WorldWideScience

Sample records for hamilton anxiety rating

  1. Relationship Between the DSM-5 Anxious Distress Specifier and the Hamilton Depression Rating Scale Anxiety/Somatization Factor.

    Science.gov (United States)

    Zimmerman, Mark; Clark, Heather; McGonigal, Patrick; Harris, Lauren; Guzman Holst, Carolina; Martin, Jacob

    2018-02-01

    We examined the association between the Hamilton Depression Scale (HAMD) approach to classifying depressed patients into anxious and nonanxious subgroups and the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) anxious distress specifier subtyping. Two hundred two depressed patients were interviewed with semistructured diagnostic interviews. Patients were rated on the 17-item HAMD and the Hamilton Anxiety Rating Scale and completed the Clinically Useful Anxiety Outcome Scale. Both approaches toward identifying anxiety in depressed patients resulted in most of the patients meeting the anxiety subtype. Both subtyping methods were significantly correlated with clinician-rated and self-report measures of anxiety, and scores on the anxiety scales were higher in the patients who met the anxious subtype. However, DSM-5 anxious distress subtyping was only marginally associated with the HAMD anxiety/somatization factor subtyping approach (k = 0.21), and dimensional scores were only moderately correlated (r = 0.50). These findings indicate that the DSM-5 and HAMD approaches toward identifying an anxious subtype of depression are not interchangeable.

  2. Generalized anxiety disorder and the Hamilton Anxiety Rating Scale in Parkinson's disease Transtorno de ansiedade generalizada e a Escala de Ansiedade de Hamilton na doença de Parkinson

    Directory of Open Access Journals (Sweden)

    Arthur Kummer

    2010-08-01

    Full Text Available Anxiety is common in Parkinson's disease (PD, but studies concerning specific anxiety disorders are scarce. Essential psychometric properties of anxiety rating scales are also lacking. OBJECTIVE: To investigate general anxiety disorder (GAD in PD and psychometric properties of the Hamilton Anxiety Rating Scale (Ham-A. METHOD: Ninety-one PD patients underwent neurological and psychiatric examination, which included the MINI-Plus, the Ham-A and the Hamilton Depression Rating Scale (Ham-D. RESULTS: GAD was present in 30.8% of PD patients. Patients with GAD had longer disease duration (p=0.044 and were in use of higher doses of levodopa (p=0.034. They also tended to have more motor fluctuations and dyskinesias. The group with GAD scored higher in Ham-A (pAnsiedade é comum na doença de Parkinson (DP, mas estudos sobre transtornos de ansiedade específicos são ainda escassos. Faltam também estudos sobre propriedades psicométricas essenciais das escalas de ansiedade. OBJETIVO: Investigar o transtorno de ansiedade generalizada (TAG na DP e propriedades psicométricas da Escala de Ansiedade de Hamilton (Ham-A. MÉTODO: Noventa e um pacientes com DP se submeteram a exames neurológico e psiquiátrico, que incluiu o MINI-Plus, a Ham-A e a Escala de Depressão de Hamilton (Ham-D. RESULTADOS: TAG esteve presente em 30,8% dos participantes. Pacientes com TAG tinham maior duração de doença (p=0,044 e estavam em uso de maiores doses de levodopa (p=0,034. Também havia uma tendência desses pacientes terem mais flutuações motoras e discinesias. O grupo com TAG pontuou mais alto na Ham-A (p<0,001, nas subescalas somática (p<0,001 e psíquica da Ham-A (p<0,001, e na Ham-D (p=0,004. A Ham-A mostrou boa consistência interna (alfa de Cronbach=0,893 e um ponto de corte de 10/11 é sugerido para triar o TAG. CONCLUSÃO: TAG é freqüente na DP e a Ham-A pode ser um instrumento útil para triar esse transtorno.

  3. Symptoms of anxiety in depression: assessment of item performance of the Hamilton Anxiety Rating Scale in patients with depression.

    Science.gov (United States)

    Vaccarino, Anthony L; Evans, Kenneth R; Sills, Terrence L; Kalali, Amir H

    2008-01-01

    Although diagnostically dissociable, anxiety is strongly co-morbid with depression. To examine further the clinical symptoms of anxiety in major depressive disorder (MDD), a non-parametric item response analysis on "blinded" data from four pharmaceutical company clinical trials was performed on the Hamilton Anxiety Rating Scale (HAMA) across levels of depressive severity. The severity of depressive symptoms was assessed using the 17-item Hamilton Depression Rating Scale (HAMD). HAMA and HAMD measures were supplied for each patient on each of two post-screen visits (n=1,668 observations). Option characteristic curves were generated for all 14 HAMA items to determine the probability of scoring a particular option on the HAMA in relation to the total HAMD score. Additional analyses were conducted using Pearson's product-moment correlations. Results showed that anxiety-related symptomatology generally increased as a function of overall depressive severity, though there were clear differences between individual anxiety symptoms in their relationship with depressive severity. In particular, anxious mood, tension, insomnia, difficulties in concentration and memory, and depressed mood were found to discriminate over the full range of HAMD scores, increasing continuously with increases in depressive severity. By contrast, many somatic-related symptoms, including muscular, sensory, cardiovascular, respiratory, gastro-intestinal, and genito-urinary were manifested primarily at higher levels of depression and did not discriminate well at lower HAMD scores. These results demonstrate anxiety as a core feature of depression, and the relationship between anxiety-related symptoms and depression should be considered in the assessment of depression and evaluation of treatment strategies and outcome.

  4. Measuring anxiety in depressed patients: A comparison of the Hamilton anxiety rating scale and the DSM-5 Anxious Distress Specifier Interview.

    Science.gov (United States)

    Zimmerman, Mark; Martin, Jacob; Clark, Heather; McGonigal, Patrick; Harris, Lauren; Holst, Carolina Guzman

    2017-10-01

    DSM-5 included criteria for an anxious distress specifier for major depressive disorder (MDD). In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project we examined whether a measure of the specifier, the DSM-5 Anxious Distress Specifier Interview (DADSI), was as valid as the Hamilton Anxiety Scale (HAMA) as a measure of the severity of anxiety in depressed patients. Two hundred three psychiatric patients with MDD were interviewed by trained diagnostic raters who administered the Structured Clinical Interview for DSM-IV (SCID) supplemented with questions to rate the DADSI, HAMA, and Hamilton Depression Rating Scale (HAMD). The patients completed self-report measures of depression, anxiety, and irritability. Sensitivity to change was examined in 30 patients. The DADSI and HAMA were significantly correlated (r = 0.60, p anxiety than with measures of the other symptom domains. The HAMD was significantly more highly correlated with the HAMA than with the DADSI. For each anxiety disorder, patients with the disorder scored significantly higher on both the DADSI and HAMA than did patients with no current anxiety disorder. A large effect size of treatment was found for both measures (DADSI: d = 1.48; HAMA: d = 1.37). Both the DADSI and HAMA were valid measures of anxiety severity in depressed patients, though the HAMA was more highly confounded with measures of depression than the DADSI. The DADSI is briefer than the HAMA, and may be more feasible to use in clinical practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Fifty years with the Hamilton scales for anxiety and depression. A tribute to Max Hamilton

    DEFF Research Database (Denmark)

    Bech, P; Bech, P

    2009-01-01

    as the method for the evaluation of the clinical effects of psychotropic drugs. Inspired by Eysenck, Hamilton took the long route around factor analysis in order to qualify his scales for anxiety (HAM-A) and depression (HAM-D) as scientific tools. From the moment when, 50 years ago, Hamilton published his first...... placebo-controlled trial with an experimental anti-anxiety drug, he realized the dialectic problem in using the total score on HAM-A as a sufficient statistic for the measurement of outcome. This dialectic problem has been investigated for more than 50 years with different types of factor analyses without...

  6. Fifty years with the Hamilton scales for anxiety and depression. A tribute to Max Hamilton.

    Science.gov (United States)

    Bech, P

    2009-01-01

    From the moment Max Hamilton started his psychiatric education, he considered psychometrics to be a scientific discipline on a par with biochemistry or pharmacology in clinical research. His clinimetric skills were in operation in the 1950s when randomised clinical trials were established as the method for the evaluation of the clinical effects of psychotropic drugs. Inspired by Eysenck, Hamilton took the long route around factor analysis in order to qualify his scales for anxiety (HAM-A) and depression (HAM-D) as scientific tools. From the moment when, 50 years ago, Hamilton published his first placebo-controlled trial with an experimental anti-anxiety drug, he realized the dialectic problem in using the total score on HAM-A as a sufficient statistic for the measurement of outcome. This dialectic problem has been investigated for more than 50 years with different types of factor analyses without success. Using modern psychometric methods, the solution to this problem is a simple matter of reallocating the Hamilton scale items according to the scientific hypothesis under examination. Hamilton's original intention, to measure the global burden of the symptoms experienced by the patients with affective disorders, is in agreement with the DSM-IV and ICD-10 classification systems. Scale reliability and obtainment of valid information from patients and their relatives were the most important clinimetric innovations to be developed by Hamilton. Max Hamilton therefore belongs to the very exclusive family of eminent physicians celebrated by this journal with a tribute. 2009 S. Karger AG, Basel.

  7. Depression, anxiety, and heart rate variability: A case-control study in Taiwan

    Directory of Open Access Journals (Sweden)

    Li-Fen Chen

    2014-01-01

    Full Text Available Objective: Decreased heart rate variability (HRV has been reported in persons with major depressive disorder (MDD, but the results obtained are inconsistent. Little is known about the impact of comorbid anxiety disorders on HRV in MDD patients. Both issues necessitate further investigation. Materials and Methods: Forty-nine unmedicated, physically healthy, MDD patients without comorbidity, 21 MDD patients with comorbid generalized anxiety disorder (GAD, 24 MDD patients with comorbid panic disorder (PD, and 81 matched controls were recruited. The Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale are employed to assess the severity of depression and anxiety, respectively. The cardiac autonomic function was evaluated by measuring the HRV parameters. The frequency-domain indices of HRV were obtained. Results: MDD patients without comorbidity had lower high-frequency (HF-HRV (which reflected vagal control of HRV than controls. Any comorbid anxiety disorder (GAD or PD was associated with significantly faster heart rates, relative to the controls, and caused greater reductions in HF-HRV among MDD patients. MDD participants with comorbid GAD displayed the greatest reductions in HF-HRV, relative to controls. Correlation analyses revealed that the severity of both depression and anxiety were significantly associated with the mean R wave to R wave (R-R intervals, variance, low-frequency (LF-HRV, and HF-HRV. Conclusion: The present results show decreased HRV in MDD patients, suggesting that reduction in HRV is a psychophysiological marker of MDD. MDD patients with comorbid GAD had the greatest reductions in HRV. Further investigation of the links between MDD and comorbid GAD, HRV, and cardiovascular disease is warranted.

  8. Patients with OCD report lower quality of life after controlling for expert-rated symptoms of depression and anxiety.

    Science.gov (United States)

    Jahangard, Leila; Fadaei, Vahid; Sajadi, Arezoo; Haghighi, Mohammad; Ahmadpanah, Mohammad; Matinnia, Nasrin; Bajoghli, Hafez; Sadeghi Bahmani, Dena; Lang, Undine; Holsboer-Trachsler, Edith; Brand, Serge

    2017-12-02

    One to three percent of the adult population suffers from obsessive-compulsive disorders (OCD). Previous studies have also shown that, compared to controls, patients with OCD report a lower QoL. The latter is associated with self-rated symptoms of depression and anxiety. The aim of the present study was to compare the quality of life of OCD patients with that of healthy controls, while introducing expert-rated symptoms of depression and anxiety as covariates. Gender was also taken into account as an additional associated factor. A total of 100 patients diagnosed with OCD (mean age: 32 years; 64% females) and healthy 100 controls (mean age: 31 years; 59% females; no discernible psychiatric disorder) took part in the present cross-sectional study. All participants completed questionnaires covering socio-demographic characteristics and dimensions of QoL. Experts rated participants' symptoms of OCD (Yale-Brown Obsessive-Compulsive Scale), anxiety (Hamilton Anxiety Rating Scale) and depression (Hamilton Depression Rating Scale). Compared to healthy controls, patients with OCD reported a lower QoL, and had higher symptoms of depression and anxiety. This pattern was particularly pronounced among female patients with OCD. QoL was lower in patients with OCD, even when controlling for depression and anxiety. Results from binary logistic regressions showed that female gender, low QoL and higher symptoms of OCD, depression and anxiety together predicted status as patient with OCD. Compared to healthy controls, patients with OCD have a poorer quality of life and this is independent of depression or anxiety, and is particularly pronounced among female patients. Thus, treatment of OCD might take into account patients' comorbidities and gender. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Depression and anxiety in multiple system atrophy.

    Science.gov (United States)

    Zhang, L-Y; Cao, B; Zou, Y-T; Wei, Q-Q; Ou, R-W; Zhao, B; Wu, Y; Shang, H-F

    2018-01-01

    It has been noticed that the patients with multiple system atrophy (MSA) can accompany with depression and anxiety. This study aimed to establish the incidence and determinants of depression and anxiety symptoms in Chinese MSA patients. A total of 237 MSA patients were enrolled in the study. Neuropsychological assessment was performed using Hamilton Depression Rating Scale-24 items and Hamilton Anxiety Rating Scale. We found that 62.0% and 71.7% patients had at least mild depression and anxiety symptoms, respectively. The severity of depression of MSA patients was associated with lower educational years (P=.024), longer disease duration (Panxiety was associated with increased disease duration (Panxiety were female gender, longer disease duration, and disease severity. Depression and anxiety symptoms are common in patients with MSA. Neurologists should pay attention to depression and anxiety in patients with MSA, especially in female patients and those with longer disease duration and severe disease condition. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Investigation of the relationship between anxiety and heart rate variability in fibromyalgia: A new quantitative approach to evaluate anxiety level in fibromyalgia syndrome.

    Science.gov (United States)

    Bilgin, Suleyman; Arslan, Evren; Elmas, Onur; Yildiz, Sedat; Colak, Omer H; Bilgin, Gurkan; Koyuncuoglu, Hasan Rifat; Akkus, Selami; Comlekci, Selcuk; Koklukaya, Etem

    2015-12-01

    Fibromyalgia syndrome (FMS) is identified by widespread musculoskeletal pain, sleep disturbance, nonrestorative sleep, fatigue, morning stiffness and anxiety. Anxiety is very common in Fibromyalgia and generally leads to a misdiagnosis. Self-rated Beck Anxiety Inventory (BAI) and doctor-rated Hamilton Anxiety Inventory (HAM-A) are frequently used by specialists to determine anxiety that accompanies fibromyalgia. However, these semi-quantitative anxiety tests are still subjective as the tests are scored using doctor-rated or self-rated scales. In this study, we investigated the relationship between heart rate variability (HRV) frequency subbands and anxiety tests. The study was conducted with 56 FMS patients and 34 healthy controls. BAI and HAM-A test scores were determined for each participant. ECG signals were then recruited and 71 HRV subbands were obtained from these ECG signals using Wavelet Packet Transform (WPT). The subbands and anxiety tests scores were analyzed and compared using multilayer perceptron neural networks (MLPNN). The results show that a HRV high frequency (HF) subband in the range of 0.15235Hz to 0.40235Hz, is correlated with BAI scores and another HRV HF subband, frequency range of 0.15235Hz to 0.28907Hz is correlated with HAM-A scores. The overall accuracy is 91.11% for HAM-A and 90% for BAI with MLPNN analysis. Doctor-rated or self-rated anxiety tests should be supported with quantitative and more objective methods. Our results show that the HRV parameters will be able to support the anxiety tests in the clinical evaluation of fibromyalgia. In other words, HRV parameters can potentially be used as an auxiliary diagnostic method in conjunction with anxiety tests. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. [Comorbid psychiatric symptoms in pathological gamblers: anxiety, depression and substance abuse].

    Science.gov (United States)

    Dannon, Pinhas; Sason, Marina; Shalgi, Bosmat; Tusan, Lali; Sapir, Yafa; Kotler, Moshe

    2004-09-01

    Over the centuries, gambling behaviour has been well known and characterized by the combination of pleasure, luck and competition. Our study explored the relationship between pathological gambling, depression and anxiety. We also explored demographic findings and behavioural patterns of the pathological gamblers. Fourty-seven patients were included in this study and they anonymously completed questionnaires which included demographic findings, the Hamilton depression rating scale and the Hamilton anxiety rating scale. The study results demonstrated a strong correlation between depression, anxiety, substance abuse, and pathological gambling. It also presented lower income and higher anxiety levels associated with a higher tendency for gambling. The subjects suffering from depression and anxiety also showed higher levels of suicidality and other abuse dependencies. In order to confirm these preliminary results larger studies are needed in this field.

  12. Depression and anxiety in hypothyroidism.

    Science.gov (United States)

    Demet, M M; Ozmen, B; Deveci, A; Boyvada, S; Adiguzel, H; Aydemir, O

    2003-09-01

    The aim of the study was to determine the prevalence and severity of depression and anxiety in patients with hypothyroidism and to compare this with euthyroid patients. Thirty patients with hypothyroidism and 30 euthyroid controls attending the Endocrinology outpatient department of Celal Bayar University, Medical Faculty were included in the study. The hormonal screening was done by immunoassay and haemagglutination methods. Then, for psychiatric assessment, Hospital Anxiety and Depression Scale (HAD), Hamilton Depression Rating Scale (HAM-D), and Hamilton Anxiety Rating Scale (HAM-A) were used. There was no difference between the two groups in terms of demographic features. Total scores obtained from the scales used in the study did not differ significantly (p > 0.05). The frequency of items of both HAM-D and HAM-A did not show any differences in the two groups. By Wilks' Lambda discriminant analysis, depressive mood (HAM-D#1) was found to be the discriminating feature between the hypothyroid group and the euthyroid group. Therefore, depression and anxiety were not outstanding features in hypothyrodism. However, depression was more significant in the hypothyroid than euthyroid group.

  13. Health Anxiety in Panic Disorder, Somatization Disorder and Hypochondriasis

    Directory of Open Access Journals (Sweden)

    Özgün Karaer KARAPIÇAK

    2012-03-01

    Full Text Available Objective: Health anxiety is the fear of being or getting seriously sick due to the misinterpretation of physical symptoms. Severe health anxiety is also named as hypochondriasis. Belief of having a disease due to the misinterpretation of physical symptoms is also seen in panic disorder and somatization disorder. The aim of this study is to search the health anxiety in panic disorder, somatization disorder and hypochondriasis and compare it with healthy volunteers. Method: SCID-I was used to determine psychiatric disorders in patient group. In order to assess the clinical state and disease severity of the patient group; Panic and Agoraphobia Scale, Hamilton Anxiety Rating Scale, Inventory of Depressive Symptomatology were used for patients with panic disorder and Symptom Interpretation Questionnaire, Hamilton Anxiety Rating Scale, Inventory of Depressive Symptomatology were used for patients with somatization disorder and hypochondriasis. Brief Symptom Inventory was used to assess psychopathology in healthy group. In order to evaluate health anxiety of both groups, Health Anxiety Inventory-Short Form was used. Results: Results of this study support that health anxiety is a significant major component of hypochondriasis. On the other hand, health anxiety seems to be common in panic disorder and somatization disorder. Health anxiety also may be a part of depression or present in healthy people. Conclusion: Further studies are needed in order to search how to manage health anxiety appropriately and which psychotherapeutic interventions are more effective.

  14. A meta-analytic comparison of the Beck Depression Inventory and the Hamilton Rating Scale for Depression as measures of treatment outcome.

    Science.gov (United States)

    Edwards, B C; Lambert, M J; Moran, P W; McCully, T; Smith, K C; Ellingson, A G

    1984-05-01

    Some clinicians have considered the Beck Depression Inventory, a self-rating scale, too reactive to patient halo effects and, therefore, a liberal measure of treatment outcome. On the other hand, interviewer-rating scales, like the Hamilton Rating Scale for Depression have been viewed as more conservative measures of treatment gain. Studies which compared the Beck Depression Inventory to the Hamilton Rating Scale, as dependent measures, were reviewed for the purpose of determining if the scales provided comparable data for assessing treatment effects. The use of meta-analysis techniques resulted in a comparison of effect sizes which indicated that the Beck Depression Inventory was significantly less liberal than the Hamilton Rating Scale for Depression. The implications of these results for selecting outcome measures and the application of meta-analysis techniques for comparing dependent measures are discussed.

  15. Factor analysis of the Hamilton Depression Rating Scale in Parkinson's disease.

    Science.gov (United States)

    Broen, M P G; Moonen, A J H; Kuijf, M L; Dujardin, K; Marsh, L; Richard, I H; Starkstein, S E; Martinez-Martin, P; Leentjens, A F G

    2015-02-01

    Several studies have validated the Hamilton Depression Rating Scale (HAMD) in patients with Parkinson's disease (PD), and reported adequate reliability and construct validity. However, the factorial validity of the HAMD has not yet been investigated. The aim of our analysis was to explore the factor structure of the HAMD in a large sample of PD patients. A principal component analysis of the 17-item HAMD was performed on data of 341 PD patients, available from a previous cross sectional study on anxiety. An eigenvalue ≥1 was used to determine the number of factors. Factor loadings ≥0.4 in combination with oblique rotations were used to identify which variables made up the factors. Kaiser-Meyer-Olkin measure (KMO), Cronbach's alpha, Bartlett's test, communality, percentage of non-redundant residuals and the component correlation matrix were computed to assess factor validity. KMO verified the sample's adequacy for factor analysis and Cronbach's alpha indicated a good internal consistency of the total scale. Six factors had eigenvalues ≥1 and together explained 59.19% of the variance. The number of items per factor varied from 1 to 6. Inter-item correlations within each component were low. There was a high percentage of non-redundant residuals and low communality. This analysis demonstrates that the factorial validity of the HAMD in PD is unsatisfactory. This implies that the scale is not appropriate for studying specific symptom domains of depression based on factorial structure in a PD population. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Depression and anxiety levels in therapy-na(i)ve patients with inflammatory bowel disease and cancer of the colon

    Institute of Scientific and Technical Information of China (English)

    Branislav R Filipovi(c); Branka F Filipovi(c); Mirko Kerkez; Nikola Milini(c); Tomislav Ran(d)elovi(c)

    2007-01-01

    AIM: To assess whether depression and anxiety are more expressed in patients with the first episode of inflammatory bowel disease (IBD) than in individuals with newly discovered cancer of the colon (CCa).METHODS: A total of 32 patients with IBD including 13males and 19 females, aged 27 to 74, and 30 patients with CCa including 20 males and 10 females, aged 39-78,underwent a structured interview, which comprised Hamilton's Depression Rating Inventory, Hamilton's Anxiety Rating Inventory and Paykel's Stressful Events Rating Scale.RESULTS: Patients of the IBD group expressed both depression and anxiety. Depressive mood, sense of guilt, psychomotor retardation and somatic anxiety were also more pronounced in IBD patients. The discriminant function analysis revealed the total depressive score was of high importance for the classification of a newly diagnosed patient into one of the groups.CONCLUSION: Newly diagnosed patients with IBD have higher levels of depression and anxiety. Moreover, a psychiatrist in the treatment team is advisable from the beginning.

  17. Depression and anxiety in patients with hereditary angioedema.

    Science.gov (United States)

    Fouche, Andrew S; Saunders, Erika F H; Craig, Timothy

    2014-04-01

    Hereditary angioedema (HAE) is characterized by edematous swelling attacks of the face, extremities, abdomen, genitalia, and upper airway. The potential for laryngeal swelling makes the disease life-threatening, and the swelling elsewhere contributes to the significant burden of illness. The increased risk for mental health disorders in HAE is due to the burden of disease and possibly associated activation of the immune system. To determine the prevalence of depression and anxiety in HAE patients and the most high-yield features of depression to target in a clinical encounter. Depression and anxiety symptoms were evaluated using the 29 items of the Hamilton Depression Rating Scale along with the 14-item Hamilton Anxiety Rating Scale. The sample size was 26 participants with a diagnosis of type 1 or 2 HAE drawn from a cohort of 60 adult patients. In addition, a literature search was performed regarding how immune modulation affects depression and anxiety. A total of 39% of participants were identified as experiencing depression of mild (50%), moderate (40%), or severe (10%) levels. Fifteen percent of participants displayed prominent anxiety, half of whom had mild anxiety, 25% moderate anxiety, and 25% severe anxiety. The literature on inflammation and depression suggests a possible link between HAE and depression. Our data and the literature support that depression and anxiety symptoms are common in patients with HAE and may be secondary to chronic disease burden, associated pathophysiologic features, or both. Treatment that addresses the psychosocial and mental health of HAE patients is critical for best practice. Copyright © 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  18. Depression and anxiety in hyperthyroidism.

    Science.gov (United States)

    Demet, Mehmet Murat; Ozmen, Bilgin; Deveci, Artuner; Boyvada, Sibel; Adigüzel, Hakan; Aydemir, Omer

    2002-01-01

    Our objective was to determine symptomatology of depression and anxiety in patients with untreated hyperthyroidism and compare with euthyroid patients. Thirty-two patients with hyperthyroidism (high free T3 and free T4, and suppressed TSH) and 30 euthyroid (normal free T3, free T4, and TSH) controls attending the Endocrinology Out-Patient Department at Celal Bayar University Hospital in Manisa, Turkey were included in the study. Hormonal screening was performed by immunoassay and hemagglutination method. For psychiatric assessment, Hospital Anxiety and Depression Scale [HAD], Hamilton Depression Rating Scale [HAM-D], and Hamilton Anxiety Rating Scale [HAM-A] were used. There was no difference between the two groups in terms of demographic features. Total scores obtained both from HAM-D and HAM-A were significantly greater in the hyperthyroidism group than that of the euthyroid group (p weight loss (HAM-D#16), insomnia (HAM-A#4), and cardiovascular symptoms (HAM-A#8) were significantly more frequent in the hyperthyroidism group. By Wilks lambda discriminant analysis, psychomotor agitation (HAM-D#9), weight loss (HAM-D#16), and insomnia (HAM-A#4) were found as the discriminating symptoms for the hyperthyroidism group, whereas somatic anxiety (HAM-A#11) and loss of interest (HAD#14) were distinguishing symptoms of the euthyroidism group. Hyperthyroidism and syndromal depression-anxiety have overlapping features that can cause misdiagnosis during acute phase. For differential diagnosis, one should follow-up patients with hyperthyroidism with specific hormonal treatment and evaluate persisting symptoms thereafter. In addition to specific symptoms of hyperthyroidism, psychomotor retardation, guilt, muscle pain, energy loss, and fatigue seem to appear more frequently in patients with comorbid depression and hyperthyroidism; thus, presence of these symptoms should be a warning sign to nonpsychiatric professionals for the need for psychiatric consultation.

  19. Sleep disturbances, anxiety and depression in patients with oral lichen planus: a case-control study.

    Science.gov (United States)

    Adamo, D; Ruoppo, E; Leuci, S; Aria, M; Amato, M; Mignogna, M D

    2015-02-01

    The psychological factors and their association with chronic inflammatory disease, aren't well recognized, yet their importance in oral lichen planus is still debated. The aim of this study was to investigate the prevalence of sleep disturbances, anxiety, depression and their association in patient with oral lichen planus. 50 patients with oral lichen planus vs. equal number of age and sex-matched healthy controls were enrolled. Questionnaires examining insomnia symptoms, excessive daytime sleepiness (Pittsburgh sleep quality index and Epworth aleepiness scale) depression and anxiety (The Hamilton rating scale for Depression and Anxiety) were used. The patients with oral lichen planus had statistically higher scores in all items of the Pittsburgh sleep quality index, the Hamilton rating scale for depression and anxiety and Epworth sleepiness scale than the healthy controls. The median and inter-quartile range of the Pittsburgh sleep quality index was 5-2 and for the oral lichen planus patients and 4-2 for the healthy controls (P Oral lichen planus patients report a greater degree of sleep problems, depressed mood and anxiety as compared with controls. We suggest to screen sleep disturbances in patients with oral lichen planus because they could be considered a prodromal symptoms of mood disorders. © 2014 European Academy of Dermatology and Venereology.

  20. Vacuum-assisted closure of wounds and anxiety.

    Science.gov (United States)

    Keskin, Mustafa; Karabekmez, Furkan E; Yilmaz, Erkan; Tosun, Zekeriya; Savaci, Nedim

    2008-01-01

    The aim of this study was to investigate the degree of anxiety in patients in whom the vacuum-assisted closure (VAC) of wounds was used. Psychological evaluations were made on the day before VAC was applied and at the 10(th) day of treatment in 20 patients with traumatic wounds of the lower extremity. Anxiety was measured with the Hamilton Rating Scale for Anxiety and with the State Anxiety Inventory test. The same measurements were also made in 20 further patients with similar wounds but managed with classic treatment as controls. Both groups showed a significant increase in anxiety during the 10 days. The mean (SD) differences in the anxiety scores measured during the 10-day period were significantly higher in the group treated by VAC than in the control group, State Anxiety Inventory test (14.0 (2.3) compared with 2.6 (1.2), pVAC is an effective tool for treating lower extremity wounds, we have concerns about possible accompanying psychological effects.

  1. High-Order Hamilton's Principle and the Hamilton's Principle of High-Order Lagrangian Function

    International Nuclear Information System (INIS)

    Zhao Hongxia; Ma Shanjun

    2008-01-01

    In this paper, based on the theorem of the high-order velocity energy, integration and variation principle, the high-order Hamilton's principle of general holonomic systems is given. Then, three-order Lagrangian equations and four-order Lagrangian equations are obtained from the high-order Hamilton's principle. Finally, the Hamilton's principle of high-order Lagrangian function is given.

  2. Depressive symptoms, anxiety, and quality of life in women with pelvic endometriosis.

    Science.gov (United States)

    Sepulcri, Rodrigo de P; do Amaral, Vivian F

    2009-01-01

    To assess depressive symptoms, anxiety and quality of life in women with pelvic endometriosis. A prospective study of 104 women diagnosed with pelvic endometriosis. The Beck Depression Inventory (BDI) and the Hamilton Rating Scale for Depression (HAM-D) were used to evaluate depressive symptoms; the Spielberger State-Trait Anxiety Inventory (STAI) and the Hamilton Rating Scale for Anxiety (HAM-A) to evaluate anxiety symptoms; and the short (26-item) version of the World Health Organization Quality Of Life instrument (WHOQOL-BREF) to evaluate quality of life. Of the patients evaluated, 86.5% presented depressive symptoms (mild in 22.1%, moderate in 31.7%, and severe in 32.7%) and 87.5% presented anxiety (minor in 24% and major in 63.5%). Quality of life was found to be substandard. Age correlated positively with depressive symptoms, as determined using the BDI (P=0.013) and HAM-D (P=0.037). There was a positive correlation between current pain intensity and anxiety symptoms, as assessed using the STAI (state, P=0.009; trait, P=0.048) and HAM-A (P=0.0001). The complaints related to physical limitations increased in parallel with the intensity of pain (P=0.017). There was an inverse correlation between duration of treatment and quality of life (P=0.017). There was no correlation between psychiatric symptoms and endometriosis stage. A rational approach to endometriosis should include an evaluation of the emotional profile and quality of life. That approach would certainly reduce the functional damage caused by the endometriosis.

  3. Burn-related factors affecting anxiety, depression and self-esteem in burn patients: an exploratory study.

    Science.gov (United States)

    Jain, M; Khadilkar, N; De Sousa, A

    2017-03-31

    Burns are physically, psychologically and economically challenging injuries, and the factors leading to them are many and under-studied. The aim of the current study was to assess level of anxiety, depression and self-esteem in burn patients, and look at various burn-related variables that affect them. This cross-sectional study included 100 patients with burn injuries admitted to a tertiary care private hospital in an urban metropolis in India. The patients were assessed for anxiety, depression and self-esteem using the Hamilton anxiety rating scale, Hamilton depression rating scale and Rosenberg self-esteem scale respectively. Assessment was carried out within 2-8 weeks of injury following medical stabilization. The data was tabulated and statistically analyzed. The study sample was predominantly male (54%), married (69%), with a mean age of 34.1 ± 10.8 years. Accidental burns (94%) were the most common modality of injury. The majority (46%) suffered burns involving 20-59% total body surface area (TBSA), and facial burns were present (57%). No significant association was found between TBSA and anxiety, depression or self-esteem, and the same was true for facial burns. Deep burns, however, were significantly associated with anxiety (p=0.03) and depression (p=0.0002). High rates of anxiety and depression are associated with burn injuries and related to burn depth. Adjustment and recovery in these patients depends on various other factors like the patient's psychological status, nature/extent of the injury and ensuing medical care. Further research is warranted to reveal the magnitude and predictors of psychological problems in burn patients.

  4. Alcohol use, anxiety, and insomnia in older adults with generalized anxiety disorder

    Science.gov (United States)

    Ivan, M. Cristina; Amspoker, Amber B.; Nadorff, Michael R.; Kunik, Mark E.; Cully, Jeffrey A.; Wilson, Nancy; Calleo, Jessica; Kraus-Schuman, Cynthia; Stanley, Melinda A.

    2013-01-01

    Objectives We examined the presence and frequency of alcohol consumption among older primary care patients with generalized anxiety disorder (GAD) and their relation to demographic variables, insomnia, worry, and anxiety. We expected alcohol-use distribution to be similar to previous reports and alcohol use to be associated with higher anxiety and insomnia. A third aim was to examine the moderating role of alcohol use on the relation between anxiety and insomnia. We expected alcohol use to worsen the relation between anxiety and insomnia. Design Baseline data from a randomized controlled trial Sample 223 patients, age 60 and older, with DSM-IV GAD diagnoses Setting Patients were recruited through internal medicine, family practice, and geriatric clinics at 2 diverse healthcare settings: Michael E. DeBakey Veterans Administration Medical Center and Baylor College of Medicine. Measurements Measures addressed alcohol use (presence and frequency); insomnia (Insomnia Severity Index); self-reported worry severity (Penn State Worry Questionnaire − Abbreviated); clinician-rated worry severity (Generalized Anxiety Disorder Severity Scale); self-reported anxiety severity (State-Trait Anxiety Inventory - Trait); and clinician-rated anxiety (Structured Interview Guidelines for the Hamilton Anxiety Rating Scale). Results Most patients endorsed alcohol use in the past month, but overall weekly frequency was low. Presence and frequency of use among patients with GAD were greater than in prior reports of primary care samples. Alcohol use among patients with GAD was associated with higher education and female gender. Higher education also was associated with more drinks per week, and Caucasians reported more drinks per week than African Americans. Alcohol use was associated with less severe insomnia, lower self-reported anxiety, and less clinician-rated worry and anxiety. More drinks per week were associated with lower clinician-rated anxiety. Moderation analyses revealed lower

  5. Severity of anxiety- but not depression- is associated with oxidative stress in Major Depressive Disorder.

    Science.gov (United States)

    Steenkamp, Lisa R; Hough, Christina M; Reus, Victor I; Jain, Felipe A; Epel, Elissa S; James, S Jill; Morford, Alexandra E; Mellon, Synthia H; Wolkowitz, Owen M; Lindqvist, Daniel

    2017-09-01

    Oxidative stress is implicated in both depression and anxiety, but it is currently unclear whether this relates to syndromal diagnoses or trans-diagnostic dimensional symptoms. We examined the relationship between oxidative stress and severity of depression and anxiety symptoms in individuals with Major Depressive Disorder (MDD). Plasma oxidative stress markers F2-isoprostanes and oxidized glutathione (GSSG), and the antioxidant reduced glutathione (GSH), were assessed in 69 physically healthy, medication-free MDD subjects. Symptoms of anxiety and depression were assessed using the Hamilton Anxiety (HAM-A) and Hamilton Depression (HAM-D) Rating Scales. Total HAM-A and HAM-D scores, along with "core" anxiety and depression subscales, and individual HAM-D items "psychic anxiety" and "depressed mood," were related to oxidative stress markers. Analyses controlled for age, sex, BMI, and smoking. Total HAM-A ratings were positively associated with F2-isoprostanes (β=.26, p=.042) and GSSG (β=.25, p=.049), but not GSH (β=.05, p=.711). Core anxiety severity was positively associated with F2-isoprostanes (β=.34, p=.012) and GSSG, although this did not reach significance (β=.24, p=.074). None of the biological markers were significantly associated with total HAM-D or core depression ratings (all p>.13). Subjects scoring high on "psychic anxiety" had elevated F2-isoprostanes (p=.030) and GSSG (p=.020). This was not seen with "depressed mood" scores (all p>.12). We assessed peripheral oxidative markers, but their relationship to the brain is unclear. Oxidative stress is more closely related to anxiety than depression symptoms in MDD. This highlights the importance of relating oxidative stress to specific symptoms and could provide new insights into the biological correlates of affective disorders. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Anxiety and depression related to the hospitalization experience of patients receiving radioiodine ablation

    International Nuclear Information System (INIS)

    Koc, Z.; Karaboc, A.; Balci, T.; Kepenek, F.; Atmaca, M.

    2015-01-01

    Full text of publication follows. Objective: the hospital rooms for radioiodine ablation of differentiated thyroid carcinoma are designed according to radiation safety lows where patients have to remain isolated. The aim of the present study is to investigate depression and anxiety levels of the patients associated with hospitalization experience for radioiodine ablation. Methods: 30 patients (8 M, 22 F; mean: 45±13 years old) with differentiated thyroid carcinoma were included into study. After withdrawal of thyroid hormone replacement at least for 3 weeks, the patients were subject of the ablation treatment. After routine psychiatric examination Hamilton Anxiety and Depression scales were administered to the patients before and after complement of hospitalization for 1-3 days. Results: according to the statistical analysis there was not any significant difference between Hamilton depression and anxiety scores and state and trait anxiety scores of the patients before and after treatment (P>0.05). However, 18 patients had depression, with major depression of six, and 21 had high anxiety levels, according to Hamilton Depression and Anxiety Scales. Conclusion: Although the patients with differentiated thyroid carcinoma do not experience anxiety or depression related to the hospitalization itself for radioiodine ablation they might frequently have depression or anxiety just before the treatment. (authors)

  7. Efficacy of an Eight Week Trial of Imipramine and Citalopram in Patients with Mixed Anxiety-Depressive Disorder

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Abbasi-Asl

    2008-12-01

    Full Text Available "n "nObjective: Mixed anxiety-depressive disorder (MADD is a condition in which patients have both anxiety and depressive symptoms but do not meet the diagnostic criteria for either an anxiety disorder or a mood disorder. "nThe aim of this study was to compare the efficacy of imipramine and citalopram in the treatment of MADD. "n "nMethods: Fifty one outpatients aged 18 to 55 who were diagnosed with MADD were randomly assigned to receive citalopram or imipramine for 8 weeks. Patients were assessed using Hamilton Depression Rating Scale (HDRS and Hamilton Anxiety Rating Scale (HARS at baseline, weeks 4 and "n8 of the study. The mean differences in Hamilton scores from the baseline  were used as the main outcome measures of response to treatment. "n "nResults: Thirty six patients completed the study. Patients in the citalopram group (n=20 received a mean dosage of 22 mg per day during the first 4 weeks and a mean dosage of 33 mg per day during weeks 4 to 8. Subjects in the Imipramine group (n= 16 received a mean dosage of 77 mg per day during the first 4 weeks and a mean dosage of 89 mg per day during weeks 4 "nto 8. It was noted that the both treatments were effective on depression and anxiety at the end of the fourth and eighth weeks. However, the mean differences of HDRS and HARS scores between citalopram and imipramine groups were not significantly different at the end of weeks 4 and 8. "n "nConclusion: The results of this study suggest that the efficacy of regular doses of citalopram is comparable with lower range of therapeutic doses of imipramine in the treatment of MADD. A more comprehensive study is warranted to confirm the results of this study.

  8. No relationship between baseline salivary alpha-amylase and State-Trait Anxiety Inventory Score in drug-naïve patients with short-illness-duration first episode major depressive disorder: An exploratory study.

    Science.gov (United States)

    Szarmach, Joanna; Cubała, Wiesław-Jerzy; Landowski, Jerzy; Chrzanowska, Anna

    2017-04-01

    Salivary α-amylase (sAA) activity alternations are observed in major depressive disorder (MDD) being associated with depression severity and its specific psychopathological dimensions with anxiety being attributed to distress. No data is available on sAA in MDD according to Hamilton Rating Scale for Depression (HAMD-17) and State-Trait Anxiety Inventory (STAI). The exploratory study examines whether and to what extent baseline sAA level is interrelated to the psychopathological features including severity of symptoms and specific psychopathological dimensions. The basal, non-stimulated sAA activity was studied in 20 non-late-life adult, treatment-naïve MDD patients with short-illness-duration and in 20 age- and sex-matched healthy controls along with psychometric assessments with Hamilton Rating Scale for Depression (HAMD-17) and Spielberger State-Trait Anxiety Inventory (STAI). Significantly lower ( p =0.011) sAA activity was observed in MDD as compared to controls. No significant correlations were observed between sAA activity and the total HAMD-17 score as well as with regard to the specific core depression, insomnia, anxiety and somatic HAM-D psychopathological dimensions. No significant correlations were also found between sAA and STAIX-1 and STAIX-2 scores. Low baseline sAA levels in MDD with no correlations between sAA and psychopathological features including severity of symptoms and specific psychopathological dimensions was found. Key words: Salivary alpha-amylase, major depressive disorder, Spielberger State-Trait Anxiety Inventory, Hamilton Rating Scale for Depression.

  9. Associations Among Plasma Stress Markers and Symptoms of Anxiety and Depression in Patients with Breast Cancer Following Surgery

    Science.gov (United States)

    Ju, Hyun-Bin; Kang, Eun-Chan; Jeon, Dong-Wook; Kim, Tae-Hyun; Moon, Jung-Joon; Kim, Sung-Jin; Choi, Ji-Min; Jung, Do-Un

    2018-01-01

    Objective The objective of present study is to analyze the prevalence of depression and anxiety following breast cancer surgery and to assess the factors that affect postoperative psychological symptoms. Methods The Hamilton Rating Scale for Depression (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Body Image Scale (BIS), and Rosenberg Self Esteem Scale (RSES) were used to assess the psychological states of patients who had been diagnosed with and had undergone surgery for breast cancer. Blood concentrations of the stress markers adrenocorticotropic hormone, cortisol, arginine-vasopressin, and angiotensin-converting enzyme were measured. Pearson’s correlation analysis and multilinear regression analysis were used to analyse the data. Results At least mild depressive symptoms were noted in 50.5% of patients, while 42.4% of patients exhibited at least mild anxiety symptoms. HAM-D score was positively correlated with HAM-A (r=0.83, p<0.001) and BIS (r=0.29, p<0.001) scores and negatively correlated with RSES score (r=-0.41, p<0.001). HAM-A score was positively correlated with BIS score (r=0.32, p<0.001) and negatively correlated with RSES score (r=-0.27, p<0.001). There were no statistically significant associations between stress markers and depression/anxiety. Conclusion Patients with breast cancer frequently exhibit postoperative depression and anxiety, which are related to low levels of self-esteem and distorted body image. PMID:29475233

  10. A Cross-sectional Study on the Proportion of Anxiety and Depression and Determinants of Quality of Life in Polycystic Ovarian Disease.

    Science.gov (United States)

    Prathap, Aparna; Subhalakshmi, T P; Varghese, P Joseph

    2018-01-01

    The polycystic ovary syndrome is a disorder characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphologic features. Earlier studies have shown that depression was significantly increased in the polycystic ovarian disease (PCOD) group and also that PCOD women had marked reduction in quality of life, impaired emotional well-being, and reduced sexual satisfaction. This study was undertaken with the objectives of studying the proportion of anxiety and depression and assessing the quality of life and its correlates in women with PCOD. A cross-sectional observational study on 64 PCOD patients using a pro forma for collecting sociodemographic and clinical details, Hamilton Depression Rating Scale, Hamilton Rating Scale for Anxiety, Ferriman-Gallewey score for hirsutism and WHO-quality of life (QOL) BREF. Depression was seen in 93.5% of the subjects and anxiety in 100% of the subjects. The patients were also seen to have a lower quality of life. Lower scores were obtained in the psychological domain (68.80 ± 12.87). Presence and severity of depression and anxiety were found to have a negative correlation with QOL in all domains but maximally affecting the social relationships domain ( P ≤ 0.001 and PCOD in this study were found to have depression and anxiety. They were also seen to have a lower quality of life. Depression, anxiety, and hirsutism were found to have a negative correlation with QOL in all domains.

  11. The Hamilton Depression Scale (HAM-D) and the Montgomery–Åsberg Depression Scale (MADRS)

    DEFF Research Database (Denmark)

    Bech, Per; Allerup, Peter; Larsen, Erik Roj

    2014-01-01

    The objective of this re-analysis of the European Genome-Based Therapeutic Drugs for Depression Study (GENDEP) was to psychometrically test the unidimensionality of the full Montgomery Åsberg Depression Rating Scale (MADRS10) and the Hamilton Depression Scale (HAM-D17) versus their respective...... subscales (MADRS5 and HAM-D6) containing the core symptoms of depression severity. Rasch analysis was applied using RUMM 2030 software to assess the overall fit for unidimensionality. Neither the MADRS10 nor the HAM-D17 was found to fit the Rasch model for unidimensionality. The HAM-D6 (containing the items...... of depressed mood, guilt, work and interests, psychomotor retardation, psychic anxiety, and somatic general) as well as the analogue MADRS5 were tested for unidimensionality by use of the RUMM 2030 programme, and only the HAM-D6 was accepted. When testing for invariance across rating weeks or centres, the RUMM...

  12. Evaluation of the effect of Spiritual care on patients with generalized anxiety and depression: a randomized controlled study.

    Science.gov (United States)

    Sankhe, A; Dalal, K; Save, D; Sarve, P

    2017-12-01

    The present study was conducted to assess the effect of spiritual care in patients with depression, anxiety or both in a randomized controlled design. The participants were randomized either to receive spiritual care or not and Hamilton anxiety rating scale-A (HAM-A), Hamilton depression rating scale-D (HAM-D), WHO-quality of life-Brief (WHOQOL-BREF) and Functional assessment of chronic illness therapy - Spiritual well-being (FACIT-Sp) were assessed before therapy and two follow-ups at 3 and 6 week. However, with regard to the spiritual care therapy group, statistically significant differences were observed in both HAM-A and HAM-D scales between the baseline and visit 2 (p scales during the follow-up periods for the control group of participants. When the scores were compared between the study groups, HAM-A, HAM-D and FACIT-Sp 12 scores were significantly lower in the interventional group as compared to the control group at both third and sixth weeks. This suggests a significant improvement in symptoms of anxiety and depression in the spiritual care therapy group than the control group; however, large randomized controlled trials with robust design are needed to confirm the same.

  13. [Anxiety and polymorphism Val66Met of BDNF gene--predictors of depression severity in ischemic heart disease].

    Science.gov (United States)

    Golimbet, V E; Volel', B A; Kopylov, F Iu; Dolzhikov, A V; Korovaitseva, G I; Kasparov, S V; Isaeva, M I

    2015-01-01

    In a framework of search for early predictors of depression in patients with ischemic heart disease (IHD) we studied effect of molecular-genetic factors (polymorphism of brain-derived neirotrophic factor--BDNF), personality traits (anxiety, neuroticism), IHD severity, and psychosocial stressors on manifestations of depression in men with verified diagnosis of IHD. Severity of depression was assessed by Hamilton Depression Rating Scale 21-item (HAMD 21), anxiety and neuroticism were evaluated by the Spielberger State-Trait Anxiety Inventory and "Big Five" questionnaire, respectively. It wa shown that personal anxiety and ValVal genotype of BDNF gene appeared to be predictors of moderate and severe depression.

  14. Detecting anxiety in individuals with Parkinson disease: A systematic review.

    Science.gov (United States)

    Mele, Bria; Holroyd-Leduc, Jayna; Smith, Eric E; Pringsheim, Tamara; Ismail, Zahinoor; Goodarzi, Zahra

    2018-01-02

    To examine diagnostic accuracy of anxiety detection tools compared with a gold standard in outpatient settings among adults with Parkinson disease (PD). A systematic review was conducted. MEDLINE, EMABASE, PsycINFO, and Cochrane Database of Systematic Reviews were searched to April 7, 2017. Prevalence of anxiety and diagnostic accuracy measures including sensitivity, specificity, and likelihood ratios were gathered. Pooled prevalence of anxiety was calculated using Mantel-Haenszel-weighted DerSimonian and Laird models. A total of 6,300 citations were reviewed with 6 full-text articles included for synthesis. Tools included within this study were the Beck Anxiety Inventory, Geriatric Anxiety Inventory (GAI), Hamilton Anxiety Rating Scale, Hospital Anxiety and Depression Scale-Anxiety, Parkinson's Anxiety Scale (PAS), and Mini-Social Phobia Inventory. Anxiety diagnoses made included generalized anxiety disorder, social phobia, and any anxiety type. Pooled prevalence of anxiety was 30.1% (95% confidence interval 26.1%-34.0%). The GAI had the best-reported sensitivity of 0.86 and specificity of 0.88. The observer-rated PAS had a sensitivity of 0.71 and the highest specificity of 0.91. While there are 6 tools validated for anxiety screening in PD populations, most tools are only validated in single studies. The GAI is brief and easy to use, with a good balance of sensitivity and specificity. The PAS was specifically developed for PD, is brief, and has self-/observer-rated scales, but with lower sensitivity. Health care practitioners involved in PD care need to be aware of available validated tools and choose one that fits their practice. Copyright © 2017 American Academy of Neurology.

  15. Excellent reliability of the Hamilton Depression Rating Scale (HDRS-21) in Indonesia after training.

    Science.gov (United States)

    Istriana, Erita; Kurnia, Ade; Weijers, Annelies; Hidayat, Teddy; Pinxten, Lucas; de Jong, Cor; Schellekens, Arnt

    2013-09-01

    The Hamilton Depression Rating Scale (HDRS) is the most widely used depression rating scale worldwide. Reliability of HDRS has been reported mainly from Western countries. The current study tested the reliability of HDRS ratings among psychiatric residents in Indonesia, before and after HDRS training. The hypotheses were that: (i) prior to the training reliability of HDRS ratings is poor; and (ii) HDRS training can improve reliability of HDRS ratings to excellent levels. Furthermore, we explored cultural validity at item level. Videotaped HDRS interviews were rated by 30 psychiatric residents before and after 1 day of HDRS training. Based on a gold standard rating, percentage correct ratings and deviation from the standard were calculated. Correct ratings increased from 83% to 99% at item level and from 70% to 100% for the total rating. The average deviation from the gold standard rating improved from 0.07 to 0.02 at item level and from 2.97 to 0.46 for the total rating. HDRS assessment by psychiatric trainees in Indonesia without prior training is unreliable. A short, evidence-based HDRS training improves reliability to near perfect levels. The outlined training program could serve as a template for HDRS trainings. HDRS items that may be less valid for assessment of depression severity in Indonesia are discussed. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

  16. Transdiagnostic group CBT for anxiety disorders

    DEFF Research Database (Denmark)

    Reinholt, Nina; Aharoni, Ruth; Winding, Clas

    2017-01-01

    to Mental Health Services. Pre-post-treatment effects were examined for psychiatric outpatients with anxiety disorders receiving UP treatment in groups. Forty-seven patients (mean-age = 34.1 (SD = 9.92), 77% females) with a principal diagnosis of anxiety were included. We found significant and clinically...... meaningful changes in the primary outcomes Clinical Global Impression Severity Scale (CGI-S; d = 1.36), Hamilton Anxiety Scale (HARS; d = .71), and WHO-5 Well-being Index (WHO-5; d = .54). Also, comorbid depressive symptoms and levels of positive and negative affect changed significantly after treatment...

  17. Lifetime posttraumatic stress disorder in Turkish alcohol-dependent inpatients: relationship with depression, anxiety and erectile dysfunction.

    Science.gov (United States)

    Evren, Cuneyt; Can, Suat; Evren, Bilge; Saatcioglu, Omer; Cakmak, Duran

    2006-02-01

    The aim of the present study was to evaluate the prevalence of lifetime posttraumatic stress disorder (PTSD) in Turkish male alcohol-dependent inpatients, and to investigate the relationship of lifetime PTSD diagnosis with anxiety, depression, hopelessness, erectile dysfunction and psychosocial problems related with alcohol dependency. Eighty-two male inpatients who met DSM-IV criteria for alcohol dependence and 48 subjects without substance use disorder as a control group were included in the study. Subjects were applied the Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A), the Michigan Alcoholism Screening Test (MAST), the Beck Hopelessness Scale (BHS) and the International Index of Erectile Function (IIEF). Rate of lifetime PTSD diagnosis was found to be 26.8% among alcohol-dependent inpatients. The mean age of patients with lifetime PTSD was lower than in patients without this diagnosis, while there were no significant differences between these two groups in terms of age of first alcohol use, lifetime major depression, current depression, presence and severity of erectile dysfunction. Mean scores of HAM-D, HAM-A, BHS and MAST in the group with lifetime PTSD were significantly higher than the group without this diagnosis. There was a positive relationship between lifetime PTSD diagnosis and depression, anxiety, hopelessness and severity of psychosocial problems related to alcohol dependency, while there was no relationship between lifetime PTSD comorbidity and erectile dysfunction in alcohol-dependent patients.

  18. Quantum Hamilton mechanics: Hamilton equations of quantum motion, origin of quantum operators, and proof of quantization axiom

    International Nuclear Information System (INIS)

    Yang, C.-D.

    2006-01-01

    This paper gives a thorough investigation on formulating and solving quantum problems by extended analytical mechanics that extends canonical variables to complex domain. With this complex extension, we show that quantum mechanics becomes a part of analytical mechanics and hence can be treated integrally with classical mechanics. Complex canonical variables are governed by Hamilton equations of motion, which can be derived naturally from Schroedinger equation. Using complex canonical variables, a formal proof of the quantization axiom p → p = -ih∇, which is the kernel in constructing quantum-mechanical systems, becomes a one-line corollary of Hamilton mechanics. The derivation of quantum operators from Hamilton mechanics is coordinate independent and thus allows us to derive quantum operators directly under any coordinate system without transforming back to Cartesian coordinates. Besides deriving quantum operators, we also show that the various prominent quantum effects, such as quantization, tunneling, atomic shell structure, Aharonov-Bohm effect, and spin, all have the root in Hamilton mechanics and can be described entirely by Hamilton equations of motion

  19. [Bromazepam against anxiety in psychiatric patients (author's transl)].

    Science.gov (United States)

    Clément, J; Lafont, B; Ballereau, J

    1982-05-13

    In this study involving 30 hospital patients (23 inpatients and 7 out-patients) with neurosis or depressive syndrome, bromazepam 12 mg/24 hours in 2 or 3 divided doses proved effective in controlling anxiety symptoms. The results, as measured by the Hamilton scale, were satisfactory in two-thirds of the cases, notably in neurotic anxiety. Free-floating anxiety and somatic symptoms were relieved. Undesirable reactions consisted of daytime somnolence (5 cases), feeling of dizziness (1 case) and fatigue (1 case).

  20. Do early changes in the HAM-D-17 anxiety/somatization factor items affect the treatment outcome among depressed outpatients? Comparison of two controlled trials of St John's wort (Hypericum perforatum) versus a SSRI.

    Science.gov (United States)

    Bitran, Stella; Farabaugh, Amy H; Ameral, Victoria E; LaRocca, Rachel A; Clain, Alisabet J; Fava, Maurizio; Mischoulon, David

    2011-07-01

    To assess whether early changes in Hamilton Depression Rating Scale-17 anxiety/somatization items predict remission in two controlled studies of Hypericum perforatum (St John's wort) versus selective serotonin reuptake inhibitors for major depressive disorder. The Hypericum Depression Trial Study Group (National Institute of Mental Health) randomized 340 patients to Hypericum, sertraline, or placebo for 8 weeks, whereas the Massachusetts General Hospital study randomized 135 patients to Hypericum, fluoxetine, or placebo for 12 weeks. The investigators examined whether remission was associated with early changes in anxiety/somatization symptoms. In the National Institute of Mental Health study, significant associations were observed between remission and early improvement in the anxiety (psychic) item (sertraline arm), somatic (gastrointestinal item; Hypericum arm), and somatic (general) symptoms (placebo arm). None of the three treatment arms of the Massachusetts General Hospital study showed significant associations between anxiety/somatization symptoms and remission. When both study samples were pooled, we found associations for anxiety (psychic; selective serotonin reuptake inhibitors arm), somatic (gastrointestinal), and hypochondriasis (Hypericum arm), and anxiety (psychic) and somatic (general) symptoms (placebo arm). In the entire sample, remission was associated with the improvement in the anxiety (psychic), somatic (gastrointestinal), and somatic (general) items. The number and the type of anxiety/somatization items associated with remission varied depending on the intervention. Early scrutiny of the Hamilton Depression Rating Scale-17 anxiety/somatization items may help to predict remission of major depressive disorder.

  1. William Rowan Hamilton: Mathematical genius

    International Nuclear Information System (INIS)

    Wilkins, D.R.

    2006-01-01

    This year Ireland celebrates the bicentenary of the mathematician William Rowan Hamilton, best remembered for quaternions and for his pioneering work on optics and dynamics. Two centuries after his birth, the extent to which terms such as Hamiltonian and Hamiltonian system have entered the everyday language of mathematicians and physicists testifies to the continuing impact of the scientific work of William Rowan Hamilton. (U.K.)

  2. Rating scales in general practice depression

    DEFF Research Database (Denmark)

    Bech, Per; Paykel, Eugene; Sireling, Lester

    2015-01-01

    BACKGROUND: Our objective was to investigate to what extent the Clinical Interview for Depression (CID) used in the general practice setting covers clinically valid subscales (depression, anxiety, and apathy) which can measure outcome of antidepressant therapy as well as identifying subsyndromes...... within major depressive disorder. The CID was compared to the Hamilton Depression Rating Scale (HAM-D17). METHODS: 146 patients from a previous study in general practice with the CID were investigated. The item response theory model established by Rasch was used to investigate the scalability (a scale...... (approximately 20%) had an atypical depression. LIMITATIONS: The samples were derived from a single study and were all rated by a single rater. CONCLUSION: The CID contains subscales of depression, anxiety, and apathy with an acceptable scalability for use in general practice. A subsyndrome of atypical...

  3. William Rowan Hamilton: Mathematical genius

    Energy Technology Data Exchange (ETDEWEB)

    Wilkins, D.R. [School of Mathematics, Trinity College, Dublin (Ireland)]. E-mail: dwilkins@maths.tcd.ie

    2005-08-01

    This year Ireland celebrates the bicentenary of the mathematician William Rowan Hamilton, best remembered for 'quaternions' and for his pioneering work on optics and dynamics. Two centuries after his birth, the extent to which terms such as 'Hamiltonian' and 'Hamiltonian system' have entered the everyday language of mathematicians and physicists testifies to the continuing impact of the scientific work of William Rowan Hamilton. (U.K.)

  4. Anxiety levels in mothers of children with specific learning disability.

    Science.gov (United States)

    Karande, S; Kumbhare, N; Kulkarni, M; Shah, N

    2009-01-01

    Parents of children with specific learning disability (SpLD) undergo stress in coping with their child's condition. To measure the levels of anxiety and find out the cause of anxiety in mothers of children with SpLD at time of diagnosis. Prospective rating-scale and interview-based study conducted in our clinic. One hundred mothers of children (70 boys, 30 girls) with SpLD were interviewed using the Hamilton anxiety rating scale (HAM-A) and a semi-structured questionnaire. Detailed clinical and demographic data of mothers were noted. Chi-square test or unpaired student's t-test was applied wherever applicable. The mean age of mothers was 40.14 years (+/-SD 4.94, range 25.07-54.0), 73% belonged to upper or upper middle socioeconomic strata of society, 67% were graduates or postgraduates, 58% were full-time home-makers, and 33% lived in joint families. Levels of anxiety were absent in 24%, mild in 75%, and moderate in 1% of mothers. Their mean total anxiety score was 5.65 (+/-SD 4.75, range 0-21), mean psychic anxiety score was 3.92 (+/-SD 3.11, range 0-13), and mean somatic anxiety score was 1.76 (+/-SD 2.05, range 0-10). Their common worries were related to child's poor school performance (95%), child's future (90%), child's behavior (51%), and visits to our clinic (31%). Most mothers of children with SpLD have already developed mild anxiety levels by the time this hidden disability is diagnosed. These anxieties should be addressed by counseling to ensure optimum rehabilitation of these children.

  5. Comorbid Anxiety Disorders and Personality Disorders%焦虑障碍与人格障碍的共病

    Institute of Scientific and Technical Information of China (English)

    黄建军; 柏晓利; 杨蕴萍

    2012-01-01

    目的:探讨焦虑障碍患者共病人格障碍的情况.方法:对127例符合DSM-IV轴I焦虑障碍的患者进行了DSM-IV轴II人格障碍的诊断评估,并进行汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、疾病严重程度(CGI-SI)、社会功能缺陷(SDSS)等评定.结果:①焦虑障碍与人格障碍的共病率为73.2%;②共病者焦虑障碍的发病年龄更早(P<0.01),焦虑障碍病程更长(P<0.05),疾病更加严重(P<0.01),其焦虑、抑郁水平更高(P<0.05;P<0.05),社会功能更差(P<0.01).结论:焦虑障碍与人格障碍有较高的共病率,焦虑障碍与人格障碍共病患者的临床特征更加复杂.%Objective: To get the prevalence rate of personality disorders in patients with anxiety disorders and to get the clinical features of these comorbid patients, the authors conducted a survey among a cohort of patients with anxiety disorder. Methods: Personality disorders of 127 patients meeting DSM-Ⅳcriteria of anxiety disorders were assessed by structured clinical interview for DSM-Ⅳ Axis Ⅱ, the Hamilton Anxiety Scale, the Hamilton Depression Scale, the Clinical Global Impression-Severity of Ⅰllness, and the Social Disability Screening Schedule. Results: The prevalence rate of personality disorders in patients with anxiety disorders was 73.2%. Compared with patients with anxiety disorders only, the patients with comorbid anxiety disorders and personality disorders had earlier age of onset of anxiety disorders (P<0.01), longer duration of anxiety disorder (P<0.05), greater severity of illness (P<0.01), worse impaired social function (P<0.01) and higher level of anxiety and depression (P<0.05; P<0.05). Conclusion: The prevalence rate of personality disorders in anxiety disorders is high in our research, and the clinical features of the comorbidity are complex.

  6. Duloxetine in the treatment of generalized anxiety disorder

    Directory of Open Access Journals (Sweden)

    Alan Wright

    2009-08-01

    Full Text Available Alan Wright, Chad VanDenBergCenter for Clinical Research, Mercer University, Atlanta, GA, USAAbstract: Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI which is FDA approved for the treatment of generalized anxiety disorder (GAD in doses of 30 mg to 120 mg daily. Duloxetine has been shown to significantly improve symptoms of GAD as measured through the Hamilton Anxiety Rating Scale (HAMA, the Clinical Global Impressions Scale (CGI-I, and other various outcome measures in several placebo-controlled, randomized, double blind, multi-center studies. Symptom improvement began within the first few weeks, and continued for the duration of the studies. In addition, duloxetine has also been shown to improve outcomes in elderly patients with GAD, and in GAD patients with clinically significant pain symptoms. Duloxetine was noninferior compared with venlafaxine XR. Duloxetine was found to have a good tolerability profile which was predictable and similar to another SNRI, venlafaxine. Adverse events (AEs such as nausea, constipation, dry mouth, and insomnia were mild and transient, and occurred at relatively low rates. It was found to have a low frequency of drug interactions. In conclusion, duloxetine, a selective inhibitor for the serotonin and norepinephrine transporters, is efficacious in the treatment of GAD, and has a predictable tolerability profile, with AEs generally being mild to moderate.Keywords: duloxetine, generalized anxiety disorder, anxiety, GAD

  7. Association between Anxiety Disorders and Heart Rate Variability in The Netherlands Study of Depression and Anxiety (NESDA)

    NARCIS (Netherlands)

    Licht, Carmilla M. M.; de Geus, Eco J. C.; van Dyck, Richard; Penninx, Brenda W. J. H.

    Objective: To determine whether patients with different types of anxiety disorder (panic disorder, social phobia, generalized anxiety disorder) have higher heart rate and lower heart rate variability compared with healthy controls in a sample that was sufficiently powered to examine the confounding

  8. Hamilton-Jacobi theory of continuos systems

    International Nuclear Information System (INIS)

    Guler, Y.

