Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Anxiety Disorders: HELP
Articles from Brisbane
Based on 270 articles published since 2009
||||

These are the 270 published articles about Anxiety Disorders that originated from Brisbane during 2009-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11
1 Guideline Clinical pathway for the screening, assessment and management of anxiety and depression in adult cancer patients: Australian guidelines. 2015

Butow, Phyllis / Price, Melanie A / Shaw, Joanne M / Turner, Jane / Clayton, Josephine M / Grimison, Peter / Rankin, Nicole / Kirsten, Laura. ·Psycho-Oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia. · Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia. · Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Australia. · HammondCare Palliative & Supportive Care Service, Pallister House, Greenwich Hospital, Sydney, NSW, Australia. · Sydney Medical School, University of Sydney, Sydney, NSW, Australia. · Chris O'Brien Lifehouse, Camperdown, NSW, Australia. · Sydney Catalyst Translational Cancer Research Centre, Camperdown, NSW, Australia. · Nepean Cancer Care Centre, Sydney West Cancer Network, Kingswood, UK. ·Psychooncology · Pubmed #26268799.

ABSTRACT: PURPOSE: A clinical pathway for anxiety and depression in adult cancer patients was developed to guide best practice in Australia. METHODS: The pathway was based on a rapid review of existing guidelines, systematic reviews and meta-analyses, stakeholder interviews, a Delphi process with 87 multidisciplinary stakeholders and input from a multidisciplinary advisory panel. RESULTS: The pathway recommends formalized routine screening for anxiety and depression in patients with cancer at key points in the patient's journey. The Edmonton Symptom Assessment System or distress thermometer with problem checklist is recommended as brief screening tools, combined with a more detailed tool, such as the Hospital Anxiety and Depression Scale, to identify possible cases. A structured clinical interview will be required to confirm diagnosis. When anxiety or depression is identified, it is recommended that one person in a treating team takes responsibility for coordinating appropriate assessment, referral and follow-up (not necessarily carrying these out themselves). A stepped care model of intervention is proposed, beginning with the least intensive available that is still likely to provide significant health gain. The exact intervention, treatment length and follow-up timelines, as well as professionals involved, are provided as a guide only. Each service should identify their own referral network based on local resources and current service structure, as well as patient preference. DISCUSSION: This clinical pathway will assist cancer services to design their own systems to detect and manage anxiety and depression in their patients, to improve the quality of care.

2 Editorial New Directions in Alleviating Anxiety in Older Adults: Applications, Modifications, and Innovations. 2017

Beaudreau, Sherry A / Pachana, Nancy A. ·a VA Palo Alto Health Care System , Stanford University, School of Medicine, and The University of Queensland , Brisbane , Australia. · c Guest Editors. · b The University of Queensland , Brisbane , Australia. ·Clin Gerontol · Pubmed #28452659.

ABSTRACT: -- No abstract --

3 Editorial Late-life anxiety is coming of age. 2015

Beekman, Aartjan T F / Voshaar, Richard Oude / Pachana, Nancy A. ·Department of Psychiatry,VUMC and GGZ inGeest,Amsterdam,the Netherlands. · Department of Psychiatry,University of Groningen,Groningen,the Netherlands. · School of Psychology,The University of Queensland,Brisbane,Australia. ·Int Psychogeriatr · Pubmed #26090588.

ABSTRACT: Anxiety is an adaptive human experience that may occur at all ages and serves to help draw attention to, avoid or cope with immanent threat and danger. Given its evolutionary importance, it has strong genetic and biological underpinnings, and when it serves that adaptive function for the organism, anxiety may be viewed as useful. However, complex adaptive systems, such as our adaptation to threat or stress, by definition provide many and often interrelated points of breakdown or dysregulation, which, if sustained, may lead to psychopathology. Anxiety has been described as a common currency for psychopathology, indicating that it is a first line and universal way for us to respond to stress and threat. It is more or less prominent in patients diagnosed with practically all psychiatric or neurodegenerative disorders. This has lead to the inclusion of anxiety as a cross-cutting symptom measure in the development of DSM-5 (APA, 2013). Given that they are rooted in a complex adaptive system that has many potential points of impact to develop pathology, it is not surprising that anxiety disorders are extremely heterogeneous. This heterogeneity of anxiety disorders pertains to symptomatology, etiology and outcomes, and poses great challenges to both research and clinical practice.

4 Editorial Clinical staging and profiling of late-life anxiety disorders; the need for collaboration and a life-span perspective. 2015

Voshaar, Richard C Oude / Beekman, Aartjan T F / Pachana, Nancy. ·University Center for Psychiatry,University Medical Center Groningen,University of Groningen,NL-9713 AV,Groningen,the Netherlands. · School of Psychology,The University of Queensland,Brisbane,Australia. · Department of Psychiatry & (EMGO) Institute for Health and Care Research,VU University Medical Center,Amsterdam,the Netherlands. ·Int Psychogeriatr · Pubmed #25881981.

ABSTRACT: Clinical staging and profiling is a diagnostic strategy that goes beyond the traditional dichotomy in medicine of merely focusing on the presence or absence of a disease. Disease staging extends this traditional dichotomy by defining where a patient lies along the continuum of the course of his or her particular illness. Successful examples include the general tumor, node, metastasis (TNM) classification in oncology, as well as the New York Heart Association (NYHA classes I-IV) functional classification system for patients with congestive heart failure. It enables clinicians to select treatments relevant to earlier stages because such interventions may be more effective and less harmful than treatments delivered later in the illness course. Profiling is a further refinement, as well as a necessary component of staging. Profiling refers to the characterization of a patient within a specific disease stage, which is relevant for its course and treatment choice. An example of profiling is estrogen receptor positivity in patients with breast cancer.

5 Review Transcranial magnetic stimulation in obsessive-compulsive disorder: A focus on network mechanisms and state dependence. 2018

Cocchi, Luca / Zalesky, Andrew / Nott, Zoie / Whybird, Geneviève / Fitzgerald, Paul B / Breakspear, Michael. ·QIMR Berghofer Medical Research Institute, Brisbane, Australia. Electronic address: luca.cocchi@qimrberghofer.com.au. · Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia; Department of Biomedical Engineering, University of Melbourne, Melbourne, Australia. · QIMR Berghofer Medical Research Institute, Brisbane, Australia. · Epworh Clinic Epworth Healthcare, Camberwell, Victoria Australia and the MAPrc, Monash University Central Clinical School and The Alfred, Melbourne, Australia. ·Neuroimage Clin · Pubmed #30023172.

