the amygdalae and hippocampus. This reduced structural connectivity supports functional data demonstrating alterations of brain activation in the amygdala and prefrontal regions in social phobia.
P01-183 The disgust sensitivity questionnaire [cuestionario de sensibilidad al ASCO, CSA]: A new self-report measure of disgust
Authors: Valiente R.M. , Sandín B. , Chorot P. , Santed M.A. , Campagne D. , Olmedo M.
Published: May 2011

Introduction and aims

Some theory and empirical-driven classification systems of disgust have stimulated the creation of several self-report instruments for the assessment of disgust sensitivity [e.g., the Disgust Scale-Reviesed (DS-R,Haidt et al., 1994) and the Disgust Propensity and Sensitivity Scale-Revised (DPSS-R; van Overveld et al., 2006;Sandín et al., 2008)]. Two main problems of current self-report scales of disgust are that

(a)

there is not a consensus about the domains of disgust to be assessed, and

(b)

all self-report scales were developed in the Anglo-Saxon culture.

Given the particular relationship of disgust to the individual's culture, it is desirable to construct self-report instruments based in other cultures.The aim of this work was to develop a new self-report instrument based in a Spanish-speaking population.

Method

The 11 domains (see Sandín et al.) in which Spanish people experience disgust served to define a broad range of disgust elicitors in our Cuestionario de Sensibilidad al Asco (CSA) [Disgust Sensitivity Questionnaire]. The initial questionnaire (92 items) was given to a sample of undergraduates at Universidad Nacional de Educación a Distancia. Based on factor and item analysis, sixty-two items were finally retained.

Results

Exploratory factor analysis of the 62 CSA items revealed a robust eleven-factor structure, describing the following 9 dimensions of disgust: hygiene, socio-moral, sex, envelop violations/death,animals, disease,atypical food, animal decomposition, and unacceptable food. Internal consistency (alpha coeffients and corrected item-total correlations) was excellent.

Conclusions

Findings suggest that the CSA is a promising new measure of disgust. The CSA demonstrated excellent factorial validity and reliability.
The role of group treatment for obsessive-compulsive disorder
Authors: Zampetaki C. , Delimpalta C. , Varouchaki E. , Zampogiannis A.
Published: May 2011

Introduction

Obsessive-Compulsive Disorder (OCD) is characterized by recurrent intrusive thoughts and/or repetitive behaviors carried out in a ritualistic fashion. Both obsessions and compulsions are ego-alien and produce anxiety if resisted. Cognitive behavioural therapy (CBT) based on exposure and response prevention (ERP) and pharmacotherapy are currently the most popular choices of treatment.

Objective

Individual CBT/ERP with or without psychopharmacological treatment has been established as the treatment of choice for OCD, but group CBT/ERP has received little attention although it has been proposed as a cost-effective alternative. The aim of this paper is to explore its pros and cons.

Method

Review of the current literature.

Results

Group CBT/ERP appears to be equally effective as individual, although the latter has been associated with a more rapid rate of improvement. Both achieve similar reductions in anxiety and depressive symptoms and have similar dropout rates. Group theray is also acceptable to most patients and saves time and money to both patients and doctors. It is not documented whether it achieves change of the same magnitude as the individual format of the respective treatment. Patients with more severe global symptoms are less likely to respond to the group format, therefore an attempt to reduce these symptoms prior to the treatment of OCD may be necessary.

Conclusion

Group treatment is an effective treatment for OCD in the long term, but more research needs to be done to compare the effectiveness of group and individual treatment formats.
Efficacy of adjunctive aripiprazole to lithium or valproate in the long-term treatment of mania in subjects with bipolar i disorder (CN138–189)
Authors: Abbar M. , Khan A. , Rollin L. , Sanchez R. , Carson W. , Morris B. , Timko K. , Marcus R.
Published: May 2011

Objectives

To evaluate the long-term safety and efficacy of adjunctive aripiprazole (ARI) to lithium (LI) or valproate (VAL) in delaying time to relapse in bipolar I disorder.

Methods

Bipolar I disorder subjects with a current manic or mixed episode received LI or VAL for at least 2 weeks; inadequate responders (YMRS score ≥ 16 and ≤35% decrease from baseline at 2 weeks) received adjunctive ARI. Subjects maintaining mood stability (YMRS and MADRS ≤ 12 for 12 consecutive weeks) were randomised 1:1 to double-blind ARI (10 to 30 mg/day) or placebo (PBO) plus LI or VAL. Relapse was monitored up to 52 weeks.

Results

337 subjects were randomised to continuation of mood stabiliser plus adjunctive ARI or PBO; 61.3% and 52.7%, respectively, completed the study. Adjunctive ARI significantly delayed the time to any relapse, hazard ratio = 0.544 (95% CI: 0.33, 0.89, log-rank p = 0.014). Overall relapse rates at 52 weeks were 14.9% and 25.4% in ARI vs PBO subjects. A superior reduction in CGI-BP Mania Severity of Illness from baseline at 52 weeks was also observed (0.3 vs. 0.0, respectively, p = 0.01). Adverse events generally were as expected per known drug and illness profiles with no significant difference in mean change in body weight between adjunctive PBO (0.60 kg) and adjunctive ARI (1.07 kg) (p = 0.49 Week 52, LOCF).