    1987-01-01

    The Hamilton-Jacobi partial differential equation for classical field systems is obtained in a 5n-dimensional phase space and it is integrated by the method of characteristics. Space-time partial derivatives of Hamilton's principal functions S μ (Φ i , x v ) (μ, v = 1, 2, 3, 4) are identified as the energy-momentum tensor of the system

  9. Guided imagery, anxiety, heart rate, and heart rate variability during centrifuge training.

    Science.gov (United States)

    Jing, Xiaolu; Wu, Ping; Liu, Fang; Wu, Bin; Miao, Danmin

    2011-02-01

    Centrifuge training is an important method of improving the hypergravity tolerance of pilots, cosmonauts, and Chinese astronauts. However, the concomitants of tension or anxiety often impede training. Guided imagery (GI), a mind-body relaxation technique, provides a behavioral and cognitive means whereby individuals are able to exert control over the focus of attention. This study aims to investigate the immediate effects of GI for reducing stress in centrifuge training. There were 12 healthy young men who were randomly assigned to a GI group or music group. We measured changes in heart rate during centrifuge training, in heart rate variability before and after centrifuge training, and also evaluated relaxation and anxiety in three phases: before intervention, after intervention, and following centrifuge training. The change in the pattern of anxiety was different in the two groups over the three phases. Anxiety (measured by State Anxiety Inventory) in the GI group changed from 31.7 +/- 5.9 to 26.8 +/- 2.6 and 27.8 +/- 4.1, whereas for the music group this changed from 32.2 +/- 7.6 to 31.2 +/- 8.3 and 26.8 +/- 6.8. During centrifuge training, the maximal HR for the GI group (101.2 +/- 8.8) was lower than that of the music group (123.0 +/- 19.1). In addition GI showed a decrease in low frequency (LF, 0.04-0.15 Hz) components and an increase in high frequency (HF, 0.15-0.4 Hz) components before and after centrifuge training. GI was capable of decreasing tension, anxiety, and sympathetic nervous system activity pre- or post-centrifugation.

  10. Prevalence of anxiety and depressive symptoms in men with erectile dysfunction

    Directory of Open Access Journals (Sweden)

    K Pankhurst

    2005-09-01

    Full Text Available Objectives. To determine the prevalence of anxiety and depressive symptoms in men presenting to a sexual dysfunction clinic in Bloemfontein with erectile dysfunction (ED; to determine the relationship, if any, between age and mood/anxiety symptoms in such patients; and to make clinicians aware of the co-morbidity of anxiety/mood symptoms and ED. Methods. An observational analytical study was undertaken of 100 consecutive male patients of all ages presenting with ED (with a score less than 20 on the 5-item intensity scale for ED. Age, race, marital and employment status were noted as well as social habits including smoking and alcohol use. The presence of known medical conditions and surgical procedures was ascertained. All current prescription medication was recorded. Panic disorder, obsessive-compulsive disorder, generalised anxiety disorder and social phobia were rated using the Mini International Neuropsychiatric Interview, while the Hamilton Rating Scale for Depression was used to rate depressive symptoms. Results. Thirty-three per cent of respondents had depressive symptoms, and of this group 36% had a co-morbid anxiety disorder. In total, 21% of patients had an anxiety disorder. Anxiety disorders were more common with moderate to severe ED. No anxiety disorders occurred in patients with mild ED. The majority of participants suffering from severe ED were evenly spread in age from 30 to 69 years. Participants suffering from moderate to severe ED were more likely to have medical conditions, most notably hypertension. Conclusion. The results of this study suggest that men suffering from ED are likely to have a co-morbid psychiatric disorder (42%, with the prevalence of depressive symptoms (33% and anxiety disorders (21% being higher than in the general population. Significant concomitant medical conditions (most notably hypertension were more common in men with moderate to severe ED.

  11. Hamilton : the electric city

    Energy Technology Data Exchange (ETDEWEB)

    Gilbert, R [Richard Gilbert Consultant, Toronto, ON (Canada)

    2006-04-13

    The City of Hamilton has launched an extensive energy planning exercise that examines the possibility of steep increases in oil and natural gas prices. This report examined and illustrated the issue of oil and gas price points. The report also examined and presented the city's role in an era of energy constraints, focusing on the city's transit system and its vehicle fleet. In addition, in response to City Council's direction, the report presented the aerotropolis proposal and discussed freight transport issues. Specific topics of discussion included oil and natural gas prospects; prospects for high oil and natural gas prices; impacts of fuel price increases; strategic planning objectives for energy constraints; reducing energy use by Hamilton's transport and in buildings; and land-use planning for energy constraints. Energy production opportunities involve the use of solar energy; wind energy; deep lake water cooling (DLWC); hydro-electric power; energy from waste; biogas production; district energy; and local food production. Economic and social development through preparing for energy constraints and matters raised by city council were also presented. The report also demonstrated how an energy-based strategy could be paid for and its components approved. The next steps for Hamilton were also identified. refs., tabs., figs.

  12. Hamilton : the electric city

    International Nuclear Information System (INIS)

    Gilbert, R.

    2006-01-01

    The City of Hamilton has launched an extensive energy planning exercise that examines the possibility of steep increases in oil and natural gas prices. This report examined and illustrated the issue of oil and gas price points. The report also examined and presented the city's role in an era of energy constraints, focusing on the city's transit system and its vehicle fleet. In addition, in response to City Council's direction, the report presented the aerotropolis proposal and discussed freight transport issues. Specific topics of discussion included oil and natural gas prospects; prospects for high oil and natural gas prices; impacts of fuel price increases; strategic planning objectives for energy constraints; reducing energy use by Hamilton's transport and in buildings; and land-use planning for energy constraints. Energy production opportunities involve the use of solar energy; wind energy; deep lake water cooling (DLWC); hydro-electric power; energy from waste; biogas production; district energy; and local food production. Economic and social development through preparing for energy constraints and matters raised by city council were also presented. The report also demonstrated how an energy-based strategy could be paid for and its components approved. The next steps for Hamilton were also identified. refs., tabs., figs

  13. 5-HTTLPR, anxiety and gender interaction moderates right amygdala volume in healthy subjects.

    Science.gov (United States)

    Cerasa, Antonio; Quattrone, Aldo; Piras, Fabrizio; Mangone, Graziella; Magariello, Angela; Fagioli, Sabrina; Girardi, Paolo; Muglia, Maria; Caltagirone, Carlo; Spalletta, Gianfranco

    2014-10-01

    Genetic variants within the serotonin transporter gene (5-HTTLPR) impact the neurobiology and risk for anxiety-related behaviours. There are also gender differences in the prevalence of anxiety-related behaviours. Although numerous studies have investigated the influence of 5-HTTLPR genotype on the neural systems involved in emotional regulation, none have investigated how these effects are modulated by gender and anxiety. We investigated this issue using two complementary region of interest-based structural neuroimaging approaches (voxel-based morphometry and Freesurfer) in 138 healthy individuals categorized into 'no anxiety' and 'subclinical anxiety' groups based on the Hamilton Rating Scale for Anxiety (HAM-A). Preliminarily, using anxiety as a continuous variable, we found a significant interaction effect of genotype by gender on anxiety. Females homozygous for the Short allele showed the highest HAM-A scores and males the lowest. In addition, a three-way significant interaction among genotype, gender and anxiety category was found for the right amygdala volume. Post hoc tests revealed that homozygous females carrying the Short variant with a subclinical anxiety condition had larger volume. The reported interaction effects demonstrate that gender strongly modulates the relationship between 5-HTTLPR genotype and subclinical expression of anxiety acting on amygdala, one region of the emotional neural network specifically involved in the anxiety-like behaviours. © The Author (2013). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  14. Anxiety and Depression in Patients with Chronic Obstructive Pulmonary Disease

    Institute of Scientific and Technical Information of China (English)

    LU Dong-mei; MA Jun-peng; ZOU Shao-hong; LENG Qiu-ping; YANG Xiao-hong

    2017-01-01

    Background: Anxiety and depression may have deleterious effects on patients with chronic obstructive pulmonary disease (COPD). However, the evidence underlying the increased risks of anxiety and depression in COPD patients in Xinjiang are poorly defined. This study aimed to investigate the burden and related factors of depression and anxiety among patients with COPD in Xinjiang. Methods: The study included 62 patients with COPD, aged (64.48±9.83) years, 59 patients were hospitalized due to exacerbations, 3 patients were included due to periodically check-up in the hospital. Depression and anxiety in these patients were evaluated through the Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD). Stepwise multiple regression analysis was used to evaluate the clinical characteristics correlated to depression and anxiety. Results: The prevalences of depression and anxiety were higher (62.9% and 95.2%) in COPD patients in Xinjiang. Anxiety was more common in patients than depression. Respectively, the female population with COPD was differentiated from males by higher levels of depression score, female COPD patients were more strongly correlated with depression (correction for regression coefficient: β=0.87; P=0.04). Patients received university education level were more likely to suffer the pain of anxiety (correction for regression coefficient: β=0.61; P=0.002) than lower education level. In addition, patients with the average monthly income less than ¥1 000 was more likely to suffer both the pain of anxiety and depression (P<0.05). Conclusion: This study showed the high prevalence of anxiety and depression in COPD patients in Xinjiang, even in the condition of moderate COPD in terms of FEV1%. Both anxiety and depression were correlated with the lower monthly income. Female COPD patients were more exposed to depression in this group. Patients with higher educational level tended to be correlated with anxiety. Screening tools may help recognition of

  15. EFFECT OF SPIRITUAL NURSING CARE ON THE LEVEL OF ANXIETY IN PATIENTS WITH STROKE

    Directory of Open Access Journals (Sweden)

    Bernadeta Trihandini

    2018-02-01

    Full Text Available Background: Anxiety in stroke patients occurs as a normal reaction to stress with life changes; however, when it becomes excessive, It becomes disabling. Effort to deal with anxiety is needed and spiritual approach nursing care is considered useful in caring patients with stroke. Objective: To examine the effect of spiritual nursing care on anxiety in stroke patients in the inpatient ward. Methods: This study used a quasy experimental design with pretest-postest control group. Thirty respondents were selected using consecutive sampling, which 15 respondents assigned in the experiment and control group. The Hamilton Anxiety Rating Scale was used to measure anxiety. Data were analyzed using paired t-test and independent t-test. Results: The results showed that the mean level of anxiety in the experiment group before intervention was 29.33 and decreased to 9 after intervention, while in the control group the mean level of anxiety before intervention was 29.47 and decreased to 17.73 after intervention. Paired t-test obtained p-value 0.000 (<0.05, which indicated that there was a significant effect of spiritual nursing care on anxiety levels in patients with stroke. Conclusion: Spiritual nursing care could reduce anxiety in patients with stroke.

  16. An overview of which health domains to consider and when to apply them in measurement-based care for depression and anxiety disorders

    DEFF Research Database (Denmark)

    Bech, Per; Timmerby, Nina

    2018-01-01

    INTRODUCTION: Measurement-based care (MBC) transfers the scientific principle from controlled clinical trials to the daily routine treatment to improve the care of patients with anxiety and depression. AIM: Within the pharmacopsychometric triangle in which the domain of desired clinical effect......: The pharmacopsychometric triangle is also important in the MBC trials for improving the care of patients with anxiety and depression. However, the amount of MBC trials is still rather sparse....... focusing on the health domains of symptoms reduction (anxiety/depression), side effects of treatment, self-reported quality of life and social functioning. RESULTS: The amount of MBC trials was found rather sparse but information emerged demonstrating that the full clinician-rated Hamilton Depression Scale...

  17. Psychometric properties of responses by clinicians and older adults to a 6-item Hebrew version of the Hamilton Depression Rating Scale (HAM-D6)

    DEFF Research Database (Denmark)

    Bachner, Yaacov G; O'Rourke, Norm; Goldfracht, Margalit

    2013-01-01

    The Hamilton Depression Rating Scale (HAM-D) is commonly used as a screening instrument, as a continuous measure of change in depressive symptoms over time, and as a means to compare the relative efficacy of treatments. Among several abridged versions, the 6-item HAM-D6 is used most widely in lar...... degree because of its good psychometric properties. The current study compares both self-report and clinician-rated versions of the Hebrew version of this scale....

  18. A randomized trial of the effect of prayer on depression and anxiety.

    Science.gov (United States)

    Boelens, Peter A; Reeves, Roy R; Replogle, William H; Koenig, Harold G

    2009-01-01

    To investigate the effect of direct contact person-to-person prayer on depression, anxiety, positive emotions, and salivary cortisol levels. Cross-over clinical trial with depression or anxiety conducted in an office setting. Following randomization to the prayer intervention or control groups, subjects (95% women) completed Hamilton Rating Scales for Depression and Anxiety, Life Orientation Test, Daily Spiritual Experiences Scale, and underwent measurement of cortisol levels. Individuals in the direct person-to-person prayer contact intervention group received six weekly 1-hour prayer sessions while those in the control group received none. Rating scales and cortisol levels were repeated for both groups after completion of the prayer sessions, and a month later. ANOVAs were used to compare pre- and post-prayer measures for each group. At the completion of the trial, participants receiving the prayer intervention showed significant improvement of depression and anxiety, as well as increases of daily spiritual experiences and optimism compared to controls (p prayer group maintained these significant improvements (p prayer session. Participants in the control group did not show significant changes during the study. Cortisol levels did not differ significantly between intervention and control groups, or between pre- and post-prayer conditions. Direct contact person-to-person prayer may be useful as an adjunct to standard medical care for patients with depression and anxiety. Further research in this area is indicated.

  19. Anxiety levels in mothers of children with specific learning disability

    Directory of Open Access Journals (Sweden)

    Karande S

    2009-01-01

    Full Text Available Background : Parents of children with specific learning disability (SpLD undergo stress in coping with their child′s condition. Aim : To measure the levels of anxiety and find out the cause of anxiety in mothers of children with SpLD at time of diagnosis. Settings and Design : Prospective rating-scale and interview-based study conducted in our clinic. Materials and Methods : One hundred mothers of children (70 boys, 30 girls with SpLD were interviewed using the Hamilton anxiety rating scale (HAM-A and a semi-structured questionnaire. Detailed clinical and demographic data of mothers were noted. Statistical Analysis : Chi-square test or unpaired student′s t-test was applied wherever applicable. Results : The mean age of mothers was 40.14 years (±SD 4.94, range 25.07-54.0, 73% belonged to upper or upper middle socioeconomic strata of society, 67% were graduates or postgraduates, 58% were full-time home-makers, and 33% lived in joint families. Levels of anxiety were absent in 24%, mild in 75%, and moderate in 1% of mothers. Their mean total anxiety score was 5.65 (±SD 4.75, range 0-21, mean psychic anxiety score was 3.92 (±SD 3.11, range 0-13, and mean somatic anxiety score was 1.76 (±SD 2.05, range 0-10. Their common worries were related to child′s poor school performance (95%, child′s future (90%, child′s behavior (51%, and visits to our clinic (31%. Conclusion : Most mothers of children with SpLD have already developed mild anxiety levels by the time this hidden disability is diagnosed. These anxieties should be addressed by counseling to ensure optimum rehabilitation of these children.

  20. Comparing the Efficacy of 8 Weeks Treatment of Cipram® and its Generic Citalopram in Patients With Mixed Anxiety-Depressive Disorder.

    Science.gov (United States)

    Khoonsari, Hasan; Oghazian, Mohammad Bagher; Kargar, Mona; Moin, Mahdiyeh; Khalili, Hossein; Alimadadi, Abbas; Torkamandi, Hassan; Ghaeli, Padideh

    2015-06-01

    Patients with mixed anxiety-depressive disorder (MADD) suffer both anxiety and depression. Antidepressants, especially, selective serotonin reuptake inhibitors are among agents of choice for treating this condition. This study compared the efficacy of Cipram® with its generic, citalopram. Forty adult outpatients (between 18 to 55 years of age) with a diagnosis of MADD who met the trial criteria, entered this double-blind, randomized study. Subjects were assigned to receive either generic citalopram or Cipram® for 8 weeks. Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A) were utilized to assess depression and anxiety at baseline, weeks 4 and 8 of the study. Statistical analysis was performed using SPSS 14.0. Twenty patients received citalopram (mean dosages of 22 mg/day during the first 4 weeks and 33 mg/day during weeks 4 to 8) and 20 received Cipram® (mean dosages of 22 mg/day during the first 4 weeks and 29 mg/day during weeks 4 to 8). Both treatments were noted to be effective in improving the symptoms of MADD at weeks 4 and 8. The mean differences of HAM-D and HAM-A between Citalopram and Cipram® groups were significantly different at the end of week 4 (HAM-D: P = 0.038, HAM-A: P = 0.025), but not at the end of week 8 (HAM-D: P = 0.239, HAM-A: P = 0.204). Both medications were tolerated well by the patients. This study suggests that the efficacy of citalopram is similar to that of Cipram® in the treatment of MADD after 8 weeks. Meanwhile, Cipram® may reduce depression and anxiety quicker than its generic, citalopram.

  1. Evaluation of anxiety, depression and suicidal intent in undergraduate dental students: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Manish Bathla

    2015-01-01

    Full Text Available Background: There is an increasing amount of stress in undergraduate dental students leading to anxiety, depression, and suicidal attempts/suicide. Aims: This study aims to evaluate anxiety, depression and suicidal intent in undergraduate dental students and to find out the various areas of stress. Materials and Methods: A cross-sectional study was conducted using a semi-structured questionnaire (to assess academic and nonacademic areas of stress and three scales-Hamilton scale for anxiety (HAM-A; Hamilton depression rating scale (HDRS and Beck′s Suicide Intent Scale (BSI. Descriptive statistics; Pearson′s Chi-square test; Multiple ANOVA; Kruskal-Wallis test and Mann-Whitney test were used to analyze the data at the significant level of P ≤ 0.05. Results: In a total of 258 dental undergraduate students, academic areas of stress that were found to be statistically significant were long teaching hours (P = 0.002; high workload (P ≤ 0.001; frequency of tests (P ≤ 0.001 and competition/fear of failure (P = 0.009. Lack of interest in the profession was a statistically significant nonacademic area for stress (P ≤ 0.001. The students of first and final year reported higher anxiety (HAM-A 13.93 ± 6.908 and 16.44 ± 7.637 respectively and depression (HDRS 14.29 ± 6.302 and 14.22 ± 5.422; whereas suicidal intent was reported almost the same throughout the study sample (BSI 5.65 ± 5.465. Conclusion: An increasing level of anxiety, depression and suicidal intent due to various stressors in undergraduate dental students indicate a need to modify current education system and timely help to have psychological healthy dental professionals in future.

  2. Treatment of Internet Addiction with Anxiety Disorders: Treatment Protocol and Preliminary Before-After Results Involving Pharmacotherapy and Modified Cognitive Behavioral Therapy.

    Science.gov (United States)

    Santos, Veruska Andrea; Freire, Rafael; Zugliani, Morená; Cirillo, Patricia; Santos, Hugo Henrique; Nardi, Antonio Egidio; King, Anna Lucia

    2016-03-22

    The growth of the Internet has led to significant change and has become an integral part of modern life. It has made life easier and provided innumerous benefits; however, excessive use has brought about the potential for addiction, leading to severe impairments in social, academic, financial, psychological, and work domains. Individuals addicted to the Internet usually have comorbid psychiatric disorders. Panic disorder (PD) and generalized anxiety disorder (GAD) are prevalent mental disorders, involving a great deal of damage in the patient's life. This open trial study describes a treatment protocol among 39 patients with anxiety disorders and Internet addiction (IA) involving pharmacotherapy and modified cognitive behavioral therapy (CBT). Of the 39 patients, 25 were diagnosed with PD and 14 with GAD, in addition to Internet addiction. At screening, patients responded to the MINI 5.0, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Clinical Global Impressions Scale, and the Young Internet Addiction Scale. At that time, IA was observed taking into consideration the IAT scale (cutoff score above 50), while anxiety disorders were diagnosed by a psychiatrist. Patients were forwarded for pharmacotherapy and a modified CBT protocol. Psychotherapy was conducted individually, once a week, over a period of 10 weeks, and results suggest that the treatment was effective for anxiety and Internet addiction. Before treatment, anxiety levels suggested severe anxiety, with an average score of 34.26 (SD 6.13); however, after treatment the mean score was 15.03 (SD 3.88) (Paddiction scores was observed, from 67.67 (SD 7.69) before treatment, showing problematic internet use, to 37.56 (SD 9.32) after treatment (Panxiety, the correlation between scores was .724. This study is the first research into IA treatment of a Brazilian population. The improvement was remarkable due to the complete engagement of patients in therapy, which contributed to the success of the

  3. Efficacy of bupropion and the selective serotonin reuptake inhibitors in the treatment of major depressive disorder with high levels of anxiety (anxious depression): a pooled analysis of 10 studies.

    Science.gov (United States)

    Papakostas, George I; Stahl, Stephen M; Krishen, Alok; Seifert, Cheryl A; Tucker, Vivian L; Goodale, Elizabeth P; Fava, Maurizio

    2008-08-01

    The goal of this work was to compare the efficacy of the norepinephrine and dopamine reuptake inhibitor bupropion with the selective serotonin reuptake inhibitors (SSRIs) in the treatment of major depressive disorder with high levels of anxiety (anxious depression). Ten double-blind, randomized studies from 1991 through 2006 were combined (N = 2122). Anxious depression was defined as a 17-item Hamilton Rating Scale for Depression (HAM-D-17) anxiety-somatization factor score >or= 7. Among patients with anxious depression (N = 1275), response rates were greater following SSRI than bupropion treatment according to the HAM-D-17 (65.4% vs. 59.4%, p = .03) and the Hamilton Rating Scale for Anxiety (61.5% vs. 54.5%, p = .03). There was also a greater reduction in HAM-D-17 mean +/- SD scores (-14.1 +/- 7.6 vs. -13.2 +/- 7.9, p = .03) and a trend toward statistical significance for a greater reduction in HAM-A mean +/- SD scores (-10.5 +/- 7.4 vs. -9.6 +/- 7.6, p = .05) in favor of SSRI treatment among patients with anxious depression. There was no statistically significant difference in efficacy between bupropion and the SSRIs among patients with moderate/low levels of anxiety. There appears to be a modest advantage for the SSRIs compared to bupropion in the treatment of anxious depression (6% difference in response rates). Using the number-needed-to-treat (NNT) statistic as 1 indicator of clinical significance, nearly 17 patients would need to be treated with an SSRI than with bupropion in order to obtain 1 additional responder. This difference falls well above the limit of NNT = 10, which was suggested by the United Kingdom's National Institute of Clinical Excellence. Nevertheless, the present work is of theoretical interest because it provides preliminary evidence suggesting a central role for serotonin in the regulation of symptoms of negative affect such as anxiety.

  4. Heart-rate variability and precompetitive anxiety in swimmers

    OpenAIRE

    Cervantes Blásquez, Julio César

    2009-01-01

    The aim of this study was to test the utility of heart-rate variability (HRV) analyses as a noninvasive means of quantifying cardiac autonomic regulation during precompetitive anxiety situations in swimmers. Psychophysiological state evaluation of 10 volunteer «master» swimmers (6 women and 4 men) was obtained by comparing baseline training condition (TC) with competition condition (CC). Self-evaluation of precompetitive somatic anxiety measured by CSAI-2 showed significant increase from the ...

  5. Hamilton-Jacobi-Bellman equations for quantum control | Ogundiran ...

    African Journals Online (AJOL)

    The aim of this work is to study Hamilton-Jacobi-Bellman equation for quantum control driven by quantum noises. These noises are annhihilation, creation and gauge processes. We shall consider the solutions of Hamilton-Jacobi-Bellman equation via the Hamiltonian system measurable in time. JONAMP Vol. 11 2007: pp.

  6. Sir William Rowan Hamilton

    Indian Academy of Sciences (India)

    IAS Admin

    In this picture, wave fronts are defined as surfaces of constant S(x), while .... Recall here that physical quantities are represented in ... his memory imperishable? Hamilton ... self in the words Ptolemy used of Hipparchus: a lover of labour and a ...

  7. Anxiety symptoms in crack cocaine and inhalant users admitted to a psychiatric hospital in southern Brazil.

    Science.gov (United States)

    Zubaran, Carlos; Foresti, Katia; Thorell, Mariana Rossi; Franceschini, Paulo Roberto

    2013-01-01

    The occurrence of psychiatric comorbidity among individuals with crack or inhalant dependence is frequently observed. The objective of this study was to investigate anxiety symptoms among crack cocaine and inhalant users in southern Brazil. The study investigated two groups of volunteers of equal size (n=50): one group consisted of crack cocaine users, and the other group consisted of inhalant users. Research volunteers completed the Portuguese versions of the State-Trait Anxiety Inventory (STAI), Hamilton Anxiety Rating Scale (HAM-A), and Self-Report Questionnaire (SRQ). Both crack and inhalant users experience significant symptoms of anxiety. Inhalant users presented significantly more anxiety symptoms than crack users according to the HAM-A questionnaire only. In contrast to the results of the HAM-A, the STAI failed to demonstrate a significant difference between the two groups of substance users. SRQ scores revealed that crack and inhalants users had significant degrees of morbidity. A significant difference regarding anxiety symptomatology, especially state anxiety, was observed among inhalant and crack users. Anxiety and overall mental psychopathology were significantly correlated in this sample. The results indicate that screening initiatives to detect anxiety and additional psychiatric comorbidities among crack and inhalant users are feasible and relevant. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

  8. Time-advance algorithms based on Hamilton's principle

    International Nuclear Information System (INIS)

    Lewis, H.R.; Kostelec, P.J.

    1993-01-01

    Time-advance algorithms based on Hamilton's variational principle are being developed for application to problems in plasma physics and other areas. Hamilton's principle was applied previously to derive a system of ordinary differential equations in time whose solution provides an approximation to the evolution of a plasma described by the Vlasov-Maxwell equations. However, the variational principle was not used to obtain an algorithm for solving the ordinary differential equations numerically. The present research addresses the numerical solution of systems of ordinary differential equations via Hamilton's principle. The basic idea is first to choose a class of functions for approximating the solution of the ordinary differential equations over a specific time interval. Then the parameters in the approximating function are determined by applying Hamilton's principle exactly within the class of approximating functions. For example, if an approximate solution is desired between time t and time t + Δ t, the class of approximating functions could be polynomials in time up to some degree. The issue of how to choose time-advance algorithms is very important for achieving efficient, physically meaningful computer simulations. The objective is to reliably simulate those characteristics of an evolving system that are scientifically most relevant. Preliminary numerical results are presented, including comparisons with other computational methods

  9. Counselors' attachment anxiety and avoidance and the congruence in clients' and therapists' working alliance ratings.

    Science.gov (United States)

    Kivlighan, Dennis M; Marmarosh, Cheri L

    2018-07-01

    To determine how counselors' attachment anxiety and avoidance related to congruence between counselors' and clients' Working alliance (WA) ratings. Congruence strength was defined as the regression coefficient for clients' WA ratings predicting counselors' WA ratings. Directional bias was defined as the difference in level between counselors' and clients' WA ratings. Twenty-seven graduate student counselors completed an attachment measure and they and their 64 clients completed a measure of WA early in therapy. The truth-and-bias analysis was adapted to analyze the data. As hypothesized counselors' WA ratings were significantly and positively related to clients' WA ratings. Also as hypothesized, counselors' WA ratings were significantly lower than their clients' WA ratings (directional bias). Increasing counselor attachment anxiety was related to increasing negative directional bias; as counselors' attachment anxiety increased the difference between counselors and clients WA ratings became more negative. There was a significant interaction between counselor attachment anxiety and congruence strength in predicting counselor WA ratings. There was a stronger relationship between client WA ratings and counselor WA ratings for counselors low versus high in attachment anxiety. Counselors' attachment anxiety is realted to their ability to accurately percieve their clients' WA.

  10. Hamilton's indicators of the force of selection

    DEFF Research Database (Denmark)

    Baudisch, Annette

    2005-01-01

    To quantify the force of selection, Hamilton [Hamilton, W. D. (1966) J. Theor. Biol. 12, 12-45] derived expressions for the change in fitness with respect to age-specific mutations. Hamilton's indicators are decreasing functions of age. He concluded that senescence is inevitable: survival...... and fertility decline with age. I show that alternative parameterizations of mutational effects lead to indicators that can increase with age. I then consider the case of deleterious mutations with age-specific effects. In this case, it is the balance between mutation and selection pressure that determines...... the equilibrium number of mutations in a population. In this balance, the effects of different parameterizations cancel out, but only to a linear approximation. I show that mutation accumulation has little impact at ages when this linear approximation holds. When mutation accumulation matters, nonlinear effects...

  11. Psychometric validation of the Hopkins Symptom Checklist (SCL-90) subscales for depression, anxiety, and interpersonal sensitivity

    DEFF Research Database (Denmark)

    Bech, P; Bille, J; Møller, S B

    2014-01-01

    BACKGROUND: The psychometric validity of many subscales of the 90-item Hopkins Symptom Checklist (SCL-90) remains largely unknown. Therefore, the aim of the present study was to evaluate the psychometric properties of the "Hamilton-subscales" for depression (SCL-D16), anxiety (SCL-A14), their 6......-item core-measures (SCL-D6 and SCL-A6), the anxiety symptom scale (SCL-ASS8) and the interpersonal sensitivity scale (IPS5). METHODS: The psychometric properties of the SCL-D16, SCL-A14, SCL-D6, SCL-A6, SCL-ASS8, and the IPS5 were evaluated based on SCL-90 ratings from 850 day patients from a Danish...... SCL-90 subscales were identified. Using these scales it is possible to perform a psychometrically valid evaluation of psychiatric patients regarding the severity of depression (HAM-D6), specific anxiety (SCL-ASS8) and interpersonal sensitivity (IPS5)....

  12. Coping, subjective burden and anxiety among family caregivers of older dependents.

    Science.gov (United States)

    del-Pino-Casado, Rafael; Pérez-Cruz, Margarita; Frías-Osuna, Antonio

    2014-12-01

    To investigate relationships between anxiety and stressors,coping and subjective burden and to contribute to defining factors related to anxiety among family caregivers of older dependents. Despite the studies analysing factors related to anxiety in caregivers, there is not enough evidence about this issue. Cross-sectional design. Data from 140 family caregivers (convenience sample) were analysed using descriptive statistics, correlation coefficients and path analysis. Socio-demographic data and several scales (Barthel Index, Short Portable Mental Status Questionnaire, Cummings Neuropsychiatric Inventory, Brief COPE, Caregiver Strain Index and Hamilton Anxiety Rating Scale) were used to collect data. Stressors (psychiatric and psychological symptoms and number of assisted activities of daily living), emotion-focused coping, dysfunctional coping and subjective burden were related to greater anxiety. Subjective burden mediated the effects of psychiatric and psychological symptoms on anxiety and partially mediated the effects of dysfunctional coping on anxiety. Stressors, dysfunctional coping and subjective burden were identified as factors related to anxiety. The mediating role of subjective burden in the relationship between dysfunctional coping and anxiety was supported. The effect of dysfunctional coping on anxiety was independent of the stressors. These conclusions justify several recommendations regarding nursing interventions for family caregivers of older dependents: (1) stressors,dysfunctional coping and subjective burden can be used in clinical practice for early detection of and early intervention for anxiety; (2) to prevent subjective burden and anxiety,approach-coping skills should be promoted through interventions such as problem-solving,positive reappraisal, assertiveness and control of negative thoughts; (3) these interventions for dysfunctional coping should be systematically developed for individuals with dysfunctional coping regardless of the level

  13. Burden of care in the caregivers of patients with anxiety disorders

    Directory of Open Access Journals (Sweden)

    Manu Agarwal

    2017-01-01

    Full Text Available Introduction: Anxiety disorders are one of the frequently encountered psychiatric disorders in psychiatric clinics which have significant impact on the psychosocial well-being of the patient as well as their caregivers. Study Design and Aims: This study is a non- invasive, cross sectional study of 91 patients with anxiety disorder (except obsessive compulsive disorder aimed to assess the burden of care on their key-relatives and to study various socio demographic and clinical variables of the patient in relation to burden of care on key-relatives. Methodology: Patients diagnosed with anxiety disorders other than obsessive compulsive disorder and their key relatives satisfying the selection criteria were enrolled in the study. Assessment was done on semi-structured proforma, ICD 10 DCR, SCAN (Schedules for Clinical Assessment in Neuropsychiatry, International Personality Disorder Examination (IPDE, Burden assessment schedule, Hamilton Anxiety Rating Scale (HAM-A. Result: Total adjusted burden score in our study was 40.41 which is suggestive of mild burden. It was found that the burden of care was higher in male gender, married individuals, in joint families, among spouses, urban background, in the age group 41 to 50 years, low income group particularly on farmers and laborers. Generalized anxiety disorder was associated with more burden of care in comparison to other anxiety disorders. Conclusion: Key relatives of patients with anxiety disorder have significant burden of care in different domains along the socio-demographic strata.

  14. Adult separation anxiety in treatment nonresponders with anxiety disorders: delineation of the syndrome and exploration of attachment-based psychotherapy and biomarkers.

    Science.gov (United States)

    Milrod, Barbara; Altemus, Margaret; Gross, Charles; Busch, Fredric; Silver, Gabrielle; Christos, Paul; Stieber, Joshua; Schneier, Franklin

    2016-04-01

    Clinically significant separation anxiety [SA] has been identified as being common among patients who do not respond to psychiatric interventions, regardless of intervention type (pharmacological or psychotherapeutic), across anxiety and mood disorders. An attachment formation and maintenance domain has been proposed as contributing to anxiety disorders. We therefore directly determined prevalence of SA in a population of adult treatment non-responders suffering from primary anxiety. In these separation anxious nonresponders, we pilot-tested an SA-focused, attachment-based psychotherapy for anxiety, Panic-Focused Psychodynamic Psychotherapy-eXtended Range [PFPP-XR], and assessed whether hypothesized biomarkers of attachment were engaged. We studied separation anxiety [SA] in 46 adults (ages 23-70 [mean 43.9 (14.9)]) with clinically significant anxiety symptoms (Hamilton Anxiety Rating Scale [HARS]≥15), and reporting a history of past non-response to psychotherapy and/or medication treatments. Thirty-seven (80%) had clinically significant symptoms of separation anxiety (Structured Clinical Interview for Separation Anxiety Symptoms [SCI-SAS] score≥8). Five of these subjects completed an open clinical trial of Panic Focused Psychodynamic Psychotherapy eXtended Range [PFPP-XR], a 21-24 session, 12-week manualized attachment-focused anxiolytic psychodynamic psychotherapy for anxiety. Patients improved on "adult threshold" SCI-SAS (current separation anxiety) (p=.016), HARS (p=0.002), and global severity, assessed by the Clinical Global Impression Scale (p=.0006), at treatment termination. Salivary oxytocin levels decreased 67% after treatment (p=.12). There was no significant change in high or low frequency HRV after treatment, but change in high frequency HRV inversely correlated with treatment change in oxytocin (ppsychotherapy, potentially supporting the clinical relevance of attachment dysfunction in this sample. The large decrease in oxytocin levels with

  15. The community takes charge : story and success of Clean Air Hamilton

    International Nuclear Information System (INIS)

    McCarry, B.

    2004-01-01

    Clean Air Hamilton was established in 2001 to identify priority air quality issues, pollution sources, and evaluate impacts and solutions for air quality issues. Clean Air Hamilton also assesses the human health effects of ambient air exposures in Hamilton. A 1997 survey of Hamilton residents showed that most citizens were extremely concerned about health effects, black fallout, smog visibility, and odours. Clean Air Hamilton has established an air monitoring network which includes 19 member companies and 22 industrial sites. The objective is to determine recent contaminant trends in upwind/downwind air quality. The timeline for establishing the Hamilton air monitoring network was presented. The network, which serves as a model for Ontario and Canada, monitors the impact of vehicular and industrial emissions and establishes ten-year air quality trends for benzo(a)pyrene, sulphur, nitrogen dioxide, and ozone at industrial sites and the downtown core. Analysis of air quality trends shows that there has been improvement in levels of some locally-generated contaminants. The data has also been used for epidemiological studies to determine the health effects of industry on Hamiltonians. figs

  16. Empty space-times with separable Hamilton-Jacobi equation

    International Nuclear Information System (INIS)

    Collinson, C.D.; Fugere, J.

    1977-01-01

    All empty space-times admitting a one-parameter group of motions and in which the Hamilton-Jacobi equation is (partially) separable are obtained. Several different cases of such empty space-times exist and the Riemann tensor is found to be either type D or N. The results presented here complete the search for empty space-times with separable Hamilton-Jacobi equation. (author)

  17. Ecological structuring of yeasts associated with trees around Hamilton, Ontario, Canada.

    Science.gov (United States)

    Maganti, Harinad; Bartfai, David; Xu, Jianping

    2012-02-01

    This study seeks to determine the distribution and diversity of yeasts in and around the Hamilton area in Canada. In light of the increasing number of fungal infections along with rising morbidity and mortality rates, especially among the immunocompromised, understanding the diversity and distribution of yeasts in natural environments close to human habitations has become an increasingly relevant topic. In this study, we analyzed 1110 samples obtained from the hollows of trees, shrubs and avian droppings at 8 geographical sites in and around Hamilton, Ontario, Canada. A total of 88 positive yeast strains were isolated and identified belonging to 20 yeast species. Despite the relative proximity of the sampling sites, our DNA fingerprinting results showed that the yeast populations were highly heterogenous. Among the 14 tree species sampled, cedar, cottonwood and basswood hollows had relatively high yeast colonization rates. Interestingly, Candida parapsilosis was isolated almost exclusively from Pine trees only. Our results are consistent with microgeographic and ecological differentiation of yeast species in and around an urban environment. © 2011 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

  18. 78 FR 9001 - Airworthiness Directives; Hamilton Sundstrand Corporation Propellers

    Science.gov (United States)

    2013-02-07

    ... airplane. The Hamilton Sundstrand investigation revealed some of their auxiliary feathering pump motors had internal corrosion that may cause the stator magnets in the pump motor to fail and rotate into the path of... using certain Hamilton Sundstrand Corporation auxiliary pumps and motors (auxiliary feathering pumps...

  19. EFFECT OF PSYCHOEDUCATION ON ANXIETY IN PATIENTS WITH CORONARY HEART DISEASE

    Directory of Open Access Journals (Sweden)

    Yuli Sulistiyo

    2017-12-01

    Full Text Available Background: Cardiovascular heart disease still remains high in Indonesia. Various interventions have been implemented as an effort to deal with cardiovascular disease. However, little is known about intervention to reduce anxiety in patients with cardiovascular disease although anxiety is related to angina attack in this patient. Psychoeducation is considered effective in decreasing anxiety. Objective: To examine the effect of psychoeducation in decreasing anxiety in patients with coronary heart disease (CHD at the General Hospital of Semarang. Methods: This was a quasy experimental design with pretest posttest control group design. The study was conducted in the inpatient wards of the General Hospital of Semarang on January 17 until March 8, 2017. Fifty-six respondents were recruited using consecutive sampling, with 28 assigned in the experiment and control group. Hamilton Anxiety Rating Scale (HARS was used to measure anxiety levels. Paired t-test and Independent t-test were used for data analysis. Results: Paired test showed that there was a statistically significant effect of psychoeducation on anxiety level in the experiment group with p-value 0.001 (<0.05, and significant effect of given a brochure of CHD on the anxiety level in the control group with p-value 0.001 (<0.05. Independent t-test showed a statistically significant difference of anxiety level after intervention in the experiment and control group with p-value 0.001 (<0.05. The mean anxiety level in the experiment group (22.46 was lower than the mean anxiety level in the control group (41.54. Conclusion: Psychoeducation is effective in reducing anxiety levels in patients with CHD. It is suggested that psychoeducation can be used as one of nursing intervention in an effort to reduce anxiety in patients with CHD.

  20. Balneotherapy versus paroxetine in the treatment of generalized anxiety disorder.

    Science.gov (United States)

    Dubois, Olivier; Salamon, Roger; Germain, Christine; Poirier, Marie-France; Vaugeois, Christiane; Banwarth, Bernard; Mouaffak, Fayçal; Galinowski, André; Olié, Jean Pierre

    2010-02-01

    Preliminary studies have suggested that balneotherapy (BT) is an effective and well-tolerated treatment for generalized anxiety disorder (GAD) and psychotropic medication withdrawal syndrome. We carried out a study in 4 spa resorts to assess the efficacy of BT in GAD. We compared BT to paroxetine in terms of efficacy and safety in a randomized multicentre study lasting 8 weeks. Patients meeting the diagnostic criteria of GAD (DSM-IV) were recruited. Assessments were conducted using the Hamilton Rating Scale for Anxiety (HAM-A) and other scales, by a specifically trained and independent physician. The primary outcome measure was the change in the total HAM-A score between baseline and week 8. A total of 237 outpatients were enrolled in four centres; 117 were assigned randomly to BT and 120 to paroxetine. The mean change in HAM-A scores showed an improvement in both groups with a significant advantage of BT compared to paroxetine (-12.0 vs -8.7; p<0.001). Remission and sustained response rates were also significantly higher in the BT group (respectively 19% vs 7% and 51% vs 28%). BT is an interesting way of treating GAD. Due to its safety profile it could also be tested in resistant forms of generalized anxiety and in patients who do not tolerate or are reluctant to use pharmacotherapies. Copyright 2009 Elsevier Ltd. All rights reserved.

  1. Solution Hamilton-Jacobi equation for oscillator Caldirola-Kanai

    Directory of Open Access Journals (Sweden)

    LEONARDO PASTRANA ARTEAGA

    2016-12-01

    Full Text Available The method allows Hamilton-Jacobi explicitly determine the generating function from which is possible to derive a transformation that makes soluble Hamilton's equations. Using the separation of variables the partial differential equation of the first order called Hamilton-Jacobi equation is solved; as a particular case consider the oscillator Caldirola-Kanai (CK, which is characterized in that the mass presents a temporal evolution exponentially  . We demonstrate that the oscillator CK position presents an exponential decay in time similar to that obtained in the damped sub-critical oscillator, which reflects the dissipation of total mechanical energy. We found that in the limit that the damping factor  is small, the behavior is the same as an oscillator with simple harmonic motion, where the effects of energy dissipation is negligible.

  2. Hamilton-Jacobi Approach to Pre-Big Bang Cosmology at Long-wavelengths

    CERN Document Server

    Saygili, K

    1999-01-01

    We apply the long-wavelength approximation to the low energy effective string action in the context of Hamilton-Jacobi theory. The Hamilton-Jacobi equation for the effective string action is explicitly invariant under scale factor duality. We present the leading order, general solution of the Hamilton-Jacobi equation. The Hamilton-Jacobi approach yields a solution consistent with the with the Lagrange formalism. The momentum constraints take an elegant, simple form. Furthermore this general solution reduces to the quasi-isotropic one, if the evolution of the gravitational field is neglected. Duality transformation for the general solution is written as a coordinate transformation in an abstract field space.

  3. MUSIC AND AROMATHERAPY: A GOOD COMBINATION FOR REDUCING ANXIETY AND STABILIZING NON-INVASIVE HEMODYNAMIC STATUS IN PATIENTS IN THE INTENSIVE CARE UNIT

    Directory of Open Access Journals (Sweden)

    Ferry Kumala

    2018-05-01

    Full Text Available Background: Combining musical and aromatherapy therapy is expected to have a stronger effect in the reduction of anxiety and non-invasive hemodynamic stability. Objective: To examine the effect of the combination of music and aromatherapy on anxiety and non-invasive hemodynamic in patients in the intensive care unit. Methods: This was a quasy experimental study with non-equivalent group. An experimental group was given a combined musical and aromatherapy, while a control group was given music therapy. Thirty samples selected using accidental sampling, with 15 samples randomly assigned in the music group and combination group. HARS scale (Hamilton Anxiety Rating Scale was used to measure anxiety. Non-invasive hemodynamic status of patients such as blood pressure and heart rate were documented in the observation sheet. Paired t-test and one-way ANOVA were used for data analysis. Results: There were significant effects of combination therapy on anxiety (p=0.001, diastole (p=0.004 and heart rate (p=0.031, but no significant effect on systole (p=0.387. While music therapy alone had a significant effect on anxiety (p=0.001, systole (p=0.047, and diastole (p=0.037. Conclusion: The combination therapy (music-aromatherapy had a greater effect than the music therapy alone in decreasing anxiety, and stabilizing diastolic blood pressure and heart rate. This therapy can be used as an alternative in nursing interventions, and can be used as inputs to develop standard of operational procedure for anxiety and non-invasive hemodynamic stability.

  4. Anxiety in major depression and cerebrospinal fluid free gamma-aminobutyric acid.

    Science.gov (United States)

    Mann, J John; Oquendo, Maria A; Watson, Kalycia Trishana; Boldrini, Maura; Malone, Kevin M; Ellis, Steven P; Sullivan, Gregory; Cooper, Thomas B; Xie, Shan; Currier, Dianne

    2014-10-01

    Low gamma-aminobutyric acid (GABA) is implicated in both anxiety and depression pathophysiology. They are often comorbid, but most clinical studies have not examined these relationships separately. We investigated the relationship of cerebrospinal fluid (CSF) free GABA to the anxiety and depression components of a major depressive episode (MDE) and to monoamine systems. Patients with a DSM-IV major depressive episode (N = 167: 130 major depressive disorder; 37 bipolar disorder) and healthy volunteers (N = 38) had CSF free GABA measured by gas chromatography mass spectroscopy. Monoamine metabolites were assayed by high performance liquid chromatography. Symptomatology was assessed by Hamilton depression rating scale. Psychic anxiety severity increased with age and correlated with lower CSF free GABA, controlling for age. CSF free GABA declined with age but was not related to depression severity. Other monoamine metabolites correlated positively with CSF GABA but not with psychic anxiety or depression severity. CSF free GABA was lower in MDD compared with bipolar disorder and healthy volunteers. GABA levels did not differ based on a suicide attempt history in mood disorders. Recent exposure to benzodiazepines, but not alcohol or past alcoholism, was associated with a statistical trend for more severe anxiety and lower CSF GABA. Lower CSF GABA may explain increasing severity of psychic anxiety in major depression with increasing age. This relationship is not seen with monoamine metabolites, suggesting treatments targeting the GABAergic system should be evaluated in treatment-resistant anxious major depression and in older patients. © 2014 Wiley Periodicals, Inc.

  5. A Hamilton-like vector for the special-relativistic Coulomb problem

    International Nuclear Information System (INIS)

    Munoz, Gerardo; Pavic, Ivana

    2006-01-01

    A relativistic point charge moving in a Coulomb potential does not admit a conserved Hamilton vector. Despite this fact, a Hamilton-like vector may be developed that proves useful in the derivation and analysis of the particle's orbit

  6. Proof of the 1-factorization and Hamilton decomposition conjectures

    CERN Document Server

    Csaba, Béla; Lo, Allan; Osthus, Deryk; Treglown, Andrew

    2016-01-01

    In this paper the authors prove the following results (via a unified approach) for all sufficiently large n: (i) [1-factorization conjecture] Suppose that n is even and D\\geq 2\\lceil n/4\\rceil -1. Then every D-regular graph G on n vertices has a decomposition into perfect matchings. Equivalently, \\chi'(G)=D. (ii) [Hamilton decomposition conjecture] Suppose that D \\ge \\lfloor n/2 \\rfloor . Then every D-regular graph G on n vertices has a decomposition into Hamilton cycles and at most one perfect matching. (iii) [Optimal packings of Hamilton cycles] Suppose that G is a graph on n vertices with minimum degree \\delta\\ge n/2. Then G contains at least {\\rm reg}_{\\rm even}(n,\\delta)/2 \\ge (n-2)/8 edge-disjoint Hamilton cycles. Here {\\rm reg}_{\\rm even}(n,\\delta) denotes the degree of the largest even-regular spanning subgraph one can guarantee in a graph on n vertices with minimum degree \\delta. (i) was first explicitly stated by Chetwynd and Hilton. (ii) and the special case \\delta= \\lceil n/2 \\rceil of (iii) answe...

  7. Correlations Between Nutrition Habits, Anxiety and Metabolic Parameters in Greek Healthy Adults.

    Science.gov (United States)

    Lambrinakou, Stavroula; Katsa, Maria Efthymia; Zyga, Sofia; Ioannidis, Anastasios; Sachlas, Athanasios; Panoutsopoulos, Georgios; Pistikou, Anna Maria; Magana, Maria; Kougioumtzi Dimoligianni, Dafni Eleni; Kolovos, Petros; Rojas Gil, Andrea Paola

    2017-01-01

    Anxiety combined with nervousness and apprehension consist a focal response to different life conditions. Lifestyle habits, anxiety and biochemical markers are in a constant interaction. To investigate the prevalence of anxiety in healthy adults and its possible association with biochemical factors-lipid profile, liver markers, thyroid hormones-and lifestyle habits. Quantitative descriptive correlation study. A total of 100 healthy adults participated in the research. A specially designed questionnaire and Hamilton's scale were used. Anthropometric and biochemical analyses were performed. Overall, 61% of the participants presented moderate to very serious anxiety. The average score on the Hamilton scale was 13.82 (±9.000), with men exhibiting less stress than women. For p ≤ 0.05: Stress was positively correlated with impaired thyroid and hepatic function. Hepatic function was affected by both sugar products and water melon, which were positively correlated with total bilirubin and AST/SGOT respectively. Tomato, peppers and legumes were negatively correlated with AST/SGOT. Deep fried food was positively correlated with GGT and triglycerides. Legumes and fish were negatively correlated with CPK. Regarding the lipid metabolism, it was found that food cooked with oil was positively associated with uric acid, but non-cooked olive oil was negatively correlated with the risk for CAD. Thyroid function was negatively correlated with non-homemade food and pasta consumption and positively correlated with consumption of whole grains and green tea. Participants with subclinical hypothyroidism seemed to consume less vitamin B12, folic acid and vegetables. No direct correlation between lifestyle habits and anxiety was found. Nevertheless, eating habits influenced biochemical markers-especially the thyroid hormones-which may be indirectly responsible for anxiety and related moods.

  8. Comorbidity of Anxiety Disorders and Substance Abusewith Bipolar Mood Disorders and Relationship with ClinicalCourse

    Directory of Open Access Journals (Sweden)

    Ali Reza Shafiee-Kandjani

    2009-12-01

    Full Text Available "n Objective: Patients with bipolar mood disorder constitute a relatively large number of individuals hospitalized in psychiatric hospitals. This disorder is highly co-morbid with other psychiatric disorders and may effect their clinical course. The goal of this study was to determine the co-occurrence rate of anxiety disorders and substance abuse with bipolar mood disorders and their impact on clinical course. "n Methods: 153 bipolar patients (type I were selected among the hospitalized patients at Razi Psychiatric Hospital in Tabriz, Iran, from September 2007 to October 2008 through convenience sampling method. The participants were evaluated by a structured clinical interview based on DSM-IV criteria (SCID, Hamilton Rating Scale for Depression (HRSD and Young Mania Rating Scale (YMRS. Results: Co-morbidity of anxiety disorders was 43% . Occurrence of anxiety disorders was 26% for obsessive-compulsive disorder, 24.8% for generalized anxiety disorder, 3.9% for phobia and 2% for panic disorder. Co-morbidity of substance abuse was 7.2% and the highest occurrence of substance abuse was 5.2% for alcoholism and 3.9% for opium. No significant difference was observed between the severity of disease and duration of hospitalization in bipolar patients with or without anxiety disorder. The severity of disease and duration of hospitalization in bipolar patients with substance abuse was higher compared to bipolar patients without substance abuse (P<0.05. "nConclusions: This study suggests that there is a high co-morbidity between anxiety disorders and substance abuse with bipolar disorder. Further, this study suggests that co-occurrence of substance abuse disorder with bipolar disorder increases the severity of the disease and duration of hospitalization.

  9. Analyzing prefrontal cortex hemoglobin concentration exchange spectrum in patients with major depressive disorder combined with anxiety and obsession through near-infrared spectroscopy

    Institute of Scientific and Technical Information of China (English)

    刘晓敏

    2014-01-01

    Objective Exploring the characteristics of prefrontal cortex activation in patients of major depressive disorder(MDD)combined with anxiety and obsession through functional near-infrared spectroscopy(fN IRS).Methods Prefrontal cortex hemoglobin concentration exchange of30 MDD patients combined with anxiety and obsession was detected by fN IRS under voice fluency task(VFT),then psychological assessment was made using Hanmilton Depression Scale(HAMD),Hamilton Anxiety Scale

  10. Influence of Competitive-Anxiety on Heart Rate Variability in Swimmers.

    Science.gov (United States)

    Fortes, Leonardo S; da Costa, Bruna D V; Paes, Pedro P; do Nascimento Júnior, José R A; Fiorese, Lenamar; Ferreira, Maria E C

    2017-12-01

    The aim of this study was to analyze the relationship between competitive anxiety and heart rate variability (HRV) in swimming athletes. A total of 66 volunteers (41 male and 27 female) who swam the 400-m freestyle in the Brazilian Swimming Championships participated. Thirty minutes before the 400-m freestyle event, the athletes answered the Competitive Anxiety Inventory (CSAI-2R) questionnaire, then underwent anthropometric (body weight, height, and skinfold thickness) and HRV measurements. Then, at a second meeting, held 3 h after the 400-m freestyle event, the athletes returned to the evaluation room for HRV measurement (Polar ® RS800cx, Kempele, Finland). Multiple linear regression was used to evaluate the relationship between competitive anxiety and HRV. The multiple linear regression was performed in three blocks (block 1: cognitive anxiety, block 2: somatic anxiety, and block 3: self-confidence), adopting the forward model. The results indicated a significant association between cognitive anxiety (p = 0.001) and HRV. An increased magnitude of the association was observed when somatic anxiety was inserted in the model (p = 0.001). In contrast, self-confidence showed, which was inserted in block 3, no relationship with HRV (p = 0.27). It was concluded that cognitive and somatic anxieties were associated with the HRV of swimmers. Athletes with a high magnitude of cognitive and/or somatic anxiety demonstrated more significant autonomic nervous system disturbance. Practically, psychological interventions are needed to improve anxiety states that are specific to perform well, and to improve HRV.

  11. Influence of Competitive-Anxiety on Heart Rate Variability in Swimmers

    Directory of Open Access Journals (Sweden)

    Leonardo S. Fortes, Bruna D. V. da Costa, Pedro P. Paes, José R.A. do Nascimento Júnior, Lenamar Fiorese, Maria E.C. Ferreira

    2017-12-01

    Full Text Available The aim of this study was to analyze the relationship between competitive anxiety and heart rate variability (HRV in swimming athletes. A total of 66 volunteers (41 male and 27 female who swam the 400-m freestyle in the Brazilian Swimming Championships participated. Thirty minutes before the 400-m freestyle event, the athletes answered the Competitive Anxiety Inventory (CSAI-2R questionnaire, then underwent anthropometric (body weight, height, and skinfold thickness and HRV measurements. Then, at a second meeting, held 3 h after the 400-m freestyle event, the athletes returned to the evaluation room for HRV measurement (Polar® RS800cx, Kempele, Finland. Multiple linear regression was used to evaluate the relationship between competitive anxiety and HRV. The multiple linear regression was performed in three blocks (block 1: cognitive anxiety, block 2: somatic anxiety, and block 3: self-confidence, adopting the forward model. The results indicated a significant association between cognitive anxiety (p = 0.001 and HRV. An increased magnitude of the association was observed when somatic anxiety was inserted in the model (p = 0.001. In contrast, self-confidence showed, which was inserted in block 3, no relationship with HRV (p = 0.27. It was concluded that cognitive and somatic anxieties were associated with the HRV of swimmers. Athletes with a high magnitude of cognitive and/or somatic anxiety demonstrated more significant autonomic nervous system disturbance. Practically, psychological interventions are needed to improve anxiety states that are specific to perform well, and to improve HRV.

  12. The effect of prayer on depression and anxiety: maintenance of positive influence one year after prayer intervention.

    Science.gov (United States)

    Boelens, Peter A; Reeves, Roy R; Replogle, William H; Koenig, Harold G

    2012-01-01

    To investigate whether the effect of direct contact person-to-person prayer on depression, anxiety, and positive emotions is maintained after 1 year. One-year follow-up of subjects with depression and anxiety who had undergone prayer intervention consisting of six weekly 1-hour prayer sessions conducted in an office setting. Subjects (44 women) completed Hamilton Rating Scales for Depression and Anxiety, Life Orientation Test, and Daily Spiritual Experiences Scale after finishing a series of six prayer sessions and then again a month later in an initial study. The current study reassessed those subjects with the same measures 1 year later. One-way repeated measures ANOVAs were used to compare findings pre-prayer, immediately following the six prayer sessions, and 1 month and again 1 year following prayer interventions. Evaluations post-prayer at 1 month and 1 year showed significantly less depression and anxiety, more optimism, and greater levels of spiritual experience than did the baseline (pre-prayer) measures (p prayer session. Direct person-to-person prayer may be useful as an adjunct to standard medical care for patients with depression and anxiety. Further research in this area is indicated.

  13. Difference in symptom profile between generalized anxiety disorder and anxiety secondary to hyperthyroidism.

    Science.gov (United States)

    Iacovides, A; Fountoulakis, K N; Grammaticos, P; Ierodiakonou, C

    2000-01-01

    The differential diagnosis between subclinical hyperthyroidism and Generalized Anxiety Disorder (GAD) is often a difficult problem to solve without laboratory examination. The aim of this pilot study was to assess whether there are differences in the symptom profile between these two disorders. Fifty patients took part in the study: Twenty-five were hyperthyroid patients, and twenty-five were GAD patients. The diagnosis was based on the TSH values and the DSM-IV criteria, respectively. The Hamilton Anxiety Scale (HAS) and the list of fifty-one symptoms produced by the detailed expansion of HAS items were used to quantify the anxiety symptomatology. The differences in the frequencies between the two diagnostic groups were calculated at each categorical response for every item of both scales. Forward Stepwise Discriminant Function Analysis was performed twice using HAS items and the fifty-one-list items. The symptoms of anxiety in subclinical hyperthyroidism were not identical to those of GAD. Four Hyperthyroid/Anxiety Indices (HAI I-IV) were developed. These indices reach optimum classification of patients (3 of them reach 100% sensitivity and specificity). The results of the current study suggest that it is possible to differentiate between GAD and subclinical cases of hyperthyroidism by the careful study of clinical symptomatology. This may be of particular help in isolated areas without laboratory support, but replication of the indices in other samples is indicated.

  14. Generally covariant Hamilton-Jacobi equation and rotated liquid sphere metrics

    International Nuclear Information System (INIS)

    Abdil'din, M.M.; Abdulgafarov, M.K.; Abishev, M.E.

    2005-01-01

    In the work Lense-Thirring problem on corrected Fock's first approximation metrics by Hamilton-Jacobi method considered. Generally covariant Hamilton-Jacobi equation had been sold by separation of variable method. Path equation of probe particle motion in rotated liquid sphere field is obtained. (author)

  15. The Magnus problem in Rodrigues-Hamilton parameters

    Science.gov (United States)

    Koshliakov, V. N.

    1984-04-01

    The formalism of Rodrigues-Hamilton parameters is applied to the Magnus problem related to the systematic drift of a gimbal-mounted astatic gyroscope due to the nutational vibration of the main axis of the rotor. It is shown that the use of the above formalism makes it possible to limit the analysis to a consideration of a linear system of differential equations written in perturbed values of Rodrigues-Hamilton parameters. A refined formula for the drift of the main axis of the gyroscope rotor is obtained, and an estimation is made of the effect of the truncation of higher-order terms.

  16. Reduced heart rate variability in social anxiety disorder: associations with gender and symptom severity.

    Directory of Open Access Journals (Sweden)

    Gail A Alvares

    Full Text Available BACKGROUND: Polyvagal theory emphasizes that autonomic nervous system functioning plays a key role in social behavior and emotion. The theory predicts that psychiatric disorders of social dysfunction are associated with reduced heart rate variability, an index of autonomic control, as well as social inhibition and avoidance. The purpose of this study was to examine whether heart rate variability was reduced in treatment-seeking patients diagnosed with social anxiety disorder, a disorder characterized by social fear and avoidance. METHODS: Social anxiety patients (n = 53 were recruited prior to receiving psychological therapy. Healthy volunteers were recruited through the University of Sydney and the general community and were matched by gender and age (n = 53. Heart rate variability was assessed during a five-minute recording at rest, with participants completing a range of self-report clinical symptom measures. RESULTS: Compared to controls, participants with social anxiety exhibited significant reductions across a number of heart rate variability measures. Reductions in heart rate variability were observed in females with social anxiety, compared to female controls, and in patients taking psychotropic medication compared to non-medicated patients. Finally, within the clinical group, we observed significant associations between reduced heart rate variability and increased social interaction anxiety, psychological distress, and harmful alcohol use. CONCLUSIONS: The results of this study confirm that social anxiety disorder is associated with reduced heart rate variability. Resting state heart rate variability may therefore be considered a marker for social approach-related motivation and capacity for social engagement. Additionally, heart rate variability may provide a useful biomarker to explain underlying difficulties with social approach, impaired stress regulation, and behavioral inhibition, especially in disorders associated with

  17. Validity study of the Beck Anxiety Inventory (Portuguese version by the Rasch Rating Scale model

    Directory of Open Access Journals (Sweden)

    Sónia Quintão

    2013-01-01

    Full Text Available Our objective was to conduct a validation study of the Portuguese version of the Beck Anxiety Inventory (BAI by means of the Rasch Rating Scale Model, and then compare it with the most used scales of anxiety in Portugal. The sample consisted of 1,160 adults (427 men and 733 women, aged 18-82 years old (M=33.39; SD=11.85. Instruments were Beck Anxiety Inventory, State-Trait Anxiety Inventory and Zung Self-Rating Anxiety Scale. It was found that Beck Anxiety Inventory's system of four categories, the data-model fit, and people reliability were adequate. The measure can be considered as unidimensional. Gender and age-related differences were not a threat to the validity. BAI correlated significantly with other anxiety measures. In conclusion, BAI shows good psychometric quality.

  18. Hamilton-Jacobi theorems for regular reducible Hamiltonian systems on a cotangent bundle

    Science.gov (United States)

    Wang, Hong

    2017-09-01

    In this paper, some of formulations of Hamilton-Jacobi equations for Hamiltonian system and regular reduced Hamiltonian systems are given. At first, an important lemma is proved, and it is a modification for the corresponding result of Abraham and Marsden (1978), such that we can prove two types of geometric Hamilton-Jacobi theorem for a Hamiltonian system on the cotangent bundle of a configuration manifold, by using the symplectic form and dynamical vector field. Then these results are generalized to the regular reducible Hamiltonian system with symmetry and momentum map, by using the reduced symplectic form and the reduced dynamical vector field. The Hamilton-Jacobi theorems are proved and two types of Hamilton-Jacobi equations, for the regular point reduced Hamiltonian system and the regular orbit reduced Hamiltonian system, are obtained. As an application of the theoretical results, the regular point reducible Hamiltonian system on a Lie group is considered, and two types of Lie-Poisson Hamilton-Jacobi equation for the regular point reduced system are given. In particular, the Type I and Type II of Lie-Poisson Hamilton-Jacobi equations for the regular point reduced rigid body and heavy top systems are shown, respectively.

