bluuebunny/crossref_metadata_2025 huggingface dataset:
The transion of consumption patterns of heroin users in Belgrade
Authors: Vucetic-Arsic S. , Stankovic M. , Alcaz S. , Nikic M.
Published: May 2011

Objective

During the last two decades illicit drug use in Belgrade has been changed.Previously, one of the most common methods of illicit heroin use was via intravenous injection. In 1987, injecting drug, as main consumption patterns was accepted by 90,6% of patients, although intravenous administration fell to 75,5% in 1995.

The aim of the study was to observe if the main pattern of heroin consumption had changed lately.

Methods

The study included 382 illicit drug users (mean age 28,8 ± 4,7; both gender) treated in Special Hospital for Addiction, Belgrade in period of a year (Sept. 2009–2010).We used data from Pompidou questionnaire and calculated prevalence through standard survey technique.

Results

A total of 94,5% respondents reported a lifetime prevalence of heroin as a main drug, 1,1% of other opiates, 0,3% of cocaine and amphetamine. More than 92,7% of respondents used heroin in the last month regularly. The lifetime prevalence consumption mode for intranasal use was 44,3%, injecting 39,8% and smoking/ inhaling 13,9%.First injectable route experience is reported for age 17–19 = 11.9%; for 20–22 = 25.6%; for 23–26 = 30-3%. The total number of 79,8% reported negative HIV testing result, 0,5% positive result.

Conclusion

The consumption model changed in last 10 years and our study confirmed significant diversity. Intranasal administration linked with young population of heroin addicts, who never or rarely use injectable route with low level of HIV infection. Older addicts prefer intravenous use and often change to intranasal route later, for safety or damaged process of peripheral blood vessel.
Pathological media use within a population of patients with depression
Authors: Vukicevic A. , Janssen C. , Putzig I. , te Wildt B.T.
Published: May 2011

Former studies show that Internet addiction goes along with a high comorbidity rate of depression and anxiety disorders. Since the Internet offers a possibility to attain social contacts safely and anonymously, depressed individuals may be at a higher risk to develop an Internet addiction. Patients with a confirmed diagnosis of depression have been recruited from the psychiatric department of Hanover Medical School. The participants were compared with a control group concerning their media use. The two groups consisted of 25 subjects, each with 56% females and mean ages of 34,4 years (patients) and 32,4 years (controls). The depressed subjects estimate themselves more frequently to be Internet addicted and are significantly (p ≤ 0,05) less satisfied with the quantity of their media consumption. Three of the depressed fulfil the criteria for Internet addiction from Young and Beard and three more hit the softer criteria from Young. The results of the Internet addiction scale (ISS) show one subject with Internet addiction and three at a high risk. The depressed patients scored significantly higher in the ISS (p ≤ 0,01). In total, the examination found six (24%) subjects among the depressed with a problematic or pathological Internet use. For further discussion, it is remarkable that 50% of the depressive patients agreed to the criterion “uses the Internet as a way of escaping from problems or of relieving an unpleasant mood”. This may contribute to the notion, that excessive use of Internet may be interpreted as a potentially pathological compensation of depressed patients’ inner conflicts.
Alcohol-related absence from work and hospital treatment are associated with higher mortality and permanent disability among workers
Authors: Wedegaertner F. , Arnhold-Kerri S. , Sittaro N.-A. , Hillemacher T. , Bleich S. , Geyer S. , te Wildt B.
Published: May 2011

Aims

It was the aim of this study to estimate effects of alcohol abuse on early retirement and premature death in the working population with special emphasis on alcohol related absenteeism from work and inpatient treatment.

Methods

Sample consisted of 125.019 resp. 128.001 health insurance clients up to age 58 resp. 74 were used. Mean follow-up period was 6.4 years. Excess risks were calculated with Cox regression models adjusted for age, gender, education and job classification.

Results

Both alcohol-related absenteeism from work (without inpatient treatment) and detoxification treatment were associated with higher risks of early retirement (RR 2.59, CI 2.21–3.04, p < 0.001; RR 2.29, CI 1.99–2.62, p < 0.001) and premature death (RR 3.26 CI 2.74–3.88, p < 0.001; RR 4.41, CI 3.90–4.98, p < 0.001).

Further analysis showed higher risks of early retirement for males. Females who sought inpatient treatment for alcohol abuse/addiction had the highest risk of premature death (RR 7.75, CI 5.61–10.68, p < 0.001). Marked increases of the risks for permanent disablity and death during the follow-up period could also be oberserved after all-cause inpatient treatment in patients with a comorbid alcohol problem.