ABSTRACT: Background: Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation technique that has shown promise as an adjunct treatment for the symptoms of Obsessive-Compulsive Disorder (OCD). Establishing a clear clinical role for TMS in the treatment of OCD is contingent upon evidence of significant efficacy and reliability in reducing symptoms. Objectives: We present the basic principles supporting the effects of TMS on brain activity with a focus on network-based theories of brain function. We discuss the promises and pitfalls of this technique as a means of modulating brain activity and reducing OCD symptoms. Methods: Synthesis of trends and critical perspective on the potential benefits and limitations of TMS interventions in OCD. Findings: Our critical synthesis suggests the need to better quantify the role of TMS in a clinical setting. The context in which the stimulation is performed, the neural principles supporting the effects of local stimulation on brain networks, and the heterogeneity of neuroanatomy are often overlooked in the clinical application of TMS. The lack of consideration of these factors may partly explain the variable efficacy of TMS interventions for OCD symptoms. Conclusions: Results from existing clinical studies and emerging knowledge about the effects of TMS on brain networks are encouraging but also highlight the need for further research into the use of TMS as a means of selectively normalising OCD brain network dynamics and reducing related symptoms. The combination of neuroimaging, computational modelling, and behavioural protocols known to engage brain networks affected by OCD has the potential to improve the precision and therapeutic efficacy of TMS interventions. The efficacy of this multimodal approach remains, however, to be established and its effective translation in clinical contexts presents technical and implementation challenges. Addressing these practical, scientific and technical issues is required to assess whether OCD can take its place alongside major depressive disorder as an indication for the use of TMS.

6 Review Innovations in the psychosocial treatment of youth with anxiety disorders: implications for a stepped care approach. 2018

Ollendick, Thomas H / Öst, Lars-Göran / Farrell, Lara J. ·Department of Psychology, Virginia Tech, Blacksburg, Virginia, USA. · Department of Psychology, Stockholm University, Stockholm, Sweden. · School of Applied Psychology, Griffith University, Southport, Queensland, Australia. ·Evid Based Ment Health · Pubmed #29976564.

ABSTRACT: Anxiety disorders are highly prevalent among children and adolescents and frequently result in impairments across multiple domains of life. While psychosocial interventions, namely cognitive-behavioural therapy (CBT), have been found to be highly effective in treating these conditions, significant numbers of youth simply do not have access to these evidence-based interventions, and of those who do, a substantial proportion (up to 40%) fail to achieve remission. Thus, there is a pressing need for innovation in both the delivery of evidence-based treatments and efforts to enhance treatment outcomes for those who do not respond to standard care. This paper reviews current innovations attempting to address these issues, including evidence for brief, low-intensity approaches to treatment; internet delivered CBT and brief, high-intensity CBT. Moreover, we propose a model of stepped care delivery of evidence-based mental health interventions for children and youth with anxiety. In general, a stepped care approach begins with a lower intensity, evidence-based treatment that entails minimal therapist involvement (ie, brief, low-intensity self-help or internet delivered CBT) and then proceeds to more intensive treatments with greater therapist involvement (ie, brief high-intensity CBT), but only for those individuals who show a poor response at each step along the way. Future research is needed in order to evaluate such a model, and importantly, to identify predictors and moderators of response at each step, in order to inform an evidence-based, fully-integrated stepped care approach to service delivery.

7 Review Moderators and predictors of response to cognitive behaviour therapy for pediatric obsessive-compulsive disorder: A systematic review. 2018

Turner, Cynthia / O'Gorman, Beth / Nair, Archana / O'Kearney, Richard. ·School of Psychology, Australian Catholic University, Brisbane, QLD, Australia; Department of Psychology, University of Queensland, Brisbane, QLD, Australia. · Department of Psychology, University of Queensland, Brisbane, QLD, Australia. · Research School of Psychology, Australian National University, Canberra, ACT 0020, Australia. · Research School of Psychology, Australian National University, Canberra, ACT 0020, Australia. Electronic address: richard.okearney@anu.edu.au. ·Psychiatry Res · Pubmed #29287236.

ABSTRACT: We report a systematic review of moderators of CBT efficacy for pediatric OCD relative to other treatments. CENTRAL, MEDLINE, EMBASE, CINAHL, and PsycINFO were searched for RCTs reporting on effect moderation for CBT outcomes. Five studies (N = 365) examined 17 variables with three significant moderators identified. Compared to pill-placebo, CBT monotherapy was not effective for children with a family history of OCD but was for those without a family history. For children with a family history, CBT plus sertraline efficacy was attenuated but remained significant. For children with tics, CBT but not sertraline remained superior to pill-placebo. For non-responders to initial treatment with CBT, continuing CBT was inferior to commencing sertraline for those with tics but was not different for those without tics. A supplementary review identified older age, symptom and impairment severity, co-morbidity and family accommodation as consistent predictors of a poorer outcome to CBT. Current evidence for moderation effects is post-hoc, from single RCTs, has small Ns and requires replication. The review identifies family history of OCD and the presence of tics as factors requiring further examination in properly conducted trials and about which clinicians need to show care in their treatment recommendations.

8 Review Exploring the East-West Divide in Prevalence of Affective Disorder: A Case for Cultural Differences in Coping With Negative Emotion. 2018

De Vaus, June / Hornsey, Matthew J / Kuppens, Peter / Bastian, Brock. ·1 Eltham Psychology Clinic, Victoria, Australia. · 2 University of Queensland, Brisbane, Australia. · 3 KU Leuven, Belgium. · 4 University of Melbourne, Parkville, Victoria, Australia. ·Pers Soc Psychol Rev · Pubmed #29034806.

ABSTRACT: Lifetime rates of clinical depression and anxiety in the West tend to be approximately 4 to 10 times greater than rates in Asia. In this review, we explore one possible reason for this cross-cultural difference, that Asian cultures think differently about emotion than do Western cultures and that these different systems of thought help explain why negative affect does not escalate into clinical disorder at the same rate. We review research from multiple disciplines-including cross-cultural psychology, social cognition, clinical psychology, and psychiatry-to make the case that the Eastern holistic principles of contradiction (each experience is associated with its opposite), change (the world exists in a state of constant flux), and context (the interconnectedness of all things) fundamentally shape people's experience of emotions in different cultures. We then review evidence for how these cultural differences influence how successfully people use common emotion regulation strategies such as rumination and suppression.

