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1.
Becker J Fliege H Kocalevent RD Bjorner JB Rose M Walter OB Klapp BF 《Depression and anxiety》2008,25(12):E182-E194
Background: The aim of this study was to evaluate the Computerized Adaptive Test to measure anxiety (A‐CAT), a patient‐reported outcome questionnaire that uses computerized adaptive testing to measure anxiety. Methods: The A‐CAT builds on an item bank of 50 items that has been built using conventional item analyses and item response theory analyses. The A‐CAT was administered on Personal Digital Assistants to n=357 patients diagnosed and treated at the department of Psychosomatic Medicine and Psychotherapy, Charité Berlin, Germany. For validation purposes, two subgroups of patients (n=110 and 125) answered the A‐CAT along with established anxiety and depression questionnaires. Results: The A‐CAT was fast to complete (on average in 2 min, 38 s) and a precise item response theory based CAT score (reliability>.9) could be estimated after 4–41 items. On average, the CAT displayed 6 items (SD=4.2). Convergent validity of the A‐CAT was supported by correlations to existing tools (Hospital Anxiety and Depression Scale‐A, Beck Anxiety Inventory, Berliner Stimmungs‐Fragebogen A/D, and State Trait Anxiety Inventory: r=.56–.66); discriminant validity between diagnostic groups was higher for the A‐CAT than for other anxiety measures. Conclusions: The German A‐CAT is an efficient, reliable, and valid tool for assessing anxiety in patients suffering from anxiety disorders and other conditions with significant potential for initial assessment and long‐term treatment monitoring. Future research directions are to explore content balancing of the item selection algorithm of the CAT, to norm the tool to a healthy sample, and to develop practical cutoff scores. Depression and Anxiety, 2008. © 2008 Wiley‐Liss, Inc. 相似文献
2.
Means-Christensen AJ Sherbourne CD Roy-Byrne PP Craske MG Stein MB 《General hospital psychiatry》2006,28(2):108-118
OBJECTIVE: Primary care providers are increasingly taking on the role of ad hoc mental health provider. However, before patients in primary care can be treated, they must be identified. This study set out to validate a very brief screening instrument for identifying primary care patients with anxiety and depression. METHOD: Eight hundred one primary care patients completed a questionnaire screening for (1) panic disorder, posttraumatic stress disorder (PTSD) and social phobia, or (2) panic disorder, generalized anxiety disorder (GAD) and major depression. Screening was followed by a diagnostic interview. The properties of the questionnaires were examined to identify a small set of items that effectively and efficiently screened for panic disorder, PTSD, social phobia, GAD and depression. RESULTS: Five items were selected across the two versions of the questionnaire, comprising the Anxiety and Depression Detector (the ADD). The sensitivities for the items ranged from 0.62 to 1.00, and the specificity values ranged from 0.56 to 0.83. When a "yes" answer to any of the screening questions was used to predict the presence of any diagnosis, sensitivity values were 0.92 to 0.96 and specificity values were 0.57 to 0.82. Sensitivity and specificity values varied little by gender, age or ethnicity. CONCLUSIONS: The five items of the ADD appear to comprise a useful screening device for anxiety and depressive disorders in primary care settings. 相似文献
3.
Yong Woo Kim M.D. Sang‐Hyuk Lee M.D. Tae Kyou Choi M.D. Shin Young Suh M.D. Borah Kim M.D. Chan Mo Kim Ph.D. Sung Joon Cho M.D. Myo Jung Kim M.S.W. Keunyoung Yook M.A. Mi Ryu M.A. Su Kyung Song R.N. Ki‐Hwan Yook M.D. 《Depression and anxiety》2009,26(7):601-606
Background: Mindfulness‐based cognitive therapy (MBCT) has been widely used to treat patients with depressive disorder to prevent relapse. The objective of this study was to examine the effectiveness of newly developed MBCT program as an adjuvant to pharmacotherapy in the treatment of patients with panic disorder or generalized anxiety disorder. Methods: Forty‐six patients with panic disorder or generalized anxiety disorder were assigned to either MBCT or an anxiety disorder education (ADE) program for a period of 8 weeks. The Hamilton Anxiety Rating Scale (HAM‐A), Hamilton Depression Rating Scale (HAM‐D), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Symptom Checklist‐90‐Revised (SCL‐90‐R) were used to assess the patients at 0 week and after the two programs had been running for 2, 4, and 8 weeks. Results: The MBCT group demonstrated significantly more improvement than the ADE group according to all anxiety (HAM‐A, p<0.01; BAI, p<0.01; anxiety subscale of SCL‐90‐R, p=0.01) and depression (HAM‐D, p<0.01; BDI, p<0.01; depression subscale of SCL‐90‐R, p<0.01) scale scores. The obsessive‐compulsive and phobic subscales of the SCL‐90‐R also showed significantly more improvement in the MBCT group. However, no significant improvement was observed in the MBCT group versus the ADE group in terms of the somatization, interpersonal sensitivity, paranoid ideation, or psychoticism subscale scores of the SCL‐90‐R. Conclusions: MBCT may be effective at relieving anxiety and depressive symptoms in patients with panic disorder or generalized anxiety disorder. However, well‐designed, randomized controlled trials are needed. Depression and Anxiety, 2009. © 2009 Wiley‐Liss, Inc. 相似文献
4.
