Prevalence and comorbidity of anxiety disorder in school-attending children and adolescents aged 6-16 years in China.

BACKGROUND: The reported prevalence rate of anxiety disorder in the paediatric population varies widely between different counties. Currently, there is no national epidemiological survey of childhood anxiety disorder in China. This study aims to investigate the national prevalence of anxiety disorder, the distribution profiles of different subtypes and its comorbidity rates among school students. METHODS: A nationwide epidemiological survey of mental disorders in school students aged 6-16 years was conducted. Participants were randomly recruited from five provinces in China. The Child Behavior Checklist was used to screen students at high risk for mental disorders. The final diagnosis was made based on the Diagnostic and Statistical Manual-IV. The point prevalence and comorbidity rate of anxiety disorder were calculated, and the difference between age, sex and socioeconomic status groups was also compared. RESULTS: Generalised anxiety disorder (GAD) was the most common anxiety disorder in school-attending children and adolescents, with a prevalence rate of 1.3% (95% CI: 1.2 to 1.3). Separation anxiety and specific phobia were more common in children than in adolescents. Girls had a higher prevalence of panic disorder (0.3% vs 0.2%, χ2=14.6, p<0.001) and agoraphobia (0.9% vs 0.8%, χ2=4.3, p=0.03) than that of boys. We found no significant difference between developed and less developed areas. Girls were more likely to have panic disorder and GAD than boys, with ratios of 2.13:1 and 1.01:1, respectively. The co-occurrence of anxiety disorder and attention-deficit and disruptive behaviour disorder was very common, ranging from 40% to 85%. CONCLUSIONS: Anxiety disorder was prevalent among school students in China, and comorbidity with attention-deficit and disruptive disorder was very common. The data imply that screening for anxiety disorder is needed in school settings. Policies should be adapted to provide psychological services to children and adolescents. A comprehensive assessment is recommended in clinical practice.

Fear of Movement in People With CRPS: A Psychometric Evaluation of the Tampa Scale-11 for Kinesiophobia.

BACKGROUND: People with complex regional pain syndrome (CRPS) commonly report a fear of movement that can worsen symptoms and increase disability. The Tampa Scale of Kinesiophobia (TSK) is used to evaluate fear of movement and (re)injury, but findings have been inconsistent in different populations. OBJECTIVE: To evaluate the psychometric properties of the Persian version of TSK-11 in individuals with upper limb CRPS. Specifically, to determine whether the factor structure aligns with the original 2-factor model, consisting of "activity avoidance" and "somatic focus." MATERIALS AND METHODS: People with CRPS (n=142, mean age=42, 54% female) completed the TSK. The psychometric testing included internal consistency, test-retest reliability (intraclass correlation coefficient), and convergent construct validity. Confirmatory and exploratory factor analyses were performed to evaluate the structural validity. RESULTS: The TSK-11 showed acceptable internal consistency (Cronbach alpha 0.93) and excellent test-retest reliability (intraclass correlation coefficient=0.93, 95% CI: 0.92-0.94). The Standard Error of Measurement and Minimal Detectable Change were 4.3 and 11.7, respectively. The results also demonstrated excellent criterion validity ( r =0.81). Confirmatory factor analysis demonstrated that the original 2-factor model did not fit. Exploratory factor analysis derived a 2-factor solution with different items. The factor structure accounted for 64.91% of the variance, and the internal consistency of the factors was acceptable (>0.90). Expert consensus suggested naming these 2 factors as fear avoidance and magnification and helplessness. DISCUSSION: The TSK-11 demonstrates excellent retest reliability in people with CRPS. The original 2-factor structure was not confirmed, and a new 2-factor structure of the TSK-11 was proposed consisting of subscales for Fear Avoidance Beliefs and Magnification/Helplessness. Given the overlap between these constructs and the construct of pain catastrophizing, further study is needed to clarify both measures' content validity and relative uniqueness.