9 Review Systematic review and meta-analysis of non-pharmacological interventions to reduce the symptoms of mild to moderate anxiety in pregnant women. 2018

Evans, Kerry / Morrell, C Jane / Spiby, Helen. ·School of Health Sciences, University of Nottingham, Nottingham, UK. · School of Nursing and Midwifery, University of Queensland, Brisbane, Australia. ·J Adv Nurs · Pubmed #28921612.

ABSTRACT: AIM: To assess the effectiveness of non-pharmacological interventions for pregnant women with symptoms of mild to moderate anxiety. BACKGROUND: Many pregnant women experience mild to moderate symptoms of anxiety and could benefit from additional support. Non-pharmacological interventions have been suggested for use during pregnancy. DESIGN: A systematic review of randomized controlled trials. DATA SOURCES: Randomized controlled trials published since 1990, identified from electronic databases: Medline; CINAHL; Maternity and Infant Care; PsycINFO; Cochrane Database of Systematic Reviews; CENTRAL; EMBASE; Centre for Reviews and Dissemination; Social Sciences Citation Index; ASSIA; HTA Library; Joanna Briggs Institute Evidence-Based Practice database; Allied and Complementary Medicine. REVIEW METHODS: Conducted according to the Centre for Reviews and Dissemination procedure. Papers were screened (N = 5,222), assessed for eligibility (N = 57) and selected for inclusion (N = 25). The Cochrane Collaboration's tool for assessing risk of bias was used. Papers were assessed for clinical and statistical heterogeneity and considered for meta-analysis. Descriptive analysis of the data was conducted. RESULTS: Psychological, mind-body, educational and supportive interventions were delivered individually and to groups of pregnant women over single or multiple sessions. The State-Trait Anxiety Inventory was the most commonly used anxiety measure. In 60% of studies there were fewer than 40 participants. Meta-analysis of three studies indicated no observed beneficial effect in the reduction of anxiety. CONCLUSION: There was insufficient evidence from which to draw overall conclusions regarding the benefit of interventions. Results were predominantly based on small samples. Many papers provided an inadequate description of methods which prevented a full assessment of methodological quality.

10 Review Mood and anxiety disorders in Australia and New Zealand's indigenous populations: A systematic review and meta-analysis. 2017

Black, Emma / Kisely, Steve / Alichniewicz, Karolina / Toombs, Maree. ·Rural Clinical School, School of Medicine, The University of Queensland, Australia. · University of Queensland, School of Medicine, Woolloongabba, Australia. Electronic address: s.kisely@uq.edu.au. ·Psychiatry Res · Pubmed #28544944.

ABSTRACT: The Indigenous populations of Australia and New Zealand are considered at higher risk of mood and anxiety disorders but many studies do not include direct comparisons with similar non-Indigenous controls. We conducted a systematic search of relevant electronic databases, as well as snowballing and targeted searches of the grey literature. Studies were included for meta-analysis if they compared rates of mood and anxiety disorders between Indigenous and non-Indigenous Australians or Maori. Seven Australian and 10 NZ studies were included. Overall, Indigenous people in both countries did not have significantly higher rates of disorder. However, in terms of specific disorders, there were differences in risk by gender, country (Australia or NZ), disorder type, and prevalence (current, 12-month or lifetime). For instance, Indigenous Australians and Maori both had significantly lower rates of simple phobias (current prevalence) and Maori participants had significantly lower rates of both lifetime simple phobia and generalised anxiety disorders. By contrast, Indigenous Australians had significantly higher rates of bipolar affective disorder and social phobia (current prevalence). Generalisations regarding the risk of psychiatric disorders in Indigenous people cannot therefore be made as this varies by several factors. These include disorder type, sociodemographic factors, Indigenous origin and study method.

11 Review D-Cycloserine Augmentation of Exposure-Based Cognitive Behavior Therapy for Anxiety, Obsessive-Compulsive, and Posttraumatic Stress Disorders: A Systematic Review and Meta-analysis of Individual Participant Data. 2017