Conclusions

The detrimental effect of alcoholism on life expectancy and capacity to work is considerable after absenteeism from work, psychiatric treatment and all-cause inpatient treatment. While female patients in detoxification wards are a minority, they may be more strongly affected by the somatic complications of alcohol abuse. Nevertheless, strong selection biases in this subsample need to be considered and the data interpreted with caution.
Audit cut-off point at 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10: which is more informative?
Authors: Welcome M.O. , Pereverzev V.A.
Published: May 2011

The Alcohol Use Disorders Identification Test (AUDIT) scores actually vary from place to place for many reasons. The traditional/cultural/ethnic, as well as gender peculiarities of alcohol problems in the given population may affect the AUDIT cut-off recommendation. Most studies have used a cut-off point of 8, others have suggested lower or higher cut-offs. Cut-off points between 5 and 8 and/or 9 and 10 have been suggested for problem drinking. How the AUDIT cut-off point varies from study to study is somewhat misleading as validation results actually show a lower AUDIT cut-off as compared to the recommended one. In this study we analyzed the various scores (0*ndash;40) of the AUDIT using psychophysiological parameters among a sample of university students in Belarus. The statistical value for significance was set at p < 0.05. This study reveals that the AUDIT cut-off which was highly informative for problem drinking among the males is 8 and above. For the females, any positive score (i.e. from 1 through 10) on the AUDIT was highly informative for problem drinking. Hence, any positive score on the AUDIT for a female and 8 for the males needs specific attention and therapeutic confirmation with additional consultation.
Psychophysiological abstinence
Authors: Welcome M.O. , Pereverzev V.A.
Published: May 2011

How the psychophysiological functions (cognition, attention, memory, neuropsychic functions) change after alcohol use at different doses remains poorly understood. This study examines the extent to which the psychophysiological functions are restored after moderate dose of alcoholic beverages. University students (non-alcohol users; alcohol users after 1–2 weeks and 3–6 weeks of drinking) approved their participation on a consent form after the aims and objectives of the study had been explained. Continuous Tests using psychphysiological methods were applied to produce maximum stressed condition for the participants. The statistical value for significance was set at p < 0.05. No significant changes in the psychophysiological functions were noted among the non-alcohol users. There was a significant decrease in psychophysiological functions of alcohol users in course of the study. Restoration of the psychophysiological functions was recorded only among drinkers of 3–6 weeks after alcohol use. Restoration of psychophysiological functions after alcohol use may take 3–6 weeks interval (abstinence time frame i.e. psychophysiological abstinence).
Risk of resit examinations among alcohol users compared to non-alcohol users
Authors: Welcome M.O. , Pereverzev V.A.
Published: May 2011

Present researches on students drinking behavior have laid down the mechanism of low academic performance among alcohol users (Welcome et al 2010). Although we had earlier shown that alcohol significantly reduces academic performance of students, how various parameters of academic performance (e.g. frequency of resit examinations) vary among alcohol users, compared to non-alcohol users remains unknown. In this study, we examined the relative risk of resit examinations among alcohol users, compared to non-alcohol users. Students of the Belarusian State Medical University, Minsk, Belarus participated after the study aims and objectives had been explained. The AUDIT screening instrument, Academic performance questionnaire according to (Welcome et al 2010) was employed with modifications. The number of times a given student had taken the same examination was stated and numbered from 0 (zero i.e. no resit) through 3 (maximum number of times to sit for a given examination). The statistical value for significance was set at p < 0.05. The risk of resit examinations was statistically higher among alcohol users, compared to the non-alcohol users by about half-times (p< 0.05). Also, the average grade point of alcohol users was lower than that of the non-alcohol users. According to the results of this study, the risk of resit examination associated with alcohol use significantly increases among alcohol users. This is not the case for non-alcohol users.
Demographic characteristics of IV drug abusers commencing treatment in opiate detoxification centers in Iran
Authors: Yassini Ardekani S.M. , Bozorgi S. , Taghavi M.
Published: May 2011

Introduction

IV drug abuse is a medical and social problem in countries all over the world including Iran

Objectives

Knowing about the characteristics of drug abuser could help policy makers to have more precise plan of action for prevention and management of addiction

Aims

This study was designed to investigate the demographic characteristics of IV drug abusers in Iran and determining the risk factors for shifting to IV drug abuse.

Methods

150 intravenous drug addicts (147 males and 3 females) aged 19–61 referred to opiate detoxification centers in Yazd city in autumn 2008 were randomly enrolled to this descriptive cross sectional study. Data collection was undertaken through a structured interview, a questionnaire for demographic data and written documents at detoxification centers. Analysis of data was done with SPSS software (version 13).

Results

There was positive family history of addiction in 56.7%, known psychiatric illness in 43.3%, known physical disease in 32% and history of psychotropic medication abuse in 58% of participants. The mean age of onset in opium and its derivatives abusers was 19.12, heroin abusers 23.5 and IV bupropion abusers 27.2 years. The most common injecting drug at the time of study was heroin (65.2%).

Conclusion

Family history of addiction, psychiatric disease, physical illness and low education could all be risk factors for exacerbating an addiction. Identification of these risk factors could lead to the development of interventions to reduce the burden of addiction. Further research about this subject is required to determine if this is true.
Comorbidity among alcohol and tobacco dependent patients
Authors: Zoghlami A. , Blauensteiner D. , Scheibenbogen O. , Zadro-Jäger S. , Musalek M.
Published: May 2011

Introduction

Psychiatric concomitant diseases are common with alcohol and tobacco dependent patients. Few studies have compared comorbidities between alcohol dependent smokers and non-smokers.

Aims

The aim of this study is to examine the pattern of psychiatric comorbidity among alcohol dependent smokers in an inpatient alcohol therapy unit.

Material and method

After successfully completing withdrawal therapy, subjects between the ages of 18–65 years who meet the ICD 10 criteria for alcohol dependence and no criteria for other drug use disorder except smoking, and who were participating in an inpatient treatment program for alcohol dependence at Anton Proksch Institut were included.

