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1.
BMC Psychiatry ; 24(1): 290, 2024 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-38632560

RESUMO

BACKGROUND: The diagnosis of adolescent Depressive Disorder (DD) lacks specific biomarkers, posing significant challenges. This study investigates the potential of Niacin Skin Flush Response (NSFR) as a biomarker for identifying and assessing the severity of adolescent Depressive Disorder, as well as distinguishing it from Behavioral and Emotional Disorders typically emerging in childhood and adolescence(BED). METHODS: In a case-control study involving 196 adolescents, including 128 Depressive Disorder, 32 Behavioral and Emotional Disorders, and 36 healthy controls (HCs), NSFR was assessed. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9) and anxious symptoms with the Generalized Anxiety Disorder 7-item scale (GAD-7). Pearson correlation analysis determined the relationships between NSFR and the severity of depression in DD patients. Receiver Operating Characteristic (ROC) was used to identify DD from BED integrating NSFR data with clinical symptom measures. RESULTS: The adolescent Depressive Disorder group exhibited a higher rate of severe blunted NSFR (21.4%) compared to BED (12.5%) and HC ( 8.3%). Adolescent Depressive Disorder with psychotic symptoms showed a significant increase in blunted NSFR (p = 0.016). NSFR had negative correlations with depressive (r = -0.240, p = 0.006) and anxious (r = -0.2, p = 0.023) symptoms in adolescent Depressive Disorder. Integrating NSFR with three clinical scales improved the differentiation between adolescent Depressive Disorder and BED (AUC increased from 0.694 to 0.712). CONCLUSION: The NSFR demonstrates potential as an objective biomarker for adolescent Depressive Disorder, aiding in screening, assessing severity, and enhancing insights into its pathophysiology and diagnostic precision.


Assuntos
Niacina , Humanos , Adolescente , Depressão , Transtornos de Ansiedade/psicologia , Estudos de Casos e Controles , Biomarcadores
2.
J Affect Disord ; 357: 138-147, 2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-38685278

RESUMO

BACKGROUND: The transdiagnostic approach to psychopathology has emerged as an alternative to traditional taxonomic approaches. The Multidimensional Emotional Disorders Inventory (MEDI) is a specifically designed self-report to measure the transdiagnostic dimensions proposed by Brown and Barlow (2009). This study aims to analyse the psychometric properties of the MEDI scores in adolescents with subthreshold anxiety and depression. METHOD: The sample consisted of a total of 476 students. The mean age was 13.77 years (SD = 1.43) (range 10 to 18 years), 73.9 % were females. Several questionnaires assessing positive affect, negative affect, mental health difficulties, and quality of life were used. RESULTS: The original 9-factor structure of the MEDI was confirmed with good fit indices. Satisfactory levels of internal consistency were observed in most of the MEDI scores using McDonald's Omega, ranging from 0.58 to 0.87. The MEDI dimensions were associated with psychopathology, positive affect, negative affect, and quality of life. LIMITATIONS: Reliance on self-reported data, a cross-sectional design limiting temporal assessment, and a 73.9 % female gender imbalance. CONCLUSION: The MEDI scores showed adequate psychometric properties among adolescents with subclinical emotional symptoms. The results found might have potential clinical implications for conceptualization, assessment, intervention, and prevention of emotional disorders at both clinical and research levels.


Assuntos
Psicometria , Humanos , Adolescente , Feminino , Masculino , Criança , Qualidade de Vida/psicologia , Depressão/diagnóstico , Depressão/psicologia , Ansiedade/diagnóstico , Ansiedade/psicologia , Reprodutibilidade dos Testes , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Inquéritos e Questionários/normas , Estudos Transversais , Autorrelato , Escalas de Graduação Psiquiátrica/normas , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/psicologia
3.
Artigo em Russo | MEDLINE | ID: mdl-38529868

