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Panic
Kinds of Panic Terms modified by Panic Selected AbstractsParsing the general and specific components of depression and anxiety with bifactor modeling,DEPRESSION AND ANXIETY, Issue 7 2008Leonard J. Simms Ph.D. Abstract Recent hierarchical models suggest that both general and specific components are needed to fully represent the variation observed among mood and anxiety disorders. However, little is known about the relative size, severity, and psychological meaning of these components. We studied these features through bifactor modeling of the symptoms from the Inventory of Depression and Anxiety Symptoms [IDAS; Watson et al., 2007] in 362 community adults, 353 psychiatric patients, and 673 undergraduates. Results revealed that although all IDAS symptom types loaded prominently both on a general factor as well as specific factors, some symptom groups,such as dysphoria, generalized anxiety, and irritability,were influenced more strongly by the general factor, whereas others,e.g., appetite gain, appetite loss, and low well-being,contained a larger specific component. Second, certain symptom groups,e.g., Suicidality, Panic, Appetite Loss, and Ill Temper,reflected higher severity than other symptom groups. Finally, general factor scores correlated strongly with markers of general distress and negative emotionality. These findings support a hierarchical structure among mood and anxiety symptoms and have important implications for how such disorders are described, assessed, and studied. Depression and Anxiety 0:1,13, 2007. Published 2007 Wiley-Liss, Inc. [source] Does occasional cannabis use impact anxiety and depression treatment outcomes?: results from a randomized effectiveness trialDEPRESSION AND ANXIETY, Issue 6 2007Jonathan B. Bricker Ph.D. Abstract This study investigated the extent to which occasional cannabis use moderated anxiety and depression outcomes in the Collaborative Care for Anxiety and Panic (CCAP) study, a combined cognitive-behavioral therapy (CBT) and pharmacotherapy randomized effectiveness trial. Participants were 232 adults from six university-based primary care outpatient clinics in three West Coast cities randomized to receive either the CCAP intervention or the usual care condition. Results showed significant (P<.01) evidence of an interaction between treatment group (CCAP vs. usual care) and cannabis use status (monthly vs. less than monthly) for depressive symptoms, but not for panic disorder or social phobia symptoms (all P>.05). Monthly cannabis users' depressive symptoms improved in the CCAP intervention just as much as those who used cannabis less than monthly, whereas monthly users receiving usual care had significantly more depressive symptoms than those using less than monthly. A combined CBT and medication treatment intervention may be a promising approach for the treatment of depression among occasional cannabis users. Depression and Anxiety 24:392,398, 2007. © 2006 Wiley-Liss, Inc. [source] A double-blind study of the efficacy of venlafaxine extended-release, paroxetine, and placebo in the treatment of panic disorderDEPRESSION AND ANXIETY, Issue 1 2007Mark H. Pollack M.D. Abstract To date, no large-scale, controlled trial comparing a serotonin,norepinephrine reuptake inhibitor and selective serotonin reuptake inhibitor with placebo for the treatment of panic disorder has been reported. This double-blind study compares the efficacy of venlafaxine extended-release (ER) and paroxetine with placebo. A total of 664 nondepressed adult outpatients who met DSM-IV criteria for panic disorder (with or without agoraphobia) were randomly assigned to 12 weeks of treatment with placebo or fixed-dose venlafaxine ER (75,mg/day or 150,mg/day), or paroxetine 40,mg/day. The primary measure was the percentage of patients free from full-symptom panic attacks, assessed with the Panic and Anticipatory Anxiety Scale (PAAS). Secondary measures included the Panic Disorder Severity Scale, Clinical Global Impressions,Severity (CGI-S) and ,Improvement (CGI-I) scales; response (CGI-I rating of very much improved or much improved), remission (CGI-S rating of not at all ill or borderline ill and no PAAS full-symptom panic attacks); and measures of depression, anxiety, phobic fear and avoidance, anticipatory anxiety, functioning, and quality of life. Intent-to-treat, last observation carried forward analysis showed that mean improvement on most measures was greater with venlafaxine ER or paroxetine than with placebo. No significant differences were observed between active treatment groups. Panic-free rates at end point with active treatment ranged from 54% to 61%, compared with 35% for placebo. Approximately 75% of patients given active treatment were responders, and nearly 45% achieved remission. The placebo response rate was slightly above 55%, with remission near 25%. Adverse events were mild or moderate and similar between active treatment groups. Venlafaxine ER