Needle phobia among adult Jordanians: General awareness, prevalence; and exploring microneedles as a promising solution.

Needle phobia remains a major drawback of conventional injectable medications, leading to avoidance and low adherence among a reasonable portion of patients. Despite this, there is a limited number of studies investigating needle phobia prevalence and symptoms. In this survey, we studied the knowledge and prevalence of needle phobia and its manifestations among 1182 adult Jordanians. Moreover, we assessed the feasibility of microneedles delivery systems as an alternative approach to conventional injectable methods. The results revealed that 28.5% of the participants identified themselves with needle phobia, with a notably higher prevalence among females compared to males (p-value < 0.001). The overall prevalence of needle phobia based on its measured manifestations was found to be 27.4%. The survey also found that 68% of the population were unfamiliar with the concept of microneedles despite the reasonable proportion of the population who were aware of the disadvantages of conventional injectable medications. Furthermore, the survey identified four significant predictors of needle phobia through hierarchical linear regression analysis. Gender, occupation, and negative past experiences with needle injections accounted for 3%, 1%, and 1% of the variance in needle phobia, respectively. In addition, the participants' preference for microneedles over conventional injectables medications appeared as another significant predictor, contributing 5% of the variance. Overall, the model explained 10% of the variance in needle phobia. Collectively, this study provides an insight into needle phobia prevalence and manifestations in Jordan, while also exploring microneedles as an alternative drug delivery system for patients with needle phobia.

Tocophobia: a nosological quagmire.

Fear of childbirth exists on a continuum of severity, and the most severe form is commonly referred to as tocophobia. Although a rare entity, tocophobia is a common reason for requesting an elective cesarean section. It is generally considered a specific phobia but is not recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a diagnostic entity. To improve the assessment and treatment of tocophobia, research is warranted to clarify its relationship with commonly occurring psychiatric disorders in pregnancy.

Virtual reality exposure aided-diagnosis system for anxiety disorders: Long short-term memory architecture for three levels of anxiety recognition.

BACKGROUND: The COVID-19 pandemic has resulted in increased psychological pressure on mental health since 2019. The resulting anxiety and stress have permeated every aspect of life during confinement. OBJECTIVE: To provide psychologists with an unbiased measure that can aid in the preliminary diagnosis of anxiety disorders and be used as an initial treatment in cognitive-behavioral therapy, this article introduces automated recognition of three levels of anxiety. METHODS: Anxiety was elicited by exposing participants to virtual environments inspired by social situations in reference to the Liebowitz social anxiety scale. Relevant parameters, such as heart rate variability and vasoconstriction were derived from the measurement of the blood volume pulse (BVP) signal. RESULTS: A long short-term memory architecture achieved an accuracy of approximately 98% on the training and test set. CONCLUSION: The generated model allowed for careful study of the state of seven phobic participants during virtual reality exposure (VRE).

Developmental Epidemiology of Pediatric Anxiety Disorders.

This review summarizes the developmental epidemiology of childhood and adolescent anxiety disorders. It discusses the coronavirus disease of 2019 (COVID-19) pandemic, sex differences, longitudinal course, and stability of anxiety disorders in addition to recurrence and remission. The trajectory of anxiety disorders-whether homotypic (ie, the same anxiety disorder persists over time) or heterotypic (ie, an anxiety disorder shifts to a different diagnosis over time) is discussed with regard to social, generalized, and separation anxiety disorders as well as specific phobia, and panic disorder. Finally, strategies for early recognition, prevention, and treatment of disorders are discussed.

Influencing factors of kinesiophobia in older patients with chronic heart failure: A structural equation model.

