Family history of alcoholism in women with generalized anxiety disorder who have premenstrual syndrome: patient reports of premenstrual alcohol consumption and symptoms of anxiety.

McLeod DR, Foster GV, Hoehn-Saric R, Svikis DS, Hipsley PA.

Department of Psychiatry, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, Maryland 21287-7144.

This study sought to determine whether family history of alcoholism is related to patient reports of premenstrual alcohol consumption and whether family history of alcoholism is related to severity of anxiety-related symptoms, in women who suffer simultaneously from both premenstrual syndrome and generalized anxiety disorder. Fifty-four women with generalized anxiety disorder and prospectively demonstrated premenstrual syndrome were questioned about family history of alcoholism and alcohol consumption patterns across the menstrual cycle. Seventy-six percent of the sample reported having an alcoholic first- or second-degree relative. Furthermore, 74% of those women having a paternal-side family history of alcoholism, but only 22% of those without such a family history, reported increased alcohol consumption premenstrually. Forty-one of these women were assessed by means of psychiatric rating scales during both the premenstrual and follicular phases of the menstrual cycle. During the premenstrual, but not the follicular, phase of the menstrual cycle, women with a paternal-side family history of alcoholism experienced more severe anxiety-related somatic, but not psychic, symptoms of anxiety, than those without such a family history. These findings suggest that family history of alcoholism may be related to premenstrual alcohol consumption patterns and to the severity of premenstrually experienced somatic symptoms of anxiety in women with premenstrual syndrome, and that these women may be self-medicating with alcohol.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7943673&dopt=Abstract anxiety medicine




Relationship between patient self-ratings and physician ratings of general health, depression, and anxiety.

Wyshak G, Barsky AJ.

Department of Population and International Health, Harvard School of Public Health, Boston, Mass.

OBJECTIVE: To examine the relationship between patient self-ratings and physician ratings of general health, depression, and anxiety and patient and physician ratings in comparison to Diagnostic Interview Schedule (DIS) diagnoses of depression and anxiety. DESIGN: Observational study. SETTING: A general medical outpatient clinic. PATIENTS: Clinic attendees. METHOD: Consecutive clinic attendees on randomly selected days completed a self-reported screening questionnaire for hypochondriasis, composed of the Whiteley Index and the Somatic Symptom Inventory. A random sample of patients (N = 79), 95% of whom had scores below the cutoff for hypochondriasis (n = 75) and 5% of whom had scores at or above the cutoff for hypochondriasis (N = 4), returned at a later date to complete a research battery consisting of self-reported questionnaires, structured and semistructured interviews, and a structured interview for diagnoses of anxiety and depression based on the DIS, which used criteria from the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition. OUTCOME MEASURES: Responses to questionnaires and interviews. RESULTS: Agreement between patients and physicians was statistically significant concerning patients' physical health, depression, and anxiety. Based on one question, both physicians' and patients' ratings of depression and anxiety compared favorably with DIS diagnoses. By means of receiver operating characteristics analysis, values for the areas under the curve and their SEs were as follows: for depression, 0.789 +/- 0.075 for patient self-ratings and 0.825 +/- 0.054 for physician ratings; for anxiety, 0.734 +/- 0.058 for patient self-ratings and 0.667 +/- 0.065 for physician ratings. CONCLUSION: One simple question about a patient's status with respect to depression or anxiety is sufficient to detect these disorders with high sensitivity and specificity, yielding values comparable to those yielded by instruments consisting of many items. Asking patients to rate their own levels of depression and anxiety may constitute one portion of the family physician's diagnostic assessment for these conditions.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8032502&dopt=Abstract anxiety medicine




Home measures of anxiety, avoidant coping and defence as predictors of anxiety, heart rate and skin conductance level just before invasive cardiovascular procedures.

de Jong M, Erdman RA, van den Brand MJ, Verhage F, Passchier J.

Department of Medical Psychology and Psychotherapy, Erasmus University, Rotterdam, The Netherlands.

