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Lifetime Prevalence, Age and Gender Distribution and Age-of-Onset of Psychiatric Disorders in the Sao Paulo Metropolitan Area, Brazil: Results from the Sao Paulo Megacity Mental Health Survey

Viana, Maria Carmen; Andrade, Laura Helena
Fonte: ASSOC BRASILEIRA PSIQUIATRIA; SAO PAULO Publicador: ASSOC BRASILEIRA PSIQUIATRIA; SAO PAULO
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
36.39%
Objectives: To estimate prevalence, age-of-onset, gender distribution and identify correlates of lifetime psychiatric disorders in the Sao Paulo Metropolitan Area (SPMA). Methods: The Sao Paulo Megacity Mental Health Survey assessed psychiatric disorders on a probabilistic sample of 5,037 adult residents in the SPMA, using the World Mental Health Survey Version of the Composite International Diagnostic Interview. Response rate was 81.3%. Results: Lifetime prevalence for any disorder was 44.8%; estimated risk at age 75 was 57.7%; comorbidity was frequent. Major depression, specific phobias and alcohol abuse were the most prevalent across disorders; anxiety disorders were the most frequent class. Early age-of-onset for phobic and impulse-control disorders and later age-of-onset for mood disorders were observed. Women were more likely to have anxiety and mood disorders, whereas men, substance use disorders. Apart from conduct disorders, more frequent in men, there were no gender differences in impulse-control disorders. There was a consistent trend of higher prevalence in the youngest cohorts. Low education level was associated to substance use disorders. Conclusions: Psychiatric disorders are highly prevalent among the general adult population in the SPMA...

Diretrizes da Associação Médica Brasileira para o diagnóstico e diagnóstico diferencial do transtorno de ansiedade social; Guidelines of the Brazilian Medical Association for the diagnosis and differential diagnosis of social anxiety disorder

Chagas, Marcos Hortes Nisihara; Nardi, Antonio Egidio; Manfro, Gisele Gus; Hetem, Luis Alberto; Andrada, Nathalia Carvalho de; Levitan, Michelle N.; Salum Junior, Giovanni Abrahão; Isolan, Luciano Rassier; Crippa, José Alexandre de Souza
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf
ENG
Relevância na Pesquisa
36.28%
Objetivo: O transtorno de ansiedade social é o transtorno de ansiedade mais comum, apresenta curso crônico, frequentemente sem remissões, sendo comumente associado com importante prejuízo funcional e comprometimento psicossocial. A Associação Médica Brasileira, por meio do projeto “Diretrizes”, busca desenvolver consensos de diagnóstico e tratamento para as doenças mais comuns. O objetivo deste trabalho é apresentar os achados mais relevantes das diretrizes da Associação Médica Brasileira relativas ao diagnóstico e diagnóstico diferencial do transtorno de ansiedade social. Método: O método utilizado foi o proposto pela Associação Médica Brasileira para o projeto Diretrizes. A busca foi realizada nas bases de dados do Medline (PubMed), Scopus, Web of Science e Lilacs, sem limite de tempo. A estratégia utilizada baseou-se em perguntas estruturadas na forma P.I.C.O. (acrônimo das iniciais “paciente ou população”; “intervenção, indicador ou exposição”; “controle ou comparação” e; “outcome ou desfecho”). Resultados: São apresentados dados relativos a manifestações clínicas, prejuízos e implicações, diferenças entre os subtipos generalizado e circunscrito, e impacto com depressão...

