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Treatment Resistant Anxiety Disorders

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https://www.readbyqxmd.com/read/28061973/the-melatonergic-system-in-anxiety-disorders-and-the-role-of-melatonin-in-conditional-fear
#1
F Huang, Z Yang, C-Q Li
BACKGROUND: Resistance to extinction of certain conditioned responses forms the basis of anxieties, phobias, and compulsions. There has been an available effective means of extinction-based exposure psychotherapy for the treatment of anxiety disorders, such as posttraumatic stress disorder (PTSD) that has been hypothesized to result from impaired extinction of fear memory. PTSD is considered as a memory disorder within a Pavlovian fear conditioning and extinction framework. Therefore, the aim of this review was to report the preclinical profile of melatonin, a pineal gland hormone, as a potential pharmacological option in the treatment of anxiety disorders such as PTSD, tested with the Pavlovian fear conditioning paradigm...
2017: Vitamins and Hormones
https://www.readbyqxmd.com/read/28043839/primary-pediatric-care-psychopharmacology-focus-on-medications-for-adhd-depression-and-anxiety
#2
Jeffrey R Strawn, Eric T Dobson, Lisa L Giles
The evidence base for psychopharmacologic interventions in youth with depressive and anxiety disorders as well as attention/deficit hyperactivity disorder (ADHD) has dramatically increased over the past two decades. Psychopharmacologic interventions commonly utilized in the pediatric primary care setting-selective serotonin (norepinephrine) reuptake inhibitors (SSRIs/SSNRIs), stimulants and α2 agonists-are reviewed. General pharmacologic principles are summarized along with class-related side effects and tolerability concerns (e...
December 30, 2016: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28043613/emotional-distress-patients-with-several-types-of-tuberculosis-a-pilot-study-with-patients-from-the-sanatorium-hospital-of-huambo
#3
Benvinda Xavier Paulo, Bruno Peixoto
BACKGROUND: There is growing evidence that emotional distress expressed in terms of anxiety and depression it is very high among tuberculosis (TB) patients. OBJECTIVES: This study aims to determine levels of anxiety, depression and emotional distress in patients with several types of TB and to determine the association between social-demographic and economical factors, clinical variables and anxiety, depression and emotional distress. METHODS: A cross-sectional study was performed in a sample of 81 TB patients...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/27995381/the-behavioral-avoidance-task-with-anxious-youth-a-review-of-procedures-properties-and-criticisms
#4
REVIEW
Peter J Castagna, Thompson E Davis, Megan E Lilly
The measurement of avoidance behavior in youth with anxiety and related disorders is essential. Historically, the behavioral avoidance task (BAT) has been used as a measure of avoidance that can be tailored to a youth's particular fear. Although in use for over 90 years, there has yet to be a systematic review of its use, properties, etc. Here we examine the use of the BAT with youth as a measure of avoidance over the past 30 years. Studies have used the BAT as a measure of treatment outcome, to explore theories related to avoidance, and provide evidence for the psychometric properties of phobia questionnaires...
December 19, 2016: Clinical Child and Family Psychology Review
https://www.readbyqxmd.com/read/27960654/a-case-of-dose-escalation-of-quetiapine-in-persistent-insomnia-disorder
#5
Claudia Cornelis, Ann Van Gastel, Glenn Dumont, Violette Coppens, Bernard Sabbe, Manuel Morrens, Filip Van Den Eede
Quetiapine, an atypical antipsychotic drug, is recommended for the treatment of schizophrenia and mood disorders. In addition, given its sedative effects, a low dose of the agent is also widely used in the treatment of anxiety disorders, personality disorders, substance abuse, and sleep disturbances. In this case study, quetiapine was the first effective drug in reducing chronic insomnia in a male patient with a long treatment history. Because its effect declined over time, in the course of two years, a gradual dose increase led to a posology 50 times higher than the off-label dosage used to obtain sedation, i...
