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1.
Adv Exp Med Biol ; 1191: 291-329, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002935

RESUMO

Anxiety disorders are an enormous societal burden given their high lifetime prevalence among adult populations worldwide. A variety of anxiety disorders can be successfully treated with psychological treatments such as cognitive behavioral therapy (CBT), mindfulness-based cognitive therapy (MBCT), and acceptance and commitment therapy (ACT), either as stand-alone individual or group treatment or as adjunctive treatment to pharmacotherapy. Furthermore, a growing body of evidence suggests that therapist-guided Internet-delivered CBT (iCBT) and, to some degree, digitalized mindfulness- and acceptance-based interventions may be an efficacious complement to traditional face-to-face therapy. In view of the current advances regarding the integration of traditional and innovative treatment approaches, this chapter provides an overview on the theory and evidence base for different delivery modes of CBT-related interventions for specific phobia, panic disorder, agoraphobia, social anxiety disorder, and generalized anxiety disorder in adults. Finally, implications for clinical practice and research will be derived, and future directions for the psychological treatment of anxiety disorders will be outlined.


Assuntos
Terapia de Aceitação e Compromisso , Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental , Atenção Plena , Humanos , Transtornos Fóbicos/psicologia , Transtornos Fóbicos/terapia , Resultado do Tratamento
2.
Adv Exp Med Biol ; 1191: 451-464, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002941

RESUMO

Psychodynamic theory is founded on the idea that much, if not most, of human behavior is influenced by forces and experiences that lie outside of conscious awareness. It posits that despite what we may or may not recognize about our lived experience, an essential connection exists between unconscious processes and everyday psychological functioning. By extension, psychodynamic theory presumes that unconscious conflicts are pathognomonic of anxiety disorders and anxiety symptoms more generally. At the same time, the term "psychodynamic" refers not only to that which occurs within one's mind but also what happens between people and within families, groups, and systems. A comprehensive psychodynamic treatment of anxiety attempts to take into account these multiple domains of experience and functioning (including biological and genetic considerations) and applies a specific therapeutic approach to working with patients based in part on clinical techniques first developed by Sigmund Freud 100 years ago.


Assuntos
Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Ansiedade/psicologia , Ansiedade/terapia , Psicoterapia Psicodinâmica , Conscientização , Humanos
3.
Adv Exp Med Biol ; 1191: 543-559, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002945

RESUMO

Anxiety is prevalent in childhood and adolescence. Youth with maladaptive responses to common situations and stressors are at risk of having anxiety disorders. Persistent anxiety symptoms and anxiety disorders can be debilitating with long-term adverse outcomes in adulthood. Hence, decreasing the burden of anxiety disorders is an important public health priority. Development of anxiety disorders has a multifactorial etiology. There is a considerable complex interaction of genetics, temperament, parenting behavior, environmental triggers, and physiologic factors. Identification of these risk factors is key to early detection, prevention, and development of applicable management approaches. Despite several evidence-based treatments published, there are limited prevention strategies available. Effective implementation of prevention strategies is essential and can be achieved by either elimination or reduction of the negative risk factors or strengthening the protective factors on anxiety symptoms and anxiety disorders. This chapter reviews the common risk and protective factors and provides current literature on prevention strategies for pediatric and adolescent anxiety disorders.


Assuntos
Transtornos de Ansiedade/prevenção & controle , Transtornos de Ansiedade/psicologia , Adolescente , Transtornos de Ansiedade/genética , Criança , Humanos , Poder Familiar , Prevalência , Fatores de Proteção , Fatores de Risco , Temperamento
4.
Adv Exp Med Biol ; 1191: 561-576, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002946

RESUMO

Recent data has linked anxiety and its disorders in late life to increased morbidity and mortality, especially related to a higher cardiovascular burden and an increased cognitive decline. Clinically, anxiety symptoms may be more difficult to elicit in older adults who are less accurate in identifying anxiety symptoms and tend to minimize symptoms and to attribute symptoms to physical illness. Although SSRIs have proven more effective than psychotherapy in late-life anxiety, many elderly anxious subjects prefer psychotherapeutic interventions. These interventions appear to work best when tailored for the needs, expectations, and cultural background of older anxious subjects.