  19. Efficacy and tolerability of escitalopram in treatment of major depressive disorder with anxiety symptoms: a 24-week, open-label, prospective study in Chinese population

    Directory of Open Access Journals (Sweden)

    Jiang KD

    2017-02-01

    Full Text Available Kaida Jiang,1 Lingjiang Li,2 Xueyi Wang,3 Maosheng Fang,4 Jianfei Shi,5 Qiuyun Cao,6 Jincai He,7 Jinan Wang,8 Weihao Tan,8 Cuili Hu8 1Psychiatry Department, Shanghai Mental Health Center, Shanghai, 2Psychiatry Department,The Second Xiangya Hospital, Central South University, Changsha, 3Psychiatry Department, First affiliated Hospital of Hebei Medical University, Shijiazhuang, 4Psychiatry Department, Wuhan Mental Health Center, Wuhan, 5Psychiatry Department, Hangzhou the 7th Hospital, Hangzhou, 6Psychology Department, Nanjing Drum Tower Hospital, Nanjing, 7Neurology Department, First affiliated Hospital of Wenzhou Medical University, Wenzhou, 8Medical Affairs Department, Xi’an Janssen Pharmaceutical Ltd., Beijing, People’s Republic of China Background: Significant anxiety symptoms are associated with poor clinical course and outcome in major depressive disorder (MDD. This single-arm, open-label study aimed to evaluate the efficacy and tolerability of escitalopram treatment in patients with MDD and anxiety symptoms. Methods: Adult patients with MDD and anxiety symptoms (Montgomery–Asberg Depression Rating Scale [MADRS] ≥22 and Hamilton Anxiety Rating Scale [HAM-A] ≥14 were enrolled and received escitalopram (10–20 mg/day treatment for 24 weeks. Symptom status was assessed by MADRS, 17-item-Hamilton Depression Rating Scale, HAM-A, and Clinical Global Impression Scale at baseline and the following visits. Quality of life was assessed by Short Form-12, and safety was evaluated by adverse events, laboratory investigations, vital signs, and physical findings. Results: Overall, 200 of 318 (66.2% enrolled patients completed the 24-week treatment. The remission (MADRS ≤10 and HAM-A ≤7 rate in the full analysis set (N=285 was 73.3% (95% confidence interval: 67.80, 78.38 at week 24. Mean (± standard deviation MADRS total score was 33.4 (±7.13 and HAM-A score was 27.6 (±7.26 at baseline, which reduced to 6.6 (±10.18 and 6.0 (±8

  20. The Effect of Provision of Information Regarding Infertility Treatment Strategies on Anxiety Level of Infertile Couples

    Directory of Open Access Journals (Sweden)

    Mustafa Hamdieh

    2009-01-01

    Full Text Available Background: Infertility may have many emotional and psychological implications on infertilecouples. So far, different methods for reducing anxiety in infertile couples have been evaluated. Thegoal of this study is to evaluate the effect of provision of information regarding infertility treatmentto infertile couples on their anxiety levels.Materials and Methods: This study was conducted as a before and after clinical trial. Forty-twoindividuals were considered as cases and 40 as controls. In order to evaluate anxiety and depressionin participants, the Hamilton Anxiety and Depression Scale (HADS questionnaire was used. Theintervention group received information about infertility treatment through a two hour face-to-facemeeting and was provided with a brochure. Anxiety level was assessed at the time of admission,immediately after the session and two weeks later. Assessment was performed twice for the controlgroup; once at the time of admission and secondly, two weeks later.Results: Our results show that receiving information about infertility treatment significantlydecreases anxiety among infertile couples two weeks post-training. This decline does not have asignificant correlation with age, sex, education level of the couple, and neither with the durationnor the cause of infertility. Providing information does not have any significant effect on the rate ofdepression among couples.Conclusion: It is recommended that provision of information regarding infertility treatmentmethods should be considered as a means of decreasing anxiety among infertile couples who referto infertility treatment centers.

  1. ANXIETY IN MAJOR DEPRESSION AND CEREBROSPINAL FLUID FREE GAMMA-AMINOBUTYRIC ACID

    Science.gov (United States)

    Mann, J. John; Oquendo, Maria A.; Watson, Kalycia Trishana; Boldrini, Maura; Malone, Kevin M.; Ellis, Steven P.; Sullivan, Gregory; Cooper, Thomas B.; Xie, Shan; Currier, Dianne

    2016-01-01

    Background Low gamma-aminobutyric acid (GABA) is implicated in both anxiety and depression pathophysiology. They are often comorbid, but most clinical studies have not examined these relationships separately. We investigated the relationship of cerebrospinal fluid (CSF) free GABA to the anxiety and depression components of a major depressive episode (MDE) and to monoamine systems. Methods and Materials Patients with a DSM-IV major depressive episode (N = 167: 130 major depressive disorder; 37 bipolar disorder) and healthy volunteers (N = 38) had CSF free GABA measured by gas chromatography mass spectroscopy. Monoamine metabolites were assayed by high performance liquid chromatography. Symptomatology was assessed by Hamilton depression rating scale. Results Psychic anxiety severity increased with age and correlated with lower CSF free GABA, controlling for age. CSF free GABA declined with age but was not related to depression severity. Other monoamine metabolites correlated positively with CSF GABA but not with psychic anxiety or depression severity. CSF free GABA was lower in MDD compared with bipolar disorder and healthy volunteers. GABA levels did not differ based on a suicide attempt history in mood disorders. Recent exposure to benzodiazepines, but not alcohol or past alcoholism, was associated with a statistical trend for more severe anxiety and lower CSF GABA. Conclusions Lower CSF GABA may explain increasing severity of psychic anxiety in major depression with increasing age. This relationship is not seen with monoamine metabolites, suggesting treatments targeting the GABAergic system should be evaluated in treatment-resistant anxious major depression and in older patients. PMID:24865448

  2. Impact of anxiety symptoms on outcomes of depression: an observational study in Asian patients

    Directory of Open Access Journals (Sweden)

    Novick D

    2016-04-01

    Full Text Available Diego Novick,1 William Montgomery,2 Jaume Aguado,3 Xiaomei Peng,4 Josep Maria Haro3 1Eli Lilly and Company, Windlesham, Surrey, UK; 2Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia; 3Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain; 4Eli Lilly and Company, Indianapolis, IN, USA Objective: To investigate the impact of anxiety symptoms on depression outcomes in Asian patients with major depressive disorder (MDD (n=714. Methods: The 17-item Hamilton Depression Scale (HAMD-17, overall severity, somatic symptoms, and quality of life (QOL (EuroQOL Questionnaire-5 Dimensions [EQ-5D] were assessed at baseline and 3 months. Anxiety was measured using items 10 and 11 from the HAMD-17. Linear, tobit, and logistic multiple regression models analyzed the impact of anxiety symptoms on outcomes. Baseline anxiety was related to age and the presence of pain symptoms at baseline. Results: Regression models showed that a higher level of anxiety was associated with a lower frequency of remission and lower QOL at 3 months. Patients with lower baseline anxiety symptoms had higher remission rates (odds ratio for each point of anxiety symptoms, 0.829 [95% confidence interval [CI]: 0.723–0.951]. Patients with higher levels of baseline anxiety had a lower QOL at 3 months (a decrease in EQ-5D tariff score for each point of anxiety symptoms, 0.023 [95% CI: 0.045–0.001]. Conclusion: In conclusion, the presence of anxiety symptoms negatively impacts the outcomes of depression. Keywords: depression, anxiety, Asia, observational, outcomes

  3. Pathological gambling: comorbid psychiatric diagnoses in patients and their families.

    Science.gov (United States)

    Dannon, Pinhas N; Lowengrub, Katherine; Aizer, Anat; Kotler, Moshe

    2006-01-01

    Pathological gambling is a highly prevalent and disabling impulse control disorder. Recent studies have consistently demonstrated that pathological gamblers respond well to treatment with selective serotonin reuptake inhibitors, mood stabilizers and opioid antagonists. These findings have supported the observation that pathological gambling is associated with anxiety and mood spectrum disorders as well as addictive disorders. Fifty-two male pathological gamblers and their first-degree relatives (n=93) completed a semi-structured DSM-IV-based diagnostic interview as well as a series of data collection instruments including the South Oaks Gambling Scale, the Hamilton Rating Scale for Depression, the Hamilton Rating Scale for Anxiety, the Yale-Brown Obsessive-Compulsive Scale, and the Young Mania Rating Scale. The study subjects and their first-degree relative were compared to demographically matched normal controls (n=96). We found higher prevalence of alcohol, substance abuse, problematic gambling, depression, and anxiety disorders in the pathological gamblers and their first-degree relatives than in the control group. In particular, the scores on the Hamilton Rating Scale for Depression, the Hamilton Rating Scale for Anxiety, and the Yale-Brown Obsessive-Compulsive Scale were higher in the study group than in the control group. Our finding of a high prevalence of psychiatric comorbidity in pathological gamblers and their families raises the question of the proper classification of pathological gambling in the DSM-IV. Furthermore, the pattern of psychiatric disorders seen in the first-degree relatives can lead to new insights about the etiopathology of pathological gambling.

  4. Cognitive Behavior Therapy for Anxiety in Parkinson's Disease: Outcomes for Patients and Caregivers.

    Science.gov (United States)

    Dissanayaka, Nadeeka N W; Pye, Deidre; Mitchell, Leander K; Byrne, Gerard J; O'Sullivan, John D; Marsh, Rodney; Pachana, Nancy A

    2017-01-01

    Anxiety negatively impacts the quality of life of Parkinson's disease (PD) patients and caregivers. Despite high prevalence, there is a paucity of trials investigating effective treatments for anxiety in PD. This uncontrolled study investigated the use of a manualized and tailored Cognitive Behavior Therapy (CBT) for anxiety in PD. Participants completed 6 weekly CBT sessions. Pre-, post- and follow-up (3 and 6 months) assessments were made. Change in outcomes were analysed using t-tests and Reliability Change Index. Of 17 PD patients who agreed to CBT, 12 completed the intervention. This study showed a significant reduction in Hamilton Anxiety Rating Scale scores in PD immediately post CBT (t(11) = 3.59, p < .01), maintained at 3-month (t(8) = 2.83, p = .02) and 6-month (t(7) = 2.07, p = .04) follow-up. A reduction in caregiver burden (t(11) = 2.68, p = .03) was observed post intervention. Improvements in motor disability (t(11) = 2.41, p = .04) and cognitive scores (t(11) = -2.92, p = .01) were also observed post intervention and at follow-up. Tailored CBT can be used to treat anxiety in PD. This study provides preliminary evidence suggesting that tailored CBT reduces anxiety in PD with persisting benefits, and lowers caregiver burden.

  5. 78 FR 73750 - Proposed Amendment of Class E Airspace; Hamilton, OH

    Science.gov (United States)

    2013-12-09

    ...: Federal Aviation Administration (FAA), DOT. ACTION: Notice of proposed rulemaking (NPRM). SUMMARY: This action proposes to amend Class E airspace at Hamilton, OH. Decommissioning of the Hamilton nondirectional... the views and suggestions presented are particularly helpful in developing reasoned regulatory...

  6. Pregabalin for anxiety in patients with schizophrenia - A randomized, double-blind placebo-controlled study

    DEFF Research Database (Denmark)

    Schjerning, Ole; Damkier, Per; Lykkegaard, Signe Engelhardt

    2017-01-01

    INTRODUCTION: Anxiety is frequent in patients with schizophrenia and poses a major impact on patients perceived quality of life, daily functioning and risk of suicide. Pregabalin has shown effective in the treatment of generalized anxiety disorder and has been suggested for the treatment of anxiety...... in patients with schizophrenia. As evidence is sparse regarding treatment of anxiety in this patient group, we aimed to investigate the use of pregabalin for anxiety in patients with schizophrenia. METHODS: A randomized, double-blind placebo controlled study was used. Patients were randomized to either...... placebo or pregabalin (≤600mg/d) as add-on treatment. Primary analyses were intention-to-treat based with change in Hamilton Anxiety Scale after 4 and 8weeks of treatment as primary outcome. Secondary outcomes were change in psychopathology, quality-of-life, cognitive functioning and sleep. The study used...

  7. The cerebral neurobiology of anxiety, anxiety displacement, and anxiety denial.

    Science.gov (United States)

    Gottschalk, L A; Fronczek, J; Abel, L; Buchsbaum, M S; Fallon, J H

    2001-01-01

    Previous studies examining the relationship of anxiety scores, derived from the content analysis of speech of normal individuals, have revealed that the anxiety scores occurring in the dreams associated with rapid eye movement (REM) sleep are significantly correlated with localized cerebral glucose metabolic rates assessed by positron emission tomography (PET) scanning. These significant intercorrelations occur in different cerebral areas when the anxiety scores are obtained from mental experiences reported during non-REM sleep or during wakeful silent mentation. The purpose of the present study was to examine the intercorrelations found between anxiety attributed to the self, anxiety-displacement, and anxiety denial measured from computerized content analysis of 5-min verbal reports of subjective thoughts and feelings obtained from wakeful normal subjects and localized cerebral glucose metabolic rates during PET scanning. The subjects were 10 wakeful young males. Their anxiety scores were derived from computerized content analysis of 5-min reports they gave of their subjective thoughts, feelings and fantasies during a 30-min period following an intravenous injection of F D-deoxyglucose (FDG). The subjects were moved 32--45 min after this injection to obtain a PET scan, which records all of the localized cerebral glucose metabolic rates during the 30 min following the FDG injection. Significant intercorrelations of localized cerebral glucose metabolic rates with the scores of self-anxiety, anxiety displacement, and anxiety-denial were found in dissimilar cerebral locations depending on the type of anxiety involved. The significant correlations occurred in brain regions known to be associated with the functions of emotions, cognition, memory, and vision. Specific combinations of cerebral areas, based on glucose metabolic rates, appear to distinguish and be associated with different verbal expressions of anxiety. Replication of this preliminary research will be

  8. Is it more effective group relaxation than individual to reduce anxiety in specific phobias?

    Directory of Open Access Journals (Sweden)

    Julián Carretero Román

    2009-05-01

    Full Text Available Relaxation is a standard technique used by nurses to reduce the level of anxiety. It seems that their implementation on a group can bring certain benefits compared with individual relaxation. This outline is intended to raise this hypothesis in caring for individuals diagnosed with specific phobia, by approaching the problem from the cognitive behavioural therapy perspective. In addition, it seeks to evaluate the usefulness of the nurse intervention relaxation to reduce the level of anxiety, in turn comparing the results obtained using an indicator of the scale of results NOC and the Hamilton Anxiety Scale. The phobia is a specific entity underdiagnosed, whose prevalence is about 10%. Those affected can live a really limited and debilitating, deteriorating quality of life. The community mental health nurses are in a unique position to participate in the cognitive behavioural therapy through relaxation, which will allow them to reduce the level of anxiety when people establish contact with the phobic stimulus. Methodology: quasi-experimental study in specific phobia diagnosed, 20 to 40 years old adults attending for the first time to the mental health facility derived from primary care. Both the control group as the pilot will be treated by conducted cognitive-behavioural psychotherapy individualized according to the therapeutic protocol MSC, except in terms of relaxation, which in the experimental group will be conducted at the group level. The effectiveness of treatment will be assessed with the Hamilton anxiety scale and the likert type scale of outcome indicators NOC "stress level" with 3 measurements, before starting, immediately after completing the sessions of relaxation and three months later, checking the decline in the average level of anxiety.

  9. A generalization of Hamilton's rule--love others how much?

    Science.gov (United States)

    Alger, Ingela; Weibull, Jörgen W

    2012-04-21

    According to Hamilton's (1964a, b) rule, a costly action will be undertaken if its fitness cost to the actor falls short of the discounted benefit to the recipient, where the discount factor is Wright's index of relatedness between the two. We propose a generalization of this rule, and show that if evolution operates at the level of behavior rules, rather than directly at the level of actions, evolution will select behavior rules that induce a degree of cooperation that may differ from that predicted by Hamilton's rule as applied to actions. In social dilemmas there will be less (more) cooperation than under Hamilton's rule if the actions are strategic substitutes (complements). Our approach is based on natural selection, defined in terms of personal (direct) fitness, and applies to a wide range of pairwise interactions. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Adaptation of abbreviated mathematics anxiety rating scale for engineering students

    Science.gov (United States)

    Nordin, Sayed Kushairi Sayed; Samat, Khairul Fadzli; Sultan, Al Amin Mohamed; Halim, Bushra Abdul; Ismail, Siti Fatimah; Mafazi, Nurul Wirdah

    2015-05-01

    Mathematics is an essential and fundamental tool used by engineers to analyse and solve problems in their field. Due to this, most engineering education programs involve a concentration of study in mathematics courses whereby engineering students have to take mathematics courses such as numerical methods, differential equations and calculus in the first two years and continue to do so until the completion of the sequence. However, the students struggled and had difficulties in learning courses that require mathematical abilities. Hence, this study presents the factors that caused mathematics anxiety among engineering students using Abbreviated Mathematics Anxiety Rating Scale (AMARS) through 95 students of Universiti Teknikal Malaysia Melaka (UTeM). From 25 items in AMARS, principal component analysis (PCA) suggested that there are four mathematics anxiety factors, namely experiences of learning mathematics, cognitive skills, mathematics evaluation anxiety and students' perception on mathematics. Minitab 16 software was used to analyse the nonparametric statistics. Kruskal-Wallis Test indicated that there is a significant difference in the experience of learning mathematics and mathematics evaluation anxiety among races. The Chi-Square Test of Independence revealed that the experience of learning mathematics, cognitive skills and mathematics evaluation anxiety depend on the results of their SPM additional mathematics. Based on this study, it is recommended to address the anxiety problems among engineering students at the early stage of studying in the university. Thus, lecturers should play their part by ensuring a positive classroom environment which encourages students to study mathematics without fear.

  11. Beyond WKB quantum corrections to Hamilton-Jacobi theory

    International Nuclear Information System (INIS)

    Jurisch, Alexander

    2007-01-01

    In this paper, we develop quantum mechanics of quasi-one-dimensional systems upon the framework of the quantum-mechanical Hamilton-Jacobi theory. We will show that the Schroedinger point of view and the Hamilton-Jacobi point of view are fully equivalent in their description of physical systems, but differ in their descriptive manner. As a main result of this, a wavefunction in Hamilton-Jacobi theory can be decomposed into travelling waves in any point in space, not only asymptotically. Using the quasi-linearization technique, we derive quantum correction functions in every order of h-bar. The quantum correction functions will remove the turning-point singularity that plagues the WKB-series expansion already in zeroth order and thus provide an extremely good approximation to the full solution of the Schroedinger equation. In the language of quantum action it is also possible to elegantly solve the connection problem without asymptotic approximations. The use of quantum action further allows us to derive an equation by which the Maslov index is directly calculable without any approximations. Stationary quantum trajectories will also be considered and thoroughly discussed

  12. The impacts of migraine, anxiety disorders, and chronic depression on quality of life in psychiatric outpatients with major depressive disorder.

    Science.gov (United States)

    Hung, Ching-I; Wang, Shuu-Jiun; Yang, Ching-Hui; Liu, Chia-Yih

    2008-08-01

    Our purpose was to determine if migraine, anxiety comorbidities, and chronic depression were independently related to health-related quality of life (HRQoL) in outpatients with major depressive disorder (MDD). Consecutive psychiatric outpatients with MDD in a medical center were enrolled. MDD, chronic depression, and seven anxiety disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR. Migraine was diagnosed based on the International Classification of Headache Disorders, 2nd edition. The acute version of the Short-Form 36 and the Hamilton Depression Rating Scale (HAMD) were used to evaluate the HRQoL and the severity of depression, respectively. Multiple linear regressions were used to determine the independent factors related to HRQoL. There were 135 participants (34 men, 101 women) with MDD. Subjects with migraine, anxiety comorbidities, or chronic depression had higher HAMD scores and poor HRQoL. Migraine, specific phobia, and panic disorder were important and independent comorbidities predicting HRQoL. The impact of migraine on HRQoL, especially on bodily pain, was not inferior to those of some anxiety comorbidities or chronic depression. Future studies related to HRQoL of MDD should consider migraine and anxiety comorbidities simultaneously.

  13. Application of positron emission tomography with 18ffdg in combined diagnosis of anxiety and depressive disorders in elderly patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    A. A. Stanzhevsky

    2013-01-01

    Full Text Available 35 patients with chronic cardiac failure of the third functional class and anxiety depressive disorders were examined. The screening group consisted of 35 patients with chronic cardiac insufficiency without affective disorders. Evaluation of the clinical state was carried out by echocardiography, 6 minute walk and estimation of therapy compliance. Severity of the symptoms of anxiety and depressive disorders were studied by MMPI test, Beck`s test, Hamilton`s scale, Spielberg scale. PET with 18FFDG was carried out on PET tomographs «EcatExact 47» and «Ecat Exact HR+» (Siemens, Germany. It was found that anxiety depressive disorders have negative effect on the clinical state and the therapy compliance in the patients with chronic cardiac failure. Significant correlation between the clinical data and the brain 18FFDG PET results was seen in most cases.

  14. An integrated approach to the diagnosis and treatment of anxiety within the practice of cardiology.

    Science.gov (United States)

    Janeway, David

    2009-01-01

    Coronary heart disease (CHD) is the leading cause of death and disability in the United States and in highly industrialized countries. Many modifiable psychosocial risk factors have been identified and can affect the course of cardiac illness. These include the negative emotional states of depression, anxiety, stress, anger/hostility, and social isolation. Anxiety has been found to increase the risk of developing CHD in healthy subjects and can lead to worsening of existing CHD. There is much overlap and confusion throughout the research literature between what authors define as anxiety, stress, Type A behavioral pattern, and anger/hostility.There is a need for better screening within the practice of cardiology for these psychosocial risk factors to ensure better integration of mental health services. Established screening tools such as the Beck Anxiety Inventory, Patient Health Questionnaire-9, Zung Self-Rating Anxiety Scale, and the Hamilton Anxiety Scale are described and compared with the newer Screening Tool for Psychologic Distress as part of the initial work-up of every cardiac patient. Recommendations are made using the author's Anxiety Treatment Algorithm regarding when to refer to a mental health professional along with how to reduce stigma and provide more integrated care. The diagnosis and treatment of anxiety disorders is reviewed, with attention to selective serotonin reuptake inhibitors, benzodiazepines, cognitive-behavioral therapy, stress reduction, and behavioral medicine group programs. These group programs are recommended because they help to overcome social isolation and counsel patients on how to adapt to a healthy lifestyle. Better clinical outcome research is needed that specifically addresses the question of whether the treatment of anxiety and anxiety disorders can affect the course of cardiac illness.

  15. El distribuidor de trafico de Hamilton-Inglaterra

    Directory of Open Access Journals (Sweden)

    Babtie Shaw and Morton, Ingenieros Consultores

    1969-06-01

    Full Text Available The first part of this article describes the initial stages in the construction of the complex traffic interchange at Hamilton, and gives details of all the special aspects which it involves. The second part deals with two of the three bridges at the Maryville interchange, and a detailed description is given of the most important features of these structures.La primera parte de este artículo muestra el trabajo de la primera etapa del complejo del distribuidor de tráfico de Hamilton, dándonos cuenta de las obras que engloba. La segunda parte trata de dos de los tres puentes que hay en el empalme de Maryville, describiéndolos y mostrando sus partes más importantes.

  16. Chaos M-ary modulation and demodulation method based on Hamilton oscillator and its application in communication.

    Science.gov (United States)

    Fu, Yongqing; Li, Xingyuan; Li, Yanan; Yang, Wei; Song, Hailiang

    2013-03-01

    Chaotic communication has aroused general interests in recent years, but its communication effect is not ideal with the restriction of chaos synchronization. In this paper a new chaos M-ary digital modulation and demodulation method is proposed. By using region controllable characteristics of spatiotemporal chaos Hamilton map in phase plane and chaos unique characteristic, which is sensitive to initial value, zone mapping method is proposed. It establishes the map relationship between M-ary digital information and the region of Hamilton map phase plane, thus the M-ary information chaos modulation is realized. In addition, zone partition demodulation method is proposed based on the structure characteristic of Hamilton modulated information, which separates M-ary information from phase trajectory of chaotic Hamilton map, and the theory analysis of zone partition demodulator's boundary range is given. Finally, the communication system based on the two methods is constructed on the personal computer. The simulation shows that in high speed transmission communications and with no chaos synchronization circumstance, the proposed chaotic M-ary modulation and demodulation method has outperformed some conventional M-ary modulation methods, such as quadrature phase shift keying and M-ary pulse amplitude modulation in bit error rate. Besides, it has performance improvement in bandwidth efficiency, transmission efficiency and anti-noise performance, and the system complexity is low and chaos signal is easy to generate.

  17. Convergent Difference Schemes for Hamilton-Jacobi equations

    KAUST Repository

    Duisembay, Serikbolsyn

    2018-01-01

    In this thesis, we consider second-order fully nonlinear partial differential equations of elliptic type. Our aim is to develop computational methods using convergent difference schemes for stationary Hamilton-Jacobi equations with Dirichlet

  18. Convergent Difference Schemes for Hamilton-Jacobi equations

    KAUST Repository

    Duisembay, Serikbolsyn

    2018-05-07

    In this thesis, we consider second-order fully nonlinear partial differential equations of elliptic type. Our aim is to develop computational methods using convergent difference schemes for stationary Hamilton-Jacobi equations with Dirichlet and Neumann type boundary conditions in arbitrary two-dimensional domains. First, we introduce the notion of viscosity solutions in both continuous and discontinuous frameworks. Next, we review Barles-Souganidis approach using monotone, consistent, and stable schemes. In particular, we show that these schemes converge locally uniformly to the unique viscosity solution of the first-order Hamilton-Jacobi equations under mild assumptions. To solve the scheme numerically, we use Euler map with some initial guess. This iterative method gives the viscosity solution as a limit. Moreover, we illustrate our numerical approach in several two-dimensional examples.

  19. Regularization of Hamilton-Lagrangian guiding center theories

    International Nuclear Information System (INIS)

    Correa-Restrepo, D.; Wimmel, H.K.

    1985-04-01

    The Hamilton-Lagrangian guiding-center (G.C.) theories of Littlejohn, Wimmel, and Pfirsch show a singularity for B-fields with non-vanishing parallel curl at a critical value of vsub(parallel), which complicates applications. The singularity is related to a sudden breakdown, at a critical vsub(parallel), of gyration in the exact particle mechanics. While the latter is a real effect, the G.C. singularity can be removed. To this end a regularization method is defined that preserves the Hamilton-Lagrangian structure and the conservation theorems. For demonstration this method is applied to the standard G.C. theory (without polarization drift). Liouville's theorem and G.C. kinetic equations are also derived in regularized form. The method could equally well be applied to the case with polarization drift and to relativistic G.C. theory. (orig.)

  20. Hamilton-Jacobi approach to non-slow-roll inflation

    International Nuclear Information System (INIS)

    Kinney, W.H.

    1997-01-01

    I describe a general approach to characterizing cosmological inflation outside the standard slow-roll approximation, based on the Hamilton-Jacobi formulation of scalar field dynamics. The basic idea is to view the equation of state of the scalar field matter as the fundamental dynamical variable, as opposed to the field value or the expansion rate. I discuss how to formulate the equations of motion for scalar and tensor fluctuations in situations where the assumption of slow roll is not valid. I apply the general results to the simple case of inflation from an open-quotes invertedclose quotes polynomial potential, and to the more complicated case of hybrid inflation. copyright 1997 The American Physical Society

  1. Algebra and Geometry of Hamilton's Quaternions

    Indian Academy of Sciences (India)

    2016-08-26

    Aug 26, 2016 ... ... Public Lectures · Lecture Workshops · Refresher Courses · Symposia. Home; Journals; Resonance – Journal of Science Education; Volume 21; Issue 6. Algebra and Geometry of Hamilton's Quaternions: 'Well, Papa, Can You Multiply Triplets?' General Article Volume 21 Issue 6 June 2016 pp 529-544 ...

  2. Modified Suanzaorentang Had the Treatment Effect for Generalized Anxiety Disorder for the First 4 Weeks of Paroxetine Medication: A Pragmatic Randomized Controlled Study

    Directory of Open Access Journals (Sweden)

    Ming-Fen Song

    2017-01-01

    Full Text Available Background. Paroxetine does not show satisfactory therapeutic effect for generalized anxiety disorder (GAD patients for the first 2–4 weeks of medication. Diazepam is always concurrently used although it has some shortcomings such as physical dependence and withdrawal reactions. In this study, we aimed to identify whether modified Suanzaorentang (MSZRT, a combined Chinese formula including Suanzaorentang (SZRT and Zhizichitang (ZZCT, could control the anxiety of GAD for the first 4 weeks of paroxetine medication. Methods. 156 GAD patients were randomized to the treatment of paroxetine, paroxetine-diazepam, or paroxetine-MSZRT for 4 weeks. Hamilton Anxiety Scale (HAMA Test and Self-Rating Anxiety Scale (SAS Test were determined each week as the evaluation of clinical efficacy. Adverse events (AEs were also closely observed by performing the Treatment Emergent Symptom Scale (TESS Test. Results. Both paroxetine-MSZRT and paroxetine-diazepam decreased more HAMA and SAS total scores than paroxetine from weeks 1 to 3. Paroxetine-MSZRT as well as paroxetine-diazepam had an obviously higher onset rate than paroxetine in each week. After 4 weeks’ treatment, the overall effectiveness rate in the paroxetine-MSZRT group (90.00% was obviously higher than those of the paroxetine group (74.42% but did not significantly differ from the paroxetine-diazepam group (93.88%. Conclusion. MSZRT had the treatment effect for GAD when paroxetine was used for the first 4 weeks.

  3. Unified Symmetry of Hamilton Systems

    International Nuclear Information System (INIS)

    Xu Xuejun; Qin Maochang; Mei Fengxiang

    2005-01-01

    The definition and the criterion of a unified symmetry for a Hamilton system are presented. The sufficient condition under which the Noether symmetry is a unified symmetry for the system is given. A new conserved quantity, as well as the Noether conserved quantity and the Hojman conserved quantity, deduced from the unified symmetry, is obtained. An example is finally given to illustrate the application of the results.

  4. Anxiety disorders are associated with reduced heart rate variability: A meta-analysis

    Directory of Open Access Journals (Sweden)

    John eChalmers

    2014-07-01

    Full Text Available Background: Anxiety disorders increase risk of future cardiovascular disease (CVD and mortality, even after controlling for confounds including smoking, lifestyle, and socioeconomic status, and irrespective of a history of medical disorders. While impaired vagal function, indicated by reductions in heart rate variability (HRV, may be one mechanism linking anxiety disorders to CVD, prior studies have reported inconsistent findings highlighting the need for meta-analysis.Method: Studies comparing resting state HRV recordings in patients with an anxiety disorder as a primary diagnosis and healthy controls were considered for meta-analysis. Results: Meta-analyses were based on 36 articles, including 2086 patients with an anxiety disorder and 2294 controls. Overall, anxiety disorders were characterised by lower HRV (high frequency: Hedges’ g = -.29. 95%CI: -.41 to -.17, p < 0.001; time domain: Hedges’ g = -0.45, 95%CI: -0.57 to -0.33, p < .001 than controls. Panic Disorder (n=447, Post-Traumatic Stress Disorder (n=192, Generalized Anxiety Disorder (n=68, and Social anxiety disorder (n=90, but not Obsessive Compulsive Disorder (n=40, displayed reductions in high frequency HRV relative to controls (all ps < .001. Conclusions: Anxiety disorders are associated with reduced HRV, findings associated with a small to moderate effect size. Findings have important implications for future physical health and wellbeing of patients, highlighting a need for comprehensive cardiovascular risk reduction.

  5. [Anna Hamilton (1864-1935), the excellence of nursing.

    Science.gov (United States)

    Diebolt, Évelyne

    2017-12-01

    A Frenchwoman, Anna Hamilton (1864-1935), daughter of a Franco-English couple, reads with passion the works of Florence Nightingale and takes an interest in nursing. In order to practice it, she first passes the equivalent of a bachelor’s degree in self-education and registers at the Marseille medical school. She wants to prepare a medical thesis on the nursing staff in the hospitals in Europe and is conducting an investigation throughout Europe. She passed her thesis on June 15, 1900 entitled “Considerations on hospital nurses”. This work is immediately published. That same year, she took up a post at the “Maison de santé protestante” in Bordeaux (MSP), founded in 1863. Without managerial staff, she is forced to recruit them abroad. She publishes a professional journal : “La Garde-Malade hospitalière” (1906-1914). Then the war turned the MSP into a military hospital, but the institution continued to receive local paying patients. She was given permission to call the school of nurses : Florence Nightingale School. Anna Hamilton is working with American women to create a medical and social service in Aisne. A graduate, Antoinette Hervey, then opened a medical-social service in Rouen, which would employ up to 30 visiting nurses. In 1916, the MSP received a donation from the domain of Bagatelle. The board of directors wants to sell it, but Anna Hamilton manages to finance a hospital-school thanks to families bereaved by the war and a subscription announced in the “Journal of Nursing”. Other establishments created by former students of the MSP opened : the School-hospital Ambroise Paré in Lille, a nursing home for nurses in Chambon-sur-Lignon in 1927 (the Edith-Seltzer foundation) and a sanatorium in Briançon. After a busy life, Anna Hamilton died of cancer in 1935 and is buried in Bordeaux.

  6. Anxiety, attention, and decision making: The moderating role of heart rate variability.

    Science.gov (United States)

    Ramírez, Encarnación; Ortega, Ana Raquel; Reyes Del Paso, Gustavo A

    2015-12-01

    The current exploratory research examined whether high frequency heart rate variability (HF-HRV) modulates the association between anxiety and (1) executive attentional control during situations involving neutral stimuli, in which the distractor stimuli are in conflict with the target stimulus, and (2) risk aversion in decision making. Forty-five participants (21 with low and 24 with high trait-anxiety) performed a modified version of the Attention Network Test to measure attentional control, and the Balloon Analog Risk Task to measure risk aversion. HF-HRV was recorded during a rest period before completion of the tasks. Results showed that individuals with high anxiety and low HF-HRV have worse attentional control in the face of conflicting information as well as greater risk aversion, in comparison with individuals with both high anxiety and high HF-HRV or low anxiety (regardless of HF-HRV). HF-HRV was positively associated with attentional control and negatively associated with risk aversion. Furthermore, a strong negative association was observed between attentional control and risk aversion. These results suggest that HF-HRV modulates the influence of anxiety on both attentional control to neutral stimuli, and risk aversion in decision making. Greater HF-HRV appears to fulfill a protective role in highly anxious individuals. The associations observed also suggest that executive control of attention plays a relevant role in decision making. These results support the relevance of the autonomic nervous system in sustained cognition and are in accordance with theories in which vagal-mediated heart rate variability is taken as an indicator of prefrontal cortex inhibitory influences. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Prevalence of Obsessive-Compulsive Disorder and its relationship with anxiety symptoms in students of Zanjan universities (2009

    Directory of Open Access Journals (Sweden)

    Seyed Abolfazl Ghoreishi

    2014-08-01

    Full Text Available Background: Obsessive-Compulsive Disorder (OCD is the fourth most common mental disorder that can adversely affect the people’s life. University education is a stressful time for almost all students and many newly-accepted students are at the risk of periodical OCD. In this study, the prevalence of Obsessive-Compulsive Disorder and its relationship with anxiety symptoms was investigated in students of Zanjan universities. Method: The students were analyzed by a questionnaire, including the demographic information, Yale-Brown Obsessive-Compulsive Scale and Hamilton Anxiety Rating Scale.The acquired data were analyzed by SPSS software using Chi-square Test. Results: 61.2% of the students (738 were affected by Obsessive-Compulsive Disorder (OCD symptoms and 25.1% of them (302 were affected by anxiety symptoms (mild to severe. Prevalence of Clinical OCD among the students was estimated 22.2 % (268 .The results of statistical analysis showed significant correlations between Obsessive-Compulsive Disorder (OCD and anxiety symptoms (P=0.0005, sex (P=0.0005 , age (P=0.005 and university (P= 0.002 Conclusion: This study demonstrated a higher prevalence of OCD among the study sample compared to the similar studies performed in Iran as well as other countries

  8. Hamilton Utilities Corporation annual report 2002 : people, performance, productivity : the business of public service

    International Nuclear Information System (INIS)

    2002-01-01

    A brief overview of the municipally-owned Hamilton Utilities Corporation was provided. When Ontario's electricity market opened to competition, it allowed wholesale and retail electricity marketers to operate on a competitive basis. This report describes how Hamilton Hydro, the largest subsidiary, successfully faced the challenges brought about by the open market. The strategy of growth as a multi-utility corporation progressed significantly. Major financial restructuring was completed, income level was maintained, as well as a strong balance sheet. The construction of Hamilton's first district energy system was effected by Hamilton Community Energy, another subsidiary. This project is expected to provide heat to 10 buildings in the downtown area, producing 3.5 megawatts of electricity for the City. The third subsidiary, FibreWired, applied its vast communications expertise to the health care sector. It offered Virtual Private Network (VPN) services to area hospitals and other health care providers in pharmaceutical and biotechnology. A major study was undertaken jointly with the City of Hamilton. It examined the feasibility of restructuring water and wastewater services into a municipally owned corporation under the umbrella of Hamilton Utilities Corporation. Various examples were provided throughout the report to better illustrate how corporate vision was translated into reality. tabs

  9. A Randomized, Placebo-Controlled Pilot Study of Quetiapine-XR Monotherapy or Adjunctive Therapy to Antidepressant in Acute Major Depressive Disorder with Current Generalized Anxiety Disorder.

    Science.gov (United States)

    Li, Ranran; Wu, Renrong; Chen, Jun; Kemp, David E; Ren, Ming; Conroy, Carla; Chan, Philip; Serrano, Mary Beth; Ganocy, Stephen J; Calabrese, Joseph R; Gao, Keming

    2016-03-01

    To pilot efficacy and safety data of quetiapine-XR monotherapy or adjunctive therapy to antidepressant(s) in the acute treatment of MDD with current generalized anxiety disorder (GAD). The Mini International Neuropsychiatric Interview was used to ascertain the diagnosis of DSM-IV Axis I disorders. Eligible patients were randomly assigned to quetiapine-XR or placebo for up to 8 weeks. Changes from baseline to endpoint in Hamilton Depression Rating Scale-17 items (HAMD-17), Hamilton Anxiety Rating Scale (HAM-A), Clinical Global Impression-Severity (CGI-S), Quick Inventory of Depression Symptomatology-16 items Self-Report (QIDS-16-SR) total scores, and other outcome measures were analyzed with the last observation carried forward strategy and/or mixed-effects modeling for repeated measures. Of the 34 patients screened, 23 patients were randomized to receive quetiapine-XR (n = 11) or placebo (n = 12), with 5 and 4 completing the study, respectively. The mean dose of quetiapine-XR was 154 ± 91 mg/d. The change from baseline to endpoint in the total scores of HAMD-17, HAM-A, QIDS-16-SR, and CGI-S were significant in the quetiapine-XR group, but only the change in HAM-A total score was significant in the placebo group. The differences in these changes between the two groups were only significant in CGI-S scores, with the rest of numerical larger in the quetiapine-XR group. The most common side effects from quetiapine-XR were dry mouth, somnolence/sedation, and fatigue. In this pilot study, quetiapine-XR was numerically superior to placebo in reducing depressive and anxiety symptoms in patients with MDD and current GAD. Large sample studies are warranted to support or refute these preliminary findings.

  10. Depression and anxiety in patients with rheumatoid arthritis: prevalence rates based on a comparison of the Depression, Anxiety and Stress Scale (DASS) and the hospital, Anxiety and Depression Scale (HADS)

    OpenAIRE

    Covic Tanya; Cumming Steven R; Pallant Julie F; Manolios Nick; Emery Paul; Conaghan Philip G; Tennant Alan

    2012-01-01

    Abstract Background While it is recognised that depression is prevalent in Rheumatoid Arthritis (RA), recent studies have also highlighted significant levels of anxiety in RA patients. This study compared two commonly used scales, the Depression Anxiety and Stress Scale (DASS) and the Hospital Anxiety and Depression Scale (HADS), in relation to their measurement range and cut points to consider the relative prevalence of both constructs, and if prevalence rates may be due to scale-specific ca...

  11. Hamilton's principle for beginners

    International Nuclear Information System (INIS)

    Brun, J L

    2007-01-01

    I find that students have difficulty with Hamilton's principle, at least the first time they come into contact with it, and therefore it is worth designing some examples to help students grasp its complex meaning. This paper supplies the simplest example to consolidate the learning of the quoted principle: that of a free particle moving along a line. Next, students are challenged to add gravity to reinforce the argument and, finally, a two-dimensional motion in a vertical plane is considered. Furthermore these examples force us to be very clear about such an abstract principle

  12. Measuring Math Anxiety (in Spanish) with the Rasch Rating Scale Model.

    Science.gov (United States)

    Prieto, Gerardo; Delgado, Ana R

    2007-01-01

    Two successive studies probed the psychometric properties of a Math Anxiety questionnaire (in Spanish) by means of the Rasch Rating Scale Model. Participants were 411 and 216 Spanish adolescents. Convergent validity was examined by correlating the scale with both the Fennema and Sherman Attitude Scale and a math achievement test. The results show that the scores are psychometrically appropriate, and replicate those reported in meta-analyses: medium-sized negative correlations with achievement and with attitudes toward mathematics, as well as moderate sex-related differences (with girls presenting higher anxiety levels than boys).

  13. Dimensional approach to symptom factors of major depressive disorder in Koreans, using the Brief Psychiatric Rating Scale: the Clinical Research Center for Depression of South Korea study.

    Science.gov (United States)

    Park, Seon-Cheol; Jang, Eun Young; Kim, Daeho; Jun, Tae-Youn; Lee, Min-Soo; Kim, Jae-Min; Kim, Jung-Bum; Jo, Sun-Jin; Park, Yong Chon

    2015-01-01

    Although major depressive disorder (MDD) has a variety of symptoms beyond the affective dimensions, the factor structure and contents of comprehensive psychiatric symptoms of this disorder have rarely been explored using the 18-item Brief Psychiatric Rating Scale (BPRS). We aimed to identify the factor structure of the 18-item BPRS in Korean MDD patients. A total of 258 MDD patients were recruited from a multicenter sample of the Clinical Research Center for Depression of South Korea study. Psychometric scales were used to assess overall psychiatric symptoms (BPRS), depression (Hamilton Depression Rating Scale), anxiety (Hamilton Anxiety Rating Scale), global severity (Clinical Global Impression of Severity Scale), suicidal ideation (Scale for Suicide Ideation), functioning (Social and Occupational Functioning Assessment Scale), and quality of life (World Health Organization Quality of Life Assessment-abbreviated version). Common factor analysis with oblique rotation was used to yield factor structure. A four-factor structure was designed and interpreted by the symptom dimensions to reflect mood disturbance, positive symptoms/apathy, bipolarity, and thought distortion/mannerism. These individual factors were also significantly correlated with clinical variables. The findings of this study support the view that the BPRS may be a promising measuring tool for the initial assessment of MDD patients. In addition, the four-factor structure of the BPRS may be useful in understanding the mood and psychotic characteristics of these patients. Copyright © 2014. Published by Elsevier Taiwan.

  14. Dimensional approach to symptom factors of major depressive disorder in Koreans, using the Brief Psychiatric Rating Scale: The Clinical Research Center for Depression of South Korea Study

    Directory of Open Access Journals (Sweden)

    Seon-Cheol Park

    2015-01-01

    Full Text Available Although major depressive disorder (MDD has a variety of symptoms beyond the affective dimensions, the factor structure and contents of comprehensive psychiatric symptoms of this disorder have rarely been explored using the 18-item Brief Psychiatric Rating Scale (BPRS. We aimed to identify the factor structure of the 18-item BPRS in Korean MDD patients. A total of 258 MDD patients were recruited from a multicenter sample of the Clinical Research Center for Depression of South Korea study. Psychometric scales were used to assess overall psychiatric symptoms (BPRS, depression (Hamilton Depression Rating Scale, anxiety (Hamilton Anxiety Rating Scale, global severity (Clinical Global Impression of Severity Scale, suicidal ideation (Scale for Suicide Ideation, functioning (Social and Occupational Functioning Assessment Scale, and quality of life (World Health Organization Quality of Life Assessment-abbreviated version. Common factor analysis with oblique rotation was used to yield factor structure. A four-factor structure was designed and interpreted by the symptom dimensions to reflect mood disturbance, positive symptoms/apathy, bipolarity, and thought distortion/mannerism. These individual factors were also significantly correlated with clinical variables. The findings of this study support the view that the BPRS may be a promising measuring tool for the initial assessment of MDD patients. In addition, the four-factor structure of the BPRS may be useful in understanding the mood and psychotic characteristics of these patients.

  15. Repetitive transcranial magnetic stimulation for treatment of major depressive disorder with comorbid generalized anxiety disorder.

    Science.gov (United States)

    White, Daniela; Tavakoli, Sason

    2015-08-01

    Repetitive transcranial magnetic stimulation (rTMS) has shown promising results in treating individuals with behavioral disorders such as major depressive disorder (MDD), posttraumatic stress disorder, obsessive-compulsive disorder, and social anxiety disorder. A number of applications of rTMS to different regions of the left and right prefrontal cortex have been used to treat these disorders, but no study of treatment for MDD with generalized anxiety disorder (GAD) has been conducted with application of rTMS to both the left and right prefrontal cortex. We hypothesized that applying low-frequency rTMS to the right dorsolateral prefrontal cortex (DLPFC) before applying it to the left DLPFC for the treatment of depression would be anxiolytic in patients with MDD with GAD. Thirteen adult patients with comorbid MDD and GAD received treatment with rTMS in an outpatient setting. The number of treatments ranged from 24 to 36 over 5 to 6 weeks. Response was defined as a ≥ 50% reduction in symptoms from baseline, and remission was defined as a score of anxiety symptoms on the 7-item Generalized Anxiety Disorder (GAD-7) scale and depressive symptoms on the 21-item Hamilton Rating Scale for Depression (HAM-D-21). At the end of the treatment period, for the GAD-7 scale, 11 out of 13 (84.6%) patients' anxiety symptoms were in remission, achieving a score of depressive symptoms. In this small pilot study of 13 patients with comorbid MDD and GAD, significant improvement in anxiety symptoms along with depressive symptoms was achieved in a majority of patients after bilateral rTMS application.

  16. Hamilton-Jacobi equations and brane associated Lagrangians

    International Nuclear Information System (INIS)

    Baker, L.M.; Fairlie, D.B.

    2001-01-01

    This article seeks to relate a recent proposal for the association of a covariant Field Theory with a string or brane Lagrangian to the Hamilton-Jacobi formalism for strings and branes. It turns out that since in this special case, the Hamiltonian depends only upon the momenta of the Jacobi fields and not the fields themselves, it is the same as a Lagrangian, subject to a constancy constraint. We find that the associated Lagrangians for strings or branes have a covariant description in terms of the square root of the same Lagrangian. If the Hamilton-Jacobi function is zero, rather than a constant, then it is in in one dimension lower, reminiscent of the 'holographic' idea. In the second part of the paper, we discuss properties of these Lagrangians, which lead to what we have called 'Universal Field Equations', characteristic of covariant equations of motion

  17. Measuring Social Capital in Hamilton, Ontario

    Science.gov (United States)

    Kitchen, Peter; Williams, Allison; Simone, Dylan

    2012-01-01

    Social capital has been studied by academics for more than 20 years and within the past decade there has been an explosion of growth in research linking social capital to health. This paper investigates social capital in Hamilton, Ontario by way of a telephone survey of 1,002 households in three neighbourhood groups representing high, mixed and…

  18. Hamilton and Hardy: Mentoring and Friendship in the Service of Occupational Health.

    Science.gov (United States)

    Sullivan, Marianne

    This article explores the mentoring relationship between Alice Hamilton and Harriet Hardy, two female physician-researchers who had a tremendous impact on the development of the field of occupational health in the United States during the 20th century. The article relies on letters the women wrote to each other. Hamilton, the elder, supported and furthered Hardy's career by asking her to coauthor the second edition of a seminal occupational health text. After beginning this intellectual collaboration, Hamilton remained a mentor to Hardy, and a decades-long friendship ensued. The article explores their relationship within the historical, political, and social context in which the women worked and made remarkable contributions to public health.

  19. Nonlinear H-infinity control, Hamiltonian systems and Hamilton-Jacobi equations

    CERN Document Server

    Aliyu, MDS

    2011-01-01

    A comprehensive overview of nonlinear Haeu control theory for both continuous-time and discrete-time systems, Nonlinear Haeu-Control, Hamiltonian Systems and Hamilton-Jacobi Equations covers topics as diverse as singular nonlinear Haeu-control, nonlinear Haeu -filtering, mixed H2/ Haeu-nonlinear control and filtering, nonlinear Haeu-almost-disturbance-decoupling, and algorithms for solving the ubiquitous Hamilton-Jacobi-Isaacs equations. The link between the subject and analytical mechanics as well as the theory of partial differential equations is also elegantly summarized in a single chapter

  20. Efficacy of esomeprazole and flupentixol and melitracen in treatment of non-erosive gastroesophageal reflux disease with depression and anxiety

    Institute of Scientific and Technical Information of China (English)

    钟英强

    2006-01-01

    Objective To investigate the efficacy of esomeprazole (Esomeprazole) and flupentixol and melitracen (Deanxit) in treatment of non-erosive gastroesophageal reflux disease (NERD) with depression and anxiety. Methods The diagnosis of NERD was based on the results of esomeprazole scale (reflux diagnostic questionnaires, RDQ) and endoscopy, the degree and frequency of symptoms were graded and scored. Hamilton depression scale was used to evaluate depression and anxiety status. Sixty-three patients were randomly divided into group A (esomeprazole 20 mg qd),B (Deanxit 1 tab

  1. [Standardization of the Greek version of Zung's Self-rating Anxiety Scale (SAS)].

    Science.gov (United States)

    Samakouri, M; Bouhos, G; Kadoglou, M; Giantzelidou, A; Tsolaki, K; Livaditis, M

    2012-01-01

    Self-rating Anxiety Scale (SAS), introduced by Zung, has been widely used in research and in clinical practice for the detection of anxiety. The present study aims at standardizing the Greek version of SAS. SAS consists of 20 items rated on a 1-4 likert type scale. The total SAS score may vary from 20 (no anxiety at all) to 80 (severe anxiety). Two hundred and fifty four participants (114 male and 140 female), psychiatric patients, physically ill and general population individuals, aged 45.40±11.35 years, completed the following: (a) a demographic characteristics' questionnaire, (b) the SAS Greek version, (c) the Spielberg's Modified Greek State-Trait Anxiety Scale (STAI-Gr.-X) and (d) the Zung Depression Rating Scale (ZDRS). Seventy six participants answered the SAS twice within a 12th-day median period of time. The following parameters were calculated: (a) internal consistency of the SAS in terms of Cronbach's α co-efficient, (b) its test-retest reliability in terms of the Intraclass Correlation Coefficient (ICC) and (c) its concurrent and convergent validities through its score's Spearman's rho correlations with both the state and trait subscales of STAI-Gr X and the ZDRS. In addition, in order to evaluate SAS' discriminant validity, the scale's scores of the three groups of participants (psychiatric patients, physically ill and general population individuals) were compared among each other, in terms of Kruskall Wallis and Mann Whitney U tests. SAS Cronbach's alpha equals 0.897 while ICC regarding its test-retest reliability equals 0.913. Spearman's rho concerning validity: (a) when SAS is compared to STAI-Gr.-X (state), equals it 0.767, (b) when SAS is compared to STAI-Gr. X (trait), it equals 0.802 and (c) when SAS is compared to ZDRS, it equals 0.835. The mentally ill scored significantly higher in SAS compared to both the healthy and the general population. In conclusion, the SAS Greek version presents very satisfactory psychometric properties regarding

  2. The influence of stress, depression, and anxiety on PSA screening rates in a nationally representative sample.

    Science.gov (United States)

    Kotwal, Ashwin A; Schumm, Phil; Mohile, Supriya G; Dale, William

    2012-12-01

    Prostate-specific antigen (PSA) testing for prostate cancer is controversial, with concerning rates of both overscreening and underscreening. The reasons for the observed rates of screening are unknown, and few studies have examined the relationship of psychological health to PSA screening rates. Understanding this relationship can help guide interventions to improve informed decision-making for screening. A nationally representative sample of men 57-85 years old without prostate cancer (N = 1169) from the National Social life, Health and Aging Project was analyzed. The independent relationship of validated psychological health scales measuring stress, anxiety, and depression to PSA testing rates was assessed using multivariable logistic regression analyses. PSA screening rates were significantly lower for men with higher perceived stress [odds ratio (OR) = 0.76, P = 0.006], but not for higher depressive symptoms (OR = 0.89, P = 0.22) when accounting for stress. Anxiety influences PSA screening through an interaction with number of doctor visits (P = 0.02). Among the men who visited the doctor once those with higher anxiety were less likely to be screened (OR = 0.65, P = 0.04). Conversely, those who visited the doctor 10+ times with higher anxiety were more likely to be screened (OR = 1.71, P = 0.04). Perceived stress significantly lowers PSA screening likelihood, and it seems to partly mediate the negative relationship of depression with screening likelihood. Anxiety affects PSA screening rates differently for men with different numbers of doctor visits. Interventions to influence PSA screening rates should recognize the role of the patients' psychological state to improve their likelihood of making informed decisions and improve screening appropriateness.

  3. Research of personal features of patients with rosacea

    Directory of Open Access Journals (Sweden)

    Davydova A.V.

    2014-09-01

    Full Text Available Aim: to study the personal characteristics of patients with different subtypes of rosacea and the establishment of the relationship with the clinical manifestations of dermatosis. Materials and methods. Through questionnaires of dermato-logical quality of life, SKINDEKS-29, The Zung Self-Rating Anxiety Scale, The Hamilton Anxiety Rating Scale, Toronto Alexithymia Scale and the method of «Type of attitude to the disease» interviewed 42 patients with different subtypes of rosacea. The data obtained were processed statistically. Results. Rosacea reduces the quality of life of patients, increases the subjective assessment of anxiety scales Zung and Hamilton with a predominance of performance anxiety in the mind. Diagnosed with intermediate degree of alexithymia and anosognosic, ergopathic, anxious and the sensitive types of attitude towards the disease. Conclusions. Predisposition, as well as the development of anxiety disorders, impaired social adjustment, reduced quality of life of patients with rosacea emphasizes the need to implement their algorithm survey assessment of personal characteristics.

  4. Efficacy of Alfa EEG wave biofeedback in the management of anxiety

    Directory of Open Access Journals (Sweden)

    Pookala Bhat

    2010-01-01

    Full Text Available Background: Biofeedback is a technique in which people are trained to improve their health by learning to control certain internal bodily processes that normally occur involuntarily. Various studies in the past have shown usefulness of Alfa electroencephalographic (EEG biofeedback in the alleviation of anxiety symptoms. Though most of the psychiatric centers in the armed forces have this facility, not much work has been done in our setup to assess its efficacy in the management of anxiety. Hence this study was undertaken. Materials and Methods: This study was carried out in a multispecialty Command Hospital by enrolling 100 patients with psychiatric diagnosis from both inpatient and outpatient services. The anxiety level was assessed clinically and by using Hamilton Anxiety Scale and Taylor′s Manifest Anxiety Scale. One group of 50 patients was treated with Alfa EEG biofeedback sessions only, 5 times in a week for 8 weeks, along with specific pharmacotherapy. The other group was treated with appropriate dose of anxiolytics. The anxiety level was reassessed after 4 weeks and 8 weeks. Results: The response was better for mixed anxiety and depressive disorder with pharmacotherapy than with the biofeedback, but female patients showed better response with EEG biofeedback. Conclusion: In the short term, Alfa EEG biofeedback therapy is almost as efficacious as pharmacological intervention in the management of anxiety symptoms, and relatively more useful in females.

  5. Prevalence and predictors of depression and anxiety among the elderly population living in geriatric homes in Cairo, Egypt.

    Science.gov (United States)

    Ahmed, Dalia; El Shair, Inas Helmi; Taher, Eman; Zyada, Fadia

    2014-12-01

    Anxiety and depression are common in the elderly and affect their quality of life. The rates of depression and anxiety are higher among those living in institutional settings and are usually undiagnosed. The aim of the study was to determine the prevalence and predictors of depression, anxiety and mixed form (i.e. depression and anxiety) in the elderly living at geriatric homes. A cross-sectional study was conducted on 240 elderly participants from four randomly selected geriatric homes in Cairo. A pretested interview questionnaire was used to collect data. A short version of the Geriatric Depression Scale (GDS-15), the Hamilton Anxiety Scale, the Katz scale for Activity of Daily living, the three-item loneliness scale and the Personal Wellbeing Index Scale were used. The prevalence of depression, anxiety and mixed disorder among the studied group were 37.5, 14.2 and 30%, respectively. Old age and the presence of comorbidities were predictors for depression and/or anxiety. Female sex, a lower social class, insufficient income, partial independence and loneliness feeling are significant predictors for depression. Being married and loneliness feeling are significant predictors for anxiety, whereas the functional status is a significant predictor for mixed depression and anxiety. Depression and/or anxiety were found in more than 80% of the studied group. An older age, female sex, insufficient income, a lower social class, a partially independent functional status, the presence of comorbidities, more frequent loneliness feeling and being married or divorced were found to be significant predictors for these problems. This study reflects the need for the screening of the elderly in geriatric homes for depression and/or anxiety, especially among high-risk groups, and developing interventions to prevent and control such problems.

  6. Researcher Profile: An Interview with Axton Betz-Hamilton

    Directory of Open Access Journals (Sweden)

    Axton Betz-Hamilton

    2015-07-01

    Full Text Available Dr. Axton Betz-Hamilton teaches consumer studies courses at Eastern Illinois University, including Personal and Family Finance, Housing, and Consumer Issues. She conducts research on identity theft as well as financial abuse within families.

  7. HPA and SAM axis responses as correlates of self- vs parental ratings of anxiety in boys with an Autistic Disorder.

    Science.gov (United States)

    Bitsika, Vicki; Sharpley, Christopher F; Sweeney, John A; McFarlane, James R

    2014-03-29

    Anxiety and Autistic Disorder (AD) are both neurological conditions and both disorders share some features that make it difficult to precisely allocate specific symptoms to each disorder. HPA and SAM axis activities have been conclusively associated with anxiety, and may provide a method of validating anxiety rating scale assessments given by parents and their children with AD about those children. Data from HPA axis (salivary cortisol) and SAM axis (salivary alpha amylase) responses were collected from a sample of 32 high-functioning boys (M age=11yr) with an Autistic Disorder (AD) and were compared with the boys' and their mothers' ratings of the boys' anxiety. There was a significant difference between the self-ratings given by the boys and ratings given about them by their mothers. Further, only the boys' self-ratings of their anxiety significantly predicted the HPA axis responses and neither were significantly related to SAM axis responses. Some boys showed cortisol responses which were similar to that previously reported in children who had suffered chronic and severe anxiety arising from stressful social interactions. As well as suggesting that some boys with an AD can provide valid self-assessments of their anxiety, these data also point to the presence of very high levels of chronic HPA-axis arousal and consequent chronic anxiety in these boys. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Variations in Sense of Place Across Immigrant Status and Gender in Hamilton, Ontario; Saskatoon, Saskatchewan; and, Charlottetown, Prince Edward Island, Canada.

    Science.gov (United States)

    Gallina, Melissa; Williams, Allison

    Past research in Hamilton, Ontario has found that age and longevity of residence are positively associated with evaluations of sense of place (SoP); further, evaluations of SoP between immigrants and Canadian-born individuals have shown no clear pattern (Williams et al. 2010; Williams and Kitchen 2012). This paper builds on this work by further examining evaluations of SoP among both immigrants and Canadian-born residents and across gender in Hamilton, while expanding the study to two other small-to-medium sized cities: Saskatoon, Saskatchewan and, Charlottetown, Prince Edward Island. This paper has two objectives: (1) to establish measures of SoP across immigrant status and gender in Hamilton, Saskatoon, and Charlottetown; and, (2) to determine how SoP varies according to immigrant status, length of residence in Canada, age, income, and neighbourhood length of residence across the three city sites. Telephone survey data (n = 1,132) was used to compare evaluations of SoP across various groups and to construct an ordered logistic regression model for SoP. Results suggest that immigrants tended to rate their SoP lower than their Canadian-born counterparts. Hamilton residents were found to rate their SoP lowest, followed by Saskatoon residents and, finally, Charlottetown residents. Younger individuals, those with lower income levels, and those with shorter neighbourhood residency in the cities concerned were more likely to have lower evaluations of SoP. This research suggests that greater attention is needed to nurture immigrants' connection with their new home.

  9. State Anxiety and Nonlinear Dynamics of Heart Rate Variability in Students.

    Science.gov (United States)

    Dimitriev, Dimitriy A; Saperova, Elena V; Dimitriev, Aleksey D

    2016-01-01

    Clinical and experimental research studies have demonstrated that the emotional experience of anxiety impairs heart rate variability (HRV) in humans. The present study investigated whether changes in state anxiety (SA) can also modulate nonlinear dynamics of heart rate. A group of 96 students volunteered to participate in the study. For each student, two 5-minute recordings of beat intervals (RR) were performed: one during a rest period and one just before a university examination, which was assumed to be a real-life stressor. Nonlinear analysis of HRV was performed. The Spielberger's State-Trait Anxiety Inventory was used to assess the level of SA. Before adjusting for heart rate, a Wilcoxon matched pairs test showed significant decreases in Poincaré plot measures, entropy, largest Lyapunov exponent (LLE), and pointwise correlation dimension (PD2), and an increase in the short-term fractal-like scaling exponent of detrended fluctuation analysis (α1) during the exam session, compared with the rest period. A Pearson analysis indicated significant negative correlations between the dynamics of SA and Poincaré plot axes ratio (SD1/SD2), and between changes in SA and changes in entropy measures. A strong negative correlation was found between the dynamics of SA and LLE. A significant positive correlation was found between the dynamics of SA and α1. The decreases in Poincaré plot measures (SD1, complex correlation measure), entropy measures, and LLE were still significant after adjusting for heart rate. Corrected α1 was increased during the exam session. As before, the dynamics of adjusted LLE was significantly correlated with the dynamics of SA. The qualitative increase in SA during academic examination was related to the decrease in the complexity and size of the Poincaré plot through a reduction of both the interbeat interval and its variation.

  10. State Anxiety and Nonlinear Dynamics of Heart Rate Variability in Students.

    Directory of Open Access Journals (Sweden)

    Dimitriy A Dimitriev

    Full Text Available Clinical and experimental research studies have demonstrated that the emotional experience of anxiety impairs heart rate variability (HRV in humans. The present study investigated whether changes in state anxiety (SA can also modulate nonlinear dynamics of heart rate.A group of 96 students volunteered to participate in the study. For each student, two 5-minute recordings of beat intervals (RR were performed: one during a rest period and one just before a university examination, which was assumed to be a real-life stressor. Nonlinear analysis of HRV was performed. The Spielberger's State-Trait Anxiety Inventory was used to assess the level of SA.Before adjusting for heart rate, a Wilcoxon matched pairs test showed significant decreases in Poincaré plot measures, entropy, largest Lyapunov exponent (LLE, and pointwise correlation dimension (PD2, and an increase in the short-term fractal-like scaling exponent of detrended fluctuation analysis (α1 during the exam session, compared with the rest period. A Pearson analysis indicated significant negative correlations between the dynamics of SA and Poincaré plot axes ratio (SD1/SD2, and between changes in SA and changes in entropy measures. A strong negative correlation was found between the dynamics of SA and LLE. A significant positive correlation was found between the dynamics of SA and α1. The decreases in Poincaré plot measures (SD1, complex correlation measure, entropy measures, and LLE were still significant after adjusting for heart rate. Corrected α1 was increased during the exam session. As before, the dynamics of adjusted LLE was significantly correlated with the dynamics of SA.The qualitative increase in SA during academic examination was related to the decrease in the complexity and size of the Poincaré plot through a reduction of both the interbeat interval and its variation.

  11. Low vagally-mediated heart rate variability and increased susceptibility to ventricular arrhythmias in rats bred for high anxiety.

    Science.gov (United States)

    Carnevali, Luca; Trombini, Mimosa; Graiani, Gallia; Madeddu, Denise; Quaini, Federico; Landgraf, Rainer; Neumann, Inga D; Nalivaiko, Eugene; Sgoifo, Andrea

    2014-04-10

    In humans, there is a documented association between anxiety disorders and cardiovascular disease. Putative underlying mechanisms may include an impairment of the autonomic nervous system control of cardiac function. The primary objective of the present study was to characterize cardiac autonomic modulation and susceptibility to arrhythmias in genetic lines of rats that differ largely in their anxiety level. To reach this goal, electrocardiographic recordings were performed in high-anxiety behavior (HAB, n=10) and low-anxiety behavior (LAB, n=10) rats at rest, during stressful stimuli and under autonomic pharmacological manipulations, and analyzed by means of time- and frequency-domain indexes of heart rate variability. During resting conditions, HAB rats displayed a reduced heart rate variability, mostly in terms of lower parasympathetic (vagal) modulation compared to LAB rats. In HAB rats, this relatively low cardiac vagal control was associated with smaller heart rate responsiveness to acute stressors compared to LAB counterparts. In addition, beta-adrenergic pharmacological stimulation induced a larger incidence of ventricular tachyarrhythmias in HABs compared to LABs. At sacrifice, a moderate increase in heart-body weight ratio was observed in HAB rats. We conclude that high levels of anxiety-related behavior in rats are associated with signs of i) impaired autonomic modulation of heart rate (low vagally-mediated heart rate variability), ii) poor adaptive heart rate responsiveness to stressful stimuli, iii) increased arrhythmia susceptibility, and iv) cardiac hypertrophy. These results highlight the utility of the HAB/LAB model for investigating the mechanistic basis of the comorbidity between anxiety disorders and cardiovascular disease. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Cultural Aspects in Social Anxiety and Social Anxiety Disorder

    Science.gov (United States)

    Hofmann, Stefan G.; Asnaani, Anu; Hinton, Devon E.