N. Schmitz J. Kruse C. Heckrath L. Alberti W. Tress 《Social psychiatry and psychiatric epidemiology》1999,34(7):360-366
Background: The treatment of mental disorders in Germany is mainly done by primary care physicians. Several studies have shown that
primary care physicians have difficulty in diagnosing these disorders. Recently, several self-report questionnaires have been
developed that can be used as screening instruments to identify psychopathology in primary care settings and in the community.
The aim of this paper was to investigate the screening properties of the General Health Questionnaire (GHQ-12) and the Symptom
Check-List (SCL-90-R) in a primary care setting in Germany. Method: A randomly selected sample (n = 408) of adult outpatients from 18 primary care offices in Düsseldorf was screened using the German versions of the GHQ-12
and the SCL-90-R. A structured diagnostic interview (SCID) and an impairment rating (IS) were used as a gold standard to which
both questionnaires were compared. Test performance was evaluated by receiver operating characteristic (ROC) analysis. Results: We found no difference in the performance of the general scores of the two questionnaires. Both instruments were able to
detect cases. Complex scoring methods offered no advantages over simpler ones for the GHQ-12. ROC analysis confirmed that
the SCL-90-R subscales “anxiety” and “depression” showed acceptable concurrent validity for the diagnostic groups anxiety
and depression (according to DSM-III-R). Conclusions: GHQ-12 and SCL-90-R appeared to be useful tools for identifying mental disorders in primary care practice and research.
The use of GHQ-12 or SCL-90-R, employed as a first step, supplemented by a second-stage interview, may enhance the detection
rate of mental disorder in primary care settings.
Accepted: 16 February 1999 相似文献
5.
Few studies have examined anxiety recurrence after symptom remission in the primary care setting. We examined anxiety recurrence in the Coordinated Anxiety Learning and Management (CALM) trial. From 2006 to 2009, CALM randomized adults with anxiety disorders (generalized anxiety disorder, panic disorder, social anxiety disorder, and post-traumatic stress disorder) in primary care clinics to usual care (UC) or a collaborative care (CC) intervention of pharmacotherapy and/or cognitive behavioral therapy. We examined 274 patients who met criteria for anxiety remission (Brief Symptom Inventory for anxiety and somatization (BSI-12) < 6) after 6 months of randomized treatment and completed a follow-up of 18 months. Logistic regression and receiver operating characteristics (ROC) were used to identify predictors of anxiety recurrence (BSI-12 ≥ 6 and 50% increase from 6-month ratings) during the year following remission. Recurrence was lower in CC (29%) compared to UC (41%) (p = 0.04). Patients with comorbid depression or lower self-perceived socioeconomic status particularly benefited (in terms of reduced recurrence) if assigned to CC instead of UC. In the multivariable logistic regression model, smoking, being single, Anxiety Sensitivity Index score, functional impairment at month 6 due to residual anxiety (measured with the Sheehan Disability Scale), and treatment with benzodiazepines were associated with subsequent anxiety recurrence. ROC identified prognostic subgroups based on the risk of recurrence. Our study was exploratory, and our findings require replication. Future studies should also examine the effectiveness of relapse prevention programs in patients at highest risk for recurrence. 相似文献
6.
