Anxiety and depressive disorders in college youth.

Bhave S, Nagpal J.

Bombay Hospital & Medical Research Center, 302, Charleville Societey, "A" Road, Churchgate Mumbai (Bombay), 400 020 India. sbhave bom7.vsnl.net.in

Fear and anxiety are common experiences throughout childhood and adolescence. Anxiety disorders, along with depression and dysthymia, are characterized as internalizing disorders; they stand in distinction from the externalizing disorders representing such conditions as oppositional-defiant disorder and conduct disorder. Clinicians evaluating anxiety disorders in college youth face the task of differentiating normal, transient, developmentally appropriate expression of anxiety from pathologic states of anxiety. The developmental course of anxiety and depression, its appropriateness, and its boundaries are areas of research and interest. A wide clinical perspective is necessary to effectively engage the assessment process. The treatment of anxiety and depression in youth is ideally multi-modal, involving medication, psychotherapy, and psychosocial interventions. This article focuses on assessment and treatment of anxiety and depression. These are presented separately, although areas of overlap often are encountered in practice.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15748927&dopt=Abstract anxiety medicine




Gender differences in the pre-competition temporal patterning of anxiety and hormonal responses.

Thatcher J, Thatcher R, Dorling D.

University of Wales, Aberystwyth, UK. jet aber.ac.uk

AIM: This study examined gender differences in the pre-competition temporal patterning of anxiety and hormonal responses. METHODS: Six male and 6 female field hockey players completed the modified Competitive State Anxiety Inventory-2, including both intensity and direction subscales, and provided saliva and urine samples 24, 2, and 1 hour prior to competition. These samples were analyzed for cortisol, and noradrenaline and adrenaline, respectively. RESULTS: Two x 3 repeated measures ANOVAs revealed significant gender x time interactions for cognitive and somatic anxiety intensity and adrenaline and noradrenaline, but not cortisol. While males' anxiety and hormonal responses demonstrated no significant changes, significant increases in females' anxiety, and significant decreases in their adrenaline and noradrenaline were observed over time. Moreover, while males' anxiety and hormonal responses mirrored each other, this was not the case for the females with increases in females' cognitive and somatic anxiety intensity levels accompanied by decreases in adrenaline and noradrenaline. CONCLUSIONS: Although this study has extended this line of research by adopting a psycho-physiological approach and measuring anxiety intensity and direction in male and female athletes, replication is required with larger samples from a greater diversity of sports.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15756170&dopt=Abstract anxiety medicine




Antianxiety and Antidepressive Behavior Produced by Physiological Estradiol Regimen may be Modulated by Hypothalamic-Pituitary-Adrenal Axis Activity.

Walf AA, Frye CA.

1Department of Psychology, The University at Albany-SUNY, Albany, NY, USA.

Variations in estradiol (E(2)) may influence expression of stress-related anxiety and depression symptoms among women. Effects of E(2) and stress on anxiety and depressive behavior were investigated using an animal model. E(2) was administered subcutaneously (0, 2, 5, 10, 20, 50 mug/rat) to ovariectomized rats 2 days before testing. In experiment 1, open field (anxiety), elevated plus maze (anxiety), or forced swim test (depressive) behavior was evaluated following 20 min of restraint or no such stressor. Rats administered 5 or 10 mug E(2), which produced physiological plasma E(2) concentrations, showed significantly less anxiety and depressive behavior and lower corticosterone levels compared to vehicle, lower, or higher E(2) dosages. Restraint stress prior to behavioral testing attenuated the antianxiety and antidepressive effects of 5 or 10 mug E(2). In experiment 2, effects of adrenalectomy or sham surgery and vehicle or corticosterone replacement in their drinking water on behavior and neuroendocrine measures of rats administered 0, 10, or 50 mug E(2) were examined. E(2), 10 mug, compared to vehicle or 50 mug, reduced anxiety and depressive behavior of sham and adrenalectomized rats administered the low dosage of corticosterone, but not vehicle or the high dosage of corticosterone, suggesting that there may be an optimal level of corticosterone necessary for E(2) to exert these effects. Together, these data suggest that E(2) may have dose-dependent effects on anxiety and depressive behavior of female rodents, which may depend on the tone of the hypothalamic-pituitary-adrenal axis.Neuropsychopharmacology advance online publication, 9 March 2005; doi:10.1038/sj.npp.1300708.

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The association between self-reported physical activity and prevalence of depression and anxiety disorder in long-term survivors of testicular cancer and men in a general population sample.

Thorsen L, Nystad W, Stigum H, Dahl O, Klepp O, Bremnes RM, Wist E, Fossa SD.

Department of Psychosocial Oncology and Rehabilitation, The Norwegian Radium Hospital, University of Oslo, Oslo, Norway, lene.thorsen radiumhospitalet.no.