Mataix-Cols, David / Fernández de la Cruz, Lorena / Monzani, Benedetta / Rosenfield, David / Andersson, Erik / Pérez-Vigil, Ana / Frumento, Paolo / de Kleine, Rianne A / Difede, JoAnn / Dunlop, Boadie W / Farrell, Lara J / Geller, Daniel / Gerardi, Maryrose / Guastella, Adam J / Hofmann, Stefan G / Hendriks, Gert-Jan / Kushner, Matt G / Lee, Francis S / Lenze, Eric J / Levinson, Cheri A / McConnell, Harry / Otto, Michael W / Plag, Jens / Pollack, Mark H / Ressler, Kerry J / Rodebaugh, Thomas L / Rothbaum, Barbara O / Scheeringa, Michael S / Siewert-Siegmund, Anja / Smits, Jasper A J / Storch, Eric A / Ströhle, Andreas / Tart, Candyce D / Tolin, David F / van Minnen, Agnes / Waters, Allison M / Weems, Carl F / Wilhelm, Sabine / Wyka, Katarzyna / Davis, Michael / Rück, Christian / Anonymous171083 / Altemus, Margaret / Anderson, Page / Cukor, Judith / Finck, Claudia / Geffken, Gary R / Golfels, Fabian / Goodman, Wayne K / Gutner, Cassidy / Heyman, Isobel / Jovanovic, Tanja / Lewin, Adam B / McNamara, Joseph P / Murphy, Tanya K / Norrholm, Seth / Thuras, Paul. ·Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden2Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden. · Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. · Institute of Psychiatry, Psychology, and Neuroscience, Department of Psychology, King's College London, London, United Kingdom. · Department of Psychology, Southern Methodist University, Dallas, Texas. · Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. · Center for Anxiety Disorders Overwaal, Institution for Integrated Mental Health Care Pro Persona, Nijmegen, the Netherlands7Behavioral Science Institute, NijCare, Radboud University Nijmegen, Nijmegen, the Netherlands. · Department of Psychiatry, Weill Cornell Medical College, New York, New York. · Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia. · School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia11Menzies Health Institute of Queensland, Brisbane, Queensland, Australia. · Department of Psychiatry, Massachusetts General Hospital, Boston13Harvard Medical School, Boston, Massachusetts. · Brain and Mind Research Institute, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia. · Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts. · Department of Psychiatry, University of Minnesota, Minneapolis. · Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri. · University of Louisville, Louisville, Kentucky. · Menzies Health Institute of Queensland, Brisbane, Queensland, Australia19School of Medicine, Griffith University, Brisbane, Queensland, Australia. · Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - University Medicine Berlin, Berlin, Germany. · Department of Psychiatry, Rush University Medical Center, Chicago, Illinois. · Harvard Medical School, Boston, Massachusetts22McLean Hospital, Belmont, Massachusetts. · Department of Psychological and Brain Sciences, Washington University School of Medicine, St Louis, Missouri. · Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, Louisiana. · School of Medicine, Griffith University, Brisbane, Queensland, Australia. · Institute for Mental Health Research, Department of Psychology, The University of Texas, Austin. · Department of Pediatrics, University of South Florida, Tampa27Rogers Behavioral Health, Tampa, Florida. · New Mexico Veterans Affairs Health Care System, Albuquerque, New Mexico. · The Institute of Living, Hartford, Connecticut30Yale University School of Medicine, New Haven, Massachusetts. · Department of Human Development and Family Studies, Iowa State University, Ames. · Department of Psychiatry, Weill Cornell Medical College, New York, New York32Cuny School of Public Health, City University of New York Graduate School of Public Health and Health Policy, New York. · Department of Psychology, Georgia State University, Atlanta. · Department of Psychiatry, University of Florida, Gainesville. · Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York. · Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts. · Great Ormond Street Hospital for Children, University College London, London, United Kingdom. · Department of Pediatrics, University of South Florida, Tampa. · Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota. ·JAMA Psychiatry · Pubmed #28122091.

ABSTRACT: Importance: Whether and under which conditions D-cycloserine (DCS) augments the effects of exposure-based cognitive behavior therapy for anxiety, obsessive-compulsive, and posttraumatic stress disorders is unclear. Objective: To clarify whether DCS is superior to placebo in augmenting the effects of cognitive behavior therapy for anxiety, obsessive-compulsive, and posttraumatic stress disorders and to evaluate whether antidepressants interact with DCS and the effect of potential moderating variables. Data Sources: PubMed, EMBASE, and PsycINFO were searched from inception to February 10, 2016. Reference lists of previous reviews and meta-analyses and reports of randomized clinical trials were also checked. Study Selection: Studies were eligible for inclusion if they were (1) double-blind randomized clinical trials of DCS as an augmentation strategy for exposure-based cognitive behavior therapy and (2) conducted in humans diagnosed as having specific phobia, social anxiety disorder, panic disorder with or without agoraphobia, obsessive-compulsive disorder, or posttraumatic stress disorder. Data Extraction and Synthesis: Raw data were obtained from the authors and quality controlled. Data were ranked to ensure a consistent metric across studies (score range, 0-100). We used a 3-level multilevel model nesting repeated measures of outcomes within participants, who were nested within studies. Results: Individual participant data were obtained for 21 of 22 eligible trials, representing 1047 of 1073 eligible participants. When controlling for antidepressant use, participants receiving DCS showed greater improvement from pretreatment to posttreatment (mean difference, -3.62; 95% CI, -0.81 to -6.43; P = .01; d = -0.25) but not from pretreatment to midtreatment (mean difference, -1.66; 95% CI, -4.92 to 1.60; P = .32; d = -0.14) or from pretreatment to follow-up (mean difference, -2.98, 95% CI, -5.99 to 0.03; P = .05; d = -0.19). Additional analyses showed that participants assigned to DCS were associated with lower symptom severity than those assigned to placebo at posttreatment and at follow-up. Antidepressants did not moderate the effects of DCS. None of the prespecified patient-level or study-level moderators was associated with outcomes. Conclusions and Relevance: D-cycloserine is associated with a small augmentation effect on exposure-based therapy. This effect is not moderated by the concurrent use of antidepressants. Further research is needed to identify patient and/or therapy characteristics associated with DCS response.

12 Review The prevalence of depression and anxiety disorders in indigenous people of the Americas: A systematic review and meta-analysis. 2017

Kisely, Steve / Alichniewicz, Karolina Katarzyna / Black, Emma B / Siskind, Dan / Spurling, Geoffrey / Toombs, Maree. ·Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Canada; School of Medicine, The University of Queensland, Australia. Electronic address: s.kisely@uq.edu.au. · Rural Clinical School, School of Medicine, The University of Queensland, Australia. · School of Medicine, The University of Queensland and Metro South Addiction and Mental Health Service, Australia. · School of Medicine, The University of Queensland and Inala Indigenous Health Service, Australia. ·J Psychiatr Res · Pubmed #27741502.

ABSTRACT: Indigenous populations are considered at higher risk of psychiatric disorder but many studies do not include direct comparisons with similar non-Indigenous controls. We undertook a meta-analysis of studies that compared the prevalence of depression and anxiety disorders in Indigenous populations in the Americas with those of non-Indigenous groups with similar socio-demographic features (Registration number: CRD42015025854). A systematic search of PubMed, Medline, PsycInfo, PsycArticles, ScienceDirect, EMBASE, and article bibliographies was performed. We included comparisons of lifetime rates and prevalence of up to 12 months. We found 19 studies (n = 250, 959) from Latin America, Canada and the US. There were no differences between Indigenous and similar non-Indigenous groups in the 12-month prevalence of depressive, generalised anxiety and panic disorders. However, Indigenous people were at greater risk of PTSD. For lifetime prevalence, rates of generalised anxiety, panic and all the depressive disorders were significantly lower in Indigenous participants, whilst PTSD (on adjusted analyses) and social phobia were significantly higher. Results were similar for sub-analyses of Latin America, Canada and the US, and sensitivity analyses by study quality or setting (e.g. health, community etc.). Risk factors for psychiatric illness may therefore be a complex interaction of biological, educational, economic and socio-cultural factors that may vary between disorders. Accordingly, interventions should reflect that the association between disadvantage and psychiatric illness is rarely due to one factor. However, it is also possible that assessment tools don't accurately measure psychiatric symptoms in Indigenous populations and that further cross-cultural validation of diagnostic instruments may be needed too.