Wim H Winthorst Wendy J Post Ybe Meesters Brenda WHJ Penninx Willem A Nolen 《BMC psychiatry》2011,11(1):1-18
Background
Little is known about seasonality of specific depressive symptoms and anxiety symptoms in different patient populations. This study aims to assess seasonal variation of depressive and anxiety symptoms in a primary care population and across participants who were classified in diagnostic groups 1) healthy controls 2) patients with a major depressive disorder, 3) patients with any anxiety disorder and 4) patients with a major depression and any anxiety disorder.Methods
Data were used from the Netherlands Study of Depression and Anxiety (NESDA). First, in 5549 patients from the NESDA primary care recruitment population the Kessler-10 screening questionnaire was used and data were analyzed across season in a multilevel linear model. Second, in 1090 subjects classified into four groups according to psychiatric status according to the Composite International Diagnostic Interview, overall depressive symptoms and atypical versus melancholic features were assessed with the Inventory of Depressive Symptoms. Anxiety and fear were assessed with the Beck Anxiety Inventory and the Fear questionnaire. Symptom levels across season were analyzed in a linear regression model.Results
In the primary care population the severity of depressive and anxiety symptoms did not show a seasonal pattern. In the diagnostic groups healthy controls and patients with any anxiety disorder, but not patients with a major depressive disorder, showed a small rise in depressive symptoms in winter. Atypical and melancholic symptoms were both elevated in winter. No seasonal pattern for anxiety symptoms was found. There was a small gender related seasonal effect for fear symptoms.Conclusions
Seasonal differences in severity or type of depressive and anxiety symptoms, as measured with a general screening instrument and symptom questionnaires, were absent or small in effect size in a primary care population and in patient populations with a major depressive disorder and anxiety disorders. 相似文献7.
Danilo Carrozzino Daniela Marchetti Daniela Laino Maria Minna Maria Cristina Verrocchio Mario Fulcheri 《Nordic journal of psychiatry》2016,70(6):424-429
Background Anxiety and depression have been considered to be neglected disorders in epilepsy. Because panic disorder is one of the most important anxiety disorders, it has been problematic to use very comprehensive anxiety questionnaires in epilepsy patients, as panic attacks and epileptic seizures, although two distinct clinical entities from a diagnostic point of view, show a significant overlap of symptoms.Aims We have focused on single items for anxiety and depression as screening candidates in adolescent epilepsy.Methods The individual panic attack item in the Screen for Children Anxiety Related Emotional Disorders Scale (SCARED) and the single depression item in the Kellner Symptom Questionnaire were tested. Our samples consisted of adolescent patients with epilepsy and a matched control group with healthy participants, as well as two numerical groups acting as controls.Results The single panic attack item identified panic anxiety in 24.1% in the group of patients with epilepsy and 0.0% in the matched control group (p?=?0.01). The single depression item identified 52.2% with depression in the epilepsy group and 6.2% in the matched control group (p?=?0.001).Conclusion As screening instruments, single items of panic attack and depression are sufficient to screen for these affective states in adolescent epilepsy. The clinical implications are that it is important to be quite specific when screening for depression and panic attacks in adolescent patients with epilepsy. 相似文献
8.
《European psychiatry》2014,29(5):293-300
PurposeTo test whether firstly, different parental rearing components were associated with different dimensions of psychiatric symptoms in adulthood, secondly BDNF-Val66Met polymorphism moderated this association and thirdly, this association was due to genetic confounding.MethodPerceived parental rearing according to Parental Bonding Instrument (PBI), psychiatric symptoms evaluated with the Brief Symptom Inventory (BSI) and the BDNF-Val66Met polymorphism were analyzed in a sample of 232 adult twins from the general population.ResultsIn the whole sample, paternal care was negatively associated with depression. Maternal overprotection was positively associated with paranoid ideation, obsession-compulsion and somatization. Gene-environment interaction effects were detected between the BDNF-Val66Met polymorphism and maternal care on phobic anxiety, paternal care on hostility, maternal overprotection on somatization and paternal overprotection also in somatization. In the subsample of MZ twins, intrapair differences in maternal care were associated with anxiety, paranoid ideation and somatization.ConclusionsMet carriers were, in general, more sensitive to the effects of parental rearing compared to Val/Val carriers in relation to anxiety and somatization. Contra-intuitively, our findings suggest that high rates of maternal care might be of risk for Met carriers regarding anxiety. Results from analyses controlling for genetic confounding were in line with this finding. 相似文献
9.
