Omega-3 Fatty Acids May Reduce Anxiety

MedicalResearch.com Interview with:
“omega 3” by Khaldaa Photographer is licensed under CC BY 2.0Yutaka MATSUOKA, MD, PhD

Division Chief of Health Care Research,
Behavioral Sciences and Survivorship Research Group,
Center for Public Health Sciences,
National Cancer Center Japan

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Anxiety is the most commonly experienced psychiatric symptom. We have now two major treatment options that include cognitive-behavioral therapy (CBT) and pharmacotherapy.  However, CBT is time-consuming, costly, and limited in availability. And there is concern over potential side effects in pharmacotherapy. Evidence-based and safer treatment options are required. Omega-3 fatty acids have potential preventive and therapeutic effects on depression and anxiety. Clinical and preclinical studies support the effectiveness of omega-3 fatty acids as a treatment for anxiety disorders. Despite the largely positive findings of these trials, the clinical application of the findings is unfortunately limited by their small sample size.

Improvement in anxiety symptoms were associated with omega-3 fatty acids treatment compared with controls. The anxiolytic effects of omega-3 fatty acids were also stronger in patients with clinical conditions than in subclinical populations.  Continue reading

Bridge Symptoms in Adolescence Linked To Adult Anxiety Disorders

MedicalResearch.com Interview with:

Dr Alexandra Rouquette MD PhD Center for Research in Epidemiology and Population... French Institute of Health and Medical Research Paris

Dr. Rouquette

Dr Alexandra Rouquette MD PhD
Center for Research in Epidemiology and Population…
French Institute of Health and Medical Research
Paris

MedicalResearch.com: What is the background for this study? What are the main findings?

 Response: There is a growing number of clues in the literature that suggest that the onset of adult psychopathologic disorders can be traced back to behavioral or emotional symptoms observed in childhood or adolescence. Targeting early childhood symptoms might thus be effective in preventing future mental disorders. However, these interventions are challenging to implement because we lack knowledge on which specific childhood symptoms have predictive associations with adult psychopathologic disorders. In our study, we used a novel methodologic approach, the network perspective, in which symptoms are conceptualized as distinct entities that can causally influence each other, be self-reinforcing and are thus part of causal chains which can culminate in disorders.

We investigated longitudinally the network structure among a broad range of emotional and behavioral symptoms (symptoms of attention deficit, symptoms of hyperactivity, disruptive symptoms, internalizing symptoms, prosocial symptoms) collected in elementary school girls (6-10 years) included in the Quebec Longitudinal Study of Kindergarten Children. We showed that symptoms “irritable”, “blames others”, “not liked by other children”, “often cries”, and “solitary” retained a distinctive position in the network because most of the direct relationships between the disruptive and internalizing symptom clusters transited through them. These symptoms have been termed bridge symptoms in the network perspective, as they constitute pathways that can connect different disorders.

We then investigated the relationships between this emotional and behavioral symptoms network in childhood and the occurrence of anxiety disorders at age 15 and 22 years. Importantly, the bridge symptoms (particularly “not liked by other children” and “irritable”) exhibited the strongest relationships with future anxiety disorders. Continue reading

Young Pregnant Women More Likely To Be Depressed Than Their Mothers

MedicalResearch.com Interview with:

Rebecca Pearson, PhD Lecturer in Psychiatric Epidemiology Centre for Academic Mental Health School of Social & Community Medicine University of Bristol

Dr. Pearson

Rebecca Pearson, PhD
Lecturer in Psychiatric Epidemiology
Centre for Academic Mental Health
School of Social & Community Medicine
University of Bristol

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: We know depression and anxiety are common in young women and during pregnancy when there are also implications for the developing child.

It is therefore important to investigate whether symptoms are rising given the pressures of modern life.