Results

This is a preliminary analysis of the survey. In total 81 patients could be examined. 53.1% of the interviewed subjects were female and 46.9% male. The explored samples age ranged from 21–66 years.

74.1% of the questioned subjects were smokers, 60% of these patients smoked more than 20 cigarettes per day.

Preliminary analysis shows that smoking alcohol dependent patients present a higher comorbidity rate than non-smokers but above all they show a tendency to increased anxiety disorders. Within the population of smokers 48.3% suffer from an anxiety disorder, 48.3% from depression and dysthymia, 12.1% from manic and hypomanic disorder and 5.2% from psychosis. These differences are not clinically significant. This can be explained by the small number of the sample and by the group allocation.

Conclusion

Alcohol addicted patients exhibit heightened psychiatric comorbidity. Smoking alcohol dependents are more frequently affected and have a disposition to psychiatric disorders.
Effect of education on anxiety and depression in patients with myocardial infarction
Authors: Aghakhani N.
Published: May 2011

Introduction

About 65 percent of patients with myocardial infarction experience mental and emotional problems like depression and anxiety that causes delay in the return to work, decreased quality of life and increased risk of death.

The purpose of this study was to determine the effect of education on anxiety and depression in patients with myocardial infarction in Urmia hospitals in 2009.

Methods

This study was a quasi-experimental study that compares the effect of education on anxiety and depression in patients with myocardial infarction in the Urmia University of medical science hospitals. 124 patients were selected randomly and divided into two groups. The experimental group was educated through face to face training and educational booklet. Control group did not receive any intervention.

Level of anxiety and depression was evaluated by using HADS questionnaire at 3 intervals after 48 hours of admission, discharge day and 2 months after discharge.

Results

There was no significant difference between control and experimental groups before the intervention, But after the intervention, anxiety and depression in the experimental group was significantly less than controls, p < 0.05.

Conclusion

Considering the beneficial results obtained from education on reducing anxiety and depression in patients with myocardial infarction, it should be one of the health care goals.
Religiosity and personal beliefs in ocd and anxiety disorders
Authors: Agorastos A. , Randjbar S. , Muhtz C. , Jelinek L. , Kellner M. , Moritz S.
Published: May 2011

Background

In the last decades the relationship between religiosity/spirituality (R/S), personal beliefs and mental health has been extensively studied, indicating a significant correlation of these variables. However, the specific relation of R/S to anxiety disorders has been less investigated.

Objective

The objective of this prospective study is the investigation of the relation of R/S, magical ideation (MI) and paranormal beliefs (PB) to anxiety disorders in general and OCD in particular, in order to specifically determine a possible impact of these variables on psychopathology scores. In addition, the relation between R/S, PB and MI can be systematically investigated.

Design & method

Unselected samples with OCD and other anxiety disorders have been equally assessed within the first week after admission with a face-to-face interview including the following instruments: MINI, HAMD, HAMA and Y-BOCS, OCI-R, STAI, Brief Multidimensional Measure of Religiosity/Spirituality, Magical Ideation Scale and Revised Paranormal Beliefs Scale. Forty healthy participants with no psychiatric history served as controls.

Results

Groups did not differ in any aspect of R/S, MI, or PB. Almost all scales referring to R/S, PB and MI were positively correlated to each other. The results showed a strong positive correlation between high scores of negative religious coping and high psychopathology scores in depression and anxiety. On the other hand, there was a significant positive correlation between MI scores and initial OCD and anxiety scores.

Conclusion

This study verifies a significant correlation between personal beliefs and psychopathology in OCD and anxiety disorders. Implications for further research are discussed.
Gender differences in anxiety among undergraduates from twenty two countries
Authors: Alansari B.M.
Published: May 2011

Objective

The aim of the current investigation was to explore gender related differences in anxiety among undergraduates from 22 countries.

Method

Standard Arabic Version of the Kuwait University Anxiety scale (comprised of 20 brief statements, answered on a 4-point intensity scale, anchored by 1: Rarely and 4: Always) was administered to Arabic undergraduates, recruited from the following countries: Palestine, Lebanon, Syria, Iraq, Jordan, Saudis Arabia, Kuwait, Qatar, Bahrain, U.A. Emirate, Oman, Yemen, Egypt, Sudan, Tunisia, Libya, Algeria, and Morocco. (n = 608, 271, 879, 842, 948, 780, 782, 435, 154, 393, 342, 833, 1185, 275, 291, 295, 375, & 706. While the English Version was administered to American (n = 273) and Pakistan (n = 462) samples, the Germen version was administered to the Germen subjects (n = 157), Moreover the Spanish version was administered to the Spanish sample (n = 312).

Results

It was found that females significantly had higher mean anxiety scores than did their male counterparts in 15 countries: Palestine, Lebanon, Iraq, Kuwait, Qatar, Oman, Yemen, Egypt, Tunisia, Libya, Algeria, Morocco, Pakistan, American, & Spain.

Conclusion

Female preponderance of anxiety has been a consistent finding. In the present researcher opinion, the anxiety score of any given person is the end product of both biological and psychosocial factors and their interaction. Furthermore, the response styles, especially social desirability and the tendency to hyperbole had an impact on anxiety score.
Panic disorder and quality of life: a tunisian study
Authors: Aloulou J. , Halouani N. , Ben Ammar H. , Naoui R. , Amami O.
Published: May 2011

Introduction

Panic disorder with or without agoraphobia is one of the most disabling anxiety disorders. It has severe consequences on psychosocial functioning and quality of life of patients.