December 14, 2016: Acta Clinica Belgica
https://www.readbyqxmd.com/read/27922040/functional-urological-disorders-a-sensitized-defence-response-in-the-bladder-gut-brain-axis
#6
REVIEW
Carsten Leue, Joanna Kruimel, Desiree Vrijens, Adrian Masclee, Jim van Os, Gommert van Koeveringe
Functional urological and gastrointestinal disorders are interrelated and characterized by a chronic course and considerable treatment resistance. Urological disorders associated with a sizeable functional effect include overactive bladder (OAB), interstitial cystitis/bladder pain syndrome (IC/BPS), and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Poor treatment outcomes might be attributable to untreated underlying psychological and psychiatric disorders, as the co-occurrence of functional urological and gastrointestinal disorders with mood and anxiety disorders is common...
December 6, 2016: Nature Reviews. Urology
https://www.readbyqxmd.com/read/27908570/sleep-related-disorders-in-latin-american-children-with-atopic-dermatitis-a-case-control-study
#7
M Urrutia-Pereira, D Solé, N A Rosario, H J C Neto, V Acosta, C F Almendarez, M M Avalos, H Badellino, F Berroa, M Álvarez-Castelló, A J Castillo, R L Castro-Almarales, M M De la Cruz, A M Cepeda, C Fernandez, M González-León, J Lozano-Saenz, C Sanchez-Silot, J C Sisul-Alvariza, M Valentin-Rostan, R O S Sarni
BACKGROUND: Atopic dermatitis (AD) has been associated with impairment of sleep. The aim of this study was to evaluate sleep disorders in AD Latin-American children (4-10 years) from nine countries, and in normal controls (C). METHODS: Parents from 454 C and 340 AD children from referral clinics answered the Children Sleep Habits Questionnaire (CSHQ), a one-week retrospective 33 questions survey under seven items (bedtime resistance, sleep duration, sleep anxiety, night awakening, parasomnias, sleep-disordered breathing and daytime sleepiness)...
November 28, 2016: Allergologia et Immunopathologia
https://www.readbyqxmd.com/read/27901245/transcranial-direct-current-stimulation-for-treatment-resistant-obsessive-compulsive-disorder-report-on-two-cases-and-proposal-for-a-randomized-sham-controlled-trial
#8
Renata de Melo Felipe da Silva, André Russowsky Brunoni, Eurípedes Constantino Miguel, Roseli Gedanke Shavitt
CONTEXT AND OBJECTIVE: Neuromodulation techniques for treating obsessive-compulsive disorder (OCD) have expanded through greater understanding of the brain circuits involved in this disorder. Transcranial direct current stimulation (tDCS), a non-invasive technique, has been studied as an alternative for treatment-resistant OCD. We describe the design of a clinical trial using tDCS for OCD and report on the outcomes from two patients with primary OCD who were resistant to cognitive-behavioral therapy and to selective serotonin reuptake inhibitors, and who received tDCS in an open manner during the training phase for the study procedures...
September 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/27866918/-children-and-adolescents-anxiety-disorders
#9
H Denis, A Baghdadli
Anxiety disorders were long underestimated in children by healthcare professionals, but they are now better diagnosed. They account for the most frequent psychiatric diagnosis between 6 and 18 years of age, with differences in prevalence or risk factors related to the clinical forms. Different clinical subtypes of anxiety disorders are detailed in this article: separation anxiety, specific phobia, generalized anxiety, social anxiety, panic disorder, post-traumatic stress syndrome, and obsessional-compulsive disorder...
January 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27857509/preventing-adolescent-social-anxiety-and-depression-and-reducing-peer-victimization-intervention-development-and-open-trial
#10
Annette M La Greca, Jill Ehrenreich-May, Laura Mufson, Sherilynn Chan
BACKGROUND: Social anxiety disorder (SAD) and depression are common among adolescents, frequently comorbid, and resistant to change. Prevention programs for adolescent SAD are scant, and depression prevention programs do not fully address peer-risk factors. One critical peer-risk factor for SAD and depression is peer victimization. We describe the development and initial evaluation of a transdiagnostic school-based preventive intervention for adolescents with elevated symptoms of social anxiety and/or depression and elevated peer victimization...