    2010-01-01

    To examine cultural aspects in social anxiety and social anxiety disorder (SAD), we reviewed the literature on the prevalence rates, expressions, and treatments of social anxiety/SAD as they relate to culture, race, and ethnicity. We further reviewed factors that contribute to the differences in social anxiety/SAD between different cultures, including individualism/collectivism, perception of social norms, self-construal, gender roles, and gender role identification. Our review suggests that the prevalence and expression of social anxiety/SAD depends on the particular culture. Asian cultures typically show the lowest rates, whereas Russian and US samples show the highest rates, of SAD. Taijin kyofusho is discussed as a possible culture-specific expression of social anxiety, although the empirical evidence concerning the validity of this syndrome has been mixed. It is concluded that the individual's social concerns need to be examined in the context of the person's cultural, racial, and ethnic background in order to adequately assess the degree and expression of social anxiety and social anxiety disorder. This has direct relevance for the upcoming DSM-V. PMID:21132847

  13. Depression and anxiety in patients with rheumatoid arthritis: prevalence rates based on a comparison of the Depression, Anxiety and Stress Scale (DASS) and the hospital, Anxiety and Depression Scale (HADS)

    Science.gov (United States)

    2012-01-01

    Background While it is recognised that depression is prevalent in Rheumatoid Arthritis (RA), recent studies have also highlighted significant levels of anxiety in RA patients. This study compared two commonly used scales, the Depression Anxiety and Stress Scale (DASS) and the Hospital Anxiety and Depression Scale (HADS), in relation to their measurement range and cut points to consider the relative prevalence of both constructs, and if prevalence rates may be due to scale-specific case definition. Methods Patients meeting the criteria for RA were recruited in Leeds, UK and Sydney, Australia and asked to complete a survey that included both scales. The data was analysed using the Rasch measurement model. Results A total of 169 RA patients were assessed, with a repeat subsample, resulting in 323 cases for analysis. Both scales met Rasch model expectations. Using the 'possible+probable' cut point from the HADS, 58.3% had neither anxiety nor depression; 13.5% had anxiety only; 6.4% depression only and 21.8% had both 'possible+probable' anxiety and depression. Cut points for depression were comparable across the two scales while a lower cut point for anxiety in the DASS was required to equate prevalence. Conclusions This study provides further support for high prevalence of depression and anxiety in RA. It also shows that while these two scales provide a good indication of possible depression and anxiety, the estimates of prevalence so derived could vary, particularly for anxiety. These findings are discussed in terms of comparisons across studies and selection of scales for clinical use. PMID:22269280

  14. Depression and anxiety in patients with rheumatoid arthritis: prevalence rates based on a comparison of the Depression, Anxiety and Stress Scale (DASS) and the hospital, Anxiety and Depression Scale (HADS).

    Science.gov (United States)

    Covic, Tanya; Cumming, Steven R; Pallant, Julie F; Manolios, Nick; Emery, Paul; Conaghan, Philip G; Tennant, Alan

    2012-01-24

    While it is recognised that depression is prevalent in Rheumatoid Arthritis (RA), recent studies have also highlighted significant levels of anxiety in RA patients. This study compared two commonly used scales, the Depression Anxiety and Stress Scale (DASS) and the Hospital Anxiety and Depression Scale (HADS), in relation to their measurement range and cut points to consider the relative prevalence of both constructs, and if prevalence rates may be due to scale-specific case definition. Patients meeting the criteria for RA were recruited in Leeds, UK and Sydney, Australia and asked to complete a survey that included both scales. The data was analysed using the Rasch measurement model. A total of 169 RA patients were assessed, with a repeat subsample, resulting in 323 cases for analysis. Both scales met Rasch model expectations. Using the 'possible+probable' cut point from the HADS, 58.3% had neither anxiety nor depression; 13.5% had anxiety only; 6.4% depression only and 21.8% had both 'possible+probable' anxiety and depression. Cut points for depression were comparable across the two scales while a lower cut point for anxiety in the DASS was required to equate prevalence. This study provides further support for high prevalence of depression and anxiety in RA. It also shows that while these two scales provide a good indication of possible depression and anxiety, the estimates of prevalence so derived could vary, particularly for anxiety. These findings are discussed in terms of comparisons across studies and selection of scales for clinical use.

  15. Depression and anxiety in patients with rheumatoid arthritis: prevalence rates based on a comparison of the Depression, Anxiety and Stress Scale (DASS and the hospital, Anxiety and Depression Scale (HADS

    Directory of Open Access Journals (Sweden)

    Covic Tanya

    2012-01-01

    Full Text Available Abstract Background While it is recognised that depression is prevalent in Rheumatoid Arthritis (RA, recent studies have also highlighted significant levels of anxiety in RA patients. This study compared two commonly used scales, the Depression Anxiety and Stress Scale (DASS and the Hospital Anxiety and Depression Scale (HADS, in relation to their measurement range and cut points to consider the relative prevalence of both constructs, and if prevalence rates may be due to scale-specific case definition. Methods Patients meeting the criteria for RA were recruited in Leeds, UK and Sydney, Australia and asked to complete a survey that included both scales. The data was analysed using the Rasch measurement model. Results A total of 169 RA patients were assessed, with a repeat subsample, resulting in 323 cases for analysis. Both scales met Rasch model expectations. Using the 'possible+probable' cut point from the HADS, 58.3% had neither anxiety nor depression; 13.5% had anxiety only; 6.4% depression only and 21.8% had both 'possible+probable' anxiety and depression. Cut points for depression were comparable across the two scales while a lower cut point for anxiety in the DASS was required to equate prevalence. Conclusions This study provides further support for high prevalence of depression and anxiety in RA. It also shows that while these two scales provide a good indication of possible depression and anxiety, the estimates of prevalence so derived could vary, particularly for anxiety. These findings are discussed in terms of comparisons across studies and selection of scales for clinical use.

  16. The comparison of severity and prevalence of major depressive disorder, general anxiety disorder and eating disorders before and after bariatric surgery.

    Science.gov (United States)

    Matini, Diana; Ghanbari Jolfaei, Atefeh; Pazouki, Abdolreza; Pishgahroudsari, Mohadeseh; Ehtesham, Mehdi

    2014-01-01

    Severe obesity is highly co-morbid with psychiatric disorders and may have effect on the quality of life. This study aimed to compare severity and prevalence rate of depression, anxiety and eating disorders and quality of life in severe obese patients before and 6 months after the gastric bypass surgery. This was a prospective observational study which conducted at Hazarat Rasool-Akram Hospital in Tehran, 2012. Questionnaires included demographic questions, eating disorder Inventory (EDI), The Short Form Health Survey (SF-36) for quality of life, Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) and Hamilton Rating Scale for Depression (HRSD) and anxiety (HRSA). Participants were interviewed two times, before surgery and six months after, to determine changes of the disorders. Patients with the history of bariatric surgery, individuals younger than 18 year old and those who disagreed to join the study were excluded. In assessing the eating disorder inventory-3rd version (EDI-3), Significant reduction in drive for thinness (DT) (p= 0.010), bulimia (B) (pdepression in HRSD (p= 0.311), prevalence of depression (p= 0.189) and prevalence of general anxiety disorder according to SCID (p=0.167) did not differ significantly, at this period. Although weight loss after bariatric surgery improved the physical component of quality of life, this improvement did not affect the mental aspect of life, depression and anxiety and it seems that these psychopathologies need attention and treatment in addition to weight loss treatments in patients with obesity.

  17. The effect of heart rate variability biofeedback training on stress and anxiety: a meta-analysis.

    Science.gov (United States)

    Goessl, V C; Curtiss, J E; Hofmann, S G

    2017-11-01

    Some evidence suggests that heart rate variability (HRV) biofeedback might be an effective way to treat anxiety and stress symptoms. To examine the effect of HRV biofeedback on symptoms of anxiety and stress, we conducted a meta-analysis of studies extracted from PubMed, PsycINFO and the Cochrane Library. The search identified 24 studies totaling 484 participants who received HRV biofeedback training for stress and anxiety. We conducted a random-effects meta-analysis. The pre-post within-group effect size (Hedges' g) was 0.81. The between-groups analysis comparing biofeedback to a control condition yielded Hedges' g = 0.83. Moderator analyses revealed that treatment efficacy was not moderated by study year, risk of study bias, percentage of females, number of sessions, or presence of an anxiety disorder. HRV biofeedback training is associated with a large reduction in self-reported stress and anxiety. Although more well-controlled studies are needed, this intervention offers a promising approach for treating stress and anxiety with wearable devices.

  18. Hamiltonization of theories with degenerate coordinates

    International Nuclear Information System (INIS)

    Gitman, D.M.; Tyutin, I.V.

    2002-01-01

    We consider a class of Lagrangian theories where part of the coordinates does not have any time derivatives in the Lagrange function (we call such coordinates degenerate). We advocate that it is reasonable to reconsider the conventional definition of singularity based on the usual Hessian and, moreover, to simplify the conventional hamiltonization procedure. In particular, in such a procedure, it is not necessary to complete the degenerate coordinates with the corresponding conjugate momenta

  19. Hamiltonization of theories with degenerate coordinates

    Energy Technology Data Exchange (ETDEWEB)

    Gitman, D.M. E-mail: gitman@fma.if.usp.br; Tyutin, I.V. E-mail: tyutin@lpi.ru

    2002-05-27

    We consider a class of Lagrangian theories where part of the coordinates does not have any time derivatives in the Lagrange function (we call such coordinates degenerate). We advocate that it is reasonable to reconsider the conventional definition of singularity based on the usual Hessian and, moreover, to simplify the conventional hamiltonization procedure. In particular, in such a procedure, it is not necessary to complete the degenerate coordinates with the corresponding conjugate momenta.

  20. Vitamin D status is associated with anxiety levels in postmenopausal women evaluated for osteoporosis

    Directory of Open Access Journals (Sweden)

    Gabriella Martino

    2018-04-01

    Full Text Available Vitamin D status has been previously associated with a wide range of acute and chronic diseases. The nervous system express vitamin D receptors and thus vitamin D may be involved in mental health. Poor data exist about the correlation between vitamin D and anxiety levels.Our aim was to investigate the association of vitamin D status with anxiety severity. A group of 177 postmenopausal women (mean age 65.5±8.22 yr. referring to an outpatients clinic for the prevention of osteoporosis were evaluated. Severity of perceived anxiety symptoms was measured by the Hamilton Anxiety rating scale (HAMA. Depression levels were also evaluated using the Beck Depression Inventory-second edition scale (BDI-II.  25(OHD serum levels, indicative of vitamin D status, were detected by high-performance liquid chromatography. 25(OHD levels were significantly related HAMA-score (r=-0.15, p=0.04; particularly a deep association was observed between 25(OHD levels and somatic symptoms (r=-0.195, p=0.009. HAMA score was associated with BDI-II score (r=0.487, p=<0.001; HAMA psychic symptom score was also related with age and time since menopause (r=0.149, p=0.039 and r=0.222, p=0.003, respectively. At a multiple regression analysis, after correcting for age and depression levels, 25(OHD was predictive of HAMA score (β =-0,05961, p= 0.02, SE=-2.206, but the strength of association was lost further correcting for time since menopause.  In conclusion, in a setting of postmenopausal women, we observed a significant association between anxiety levels and serum 25(OHD concentrations irrespective of age and depression levels.

  1. Anxiety, depression, and posttraumatic stress in Iranian survivors of chemical warfare.

    Science.gov (United States)

    Hashemian, Farnoosh; Khoshnood, Kaveh; Desai, Mayur M; Falahati, Farahnaz; Kasl, Stanislav; Southwick, Steven

    2006-08-02

    In the 1980-1988 Iran-Iraq War, extensive use of chemical weapons resulted in high rates of morbidity and mortality. While much is known about the physical consequences of chemical warfare, there is a paucity of information about the long-term effects of chemical attacks on mental health. To assess the long-term psychological impact of chemical warfare on a civilian population. Cross-sectional randomized survey conducted in July 2004 of 153 civilians in 3 towns exposed to warfare in northwestern Iran: Oshnaviyeh (low-intensity conventional warfare), Rabat (high-intensity conventional warfare), and Sardasht (both high-intensity conventional warfare and chemical weapons). Full or partial posttraumatic stress disorder (PTSD) diagnosis, anxiety symptoms, and depressive symptoms were assessed using Farsi versions of the Clinician-Administered PTSD Scale, Hamilton Scale for Anxiety, and Beck Depression Inventory, respectively. Overall participation rate was 93%. Respondents had a mean age of 45 years and were all of Kurdish ethnicity. Among individuals exposed to both high-intensity warfare and chemical weapons, prevalence rates for lifetime PTSD, current PTSD, major anxiety symptoms, and severe depressive symptoms were 59%, 33%, 65%, and 41%, respectively. Among the low-intensity warfare group, the corresponding rates were 8%, 2%, 18%, and 6%, respectively, while intermediate rates were found among those exposed to high-intensity warfare but not to chemical weapons (31%, 8%, 26%, and 12%, respectively). Compared with individuals exposed to low-intensity warfare, those exposed to both high-intensity warfare and chemical weapons were at higher risk for lifetime PTSD (odds ratio [OR], 18.6; 95% confidence interval [CI], 5.8-59.4), current PTSD (OR, 27.4; 95% CI, 3.4-218.2), increased anxiety symptoms (OR, 14.6; 95% CI, 6.0-35.6), and increased depressive symptoms (OR, 7.2; 95% CI, 3.3-15.9). Exposure to high-intensity warfare but not to chemical weapons was also

  2. Thorax deformity, joint hypermobility and anxiety disorder

    International Nuclear Information System (INIS)

    Gulsun, M.; Dumlu, K.; Erbas, M.; Yilmaz, Mehmet B.; Pinar, M.; Tonbul, M.; Celik, C.; Ozdemir, B.

    2007-01-01

    Objective was to evaluate the association between thorax deformities, panic disorder and joint hypermobility. The study includes 52 males diagnosed with thorax deformity, and 40 healthy male controls without thorax deformity, in Tatvan Bitlis and Isparta, Turkey. The study was carried out from 2004 to 2006. The teleradiographic and thoracic lateral images of the subjects were evaluated to obtain the Beighton scores; subjects psychiatric conditions were evaluated using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-1), and the Hamilton Anxiety Scale (HAM-A) was applied in order to determine the anxiety levels. Both the subjects and controls were compared in sociodemographic, anxiety levels and joint mobility levels. In addition, males with joint hypermobility and thorax deformity were compared to the group with thorax deformity without joint hypermobility. A significant difference in HAM-A scores was found between the groups with thorax deformity and without. In addition, 21 subjects with thorax deformity met the joint hypermobility criteria in the group with thorax deformity and 7 subjects without thorax deformity met the joint hypermobility criteria in the group without thorax deformity, according to Beighton scoring. The Beighton score of subjects with thorax deformity were significantly different from those of the group without deformity. Additionally, anxiety scores of the males with thorax deformity and joint hypermobility were found higher than males with thorax deformity without joint hypermobility. Anxiety disorders, particularly panic disorder, have a significantly higher distribution in males subjects with thorax deformity compared to the healthy control group. In addition, the anxiety level of males with thorax deformity and joint hypermobility is higher than males with thorax deformity without joint hypermobility. (author)

  3. Attachment style dimensions can affect prolonged grief risk in caregivers of terminally ill patients with cancer.

    Science.gov (United States)

    Lai, Carlo; Luciani, Massimiliano; Galli, Federico; Morelli, Emanuela; Cappelluti, Roberta; Penco, Italo; Aceto, Paola; Lombardo, Luigi

    2015-12-01

    The aim of the present study was to evaluate the predictive role of attachment dimensions on the risk of prolonged grief. Sixty caregivers of 51 terminally ill patients with cancer who had been admitted in a hospice were selected. Caregivers were interviewed using Attachment Scale Questionnaire, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and Prolonged Grief Disorder 12 (PG-12). The consort caregivers showed higher PG-12 level compared to the sibling caregivers. Anxiety, depression, need for approval, and preoccupation with relationships levels were significantly correlated with PG-12 scores. Female gender, high levels of depression, and preoccupation with relationships significantly predicted higher levels of prolonged grief risk. © The Author(s) 2014.

  4. 'From Man to Bacteria': W.D. Hamilton, the theory of inclusive fitness, and the post-war social order.

    Science.gov (United States)

    Swenson, Sarah A

    2015-02-01

    W.D. Hamilton's theory of inclusive fitness aimed to define the evolved limits of altruism with mathematical precision. Although it was meant to apply universally, it has been almost irretrievably entwined with the particular case of social insects that featured in his famous 1964 papers. The assumption that social insects were central to Hamilton's early work contradicts material in his rich personal archive. In fact, careful study of Hamilton's notes, letters, diaries, and early essays indicates the extent to which he had humans in mind when he decided altruism was a topic worthy of biological inquiry. For this reason, this article reconsiders the role of extra-scientific factors in Hamilton's early theorizing. In doing so, it offers an alternative perspective as to why Hamilton saw self-sacrifice to be an important subject. Although the traditional narrative prioritizes his distaste for benefit-of-the-species explanations as a motivating factor behind his foundational work, I argue that greater attention ought to be given to Hamilton's hope that science could be used to address social ills. By reconsidering the meaning Hamilton intended inclusive fitness to have, we see that while he was no political ideologue, the socio-political relevance of his theory was nevertheless integral to its development. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder.

    Science.gov (United States)

    Hayes-Skelton, Sarah A; Roemer, Lizabeth; Orsillo, Susan M

    2013-10-01

    To examine whether an empirically and theoretically derived treatment combining mindfulness- and acceptance-based strategies with behavioral approaches would improve outcomes in generalized anxiety disorder (GAD) over an empirically supported treatment. This trial randomized 81 individuals (65.4% female, 80.2% identified as White, average age 32.92) diagnosed with GAD to receive 16 sessions of either an acceptance-based behavior therapy (ABBT) or applied relaxation (AR). Assessments at pretreatment, posttreatment, and 6-month follow-up included the following primary outcome measures: GAD clinician severity rating, Structured Interview Guide for the Hamilton Anxiety Rating Scale, Penn State Worry Questionnaire, Depression Anxiety Stress Scale, and the State-Trait Anxiety Inventory. Secondary outcomes included the Beck Depression Inventory-II, Quality of Life Inventory, and number of comorbid diagnoses. Mixed effect regression models showed significant, large effects for time for all primary outcome measures (ds = 1.27 to 1.61) but nonsignificant, small effects for condition and Condition × Time (ds = 0.002 to 0.20), indicating that clients in the 2 treatments improved comparably over treatment. For secondary outcomes, time was significant (ds = 0.74 to 1.38), but condition and Condition × Time effects were not (ds = 0.004 to 0.31). No significant differences emerged over follow-up (ds = 0.03 to 0.39), indicating maintenance of gains. Between 63.3 and 80.0% of clients in ABBT and 60.6 and 78.8% of clients in AR experienced clinically significant change across 5 calculations of change at posttreatment and follow-up. ABBT is a viable alternative for treating GAD. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

  6. Alterations of benzodiazepine receptor binding potential in anxiety and somatoform disorders measured by 123I-iomazenil SPECT

    International Nuclear Information System (INIS)

    Tokunaga, Mari; Ida, Ituro; Mikuni, Masahiko; Higuchi, Teruhiko.

    1997-01-01

    123 I-iomazenil (IMZ), a newly developed radioligand which acts on benzodiazepine receptors (BZR) as a partial inverse agonist, made it possible to evaluate the function of central BZR by single photon emission tomography (SPECT). To examine the alterations of the binding potential (BP) in the anxiety state, 123 I-IMZ SPECT was performed in five patients with anxiety and somatoform disorders, and five epileptic patients without anxiety symptoms served as a reference. The BP of BZR was determined by using a table look-up procedure based on a three-compartment, two-parameter model in the bilateral superior frontal, inferior frontal, temporal, parietal, occipital, and cerebellar cortex. The mean BP of patients with anxiety and somatoform disorders was significantly decreased in the superior frontal, temporal, and parietal cortex, in comparison with that of epileptic patients. A significant correlation was observed between the anxiety levels scored on the Hamilton anxiety scale and BP in the right temporal cortex and left superior frontal cortex. These changes in BZR revealed by SPECT suggest the usefulness of 123 I-IMZ SPECT to objectively evaluate anxiety levels in patients with anxiety symptoms. (author)

  7. Elementary Pre-Service Teachers' Mathematics Anxiety and Mathematics Teaching Anxiety

    Science.gov (United States)

    Haciomeroglu, Guney

    2014-01-01

    The present study examined the structure of elementary pre-service teachers' mathematics anxiety and mathematics teaching anxiety by asking whether the two systems of anxiety are related. The Turkish Mathematics Anxiety Rating Scale Short Version and the Mathematics Teaching Anxiety Scale were administered to 260 elementary pre-service teachers.…

  8. Severity of Anxiety Disorders in Patients with Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Mitra Safa

    2015-10-01

    Full Text Available Objective: Patients with chronic physical diseases sometimes show increased loss of function; such patients need more care. Anxiety is a well-known symptom that is prevalent among chronic obstructive pulmonary disease patients that can prolong and increase the risk of hospitalization. The purpose of this study was to evaluate the severity of anxiety in the mentioned patients and to examine the presence of symptoms and appropriate treatment strategies to understand the role of psychological functions in physical patients.Methods: This was a cross sectional study conducted in Masih Daneshvari Hospital. One hundred forty- three patients entered into the project by accessible method and signed the informed consent; they filled demographic information and Hamilton anxiety and depression questionnaires. Data were analyzed by SPSS-16 .Results: Of the participants, 68% were above 60 years of age; 78% were male; 89% were married; and 38% were self-employed. Also, among the participants, 51% were illiterate; 72% had history of smoking; 46% had history of substance abuse; and 49% had moderate to severe anxiety disorder. Moreover, of the patients with severe anxiety, 41.3% had severe muscle spasms; and severe sleeplessness was found in 38.5% of those with severe anxiety disorder. Severe anxiety related symptoms were found in 20.3% of the patients with severe anxiety disorder. Depressed mood was found in 27.3% of the patients with severe anxiety disorder. Severe physical and muscular signs were found in 35.7% of those with severe anxiety disorder .Conclusion: According to our findings, many chronic diseases such as chronic obstructive pulmonary disease may contain anxiety and depression which result in vulnerability. Therefore, evaluation of anxiety in such patients is of importance for alleviating the disease.

  9. Directional anxiety responses in elite and sub-elite young athletes: intensity of anxiety symptoms matters.

    Science.gov (United States)

    Lundqvist, C; Kenttä, G; Raglin, J S

    2011-12-01

    The objective was to examine the differences in anxiety ratings of elite and sub-elite athletes when the relationship between intensity and direction scores of anxiety ratings is considered in analyses. Participants were 31 junior elite (Mean age: 17.7, SD=1.1) and 53 sub-elite (Mean age: 17.5, SD=1.1) cross country skiers and swimmers who completed the direction modified CSAI-2R before important competitions. Results showed that elite athletes rated a higher percent of items as facilitative to their performance whereas sub-elite athletes rated a higher percent of items as debilitative. No significant differences between the elite and sub-elite samples were displayed regarding rated direction scores of cognitive or somatic anxiety at moderate to high-intensity levels. A significant difference in facilitative anxiety ratings was displayed at a low anxiety intensity level (Z=-2.20, Pperformance data showed no consistent congruence with athletes' anxiety direction ratings. The findings suggest that facilitative direction scores are a consequence of low anxiety intensity, possibly combined with high self-confidence levels. Directional anxiety researchers analyzing separate total scores of intensity and direction respectively, which is the traditional approach, may draw incorrect conclusions about the importance of facilitative ratings of anxiety symptoms. © 2010 John Wiley & Sons A/S.

  10. A double-blind crossover comparison of clomipramine and desipramine in the treatment of panic disorder.

    Science.gov (United States)

    Sasson, Y; Iancu, I; Fux, M; Taub, M; Dannon, P N; Zohar, J

    1999-03-01

    To compare the efficacy of clomipramine hydrochloride (CMI), a serotonin reuptake inhibitor with the noradrenergic tricyclic antidepressant agent, and desipramine hydrochloride (DMI) for patients with panic disorder (PD). Following a 2-week, single-blind placebo washout phase, 17 PD outpatients completed a 16-week, double-blind, crossover comparison of CMI and DMI. Key outcome measures included panic attacks frequency, the NIMH Global Scales for Anxiety, Depression and Impairment, Hamilton Anxiety Scale (Psychic and Somatic Subscales), Zung Anxiety Inventory (Raw and Index Subscales) and the Spielberger State Anxiety Scale. Both CMI and DMI led to significant improvement from baseline placebo state in panic attacks frequency and behavioral ratings (p<0.001). CMI led to a greater reduction in the frequency of panic attacks (p=0.028) and was superior to DMI on ratings of anxiety: NIMH Global Anxiety, Zung Anxiety Scale (Raw and Index) and the Spielberger Anxiety Scale. No difference was found between the drugs on the NIMH Global Impairment Scale and the Hamilton Somatic and Psychic Scales. Both drugs appeared to have significant therapeutic effects in patients with PD, but CMI appeared to be more effective. The effectiveness of the serotonergic drug suggests that the role of the serotonergic system in the pathogenesis of PD should be further explored.

  11. Dynamic relationship between Japanese Yen exchange rates and market anxiety: A new perspective based on MF-DCCA

    Science.gov (United States)

    Lu, Xinsheng; Sun, Xinxin; Ge, Jintian

    2017-05-01

    This paper investigates the dynamic relationship between Japanese Yen exchange rates and market anxiety during the period from January 5, 1998 to April 18, 2016. A quantitative technique of multifractal detrended cross-correlation analysis (MF-DCCA) is used to explore the multifractal features of the cross-correlations between USD/JPY, AUD/JPY exchange rates and the market anxiety gauge VIX. The investigation shows that the causal relationship between Japanese Yen exchange rates and VIX are bidirectional in general, and the cross-correlations between the two sets of time series are multifractal. Strong evidence suggests that the cross-correlation exponents tend to exhibit different volatility patterns in response to diverse external shocks such as financial distress and widening in interest rate spread, suggesting that the cross-correlated behavior between Japanese Yen exchange rates and VIX are susceptible to economic uncertainties and risks. In addition, the performances of two market anxiety gauges, the VIX and the TED spread, are compared and the sources of multifractality are also traced. Thus, this paper contributes to the literature by shedding light on the unique driving forces of the Yen exchange rate fluctuations in the international foreign exchange market.

  12. Correlations between sexual dysfunction, depression, anxiety, and somatic symptoms among patients with major depressive disorder.

    Science.gov (United States)

    Lin, Chiao-Fan; Juang, Yeong-Yuh; Wen, Jung-Kwang; Liu, Chia-Yih; Hung, Ching-I

    2012-01-01

    The purpose of this study was to investigate the degree of correlation between sexual dysfunction and depression, anxiety, and somatic symptoms among patients with major depressive disorder (MDD) and to identify the dimension most predictive of sexual dysfunction. One-hundred and thirty-five outpatients with MDD were enrolled and were treated with open-label venlafaxine 75 mg daily for one month. The Arizona Sexual Experience Scale-Chinese Version (ASEX-CV), Depression and Somatic Symptoms Scale (DSSS), Hamilton Depression Rating Scale, and Hospital Anxiety and Depression Scale (HADS) were administered at baseline and at one-month follow-up and the improvement percentage (IP) of each scale posttreatment was calculated. Multiple linear regression was used to determine the dimension most predictive of the total ASEX-CV score. Seventy subjects (20 men, 50 women) completed the one-month pharmacotherapy and the four scales. The depression subscale of the HADS was most strongly correlated with the ASEX-CV scale and was the only subscale to independently predict the total ASEX-CV score at the two points. However, the somatic subscale of the DSSS was not correlated with any ASEX-CV item. At the endpoint, depression, anxiety, and somatic symptoms were significantly improved (IP 48.5% to 26.0%); however, very little improvement was observed in the total ASEX-CV score (IP -1.6%). The severity of sexual dysfunction among patients with MDD was most correlated with the severity of the depressive dimension, but not the severity of the somatic dimension. Further studies are indicated to explore the relationships between sexual dysfunction, depression, anxiety, and somatic symptoms.

  13. Using effort-reward imbalance theory to understand high rates of depression and anxiety among clergy.

    Science.gov (United States)

    Proeschold-Bell, Rae Jean; Miles, Andrew; Toth, Matthew; Adams, Christopher; Smith, Bruce W; Toole, David

    2013-12-01

    The clergy occupation is unique in its combination of role strains and higher calling, putting clergy mental health at risk. We surveyed all United Methodist clergy in North Carolina, and 95% (n = 1,726) responded, with 38% responding via phone interview. We compared clergy phone interview depression rates, assessed using the Patient Health Questionnaire (PHQ-9), to those of in-person interviews in a representative United States sample that also used the PHQ-9. The clergy depression prevalence was 8.7%, significantly higher than the 5.5% rate of the national sample. We used logistic regression to explain depression, and also anxiety, assessed using the Hospital Anxiety and Depression Scale. As hypothesized by effort-reward imbalance theory, several extrinsic demands (job stress, life unpredictability) and intrinsic demands (guilt about not doing enough work, doubting one's call to ministry) significantly predicted depression and anxiety, as did rewards such as ministry satisfaction and lack of financial stress. The high rate of clergy depression signals the need for preventive policies and programs for clergy. The extrinsic and intrinsic demands and rewards suggest specific actions to improve clergy mental health.

  14. Higher order derivatives via Hamilton-Jacobi approach

    International Nuclear Information System (INIS)

    Bertin, M.C.; Pimentel, B.M.; Pompeia, P.J.

    2006-01-01

    In this work we will show how can be derived a general method for dealing with Lagrangians containing high order derivatives using the Hamilton-Jacobi Formalism for singular systems. By the expansion the configuration space of a n dimensional system we will be able to introduce first order actions and build the equations of motion of the system. We will work with the Generalized Electrodynamics of Podolsky as an example. (author)

  15. Developmental Trajectories of Anxiety Symptoms in Early Adolescence: The Influence of Anxiety Sensitivity

    OpenAIRE

    Allan, Nicholas P.; Capron, Daniel W.; Lejuez, Carl W.; Reynolds, Elizabeth K.; MacPherson, Laura; Schmidt, Norman B.

    2014-01-01

    Children and adolescents seem to suffer from anxiety disorders at rates similar to adults. Interestingly, anxiety symptoms appear to generally decline over time within children as evidenced by lower rates in early and middle adolescence. There is some evidence that there may be heterogeneous subpopulations of adolescent children with different trajectories of anxiety symptoms, including a class of adolescents with elevated levels of anxiety that do not dissipate over time. Anxiety sensitivity...

  16. Durand Neighbourhood Heritage Inventory: Toward a Digital Citywide Survey Approach to Heritage Planning in Hamilton

    Science.gov (United States)

    Angel, V.; Garvey, A.; Sydor, M.

    2017-08-01

    In the face of changing economies and patterns of development, the definition of heritage is diversifying, and the role of inventories in local heritage planning is coming to the fore. The Durand neighbourhood is a layered and complex area located in inner-city Hamilton, Ontario, Canada, and the second subject area in a set of pilot inventory studies to develop a new city-wide inventory strategy for the City of Hamilton,. This paper presents an innovative digital workflow developed to undertake the Durand Built Heritage Inventory project. An online database was developed to be at the centre of all processes, including digital documentation, record management, analysis and variable outputs. Digital tools were employed for survey work in the field and analytical work in the office, resulting in a GIS-based dataset that can be integrated into Hamilton's larger municipal planning system. Together with digital mapping and digitized historical resources, the Durand database has been leveraged to produce both digital and static outputs to shape recommendations for the protection of Hamilton's heritage resources.

  17. The effect of somatic symptom attribution on the prevalence rate of depression and anxiety among nursing home patients.

    Science.gov (United States)

    Smalbrugge, Martin; Pot, Anne Margriet; Jongenelis, Lineke; Beekman, Aartjan T F; Eefsting, Jan A

    2005-01-01

    The validity of diagnostic psychiatric instruments for depression and anxiety disorders may be compromised among patients with complex physical illness and disability. The objective of this study was to determine the effect on the prevalence rate of depression and anxiety in a nursing home population of attributing somatic symptoms of depression and anxiety to either somatic or psychiatric disorder. Symptoms of major depression (MD), generalized anxiety disorder (GAD) and panic disorder (PD) were measured using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Somatic symptoms of MD, GAD and PD were attributed to somatic causes when the interviewer was not sure about a psychiatric cause. To analyse the effect of this attribution on the prevalence rate of MD, GAD and PD, a sensitivity analysis was undertaken in which symptoms that were attributed to somatic causes were recoded as symptoms attributed to psychiatric disorder. Prevalence rates of MD, GAD and PD were calculated before and after recoding. The prevalence of MD after recoding rose from 7.5% to 8.1%. The prevalence of GAD did not change. The prevalence of PD rose from 1.5% to 1.8%. Attribution of somatic symptoms to either somatic or psychiatric disorder when the interviewer was not sure about a psychiatric cause of the somatic symptoms had only a very modest effect on the prevalence rate of major depression, generalized anxiety disorder and panic disorder in a nursing home population.

  18. Mothers' and fathers' ratings of family relationship quality: associations with preadolescent and adolescent anxiety and depressive symptoms in a clinical sample.

    Science.gov (United States)

    Queen, Alexander H; Stewart, Lindsay M; Ehrenreich-May, Jill; Pincus, Donna B

    2013-06-01

    This study examined the independent associations among three family relationship quality factors--cohesion, expressiveness, and conflict--with youth self-reported depressive and anxiety symptoms in a clinical sample of anxious and depressed youth. Ratings of family relationship quality were obtained through both mother and father report. The sample included families of 147 preadolescents and adolescents (56.6 % female; 89.8 % Caucasian), 11-18 years old (M = 13.64, SD = 1.98) assigned a principal diagnosis of an anxiety or depressive disorder. When controlling for age and concurrent anxiety symptoms, regression analyses revealed that for boys, both father- and mother-rated family cohesion predicted depressive symptoms. For girls, mother-rated family expressiveness and conflict predicted depressive symptoms. Youth anxiety symptoms were not significantly associated with any family relationship variables, controlling for concurrent depressive symptoms. Findings suggest that parent-rated family relationship factors may be more related to youth depressive than anxiety symptoms in this clinical sample. In addition, family cohesion, as perceived by parents, may be more related to boys' depression, whereas expressiveness and conflict (as rated by mothers) may be more related to girls' depression. Clinical implications and recommendations for future research are discussed.

  19. Anxiety symptoms and quality of interaction among oncology nurses: a correlational, cross-sectional study.

    Science.gov (United States)

    Karanikola, Maria Nk; Giannakopoulou, Margarita; Kalafati, Maria; Kaite, Charis P; Patiraki, Elisabeth; Mpouzika, Meropi; Papathanassoglou, Elisabeth E D; Middleton, Nicos

    2016-01-01

    To explore the severity of Anxiety Symptoms (AS) among Greek oncology nursing personnel, the degree of satisfaction from professional relationships, and potential association between them. A descriptive cross-sectional correlational study was performed in 2 Greek Oncology Hospitals, in 72 members of nursing personnel. Hamilton Anxiety Scale was used for the assessment of AS severity and the Index of Work Satisfaction subscale "Satisfaction from Interaction" for the degree of satisfaction from professional relationships among nursing personnel (NN) and between nursing personnel and physicians (NP). 11% of the sample reported clinical AS [≥26, scale range (SR): 0-52]. Satisfaction from NN [5.10 (SD: 1.04), SR: 1-7], and NP [4.21 (SD: 0.77), SR: 1-7] professional interaction were both moderate. Statistically significantly associations were observed between clinical AS and satisfaction from NN (p=0.014) and NP (p=0.013) professional interaction. Anxiety reduction interventions and improvement of professional relationships are essentials in order to reduce oncology nurses' psychological distress.

  20. Game theory to characterize solutions of a discrete-time Hamilton-Jacobi equation

    International Nuclear Information System (INIS)

    Toledo, Porfirio

    2013-01-01

    We study the behavior of solutions of a discrete-time Hamilton-Jacobi equation in a minimax framework of game theory. The solutions of this problem represent the optimal payoff of a zero-sum game of two players, where the number of moves between the players converges to infinity. A real number, called the critical value, plays a central role in this work; this number is the asymptotic average action of optimal trajectories. The aim of this paper is to show the existence and characterization of solutions of a Hamilton-Jacobi equation for this kind of games

  1. A generalization of Hamilton's rule for the evolution of microbial cooperation.

    Science.gov (United States)

    Smith, Jeff; Van Dyken, J David; Zee, Peter C

    2010-06-25

    Hamilton's rule states that cooperation will evolve if the fitness cost to actors is less than the benefit to recipients multiplied by their genetic relatedness. This rule makes many simplifying assumptions, however, and does not accurately describe social evolution in organisms such as microbes where selection is both strong and nonadditive. We derived a generalization of Hamilton's rule and measured its parameters in Myxococcus xanthus bacteria. Nonadditivity made cooperative sporulation remarkably resistant to exploitation by cheater strains. Selection was driven by higher-order moments of population structure, not relatedness. These results provide an empirically testable cooperation principle applicable to both microbes and multicellular organisms and show how nonlinear interactions among cells insulate bacteria against cheaters.

  2. Distinctions between separation anxiety and social anxiety in children and adolescents

    NARCIS (Netherlands)

    Ferdinand, Robert F.; Bongers, Ilja L.; van der Ende, Jan; van Gastel, Willemijn; Tick, Nouchka; Utens, Elisabeth; Verhulst, Frank C.

    2006-01-01

    Separation anxiety and social phobia are intertwined to a considerable degree, and high comorbidity rates have been reported. The present study used latent class analysis (LCA) to investigate if classes of children and adolescents with-simultaneously-high rates of separation anxiety and low rates of

  3. Numerical Solution of Hamilton-Jacobi Equations in High Dimension

    Science.gov (United States)

    2012-11-23

    high dimension FA9550-10-1-0029 Maurizio Falcone Dipartimento di Matematica SAPIENZA-Universita di Roma P. Aldo Moro, 2 00185 ROMA AH930...solution of Hamilton-Jacobi equations in high dimension AFOSR contract n. FA9550-10-1-0029 Maurizio Falcone Dipartimento di Matematica SAPIENZA

  4. Lie-Hamilton systems on curved spaces: a geometrical approach

    Science.gov (United States)

    Herranz, Francisco J.; de Lucas, Javier; Tobolski, Mariusz

    2017-12-01

    A Lie-Hamilton system is a nonautonomous system of first-order ordinary differential equations describing the integral curves of a t-dependent vector field taking values in a finite-dimensional Lie algebra, a Vessiot-Guldberg Lie algebra, of Hamiltonian vector fields relative to a Poisson structure. Its general solution can be written as an autonomous function, the superposition rule, of a generic finite family of particular solutions and a set of constants. We pioneer the study of Lie-Hamilton systems on Riemannian spaces (sphere, Euclidean and hyperbolic plane), pseudo-Riemannian spaces (anti-de Sitter, de Sitter, and Minkowski spacetimes) as well as on semi-Riemannian spaces (Newtonian spacetimes). Their corresponding constants of motion and superposition rules are obtained explicitly in a geometric way. This work extends the (graded) contraction of Lie algebras to a contraction procedure for Lie algebras of vector fields, Hamiltonian functions, and related symplectic structures, invariants, and superposition rules.

  5. Effect of anxiety on the rate of gastric emptying of liquids.

    LENUS (Irish Health Repository)

    Lydon, A

    2012-02-03

    The efficacy of preoperative fasting is reduced in the presence of any factor which delays gastric emptying. We examined the association between anxiety and gastric emptying in adult patients undergoing elective surgery. Immediately before operation, 21 patients completed both a Spielberger state trait inventory (used to quantify current anxiety state (STAIs) and anxiety predisposition (STAIt)), and the Amsterdam preoperative anxiety and information scale (used to quantify anxiety and need for information). Gastric emptying was measured using the paracetamol absorption technique. Four to 10 weeks later, gastric emptying and STAI were measured again. Patients were more anxious before than after operation (STAIs = mean 35.4 (SD 10.9) and 25 (4.1), respectively; P = 0.0004). Neither anxiety state (P = 0.40) nor measures of anxiety relative to anxiety predisposition (P = 0.86) influenced gastric emptying (as measured by area under the paracetamol absorption-time curve). This contrasts with previous findings that anxiety in patients with low anxiety predisposition scores delays gastric emptying.

  6. The effect of somatic symptom attribution on the prevalence rate of depression and anxiety among nursing home patients

    NARCIS (Netherlands)

    Smalbrugge, M.; Pot, A.M.; Jongenelis, L.; Beekman, A.T.F.; Eefsting, J.A.

    2005-01-01

    The validity of diagnostic psychiatric instruments for depression and anxiety disorders may be compromised among patients with complex physical illness and disability. The objective of this study was to determine the effect on the prevalence rate of depression and anxiety in a nursing home

  7. Heart-related anxieties in relation to general anxiety and severity of illness in cardiology patients.

    Science.gov (United States)

    Muschalla, Beate; Glatz, Johannes; Linden, Michael

    2014-01-01

    Absence of an adequate reason for anxiety is a criterion for pathological anxiety. However, the presence of danger or fear-provoking stimuli may even be a risk factor for anxiety and does not exclude that there is additionally pathological anxiety too. The question is, to what degree can heart-related anxiety be explained by the severity of illness or trait anxiety? Two hundred and nine patients (37.8% women) from a cardiology inpatient unit completed the Heart-Anxiety-Questionnaire, Progression-Anxiety-Questionnaire, Job-Anxiety-Scale and the State-Trait-Anxiety-Inventory. The severity of cardiac illness was rated by the treating cardiologists using the Multidimensional Severity of Morbidity Rating. Time absent from work due to sickness was assessed as an indicator for illness-related impairment. Heart anxiety was significantly related to progression anxiety and, to a lesser extent, trait anxiety and indicators of subjective symptoms of somatic illness. No association was found with medical ratings for prognosis, multimorbidity, or reduction in life expectancy. Heart-related anxiety is a symptom of an anxiety disorder. Although partially dependent on subjective suffering, it cannot be explained by the severity of medical illness. Treatment of health-related anxieties should focus on how to cope with subjective symptoms of illness.

  8. Assessment of dependence and anxiety among benzodiazepine users in a provincial municipality in Rio Grande do Sul, Brazil

    Directory of Open Access Journals (Sweden)

    Janaína Barden Schallemberger

    Full Text Available Abstract Introduction: Benzodiazepines are among the most prescribed drugs for anxiety and one of the most used drug classes in the world and have a high potential for addiction. The objective of this study was to assess levels of dependence and anxiety among users of these drugs in the public health system. Methods: This was a cross-sectional, descriptive and quantitative study. Benzodiazepine users treated on the public health system were selected. Anxiety levels were assessed with the Hamilton Anxiety Scale and dependency with the Benzodiazepine Dependence Self-Report Questionnaire. Results: Benzodiazepine use was higher among women and in older age groups. Duration of benzodiazepine use was greater than 1 year for all respondents. The dependence assessment indicated that more than half of users were dependent on taking benzodiazepines and most had a severe degree of anxiety. Conclusion: This study found evidence of prolonged and inappropriate use of benzodiazepines. It is necessary to educate users about the risks of these drugs and to develop strategies to rationalize use of these drugs by working with prescribers and dispensers.

  9. The Influence of Parent Preprocedural Anxiety on Child Procedural Pain: Mediation by Child Procedural Anxiety

    OpenAIRE

    Bearden, Donald J.; Feinstein, Amanda; Cohen, Lindsey L.

    2012-01-01

    Objective Data suggest parents’ preprocedural anxiety is related to children's acute procedural anxiety and pain. This study examined the temporal relations among these constructs to determine whether children's anxiety mediates the relation between parents' anticipatory anxiety and children's procedural pain. Methods A total of 90 preschoolers receiving immunizations, their parents, and the nurses rated children's procedural anxiety and pain. Parents provided ratings of their own preprocedur...

  10. Illness severity, trait anxiety, cognitive impairment and heart rate variability in bipolar disorder.

    Science.gov (United States)

    Levy, Boaz

    2014-12-30

    Numerous studies have documented a significant association between symptom severity and cognitive functioning in bipolar disorder (BD). These findings advanced speculations about a potential link between the physiological stress associated with illness severity and cognitive dysfunction. To explore this hypothesis, the current study employed heart rate variability (HRV) as a physiological measure that is sensitive to the effects of chronic stress, and a scale of trait anxiety for assessing a psychological condition that is correlated with hyper sympathetic arousal. Analyses indicated that BD patients with High Illness Severity reported more symptoms of trait-anxiety (i.e., State Trait Anxiety Inventory), performed more poorly on a computerized neuropsychological battery (i.e., CNS Vital Signs), and exhibited a more constricted HRV profile (i.e., lower SDNN with elevated LF/HF ratio) than patients with Low Illness Severity. Illness severity was determined by a history of psychosis, illness duration, and number of mood episodes. A third group of healthy controls (n=22) performed better on the neuropsychological battery and exhibited a healthier HRV profile than the BD groups. This study provides preliminary evidence that illness severity and cognitive impairment in BD may be associated with state anxiety and neuro-cardiac alterations that are sensitive to physiological stress. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. The effects of hypnotherapy during transrectal ultrasound-guided prostate needle biopsy for pain and anxiety.

    Science.gov (United States)

    Hızlı, Fatih; Özcan, Osman; Selvi, İsmail; Eraslan, Pınar; Köşüş, Aydın; Baş, Okan; Yıkılmaz, Taha Numan; Güven, Oğuz; Başar, Halil

    2015-11-01

    Several studies evaluating the tolerance of transrectal ultrasound (TRUS)-guided needle biopsies showed that moderate-to-severe pain was associated with the procedure. Additionally, prebiopsy anxiety or rebiopsy as a result of a prior biopsy procedure is mentioned as factors predisposing to higher pain intensity. Thus, in this study, we investigated the effects of hypnotherapy during transrectal ultrasound-guided prostate needle biopsy for pain and anxiety. Sixty-four patients presenting for TRUS-guided prostate needle biopsy were randomly assigned to receive either 10-min presurgery hypnosis session (n = 32, mean age 63.5 ± 6.1, p = 0.289) or a presurgery control session (n = 32, mean age 61.8 ± 6.8, p = 0.289). The hypnosis session involved suggestions for increased relaxation and decreased anxiety. Presurgery pain and anxiety were measured using visual analog scales (VAS), Beck Anxiety Inventory (BAI), and Hamilton Anxiety Scale (HAS), respectively. In our statistics, p < 0.05 was considered statistically significant. Postintervention, and before surgery, patients in the hypnosis group had significantly lower mean values for presurgery VAS [mean 1 (0-8); p = 0.011], BAI (6.0 vs 2.0; p < 0.001), and HAS (11.0 vs 6.0; p < 0.001). The study results indicate that a brief presurgery hypnosis intervention can be an effective means of controlling presurgical anxiety, and therefore pain, in patients awaiting diagnostic prostate cancer surgery.

  12. Work-related psychopathology: rates in different work activities and relationship between subjective perception of work distress and psychiatric disturbances.

    Science.gov (United States)

    Nolfe, Giovanni; Mancini, Paola; Mancusi, Riccardo; Zontini, Gemma; Nolfe, Giuseppe

    2014-01-01

    The link between work distress and negative mental health outcome is an emergent topic in the scientific literature. The studies that evaluated the risk of work-related psychopathologies in the different job sectors have obtained so far controversial and inconclusive results. The identification, by means of standardized evaluation tools, of the work activities at higher risk of poor mental health is a relevant target for the occupational psychiatry and medicine. To evaluate the relationship between the psychosocial work conditions and work related psychiatric disturbances and to verify the relationship between the higher pathogenic effect of work and specific job activities. A six-month diagnostic trial was conducted on 234 patients (35.4% women and 64.6% men). Psychiatric diagnoses were according to DSM-IV criteria; anxious and depressive dimensions were studied by means of Hamilton-Anxiety-Scale and Hamilton Scale for Depression; psychosocial work environments and bio-psycho-social features were measured by Naples-Questionnaire of Work Distress. Groups with higher and lower work-related pathogenesis were compared and their distribution among specific job activities was evaluated. Mood disorders were strongly linked to negative work environment. Patients with severe bullying obtained higher scores on Hamilton-Anxiety-Scale and Hamilton Scale for Depression than those with lower work-pathogenesis. The highest scores on Naples-Questionnaire of Work Distress were related to mood disorders, to poorer bio-psycho-social functioning and to higher work etiology. No significant relationship between work activities and work-related psychopathologies was found. Workplace bullying is predictive of work-related psychiatric disturbances with more severe clinical features and bio-psycho-social consequences. No significant differences were found about the relationship between work-related psychopathologies and work activities.

  13. Nuclear power and the Hamilton-Jefferson debate

    International Nuclear Information System (INIS)

    Hacker, A.

    1980-01-01

    The basic sources of nuclear opposition derive from the philosophical arguments of Thomas Jefferson against Alexander Hamilton's vision of an industrial society with a strong central authority. Today's young people continue Jefferson's radical plea for the individual freedoms associated with personal ownership and limited government, but they accept the structure of the former while searching for the romanticism of the latter. The nuclear debate reflects this dichotomy and will continue even if the issues of waste disposal and safety are resolved

  14. Adjustment disorder with anxiety in old age: comparing prevalence and clinical management in primary care and mental health care.

    Science.gov (United States)

    Arbus, C; Hergueta, T; Duburcq, A; Saleh, A; Le Guern, M-E; Robert, P; Camus, V

    2014-05-01

    Adjustment disorder with anxiety (AjD-A) is a common cause of severe anxiety symptoms, but little is known about its prevalence in old age. This cross-sectional study examined the prevalence of AjD-A in outpatients over the age of 60 who consecutively consulted 34 general practitioners and 22 psychiatrists during a 2-week period. The diagnosis of AjD-A was obtained using the optional module for diagnostic of adjustment disorder of the Mini International Neuropsychiatric Interview (MINI). The study procedure also explored comorbid psychiatric conditions and documented recent past stressful life events, as well as social disability and current pharmacological and non-pharmacological management. Overall, 3651 consecutive subjects were screened (2937 in primary care and 714 in mental health care). The prevalence rate of AjD-A was 3.7% (n=136). Up to 39% (n=53) of AjD-A subjects had a comorbid psychiatric condition, mostly of the anxious type. The most frequently stressful life event reported to be associated with the onset of AjD-A was personal illness or health problem (29%). More than 50% of the AjD-A patients were markedly to extremely disabled by their symptoms. Compared to patients who consulted psychiatrists, patients who were seen by primary care physicians were older, had obtained lower scores at the Hamilton Anxiety Rating Scale, benefited less frequently from non-pharmacological management and received benzodiazepines more frequently. AjD-A appears to be a significantly disabling cause of anxiety symptoms in community dwelling elderly persons, in particular those presenting personal health related problems. Improvement of early diagnosis and non-pharmacological management of AjD-A would contribute to limit risks of benzodiazepine overuse, particularly in primary care settings. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  15. A double-blind, randomized, placebo-controlled, fixed-dose phase III study of vilazodone in patients with generalized anxiety disorder.

    Science.gov (United States)

    Gommoll, Carl; Durgam, Suresh; Mathews, Maju; Forero, Giovanna; Nunez, Rene; Tang, Xiongwen; Thase, Michael E

    2015-06-01

    Vilazodone, a selective serotonin reuptake inhibitor and 5-HT1A receptor partial agonist, is approved for treating major depressive disorder in adults. This study (NCT01629966 ClinicalTrials.gov) evaluated the efficacy and safety of vilazodone in adults with generalized anxiety disorder (GAD). A multicenter, double-blind, parallel-group, placebo-controlled, fixed-dose study in patients with GAD randomized (1:1:1) to placebo (n = 223), or vilazodone 20 mg/day (n = 230) or 40 mg/day (n = 227). Primary and secondary efficacy parameters were total score change from baseline to week 8 on the Hamilton Rating Scale for Anxiety (HAMA) and Sheehan Disability Scale (SDS), respectively, analyzed using a predefined mixed-effect model for repeated measures (MMRM). Safety outcomes were presented by descriptive statistics. The least squares mean difference (95% confidence interval) in HAMA total score change from baseline (MMRM) was statistically significant for vilazodone 40 mg/day versus placebo (-1.80 [-3.26, -0.34]; P = .0312 [adjusted for multiple comparisons]), but not for vilazodone 20 mg/day versus placebo. Mean change from baseline in SDS total score was not significantly different for either dose of vilazodone versus placebo when adjusted for multiplicity; significant improvement versus placebo was noted for vilazodone 40 mg/day without adjustment for multiplicity (P = .0349). The incidence of adverse events was similar for vilazodone 20 and 40 mg/day (∼71%) and slightly lower for placebo (62%). Nausea, diarrhea, dizziness, vomiting, and fatigue were reported in ≥5% of patients in either vilazodone group and at least twice the rate of placebo. Vilazodone was effective in treating anxiety symptoms of GAD. No new safety concerns were identified. © 2015 The Authors. Depression and Anxiety published by Wiley Periodicals, Inc.

  16. Anxiety and Tobacco

    Directory of Open Access Journals (Sweden)

    Cristina Mae Wood

    2010-02-01

    Full Text Available Tobacco use is the first preventable cause of death. This is associated not only with physical illness and a shorter life expectancy, but also with different mental disorders such as anxiety disorders. Given the low risk perception of use, this paper reports a systematic review of the scientific literature on the relationship between anxiety and tobacco from an emotional perspective, including data on smoking prevalence, factors associated with the onset and maintenance of tobacco use, as well as those factors that hamper smoking cessation and increase relapse rates. The high rates of comorbidity between tobacco use and anxiety disorders make necessary the development of new and better tobacco cessation treatments, especially designed for those smokers with high state anxiety or anxiety sensitivity, with the aim of maximizing the efficacy.

  17. Depresión y ansiedad en estudiantes universitarios

    Directory of Open Access Journals (Sweden)

    Marisol Cynthia Vargas Orozco

    2014-05-01

    Full Text Available In this research we present rates of depression and anxiety of students of Autonomous University of Tamaulipas campus Reynosa-Aztlan. The sample was composed by 500 students, classified by gender and academic program, we applied two standardized instruments, to measure depression used Beck Depression Scale and the Hamilton Anxiety Scale. Results show us that there is a higher score in tables of depressive female as well as female anxiety.

  18. An optimal L1-minimization algorithm for stationary Hamilton-Jacobi equations

    KAUST Repository

    Guermond, Jean-Luc; Popov, Bojan

    2009-01-01

    We describe an algorithm for solving steady one-dimensional convex-like Hamilton-Jacobi equations using a L1-minimization technique on piecewise linear approximations. For a large class of convex Hamiltonians, the algorithm is proven

  19. Assessment of cerebral benzodiazepine receptor distribution in anxiety disorders by 123I-iomazenil-SPECT. Comparison to cerebral perfusion scintigraphy by 123I-IMP

    International Nuclear Information System (INIS)

    Uchiyama, Mayuki; Sue, Hironari; Fukumitsu, Nobuyoshi; Mori, Yutaka; Kawakami, Kenji

    1997-01-01

    123 I-Iomazenil ( 123 I-IMZ) and 123 I-IMP imaging were performed in 5 patients with anxiety disorder (PAD) and 6 normal volunteers (NV). On 123 I-IMZ delayed imaging, the 2 PAD showed abnormally decreased findings. In anxiety disorder, decreased accumulation on 123 I-IMZ delayed images was seen in left hippocampus and parahippocampal gyrus in one patient, in right frontal and temporal lobe and left occipital pole in the other. Compared with NV, PAD had lower 123 I-IMZ uptake on delayed image in right upper and left lower frontal cortices, indicating the involvement of the benzodiazepine receptor complex in anxiety disorder. Compared with grading for anxiety disorder with Hamilton anxiety scale (HAS) and delayed to early count ratios of 123 I-IMZ, negative correlation (R 123 I-IMP image, positive correlation (R>0.7) was recognized in the hippocampus, the parahippocampal gyrus, the lower outer temporal cortex and the lower frontal cortex. (author)

  20. New Li-Yau-Hamilton Inequalities for the Ricci Flow via the Space-Time Approach

    OpenAIRE

    Chow, Bennett; Knopf, Dan

    2002-01-01

    We generalize Hamilton's matrix Li-Yau-type Harnack estimate for the Ricci flow by considering the space of all LYH (Li-Yau-Hamilton) quadratics that arise as curvature tensors of space-time connections satisfying the Ricci flow with respect to the natural space-time degenerate metric. As a special case, we employ scaling arguments to derive a linear-type matrix LYH estimate. The new LYH quadratics obtained in this way are associated to the system of the Ricci flow coupled to a 1-form and a 2...

  1. Autonomic arousal in childhood anxiety disorders: Associations with state anxiety and social anxiety disorder

    Science.gov (United States)

    Alkozei, Anna; Creswell, Cathy; Cooper, Peter J.; Allen, John J.B.

    2015-01-01

    Background Psychophysiological theories suggest that individuals with anxiety disorders may evidence inflexibility in their autonomic activity at rest and when responding to stressors. In addition, theories of social anxiety disorder, in particular, highlight the importance of physical symptoms. Research on autonomic activity in childhood (social) anxiety disorders, however, is scarce and has produced inconsistent findings, possibly because of methodological limitations. Method The present study aimed to account for limitations of previous studies and measured respiratory sinus arrhythmia (RSA) and heart rate (HR) using Actiheart heart rate monitors and software (Version 4) during rest and in response to a social and a non-social stressor in 60 anxious (30 socially anxious and 30 ‘other’ anxious), and 30 nonanxious sex-and age-matched 7–12 year olds. In addition, the effect of state anxiety during the tasks was explored. Results No group differences at rest or in response to stress were found. Importantly, however, with increases in state anxiety, all children, regardless of their anxiety diagnoses showed less autonomic responding (i.e., less change in HR and RSA from baseline in response to task) and took longer to recover once the stressor had passed. Limitations This study focused primarily on parasympathetic arousal and lacked measures of sympathetic arousal. Conclusion The findings suggest that childhood anxiety disorders may not be characterized by inflexible autonomic responding, and that previous findings to the contrary may have been the result of differences in subjective anxiety between anxious and nonanxious groups during the tasks, rather than a function of chronic autonomic dysregulation. PMID:25590763

  2. Cognitive behavioral group therapy versus psychoeducational intervention in Parkinson's disease.

    Science.gov (United States)

    Berardelli, Isabella; Bloise, Maria Carmela; Bologna, Matteo; Conte, Antonella; Pompili, Maurizio; Lamis, Dorian A; Pasquini, Massimo; Fabbrini, Giovanni

    2018-01-01

    The aim of the current study was to evaluate whether cognitive behavioral group therapy has a positive impact on psychiatric, and motor and non-motor symptoms in Parkinson's disease (PD). We assigned 20 PD patients with a diagnosis of psychiatric disorder to either a 12-week cognitive behavioral therapy (CBT) group or a psychoeducational protocol. For the neurological examination, we administered the Unified Parkinson's Disease Rating Scale and the non-motor symptoms scale. The severity of psychiatric symptoms was assessed by means of the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Brief Psychiatric Rating Scale, and the Clinical Global Impressions. Cognitive behavioral group therapy was effective in treating depression and anxiety symptoms as well as reducing the severity of non-motor symptoms in PD patients; whereas, no changes were observed in PD patients treated with the psychoeducational protocol. CBT offered in a group format should be considered in addition to standard drug therapy in PD patients.

  3. A comparison of a patient-rated visual analogue scale with the Liebowitz Social Anxiety Scale for social anxiety disorder: A cross-sectional study

    OpenAIRE

    興津, 裕美

    2014-01-01

    博士(医学) 乙第2814号, 著者名:Hiromi Okitsu・Jitsuki Sawamura・Katsuji Nishimura・Yasuto Sato・Jun Ishigooka,タイトル:A comparison of a patient-rated visual analogue scale with the Liebowitz Social Anxiety Scale for social anxiety disorder: A cross-sectional study,掲載誌:Open Journal of Psychiatry (2161-7325),巻・頁・年:4巻1号 p.68~74 (2014),著作権関連情報:Copyright © 2014 by authors and Scientific Research Publishing Inc.,DOI:10.4236/ojpsych.2014.41010...

  4. Developmental trajectories of anxiety symptoms in early adolescence: the influence of anxiety sensitivity.

    Science.gov (United States)

    Allan, Nicholas P; Capron, Daniel W; Lejuez, Carl W; Reynolds, Elizabeth K; MacPherson, Laura; Schmidt, Norman B

    2014-05-01

    Children and adolescents seem to suffer from anxiety disorders at rates similar to adults. Interestingly, anxiety symptoms appear to generally decline over time within children as evidenced by lower rates in early and middle adolescence. There is some evidence that there may be heterogeneous subpopulations of adolescent children with different trajectories of anxiety symptoms, including a class of adolescents with elevated levels of anxiety that do not dissipate over time. Anxiety sensitivity has been identified as an important risk factor in the development of anxiety psychopathology. This study prospectively examined the development of anxiety symptoms in a sample of 277 adolescents (M age = 11.52; 44 % female, 56 % male) over a 3 year period including the influence of anxiety sensitivity on this development. Further, this study investigated whether there were distinct classes of adolescents based on their anxiety symptom trajectories and including anxiety sensitivity as a predictor. Consistent with other reports, findings indicated an overall decline in anxiety symptoms over time in the sample. However, three classes of adolescents were found with distinct anxiety symptom trajectories and anxiety sensitivity was an important predictor of class membership. Adolescents with elevated anxiety sensitivity scores were more likely to be classified as having high and increasing anxiety symptoms over time versus having moderate to low and decreasing anxiety symptoms over time. There are important implications for identification of adolescents and children who are at risk for the development of an anxiety disorder.

  5. Anxiety symptoms and quality of interaction among oncology nurses: a correlational, cross-sectional study

    Directory of Open Access Journals (Sweden)

    Maria NK. Karanikola

    Full Text Available Abstract OBJECTIVE To explore the severity of Anxiety Symptoms (AS among Greek oncology nursing personnel, the degree of satisfaction from professional relationships, and potential association between them. METHOD A descriptive cross-sectional correlational study was performed in 2 Greek Oncology Hospitals, in 72 members of nursing personnel. Hamilton Anxiety Scale was used for the assessment of AS severity and the Index of Work Satisfaction subscale "Satisfaction from Interaction" for the degree of satisfaction from professional relationships among nursing personnel (NN and between nursing personnel and physicians (NP. RESULTS 11% of the sample reported clinical AS [≥26, scale range (SR: 0-52]. Satisfaction from NN [5.10 (SD: 1.04, SR: 1-7], and NP [4.21 (SD: 0.77, SR: 1-7] professional interaction were both moderate. Statistically significantly associations were observed between clinical AS and satisfaction from NN (p=0.014 and NP (p=0.013 professional interaction. CONCLUSIONS Anxiety reduction interventions and improvement of professional relationships are essentials in order to reduce oncology nurses' psychological distress.

  6. Nuclear power and the Hamilton-Jefferson debate

    Energy Technology Data Exchange (ETDEWEB)

    Hacker, A.

    The basic sources of nuclear opposition derive from the philosophical arguments of Thomas Jefferson against Alexander Hamilton's vision of an industrial society with a strong central authority. Today's young people continue Jefferson's radical plea for the individual freedoms associated with personal ownership and limited government, but they accept the structure of the former while searching for the romanticism of the latter. The nuclear debate reflects this dichotomy and will continue even if the issues of waste disposal and safety are resolved. (DCK)

  7. Anxiety, Mood, and Substance Use Disorders in Parents of Children with Anxiety Disorders

    Science.gov (United States)

    Hughes, Alicia A.; Furr, Jami M.; Sood, Erica D.; Barmish, Andrea J.; Kendall, Philip C.

    2009-01-01

    Examined the prevalence of anxiety, mood, and substance use disorders in the parents of anxiety disordered (AD) children relative to children with no psychological disorder (NPD). The specificity of relationships between child and parent anxiety disorders was also investigated. Results revealed higher prevalence rates of anxiety disorders in…

  8. Effectiveness of music therapy in state-trait anxiety rate of addicts in drug-free rehabilitation stage

    Directory of Open Access Journals (Sweden)

    E Soleimani

    2016-02-01

    Full Text Available Objective: This study was an attempt to investigate the effect of music therapy on addicts’ state-trait anxiety rate in the stage of drug-free rehabilitation. Method: A quasi-experimental research design, along with pretest-posttest and control group was employed for the conduct of this study. The statistical population of the study included the addicts in the rehabilitation stage who had referred to the clean collaborators rehabilitation camp in Ardebil province in November 2014. From this population, the number of 32 addicts in 16-50-year-old age range was selected as the participants of the study by convenience sampling method. State-Trait Anxiety Inventory was used for data collection. Results: The results of multivariate covariant analysis showed that there is a significant difference between control and experimental groups in state and trait anxiety. In other words, the state and trait anxiety of addicts in the experimental group had been reduced after music therapy. Conclusion: Considering the obtained results, it can be concluded that music therapy alone or along other psychological interventions can be an effective method for reducing addicts’ anxiety in drug-free rehabilitation stage.

  9. DSM-IV obsessive-compulsive personality disorder: prevalence in patients with anxiety disorders and in healthy comparison subjects.