and paroxetine were effective and well tolerated in the treatment of panic disorder. Depression and Anxiety 24:1,14, 2007. © 2006 Wiley-Liss, Inc. [source] Panic and suicidal ideation and suicide attempts: results from the National Comorbidity SurveyDEPRESSION AND ANXIETY, Issue 3 2006M.P.H., Renee D. Goodwin Ph.D. Abstract Our objective was to determine the association between panic attacks (PAs) and panic disorder (PD), and suicidal ideation (SI) and suicide attempts (SAs) in a nationally representative sample of adults in the community. Data were drawn from the National Comorbidity Survey (n=5,877), a representative household sample of adults ages 15,54 in the United States. Multiple logistic regression analyses were used to examine the relationship between current and lifetime PA and PD and SI and SA, adjusting for differences in demographic characteristics, comorbid mental disorders (major depression, alcohol dependence, and substance dependence), childhood trauma (physical and sexual abuse), and number of lifetime mental disorders. Past-year and lifetime PA and PD were associated with increased SI (both past year and lifetime), and persisted after adjusting for comorbidity and early trauma. Associations between PA and SA were no longer statistically significant after adjusting for comorbidity. Past-year and lifetime PD were associated with lifetime SA, but these associations were no longer statistically significant after adjusting for comorbidity. Past-year and lifetime PD were associated with past-year SA, and this association persisted after adjusting for demographics, comorbidity, and number of lifetime mental disorders. These findings are consistent with previous results, and further help to clarify the relationships between panic and suicide behavior by identifying potential methodological reasons for inconsistencies in results from previous studies. Depression and Anxiety 23:124,132, 2006. © 2006 Wiley-Liss, Inc. [source] Panic Disorder Severity Scale: Reliability and validity of the Turkish version,,DEPRESSION AND ANXIETY, Issue 1 2004E. Serap Monkul M.D. Abstract We assessed the reliability and validity of the Turkish version of the seven-item Panic Disorder Severity Scale (PDSS). We recruited 174 subjects, including 104 with current DSM-IV panic disorder with (n = 76) or without(n = 28)agoraphobia, 14 with a major depressive episode, 24 with a non-panic anxiety disorder, and 32 healthy controls. Assessment instruments were Panic Disorder Severity Scale, Panic and Agoraphobia Scale, both the observer-rated (P&Ao) and self-rating (P&Asr); Clinical Global Impression Scale (CGI); Hamilton Anxiety Scale, and Beck Depression Inventory. We repeated the measures for a group of panic disorder patients (n = 51) after 4 weeks to assess test,retest reliability. The internal consistency (Cronbach's ,) of the PDSS was .92,94. The inter-rater correlation coefficient was .79. The test,retest correlation coefficient after 4 weeks was .63. In discriminant validity analyses, the highest correlation for PDSS was with P&Ao, P&Asr (r=.87 and .87, respectively) and CGI (r=.76) and the lowest with Beck Depression Inventory (r=.29). The cut-off point was six/seven, associated with high sensitivity (99%) and specificity (98%). This study confirmed the objectivity, reliability and validity of the Turkish version of the PDSS. Depression and Anxiety 00:000,000, 2004. © 2004 Wiley-Liss, Inc. [source] The Dynamic of PanicGERMAN RESEARCH, Issue 3 2006Rembert Unterstell Simulations can be used to model panic situations and pedestrian flows. The results of such simulations help make mass events safer [source] Crime, Media and Moral Panic in an Expanding European UnionTHE HOWARD JOURNAL OF CRIMINAL JUSTICE, Issue 1 2009ROB C. MAWBY Abstract: In the latest phase of European Union enlargement Bulgaria and Romania were admitted to EU membership on 1 January 2007. In the UK, media coverage of the accession process focused on the potential movement of large numbers of people from Eastern to Western European states; a particular focus was the crime risk associated with enlargement. This article examines how newspapers reported the perceived crime threats and assesses the extent to which the concerns can be understood as a moral panic. The article confirms the contemporary utility of moral panic analysis, albeit with some flexibility to reflect the modern media landscape. [source] Gay Rights and Moral Panic: The Origins of America's Debate on Homosexuality by Fred FejesTHE JOURNAL OF AMERICAN CULTURE, Issue 4 2009Peter Cava No abstract is available for this article. [source] Banking Panics in the Gilded AgeECONOMICA, Issue 287 2005Forrest Capie No abstract is available for this article. [source] You Keep Coming Back Like A Song: Adult Audiences, Taste Panics, and the Idea of the StandardJOURNAL OF POPULAR MUSIC STUDIES, Issue 1 2001Keir Keightley [source] The Politics of Antisocial Behaviour: Amoral Panics by S. WaitonTHE HOWARD JOURNAL OF CRIMINAL