We found that compared to their mothers generation in the 1990s young pregnancy women today are more likely to be depressed. This was driven largely by symptoms of anxiety and feeling overwhelmed rather than feeling down.  Continue reading

No Evidence Probiotics Will Reduce Your Anxiety

MedicalResearch.com Interview with:

Daniel Reis MA Graduate Student Clinical Psychology University of Kansas

Daniel Reis

Daniel Reis MA
Graduate Student
Clinical Psychology
University of Kansas

MedicalResearch.com: What is the background for this study? What are the main findings?

Probiotics have generated considerable interest as a possible treatment for numerous forms of physical and mental illness. Preliminary evidence from both preclinical and clinical studies suggest that probiotics may be able to reduce anxiety. Our goal was to comprehensively review and summarize existing preclinical and clinical studies.

Overall, probiotic administration reduced anxiety-like behaviors in rodents, but only in those with some form of experimentally-induced disease (such as early-life stress or socieal defeat). Probiotics did not reduce anxiety in humans.

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Thyroid Inflammation Linked to Depression and Anxiety

MedicalResearch.com Interview with:
Thyroid gland Wikipedia imageTeja Grömer PD Dr. med. Habil

Facharzt für Psychiatrie und Psychotherapie
Lehrbefugter der Universität Erlangen-Nürnberg im Fach Psychiatrie
Bamberg 

MedicalResearch.com: What is the background for this study?

1) I had seen hundreds of clinical cases with combined depression and anxiety and noted end of 2015 that most (far more than 50%) from the subjective clinical impression were associated with autoimmune thyroiditis (AIT)

2) Autoimmune thyroiditis on the mental side leads to specific symptoms, exhaustion, tachycardia, restlessness.

3) I thus decided to do a systematic review and meta-analysis.  Continue reading

Over 2.5 Million US Kids Diagnosed With Anxiety and Depression

MedicalResearch.com Interview with:
Rebecca H. Bitsko, PhD

National Center on Birth Defects and Developmental Disabilities
Centers for Disease Control and Prevention 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: CDC’s National Center on Birth Defects and Developmental Disabilities(https://www.cdc.gov/ncbddd/index.html) (NCBDDD) is committed to helping children who have mental, emotional, and behavioral disorders. Anxiety and depression are both internalizing mental disorders that often start during childhood, and that frequently occur together.

In this study, we show that more than 1 in 20, or 2.6 million, US children aged 6-17 had a current diagnosis of anxiety or depression, by parent report, in 2011-12. We also found an increase of diagnosed anxiety in these children from 1 in 28 in 2007 to 1 in 24 in 2011-12.

Further, in 2011-12, approximately 1 in 5 children with current anxiety or depression did not receive mental health treatment in the past year.

Children with current anxiety or depression were more likely than those without to have:

  • Another mental, behavioral, or developmental disorder such as ADHD, learning disability, or speech or language problems
  • School problems
  • Parents who report high levels of stress and frustration with parenting
  • Unmet medical and mental health service needs

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PCPs Need More Training In Assessing and Treating Irritability in Children

MedicalResearch.com Interview with:
Anna Scandinaro
Medical student
Penn State College of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Dr. Usman Hameed, a child and adolescent psychiatrist, and Dr. Dellasega wrote a previous paper called “What is irritability?” which examined the idea and concept of what irritability in school aged children can encompass. After considering possible definitions of irritability, we wanted to see how the concept manifested in clinical practice, especially with the controversy around the new diagnosis of Disruptive Mood Dysregulation Disorder (DMDD) in the DSM 5.

The main findings of this study are that primary care providers (PCP)​identified a need for more training and education in how to assess irritability in pediatric and adolescent populations.

In contrast, the child and adolescent psychiatrists we interviewed thought more triage from PCPs who care for school aged children with irritability would be helpful.  Continue reading

Brain Signals Reflect Social Anxiety and Performance Fears in ASD

MedicalResearch.com Interview with:

Tamara Rosen

Tamara Rosen

Tamara Rosen
Graduate student in Clinical Psychology
Stony Brook University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Approximately 40 percent of youth with autism spectrum disorder (ASD) are diagnosed with a co-occurring anxiety disorder.  Social anxiety is a common presenting problem for these youth.