    Science.gov (United States)

    Albert, Umberto; Maina, Giuseppe; Forner, Federica; Bogetto, Filippo

    2004-01-01

    The relationship between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) has not yet been fully clarified. The aim of the present study was to analyze DSM-IV OCPD prevalence rates in OCD and panic disorder (PD) patients to test for the specificity of the OCPD-OCD link, and to compare them to OCPD prevalence in a control group of subjects without any psychiatric disorder. A total of 109 patients with a principal diagnosis of DSM-IV (SCID-I) OCD and 82 with PD were interviewed using the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) in order to assess the prevalence of OCPD. All patients with a coexisting axis I diagnosis were excluded from the study to eliminate confounding factors when evaluating the association between prevalence rates of OCPD and anxiety disorder diagnoses. An exclusion criteria was also a Hamilton Depression Rating Scale (HAM-D) score >/=16. A sample of comparison subjects (age 18 to 65 years) without any psychiatric disorder was recruited from people registered with two general practitioners (GPs), whether or not they consulted the doctor, in order to evaluate OCPD prevalence rate in the community. A significant difference was found between the prevalence of OCPD in OCD (22.9%) and in PD (17.1%) on one hand, and that in the comparison sample (3.0%) on the other. No differences were found between the two psychiatric groups, even when splitting the samples according to gender. Our study failed to support the hypothesis of a specific relationship between OCPD and OCD; we confirmed the higher prevalence rate of this personality disorder in OCD subjects with regard to the general population, but we also confirmed the higher rate of OCPD in another anxiety disorder which is phenomenologically well characterized and different from OCD, such as PD.

  10. The Validity of the Different Versions of the Hamilton Depression Scale in Separating Remission Rates of Placebo and Antidepressants in Clinical Trials of Major Depression

    DEFF Research Database (Denmark)

    Kyle, Phillip Raphael; Lemming, Ole Michael; Timmerby, Nina

    2016-01-01

    . The traditional HAM-D17 version was compared with the shorter HAM-D6 and the longer HAM-D21 or HAM-D24 in a fixed-dose placebo-controlled vortioxetine study. Clinical Global Impression of Severity scores were used to establish standardized cutoff scores for remission across each scale. Using these cutoff scores......Our objective was to validate the different versions of the Hamilton Depression Scale (HAM-D) both psychometrically (scalability) and clinically in discriminating antidepressants from placebo in terms of remission rates in an 8-week clinical trial in the acute treatment of major depression...... in the longer HAM-D versions indicated smaller discriminating validity over placebo. The HAM-D6 indicated a dose effect on remission for vortioxetine in both moderate and severe major depression. The brief HAM-D6 was thus found superior to HAM-D17, HAM-D21, and HAM-D24 both in terms of scalability...

  11. Non-suicidal Self-Injury in Eating Disordered Patients: Associations with Heart Rate Variability and State-Trait Anxiety

    Directory of Open Access Journals (Sweden)

    Cristina Giner-Bartolome

    2017-07-01

    Full Text Available Background: Non-suicidal self-injury (NSSI is commonly present in individuals with eating disorders (EDs and is often employed as a maladaptive emotion regulation strategy to avoid or abate negative emotions. One of the most prevalent negative emotions experienced by self-injurers is anxiety; however, this emotion has not been extensively studied in this population. Thus, the aim of our study was to investigate the influence of anxiety on NSSI in patients with ED from two different dimensions: state anxiety and trait anxiety.Methods: The study comprised a total of 66 females: 12 ED patients with NSSI, 32 ED patients without a history of NSSI, and 22 healthy controls. State and trait anxiety were assessed by means of State-Trait Anxiety Inventory (STAI-S-T and physiological data [i.e., heart rate variability (HRV] were collected.Results: STAI-trait scores were significantly higher in ED patients with NSSI than ED patients without NSSI. Furthermore, when conducting logistic regression analyses higher STAI-trait scores were associated with NSSI in ED patients. However, no differences in STAI-state scores and HRV were found between ED patients with and without NSSI.Discussion: The present findings suggest that anxiety as a trait is associated with the use of maladaptive strategies (i.e., NSSI in ED patients. These results uphold the need to target trait anxiety in ED treatment in order to prevent possible NSSI behaviors.

  12. Lax-Friedrichs sweeping scheme for static Hamilton-Jacobi equations

    International Nuclear Information System (INIS)

    Kao, C.Y.; Osher, Stanley; Qian Jianliang

    2004-01-01

    We propose a simple, fast sweeping method based on the Lax-Friedrichs monotone numerical Hamiltonian to approximate viscosity solutions of arbitrary static Hamilton-Jacobi equations in any number of spatial dimensions. By using the Lax-Friedrichs numerical Hamiltonian, we can easily obtain the solution at a specific grid point in terms of its neighbors, so that a Gauss-Seidel type nonlinear iterative method can be utilized. Furthermore, by incorporating a group-wise causality principle into the Gauss-Seidel iteration by following a finite group of characteristics, we have an easy-to-implement, sweeping-type, and fast convergent numerical method. However, unlike other methods based on the Godunov numerical Hamiltonian, some computational boundary conditions are needed in the implementation. We give a simple recipe which enforces a version of discrete min-max principle. Some convergence analysis is done for the one-dimensional eikonal equation. Extensive 2-D and 3-D numerical examples illustrate the efficiency and accuracy of the new approach. To our knowledge, this is the first fast numerical method based on discretizing the Hamilton-Jacobi equation directly without assuming convexity and/or homogeneity of the Hamiltonian

  13. Lax-Friedrichs sweeping scheme for static Hamilton-Jacobi equations

    Science.gov (United States)

    Kao, Chiu Yen; Osher, Stanley; Qian, Jianliang

    2004-05-01

    We propose a simple, fast sweeping method based on the Lax-Friedrichs monotone numerical Hamiltonian to approximate viscosity solutions of arbitrary static Hamilton-Jacobi equations in any number of spatial dimensions. By using the Lax-Friedrichs numerical Hamiltonian, we can easily obtain the solution at a specific grid point in terms of its neighbors, so that a Gauss-Seidel type nonlinear iterative method can be utilized. Furthermore, by incorporating a group-wise causality principle into the Gauss-Seidel iteration by following a finite group of characteristics, we have an easy-to-implement, sweeping-type, and fast convergent numerical method. However, unlike other methods based on the Godunov numerical Hamiltonian, some computational boundary conditions are needed in the implementation. We give a simple recipe which enforces a version of discrete min-max principle. Some convergence analysis is done for the one-dimensional eikonal equation. Extensive 2-D and 3-D numerical examples illustrate the efficiency and accuracy of the new approach. To our knowledge, this is the first fast numerical method based on discretizing the Hamilton-Jacobi equation directly without assuming convexity and/or homogeneity of the Hamiltonian.

  14. Effect of ketamine dose on self-rated dissociation in patients with treatment refractory anxiety disorders.

    Science.gov (United States)

    Castle, Cameron; Gray, Andrew; Neehoff, Shona; Glue, Paul

    2017-10-01

    Patients receiving ketamine for refractory depression and anxiety report dissociative symptoms in the first 60 min post-dose. The most commonly used instrument to assess this is the Clinician-Administered Dissociative States Scale (CADSS), developed based on the assessment of patients with dissociative symptoms. Its psychometric properties for ketamine-induced dissociation have not been reported. We evaluated these from a study using 0.25-1 mg/kg ketamine and midazolam (as an active control) in 18 patients with treatment-resistant anxiety. Dissociation ratings were increased by ketamine in a dose-dependent manner. In contrast, midazolam showed no effect on ratings of dissociation. For individual CADSS items, the magnitude of change and the ketamine dose at which changes were observed were not homogenous. The Cronbach alpha for the total scale was high (0.937), with acceptable item-rest correlations for almost all individual items. Purposefully removing items to maximise alpha did not lead to meaningful improvements. Acceptable internal consistency was still observed after removing items which lacked evidence of responsiveness at lower doses. The high Cronbach alpha values identified in this study suggests that the CADSS is an internally consistent instrument for evaluating ketamine-induced dissociation in clinical trials in anxiety, although it does not capture symptoms such as thought disorder.

  15. An evaluation of the quick inventory of depressive symptomatology and the hamilton rating scale for depression: a sequenced treatment alternatives to relieve depression trial report.

    Science.gov (United States)

    Rush, A John; Bernstein, Ira H; Trivedi, Madhukar H; Carmody, Thomas J; Wisniewski, Stephen; Mundt, James C; Shores-Wilson, Kathy; Biggs, Melanie M; Woo, Ada; Nierenberg, Andrew A; Fava, Maurizio

    2006-03-15

    Nine DSM-IV-TR criterion symptom domains are evaluated to diagnose major depressive disorder (MDD). The Quick Inventory of Depressive Symptomatology (QIDS) provides an efficient assessment of these domains and is available as a clinician rating (QIDS-C16), a self-report (QIDS-SR16), and in an automated, interactive voice response (IVR) (QIDS-IVR16) telephone system. This report compares the performance of these three versions of the QIDS and the 17-item Hamilton Rating Scale for Depression (HRSD17). Data were acquired at baseline and exit from the first treatment step (citalopram) in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial. Outpatients with nonpsychotic MDD who completed all four ratings within +/-2 days were identified from the first 1500 STAR*D subjects. Both item response theory and classical test theory analyses were conducted. The three methods for obtaining QIDS data produced consistent findings regarding relationships between the nine symptom domains and overall depression, demonstrating interchangeability among the three methods. The HRSD17, while generally satisfactory, rarely utilized the full range of item scores, and evidence suggested multidimensional measurement properties. In nonpsychotic MDD outpatients without overt cognitive impairment, clinician assessment of depression severity using either the QIDS-C16 or HRSD17 may be successfully replaced by either the self-report or IVR version of the QIDS.

  16. Hamilton-Jacobi equation and the breaking of the WKB approximation

    Energy Technology Data Exchange (ETDEWEB)

    Canfora, F. [Istituto Nazionale di Fisica Nucleare, GC di Salerno (Italy) and Dipartimento di Fisica E.R. Caianiello, Universita di Salerno, Via S. Allende, 84081 Baronissi (Salerno) (Italy)]. E-mail: canfora@sa.infn.it

    2005-03-17

    A simple method to deal with four-dimensional Hamilton-Jacobi equation for null hypersurfaces is introduced. This method allows to find simple geometrical conditions which give rise to the failure of the WKB approximation on curved spacetimes. The relation between such failure, extreme blackholes and the Cosmic Censor hypothesis is briefly discussed.

  17. Hamilton-Jacobi formalism for Podolsky's electromagnetic theory on the null-plane

    Science.gov (United States)

    Bertin, M. C.; Pimentel, B. M.; Valcárcel, C. E.; Zambrano, G. E. R.

    2017-08-01

    We develop the Hamilton-Jacobi formalism for Podolsky's electromagnetic theory on the null-plane. The main goal is to build the complete set of Hamiltonian generators of the system as well as to study the canonical and gauge transformations of the theory.

  18. Depression and social phobia secondary to alcohol dependence.

    Science.gov (United States)

    Olgiati, Paolo; Liappas, Ioannis; Malitas, Petros; Piperi, Christina; Politis, Antonis; Tzavellas, Elias O; Zisaki, Aikaterini; Ferrari, Barbara; De Ronchi, Diana; Kalofoutis, Anastasios; Serretti, Alessandro

    2007-01-01

    According to the self-medication hypothesis, individuals with depression and anxiety disorders use alcohol to control their symptoms and subsequently become dependent. Conversely, alcohol dependence disorder (ADD) can cause or exacerbate psychiatric disorders. This study analyzed the characteristics of depression and social phobia secondary to ADD. (1) What is their functional impact? (2) Are they independent or associated conditions? (3) Do they completely remit in abstinent individuals? (4) Is the remission of one disorder associated with the remission of the other disorder? Sixty-four inpatients with ADD were evaluated with depression and anxiety disorder scales upon admission to hospital and after 5 weeks of detoxification. Baseline comparisons differentiated patients with a Hamilton Rating Scale for Depression (HDRS) score > 35 (n = 50; 78%) from those with an HDRS score social phobia [Leibowitz Social Anxiety Scale (LSAS) score > 60: n = 20; 31.2%] were not distinguishable from those with an LSAS score depressive and anxiety disorder symptoms. In postdetoxification assessment, patients who remitted from depression (HDRS score or = 7). Patients who remitted from social phobia (LSAS score depressive and anxiety disorder symptoms. Generalized anxiety (Hamilton Rating Scale for Anxiety) and hypochondriasis (Whiteley Index) were the significant predictors of global functioning (Global Assessment Scale). Depression and social phobia secondary to ADD are independent conditions that do not completely remit after cessation of drinking. Specific treatments are needed to reduce residual depressive and anxiety symptoms in abstinent alcoholics. 2008 S. Karger AG, Basel

  19. Derivation of the Schrodinger Equation from the Hamilton-Jacobi Equation in Feynman's Path Integral Formulation of Quantum Mechanics

    Science.gov (United States)

    Field, J. H.

    2011-01-01

    It is shown how the time-dependent Schrodinger equation may be simply derived from the dynamical postulate of Feynman's path integral formulation of quantum mechanics and the Hamilton-Jacobi equation of classical mechanics. Schrodinger's own published derivations of quantum wave equations, the first of which was also based on the Hamilton-Jacobi…

  20. The relationship between early changes in the HAMD-17 anxiety/somatization factor items and treatment outcome among depressed outpatients.

    Science.gov (United States)

    Farabaugh, Amy; Mischoulon, David; Fava, Maurizio; Wu, Shirley L; Mascarini, Alessandra; Tossani, Eliana; Alpert, Jonathan E

    2005-03-01

    The 17-item Hamilton Rating Scale for Depression (HAMD-17) Anxiety/Somatization factor includes six items: Anxiety (psychic), Anxiety (somatic), Somatic Symptoms (gastrointestinal), Somatic Symptoms (general), Hypochondriasis and Insight. This study examines the relationship between early changes (defined as those observed between baseline and week 1) in these HAMD-17 Anxiety/Somatization Factor items and treatment outcome among major depressive disorder (MDD) patients who participated in a study comparing the antidepressant efficacy of a standardized extract of hypericum with both placebo and fluoxetine. Following a 1-week, single-blind washout, patients with MDD diagnosed by the Structured Clinical Interview for DSM-IV (SCID) were randomized to 12 weeks of double-blind treatment with hypericum extract (900 mg/day), fluoxetine (20 mg/day) or placebo. The relationship between early changes in HAMD-17 anxiety/somatization factor items and treatment outcome was assessed separately for patients who received study treatment (hypericum or fluoxetine) versus placebo with a logistic regression method. One hundred and thirty-five patients (female 57%, mean age=37.3+/-11.0 years; mean baseline HAMD-17=19.7+/-3.2 years) were randomized to double-blind treatment and were included in the intent-to-treat (ITT) analyses. After adjusting for baseline HAMD-17 scores and for multiple comparisons with the Bonferroni correction, patients who remitted (HAMD-17 score Somatic Symptoms (General) scores than non-remitters. No other significant differences in early changes were noted for the remaining items between remitters versus non-remitters who received active treatment. For patients treated with placebo, early change was not predictive of remission for any of the items after Bonferroni correction. In conclusion, the presence of early improvement on the HAMD-17 item concerning fatigue and general somatic symptoms is significantly predictive of achieving remission at endpoint with

  1. A case series on the use of lavendula oil capsules in patients suffering from major depressive disorder and symptoms of psychomotor agitation, insomnia and anxiety.

    Science.gov (United States)

    Fißler, Maria; Quante, Arnim

    2014-02-01

    Symptoms of agitation, anxiety and insomnia are frequent among patients with major depressive disorder (MDD) during the first weeks of psychiatric care. But a substantial number of patients declines taking pharmaceutical medication to avoid side effects. Therefore, an alternative herbal medication is needed. Clinical studies demonstrated that lavender oil capsules, termed Lasea®, have an anxiolytic effect comparable to Lorazepam and significantly reduce insomnia and agitation in non-depressed patients. Therefore, the aim of this retrospective case series was to analyze the effectiveness of Lasea® for patients with MDD and symptoms of anxiety, insomnia and psychomotor agitation. Eight cases were analyzed retrospectively regarding the dosage, length of treatment, possible side effects and effectiveness of Lasea®. All cases were treated at the Department of Psychiatry at Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin in a naturalistic setting. Effectiveness was measured by a change in the Hamilton Rating Scale for Depression (HAMD-17) total score and subscores. In 6 cases, the combination of Lasea® and an antidepressant resulted in a reduction of MDD. Lasea® also reduced agitation in 6 cases. Psychological anxiety was reduced in 5, somatic anxiety in 4 cases whereas sleep-onset and sleep-maintenance insomnia improved in 3 cases each. The results demonstrate that Lasea® reduces some of the anxiety related symptoms and sleep disturbances in MDD patients. Furthermore Lasea® significantly reduces psychomotor agitation. Additionally, the results indicate a significant global improvement stemming from the combinational therapy of Lasea® and antidepressant medication. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. An orally administered lavandula oil preparation (Silexan) for anxiety disorder and related conditions: an evidence based review.

    Science.gov (United States)

    Kasper, Siegfried

    2013-11-01

    Silexan is a lavender oil preparation in gelatine capsules containing 80 mg. We reviewed the clinical trials investigating the anxiolytic efficacy and tolerability of Silexan as well as its safety and potential for drug interactions. Seven trials were included, among which four therapeutic trials had a treatment duration of 6 or 10 weeks. In patients with subsyndromal anxiety or generalised anxiety disorder (GAD) an anxiolytic effect of Silexan was evident after 2 weeks. Patients treated with Silexan showed Hamilton Anxiety Scale (HAMA) total score decreases between 10.4 ± 7.1 and 12.0 ± 7.2 points at Week 6 and between 11.8 ± 7.7 and 16.0 ± 8.3 points at Week 10. HAMA total score reductions between baseline and end of treatment were significantly superior to placebo in patients with subsyndromal anxiety and comparable to lorazepam in its starting dose in patients with GAD. Silexan had beneficial effects on typical co-morbidity symptoms of anxiety disorders, for example, disturbed sleep, somatic complaints, or decreased quality of life. Except for mild gastrointestinal symptoms, the drug was devoid of adverse effects and did not cause drug interactions or withdrawal symptoms at daily doses of 80 or 160 mg.

  3. Lifetime anxiety disorder and current anxiety symptoms associated with hastened depressive recurrence in bipolar disorder.

    Science.gov (United States)

    Shah, Saloni; Kim, Jane P; Park, Dong Yeon; Kim, Hyun; Yuen, Laura D; Do, Dennis; Dell'Osso, Bernardo; Hooshmand, Farnaz; Miller, Shefali; Wang, Po W; Ketter, Terence A

    2017-09-01

    To assess differential relationships between lifetime anxiety disorder/current anxiety symptoms and longitudinal depressive severity in bipolar disorder (BD). Stanford BD Clinic outpatients enrolled during 2000-2011 were assessed with the Systematic Treatment Enhancement Program for BD (STEP-BD) Affective Disorders Evaluation and followed with the STEP-BD Clinical Monitoring Form while receiving naturalistic treatment for up to two years. Baseline unfavorable illness characteristics/current mood symptoms and times to depressive recurrence/recovery were compared in patients with versus without lifetime anxiety disorder/current anxiety symptoms. Among 105 currently recovered patients, lifetime anxiety disorder was significantly associated with 10/27 (37.0%) demographic/other unfavorable illness characteristics/current mood symptoms/current psychotropics, hastened depressive recurrence (driven by earlier onset age), and a significantly (> two-fold) higher Kaplan-Meier estimated depressive recurrence rate, whereas current anxiety symptoms were significantly associated with 10/27 (37.0%) demographic/other unfavorable illness characteristics/current mood symptoms/current psychotropics and hastened depressive recurrence (driven by lifetime anxiety disorder), but only a numerically higher Kaplan-Meier estimated depressive recurrence rate. In contrast, among 153 currently depressed patients, lifetime anxiety disorder/current anxiety symptoms were not significantly associated with time to depressive recovery or depressive recovery rate. American tertiary BD clinic referral sample, open naturalistic treatment. Research is needed regarding differential relationships between lifetime anxiety disorder and current anxiety symptoms and hastened/delayed depressive recurrence/recovery - specifically whether lifetime anxiety disorder versus current anxiety symptoms has marginally more robust association with hastened depressive recurrence, and whether both have marginally more robust

  4. Light Rail Transit in Hamilton: Health, Environmental and Economic Impact Analysis

    Science.gov (United States)

    Topalovic, P.; Carter, J.; Topalovic, M.; Krantzberg, G.

    2012-01-01

    Hamilton's historical roots as an electric, industrial and transportation-oriented city provide it with a high potential for rapid transit, especially when combined with its growing population, developing economy, redeveloping downtown core and its plans for sustainable growth. This paper explores the health, environmental, social and economic…

  5. The Effect of Listening to Music During Percutaneous Nephrostomy Tube Placement on Pain, Anxiety, and Success Rate of Procedure: A Randomized Prospective Study.

    Science.gov (United States)

    Hamidi, Nurullah; Ozturk, Erdem

    2017-05-01

    To evaluate the effect of listening to music on pain, anxiety, and success of procedure during office-based percutaneous nephrostomy tube placement (PNTP). One hundred consecutive patients (age >18 years) with hydronephrosis were prospectively enrolled in this study. All patients were prospectively randomized to undergo office-based PNTP with (Group I, n = 50) or without music (Group II, n = 50). Anxiety levels were evaluated with State Trait Anxiety Inventory. A visual analog scale was used to evaluate pain levels, patient's satisfaction, and willingness to undergo the procedure. We also compared success rates of procedures. The mean age, duration of procedure, and gender distribution were statistically similar between the two groups. The mean postprocedural heart rates and systolic blood pressures in Group I patients were significantly lower than Group II patients (p = 0.01 and p = 0.028, respectively), whereas preprocedural pulse rate and systolic blood pressure were similar. The mean anxiety level and mean pain score of Group I were significantly lower than those of Group II (p = 0.008 and p music during office-based PNTP decreases anxiety or pain and increases success rate of procedure. As an alternative to sedation or general anesthesia, music is easily accessible without side effect and cost.

  6. A novel visual facial anxiety scale for assessing preoperative anxiety.

    Directory of Open Access Journals (Sweden)

    Xuezhao Cao

    Full Text Available There is currently no widely accepted instrument for measuring preoperative anxiety. The objective of this study was to develop a simple visual facial anxiety scale (VFAS for assessing acute preoperative anxiety.The initial VFAS was comprised of 11 similarly styled stick-figure reflecting different types of facial expressions (Fig 1. After obtaining IRB approval, a total of 265 participant-healthcare providers (e.g., anesthesiologists, anesthesiology residents, and perioperative nurses were recruited to participate in this study. The participants were asked to: (1 rank the 11 faces from 0-10 (0 = no anxiety, while 10 = highest anxiety and then to (2 match one of the 11 facial expression with a numeric verbal rating scale (NVRS (0 = no anxiety and 10 = highest level of anxiety and a specific categorical level of anxiety, namely no anxiety, mild, mild-moderate, moderate, moderate-high or highest anxiety. Based on these data, the Spearman correlation and frequencies of the 11 faces in relation to the 11-point numerical anxiety scale and 6 categorical anxiety levels were calculated. The highest frequency of a face assigned to a level of the numerical anxiety scale resulted in a finalized order of faces corresponding to the 11-point numeric rating scale.The highest frequency for each of the NVRS anxiety scores were as follow: A0, A1, A2, A3, A4, A5, A7, A6, A8, A9 and A10 (Fig 2. For the six categorical anxiety levels, a total of 260 (98.1% participants chose the face A0 as representing 'no' anxiety, 250 (94.3% participants chose the face A10 as representing 'highest' anxiety and 147 (55.5% participants chose the face A8 as representing 'moderate-high' anxiety. Spearman analysis showed a significant correlation between the faces A3 and A5 assigned to the mild-moderate anxiety category (r = 0.58, but A5 was ultimately chosen due to its higher frequency compared to the frequency of A3 (30.6% vs 24.9%(Fig 3. Similarly, the correlation of the faces A7

  7. The outcome of health anxiety in primary care. A two-year follow-up study on health care costs and self-rated health.

    Science.gov (United States)

    Fink, Per; Ørnbøl, Eva; Christensen, Kaj Sparle

    2010-03-24

    Hypochondriasis is prevalent in primary care, but the diagnosis is hampered by its stigmatizing label and lack of valid diagnostic criteria. Recently, new empirically established criteria for Health anxiety were introduced. Little is known about Health anxiety's impact on longitudinal outcome, and this study aimed to examine impact on self-rated health and health care costs. 1785 consecutive primary care patients aged 18-65 consulting their family physicians (FPs) for a new illness were followed-up for two years. A stratified subsample of 701 patients was assessed by the Schedules for Clinical Assessment in Neuropsychiatry interview. Patients with mild (N = 21) and severe Health anxiety (N = 81) and Hypochondriasis according to the DSM-IV (N = 59) were compared with a comparison group of patients who had a well-defined medical condition according to their FPs and a low score on the screening questionnaire (N = 968). Self-rated health was measured by questionnaire at index and at three, 12, and 24 months, and health care use was extracted from patient registers. Compared with the 968 patients with well-defined medical conditions, the 81 severe Health anxiety patients and the 59 DSM-IV Hypochondriasis patients continued during follow-up to manifest significantly more Health anxiety (Whiteley-7 scale). They also continued to have significantly worse self-rated functioning related to physical and mental health (component scores of the SF-36). The severe Health anxiety patients used about 41-78% more health care per year in total, both during the 3 years preceding inclusion and during follow-up, whereas the DSM-IV Hypochondriasis patients did not have statistically significantly higher total use. A poor outcome of Health anxiety was not explained by comorbid depression, anxiety disorder or well-defined medical condition. Patients with mild Health anxiety did not have a worse outcome on physical health and incurred significantly less health care costs than the group of

  8. The outcome of health anxiety in primary care. A two-year follow-up study on health care costs and self-rated health.

    Directory of Open Access Journals (Sweden)

    Per Fink

    Full Text Available BACKGROUND: Hypochondriasis is prevalent in primary care, but the diagnosis is hampered by its stigmatizing label and lack of valid diagnostic criteria. Recently, new empirically established criteria for Health anxiety were introduced. Little is known about Health anxiety's impact on longitudinal outcome, and this study aimed to examine impact on self-rated health and health care costs. METHODOLOGY/PRINCIPAL FINDINGS: 1785 consecutive primary care patients aged 18-65 consulting their family physicians (FPs for a new illness were followed-up for two years. A stratified subsample of 701 patients was assessed by the Schedules for Clinical Assessment in Neuropsychiatry interview. Patients with mild (N = 21 and severe Health anxiety (N = 81 and Hypochondriasis according to the DSM-IV (N = 59 were compared with a comparison group of patients who had a well-defined medical condition according to their FPs and a low score on the screening questionnaire (N = 968. Self-rated health was measured by questionnaire at index and at three, 12, and 24 months, and health care use was extracted from patient registers. Compared with the 968 patients with well-defined medical conditions, the 81 severe Health anxiety patients and the 59 DSM-IV Hypochondriasis patients continued during follow-up to manifest significantly more Health anxiety (Whiteley-7 scale. They also continued to have significantly worse self-rated functioning related to physical and mental health (component scores of the SF-36. The severe Health anxiety patients used about 41-78% more health care per year in total, both during the 3 years preceding inclusion and during follow-up, whereas the DSM-IV Hypochondriasis patients did not have statistically significantly higher total use. A poor outcome of Health anxiety was not explained by comorbid depression, anxiety disorder or well-defined medical condition. Patients with mild Health anxiety did not have a worse outcome on physical health and incurred

  9. Generalised anxiety disorder

    OpenAIRE

    Gale, Christopher K; Millichamp, Jane

    2011-01-01

    Generalised anxiety disorder is characterised by persistent, excessive and difficult-to-control worry, which may be accompanied by several psychic and somatic symptoms, including suicidality. Generalized anxiety disorder is the most common psychiatric disorder in the primary care, although it is often underrecognised and undertreated. Generalized anxiety disorder is typically a chronic condition with low short- and medium-term remission rates. Clinical presentations often include depression, ...

  10. Perceptions of Quality Life in Hamilton's Neighbourhood Hubs: A Qualitative Analysis

    Science.gov (United States)

    Eby, Jeanette; Kitchen, Peter; Williams, Allison

    2012-01-01

    This paper examines perceptions of quality of life in Hamilton, Ontario, Canada from the perspective of residents and key community stakeholders. A series of eight focus groups were conducted. Six sessions were held with residents of neighbourhood "hubs", areas characterized by high levels of poverty. The following themes were…

  11. Air Quality in Hamilton: Who Is Concerned? Perceptions from Three Neighbourhoods

    Science.gov (United States)

    Simone, Dylan; Eyles, John; Newbold, K. Bruce; Kitchen, Peter; Williams, Allison

    2012-01-01

    This study investigates the factors influencing perceptions of air quality in the industrial city of Hamilton, Canada. The research employs data collected via a telephone survey of 1,002 adult residents in three neighbourhoods. Perceptions in the neighbourhoods were examined by individual socio-demographic factors (age, gender, marital and…

  12. Effect on return to work or education of Individual Placement and Support modified for people with mood and anxiety disorders: results of a randomised clinical trial.

    Science.gov (United States)

    Hellström, Lone; Bech, Per; Hjorthøj, Carsten; Nordentoft, Merete; Lindschou, Jane; Eplov, Lene Falgaard

    2017-10-01

    The effect of Individual Placement and Support (IPS) on return to work or education among people with mood or anxiety disorders is unclear, while IPS increases return to work for people with severe mental illness. We examined the effect of IPS modified for people with mood and anxiety disorders (IPS-MA) on return to work and education compared with services as usual (SAU). In a randomised clinical superiority trial, 326 participants with mood and anxiety disorders were centrally randomised to IPS-MA, consisting of individual mentor support and career counselling (n=162) or SAU (n=164). The primary outcome was competitive employment or education at 24 months, while weeks of competitive employment or education, illness symptoms and level of functioning, and well-being were secondary outcomes. After 24 months, 44.4% (72/162) of the participants receiving IPS-MA had returned to work or education compared with 37.8% (62/164) following SAU (OR=1.34, 95% CI: 0.86 to 2.10, p=0.20). We found no difference in mean number of weeks in employment or education (IPS-MA 32.4 weeks vs SAU 26.7 weeks, p=0.14), level of depression (Hamilton Depression 6-Item Scale score IPS-MA 5.7 points vs SAU 5.0 points, p=0.12), level of anxiety (Hamilton Anxiety 6-Item Scale score IPS-MA 5.8 points vs SAU 5.1 points, p=0.17), level of functioning (Global Assessment of Functioning IPS-MA 59.1 points vs SAU 59.5 points, p=0.81) or well-being measured by WHO-Five Well-being Index (IPS-MA 49.6 points vs SAU 48.5 points, p=0.83) at 24 months. The modified version of IPS, IPS-MA, was not superior to SAU in supporting people with mood or anxiety disorders in return to work at 24 months. NCT01721824. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Social Anxiety Disorder

    Directory of Open Access Journals (Sweden)

    S Seedat

    2013-08-01

    Full Text Available According to epidemiological studies, rates of social anxiety disorder(SAD or social phobia range from 3% to 16% in the generalpopulation.[1,2]Social phobia and specific phobias have an earlier ageof onset than other anxiety disorders.

  14. Silexan, an orally administered Lavandula oil preparation, is effective in the treatment of 'subsyndromal' anxiety disorder: a randomized, double-blind, placebo controlled trial.

    Science.gov (United States)

    Kasper, Siegfried; Gastpar, Markus; Müller, Walter E; Volz, Hans-Peter; Möller, Hans-Jürgen; Dienel, Angelika; Schläfke, Sandra

    2010-09-01

    This study was performed to investigate the anxiolytic efficacy of silexan, a new oral lavender oil capsule preparation, in comparison to placebo in primary care. In 27 general and psychiatric practices 221 adults suffering from anxiety disorder not otherwise specified (Diagnostic and Statistical Manual of Mental disorders-IV 300.00 or International Statistical Classification of Diseases and Related Health Problems, Tenth revision F41.9) were randomized to 80 mg/day of a defined, orally administered preparation from Lavandula species or placebo for 10 weeks with visits every 2 weeks. A Hamilton Anxiety Scale (HAMA) total score >or=18 and a total score >5 for the Pittsburgh Sleep Quality Index (PSQI) were required. The primary outcome measures were HAMA and PSQI total score decrease between baseline and week 10. Secondary efficacy measures included the Clinical Global Impressions scale, the Zung Self-rating Anxiety Scale, and the SF-36 Health Survey Questionnaire. Patients treated with silexan showed a total score decrease by 16.0+/-8.3 points (mean+/-SD, 59.3%) for the HAMA and by 5.5+/-4.4 points (44.7%) for the PSQI compared to 9.5+/-9.1 (35.4%) and 3.8+/-4.1 points (30.9%) in the placebo group (PLavandula oil preparation had a significant beneficial influence on quality and duration of sleep and improved general mental and physical health without causing any unwanted sedative or other drug specific effects. Lavandula oil preparation silexan is both efficacious and safe for the relief of anxiety disorder not otherwise specified. It has a clinically meaningful anxiolytic effect and alleviates anxiety related disturbed sleep.

  15. Hamilton-Jacobi formalism to warm inflationary scenario

    Science.gov (United States)

    Sayar, K.; Mohammadi, A.; Akhtari, L.; Saaidi, Kh.

    2017-01-01

    The Hamilton-Jacobi formalism as a powerful method is being utilized to reconsider the warm inflationary scenario, where the scalar field as the main component driving inflation interacts with other fields. Separating the context into strong and weak dissipative regimes, the goal is followed for two popular functions of Γ . Applying slow-rolling approximation, the required perturbation parameters are extracted and, by comparing to the latest Planck data, the free parameters are restricted. The possibility of producing an acceptable inflation is studied where the result shows that for all cases the model could successfully suggest the amplitude of scalar perturbation, scalar spectral index, its running, and the tensor-to-scalar ratio.

  16. Identifying Dental Anxiety in Children's Drawings and correlating It with Frankl's Behavior Rating Scale.

    Science.gov (United States)

    Mathur, Jyoti; Diwanji, Amish; Sarvaiya, Bhumi; Sharma, Dipal

    2017-01-01

    To develop a simple method to assess the level of anxiety by using children's drawings and correlating them with Frankl's behavior rating scale. A total of 178 patients aged of 3 to 14 years were handed out two-page forms which contained three sections on coloring and drawing, along with general information, and Frankl's behavior rating scale for the visit. The three types of drawing exercises given to the patients were geometric copy drawings, coloring a nonthreatening figure, and an empty sheet for freehand drawing. Out of 178 patients, 60 showed definitely positive behavior, 73 exhibited positive behavior, 37 showed negative behavior, and 8 were definitely negative on Frankl's behavior rating scale; 133 children had none or, 1 stress marker and 45 exhibited 2 or 3 stress markers in their drawings. Chi-square (χ 2 ) analysis was done with a 2 × 2 contingency table. Observed χ 2 value was 46.166, which at 1 degree of freedom was much greater than that at 0.995 percentile. Therefore, the result was highly significant. Children requiring specialized behavioral techniques can be identified by the presence of stress markers in their drawings. This nonverbal activity by itself can have an overall positive effect on the behavior displayed in the dental clinic. Mathur J, Diwanji A, Sarvaiya B, Sharma D. Identifying Dental Anxiety in Children's Drawings and correlating It with Frankl's Behavior Rating Scale. Int J Clin Pediatr Dent 2017;10(1):24-28.

  17. Hamilton and Hardy for the 21st Century

    Science.gov (United States)

    Ogden, Trevor

    2016-01-01

    Hamilton and Hardy’s Industrial Toxicology is now 80 years old, and the new sixth edition links us with a pioneer era. This is an impressive book, but the usefulness of the hardback version as a reference book is unfortunately limited by its poor index. There is now an ebook version, and for the practitioner on the move this has the great advantages of searchability and portability. However, Wiley ebooks can apparently only be downloaded when first purchased, so their lifetime is limited to that of the device. The Kindle edition should avoid this shortcoming.

  18. Effect on return to work or education of individual placement and support modified for people with mood and anxiety disorders

    DEFF Research Database (Denmark)

    Hellström, Lone; Bech, Per; Hjorthøj, Carsten

    2017-01-01

    disorders (IPS-MA) on return to work and education compared with services as usual (SAU). Methods: In a randomised clinical superiority trial, 326 participants with mood and anxiety disorders were centrally randomised to IPS-MA, consisting of individual mentor support and career counselling (n=162) or SAU......Objectives: The effect of Individual Placement and Support (IPS) on return to work or education among people with mood or anxiety disorders is unclear, while IPS increases return to work for people with severe mental illness. We examined the effect of IPS modified for people with mood and anxiety...... returned to work or education compared with 37.8% (62/164) following SAU (OR=1.34, 95% CI: 0.86 to 2.10, p=0.20). We found no difference in mean number of weeks in employment or education (IPS-MA 32.4 weeks vs SAU 26.7 weeks, p=0.14), level of depression (Hamilton Depression 6-Item Scale score IPS-MA 5...

  19. Octavia Butler and Virginia Hamilton: Black Women Writers and Science Fiction.

    Science.gov (United States)

    Hampton, Gregory Jerome; Brooks, Wanda M.

    2003-01-01

    Notes that African American literature has always had science fiction elements in its focus on narratives of the alienated and marginalized "other." Contends that Octavia Butler and Virginia Hamilton are two African American writers of science fiction who examine the connections between the stories of a culture and the genre of science…

  20. Effectiveness of reboxetine in treatment of outpatient children and adolescents with attention deficit-hyperactivity disorder with comorbid anxiety disorders.

    Directory of Open Access Journals (Sweden)

    Forough Riahi

    2013-12-01

    Full Text Available Some previous studies have reported that ADHD is often comorbid with anxiety disorders. The aim of the present study was to evaluate the effectiveness of reboxetine in treating outpatient children and adolescents with ADHD and comorbid anxiety disorders.In this open-label study, 25 outpatient children and adolescents, aged 6-16 years were selected by convenient sampling and underwent treatment with 4mg reboxetine for four weeks. Data were collected at baseline, two weeks and four weeks after the start of the medication using Conners' Parent Questionnaire, Hamilton's Rating Scale for Anxiety, Clinical Global Assessment Scale, Clinical Global Impression-Severity Scale and Side Effects Form. Data were analyzed using repeated measure, analyses of variance (ANOVA, Tukey post hoc test and paired t-test.There were significant reduction in the total score of ADHD (F = 31.441; P <0.001 at the end of the treatment compared to baseline (Table 1. The differences between T0 and T2 in the subscales of attention deficit, hyperactivity and confrontation (F = 20.691; P <0.001, F = 28.810; P < 0.001, and F = 17.463; P <0.001, respectively were also significant. Findings also indicated significant differences between T0 and T1 (P<0.01 and T1 and T2 (P<0.01 in all of the subscales except for confrontation. A significant improvement was observed in the severity of ADHD and anxiety disorders during different courses of the treatment (p<0.001. No significant changes were observed in systolic and diastolic blood pressure and pulse and weight of the patients during the study. The most common complications were headache and anorexia.The short-term treatment with reboxetine was effective in improving ADHD with comorbid anxiety disorders. Therefore, reboxetine could be used as a treatment option for ADHD in those children who experience comorbid anxiety disorders or in those who are non-responsive or intolerant to methylphenidate.

  1. Generalised anxiety disorder

    Directory of Open Access Journals (Sweden)

    Bojana Avguštin Avčin

    2013-10-01

    Full Text Available Generalised anxiety disorder is characterised by persistent, excessive and difficult-to-control worry, which may be accompanied by several psychic and somatic symptoms, including suicidality. Generalized anxiety disorder is the most common psychiatric disorder in the primary care, although it is often underrecognised and undertreated. Generalized anxiety disorder is typically a chronic condition with low short- and medium-term remission rates. Clinical presentations often include depression, somatic illness, pain, fatigue and problems sleeping. The evaluation of prognosis is complicated by frequent comorbidity with other anxiety disorders and depression, which worsen the long-term outcome and accompanying burden of disability. The two main treatments for generalised anxiety disorder are medications and psychotherapy. Selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors represent first-line psychopharmacologic treatment for generalised anxiety disorder. The most extensively studied psychotherapy for anxiety is cognitive behavioural therapy which has demonstrated efficacy throughout controlled studies.

  2. Recurrence of anxiety disorders and its predictors

    NARCIS (Netherlands)

    Scholten, Willemijn D.; Batelaan, Neeltje M.; van Balkom, Anton J. L. M.; Penninx, Brenda; Smit, Johannes H.; van Oppen, Patricia

    Background: The chronic course of anxiety disorders and its high burden of disease are partly due to the recurrence of anxiety disorders after remission. However, knowledge about recurrence rates and predictors of recurrence is scarce. This article reports on recurrence rates of anxiety disorders

  3. Recurrence of anxiety disorders and its predictors

    NARCIS (Netherlands)

    Scholten, W.D.; Batelaan, N.M.; van Balkom, A.J.L.M.; Penninx, B.W.J.H.; Smit, J.H.; van Oppen, P.

    2013-01-01

    Background: The chronic course of anxiety disorders and its high burden of disease are partly due to the recurrence of anxiety disorders after remission. However, knowledge about recurrence rates and predictors of recurrence is scarce. This article reports on recurrence rates of anxiety disorders

  4. Initial severity and antidepressant efficacy for anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder: An individual patient data meta-analysis.

    Science.gov (United States)

    de Vries, Ymkje Anna; Roest, Annelieke M; Burgerhof, Johannes G M; de Jonge, Peter

    2018-06-01

    It has been suggested that antidepressant benefits are smaller for mild than severe depression. Because antidepressants are also used for anxiety disorders, obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD), we examined the influence of severity for these disorders. We used individual patient data of eight trials (3,430 participants) for generalized anxiety disorder (GAD); four trials (1,195 participants) for social anxiety disorder (SAD); four trials (1,132 participants) for OCD; three trials (1,071 participants) for PTSD; and 10 trials (2,151 participants) for panic disorder (PD). Mixed-effects models were used to investigate an interaction between severity and treatment group. For GAD and PD, severity moderated antidepressant efficacy. The antidepressant-placebo difference was 1.4 (95% CI: 0.4-2.5; SMD: 0.21) Hamilton Anxiety Rating Scale (HAM-A) points for participants with mild GAD (baseline HAM-A = 10), increasing to 4.0 (3.4-4.6; SMD: 0.45) or greater for severely ill participants (HAM-A ≥ 30). For PD, the difference was 0.4 (0.3-0.6) panic attacks/2 weeks for participants with 10 panic attacks/2 weeks at baseline, increasing to 4.7 (3.0-6.4) for participants with 40. For SAD, OCD, and PTSD, no interaction was found. Across severity levels, the differences were 16.1 (12.9-19.3; SMD: 0.59) Liebowitz Social Anxiety Scale points, 3.4 (2.5-4.4, SMD: 0.39) Yale-Brown Obsessive-Compulsive Scale points, and 10.3 (6.9-13.6; SMD: 0.41) Clinician-Administered PTSD Scale points. Antidepressants are equally effective across severity levels for SAD, OCD, and PTSD. For GAD and PD, however, benefits are small at low severity, and the benefit-risk ratio may be unfavorable for these patients. © 2018 Wiley Periodicals, Inc.

  5. Effect of music therapy on pain and anxiety levels of cancer patients: A pilot study

    Directory of Open Access Journals (Sweden)

    Priyadharshini Krishnaswamy

    2016-01-01

    Full Text Available Background: The pain associated with cancer is highly detrimental to the quality of life of the affected individuals. It also contributes to the anxiety of the patient. There is a need for a nonpharmacological approach in addition to the pharmacological therapy for the management of the pain for a more holistic improvement in the individual. With this study, we wish to achieve this through music. Objective: To assess the effect of music therapy on pain scores and anxiety levels of cancer patients with pain. Study Design: In this quantitative study, a comparative study was done on fourteen cancer patients admitted for pain relief under the Department of Pain and Palliative Medicine, of a tertiary care hospital, having moderate to severe pain (numerical pain rating scale [NRS] - of 4 to 10. Subjects and Methods: Convenience sampling was used. Patients were allocated to test group or control group nonrandomly. The test group patients were subjected to music therapy for 20 min while the control group patients were kept occupied by talking to them for 20 min. The NRS scale was used to assess the pre- and post-interventional pain scores and the Hamilton anxiety rating scale was used to assess the pre- and post-interventional anxiety scores in the two groups. Statistics: Student′s t-test was used for comparing the pre- and post-interventional data. Two sample t-test was used to compare the data obtained from the control and study groups. Results: Statistically significant reduction seen in the pain scores in the test group after music therapy (P = 0.003. No statistically significant reduction seen in the pain score in the control group (P = 0.356. There was a statistically significant reduction in the postintervention pain scores in the test group compared to the control group (P = 0.034. The reduction in anxiety levels in both groups after intervention was not statistically significant. Conclusion: Music therapy was found to lower the pain score of

  6. The TAS-20 more likely measures negative affects rather than alexithymia itself in patients with major depression, panic disorder, eating disorders and substance use disorders.

    Science.gov (United States)

    Marchesi, Carlo; Ossola, Paolo; Tonna, Matteo; De Panfilis, Chiara

    2014-05-01

    This study evaluates whether the difference in Toronto Alexithymia Scale-20 item (TAS-20) between patients with major depression (MD), panic disorder (PD), eating disorders (ED), and substance use disorders (SUD) and healthy controls persisted after controlling for the severity of anxiety and depression. Thirty-eight patients with MD, 58 with PD, 52 with ED, and 30 with SUD and 78 healthy controls (C) completed the TAS-20, the Hamilton Rating Scale for Anxiety (Ham-A), the Hamilton Rating Scale for Depression (Ham-D). The differences in TAS-20 scores observed between patient groups, regardless of the type of their disorders, and controls disappeared after controlling for the effect of anxiety and depression severity. In contrast, the differences in severity of anxiety and depression between patients and controls were still present, after excluding the effect of alexithymic levels. Our data suggest that alexithymic levels, as measured by the TAS-20, are modulated by the severity of symptoms, supporting the view that alexithymia can represent a state phenomenon in patients with MD, PD, ED and SUD, because the TAS-20 seems overly sensitive to a general distress syndrome, and it is more likely to measure negative affects rather than alexithymia itself. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Expanded social fitness and Hamilton's rule for kin, kith, and kind.

    Science.gov (United States)

    Queller, David C

    2011-06-28

    Inclusive fitness theory has a combination of simplicity, generality, and accuracy that has made it an extremely successful way of thinking about and modeling effects on kin. However, there are types of social interactions that, although covered, are not illuminated. Here, I expand the inclusive fitness approach and the corresponding neighbor-modulated approach to specify two other kinds of social selection. Kind selection, which includes greenbeards and many nonadditive games, is where selection depends on an actor's trait having different effects on others depending on whether they share the trait. Kith selection includes social effects that do not require either kin or kind, such as mutualism and manipulation. It involves social effects of a trait that affect a partner, with feedback to the actor's fitness. I derive expanded versions of Hamilton's rule for kith and kind selection, generalizing Hamilton's insight that we can model social selection through a sum of fitness effects, each multiplied by an appropriate association coefficient. Kinship is, thus, only one of the important types of association, but all can be incorporated within an expanded inclusive fitness.

  8. The Single-Item Math Anxiety Scale: An Alternative Way of Measuring Mathematical Anxiety

    Science.gov (United States)

    Núñez-Peña, M. Isabel; Guilera, Georgina; Suárez-Pellicioni, Macarena

    2014-01-01

    This study examined whether the Single-Item Math Anxiety Scale (SIMA), based on the item suggested by Ashcraft, provided valid and reliable scores of mathematical anxiety. A large sample of university students (n = 279) was administered the SIMA and the 25-item Shortened Math Anxiety Rating Scale (sMARS) to evaluate the relation between the scores…

  9. Attachment as Moderator of Treatment Outcome in Major Depression: A Randomized Control Trial of Interpersonal Psychotherapy versus Cognitive Behavior Therapy

    Science.gov (United States)

    McBride, Carolina; Atkinson, Leslie; Quilty, Lena C.; Bagby, R. Michael

    2006-01-01

    Anxiety and avoidance dimensions of adult attachment insecurity were tested as moderators of treatment outcome for interpersonal psychotherapy (IPT) and cognitive-behavioral therapy (CBT). Fifty-six participants with major depression were randomly assigned to these treatment conditions. Beck Depression Inventory-II, Six-Item Hamilton Rating Scale…

  10. Clinical and non-clinical depression and anxiety in young people: A scoping review on heart rate variability.

    Science.gov (United States)

    Paniccia, Melissa; Paniccia, David; Thomas, Scott; Taha, Tim; Reed, Nick

    2017-12-01

    Heart rate variability (HRV), a measure of cardiac autonomic nervous system functioning, has emerged as a physiological indicator for emotional regulation and psychological well-being. HRV is understudied in the context of depression and anxiety in young people (10-24years old). Main objectives: (1) describe the nature and breadth of reviewed studies; and (2) synthesize main findings in the context of clinical and non-clinical populations of young people with depression and/or anxiety. The Arksey and O'Malley methodology was utilized for this scoping review. CINHAL, EMBASE, Medline, PsychInfo, Scopus, Web of Science, as well as grey literature, were searched. Two reviewers screened titles, abstracts and full papers for inclusion. A total of 20 citations were included in the final review (19 citations peer-reviewed journal articles, 1 journal abstract). Numerical and thematic analysis was used to summarize study findings. In clinical populations of either depression or anxiety, HRV was lower compared to controls. In non-clinical populations of either depression or anxiety, HRV was found to be lower in those who reported more depression or anxiety symptoms. The quality of the reviewed articles was not assessed which limits the ability to generate conclusions regarding study findings. Changes in HRV were found across the spectrum of clinical and non-clinical populations of young people with depression or anxiety. Neurophysiological research on depression and anxiety in young people can act as a first step to understanding how physiological flexibility (i.e. HRV) is related to psychological flexibility (i.e. adaptive or maladaptive responses to life events). Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Hamilton y el Descubrimiento de los Cuaterniones

    Directory of Open Access Journals (Sweden)

    José Manuel Sánchez Muñoz

    2011-10-01

    Full Text Available Este artículo pretende ofrecer una visión general del descubrimiento de los llamados cuaterniones por parte del matemático irlandés William Rowan Hamilton. Se pretende dar al lector algunos detalles del nacimiento de los números imaginarios en el siglo XVI, su interpretación geométrica a principios del siglo XIX, y la extensión del plano complejo a las tres dimensiones a través de los cuaterniones, que abrirían el paso al estudio y el desarrollo de las nuevas álgebras no conmutativas y a una nueva interpretación tridimensional de la realidad física.

  12. Systematic review and meta-analysis of dropout rates in individual psychotherapy for generalized anxiety disorder.

    Science.gov (United States)

    Gersh, Elon; Hallford, David J; Rice, Simon M; Kazantzis, Nikolaos; Gersh, Hannah; Gersh, Benji; McCarty, Carolyn A

    2017-12-01

    Despite being a relatively prevalent and debilitating disorder, Generalized Anxiety Disorder (GAD) is the second least studied anxiety disorder and among the most difficult to treat. Dropout from psychotherapy is concerning as it is associated with poorer outcomes, leads to service inefficiencies and can disproportionately affect disadvantaged populations. No study to date has calculated a weighted mean dropout rate for GAD and explored associated correlates. A systematic review was conducted using PsycINFO, Medline and Embase databases, identifying studies investigating individual psychotherapies for adults with GAD. Forty-five studies, involving 2224 participants, were identified for meta-analysis. The weighted mean dropout rate was 16.99% (95% confidence interval 14.42%-19.91%). The Q-statistic indicated significant heterogeneity among studies. Moderator analysis and meta-regressions indicated no statistically significant effect of client age, sex, symptom severity, comorbidity, treatment type, study type (randomized trial or not), study quality, number of sessions or therapist experience. In research investigating psychotherapy for GAD, approximately one in six clients can be expected to drop out of treatment. Dropout rate was not significantly moderated by the client, therapist or treatment variables investigated. Future research should specify the definition of dropout, reasons for dropout and associated correlates to assist the field's progression. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Relationship between anxiety, anxiety sensitivity and conduct disorder symptoms in children and adolescents with attention-deficit/hyperactivity disorder (ADHD).

    Science.gov (United States)

    Bilgiç, Ayhan; Türkoğlu, Serhat; Ozcan, Ozlem; Tufan, Ali Evren; Yılmaz, Savaş; Yüksel, Tuğba

    2013-09-01

    Attention-deficit hyperactivity disorder (ADHD) is often comorbid with anxiety disorders and previous studies observed that anxiety could have an impact on the clinical course of ADHD and comorbid disruptive behavioral disorders (conduct disorders and oppositional-defiant disorders). Anxiety sensitivity (AS) is a different concept from anxiety per se and it is believed to represent the constitutionally based sensitivity of individuals to anxiety and anxiety symptoms. We aimed to assess the associations between anxiety, AS and symptoms of disruptive behavioral disorders (DBD) in a clinical sample of children and adolescents with ADHD. The sample consisted of 274 treatment naive children with ADHD aged 8-17 years. The severity of ADHD symptoms and comorbid DBD were assessed via parent rated Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), Conners' Parent Rating Scale (CPRS), and Conners' Teacher Rating Scale (CTRS). AS and severity of anxiety symptoms of children were evaluated by self-report inventories. The association between anxiety, AS, and DBD was evaluated using structural equation modeling. Analyses revealed that AS social subscale scores negatively predicted symptoms of conduct disorder (CD) reported in T-DSM-IV-S. On the other hand, CD symptoms positively predicted severity of anxiety. No direct relationships were detected between anxiety, AS and oppositional-defiant behavior scores in any scales. These results may suggest a protective effect of AS social area on the development of conduct disorder in the presence of a diagnosis of ADHD, while the presence of symptoms of CD may be a vulnerability factor for the development of anxiety symptoms in children and adolescents with ADHD.

  14. Feeling safe but appearing anxious: Differential effects of alcohol on anxiety and social performance in individuals with social anxiety disorder.

    Science.gov (United States)

    Stevens, Stephan; Cooper, Ruth; Bantin, Trisha; Hermann, Christiane; Gerlach, Alexander L

    2017-07-01

    Social anxiety disorder (SAD) and alcohol use disorders (AUD) co-occur frequently and there is preliminary evidence that alcohol might reduce social anxiety. It is, however, unclear which mechanisms contribute to the anxiety reducing effect, particularly regarding key aspects of social anxiety such as deficits in social performance. We compared self-rated and physiological measures of anxiety as well as self- and observer-rated social performance in a sample of 62 individuals with SAD and 60 nonanxious control participants during a speech task after receiving either alcohol, an alcohol-free placebo drink or orange juice. SAD patients reported more anxiety during the speech task than did control participants. Furthermore, SAD patients underestimated their performance in comparison to observer ratings. Alcohol reduced self-report anxiety only in SAD patients, while observers rated all participants as less competent when intoxicated. Although individuals with SAD experience a reduction in anxiety when drinking alcohol, simultaneous decreases in social performance might contribute to negative reactions from others and consequently increase the risk of further alcohol use to cope with these negative reactions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Periodic solutions of the Hamilton-Jacobi equation by the shooting method: A technique for beam dynamics

    International Nuclear Information System (INIS)

    Gabella, W.E.; Ruth, R.D.; Warnock, R.L.

    1988-05-01

    Periodic solutions of the Hamilton-Jacobi equation determine invariant tori in phase space. The Fourier spectrum of a torus with respect to angular coordinates gives useful information about nonlinear resonances and their potential for causing instabilities. We describe a method to solve the Hamilton-Jacobi equation for an arbitrary accelerator lattice. The method works with Fourier modes of the generating functions, and imposes periodicity in the machine azimuth by a shooting method. We give examples leading to three-dimensional plots in a surface of section. It is expected that the technique will be useful in lattice optimization. 14 refs., 6 figs., 1 tab

  16. Pregabalin versus SSRIs and SNRIs in benzodiazepine-refractory outpatients with generalized anxiety disorder: a post hoc cost-effectiveness analysis in usual medical practice in Spain

    Directory of Open Access Journals (Sweden)

    De Salas-Cansado M

    2012-06-01

    Full Text Available Marina De Salas-Cansado,1 José M Olivares,2 Enrique Álvarez,3 Jose L Carrasco,4 Andoni Barrueta,5 Javier Rejas,51Trial Form Support Spain, Madrid; 2Department of Psychiatry, Hospital Meixoeiro, Complejo Hospitalario Universitario, Vigo; 3Department of Psychiatry, Hospital de la Santa Creu i San Pau, Barcelona; 4Department of Psychiatry, Hospital Clínico San Carlos, Madrid; 5Health Outcomes Research Department, Medical Unit, Pfizer Spain, Alcobendas, Madrid, SpainBackground: Generalized anxiety disorder (GAD is a prevalent health condition which seriously affects both patient quality of life and the National Health System. The aim of this research was to carry out a post hoc cost-effectiveness analysis of the effect of pregabalin versus selective serotonin reuptake inhibitors (SSRIs/serotonin norepinephrine reuptake inhibitors (SNRIs in treated benzodiazepine-refractory outpatients with GAD.Methods: This post hoc cost-effectiveness analysis used secondary data extracted from the 6-month cohort, prospective, noninterventional ADAN study, which was conducted to ascertain the cost of illness in GAD subjects diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. Benzodiazepine-refractory subjects were those who claimed persistent symptoms of anxiety and showed a suboptimal response (Hamilton Anxiety Rating Scale ≥16 to benzodiazepines, alone or in combination, over 6 months. Patients could switch to pregabalin (as monotherapy or addon or to an SSRI or SNRI, alone or in combination. Effectiveness was expressed as quality-adjusted life years gained, and the perspective was that of the National Health System in the year 2008. A sensitivity analysis was performed using bootstrapping techniques (10,000 resamples were obtained in order to obtain a cost-effectiveness plane and a corresponding acceptability curve.Results: A total of 282 subjects (mean Hamilton Anxiety Rating Scale score 25.8 were

  17. Functional brain imaging study in patients with anxiety disorders using SPECT

    International Nuclear Information System (INIS)

    Sun Da; Zhan Hongwei; Liu Hongbiao; Li Huichun

    2005-01-01

    Objective: To evaluate the changes of brain function in patients with anxiety disorders. Methods: Regional cerebral perfusion was investigated using SPECT in 65 patients with anxiety disorders dragnosed according to the fourth edition of the diagnostic and statistical manual of mental disorder (DSMTD) criteria and in a matched control group of 21 healthy volunteers. 65 cases of the patients were further divided into: drug treated group (31 patients) and non-drug treated group (34 patients). The mean ages of the patients and the controls were (39.2±26.1) and (34.4±9.7) years, respectively. The severity of the anxiety was assessed using the 17-item Hamilton Anxiety scale (mean: 24.8±5.5 and 24.7±7.5, respectively). After administration of 740-925 MBq 99 Tc m -ethylene cysteinate direct (ECD) brain SPECT image study was performed. For the semi- quantitative analysis of the data, the ratios of the mean counts/pixel in the different cerebral regions of interest (ROI) to that of cerebellum were calculated respectively as a regional perfusion index (RPI). Some patients had a repeated SPECT after three months of treatment. Results: 93.8% (61/65) patients had relative hypoperfusions in some cerebral regions. Compared with the control group, the patients had a significant decrease of regional cerebral blood flow (rCBF) in the bilateral frontal lobes, paralimbic system, temporal lobes and basal ganglia. The course of disease had negatively correlated with the changes of rCBF in both groups of patients. Follow-up SPECT study demonstrated increased rCBF related with the symptomatic improvement. Conclusions: Patients with anxiety disorders had profound dysfunction of the frontal and temporal cortices, and was closely related to the symptom and therapy. 99 Tc m -ECD brain SPECT may offer the most accurate assessment of response to therapy. . (authors)

  18. 76 FR 25534 - Airworthiness Directives; Hamilton Sundstrand Propellers Model 247F Propellers

    Science.gov (United States)

    2011-05-05

    ... 5 p.m., Monday through Friday, except Federal holidays. The AD docket contains this AD, the... through FR2279 inclusive, FR 2398, FR2449 to FR2958 inclusive, FR20010710 to FR20010722 inclusive, and FR20010723RT to FR20020127RT inclusive, installed. Propeller blades reworked to Hamilton Sundstrand Service...

  19. An optimal L1-minimization algorithm for stationary Hamilton-Jacobi equations

    KAUST Repository

    Guermond, Jean-Luc

    2009-01-01

    We describe an algorithm for solving steady one-dimensional convex-like Hamilton-Jacobi equations using a L1-minimization technique on piecewise linear approximations. For a large class of convex Hamiltonians, the algorithm is proven to be convergent and of optimal complexity whenever the viscosity solution is q-semiconcave. Numerical results are presented to illustrate the performance of the method.

  20. Experiencing More Mathematics Anxiety than Expected? Contrasting Trait and State Anxiety in High Achieving Students

    Science.gov (United States)

    Roos, A.-L.; Bieg, M.; Goetz, T.; Frenzel, A. C.; Taxer, J.; Zeidner, M.

    2015-01-01

    This study examined mathematics anxiety among high and low achieving students (N = 237, grades 9 and 10) by contrasting trait (habitual) and state (momentary) assessments of anxiety. Previous studies have found that trait anxiety measures are typically rated higher than state measures. Furthermore, the academic self-concept has been identified to…

  1. Association of professional identity, gender, team understanding, anxiety and workplace learning alignment with burnout in junior doctors: a longitudinal cohort study.

    Science.gov (United States)

    Monrouxe, Lynn V; Bullock, Alison; Tseng, Hsu-Min; Wells, Stephanie E

    2017-12-27

    To examine how burnout across medical student to junior doctor transition relates to: measures of professional identity, team understanding, anxiety, gender, age and workplace learning (assistantship) alignment to first post. A longitudinal 1-year cohort design. Two groups of final-year medical students: (1) those undertaking end-of-year assistantships aligned in location and specialty with their first post and (2) those undertaking assistantships non-aligned. An online questionnaire included: Professional Identity Scale, Team Understanding Scale, modified Hamilton Anxiety Rating Scale and modified Copenhagen Burnout Inventory. Data were collected on four occasions: (T1) prior to graduation; (T2) 1 month post-transition; (T3) 6 months post-transition and (T4) 10 months post-transition. Questionnaires were analysed individually and using linear mixed-effect models. Medical schools and postgraduate training in one UK country. All aligned assistantship (n=182) and non-aligned assistantship students (n=319) were contacted; n=281 (56%) responded: 68% (n=183) females, 73% (n=206) 22-30 years, 46% aligned (n=129). Completion rates: aligned 72% (93/129) and non-aligned 64% (98/152). Analyses of individual scales revealed that self-reported anxiety, professional identity and patient-related burnout were stable, while team understanding, personal and work-related burnout increased, all irrespective of alignment. Three linear mixed-effect models (personal, patient-related and work-related burnout as outcome measures; age and gender as confounding variables) found that males self-reported significantly lower personal, but higher patient-related burnout, than females. Age and team understanding had no effect. Anxiety was significantly positively related and professional identity was significantly negatively related to burnout. Participants experiencing non-aligned assistantships reported higher personal and work-related burnout over time. Implications for practice

  2. Association of professional identity, gender, team understanding, anxiety and workplace learning alignment with burnout in junior doctors: a longitudinal cohort study

    Science.gov (United States)

    Bullock, Alison; Tseng, Hsu-Min; Wells, Stephanie E

    2017-01-01

    Objectives To examine how burnout across medical student to junior doctor transition relates to: measures of professional identity, team understanding, anxiety, gender, age and workplace learning (assistantship) alignment to first post. Design A longitudinal 1-year cohort design. Two groups of final-year medical students: (1) those undertaking end-of-year assistantships aligned in location and specialty with their first post and (2) those undertaking assistantships non-aligned. An online questionnaire included: Professional Identity Scale, Team Understanding Scale, modified Hamilton Anxiety Rating Scale and modified Copenhagen Burnout Inventory. Data were collected on four occasions: (T1) prior to graduation; (T2) 1 month post-transition; (T3) 6 months post-transition and (T4) 10 months post-transition. Questionnaires were analysed individually and using linear mixed-effect models. Setting Medical schools and postgraduate training in one UK country. Participants All aligned assistantship (n=182) and non-aligned assistantship students (n=319) were contacted; n=281 (56%) responded: 68% (n=183) females, 73% (n=206) 22–30 years, 46% aligned (n=129). Completion rates: aligned 72% (93/129) and non-aligned 64% (98/152). Results Analyses of individual scales revealed that self-reported anxiety, professional identity and patient-related burnout were stable, while team understanding, personal and work-related burnout increased, all irrespective of alignment. Three linear mixed-effect models (personal, patient-related and work-related burnout as outcome measures; age and gender as confounding variables) found that males self-reported significantly lower personal, but higher patient-related burnout, than females. Age and team understanding had no effect. Anxiety was significantly positively related and professional identity was significantly negatively related to burnout. Participants experiencing non-aligned assistantships reported higher personal and work

  3. Viscous warm inflation: Hamilton-Jacobi formalism

    Science.gov (United States)

    Akhtari, L.; Mohammadi, A.; Sayar, K.; Saaidi, Kh.