Conclusion

Continuation of aripiprazole treatment increased time to relapse to any mood episode compared with placebo plus LI/VAL over 1 year, indicating a long-term benefit in continuing adjunctive aripiprazole to a mood stabiliser after sustained remission is achieved.
Strong scalability indexes for a new self-rating scale for mania and depression
Authors: Adler M.
Published: May 2011

The Affective Self Rating Scale (AS-18) was developed in response to clinical need for a user friendly self-rating scale for simultaneous assessment of depression, mania and mixed affective states in outpatient settings. The two subscales of AS-18 have nine items each (AS-18-M and AS-18-D). There are five levels of response categories graded from 0 to 4. AS-18 has been evaluated in two samples of bipolar 1 patients, using the non-parametric Mokken method. The Mokken method was especially developed for analysis of scales of ordinal type and gives scalability indexes that are measures of the ability of items and a full scale to rank persons according to their total score on a common dimension (unidimensionality).

The AS-18 have in two samples shown scalability indexes above the generally accepted cut-offs of ≥ 0.3 for items and ≥ 0.5 for a strong full scale.

Conclusion

AS-18 has good basic psychometric properties. It takes only a few minutes for patients to perform and is suitable for routine use in outpatients with bipolar 1 disorder.
Mixed affective states; a study within a community mental health team with treatment recommendations
Authors: Agius M. , Singh S. , Ho J. , Zaman R.
Published: May 2011

Introduction

Agitated Unipolar Depression and Bipolar mixed states combine depressive and manic symptoms, reflecting severe forms of affective disorders with an increased suicide risk. These states have not been defined with adequate consensus and hence present a diagnostic and therapeutic challenge.

Method

We searched the records of patients with Affective Mixed States in a community Mental Health Team to identify patients with affective mixed states.

We assessed the treatments prescribed and the time it took to treat the Mixed states so that they then suffered from depression or were euthymic.

Results

Ten out of 17 patients were suicidal when experiencing a mixed state. Of the 6 patients that were agitated, 5 were suicidal. Best results were achieved with a combination of -Reducing antidepressant -Increasing mood stabilisers (Depakote, Lithium) -Increasing/adding atypical antipsychotics. With such treatment, the average duration to resolution was 2.5 weeks. The worse results were achieved by adding antidepressants to a patient experiencing low mood with a mixed state such treatment led to resolution in 10 weeks

Discussion

Agitation is a strong predictor of suicide risk. Reducing antidepressants is important thus Increasing/adding antipsychotics and mood stabilisers without changing antidepressants led to an 8.5 weeks duration of treatment.

Conclusion

Patients with mixed states should be reviewed regularly and risk-assessed -We suggest weekly due to increased suicide risk. With very high-risk patients, referral should be made to the Crisis Team. Care coordinators should be involved for regular contact with services.
Bipolar depression symptoms across the lifespan
Authors: Al Jurdi R.K. , Gyulai L. , Sajatovic M. , Nguyen C.X.
Published: May 2011

Introduction

A paucity of evidence describes the presentation of depression across age groups among patients with bipolar disorder.

Objectives

We explored the symptoms and the severity of acute bipolar depression in a multicenter, naturalistic follow-up study for treating bipolar disorder.

Aims

To investigate whether specific depression symptoms are more frequent and/or severe in the elderly with bipolar disorder compared to a younger cohort.

Methods

The Systematic Treatment Enhancement Program for Bipolar Disorder is a National Institute of Mental Health-funded project to evaluate the longitudinal outcome of patients with bipolar disorder. Patients were categorized with “depression” if they experienced at least two consecutive weeks of five clinically significant depression symptoms (change in sleep or appetite; decreased energy; low mood, guilt or low self-esteem; anhedonia; decreased concentration or increased distractibility; psychomotor agitation or retardation; and presence of suicidal thoughts, intent or plans). Patients were stratified by age, (20-59 and >60), and data of all diagnosed with depression were analyzed.

Results

Of 3,615 participants with bipolar subtype-I or II, 1,564 were diagnosed with depression. Ninety-eight (6.3%) were at least 60 years of age. The most common symptoms in both groups were anhedonia and decreased energy. Younger adults were more likely to have low self-esteem, distractibility, and psychomotor agitation. Except for decreased sleep in the younger cohort, the severity of symptoms was comparable between groups. The two cohorts had a Clinical Global Impression score of 3.99 (p = .887).

[Step BD- Depression Rating Guidelines]

[STEP-BD Bipolar Depression Symptoms by Age]

[STEP BD Bipolar Depression Symptom Severity]

Conclusions

Presenting symptoms and severity of depression in patients with bipolar disorder are comparable across age groups.
Theory of mind and neurocognitive functioning in patients with bipolar disorder
Authors: Assion H.-J. , Wolf F. , Brüne M.
Published: May 2011

Objectives

Studies into social cognition in psychiatric disorders have recently been expanded to address the questions whether or not “theory of mind” (ToM), that is, the ability to represent own and others’ mental states, is impaired in bipolar affective disorder (BPD).

Results have been mixed so far, mainly due to possible confounding effects of neurocognition, as well as, clinical factors such as acuity and current mood. Here, we explored ToM and its associations with neurocognitive functioning in BPD.

Methods

33 patients with bipolar I disorder (of which 12 were currently depressed, 10 manic, and 11 remitted) and 29 healthy controls were assessed using a test battery that was identical to the one that was used in previous studies into schizophrenia, comprising diverse neurocognitive tasks, including measures of intelligence, executive functioning, and ToM tasks.

Results

The bipolar patient group as a whole, as well as all three clinical subgroups, were impaired on all measures of ToM relative to controls, but did not differ from each other in most ToM scores. Patients’ poorer performance on executive tasks did not fully explain ToM differences between patients and controls, suggesting a partially selective ToM deficit in BPD.

Conclusions

Patients with BPD are impaired in ToM, partially independent of other cognitive dysfunctions and current mood.