The aim of our study was to evaluate the quality of life in a population of patients treated for panic disorder.

Methods

Thirty patients were evaluated using a standardized questionnaire exploring socio-demographic parameters, clinical parameters and evolutionary parameters. It also explore the the disorder impact on social life, family and work.

Assessing the quality of life was performed using the (SF-36). This scale includes 36 questions divided into eight dimensions.

Statistical analysis was performed by SPSS in its 18th version.

Results

The average age of our population was 42.07 years with extremes ranging from 22 to 71years. The sex ratio was 1.

The socioeconomic level was low in 56.7% of cases, medium in 40% of cases and high in 3.3% of cases.

Half of the patients reported having marital conflicts; these conflicts had led to divorce in 3.3% of cases.

Regarding the professional impact of panic disorder, 33.3% of patients were off work, and 20% used sick leave.

The overall average scores of the SF-36 of all patients ranged from 0 to 76 with an average of 37, 98 and a standard deviation of 18.46.

Ninety percent had impaired quality of life (overall mean score of less than 66, 7) All dimensions are altered in 100% of the cases except D1 (physical dimension) that is altered in 63.7% of cases.
Prevalence, symptom patterns and comorbidity of anxiety and depressive disorders in primary care in qatar
Authors: Bener A.
Published: May 2011

Aim

To determine the prevalence of anxiety and depressive disorders in Qatari population who attend the primary health care settings and examine their symptoms patterns and co-morbidity.

Design

A cross sectional.

Setting

Primary health care center, Qatar

Subjects

A total of 2080 Qatari subjects aged 18 to 65 years were approached and 1660 (79.8%) patients participated in this study.

Methods

The study was based on a face to face interview with a designed diagnostic screening questionnaire which consists of 17 questions about symptoms and signs of anxiety and depression disorders. Physicians determined the definitive diagnosis for depression and anxiety disorders by further checking and screening their symptoms.

Results

The overall prevalence of depression and anxiety disorder was 13.5% and 10.3% respectively. Qatari women were at higher risk for depression (53.1% vs 46.9%) and anxiety disorder (56.7% vs 43.3%) compared to men. More than half of the sufferers with anxiety (56.7%) and depression (53.1%) were Qatari women with a higher frequency in the age group 18

34 years. There were significant differences between men and women with depression in terms of age group (p = 0.004), marital status (p = 0.04), occupation (p < 0.001) and household income (p = 0.002). Nervousness was the most common symptom in subjects with anxiety disorders (68.4%), whereas sleep difficulty was the most common symptom in subjects with depressive disorder (59.4%).

Conclusion

The depression was more prevalent in Qatari than anxiety disorders. The high risk groups of depression and anxiety disorders were being female, married, middle aged and highly educated.
Prevalence of specific fears in children of karachi
Authors: Bhatti U.H. , Khalid U. , Zakaria M.M.H. , Afridi I.M.
Published: May 2011

Introduction

Children's fears are not only a part of their development but can also reflect unique cultural and societal norms as well as the influence of current affairs on cognition & behaviour

Objectives

Identifying prevalent fears in children of Karachi,Pakistan and gender/age differences.

Aims

Identifying common fears and assessing the impact of sociopolitical factors on children's perception

Methods

1171 children (731 boys, 440 girls) from classes 3–10 of a large school were selected and completed the Fear Survey Schedule for Children (Revised).

Results

The highest overall fear was of’Bombing attacks/being invaded’, which was also the highest in boys (’Snakes’ in girls). The greatest gender difference was seen in the fear of lizards (p < 0.001). The overall average FSSC-R score was 133(27.5) and frequency of intense fears was 16(12.4), both higher in girls. Younger children had greater scores and intense fears compared to adolescents.

Conclusions

Children are uniquely sensitive to “adult” issues, evidenced by the highest fear overall: bombing attacks/invasions, while fear of terrorists also ranked high (#11). Fears related to academic performance increased with age whereas younger children were more fearful of items perceived as causing physical harm; reflecting that stresses of education displace fears of danger and injury. Of the ten items with the greatest gender-differences, all belonged to the “Minor Injury/Small Animals” category. Lastly, comparison with previous studies showed no significant difference (p > 0.1) in either total scores or intensity of fears, suggesting that despite varying individual fears the overall profile remained constant for children of different cultures.
Brief therapy for PTSD: role and specificity of hypnosis
Authors: Boualem S. , Semaoune P. , Ousalah A.
Published: May 2011

Throughout its history, hypnosis has often been associated with the treatment of posttraumatic stress disorder (PTSD), but the authors differ in the evaluation of its effectiveness. Hypnosis can be useful for the exposure to the event, which is necessary but not sufficient, especially when pathogenic fragments of the event are dissociated, and stand in the way of the healing process.