The multidimensional evaluation and treatment of anxiety in children and adolescents : rationale, design, methods and preliminary findings; Avaliação multidimensional e tratamento da ansiedade em crianças e adolescentes : marco teórico, desenho, métodos e resultados preliminares

Salum Junior, Giovanni Abrahão; Isolan, Luciano Rassier; Bosa, Vera Lúcia; Tocchetto, Andréa Goya; Teche, Stefania Pigatto; Schuch, Ilaine; Costa, Jandira Rahmeier; Costa, Marianna de Abreu; Jarros, Rafaela Behs; Mansur, Maria Augusta; Knijnik, Daniela
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf
ENG
Relevância na Pesquisa
36.28%
Objetivo: o objetivo deste estudo é descrever o desenho, os métodos e as características amostrais da Avaliação Multidimensional e Tratamento da Ansiedade em Crianças e Adolescentes – Projeto PROTAIA. Método: Escolares entre 10 e 17 anos de todas as escolas pertencentes à área de abrangência da unidade de atenção primária do Hospital de Clínicas de Porto Alegre foram incluídos no projeto. O projeto compreende cinco fases: 1) triagem comunitária; 2) diagnóstico psiquiátrico; 3) avaliação multidimensional, incluindo fatores ambientais, neuropsicológicos, nutricionais e marcadores biológicos; 4) tratamento; e 5) fase translacional. Resultados: Um total de 2.457 sujeitos foram triados para transtornos de ansiedade na comunidade. Dos indivíduos que compareceram à avaliação diagnóstica, 138 foram detectados com ao menos um transtorno de ansiedade (excluindo fobia específica) e 102 indivíduos sem nenhum transtorno de ansiedade. Dentre os casos de ansiedade, o transtorno de ansiedade generalizada (n = 95; 68,8%), transtorno de ansiedade social (n = 57; 41,3%) e o transtorno de ansiedade de separação (n = 49; 35,5%) foram os mais frequentes. Conclusão: O projeto PROTAIA é um projeto de pesquisa promissor que pode contribuir para o entendimento da relação entre transtornos de ansiedade e fenótipos relacionados à ansiedade com vários fatores de risco...

Psychological assessment in patients with phobic postural vertigo

Ferreira,Liliani Souza dos Santos; Pereira,Cristiana Borges; Rossini,Sueli; Kanashiro,Aline Mizuta Kozoroski; Adda,Carla Cristina; Scaff,Milberto
Fonte: Academia Brasileira de Neurologia - ABNEURO Publicador: Academia Brasileira de Neurologia - ABNEURO
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2010 EN
Relevância na Pesquisa
36.69%
Phobic postural vertigo (PPV) is a frequent diagnosis which can be challenging to treat. OBJECTIVE: To investigate the presence of psychiatric disturbances in patients with PPV; to assess the psychological status of patients using adaptive diagnosis; to verify possible correlations between severity of psychiatric disturbance and adaptive efficacy. METHOD: A total of nineteen subjects were assessed and two instruments applied: the Primary Care Evaluation of Mental Disorders Questionnaire (PRIME-MD) and the Adaptive Operationalized Diagnostic Scale (AODS), and results from both tests were compared. RESULTS: Fourteen patients presented with mood disorder and thirteen with anxiety. All patients presented compromised adaptive efficacy. Correlation was found between overall outcome on the PRIME and the AODS (tau= -0.42, p=0.027), Separate analysis revealed correlation between results of the AODS and anxiety disorders (tau= -0.45, p=0.018) but not with mood disorders (tau= -0.36, p=0.054). CONCLUSION: Adaptive compromise was observed in individuals with PPV which was shown to be associated to psychiatric disorders.

Behaviorial inhibition and history of childhood anxiety disorders in Brazilian adult patients with panic disorder and social anxiety disorder