    2017-04-01

    Using Hamilton-Jacobi formalism, the scenario of warm inflation with viscous pressure is considered. The formalism gives a way of computing the slow-rolling parameter without extra approximation, and it is well-known as a powerful method in cold inflation. The model is studied in detail for three different cases of the dissipation and bulk viscous pressure coefficients. In the first case where both coefficients are taken as constant, it is shown that the case could not portray warm inflationary scenario compatible with observational data even it is possible to restrict the model parameters. For other cases, the results shows that the model could properly predicts the perturbation parameters in which they stay in perfect agreement with Planck data. As a further argument, r -ns and αs -ns are drown that show the acquired result could stand in acceptable area expressing a compatibility with observational data.

  4. The Major Depressive Disorder Hierarchy: Rasch Analysis of 6 items of the Hamilton Depression Scale Covering the Continuum of Depressive Syndrome.

    Directory of Open Access Journals (Sweden)

    Lucas Primo de Carvalho Alves

    Full Text Available Melancholic features of depression (MFD seem to be a unidimensional group of signs and symptoms. However, little importance has been given to the evaluation of what features are related to a more severe disorder. That is, what are the MFD that appear only in the most depressed patients. We aim to demonstrate how each MFD is related to the severity of the major depressive disorder.We evaluated both the Hamilton depression rating scale (HDRS-17 and its 6-item melancholic subscale (HAM-D6 in 291 depressed inpatients using Rasch analysis, which computes the severity of each MFD. Overall measures of model fit were mean (±SD of items and persons residual = 0 (±1; low χ2 value; p>0.01.For the HDRS-17 model fit, mean (±SD of item residuals = 0.35 (±1.4; mean (±SD of person residuals = -0.15 (±1.09; χ2 = 309.74; p<0.00001. For the HAM-D6 model fit, mean (±SD of item residuals = 0.5 (±0.86; mean (±SD of person residuals = 0.15 (±0.91; χ2 = 56.13; p = 0.196. MFD ordered by crescent severity were depressed mood, work and activities, somatic symptoms, psychic anxiety, guilt feelings, and psychomotor retardation.Depressed mood is less severe, while guilt feelings and psychomotor retardation are more severe MFD in a psychiatric hospitalization. Understanding depression as a continuum of symptoms can improve the understanding of the disorder and may improve its perspective of treatment.

  5. Perturbation to Unified Symmetry and Adiabatic Invariants for Relativistic Hamilton Systems

    International Nuclear Information System (INIS)

    Zhang Mingjiang; Fang Jianhui; Lu Kai; Pang Ting; Lin Peng

    2009-01-01

    Based on the concept of adiabatic invariant, the perturbation to unified symmetry and adiabatic invariants for relativistic Hamilton systems are studied. The definition of the perturbation to unified symmetry for the system is presented, and the criterion of the perturbation to unified symmetry is given. Meanwhile, the Noether adiabatic invariants, the generalized Hojman adiabatic invariants, and the Mei adiabatic invariants for the perturbed system are obtained. (general)

  6. Modeling the longitudinal latent effect of pregabalin on self-reported changes in sleep disturbances in outpatients with generalized anxiety disorder managed in routine clinical practice

    Directory of Open Access Journals (Sweden)

    Ruiz MA

    2015-08-01

    Full Text Available Miguel A Ruiz,1 Enrique Álvarez,2 Jose L Carrasco,3 José M Olivares,4 María Pérez,5 Javier Rejas6 1Department of Methodology, School of Psychology, Universidad Autónoma de Madrid, Madrid, 2Department of Psychiatry, Hospital de la Santa Creu i San Pau, Barcelona, 3Department of Psychiatry, Hospital Clínico San Carlos, Madrid, 4Department of Psychiatry, Hospital Meixoeiro, Complejo Hospitalario Universitario, Vigo, 5Medical Department, Pfizer, S.L.U., Alcobendas, Madrid, 6Health Economics and Outcomes Research Department, Pfizer, S.L.U., Alcobendas, Madrid, Spain Background: Anxiety disorders are among the most common psychiatric illnesses, with generalized anxiety disorder (GAD being one of the most common. Sleep disturbances are highly prevalent in GAD patients. While treatment with pregabalin has been found to be associated with significant improvement in GAD-related sleep disturbance across many controlled clinical trials, mediational analysis has suggested that a substantial portion of this effect could be the result of a direct effect of pregabalin. Thus, the objective of this study was to model the longitudinal latent effect of pregabalin or usual care (UC therapies on changes in sleep in outpatients with GAD under routine clinical practice. Methods: Male and female GAD outpatients, aged 18 years or above, from a 6-month prospective noninterventional trial were analyzed. Direct and indirect effects of either pregabalin or UC changes in anxiety symptoms (assessed with Hamilton Anxiety Scale and sleep disturbances (assessed with Medical Outcomes Study-Sleep Scale [MOS-S] were estimated by a conditional latent curve model applying structural equation modeling. Results: A total of 1,546 pregabalin-naïve patients were analyzed, 984 receiving pregabalin and 562 UC. Both symptoms of anxiety and sleep disturbances were significantly improved in both groups, with higher mean (95% confidence interval score reductions in subjects receiving

  7. Assessment of cerebral benzodiazepine receptor distribution in anxiety disorders by {sup 123}I-iomazenil-SPECT. Comparison to cerebral perfusion scintigraphy by {sup 123}I-IMP

    Energy Technology Data Exchange (ETDEWEB)

    Uchiyama, Mayuki; Sue, Hironari; Fukumitsu, Nobuyoshi; Mori, Yutaka; Kawakami, Kenji [Jikei Univ., Tokyo (Japan). School of Medicine

    1997-01-01

    {sup 123}I-Iomazenil ({sup 123}I-IMZ) and {sup 123}I-IMP imaging were performed in 5 patients with anxiety disorder (PAD) and 6 normal volunteers (NV). On {sup 123}I-IMZ delayed imaging, the 2 PAD showed abnormally decreased findings. In anxiety disorder, decreased accumulation on {sup 123}I-IMZ delayed images was seen in left hippocampus and parahippocampal gyrus in one patient, in right frontal and temporal lobe and left occipital pole in the other. Compared with NV, PAD had lower {sup 123}I-IMZ uptake on delayed image in right upper and left lower frontal cortices, indicating the involvement of the benzodiazepine receptor complex in anxiety disorder. Compared with grading for anxiety disorder with Hamilton anxiety scale (HAS) and delayed to early count ratios of {sup 123}I-IMZ, negative correlation (R<-0.7) was recognized hippocampus and parahippocampal gyrus, frontal and occipital cortices. Compared between HAS and the count ratio to the cerebellum on {sup 123}I-IMP image, positive correlation (R>0.7) was recognized in the hippocampus, the parahippocampal gyrus, the lower outer temporal cortex and the lower frontal cortex. (author)

  8. Variational energy principle for compressible, baroclinic flow. 2: Free-energy form of Hamilton's principle

    Science.gov (United States)

    Schmid, L. A.

    1977-01-01

    The first and second variations are calculated for the irreducible form of Hamilton's Principle that involves the minimum number of dependent variables necessary to describe the kinetmatics and thermodynamics of inviscid, compressible, baroclinic flow in a specified gravitational field. The form of the second variation shows that, in the neighborhood of a stationary point that corresponds to physically stable flow, the action integral is a complex saddle surface in parameter space. There exists a form of Hamilton's Principle for which a direct solution of a flow problem is possible. This second form is related to the first by a Friedrichs transformation of the thermodynamic variables. This introduces an extra dependent variable, but the first and second variations are shown to have direct physical significance, namely they are equal to the free energy of fluctuations about the equilibrium flow that satisfies the equations of motion. If this equilibrium flow is physically stable, and if a very weak second order integral constraint on the correlation between the fluctuations of otherwise independent variables is satisfied, then the second variation of the action integral for this free energy form of Hamilton's Principle is positive-definite, so the action integral is a minimum, and can serve as the basis for a direct trail and error solution. The second order integral constraint states that the unavailable energy must be maximum at equilibrium, i.e. the fluctuations must be so correlated as to produce a second order decrease in the total unavailable energy.

  9. Relationship between the prefrontal function and the severity of the emotional symptoms during a verbal fluency task in patients with major depressive disorder: a multi-channel NIRS study.

    Science.gov (United States)

    Liu, Xiaomin; Sun, Gaoxiang; Zhang, Xiaoqian; Xu, Bo; Shen, Chenyu; Shi, Lujie; Ma, Xiangyun; Ren, Xiajin; Feng, Kun; Liu, Pozi

    2014-10-03

    Multi-channel near-infrared spectroscopy (NIRS) is a noninvasive and low-cost functional neuroimaging technique in psychiatric research, and it has been wildly used for detecting the spatiotemporal characteristics of brain activity. In order to evaluate the clinical value of NIRS data in the assistant diagnosis of major depressive disorder (MDD), prefrontal cortex (PFC) hemoglobin concentration exchange of 30 MDD patients combined with anxious and obsessive-compulsive symptom was detected by NIRS under voice fluency task (VFT), then the relationship between the severity of depressive, anxious and obsessive-compulsive symptom assessed by Hamilton Rating Scale for Depression (HAMD), Hamilton Anxiety Rating Scale (HAMA) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) with NIRS data in PFC was analyzed. Hypoactivation in lateral and lower PFC of MDD patients was confirmed in this study. Furthermore, Spearman correlation found that oxy-hemoglobin concentration ([oxy-Hb]) exchange in right-lateral PFC was associated with the severity of anxiety, while bilateral PFC and antero-medial PFC were associated with severity of depression. Meanwhile, no statistical correlation was observed on the severity of obsessive-compulsive symptom. The results prompted that MDD patients with anxiety and obsession-compulsion symptom showed a PFC hypoactivation state in NIRS. Furthermore, the function of right-lateral PFC was associated with anxiety symptom, while bilateral PFC and antero-medial PFC were associated with depression symptom. Different from depression and anxiety, obsession-compulsion may have a different biological character in PFC function. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Afraid to be there? Evaluating the relation between presence, self-reported anxiety, and heart rate in a virtual public speaking task.

    Science.gov (United States)

    Felnhofer, Anna; Kothgassner, Oswald D; Hetterle, Thomas; Beutl, Leon; Hlavacs, Helmut; Kryspin-Exner, Ilse

    2014-05-01

    The link between anxiety and presence in a virtual environment (VE) is still a subject of an unresolved debate, with little empirical research to support theoretical claims. Thus, the current study analyzed presence, self-reported anxiety, and a physiological parameter (heart rate [HR]) in a sample of 30 high anxious and 35 low anxious participants. Both groups delivered a 5 minute speech in a virtual lecture hall. Results indicate no mediating influences of presence on group differences in self-reported state anxiety during the speech, but point toward negative correlations between state anxiety and the iGroup Presence Questionnaire (IPQ) scales "sense of being there" and "realism." Furthermore, HR was found to be unrelated to self-reported presence. Only the IPQ scale "spatial presence" showed a marginally significant influence on group differences in state anxiety. The present results support the assumption that presence and anxiety are logically distinct, meaning that presence does not directly influence the intensity of an emotion felt in a VE. Rather, it constitutes a precondition for an emotion to be at all elicited by a VE. Also, HR has proven to be no adequate substitute measure for presence, since it only assesses anxiety not presence. It may, however, mediate the interplay between trait anxiety and state anxiety. Possible implications of the current findings are discussed alongside the problem of using presence questionnaires that seem to be prone to subjective bias (i.e., participants confusing presence and emotion).

  11. Effect of music therapy on the anxiety levels and pregnancy rate of women undergoing in vitro fertilization-embryo transfer: A randomized controlled trial.

    Science.gov (United States)

    Aba, Yilda Arzu; Avci, Dilek; Guzel, Yilmaz; Ozcelik, Semanur Kumral; Gurtekin, Basak

    2017-08-01

    The aim of this study was to determine the effect of music therapy on the anxiety levels and pregnancy rates of women who underwent in vitro fertilization-embryo transfer. This prospective randomized controlled trial was conducted with 186 infertile women who presented to the In Vitro Fertilization Unit at the American Hospital in Turkey between April 2015 and April 2016. The infertile women who met the inclusion criteria were assigned to the music therapy group or the standard therapy group through block randomization. The study data were collected using the Personal Information Form, and State-Trait Anxiety Inventory. Early treatment success was determined by serum beta human chorionic gonadotrophin levels seven or ten days after the luteal day zero. For the analysis, descriptive statistics, chi-square test, Fisher's exact test, independent sample t-test were used. After the embryo transfer, the mean state anxiety scores decreased in both groups, and the mean trait anxiety score decreased in the music therapy group; however, the difference was not statistically significant (p>0.05). Clinical pregnancy rates did not differ between the music (48.3%) and standard (46.4%) therapy groups. After the two sessions of music therapy, state and trait anxiety levels decreased and pregnancy rates increased, but the difference was not significant. Therefore, larger sample sizes and more sessions are needed to evaluate whether music therapy has an effect on clinical outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Well-spread sequences and edge-labellings with constant Hamilton-weight

    Directory of Open Access Journals (Sweden)

    P. Mark Kayll

    2004-12-01

    Full Text Available A sequence (a i of integers is well-spread if the sums a i +a j, for irate of the maximum label Λ(n in a `most-efficient' metric, injective edge-labelling of K n with the property that every Hamilton cycle has the same length; we prove that 2n 2-O(n 3/2<Λ(n<2n 2 +O(n 61/40.

  13. Hamilton's inclusive fitness maintains heritable altruism polymorphism through rb = c.

    Science.gov (United States)

    Wang, Changcao; Lu, Xin

    2018-02-20

    How can altruism evolve or be maintained in a selfish world? Hamilton's rule shows that the former process will occur when rb > c -the benefits to the recipients of an altruistic act b , weighted by the relatedness between the social partners r , exceed the costs to the altruists c -drives altruistic genotypes spreading against nonaltruistic ones. From this rule, we infer that altruistic genotypes will persist in a population by forming a stable heritable polymorphism with nonaltruistic genotypes if rb = c makes inclusive fitness of the two morphs equal. We test this prediction using the data of 12 years of study on a cooperatively breeding bird, the Tibetan ground tit Pseudopodoces humilis , where helping is performed by males only and kin-directed. Individual variation in ever acting as a helper was heritable ( h 2 = 0.47), and the resultant altruism polymorphism remained stable as indicated by low-level annual fluctuation of the percentage of helpers among all adult males (24-28%). Helpers' indirect fitness gains from increased lifetime reproductive success of related breeders statistically fully compensated for their lifetime direct fitness losses, suggesting that rb = c holds. While our work provides a fundamental support for Hamilton's idea, it highlights the equivalent inclusive fitness returns to altruists and nonaltruists mediated by rb = c as a theoretically and realistically important mechanism to maintain social polymorphism.

  14. Dual psychiatric diagnosis and substance abuse in pathological gamblers: a preliminary gender comparison study.

    Science.gov (United States)

    Dannon, Pinhas N; Lowengrub, Katherine; Shalgi, Bosmat; Sasson, Marina; Tuson, Lali; Saphir, Yafa; Kotler, Moshe

    2006-01-01

    Pathological Gambling (PG) is a highly prevalent and disabling impulse control disorder. Recent studies have consistently shown that PG patients have responded well to treatment with SSRI's, mood stabilizers, and opioid antagonists. These findings have supported the observation that PG is strongly associated with both mood and anxiety disorders as well as substance abuse. The aim of the study is to evaluate the comorbid psychiatric diagnoses in our sample. Thirty-six female, and forty-two male PG's were enrolled in our study. A comprehensive psychiatric diagnostic evaluation was performed on all patients, and patients were screened for symptoms of depression and anxiety using the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Yale-Brown Obsessive Compulsive Scale, and the Frost Multidimensional Perfectionism Scale. In addition, the patients completed self-report questionnaires about their demographic status and substance abuse. The majority of patients were married with full or part-time employment. The study results demonstrated that PG in males is correlated with substance and alcohol abuse. Diagnoses, which were prevalent among our cohort of female PG's included major depression, affective disorders, anxiety disorders, and eating disorders. In our sample of PGs, the men and women had different patterns of psychiatric comorbidity. The different patterns of psychiatric comorbidity seen in our male versus female PG's raises the question of whether the underlying etiopathology in PG may differ according to gender.

  15. Comparison of psychiatric morbidity in patients with irritable bowel syndrome and non-ulcer dyspepsia

    Directory of Open Access Journals (Sweden)

    Susanta Kumar Padhy

    2016-01-01

    Full Text Available Background and Aims: The present study aimed to find psychiatric morbidity, stress, anxiety, and depression in patients with irritable bowel syndrome (IBS and compare it with patients having non-ulcer dyspepsia (NUD. Methods: This case NUD study compared 50 patients each with IBS and NUD. The two groups were compared on demographic data, psychiatric diagnosis using the Structured Clinical Interview for DSM-IV Axis 1 disorders, anxiety levels using the Hamilton Anxiety Rating Scale (HAM-A, and depression using the Hamilton Depression Rating Scale (HAM-D. The Presumptive Stressful Life Events Scale (PSLES was used to measure stress. Results: The cases of IBS were more likely to be of female gender (P = 0.012, married (P = 0.009, and employed (P < 0.001. Psychiatric diagnoses were more common in the cases of IBS than NUDs (88% vs. 30%, P< 0.001, the most common being major depression and somatization disorder. Symptoms of anxiety and depression were more common in patients with IBS (P < 0.001 for HAM-A and HAM-D. Logistic regression revealed that having IBS and increased age were independent predictors of having a psychiatric diagnosis. Conclusions: IBS is associated with the considerable degree of psychiatric morbidity. Adequate attention should be paid toward comorbid psychiatric illnesses, and prompt treatment should be instituted.

  16. A multicomponent yoga-based, breath intervention program as an adjunctive treatment in patients suffering from generalized anxiety disorder with or without comorbidities.

    Science.gov (United States)

    Katzman, Martin A; Vermani, Monica; Gerbarg, Patricia L; Brown, Richard P; Iorio, Christina; Davis, Michele; Cameron, Catherine; Tsirgielis, Dina

    2012-01-01

    The aim of this study is to evaluate the efficacy and tolerability of Sudarshan Kriya Yoga (SKY) course in generalized anxiety disorder (GAD) outpatients, who after eight weeks of an appropriate dose of traditional therapy had not yet achieved remission. The adult participants (18-65 years) were outpatients with a primary diagnosis of GAD with or without comorbidities on the Mini-International Neuropsychiatric Interview (MINI). Participants had a minimum of eight weeks standard treatment with an appropriate dose of a standard prescription anxiolytic, a clinician global impression-severity (CGI-S) score of 5-7, a Hamilton anxiety scale (HAM-A) total score ≥20 including a score of >2 on the anxious mood and tension items. Forty-one patients were enrolled in an open-label trial of the SKY course as an adjunct to standard treatment of GAD at the START Clinic for Mood and Anxiety Disorders, a tertiary care mood and anxiety disorder clinic in Toronto. The SKY course was administered over five days (22 h total). Subjects were encouraged to practice the yoga breathing techniques at home for 20 min per day after the course and were offered group practice sessions for 2 h once a week led by certified yoga instructors. The primary outcome measure was the mean change from pre-treatment on the HAM-A scale. Psychological measures were obtained at baseline and four weeks after completing the intervention. Thirty-one patients completed the program (mean age 42.6 ± 13.3 years). Among completers, significant reductions occurred in the pre- and post-intervention mean HAM-A total score (t=4.59; P<0.01) and psychic subscale (t=5.00; P≤0.01). The response rate was 73% and the remission rate 41% as measured on the HAM-A. The results of this small pilot trial suggest that the SKY course represents a potentially valuable adjunct to standard pharmacotherapy in patients with GAD or treatment-resistant GAD, and warrants further investigation. In particular, changes in worry and body

  17. Types of Anxiety and Depression: Theoretical Assumptions and Development of the Anxiety and Depression Questionnaire

    Directory of Open Access Journals (Sweden)

    Małgorzata Fajkowska

    2018-01-01

    Full Text Available The present paper is addressed to (1 the validation of a recently proposed typology of anxiety and depression, and (2 the presentation of a new tool—the Anxiety and Depression Questionnaire (ADQ—based on this typology. Empirical data collected across two stages—construction and validation—allowed us to offer the final form of the ADQ, designed to measure arousal anxiety, apprehension anxiety, valence depression, anhedonic depression, and mixed types of anxiety and depression. The results support the proposed typology of anxiety and depression and provide evidence that the ADQ is a reliable and valid self-rating measure of affective types, and accordingly its use in scientific research is recommended.

  18. Is the Parkinson Anxiety Scale comparable across raters?

    Science.gov (United States)

    Forjaz, Maria João; Ayala, Alba; Martinez-Martin, Pablo; Dujardin, Kathy; Pontone, Gregory M; Starkstein, Sergio E; Weintraub, Daniel; Leentjens, Albert F G

    2015-04-01

    The Parkinson Anxiety Scale is a new scale developed to measure anxiety severity in Parkinson's disease specifically. It consists of three dimensions: persistent anxiety, episodic anxiety, and avoidance behavior. This study aimed to assess the measurement properties of the scale while controlling for the rater (self- vs. clinician-rated) effect. The Parkinson Anxiety Scale was administered to a cross-sectional multicenter international sample of 362 Parkinson's disease patients. Both patients and clinicians rated the patient's anxiety independently. A many-facet Rasch model design was applied to estimate and remove the rater effect. The following measurement properties were assessed: fit to the Rasch model, unidimensionality, reliability, differential item functioning, item local independency, interrater reliability (self or clinician), and scale targeting. In addition, test-retest stability, construct validity, precision, and diagnostic properties of the Parkinson Anxiety Scale were also analyzed. A good fit to the Rasch model was obtained for Parkinson Anxiety Scale dimensions A and B, after the removal of one item and rescoring of the response scale for certain items, whereas dimension C showed marginal fit. Self versus clinician rating differences were of small magnitude, with patients reporting higher anxiety levels than clinicians. The linear measure for Parkinson Anxiety Scale dimensions A and B showed good convergent construct with other anxiety measures and good diagnostic properties. Parkinson Anxiety Scale modified dimensions A and B provide valid and reliable measures of anxiety in Parkinson's disease that are comparable across raters. Further studies are needed with dimension C. © 2014 International Parkinson and Movement Disorder Society.

  19. L∞-error estimates of a finite element method for the Hamilton-Jacobi-Bellman equations

    International Nuclear Information System (INIS)

    Bouldbrachene, M.

    1994-11-01

    We study the finite element approximation for the solution of the Hamilton-Jacobi-Bellman equations involving a system of quasi-variational inequalities (QVI). We also give the optimal L ∞ -error estimates, using the concepts of subsolutions and discrete regularity. (author). 7 refs

  20. A clinician-administered severity rating scale for illness anxiety: development, reliability, and validity of the H-YBOCS-M.

    Science.gov (United States)

    Skritskaya, Natalia A; Carson-Wong, Amanda R; Moeller, James R; Shen, Sa; Barsky, Arthur J; Fallon, Brian A

    2012-07-01

    Clinician-administered measures to assess severity of illness anxiety and response to treatment are few. The authors evaluated a modified version of the hypochondriasis-Y-BOCS (H-YBOCS-M), a 19-item, semistructured, clinician-administered instrument designed to rate severity of illness-related thoughts, behaviors, and avoidance. The scale was administered to 195 treatment-seeking adults with DSM-IV hypochondriasis. Test-retest reliability was assessed in a subsample of 20 patients. Interrater reliability was assessed by 27 interviews independently rated by four raters. Sensitivity to change was evaluated in a subsample of 149 patients. Convergent and discriminant validity was examined by comparing H-YBOCS-M scores to other measures administered. Item clustering was examined with confirmatory and exploratory factor analyses. The H-YBOCS-M demonstrated good internal consistency, interrater and test-retest reliability, and sensitivity to symptom change with treatment. Construct validity was supported by significant higher correlations with scores on other measures of hypochondriasis than with nonhypochondriacal measures. Improvement over time in response to treatment correlated with improvement both on measures of hypochondriasis and on measures of somatization, depression, anxiety, and functional status. Confirmatory factor analysis did not show adequate fit for a three-factor model. Exploratory factor analysis revealed a five-factor solution with the first two factors consistent with the separation of the H-YBOCS-M items into the subscales of illness-related avoidance and compulsions. H-YBOCS-M appears to be valid, reliable, and appropriate as an outcome measure for treatment studies of illness anxiety. Study results highlight "avoidance" as a key feature of illness anxiety-with potentially important nosologic and treatment implications. © 2012 Wiley Periodicals, Inc.

  1. Dopaminergic dysfunction and psychiatric symptoms in movement disorders: a {sup 123}I-FP-CIT SPECT study

    Energy Technology Data Exchange (ETDEWEB)

    Di Giuda, Daniela; Cocciolillo, Fabrizio; Bruno, Isabella; Giordano, Alessandro [Universita Cattolica del Sacro Cuore, Istituto di Medicina Nucleare, Rome (Italy); Camardese, Giovanni; Pucci, Lorella; Janiri, Luigi [Universita Cattolica del Sacro Cuore, Istituto di Psichiatria e Psicologia, Rome (Italy); Bentivoglio, Anna Rita; Guidubaldi, Arianna [Universita Cattolica del Sacro Cuore, Istituto di Neurologia, Rome (Italy); Fasano, Alfonso [Universita Cattolica del Sacro Cuore, Istituto di Neurologia, Rome (Italy); AFaR-Associazione Fatebenefratelli per la Ricerca, Rome (Italy)

    2012-12-15

    Psychiatric symptoms frequently occur in patients with movement disorders. They are not a mere reaction to chronic disability, but most likely due to a combination of psychosocial factors and biochemical dysfunction underlying the movement disorder. We assessed dopamine transporter (DAT) availability by means of {sup 123}I-FP-CIT SPECT, and motor and psychiatric features in patients with Parkinson's disease, primary dystonia and essential tremor, exploring the association between SPECT findings and symptom severity. Enrolled in the study were 21 patients with Parkinson's disease, 14 patients with primary dystonia and 15 patients with essential tremor. The severity of depression symptoms was assessed using the Hamilton depression rating scale, anxiety levels using the Hamilton anxiety rating scale and hedonic tone impairment using the Snaith-Hamilton pleasure scale. Specific {sup 123}I-FP-CIT binding in the caudate and putamen was calculated based on ROI analysis. The control group included 17 healthy subjects. As expected, DAT availability was significantly decreased in patients with Parkinson's disease, whereas in essential tremor and dystonia patients it did not differ from that observed in the control group. In Parkinson's disease patients, an inverse correlation between severity of depression symptoms and DAT availability in the left caudate was found (r = -0.63, p = 0.002). In essential tremor patients, levels of anxiety symptoms were inversely correlated with DAT availability in the left caudate (r = -0.69, p = 0.004). In dystonia patients, the severities of both anxiety and depression symptoms were inversely associated with DAT availability in the left putamen (r = -0.71, p = 0.004, and r = -0.75, p = 0.002, respectively). There were no correlations between psychometric scores and {sup 123}I-FP-CIT uptake ratios in healthy subjects. We found association between presynaptic dopaminergic function and affective symptoms in different movement

  2. Dopaminergic dysfunction and psychiatric symptoms in movement disorders: a 123I-FP-CIT SPECT study

    International Nuclear Information System (INIS)

    Di Giuda, Daniela; Cocciolillo, Fabrizio; Bruno, Isabella; Giordano, Alessandro; Camardese, Giovanni; Pucci, Lorella; Janiri, Luigi; Bentivoglio, Anna Rita; Guidubaldi, Arianna; Fasano, Alfonso

    2012-01-01

    Psychiatric symptoms frequently occur in patients with movement disorders. They are not a mere reaction to chronic disability, but most likely due to a combination of psychosocial factors and biochemical dysfunction underlying the movement disorder. We assessed dopamine transporter (DAT) availability by means of 123 I-FP-CIT SPECT, and motor and psychiatric features in patients with Parkinson's disease, primary dystonia and essential tremor, exploring the association between SPECT findings and symptom severity. Enrolled in the study were 21 patients with Parkinson's disease, 14 patients with primary dystonia and 15 patients with essential tremor. The severity of depression symptoms was assessed using the Hamilton depression rating scale, anxiety levels using the Hamilton anxiety rating scale and hedonic tone impairment using the Snaith-Hamilton pleasure scale. Specific 123 I-FP-CIT binding in the caudate and putamen was calculated based on ROI analysis. The control group included 17 healthy subjects. As expected, DAT availability was significantly decreased in patients with Parkinson's disease, whereas in essential tremor and dystonia patients it did not differ from that observed in the control group. In Parkinson's disease patients, an inverse correlation between severity of depression symptoms and DAT availability in the left caudate was found (r = -0.63, p = 0.002). In essential tremor patients, levels of anxiety symptoms were inversely correlated with DAT availability in the left caudate (r = -0.69, p = 0.004). In dystonia patients, the severities of both anxiety and depression symptoms were inversely associated with DAT availability in the left putamen (r = -0.71, p = 0.004, and r = -0.75, p = 0.002, respectively). There were no correlations between psychometric scores and 123 I-FP-CIT uptake ratios in healthy subjects. We found association between presynaptic dopaminergic function and affective symptoms in different movement disorders. Interestingly, the

  3. Respiratory Medicine at McMaster University, Hamilton, Ontario: 1968 to 2013

    Directory of Open Access Journals (Sweden)

    Norman L Jones

    2014-01-01

    Full Text Available The medical school at McMaster University (Hamilton, Ontario was conceived in 1965, and admitted the first class in 1969. John Evans became the founding Dean and he invited EJ Moran Campbell to be the first Chairman of the Department of Medicine. Moran Campbell, already a world figure in respiratory medicine and physiology, arrived at McMaster in September 1968, and he invited Norman Jones to be Coordinator of the Respiratory Programme.

  4. Respiratory Medicine at McMaster University, Hamilton, Ontario: 1968 To 2013

    Directory of Open Access Journals (Sweden)

    Norman L Jones

    2014-01-01

    Full Text Available The medical school at McMaster University (Hamilton, Ontario was conceived in 1965 and admitted the first class in 1969. John Evans became the founding Dean and he invited Moran Campbell to be the first Chairman of the Department of Medicine. Moran Campbell, already a world figure in respiratory medicine and physiology, arrived at McMaster in September 1968, and he invited Norman Jones to be Coordinator of the Respiratory Programme.

  5. Hamilton-Jacobi-Bellman approach for the climbing problem for heavy launchers

    OpenAIRE

    Bokanowski , Olivier; Cristiani , Emiliano; Laurent-Varin , Julien; Zidani , Hasnaa

    2012-01-01

    International audience; In this paper we investigate the Hamilton-Jacobi-Bellman (HJB) approach for solving a complex real-world optimal control problem in high dimension. We consider the climbing problem for the European launcher Ariane V: The launcher has to reach the Geostationary Transfer Orbit with minimal propellant consumption under state/control constraints. In order to circumvent the well-known curse of dimensionality, we reduce the number of variables in the model exploiting the spe...

  6. Sensitivity and specificity of the Geriatric Anxiety Inventory and the Hospital Anxiety and Depression Scale in the detection of anxiety disorders in older people with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Cheung, Gary; Patrick, Colin; Sullivan, Glenda; Cooray, Manisha; Chang, Catherina L

    2012-01-01

    Anxiety and depression are prevalent in patients with chronic obstructive pulmonary disease (COPD). This study evaluates the sensitivity and specificity of two self-administered anxiety rating scales in older people with COPD. The Geriatric Anxiety Inventory (GAI) and the Hospital Anxiety and Depression Scale (HADS) are established useful screening tools but they have not been previously validated in this population. Older people with COPD completed the GAI and the HADS along with a structured diagnostic psychiatric interview, the Mini International Neuropsychiatric Interview (MINI). The outcomes of both rating scales were compared against the diagnosis of anxiety disorders based on the MINI. Receiver operating characteristic (ROC) curves were used to identify the optimal diagnostic cut points for each scale. Fourteen (25.5%) of the 55 participants, were diagnosed with an anxiety disorder. Mean GAI and HADS-anxiety subscale scores were significantly higher in subjects with an anxiety disorder than those without the diagnosis (p = 0.002 and 0.005 respectively). Both scales demonstrated moderate diagnostic value (area under the ROC curve was 0.83 for GAI and 0.79 for HADS). Optimal cut points were ≥3 (GAI) and ≥4 (HADS-anxiety subscale). At these cut-points, the GAI had a sensitivity of 85.7%, specificity of 78.0% and the HADS had a sensitivity of 78.6%, specificity 70.7%. Our results support the use of the GAI and HADS as screening instruments for anxiety disorders in older people with COPD. The optimal cut points in this population were lower than previously recommended for both rating scales. The results of this study should be replicated before these cut points can be recommended for general use in older people with COPD.

  7. Effects of citalopram on heart rate variability in women with generalized anxiety disorder

    Directory of Open Access Journals (Sweden)

    Fatemeh Ranjbar

    2015-07-01

    Full Text Available BACKGROUND: Heart rate variability (HRV is defined as variations in R-R interval with time. Dysautonomia is common in patients with psychiatric disorders such as depression and anxiety. Using HRV analysis, recent studies showed that in anxiety disorders, the vagal cardiac function decreases, and sympathetic function increases. This study aimed at investigating citalopram effects on HRV. METHODS: This before and after study was conducted in 25 generalized anxiety disorder (GAD patients. GAD was diagnosed based on clinical interview according to diagnostic and statistical manual of mental disorders IV-Text revised (DSM-IV-TR criteria using Structured Clinical Interview for DSM Disorders-I questionnaire. A cardiologist studied 24 h ambulatory monitoring of the electrocardiogram (Holter on all patients before the treatment. A volume of 20 mg of citalopram was administered to the subjects on a daily basis. Then, they were studied by Holter monitoring again after 1-month of administration of citalopram. RESULTS: The average age of participants was 35.32 ± 8.7. The average Holter monitoring time was 23.29 ± 1.14 h before treatment and 23.81 ± 0.68 after it. The 3 h low frequency/high frequency ratio was significantly different between 3 h segments of time before treatment (P < 0.001. This difference was even higher after treatment (P = 0.001. Data showed an increase in parasympathetic tone during sleep both before and after treatment. CONCLUSION: These patients showed some impairments of HRV indices that did not improve by citalopram in future, the clinical importance of such disturbances should be evaluated in details with prolonged follow-up and greater sample size.   

  8. Comorbid psychiatric diagnoses in kleptomania and pathological gambling: a preliminary comparison study.

    Science.gov (United States)

    Dannon, Pinhas N; Lowengrub, Katherine; Sasson, Marina; Shalgi, Bosmat; Tuson, Lali; Saphir, Yafa; Kotler, Moshe

    2004-08-01

    Kleptomania and pathological gambling (PG) are currently classified in the DSM IV as impulse control disorders. Impulse control disorders are characterized by an overwhelming temptation to perform an act that is harmful to the person or others. The patient usually feels a sense of tension before committing the act and then experiences pleasure or relief while in the process of performing the act. Kleptomania and PG are often associated with other comorbid psychiatric diagnoses. Forty-four pathological gamblers and 19 kleptomanics were included in this study. All enrolled patients underwent a complete diagnostic psychiatric evaluation and were examined for symptoms of depression and anxiety using the Hamilton depression rating scale and the Hamilton anxiety rating scale, respectively. In addition, the patients completed self-report questionnaires about their demographic status and addictive behavior. The comorbid lifetime diagnoses found at a high prevalence among our kleptomanic patients included 47% with affective disorders (9/19) and 37% with anxiety disorders (7/19). The comorbid lifetime diagnoses found at a high prevalence in our sample of pathological gamblers included 27% with affective disorders (12/44), 21% with alcohol abuse (9/44), and 7% with a history of substance abuse (3/44). A larger study is needed to confirm these preliminary results.

  9. Symptoms and development of anxiety in children with or without intellectual disability.

    Science.gov (United States)

    Green, Shulamite A; Berkovits, Lauren D; Baker, Bruce L

    2015-01-01

    The purpose of this study was to examine group differences in presentation and trajectory of anxiety symptoms and disorders in children with moderate to borderline intellectual disability (ID) and children with typical cognitive development (TD). Examined anxiety disorders and symptoms in children with ID (n=74) or TD (n=116) annually from ages 5 through 9 using a parent structured interview and questionnaire. Logistic regression was used to examine odds of meeting anxiety criteria and hierarchical linear modeling was used to examine anxiety trajectory. Children with ID had significantly higher rates of clinical levels of anxiety on the Child Behavior Checklist at ages 8 and 9 and higher rates of separation anxiety disorder at age 5 compared to those with TD. Children with ID were also more likely to have externalizing problems co-occurring with anxiety. The rate of increase of anxiety symptoms over time was positive and similar in the two groups, and neither group showed sex differences in anxiety rates. Results suggest that children with ID have both higher rates of anxiety across time and are delayed in showing typical decreases in separation anxiety in early childhood. Implications for intervention are discussed in terms of the importance of screening for and treating anxiety in children with ID.

  10. Betaxolol in anxiety disorders.

    Science.gov (United States)

    Swartz, C M

    1998-03-01

    Betaxolol, a long-acting beta-adrenergic blocker that enters the central nervous system, was examined for therapeutic effects on the persistent anxiety of anxiety disorders. Prior studies of beta-blockers examined only agents that were short-acting or did not enter the brain. Betaxolol was administered to 31 patients in open trials. Of 13 outpatients, 11 had generalized anxiety disorder (GAD) and 2 had adjustment disorder with anxiety. Five with GAD had concurrent panic disorder. Of 18 inpatients, 16 had GAD and 2 had adjustment disorder with anxiety. Betaxolol doses were increased until the patient responded or declined further dosage. Severity was rated on a 4-point global scale. Before betaxolol, all were moderately or severely ill. In all patients with panic disorder panic attacks stopped within 2 days (pAnxiety decreased to no more than marginally ill in 85% of outpatients (panxiety and obsessive-compulsive personality disorder. Preliminary observations in posttraumatic stress disorder are similar.

  11. Sleep disturbances in restless legs syndrome

    Directory of Open Access Journals (Sweden)

    Jović Jasmina

    2018-01-01

    Full Text Available Background/Aim. Resteless legs syndrome (RLS is chronical neurological disorder characterized by urge to move legs that is usually accompanied by unpleasant sensations in the lower extremities. Sleep disturbance is one of the main accompanying symptoms of RLS which exists in approximatelly 90% of patients. Impairment of sleep is related to daily sleepiness, depressive and anxiety disorders. The aim of this study was to detect frequency and characterisitics of sleep-related symptoms in patients with RLS, and its impairrment to daily sleepiness, fatique, anxiety and depression. Methods. We have examinated 94 patients with RLS. The diagnose of RLS was based on questionnaire with 4 specific questions according to the International Restless Legs Syndrome Study Group (IRLSSG criteria updated in 2003. Severity of symptoms was astimated with IRLSSG Rating Scale, depression and anxiety with Hamilton Depression Rating Scale (HDRS and Hamilton Anxiety Rating Scale (HARS and sleepiness with Epworth Sleepiness scale (ESS. We astimated sleep characteristics and disturbances with specific questionnaire. Results. In our study 79.9% of patients had sleep-related symptoms. Average sleep duration was 6.50 ± 1.42 hours, with average frequency of awakening 2.34 ± 1.69 times per night. Average ESS score was 5.12 ± 4.08 (0–17. Patients with more severe symptoms had higher degree of sleepiness (p = 0.005. Patients with higher symptoms frequency, significantly more often had sleep disturbance (p = 0.016, tiredness and daily sleepiness (p = 0.001. Daily sleepiness (ESS also significantly correlates with depression (p < 0.05 and anxiety (p = 0.012. Conclusion. Our results confirm that sleep disturbances are one of the key accompanying symptoms of RLS which cause daily sleepiness, tiredness, depression and anxiety. Therefore, their early recognition and appropriate treatment must be a priority in RLS patients.

  12. Cognitive behavioral therapy for depression in Japanese Parkinson’s disease patients: a pilot study

    Science.gov (United States)

    Shinmei, Issei; Kobayashi, Kei; Oe, Yuki; Takagishi, Yuriko; Kanie, Ayako; Ito, Masaya; Takebayashi, Yoshitake; Murata, Miho; Horikoshi, Masaru; Dobkin, Roseanne D

    2016-01-01

    Objectives This study evaluated the feasibility of cognitive behavioral therapy (CBT) for Japanese Parkinson’s disease (PD) patients with depression. To increase cultural acceptability, we developed the CBT program using manga, a type of Japanese comic novel. Methods Participants included 19 non-demented PD patients who had depressive symptoms (GRID-Hamilton Rating Scale for Depression score ≥8). A CBT program comprising six sessions was individually administered. We evaluated the feasibility and safety of the CBT program in terms of the dropout rate and occurrence of adverse events. The primary outcome was depressive symptom reduction in the GRID-Hamilton Rating Scale for Depression upon completion of CBT. Secondary outcomes included changes in the self-report measures of depression (Beck Depression Inventory-II, Hospital Anxiety and Depression Scale-Depression), anxiety (Hospital Anxiety and Depression Scale-Anxiety, State and Trait Anxiety Inventory, Overall Anxiety Severity and Impairment Scale), functional impairment, and quality of life (Medical Outcomes Study 36-Item Short-Form Health Survey). Results Of the 19 participants (mean age =63.8 years, standard deviation [SD] =9.9 years; mean Hohen–Yahr score =1.7, SD =0.8), one patient (5%) withdrew. No severe adverse event was observed. The patients reported significant improvements in depression (Hedges’ g =−1.02, 95% confidence interval =−1.62 to −0.39). The effects were maintained over a 3-month follow-up period. Most of the secondary outcome measurements showed a small-to-moderate but nonsignificant effect size from baseline to post-intervention. Conclusion This study provides preliminary evidence that CBT is feasible among Japanese PD patients with depression. Similar approaches may be effective for people with PD from other cultural backgrounds. The results warrant replication in a randomized controlled trial. PMID:27354802

  13. Direct oral anticoagulants for treatment of HIT: update of Hamilton experience and literature review.

    Science.gov (United States)

    Warkentin, Theodore E; Pai, Menaka; Linkins, Lori-Ann

    2017-08-31

    Direct oral anticoagulants (DOACs) are attractive options for treatment of heparin-induced thrombocytopenia (HIT). We report our continuing experience in Hamilton, ON, Canada, since January 1, 2015 (when we completed our prospective study of rivaroxaban for HIT), using rivaroxaban for serologically confirmed HIT (4Ts score ≥4 points; positive platelet factor 4 [PF4]/heparin immunoassay, positive serotonin-release assay). We also performed a literature review of HIT treatment using DOACs (rivaroxaban, apixaban, dabigatran, edoxaban). We focused on patients who received DOAC therapy for acute HIT as either primary therapy (group A) or secondary therapy (group B; initial treatment using a non-DOAC/non-heparin anticoagulant with transition to a DOAC during HIT-associated thrombocytopenia). Our primary end point was occurrence of objectively documented thrombosis during DOAC therapy for acute HIT. We found that recovery without new, progressive, or recurrent thrombosis occurred in all 10 Hamilton patients with acute HIT treated with rivaroxaban. Data from the literature review plus these new data identified a thrombosis rate of 1 of 46 patients (2.2%; 95% CI, 0.4%-11.3%) in patients treated with rivaroxaban during acute HIT (group A, n = 25; group B, n = 21); major hemorrhage was seen in 0 of 46 patients. Similar outcomes in smaller numbers of patients were observed with apixaban (n = 12) and dabigatran (n = 11). DOACs offer simplified management of selected patients, as illustrated by a case of persisting (autoimmune) HIT (>2-month platelet recovery with inversely parallel waning of serum-induced heparin-independent serotonin release) with successful outpatient rivaroxaban management of HIT-associated thrombosis. Evidence supporting efficacy and safety of DOACs for acute HIT is increasing, with the most experience reported for rivaroxaban. © 2017 by The American Society of Hematology.

  14. Convergence of a semi-discretization scheme for the Hamilton-Jacobi equation: A new approach with the adjoint method

    KAUST Repository

    Cagnetti, Filippo; Gomes, Diogo A.; Tran, Hung Vinh

    2013-01-01

    We consider a numerical scheme for the one dimensional time dependent Hamilton-Jacobi equation in the periodic setting. This scheme consists in a semi-discretization using monotone approximations of the Hamiltonian in the spacial variable. From classical viscosity solution theory, these schemes are known to converge. In this paper we present a new approach to the study of the rate of convergence of the approximations based on the nonlinear adjoint method recently introduced by L.C. Evans. We estimate the rate of convergence for convex Hamiltonians and recover the O(h) convergence rate in terms of the L∞ norm and O(h) in terms of the L1 norm, where h is the size of the spacial grid. We discuss also possible generalizations to higher dimensional problems and present several other additional estimates. The special case of quadratic Hamiltonians is considered in detail in the end of the paper. © 2013 IMACS.

  15. Convergence of a semi-discretization scheme for the Hamilton-Jacobi equation: A new approach with the adjoint method

    KAUST Repository

    Cagnetti, Filippo

    2013-11-01

    We consider a numerical scheme for the one dimensional time dependent Hamilton-Jacobi equation in the periodic setting. This scheme consists in a semi-discretization using monotone approximations of the Hamiltonian in the spacial variable. From classical viscosity solution theory, these schemes are known to converge. In this paper we present a new approach to the study of the rate of convergence of the approximations based on the nonlinear adjoint method recently introduced by L.C. Evans. We estimate the rate of convergence for convex Hamiltonians and recover the O(h) convergence rate in terms of the L∞ norm and O(h) in terms of the L1 norm, where h is the size of the spacial grid. We discuss also possible generalizations to higher dimensional problems and present several other additional estimates. The special case of quadratic Hamiltonians is considered in detail in the end of the paper. © 2013 IMACS.

  16. Social Anxiety and Aggression in Behaviorally Disordered Children.

    Science.gov (United States)

    Gonzalez, Ketty P.; And Others

    1996-01-01

    Thirty-nine boys in classes for students with behavioral disturbances were given questionnaires on trait anxiety, social anxiety, empathy, depression, and self-esteem, while teachers rated their aggression. Results showed that anxiety and empathy scores were not correlated with aggression, while social anxiety was positively correlated with trait…

  17. Anxiety in Medically Ill Children/Adolescents

    OpenAIRE

    Pao, Maryland; Bosk, Abigail

    2010-01-01

    Anxiety disorders are thought to be one of the most common psychiatric diagnoses in children/adolescents. Chronic medical illness is a significant risk factor for the development of an anxiety disorder and the prevalence rate of anxiety disorders among youths with chronic medical illnesses is higher compared to their healthy counterparts. Anxiety disorders may develop secondary to predisposing biological mechanisms related to a child’s specific medical illness, as a response to being ill or i...

  18. On global solutions of the random Hamilton-Jacobi equations and the KPZ problem

    Science.gov (United States)

    Bakhtin, Yuri; Khanin, Konstantin

    2018-04-01

    In this paper, we discuss possible qualitative approaches to the problem of KPZ universality. Throughout the paper, our point of view is based on the geometrical and dynamical properties of minimisers and shocks forming interlacing tree-like structures. We believe that the KPZ universality can be explained in terms of statistics of these structures evolving in time. The paper is focussed on the setting of the random Hamilton-Jacobi equations. We formulate several conjectures concerning global solutions and discuss how their properties are connected to the KPZ scalings in dimension 1  +  1. In the case of general viscous Hamilton-Jacobi equations with non-quadratic Hamiltonians, we define generalised directed polymers. We expect that their behaviour is similar to the behaviour of classical directed polymers, and present arguments in favour of this conjecture. We also define a new renormalisation transformation defined in purely geometrical terms and discuss conjectural properties of the corresponding fixed points. Most of our conjectures are widely open, and supported by only partial rigorous results for particular models.

  19. Hamilton's gradient estimate for the heat kernel on complete manifolds

    OpenAIRE

    Kotschwar, Brett

    2007-01-01

    In this paper we extend a gradient estimate of R. Hamilton for positive solutions to the heat equation on closed manifolds to bounded positive solutions on complete, non-compact manifolds with $Rc \\geq -Kg$. We accomplish this extension via a maximum principle of L. Karp and P. Li and a Bernstein-type estimate on the gradient of the solution. An application of our result, together with the bounds of P. Li and S.T. Yau, yields an estimate on the gradient of the heat kernel for complete manifol...

  20. Social anxiety disorder: A review of environmental risk factors

    Directory of Open Access Journals (Sweden)

    Christina A Brook

    2008-03-01

    Full Text Available Christina A Brook, Louis A SchmidtDepartment of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario, CanadaAbstract: Social anxiety disorder (SAD is a debilitating and chronic illness characterized by persistent fear of one or more social or performance situations, with a relatively high lifetime prevalence of 7% to 13% in the general population. Although the last two decades have witnessed enormous growth in the study of biological and dispositional factors underlying SAD, comparatively little attention has been directed towards environmental factors in SAD, even though there has been much ongoing work in the area. In this paper, we provide a recent review and critique of proposed environmental risk factors for SAD, focusing on traditional as well as some understudied and overlooked environmental risk factors: parenting and family environment, adverse life events, cultural and societal factors, and gender roles. We also discuss the need for research design improvements and considerations for future directions.

  1. Multimodal electromechanical model of piezoelectric transformers by Hamilton's principle.

    Science.gov (United States)

    Nadal, Clement; Pigache, Francois

    2009-11-01

    This work deals with a general energetic approach to establish an accurate electromechanical model of a piezoelectric transformer (PT). Hamilton's principle is used to obtain the equations of motion for free vibrations. The modal characteristics (mass, stiffness, primary and secondary electromechanical conversion factors) are also deduced. Then, to illustrate this general electromechanical method, the variational principle is applied to both homogeneous and nonhomogeneous Rosen-type PT models. A comparison of modal parameters, mechanical displacements, and electrical potentials are presented for both models. Finally, the validity of the electrodynamical model of nonhomogeneous Rosen-type PT is confirmed by a numerical comparison based on a finite elements method and an experimental identification.

  2. 77 FR 52058 - Notice of Inventory Completion: Longyear Museum of Anthropology, Colgate University, Hamilton, NY

    Science.gov (United States)

    2012-08-28

    ... Inventory Completion: Longyear Museum of Anthropology, Colgate University, Hamilton, NY AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Longyear Museum of Anthropology has completed an... cultural affiliation with the human remains should contact the Longyear Museum of Anthropology at the...

  3. Conditioned Subjective Responses to Socially Relevant Stimuli in Social Anxiety Disorder and Subclinical Social Anxiety.

    Science.gov (United States)

    Tinoco-González, Daniella; Fullana, Miquel Angel; Torrents-Rodas, David; Bonillo, Albert; Vervliet, Bram; Pailhez, Guillem; Farré, Magí; Andión, Oscar; Perez, Víctor; Torrubia, Rafael

    2015-01-01

    Although enhanced fear conditioning has been implicated in the origins of social anxiety disorder (SAD), laboratory evidence in support of this association is limited. Using a paradigm employing socially relevant unconditioned stimuli, we conducted two separate studies to asses fear conditioning in individuals with SAD and non-clinical individuals with high social anxiety (subclinical social anxiety [SSA]). They were compared with age-matched and gender-matched individuals with another anxiety disorder (panic disorder with agoraphobia) and healthy controls (Study 1) and with individuals with low social anxiety (Study 2). Contrary to our expectations, in both studies, self-report measures (ratings of anxiety, unpleasantness and arousal to the conditioned stimuli) of fear conditioning failed to discriminate between SAD or SSA and the other participant groups. Our results suggest that enhanced fear conditioning does not play a major role in pathological social anxiety. We used a social conditioning paradigm to study fear conditioning in clinical and subclinical social anxiety. We found no evidence of enhanced fear conditioning in social anxiety individuals. Enhanced fear conditioning may not be a hallmark of pathological social anxiety. Copyright © 2014 John Wiley & Sons, Ltd.

  4. Cardiac response and anxiety levels in psychopathic murderers.

    Science.gov (United States)

    Serafim, Antonio de Pádua; Barros, Daniel Martins de; Valim, André; Gorenstein, Clarice

    2009-09-01

    To compare the emotional response and level of anxiety of psychopathic murderers, non-psychopathic murderers, and nonpsychopathic non-criminals. 110 male individuals aged over 18 years were divided into three groups: psychopathic murderers (n = 38); non-psychopathic murderers (n = 37) serving sentences for murder convictions in Maximum Security Prisons in the State of Sao Paulo; and non-criminal, non-psychopathic individuals (n = 35) according to the Psychopathy Checklist-Revised. The emotional response of subjects was assessed by heart rate variation and anxiety level (State-Trait Anxiety Inventory) after viewing standardized pictures depicting pleasant, unpleasant and neutral content from the International Affective Picture System. Psychopathic murderers presented lower anxiety levels and smaller heart rate variations when exposed to pleasant and unpleasant stimuli than nonpsychopathic murderers or non-psychopathic non-criminals. The results also demonstrated that the higher the score for factor 1 on the Psychopathy Checklist-Revised, the lower the heart rate variation and anxiety level. The results suggest that psychopathic murderers do not present variation in emotional response to different visual stimuli. Although the non-psychopathic murderers had committed the same type of crime as the psychopathic murderers, the former tended to respond with a higher level of anxiety and heart rate variation.

  5. The Outcome of Health Anxiety in Primary Care. A Two-Year Follow-up Study on Health Care Costs and Self-Rated Health

    OpenAIRE

    Fink, Per; ?rnb?l, Eva; Christensen, Kaj Sparle

    2010-01-01

    BACKGROUND: Hypochondriasis is prevalent in primary care, but the diagnosis is hampered by its stigmatizing label and lack of valid diagnostic criteria. Recently, new empirically established criteria for Health anxiety were introduced. Little is known about Health anxiety's impact on longitudinal outcome, and this study aimed to examine impact on self-rated health and health care costs. METHODOLOGY/PRINCIPAL FINDINGS: 1785 consecutive primary care patients aged 18-65 consulting their family p...

  6. Potential benefits of slow titration of paroxetine treatment in an elderly population: eight-week results from a naturalistic setting.

    Science.gov (United States)

    Gibiino, Sara; Mori, Elisa; De Ronchi, Diana; Serretti, Alessandro

    2013-08-01

    Late-life depression, often in association with anxiety, affects approximately 15% of individuals older than 65 years. Selective serotonin reuptake inhibitors are the first-line treatment but could be responsible of an early exacerbation of anxiety, possibly reduced by a very gradual titration of drugs. The main aim of this study is to compare gradual and rapid (standard) titration of paroxetine in an elderly population. In a naturalistic setting, 50 elderly (≥60 years old) outpatients with unipolar mood disorder or anxiety disorder were naturalistically assigned to abrupt initiation of 10 mg of paroxetine or to a gradual increase with 2.5 mg on alternate days up to 10 mg in 7 days. Then dosage could be maintained at 10 mg or increased according to clinical response. Primary outcome was efficacy as assessed by the Hamilton Depression Rating Scale (HAM-D) 21, HAM-D symptom subscales (core, psychic anxiety, somatic anxiety cluster), and Hamilton Anxiety Rating Scale changes. Secondary outcome was evaluation of overall dropouts at eighth week and evaluation of most common adverse effects through the global judgment of the Dosage Record and Treatment Emergent Symptom Scale. All data were recorded weekly for the first 8 weeks of treatment (with 1 more evaluation after 3 days from the baseline). Samples were comparable at baseline, with patients in gradual titration showing a higher level of psychic anxiety. During the first 3 days of treatment, a significant worsening in psychic anxiety was observed in patients treated abruptly with 10 mg of paroxetine (difference in HAM-D psychic anxiety subscale from baseline: 110.61% vs 89.38% with rapid and slow titration, respectively; t test P = 0.03). Overall, a significantly greater improvement in depressive and anxious symptoms favored gradual titration (HAM-D core cluster and HAM-D psychic anxiety cluster, respectively, P = 0.014 and P titration). Our results suggest that a gradual titration of paroxetine could avoid the

  7. Existence of solutions for Hamiltonian field theories by the Hamilton-Jacobi technique

    International Nuclear Information System (INIS)

    Bruno, Danilo

    2011-01-01

    The paper is devoted to prove the existence of a local solution of the Hamilton-Jacobi equation in field theory, whence the general solution of the field equations can be obtained. The solution is adapted to the choice of the submanifold where the initial data of the field equations are assigned. Finally, a technique to obtain the general solution of the field equations, starting from the given initial manifold, is deduced.

  8. Is math anxiety in the secondary classroom limiting physics mastery? A study of math anxiety and physics performance

    Science.gov (United States)

    Mercer, Gary J.

    This quantitative study examined the relationship between secondary students with math anxiety and physics performance in an inquiry-based constructivist classroom. The Revised Math Anxiety Rating Scale was used to evaluate math anxiety levels. The results were then compared to the performance on a physics standardized final examination. A simple correlation was performed, followed by a multivariate regression analysis to examine effects based on gender and prior math background. The correlation showed statistical significance between math anxiety and physics performance. The regression analysis showed statistical significance for math anxiety, physics performance, and prior math background, but did not show statistical significance for math anxiety, physics performance, and gender.

  9. Depression, comorbid anxiety disorders, and heart rate variability in physically healthy, unmedicated patients: implications for cardiovascular risk.

    Science.gov (United States)

    Kemp, Andrew H; Quintana, Daniel S; Felmingham, Kim L; Matthews, Slade; Jelinek, Herbert F

    2012-01-01

    There is evidence that heart rate variability (HRV) is reduced in major depressive disorder (MDD), although there is debate about whether this effect is caused by medication or the disorder per se. MDD is associated with a two to fourfold increase in the risk of cardiac mortality, and HRV is a robust predictor of cardiac mortality; determining a direct link between HRV and not only MDD, but common comorbid anxiety disorders, will point to psychiatric indicators for cardiovascular risk reduction. To determine in physically healthy, unmedicated patients whether (1) HRV is reduced in MDD relative to controls, and (2) HRV reductions are driven by MDD alone, comorbid generalized anxiety disorder (GAD, characterized by anxious anticipation), or comorbid panic and posttraumatic stress disorders (PD/PTSD, characterized by anxious arousal). A case-control study in 2006 and 2007 on 73 MDD patients, including 24 without anxiety comorbidity, 24 with GAD, and 14 with PD/PTSD. Seventy-three MDD and 94 healthy age- and sex-matched control participants were recruited from the general community. Participants had no history of drug addiction, alcoholism, brain injury, loss of consciousness, stroke, neurological disorder, or serious medical conditions. There were no significant differences between the four groups in age, gender, BMI, or alcohol use. HRV was calculated from electrocardiography under a standardized short-term resting state condition. HRV was reduced in MDD relative to controls, an effect associated with a medium effect size. MDD participants with comorbid generalized anxiety disorder displayed the greatest reductions in HRV relative to controls, an effect associated with a large effect size. Unmedicated, physically healthy MDD patients with and without comorbid anxiety had reduced HRV. Those with comorbid GAD showed the greatest reductions. Implications for cardiovascular risk reduction strategies in otherwise healthy patients with psychiatric illness are discussed.

  10. Factors that might be predictive of completion of vaginismus treatment.

    Science.gov (United States)

    Özdel, Kadir; Yılmaz Özpolat, Ayşegül; Çeri, Özge; Kumbasar, Hakan

    2012-01-01

    Vaginismus is defined as a recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with sexual intercourse. The aim of this study was to assess the level of symptoms of depression, anxiety, obsessive-compulsive symptoms, and perfectionism among patients with vaginismus, as well as to determine if these clinical variables are related to the completion of treatment. The study included 20 women with vaginismus and their spouses that were referred as outpatients to Ankara University, School of Medicine, Department of Psychiatry, Consultation and Liaison Unit. All couples underwent cognitive behavioral therapy, which was administered as 40-60-min weekly sessions. At the first (assessment) session, the female patients were assessed using a sociodemographic evaluation form, the Hamilton Rating Scale for Depression (HAM-D), the Hamilton Rating Scale for Anxiety (HAM-A), the Maudsley Obsessive-Compulsive Inventory (MOCI), the Multidimensional Perfectionism Scale (MPS), and the Golombok Rust Inventory of Sexual Satisfaction (GRISS). The male spouses were evaluated using the GRISS. The same scales were administered after the completion of treatment to those that completed the treatment. The correlation between completion of treatment, and an elevated level of anxiety and self-oriented perfectionism was significant (P Vaginismus is not only a sexual dysfunction, but it is related to multiple components of mental health. Anxiety and a perfectionist personality trait were important factors associated with the completion of treatment; therefore, these factors should be evaluated before treatment.

  11. Resting Heart Rate Variability, Facets of Rumination and Trait Anxiety: Implications for the Perseverative Cognition Hypothesis

    Directory of Open Access Journals (Sweden)

    DeWayne P. Williams

    2017-10-01

    Full Text Available The perseverative cognition hypothesis (PCH posits that perseveration, defined as the repetitive or sustained activation of cognitive representations of a real or imagined stressor, is a primary mechanism linking psychological (or stress vulnerability with poor health and disease. Resting vagally mediated heart rate variability (vmHRV is an important indicator of self-regulatory abilities, stress vulnerability and overall health. Those with lower resting vmHRV are more vulnerable to stress, and thus more likely to engage in perseverative cognition and experience subsequent negative mental health outcomes such as anxiety. Recent research suggests that rumination—one of the core mechanisms underlying perseveration—is a construct containing (at least two maladaptive (depressive and brooding and one adaptive (reflective types of rumination. However, to date, research has not examined how the association between resting vmHRV may differ between these three facets of rumination, in addition to these facets’ mechanistic role in linking lower resting vmHRV with greater trait anxiety. The current cross-sectional study explores these relationships in a sample of 203 participants (112 females, 76 ethnic minorities, mean age = 19.43, standard deviation = 1.87. Resting vmHRV was assessed during a 5-min-resting period using an Electrocardiogram (ECG. Both trait rumination (including the three facets and anxiety were assessed via self-report scales. Significant negative associations were found between resting vmHRV and maladaptive, but not adaptive, forms of perseveration. Similarly, mediation analyses showed a significant indirect relationship between resting vmHRV and anxiety through maladaptive, but not adaptive, facets of rumination. Our findings support the PCH such that those with stress vulnerability, as indexed by lower resting vmHRV, are more likely to engage in maladaptive perseverative cognition and thus experience negative outcomes such as

  12. Resting Heart Rate Variability, Facets of Rumination and Trait Anxiety: Implications for the Perseverative Cognition Hypothesis.

    Science.gov (United States)

    Williams, DeWayne P; Feeling, Nicole R; Hill, LaBarron K; Spangler, Derek P; Koenig, Julian; Thayer, Julian F

    2017-01-01

    The perseverative cognition hypothesis (PCH) posits that perseveration, defined as the repetitive or sustained activation of cognitive representations of a real or imagined stressor, is a primary mechanism linking psychological (or stress) vulnerability with poor health and disease. Resting vagally mediated heart rate variability (vmHRV) is an important indicator of self-regulatory abilities, stress vulnerability and overall health. Those with lower resting vmHRV are more vulnerable to stress, and thus more likely to engage in perseverative cognition and experience subsequent negative mental health outcomes such as anxiety. Recent research suggests that rumination-one of the core mechanisms underlying perseveration-is a construct containing (at least) two maladaptive (depressive and brooding) and one adaptive (reflective) types of rumination. However, to date, research has not examined how the association between resting vmHRV may differ between these three facets of rumination, in addition to these facets' mechanistic role in linking lower resting vmHRV with greater trait anxiety. The current cross-sectional study explores these relationships in a sample of 203 participants (112 females, 76 ethnic minorities, mean age = 19.43, standard deviation = 1.87). Resting vmHRV was assessed during a 5-min-resting period using an Electrocardiogram (ECG). Both trait rumination (including the three facets) and anxiety were assessed via self-report scales. Significant negative associations were found between resting vmHRV and maladaptive, but not adaptive, forms of perseveration. Similarly, mediation analyses showed a significant indirect relationship between resting vmHRV and anxiety through maladaptive, but not adaptive, facets of rumination. Our findings support the PCH such that those with stress vulnerability, as indexed by lower resting vmHRV, are more likely to engage in maladaptive perseverative cognition and thus experience negative outcomes such as anxiety. Our data

  13. Negative correlation between nuptial throat colour and blood parasite load in male European green lizards supports the Hamilton-Zuk hypothesis

    Science.gov (United States)

    Molnár, Orsolya; Bajer, Katalin; Mészáros, Boglárka; Török, János; Herczeg, Gábor

    2013-06-01

    During female mate choice, conspicuous male sexual signals are used to infer male quality and choose the best sire for the offspring. The theory of parasite-mediated sexual selection (Hamilton-Zuk hypothesis) presumes that parasite infection can influence the elaboration of sexual signals: resistant individuals can invest more energy into signal expression and thus advertise their individual quality through signal intensity. By preferring these males, females can provide resistance genes for their offspring. Previous research showed that nuptial throat colour of male European green lizard, Lacerta viridis, plays a role in both inter- and intrasexual selections as a condition-dependent multiple signalling system. The aim of this study was to test the predictions of the Hamilton-Zuk hypothesis on male European green lizards. By blood sampling 30 adult males during the reproductive season, we found members of the Haemogregarinidae family in all but one individual (prevalence = 96 %). The infection intensity showed strong negative correlation with the throat and belly colour brightness in line with the predictions of the Hamilton-Zuk hypothesis. In addition, we found other correlations between infection intensity and other fitness-related traits, suggesting that parasite load has a remarkable effect on individual fitness. This study shows that throat patch colour of the European green lizards not only is a multiple signalling system but also possibly acts as an honest sexual signal of health state in accordance with the Hamilton-Zuk hypothesis.

