Depressive and Anxiety Disorders in Alcohol Use and Related Problems among Older African Americans

The older African American (AA) population is expected to triple by 2050; however, research on depression, anxiety, and alcohol use among older AAs is lacking. Current mental health and substance use studies involving older AAs often focus on between-race differences, frequently comparing AAs to Whites, without addressing within-group variation in the former. As such, little is known about the associations between depression, anxiety, alcohol use and related disorders in this population. The present study used data from 2016-2017 Midlife in the United States (MIDUS) Milwaukee 2 to examine whether depressive and anxiety symptoms and disorders are associated with alcohol use and alcohol problems among 274 African Americans aged 50 to 93 (62.8% women). Of the sample, 9.5%, 3.6%, and 6.6% met criteria for depression, generalized anxiety (GAD), and panic disorders, respectively. About 8.1% had drank heavily and 18.5% binge drank in the past month with 10.2% reporting alcohol problems in the past year. Those with depression and those with panic disorder were more likely to be heavy drinkers; while only those with panic disorder were more likely to be binge drinkers. Meeting criteria for depression or panic disorder but not GAD disorder were both more likely to have had alcohol-related problems than those not meeting criteria. Only panic disorder was associated with increased likelihood of drinking more than intended in the past year. Preliminary exploratory findings suggest that the associations between depressive symptoms, type of anxiety disorder, alcohol use, and problems varied by gender.

Dual Disorders in the Consultation Liaison Addiction Service: Gender Perspective and Quality of Life

Dual disorders (DD) and gender differences comprise an area of considerable concern in patients with substance use disorder (SUD). This study aims to describe the presence of DD among patients with SUD admitted to a general hospital and attended by a consultation liaison addiction service (CLAS), in addition to assessing its association with addiction severity and quality of life from a gender perspective, between 1st January and 30th September, 2020. The dual diagnosis screening interview (DDSI), the severity of dependence scale (SDS), and the WHO well-being index were used to evaluate the patients. In the overall sample, DD prevalence was 36.8%, (women: 53.8% vs. men: 32.7%, NS). In both genders the most prevalent DD was depression (33.8%, women: 46.2% vs. men: 30.9%, p = 0.296). Women presented more panic disorders (46.2% vs. 12.7%, p = 0.019) and generalized anxiety (38.5% vs. 10.9%, p = 0,049) than men. When DD was present, women had worse quality of life than men (21,7 vs. 50 points, p = 0.02). During lockdown period 77 patients were attended to and 13 had COVID-19 infection, with no differences in relation to sociodemographic and consumption history variables. The study confirms a high prevalence of DD among patients with SUD admitted to a general hospital for any pathology, and its being associated with worse quality of life, particularly in women.

The Brain Activation of Anxiety Disorders During Emotional Stimulations: A Coordinate-Based Activation Likelihood Estimation Meta-Analysis

Many studies have been analyzed the state of brain activation about anxiety under neuroimaging experiments with emotional stimuli. However, there is no meta-analysis to assess the commonality and specificity activation of different anxiety subtypes. Here, we used the activation likelihood estimation (ALE) to define the common and different activation between different subtypes of anxiety. A total of 29 functional magnetic resonance imaging (fMRI) studies revealed significantly increased bilateral amygdala, anterior cingulate gyrus, and parahippocampal gyrus activation in anxiety during emotional stimuli. Moreover, we observed the decreased activations in the posterior cingulate, lingual gyrus, and precuneus. In subanalyses of anxiety disorders, the increased activation of generalized anxiety and specific phobias are present in the left hippocampus and thalamus, respectively. Social anxiety and panic disorders showed increased activation in the parahippocampal gyrus, amygdala, thalamus, and insula. Social anxiety, generalized anxiety, and panic disorders displayed decreased activations in the fusiform gyrus, posterior cingulate, and specific phobias exhibited in the medial frontal gyrus. Although different anxiety showed dissimilar activations, the principal activations were observed in the limbic lobe, which might indicate the limbic circuit was a neural reflection of anxiety symptoms.

Distinct neurostructural signatures of anxiety-, fear-related and depressive disorders: a comparative voxel-based meta-analysis

Internalizing disorders encompass anxiety, fear and depressive disorders. While the DSM-5 nosology conceptualizes anxiety and fear-related disorders as an entity, dimensional psychopathology models suggest that generalized anxiety disorders (GAD) and major depression originate from an overarching "anxious-misery" factor whereas fear-related disorders originate from the "fear" factor. Given that a neurobiological evaluation is lacking, we conducted a comparative neuroimaging meta-analysis of gray matter volume alterations to determine common and disorder-specific brain structural signatures in these disorders. The PubMed, Web of Knowledge, and Scopus databases were searched for case-control voxel-based morphometric studies through December, 2020 in GAD, fear-related anxiety disorders (FAD, i.e., social anxiety disorders, SAD; specific phobias, SP; panic disorders, PD; and agoraphobia, AG) and major depressive disorder (MDD). Neurostructural abnormalities were assessed within each disorder group followed by quantitative comparison and conjunction analyses using Seed-based d-Mapping (SDM-PSI). GAD (9 studies, 226 patients) showed disorder-specific decreased volumes in left insula (z=-2.98, pFWE-corrected <0.05) and lateral/medial prefrontal cortex (z=-2.10, pFWE-corrected<0.05,) as well as increased right putamen volume (z=1.86, pFWE-corrected<0.05) relative to FAD (10 SAD, 11 PD, 2 SP studies, 918 patients). Both GAD and MDD (46 studies, 2,575 patients) exhibited decreased prefrontal volumes compared to controls and FAD. While FAD showed less robust alterations in lingual gyrus (p < 0.0025, uncorrected), this group presented intact frontal integrity. No shared structural abnormalities were found. Unique clinical features characterizing anxiety-, fear-related and depressive disorders are reflected by disorder-specific neuroanatomical abnormalities. Targeting the disorder-specific neurostructural signatures could improve therapeutic efficacy.

