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High Comorbidity (high + comorbidity)
Selected AbstractsConceptual background, development, and preliminary data from the unified protocol for transdiagnostic treatment of emotional disorders,DEPRESSION AND ANXIETY, Issue 10 2010Zofia A. Wilamowska M.A. Abstract Anxiety and mood disorders are common, chronic, costly, and characterized by high comorbidity. The development of cognitive behavioral approaches to treating anxiety and mood disorders has left us with highly efficacious treatments that are increasingly widely accepted. The proliferation of treatment manuals targeting single disorders, sometimes with trivial differences among them, leaves the mental health professional with no clear way to choose one manual over another and little chance of ever becoming familiar with most of them, let alone trained to competence in their delivery. Deepening understanding of the nature of emotional disorders reveals that commonalities in etiology and latent structures among these disorders supersedes differences. Based on empirical evidence from the domains of learning, emotional development and regulation, and cognitive science, we have distilled a set of psychological procedures that comprise a unified intervention for emotional disorders. The Unified Protocol (UP) is a transdiagnostic, emotion-focused cognitive behavioral treatment, which emphasizes the adaptive, functional nature of emotions, and seeks to identify and correct maladaptive attempts to regulate emotional experiences, thereby facilitating appropriate processing and extinction of excessive emotional responding to both internal (somatic) and external cues. The treatment components of the UP are briefly outlined. Theory and rationale supporting this new approach are described along with some preliminary evidence supporting its efficacy. Implications for the treatment of emotional disorders using the UP are discussed. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source] Short-Term Mortality in Relation to Age and Comorbidity in Older Adults with Community-Acquired Bacteremia: A Population-Based Cohort StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2008Mette Søgaard DVM OBJECTIVES: To assess 30-day mortality from bacteremia in relation to age and comorbidity and the association between age and mortality with increasing comorbidity. DESIGN: Population-based cohort study. SETTING: North Jutland County, Denmark. PARTICIPANTS: Adults in medical wards with community-acquired bacteremia, 1995 to 2004. MEASUREMENTS: Smoothed mortality curves and computed mortality rate ratios (MRRs) using Cox regression analysis. RESULTS: Two thousand eight hundred fifty-one patients, 851 aged 15 to 64, 1,092 aged 65 to 79, and 909 aged 80 and older were included. Mortality increased linearly with age. Compared with patients younger than 65, adjusted MRRs in patients aged 65 to 79 and 80 and older were 1.5 (95% confidence interval (CI)=1.2,2.0) and 1.8 (95% CI=1.4,2.3), respectively. Mortality also increased with level of comorbidity. Compared with patients with low comorbidity, adjusted MRRs in patients with medium and high comorbidity were 1.5 (95% CI=1.2,1.8) and 1.7 (95% CI=1.4,2.2), respectively. Regardless of the level of comorbidity, MRRs were consistently higher in older than in younger patients. CONCLUSION: Older age and greater comorbidity predicted mortality, and increasing age-related comorbidity did not explain the effect of age. [source] Distinguishing anxiety and depression in self-report: purification of the beck anxiety inventory and beck depression inventory-II,JOURNAL OF CLINICAL PSYCHOLOGY, Issue 9 2010Niklaus Stulz Abstract The overlap of symptoms associated with anxiety and depressive disorders hinders their differentiation using self-report scales. The aim of this study was to develop purified versions of the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory-II (BDI-II) that encompass only items highly specific to anxiety and depression, respectively. However, using these purified scales only increased the ability to differentiate anxiety and depressive disorders slightly. Anxiety and depression seem to be inherently linked and, thus, the high comorbidity of anxiety and depressive disorders seems to be not a function of the same types of symptoms being reported for each disorder. Nevertheless, purified BAI and BDI-II scales might be useful for separating the effects of interventions on anxiety and depressive symptoms. © 2010 Wiley Periodicals, Inc. J Clin Psychol: 66:1,14, 2010. [source] The Relationship Between Serotonin Receptor 1B Polymorphisms A-161T and Alcohol DependenceALCOHOLISM, Issue 9 2009Sheng-Yu Lee Background:, Several studies have suggested that the serotonin receptor 1B gene (5HT1B) may be important in the pathogenesis of alcohol dependence (alcoholism; ALC; AD). We examined whether 5HT1B gene A-161T polymorphisms (rs130058) are a susceptibility factor for total AD and subgroups of AD. We further explored correlation of this 5HT1B gene variant between anxiety,depression alcoholism (ANX/DEP ALC) and antisocial alcoholism (antisocial ALC) subgroups because of the high comorbidity of anxiety,depression, antisocial personality disorder, and AD. Methods:, We recruited 522 Han Chinese in Taiwan for this study: 322 AD patients and 200 controls. The patient group was recruited primarily from medical teaching hospitals; patients with antisocial alcoholism were recruited from Taiwanese prisons. Individuals with AD were classified into 3 homogeneous clinical subgroups,pure alcoholism (pure ALC), ANX/DEP ALC, and antisocial ALC,using DSM-IV diagnosis. The 5HT1B gene A-161T polymorphism was determined using PCR,RFLP. Results:, No significant differences in