Assuntos
Transtornos de Ansiedade , Idoso , Ansiolíticos/uso terapêutico , Ansiedade/complicações , Ansiedade/diagnóstico , Ansiedade/psicologia , Ansiedade/terapia , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Doenças Cardiovasculares/complicações , Comorbidade , Humanos , Psicoterapia , Inibidores de Captação de Serotonina/uso terapêutico
5.
Adv Exp Med Biol ; 1191: 141-153, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002927

RESUMO

Substantial evidence from various studies suggests a preeminent role for early adverse experiences in the development of psychopathology. The most recent studies reviewed here suggest that early life stressors are associated with an increased risk for anxiety disorders in adulthood. Early life stress predisposes individuals to develop a number of psychiatric syndromes, particularly affective disorders, including anxiety disorders, and is therefore a significant health problem.This review examines the emerging literature on the relationship between stress, hypothalamic-pituitary-adrenal (HPA) axis function, and generalized anxiety disorder (GAD), panic disorder, and phobias and the role of early life stress as an important risk factor for HPA axis dysfunction.The most consistent findings in the literature show increased activity of the HPA axis in depression associated with hypercortisolemia and reduced inhibitory feedback. In addition to melancholic depression, a spectrum of other conditions may be associated with increased and prolonged activation of the HPA axis, including panic, GAD, phobias and anxiety. Moreover, HPA axis changes appear to be state-dependent, tending to improve upon resolution of the anxiety syndrome. Interestingly, persistent HPA hyperactivity has been associated with higher rates of relapse. These studies suggest that an evaluation of the HPA axis during treatment may help identify patients who are at a higher risk for relapse. These findings suggest that this dysfunction of the HPA axis is partially attributable to an imbalance between glucocorticoid and mineralocorticoid receptors. Evidence has consistently demonstrated that glucocorticoid receptor function is impaired in anxiety disorders. Moreover, normal basal cortisol levels and hyper-responsiveness of the adrenal cortex during a psychosocial stressor are observed in social phobics. Finally, abnormal HPA axis activity has also been observed in generalized anxiety disordered patients. Early stressful life events may provoke alterations of the stress response and thus of the HPA axis that can endure during adulthood, predisposing individuals to develop psychopathology.


Assuntos
Experiências Adversas da Infância , Transtornos de Ansiedade/etiologia , Transtornos de Ansiedade/fisiopatologia , Ansiedade/etiologia , Ansiedade/fisiopatologia , Sistema Hipotálamo-Hipofisário/fisiopatologia , Sistema Hipófise-Suprarrenal/fisiopatologia , Estresse Psicológico/complicações , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Humanos , Estresse Psicológico/psicologia
6.
Adv Exp Med Biol ; 1191: 169-184, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002929

RESUMO

This chapter describes the various animal models that seem relevant to the development of anxiolytic drugs, as well as the human models of induced anxiety, or more precisely the panic inducers including cholecystokinin. It is also mentioned the theoretical model of Deakin and Graeff which seems to keep all its relevance. The knock animals are evoked as relevant tools as well as a new optogenetic technique that needs to be used in this field.