Isolan,Luciano Rassier; Zeni,Cristian Patrick; Mezzomo,Kelin; Blaya,Carolina; Kipper,Leticia; Heldt,Elizeth; Manfro,Gisele Gus
Fonte: Associação Brasileira de Psiquiatria - ABP Publicador: Associação Brasileira de Psiquiatria - ABP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2005 EN
Relevância na Pesquisa
46.32%
PURPOSE: To evaluate the presence of behavioral inhibition and anxiety disorders during childhood in Brazilian adult patients with panic disorder and social anxiety disorder compared to a control group. METHODS: Fifty patients with panic disorder, 50 patients with social anxiety disorder, and 50 control subjects were included in the study. To assess the history of childhood anxiety, the Schedule for Affective Disorders and Schizophrenia for School Age Children, Epidemiologic Version (K-SADS-E), and the Diagnostic Interview for Children and Adolescents-Parent Version (DICA-P) were used. The presence of behavioral inhibition in childhood was assessed by the self-reported scale of Behavioral Inhibition Retrospective Version (RSRI-30). RESULTS: Patients showed significantly higher prevalence of anxiety disorders and behavioral inhibition in childhood compared to the control group. Patients with social anxiety disorder also showed significantly higher rates of avoidance disorder (46% vs. 18%, p = 0.005), social anxiety disorder (60% vs. 26%, p = 0.001), presence of at least one anxiety disorder (82% vs. 56%, p = 0.009) and global behavioral inhibition (2.89 ± 0.61 vs. 2.46 ± 0.61, p < 0.05) and school/social behavioral inhibition (3.56 ± 0.91 vs. 2.67 ± 0.82...

Cross-cultural validation of the Brief Social Phobia Scale for use in Portuguese and the development of a structured interview guide

Osório,Flávia de Lima; Crippa,José Alexandre de Souza; Loureiro,Sonia Regina
Fonte: Associação Brasileira de Psiquiatria - ABP Publicador: Associação Brasileira de Psiquiatria - ABP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2006 EN
Relevância na Pesquisa
36.28%
OBJECTIVE: To present the translation and validation of the Brief Social Phobia Scale for use in Brazilian Portuguese, to develop a structured interview guide in order to systemize its use and to perform a preliminary study of inter-rater reliability. METHOD: The instrument was translated and adapted to Portuguese by specialists in anxiety disorders and rating scales. A structured interview guide was created with the aim of covering all of the items of the instrument and grouping them into six categories. Specialists in mental health evaluated the guide. These professionals also watched the videotaped interviews of patients with and without social anxiety disorders, and, based on the interview guide, they rated the scale to evaluate its reliability. RESULTS: No semantic or linguistic adjustments were needed. For the complete scale, the general evaluation showed a percentage of agreement of 0.84 and intraclass coefficient of 0.91. The mean inter-rater correlation was 0.84. CONCLUSIONS: The Portuguese-language version of the Brief Social Phobia Scale is available for use in the Brazilian population, with rather acceptable indicators of inter-rater reliability. The interview guide was useful in providing these values. Further studies are needed in order to improve the reliability and to study other psychometric properties of the instrument.

The multidimensional evaluation and treatment of anxiety in children and adolescents: rationale, design, methods and preliminary findings

Salum,Giovanni Abrahão; Isolan,Luciano Rassier; Bosa,Vera Lúcia; Tocchetto,Andrea Goya; Teche,Stefania Pigatto; Schuch,Ilaine; Costa,Jandira Rahmeier; Costa,Marianna de Abreu; Jarros,Rafaela Behs; Mansur,Maria Augusta; Knijnik,Daniela; Silva,Estácio Am
Fonte: Associação Brasileira de Psiquiatria - ABP Publicador: Associação Brasileira de Psiquiatria - ABP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2011 EN
Relevância na Pesquisa
36.28%
OBJECTIVE: This study aims to describe the design, methods and sample characteristics of the Multidimensional Evaluation and Treatment of Anxiety in Children and Adolescents - the PROTAIA Project. METHOD: Students between 10 and 17 years old from all six schools belonging to the catchment area of the Primary Care Unit of Hospital de Clínicas de Porto Alegre were included in the project. It comprises five phases: (1) a community screening phase; (2) a psychiatric diagnostic phase; (3) a multidimensional assessment phase evaluating environmental, neuropsychological, nutritional, and biological factors; (4) a treatment phase, and (5) a translational phase. RESULTS: A total of 2,457 subjects from the community were screened for anxiety disorders. From those who attended the diagnostic interview, we identified 138 individuals with at least one anxiety disorder (apart from specific phobia) and 102 individuals without any anxiety disorder. Among the anxiety cases, generalized anxiety disorder (n = 95; 68.8%), social anxiety disorder (n = 57; 41.3%) and separation anxiety disorder (n = 49; 35.5%) were the most frequent disorders. CONCLUSION: The PROTAIA Project is a promising research project that can contribute to the knowledge of the relationship between anxiety disorders and anxiety-related phenotypes with several genetic and environmental risk factors.