Specific hypnotic techniques help to access and to integrate these elements. Four clinical cases representing the type of patients we treat illustrate our approach.
Adult separation anxiety in patients with complicated grief: relationship with post traumatic stress versus mood spectrum symptomatology
Authors: Carmassi C. , Socci C. , Corsi M. , Pergentini I. , Massimetti E. , Perugi G. , Dell’Osso L.
Published: May 2011

Introduction

Around 9–20% of bereaved individuals experience symptoms of complicated grief (CG) associated with significant distress and impairment. Increasing research has been focused on identifying the distinctive set of psychiatric symptoms that characterize this condition with respect to major depression, corroborating the need to include this syndrome in the forthcoming DSM-V as a distinctive diagnosis. Vulnerability to CG has been rooted in attachment disturbances and authors reported that symptoms of separation anxiety in childhood should be considered as predictors of CG onset in adulthood.

Objectives

To date no study explored symptoms of adult separation anxiety among patients with CG with respect to healthy control subjects (HC).

Aims

To explore adult separation anxiety and mood spectrum symptoms in patients with CG with respect to HC.

Methods

53 patients with CG and 50 control subjects were recruited, Department of Psychiatry, University of Pisa. Assessments: SCID-I/P, the Inventory of Complicated Grief (ICG), the Adult Separation Anxiety Questionnaire (ASA-27), the Work and Social Adjustment Scale (WSAS), the Impact of Event Scale (IES) and the Mood Spectrum-Self Report (MOODS-SR) lifetime version.

Results

Patients with CG reported significantly higher scores on the MOODS-SR, ASA_27, IES and WSAS with respect to controls. The scores on the ASA_27 were more strongly associated with IES scores with respect to other scales.

Conclusions

Our results suggest a correlation between adult separation anxiety and CG onset after the loss of a loved one in adulthood, with a possible correlation to a post-traumatic stress symptomatology. Further studies are needed.
Gender differences in the correlations between cortisol levels or DHEA-S/cortisol ratio and panic-agoraphobic dimensions in healthy subjects
Authors: Dell’Osso L. , Carmassi C. , Massimetti E. , Corsi M. , Pergentini I. , Socci C. , Vizzaccaro C. , Da Pozzo E. , Conversano C. , Marazziti D. , Martini C.
Published: May 2011

Introduction

A link between anxiety and disfunctions of the Hypotalamic-pituitary-adrenal (HPA) axis has been widely reported in both normal and pathological anxiety, but research findings are controversial.

Objectives

To explore gender differences in the relationships between cortisol and neurosteroids and subthreshold anxiety dimensions.

Aims

To investigate the possible correlations between serum cortisol and dehydroepiandrosterone sulphate (DHEA-S) levels, or DHEA-S/cortisol ratio, and the subthreshold panic dimensions in a sample of healthy subjects.

Methods

Forty-two Italian civilians, without current or lifetime psychiatry disorders, were recruited and assessed by means of the Structured Clinical Interview for DSM-IV (SCID-I/P) and a specific questionnaire, the so-called Panic Agoraphobic Spectrum-Self Report lifetime version (PAS-SR), for assessing subthreshold panic-agoraphobic dimensions.

Results

The results showed the presence of significant negative correlations between the cortisol levels and the total scores of the PAS-SR and of the following domains: separation sensitivity, panic like symptoms and medication/substance sensitivity. The PAS-SR total and the panic-like symptoms domain scores were related positively to the DHEAS/cortisol ratio. When the sample was distinguished in women and men, it turned out that this correlations were present only in women.

Conclusions

This findings would indicate that cortisol levels are related to subthreshold panic-agoraphobic symptoms, with a gender specificity. Therefore, further studies are needed to investigate those subthreshold conditions in order to indentify possible gender differences that may account for phenotypes at higher risk for psychiatric disorders.
Different types of panic attacks-three case reports
Authors: Chai M.
Published: May 2011

Case report/ Introduction

A panic attack is an explosion of high anxiety. It is strongly associated with a sense of losing control or predicting that the very worst will happen. It is not a mental disorder, more than one in five people experience one or more panic attacks in their lifetime, but few go on to develop panic disorder or agoraphobia. There are different types of panic attacks: Cued Panic Attacks, Situational Predisposed Panic Attacks and Spontaneous Panic Attacks.

Objectives

To discuss three case reports with one year follow-up, each one of a different type of panic attack.

Case report

1 Female, 25-years-old. First panic attack at age 20, since there several spontaneous episodes with a mean of 4 a week, not related to any specific situation, event, or place, without any warning.

Case report

2 Male, 28-years-old. Has always been afraid of airplanes but it was only 3 years ago that riding on an airplane has started to trigger panic attack. He don’t experience panic attacks in any other situation.

Case report

3 Male, 31-years-old. First episode 4 years ago while driving alone and since there driving, traveling alone, enclosed spaces and crowds are more likely to trigger a panic attack but not always. They don’t have a specific fear or phobia tied to that situation or place; they simply tend to experience panic attacks when there.

Conclusion

Understanding the different types of panic attacks can help you and your doctor determine the cause of your attacks and the best way to go about treating them.
Disgust sensitivity predicts obsessive-compulsive disorder symptoms above and beyond anxiety sensitivity and negative affectivity
Authors: Chorot P. , Sandin B. , Santed M.A. , Valiente R.M. , Olmedo M. , Campagne D.
Published: May 2011

Introduction and aims

Both anxiety sensitivity (AS) and negative affect (NA) are significant general predictors of anxiety disorders, including the obsessive-compulsive disorder (OCD; Taylor, 1999). Recently, our group reported preliminary findings suggesting that disgust sensitivity was able to predict OCD symptoms, particularly contamination obsessions and washing compulsions, when controlling for AS and NA (Sandín et al., 2008). The present study examines whether disgust domains of the Cuestionario de Sensibilidad al Asco (CSA) [Disgust Sensitivity Questionnaire] predict obsessive-compulsive symptoms above and beyond AS and NA.