Assuntos
Ansiolíticos , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/psicologia , Ansiedade/tratamento farmacológico , Ansiedade/psicologia , Modelos Animais de Doenças , Descoberta de Drogas , Animais , Ansiolíticos/farmacologia , Ansiolíticos/uso terapêutico , Colecistocinina/efeitos adversos , Humanos , Optogenética
7.
Adv Exp Med Biol ; 1191: 187-196, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002930

RESUMO

Under the partial influences of paradigm shift form category to dimension, the Diagnostic and Statistical Manual of Mental Disorder (DSM) was revised to the fifth edition (DSM-5); however, due to the lack of consistent biological makers and processes and the restricted availability of dimensional meta-structure, the revisions for the DSM-5 were based on a combination of categorical and dimensional approaches. Anxiety disorders were more clearly and consistently defined in the DSM-5 with the removal of obsessive compulsive, acute stress, and post-traumatic stress disorders. Differences between the childhood and adulthood categories of anxiety disorders were decreased, and overall, the symmetrical classification of anxiety subtypes was increased, since separation anxiety disorder and selective mutism were considered anxiety disorders, not neurodevelopmental disorders. Additionally, based on growing evidence, agoraphobia is distinct from panic disorder. Next, considering cultural syndromes including taijin kyofusho, khyal cap, trung gio attacks, and ataque de nervios, cultural influences are considered a significant factor for definitions and presentations of anxiety disorders. Controversies in the DSM-5 criteria for anxiety disorders are lowering the diagnostic thresholds of anxiety disorders and limiting the dichotomous view of anxiety and depression when defining generalized anxiety disorder. Further studies of alternative approaches to the restrictions of the DSM-5 criteria of anxiety disorders, including transdiagnostic specifiers and dimensional assessment tools, may be required.


Assuntos
Transtornos de Ansiedade/classificação , Transtornos de Ansiedade/diagnóstico , Manual Diagnóstico e Estatístico de Transtornos Mentais , Fatores Etários , Ansiedade/complicações , Ansiedade/psicologia , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/psicologia , Depressão/complicações , Depressão/psicologia , Humanos , Transtornos de Estresse Pós-Traumáticos/classificação , Transtornos de Estresse Pós-Traumáticos/diagnóstico
8.
Adv Exp Med Biol ; 1191: 237-261, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002933

RESUMO

Anxiety disorders are debilitating psychological disorders characterized by a wide range of cognitive and somatic symptoms. Anxiety sufferers have a higher lifetime prevalence of various medical problems. Chronic medical conditions furthermore increase the likelihood of psychiatric disorders and overall dysfunction. Lifetime rates of cardiovascular, respiratory, gastrointestinal, and other medical problems are disproportionately high in anxiety and panic/fear sufferers. The heightened comorbidity is not surprising as many symptoms of anxiety and panic/fear mimic symptoms of medical conditions. Panic disorder specifically is strongly linked to medical conditions due to its salient somatic symptoms, such as dyspnea, dizziness, numbness, chest pain, and heart palpitations, all of which can signal danger and deterioration for chronic disease sufferers. This chapter identifies shared correlates of medical illness and anxiety disorders and evidence for misinterpretation of symptoms as medically relevant and offers an analysis of implications for treatment of both types of conditions. We will concentrate on medical conditions with high associations for anxiety and panic by aspects of symptomatology, specifically neurological disorders (fibromyalgia, epilepsy, cerebral palsy), diabetes, gastrointestinal illness (irritable bowel syndrome, gastroesophageal reflux disease), and cardiovascular and respiratory illnesses (asthma).


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/terapia , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/psicologia , Doença Crônica , Comorbidade , Humanos , Transtorno de Pânico/complicações , Transtorno de Pânico/epidemiologia , Transtorno de Pânico/psicologia , Transtorno de Pânico/terapia
9.
Adv Exp Med Biol ; 1191: 389-414, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002939

RESUMO

The principal aim to this chapter is to present the latest ideas in virtual reality (VR), some of which have already been applied to the field of anxiety disorders, and others are still pending to be materialized. More than 20 years ago, VR emerged as an exposure tool in order to provide patients and therapists with more appealing ways of delivering a technique that was undoubtedly effective but also rejected and thus underused. Throughout these years, many improvements were achieved. The first section of the chapter describes those improvements, both considering the research progresses and the applications in the real world. In a second part, our main interest is to expand the discussion of the new applications of VR beyond its already known role as an exposure tool. In particular, VR is enabling the materialization of numerous ideas that were previously confined to a merely philosophical discussion in the field of cognitive sciences. That is, VR has the enormous potential of providing feasible ways to explore nonclassical ways of cognition, such as embodied and situated information processing. Despite the fact that many of these developments are not fully developed, and not specifically designed for anxiety disorders, we want to introduce these new ideas in a context in which VR is experiencing an enormous transformation.