Youth with ASD and increased social anxiety have heightened threat sensitivity, particularly in relation to performance fears, as measured by a brain signal response called the error-related negativity (ERN), which measures response to errors. The threat sensitivity-performance fears association remained even after controlling for anxiety symptoms other than social fearfulness.

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Migraines More Frequent With Increased Anxiety and Depression

MedicalResearch.com Interview with:

“Headache.” by Avenue G is licensed under CC BY 2.0

“Headache.” by Avenue G

Fu-Chi Yang, M.D., Ph.D.Assistant Professor
Department of Neurology,
Tri-Service General Hospital
National Defense Medical Center
Taipei, Taiwan

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Migraineurs are likely to suffer from comorbid depression and anxiety. Furthermore, increased migraine frequency is associated with an increased risk of mood/anxiety disorders. It is not distinguished by grouping frequency of migraine attacks, whether it is associated with severity scores of depression and anxiety. Thus, we evaluated the relationship between severity of depression/anxiety and migraine frequency

We mainly found that the severity of depression (BDI and HADS-depression scores) and anxiety (HADS anxiety score) were related to migraine frequency, after adjusting confounding factors.

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Efficacy of SSRIs for Anxiety Influenced By Patient’s Expectations

MedicalResearch.com Interview with:
Vanda Faria PhD
Department of Psychology
Uppsala, Sweden 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It has been debated whether selective serotonin reuptake inhibitors (SSRIs), which are commonly prescribed for depression and anxiety, are more effective than placebo. Concerns have been raised that the beneficial effects of SSRIs, as measured in double-blind clinical trials, may be explained by expectancies (a crucial placebo mechanism) rather than the biochemical compound. But no study has tested experimentally the extent to which the SSRI treatment effect can be influenced by expectancies induced by verbal suggestions.

We compared the efficacy of overt vs. covert administration of an SSRI (escitalopram) in patients with social anxiety disorder. Rather than comparing the SSRI with placebo, we compared it with itself while manipulating the patients’ expectations of improvement. This was achieved by informing one group correctly about the SSRI and its effectiveness (overt group) whereas the comparison (covert) group received incorrect information. By use of a cover story, the covert group was led to believe they were treated with a so called “active placebo”, an ineffective neurokinin-1 antagonist yielding similar side effects as the SSRI but lacking anxiety-reducing properties. But the treatment, dosage and duration was in fact identical in both groups.

Results showed that overt outperformed covert SSRI treatment, as the number of treatment responders was more than three times higher on the main clinical outcome measure when correct information was given. Using neuroimaging (fMRI) we also noted differences between the overt and covert SSRI groups on objective brain activity measures. There were differences between the groups e.g. with regard to activation of the posterior cingulate cortex with treatment, and the functional coupling between this region and the amygdala which is a brain region crucially involved in fear and anxiety. The fMRI  results may reflect the interaction between cognition and emotion as the brain changes differently with treatment pending on the expectations of improvement.

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Educational Interventions May Head Off Anxiety Attacks

MedicalResearch.com Interview with:

Dr. Patricia Moreno-Peral, PhD Research Unit, Primary Care District of Málaga-Guadalhorce Prevention and Health Promotion Research Network Institute of Biomedical Research in Málaga Málaga, Spain 

Dr. Moreno-Peral

Dr. Patricia Moreno-Peral, PhD
Research Unit, Primary Care District of Málaga-Guadalhorce
Prevention and Health Promotion Research Network
Institute of Biomedical Research in Málaga Málaga, Spain 

MedicalResearch.com: What is the background for this study?

Response:  No systematic reviews or meta-analyses have been performed on the effectiveness of preventive psychological and/or educational interventions for anxiety in varied populations. Previously, other systematic reviews have been focused on prevention efficacy in specific interventions (e.g. cognitive behavior interventions) or age groups (e.g. adolescents).