Method

A sample of undergraduates completed the CSA (see Valiente et al.), the Padua Inventory-Whasington State University Revision (Burns et al., 1996), the Anxiety Sensitivity Index-3 (Taylor et al., 2007; Sandín et al., 2007), and the Positive and Negative Affect Schedule (Watson et al., 1988, Sandín et al., 1999).

Results

Hierarchic regression analysis revealed that CSA was a better predictor of contamination obsessions and washing compulsions than anxiety sensitivity and negative affect. Also, CSA domains predicted differentially each obsessive-compulsive dimension.

Conclusions

Contamination-based OCD symptoms appears to be particularly associated to disgust sensitivity, specially with the CSA dimension of hygiene (it includes items such as “Seeing someone spit”, Touching the clothes of a beggar or homeless”). Assuming that contamination-based OCD is a very prevalent type of OCD, future studies on implication of this dimension in its development and/or maintenance is warranted.
Heart rate variability and dissociation in panic disorder
Authors: Diveky T. , Kamaradova D. , Grambal A. , Latalova K. , Prasko J. , Velartova H. , Trcova A.
Published: May 2011

The aim of our study is to measure very low frequency band (VLF), low frequency band (LF) and high frequency band (HF) components of R-R interval during orthostatic experiment in panic disorder patients before and after treatment.

Methods

We assessed heart rate variability in 19 patients with panic disorder before and after 6-weeks treatment with antidepressants combined with CBT and 18 healthy controls. They were regularly assessed on the CGI, BAI and BDI. Heart rate variability was assessed during 5 min standing, 5 min supine and 5 min standing positions before and after the treatment. Power spectra were computed using a fast Fourier transformation for very low frequency - VLF (0.0033 - 0.04 Hz), low-frequency - LF (0.04-0.15 Hz) and high frequency - HF (0.15-0.40 Hz) powers.

Results

19 panic disorder patients entered a 6-week open-label treatment study with combination of SSRI and cognitive behavioral therapy. A combination of CBT and pharmacotherapy proved to be the effective treatment of patients. They significantly improved in all rating scales. There were highly statistical significant differences between panic patients and control group in all components of power spectral analysis in 2nd and in two component of 3rd (LF and HF in standing) positions. There was also statistically significant difference between these two groups in LF/HF ratio in supine position (2nd). During therapy there was tendency to increasing values in all three positions in components of HRV power spectra, but there was only statistically significant increasing in HF1 component.

Supported by project IGA MZ ČR NS 10301-3/2009
Social anxiety disorder (SAD) among outpatients attending a tertiary care psychiatric service in eastern nile delta
Authors: Amr M. , El-Wasify M. , El-Gilany A.-H.
Published: May 2011

Thirty patients suffering from generalized social anxiety disorder (SAD) and diagnosed according to DSM-IV criteria attending the psychiatric outpatient clinic of a University hospital in Egypt 2009–2010 were assessed by the Liebowitz Social Anxiety Scale to estimate the severity of symptoms.Anxiety and depressive symptoms were also assessed by Hamilton anxiety rating Scale and Montgomery-Asberg Depression Rating Scale (MADRS).

The Global assessment of functioning was completed following the appointment. Forty-seven percent of the patients were males, and 53% were females. The mean age of the sample was 22.5 years, with a mean duration of SAD of 5.6 years. Forty percent of patients had a positive family history for SAD. Forty percent of patients presented with co-morbid depressive disorder, whereas 24% presented with anxiety disorder and 31% with other disorders. The age of patients was found to correlate positively with total LSAS score, but it correlated negatively with the total depressive score. The severity of social anxiety symptoms was significantly greater in patients with co-morbid diagnoses and in depressive disorders than in anxiety disorders. High Correlations between MADRS and LSAS scores were observed in depressive disorders.

Limitations

Small size of convenience sample undergoing varying treatments within a single specialist tertiary referral centre. Early recognition and treatment of SAD, may ameliorate the occurrence of depression. Follow up studies are needed to investigate the risk factors that may lead to depression in SAD.
The pre-pulse inhibition deficit in obsessive-compulsive disorder
Authors: Martoni R. , Sottocorno S. , Galimberti E. , Fadda E. , Bellodi L.
Published: May 2011

Pre-Pulse Inhibition (PPI) of the Acoustic Startle Response (ASR) is an operational measure of sensorimotor gating. Because top-level symptoms in obsessive compulsive disorder (OCD) suggest failures in inhibition processes and the pathophysiology of this disorder includes disturbances in brain regions that control PPI, we hypothesized that OCD patients should exhibit deficient PPI.

PPI was examined in 17 OCD patients and 29 healthy controls (HC). Electromyography response (EMG) was used as dependent variable. We used an acoustic stimulation and three Inter-Stimulus Intervals (ISI): 120, 60 and 30 ms.

