广泛性焦虑障碍影像学研究进展

广泛性焦虑障碍（generalized anxiety disorder, GAD）是一种常见的精神障碍,世界范围内GAD成人的终身患病率估计为4．1％-6．6％。GAD的病因机制尚未明了。     

国外社交焦虑障碍的临床常用量表介绍

社交焦虑障碍(social anxiety disorder,SAD)是一种常见而可致残的精神障碍,临床对其精确评估还有一定困难,量表是帮助评估的有效工具之一。本文主要从SAD的筛选、诊断、疗效评估和残疾评估四方面的临床常用量表作一简述。     

儿童焦虑障碍的病因研究

本文从气质、遗传、家庭环境和父母教养方式、依恋、应激以及认知等方面综述了近年来国内外对儿童焦虑障碍病因的研究。     

焦虑障碍患者焦虑敏感与特质焦虑的相关研究

目的:探讨焦虑障碍患者焦虑敏感与特质焦虑、临床特征的相关性。方法:68例焦虑障碍患者(焦虑组)根据汉密尔顿焦虑量表(HAMA)评分≥7分为分界值,分为焦虑未缓解组43例和缓解组25例,进行焦虑敏感测定量表(ASI-R)及状态-特质焦虑问卷中特质焦虑量表部份(T-AI)的评定;ASI-R评分结果与70名正常对照(正常对照组)进行比较,分析ASI-R评分与T-AI总分及临床特征的相关性。结果:焦虑组ASI-R总分、对躯体感觉的焦虑因子分、对躯体感觉的恐惧因子分、对认知失控焦虑恐惧因子分、对社会后果焦虑恐惧因子分均高于正常对照组(t分别=8.51,9.00,8.15,8.74,3.24;P均<0.01)。焦虑缓解组ASI-R总分、及对躯体感觉的焦虑因子分、对躯体感觉的恐惧因子分、对认知失控焦虑恐惧因子分均高于正常对照组(t分别=4.41,3.37,4.24,3.76;P均<0.01);未缓解组ASI-R总分及各因子分高于缓解组(t分别=3.30,3.41,2.61,2.78,2.14;P<0.05或P<0.01)。经相关分析,ASI-R总分、及躯体感觉的焦虑因子分、对认知失控的焦虑恐惧因子分与T-AI总分显著相关(r分别=0.33,0.28,0.40;P<0.05或P<0.01);ASI-R总分、对认知失控焦虑恐惧因子分、对社会后果焦虑恐惧因子分与病程显著相关(r分别=0.27,0.26,0.31;P均<0.05)。结论:焦虑障碍患者的焦虑敏感程度高于正常人群;焦虑敏感水平部分与焦虑特质有关。     

强迫症与广泛性焦虑障碍关系的研究现状

通过综述强迫症与广泛性焦虑障碍关系的研究献，发现二在概念界定、共病率、临床特点、非临床特点及行为特征上有一定的关系，并就目前存在的一些问题进行探讨。     

焦虑障碍的治疗

焦虑障碍包括惊恐障碍、强迫性障碍、创伤后应激障碍、社交焦虑障碍和广泛性焦虑障碍等。美国国立精神卫生研究所报告，有1600万年龄介乎18至54岁的美国人患焦虑障碍，焦虑障碍的终生患病率高达14．6％。焦虑障碍虽不少见，但得到治疗的患者的比例却远比抑郁症低。英国医生对焦虑障碍患者10108例进行的面谈调查发现，大多数病人没有得到治疗，得到治疗的比例为：     

焦虑障碍的核心特征与治疗

焦虑障碍的代表疾病主要包括广泛性焦虑障碍、惊恐障碍、场所恐怖症、社交焦虑障碍(社交恐怖症)等,该组障碍的共同特征是过度害怕和焦虑的心境,以及相关的行为紊乱。广泛性焦虑障碍表现为对多种主题、事件或任务感到严重的焦虑与担心。惊恐障碍是指在没有预警的情况下反复出现惊恐发作并担心再次发作。场所恐怖症是指个体对某些场合的强烈恐惧、焦虑与回避,患者常担心无法逃离、得不到帮助或健康受到威胁。社交焦虑障碍表现为回避社交环境,过分担心他人的负性评价。焦虑障碍的治疗方法包括药物治疗、心理咨询等。     