13 Review Towards a cognitive-learning formulation of youth anxiety: A narrative review of theory and evidence and implications for treatment. 2016

Waters, Allison M / Craske, Michelle G. ·School of Applied Psychology, Griffith University, Brisbane, Australia. Electronic address: a.waters@griffith.edu.au. · Department of Psychology, University of California, Los Angeles, USA. ·Clin Psychol Rev · Pubmed #27693665.

ABSTRACT: The tendency to disproportionately allocate attention to threat stimuli, to evaluate ambiguous or benign situations as overly threatening, and to exhibit overgeneralised and indiscriminate conditioned fear responses to threat and safe stimuli are hallmark clinical correlates of pathological anxiety. Investigation of these processes in children and adolescents suggests that anxiety-related differences increase with age, and that the specific conditions under which anxious children differ from non-anxious peers are poorly understood. Furthermore, research on cognitive biases and fear conditioning in anxious children and adolescents has progressed as quite distinct lines of investigation. Greater integration of key tenets from each perspective could advance knowledge and provide new directions for improving treatments. The purpose of this paper is threefold. First, we provide a qualitative review of the key principles from cognitive and conditioning theories of anxiety and the associated empirical research, including the underlying neurophysiological basis of these processes in anxious children and adolescents, in order to delineate the conditions under which anxiety-specific differences in threat-related cognitive biases and overgeneralised conditioned fear manifest in children and adolescents. Second, we synthesize these theoretical and empirical insights to propose a cognitive-learning formulation of anxiety in children and adolescents. We propose that conditioning and cognitive factors linked to differences in engagement of underlying neural circuits across development contribute to an internal representation of a wide range of stimuli as threatening, to which anxious children and adolescents adopt maladaptive attention regulation patterns of predominantly threat monitoring or threat avoidance. These maladaptive attention regulation patterns differentiate anxious children and adolescents in terms of predominantly high cognitive distress (e.g., worry and rumination) and high behavioural avoidance respectively. Third, we consider the clinical implications of the cognitive-learning formulation for understanding outcomes from current treatments and provide suggestions for improving treatment outcomes.

14 Review Anxiety disorders and all-cause mortality: systematic review and meta-analysis. 2016

Miloyan, Beyon / Bulley, Adam / Bandeen-Roche, Karen / Eaton, William W / Gonçalves-Bradley, Daniela C. ·Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. beyon@jhu.edu. · School of Psychology, The University of Queensland, St Lucia, QLD, Australia. · Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. · Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. · Nuffield Department of Population Health, University of Oxford, Oxford, UK. ·Soc Psychiatry Psychiatr Epidemiol · Pubmed #27628244.

ABSTRACT: PURPOSE: The purpose of this study was to perform a systematic review and meta-analysis of prospective cohort studies that examined the relationship between anxiety disorders, or clinically significant anxiety symptoms, at baseline and all-cause mortality at follow-up relative to control participants without clinically significant anxiety. METHODS: PubMed, EMBASE, PsycInfo, and CINAHL were searched through July 2015, along with manual searches of published reviews and forward and backward snowball searches of included studies. Studies were excluded if anxiety was not defined with a standardized instrument, or if participants were followed-up for 1 year or less. The initial search yielded 7901 articles after the removal of duplicates, of which 328 underwent full-text screening. RESULTS: Forty-two estimates from 36 articles were included in the meta-analysis with a total sample of 127,552 participants and over 11,573 deaths. The overall hazard ratio (HR) estimate of mortality in clinically anxious participants relative to controls was 1.09 (95 % CI 1.01-1.16); however, this was reduced after adjusting for publication bias (1.03; 95 % CI 0.95-1.13). There was no evidence of increased mortality risk among anxious participants derived from community samples (0.99; 95 % CI 0.96-1.02) and in studies that adjusted for a diagnosis of depression (1.01; 95 % CI 0.96-1.06). CONCLUSIONS: These findings suggest that positive associations in the literature are attributable to studies in smaller samples, comorbid depression (or other psychiatric conditions) among participants, and possible confounding in medical patient samples followed-up for short durations.

15 Review The etiology of social anxiety disorder: An evidence-based model. 2016

Spence, Susan H / Rapee, Ronald M. ·School of Applied Psychology and Australian Institute for Suicide Prevention and Research, Griffith University, Brisbane, QLD 4121, Australia. Electronic address: s.spence@griffith.edu.au. · Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW 2109, Australia. ·Behav Res Ther · Pubmed #27406470.

ABSTRACT: The current paper presents an update to the model of social anxiety disorder (social phobia) published by Rapee and Spence (2004). It evaluates the research over the intervening 11 years and advances the original model in response to the empirical evidence. We review the recent literature regarding the impact of genetic and biological influences, temperament, cognitive factors, peer relationships, parenting, adverse life events and cultural variables upon the development of SAD. The paper draws together recent literature demonstrating the complex interplay between these variables, and highlights the many etiological pathways. While acknowledging the considerable progress in the empirical literature, the significant gaps in knowledge are noted, particularly the need for further longitudinal research to clarify causal pathways, and moderating and mediating effects. The resulting model will be valuable in informing the design of more effective treatment and preventive interventions for SAD and will provide a useful platform to guide future research directions.

16 Review The oral health of people with anxiety and depressive disorders - a systematic review and meta-analysis. 2016

Kisely, Steve / Sawyer, Emily / Siskind, Dan / Lalloo, Ratilal. ·School of Medicine, The University of Queensland, Woolloongabba, Qld, Australia; Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia; Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Canada. Electronic address: s.kisely@uq.edu.au. · School of Medicine, James Cook University, Qld, Australia. · School of Medicine, The University of Queensland, Woolloongabba, Qld, Australia. · School of Dentistry, The University of Queensland, Herston, Qld, Australia. ·J Affect Disord · Pubmed #27130961.