Assuntos
Transtornos de Ansiedade/terapia , Terapia de Exposição à Realidade Virtual , Transtornos de Ansiedade/psicologia , Cognição , Humanos , Realidade Virtual
10.
Adv Exp Med Biol ; 1191: 523-541, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002944

RESUMO

Exposure therapy, a key treatment for anxiety disorders, can be modelled in the laboratory using Pavlovian fear extinction. Understanding the hormonal and neurobiological mechanisms underlying fear extinction in females, who are twice more likely than males to present with anxiety disorders, may aid in optimising exposure therapy outcomes in this population. This chapter will begin by discussing the role of the sex hormones, estradiol and progesterone, in fear extinction in females. We will also propose potential mechanisms by which these hormones may modulate fear extinction. The second half of this chapter will discuss the long-term hormonal, neurological and behavioural changes that arise from pregnancy and motherhood and how these changes may alter the features of fear extinction in females. Finally, we will discuss implications of this research for the treatment of anxiety disorders in women with and without prior reproductive experience.


Assuntos
Transtornos de Ansiedade/metabolismo , Transtornos de Ansiedade/terapia , Ansiedade/metabolismo , Ansiedade/terapia , Estradiol/metabolismo , Progesterona/metabolismo , Reprodução , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Extinção Psicológica , Medo , Feminino , Humanos , Gravidez
11.
Psychiatr Hung ; 35(1): 58-67, 2020.
Artigo em Húngaro | MEDLINE | ID: mdl-31854323

RESUMO

INTRODUCTION: Several long-term follow-up studies investigate the progression of adolescent onset major depressive disorder but much less explore short and long-term consequences and prognosis into adulthood of childhood- onset depression. The aim of the present study is to follow childhood-onset depression, lifetime comorbid psychiatric disorders and suicidal behavior into adulthood. METHODS: Subjects (N=166) were 25.95+2.42 years old on average, 54.2% were women. Follow-up period lasted for a mean of 14.74+1.31 years. Psychiatric diagnosis was assessed by a DSM-IV based semi-structured interview. Subjects reported on 4 stages of suicidal behavior as one of the symptoms of depressive disorder. RESULTS: The onset of the first depressive episode was at the mean age of 10.17+2.34 years. 40,4% of the sample had only 1 episode while recurrent depressive episode presented in 32.5% above 18 years of age. Lifetime comorbid psychiatric disorders were present in more than 1/3 of the sample. The most frequent lifetime comorbidity was anxiety (42.4%), and specific phobia among anxiety disorders. Lifetime attention deficit-hyperactivity disorder and oppositional/conduct disorder were also frequent (25.9% and 16.9%, respectively). Suicidal behavior was not present life-time in 19.1% of the sample. Thoughts of death and thoughts of suicide were quite frequent (80.8% and 69.5%, respectively), specific plans and suicidal attempt were more frequent in girls (plan:female vs male 53.9% vs 38.4%, attempt: 33.3% vs 9.6%) during follow-up. CONCLUSION: About one-third of childhood-onset depression had recurrence above 18 years of age, which is lower than the recurrence rate for adolescent onset depression. A high rate of lifetime comorbidity was found between depression and anxiety disorders. The assessment of the actual level of suicidal behavior is important in the prevention of selfdestructive behavior.