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Similar Signaling Pathways Trigger Anxiety In Variety of Species

MedicalResearch.com Interview with:

Yuanyuan Xie, PhD Postdoctoral Researcher Department of Neuroscience University of Pennsylvania Philadelphia, PA 19104

Dr.Yuanyuan Xie

Yuanyuan Xie, PhD
Postdoctoral Researcher
Department of Neuroscience
University of Pennsylvania
Philadelphia, PA 19104

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: I joined Dr. Richard Dorsky’s lab in mid 2013 after a lab switch toward the end of the fourth year in my PhD. By then, the Dorsky lab at the University of Utah had published zebrafish lef1 mutants with a hypothalamic neurogenesis phenotype. I was asked to perform an RNA-sequencing (RNA-seq) experiment to identify Lef1-dependent genes. In doing so, I also characterized the cellular phenotype in the hypothalamus of our zebrafish mutants in a greater detail.

The first transition of this project happened when I proposed in late 2013 to test whether Lef1’s function was conserved in the mouse hypothalamus. Dr. Dorsky liked that idea, but told me that I could only pursue that idea if there was a Lef1-flox mouse strain available, because he did not want me to delay my graduation after a lab switch by making a new mouse line. Fortunately, a quick google search located the right mouse line published from the group of Dr. Hai-Hui Xue, who was generous enough to share some mice with us. Because the Dorsky lab was a zebrafish lab by then, we collaborated with Dr. Edward Levine to maintain our mice under his animal protocol. I was initially trained by Dr. Levine and his lab specialist Anna Clark for general mouse colony management. After Dr. Levine moved to Vanderbilt University in early 2016, we began to maintain our mice under Dr. Camille Fung’s animal protocol. Dr. Dorsky also supported me in attending a 3-week Cold Spring Harbor Laboratory Course on Mouse Development, Stem Cells & Cancer in mid 2015, which made me much more confident in handling mouse work afterwards.

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Fear of Uncertain Future Linked To Brain Region Associated With OCD

MedicalResearch.com Interview with:
Justin M. Kim, Ph.D

Dartmouth College
Advisor: Paul J. Whalen

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Anxiety (and its co-conspirator ‘worry’) is an active, energy consuming process. You haven’t given up – you are still fighting back, trying to anticipate what might happen tomorrow. The problem of course is that there are an infinite number of ‘what if…’ scenarios you can come up with. For some individuals, the uncertainty of what ‘might happen’ tomorrow, is actually worse than the negative event itself actually happening. These individuals are intolerant of uncertainty.

We were interested in how uncertainty and ambiguity of potential future threat contribute to the generation of anxiety and how they might be represented in our brain. In the psychology literature, how we deal with an uncertain future can be quantified as intolerance of uncertainty (IU). As is the case with any other personality characteristic, we all have varying degrees of IU. For example, individuals high in IU display difficulty accepting the possibility of potential negative events in the future. Importantly, psychiatric disorders such as generalized anxiety disorder (GAD) or obsessive-compulsive disorder (OCD), whose symptoms are marked with worrying/obsessing, are commonly associated elevated IU. We noticed that while much of the neuroimaging research on IU has been primarily focused on brain function, brain structural correlates of IU have received little attention so far. As such, we believed that it was an important endeavor to assess the relationship between IU and the structural properties of the brain, which can be done through the use of magnetic resonance imaging (MRI) techniques.

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Effects of ICD Shock and Anti-Tachycardia Pacing on Anxiety and Quality of Life

MedicalResearch.com Interview with:
Alessandro Paoletti Perini, MD, PhD and

Valentina Kutyifa MD, PhD
University of Rochester Medical Center
Heart Research Follow-Up Program
Rochester, New York, 14642

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The present study is a pre-specified sub-study of the Multicenter Automatic Defibrillator Implantation Trial – Reduce Inappropriate Therapy (MADIT-RIT), which was published on the New England Journal of Medicine in 2012. The main trial showed that innovative ICD programming was associated with reduction in inappropriate ICD therapy and mortality.