Cassandra Shields Tamara Ownsworth Analise O'Donovan Jennifer Fleming 《Neuropsychological rehabilitation》2016,26(3):410-445
Emotional distress after traumatic brain injury (TBI) often presents as a range of neurobehavioural and emotional reactions rather than distinct disorders. This study adopted a transdiagnostic approach with the aim of identifying psychological processes common to depression, anxiety and global distress after TBI. Fifty participants with TBI (aged 19–66 years, 12–65 months post-injury) completed measures of threat appraisals and avoidance behaviour (Appraisal of Threat and Avoidance Questionnaire), self-discrepancy (Head Injury Semantic Differential Scale III), emotion dysregulation (Difficulties in Emotion Regulation Scale), worry (Penn State Worry Questionnaire), negative self-focused attention (Self-Focus Sentence Completion) and emotional distress (Depression Anxiety Stress Scales and Brief Symptom Inventory). Significant correlations were found among the proposed transdiagnostic variables (rs?=?.29–.82, p?.05). A principal components analysis revealed two underlying factors: (1) Threats to Self, and (2) Emotion Dysregulation. Only the Emotion Dysregulation factor accounted for significant unique variance in levels of depression, anxiety and global distress (sr2?=?.12–.17). Such findings indicate the need for interventions to target difficulties in identifying and regulating emotions after TBI to facilitate emotional adjustment. 相似文献
10.
I.M. Cameron L. Cunningham J.R. Crawford J.M. Eagles S.V. Eisen K. Lawton 《International journal of psychiatry in clinical practice》2013,17(1):36-43
Objective. Outcome measurement in mental health services is an area of considerable clinical interest and policy priority. This study sought to assess the Behaviour and Symptom Identification Scale-24 (BASIS-24©), a brief, patient self-reported measure of psychopathology and functioning, in a UK sample, including establishing population norms for comparative purposes. Methods. Participants were 588 adults recruited from psychiatric inpatient, outpatient and primary care settings; and 630 adults randomly sampled from primary care lists who completed the BASIS-24©, and the Brief Symptom Inventory (BSI) at two time points. Results. BASIS-24© demonstrated adequate reliability (coefficient α values for combined clinical sample across subscales ranged from 0.75 to 0.91), validity and responsiveness to change (effect size for change of the BASIS-24© was 0.56 compared with 0.48 for BSI Global Severity Index). Population norms were established for the general population and adult in-patients (at in-take). The scale proved straightforward to complete across clinical settings. Variable rates of questionnaire distribution across clinical settings highlighted the ongoing challenge of incorporating outcome measures in clinical settings. Conclusion. BASIS-24© is a brief, easily administered, self-complete measure of mental well-being and functioning that adequately meets the requirements of reliability, validity and responsiveness to change required of an outcome measure. 相似文献
11.
Cano A Sprafkin RP Scaturo DJ Lantinga LJ Fiese BH Brand F 《Primary care companion to the Journal of clinical psychiatry》2001,3(5):206-210
BACKGROUND: The current study compared 3 brief mental health screening measures in a sample of older patients in a primary care outpatient setting. Previous mental health screening research has been conducted primarily with younger patients, often with only 1 screening measure, thereby limiting the generalizability of findings. In addition, measures have not yet been compared in terms of their ability to discriminate between cases and noncases of psychiatric disorder. METHOD: One hundred thirty-four male patients attending their appointments at a primary care clinic in a Department of Veterans Affairs Medical Center participated in this study. Participants completed the General Health Questionnaire-12 (GHQ-12), the Symptom Checklist-10 (SCL-10), and the Primary Care Evaluation of Mental Disorders screening questionnaire and interview. RESULTS: Receiver operating characteristic analysis yielded the optimum cutoff scores on each brief mental health screening measure and showed that all 3 measures discriminated well between cases and noncases of psychiatric disorders. The 3 measures performed slightly better in terms of discriminating between cases and noncases of mood or anxiety disorders than between cases and noncases of any psychiatric disorder. There were no significant differences between the measures' abilities to accurately identify cases and noncases of disorder. CONCLUSION: Primary care physicians are encouraged to use brief mental health screening measures with their patients, since many report symptoms of psychological distress and disorder. It is recommended that the SCL-10 and GHQ-12 be used to detect mood or anxiety disorders in patients such as these because of the accuracy and brevity of these measures. 相似文献
12.