The question was whether anxiety, heart rate and skin conductance level just before invasive cardiac procedures could be predicted by anxiety related measures obtained at patients homes approximately 3 weeks before treatment. Trait measures of avoidant coping and defence were provided by sixty-three male and thirty-three female patients who were scheduled for a diagnostic or interventional heart catheterization. In hospital physiological measures were registered continuously during a 20 min interview and subsequently patients reported their anxiety. Results with hierarchical regression analysis showed that sex, age, medical variables and state anxiety at home explained 62% of state anxiety in hospital. Female sex predicted high anxiety in hospital while advanced age predicted low anxiety. Medical variables and measures of coping and defence did not add a significant contribution to this prediction of anxiety. Skin conductance and heart rate measures could not be predicted by the psychological measures collected at home.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8064649&dopt=Abstract anxiety medicine




Evaluation of the anxiolytic-like effect of NKP608, a NK1-receptor antagonist, in two rat strains that differ in anxiety-related behaviors.

Vendruscolo LF, Takahashi RN, Bruske GR, Ramos A.

Departamento de Farmacologia, Universidade Federal de Santa Catarina, 88.040-900, Florianopolis SC, Brazil.

RATIONALE: NKP608, a selective NK1 receptor antagonist, has been shown to produce anxiolytic-like effects in rodents tested in different anxiety models. However, most of these findings are based on social behaviors and, to our knowledge, there is no report concerning the effects of NKP608 in the elevated plus-maze (EPM) and the open field (OF), two classical models of anxiety/emotionality. Moreover, this compound has never been tested in rodent strains that display contrasting levels of anxiety-related behaviors. OBJECTIVES: To investigate the anxiolytic-like effects of NKP608 in Lewis and SHR inbred rats, proposed as a genetic model of anxiety for showing high and low indices of anxiety, respectively. METHODS: Lewis and SHR rats of both sexes were tested in the EPM and OF tests following acute administration of NKP608 (0.003, 0.03 or 0.3 mg/kg) or chlordiazepoxide (CDZ, 5 mg/kg). Measures of approach/avoidance towards the open arms of the EPM and the central area of the OF were used as indices of anxiety. RESULTS: All doses of NKP608 produced anxiolytic-like effects, similar to those of CDZ, in SHR males tested in the OF but not in the EPM. Conversely, this compound had a partial anxiolytic effect in LEW males (and, to a lower degree, in SHR females) in the EPM, but not in the OF. LEW females were unaffected following all pharmacological treatments. CONCLUSIONS: These findings indicate that the anxiety-related effects of NKP608 are strain-, sex- and test-dependent. Moreover, the present data confirm and extend the therapeutic potential of NK1 receptor antagonists for the treatment of anxiety.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12915956&dopt=Abstract anxiety medicine




Prospective study of phobic anxiety and risk of coronary heart disease in men.

Kawachi I, Colditz GA, Ascherio A, Rimm EB, Giovannucci E, Stampfer MJ, Willett WC.

Department of Nutrition, Harvard School of Public Health, Boston, MA 02115.

BACKGROUND: To examine prospectively the association between self-reported symptoms of phobic anxiety and subsequent risk of coronary heart disease, a 2-year follow-up study was conducted of a cohort of 33,999 US male health professionals, aged 42 to 77 years in 1988, who were free of diagnosed cardiovascular disease at baseline. Levels of phobic anxiety were assessed using the Crown-Crisp index, a short, diagnostic self-rating scale used for common phobias. Main outcomes were incidents of coronary heart disease consisting of nonfatal myocardial infarction (MI) and fatal coronary heart disease (CHD). METHODS AND RESULTS: One hundred sixty-eight incident cases of CHD occurred during 2 years of follow-up (128 cases of nonfatal MI and 40 cases of fatal CHD). The age-adjusted relative risk of fatal CHD among men with highest levels of phobic anxiety (scoring 4 or higher on the Crown-Crisp index) was 3.01 (95% confidence interval, 1.31 to 6.90) compared with men with the lowest levels of anxiety (scoring 0 or 1 on the phobia index). Risk of fatal CHD increased with levels of phobic anxiety (P trend = .002). When fatal CHD was further categorized into sudden and nonsudden coronary death, the excess risk was confined to sudden death (relative risk among men scoring 3 or higher on the phobia index was 6.08; 95% confidence interval, 2.35 to 15.73). No association was found between phobic anxiety and risk of nonfatal MI. These findings remained essentially unchanged after adjusting for a broad range of cardiovascular risk factors. CONCLUSIONS: The specificity, strength, and dose-response gradient of the association, together with the consistency and biological plausibility of the experimental and epidemiologic evidence, support a strong causal association between phobic anxiety and fatal CHD.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8181122&dopt=Abstract anxiety medicine




Childhood separation anxiety disorder in patients with adult anxiety disorders.