In the present investigation we focused on the detrimental effects that ICD firings, either appropriate or inappropriate, may have on patients’ psychological well-being.

We observed that multiple appropriate and inappropriate shocks are associated with increased levels of ICD-related anxiety, a specific kind of psychological disorder which affects patients implanted with an ICD. Multiple appropriate ATP were also proved associated with higher anxiety, although not as much as shocks. On the other hand, we did not find a significant association with anxiety for multiple inappropriate ATP.

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Cognitive Behavior Therapy Most Effective Treatment for OCD, Anxiety and PTSD

David Mataix-Cols

Prof. Mataix-Cols

MedicalResearch.com Interview with:
David Mataix-Cols PhD
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, Stockholm County Council
Stockholm, Sweden

MedicalResearch.com: What is the background for this study?

Response: Exposure-based Cognitive Behavior Therapy (CBT) is the treatment of choice for patients with anxiety, obsessive compulsive disorder (OCD) and post-traumatic stress disorders. Some patients do not respond sufficiently to such treatment. This has led researchers to find ways to augment (enhance) CBT with pharmacological agents, such as D-cycloserine (DCS).

Because CBT is such a powerful treatment for most patients, we suspected that the effects of DCS would probably be small. This means that very large samples of patients are needed to show statistically significant differences between groups. Previous studies and meta-analyses were underpowered to detect such small effects. Combining the raw data from all available studies to date gave us the power we needed to address the question of whether DCS is an efficacious augmenting strategy, over and above CBT.

We also had a second research question. Previous research from our group had suggested that there may be undesirable interactions between DCS and antidepressants, whereby patients taking both types of drugs would have significantly worse outcomes (see Andersson et al JAMA Psychiatry. 2015 Jul;72(7):659-67.
doi: 10.1001/jamapsychiatry.2015.0546).

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Can Probiotics in Yogurt Protect Against Stress and Anxiety?

MedicalResearch.com Interview with:

Elizabeth Bryda, PhD Professor, Director, Rat Resource and Research Center Veterinary Pathobiology University of Missouri Columbia, Missouri

Dr. Elizabeth Bryda

Elizabeth Bryda, PhD
Professor, Director, Rat Resource and Research Center
Veterinary Pathobiology
University of Missouri
Columbia, Missouri

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: A number of groups have demonstrated the ability of probiotics to benefit digestive health and there is a growing body of evidence to suggest an association between mental health and “gut health”. We were interested to see if probiotic bacteria could decrease anxiety- or stress-related behavior in a controlled setting using zebrafish as our model organism of choice for these studies.

We were able to show that Lactobacillus plantarum decreased overall anxiety-related behavior and protected against stress-induced dysbiosis (microbial imbalance). The fact that administration of probiotic bacteria also protected other resident gut bacteria from the dramatic changes seen in “stressed” fish not receiving the probiotic was unexpected and suggested that these bacteria may be working at the level of the GI tract and the central nervous system.

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Gut and Brain Communicate To Drive Irritable Bowel Syndrome

MedicalResearch.com Interview with:

Laureate Professor Nicholas J. Talley, MBBS (Hons.)(NSW), MD (NSW), PhD (Syd), MMedSci (Clin Epi)(Newc.), FRACP, FAFPHM, FAHMS, FRCP (Lond. & Edin.), FACP, FACG, AGAF, FAMS, FRCPI (Hon), GAICD Pro Vice-Chancellor, Global Research, University of Newcastle, Australia Professor of Medicine, Faculty of Health and Medicine, University of Newcastle, Australia