ABSTRACT: BACKGROUND: Many psychological disorders are associated with comorbid physical illness. There are less data on dental disease in common psychological disorders such as depression and anxiety in spite of risk factors in this population of diet, lifestyle or antidepressant-induced dry mouth. METHODS: We undertook a systematic search for studies of the oral health of people with common psychological disorders including depression, anxiety and dental phobia. We searched MEDLINE, PsycInfo, EMBASE and article bibliographies. Results were compared with the general population. Outcomes included partial or total tooth-loss, periodontal disease, and dental decay measured through standardized measures such as the mean number of decayed, missing and filled teeth (DMFT) or surfaces (DMFS). RESULTS: There were 19 papers on depression and/or anxiety, and seven on dental phobia/anxiety (total n=26). These covered 334,503 subjects. All the psychiatric diagnoses were associated with increased dental decay on both DMFT and DMFS scores, as well as greater tooth loss (OR=1.22; 95%CI=1.14-1.30). There was no association with periodontal disease, except for panic disorder. LIMITATIONS: Cross-sectional design of included studies, heterogeneity in some results, insufficient studies to test for publication bias. CONCLUSION: The increased focus on the physical health of psychiatric patients should encompass oral health including closer collaboration between dental and medical practitioners. Possible interventions include oral health assessment using standard checklists that can be completed by non-dental personnel, help with oral hygiene, management of iatrogenic dry mouth, and early dental referral. Mental health clinicians should also be aware of the oral consequences of inappropriate diet and psychotropic medication.

17 Review Prevalence of anxiety in Parkinson's disease: A systematic review and meta-analysis. 2016

Broen, Martijn P G / Narayen, Nadia E / Kuijf, Mark L / Dissanayaka, Nadeeka N W / Leentjens, Albert F G. ·Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands. · School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands. · Department of Neurology, Royal Brisbane & Women's Hospital, Brisbane, Australia. · The University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia. · School of Psychology, The University of Queensland, Brisbane, Australia. · Department of Psychiatry, Maastricht University Medical Center, Maastricht, the Netherlands. ·Mov Disord · Pubmed #27125963.

ABSTRACT: OBJECTIVE: Prevalence rates of anxiety disorders in Parkinson's disease (PD) vary widely, ranging from 6% up to 55%. The aim of this systematic review was to calculate the average point prevalence of anxiety disorders and clinically relevant anxiety symptoms in PD. METHODS: Using PubMed, we carried out a systematic literature search for studies reporting Diagnostic and Statistical Manual-defined anxiety disorders or clinically relevant anxiety symptoms assessed by an anxiety rating scale. RESULTS: A total of 49 articles were included and assessed for quality, and 45 articles fulfilled the quality criteria. The average point prevalence of anxiety disorders in PD was 31%, with nonepisodic anxiety being more prevalent than episodic anxiety. Generalized anxiety disorder was the most frequent in 14%, followed by social phobia (13.8%), anxiety not otherwise specified (13.3%), and specific phobia (13.0%). Panic disorder with or without phobia was present in 6.8% of PD patients. Of the patients, 31% fulfilled the criteria for current multiple anxiety disorders. Based on anxiety rating scale cutoff scores, clinically significant anxiety symptoms were present in a weighted average of 25.7%. CONCLUSION: This systematic review confirms that anxiety, although often unrecognized, is very common and highlights the need for efficient identification of anxiety in PD. © 2016 International Parkinson and Movement Disorder Society.

18 Review An evolutionary perspective on the co-occurrence of social anxiety disorder and alcohol use disorder. 2016

Bulley, Adam / Miloyan, Beyon / Brilot, Ben / Gullo, Matthew J / Suddendorf, Thomas. ·The University of Queensland, St. Lucia, Qld. 4072, Australia. Electronic address: adam.bulley@uqconnect.edu.au. · Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 2024 E. Monument St., Suite 2-700, Baltimore, MD 21287, United States. Electronic address: beyon@jhu.edu. · Plymouth University, Drake Circus, Plymouth, Devon PL4 8AA, United Kingdom. Electronic address: ben.brilot@plymouth.ac.uk. · Centre for Youth Substance Abuse Research, University of Queensland, Mental Health Centre, Royal Brisbane and Women's Hospital, Herston, Queensland 4029, Australia. Electronic address: m.gullo@uq.edu.au. · The University of Queensland, St. Lucia, Qld. 4072, Australia. Electronic address: t.suddendorf@psy.uq.edu.au. ·J Affect Disord · Pubmed #26914963.

ABSTRACT: Social Anxiety Disorder (SAD) commonly co-occurs with, and often precedes, Alcohol Use Disorder (AUD). In this paper, we address the relationship between SAD and AUD by considering how natural selection left socially anxious individuals vulnerable to alcohol use, and by addressing the underlying mechanisms. We review research suggesting that social anxiety has evolved for the regulation of behaviors involved in reducing the likelihood or consequences of threats to social status. The management of potential threats to social standing is important considering that these threats can result in reduced cooperation or ostracism - and therefore to reduced access to coalitional partners, resources or mates. Alcohol exerts effects upon evolutionarily conserved emotion circuits, and can down-regulate or block anxiety (or may be expected to do so). As such, the ingestion of alcohol can artificially signal the absence or successful management of social threats. In turn, alcohol use may be reinforced in socially anxious people because of this reduction in subjective malaise, and because it facilitates social behaviors - particularly in individuals for whom the persistent avoidance of social situations poses its own threat (i.e., difficulty finding mates). Although the frequent co-occurrence of SAD and AUD is associated with poorer treatment outcomes than either condition alone, a richer understanding of the biological and psychosocial drives underlying susceptibility to alcohol use among socially anxious individuals may improve the efficacy of therapeutic interventions aimed at preventing or treating this comorbidity.

19 Review Fear of cancer recurrence: a theoretical review and novel cognitive processing formulation. 2016

Fardell, Joanna E / Thewes, Belinda / Turner, Jane / Gilchrist, Jemma / Sharpe, Louise / Smith, Allan 'Ben' / Girgis, Afaf / Butow, Phyllis. ·Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia. · Behavioural Sciences Unit, School of Women's and Children's Health, University of New South Wales, Sydney, Australia. · Department of Medical Psychology, Radboud University Medical Centre, Postbus 9101, 6500, HB, Nijmegen (840), The Netherlands. · Mental Health Centre, School of Medicine, University of Queensland, St Lucia, Australia. · Crown Princess Mary Cancer Centre, Breast Cancer Institute, Westmead Hospital, Sydney, Australia. · School of Psychology, University of Sydney, Sydney, Australia. · Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Medicine, University of New South Wales, Sydney, Australia. · Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia. phyllis.butow@sydney.edu.au. · Chris O'Brien Lifehouse (C39Z), School of Psychology, The University Of Sydney, Sydney, Australia. phyllis.butow@sydney.edu.au. ·J Cancer Surviv · Pubmed #26782171.