MYRON F. WEINER DORIS SVETLIK RICHARD C. RISSER 《International journal of geriatric psychiatry》1997,12(6):648-652
Purpose. To ascertain the nature of depression-related symptoms in AD. Method. The Hamilton Rating Scale for Depression (HAM-D) was administered as a semi-structured interview to 30 consecutive Alzheimer's disease (AD) patients who also underwent independent psychiatric evaluation. The HAM-D was also administered with a caregiver as the informant. Results. There was no relationship between the number of symptoms reported by patients or caregivers and patients' level of cognitive impairment. Symptom reports by caregivers living in the same household did not differ significantly from symptom reports by caregivers living elsewhere. Caregivers rated AD patients as having significantly more depressive symptoms than did patients themselves. The items most frequently endorsed by caregivers were psychic anxiety (77%), suspiciousness (50%), low energy (50%) and depression (43%). The items most frequently endorsed by AD patients were weight loss (36%), psychic anxiety (33%) and somatic anxiety (33%). Depression was endorsed by 20% of patients. Caregiver-respondent HAM-D scores suggested clinically significant depression in 27% of cases, but AD patients' scores suggested clinically significant depression in only 7% of cases. No case of major depression was found on psychiatric examination. Conclusions. Depressive symptoms seemed more an executive function loss than of primary mood disturbance in that guilt, suicidal rumination and self-perceived loss of interest were uncommon, suggesting that simple environmental measures might be the most appropriate treatment of these symptoms. 相似文献
13.
Spitzer C Hammer S Löwe B Grabe HJ Barnow S Rose M Wingenfeld K Freyberger HJ Franke GH 《Fortschritte der Neurologie-Psychiatrie》2011,79(9):517-523
The short version of the Brief Symptom Inventory (BSI-18) is an easily applicable, reliable and valid self-report measure in wide international use. It assesses the syndroms of somatisation, depression and anxiety by means of 6?items each. For the psychometric evaluation of the German translation, undergraduate students, non-clinical subjects and psychosomatic outpatients were administered the BSI-18. Across these populations, all scales showed satisfactory to good internal consistencies (Cronbachs alpha ranged between 0.63 and 0.93). The item-total correlation as item discrimination index was sufficiently high, patricularly in the patient sample (rit ≥?0.40). The correlations of the BSI-18 with measures of similar dimensions were moderate to high indicating a good convergent validity. Criterion-related validity was established in so far that patients scored significantly higher in all BSI-18 scales than did the non-clinical samples. With some exceptions, the German translation of the BSI-18 has similarly good psychometric qualities as the American original. 相似文献
14.
Kissane DW McKenzie M Bloch S Moskowitz C McKenzie DP O'Neill I 《The American journal of psychiatry》2006,163(7):1208-1218
OBJECTIVE: The aim of family focused grief therapy is to reduce the morbid effects of grief among families at risk of poor psychosocial outcome. It commences during palliative care of terminally ill patients and continues into bereavement. The authors report a randomized, controlled trial. METHOD: Using the Family Relationships Index, the authors screened 257 families of patients dying from cancer: 183 (71%) were at risk, and 81 of those (44%) participated in the trial. They were randomly assigned (in a 2:1 ratio) to family focused grief therapy (53 families, 233 individuals) or a control condition (28 families, 130 individuals). Assessments occurred at baseline and 6 and 13 months after the patient's death. The primary outcome measures were the Brief Symptom Inventory, Beck Depression Inventory, and Social Adjustment Scale. The Family Assessment Device was a secondary outcome measure. Analyses allowed for correlated family data and employed generalized estimating equations based on intention to treat and controlling for site. RESULTS: The overall impact of family focused grief therapy was modest, with a reduction in distress at 13 months. Significant improvements in distress and depression occurred among individuals with high baseline scores on the Brief Symptom Inventory and Beck Depression Inventory. Global family functioning did not change. Sullen families and those with intermediate functioning tended to improve overall, whereas depression was unchanged in hostile families. CONCLUSIONS: Family focused grief therapy has the potential to prevent pathological grief. Benefit is clear for intermediate and sullen families. Care is needed to avoid increasing conflict in hostile families. 相似文献
15.