Prof. Nicholas Talley

Laureate Professor Nicholas J. Talley, MBBS (Hons.)(NSW), MD (NSW), PhD (Syd), MMedSci (Clin Epi)(Newc.), FRACP, FAFPHM, FAHMS, FRCP (Lond. & Edin.), FACP, FACG, AGAF, FAMS, FRCPI (Hon), GAICD
Pro Vice-Chancellor, Global Research,
University of Newcastle, Australia
Professor of Medicine, Faculty of Health and Medicine, University of Newcastle, Australia
President, Royal Australasian College of Physicians
Chair, Committee of Presidents of Medical Colleges
Hon. Treasurer, Australian Academy of Health and Medical Sciences
Editor-in-Chief, Medical Journal of Australia
Senior Staff Specialist, John Hunter Hospital, Newcastle, Australia
Professor of Medicine and Professor of Epidemiology, Joint Supplemental Consultant Gastroenterology and Health Sciences Research, Mayo Clinic, Rochester, MN, USA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Functional gastrointestinal diseases (FGIDs) like the irritable bowl syndrome (IBS) are very common, cause major distress including pain and psychological dysfunction, impact on quality of life and drive high health care costs. We speculated that there are two distinct types of functional gastrointestinal disease that others have not recognized.

For example, IBS in a subgroup may first begin with gut symptoms (pain, diarrhea, constipation, bloating etc) in those free of psychological distress and only later does new onset anxiety or depression develop, implicating gut disease as the primary driver of the entire symptom complex (a gut-to-brain disease). On the other hand, we speculated there is another quite different subgroup where disease begins with anxiety or depression and only later do new onset gut symptoms develop, and this is likely primarily a central nervous system cause (probably through the stress system), or a brain-to-gut disease. This is exactly what we found, with gut disease occurring first followed by new onset psychological distress in about two thirds of people from the community over a one year follow-up.

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Soothing Words Do More Than Pills To Decrease Patient Anxiety

Dr Emmanuel Boselli, MD, PhD Anesthesiology and Intensive Care University Claude Bernard Lyon I University of Lyon Lyon, France

Dr. Boselli

MedicalResearch.com Interview with:
Dr Emmanuel Boselli, MD, PhD
Anesthesiology and Intensive Care
University Claude Bernard Lyon I
University of Lyon
Lyon, France

Medical Research: What is the background for this study? What are the main findings?

Dr. Boselli: We hypothesized that the use of conversational hypnosis in patients undergoing regional anesthesia procedures for ambulatory upper limb surgery might provide better comfort than the use of oral premedication during the regional anesthesia procedure. We assessed the subjective effect of conversational hypnosis on a patient self-reported comfort scale ranging from 0 (no comfort) to 10 (maximal comfort), and the objective effect was assessed using the Analgesia/Nociception Index (ANI), a 0-100 index derived from heart rate variability reflecting the relative parasympathetic tone. In our study of 100 patients undergoing hand surgery in two different centers, 50 had conversational hypnosis while being given regional anesthesia (Saint-Grégoire hospital), and 50 were given of oral hydroxyzine 30 minutes to an hour before the regional anesthesia procedure (Lyon hospital). Patients having hypnosis measured an average ANI of 51 before and 78 after hypnosis, whereas those who had premedication averaged 63 before and 70 after. The average comfort scale of those who had received hypnosis was 6.7 before and 9.3 after, while patients who had medication averaged 7.8 before and 8.3 after. The main finding of this study is that conversational hypnosis induced greater increase in comfort scales and ANI values than oral premedication.

Medical Research: What is conversational hypnosis? What does it consist of?

Dr. Boselli: Conversational hypnosis consists of matching the patient’s behavioral communication patterns, reflective listening, avoiding any negative suggestion (e.g. “Keep calm and quiet” instead of “Please don’t move!”) and focalizing the patient’s attention on something else than the regional anesthesia procedure, such as the ultrasound machine screen.

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Anxiety Symptoms Raised by Air Pollution

Melinda C Power, ScD Post-Doctoral Research Fellow Epidemiology Department, Johns Hopkins Bloomberg School of Public Health Neurology Department, Johns Hopkins School of MedicineMedicalResearch.com Interview with:
Melinda C Power, ScD
Post-Doctoral Research Fellow
Epidemiology Department, Johns Hopkins Bloomberg School of Public Health
Neurology Department, Johns Hopkins School of Medicine

Medical Research: What is the background for this study? What are the main findings?