JUSTICE, Issue 4 2009ROD MORGAN No abstract is available for this article. [source] Schoolyard Shootings: Racism, Sexism, and Moral Panics over Teen ViolenceANTIPODE, Issue 4 2001Stuart C Aitken First page of article [source] The impact of panic-agoraphobic comorbidity on suicidality in hospitalized patients with major depressionDEPRESSION AND ANXIETY, Issue 3 2010Lily A. Brown B.S. Abstract Background: Previous research in outpatient samples suggests that panic and agoraphobic comorbidity is related to suicidality in outpatients with major depression. The purpose of the study was to further investigate this relationship specifically in a hospitalized sample. Method: This study examined the severity of current suicidal ideation and behaviors in a psychiatric hospital sample diagnosed with major depressive disorder alone (MDD; n=28) versus MDD plus panic-agoraphobic spectrum disorders (MDD+PAS; n=69). Results: Members of the MDD+PAS group were significantly more likely to have had a suicide attempt history, higher current depression severity, and higher current suicidal severity compared with individuals in the MDD alone group. The relationship between the current suicidality and comorbid PAS remained significant after controlling for the overall depression severity and other clinical factors. Conclusions: These findings suggest that panic-agoraphobic comorbidity is associated with a greater risk for suicidality in hospitalized patients, which cannot be adequately explained by the level of current depression alone. The clinical and research implications for these findings are discussed. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source] Panic disorder: a review of DSM-IV panic disorder and proposals for DSM-V,DEPRESSION AND ANXIETY, Issue 2 2010Michelle G. Craske Ph.D Abstract This review covers the literature since the publication of DSM-IV on the diagnostic criteria for panic attacks (PAs) and panic disorder (PD). Specific recommendations are made based on the evidence available. In particular, slight changes are proposed for the wording of the diagnostic criteria for PAs to ease the differentiation between panic and surrounding anxiety; simplification and clarification of the operationalization of types of PAs (expected vs. unexpected) is proposed; and consideration is given to the value of PAs as a specifier for all DSM diagnoses and to the cultural validity of certain symptom profiles. In addition, slight changes are proposed for the wording of the diagnostic criteria to increase clarity and parsimony of the criteria. Finally, based on the available evidence, no changes are proposed with regard to the developmental expression of PAs or PD. This review presents a number of options and preliminary recommendations to be considered for DSM-V. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source] Diversity of effective treatments of panic attacks: what do they have in common?,DEPRESSION AND ANXIETY, Issue 1 2010Walton T. Roth M.D. Abstract By comparing efficacious psychological therapies of different kinds, inferences about common effective treatment mechanisms can be made. We selected six therapies for review on the basis of the diversity of their theoretical rationales and evidence for superior efficacy: psychoanalytic psychotherapy, hypercapnic breathing training, hypocapnic breathing training, reprocessing with and without eye-movement desensitization, muscle relaxation, and cognitive behavior therapy. The likely common element of all these therapies is that they reduce the immediate expectancy of a panic attack, disrupting the vicious circle of fearing fear. Modifying expectation is usually regarded as a placebo mechanism in psychotherapy, but may be a specific treatment mechanism for panic. The fact that this is seldom the rationale communicated to the patient creates a moral dilemma: Is it ethical for therapists to mislead patients to help them? Pragmatic justification of a successful practice is a way out of this dilemma. Therapies should be evaluated that deal with expectations directly by promoting positive thinking or by fostering non-expectancy. Depression and Anxiety, 2010. Published 2009 Wiley-Liss, Inc. [source] Are there gender differences in catastrophic appraisals in panic disorder with agoraphobia?DEPRESSION AND ANXIETY, Issue 8 2007F.R.A.N.Z.C.P., Ph.D., Vladan Starcevic M.D. Abstract Our aim in this study was to compare panic-related catastrophic appraisals between women and men with panic disorder with agoraphobia (PDA). One hundred two outpatients with PDA (75 women and 27 men) participated. Two instruments for the assessment of catastrophic appraisals, Agoraphobic Cognitions Questionnaire and Panic Appraisal Inventory, were administered before and after cognitive-behavioral therapy (CBT) that also included pharmacotherapy in three-fourths of the patients. Female and male patients did not differ significantly in terms of their tendency to anticipate catastrophic consequences of panic, before