The impacts of cognitive-behavioral therapy on the treatment of phobic disorders measured by functional neuroimaging techniques: a systematic review

Almeida,Amanda Galvao-de; Araujo Filho,Gerardo Maria de; Berberian,Arthur de Almeida; Trezsniak,Clarissa; Nery-Fernandes,Fabiana; Araujo Neto,Cesar Augusto; Jackowski,Andrea Parolin; Miranda-Scippa,Ângela; Oliveira,Irismar Reis de
Fonte: Associação Brasileira de Psiquiatria - ABP Publicador: Associação Brasileira de Psiquiatria - ABP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2013 EN
Relevância na Pesquisa
46.86%
Objective: Functional neuroimaging techniques represent fundamental tools in the context of translational research integrating neurobiology, psychopathology, neuropsychology, and therapeutics. In addition, cognitive-behavioral therapy (CBT) has proven its efficacy in the treatment of anxiety disorders and may be useful in phobias. The literature has shown that feelings and behaviors are mediated by specific brain circuits, and changes in patterns of interaction should be associated with cerebral alterations. Based on these concepts, a systematic review was conducted aiming to evaluate the impact of CBT on phobic disorders measured by functional neuroimaging techniques. Methods: A systematic review of the literature was conducted including studies published between January 1980 and April 2012. Studies written in English, Spanish or Portuguese evaluating changes in the pattern of functional neuroimaging before and after CBT in patients with phobic disorders were included. Results: The initial search strategy retrieved 45 studies. Six of these studies met all inclusion criteria. Significant deactivations in the amygdala, insula, thalamus and hippocampus, as well as activation of the medial orbitofrontal cortex, were observed after CBT in phobic patients when compared with controls. Conclusion: In spite of their technical limitations...

The joint structure of major depression, anxiety disorders, and trait negative affect

Carvalho,Hudson W. de; Andreoli,Sérgio B.; Lara,Diogo R.; Patrick,Christopher J.; Quintana,Maria I.; Bressan,Rodrigo A.; Mello,Marcelo F.; Mari,Jair de J.; Jorge,Miguel R.
Fonte: Associação Brasileira de Psiquiatria - ABP Publicador: Associação Brasileira de Psiquiatria - ABP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2014 EN
Relevância na Pesquisa
36.32%
Background: Dimensional models of psychopathology demonstrate that two correlated factors of fear and distress account for the covariation among depressive and anxiety disorders. Nevertheless, these models tend to exclude variables relevant to psychopathology, such as temperament traits. This study examined the joint structure of DSM-IV-based major depression and anxiety disorders along with trait negative affect in a representative sample of adult individuals residing in the cities of São Paulo and Rio de Janeiro, Brazil. Methods: The sample consisted of 3,728 individuals who were administered sections D (phobic, anxiety and panic disorders) and E (depressive disorders) of the Composite International Diagnostic Interview (CIDI) 2.1 and a validated version of the Positive and Negative Affect Schedule. Data were analyzed using correlational and structural equation modeling. Results: Lifetime prevalence ranged from 2.4% for panic disorder to 23.2% for major depression. Most target variables were moderately correlated. A two-factor model specifying correlated fear and distress factors was retained and confirmed for models including only diagnostic variables and diagnostic variables along with trait negative affect. Conclusions: This study provides support for characterization of internalizing psychopathology and trait negative affect in terms of correlated dimensions of distress and fear. These results have potential implications for psychiatric taxonomy and for understanding the relationship between temperament and psychopathology.