社交焦虑障碍患者家庭环境的分析

目的分析社交焦虑障碍(SAD)与患者家庭环境的关系。方法采用自编社会人口学资料表及家庭环境量表中文版(FES-CV)对42例社交焦虑障碍患者和30例正常对照者进行评估。结果社交焦虑障碍组的亲密度、情感表达、知识性、娱乐性因子分低于正常对照组(P<0.01);矛盾性因子分高于正常对照组(P<0.01)。结论社交焦虑障碍的发生与家庭环境因素有关,不良的家庭环境可能是社交焦虑障碍的发病原因之一。     

焦虑障碍患者焦虑素质及临床特征相关性研究

正焦虑谱系障碍包括广泛性焦虑、惊恐障碍、强迫症、恐惧症等多种疾病,因其发病率高,疾病负担重~([1-2]),近年来日益受到重视。国内目前对焦虑素质与焦虑障碍的关系、临床特征、预后及其影响因素的研究较少。焦虑障碍与个性因素关系密切,而其中焦虑素质与焦虑症状最受关注。焦虑素质是相信与焦虑有关的感觉对自身的生理、心理和社会评价有危害,从而产生的对焦虑症状的害怕和担心,是反映个体对自身发生焦虑的恐惧程度的一个相对稳定     

Translational research in neurology and neuroscience 2011: movement disorders

We provide an update on the state of translational research in movement disorders, using examples of Huntington disease, Parkinson disease, and dystonia. While substantial progress in our understanding of these disorders has been achieved, development of neuroprotective treatments remains an unrealized goal. Here we highlight some of the emerging research areas that show the most promise for translational research in Huntington disease, Parkinson disease, and dystonia. Aetiology and pathogenesis, biomarker directions, and causal treatment opportunities are discussed for each disease, followed by a brief discussion drawing attention to important translational initiatives.     

Translational neuroscience and magnetic-resonance microscopy

Magnetic-resonance microscopy is a rapidly growing and a widely applied imaging method in translational neuroscience studies. Emphasis has been placed on anatomical, functional, and metabolic studies of genetically engineered mouse models of human disease and the need for efficient phenotyping at all levels. Magnetic-resonance microscopy is now implemented in many laboratories worldwide due to the availability of commercial high-field magnetic-resonance instruments for use in small animals, the development of accessories (including miniature radio-frequency coils), magnetic-resonance compatible physiological monitoring equipment, and access to adjustable anaesthesia techniques. Two of the major magnetic-resonance microscopy applications in the neurosciences-structural and functional magnetic-resonance microscopy-will be reviewed.     

Translational neuroscience in pediatric bipolar disorder

While controversial and often confounded with other forms of psychopathology, recent studies have shown that bipolar disorder (BD) is on the rise in children and adolescents. Research has made important strides in advancing our understanding of the phenomenology, neural underpinnings and treatment outcomes for BD youths. However, there is an increasing need to unite these domains to identify potential neural effects and predictors of treatment outcome. Pavuluri et al. have conducted such a study, evaluating the neural effects of divalproex or risperidone for pediatric BD. The future is likely to bring more of such studies, potentially resulting in a biomarker augmented approach to the diagnosis and treatment of pediatric BD.     

Advances in understanding the anxiety disorders: the cognitive-affective neuroscience of 'false alarms'.

BACKGROUND: There have been significant advances in our understanding of the anxiety disorders; a range of data is now available on their epidemiology, nosology, psychobiology, and management. An integrative framework is required in order to conceptualize this data and to apply it in the clinic. METHODS: This is a nonsystematic review of literature on the psychobiology of some the major anxiety disorders, focused on the idea that each of these conditions can be conceptualized in terms of a different "false alarm," mediated by specific neurocircuitry and with a particular evolutionary origin. RESULTS: The "false alarm" concept is able to integrate a range of data on the proximal mechanisms of anxiety disorders (including their mediating neurochemistry and neurogenetics), as well as hypotheses about the distal or evolutionary underpinnings of these conditions. CONCLUSION: Fortunately, serotonergic antidepressants and cognitive-behavioral psychotherapy appear to be able to normalize the putative "false alarms" in anxiety disorders. A better understanding of the cognitive-affective neuroscience of anxiety disorders will hopefully lead to improved treatments.     

Psychobiology of anxiety and anxiety disorders

New techniques for studying receptor pharmacology, neurotransmitter activity, and neuroendocrine function in affective illness have made it possible to carry out sophisticated neurochemical and neuropharmacologic investigations of the anxiety disorders. Some important reasons for pursuing these strategies have been the high frequency of depression in anxious patients, the effectiveness of antidepressants in the treatment of panic disorder, and the availability of probes for studying the physiologic changes that occur during anxiety states in human subjects. In addition, the ability reliably to induce anxiety states in man has made it possible to study at least some clinical forms of anxiety under laboratory conditions. Although animal models for simple phobia have been developed, there are currently no adequate animal models of panic disorder in man. If valid, reliable animal models, for panic disorder and other human anxiety disorders can also be identified, then a much better understanding of the nature and causes of anxiety and more effective diagnosis and treatment of clinically important anxiety disorders may be possible.     