Wetherell JL Birchler GD Ramsdell J Unützer J 《International journal of geriatric psychiatry》2007,22(2):115-123
OBJECTIVE: To compare two brief screening measures as tools for detecting generalized anxiety disorder (GAD) among older primary care patients. METHODS: Receiver operating characteristic curve analysis was used to compare the Hospital Anxiety and Depression Scale (HADS) and the Brief Symptom Inventory-18 (BSI-18) against GAD diagnoses obtained from a structured diagnostic interview. RESULTS: The HADS Anxiety subscale was the only measure that distinguished individuals with and without GAD. A cutpoint greater than or equal to 8 on the HADS Anxiety subscale resulted in a sensitivity of 0.967 and a specificity of 0.667 for detecting GAD. CONCLUSIONS: The HADS Anxiety subscale appears to show some advantages over the BSI-18 Anxiety subscale as a brief, self-report measure of anxiety symptoms among older medical patients. 相似文献
16.
M.E. den Hollander-Gijsman E. de Beurs N.J.A. van der Wee Y.R. van Rood F.G. Zitman 《European psychiatry》2010,25(4):197-205
AimThe aim of the current study was to develop scales that assess symptoms of depression and anxiety and can adequately differentiate between depression and anxiety disorders, and also can distinguish within anxiety disorders. As point of departure, we used the tripartite model of Clark and Watson that discerns three dimensions: negative affect, positive affect and physiological hyperarousal.MethodsAnalyses were performed on the data of 1449 patients, who completed the Mood and Anxiety Symptoms Questionnaire (MASQ) and the Brief Symptom Inventory (BSI). From this, 1434 patients were assessed with a standardized diagnostic interview.ResultsA model with five dimensions was found: depressed mood, lack of positive affect, somatic arousal, phobic fear and hostility. The scales appear capable to differentiate between patients with a mood and with an anxiety disorder. Within the anxiety disorders, somatic arousal was specific for patients with panic disorder. Phobic fear was associated with panic disorder, simple phobia and social anxiety disorder, but not with generalized anxiety disorder.ConclusionsWe present a five-factor model as an extension of the tripartite model. Through the addition of phobic fear, anxiety is better represented than in the tripartite model. The new scales are capable to accurately differentiate between depression and anxiety disorders, as well as between several anxiety disorders. 相似文献
17.
《Nordic journal of psychiatry》2013,67(4):258-264
Background: Anger attacks and alcohol use may mask depressive symptoms in men. Only the Gotland Male Depression Scale (GS) includes such items. Aims: To study the usefulness of the GS and Beck Depression Inventory (BDI) in detecting depression among men in primary care. Methods: At a family doctor's drop-in clinic in Stockholm, Sweden, all men were invited into the study 2 days a week (opportunistic screening). On other days, the men who mentioned mental symptoms were invited (targeted screening). The men filled in BDI, GS and a social questionnaire. The doctor invited the men with BDI≥10 and /or GS≥13 to a repeat visit. The outcome was depression diagnosed according to DSM-IV and the severity was assessed with the Montgomery–Åsberg Depression Rating Scale. Results: 223 men were recruited, 190 by opportunistic and 33 by targeted screening. Seventeen per cent of the men reported an alcohol consumption that might put them at risk. In the opportunistic screening, 23% scored BDI≥10 and 14% scored GS≥13. The prevalence of depression in the opportunistic screening was 10.5%. The proportion of depressed men in the targeted screening was 60.6%. In total, 40 men were depressed, 63% had a mild and 35% moderate depression. The correlation between the scales was 0.80. The GS identified no additional cases. Conclusions: Clinical depression was quite common among those men who often had a high alcohol consumption, indicating an advantage for the GS when screening for depression among men. In primary care, a targeted screening procedure seems to be the most feasible method. 相似文献
18.