RESUMO

OBJECTIVE: To assess the validity of the screening method based on EEG analysis using predictive analytics algorithms with the calculation of linear discriminant functions (LDFs), in comparison with a classification system based on psychometric self-report scales. MATERIAL AND METHODS: A comparative cross-sectional study with partial blinding involving healthy volunteers was conducted at two investigational sites. The calculated scores of LDFs used to assess risks of impulsivity, depression and anxiety acted as quantitative characteristics of subjects' mental state. Testing included completing psychometric scales. RESULTS: As a result of the performed validation of the original screening method based on EEG analysis in comparison with the scores of psychometric scales chosen as a reference method, satisfactory results were obtained with the best parameters of sensitivity, specificity, and accuracy for detecting high levels of impulsivity associated with pronounced aggressiveness. Of considerable interest is also the direct correlation found between high levels of LDF impulsivity scores and high levels of self-rated aggression on a psychometric scale (BPAQ-24). CONCLUSION: The results open up the possibility of using the proposed method to predict a number of emotional and behavioral characteristics of subjects, including a high risk of aggressive behavior as part of professional selection.


Assuntos
Transtornos de Ansiedade , Eletroencefalografia , Humanos , Projetos Piloto , Estudos Transversais , Transtornos de Ansiedade/psicologia , Medição de Risco , Psicometria , Reprodutibilidade dos Testes
4.
J Affect Disord ; 354: 500-508, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38484883

RESUMO

BACKGROUND: The dynamic and hierarchical nature of the functional brain network. The neural dynamical systems tend to converge to multiple attractors (stable fixed points or dynamical states) in long run. Little is known about how the changes in this brain dynamic "long-term" behavior of the connectivity flow of brain network in generalized anxiety disorder (GAD). METHODS: This study recruited 92 patients with GAD and 77 healthy controls (HC). We applied a reachable probability approach combining a Non-homogeneous Markov model with transition probability to quantify all possible connectivity flows and the hierarchical structure of brain functional systems at the dynamic level and the stationary probability vector (10-step transition probabilities) to describe the steady state of the system in the long run. A random forest algorithm was conducted to predict the severity of anxiety. RESULTS: The dynamic functional patterns in distributed brain networks had larger possibility to converge in bilateral thalamus, posterior cingulate cortex (PCC), right superior occipital gyrus (SOG) and smaller possibility to converge in bilateral superior temporal gyrus (STG) and right parahippocampal gyrus (PHG) in patients with GAD compared to HC. The abnormal transition probability pattern could predict anxiety severity in patients with GAD. LIMITATIONS: Small samples and subjects taking medications may have influenced our results. Future studies are expected to rule out the potential confounding effects. CONCLUSION: Our results have revealed abnormal dynamic neural communication and integration in emotion regulation in patients with GAD, which give new insights to understand the dynamics of brain function of patients with GAD.


Assuntos
Encéfalo , Imageamento por Ressonância Magnética , Humanos , Encéfalo/diagnóstico por imagem , Transtornos de Ansiedade/psicologia , Mapeamento Encefálico/métodos , Lobo Temporal
5.
Autism Res ; 17(3): 610-625, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38450955

RESUMO

Youth diagnosed with autism spectrum disorder (ASD) and those with developmental coordination disorder (DCD) are at heightened risk for co-occurring mental health diagnoses, especially anxiety and attention-deficit/hyperactivity disorder (ADHD). However, caregiver-child agreement on presence of related symptoms in populations with neurodevelopmental conditions is not well understood. Here, we examine the extent to which 37 ASD, 26 DCD, and 40 typically developing children and their caregivers agree on the degree of the child's symptoms of anxiety and ADHD. All caregiver-child dyads completed the Screen for Child Anxiety Related Emotional Disorders and Conners 3 ADHD Index. Across groups, intraclass correlations indicated generally poor agreement on anxiety and ADHD symptomatology. Although youth generally reported greater internalizing symptoms (i.e., anxiety), caregivers tended to report more observable externalizing behaviors (i.e., ADHD). Together, the results of this study support the need for a multi-informant approach in assessments of anxiety and ADHD in youth with neurodevelopmental disorders.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Espectro Autista , Transtornos das Habilidades Motoras , Humanos , Adolescente , Transtorno do Espectro Autista/complicações , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/psicologia , Cuidadores , Transtornos das Habilidades Motoras/diagnóstico , Transtornos de Ansiedade/psicologia , Ansiedade/complicações , Ansiedade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/psicologia
6.
Psychiatry Res ; 335: 115862, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38554493