Significant differences between OCD and HC in percent inhibition (% PPI) were found in in pp 120 ms [F = 7.71, p < .008] and in pp 60 ms [F = 10.22, p < .002] conditions. In both conditions there was no significant main effect of Block on % PPI. In pp 30 ms trials, PPI was considerably lower in patients (−0,54 ± 23,45%PPI) than healthy subjects (17,42 ± 55,99%PPI) but no main effect for group was found [F= 1.29, p=.26].% PPI correlations with clinical variables like severity of OCD symptoms, age of onset or durations of illness were not significant in our study.

Two precedent studies and this results strongly suggest that OCD patients were characterized by reduced PPI, suggesting a deficient sensorimotor gating, but it is not clear if could be a stable or a state dependent trait. Further research could focus on this issue, because if reduced PPI is a stable trait in OCD, it may qualify as an endophenotype for this disorder.
Response inhibition in the obsessive-compulsive spectrum
Authors: Sottocorno S. , Martoni R. , Galimberti E. , Fadda E. , Bellodi L.
Published: May 2011

Introduction

Some authors suggest that Anorexia Nervosa (AN) could be considered as part of the Obsessive Compulsive Spectrum. Obsessive-compulsive disorder (OCD) might be best characterized in terms of failures in cognitive and behavioral inhibitory functions. Impairments in intentionally inhibiting simple motor actions (Response Inhibition) have been demonstrated in these patients but no studies were conducted in AN patients.

Objective

The aim of this study was to evaluate Response Inhibition (RI) in patients with Obsessive Compulsive Disorder (OCD), patients with Anorexia Nervosa (AN) and Healthy Controls (HC).

Methods

29 HC, 17 patients with OCD and 15 patients with AN were recruited. Stop Signal Task (SST) selected from Cambridge Neuropsychological Test Automated Battery (CANTAB) was administered to all participants. SST is based on the Logan's theory and it gives an index of Response Inhibition, called Stop Signal Reaction Time (SSRT).

Results

A significant difference in SSRT between HC and the clinical groups was found. No differences in SSRT and number of “Direction Errors” were found between OCD and AN groups. No gender influence on the SST performance was found.OCD group showed slower reaction times to the main task than AN and HC.

Conclusion

Results from neuropsychological assessment have shown a deficit in the Response Inhibition in OCD and AN patients, in line with our hypothesis. Findings supports evidences in literature about OCD patients, but it represents a pioneer result in the contest of AN patients.
Executive dysfunctions in Anorexia Nervosa patients, obsessive-compulsive patients and their unaffected relatives: searching for a new intermediate phenotype
Authors: Galimberti E. , Sani V. , Scavelli V. , Fadda E. , Fanini F. , Bellodi L.
Published: May 2011

Introduction

Some authors suggested that Anorexia Nervosa (AN) could be part of Obsessive-Compulsive Spectrum. Evidences suggested that Obsessive-Compulsive Disorder (OCD) could be characterized by an impaired neuropsychological profile, referring particularly to cognitive flexibility, decision making and planning. It's possible that these deficits could represent possible endophenotypes that characterizes OCD spectrum.

Objectives

The aim of this study was compared, cognitive flexibility, decision making and planning in 38 patients with OCD, in 21 patients with AN and in their first degree unaffected relatives (OCD relatives: 46; AN relatives: 21). Results have been also compared to a sample of 41 healthy controls (HC) and their unaffected first degree relatives (43).

Method

All participants have been assessed by a neuropsychological battery composed by the Iowa Gambling Task (IGT), the Wisconsin Sorting Card Test (WISC) and the Hanoi Tower (TH).

Results

Results showed an impaired cognitive flexibility only in OCD patients and their relatives. Patients with AN and their relatives didn’t seem to be characterized by a deficit in this area. Results obtained from the TH scores showed an impaired planning ability both in OCD and AN patients. The same deficit has been also observed in OCD relatives. Impaired decision making seemed to characterize both AN and OCD patients, compared HC. Moreover, OCD and AN relatives showed a deficit performance, suggesting an impairment in this function.

Conclusion

Results regarding planning and decision making seem to be in line with the hypothesis that this two domains could represent possible endophenotypes of obsessive compulsive spectrum.
Smoking and respiratory irregularity at rest in patients with panic disorder
Authors: Fanini F. , Fadda E. , Galimberti E. , Sani V. , Scavelli V. , Bellodi L.
Published: May 2011

Objective

In the past decades different evidences suggested a relationship between Panic Disorder (PD) and respiration, among which the presence of different respiratory irregularities at rest in PD patients. It has been hypothesized that PD could be characterized by a dysfunction of those areas involved in the central control of respiration. The aim of this study was to unravel possible differences in the respiratory patterns at rest between PD patients and healthy controls (HC). Moreover we investigate possible mechanisms linking smoking to respiration.

Methods

Respiratory physiology has been assessed in 32 PD patients with Agoraphobia and 24 HC, for 15 consecutive minutes. Mean and standard deviation of respiratory rate (RR), tidal volume (TV), minute ventilation (VE), and end-tidal CO2 (pCO2) have been assessed.

Results

No significant difference between the two groups in all physiological indexes has been found. A significant diagnosis-by-smoking interaction has been found for RR and VT mean value (p < 0,05), that were significantly higher in non-smokers PD patients compared to non-smokers HC.

Conclusion

Results seem to suggest the existence of a peculiar equilibrium condition in PD patients. Respiratory system in PD responds to nicotine assumption differently from that of the HC. These data seem to be consistent with the hypothesis of a central homeostatic dysfunction in PD.