Dr. Power: Air pollution may be related to mental health, particularly anxiety, through effects on oxidative stress and systemic inflammation or through promotion or aggravation of chronic diseases.  However, there has been very little research on the relation between air pollution exposures and anxiety in people.   Our study found that those with higher exposures to fine particulate matter, a type of air pollution, were more likely to experience elevated anxiety symptom levels.  Our study also suggests that recent exposures to find particulate matter air pollution are potentially more relevant to anxiety symptom levels than long-term past exposures.

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Study Highlights Benefits of Cognitive-Behavioral Therapy for Childhood Anxiety.

Courtney Benjamin Wolk, Ph.D. Postdoctoral Researcher Center for Mental Health Policy and Services Research Perelman School of Medicine Department of Psychiatry University of Pennsylvania Philadelphia, PA 19104MedicalResearch.com Interview with:
Courtney Benjamin Wolk, Ph.D.

Postdoctoral Researcher
Center for Mental Health Policy and Services Research
Perelman School of Medicine Department of Psychiatry
University of Pennsylvania Philadelphia, PA 19104

Medical Research: What is the background for this study? What are the main findings?

Response: Previous research investigating the relationship between anxiety and suicidality has been mixed. An ongoing question in the field has been whether anxiety disorders independently increase risk for suicidal ideation and behavior or if the high co-occurrence of anxiety and mood symptoms or other shared demographic factors are driving relationships that have been observed between anxiety and suicidality.

We examined the relationship between response to treatment for an anxiety disorder in childhood and suicidal ideation, plans, and attempts 7 to 19 years after treatment with cognitive-behavioral therapy, more commonly referred to as CBT. Our results indicated that participants who responded favorably to cognitive-behavioral therapy during childhood had lower rates of lifetime, past month, and past two-week suicidal ideation endorsement than treatment non-responders. This was the case across both self-report and interview-report of suicidal ideation. Treatment response was not significantly associated with suicide plans or attempts, though plans and attempts were infrequently endorsed in our sample, limiting the ability to detect findings.

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Anxiety Disorders Common in Patients With Coronary Heart Disease

MedicalResearch.com Interview with:
Phil Tully PhD
Early Career Research Fellow, Discipline of Medicine
University of Adelaide Australia and
Abteilung für Rehabilitationspsychologie und Psychotherapie
Institut für Psychologie, Universität Freiburg Freiburg Germany

Medical Research: What are the main findings of the study?

Response: The systematic review indicated that anxiety disorders ascertained by clinical interview are highly prevalent in patients with verified coronary heart disease. Also, approximately 50% of anxiety disorders were comorbid with depression. There was however some uncertainty in prevalence estimates with high level heterogeneity observed between studies. It was also evident that studies measuring generalized anxiety disorder in outpatient samples reported an increased prognostic risk for major adverse cardiac events in the longer term, when adjusted for confounding factors, however there was limited data. There were no randomized controlled trials targeting anxiety disorders in this population.
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Neurotic Symptoms In Midlife May Presage Alzheimer’s Dementia

Lena Johansson, PhD, MSc, RN Institute of Neuroscience and Physiology Department of Psychiatry and Neurochemistry Sahlgrenska Academy at Gothenburg UniversityMedicalResearch.com Interview with:
Lena Johansson, PhD, MSc, RN
Institute of Neuroscience and Physiology
Department of Psychiatry and Neurochemistry
Sahlgrenska Academy at Gothenburg University


Medical Research: What are the main findings of the study?

Dr. Johansson: We found that a higher degree of neuroticism in midlife was associated with increased risk of Alzheimer’s disease over 38 years. On the 24 point scale, the risk increased with 4% per each step. Women who score high on the neuroticism scale were more likely to experience feelings such as anxiety, nervousness, worry, and irritability, and they were more moodiness and stress-prone.