Translational research in early neuroscience careers of high school students

<正>Essentially,the knowledge of science alone offers little utility.Without the ability to investigate,apply and communicate,science serves no purpose.That is not to undermine the importance of scientific knowledge,but there currently exists a major flaw in our high school educational system that inhibits meaningful learning experiences for most students.Application of science in local high schools is largely     

Obsessive-compulsive spectrum disorders and anxiety disorders

Although obsessive-compulsive disorder (OCD) is classified as an anxiety disorder in the DSM-IV, recent considerations for a reclassification into an obsessive-compulsive spectrum disorders (OCSDs) cluster are gaining prominence. Hollander and colleague indicate that similarities in symptomatology, course of illness, patient population, and neurocircuitry of OCD and OCSD are supported by comorbidity, family, and neurological studies, which also offer a critical re-evaluation of the relationship between OCD and anxiety disorders. In February 2010, as a consequence, members of the DSM-5 Task Force and Work Groups have updated draft DSM-5 and have added many diagnostic-specific severity measures, including the Anxiety, Obsessive-Compulsive-Related, and Trauma-Related Disorders. Recently, however, there are some results indicated that support the current association of OCD with other anxiety disorders rather than with OCSDs. Thus, controversy surrounds the classification of OCSD symptoms. In this review, we investigated the relationship of OCD, OCSDs, and anxiety disorders to answer the question of where OCD should be located in the diagnostic system.     

Pain-related anxiety and anxiety sensitivity across anxiety and depressive disorders

Fear–anxiety–avoidance models posit pain-related anxiety and anxiety sensitivity as important contributing variables in the development and maintenance of chronic musculoskeletal pain [Asmundson, G. J. G, Vlaeyen, J. W. S., & Crombez, G. (Eds.). (2004). Understanding and treating fear of pain. New York: Oxford University Press]. Emerging evidence also suggests that pain-related anxiety may be a diathesis for many other emotional disorders [Asmundson, G. J. G., & Carleton, R. N. (2005). Fear of pain is elevated in adults with co-occurring trauma-related stress and social anxiety symptoms. Cognitive Behaviour Therapy, 34, 248–255; Asmundson, G. J. G., & Carleton, R. N. (2008). Fear of pain. In: M. M. Antony & M. B. Stein (Eds.), Handbook of anxiety and the anxiety disorders (pp. 551–561). New York: Oxford University Press] and appears to share several elements in common with other fears (e.g., anxiety sensitivity, illness/injury sensitivity, fear of negative evaluation) as described by Reiss [Reiss, S. (1991). Expectancy model of fear, anxiety, and panic. Clinical Psychology Review, 11, 141–153] and Taylor [Taylor, S. (1993). The structure of fundamental fears. Journal of Behavior Therapy and Experimental Psychiatry, 24, 289–299]. The purpose of the present investigation was to assess self-reported levels of pain-related anxiety [Pain Anxiety Symptoms Scale-Short Form; PASS-20; McCracken, L. M., & Dhingra, L. (2002). A short version of the Pain Anxiety Symptoms Scale (PASS-20): preliminary development and validity. Pain Research and Management, 7, 45–50] across several anxiety and depressive disorders and to compare those levels to non-clinical and chronic pain samples. Participants consisted of a clinical sample (n = 418; 63% women) with principal diagnoses of a depressive disorder (DD; n = 22), panic disorder (PD; n = 114), social anxiety disorder (SAD; n = 136), obsessive-compulsive disorder (OCD; n = 86), generalized anxiety disorder (GAD; n = 46), or specific phobia (n = 14). Secondary group comparisons were made with a community sample as well as with published data from a treatment-seeking chronic pain sample [McCracken, L. M., & Dhingra, L. (2002). A short version of the Pain Anxiety Symptoms Scale (PASS-20): preliminary development and validity. Pain Research and Management, 7, 45–50]. Results suggest that pain-related anxiety is generally comparable across anxiety and depressive disorders; however, pain-related anxiety was typically higher (p < .01) in individuals with anxiety and depressive disorders relative to a community sample, but comparable to or lower than a chronic pain sample. Results imply that pain-related anxiety may indeed be a construct independent of other fundamental fears, warranting subsequent hierarchical investigations and consideration for inclusion in treatments of anxiety disorders. Additional implications and directions for future research are discussed.