BACKGROUND: Our recent study has demonstrated that kinesiophobia is common in Chinese inpatients with chronic heart failure (CHF). Symptoms of heart failure (HF), coping mode, self-efficacy for exercise (SEE), and social support have been reported to be associated with kinesiophobia. However, little is known about the relationships between these four variables and kinesiophobia in older patients with CHF. OBJECTIVE: To test a model of influencing factors of kinesiophobia in older CHF patients. METHODS: A cross-sectional design was conducted from January 2021 to October 2021. The general information questionnaire, the Chinese version of the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart-C), Symptom Status Questionnaire-Heart Failure, SEE, the Medical Coping Modes Questionnaire, and Social Support Rating Scale were used. Spearman correlation analysis and structural equation model (SEM) were performed for data analysis. RESULTS: A total of 270 older patients with CHF were recruited. Symptom status of HF (r = 0.455, p < .01), avoidance coping mode (r = 0.393, p <.01), and yielding coping mode (r = 0.439, p < .01) were positively correlated with kinesiophobia, while SEE (r = -0.530, p < .01), facing coping mode (r = -0.479, p < .01), and social support (r = -0.464, p < .01) were negatively correlated with kinesiophobia. SEM analysis showed that social support could affect kinesiophobia through the mediating variables of symptom status of HF, avoidance coping mode, and exercise self-efficacy. CONCLUSIONS: Symptoms of HF, coping mode, SEE, and social support may play role in kinesiophobia in older CHF patients. We should pay more attention to the synergies among these four variables in the improvement of kinesiophobia.

Psychometric properties of the Persian version of the COVID-19 Phobia Scale (C19P-S).

BACKGROUND: During various infectious pandemics, phobia or panic has been suggested as one of the most common mental disorders. The current study reports on the psychometric properties of the Persian version of the COVID-19 Phobia Scale (C19P-S) in Iran. METHODS: The forward-backward translation procedure was applied to translate the English version of the C19P-S into Persian. Then, content and face validity, structural validity (exploratory and confirmatory factor analyses), convergent and discriminant validity, concurrent validity, reliability, and stability were performed to evaluate the Persian version. RESULTS: In all, 660 people participated in the study. The mean age of patients was 35.55 (SD = 12.24) years. Exploratory factor analysis confirmed a four-factor structure for the scale. Confirmatory factor analysis showed that almost all fitness indices for the model were satisfactory (RMSEA = 0.06, CFI = 0.96, TLI = 0.96, IFI = 0.97). The Cronbach's alpha coefficient and intraclass correlation coefficient (ICC) for the questionnaire were 0.95 and 0.96, respectively. CONCLUSION: The Persian version of C19P-S showed good psychometric properties and a good fit for the four-factor structure. It can now be used to assess panic disorder in therapeutic settings and identify candidates needing clinical intervention.

Female migraine patients had lower COVID-19 phobia and PCL-5 scores during the lockdown period.

BACKGROUND: To examine the impact of the lockdown period of the pandemic on COVID-19 phobia and post-traumatic stress disorder (PTSD) in migraine patients. METHODS: A total of 73 patients, including 39 migraine and 34 controls, completed the study during the lockdown period. The patients were evaluated using the Structured Headache Questionnaire, PTSD Checklist for DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) (PCL-5) and COVID-19 Phobia Scale via the telephone-based telemedicine method. RESULTS: Migraine patients had significantly lower scores in all subgroups of the COVID-19 Phobia Scale (mean = 42.33 ± 12.67) than those in the healthy control group (mean = 52.88 ± 13.18). PCL-5 scale scores in migraine patients were significantly lower (mean = 27.18 ± 14.34) compared to the healthy controls (Mean = 34.03 ± 14.36). Migraine attack frequency decreased or did not change in 67% of the patients during the lockdown period. CONCLUSION: Acute stress response to an extraordinary situation such as a pandemic may be more controlled in migraine patients, yet specific phobia and post-traumatic stress disorder have been reported more frequently in patients with migraine under normal living conditions. We interpreted that the life-long headache-associated stress may generate a tendency to resilience and resistance to extraordinary traumatic events in migraine patients.

[The application of virtual reality in the treatment of mental disorders]. / Die Anwendung der Virtuellen Realität in der Behandlung psychischer Störungen.