GOALS OF WORK: Physical activity is claimed to have a beneficial influence on a person's mental health, though its impact may be different in cancer patients and individuals in the general population. The objective of this cross-sectional study was (1) to estimate the associations between the level of self-reported physical activity as a lifestyle factor (LPA) and the prevalence of depression and anxiety disorder in testicular cancer survivors (TCSs) and in men of similar age from the general population (GenPop), and (2) to examine whether these associations differ in the two groups. PATIENTS AND METHOD: A total of 1260 TCSs and 20,207 men from the GenPop completed a questionnaire that assessed LPA, and depression and anxiety disorder on the Hospital Anxiety and Depression Scale (HADS). MAIN RESULTS: The prevalence of HADS-defined depression was lower among those who were physically active than in those who were physically inactive (TCSs 9% vs 17%, P<0.001; GenPop 8% vs 15%, P<0.001). Among physically inactive TCSs there was a trend towards higher a prevalence of HADS-defined anxiety disorder compared to physically active TCSs (P=0.07). In the GenPop this difference was statistically significant (P<0.001). Multivariate analysis confirmed the association between LPA and HADS-defined depression in both the TCSs [adjusted odds ratio (aOR)=0.56; 95% confidence interval (CI) (0.31, 1.02)] and the GenPop [aOR=0.58; 95% CI (0.51, 0.65)], but not the association between LPA and HADS-defined anxiety disorder. The associations between LPA and HADS-defined depression and HADS-defined anxiety disorder did not differ between the TCSs and the GenPop. CONCLUSION: In both the TCSs and the GenPop, the prevalence of HADS-defined depression was higher among those who were physically inactive than among those who were physically active, with no intergroup difference. There was no association between LPA and prevalence of HADS-defined anxiety disorder in either of the groups after adjusting for background variables. Prospective studies are needed to allow causal inferences to be drawn.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15756585&dopt=Abstract anxiety medicine




Mood and anxiety disorders in women with treated hyperthyroidism and ophthalmopathy caused by Graves' disease.

Bunevicius R, Velickiene D, Prange AJ Jr.

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7160, USA; Institute of Endocrinology, Kaunas Univeristy of Medicine, Kaunas, Kaunas, LT-50009, Lithuania.

OBJECTIVE: To evaluate the prevalence of mood and anxiety disorders in women with treated hyperthyroidism caused by Graves' disease and to compare them with the prevalence of such findings in women without past or present thyroid disease. METHODS: Thirty inpatient women with treated hyperthyroidism and ophthalmopathy caused by Graves' disease and 45 women hospitalized for treatment of gynecologic disorders such as abnormal vaginal bleeding, benign tumors or infertility were evaluated for the prevalence of mood and anxiety diagnoses using a standard Mini-International Neuropsychiatric Interview and for mood and anxiety ratings using the Profile of Mood States (POMS). At the time of assessment, it was discovered that 14 of 30 women with treated hyperthyroidism caused by Graves' disease were still hyperthyroid, while 16 women were euthyroid. RESULTS: Significantly greater prevalence of social anxiety disorder, generalized anxiety disorder, major depression and total mood and anxiety disorders, as well as higher symptom scores on the POMS, was found in hyperthyroid women with Graves' disease in comparison with the control group. A prevalence of total anxiety disorder, as well as history of mania or hypomania and lifetime bipolar disorder, but not lifetime unipolar depression, was more frequent in both the euthyroid and the hyperthyroid subgroups of study women in comparison with the control group. CONCLUSIONS: These results confirm a high prevalence of mood and anxiety disorders in women with treated hyperthyroidism and ophthalmopathy caused by Graves' disease. Hyperthyroidism plays a major role in psychiatric morbidity in Graves' disease.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15763125&dopt=Abstract anxiety medicine




The dental anxiety scale and effects of dental fear on salivary cortisol.

Krueger TH, Heller HW, Hauffa BP, Haake P, Exton MS, Schedlowski M.

Division of Psychology and Behavioral Immunobiology, Swiss Federal Institute of Technology Zurich, SES C4, Scheuchzerstrafle 17, 8092 Zurich, Switzerland. krueger ifv.gess.ethz.ch

Only a few studies have investigated use of the Dental Anxiety Scale in dental fear-induced neuroendocrine changes. The present study examined 19 female patients, each at two timepoints across an educational and a treatment session within periodontitis therapy. Subjective measures included a visual analogue scale, the STAI State scale, and the Dental Anxiety Scale. Salivary cortisol was measured in parallel across all four timepoints. Although patients were significantly more aroused and anxious prior to the treatment session, salivary cortisol remained unchanged. However, patients with high Dental Anxiety were significantly more aroused and anxious and showed significantly higher salivary cortisol during the educational session than those with low scores on Dental Anxiety. In conclusion, the Dental Anxiety Scale differentiated mean neuroendocrine change between patients scoring low and high for Dental Anxiety and its use as an accurate tool to identify patients with high dental anxiety should be further studied predictively.