RESUMO

Large-scale studies and burdened clinical settings require precise, efficient measures that assess multiple domains of psychopathology. Computerized adaptive tests (CATs) can reduce administration time without compromising data quality. We examined feasibility and validity of an adaptive psychopathology measure, GOASSESS, in a clinical community-based sample (N = 315; ages 18-35) comprising three groups: healthy controls, psychosis, mood/anxiety disorders. Assessment duration was compared between the Full and CAT GOASSESS. External validity was tested by comparing how the CAT and Full versions related to demographic variables, study group, and socioeconomic status. The relationships between scale scores and criteria were statistically compared within a mixed-model framework to account for dependency between relationships. Convergent validity was assessed by comparing scores of the CAT and the Full GOASSESS using Pearson correlations. The CAT GOASSESS reduced interview duration by more than 90 % across study groups and preserved relationships to external criteria and demographic variables as the Full GOASSESS. All CAT GOASSESS scales could replace those of the Full instrument. Overall, the CAT GOASSESS showed acceptable psychometric properties and demonstrated feasibility by markedly reducing assessment time compared to the Full GOASSESS. The adaptive version could be used in large-scale studies or clinical settings for intake screening.


Assuntos
Transtornos de Ansiedade , Transtornos Psicóticos , Humanos , Transtornos de Ansiedade/psicologia , Psicopatologia , Transtornos do Humor/diagnóstico , Ansiedade , Psicometria , Reprodutibilidade dos Testes
7.
J Affect Disord ; 351: 808-817, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38320660

RESUMO

BACKGROUND: Affective dynamics have been identified as a correlate of a broad span of mental health issues, making them key candidate transdiagnostic factors. However, there remains a lack of knowledge about which aspects of affective dynamics - especially as they manifest in the course of daily life - relate to a general risk for mental health issues versus specific symptoms. METHODS: We leverage an ecological momentary assessment (EMA) study design with four measures per day over a two-week period to explore how negative affect levels, inertia, lability, and reactivity to provocation and stress in the course of daily life relate to mental health symptoms in young adults (n = 256) in the domains of anxiety, depression, psychosis-like symptoms, behaviour problems, suicidality, and substance use. RESULTS: Dynamic structural equation modelling (DSEM) suggested that negative affect levels in daily life were associated with depression, anxiety, indirect and proactive aggression, psychosis, anxiety, and self-injury; negative affective lability was associated with depression, physical aggression, reactive aggression, suicidal ideation, and ADHD symptoms; negative affective inertia was associated with depression, anxiety, physical aggression, and cannabis use; and emotional reactivity to provocation was related to physical aggression. LIMITATIONS: The cross-sectional design, the limited span of mental health issues included, and the convenience nature and small size of the sample are limitations. CONCLUSIONS: Findings suggest that a subset of mental health symptoms have shared negative affective dynamics patterns. Longitudinal research is needed to rigorously examine the directionality of the effects underlying the association between affective dynamics and mental health issues.


Assuntos
Avaliação Momentânea Ecológica , Saúde Mental , Adulto Jovem , Humanos , Estudos Transversais , Ansiedade/diagnóstico , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia
8.
Clin Obstet Gynecol ; 67(1): 134-153, 2024 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-38281173

RESUMO

Perinatal mood and anxiety disorders (PMADs) are common, yet obstetricians receive little training prior to independent practice on screening, assessing, diagnosing, and treating patients with depression and anxiety. Untreated PMADs lead to adverse pregnancy and fetal outcomes. Obstetricians are in a unique position to address PMADs. The following serves as a resource for addressing PMADs in obstetric practice.