  14. Heart rate variability and pre-competitive anxiety in BMX discipline.

    Science.gov (United States)

    Mateo, Manuel; Blasco-Lafarga, Cristina; Martínez-Navarro, Ignacio; Guzmán, José F; Zabala, Mikel

    2012-01-01

    Altered neural mechanisms implying autonomic functioning have been described related to anxiety. Pre-competitive stress may be considered as an anxiety-state associated with disorders (i.e. somatic and cognitive alterations, and self-confidence worsening) that severely impair sport performance, conditioning short-lasting strength-related disciplines like BMX. From the psychological perspective, coaches use questionnaires like CSAI-2R to identify these alterations. However, with the emergence of psycho-physiological and non-linear approaches, recent studies suggest that HRV analysis provides a non-invasive tool to assess them. Hence, our purpose was to analyze how BMX competition affects subjective perception of anxiety, and if this emotional alteration is reflected in HR dynamics, analyzed both linear and nonlinearly, exploring the evolution of this relationship in a 2-day competition. Eleven male athletes from the BMX Spanish National Team were assessed from baseline HRV the morning of a training session (rT) and on two successive days of competition (rC1 and rC2), repeating HRV recording with CSAI-2R 20 min prior to training (aT) and competition (pre-competitive: aC1 and aC2). Repeated measures MANOVA showed significant vagal slow-down responses in aC1 and aC2 comparing not only with aT, but also comparing with rT, rC1 and rC2, coinciding with significant greater scores for the somatic and cognitive anxiety (SA and CA) in aC1 and aC2 versus aT. Pearson analysis showed a large and positive correlation between α1 and SA in C1, and close to it between SampEn and CA in aC2; both were confirmed by Bland-Altman chart analysis. Our results confirm that HRV analysis provide a complementary tool to assess competitive pressure.

  15. [Anxiety disorders and influence factors in adolescent patients with cleft lip and palate].

    Science.gov (United States)

    Liu, Chao; Ran, Hao; Jiang, Chang-wei; Zhou, Meng

    2015-10-01

    To investigate the anxiety disorders and influence factors that occur in adolescent patients with cleft lip and palate and to provide theoretical foundation for mental intervention. A total of 120 adolescent patients with cleft lip and palate were investigated using a general information questionnaire, the self-rating anxiety scale, and the social support rating scale (SSRS). The influence factors of anxiety disorders were analyzed. The effective questionnaires were 119. The occurrence rate of anxiety disorder in adolescent patients was 49.6% (59/119), and the occurrence rates of mild, moderate, and severe anxieties were 41.2% (49/119), 7.6% (9/119), and 0.8% (1/119), respectively. The gender, residential area, disease category, family status (one child or no children), and incidence rate of anxiety disorder in patients were statistically different (Ppalate. dender and social support were important influencing factors for anxiety disorder. In the after-mental intervention, considerable attention should be given to the anxiety disorders of patients and improve their mental health.

  16. Factors Associated with Pain, Disability and Quality of Life in Patients Suffering from Frozen Shoulder

    Directory of Open Access Journals (Sweden)

    Farshid Bagheri

    2016-07-01

    Full Text Available Background: Frozen shoulder is resulting in limb disability and reduction of quality of life but the factors associated with patients’ disability and quality of life is not clear. To assess pain, disability, the quality of life and factors associated with them in patients suffering from frozen shoulder.  Methods: We enrolled 120 patients (37 men and 83 women with phase-II idiopathic frozen shoulder in our cross-sectional study. Demographic data were collected and shoulder range of motion was measured in four different directions (elevation, abduction, external and internal rotation in both upper limbs. Patients were asked to fill out Visual Analog Scale for pain (VAS and, Short-Form Health Survey questionnaire (SF-36 as well as Disabilities of the Arm, Shoulder and Hand (DASH questionnaires. We asked the patients to fill out the Hamilton anxiety and depression questionnaires. Results: The mean of VAS pain, DASH, PCS, and MCS scores were 69(18, 53(17, 35(8.0, and 42(10 respectively. All the domains of SF36 questionnaires where below the normal population except physical function. VAS pain score was correlated to Hamilton depression scores in both bivariate and mulivarilable analysis. DASH score were correlated to sex, age, ROM, and both Hamilton anxiety and depression scores; However, DASH score only impact with Hamilton anxiety and ROM independently. PCS is correlated to age and MCS to Hamilton depression. Conclusion: Patient with frozen shoulder are more suffering from pain and disability secondary to psychiatric parameters such as depression and anxiety than demographic features or even restriction of range of motion.

  17. 76 FR 48178 - Notice of Inventory Completion: Longyear Museum of Anthropology, Colgate University, Hamilton, NY

    Science.gov (United States)

    2011-08-08

    ...: Longyear Museum of Anthropology, Colgate University, Hamilton, NY AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Longyear Museum of Anthropology has completed an inventory of a human remain... human remain should contact the Longyear Museum of Anthropology at the address below by September 7...

  18. 'Morals can not be drawn from facts but guidance may be': the early life of W.D. Hamilton's theory of inclusive fitness.

    Science.gov (United States)

    Swenson, Sarah A

    2015-12-01

    W.D. Hamilton's theory of inclusive fitness saw the evolution of altruism from the point of view of the gene. It was at heart a theory of limits, redefining altruistic behaviours as ultimately selfish. This theory inspired two controversial texts published almost in tandem, E.O. Wilson's Sociobiology: The New Synthesis (1975) and Richard Dawkins's The Selfish Gene (1976). When Wilson and Dawkins were attacked for their evolutionary interpretations of human societies, they claimed a distinction between reporting what is and declaring what ought to be. Can the history of sociobiological theories be so easily separated from its sociopolitical context? This paper draws upon unpublished materials from the 1960s and early 1970s and documents some of the ways in which Hamilton saw his research as contributing to contemporary concerns. It pays special attention to the 1969 Man and Beast Smithsonian Institution symposium in order to explore the extent to which Hamilton intended his theory to be merely descriptive versus prescriptive. From this, we may see that Hamilton was deeply concerned about the political chaos he perceived in the world around him, and hoped to arrive at a level of self-understanding through science that could inform a new social order.

  19. 78 FR 28838 - Hamilton Street Hydro, LLC; Notice of Preliminary Permit Application Accepted for Filing and...

    Science.gov (United States)

    2013-05-16

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 14507-000] Hamilton Street... Project would consist of the following: (1) An existing 10.5-foot-high rock fill gravity dam with a 655... a storage [[Page 28839

  20. The role of state anxiety in children's memories for pain.

    Science.gov (United States)

    Noel, Melanie; Chambers, Christine T; McGrath, Patrick J; Klein, Raymond M; Stewart, Sherry H

    2012-06-01

    To investigate the impact of experimentally manipulated state anxiety and the influence of anxiety-related variables on children's memories for pain. A total of 110 children (60 boys) between the ages of 8 and 12 years were randomly assigned to complete a state anxiety induction task or a control task. Following experimental manipulation, children completed a laboratory pain task, pain ratings, and questionnaire measures of anxiety-related variables. 2 weeks later, children provided pain ratings based on their memories of the pain task. The experimental manipulation effectively induced state anxiety; however, pain memories did not differ between groups. Irrespective of group assignment, children with higher state anxiety had more negative pain memories. State anxiety uniquely predicted children's pain memories over and above other well established factors. Anxiety sensitivity and trait anxiety were significant predictors of recalled pain-related fear. These data highlight the importance of anxiety in the development of children's memories for pain.

  1. DIGITAL FLOOD INSURANCE RATE MAP DATABASE, HAMILTON COUNTY, OHIO, USA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — The Digital Flood Insurance Rate Map (DFIRM) Database depicts flood risk information and supporting data used to develop the risk data. The primary risk...

  2. DIGITAL FLOOD INSURANCE RATE MAP DATABASE, HAMILTON COUNTY, FLORIDA, USA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — The Digital Flood Insurance Rate Map (DFIRM) Database depicts flood risk information and supporting data used to develop the risk data. The primary risk...

  3. A clinical trial of the beta blocker propranolol in premature ejaculation.

    Science.gov (United States)

    Cooper, A J; Magnus, R V

    1984-01-01

    Twelve male patients, with a primary complaint of premature ejaculation in a setting of chronic anxiety with prominent somatic manifestations, participated in a double-blind trial: propranolol against placebo. The study consisted of 5 X 4 week phases: run-in, propranolol or placebo--120 mg/day allocated randomly, wash-out; placebo or propranolol and run-out, in a balanced design. Anxiety was rated initially, and every 2 weeks, throughout the trial using the Hamilton Rating Scale. Sitting blood pressure and pulse were also noted. The time to coital ejaculation (every 3 days) was recorded using a stopwatch, and subjects were also required to rate "overall coital satisfaction" and "quality of erection". Neither prematurity nor other signs/symptoms of anxiety improved on the preparations, which were statistically equivalent. Moderate beta-blockade was achieved with propranolol as evidenced by a median reduction in pulse rate of 5 beats/min.

  4. Anxiety and depressive features in chronic disease patients in ...

    African Journals Online (AJOL)

    Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale. Results: Overall, 17.0% of patients screened positive for anxiety disorder and 39.1% for depressive disorder. Patients with cancer (47.8%) had the highest rate of anxiety features, and those with chronic obstructive pulmonary disease ...

  5. Reduced heart rate variability and vagal tone in anxiety: trait versus state, and the effects of autogenic training.

    Science.gov (United States)

    Miu, Andrei C; Heilman, Renata M; Miclea, Mircea

    2009-01-28

    This study investigated heart rate variability (HRV) in healthy volunteers that were selected for extreme scores of trait anxiety (TA), during two opposite psychophysiological conditions of mental stress, and relaxation induced by autogenic training. R-R intervals, HF and LF powers, and LF/HF ratios were derived from short-term electrocardiographic recordings made during mental stress and relaxation by autogenic training, with respiratory rate and skin conductance being controlled for in all the analyses. The main finding was that high TA was associated with reduced R-R intervals and HF power across conditions. In comparison to mental stress, autogenic training increased HRV and facilitated the vagal control of the heart. There were no significant effects of TA or the psychophysiological conditions on LF power, or LF/HF ratio. These results support the view that TA, which is an important risk factor for anxiety disorders and predictor of cardiovascular morbidity and mortality, is associated with autonomic dysfunction that seems likely to play a pathogenetic role in the long term.

  6. Investigating the Effect of Sympathetic Skin Response Parameters on the Psychological Test Scores in Patients with Fibromyalgia Syndrome by Using ANNS

    Directory of Open Access Journals (Sweden)

    Murat Yıldız

    2013-01-01

    Full Text Available In this study, psychological tests such as Visual Analogue Pain Scale, Verbal Pain Scale, Beck Depression Inventory, Beck Anxiety Inventory, Hamilton Depression Rating Scale and Hamilton Anxiety Scale were applied to the selected healthy subjects and patients with Fibromyalgia Syndrome (FMS in Suleyman Demirel University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation and the scores were recorded. A measurement system was established in the same department of the university to measure the sympathetic skin response (SSR from the subjects. The SSR was measured and recorded. The parameters such as latency time, maximum amplitude and the elapsed time were calculated by using Matlab software from the recorded SSR data. SSR parameters were added to the scores and diagnosis accuracy percentages of the FMS calculated by using artificial neural networks (ANNs. Obtained results from the simulations showed that the specified parameters of the SSR and FMS were concerned and these parameters can be used as a diagnostic method in FMS.

  7. Quantitative Compactness Estimates for Hamilton-Jacobi Equations

    Science.gov (United States)

    Ancona, Fabio; Cannarsa, Piermarco; Nguyen, Khai T.

    2016-02-01

    We study quantitative compactness estimates in {W^{1,1}_{loc}} for the map {S_t}, {t > 0} that is associated with the given initial data {u_0in Lip (R^N)} for the corresponding solution {S_t u_0} of a Hamilton-Jacobi equation u_t+Hbig(nabla_{x} ubig)=0, qquad t≥ 0,quad xinR^N, with a uniformly convex Hamiltonian {H=H(p)}. We provide upper and lower estimates of order {1/\\varepsilon^N} on the Kolmogorov {\\varepsilon}-entropy in {W^{1,1}} of the image through the map S t of sets of bounded, compactly supported initial data. Estimates of this type are inspired by a question posed by Lax (Course on Hyperbolic Systems of Conservation Laws. XXVII Scuola Estiva di Fisica Matematica, Ravello, 2002) within the context of conservation laws, and could provide a measure of the order of "resolution" of a numerical method implemented for this equation.

  8. Hamilton-Jacobi approach for quasi-exponential inflation: predictions and constraints after Planck 2015 results

    Energy Technology Data Exchange (ETDEWEB)

    Videla, Nelson [FCFM, Universidad de Chile, Departamento de Fisica, Santiago (Chile)

    2017-03-15

    In the present work we study the consequences of considering an inflationary universe model in which the Hubble rate has a quasi-exponential dependence in the inflaton field, given by H(φ) = H{sub inf} exp[((φ)/(m{sub p}))/(p(1+(φ)/(m{sub p})))]. We analyze the inflation dynamics under the Hamilton-Jacobi approach, which allows us to consider H(φ), rather than V(φ), as the fundamental quantity to be specified. By comparing the theoretical predictions of the model together with the allowed contour plots in the n{sub s} - r plane and the amplitude of primordial scalar perturbations from the latest Planck data, the parameters charactering this model are constrained. The model predicts values for the tensor-to-scalar ratio r and for the running of the scalar spectral index dn{sub s}/d ln k consistent with the current bounds imposed by Planck, and we conclude that the model is viable. (orig.)

  9. Patient anxiety before invasive diagnostic examinations: coronarography, arteriography, and colonoscopy

    International Nuclear Information System (INIS)

    Gryz, J.; Izdebski, P.

    2005-01-01

    The aim of this study was to answer such questions as: 1) Do patients show higher levels of anxiety (cognitive and/or physiological rates) before invasive examinations? 2) Does the type of invasive diagnostic examinations influence the patients' anxiety level? 3) Does the level of the patients' knowledge about coronarography, arteriography, or colonoscopy cause differences in their anxiety levels? The study was conducted at the Military Clinical Hospital in Bydgoszcz in the Departments of Gastroenteriology, Radiology, and Cardiology and in the Clinic of General Surgery, Chest and Vessels, and lasted seven months, from August 2002 to February 2003. 93 patients (29 women and 64 men) qualifying for different invasive examinations participated in the study. The participants were divided in three groups. The first consisted of patients awaiting coronarography, the second arteriography of the lower limbs, and the third colonoscopy. The participants were chosen on the basis of medical criteria. A structured interview was used to assess their levels of knowledge about the invasive examination they were to undergo. Anxiety was assessed with the Inventory of State and Trait Anxiety and by blood pressure measurement. On the basis of the obtained data we conclude that patients awaiting invasive examinations have higher physiological anxiety rates and that the type of invasive examination significantly influences patient anxiety levels. The type of examination did not differentiate patients according to their cognitive rates of anxiety: the level was average. The levels of patient knowledge about coronarography, colonoscopy, and arteriography did not cause any differences in physiological and cognitive rates of anxiety. The authors conclude that the cognitive aspects of anxiety do not influence the way patients experience physiological anxiety before invasive examinations. (author)

  10. How Does Mozart's Music Affect Children's Reading? The Evidence from Learning Anxiety and Reading Rates with E-Books

    Science.gov (United States)

    Su, Yen-Ning; Kao, Chih-Chien; Hsu, Chia-Cheng; Pan, Lu-Chun; Cheng, Shu-Chen; Huang, Yueh-Min

    2017-01-01

    Some music has been proved effectively to mitigate anxiety, beneficial to reading. However, little was known on its influence of reading behaviors and outcomes. Thanks to the advance of e-book technology, it becomes possible to track reading rate and outcomes in a real-time manner by the underlying mobile devices. This study intends to examine the…

  11. The psychometric properties, sensitivity and specificity of the geriatric anxiety inventory, hospital anxiety and depression scale, and rating anxiety in dementia scale in aged care residents.

    Science.gov (United States)

    Creighton, Alexandra S; Davison, Tanya E; Kissane, David W

    2018-02-22

    Limited research has been conducted into the identification of a valid and reliable screening measure for anxiety in aged care settings, despite it being one of the most common psychological conditions. This study aimed to determine an appropriate anxiety screening tool for aged care by comparing the reliability and validity of three commonly used measures and identifying specific cut-offs for the identification of generalized anxiety disorder (GAD). One-hundred and eighty nursing home residents (M age = 85.39 years) completed the GAI, HADS-A, and RAID, along with a structured diagnostic interview. Twenty participants (11.1%) met DSM-5 criteria for GAD. All measures had good psychometric properties , although reliability estimates for the HADS-A were sub-optimal. Privileging sensitivity , the GAI cut-off score of 9 gave sensitivity of 90.0% and specificity of 86.3%; HADS-A cut-off of 6 gave sensitivity of 90.0% and specificity of 80.6%; and RAID cut-off of 11 gave sensitivity of 85.0% and specificity of 72.5%. While all three measures had adequate reliability, validity, and cut-scores with high levels of sensitivity and specificity to detect anxiety within aged care, the GAI was the most consistently reliable and valid measure for screening for GAD.

  12. Anxiety trajectories in response to a speech task in social anxiety disorder: Evidence from a randomized controlled trial of CBT

    Science.gov (United States)

    Morrison, Amanda S.; Brozovich, Faith A.; Lee, Ihno A.; Jazaieri, Hooria; Goldin, Philippe R.; Heimberg, Richard G.; Gross, James J.

    2016-01-01

    The subjective experience of anxiety plays a central role in cognitive behavioral models of social anxiety disorder (SAD). However, much remains to be learned about the temporal dynamics of anxiety elicited by feared social situations. The aims of the current study were: 1) to compare anxiety trajectories during a speech task in individuals with SAD (n = 135) versus healthy controls (HCs; n = 47), and 2) to compare the effects of CBT on anxiety trajectories with a waitlist control condition. SAD was associated with higher levels of anxiety and greater increases in anticipatory anxiety compared to HCs, but not differential change in anxiety from pre- to post-speech. CBT was associated with decreases in anxiety from pre- to post-speech but not with changes in absolute levels of anticipatory anxiety or rates of change in anxiety during anticipation. The findings suggest that anticipatory experiences should be further incorporated into exposures. PMID:26760456

  13. "Social Anxiety Disorder Carved at its Joints": evidence for the taxonicity of social anxiety disorder.

    Science.gov (United States)

    Weeks, Justin W; Carleton, R Nicholas; Asmundson, Gordon J G; McCabe, Randi E; Antony, Martin M

    2010-10-01

    Previous findings suggest that social anxiety disorder may be best characterized as having a dimensional latent structure (Kollman et al., 2006; Weeks et al., 2009). We attempted to extend previous taxometric investigations of social anxiety by examining the latent structure of social anxiety disorder symptoms in a large sample comprised of social anxiety disorder patients (i.e., putative taxon members) and community residents/undergraduate respondents (i.e., putative complement class members). MAXEIG and MAMBAC were performed with indicator sets drawn from a self-report measure of social anxiety symptoms, the Social Interaction Phobia Scale (Carleton et al., 2009). MAXEIG and MAMBAC analyses, as well as comparison analyses utilizing simulated taxonic and dimensional datasets, yielded converging evidence that social anxiety disorder has a taxonic latent structure. Moreover, 100% of the confirmed social anxiety disorder patients in our overall sample were correctly assigned to the identified taxon class, providing strong support for the external validity of the identified taxon; and k-means cluster analysis results corroborated our taxometric base-rate estimates. Implications regarding the conceptualization, diagnosis, and assessment of social anxiety disorder are discussed. Copyright 2010 Elsevier Ltd. All rights reserved.

  14. Psychiatric morbidity and quality of life in skin diseases: A comparison of alopecia areata and psoriasis

    Directory of Open Access Journals (Sweden)

    Sagar B Karia

    2015-01-01

    Full Text Available Background: Alopecia areata (AA and psoriasis are associated with various psychiatric comorbidities. Both greatly affect the quality of life (QOL of patients and psychiatric comorbidities can further worsen it. Thus there is need to recognise psychiatric comorbidities and treat them in these patients. Aims: To determine the psychiatric morbidity and the QOL in these patients to study the factors affecting them. Methodology: 50 patients each of psoriasis and AA were included. 50 people accompanying these patients served as control group. They were diagnosed for psychiatric disorders by clinical interview. Scales used were severity of alopecia tool for AA, psoriasis area and severity index for psoriasis, WHO-QOL scale, Hamilton Rating Scale for anxiety and depression. Results: 22% and 38% patients in AA and psoriasis group respectively suffered from psychiatric disorder, depression was present in 18% and 24% of patients and 4% and 12% had anxiety disorders in respective groups. The control group had only 6% of psychiatric comorbidities. QOL scores had negative correlation with Hamilton-A, Hamilton-D and severity of psoriasis scores and they were statistically significant but not with severity of AA. Conclusion: Thus AA and psoriasis patients had more prevalence of psychiatric comorbidities and it had bearing on their QOL.

  15. Subjective and Objective Assessment of Mathematics Anxiety Levels among College Students

    OpenAIRE

    Baloğlu, Mustafa

    2015-01-01

    The study investigated the relationship between college students’ subjective and objective assessment of mathematics anxiety levels. Students rated their general and current mathematics anxiety levels, mathematical ability levels, and confidence in doing mathematics. The Revised Mathematics Anxiety Rating Scale was used as an objective measure of their mathematics anxiety levels. Participants were 559 students, 406 (72.6%) women and 151 (27.0%) men. Results showed that perceived general mathe...

  16. Effect of the refractive index on the hawking temperature: an application of the Hamilton-Jacobi method

    Science.gov (United States)

    Sakalli, I.; Mirekhtiary, S. F.

    2013-10-01

    Hawking radiation of a non-asymptotically flat 4-dimensional spherically symmetric and static dilatonic black hole (BH) via the Hamilton-Jacobi (HJ) method is studied. In addition to the naive coordinates, we use four more different coordinate systems that are well-behaved at the horizon. Except for the isotropic coordinates, direct computation by the HJ method leads to the standard Hawking temperature for all coordinate systems. The isotropic coordinates allow extracting the index of refraction from the Fermat metric. It is explicitly shown that the index of refraction determines the value of the tunneling rate and its natural consequence, the Hawking temperature. The isotropic coordinates in the conventional HJ method produce a wrong result for the temperature of the linear dilaton. Here, we explain how this discrepancy can be resolved by regularizing the integral possessing a pole at the horizon.

  17. Effect of the refractive index on the hawking temperature: an application of the Hamilton-Jacobi method

    Energy Technology Data Exchange (ETDEWEB)

    Sakalli, I., E-mail: izzet.sakalli@emu.edu.tr; Mirekhtiary, S. F., E-mail: fatemeh.mirekhtiary@emu.edu.tr [Eastern Mediterranean University G. Magosa, Department of Physics (Turkey)

    2013-10-15

    Hawking radiation of a non-asymptotically flat 4-dimensional spherically symmetric and static dilatonic black hole (BH) via the Hamilton-Jacobi (HJ) method is studied. In addition to the naive coordinates, we use four more different coordinate systems that are well-behaved at the horizon. Except for the isotropic coordinates, direct computation by the HJ method leads to the standard Hawking temperature for all coordinate systems. The isotropic coordinates allow extracting the index of refraction from the Fermat metric. It is explicitly shown that the index of refraction determines the value of the tunneling rate and its natural consequence, the Hawking temperature. The isotropic coordinates in the conventional HJ method produce a wrong result for the temperature of the linear dilaton. Here, we explain how this discrepancy can be resolved by regularizing the integral possessing a pole at the horizon.

  18. The efficacy of reboxetine in the treatment-refractory patients with panic disorder: an open label study.

    Science.gov (United States)

    Dannon, P N; Iancu, I; Grunhaus, L

    2002-10-01

    Selective serotonin reuptake inhibitors (SSRIs) are currently the first-line treatment for panic disorder, although up to 30% of patients either do not respond to SSRIs or withdraw due to adverse events. Reboxetine, a selective norepinephrine reuptake inhibitor (selective NRI), is effective in treating depression and may alleviate depression-related anxiety. This study aimed to investigate the efficacy of reboxetine in the treatment of patients with panic disorder who did not respond to SSRIs. In this 6-week, open-label study, 29 adult outpatients with panic disorder who had previously failed to respond to SSRI treatment received reboxetine 2 mg/day, titrated to a maximum of 8 mg/day over the first 10 days. Efficacy was assessed using the Panic Self-Questionnaire (PSQ), the Hamilton Rating Scale for Anxiety (HAM-A), the 17-item Hamilton Rating Scale for Depression (HRSD) and the Global Assessment of Functioning (GAF) Scale. The 24 patients who completed the study responded well to reboxetine treatment. Significant improvement (p < 0.001) was observed in the number of daily panic attacks, and on the scales measuring anxiety, depression and functioning. Reboxetine was generally well tolerated. Five patients withdrew due to adverse events. Reboxetine appears to be effective in the treatment of SSRI-refractory panic disorder patients and warrants further clinical investigation. Copyright 2002 John Wiley & Sons, Ltd.

  19. Anxiety trajectories in response to a speech task in social anxiety disorder: Evidence from a randomized controlled trial of CBT.

    Science.gov (United States)

    Morrison, Amanda S; Brozovich, Faith A; Lee, Ihno A; Jazaieri, Hooria; Goldin, Philippe R; Heimberg, Richard G; Gross, James J

    2016-03-01

    The subjective experience of anxiety plays a central role in cognitive behavioral models of social anxiety disorder (SAD). However, much remains to be learned about the temporal dynamics of anxiety elicited by feared social situations. The aims of the current study were: (1) to compare anxiety trajectories during a speech task in individuals with SAD (n=135) versus healthy controls (HCs; n=47), and (2) to compare the effects of CBT on anxiety trajectories with a waitlist control condition. SAD was associated with higher levels of anxiety and greater increases in anticipatory anxiety compared to HCs, but not differential change in anxiety from pre- to post-speech. CBT was associated with decreases in anxiety from pre- to post-speech but not with changes in absolute levels of anticipatory anxiety or rates of change in anxiety during anticipation. The findings suggest that anticipatory experiences should be further incorporated into exposures. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Four-year follow-up study of pharmacological treatment in pathological gamblers.

    Science.gov (United States)

    Rosenberg, Oded; Dinur, Limor Klein; Dannon, Pinhas N

    2013-01-01

    In the past decade, we have witnessed the emergence of pharmacological treatments for pathological gambling with some success but many question marks. We aimed to explore pharmacological treatments that have been previously explored with some success, with the intent of comparing their efficacy and pave the way to larger placebo-controlled trials. In this study, we allocated 78 patients to 4 different types of psychotropic medications: naltrexone, topiramate, bupropion, and escitalopram. We treated patients for more than 2 years, with additional 2-year follow-ups without medication. The sample was evaluated using the 21-item Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Global Assessment of Functioning, and the Visual Analog Scale to measure general well-being before enrollment as well as at 1 month, 6 months, 24 months, and 48 months after beginning medication treatment. During the first 2 years of treatment, 34 patients dropped out, with one more dropping out during the additional 2 years of follow-up. Significant improvement on all rating scales was seen in all groups after 2 years, except HAMD in the group that received topiramate. We found the naltrexone-treated group of patients to have a statistically significant lower dropout rate compared with other groups, statistically significant lower HAMD scores in comparison to the group treated with bupropion, statistically significant lower Hamilton Anxiety Rating Scale score compared to the groups treated with escitalopram and topiramate, and significantly higher Visual Analog Scale scores compared to the groups treated with bupropion and topiramate. Pathological gambling is essentially a biopsychological disorder that may be attenuated provided that patients adhere to medication. In our study, among 4 medications with different mechanisms of action, naltrexone was found to be the most effective. Placebo-controlled studies involving large numbers of subjects are required before

  1. Biofeedback-assisted relaxation training to decrease test anxiety in nursing students.

    Science.gov (United States)

    Prato, Catherine A; Yucha, Carolyn B

    2013-01-01

    Nursing students experiencing debilitating test anxiety may be unable to demonstrate their knowledge and have potential for poor academic performance. A biofeedback-assisted relaxation training program was created to reduce test anxiety. Anxiety was measured using Spielberger's Test Anxiety Inventory and monitoring peripheral skin temperature, pulse, and respiration rates during the training. Participants were introduced to diaphragmatic breathing, progressive muscle relaxation, and autogenic training. Statistically significant changes occurred in respiratory rates and skin temperatures during the diaphragmatic breathing session; respiratory rates and peripheral skin temperatures during progressive muscle relaxation session; respiratory and pulse rates, and peripheral skin temperatures during the autogenic sessions. No statistically significant difference was noted between the first and second TAI. Subjective test anxiety scores of the students did not decrease by the end of training. Autogenic training session was most effective in showing a statistically significant change in decreased respiratory and pulse rates and increased peripheral skin temperature.

  2. Freezing of gait is associated with cognitive impairment in patients with Parkinson disease.

    Science.gov (United States)

    Yao, Zhiwen; Shao, Yuan; Han, Xiang

    2017-08-24

    To explore whether the cognitive impairment is correlated with freezing of gait (FOG) in patients with Parkinson disease (PD). A total of 186 patients with Parkinson disease (104 patients with FOG and 82 patients with no clinical history of freezing behavior) and 125 healthy individuals were selected for this study. Neuropsychological assessments, including the scales for outcomes in Parkinson disease cognition, unified Parkinson's disease rating scale, and Hamilton depression/anxiety rating scale etc., were applied to evaluate the patients'cognitive functioning. We found that the scores of Unified Parkinson's Disease Rating Scale (UPDRS) were significantly higher among PD patients with FOG, compared with non-FOG group. We also showed that Mini-Mental State Examination score (MMSE) was lower among subjects with FOG than in patients without FOG. Patients with FOG displayed lower Scales for OUTCOMES: in Parkinson's Disease Cognition (SCOPA-COG) score than non-FOG patients. In addition, significant higher Hamilton Anxiety Rating Scale (HAMD) scores were found in patients with FOG than patients without FOG. Moreover, disease duration, stage of the disease, the severity of motor symptom, increased depressive and anxiety complaints measured by FOG questionnaire were significantly associated with severity of FOG. Meanwhile, we also found that the score of Freezing of Gait Questionnaire (FOGQ) score was negatively correlated with MMSE. Our results demonstrated that FOG is related to impaired cognitive functions in PD patients with FOG. The understanding of impaired cognitive functions in PD patients with FOG can provide evidences for possible therapeutic interventions. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. The Impact of Mindfulness-Based Stress Reduction on Emotional Wellbeing and Glycemic Control of Patients with Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    A. Armani Kian

    2018-01-01

    Full Text Available Objective. The aim of the study was to determine the effect of mindfulness-based stress reduction (MBSR intervention on emotion regulation and glycemic control of patients with type 2 diabetes. Materials and Methods. Sixty patients with type 2 diabetes were recruited for this randomized controlled trial from an outpatient clinic at Imam Hospital in Iran. The intervention group participated in 8 sessions of MBSR, and the control group continued the treatment as usual. Fasting blood sugar and HbA1c were measured as two indices of glycemic control. Overall mental health, depression, and anxiety were measured using the General Health Questionnaire (GHQ-28, Hamilton Depression Rating Scale (HDRS, and Hamilton Anxiety Rating Scale (HARS, respectively. All the assessments were performed at baseline and after 8 weeks and 3 months as follow-up. Results. In comparison with the control group, the MBSR intervention group showed a significant reduction on all outcome measures including FBS, HbA1C, HARS, and HDRS scores (p<0/05. Conclusion. MBSR had a remarkable improvement on emotional wellbeing and glycemic control of patients with type 2 diabetes.

  4. Kleptomania: comorbid psychiatric diagnosis in patients and their families.

    Science.gov (United States)

    Dannon, Pinhas N; Lowengrub, Katherine M; Iancu, Iulian; Kotler, Moshe

    2004-01-01

    Kleptomania, defined by DSM-IV as the inability to resist the impulse to steal objects which are not needed for personal use or for their monetary value, may reflect a form of obsessive-compulsive spectrum disorder and/or affective spectrum disorder. Twenty-one kleptomanic patients and 57 first-degree relatives completed a semistructured DSM-IV-based interview and questionnaires. Questionnaires are: the HDRS-17 (the Hamilton Rating Scale for Depression), the HARS (Hamilton Rating Scale for Anxiety), the Y-BOCS (Yale-Brown Obsessive Compulsive Scale), the YMRS (Young Mania Rating Scale). The two groups were compared to demographically matched normal controls (n = 64). We found a high prevalence of affective and anxiety disorders in our sample of kleptomanic patients and their first-degree relatives. In addition, the scores on the HDRS, HARS, and Y-BOCS were significantly higher in the study group than in the control group. Our finding of a high prevalence of psychiatric comorbidity in kleptomanic patients could lead to the development of new treatment strategies for this disorder. Furthermore, the pattern of psychiatric disorders seen in the first-degree relatives can lead to new insights about the nosology and etiopathology of kleptomania. Copyright 2004 S. Karger AG, Basel

  5. [Six-month follow-up study of drug treatment for cannabis addiction: comparison study of four drugs].

    Science.gov (United States)

    Shoenfeld, Netta; Bodnik, Dana; Rosenberg, Oded; Kotler, Moshe; Dannon, Pinhas

    2011-12-01

    Marijuana addiction is one of the most common forms of addiction worldwide. A variety of reasons for use exist, however, there are only a few tested treatments with frequent relapses. In this study, we examined the efficacy of four pharmacotherapy agents for the treatment of marijuana addiction: naltrexone, bupropion, escitalopram and bromazepam. A total of 59 patients were randomly assigned into four groups. Each group received one of the pharmacological agents for 120 days. Four types of questionnaires were employed: The Hamilton Rating Scale for Depression--21 items, the Hamilton Rating Scale for Anxiety, the Global Assessment of Functioning and a Visual Analogue Scale for perceived need of the drug. In addition, random urine tests were performed to detect tetrahydrocannabinol [THC). Naltrexone proved to be the most efficacious of the four agents, with only four dropouts. Other agents proved less efficacious with six, seven and eights dropouts for bupropion, bromazepam and escitalopram, respectively. In addition, naltrexone was most efficacious in reducing anxiety and depression rates, and increasing functioning and perceived need for drug use. Out of four pharmacological agents, naltrexone proved to be most efficacious in treating marijuana addiction and related disorders. Further studies are needed to confirm our results.

  6. Mobile Air Monitoring: Measuring Change in Air Quality in the City of Hamilton, 2005-2010

    Science.gov (United States)

    Adams, Matthew D.; DeLuca, Patrick F.; Corr, Denis; Kanaroglou, Pavlos S.

    2012-01-01

    This paper examines the change in air pollutant concentrations between 2005 and 2010 occurring in the City of Hamilton, Ontario, Canada. After analysis of stationary air pollutant concentration data, we analyze mobile air pollutant concentration data. Air pollutants included in the analysis are CO, PM[subscript 2.5], SO[subscript 2], NO,…

  7. Childhood Anxiety/Withdrawal, Adolescent Parent-Child Attachment and Later Risk of Depression and Anxiety Disorder

    DEFF Research Database (Denmark)

    Jakobsen, I. S.; Horwood, L. J.; Fergusson, D. M.

    2012-01-01

    . The implications of these findings for the role of parent-child attachment in mitigating the adverse effects of early anxiety/withdrawal are discussed. It is concluded that positive parent-child attachment in adolescence may act as a compensatory factor which buffers the adverse effects of childhood anxiety......Previous research has shown that children with high levels of early anxiety/withdrawal are at increased risk of later anxiety and depression. It has also been found that positive parent-child attachment reduces the risk of these disorders. The aim of this paper was to examine the extent to which...... positive parent-child attachment acted to mitigate the risk of later internalising disorders amongst children with high levels of early anxiety/withdrawal using data from a 30 years longitudinal study of a New Zealand birth cohort. The findings of this study showed that: (a) increasing rates of early...

  8. Meditation therapy for anxiety disorders.

    Science.gov (United States)

    Krisanaprakornkit, T; Krisanaprakornkit, W; Piyavhatkul, N; Laopaiboon, M

    2006-01-25

    transcendental meditation showed a reduction in anxiety symptoms and electromyography score comparable with electromyography-biofeedback and relaxation therapy. Another study compared Kundalini Yoga (KY), with Relaxation/Mindfulness Meditation. The Yale-Brown Obsessive Compulsive Scale showed no statistically significant difference between groups. The overall dropout rate in both studies was high (33-44%). Neither study reported on adverse effects of meditation. The small number of studies included in this review do not permit any conclusions to be drawn on the effectiveness of meditation therapy for anxiety disorders. Transcendental meditation is comparable with other kinds of relaxation therapies in reducing anxiety, and Kundalini Yoga did not show significant effectiveness in treating obsessive-compulsive disorders compared with Relaxation/Meditation. Drop out rates appear to be high, and adverse effects of meditation have not been reported. More trials are needed.

  9. Traditional Korean islanders encounters with the British navy in the 1880s: The Port Hamilton Affair of 1885–1887

    Directory of Open Access Journals (Sweden)

    Stephen A. Royle

    2016-06-01

    Full Text Available This article deals with the encounters between a traditional Korean rural and island population and western military forces when the British navy occupied Geomundo, an archipelago known to them as Port Hamilton, for 22 months between 1885 and 1887. The paper first outlines the sometimes painful process of East Asian countries being opened up to trade and outside influences in the 19th century, a process sometimes urged upon them by naval weapons in this era of gunboat diplomacy. This provides the setting for the Port Hamilton Affair itself when in preparation for possible war with Russia, a British naval squadron steamed into Port Hamilton and took it without reference to the local people or their national government. After brief reference to the political consequences of this action, the focus is then on what the records from the occupation and earlier investigations by the British, who had long coveted the islands’ strategic harbour, reveal about the life of the islanders. The article considers both their traditional life, from a time rather before western travel accounts were written about the Korean mainland, and how the islanders fared under the British.

  10. On the Geometry of the Hamilton-Jacobi Equation and Generating Functions

    Science.gov (United States)

    Ferraro, Sebastián; de León, Manuel; Marrero, Juan Carlos; Martín de Diego, David; Vaquero, Miguel

    2017-10-01

    In this paper we develop a geometric version of the Hamilton-Jacobi equation in the Poisson setting. Specifically, we "geometrize" what is usually called a complete solution of the Hamilton-Jacobi equation. We use some well-known results about symplectic groupoids, in particular cotangent groupoids, as a keystone for the construction of our framework. Our methodology follows the ambitious program proposed by Weinstein (In Mechanics day (Waterloo, ON, 1992), volume 7 of fields institute communications, American Mathematical Society, Providence, 1996) in order to develop geometric formulations of the dynamical behavior of Lagrangian and Hamiltonian systems on Lie algebroids and Lie groupoids. This procedure allows us to take symmetries into account, and, as a by-product, we recover results from Channell and Scovel (Phys D 50(1):80-88, 1991), Ge (Indiana Univ. Math. J. 39(3):859-876, 1990), Ge and Marsden (Phys Lett A 133(3):134-139, 1988), but even in these situations our approach is new. A theory of generating functions for the Poisson structures considered here is also developed following the same pattern, solving a longstanding problem of the area: how to obtain a generating function for the identity transformation and the nearby Poisson automorphisms of Poisson manifolds. A direct application of our results gives the construction of a family of Poisson integrators, that is, integrators that conserve the underlying Poisson geometry. These integrators are implemented in the paper in benchmark problems. Some conclusions, current and future directions of research are shown at the end of the paper.

  11. From the Snell-Descartes refraction law, to the Hamilton equations in the phase space of geometrical optics

    International Nuclear Information System (INIS)

    Lopez Moreno, E.; Wolf, K.B.

    1989-01-01

    Starting from the Snell-Descartes' refraction law, we obtain in a brief and direct way the Hamilton equations of Geometrical Optics. We show the global structure of phase space and compare it with that used in paraxial optics. (Author)

  12. Social anxiety symptoms across diagnoses among outpatients attending a tertiary care mood and anxiety disorders service.

    Science.gov (United States)

    Graystone, H J; Garner, M J; Baldwin, D S

    2009-04-01

    Social phobia is a common, persistent and disabling anxiety disorder in which co-existing depressive symptoms are common. However the prevalence of social anxiety symptoms in patients with other mood and anxiety disorders is uncertain. In consecutive patients attending a tertiary referral mood and anxiety disorders service, depressive symptoms were assessed by the Montgomery-Asberg Depression Rating Scale (MADRS) and social anxiety symptoms by the Liebowitz Social Anxiety Scale (LSAS). The Clinical Global Impression of Severity (CGI-S) was completed following the appointment. 75 patients (48 women, 27 men; mean age 45.9 years) completed the study. 38 had a single diagnosis and 37 co-morbid diagnoses: 15 patients had bipolar disorder, 35 unipolar depressive disorder, 19 an anxiety disorder, and 6 other disorders. Independent samples t-tests and one-way between-subjects ANOVA revealed that the severity of social anxiety symptoms but not depressive symptoms was significantly greater in patients with co-morbid diagnoses (LSAS 73.7 vs 54.2, t(72)=2.44, pdepression or bipolar disorder (respectively; LSAS 78.8 vs 59.4 vs 50.0, F(2, 65)=3.13, p=.05; MADRS 22.2 vs 19.8 vs 17.5, F(2, 66)depression (R(2)=0.376, pdepressive and social anxiety symptoms across a range of diagnoses. Depressive and social anxiety symptoms were most severe but least well correlated among tertiary care outpatients with anxiety disorders, emphasising the need for comprehensive evaluation and treatment.

  13. Impact of Self-concept on Preschoolers’ Dental Anxiety and Behavior

    Science.gov (United States)

    Erfanparast, Leila; Vafaei, Ali; Sohrabi, Azin; Ranjkesh, Bahram; Bahadori, Zahra; Pourkazemi, Maryam; Dadashi, Shabnam; Shirazi, Sajjad

    2015-01-01

    Background and aims. Different factors affect children’s behavior during dental treatment, including psychological and behavioral characteristics. The aim of this study was to evaluate the correlation of self-concept on child’s anxiety and behavior during dental treatment in 4 to 6-year-old children. Materials and methods. A total of 235 preschoolers aged 4 to 6 years were included in this descriptive analytic study. Total self-concept score for each child was assessed according to Primary Self-concept Scale before dental treatment. Child’s anxiety and child’s behavior were assessed, during the restoration of mandibular primary molar, using clinical anxiety rating scale and Frankl Scale, respectively. Spearman’s correlation coefficient was used to evaluate the correlation between the total self-concept score with the results of clinical anxiety rating scale and Frankl Scale. Results. There was a moderate inverse correlation between the self-concept and clinical anxiety rating scale scores (r = -0.545, P self-concept and child’s behavior scores (r = 0.491, P self-concept had lower anxiety level and better behavioral feedback during dental treatment. PMID:26697152

  14. Impact of Self-concept on Preschoolers' Dental Anxiety and Behavior.

    Science.gov (United States)

    Erfanparast, Leila; Vafaei, Ali; Sohrabi, Azin; Ranjkesh, Bahram; Bahadori, Zahra; Pourkazemi, Maryam; Dadashi, Shabnam; Shirazi, Sajjad

    2015-01-01

    Background and aims . Different factors affect children's behavior during dental treatment, including psychological and behavioral characteristics. The aim of this study was to evaluate the correlation of self-concept on child's anxiety and behavior during dental treatment in 4 to 6-year-old children. Materials and methods. A total of 235 preschoolers aged 4 to 6 years were included in this descriptive analytic study. Total self-concept score for each child was assessed according to Primary Self-concept Scale before dental treatment. Child's anxiety and child's behavior were assessed, during the restoration of mandibular primary molar, using clinical anxiety rating scale and Frankl Scale, respectively. Spearman's correlation coefficient was used to evaluate the correlation between the total self-concept score with the results of clinical anxiety rating scale and Frankl Scale. Results. There was a moderate inverse correlation between the self-concept and clinical anxiety rating scale scores (r = -0.545, P self-concept and child's behavior scores (r = 0.491, P self-concept had lower anxiety level and better behavioral feedback during dental treatment.

  15. DURAND NEIGHBOURHOOD HERITAGE INVENTORY: TOWARD A DIGITAL CITYWIDE SURVEY APPROACH TO HERITAGE PLANNING IN HAMILTON

    Directory of Open Access Journals (Sweden)

    V. Angel

    2017-08-01

    Full Text Available In the face of changing economies and patterns of development, the definition of heritage is diversifying, and the role of inventories in local heritage planning is coming to the fore. The Durand neighbourhood is a layered and complex area located in inner-city Hamilton, Ontario, Canada, and the second subject area in a set of pilot inventory studies to develop a new city-wide inventory strategy for the City of Hamilton,. This paper presents an innovative digital workflow developed to undertake the Durand Built Heritage Inventory project. An online database was developed to be at the centre of all processes, including digital documentation, record management, analysis and variable outputs. Digital tools were employed for survey work in the field and analytical work in the office, resulting in a GIS-based dataset that can be integrated into Hamilton’s larger municipal planning system. Together with digital mapping and digitized historical resources, the Durand database has been leveraged to produce both digital and static outputs to shape recommendations for the protection of Hamilton’s heritage resources.

  16. Overview and clinical presentation of generalized anxiety disorder.

    Science.gov (United States)

    Rickels, K; Rynn, M

    2001-03-01

    primary and if no such current comorbid diagnosis, such as other anxiety disorders or MDD, is present, except for minor depression and dysthymia, or if only subthreshold symptoms of other anxiety disorders are present, GAD should be considered primary and treated as GAD; however, patients with concurrent threshold anxiety or mood disorders should be diagnosed according to the definitions of these disorders in the DSM-IV and ICD-10 and treated as such. 4. Somatization disorders are now classified separately from anxiety disorders. Some of these, particularly undifferentiated somatization disorder, may overlap with GAD and be diagnostically difficult to distinguish. The authors believe that, as long as psychic symptoms of anxiety are present and predominant, patients should be given a primary diagnosis of GAD. 5. Two major shifts in the DSM diagnostic criteria for GAD have markedly redefined the definition of this disorder. One shift involves the duration criterion from 1 to 6 months, and the other, the increased emphasis on worry and secondary psychic [table: see text] symptoms accompanied by the elimination of most somatic symptoms. This decision has had the consequence of orphaning a large population of patients suffering from GAD that is more transient and somatic in its focus and who typically present not to psychiatrists but to primary care physicians. Therefore, clinicians should consider using the ICD-10 qualification of illness duration of "several months" to replace the more rigid DSM-IV criterion of 6 months and to move away from the DSM-IV focus on excessive worry as the cardinal symptom of anxiety and demote it to only another important anxiety symptom, similar to free-floating anxiety. One also might consider supplementing this ICD-10 criterion with an increased symptom severity criterion as, for example, a Hamilton Anxiety Scale of 18. Finally, the adjective excessive, not used in the definition of other primary diagnostic criteria, such as depressed mood for

  17. [Effectiveness of cognitive-behavioral therapy in childhood anxiety disorders in a university psychiatric outpatient clinic].

    Science.gov (United States)

    Goletz, Hildegard; Yang, Young-Im; Suhr-Dachs, Lydia; Walter, Daniel; Döpfner, Manfred

    2013-07-01

    Only few studies have examined whether the efficacy of cognitive-behavioral therapy for childhood anxiety disorders as demonstrated in randomized controlled trials (RCTs) generalizes to clinical practice. This study examines the effectiveness of cognitive-behavioral therapy for juvenile anxiety disorders under routine care conditions in a university-based psychiatric outpatient clinic. 92 children and adolescents with parent-ratings regarding anxiety and comorbid symptoms and 61 children and adolescents with self-ratings regarding anxiety and comorbid symptoms were treated with cognitive-behavioral interventions. Pre/post mean comparisons, effect sizes, and the clinical significance of changes in symptoms were examined. The effect size for reduction of anxiety symptoms was .81 for children whose parents had completed the rating scale and .79 for children who had filled in a self-rating scale. Effect sizes for reduction of comorbid symptoms varied between .37 and .84 for parent ratings and between .21 and .62 for self-ratings. The percentage of children and adolescents who achieved clinically significant improvements in anxiety symptoms was 55.1 % according to the parent ratings and 65.7 % according to the children's self-ratings. More than 50 % of parents and children reported clinically significant improvements in comorbid symptoms. Significant reductions in both anxiety and comorbid symptoms were demonstrated over the course of cognitive-behavioral therapy of juvenile anxiety disorders in a university psychiatric outpatient clinic. The effect sizes for anxiety symptoms were found to be comparable to the effect sizes reported in RCTs. Similarly, clinically significant improvements were as frequent as the rates of remission of anxiety symptoms reported in RCTs.

  18. Mathematics anxiety in secondary students in England.

    Science.gov (United States)

    Chinn, Steve

    2009-02-01

    Whatever the changes that are made to the mathematics curriculum in England, there will always remain a problem with mathematics anxiety. Maths anxiety is rarely facilitative. This study examined aspects of mathematics in secondary schools and how students rated them as sources of anxiety. Over 2000 students in independent and mainstream schools in England completed a 20-item questionnaire designed to investigate maths anxiety levels. The same questionnaire was given to over 440 dyslexic males in specialist schools within the same age range. The results showed that examinations and tests create high levels of anxiety in approximately 4% of students. The results suggest that certain aspects and topics in the maths curriculum, such as long division, cause similar levels of anxiety for students in all year groups in secondary schools.

  19. Depression and anxiety in patients with coronary artery disease, measured by means of self-report measures and clinician-rated instrument.

    Science.gov (United States)

    Moryś, Joanna M; Bellwon, Jerzy; Adamczyk, Katarzyna; Gruchała, Marcin

    2016-01-01

    The presence of depression symptomatology significantly deteriorates the prognosis for the patient. There are many instruments developed to measure depression and anxiety in clinical trials; however, the suitability of the specific scale for screening these disorders in cardiovascular patients is debatable. The aim of current study is to verify which of the major assessment instruments is the most relevant for the screening evaluation of depression and anxiety in patients with cardiovascular system diseases. The sample studied consisted of 120 patients with stable coronary artery disease (CAD). They did not display serious psychiatric or somatic disorders. To assess depressive and anxiety symptoms we used self-reporting measures (BDI-II, HADS, SSAI/STAI, and PHQ), the results of which were compared to results obtained on the basis of a clinician-rating instrument (HRSD). We found that depressive symptoms assessed on the basis of HRSD, BDI-II, and PHQ-9 were equivalent in results, while the results obtained in HADS-D were significantly lower. Anxiety symptoms were found at approximate levels in HADS, SSAI, and GAD-7. The assessment of somatic symptoms in patients with CAD indicates that 87.5% of the subjects reported somatic symptoms of various intensity. Screening assessment of depression in patients with CAD gives different results depending on the tool used. We found that HADS significantly underestimates the percentage of patients with symptoms of depression in patients with CAD. Assessing anxiety symptoms with the aid of HADS gave outcomes close to the results gained by use of other tools.

  20. 78 FR 22873 - Hamilton Street Hydro, LLC; Notice of Preliminary Permit Application Accepted for Filing and...

    Science.gov (United States)

    2013-04-17

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 14500-000] Hamilton Street... Hydroelectric Project would consist of the following: (1) An existing 14-foot-high concrete gravity dam with a 480-foot-long spillway; (2) an existing impoundment having a surface area of 50 acres and a storage...

  1. Eclectic approach to anxiety disorders among rural children.

    Science.gov (United States)

    Ahmadi, Atefeh; Mustaffa, Mohamed Sharif; Haghdoost, Ali Akbar; Mansor, Syed Mohamed Shafeq

    2017-01-01

    Anxiety disorders in primary school-aged children negatively affect their mental health and psychological development. Available non-medical treatments for these conditions are time-consuming and expensive. In this context, eclectic therapy is a therapeutic approach that incorporates some therapeutic techniques and philosophies to create the ideal treatment. In this study, eclectic therapy consisted of art therapy and cognitive-behavioral therapy designed for children suffering from high level of anxiety in their middle childhood years. The therapy also included group guidance sessions for their mothers. The effectiveness of this intervention was examined in the study. 61 students aged 9-12 years with high levels of anxiety participated in the study. Intervention A (n = 20) consisted of 9-hour eclectic therapy for children with 3-hour group guidance sessions for their mothers. Intervention B (n = 20) consisted of 9-hour eclectic therapy for children. There was also a control group (n = 21). Teacher ratings of children's mental health difficulties and self-report ratings of anxiety disorders indicated a significant difference from pretest to posttest, revealing a large effect size between the two interventions. Higher levels of pretest scores significantly predicted higher posttest scores for all domains of anxiety and mental health difficulties. Furthermore, age, gender, mothers working a 15-hour day, mother's educational level, parental divorce rates, parental death, and family monthly income predicted therapy outcomes. Results provide support for the effectiveness of eclectic art and CBT to improve children's mental health and reduce anxiety through changing thoughts, beliefs, emotions, and behaviors that may cause fear and anxiety.

  2. Adult Attachment as a Moderator of Treatment Outcome for Generalized Anxiety Disorder: Comparison Between Cognitive–Behavioral Therapy (CBT) Plus Supportive Listening and CBT Plus Interpersonal and Emotional Processing Therapy

    Science.gov (United States)

    Newman, Michelle G.; Castonguay, Louis G.; Jacobson, Nicholas C.; Moore, Ginger A.

    2016-01-01

    Objective To determine whether baseline dimensions of adult insecure attachment (avoidant and anxious) moderated outcome in a secondary analysis of a randomized controlled trial comparing cognitive–behavioral therapy (CBT) plus supportive listening (CBT + SL) versus CBT plus interpersonal and emotional processing therapy (CBT + I/EP). Method Eighty-three participants diagnosed with generalized anxiety disorder (GAD) were recruited from the community and assigned randomly to CBT + SL (n = 40) or to CBT + I/EP (n = 43) within a study using an additive design. PhD-level psychologists treated participants. Blind assessors evaluated participants at pretreatment, posttreatment, 6-month, 12-month, and 2-year follow-up with a composite of self-report and assessor-rated GAD symptom measures (Penn State Worry Questionnaire, Hamilton Anxiety Rating Scale, Clinician’s Severity Rating). Avoidant and anxious attachment were assessed using self-reported dismissing and angry states of mind, respectively, on the Perceptions of Adult Attachment Questionnaire. Results Consistent with our prediction, at all assessments higher levels of dismissing styles in those who received CBT + I/EP predicted greater change in GAD symptoms compared with those who received CBT + SL for whom dismissiveness was unrelated to the change. At postassessment, higher angry attachment was associated with less change in GAD symptoms for those receiving CBT + I/EP, compared with CBT + SL, for whom anger was unrelated to change in GAD symptoms. Pretreatment attachment-related anger failed to moderate outcome at other time points and therefore, these moderation effects were more short-lived than the ones for dismissing attachment. Conclusions When compared with CBT + SL, CBT + I/EP may be better for individuals with GAD who have relatively higher dismissing styles of attachment. PMID:26052875

  3. Adult attachment as a moderator of treatment outcome for generalized anxiety disorder: Comparison between cognitive-behavioral therapy (CBT) plus supportive listening and CBT plus interpersonal and emotional processing therapy.

    Science.gov (United States)

    Newman, Michelle G; Castonguay, Louis G; Jacobson, Nicholas C; Moore, Ginger A

    2015-10-01

    To determine whether baseline dimensions of adult insecure attachment (avoidant and anxious) moderated outcome in a secondary analysis of a randomized controlled trial comparing cognitive-behavioral therapy (CBT) plus supportive listening (CBT + SL) versus CBT plus interpersonal and emotional processing therapy (CBT + I/EP). Eighty-three participants diagnosed with generalized anxiety disorder (GAD) were recruited from the community and assigned randomly to CBT + SL (n = 40) or to CBT + I/EP (n = 43) within a study using an additive design. PhD-level psychologists treated participants. Blind assessors evaluated participants at pretreatment, posttreatment, 6-month, 12-month, and 2-year follow-up with a composite of self-report and assessor-rated GAD symptom measures (Penn State Worry Questionnaire, Hamilton Anxiety Rating Scale, Clinician's Severity Rating). Avoidant and anxious attachment were assessed using self-reported dismissing and angry states of mind, respectively, on the Perceptions of Adult Attachment Questionnaire. Consistent with our prediction, at all assessments higher levels of dismissing styles in those who received CBT + I/EP predicted greater change in GAD symptoms compared with those who received CBT + SL for whom dismissiveness was unrelated to the change. At postassessment, higher angry attachment was associated with less change in GAD symptoms for those receiving CBT + I/EP, compared with CBT + SL, for whom anger was unrelated to change in GAD symptoms. Pretreatment attachment-related anger failed to moderate outcome at other time points and therefore, these moderation effects were more short-lived than the ones for dismissing attachment. When compared with CBT + SL, CBT + I/EP may be better for individuals with GAD who have relatively higher dismissing styles of attachment. (c) 2015 APA, all rights reserved).

  4. Interpretation and expectations among mothers of children with anxiety disorders: associations with maternal anxiety disorder.

    Science.gov (United States)

    Orchard, Faith; Cooper, Peter J; Phil, D; Creswell, Cathy

    2015-02-01

    Models of the development and maintenance of childhood anxiety suggest an important role for parent cognitions: that is, negative expectations of children's coping abilities lead to parenting behaviors that maintain child anxiety. The primary aims of the current study were to (1) compare expectations of child vulnerability and coping among mothers of children with anxiety disorders on the basis of whether or not mothers also had a current anxiety disorder, and (2) examine the degree to which the association between maternal anxiety disorder status and child coping expectations was mediated by how mothers interpreted ambiguous material that referred to their own experience. The association between interpretations of threat, negative emotion, and control was assessed using hypothetical ambiguous scenarios in a sample of 271 anxious and nonanxious mothers of 7- to 12-year-old children with an anxiety disorder. Mothers also rated their expectations when presented with real life challenge tasks. There was a significant association between maternal anxiety disorder status and negative expectations of child coping behaviors. Mothers’ self-referent interpretations were found to mediate this relationship. Responses to ambiguous hypothetical scenarios correlated significantly with responses to real life challenge tasks. Treatments for childhood anxiety disorders in the context of parental anxiety disorders may benefit from the inclusion of a component to directly address parental cognitions. Some inconsistencies were found when comparing maternal expectations in response to hypothetical scenarios with real life challenges. This should be addressed in future research.

  5. Trauma-affected refugees

    DEFF Research Database (Denmark)

    Sonne, Charlotte Kærgaard

    2016-01-01

    received the same manual-based Cognitive Behavioural Therapy (CBT) as well as social counselling. The mean length of the treatment course was 6.3 months. The primary outcome measure was self-reported PTSD symptoms assessed on the Harvard Trauma Questionnaire (HTQ). Other outcome measures were self......-reported depression and anxiety symptoms measured on Hopkins Symptom Check List-25 (HSCL-25), self-reported social functioning measured on the Social Adjustment Scale Self Report, short version (SAS-SR), and observer-rated depression and anxiety symptoms assessed on the Hamilton Depression and Anxiety Ratings Scales...... (HAM D+A ). Social support was assessed on the Crisis Support Scale (CSS), level of functioning assessed on the Sheehan Disability Scale (SDS), quality of life was assessed on the WHO-5, the somatisation items of the Symptom Checklist-90 (SCL-90), pain in four different body areas measured on Visual...

  6. Calculation of blade-data for the Hamilton standard structural analysis of the composite blade for the 18 meter diameter rotor and a comparison with FFA-calculation

    Energy Technology Data Exchange (ETDEWEB)

    Lundemo, C

    1979-04-01

    Section property data for the composite blade manufactured by Karlskronavarvet was calculated for the analysis performed by Hamilton Standard. The HS investigation was carried out for various operating conditions, including dynamic response loads, stresses, frequencies and dynamic stability. The Hamilton Standard results has been compared with the FFA (The Aeronautical Research Institute of Sweden) calculation. The results show that the stresses and moments calculated by HS never exceed the allowable levels for the hinged hub configuration. The natural frequencies seem to agree quite well with the measured frequencies. In the input data of the Hamilton Standard dynamic response analysis a too far aft position of the cordwise center of gravity of the outher third of the blade was used. Correct position will give lower stresses.

  7. The assessment and treatment of performance anxiety in musicians.

    Science.gov (United States)

    Clark, D B; Agras, W S

    1991-05-01

    Performance anxiety in musicians may be severe enough to require intervention but has been the subject of relatively little clinical research. The authors' objectives were to describe the results of a comprehensive clinical and laboratory assessment and to perform a double-blind, placebo-controlled study comparing buspirone, cognitive-behavior therapy, and the combination of these treatments for performance anxiety. Ninety-four subjects were recruited by mass media announcements and were seen in a university-based outpatient psychiatric clinic. Assessments were 1) questionnaires for all 94 subjects, 2) diagnostic interview of 50 subjects, and 3) laboratory performance of 34 subjects. Treatment conditions were 1) 6 weeks of buspirone, 2) 6 weeks of placebo, 3) a five-session, group cognitive-behavior therapy program with buspirone, or 4) the cognitive-behavior therapy program with placebo. Treatment outcome measures included subjective anxiety ratings and heart rate measures during a laboratory performance, a questionnaire measure of performance confidence, and a blind rating of musical performance quality. All subjects fulfilled criteria for DSM-III-R social phobia. Of the 15 full-time professional musicians, ten had tried propranolol and three had stopped performing. Most of the subjects had substantial anxiety and heart rate increases during laboratory speech and musical performances. Cognitive-behavior therapy resulted in statistically significant reductions in subjective anxiety, improved quality of musical performance, and improved performance confidence. Buspirone was not an effective treatment. Cognitive-behavior therapy is a viable treatment approach for performance anxiety in musicians.

  8. In Schizophrenia, Depression, Anxiety, and Physiosomatic Symptoms Are Strongly Related to Psychotic Symptoms and Excitation, Impairments in Episodic Memory, and Increased Production of Neurotoxic Tryptophan Catabolites: a Multivariate and Machine Learning Study.

    Science.gov (United States)

    Kanchanatawan, Buranee; Thika, Supaksorn; Sirivichayakul, Sunee; Carvalho, André F; Geffard, Michel; Maes, Michael

    2018-04-01

    The depression, anxiety and physiosomatic symptoms (DAPS) of schizophrenia are associated with negative symptoms and changes in tryptophan catabolite (TRYCAT) patterning. The aim of this study is to delineate the associations between DAPS and psychosis, hostility, excitation, and mannerism (PHEM) symptoms, cognitive tests as measured using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) and IgA/IgM responses to TRYCATs. We included 40 healthy controls and 80 participants with schizophrenia. Depression and anxiety symptoms were measured with The Hamilton Depression (HAM-D) and Anxiety (HAM-A) Rating Scales, respectively. Physiosomatic symptoms were assessed with the Fibromyalgia and Chronic Fatigue Syndrome Rating Scale (FF). Negative symptoms as well as CERAD tests, including Verbal Fluency Test (VFT), Mini-Mental State Examination (MMSE), Word List Memory (WLM), and WL Delayed Recall were measured, while ratios of IgA responses to noxious/protective TRYCATs (IgA NOX_PRO) were computed. Schizophrenia symptoms consisted of two dimensions, a first comprising PHEM and negative symptoms, and a second DAPS symptoms. A large part of the variance in DAPS was explained by psychotic symptoms and WLM. Of the variance in HAM-D, 58.9% was explained by the regression on excitement, IgA NOX_PRO ratio, WLM, and VFT; 29.9% of the variance in HAM-A by psychotic symptoms and IgA NOX/PRO; and 45.5% of the variance in FF score by psychotic symptoms, IgA NOX/PRO, and WLM. Neural network modeling shows that PHEM, IgA NOX_PRO, WLM, and MMSE are the dominant variables predicting DAPS. DAPS appear to be driven by PHEM and negative symptoms coupled with impairments in episodic memory, especially false memory creation, while all symptom dimension and cognitive impairments may be driven by an increased production of noxious TRYCATs, including picolinic, quinolinic, and xanthurenic acid.