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Anxiety as a predictor of pain magnitude following termination of first-trimester pregnancy.

Pud D, Amit A.

Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel.

ABSTRACT Objective. The purpose of the study was to investigate anxiety and other factors that may predict pain magnitude following termination of pregnancy (TOP) during the first trimester. Design. Prospective, nonrandomized study. Setting. Department of Obstetrics and Gynecology, Rambam Medical Center in Haifa, Israel. Patients. Forty consecutive women undergoing TOP. Outcome Measures. Women undergoing a TOP were asked to fill out the State-Trait Anxiety Inventory. Pain magnitude was measured by using a visual analog scale (VAS) at 15, 30, and 60 minutes following the procedure. Correlations between state anxiety, trait anxiety, age, parity, number of TOP, gestational age, and pain magnitude were measured. Results. State anxiety was able to predict pain magnitude on VAS 15 minutes after TOP (P = 0.023), and trait anxiety was able to predict pain magnitude on VAS 30 minutes after TOP (P = 0.013). Other variables failed to show significant results. Conclusions. Preoperative assessment of anxiety levels may lead to appropriate treatment in order to alleviate discomfort and ensure pain control outcome.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15773879&dopt=Abstract anxiety medicine




Anxiety about food supply in cree women with infants in Quebec.

Willows ND, Iserhoff R, Napash L, Leclerc L, Verrall T.

Department of Agricultural, Food and Nutritional Science, University of Alberta. noreen.willows ualberta.ca

OBJECTIVES: The objectives were to document the prevalence of maternal anxiety about food supply in Cree women who had 9-month-old infants, and to understand maternal and infant characteristics associated with anxiety. STUDY DESIGN: The design was descriptive and combined both cross-sectional and retrospective analyses. METHODS: The study took place in nine Cree communities in northern Quebec. Data on maternal characteristics in pregnancy (age, parity, anemia, smoking status) and infant characteristics (gestational age, birth weight, weight and hemoglobin concentration at 9 months old) were obtained from medical records. At 9 months postpartum, mothers were asked about infant feeding practices, the health of their infant, and the question, "Do you ever worry you don't have enough money to buy your children food to eat?" Affirmative responses were considered evidence for anxiety about food supply. Pricing data was collected for commercial baby food, formula, milk and water in the communities and, for comparison, in the large urban city of Montreal. RESULTS: 245 woman-infant pairs participated. One-fifth (20.8%) of mothers were anxious about food supply. The prevalences of anxiety in women who had anemia, or smoked, during pregnancy, or who bottle-fed their 9-month-old infants, were 44.4%, 27.5% and 24.0%, respectively. The corresponding prevalences of anxiety in women who did not have anemia, who did not smoke, or who breastfed without bottle-feeding at 9-months postpartum, were 19.0%, 13.6% and 6.7%. The adjusted ORs for anxiety were 3.10 (95% CI, 1.11-8.65), 2.12 (95% CI, 1.05-4.29) and 3.87 (95% CI, 1.12-13.36) for anemia, smoking and bottle-feeding, respectively. Prevalences of anemia and infection were comparable between infants of mothers who did and did not express anxiety. However, infants whose mothers had anemia during pregnancy had higher prevalences of anemia (44.0% vs. 24.6%, p = 0.04) and infection (77.8% vs. 50.2%, p = 0.03) at 9 months old. CONCLUSION: Women who had anxiety about food supply for their children had characteristics that distinguished them from women who did not have anxiety. Anxiety was associated with anemia and smoking during pregnancy, and with bottle-feeding at 9 months postpartum.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15776993&dopt=Abstract anxiety medicine




The influence of acute anxiety on assessment of nociceptive flexion reflex thresholds in healthy young adults.

French DJ, France CR, France JL, Arnott LF.

Ecole de psychologie, Universite de Moncton, 507 Taillon, Moncton, NB, Canada E1A 3E9.

The nociceptive flexion reflex (NFR) is a polysynaptic withdrawal reflex that occurs in response to painful stimulation. In human studies, NFR responsiveness has been used as a direct measure of nociception as well as an indirect measure of supraspinal modulation of nociceptive transmission. Previous studies have suggested that anxiety may influence NFR responding, and therefore it has been recommended that anxiety be reduced by familiarizing participants with assessment methodology prior to formal NFR assessment. The present study was designed to assess the influence of anxiety on NFR threshold. Using a repeated measures design, 40 men and women completed an NFR threshold assessment twice within session one, and twice again during a second session conducted 24h later. Within each assessment session, state anxiety was measured at the beginning of the session and immediately following each NFR threshold assessment. Results indicated that although anxiety increased in response to NFR threshold assessment and was positively related to subjective pain reports, anxiety was not related to observed NFR threshold levels. These findings suggest that individual differences in anxiety do not significantly affect NFR threshold level determinations under standard testing conditions.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15777861&dopt=Abstract anxiety medicine