or after CBT-based treatment. For both females and males, the tendency to make catastrophic appraisals decreased significantly with treatment. We conclude that among patients with PDA there are no gender differences in catastrophic appraisals of panic sensations and symptoms. The apparently higher risk of panic recurrence in women does not seem to be related to their panic-related catastrophic appraisals. These findings also support a notion that there is no gender difference in response to CBT-based treatment of PDA. Depression and Anxiety 24:545,552, 2007. © 2006 Wiley-Liss, Inc. [source] Panic and suicidal ideation and suicide attempts: results from the National Comorbidity SurveyDEPRESSION AND ANXIETY, Issue 3 2006M.P.H., Renee D. Goodwin Ph.D. Abstract Our objective was to determine the association between panic attacks (PAs) and panic disorder (PD), and suicidal ideation (SI) and suicide attempts (SAs) in a nationally representative sample of adults in the community. Data were drawn from the National Comorbidity Survey (n=5,877), a representative household sample of adults ages 15,54 in the United States. Multiple logistic regression analyses were used to examine the relationship between current and lifetime PA and PD and SI and SA, adjusting for differences in demographic characteristics, comorbid mental disorders (major depression, alcohol dependence, and substance dependence), childhood trauma (physical and sexual abuse), and number of lifetime mental disorders. Past-year and lifetime PA and PD were associated with increased SI (both past year and lifetime), and persisted after adjusting for comorbidity and early trauma. Associations between PA and SA were no longer statistically significant after adjusting for comorbidity. Past-year and lifetime PD were associated with lifetime SA, but these associations were no longer statistically significant after adjusting for comorbidity. Past-year and lifetime PD were associated with past-year SA, and this association persisted after adjusting for demographics, comorbidity, and number of lifetime mental disorders. These findings are consistent with previous results, and further help to clarify the relationships between panic and suicide behavior by identifying potential methodological reasons for inconsistencies in results from previous studies. Depression and Anxiety 23:124,132, 2006. © 2006 Wiley-Liss, Inc. [source] Prevalence and relationship to delusions and hallucinations of anxiety disorders in schizophreniaDEPRESSION AND ANXIETY, Issue 2 2003F.R.C.P.C., Philip Tibbo M.D. Abstract We investigated the prevalence of anxiety disorders in a sample of individuals with chronic schizophrenia, controlling for anxiety symptoms that may be related to delusions and hallucinations, and the possible differences in clinical variables between the groups. Individuals with a diagnosis of schizophrenia and able to give informed consent were recruited from the community. The Mini International Neuropsychiatric Interview (MINI) was administered to both confirm the DSM-IV diagnosis of schizophrenia and screen for comorbid anxiety disorders. If a comorbid anxiety disorder was found, its relation to the individual's delusions and hallucinations was examined. Clinical rating scales for schizophrenia were administered as well as rating scales for specific anxiety disorders where appropriate. Overall, anxiety disorders ranged from 0% [ for Post Traumatic Stress Disorder (PTSD)] to 26.7% [ for generalized anxiety disorder (GAD) and agoraphobia without panic] with lower rates when controlled for anxiety symptoms related to delusions and hallucinations. In investigating clinical variables, the cohort was initially divided into schizophrenics with no anxiety disorders and those with an anxiety disorder; with further analyses including schizophrenics with anxiety disorders related to delusions and hallucinations and those with anxiety disorders not related to delusions and hallucinations. The most consistent difference between all the groups was on the PANSS-G subscale. No significant differences were found on the remaining clinical variables. Comorbid anxiety disorders in schizophrenia can be related to the individual's delusions and hallucinations, though anxiety disorders can occur exclusive of these positive symptoms. Clinicians must be aware that this comorbidity exists in order to optimize an individual's treatment. Depression and Anxiety 17:65,72, 2003. © 2003 Wiley-Liss, Inc. [source] Posttraumatic stress disorder and the structure of common mental disordersDEPRESSION AND ANXIETY, Issue 4 2002Brian J. Cox Ph.D. Abstract Krueger [1999: Arch Gen Psychiatry 56:921,926] identified a three-factor structure of psychopathology that explained the covariation or grouping of common mental disorders found in the U.S. National Comorbidity Survey (NCS) [Kessler et al., 1994: Arch Gen Psychiatry 51:8,19]. These three fundamental groupings included an externalizing disorders factor and two internalizing