Role of Corticotropin Releasing Factor in Anxiety Disorders: A Translational Research Perspective

Risbrough, Victoria B.; Stein, Murray B.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.35%
Anxiety disorders are a group of mental disorders that include generalized anxiety disorder (GAD), panic disorder, phobic disorders (e.g., specific phobias, agoraphobia, social phobia) and posttraumatic stress disorder (PTSD). Anxiety disorders are among the most common of all mental disorders and, when coupled with an awareness of the disability and reduced quality of life they convey, they must be recognized as a serious public health problem. Over 20 years of preclinical studies point to a role for the CRF system in anxiety and stress responses. Clinical studies have supported a model of CRF dysfunction in depression and more recently a potential contribution to specific anxiety disorders (i.e., panic disorder and PTSD). Much work remains in both the clinical and preclinical fields to inform models of CRF function and its contribution to anxiety. First, we will review the current findings of CRF and HPA axis abnormalities in anxiety disorders. Second, we will discuss startle reflex measures as a tool for translational research to determine the role of the CRF system in development and maintenance of clinical anxiety.

Panic Attacks and Panic Disorders

Fontaine, Rejean; Beaudry, Paul
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /06/1984 EN
Relevância na Pesquisa
36.28%
The diagnosis and treatment of panic attacks and panic disorders have progressed markedly during the last decade. Unlike phobic disorders, the key feature of panic disorders is the many panic attacks that are mostly spontaneous or not caused by a particular situation. Recent studies linking its pathogenesis with lactate infusion tests are reviewed. For treatment, psychotherapy combined with in vivo exposure and pharmacotherapy is more efficacious than either treatment alone. In most cases, psychological treatment is supportive psychotherapy. The use of imipramine, as reported by Klein et al., is described, and alprazolam is presented as an alternative.

The epidemiology of anxiety disorders: a review

Martin, Patrick
Fonte: Les Laboratoires Servier Publicador: Les Laboratoires Servier
Tipo: Artigo de Revista Científica
Publicado em /09/2003 EN
Relevância na Pesquisa
36.39%
Epidemiological studies show that anxiety disorders are highly prevalent and an important cause of functional impairment; they constitute the most frequent menial disorders in the community. Phobias are the most common with the highest rates for simple phobia and agoraphobia. Panic disorder (PD) and obsessive-compulsive disorder (OCD) are less frequent (2% lifetime prevalence), and there are discordant results for social phobia (SP) (2%-16%) and generalized anxiety disorder (GAD) (3%-30%). These studies underline the importance of an accurate definition of disorders using unambiguous diagnostic and assessment criteria. The boundaries between anxiety disorders are often ill defined and cases may vary widely according to the definition applied. Simple phobia, agoraphobia, and GAD are more common in vmrnen, while there is no gender différence for SP, PD, and OCD, Anxiety disorders are more common in separated, divorced, and widowed subjects; their prevalence is highest in subjects aged 25 to 44 years and lowest in subjects aged >65 years. The age of onset of the different types of anxiety disorders varies widely: phobic disorders begin early in life, whereas PD occurs in young adulthood. Clinical - rather than epidemiological - studies have examined risk factors such as life events...

Validation of the diagnoses of panic disorder and phobic disorders in the US National Comorbidity Survey Replication Adolescent (NCS-A) Supplement