Lipsitz JD, Martin LY, Mannuzza S, Chapman TF, Liebowitz MR, Klein DF, Fyer AJ.

Department of Therapeutics, New York State Psychiatric Institute, NY 10032.

The authors examined the relation between retrospectively reported childhood separation anxiety disorder and adult DSM-III-R anxiety disorders in 252 outpatients at an anxiety disorders research clinic. The prevalence of childhood separation anxiety disorder was significantly greater among patients with two or more lifetime adult anxiety disorder diagnoses than it was among patients with only one anxiety disorder, suggesting that childhood separation anxiety disorder may be a risk factor for multiple anxiety syndromes in adulthood.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8185008&dopt=Abstract anxiety medicine




The effect of children's dental anxiety on the behaviour of a dentist.

Alwin N, Murray JJ, Niven N.

Department of Child Dental Health, University of Newcastle upon Tyne, England.

Two groups of children were given the Child Manifest Anxiety Scale to measure their general anxiety and the Venham Picture Scale to assess their dental anxiety. The experimental group consisted of children who had been referred with a specific problem of anxiety. The control group had been referred for dental problems other than anxiety. The two groups of children did not differ with respect to general anxiety but the experimental group showed significantly higher scores on the scale of dental anxiety, indicating that dentally anxious children are not always anxious in other situations. The children were treated by one dentist and, during treatment, the behaviour of the dentist was observed and measured using the Weinstein Dentist Behaviour Scale. It was found that the dentist changed his behaviour when dealing with anxious children and adopted some, but not all, of the anxiety management techniques that have been found in previous studies to reduce stress of dentally anxious children.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7748843&dopt=Abstract anxiety medicine




Anxiety in acutely bereaved prepubertal children.

Sanchez L, Fristad M, Weller RA, Weller EB, Moye J.

New York University Medical Center, New York.

Anxiety symptoms present immediately following parental death and approximately 8 weeks following the death were evaluated in 38 prepubertal children. Comparison groups included 38 hospitalized depressed children and 19 normal children. Bereaved children and parents were administered the Grief Interview and all were administered standard diagnostic interviews (DICA-C/P). While no bereaved children met DSM-III-R criteria for any anxiety disorder, anxiety regarding other family members dying was reported in 55% of bereaved children immediately after death and in 63% approximately 8 weeks later. When DSM-III-R anxiety symptoms were assessed, bereaved children did not report significantly more anxiety symptoms in the approximate 8-week interval post-parental death than normal comparison children, and had significantly fewer anxiety symptoms than depressed children (p < 0.0001). Bereaved children who had the most anxiety symptoms were also likely to have a depressive disorder (p < 0.002). Age and sex of child, sex of surviving parent, anticipation of death, and family history of anxiety or depressive disorders were not significantly associated with increased anxiety.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7951644&dopt=Abstract anxiety medicine




The influence of anxiety on pain: attentional and attributional mediators.

Arntz A, Dreessen L, De Jong P.

Department of Medical Psychology, Limburg University, Maastricht, The Netherlands.

Two psychological processes mediating the influence of anxiety on pain have been proposed: an attributional process in which the pain-relevance of anxiety is the essential factor, and an attentional process in which the focus of attention is the essential factor. The present study investigated the influences of attentional focus, pain-irrelevant anxiety and pain-relevant anxiety in a within-subject design (n = 40). Subjects received painful electrical stimulation in each of 5 experimental conditions. The results indicate that pain ratings were only influenced by attentional focus and not by anxiety, regardless of whether it was pain-relevant or pain-irrelevant. Autonomic responses (skin conductance responses) were, however, only influenced by pain-relevant anxiety. Thus, it seems that with respect to subjective pain responses the attentional theory on the influence of anxiety on pain can explain the results. The attributional theory seems to hold for autonomic pain responses. However, these responses might as well be considered as fear responses. Whereas there is clear evidence for a role of attentional focus in the influence of anxiety on pain, the role of attributional processes remains to be demonstrated.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8022624&dopt=Abstract anxiety medicine