Assuntos
Saúde Mental , Obstetrícia , Gravidez , Feminino , Humanos , Ansiedade , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Transtornos do Humor
9.
Br J Psychiatry ; 224(4): 132-138, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38270148

RESUMO

BACKGROUND: Anxiety in pregnancy and after giving birth (the perinatal period) is highly prevalent but under-recognised. Robust methods of assessing perinatal anxiety are essential for services to identify and treat women appropriately. AIMS: To determine which assessment measures are most psychometrically robust and effective at identifying women with perinatal anxiety (primary objective) and depression (secondary objective). METHOD: We conducted a prospective longitudinal cohort study of 2243 women who completed five measures of anxiety and depression (Generalized Anxiety Disorder scale (GAD) two- and seven-item versions; Whooley questions; Clinical Outcomes in Routine Evaluation (CORE-10); and Stirling Antenatal Anxiety Scale (SAAS)) during pregnancy (15 weeks, 22 weeks and 31 weeks) and after birth (6 weeks). To assess diagnostic accuracy a sample of 403 participants completed modules of the Mini-International Neuropsychiatric Interview (MINI). RESULTS: The best diagnostic accuracy for anxiety was shown by the CORE-10 and SAAS. The best diagnostic accuracy for depression was shown by the CORE-10, SAAS and Whooley questions, although the SAAS had lower specificity. The same cut-off scores for each measure were optimal for identifying anxiety or depression (SAAS ≥9; CORE-10 ≥9; Whooley ≥1). All measures were psychometrically robust, with good internal consistency, convergent validity and unidimensional factor structure. CONCLUSIONS: This study identified robust and effective methods of assessing perinatal anxiety and depression. We recommend using the CORE-10 or SAAS to assess perinatal anxiety and the CORE-10 or Whooley questions to assess depression. The GAD-2 and GAD-7 did not perform as well as other measures and optimal cut-offs were lower than currently recommended.


Assuntos
Transtornos de Ansiedade , Ansiedade , Feminino , Gravidez , Humanos , Estudos Prospectivos , Estudos Longitudinais , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Ansiedade/diagnóstico , Escalas de Graduação Psiquiátrica , Psicometria
10.
J Psychiatr Pract ; 30(1): 62-67, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38227730

RESUMO

This article presents a unique framework that combines insights from neuroscience with clinical assessment to evaluate individuals who have co-occurring alcohol use disorder, anxiety, and trauma. Through the use of a case study, the authors demonstrate the practical application of this framework and contextualize the relevant neurocircuitry associated with alcohol withdrawal, maladaptive fear and anxiety, and chronic stress. By integrating these perspectives, they provide a comprehensive approach for assessing and treating patients with complex psychiatric histories, particularly those presenting with anxiety symptoms, offering valuable insights for practitioners.


Assuntos
Alcoolismo , Síndrome de Abstinência a Substâncias , Humanos , Alcoolismo/complicações , Alcoolismo/diagnóstico , Alcoolismo/psicologia , Transtornos de Ansiedade/psicologia , Ansiedade/psicologia , Consumo de Bebidas Alcoólicas/psicologia
11.
Arch Womens Ment Health ; 27(2): 309-316, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38044340

RESUMO

To identify subgroups of postpartum women with different psychological symptom profiles at 2 and 6 months postpartum and to examine how they transition between symptom profiles over time using latent transition analysis (LTA). We used secondary data from the Family Life Project (N = 1,117) and performed LTA based on observed variables (depression, anxiety, somatization, and hostility). We examined transition probabilities and changes in latent status prevalence from 2 to 6 months postpartum. Considering the known influences of social determinants of health on psychological symptoms, bivariate analyses were conducted to describe the characteristics of different transition patterns. A 3-class model with better fit indices, entropy, and interpretability was selected. Based on symptom severity, the identified profiles were Profile 1: Low, Profile 2: Moderate, and Profile 3: High. From 2 to 6 months postpartum, the prevalence of low symptom profile decreased (82 to 78.2%) while the prevalence increased for moderate (15.8 to 17.5%) and high symptom profiles (2.2 to 4.4%). For all profiles, it was most likely for postpartum women to stay in the same profile from 2 to 6 months (low to low, moderate to moderate, and high to high). Those in persistent or worsening transition patterns were significantly younger or had less social support or education. Postpartum women in moderate or high symptom profiles at 2 months were most likely to stay in the same profile at 6 months postpartum, indicating persistent symptom burden. Clinicians should consider providing early, targeted support to prevent persistent symptom burden.