Green, Jennifer Greif; Avenevoli, Shelli; Finkelman, Matthew; Gruber, Michael J.; Kessler, Ronald C.; Merikangas, Kathleen R.; Sampson, Nancy A.; Zaslavsky, Alan M.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /06/2011 EN
Relevância na Pesquisa
46.54%
Validity of the adolescent version of the World Health Organization Composite International Diagnostic Interview (CIDI) Version 3.0, a fully-structured research diagnostic interview designed to be used by trained lay interviewers, is assessed in comparison to independent clinical diagnoses based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). This assessment is carried out in the clinical reappraisal sub-sample (n = 347) of the US National Comorbidity Survey Adolescent Supplement (NCS-A), a large (n = 10,148) community epidemiological survey of the prevalence and correlates of adolescent mental disorders in the US. The diagnoses considered are panic disorder and phobic disorders (social phobia, specific phobia, agoraphobia). CIDI diagnoses are found to have good concordance with K-SADS diagnoses (AUC = .81–.94), although the CIDI diagnoses are consistency somewhat higher than the K-SADS diagnoses. Data are also presented on criterion-level concordance in an effort to pinpoint CIDI question series that might be improved in future modifications of the instrument. Finally, data are presented on the factor structure of the fears associated with social phobia, the only disorder in this series where substantial controversy exists about disorder subtypes.

Evidence-based medicine evaluation of electrophysiological studies of the anxiety disorders

Clark, C.; Galletly, C.; Ash, D.; Moores, K.; Penrose, R.; McFarlane, A.
Fonte: Electroencephalography and Clinical Neuroscience Society Publicador: Electroencephalography and Clinical Neuroscience Society
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
Relevância na Pesquisa
46.35%
We provide a systematic, evidence-based medicine (EBM) review of the field of electrophysiology in the anxiety disorders. Presently, electrophysiological studies of anxiety focus primarily on etiological aspects of brain dysfunction. The review highlights many functional similarities across studies, but also identifies patterns that clearly differentiate disorder classifications. Such measures offer clinical utility as reliable and objective indicators of brain dysfunction in individuals and indicate potential as biomarkers for the improvement of diagnostic specificity and for informing treatment decisions and prognostic assessments. Common to most of the anxiety disorders is basal instability in cortical arousal, as reflected in measures of quantitative electroencephalography (qEEG). Resting electroencephalographic (EEG) measures tend to correlate with symptom sub-patterns and be exacerbated by condition-specific stimulation. Also common to most of the anxiety disorders are condition-specific difficulties with sensory gating and the allocation and deployment of attention. These are clearly evident from evoked potential (EP) and event-related potential (ERP) electrical measures of information processing in obsessive compulsive disorder (OCD)...

The psychiatric sequelae of traumatic injury

Bryant, R.; O'Donnell, M.; Creamer, M.; McFarlane, A.; Clark, C.; Silove, D.
Fonte: Amer Psychiatric Press Inc Publicador: Amer Psychiatric Press Inc
Tipo: Artigo de Revista Científica
Publicado em //2010 EN
Relevância na Pesquisa
36.37%
Objective: Traumatic injury affects millions of people each year. There is little understanding of the extent of psychiatric illness that develops after traumatic injury or of the impact of mild traumatic brain injury (TBI) on psychiatric illness. The authors sought to determine the range of new psychiatric disorders occurring after traumatic injury and the influence of mild TBI on psychiatric status. Method: In this prospective cohort study, patients were drawn from recent admissions to four major trauma hospitals across Australia. A total of 1,084 traumatically injured patients were initially assessed during hospital admission and followed up 3 months (N=932, 86%) and 12 months (N=817, 75%) after injury. Life time psychiatric diagnoses were assessed in hospital. The prevalence of psychiatric disorders, levels of quality of life, and mental health service use were assessed at the follow-ups. The main outcome measures were 3- and 12-month prevalence of axis I psychiatric disorders, levels of quality of life, and mental health service use and lifetime axis I psychiatric disorders. Results: Twelve months after injury, 31% of patients reported a psychiatric disorder, and 22% developed a psychiatric disorder that they had never experienced before. The most common new psychiatric disorders were depression (9%)...