Assuntos
Depressão/diagnóstico , Depressão/psicologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Suicídio/psicologia , Adolescente , Adulto , Idade de Início , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Criança , Comorbidade , Depressão/complicações , Transtorno Depressivo Maior/complicações , Feminino , Seguimentos , Humanos , Masculino , Prognóstico , Fatores de Risco , Adulto Jovem
12.
Arq Gastroenterol ; 56(3): 252-255, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31633720

RESUMO

BACKGROUND: Fatigue is highly prevalent in end stage liver disease, the studies about its association with exercise capacity in cirrhotic patients before liver are scarse. OBJECTIVE: In this study, we evaluated fatigue in 95 in end stage liver disease patients awaiting transplantation, compared to healthy volunteers, and tested the association between exercise capacity and fatigue. METHODS: Cross-sectional study of patients with chronic liver disease treated at a referral center in Fortaleza, Brazil. Fatigue was quantified with the Fatigue Severity Scale. The patients were submitted to the 6-min walk test, the 6-min step test, the Hospital Anxiety and Depression Scale, C-reative protein measurement and hematocrit count, measurement of dyspnea among other tests. Fatigue data were obtained from healthy individuals for comparison with patients. RESULTS: The mean age of patients was 45.9±12.3 years, and 53.7% were male. Fatigue, anxiety and depression levels were higher among end stage liver disease patients than among controls. A negative correlation was observed between 6 min step test and Fatigue Severity Scale score (r= -0.2; P=0.02) and between hematocrit count and Fatigue Severity Scale score (r= -0.24; P=0.002). Dyspnea on the Borg scale and fatigue were positively correlated (r=31; P=0.002). In the multivariate analysis, low 6-min step test values and high levels of dyspnea were associated with fatigue. CONCLUSION: Fatigue was more prevalent and severe in end stage liver disease patients than in healthy controls. Low 6MST values and high levels of dyspnea were associated with fatigue in this scenario.


Assuntos
Doença Hepática Terminal/psicologia , Tolerância ao Exercício/fisiologia , Fadiga/psicologia , Transplante de Fígado/psicologia , Adulto , Transtornos de Ansiedade/psicologia , Estudos Transversais , Transtorno Depressivo/psicologia , Doença Hepática Terminal/fisiopatologia , Fadiga/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Listas de Espera
13.
Rev Lat Am Enfermagem ; 27: e3191, 2019.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-31596421

RESUMO

OBJECTIVE: to evaluate the impact on the quality of life as well as anxiety and pain in patients with nephrostomy tubes. METHOD: this is a longitudinal descriptive study performed on a sample of n=150 patients. To evaluate the quality of life, the EuroQol-5D questionnaire was used; anxiety was quantified by the Beck Anxiety Inventory; to study pain, a visual analogue scale was employed. RESULTS: statistically significant differences were found in the quality of life, with its worsening (r = 0.51; p <0.01) when evaluated at the first tube replacement. Patients presented mild to moderate anxiety before the procedure, which was reduced at the first tube replacement, although this difference was not significant (r = 0.028, p = 0.393). Finally, the degree of pain was also significantly reduced (r = 0.13, p<0.01) after six weeks. As for gender, women presented the worst values ​​in the three variables studied (worse quality of life and greater anxiety and pain). CONCLUSIONS: nephrostomy tubes have a negative impact on the patient's quality of life. During the time they live with these tubes, patients have mild to moderate pain and anxiety.


Assuntos
Transtornos de Ansiedade/psicologia , Nefrostomia Percutânea/efeitos adversos , Dor/etiologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Nefrostomia Percutânea/enfermagem , Nefrostomia Percutânea/psicologia , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Inquéritos e Questionários
14.
Medicine (Baltimore) ; 98(38): e16973, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567932