Assuntos
Ansiedade , Período Pós-Parto , Feminino , Humanos , Período Pós-Parto/psicologia , Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Mães/psicologia
12.
J Psychosom Obstet Gynaecol ; 44(1): 2265050, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37800570

RESUMO

Pregnancy often triggers anxiety and health concerns in women, leading many to search for health information online. Excessive, compulsive, and repetitive online health research, accompanied by heightened anxiety, can result in cyberchondria. This study aimed to explore the risk factors, triggers, and outcomes of cyberchondria in pregnant women. A total of 149 participants completed an online questionnaire longitudinally across three stages of pregnancy: early (14-19 weeks), mid (24-29 weeks), and late pregnancy (34-39 weeks). The findings revealed that health anxiety and the cognitive component of anxiety sensitivity are risk factors for cyberchondria during pregnancy. Pregnancy concerns related to motherhood emerged as triggers for cyberchondria. While a connection between cyberchondria and fear of birth was observed, fear of birth did not appear to be a direct outcome of cyberchondria. These results highlight the importance of addressing health anxiety, cognitive anxiety sensitivity and motherhood concerns in prenatal care and support interventions. Understanding the factors contributing to cyberchondria in pregnant women can assist healthcare professionals in providing targeted support and resources to mitigate excessive online health searching behaviors and alleviate anxiety during pregnancy.


Assuntos
Hipocondríase , Gestantes , Humanos , Feminino , Gravidez , Hipocondríase/epidemiologia , Hipocondríase/psicologia , Transtornos de Ansiedade/psicologia , Ansiedade/psicologia , Fatores de Risco , Internet
13.
BMC Psychol ; 11(1): 306, 2023 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-37798802

RESUMO

BACKGROUND: The prevalence of anxiety and depression disorders is surging worldwide, prompting a pressing demand for psychological interventions, especially in less severe cases. Responding to this need, the Italian government implemented the "Psychological Bonus" (PB) policy, allotting 25 million euros for mental health support. This policy entitles individuals to a minimum of four to twelve psychological sessions. In collaboration with the National Board of Italian Psychologists, our study assesses this policy's effectiveness. Indeed, the PsyCARE study aims to examine the utilization of the Psychological Bonus, evaluate its impact on adult and adolescent participants' psychological well-being through pre- and post-intervention assessments and six-month follow-up, and conduct a longitudinal cost-effectiveness analysis of this policy. A secondary aim is to investigate the influence of these interventions on transdiagnostic factors, including emotion regulation and epistemic trust. METHODS: The study involves licensed psychotherapists and their patients, both adults and adolescents, benefiting from the Psychological Bonus. Data collection is underway and set to conclude in December 2023. Psychotherapists will provide diagnostic information and assess patient functioning. In addition, patients will be evaluated on mental health aspects such as clinical symptoms, emotion regulation, epistemic trust, and quality of life. We will employ linear mixed-effects models to analyze the outcomes, accounting for both fixed and random effects to capture the hierarchical structure of the data. DISCUSSION: We anticipate the study's findings will highlight reduced psychological distress and improved quality of life for participants and demonstrate the Psychological Bonus policy's cost-effectiveness. The study will gather data on the role of specific versus nonspecific therapeutic factors in psychotherapy while adopting a patient-tailored approach to identify effective therapeutic elements and examine transdiagnostic factors. Overall, this study's findings will guide future measures within the Italian healthcare system, fostering a psychological health culture and providing valuable insights to the broader public. STUDY REGISTRATION: https://osf.io/6zk2j.