disorders factors (anxious-misery and fear). We extended this research through the examination of additional data from a large subsample of the NCS (n=5,877) that contained diagnostic information on posttraumatic stress disorder (PTSD). Factor analytic findings revealed that PTSD showed no affinity with the fear factor defined by panic and phobic disorders, and instead loaded on the anxious-misery factor defined primarily by mood disorders. An identical pattern of results emerged for both lifetime PTSD and 12-month PTSD prevalence figures. Implications of these findings for the classification of PTSD and research on its etiology are briefly discussed. © 2002 Wiley-Liss, Inc. [source] Cognitive mediation of panic reduction during an early intervention for panicACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2010P. Meulenbeek Meulenbeek P, Spinhoven P, Smit F, van Balkom A, Cuijpers P. Cognitive mediation of panic reduction during an early intervention for panic. Objective:, This study investigated cognitive mediation of improvement in panic disorder (PD) symptomatology during and after an early intervention for panic symptoms in subthreshold and mild PD. Method:, We executed a pragmatic, pre-post, two-group, multi-site, randomized trial of an early intervention for panic symptoms, based on cognitive-behavioural therapy, vs. a wait-list control group in a sample of 217 participants with subthreshold PD or mild PD. Results:, First, two of the three subscales of the mediator variable Panic Appraisal Inventory (PAI-anticipation and PAI-coping) significantly mediated residual change in PD symptomatology on the PD Severity Scale-Self Report. Second, preintervention to postintervention PAI-anticipation and PAI-coping change scores significantly predicted postintervention to follow-up change in PD symptomatology after controlling for other change scores. However, the converse association was also significant. Conclusion:, The results suggest that changes in cognitions may mediate changes in PD symptomatology and that the process of change is circular. [source] Are there Characteristics of Infectious Diseases that Raise Special Ethical Issues?1DEVELOPING WORLD BIOETHICS, Issue 1 2004Charles B. Smith ABSTRACT This paper examines the characteristics of infectious diseases that raise special medical and social ethical issues, and explores ways of integrating both current bioethical and classical public health ethics concerns. Many of the ethical issues raised by infectious diseases are related to these diseases' powerful ability to engender fear in individuals and panic in populations. We address the association of some infectious diseases with high morbidity and mortality rates, the sense that infectious diseases are caused by invasion or attack on humans by foreign micro-organisms, the acute onset and rapid course of many infectious diseases, and, in particular, the communicability of infectious diseases. The individual fear and community panic associated with infectious diseases often leads to rapid, emotionally driven decision making about public health policies needed to protect the community that may be in conflict with current bioethical principles regarding the care of individual patients. The discussion includes recent examples where dialogue between public health practitioners and medical-ethicists has helped resolve ethical issues that require us to consider the infected patient as both a victim with individual needs and rights and as a potential vector of disease that is of concern to the community. [source] Early detection of relapse in panic disorderACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2004M. R. Mavissakalian Objective:, To explore predictive models of relapsing based on change in symptoms at a time when panic disorder patients are still in remission following discontinuation of antidepressants. Method:, Forty-seven subjects, who were randomized to double-blind placebo and who had valid data at four time points: pretreatment, randomization to placebo substitution, an assessment on placebo prior to the last assessment or relapse and their last assessment (relapsers n = 15, non-relapsers n = 32) were studied using descriptive, growth curve analysis and logistic regression methodologies. Results:, Measures of generalized anxiety, fearfulness and disability at work and at home were better predictors of relapse than measures of panic and anxiety sensitivity. Logistic regression models using any one of these four general variables and its linear change correctly predicted relapse for 78.7,84.4% of the study subjects. Conclusion:, It is possible to gauge, with a fair degree of accuracy, the probability of relapsing in panic disorder patients who have discontinued serotonergic antidepressants 2 months prior to the return of panic. [source] The co-morbidity of eating disorders and anxiety disorders: a reviewEUROPEAN EATING DISORDERS REVIEW, Issue 4 2007Jessica M. Swinbourne Abstract Objective To critically