genotypic and allelic frequencies were found between controls and the total AD group or between controls and the 3 AD subgroups. However, there were significant differences in the 5HT1B gene A-161T polymorphism at both the genotype and allelic levels between the ANX/DEP ALC and antisocial ALC subgroups. Conclusions:, This study suggests that the 5HT1B gene A-161T polymorphism alone is not a risk factor for increasing susceptibility to either AD or its subtypes. However, 5HT1B gene A-161T polymorphisms might be one of the common genetic factors between the ANX/DEP ALC and antisocial ALC subgroups. [source] Neither Antisocial Personality Disorder Nor Antisocial Alcoholism Is Associated With the MAO-A Gene in Han Chinese MalesALCOHOLISM, Issue 6 2003Ru-Band Lu Background: Recent studies on the genetics of alcoholism have suggested an association between antisocial alcoholism and the MAO-A gene. However, previous studies have failed to include subjects with antisocial personality disorder without alcoholism even though there is a high comorbidity between antisocial personality disorder and alcoholism. Consequently, the finding of an association between the MAO-A gene and alcoholism or antisocial personality disorder seems tenuous. In Taiwan, about 70% of the Han Chinese population have the ADH2*2 allele and 50% show ALDH2*1/*2 or ALDH2*2/*2 genotypes, which offer protection against drinking behavior and the risk of developing alcoholism. Thus, it is possible to recruit individuals with antisocial personality disorder but without alcoholism in Taiwan. Therefore, association studies of alcoholism or antisocial personality disorder in Chinese may be more reliable if pure antisocial alcoholics, pure antisocial personality disorders, and normal controls as MAO-A gene are examined. Methods: In this study, the associations among antisocial alcoholism, antisocial personality disorder, and the uVNTR and Eco RV polymorphisms of the MAO-A gene, both individually and as a haplotype, were investigated among male adults recruited from jails in Taipei. A total of 129 Chinese Han males were studied, including 41 with antisocial personality disorder with alcoholism, 50 with antisocial personality disorder but without alcoholism, and 38 without either disorder as a jail control group. The diagnoses of alcohol dependence and antisocial personality disorder were made according to DSM-IV criteria. In addition, 77 normal controls were collected from the community. Results: Strong linkage disequilibrium was found for the uVNTR and Eco RV variants of MAO-A gene in each study group. Conclusions: No significant association was observed between these two polymorphisms and antisocial personality disorder with alcoholism, either individually or for the haplotype, or for antisocial personality disorder without alcoholism. Thus, neither antisocial alcoholism nor antisocial personality disorder was associated with the genetic variants of MAO-A gene. [source] Delusional disorder: Study from North IndiaPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2007SANDEEP GROVER md Abstract, The aim of the present study was to study sociodemographic profile, clinical parameters including comorbidity, usefulness of antipsychotics especially atypicals, family history, and follow-up rates for delusional disorder. The records of all subjects who were seen in the Department of Psychiatry during a period of 10 years (i.e. 1994,2003) were reviewed. Eighty-eight subjects fulfilling the inclusion criteria were enrolled. The sample consisted predominantly of female subjects (55.7%), most of the total subjects were married and had favorable social functioning. The most common delusion was persecutory (54.5%), followed by delusion of reference (46.6%). The majority of the subjects had a comorbid psychiatric disorder. Education was negatively correlated with age at onset and positively correlated with the number of delusions. Age at onset was negatively correlated with total number of delusions. The sociodemographic profile of delusional disorder is consistent across various cultures, has high comorbidity and, when treated appropriately, responds to various antipsychotic agents. [source] The relationship between attention deficit hyperactivity disorder, conduct disorder, and psychopathy in adolescent male and female detaineesBEHAVIORAL SCIENCES & THE LAW, Issue 4 2009Kathrin Sevecke M.D. Although ADHD and CD are apparent risk factors for adult psychopathy, there are three distinct perspectives regarding their relationships to psychopathy: (1) ADHD may contribute uniquely to the development of psychopathy or (2) its contribution may reflect its high comorbidity with CD. Alternatively, (3) the comorbid presence of ADHD and CD may confer unique risk for the development of psychopathy. Although prior adult studies have yielded conflicting findings, no prior studies of adolescents address this issue. We examined these three hypotheses and the possibility of sex differences using cross-sectional analyses in 90 male and 123 female incarcerated adolescents. Among males the influence of ADHD was largely attributable to the overlap between ADHD and CD, whereas among females ADHD contributed independently to psychopathy scores and to scores on several dimensions of psychopathy. In addition, among females, the ADHD,×,CD interaction was significant for the total score and the antisocial component of psychopathy and in a direction opposite to that predicted by the comorbid subtype hypothesis. These findings indicate that there may be sex-specific pathways to elevations in psychopathic traits and suggest that the comorbid subtype hypothesis is probably not correct for either boys or girls. Copyright © 2009 John Wiley & Sons, Ltd. [source] | |||||||||||||