BACKGROUND: Virtual reality (VR) enables immersion in an interactive digital world with realistic experiences, that can be applied for controlled and personalized interventions. This review summarizes the current research on VR in the treatment of mental disorders. METHODS: Selective literature search in PubMed and Google Scholar. RESULTS: An increasing number of publications report the therapeutic application of VR for the treatment of mental disorders. Most VR applications are based on established therapy approaches, such as exposure therapy. According to meta-analytic data, virtual exposure therapy (VRET) for specific phobia and agoraphobia with panic disorder is as effective as traditional in vivo exposure therapy. VRET for the treatment of social phobia is significantly more effective than waitlist and placebo control groups with, however, currently inconsistent metanalytic results when compared to in vivo exposure therapy. VRET for the treatment of posttraumatic stress disorder (PTSD) is similar in effectiveness compared to active psychotherapy. For psychosis, positive results have been reported for the VR-based treatment of auditory verbal hallucinations. For patients with a substance use disorder, VR can induce craving, with still unverified diagnostic and therapeutic relevance. CONCLUSIONS: VRET can broaden the psychotherapy options for anxiety disorders. Encouraging results of VR-based treatments for psychosis and PTSD indicate the need for further research concerning its effectiveness and safety. In the field of substance use disorders, evaluation of clinical-orientated VR applications is needed.

Sensibility and measurement properties of the Tampa Scale of Kinesiophobia to measure fear of movement in children and adults in surgical settings.

Purpose: Fear of movement, or kinesiophobia, is a risk factor for developing chronic post-surgical pain (CPSP) and may impede recovery. Identifying people with kinesiophobia peri-operatively is potentially valuable to intervene to optimize rehabilitation and prevent CPSP. This narrative review aims to describe and critically appraise the sensibility and measurement properties of the Tampa Scale of Kinesiophobia (TSK) in the surgical setting in both pediatric and adult populations.Material and methods: PubMed was searched for relevant articles using search terms related to the TSK and measurement properties; the search was restricted to articles published in English. COSMIN guidelines were used to rate measurement property sufficiency and study quality.Results: Four articles examined the measurement properties of the TSK-17 in the surgical setting. Included studies demonstrated sufficient internal consistency, structural validity, construct validity, but insufficient predictive validity. Study quality was variable. Although the TSK was not originally intended for the surgical setting, with minor modification, it appears sensible to use in this population.Conclusions: The TSK is a sensible tool to measure fear of movement in children and adults undergoing, or who underwent, surgery. Future studies are needed to test content validity, test-retest reliability, measurement error, and responsiveness in the surgical setting.IMPLICATIONS FOR REHABILITATIONFear of movement is a predictor of developing chronic post-surgical pain in children and adults.Rehabilitation interventions can address fear of movement in hopes to optimize surgical outcomes and prevent chronic post-surgical pain.The Tampa Scale of Kinesiophobia (TSK), with minor modification, is a sensible tool to measure fear of movement in surgical settings.There is some evidence that the TSK is reliable and valid to use with older children, adolescents, and adults who are undergoing or underwent surgery.

Half of the patients with subepithelial tumors present borderline or pathologic anxiety-distress and carcinophobia: a multicenter cohort study