Spence J Titov N Dear BF Johnston L Solley K Lorian C Wootton B Zou J Schwenke G 《Depression and anxiety》2011,28(7):541-550
Background: Posttraumatic stress disorder (PTSD) is a severe and disabling condition and few receive appropriate care. Internet‐based treatment of PTSD shows promise in reducing barriers to care and preliminary evidence suggests it is efficacious in treating symptoms of PTSD. Methodology: Forty‐two individuals with a diagnosis of PTSD confirmed by clinician interview completed a randomized controlled comparison of Internet‐based cognitive behavioral therapy (CBT) with a waitlist control condition. Principle Findings: Large pre‐ to posttreatment effect sizes (ESs) were found for the Treatment group on measures of PTSD symptoms, depression, anxiety, and disability. A small between‐group ES was found for PTSD symptoms and moderate between‐group ESs were found for depression, anxiety, and disability. Conclusions: Results provide preliminary support for Internet‐based CBT as an efficacious treatment for individuals with a confirmed primary diagnosis of PTSD. Depression and Anxiety, 2011. © 2011 Wiley‐Liss, Inc. 相似文献
19.
Kurt Kroenke Samantha Outcalt Erin Krebs Matthew J. Bair Jingwei Wu Neale Chumbler Zhangsheng Yu 《General hospital psychiatry》2013
Objective
Anxiety and chronic pain are prevalent and frequently co-occur. Our purpose was to examine the association between anxiety, health-related quality of life (HRQL) and functional impairment in primary care patients with chronic musculoskeletal pain.Methods
Data were drawn from baseline interviews of the 250 primary care patients enrolled in the Stepped Care to Optimize Pain care Effectiveness trial. Validated measures were used to determine the proportion of patients screening positive for five common anxiety disorders: generalized anxiety, panic, social anxiety, posttraumatic stress and obsessive–compulsive disorder. Bivariate analyses examined associations between the type and number of anxiety disorders for which patients screened positive and representative pain, psychological and other HRQL outcomes. Multivariable models controlling for major depression and other covariates examined the association between the number of screen-positive anxiety conditions and functional impairment in psychological [SF-12 mental component summary (MCS) score], pain [Brief Pain Inventory (BPI) interference score] and work (disability days) domains.Results
One hundred fourteen (45%) patients screened positive for at least one anxiety disorder and, compared to the 136 screen-negative patients, had significantly worse scores across multiple pain, psychological and other HRQL domains. Substantial impairment was seen for each of the five screen-positive anxiety conditions and progressively worsened as the number of conditions increased from one (n= 54) to two (n= 26) to ≥ 3 (n= 34). The number of screen-positive anxiety conditions was strongly associated (P< .0001) with worse BPI interference and MCS scores and more disability days in models adjusting for age, sex and medical comorbidity. After further adjusting for major depression, associations were attenuated but remained significant for BPI interference (P< .0001) and MCS (P= .018) and marginally significant for disability days (P= .062).Conclusion
Nearly half of primary care patients with chronic pain screen positive for one or more anxiety disorders, which in turn are adversely associated with impairment across multiple domains of HRQL. Detecting and treating anxiety may be an important component of pain management. 相似文献20.
Abdul Qayyum Rana Abdul Rehman M. Qureshi Ajantha Jesudasan Kevin K. Hafez Mohammad A. Rana 《The International journal of neuroscience》2016,126(2):116-120
Purpose/Aims: The objectives of the study were to analyze the association between Parkinson's disease and restless legs syndrome, and to explore the relationship between mood disorder comorbidity (anxiety and depression), pain, and restless legs syndrome. Methods: This study included 123 Parkinson's disease patients and 123 non-Parkinson's disease patients matched for age and gender, and evaluated for anxiety severity, depression severity, pain severity, pain interference, pain disability, and restless legs syndrome prevalence. This was performed using semi-structured interviews and a neurological examination through the restless legs syndrome diagnostic criteria and the following inventories; Hospital Anxiety and Depression Scale, Brief Pain Inventory, and Pain Disability Index. Results: Parkinson's disease patients had significantly greater anxiety severity, depression severity, pain severity, pain interference, pain disability, and restless legs syndrome prevalence in comparison to controls. In addition, Parkinson's disease patients’ comorbid for anxiety and depression had significantly greater pain severity, pain interference, and pain disability, but not RLS prevalence, in comparison to Parkinson's disease only, Parkinson's disease anxiety, and Parkinson's disease depression patients. Conclusions: Pain interference, pain severity, and pain disability is greater among Parkinson's disease patients with anxiety and depression, in comparison to Parkinson's disease patients without anxiety and depression. On the contrary, the prevalence of restless legs syndrome was not found to be relevant. 相似文献