A preliminary investigation of the relationship of dental fear to other specific fears, general fearfulness, disgust sensitivity and harm sensitivity

Armfield, J.
Fonte: Blackwell Munksgaard Publicador: Blackwell Munksgaard
Tipo: Artigo de Revista Científica
Publicado em //2008 EN
Relevância na Pesquisa
36.24%
OBJECTIVES: People with dental fear often suffer from other psychological disorders, as well as from a number of other specific fears. Fear of going to the dentist may be associated not only with general fearfulness, but also with underlying personality dispositions. This exploratory study, therefore, investigated the associations between dental fear and 67 other specific fears, general fearfulness, disgust sensitivity and harm sensitivity. METHODS: Participants were 88 Australian adults who were administered the Fear Survey Schedule III (FSS-III), the Harm Sensitivity Index and the Disgust Sensitivity Index. Principle axis factor analysis with Promax rotation was used to examine how dental fear related to other specific fears as measured with the FSS-III. RESULTS: Dental fear was significantly correlated with most of the other specific fears, with factor analysis indicating that it tended to load more with fears related to lack of control rather than with what have often been classed as 'medical' fears. Significant associations were found between dental fear and the personality dispositions of general fearfulness, harm sensitivity and disgust sensitivity, although these associations were not linear. CONCLUSIONS: Findings reveal extensive co-occurrence of other specific fears with dental fear...

A longitudinal analysis of posttraumatic stress disorder symptoms and their relationship with Fear and Anxious-Misery disorders: Implications for DSM-V

Forbes, D.; Parslow, R.; Creamer, M.; O'Donnell, M.; Bryant, R.; McFarlane, A.; Silove, D.; Shalev, A.
Fonte: Elsevier Science BV Publicador: Elsevier Science BV
Tipo: Artigo de Revista Científica
Publicado em //2010 EN
Relevância na Pesquisa
36.24%
This paper examined the hypothesis that PTSD-unique symptom clusters of re-experiencing, active avoidance and hyperarousal were more related to the fear/phobic disorders, while shared PTSD symptoms of dysphoria were more closely related to Anxious-Misery disorders (MDD/GAD). Confirmatory factor and correlation analyses examining PTSD, anxiety and mood disorder data from 714 injury survivors interviewed 3, 12 and 24-months following their injury supported this hypothesis with these relationships remaining robust from 3-24 months posttrauma. Of the nine unique fear-oriented PTSD symptoms, only one is currently required for a DSM-IV diagnosis. Increasing emphasis on PTSD fear symptoms in DSM-V, such as proposed DSM-V changes to mandate active avoidance, is critical to improve specificity, ensure inclusion of dimensionally distinct features and facilitate tailoring of treatment.; David Forbes, Ruth Parslow, Mark Creamer, Meaghan O'Donnell, Richard Bryant, Alexander McFarlane, Derrick Silove, Arieh Shalev

Diretrizes da Associação Médica Brasileira para o diagnóstico e diagnóstico diferencial do transtorno de ansiedade social; Guidelines of the Brazilian Medical Association for the diagnosis and differential diagnosis of social anxiety disorder

CHAGAS, Marcos Hortes N.; NARDI, Antonio E.; MANFRO, Gisele G.; HETEM, Luiz Alberto B.; ANDRADA, Nathalia C.; LEVITAN, Michelle N.; SALUM, Giovanni A.; ISOLAN, Luciano; FERRARI, Maria Cecília Freitas; CRIPPA, José Alexandre S.
Fonte: Associação Brasileira de Psiquiatria - ABP Publicador: Associação Brasileira de Psiquiatria - ABP
Tipo: Artigo de Revista Científica
POR
Relevância na Pesquisa
36.28%
OBJETIVO: O transtorno de ansiedade social é o transtorno de ansiedade mais comum, apresenta curso crônico, frequentemente sem remissões, sendo comumente associado com importante prejuízo funcional e comprometimento psicossocial. A Associação Médica Brasileira, por meio do projeto "Diretrizes", busca desenvolver consensos de diagnóstico e tratamento para as doenças mais comuns. O objetivo deste trabalho é apresentar os achados mais relevantes das diretrizes da Associação Médica Brasileira relativas ao diagnóstico e diagnóstico diferencial do transtorno de ansiedade social. MÉTODO: O método utilizado foi o proposto pela Associação Médica Brasileira para o projeto Diretrizes. A busca foi realizada nas bases de dados do Medline (PubMed), Scopus, Web of Science e Lilacs, sem limite de tempo. A estratégia utilizada baseou-se em perguntas estruturadas na forma P.I.C.O. (acrônimo das iniciais "paciente ou população"; "intervenção, indicador ou exposição"; "controle ou comparação" e; "outcome ou desfecho"). RESULTADOS: São apresentados dados relativos a manifestações clínicas, prejuízos e implicações, diferenças entre os subtipos generalizado e circunscrito, e impacto com depressão, abuso e dependência de drogas e outros transtornos de ansiedade. Além disso...