The association between neuroticism and Alzheimer’s disease diminished after adjusting for longstanding perceived distress symptoms, which suggest that the associations was at least partly depended on long-standing distress symptoms.

When the two personality dimensions were combined, women with high neuroticism/low extraversion had a double risk of Alzheimer’s disease compared to those with low neuroticism/high extraversion.

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Specific Brain Circuit Permanently Switched On In Patients With Anxiety Disorders

MedicalResearch.com Interview with:
Dr Oliver J Robinson Ph.D.
Section on Neurobiology of Fear and Anxiety,
National Institute of Mental Health, NIH, Bethesda, MD,
Institute of Cognitive Neuroscience
University College London, London, UK

Medical Research: What are the main findings of the study?

Dr. Robinson: This study is looking at a symptom of anxiety disorders known as “negative affective bias”. This describes the tendency of people with anxiety disorders to focus on negative or threatening information at the expense of positive information.

We completed a number of previous studies looking at so called “adaptive” anxiety in healthy individuals – this is the normal, everyday anxiety that everyone experiences; walking home in the dark, for instance (in these prior studies we used unpredictable electrical shocks to make people anxious and stressed). When we made healthy people transiently anxious in this way we showed that this was also associated with negative affective bias and driven by a specific brain circuit: the dorsal medial prefrontal (anterior cingulate) cortex—amygdala aversive amplification circuit.

In this study we showed that the same circuit that was engaged by transient anxiety in our healthy sample was actually engaged ‘at baseline’ (i.e. without stress) in our patient group. This suggests that this mechanism which can be temporarily activated in healthy controls becomes permanently ‘switched on’ in our patient group. This might explain why people with anxiety disorders show persistent ‘negative affective biases’.

Furthermore, the extent to which this circuit was turned on correlated with self-reported anxiety. That is to say the more anxious an individual said they were, the greater the activity in this circuit. Therefore, there seems to be more of a dimension or scale of anxiety, rather than a simple well/unwell diagnosis.
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Maternal Anxiety Disorders Linked To Excessive Infant Crying

Johanna Petzoldt Institute of Clinical Psychology and Psychotherapy Chemnitzer Straße Dresden, GermanyMedicalResearch.com Interview with:
Johanna Petzoldt
Institute of Clinical Psychology and Psychotherapy
Chemnitzer Straße
Dresden, Germany

MedicalResearch: What are the main findings of the study?

Answer: We investigated 286 mother-infant couples from the Maternal Anxiety in Relation to Infant Development (MARI) Study from Dresden (Germany) via standardized interview and questionnaire. We found a robust relation from maternal lifetime anxiety disorders as early as prior to pregnancy to excessive crying in the offspring. Also, the association increased when considering incident anxiety disorders during pregnancy and after delivery.
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Genetic Structures Underlying Depression and Anxiety During Development

Monika Waszczuk 1+3 PhD Student MRC SGDP Research Centre Institute of Psychiatry, King's College London DeCrespigny Park London UKMedicalResearch.com Interview with:
Monika Waszczuk
1+3 PhD Student
MRC SGDP Research Centre
Institute of Psychiatry, King’s College London
DeCrespigny Park London UK

MedicalResearch: What are the main findings of the study?

Answer: Little is known about the genetic influences on the relationship between depression and anxiety disorders across development. We used two population-based prospective longitudinal twin and sibling studies to investigate phenotypic associations between the symptoms of these disorders, and tested genetic structures underlying these symptoms across three developmental stages: childhood, adolescence and early adulthood.

We found that depression and anxiety disorder symptoms are largely distinct in childhood and are influenced by largely independent genetic factors. Depression and anxiety symptoms become more associated and shared most of their genetic etiology from adolescence. An overarching internalizing genetic factor influencing depression and all anxiety subscales emerged in early adulthood. These results provide preliminary evidence for different phenotypic and genetic structures of internalizing disorder symptoms in childhood, adolescence and young adulthood, with depression and anxiety becoming more associated from adolescence.
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