ABSTRACT: PURPOSE: Fear of cancer recurrence (FCR) is prevalent among survivors. However, a comprehensive and universally accepted theoretical framework of FCR to guide intervention is lacking. This paper reviews theoretical frameworks previously used to explain FCR and describes the formulation of a novel theoretical framework for FCR. METHODS: A systematic review of the literature was undertaken to identify conceptual frameworks or theories applied to FCR. MEDLINE, PubMED, CINAHL, AMED, PsycINFO and Web of Science were searched. Identified conceptual frameworks were reviewed for strength of evidence supporting their validity. RESULTS: Of 558 papers initially identified, 16 made reference to six different conceptual frameworks relating to FCR. The most comprehensive and evidence-based theoretical approach is the Common Sense Model (CSM). Other approaches have limited evidence supporting their application to FCR. Two theoretical approaches developed in the context of emotional disorders that appear to be highly relevant to FCR: the Self-Regulatory Executive Function (S-REF) model and Relational Frame Theory were combined with the CSM to produce a novel cognitive processing account of FCR. CONCLUSIONS: Few conceptual frameworks have been used consistently to guide FCR research, and not all frameworks are empirically well supported, suggesting that further discussion regarding the conceptualisation of FCR is needed. The novel theoretical framework for FCR presented highlights the multidimensional nature of FCR and the importance of cognitive processing and metacognitions in the development and maintenance of FCR. IMPLICATIONS FOR CANCER SURVIVORS: The novel theoretical formulation of FCR outlined here provides a much-needed comprehensive framework to further investigate and address FCR in cancer survivors.

20 Review Screening for depression and anxiety among older Chinese immigrants living in Western countries: The use of the Geriatric Depression Scale (GDS) and the Geriatric Anxiety Inventory (GAI). 2016

Lin, Xiaoping / Haralambous, Betty / Pachana, Nancy A / Bryant, Christina / LoGiudice, Dina / Goh, Anita / Dow, Briony. ·National Ageing Research Institute Ltd, Health Promotion Division, Parkville, Victoria, Australia. · The University of Queensland, School of Psychology, Brisbane, Queensland, Australia. · The Royal Women's Hospital, Centre for Women's Mental Health, Parkville, Victoria, Australia. · The University of Melbourne, Melbourne School of Psychological Sciences, Parkville, Victoria, Australia. · Royal Melbourne Hospital, Royal Park Campus, Parkville, Victoria, Australia. · The University of Melbourne, Academic Unit for Psychiatry of Old Age, Kew, Victoria, Australia. · Royal Melbourne Hospital, Neuropsychiatry Unit, Parkville, Victoria, Australia. · The University of Melbourne, Department of Psychiatry, Parkville, Victoria, Australia. ·Asia Pac Psychiatry · Pubmed #26010903.

ABSTRACT: BACKGROUND: Depression and anxiety are two common mental health problems among older people. There is evidence that using well-validated screening tools can improve detection of depression and anxiety among this group. The review explored the use of the Geriatric Depression Scale (GDS) and the Geriatric Anxiety Inventory (GAI) for screening depression and anxiety among older Chinese immigrants, one of the largest and fastest growing groups of older immigrants in Western society. It focused on the GDS and GAI because both are designed specifically for older people. METHODS: Online literature searches were conducted in MEDLINE, CINAHL, and PsycINFO. A narrative approach was used to review included papers. RESULTS: A total of 21 articles were included. There were limited data on anxiety among older Chinese immigrants, with only one unpublished report identified. There were 13 studies (20 articles) using the GDS with this group. Results of these studies indicated that the GDS is a reliable tool in this population; however, there was limited validity data. Two versions of the GDS-15 have been used with older Chinese immigrants, including the standard GDS-15 and Mui's GDS-15. Prevalence of depression ranged between 20% and 30% in most reviewed studies. DISCUSSION: Results of this review have practical implications for clinicians in their use of these tools with older Chinese immigrants in Western countries, such as the different GDS versions. It also suggests a number of directions for future research, such as the inclusion of clinical samples and consideration of the diversity within this group.

21 Review Episodic foresight and anxiety: Proximate and ultimate perspectives. 2016

Miloyan, Beyon / Bulley, Adam / Suddendorf, Thomas. ·University of Queensland, Brisbane, Australia. ·Br J Clin Psychol · Pubmed #25777789.

ABSTRACT: OBJECTIVE: In this paper, we examine the relationship between episodic foresight and anxiety from an evolutionary perspective, proposing that together they confer an advantage for modifying present moment decision-making and behaviour in the light of potential future threats to fitness. METHODS: We review the body of literature on the role of episodic foresight in anxiety, from both proximate and ultimate perspectives. RESULTS: We propose that anxious feelings associated with episodic simulation of possible threat-related future events serve to imbue these simulations with motivational currency. Episodic and semantic details of a future threat may be insufficient for motivating its avoidance, but anxiety associated with a simulation can provoke adaptive threat management. As such, we detail how anxiety triggered by a self-generated, threat-related future simulation prepares the individual to manage that threat (in terms of its likelihood and/or consequences) over greater temporal distances than observed in other animals. We then outline how anxiety subtypes may represent specific mechanisms for predicting and managing particular classes of fitness threats. CONCLUSIONS: This approach offers an inroad for understanding the nature of characteristic future thinking patterns in anxiety disorders and serves to illustrate the adaptive function of the mechanism from which clinical anxiety deviates.

22 Review One Session Treatment for Specific Phobias: An Adaptation for Paediatric Blood-Injection-Injury Phobia in Youth. 2015

Oar, Ella L / Farrell, Lara J / Ollendick, Thomas H. ·School of Applied Psychology, Behavioural Basis of Health and Menzies Health Institute, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia. e.oar@griffith.edu.au. · School of Applied Psychology, Behavioural Basis of Health and Menzies Health Institute, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia. · Child Study Centre, Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24060, USA. ·Clin Child Fam Psychol Rev · Pubmed #26374227.