Assuntos
Psicoterapia , Qualidade de Vida , Adulto , Adolescente , Humanos , Análise Custo-Benefício , Transtornos de Ansiedade/psicologia , Ansiedade/terapia , Ansiedade/diagnóstico
14.
Clin Child Fam Psychol Rev ; 26(3): 727-750, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37500948

RESUMO

The present article reviews the current status of cognitive-behavioral therapy (CBT) interventions for anxiety and depression in Japanese youth. First, a literature review of youth CBT programs for anxiety and depression is provided. Through this process, we identify which program/protocol has been most researched within Japan. Second, through a systematic interview to the authors, the development process of four predominant programs is outlined. The programs included were a family CBT program for anxiety disorders (the Japanese Anxiety Children/Adolescents Cognitive Behavior Therapy program), two school-based prevention programs for anxiety and depression (Journey of the Brave and Phoenix Time), and a transdiagnostic protocol for anxiety and depression (Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents). Third, cultural adaptation and modification of the programs are discussed from the scope of user-centered design principles as described by Lyon and Koerner (Sci Pract 23:180-200, 2016). As a result, changes in program content and material, as represented by the use of culture-friendly program names, acronyms, illustrations, and characters were endorsed in all of the programs. Structured but flexible session formats helped increase learnability and efficiency while keeping the cognitive load of providers and consumers low. A careful selection of providers, as well as quality training and consultation are important factors to maximize competency and ensure appropriate implementation. Application of existing time frames and staff who work in each setting were effective ways to increase scalability. Overall, it was shown that many of the modifications adopted overlap among successful programs; these represent the most basic and essential requirements for a program to be applicable to a wide range of contexts. Implications and further directions are explored.


Assuntos
Terapia Cognitivo-Comportamental , Depressão , Adolescente , Criança , Humanos , Ansiedade/terapia , Transtornos de Ansiedade/terapia , Transtornos de Ansiedade/psicologia , Cognição , Terapia Cognitivo-Comportamental/métodos , Depressão/psicologia , População do Leste Asiático , Intervenção Psicossocial , Assistência à Saúde Culturalmente Competente
15.
Updates Surg ; 75(8): 2291-2296, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37269423

RESUMO

Patients with gastrointestinal diseases have been shown to report greater stress, anxiety, depression and obsessive-compulsive characteristics. The aim of our study is to investigate personality characteristics and general distress of adult patients suffering from common coloproctological conditions. We conducted a retrospective observational study including patients aged 18 years or older, with diagnosis of haemorrhoidal disease (HD group) or anal fissure (AF group). The final sample was composed of 64 participants, who were asked to complete a battery of questionnaires. They were compared with a control group of healthy volunteers. In terms of general distress, HD group scored higher than both the CG and AF groups. The two proctological groups had higher scores in neuroticism/emotional lability compared to the CG group. In the MOCQ-R scale (obsessive-compulsive tendency), HD group had significantly higher scores compared to the CG group in the total score (p < 0.01,) and also scored higher in the doubting/ruminating subscale compared to the AF group. We support the importance of taking a multidisciplinary perspective and incorporating psychometric tools to assess the psychological and personality dimensions of patients into proctological clinical practice. The correct early evaluation and management of these conditions may result in an improvement in patients' quality of life and better response to treatment.


Assuntos
Transtornos de Ansiedade , Qualidade de Vida , Adulto , Humanos , Psicometria , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Estudos Retrospectivos , Personalidade , Inquéritos e Questionários
16.
Gen Hosp Psychiatry ; 83: 130-139, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37187032