review the literature examining the co-morbidity between eating disorders and anxiety disorders. Method A review of the literature on the co-morbidity between anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified and the anxiety disorders of OCD, PTSD, social anxiety, GAD, panic and agoraphobia. Results Of the empirical studies undertaken, it is clear that anxiety disorders are significantly more frequent in subjects with eating disorders than the general community. Researchers have shown that often anxiety disorders pre-date eating disorders, leading to a suggestion that early onset anxiety may predispose individuals to developing an eating disorder. To date however, the research presents strikingly inconsistent findings, thus complicating our understanding of eating disorder and anxiety co-morbidity. Furthermore, despite indications that eating disorder prevalence amongst individuals presenting for anxiety treatment may be high, there is a distinct lack of research in this area. Discussion This review critically examines the available research to date on the co-morbidity of eating disorders and anxiety disorders. Some of the methodological limitations of previous research are presented, in order to highlight the issues which warrant further scientific investigation in this area. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Unmarried in Palestine: Embodiment and (dis)Empowerment in the Lives of Single Palestinian WomenIDS BULLETIN, Issue 2 2010Penny Johnson There are rising numbers of single women across the Arab world. While this is usually connected with delayed marriage, Palestine shows a unique pattern of early but not universal marriage. This article looks beneath the statistics to investigate the stories behind this trend. How do young unmarried women negotiate boundaries and understand and enact choice in the context of a society experiencing prolonged insecure and warlike conditions, political crisis and social fragmentation and where the high number of unmarried women can be an increasing locus of moral panic? In conducting focus groups with two generations of women, my research looks at the prevailing importance of education, civil society and security in negotiating space within women's lives and uncovers a long tradition of unmarried women leading full and significant lives which needs to be recovered from the past. [source] Still crazy after all these years: "the paranoid style in American politics"INTERNATIONAL JOURNAL OF APPLIED PSYCHOANALYTIC STUDIES, Issue 2 2006Victor Wolfenstein Abstract In the US, the 9/11 attacks resulted in the instantaneous crystallization of a paranoid group formation, functioning as defense , not against the real dangers of the situation , but rather against an underlying, identity-shattering state of psychotic panic. This regressed collective emotional state was exploited by the Bush regime to initiate the war in Iraq, a war that plays out internationally the Ur-Fascistic tendencies that late capitalistic systems have difficulty containing. Copyright © 2006 John Wiley & Sons, Ltd. [source] Insulin, insulin analogues and cancer: no cause for panicINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 5 2010G. A. Thomson No abstract is available for this article. [source] The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) surveysINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 1 2003Laura Andrade Abstract Absence of a common diagnostic interview has hampered cross-national syntheses of epidemiological evidence on major depressive episodes (MDE). Community epidemiological surveys using the World Health Organization Composite International Diagnostic Interview administered face-to-face were carried out in 10 countries in North America (Canada and the US), Latin America (Brazil, Chile, and Mexico), Europe (Czech Republic, Germany, the Netherlands, and Turkey), and Asia (Japan). The total sample size was more than 37,000. Lifetime prevalence estimates of hierarchy-free DSM-III-R/DSM-IV MDE varied widely, from 3% in Japan to 16.9% in the US, with the majority in the range of 8% to 12%. The 12-month/lifetime prevalence ratio was in the range 40% to 55%, the 30-day/12-month prevalence ratio in the range 45% to 65%, and median age of onset in the range 20 to 25 in most countries. Consistent socio-demographic correlates included being female and unmarried. Respondents in recent cohorts reported higher lifetime prevalence, but lower persistence than those in earlier cohorts. Major depressive episodes were found to be strongly co-morbid with, and temporally secondary to, anxiety disorders in all countries, with primary panic and generalized anxiety disorders the most powerful predictors of the first onset of secondary MDE. Major depressive episodes are a commonly occurring disorder that usually has a chronic-intermittent course. Effectiveness trials are needed to evaluate the impact of early detection and treatment on the course of MDE as well as to evaluate