RESUMO

BACKGROUND: As the most important component of cardiovascular disease, coronary heart disease (CHD) is closely related to psychological factors such as anxiety. Anxiety, whether present before or after the onset of illness, can lead to many serious consequences. The aim of this systematic review and meta-analysis was to assess the prevalence of and potential risk factors for anxiety after coronary heart disease (post-CHD anxiety). METHOD: Systematic searches were performed in electronic databases including China National Knowledge Infrastructure (CNKI), Wanfang, Technology Journal database (VIP), PubMed, Web of Science, Embase and Medline. RESULT: Thirteen studies were included. With regard to cross-sectional studies, the prevalence of post-CHD anxiety was P = .37, 95% CI (0.26-0.49). The overall analysis among cohort studies revealed that the prevalence of post-CHD anxiety was P = .50, 95% CI (0.05-0.95). Among the 11 potential risk factors, low education level [OR = 1.46, 95% CI (1.05-2.02)] and long duration of disease [OR = 2.05, 95% CI (1.05-4.00)] were statistically significant. CONCLUSION: There is high heterogeneity between studies and many defects; thus, further research is required to support these results. Attention should be paid to post-CHD anxiety, and clinical caring should include psychological counselling and imparting disease-related knowledge to patients with a long disease duration and low educational background.


Assuntos
Transtornos de Ansiedade/epidemiologia , Infarto do Miocárdio/psicologia , Transtornos de Ansiedade/psicologia , China/epidemiologia , Humanos , Prevalência , Fatores de Risco
15.
J Consult Clin Psychol ; 87(11): 989-1002, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31556653

RESUMO

OBJECTIVE: The investigation of session-to-session effects of working alliance on symptoms and coping experiences in patients diagnosed with generalized anxiety disorder. In addition, investigating these effects dependent on whether therapists are primed to work with patients strength (resource priming) or to adhere to the treatment manual (adherence priming). METHOD: Data was drawn from a randomized controlled trial in which 57 patients were randomly assigned to either the resource priming condition or the adherence priming condition. Within- and between patient associations were disentangled using dynamic structural equation modeling. RESULTS: The total score of the working alliance, as well as all its overlapping components (i.e., goal agreement, task consensus, bond) showed significant within-patient effects on next session coping experiences. More specifically, better alliance scores in one session were followed by more coping experiences in the subsequent session. With regard to anxiety symptoms, an association was found only with the working alliance total score as well as for the bonds component, but not for the goals and task components of the working alliance. The priming condition (resource priming vs. adherence priming) had no influence on the within-patient alliance-outcome association. Between-patient alliance associations were only present with coping experiences, but not with anxiety symptoms. CONCLUSION: The findings provide further empirical evidence for the hypothesis that the working alliance may be a robust facilitative factor for change in CBT treatments for generalized anxiety disorder, which evolves irrespective of the strictness with which therapists adhere to the treatment manual. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Relações Profissional-Paciente , Adaptação Psicológica , Adulto , Transtornos de Ansiedade/psicologia , Feminino , Fidelidade a Diretrizes , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
16.
Orthopade ; 48(11): 957-962, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31559467

RESUMO

BACKGROUND: Rheumatic and mental disorders are common and affect each other. The comorbidities are often diagnosed too late or not at all but cause considerable suffering for those affected and have a negative effect on the health-related quality of life and therapeutic success. OBJECTIVES: Is there any evidence regarding common pathophysiological mechanisms and how can they be considered in terms of therapy? METHODS: Recent findings, reviews and basic literature are analyzed and an update is presented and discussed. RESULTS: The current data suggest a mutual influence of the factors stress and inflammation both in depressive disorders, anxiety disorders and chronic pain, as well as in diseases of the rheumatic type. There is a close relationship between immunological and neuronal processes that bi-directionally regulate the individual's stress response. CONCLUSIONS: For sufficient therapy the establishment of an interdisciplinary treatment concept in clinical everyday life is to be striven for. In addition to rheumatic treatment, this should include a multimodal approach to both pharmacological and psycho-socio-therapeutic components. In particular, potential interactions must be taken into account.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Inflamação , Doenças Reumáticas/psicologia , Estresse Psicológico/epidemiologia , Antidepressivos/uso terapêutico , Transtornos de Ansiedade/tratamento farmacológico , Comorbidade , Depressão , Humanos , Inflamação/epidemiologia , Inflamação/psicologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Qualidade de Vida , Doenças Reumáticas/epidemiologia , Estresse Psicológico/tratamento farmacológico , Estresse Psicológico/psicologia
17.
Postgrad Med ; 131(7): 438-444, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31482756