Background and Aims: Minor nonspecific gastrointestinal subepithelial lesions (usually defined by the term ‘tumor’) are usually associated with a malignant illness and cancer. The aim of this study was to assess anxiety-distress and carcinophobia in patients referred to specialized monographic outpatient clinics for evaluation and treatment of this type of lesion. Methods: Prospective, multicenter, cohort study. Specific self-reported questionnaires were used to report threatening life-experiences and to assess levels of distress (The Hospital Anxiety and Depression Scale) and cancer-related worries (The Cancer Worry Scale). Results: Forty participants were included and analyzed at baseline. Pathologic and borderline anxiety were detected in 13% (5/40, 95%CI: 4-27%) and 35% (14/40, 95%CI: 21-52%) of participants, respectively, whereas, cancer-related worries (moderate to very high) were observed in 48% (19/40, 95%CI: 32-64%) of participants. Pathologic global distress was identified in 25% (10/40, 95%CI: 13-42%) of subjects. Higher educational level (university studies), a lack of lifetime psychiatric comorbidity and a lack of family history of cancer were associated with less anxiety, global distress and carcinophobia. Conclusions: Almost half of the patients diagnosed with a minor nonspecific gastrointestinal subepithelial lesion presented anxiety-distress and/or carcinophobia. Specific associations with anxiety-distress reaction and fears were detected (AU)

Reliability and validity of the Chinese version of the COVID-19 Phobia Scale.

BACKGROUND: The COVID-19 pandemic has become a source of fear worldwide and has negative mental health effects on the general population. In 2022, the epidemic continues to be characterized by many points, widespread and frequent in China, and the situation is serious and complex. To provide an effective and scientific tool, the study validated the Chinese version of the COVID-19 Phobia Scale (C19P-SC). METHODS: This study selected 1138 Chinese individuals (age ranged 13 to 80). RESULTS: Cronbach's alpha coefficient for the C19P-SC was 0.93 (the coefficients of the four dimensions ranged from 0.75 to 0.85). The results of the confirmatory factor analysis supported the four-factor structure of the C19P-SC. Meanwhile, there was a positive and significant correlation between coronaphobia and state anxiety (r = 0.48, p < 0.001). The metric invariance hypothesis and the scalar invariance hypothesis were valid in the different subgroups. Significant multivariate effects of gender, education level, and identity differences on coronaphobia were found. CONCLUSIONS: The Chinese version of the COVID-19 Phobia Scale has good psychometric properties and is suitable for measuring COVID-19 phobia in Chinese individuals.

Exploring nomophobia with a German adaption of the nomophobia questionnaire (NMP-Q-D).

Nomophobia is considered a disorder of the modern world and describes the fear of being separated from one's smartphone and being no longer connected and reachable. The aims of this Study were to translate the nomophobia questionnaire (NMP-Q) into German, validate the NMP-Q-D, and use it to shed light on the nomophobia construct. A total of 807 volunteer test subjects were included in the evaluation, 50 of them participated five months later in a retest study. A 4-factor structure of the NMP-Q-D could be confirmed by exploratory as well as by confirmatory factor analyses. The four factors are: (1) "Not being able to communicate", (2) "Losing connectedness", (3) "Not being able to access information", and (4) "Giving up convenience". The Cronbach's alpha coefficient of the NMP-Q-D was .92 and the test-retest-reliability was .80. Significant correlations of frequency of smartphone usage with time spent confirmed criterion validity of NMP-Q-D. Construct validity was given by significant correlations of NMP-Q-D to fear of missing out and smartphone addiction. Neuroticism was positively associated with nomophobia, while consciousness and openness were lightly negatively associated. Anxiety correlated significantly positively with factor 1, and stress with factors 1 and 4. Life satisfaction was positively associated with factor 3 and well-being negatively with factor 4. A multiple regression analysis revealed smartphone usage, gender, and neuroticism as significant predictors of nomophobia. Females scored significantly higher for factors 1 and 4 compared to males. Nomophobia was rather widespread in the sample: Nearly half of the participants (49.4%) had a moderate level of nomophobia and 4.1% a severe nomophobia.

Anxiety Disorders in Children and Adolescents.