ABSTRACT: Blood-injection-injury (BII) phobia is a chronic and debilitating disorder, which has largely been neglected in the child literature. The present paper briefly reviews the aetiology of specific phobias with particular attention to BII and provides an integrated developmental model of this disorder in youth. Evidence-based treatments for child-specific phobias are discussed, and the development of a modified one session treatment (OST) approach to enhance treatment outcomes for BII phobia in children and adolescents is described. This approach is illustrated in two children with a primary diagnosis of BII phobia. The cases illustrate the unique challenges associated with treating BII in youth and the need for a modified intervention. Modifications included addressing the role of pain (e.g., psychoeducation, more graduated exposure steps) and disgust (e.g., disgust eliciting exposure tasks) in the expression of the phobia and fainting in the maintenance of this phobia. Moreover, it is recommended that parents be more actively involved throughout treatment (e.g., education session prior to OST, contingency management training, guidance regarding planning exposure tasks following treatment) and for families to participate in a structured e-therapy maintenance programme post-treatment.

23 Review Effective behavioural strategies for reducing disgust in contamination-related OCD: A review. 2015

Ludvik, Dominika / Boschen, Mark J / Neumann, David L. ·School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast 4222, Australia. Electronic address: dominika.ludvik@griffithuni.edu.au. · School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast 4222, Australia. Electronic address: m.boschen@griffith.edu.au. · School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast 4222, Australia. Electronic address: d.neumann@griffith.edu.au. ·Clin Psychol Rev · Pubmed #26190372.

ABSTRACT: Disgust is an understudied but important emotion in various psychological disorders. Over the last decade, increasing evidence suggests that disgust is also present in various subtypes of obsessive-compulsive disorder (OCD), especially in contamination-related OCD (C-OCD). The treatment of choice for C-OCD is exposure with response prevention, originally designed to reduce fear-associated emotions thought to be acquired through Pavlovian conditioning (PC). However, disgust has been proposed to be acquired through evaluative conditioning (EC) and according to the referential model of this form of learning, there are functional differences between PC and EC that need to be considered in the treatment of disgust-related responses. Alternative strategies suggested by EC-based models include counterconditioning (contingent presentation of the CS with a US of opposite valence) and US revaluation (contingent presentation of the US with US of opposite valence). Drawing on the referential model, this paper reviews evidence for the effectiveness of each strategy to identify the most theoretically sound and empirically valid intervention to reduce disgust in C-OCD.

24 Review Suicide in patients suffering from late-life anxiety disorders; a comparison with younger patients. 2015

Voshaar, R C Oude / van der Veen, D C / Kapur, N / Hunt, I / Williams, A / Pachana, N A. ·Department of Psychiatry and Interdisciplinary Center of Psychopathology of Emotion regulation (ICPE),University Medical Center Groningen,University of Groningen,Groningen,the Netherlands. · Centre for Suicide Prevention,University of Manchester,Manchester,UK. · School of Psychology,The University of Queensland,Brisbane,Australia. ·Int Psychogeriatr · Pubmed #25669916.

ABSTRACT: BACKGROUND: Anxiety disorders are assumed to increase suicide risk, although confounding by comorbid psychiatric disorders may be one explanation. This study describes the characteristics of older patients with an anxiety disorder who died by suicide in comparison to younger patients. METHOD: A 15-year national clinical survey of all suicides in the UK (n = 25,128). Among the 4,481 older patients who died by suicide (≥ 60 years), 209 (4.7%) suffered from a primary anxiety disorder, and 533 (11.9%) from a comorbid anxiety disorder. Characteristics of older (n = 209) and younger (n = 773) patients with a primary anxiety disorder were compared by logistic regression adjusted for sex and living arrangement. RESULTS: Compared to younger patients, older patients with a primary anxiety disorder were more often males and more often lived alone. Although 60% of older patients had a history of psychiatric admissions and 50% of deliberate self-harm, a history of self-harm, violence, and substance misuse was significantly less frequent compared to younger patients, whereas physical health problems and comorbid depressive illness were more common. Older patients were prescribed significantly more psychotropic drugs and received less psychotherapy compared to younger patients. CONCLUSION: Anxiety disorders are involved in one of every six older patients who died by suicide. Characteristics among patients who died by suicide show severe psychopathology, with a more prominent role for physical decline and social isolation compared to their younger counterparts. Moreover, treatment was less optimal in the elderly, suggesting ageism. These results shed light on the phenomenon of suicide in late-life anxiety disorder and suggest areas where prevention efforts might be focused.

25 Review Visuo-vestibular contributions to anxiety and fear. 2015

Coelho, Carlos M / Balaban, Carey D. ·University of Minho, School of Engineering, Centro Algoritmi, Guimarães, Portugal; University of Queensland, Queensland Brain Institute, Brisbane, Australia. Electronic address: coelho@uma.pt. · University of Pittsburgh, School of Med, Department of Otolaryngology, Eye & Ear Inst., Pittsburgh, PA, USA; University of Pittsburgh, Department of Neurobiology, Pittsburgh, PA, USA; University of Pittsburgh, Department of Communication Sciences & Disorders, Pittsburgh, PA, USA; University of Pittsburgh, Department of Bioengineering, Pittsburgh, PA, USA. ·Neurosci Biobehav Rev · Pubmed #25451199.

ABSTRACT: The interactive roles of the visual and vestibular systems allow for postural control within boundaries of perceived safety. In specific circumstances, visual vestibular and postural interactions act as a cue that trigger fear, similarly to what occurs in motion sickness. Unusual patterns of visuo-vestibular interaction that emerge without warning can elicit fear, which can then become associated to a certain stimuli or situation, creating a CS-US association, (i.e., phobia), or can emerge without warning but also without becoming associated to a particular concomitant event (i.e., panic). Depending on the individual sensitivity to visuo-vestibular unusual patterns and its impact in postural control, individuals will be more or less vulnerable to develop these disorders. As such, the mechanism we here propose is also sufficient to explain the lack of certain fears albeit exposure. Following this rationale, a new subcategory of anxiety disorders, named visuo-vestibular fears can be considered. This model brings important implications for developmental and evolutionary psychological science, and invites to place visuo-vestibular fears in a particular subtype or specification within the DSM-5 diagnostic criteria.

Next