RESUMO

Pain is a subjective experience that is influenced by genetics, gender, social, cultural and personal parameters. Opposed to chronic pain, which by definition has to last for at least 3 months, acute pain is mostly because of trauma, acute medical conditions or treatment. The link between mood disorders and acute pain has proven to be increasingly significant since the link is bi-directional, and both act as risk factors for each other. Depression and anxiety are associated with increased perception of pain severity, whereas prolonged duration of acute pain leads to increased mood dysregulation. Although both depression and anxiety have a proven association with acute pain, the link between depression and acute pain is more thoroughly studied. Pain can be the presenting or sole complaint in depressed patients who present to primary care practices and is often overlooked by clinicians. However, reports on the perception of experimentally-induced pain in depressed patients are mixed, showing both an increased and decreased pain threshold and pain tolerance across various studies. Although less data is published about anxiety and pain, the relationship is consistent across studies as increased anxiety leads to increased severity of pain perceived and decreased pain tolerance. Anxiety as well as fear, stress, and catastrophizing are also shown to be mediators in the causal pathway between pain and disability.


Assuntos
Dor Aguda/psicologia , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/psicologia , Dor Aguda/epidemiologia , Dor Aguda/fisiopatologia , Dor Aguda/terapia , Analgésicos/uso terapêutico , Antidepressivos/uso terapêutico , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/fisiopatologia , Transtornos de Ansiedade/terapia , Catastrofização/epidemiologia , Catastrofização/fisiopatologia , Catastrofização/psicologia , Terapia Cognitivo-Comportamental , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/fisiopatologia , Transtorno Depressivo/terapia , Humanos , Manejo da Dor , Limiar da Dor , Índice de Gravidade de Doença
18.
Psychiatr Danub ; 31(Suppl 3): 386-389, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488757

RESUMO

BACKGROUND: Nowadays, anxiety disorders are becoming more and more important in our population. And if there is one category of people more vulnerable to this problem, it is the teenagers. In addition, more and more children and teenagers are diagnosed with an IQ greater than 130, causing all the stress and questions that it generates. In this project, we are comparing two groups of adolescents, one with an IQ over 130, the other with an IQ less than 130. We are wondering if there is any difference between these groups, in terms of phobia and other psychopathologies. SUBJECTS AND METHODS: A sample of 35 teenagers, from 12 to 16 years old, separated in two groups (IQ over 130 and IQ below 130), fulfilled the following questionnaires: the School Rehabilitation Assessment Scale-Revised (SARS-R), the "Family Adaptability and Cohesiveness Evaluation Scale III" (FACES III), and the "Kiddie- SADS-lifetime" (K-SADS-PL), and a social data collection questionnaire. RESULTS: At the end of this study, we can retain the following relevant elements: adolescents with IQs greater than 130 are statistically more likely to be the eldest siblings (Cochran Test F=9.159, p=0.010). They do not develop more phobias, but are more shy (t=4.375, p=0.036) than the control population. These high-potential and shy teenagers have a whole list of commonalities, such as being easily irritable, being easily distracted, ect... They have fewer friends in real life (t=2.255, p=0.033), fewer virtual friends (t=4.346, p=0.000) and fewer virtual relationships (t=2.431, p=0.021). Their families are very cohesive (Test t=0.004). There is no significant role of the socio-professional class of parents playing in the value of the IQ of their children (t=4.667, p=0.323). CONCLUSION: To conclude, being a teenager and having an IQ greater than 130 is not always a pleasure. Our results showed us that the majority of these young people consider themselves as shy, unsure of themselves and claim to have many fears. This is evidence of an increased anxiety component compared to the control sample. It seems important to insist on the need to be able and to know how to identify these young people as soon as possible, in order to propose appropriate therapeutic management.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Ansiedade/epidemiologia , Ansiedade/psicologia , Testes de Inteligência/estatística & dados numéricos , Inteligência , Psicopatologia , Timidez , Adolescente , Ansiedade/prevenção & controle , Transtornos de Ansiedade/prevenção & controle , Estudos de Casos e Controles , Criança , Medo , Amigos/psicologia , Humanos , Fatores Socioeconômicos , Inquéritos e Questionários
19.
Psychiatr Danub ; 31(Suppl 3): 452-454, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488771