RESUMO

OBJECTIVE: To assess the rates and feasibility of assessing comorbid mental health disorders and referral rates in low-income urban and rural perinatal patients. METHODS: In two urban and one rural clinic serving primarily low-income perinatal patients of color, a computerized adaptive diagnostic tool CAT-MH® was implemented to assess major depressive disorder (MDD), general anxiety disorder (GAD), suicidality (SS), substance use disorder (SUD), and post-traumatic stress disorder (PTSD) at the first obstetric visit and/or 8 weeks postpartum. RESULTS: Of a total of 717 screens, 10.7% (n = 77 unique patients) were positive for one or more disorders (6.1% one, 2.5% two, 2.1% three or more). MDD was the most common disorder (9.6%) and was most commonly comorbid with GAD (33% of MDD cases), SUD (23%), or PTSD (23%). For patients with a positive screen, referral to treatment was 35.1% overall, with higher rates in urban (51.6%) versus rural (23.9%) clinics (p = 0.03). CONCLUSION: Mental health comorbidities are common in low-income urban and rural populations, but referral rates are low. Promoting mental health in these populations requires comprehensive screening and treatment approaches for psychiatric comorbidities and dedication to increase the availability of mental health prevention and treatment options.


Assuntos
Transtorno Depressivo Maior , Transtornos de Estresse Pós-Traumáticos , Transtornos Relacionados ao Uso de Substâncias , Feminino , Gravidez , Humanos , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Saúde Mental , População Rural , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos Relacionados ao Uso de Substâncias/diagnóstico
17.
J Anxiety Disord ; 97: 102724, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37207556

RESUMO

BACKGROUND: Intentional attempts to savor positive emotions may be infrequent in Generalized Anxiety Disorder (GAD) due to avoidance of emotional contrasts. Yet purposeful enjoyment may help reduce worry and increase wellbeing in GAD. We sought to explore 1) the frequency, intensity, and duration of positive emotions from savoring in GAD and 2) its effect on pre-existing worry. METHOD: The same 139 participants participated in two studies. They first took baseline measures. After, they were explicitly taught about savoring practices. In study 1, all participants were instructed to savor a photograph and video, timing and rating their emotion. Then in study 2, participants underwent a worry induction followed by an interventional experiment. In a savoring condition, participants were instructed to savor a personally-chosen enjoyable video. In a control condition, participants watched an emotionally neutral video. RESULTS: Participants who met DSM-5 criteria for GAD had significantly lower scores on naturalistic savoring via self-report than those without GAD. Yet when explicitly taught and directed to savor in study 1, there were no differences between those with and without GAD in positive emotion duration and intensity. In study 2, longitudinal linear mixed models demonstrated that savoring after a worry induction significantly decreased worry, decreased anxiety, and increased positive emotions to greater degrees than the control task. These changes did not differ between diagnostic groups. All analyses controlled for depression symptoms. CONCLUSION: Although persons with GAD tend to savor less in daily life than those without GAD, intentional savoring may decrease worry and increase positive emotion for both groups.


Assuntos
Transtornos de Ansiedade , Ansiedade , Humanos , Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Transtornos de Ansiedade/psicologia , Emoções , Felicidade , Autorrelato
18.
Psychiatr Danub ; 35(1): 97-102, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37060599

RESUMO

BACKGROUND: The pandemic caused by the coronavirus disease of 2019 (COVID-19) has affected the mental health of the general population, leading to an increase in depression, anxiety and stress. The results of the studies on the psychological effects of the pandemic in patients with psychiatric illnesses were contradictory in that some reported higher adverse effects in patients with psychiatric illnesses compared to the healthy control subjects, whereas some did not. Thus, the aim of this study is to compare the patients with a diagnosis of generalized anxiety disorder and the healthy control subjects in terms of certain psychological parameters during the pandemic period. SUBJECTS AND METHODS: 81 patients, who were diagnosed with generalized anxiety disorder and 80 healthy volunteers of matching characteristics were included in this study. Both the patient and control groups were administered a sociodemographic questionnaire, short form of the Depression, Anxiety and Stress Scale (DASS-21) and the Revised Impact of Event Scale (IES-R). The resulting research data were analyzed using the SPSS 22.0 software. RESULTS: No significant difference was found between the two groups in terms of depression, stress, intrusion, hyperarousal and avoidance. On the other hand, the increase observed in the anxiety symptoms was found to be significant in the patient group compared to the control group. CONCLUSION: The findings of this study revealed that the depression, stress and trauma-related stress responses of GAD patients have not differred during the COVID-19 pandemic period, whereas that their anxiety levels have increased significantly, as compared to the healthy control subjects. In this context, it is recommended that the clinicians take into consideration that the pandemic may lead to an increase in the symptoms of individuals diagnosed with anxiety disorder.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Pandemias , SARS-CoV-2 , Depressão/psicologia , Estresse Psicológico/psicologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Ansiedade/epidemiologia , Ansiedade/psicologia
19.
Mol Psychiatry ; 28(7): 2894-2912, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36878964