Psychological Backgrounds of Medically Compromised Patients and Its Implication in Dentistry: A Narrative Review

The number of medically compromised dental patients is increasing every year with the increase in the super-aged population. Many of these patients have underlying psychiatric problems and diseases, which need to be recognized by dental professionals for better treatment outcomes. The aim of this narrative review article is to summarize the psychological and psychiatric backgrounds of medically compromised patients who are frequently visited and taken care of by dentists using findings from recent systematic reviews and meta-analyses. Anxiety and symptoms of depression, post-traumatic stress disorders, panic disorders, poor cognitive functions, and poor quality of life were some of the common psychological backgrounds in medically compromised patients. Additionally, the consequences of these psychological problems and the considerations that need to be taken by the dentist while treating these patients have been discussed. Dental professionals should be aware of and recognize the different psychological backgrounds of medically compromised dental patients in order to provide appropriate dental treatment and to prevent oral conditions from worsening.

A descriptive study of agoraphobic situations and correlates on panic disorder

Background We aimed to identify the distribution and effective factors of agoraphobic situations and how they relate to panic disorder. We included confirmed 61 patients with agoraphobia in Bozorgmehr Psychiatric Clinic of Tabriz. Multiple logistic regression was used to measure panic disorder, agoraphobia, and effective factors. Results The average age of participants was 37.26 (SD 10.9), including 68.85% female and 31.15% male. Out of those, around three-fourths, 45 (73.7%), had panic disorder or comorbidity at least by one psychiatric disorder. Among various types of agoraphobia situations, leaving 34.63% and being 32.63% home alone had the most occurrences. A trend was observed between the rising of agoraphobia situations and panic risk. The final analysis was found a significant relationship between being bathroom alone (OR = 1.3; CI 1.12–1.56), having more than one psychiatric disorder (AOR = 8.25; CI 1.12–27.17), and panic risk. Conclusions We found leaving home alone, being home alone, being in a crowd, and standing in line as the most common agoraphobic situations. There appears agoraphobia and panic disorders are poorly understood in primary mental health care systems. The screening and treating programs are needed for increasing the quality of life and early identification of these disorders.

Is pseudomyopia associated with anxiety and related disorders?

Objective: To investigate in detail the exact relationship between Pseudomyopia, also termed accommodative spasm, and psychiatric disorders. Methods: Twenty-one young people between the ages of 12-18 who were diagnosed with pseudomyopia between March 2019 and July 2020 in the ophthalmology eye clinic of a university hospital, Turkey were included in the study. A difference of at least 2.20 D between refractive error measurements before and after cycloplegic drop was accepted as pseudomyopia. Scl-90-r symptom screening scale was applied to each case. Afterwards, each case was evaluated by k-sads-pl-dsm-5-t semi-structured technique according to age. The relationship between psychiatric disorders in cases of pseudomyopia was examined. Results: The average age of patients in the study was 15,4 ± 1,9 (12-18), 13 (61,9%) girl and 8 (38,1%) boy. The mean initial refraction was -4,19D ± 2,48D (-1,75D /-8,50D), and the result refraction was +0,38D ± 0,22D (0,25D / -1,00D). The average amount of accommodation was 4,56D ± 2,59D (2,25D / 9,50D). Following the SCL-90-R screening scale and psychiatric evaluation, five generalized anxiety disorders, three obsessive compulsive disorders, three panic disorders, one social anxiety disorder, one posttraumatic stress disorder, one conversion disorder, one major depressive disorder were diagnosed. As a result, 15 (71,4%) of 21 patients were treated with a psychiatric diagnosis. In addition, a positive correlation (p: 0,010-r: 0,621, p: 0,029-r: 0,546) was detected between anxiety- somatization scores and accommodation amount. Conclusions: It is necessary to request psychiatric consultation in each case of pseudomyopia. Comorbidity of anxiety and depressive disorders is more common in pseudomyopia cases. In addition, as the severity of psychiatric symptoms increases, the amount of accommodation also appears to increase. doi: https://doi.org/10.12669/pjms.37.5.3991 How to cite this:Kara H, Yasar E, Gurlevik U. Is pseudomyopia associated with anxiety and related disorders? Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.3991 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Prevalence and Clinical Correlates of Comorbid Anxiety and Panic Disorders in Patients with Parkinson’s Disease

Mood and anxiety disorders are the most common neuropsychiatric syndromes associated with Parkinson’s disease (PD). The aim of our study was to estimate the prevalence of lifetime and current anxiety disorders in patients with Parkinson’s Disease (PD), to explore possible distinctive neurological and psychiatric features associated with such comorbidity. One hundred patients were consecutively recruited at the Movement Disorders Section of the Neurological Outpatient Clinic of the University of Pisa. According to the MINI-Plus 5.0.0, 41 subjects were diagnosed with lifetime anxiety disorder (22 with panic disorder) and 26 were diagnosed with current anxiety disorders. Patients with anxiety disorders were more frequently characterized by psychiatric symptoms preceding PD, lifetime major depression and antidepressant treatments. They showed more anxious temperamental traits and scored higher at Parkinson Anxiety Scale (PAS) and persistent anxiety subscale. Current anxiety disorders were associated with more severe psychopathology, depressive symptomatology, and avoidant behavior. Among anxiety subtypes, patients with lifetime panic disorder showed higher rates of psychiatric symptoms before PD, lifetime unipolar depression, current psychiatric treatment, and a more severe psychopathology. Given the overall high impact of anxiety on patients’ quality of life, clinicians should not underestimate the extent of different anxiety dimensions in PD.