Anxiety disorders are the most common psychiatric conditions in children and adolescents, affecting nearly 1 in 12 children and 1 in 4 adolescents. Anxiety disorders include specific phobias, social anxiety disorder, separation anxiety disorder, agoraphobia, panic disorder, and generalized anxiety disorder. Risk factors include parental history of anxiety disorders, socioeconomic stressors, exposure to violence, and trauma. The U.S. Preventive Services Task Force recommends screening for anxiety disorders in children eight years and older; there is insufficient evidence to support screening in children younger than eight years. Symptoms of anxiety disorders in children and adolescents are similar to those in adults and can include physical and behavioral symptoms such as diaphoresis, palpitations, and tantrums. Care should be taken to distinguish symptoms of a disorder from normal developmental fears and behaviors, such as separation anxiety in infants and toddlers. Several validated screening measures are useful for initial assessment and ongoing monitoring. Cognitive behavior therapy and selective serotonin reuptake inhibitors are the mainstay of treatment and may be used as monotherapies or in combination. Prognosis is improved with early intervention, caretaker support, and professional collaboration.

[Kinesiophobia in patients requiring hip and knee endoprosthetics: severity and provoking factors]. / Kineziofobiya u patsientov, nuzhdayushchikhsya v endoprotezirovanii tazobedrennogo i kolennogo sustavov: vyrazhennost' i provotsiruyushchie faktory.

Kinesiophobia (KP), or an irrational fear of physical activity, significantly hinders the active rehabilitation of patients with joint pathology. PURPOSE OF THE STUDY: To study the severity and risk factors of KP in patients requiring total hip and knee endoprosthetics (EP). MATERIAL AND METHODS: We examined 50 patients requiring total EP of the hip and knee joints. Pain syndrome was assessed in the preoperative and early postoperative periods in all patients using a visual analog scale, as well as the levels of kinesiophobia, anxiety, and depression using the Hospital Anxiety and Depression Scale and the Tampa Scale for Kinesiophobia (TSK). Quality of patients life was studied in the preoperative period (RAND SF36 questionnaire). RESULTS: In the majority of cases, both before and after EP, the level of KP corresponded to an average degree of severity. Both in the preoperative and in the early postoperative periods, not a single case of the absence of KP was detected (≤17 points according to the TSK); at the same time, a very high level of KP (≥55 points according to TSK) was also rarely recorded - in 3 patients in the postoperative period after EP of the hip joint. KP level significantly correlated with the duration of the pain syndrome, while the mental component of the KP, in addition to the duration of the pain syndrome, was influenced by the social status: in patients who had a steady job, the psychological component of the KP was expressed in a less degree. KP level was negatively correlated with such indicators of quality of life as vitality and physical functioning. In addition, the physical component of the KP significantly correlated with the pain intensity, the mental component - with role-playing behavior. CONCLUSION: Early detection of KP and timely correction of distorted ideas about physical activity are necessary for successful rehabilitation of patients requiring total joint endoprosthetics of the lower limb.

[Social Anxiety Disorder - an Update]. / Die soziale Angststörung ­ ein Update.

It can happen that one behaves in a supposedly embarrassing or insufficient manner; however, short-term feelings such as shame or self-doubt usually remain without significance. However, if there is excessive and persistent fear or significant avoidance behaviour, it may be a case of social anxiety disorder (SAS). This article provides an overview of the current status of the aetiology, diagnosis and therapy of SAS.

Interictal osmophobia is associated with longer migraine disease duration.

BACKGROUND: Sensitization to sensory stimuli is an essential feature of migraine attacks. The relationship between the clinical course of migraine and increased sensitivity to olfactory stimuli has been little studied so far. METHODS: We analyzed the frequency and quality of osmophobia depending on the phase of migraine in patients with episodic and chronic migraine treated in an tertiary headache center with regard to gender, age, medical history and migraine disability assessment score (MIDAS). Standardized diagnostic questions were used for the assessment of osmophobia. RESULTS: In our cross-sectional investigation (n = 113), 38.1% of the patients showed an increased preictal hypersensitivity to odors, whereas 61.9% described ictal and 31.9% interictal hypersensitivity to odors, odor-triggered migraine was described in 30.1%. Median migraine disease duration has been statistically significantly longer in patients who suffered from interictal hypersensitivity to odors (28.5 years vs. 20 years; p = 0.012). There was a significant correlation between interictal hypersensitivity and higher age (54.50 vs. 45; p = 0.015). Patients with higher migraine disability in MIDAS experienced more frequently preictal and interictal olfactory sensitization and odor triggered migraine attacks. CONCLUSIONS: In patients with longer migraine disease duration and higher migraine-related impairment, osmophobia was more frequently observed. These results might support the hypothesis of increasing sensitization with increasing burden of migraine.