Further studies are needed, that take in account age of onset of smoking and number of cigarettes smoked daily. Moreover investigation on the Homeostatic Brain’ functioning should need a more integrated consideration of the cardiac, respiratory and balance systems together.
Treatment effect of cognitive behavioral psychotherapy in panic disorder - fmri study
Authors: Grambal A. , Hluštík P. , Praško J.
Published: May 2011

Introduction

The aim of our study was the correlation of regional brain activity with intensity of psychopathology and the correlation of treatment effect of CBT in patients suffering from panic disorder.

Method

Five patients suffering from panic disorder and five healthy controls were studied in fMRI during the exposition of threat-related words compared with neutral words and emotional faces compared with fixation points. Inpatients were treated with CBT (Cognitive Behavioral Therapy) and existing pharmacotherapy for 6 weeks. Patients were studied in fMRI scanner before and after the treatment. Psychopathology was assessed using Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI), The Clinical Global Impression rating scales (CGI), Panic Disorder Severity Scale (PDSS), Dissociative Experiences Scale (DES). Data were analyzed using software for functional magnetic analysis (AFNI) and compared with psychopathology rating scales.

Results

Hyperactivity of cerebellum in patient treated with CBT compared with healthy controls was observed after activation by anxiety words and faces. The scores of psychopathology rating scales decreased in patient treated with CBT and correlates with decrease of hyperactivity in cerebellum.

Conclusion

Changes of brain activity in fMRI after the CBT treatment were observed in patient suffering from panic disorder. Threat-related words and emotional faces showed cerebellum hyperactivity in patients compared with healthy controls. Decrease of cerebellum hyperactivity was observed after treatment with CBT, compared with healthy controls. Predictor of therapeutic response in fMRI was not find. Cerebellum play an important role in panic disorder.

Supported with project IGA NS 10301-3/2009
Preliminary analysis of characteristics of coping in a sample of outpatient with anxiety disorders
Authors: Grandinetti P. , Frustaci A. , Guerriero G. , Solaroli S. , Janiri L. , Pozzi G.
Published: May 2011

Introduction

The ways of coping with problems and emotions are particularly important in anxiety disorders. It is also likely that subjective functional styles help identify the mode of presentation of these disorders, regardless of diagnosis psychopathology.

Objectives

Clinical and functional investigation of outpatients attending a third-level Anxiety Disorders Unit.

Aims

To identify the most employed coping strategies and investigate whether different coping styles are linked to specific expressions of psychopathology by means of a cross-correlation analysis between dimensional measures of coping and characteristics of psychopathology.

Methods

We administered a set of instruments including SCL-90-R and Brief-COPE to 172 patients; categorical diagnoses according to DSM-IV-TR were as follows: GAD 80 (46.5%), 33 PD (19.2%), other miscellaneous 59 (34.3%). The statistical analyses of correlation between COPE and SCL scores were performed by means of Spearman's Rho.

Results

The most represented (mean score >5) coping strategies include: active coping, planning, self-blame, instrumental support, emotional support, self-distraction, acceptance, venting. Venting, denial, behavioural disengagement, and use of emotional support, show positive correlations (p ≤ 0.04) with anxiety, phobic anxiety and GSI; self-blame with anxiety and GSI. Conversely, humour correlates (p ≤ 0.04) negatively with anxiety and GSI.

Conclusions

Correlations between high scores of GSI and specific coping strategies suggest possible mechanisms of interaction between functioning styles and expressions of psychopathology. The interpretation of these findings requires further investigation of interactive mechanisms, taking into account phases of activity or remission of the clinical syndrome.
Long-term outcome in pharmacotherapy-resistant patients with panic disorder treated with cognitive-behavior therapy: 5-year follow-up
Authors: Heldt E. , Blaya C. , Kipper L. , Salum Junior G. , Hirakata V.N. , Manfro G.G.
Published: May 2011

Background

There is a limitation of data about factors associated with treatment response in panic disorder (PD) patients at long-term follow-up period. The aim of this study was to evaluate the long-term treatment response of pharmacotherapy-resistant patients with PD after 5 years of cognitive-behavior group therapy (CBGT) and to identify factors that predict this outcome.

Method

Sixty-four patients who completed 12 sessions of CBGT were followed for 5-year. Outcome measures were evaluated by the Clinical Global Impression (CGI) and quality of life (QoL) using WHOQOL-bref. Demographic and clinical features, stressful life events were the variables investigated as predictors of CBGT response across follow-up period.

Results

Treatment was associated with significant reduction in symptoms severity (agoraphobia, anticipatory anxiety and panic attacks) with maintenance of gains at 5-year of follow-up (p < 0.05). Twenty-four (40%) of the sample remained in remission after 5 years, 12 (20%) relapsed during the follow-up period and 24 (40%) were non-responder to CBGT. The poor CBGT response had an important negative impact in QoL. Regression analyzes showed that comorbidity with dysthymia (p = 0.017) and stressful life events (p = 0.012) as the most important predictors to worse response.

Conclusions

The improvement in all evaluations suggested that brief CBGT for pharmacotherapy-resistant patients could be an alternative as next-step strategy for residual symptoms with maintenance of the gains after 5 years as assessed across follow-up period. New strategies should be tried for resistant patients, such as those with dysthymia comorbidity, and some specific tool in order to cope with adverse events.