RESUMO

"Before convincing the intellectual part of the mind it is necessary to touch and prepare the heart", an aphorism by Blaise Pascal (Vozza 1995), refers to one of the most important functions of strategic training, not only being successful in making communicative messages correctly and rationally understood, but also involving its addressee, above all by making one enter into emotional syntony with the communicative content. To understand the precious wealth of knowledge that has over time brought the necessary skills to do strategic training, it is necessary to find its roots by taking a step back in time. It is necessary to go as far as the fifth century BC, with Protagoras and its persuasive efficacy, with a rapid historical excursus passing by Aristotle and his Sophistic communication techniques to arrive at about 2000 years later, passing through social psychology, up to the Palo Alto strategic school. Among its various activities, the Genius Academy Centre for Research and Psychological Studies has decided to push two strategic training projects aiming to increase the level of well-being perceived by the addressee and encouraging the desired change. One of the two strategic training projects, A "Journey" in a journey, conceived by the writer, started in 2013. The educational and therapeutic value are amplified by optimizing the suggestions and stimuli of the journey. Another strategic training project for future aeronautical professionals, which gives a great contribution to the traditional technical training, is an innovative psychological programme specifically designed to prepare, not only for technical operational challenges, but also for numerous psychological challenges deriving from working in a particular environment such as the airport. It is specifically designed to study and improve the travel experience of people in airport transit and aims to raise the level of traveller's well-being, through a series of highly innovative interventions in specifically provided areas with the use of digital reality in coping and helping with anxiety and fear of flying.


Assuntos
Adaptação Psicológica , Transtornos de Ansiedade/prevenção & controle , Transtornos de Ansiedade/psicologia , Ansiedade/prevenção & controle , Ansiedade/psicologia , Comunicação Persuasiva , Viagem/psicologia , Ansiedade/terapia , Transtornos de Ansiedade/terapia , História do Século XXI , História Antiga , Humanos
20.
J Clin Neurosci ; 69: 21-25, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31473092

RESUMO

This study evaluated suicidality and its risk factors in patients with tension-type headache (TTH). We recruited new patients with TTH who visited general hospitals. We recorded their clinical characteristics and conducted the Headache Impact Test-6 (HIT-6) and the Insomnia Severity Index (ISI) for assessment. We also interviewed the patients to identify major depressive disorder (MDD), generalized anxiety disorder (GAD), and suicidality with the Mini International Neuropsychiatric Interview-Plus Version 5.0.0 (MINI). The frequency of suicidality was compared between TTH patients and healthy controls. Major risk factors for suicidality were also determined. A total of 332 TTH patients with the same number of healthy controls were recruited from five general hospitals. Suicidality was observed in 82 (24.7%) TTH patients. The frequency of suicidality was significantly higher in patients with TTH than in the controls. Furthermore, the frequency of suicidality was higher in patients with chronic TTH (CTTH) than in the controls. The major risk factors for suicidality were MDD, GAD, a low education level, insomnia, chronicity of TTH, and pericranial tenderness. Suicidal ideation or attempt seems to be a common feature in TTH. Therefore, it is important to identify risk factors related to suicidality in TTH patients, which may help reduce suicidality.


Assuntos
Ideação Suicida , Cefaleia do Tipo Tensional/psicologia , Adulto , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/psicologia , Estudos de Casos e Controles , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Fatores de Risco
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