[Hysteroform depressions in young female patients]. / Isteroformnye depressii u patsientok molodogo vozrasta.

OBJECTIVE: To study the features of the psychopathological structure of depression in young women with hysteroform symptoms, as well as the features of auto-aggressive non-suicidal and suicidal behavior in these conditions. MATERIAL AND METHODS: The results of a clinical/psychopathological examination of 50 female adolescent patients, aged 16 to 25 years, with endogenous depressions with one of the following ICD-10 diagnosis: (F31.3-4, F34.0, F21.3-4 + F31.3-4, F60.X + F31.3-4) and prevail of hysteroform symptoms in the form of conversion/dissociative disorders in their clinical picture were analyzed. RESULTS: Depression was characterized by an acute onset due to a traumatic situation represented by difficulties in personal or family relationships (36%, n=18), bereavement reactions (28%, n=14) and problems in school/work (22%, n=11). The depressive triad had an erased character, the thymic component was represented by a variable character of affect with a predominance of dysphoria (38%, n=19) and anxiety (32%, n=16). The ideational component of the triad was detected in 50% of cases (n=25), while in 38% (n=19) there was ideational acceleration. In 44% of cases (n=22), dissociative disorders were noted in the form of delusional fantasizing, represented by symptoms close to the «multiple personality¼ phenomenon. Often there were obsessional disorders (58%, n=29), anxiety-phobic symptoms in the form of panic attacks (46%, n=23), isolated phobias (28%, n=14), social phobias (30%, n=15). In 40% of cases (n=20) the formation of overvalued hypochondriacal ideas was noted. Non-suicidal self-harm occurred in 41 patients (82%), in 42% of cases (n=21) the patients made suicide attempts that were distinguished by a low danger to life. CONCLUSION: Hysteroform depressions in girls are characterized by polymorphism of the psychopathological structure, erosion of the depressive triad, originality of the clinical picture of dissociative disorders, presence of comorbid disorders, and frequent, but with a low danger to life suicidal attempts.

The Childbirth Fear Questionnaire and the Wijma Delivery Expectancy Questionnaire as Screening Tools for Specific Phobia, Fear of Childbirth.

BACKGROUND: Perinatal anxiety and related disorders are common (20%), distressing and impairing. Fear of childbirth (FoB) is a common type of perinatal anxiety associated with negative mental health, obstetrical, childbirth and child outcomes. Screening can facilitate treatment access for those most in need. OBJECTIVES: The purpose of this research was to evaluate the accuracy of the Childbirth Fear Questionnaire (CFQ) and the Wijma Delivery Expectations Questionnaire (W-DEQ) of FoB as screening tools for a specific phobia, FoB. METHODS: A total of 659 English-speaking pregnant women living in Canada and over the age of 18 were recruited for the study. Participants completed an online survey of demographic, current pregnancy and reproductive history information, as well as the CFQ and the W-DEQ, and a telephone interview to assess specific phobia FoB. RESULTS: Symptoms meeting full and subclinical diagnostic criteria for a specific phobia, FoB, were reported by 3.3% and 7.1% of participants, respectively. The W-DEQ met or exceeded the criteria for a "good enough" screening tool across several analyses, whereas the CFQ only met these criteria in one analysis and came close in three others. CONCLUSIONS: The W-DEQ demonstrated high performance as a screening tool for a specific phobia, FoB, with accuracy superior to that of the CFQ. Additional research to ensure the stability of these findings is needed.