whether timely treatment of primary anxiety disorders would reduce the subsequent onset, persistence, and severity of secondary MDE. Copyright © 2003 Whurr Publishers Ltd. [source] Re-estimating the prevalence of psychiatric disorders in a nationally representative sample of persons receiving care for HIV: results from the HIV cost and services utilization studyINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 2 2002PhD Maria Orlando Abstract The objective of this study was to obtain accurate estimates of the prevalence of psychiatric disorder in the population represented by the HIV Costs and Services Utilization Study cohort. We constructed logistic regression models to predict DSM-IV diagnoses of depression, generalized anxiety disorder, panic, and dysthymia among a subsample of the HCSUS cohort who in separate interviews completed the CIDI-SF and the full CIDI diagnostic interview. Diagnoses were predicted using responses to the CIDI-SF as well as other variables contained in the baseline and first follow-up interviews. Resulting regression equations were applied to the entire baseline and first follow-up samples to obtain new estimates of the prevalence of disorder. Compared to estimates based on the CIDI-SF alone, estimates obtained from this procedure provide a more accurate representation of the prevalence of the presence of any one of these four psychiatric disorders in this population, yielding more correct classifications and a lower false-positive rate. Prevalence rates reported in this study are as much as 16% lower than rates estimated using the CIDI-SF alone, but are still considerably higher than estimates for the general community population. Copyright © 2002 Whurr Publishers Ltd. [source] Patients' experiences of being deliriousJOURNAL OF CLINICAL NURSING, Issue 5 2007Gill Sörensen Duppils PhD Aim., The aim was to describe patients' experiences of being delirious. Background., Delirium is a serious psychiatric disorder that is frequently reported from hospital care settings, particularly among older patients undergoing hip surgery. It involves disturbances of consciousness and changes in cognition, a state which develops over a short period of time and tends to fluctuate during the course of the day. It is a certified fact that delirium is poorly diagnosed and recognized although the state often is described as terrifying. To be able to give professional care, it is of the utmost importance to know more about patients' experience of delirium. Method., Included in the interviews were patients who had undergone hip-related surgery and during the hospital stay experienced delirium. Fifteen patients participated in the interviews. Of these, six had experienced episodes of nightly delirium (sundown syndrome) and nine experienced delirium during at least one day. The interviews were analysed by qualitative content analysis. Results., The entry of delirium was experienced as a sudden change of reality that, in some cases, could be connected to basic unfulfilled physiological needs. The delirium experiences were like dramatic scenes that gave rise to strong emotional feelings of fear, panic and anger. The experiences were also characterized by opposite pairs; they took place in the hospital but at the same time somewhere else; it was like dreaming but still being awake. The exit from the delirium was associated with disparate feelings. Relevance to clinical practice., It is necessary to understand patients' thoughts and experiences during the delirious phase to be able to give professional care, both during the delirium phase and after the recovery. [source] Disability and posttraumatic stress disorder in disaster relief workers responding to september 11, 2001 World Trade Center DisasterJOURNAL OF CLINICAL PSYCHOLOGY, Issue 7 2009Susan Evans Abstract Empirical evidence suggests that social and occupational disability plays a significant role in posttraumatic stress disorder (PTSD). The purpose of this study was to assess the role of social/occupational disability and to identify predictors of the development of PTSD in a group of disaster relief workers (DRWs) who had been deployed to the World Trade Center (WTC) following September 11, 2001. Eight hundred forty-two utility workers completed a battery of comprehensive tests measuring PTSD and social occupational functioning. Results indicated a significant association between PTSD symptoms and impaired social/occupational functioning. Symptomatic workers were also more likely to have a history of trauma, panic disorder, and depression. Those with a history of trauma, depression, generalized anxiety disorder or panic reported significantly more disability than those without a psychiatric history. Careful screening of PTSD and social/occupational functioning in DRWs following a disaster is warranted so that early treatment can be undertaken to prevent a chronic and disabling course. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65: 1,11, 2009. [source] |