December 2016: Child & Youth Care Forum
https://www.readbyqxmd.com/read/27825555/neuroticism-traits-selectively-impact-long-term-illness-course-and-cognitive-decline-in-late-life-depression
#11
Kevin J Manning, Grace Chan, David C Steffens
OBJECTIVES: Neuroticism is a broad construct that conveys a predisposition to experience psychological distress and negative mood states. Vulnerability to stress (VS) is one neuroticism trait that has been linked to worse mood and cognitive outcomes in older adults. We hypothesized that elevated VS would be associated with worse illness course and cognitive decline in older adults with late-life major depression (LLD). DESIGN: Participants were enrolled in the Neurocognitive Outcomes of Depression in the Elderly (NCODE), a longitudinal investigation of the predictors of poor illness course and cognitive decline in LLD...
October 13, 2016: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27806711/prevalence-and-correlates-of-depression-and-anxiety-among-patients-with-hiv-on-follow-up-at-alert-hospital-addis-ababa-ethiopia
#12
Getachew Tesfaw, Getinet Ayano, Tadesse Awoke, Dawit Assefa, Zelalem Birhanu, Getenet Miheretie, Genet Abebe
BACKGROUND: Depression and anxiety disorders are common among people living with Human Immunodeficiency Virus than the non-infected individuals. The co-existence of these disorders are associated with barriers to treatment and worsening medical outcomes, including treatment resistance, increased risk for suicide, greater chance for recurrence and utilization of medical resources and/or increase morbidity and mortality. Therefore, assessing depression and anxiety among HIV patients has a pivotal role for further interventions...
November 2, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27799774/impact-of-dissociation-on-treatment-of-depressive-and-anxiety-spectrum-disorders-with-and-without-personality-disorders
#13
Jan Prasko, Ales Grambal, Petra Kasalova, Dana Kamardova, Marie Ociskova, Michaela Holubova, Kristyna Vrbova, Zuzana Sigmundova, Klara Latalova, Milos Slepecky, Marta Zatkova
OBJECTIVE: The central goal of the study was to analyze the impact of dissociation on the treatment effectiveness in patients with anxiety/neurotic spectrum and depressive disorders with or without comorbid personality disorders. METHODS: The research sample consisted of inpatients who were hospitalized in the psychiatric department and met the ICD-10 criteria for diagnosis of depressive disorder, panic disorder, generalized anxiety disorder, mixed anxiety-depressive disorder, agoraphobia, social phobia, obsessive compulsive disorder, posttraumatic stress disorder, adjustment disorders, dissociative/conversion disorders, somatoform disorder, or other anxiety/neurotic spectrum disorder...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/27775823/improving-outcomes-for-patients-with-medication-resistant-anxiety-effects-of-collaborative-care-with-cognitive-behavioral-therapy
#14
Laura Campbell-Sills, Peter P Roy-Byrne, Michelle G Craske, Alexander Bystritsky, Greer Sullivan, Murray B Stein
BACKGROUND: Many patients with anxiety disorders remain symptomatic after receiving evidence-based treatment, yet research on treatment-resistant anxiety is limited. We evaluated effects of cognitive behavioral therapy (CBT) on outcomes of patients with medication-resistant anxiety disorders using data from the Coordinated Anxiety Learning and Management (CALM) trial. METHODS: Primary care patients who met study entry criteria (including DSM-IV diagnosis of generalized anxiety disorder, panic disorder, posttraumatic stress disorder, or social anxiety disorder) despite ongoing pharmacotherapy of appropriate type, dose, and duration were classified as medication resistant (n = 227)...
December 2016: Depression and Anxiety
https://www.readbyqxmd.com/read/27759809/transcranial-magnetic-stimulation-and-transcranial-direct-current-stimulation-appear-to-be-safe-neuromodulatory-techniques-useful-in-the-treatment-of-anxiety-disorders-and-other-neuropsychiatric-disorders
#15
Aline Iannone, Antonio Pedro de Mello Cruz, Joaquim Pereira Brasil-Neto, Raphael Boechat-Barros
Transcranial magnetic stimulation (TMS) has recently been investigated as a possible adjuvant treatment for many neuropsychiatric disorders, and has already been approved for the treatment of drug-resistant depression in the United States and in Brazil, among other countries. Although its use in other neuropsychiatric disorders is still largely experimental, many physicians have been using it as an off-label add-on therapy for various disorders. More recently, another technique, transcranial direct current stimulation (tDCS), has also become available as a much cheaper and portable alternative to TMS, although its mechanisms of action are different from those of TMS...