High Phobic Anxiety Is Related to Lower Leukocyte Telomere Length in Women

Okereke, Olivia Ifeoma; Prescott, Jennifer; Wong, Jason Yat Yang; Han, Jiali; Rexrode, Kathryn Marian; De Vivo, Immaculata
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
36.7%
Background: Chronic psychological distress has been linked to shorter telomeres, an indication of accelerated aging. Yet, little is known about relations of anxiety to telomeres. We examined whether a typically chronic form of anxiety – phobic anxiety – is related to telomere length. Methodology/Principal Findings Relative telomere lengths (RTLs) in peripheral blood leukocytes were measured by quantitative real-time polymerase chain reaction among 5,243 women (aged 42–69 years) who: were participants in the Nurses' Health Study; were controls in prior case-control studies of telomeres and disease, or randomly selected healthy participants in a cognitive function sub-study; had completed the Crown-Crisp phobic index proximal to blood collection. Adjusted least-squares mean RTLs (z-scores) were calculated across phobic categories. Higher phobic anxiety was generally associated with lower RTLs (age-adjusted p-trend = 0.09); this association was similar after adjustment for confounders – paternal age-at-birth, smoking, body mass index (BMI) and physical activity (p-trend = 0.15). Notably, a threshold was identified. Among women with Crown-Crisp<6 points, the multivariable-adjusted least-squares mean RTL z-score = 0.02 standard units; however...

Early-onset social anxiety disorder in adults: clinical and therapeutic features

Menezes,Gabriela Bezerra de; Fontenelle,Leonardo F.; Versiani,Márcio
Fonte: Associação Brasileira de Psiquiatria - ABP Publicador: Associação Brasileira de Psiquiatria - ABP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2005 EN
Relevância na Pesquisa
36.44%
OBJECTIVE: To investigate possible differences in clinical and treatment response in patients suffering from early-onset (< 18 years) and late-onset (>18 years) social anxiety disorder. METHODS: Patients diagnosed with social anxiety disorder of early-onset (n = 47; 75.8%) were compared to those diagnosed with late-onset social anxiety disorder (n = 15; 24.2%) in terms of age, mode of onset, subtype, psychiatric comorbidities (according to the Structured Clinical Interview for DSM-IV), symptom severity and response (assessed according to the Clinical Global Impression scale) after at least ten weeks of drug treatment. The statistical analyses included chi² tests with Yates correction or Fisher's exact test, as well as Student's t-test or Mann-Whitney test. The level of statistic significance adopted was 5%. RESULTS: Patients presenting early-onset phobic symptoms more frequently: were inactive (chi² = 4.28; df = 1; p = 0.04); suffered from the generalized subtype of social phobia (chi² = 6.53; df = 1; p = 0.01); and presented psychiatric comorbidity (chi² = 6.71; df = 1; p = 0.01). No differences were observed between the groups in severity of symptoms and therapeutic response. CONCLUSION: The findings suggest the existence of a possible social anxiety disorder subtype characterized by early onset of symptoms...