RESUMO

Anxiety disorders are increasingly prevalent, affect people's ability to do things, and decrease quality of life. Due to lack of objective tests, they are underdiagnosed and sub-optimally treated, resulting in adverse life events and/or addictions. We endeavored to discover blood biomarkers for anxiety, using a four-step approach. First, we used a longitudinal within-subject design in individuals with psychiatric disorders to discover blood gene expression changes between self-reported low anxiety and high anxiety states. Second, we prioritized the list of candidate biomarkers with a Convergent Functional Genomics approach using other evidence in the field. Third, we validated our top biomarkers from discovery and prioritization in an independent cohort of psychiatric subjects with clinically severe anxiety. Fourth, we tested these candidate biomarkers for clinical utility, i.e. ability to predict anxiety severity state, and future clinical worsening (hospitalizations with anxiety as a contributory cause), in another independent cohort of psychiatric subjects. We showed increased accuracy of individual biomarkers with a personalized approach, by gender and diagnosis, particularly in women. The biomarkers with the best overall evidence were GAD1, NTRK3, ADRA2A, FZD10, GRK4, and SLC6A4. Finally, we identified which of our biomarkers are targets of existing drugs (such as a valproate, omega-3 fatty acids, fluoxetine, lithium, sertraline, benzodiazepines, and ketamine), and thus can be used to match patients to medications and measure response to treatment. We also used our biomarker gene expression signature to identify drugs that could be repurposed for treating anxiety, such as estradiol, pirenperone, loperamide, and disopyramide. Given the detrimental impact of untreated anxiety, the current lack of objective measures to guide treatment, and the addiction potential of existing benzodiazepines-based anxiety medications, there is a urgent need for more precise and personalized approaches like the one we developed.


Assuntos
Farmacogenética , Medicina de Precisão , Humanos , Feminino , Medicina de Precisão/métodos , Qualidade de Vida , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/genética , Transtornos de Ansiedade/psicologia , Biomarcadores , Medição de Risco , Benzodiazepinas , Proteínas da Membrana Plasmática de Transporte de Serotonina
20.
J Anxiety Disord ; 95: 102679, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36863193

RESUMO

The contrast avoidance model (CAM) suggests that individuals with generalized anxiety disorder (GAD) are sensitive to a sharp increase in negative and/or decrease in positive affect. They thus worry to increase negative emotion to avoid negative emotional contrasts (NECs). However, no prior naturalistic study has examined reactivity to negative events, or ongoing sensitivity to NECs, or the application of CAM to rumination. We used ecological momentary assessment to examine effects of worry and rumination on negative and positive emotion before and after negative events and intentional use of repetitive thinking to avoid NECs. Individuals with major depressive disorder (MDD) and/or GAD (N = 36) or without psychopathology (N = 27) received 8 prompts/day for 8 days and rated items on negative events, emotions, and repetitive thoughts. Regardless of group, higher worry/rumination before negative events was associated with less increased anxiety and sadness, and less decreased happiness from before to after the events. Participants with MDD/GAD (vs. controls) reported higher ratings on focusing on the negative to avoid NECs and greater vulnerability to NECs when feeling positive. Results support the transdiagnostic ecological validity for CAM extending to rumination and intentional engagement in repetitive thinking to avoid NECs among individuals with MDD/GAD.


Assuntos
Transtorno Depressivo Maior , Humanos , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Ansiedade/psicologia , Emoções , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Estudos Longitudinais
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