October 2016: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/27756184/the-impact-of-resistance-on-empathy-in-cbt-for-generalized-anxiety-disorder
#16
Kimberley M Hara, Henny A Westra, Michael J Constantino, Martin M Antony
OBJECTIVE: Client resistance has been shown to relate to poorer therapy outcomes, thus making it important to better understand the mechanisms underlying this association. Given observational research suggesting that therapist empathy decreases during moments of resistance, the present study examined client-rated therapist empathy as a potential mediator of the resistance-outcome association. METHOD: Participants included 44 therapist-client dyads receiving cognitive-behavioral therapy for generalized anxiety disorder...
October 19, 2016: Psychotherapy Research: Journal of the Society for Psychotherapy Research
https://www.readbyqxmd.com/read/27754700/effect-of-aptensio-xr-methylphenidate-hcl-extended-release-capsules-on-sleep-in-children-with-attention-deficit-hyperactivity-disorder
#17
Judith Owens, Margaret Weiss, Earl Nordbrock, Greg Mattingly, Sharon Wigal, Laurence L Greenhill, Wei-Wei Chang, Ann Childress, Robert J Kupper, Akwete Adjei
OBJECTIVE: To evaluate measures of sleep (exploratory endpoints) in two pivotal studies of a multilayer bead extended-release methylphenidate (MPH-MLR) treatment of attention-deficit/hyperactivity disorder in children. METHODS: Study 1 evaluated the time course of response to MPH-MLR (n = 26) patients in an analog classroom setting through four phases: screening (≤28 days), open label (OL) dose optimization (4 weeks), double-blind (DB) crossover (2 weeks; placebo vs...
December 2016: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/27719778/assessment-and-care-of-childbearing-women-with-severe-and-persistent-mental-illness
#18
REVIEW
Amy McKeever, SueEllen Alderman, Stephanie Luff, Brian DeJesus
Severe and persistent mental illness (SPMI) refers to complex mood disorders that include major depressive disorder with or without psychosis; severe anxiety disorders resistant to treatment; affective psychotic disorders including bipolar affective disorder, schizophrenia, and schizoaffective disorder; and other nonaffective subtypes of schizophrenia. SPMIs affect 1 in 17 people and are among the leading causes of disability and impaired health-related quality of life in the United States. Caring for childbearing women with preexisting SPMI can be challenging for maternal-child health clinicians...
October 2016: Nursing for Women's Health
https://www.readbyqxmd.com/read/27716920/modified-cognitive-behavior-therapy-for-severe-treatment-resistant-obsessive-compulsive-disorder-in-an-adolescent-with-autism-spectrum-disorder
#19
Georgina Krebs, Kim Murray, Amita Jassi
There is a high rate of comorbidity between obsessive-compulsive disorder (OCD) and autism spectrum disorders (ASD). Standard cognitive-behavior therapy (CBT) protocols have been shown to be less effective in treating OCD in young people with ASD than in typically developing youth. This case study describes the treatment of an adolescent boy with severe, treatment-resistant OCD and ASD using a modified CBT approach. Modifications to a standard evidence-based CBT for OCD protocol included extended psychoeducation about anxiety; regular home-based sessions; and increased involvement of systems, including family and school...
November 2016: Journal of Clinical Psychology
https://www.readbyqxmd.com/read/27669887/group-based-relaxation-response-skills-training-for-pharmacologically-resistant-depressed-and-anxious-patients
#20
Roberto Truzoli, Cecilia Rovetta, Caterina Viganò, Paola Marianna Marinaccio, Gabriella Ba, Phil Reed
BACKGROUND: Drug-resistance for depression and anxiety is a major limitation in the treatment of these common disorders, and adjunct support interventions may be beneficial in the treatment of these patients. AIMS: The purpose of this study was to evaluate the effects of a short-term (8 session) Relaxation Response Skills Training (RRST) programme for a population of psychiatric outpatients with anxiety and mood disorders who were unresponsive to drug treatment, and to test the feasibility of this intervention as complementary treatment for a psychiatric setting...
September 27, 2016: Behavioural and Cognitive Psychotherapy
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