  9. Trait vs. state anxiety in different threatening situations

    Directory of Open Access Journals (Sweden)

    Pollyana Caldeira Leal

    2017-08-01

    Full Text Available Abstract Objective Anxiety as a uni- or multidimensional construct has been under discussion. The unidimensional approach assumes that there is a general trait anxiety, which predisposes the individuals to increases in state anxiety in various threatening situations. In this case, there should be a correlation between state and trait anxiety in any situation of threat. Therefore, the aim of this study was to investigate the correlation between trait and state anxiety in participants exposed to two different anxiogenic situations: interpersonal threat (Video-Monitored Stroop Test – VMST and physical threat (third molar extraction – TME. Methods Participants with various levels of trait anxiety (general trait: State-Trait Anxiety Inventory – STAI, Hospital Anxiety and Depression Scale; specific trait: Social Phobia Inventory, Dental Anxiety Scale had their anxious state evaluated (STAI, self-evaluation of tension level, heart rate, electromyogram activity before, during and after the VMST or the TME. Results In VMST, trait anxiety correlated to state anxiety (psychological parameters in all test phases. However, in TME, the only trait measurement that correlated to state anxiety (psychological parameters was the Dental Anxiety Scale. Conclusion Trait anxiety correlates positively to state anxiety in situations of interpersonal threat, but not of physical threat.

  10. Hamilton Place - Ontario Canadá

    Directory of Open Access Journals (Sweden)

    Garwood-Jones, T. P.

    1975-04-01

    Full Text Available Although comparatively modest as to its exterior, the interior of the theatre-auditorium Hamilton Place has been most successfully solved, both as regards design and acoustics. Construction techniques and elements have been utilized to achieve two different sections in one and the same hall with on one hand the capacity to be able to capture shades of the spoken word at theatrical functions and on the other to reproduce the sharpness and variety of orchestras and choirs. The following elements deserve special mention: the mobile wall which incorporates the orchestra into the hall by closing the proscenium arch; the two elevating platforms where the orchestra is placed; the vertical velvet surfaces, hung like banners which soften the repercussion of the sound; the mobile horizontal surfaces over the orchestra that direct and orient the sound. The most interesting construction techniques are: the subdivision of the building into different parts, each one with independent foundation so as to avoid the transmission of the sound from one section to the other; the texture of the brick walls that disperse the reflected sound; and the use of counterforts to create smaller more personal sections for varied use. The acoustic characteristics are improved by means of a sound installation, formed by small loudspeakers placed under each seat and by other bigger ones distributed in the walls that surround the hall. The building is completed by various service installations that are appropriate to this type of construction, as well as by a small theatre-studio for the rehearsals of the orchestra and the actors, while other functions are going on in the main hall.El teatro-auditorio Hamilton Place, aunque relativamente modesto por fuera, tiene soluciones muy afortunadas en el interior, tanto por su diseño como por su adecuación acústica. Se han utilizado elementos y técnicas constructivas destinadas a conseguir, en una única sala, dos espacios

  11. 78 FR 22872 - Hamilton Street Hydro, LLC; Notice of Preliminary Permit Application Accepted for Filing and...

    Science.gov (United States)

    2013-04-17

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 14499-000] Hamilton Street... Project would consist of the following: (1) An existing 20-foot-high concrete gravity dam with a 690-foot-long spillway; (2) an existing impoundment having a surface area of 300 acres and a storage capacity of...

  12. Mothers' and Fathers' Ratings of Family Relationship Quality: Associations with Preadolescent and Adolescent Anxiety and Depressive Symptoms in a Clinical Sample

    Science.gov (United States)

    Queen, Alexander H.; Stewart, Lindsay M.; Ehrenreich-May, Jill; Pincus, Donna B.

    2013-01-01

    This study examined the independent associations among three family relationship quality factors--cohesion, expressiveness, and conflict--with youth self-reported depressive and anxiety symptoms in a clinical sample of anxious and depressed youth. Ratings of family relationship quality were obtained through both mother and father report. The…

  13. Direct manipulation of physiological arousal in induced anxiety therapy - biofeedback approach.

    Science.gov (United States)

    Sappington, A A

    1977-10-01

    This study investigated the role of physiological arousal in the affect induction phase of Induced Anxiety therapy by using biofeedback to facilitate arousal. Twenty-one college students who were suffering from free-floating anxiety were assigned randomly to one of three groups: (1) a no-treatment control group simply completed the measures before and after therapy; (2) a conventional Induced Anxiety group went through five standard Induced Anxiety sessions; and (3) biofeedback Induced Anxiety group went through a similar procedure except that biofeedback was used in the affect induction phase to facilitate heart rate increase. It was found that the biofeedback procedure did result in a greater heart rate increase during the affect induction phase arousal than did the conventional procedure (.01 level of significance), but did not facilitate subjective emotional arousal. Biofeedback Induced Anxiety resulted in a greater reduction of trait anxiety as measured by the Multiple Affect Adjective Check List than did the no-treatment group or the conventonal Induced Anxiety group. The conventional Induced Anxiety group did not differ significantly from the no-treatment control group.

  14. The moderating role of avoidance behavior on anxiety over time: Is there a difference between social anxiety disorder and specific phobia?

    Directory of Open Access Journals (Sweden)

    Myriam Rudaz

    Full Text Available Theories of anxiety disorders and phobias have ascribed a critical role to avoidance behavior in explaining the persistence of fear and anxiety, but knowledge about the role of avoidance behavior in the maintenance of anxiety in social anxiety disorder relative to specific phobia is lacking. This study examined the extent to which avoidance behavior moderates the relationship between general anxiety at baseline and 18 months later in women with a diagnosed social anxiety disorder (n = 91 and women with a diagnosed specific phobia (n = 130 at baseline. Circumscribed avoidance of social and specific situations were clinician-rated using the Anxiety Disorders Interview Schedule-Lifetime (ADIS-IV-L, and general anxiety was measured using the Beck Anxiety Inventory (BAI. Moderated regression analyses revealed that (a general anxiety at baseline predicted general anxiety at follow-up in both women with a specific phobia and women with a social anxiety disorder and (b avoidance behavior moderated this relationship in women with a specific phobia but not in women with a social anxiety disorder. Specifically, high avoidance behavior was found to amplify the effect between general anxiety at baseline and follow-up in specific phobia. Reasons for the absence of a similar moderating effect of avoidance behavior within social anxiety disorder are discussed.

  15. The moderating role of avoidance behavior on anxiety over time: Is there a difference between social anxiety disorder and specific phobia?

    Science.gov (United States)

    Rudaz, Myriam; Ledermann, Thomas; Margraf, Jürgen; Becker, Eni S.; Craske, Michelle G.

    2017-01-01

    Theories of anxiety disorders and phobias have ascribed a critical role to avoidance behavior in explaining the persistence of fear and anxiety, but knowledge about the role of avoidance behavior in the maintenance of anxiety in social anxiety disorder relative to specific phobia is lacking. This study examined the extent to which avoidance behavior moderates the relationship between general anxiety at baseline and 18 months later in women with a diagnosed social anxiety disorder (n = 91) and women with a diagnosed specific phobia (n = 130) at baseline. Circumscribed avoidance of social and specific situations were clinician-rated using the Anxiety Disorders Interview Schedule-Lifetime (ADIS-IV-L), and general anxiety was measured using the Beck Anxiety Inventory (BAI). Moderated regression analyses revealed that (a) general anxiety at baseline predicted general anxiety at follow-up in both women with a specific phobia and women with a social anxiety disorder and (b) avoidance behavior moderated this relationship in women with a specific phobia but not in women with a social anxiety disorder. Specifically, high avoidance behavior was found to amplify the effect between general anxiety at baseline and follow-up in specific phobia. Reasons for the absence of a similar moderating effect of avoidance behavior within social anxiety disorder are discussed. PMID:28671977

  16. The moderating role of avoidance behavior on anxiety over time: Is there a difference between social anxiety disorder and specific phobia?

    Science.gov (United States)

    Rudaz, Myriam; Ledermann, Thomas; Margraf, Jürgen; Becker, Eni S; Craske, Michelle G

    2017-01-01

    Theories of anxiety disorders and phobias have ascribed a critical role to avoidance behavior in explaining the persistence of fear and anxiety, but knowledge about the role of avoidance behavior in the maintenance of anxiety in social anxiety disorder relative to specific phobia is lacking. This study examined the extent to which avoidance behavior moderates the relationship between general anxiety at baseline and 18 months later in women with a diagnosed social anxiety disorder (n = 91) and women with a diagnosed specific phobia (n = 130) at baseline. Circumscribed avoidance of social and specific situations were clinician-rated using the Anxiety Disorders Interview Schedule-Lifetime (ADIS-IV-L), and general anxiety was measured using the Beck Anxiety Inventory (BAI). Moderated regression analyses revealed that (a) general anxiety at baseline predicted general anxiety at follow-up in both women with a specific phobia and women with a social anxiety disorder and (b) avoidance behavior moderated this relationship in women with a specific phobia but not in women with a social anxiety disorder. Specifically, high avoidance behavior was found to amplify the effect between general anxiety at baseline and follow-up in specific phobia. Reasons for the absence of a similar moderating effect of avoidance behavior within social anxiety disorder are discussed.

  17. İki uçlu bozuklukta damgalanma hissinin işlevsellik üzerine etkisi

    OpenAIRE

    Aydemir, Ömer

    2014-01-01

    Objective: It has been shown that self-stigmatization causes low self-esteem and social anxiety in bipolar patients. In this study it is aimed to demonstrate the impact of self-stigmatization on psychosocial functioning in bipolar disorder. Method: The study was carried out with 70 patients diagnosed with bipolar disorder. All patients were in remission and the remission state was confirmed by a 17-item Hamilton Depression Rating Scale score less than 7 and a Young Mania Rating Scale score...

  18. Pindolol augmentation in patients with treatment-resistant panic disorder: A double-blind, placebo-controlled trial.

    Science.gov (United States)

    Hirschmann, S; Dannon, P N; Iancu, I; Dolberg, O T; Zohar, J; Grunhaus, L

    2000-10-01

    The objective of this study was to determine the efficacy of pindolol as an augmentor of fluoxetine in treatment-resistant panic disorder (PD). Twenty-five outpatients having PD with or without agoraphobia were included. These patients had not responded to two different trials with antidepressants and an 8-week trial of fluoxetine 20 mg/day. Treatment-resistant PD was defined as a less than 20% reduction in score on the Panic Self-Questionnaire (number of attacks per week) (PSQ) and the Clinical Anxiety Scale With Panic Attacks (CAS+PA). These patients continued to receive fluoxetine 20 mg/day and were randomly assigned to additionally receive either pindolol (2.5 mg three times daily) or placebo for the following 4 weeks. Evaluations were performed weekly using the Hamilton Rating Scale for Anxiety, the Hamilton Rating Scale for Depression (HAM-D), the CAS+PA, the NIMH Anxiety Scale, the PSQ, and the Clinical Global Impression Scale. The data were analyzed using a repeated-measures analysis of variance (ANOVA) and a t-test for independent samples. Patients treated with the combination of pindolol and fluoxetine (N = 13) demonstrated a significant improvement over the patients treated with fluoxetine and placebo on all rating scales, with the exception of HAM-D. The statistical differences were shown using the repeated-measures ANOVA (baseline, week 2, week 4) and also with t-tests from the second week of the trial. These preliminary results demonstrate that pindolol has an augmenting effect on fluoxetine in patients with treatment-resistant PD.

  19. The effect of fecal microbiota transplantation on psychiatric symptoms among patients with irritable bowel syndrome, functional diarrhea and functional constipation: An open-label observational study.

    Science.gov (United States)

    Kurokawa, Shunya; Kishimoto, Taishiro; Mizuno, Shinta; Masaoka, Tatsuhiro; Naganuma, Makoto; Liang, Kuo-Ching; Kitazawa, Momoko; Nakashima, Moeko; Shindo, Chie; Suda, Wataru; Hattori, Masahira; Kanai, Takanori; Mimura, Masaru

    2018-08-01

    The intestinal microbiota is considered as a potential common underpinning pathophysiology of Functional Gastrointestinal Disorders (FGIDs) and psychiatric disorders such as depression and anxiety. Fecal Microbiota Transplantation (FMT) has been reported to have therapeutic effects on diseases related to dysbiosis, but few studies have evaluated its effect on psychiatric symptoms. We followed 17 patients with either Irritable Bowel Syndrome (IBS), Functional Diarrhea (FDr) or Functional Constipation (FC) who underwent FMT for the treatment of gastrointestinal symptoms and observation of psychiatric symptoms. Changes in Hamilton Rating Scale for Depression (HAM-D) and subscale of sleep-related items, Hamilton Rating Scale for Anxiety (HAM-A) and Quick Inventory for Depressive Symptoms (QIDS) between baseline and 4 weeks after FMT, and relationship with the intestinal microbiota were measured. At baseline, 12 out of 17 patients were rated with HAM-D ≥ 8. Significant improvement in HAM-D total and sleep subscale score, HAM-A and QIDS were observed (p = 0.007, p = 0.007, p = 0.01, p = 0.007, respectively). Baseline Shannon index indicated that microbiota showed lower diversity in patients with HAM-D ≥ 8 compared to those of healthy donors and patients with HAM-D control group. Our results suggest that depression and anxiety symptoms may be improved by FMT regardless of gastrointestinal symptom change in patients with IBS, FDr and FC, and the increase of microbiota diversity may help to improve patient's mood. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. Eclectic approach to anxiety disorders among rural children

    Directory of Open Access Journals (Sweden)

    Atefeh Ahmadi

    Full Text Available Abstract Introduction Anxiety disorders in primary school-aged children negatively affect their mental health and psychological development. Available non-medical treatments for these conditions are time-consuming and expensive. In this context, eclectic therapy is a therapeutic approach that incorporates some therapeutic techniques and philosophies to create the ideal treatment. In this study, eclectic therapy consisted of art therapy and cognitive-behavioral therapy designed for children suffering from high level of anxiety in their middle childhood years. The therapy also included group guidance sessions for their mothers. The effectiveness of this intervention was examined in the study. Methods 61 students aged 9-12 years with high levels of anxiety participated in the study. Intervention A (n = 20 consisted of 9-hour eclectic therapy for children with 3-hour group guidance sessions for their mothers. Intervention B (n = 20 consisted of 9-hour eclectic therapy for children. There was also a control group (n = 21. Results Teacher ratings of children’s mental health difficulties and self-report ratings of anxiety disorders indicated a significant difference from pretest to posttest, revealing a large effect size between the two interventions. Higher levels of pretest scores significantly predicted higher posttest scores for all domains of anxiety and mental health difficulties. Furthermore, age, gender, mothers working a 15-hour day, mother’s educational level, parental divorce rates, parental death, and family monthly income predicted therapy outcomes. Conclusion Results provide support for the effectiveness of eclectic art and CBT to improve children’s mental health and reduce anxiety through changing thoughts, beliefs, emotions, and behaviors that may cause fear and anxiety.

  1. Social Skills as a Mediator between Anxiety Symptoms and Peer Interactions among Children and Adolescents

    Science.gov (United States)

    Motoca, Luci M.; Williams, Sandra; Silverman, Wendy K.

    2012-01-01

    Objective The present study used a cross-sectional design to examine the relations among youth anxiety symptoms, positive and negative peer interactions, and social skills. Also examined was the mediating role of social skills in the relations between youth anxiety symptoms and positive and negative peer interactions. Youth sex and age were examined as moderators. Method The sample consisted of 397 children and adolescents (M = 10.11 years; 53.4% boys; 74.8% Hispanic Latino) referred to an anxiety disorders clinic. Anxiety symptoms, positive and negative peer interactions, and social skills were assessed using youth and parent ratings. Results Structural equation modeling results indicated that for youth ratings only, youth anxiety symptoms were negatively related to positive peer interactions controlling for primary social phobia and comorbid depressive disorders. For both youth and parent ratings, youth anxiety symptoms were positively related to negative peer interactions and negatively related to social skills. Also for both youth and parent ratings, social skills mediated the relations between youth anxiety symptoms and positive and negative peer interactions. For parent ratings only, the effects of youth anxiety symptoms and social skills on peer interactions were significantly moderated by youth age. Youth sex was not a significant moderator using youth and parent ratings. Conclusions Findings suggest difficulties with social skills and peer interactions are problematic features of youth referred for anxiety problems. Findings highlight the need to improve understanding of anxiety symptoms, social skills, and peer interactions in this population. PMID:22471319

  2. Social skills as a mediator between anxiety symptoms and peer interactions among children and adolescents.

    Science.gov (United States)

    Motoca, Luci M; Williams, Sandra; Silverman, Wendy K

    2012-01-01

    The present study used a cross-sectional design to examine the relations among youth anxiety symptoms, positive and negative peer interactions, and social skills. Also examined was the mediating role of social skills in the relations between youth anxiety symptoms and positive and negative peer interactions. Youth sex and age were examined as moderators. The sample consisted of 397 children and adolescents (M = 10.11 years; 53.4% boys; 74.8% Hispanic Latino) referred to an anxiety disorders clinic. Anxiety symptoms, positive and negative peer interactions, and social skills were assessed using youth and parent ratings. Structural equation modeling results indicated that for youth ratings only, youth anxiety symptoms were negatively related to positive peer interactions controlling for primary social phobia and comorbid depressive disorders. For both youth and parent ratings, youth anxiety symptoms were positively related to negative peer interactions and negatively related to social skills. Also for both youth and parent ratings, social skills mediated the relations between youth anxiety symptoms and positive and negative peer interactions. For parent ratings only, the effects of youth anxiety symptoms and social skills on peer interactions were significantly moderated by youth age. Youth sex was not a significant moderator using youth and parent ratings. Findings suggest that difficulties with social skills and peer interactions are problematic features of youth referred for anxiety problems. Findings highlight the need to improve understanding of anxiety symptoms, social skills, and peer interactions in this population.

  3. Depression and Anxiety in University Music Students

    Science.gov (United States)

    Wristen, Brenda G.

    2013-01-01

    Performance anxiety among musicians and music students has been widely addressed, but far less attention has been given to examining the rates and characteristics of broader mental distress in this population. This study examined depression and anxiety in music students at one university. A considerable number of students reported symptoms…

  4. The role of interfacial layers in the enhanced thermal conductivity of nanofluids: A renovated Hamilton-Crosser model

    International Nuclear Information System (INIS)

    Yu, W; Choi, S.U.S.

    2004-01-01

    We previously developed a renovated Maxwell model for the effective thermal conductivity of nanofluids and determined that the solid/liquid interfacial layers play an important role in the enhanced thermal conductivity of nanofluids. However, this renovated Maxwell model is limited to suspensions with spherical particles. Here, we extend the Hamilton--Crosser model for suspensions of nonspherical particles to include the effect of a solid/liquid interface. The solid/liquid interface is described as a confocal ellipsoid with a solid particle. The new model for the three-phase suspensions is mathematically expressed in terms of the equivalent thermal conductivity and equivalent volume fraction of anisotropic complex ellipsoids, as well as an empirical shape factor. With a generalized empirical shape factor, the renovated Hamilton--Crosser model correctly predicts the magnitude of the thermal conductivity of nanotube-in-oil nanofluids. At present, this new model is not able to predict the nonlinear behavior of the nanofluid thermal conductivity

  5. The Efficacy of Neurofeedback in Patients with Major Depressive Disorder: An Open Labeled Prospective Study.

    Science.gov (United States)

    Cheon, Eun-Jin; Koo, Bon-Hoon; Choi, Joong-Hyun

    2016-03-01

    The purpose of this study was to evaluate the effect of neurofeedback on depressive symptoms and electrophysiological disturbances in patients with major depressive disorder. We recruited participants suffering from depression to evaluate efficacy of left prefrontal beta with alpha/theta training. An 8-week, prospective, open-label study was undertaken. Twenty participants were recruited. The treatment protocol was twice or three times a week training of beta at F3 with alpha/theta at Pz for 8 weeks. When every visit, patients were received beta training for 30 min, and then alpha/theta training for 30 min. Baseline, 4 and 8 week scores of; the Hamilton rating scale for Depression (HAM-D), the Hamilton rating scale for Anxiety (HAM-A), the Beck Depression Inventory (BDI)-II, the Beck Anxiety Inventory (BAI), Clinical global impression-severity (CGI-S), and pre- and post-treatment resting state EEGs were compared. Interhemispheric alpha power asymmetry (A score) was computed for homologous sites F3-F4. Pre- and post-training clinical assessments revealed significant improvements in HAM-D, HAM-A, BDI, and CGI-S scores. Cumulative response rates by HAM-D were 35.0 and 75.0 % at 4 and 8 weeks, respectively, corresponding cumulative remission rates by HAM-D were 15.0 and 55.0 %, respectively. No significant differences were found between pre- and post-treatment A score. Neurofeedback treatment could improve depressive symptoms significantly. In addition, anxiety symptoms and clinical illness severity decreased significantly after neurofeedback treatment. Despite its several limitations, such as, small sample size and lack of a control group, this study suggested neurofeedback has significant effects in patients with major depressive disorder.

  6. Hamilton-Jacobi formalism for inflation with non-minimal derivative coupling

    International Nuclear Information System (INIS)

    Sheikhahmadi, Haidar; Saridakis, Emmanuel N.; Aghamohammadi, Ali; Saaidi, Khaled

    2016-01-01

    In inflation with nonminimal derivative coupling there is not a conformal transformation to the Einstein frame where calculations are straightforward, and thus in order to extract inflationary observables one needs to perform a detailed and lengthy perturbation investigation. In this work we bypass this problem by performing a Hamilton-Jacobi analysis, namely rewriting the cosmological equations considering the scalar field to be the time variable. We apply the method to two specific models, namely the power-law and the exponential cases, and for each model we calculate various observables such as the tensor-to-scalar ratio, and the spectral index and its running. We compare them with 2013 and 2015 Planck data, and we show that they are in a very good agreement with observations.

  7. Hamilton-Jacobi formalism for inflation with non-minimal derivative coupling

    Energy Technology Data Exchange (ETDEWEB)

    Sheikhahmadi, Haidar [Institute for Advance Studies in Basic Sciences (IASBS) Gava Zang, Zanjan 45137-66731 (Iran, Islamic Republic of); Saridakis, Emmanuel N. [Instituto de Física, Pontificia Universidad de Católica de Valparaíso, Casilla 4950, Valparaíso (Chile); Aghamohammadi, Ali [Sanandaj Branch Islamic Azad University (Iran, Islamic Republic of); Saaidi, Khaled, E-mail: h.sh.ahmadi@gmail.com, E-mail: Emmanuel_Saridakis@baylor.edu, E-mail: a.aqamohamadi@iausdj.ac.ir, E-mail: ksaaidi@uok.ac.ir [Department of Physics, Faculty of Science, University of Kurdistan, Sanandaj (Iran, Islamic Republic of)

    2016-10-01

    In inflation with nonminimal derivative coupling there is not a conformal transformation to the Einstein frame where calculations are straightforward, and thus in order to extract inflationary observables one needs to perform a detailed and lengthy perturbation investigation. In this work we bypass this problem by performing a Hamilton-Jacobi analysis, namely rewriting the cosmological equations considering the scalar field to be the time variable. We apply the method to two specific models, namely the power-law and the exponential cases, and for each model we calculate various observables such as the tensor-to-scalar ratio, and the spectral index and its running. We compare them with 2013 and 2015 Planck data, and we show that they are in a very good agreement with observations.

  8. Impact of Self-concept on Preschoolers’ Dental Anxiety and Behavior

    Directory of Open Access Journals (Sweden)

    Leila Erfanparast

    2015-09-01

    Full Text Available Background and aims. Different factors affect children’s behavior during dental treatment, including psychological and behavioral characteristics. The aim of this study was to evaluate the correlation of self-concept on child’s anxiety and be-havior during dental treatment in 4 to 6-year-old children. Materials and methods. A total of 235 preschoolers aged 4 to 6 years were included in this descriptive analytic study. Total self-concept score for each child was assessed according to Primary Self-concept Scale before dental treatment. Child’s anxiety and child’s behavior were assessed, during the restoration of mandibular primary molar, using clinical anxi-ety rating scale and Frankl Scale, respectively. Spearman’s correlation coefficient was used to evaluate the correlation be-tween the total self-concept score with the results of clinical anxiety rating scale and Frankl Scale. Results. There was a moderate inverse correlation between the self-concept and clinical anxiety rating scale scores (r = −0.545, P < 0.001, and a moderate correlation between the self-concept and child’s behavior scores (r = 0.491, P < 0.001. A strong inverse relation was also found between the anxiety and behavior scores (r = −0.91, P < 0.001. Conclusion. Children with higher self-concept had lower anxiety level and better behavioral feedback during dental treat-ment.

  9. Self-reported immature defense style as a predictor of outcome in short-term and long-term psychotherapy.

    Science.gov (United States)

    Laaksonen, Maarit A; Sirkiä, Carlos; Knekt, Paul; Lindfors, Olavi

    2014-07-01

    Identification of pretreatment patient characteristics predictive of psychotherapy outcome could help to guide treatment choices. This study evaluates patients' initial level of immature defense style as a predictor of the outcome of short-term versus long-term psychotherapy. In the Helsinki Psychotherapy Study, 326 adult outpatients with mood or anxiety disorder were randomized to individual short-term (psychodynamic or solution-focused) or long-term (psychodynamic) psychotherapy. Their defense style was assessed at baseline using the 88-item Defense Style Questionnaire and classified as low or high around the median value of the respective score. Both specific (Beck Depression Inventory [BDI], Hamilton Depression Rating Scale [HDRS], Symptom Check List Anxiety Scale [SCL-90-Anx], Hamilton Anxiety Rating Scale [HARS]) and global (Symptom Check List Global Severity Index [SCL-90-GSI], Global Assessment of Functioning Scale [GAF]) psychiatric symptoms were measured at baseline and 3-7 times during a 3-year follow-up. Patients with high use of immature defense style experienced greater symptom reduction in long-term than in short-term psychotherapy by the end of the 3-year follow-up (50% vs. 34%). Patients with low use of immature defense style experienced faster symptom reduction in short-term than in long-term psychotherapy during the first year of follow-up (34% vs. 19%). Knowledge of patients' initial level of immature defense style may potentially be utilized in tailoring treatments. Further research on defense styles as outcome predictors in psychotherapies of different types is needed.

  10. Hamilton's equations for a fluid membrane

    International Nuclear Information System (INIS)

    Capovilla, R; Guven, J; Rojas, E

    2005-01-01

    Consider a homogeneous fluid membrane described by the Helfrich-Canham energy, quadratic in the mean curvature of the membrane surface. The shape equation that determines equilibrium configurations is fourth order in derivatives and cubic in the mean curvature. We introduce a Hamiltonian formulation of this equation which dismantles it into a set of coupled first-order equations. This involves interpreting the Helfrich-Canham energy as an action; equilibrium surfaces are generated by the evolution of space curves. Two features complicate the implementation of a Hamiltonian framework. (i) The action involves second derivatives. This requires treating the velocity as a phase-space variable and the introduction of its conjugate momentum. The canonical Hamiltonian is constructed on this phase space. (ii) The action possesses a local symmetry-reparametrization invariance. The two labels we use to parametrize points on the surface are themselves physically irrelevant. This symmetry implies primary constraints, one for each label, that need to be implemented within the Hamiltonian. The two Lagrange multipliers associated with these constraints are identified as the components of the acceleration tangential to the surface. The conservation of the primary constraints implies two secondary constraints, fixing the tangential components of the momentum conjugate to the position. Hamilton's equations are derived and the appropriate initial conditions on the phase-space variables are identified. Finally, it is shown how the shape equation can be reconstructed from these equations

  11. Anxiety during pregnancy and autonomic nervous system activity: A longitudinal observational and cross-sectional study.

    Science.gov (United States)

    Mizuno, Taeko; Tamakoshi, Koji; Tanabe, Keiko

    2017-08-01

    To assess the longitudinal change in autonomic nervous system (ANS) activity during pregnancy and the association between anxiety during pregnancy and ANS activity. Pregnant Japanese women with a singleton fetus and normal pregnancy were recruited (n=65). ANS activity and anxiety were measured using a self-rating questionnaire at approximately 20, 30, and 36weeks of gestation. Very low (VLF) and high (HF) frequency bands of heart rate variability spectrums were used. Anxiety was assessed using the Japanese version of the State-Trait Anxiety Inventory. A score of 45 or more on trait-anxiety and the other represent the trait-anxiety group and the non- trait-anxiety group, respectively. The state-anxiety group and the non-state-anxiety group were defined in the same manner. Longitudinal observation of individual pregnant women indicated the significant increasing trend (p=0.002) of VLF power and the significant decreasing trend (p<0.001) of HF power during 20 to 36 gestation weeks. Compared with the non-trait-anxiety group, the trait-anxiety group had significantly lower VLF values at 20 gestational weeks (p=0.033) and had significantly lower HF values at 30 and 36 gestational weeks (p=0.015 and p=0.044, respectively). The increasing rate of VLF from 20 to 36 gestational weeks was higher among the trait-anxiety group. The same associations were observed between the state-anxiety and non-state-anxiety groups at 20 gestational weeks. Anxiety during pregnancy decreased heart rate variability. Anxiety in second trimester pregnancy promoted a subsequent increase in sympathetic activity. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Factor structure of the Liebowitz Social Anxiety Scale for Children and Adolescents.

    Science.gov (United States)

    Storch, Eric A; Masia-Warner, Carrie; Heidgerken, Amanda D; Fisher, Paige H; Pincus, Donna B; Liebowitz, Michael R

    2006-01-01

    The purpose of this study was to evaluate the factor structure of the Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA). The LSAS-CA was administered to 225 children and adolescents as a component of various clinical studies. In addition, other measures of psychopathology and impairment were administered to a subgroup of the sample. Confirmatory factor analyses of the social interaction and performance subscales for the anxiety and avoidance ratings yielded poor fit indices. Exploratory factor analysis supported a two-factor solution with a higher order factor for the LSAS-CA anxiety and avoidance ratings. Based on item content, factors were named Social and School Performance. The internal consistency of the factors was high and the convergent and divergent validity was supported vis-à-vis correlations with measures of depression and social anxiety, and clinician ratings of impairment and functioning. Findings suggest that the anxiety and avoidance ratings are best explained by a two-factor solution that measures social anxiety and avoidance in social and school performance interactions. This factor structure appears to be a reliable and valid framework for assessing childhood social phobia.

  13. The strategy does not matter: Effects of acceptance, reappraisal, and distraction on the course of anticipatory anxiety in social anxiety disorder.

    Science.gov (United States)

    Helbig-Lang, Sylvia; Rusch, Silke; Rief, Winfried; Lincoln, Tania M

    2015-12-01

    Anticipatory anxiety is a core feature of social anxiety disorder (SAD); however, there is a paucity of data on effective strategies for dealing with this affective state. The present study examined the effects of reappraisal, acceptance, and distraction on the course of anticipatory anxiety. The study used an experimental design, randomly assigning participants to one of three strategy groups. Participants were instructed to employ these strategies during the anticipation of an impromptu speech. Participants with SAD (n = 67) and healthy controls (n = 72) were compared with regard to their ability to adopt the prescribed strategies and with regard to the effects of strategy use on self-reported and psychophysiological markers of arousal. SAD participants reported more problems in adopting the assigned strategies than controls, although the time spent with each strategy did not differ by group. In both groups, acceptance was rated as more difficult to adopt than reappraisal and distraction. Subjective ratings of anxiety decreased during the first 10 min of anticipation regardless of diagnostic group or strategy, but anxiety increased again immediately prior to the speech. Psychophysiological parameters were largely unaffected by group or strategy. The results question whether there are differential benefits of different emotion regulation (ER) strategies in dealing with anticipatory anxiety. The observed rebound of anxiety prior to the social event calls into doubt the long-term effectiveness of these strategies, at least during the regulation of anticipatory anxiety. Coping with anticipatory anxiety is an important issue in treating SAD. Compared to healthy controls, individuals diagnosed with SAD experienced more problems in adopting prescribed ER strategies for dealing with anticipatory anxiety. We found no differences between acceptance, reappraisal, and distraction, calling into question that one strategy should be generally recommended by clinicians. © 2015

  14. Depression and anxiety in patients with oral squamous cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    PURPOSE: The aim of this study was to investigate symptoms of depression and anxiety in the patients with oral squamous cell carcinoma (OSCC). METHODS: 76 patients with oral squamous cell carcinoma participated in this program. All patients were rated with the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS). The mean scores of SAS and SDS were compared to those scores of the Norm of Chinese people. In addition, the different treatment results of the patients with different levels of anxiety and depression were studied. Further, the number of patients of SAS, SDS with more than 50 score were compared between primary cancer patients and recurrent cancer patients. RESULTS: The scores of SAS, SDS and the number of patients with more than 50 score in the patients group were obviously higher than those in Chinese Norm (P<0.01).The levels of anxiety and depression in 32 patients with recurrent cancer were more severe than those of 44 patients with primary cancer. The patients with anxiety and/or depression showed poor prognosis. CONCLUSION: Anxiety and depression are common symptoms in patients with OSCC and have negative effects on the prognosis, thus the psychological intervention for the patients must be carried out.

  15. The link between Foreign Language Classroom Anxiety, Second Language Tolerance of Ambiguity and Self-rated English proficiency among Chinese learners

    Directory of Open Access Journals (Sweden)

    Jean-Marc Dewaele

    2013-10-01

    Full Text Available Previous research has suggested that high levels of Foreign Language Classroom Anxiety (FLCA have a negative effect on foreign language learning (Horwitz, 2001; Lu & Liu, 2011 while moderate levels of Second Language Tolerance of Ambiguity (SLTA are believed to boost foreign language learning (Ely, 1995. There is prima facie evidence that both dimensions are inversely related as Foreign Language Learning contexts are full of ambiguities which may contribute to anxiety. However, the relationship between FLCA and SLTA has been under-researched. The present study is an attempt to fill this gap by investigating the link between SLTA and FLCA in English of 73 secondary school students in Hong Kong. They filled out an online questionnaire consisting of the Foreign Language Classroom Anxiety Scale (Horwitz, Horwitz, & Cope, 1986 and the Second Language Tolerance of Ambiguity Scale (Ely, 1995. Statistical analyses revealed that FLCA, SLTA and Self-rated English proficiency predict half of the variance in each other; in other words, students who were more tolerant of second language ambiguity were less anxious in their EFL classes and they also felt more proficient.

  16. The DSM-5 Dimensional Anxiety Scales in a Dutch non-clinical sample: psychometric properties including the adult separation anxiety disorder scale.

    Science.gov (United States)

    Möller, Eline L; Bögels, Susan M

    2016-09-01

    With DSM-5, the American Psychiatric Association encourages complementing categorical diagnoses with dimensional severity ratings. We therefore examined the psychometric properties of the DSM-5 Dimensional Anxiety Scales, a set of brief dimensional scales that are consistent in content and structure and assess DSM-5-based core features of anxiety disorders. Participants (285 males, 255 females) completed the DSM-5 Dimensional Anxiety Scales for social anxiety disorder, generalized anxiety disorder, specific phobia, agoraphobia, and panic disorder that were included in previous studies on the scales, and also for separation anxiety disorder, which is included in the DSM-5 chapter on anxiety disorders. Moreover, they completed the Screen for Child Anxiety Related Emotional Disorders Adult version (SCARED-A). The DSM-5 Dimensional Anxiety Scales demonstrated high internal consistency, and the scales correlated significantly and substantially with corresponding SCARED-A subscales, supporting convergent validity. Separation anxiety appeared present among adults, supporting the DSM-5 recognition of separation anxiety as an anxiety disorder across the life span. To conclude, the DSM-5 Dimensional Anxiety Scales are a valuable tool to screen for specific adult anxiety disorders, including separation anxiety. Research in more diverse and clinical samples with anxiety disorders is needed. © 2016 The Authors International Journal of Methods in Psychiatric Research Published by John Wiley & Sons Ltd. © 2016 The Authors International Journal of Methods in Psychiatric Research Published by John Wiley & Sons Ltd.

  17. Anxiety management groups in clinical practice.

    Science.gov (United States)

    Childs-Clarke, A; Whitfield, W; Cadbury, S; Sandu, S

    Anxiety symptoms are commonly reported both in patients and in the general population. There is also increasing concern being expressed over the widespread use of prescribed anxiolytics. This has encouraged the development of psychological interventions for both specific and generalised anxiety. In this paper, 29 patients, most of whom suffered from generalised or free-floating anxiety, were treated in small groups as part of a staff training programme. Their treatment was standardised, and consisted of progressive muscular relaxation, cognitive therapy and an educational input as to the nature of anxiety. Two measures, the Spielberger Trait Scale and an individualised problem rating scale were completed before and after the group and at three months follow-up. All but one of the results was statistically significant. The implications of these results are discussed.

  18. Double-blind, placebo-controlled pilot study of adjunctive quetiapine SR in the treatment of PMS/PMDD.

    Science.gov (United States)

    Jackson, Christine; Pearson, Brenda; Girdler, Susan; Johnson, Jacqueline; Hamer, Robert M; Killenberg, Susan; Meltzer-Brody, Samantha

    2015-11-01

    Premenstrual dysphoric disorder (PMDD), a more severe form of premenstrual syndrome (PMS), afflicts 5-8% of reproductive age women and results in significant functional impairment. We conducted a double-blind, placebo-controlled trial of adjunctive quetiapine in patients with PMS/PMDD who had inadequate response to selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitor therapy for their symptoms. A PMS/PMDD diagnosis was confirmed by 2-month prospective diagnostic assessment of PMS/PMDD using the Prospective Record of the Impact and Severity of Premenstrual Symptoms (PRISM) calendar. Women were randomized equally to receive quetiapine sustained-release (SR) or placebo (25-mg starting dose) during the luteal phase for 3 months. Outcome variables included the Hamilton Depression and Anxiety Scales, Clinical Global Impression Scale, and PRISM. Twenty women were enrolled in the treatment phase. Although the study was underpowered, greater reductions in luteal phase mood ratings were observed in the quetiapine group on the 17-item Hamilton Depression Rating Scale, Clinical Global Impression improvement rating, and PRISM daily score. The quetiapine group showed most improvement in symptoms of mood lability, anxiety, and irritability. This small double-blind study suggests that adjunctive treatment with quetiapine SR may be a useful addition to selective serotonin reuptake inhibitor therapy in women with PMS/PMDD by reducing symptoms and improving quality of life. Copyright © 2015 John Wiley & Sons, Ltd.

  19. Recognition of anxiety disorders by family physicians after rigorous medical record case extraction Results of the Netherlands Study of Depression and Anxiety

    NARCIS (Netherlands)

    Janssen, Evelien H. C.; van de Ven, Peter M.; Terluin, Berend; Verhaak, Peter F. M.; van Marwijk, Harm W. J.; Smolders, Mirrian; van der Meer, Klaas; Penninx, Brenda W. J. H.; van Hout, Hein P. J.

    2012-01-01

    Objective: Previous studies reported low and inconsistent rates of recognition of anxiety disorders by family physicians (FPs). Our objectives were to examine (a) which combination of indications within medical records most accurately reflects recognition of anxiety disorders and (b) whether patient

  20. Recognition of anxiety disorders by family physicians after rigorous medical record case extraction: results of the Netherlands Study of Depression and Anxiety.

    NARCIS (Netherlands)

    Janssen, E.H.C.; Ven, P.M. van de; Terluin, B.; Verhaak, P.F.M.; Marwijk, H.W.J. van; Smolders, M.; Meer, K. van der; Penninx, B.W.J.H.; Hout, H.P.J. van

    2012-01-01

    Objective: Previous studies reported low and inconsistent rates of recognition of anxiety disorders by family physicians (FPs). Our objectives were to examine (a) which combination of indications within medical records most accurately reflects recognition of anxiety disorders and (b) whether patient

  1. Relations among Social Anxiety, Eye Contact Avoidance, State Anxiety, and Perception of Interaction Performance during a Live Conversation.

    Science.gov (United States)

    Howell, Ashley N; Zibulsky, Devin A; Srivastav, Akanksha; Weeks, Justin W

    2016-01-01

    There is building evidence that highly socially anxious (HSA) individuals frequently avoid making eye contact, which may contribute to less meaningful social interactions and maintenance of social anxiety symptoms. However, research to date is lacking in ecological validity due to the usage of either static or pre-recorded facial stimuli or subjective coding of eye contact. The current study examined the relationships among trait social anxiety, eye contact avoidance, state anxiety, and participants' self-perceptions of interaction performance during a live, four-minute conversation with a confederate via webcam, and while being covertly eye-tracked. Participants included undergraduate women who conversed with same-sex confederates. Results indicated that trait social anxiety was inversely related to eye contact duration and frequency averaged across the four minutes, and positively related to state social anxiety and negative self-ratings. In addition, greater anticipatory state anxiety was associated with reduced eye contact throughout the first minute of the conversation. Eye contact was not related to post-task state anxiety or self-perception of poor performance; although, trends emerged in which these relations may be positive for HSA individuals. The current findings provide enhanced support for the notion that eye contact avoidance is an important feature of social anxiety.

  2. Statistics Anxiety and Business Statistics: The International Student

    Science.gov (United States)

    Bell, James A.

    2008-01-01

    Does the international student suffer from statistics anxiety? To investigate this, the Statistics Anxiety Rating Scale (STARS) was administered to sixty-six beginning statistics students, including twelve international students and fifty-four domestic students. Due to the small number of international students, nonparametric methods were used to…

  3. Social Anxiety and Social Support in Romantic Relationships.

    Science.gov (United States)

    Porter, Eliora; Chambless, Dianne L

    2017-05-01

    Little is known about the quality of socially anxious individuals' romantic relationships. In the present study, we examine associations between social anxiety and social support in such relationships. In Study 1, we collected self-report data on social anxiety symptoms and received, provided, and perceived social support from 343 undergraduates and their romantic partners. One year later couples were contacted to determine whether they were still in this relationship. Results indicated that men's social anxiety at Time 1 predicted higher rates of breakup at Time 2. Men's and women's perceived support, as well as men's provided support, were also significantly predictive of breakup. Social anxiety did not interact with any of the support variables to predict breakup. In Study 2, a subset of undergraduate couples with a partner high (n=27) or low (n=27) in social anxiety completed two 10-minute, lab-based, video-recorded social support tasks. Both partners rated their received or provided social support following the interaction, and trained observers also coded for support behaviors. Results showed that socially anxious individuals received less support from their partners during the interaction according to participant but not observer report. High and lower social anxiety couples did not differ in terms of the target's provision of support. Taken together, results suggest that social anxiety is associated with difficulties even in the context of established romantic relationships. Clinical implications are discussed. Copyright © 2016. Published by Elsevier Ltd.

  4. Are Anxiety and Depression the Same Disorder?

    Directory of Open Access Journals (Sweden)

    Carey, Stephen

    2015-06-01

    Full Text Available The issue of co-morbidity in Anxiety and Depression as disorders leads to questions about the integrity of their present taxonomies in mental health diagnostics. At face value the two appear to have discrete differences, yet nonetheless demonstrate a high co-morbidity rate and shared symptoms implying pathological similarities rather than that of chance. Reviewing evidence from behavioural, neural, and biological sources that elaborate on the aspects of these two constructs, helps to illustrate the nature of these apparent differences and similarities. Integrating evidence from the anxiety and depression literature with the pathological process best illustrated by the burnout theory, alongside with support from the neurobiology of anxiety and stress, presents a proposition of a basic and natural anxiety pathology that when excessive, may result in the symptoms psychology has come to know as representative of anxiety and depressive disorders.

  5. [Therapeutic effects of venlafaxine extended release for patients with depressive and anxiety disorders in the German outpatient setting - results of 2 observational studies including 8500 patients].

    Science.gov (United States)

    Anghelescu, I-G; Dierkes, W; Volz, H-P; Loeschmann, P-A; Schmitt, A B

    2009-11-01

    The therapeutic effects of venlafaxine extended release have been investigated by two prospective observational studies including 8506 patients in the outpatient setting of office based general practitioners and specialists. The efficacy has been documented by the Clinical Global Impression (CGI) scale and by the Hamilton depression (HAMD-21) scale. The tolerability has been assessed by the documentation of adverse events. About (2/3) of the patients were treated because of depression and about (1/3) mainly because of anxiety disorder. The patients of specialists did receive higher dosages and were more severely affected. The response rate on the CGI scale was 87.4 for the patients of general practitioners and 74.2 % for the patients of specialists. The results of the HAMD-21 scale, which has been used by specialists, showed a response rate of 71.8 and a remission rate of 56.3 %. These positive effects could be demonstrated even for the more severely and chronically affected patients. The incidence of adverse events was low in both studies and comparable to the tolerability profile of randomized studies. Importantly, the good tolerability profile was similar even for patients with concomitant cardiovascular disease. In conclusion, these results confirm the efficacy and good tolerability of venlafaxine extended release in the outpatient setting in Germany. Georg Thieme Verlag KG Stuttgart, New York.

  6. Effects of Heart Rate Variability Biofeedback on EEG Alpha Asymmetry and Anxiety Symptoms in Male Athletes: A Pilot Study.

    Science.gov (United States)

    Dziembowska, Inga; Izdebski, Paweł; Rasmus, Anna; Brudny, Janina; Grzelczak, Marta; Cysewski, Piotr

    2016-06-01

    Heart rate variability biofeedback (HRV-BFB) has been shown as useful tool to manage stress in various populations. The present study was designed to investigate whether the biofeedback-based stress management tool consisting of rhythmic breathing, actively self-generated positive emotions and a portable biofeedback device induce changes in athletes' HRV, EEG patterns, and self-reported anxiety and self-esteem. The study involved 41 healthy male athletes, aged 16-21 (mean 18.34 ± 1.36) years. Participants were randomly divided into two groups: biofeedback and control. Athletes in the biofeedback group received HRV biofeedback training, athletes in the control group didn't receive any intervention. During the randomized controlled trial (days 0-21), the mean anxiety score declined significantly for the intervention group (change-4 p athletes in biofeedback group showed substantial and statistically significant improvement in heart rate variability indices and changes in power spectra of both theta and alpha brain waves, and alpha asymmetry. These changes suggest better self-control in the central nervous system and better flexibility of the autonomic nervous system in the group that received biofeedback training. A HRV biofeedback-based stress management tool may be beneficial for stress reduction for young male athletes.

  7. Generalized anxiety disorder: comorbidity, comparative biology and treatment.

    Science.gov (United States)

    Nutt, David J; Ballenger, James C; Sheehan, David; Wittchen, Hans-Ulrich

    2002-12-01

    Generalized anxiety disorder (GAD) is a severe and chronic anxiety disorder characterized by uncontrollable worrying and somatic anxiety (tension, insomnia and hypervigilance). It is a common condition, with lifetime prevalence rates for DSM-IV GAD in the general population of approx. 5-6% being reported. In addition, like other anxiety disorders, GAD also shows comorbidity with depression and most of the other anxiety disorders. This article reviews data on the prevalence of GAD, its comorbidity with depression, and its social and economic impact. Proposed neurobiological mechanisms for GAD are discussed, since an understanding of these may help in the development of future therapies. Finally, current pharmacological and non-pharmacological treatment options for GAD are reviewed, with particular attention being paid to published clinical-trial data.

  8. [Between anxiety and depression. The status of assertiveness disorders and social phobias].

    Science.gov (United States)

    Granger, B; Azais, F; Albercque, C; Debray, Q

    1995-05-01

    The authors try to answer the question of the nosological status of social phobias and assertiveness difficulties, which are usually included in the large group of anxious troubles. The correlation between Rathus Rating Scale, Hamilton Depression Rating Scale (HDRS) and sub-scores of HDRS were studied in two populations; the first one was constituted by anxious and/or depressed patients, the second, extracted from the first one, by anxious patients only. The results show that lack of assertiveness has probably both affective and anxious components. These results are important from a nosological and therapeutic point of view.

  9. Anxiety Predicts Mortality in ICD Patients

    DEFF Research Database (Denmark)

    Kikkenborg Berg, Selina; Caspar Thygesen, Lau; Hastrup Svendsen, Jesper

    2014-01-01

    BACKGROUND: Although highly effective in preventing arrhythmic death, patients receiving an implantable cardioverter defibrillator (ICD) may still experience psychological difficulties such as anxiety, depression, and reduced quality of life. The objectives of this study were to describe patient...... receiving ICD between January 1, 2011 and June 30, 2011 (n = 499). The following instruments were used: SF-36, Hospital Anxiety and Depression Scale, HeartQoL, EQ-5D, and the Multidimensional Fatigue Inventory. RESULTS: The response rate was 72%. Mean age was 65.5 years and 82% patients were males. Fifty...... of perceived health, quality of life, and fatigue; for example, physical health 39.8 versus 44.3 points, compared to secondary prevention indication. Anxiety, poor perceived health, fatigue, and low quality of life were all predictors of mortality, anxiety being the strongest with an adjusted odds ratio of 4...

  10. Bilingual/Multilingual Learners' Willingness to Communicate in and Anxiety on Speaking Chinese and Their Associations with Self-Rated Proficiency in Chinese

    Science.gov (United States)

    Liu, Meihua

    2018-01-01

    The present research explored bilingual/multilingual students' willingness to communicate in Chinese (WTCC) and foreign language anxiety (FLA) when speaking Chinese and their associations with self-rated proficiency in Chinese in a university in Beijing. The study recruited 167 bilingual and multilingual learners of Chinese to fill in a battery of…

  11. Measuring Anxiety as a Treatment Endpoint in Youth with Autism Spectrum Disorder

    Science.gov (United States)

    Lecavalier, Luc; Wood, Jeffrey J.; Halladay, Alycia K.; Jones, Nancy E.; Aman, Michael G.; Cook, Edwin H.; Handen, Benjamin L.; King, Bryan H.; Pearson, Deborah A.; Hallett, Victoria; Sullivan, Katherine Anne; Grondhuis, Sabrina; Bishop, Somer L.; Horrigan, Joseph P.; Dawson, Geraldine; Scahill, Lawrence

    2014-01-01

    Despite the high rate of anxiety in individuals with autism spectrum disorder (ASD), measuring anxiety in ASD is fraught with uncertainty. This is due, in part, to incomplete consensus on the manifestations of anxiety in this population. Autism Speaks assembled a panel of experts to conduct a systematic review of available measures for anxiety in…

  12. Social Anxiety, Reasons for Drinking, and College Students

    Science.gov (United States)

    Norberg, Melissa M.; Norton, Alice R.; Olivier, Jake; Zvolensky, Michael J.

    2010-01-01

    Recent research suggests that social anxiety may be associated with higher rates of alcohol problems in women, yet may be associated with lower levels of drinking in men. The current study investigated putative mechanisms that may underlie potential gender differences in the social anxiety-alcohol relationship. One hundred and eighteen college…

  13. Increased mortality among people with anxiety disorders

    DEFF Research Database (Denmark)

    Meier, Sandra M; Mattheisen, Manuel; Mors, Ole

    2016-01-01

    BACKGROUND: Anxiety disorders and depression are the most common mental disorders worldwide and have a striking impact on global disease burden. Although depression has consistently been found to increase mortality; the role of anxiety disorders in predicting mortality risk is unclear. AIMS......: To assess mortality risk in people with anxiety disorders. METHOD: We used nationwide Danish register data to conduct a prospective cohort study with over 30 million person-years of follow-up. RESULTS: In total, 1066 (2.1%) people with anxiety disorders died during an average follow-up of 9.7 years....... The risk of death by natural and unnatural causes was significantly higher among individuals with anxiety disorders (natural mortality rate ratio (MRR) = 1.39, 95% CI 1.28-1.51; unnatural MRR = 2.46, 95% CI 2.20-2.73) compared with the general population. Of those who died from unnatural causes, 16.5% had...

  14. Source apportionment of PAH in Hamilton Harbour suspended sediments: comparison of two factor analysis methods.

    Science.gov (United States)

    Sofowote, Uwayemi M; McCarry, Brian E; Marvin, Christopher H

    2008-08-15

    A total of 26 suspended sediment samples collected over a 5-year period in Hamilton Harbour, Ontario, Canada and surrounding creeks were analyzed for a suite of polycyclic aromatic hydrocarbons and sulfur heterocycles. Hamilton Harbour sediments contain relatively high levels of polycyclic aromatic compounds and heavy metals due to emissions from industrial and mobile sources. Two receptor modeling methods using factor analyses were compared to determine the profiles and relative contributions of pollution sources to the harbor; these methods are principal component analyses (PCA) with multiple linear regression analysis (MLR) and positive matrix factorization (PMF). Both methods identified four factors and gave excellent correlation coefficients between predicted and measured levels of 25 aromatic compounds; both methods predicted similar contributions from coal tar/coal combustion sources to the harbor (19 and 26%, respectively). One PCA factor was identified as contributions from vehicular emissions (61%); PMF was able to differentiate vehicular emissions into two factors, one attributed to gasoline emissions sources (28%) and the other to diesel emissions sources (24%). Overall, PMF afforded better source identification than PCA with MLR. This work constitutes one of the few examples of the application of PMF to the source apportionment of sediments; the addition of sulfur heterocycles to the analyte list greatly aided in the source identification process.

  15. Anxiety in individuals with ASD: Prevalence, phenomenology, etiology, assessment, and interventions

    NARCIS (Netherlands)

    van Steensel, F.J.A.; Bögels, S.M.; Magiati, I.; Perrin, S.; Patel, V.B.; Preedy, V.R.; Martin, C.R.

    2014-01-01

    ndividuals with autism spectrum disorder (ASD) experience high levels of anxiety symptomatology with an estimated prevalence rate of anxiety disorders as high as 40 %. It is likely that anxiety is prominent in individuals with ASD throughout the life-span and that factors such as age, IQ, and ASD

  16. Irritability and Anxiety Severity Among Youth With Anxiety

    Science.gov (United States)

    Cornacchio, Danielle; Crum, Kathleen I.; Coxe, Stefany; Pincus, Donna B.; Comer, Jonathan S.

    2015-01-01

    Objective Most research on irritability and child psychopathology has focused on depressive disorders, bipolar disorder, and/or oppositional defiant disorder (ODD). Less is known about relationships between child anxiety and irritability and moderators of such associations. Method Structural equation modeling (SEM) examined associations between anxiety severity and irritability in a large sample of treatment-seeking youth with anxiety disorders (N=663, ages 7–19 years, M=12.25), after accounting for comorbid depressive disorders and ODD. Additional analyses examined whether associations were moderated by child gender, age, and generalized anxiety disorder (GAD) status. Results There was a direct link between child anxiety and irritability even after accounting for comorbid depressive disorders and ODD. Links between child anxiety and irritability were robust across child gender and age. Further, relationships between child anxiety and irritability were comparable across youth with and without GAD, suggesting that the anxiety–irritability link is relevant across child anxiety disorders and not circumscribed to youth with GAD. Conclusion Findings add to an increasing body of evidence linking child irritability to a range of internalizing and externalizing psychopathologies, and suggest that child anxiety assessment should systematically incorporate irritability evaluations. Further, youth in clinical settings displaying irritability should be assessed for the presence of anxiety. Moreover, treatments for childhood anxiety may do well to incorporate new treatment modules as needed that specifically target problems of irritability. PMID:26703910

  17. Math anxiety differentially affects WAIS-IV arithmetic performance in undergraduates.

    Science.gov (United States)

    Buelow, Melissa T; Frakey, Laura L

    2013-06-01

    Previous research has shown that math anxiety can influence the math performance level; however, to date, it is unknown whether math anxiety influences performance on working memory tasks during neuropsychological evaluation. In the present study, 172 undergraduate students completed measures of math achievement (the Math Computation subtest from the Wide Range Achievement Test-IV), math anxiety (the Math Anxiety Rating Scale-Revised), general test anxiety (from the Adult Manifest Anxiety Scale-College version), and the three Working Memory Index tasks from the Wechsler Adult Intelligence Scale-IV Edition (WAIS-IV; Digit Span [DS], Arithmetic, Letter-Number Sequencing [LNS]). Results indicated that math anxiety predicted performance on Arithmetic, but not DS or LNS, above and beyond the effects of gender, general test anxiety, and math performance level. Our findings suggest that math anxiety can negatively influence WAIS-IV working memory subtest scores. Implications for clinical practice include the utilization of LNS in individuals expressing high math anxiety.

  18. Effect of anxiety on cortical cerebral blood flow and metabolism

    International Nuclear Information System (INIS)

    Gur, R.C.; Gur, R.E.; Resnick, S.M.; Skolnick, B.E.; Alavi, A.; Reivich, M.

    1987-01-01

    The relation between anxiety and cortical activity was compared in two samples of normal volunteers. One group was studied with the noninvasive xenon-133 inhalation technique for measuring cerebral blood flow (CBF) and the other with positron emission tomography (PET) using 18 Flurodeoxyglucose ( 18 FDG) for measuring cerebral metabolic rates (CMR) for glucose. The inhalation technique produced less anxiety than the PET procedure, and for low anxiety subjects, there was a linear increase in CBF with anxiety. For higher anxiety subjects, however, there was a linear decrease in CBF with increased anxiety. The PET group manifested a linear decrease in CMR with increased anxiety. The results indicate that anxiety can have systematic effects on cortical activity, and this should be taken into consideration when comparing data from different procedures. They also suggest a physiologic explanation of a fundamental behavioral law that stipulates a curvilinear, inverted-U relationship between anxiety and performance

  19. Health anxiety in a disease-avoidance framework: Investigation of anxiety, disgust and disease perception in response to sickness cues.

    Science.gov (United States)

    Hedman, Erik; Lekander, Mats; Karshikoff, Bianka; Ljótsson, Brjánn; Axelsson, Erland; Axelsson, John

    2016-10-01

    Severe health anxiety is characterized by a debilitating fear of somatic illness, and avoidance of disease-related stimuli plays a key role in the maintenance of the disorder. The aim of this study was to investigate severe health anxiety within an evolutionary disease-avoidance framework. We hypothesized that, compared to healthy controls, participants with severe health anxiety would perceive others as sicker, more contagious, and less attractive. We also expected individuals with severe health anxiety to be more prone to avoid interaction with persons who appeared sick, as well as to respond with more health-related worry, more disgust, and more anxiety when confronting such individuals. In addition, this sensitivity was expected to be larger if people showed manifest sickness symptoms. Participants with and without severe health anxiety (N = 224) were exposed to facial photos with a varying degree of apparent sickness. Patients with severe health anxiety, compared to controls, rated apparently healthy people as being less healthy and less attractive. There were significant interaction effects showing that that the increase in disgust, anxiety, perceived contagiousness, and worry over one's own health as a function of how sick the person in the photo appeared, was significantly larger in the clinical sample compared to the healthy control sample (ps anxiety as a dimensional predictor also supported our hypotheses. We suggest that disgust and cognitive biases relating to the disease-avoidance model are significant features of severe health anxiety. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  20. Effects of hand massage on anxiety in patients undergoing ophthalmology surgery using local anesthesia

    Directory of Open Access Journals (Sweden)

    Jafar Rafiei Kiasari

    2012-08-01

    Full Text Available Introduction: Anxiety is a common disorder in patients before surgery. Inappropriately managed anxiety can cause psychological and physiological reactions and will affect the process of surgery and recovery. Therefore, this study examined the effects of hand mas-sage on anxiety in patients undergoing ophthalmology surgery using local anesthesia. Methods: In this interventional study, 52 patients who were supposed to undergo oph-thalmology surgery using local anesthesia were studied. Patients were randomly as-signed to two groups of intervention, who received hand massage before surgery (n = 27 and control (n = 25. Massaging lasted for 5 minutes (2.5 minutes on each hand before surgery. Stroking and scrubbing methods were performed by 2 trained research-ers. Anxiety level, blood pressure, heart rate, and respiratory rate were measured before and after the intervention in both groups. Anxiety was evaluated using Spielberger State-Trait Anxiety Inventory. Data was analyzed by chi-square, independent samples t-test, and paired t-test. Results: There were no significant differences in mean anxiety, systolic blood pressure, diastolic blood pressure, heart rate, and respiratory rate between the two groups before the intervention (p > 0.05. However, there was a significant differenc in the mean stress level between the two groups after the intervention (p 0.05. Conclusion: Our findings suggested that 5 minutes of hand massage before ophthalmology surgery (under local anesthesia could reduce anxiety. Therefore, this method can be used to increase patient comfort and reduce anxiety before surgical interventions.

  1. Distress and functioning in mixed anxiety and depressive disorder.

    Science.gov (United States)

    Małyszczak, Krzysztof; Pawłowski, Tomasz

    2006-04-01

    The aim of the present study was to evaluate the validity of mixed anxiety and depressive disorder (MADD) with reference to functional characteristics and symptomatic characteristics in comparison with anxiety disorders, depressive disorders, and groups showing subthreshold symptoms (exclusively depressive or anxiety related). The present study was carried out in the following three medical settings: two psychiatric and one primary care. Patients seeking care in psychiatric institutions due to anxiety and depressive symptoms and attending primary medical settings for any reason were taken into account. A total of 104 patients (65 women and 39 men, mean age 41.1 years) were given a General Health Questionnaire (GHQ-30), Global Assessment of Functioning (GAF) and Present State Examination questionnaire, a part of Schedules for Clinical Assessment in Neuropsychiatry, Version 2.0. There were no statistically relevant differences between MADD and anxiety disorders in median GHQ score (19 vs 16) and median GAF score (median 68.5 vs 65). When considering depressive disorders the median GHQ score (28) was higher, and median GAF score (59) was lower than that in MADD. In groups with separated subthreshold anxiety or depressive symptoms, median GHQ scores (12) were lower and median GAF scores (75) were higher than that in MADD. The most frequent symptoms of MADD are symptoms of generalized anxiety disorder (GAD) and depression. Mixed anxiety and depressive disorder differs significantly from GAD only in higher rates of depressed mood and lower rates of somatic anxiety symptoms. Distinction from depression was clearer; six of 10 depressive symptoms are more minor in severity in MADD than in the case of depression. Distress and interference with personal functions in MADD are similar to that of other anxiety disorders. A pattern of MADD symptoms locates this disorder between depression and GAD.

  2. Reducing psychological distress and obesity through Yoga practice

    Directory of Open Access Journals (Sweden)

    S Dhananjai

    2013-01-01

    Full Text Available Yoga practice has been effectively prescribed in conjunction with other medical and yogic procedures in the management of severe psychosomatic diseases, including cancer, bronchial asthma, colitis, peptic and ulcer. It improves strength and flexibility, and may help control physiological variables such as blood pressure, lipids, respiration, heart rate, and metabolic rate to improve overall exercise capacity. The aim of this study is to evaluate the effects of Yogic Practice on anxiety/depression associated with obesity. Patients were recruited from the Department of Physiology, C.S.M. Medical University (erstwhile KGMU, Lucknow, Uttar Pradesh, India. A total of 272 subjects were divided into two groups: 1 group of 205 subjects (with yogic practice and 2 a control group of 67 subjects (with aerobic exercise. Assessment of anxiety and depression were done by Hamilton Rating Scale.

  3. Assessment of Anxiety in Older Home Care Recipients

    Science.gov (United States)

    Diefenbach, Gretchen J.; Tolin, David F.; Meunier, Suzanne A.; Gilliam, Christina M.

    2009-01-01

    Purpose: This study determined the psychometric properties of a variety of anxiety measures administered to older adults receiving home care services. Design and Methods: Data were collected from 66 adults aged 65 years and older who were receiving home care services. Participants completed self-report and clinician-rated measures of anxiety and…

  4. Anxiety Symptoms and Disorders in College Students With ADHD.

    Science.gov (United States)

    O'Rourke, Sarah R; Bray, Allison C; Anastopoulos, Arthur D

    2017-01-01

    This study examined anxiety symptoms and disorders in college students with ADHD. Forty-six college students with ADHD and a matched group of students without ADHD participated. Participants completed self-report measures of anxiety symptoms and associated features, including worry, maladaptive beliefs about worry, panic symptoms, social anxiety, obsessive-compulsive symptoms, and self-efficacy. Participants also completed a diagnostic interview to assess lifetime and current anxiety disorders. Participants with ADHD endorsed more maladaptive beliefs about worry, more obsessive-compulsive symptoms, and poorer self-efficacy compared with comparison participants. There were no group differences in rates of current anxiety disorders. Participants with ADHD were over 2 times more likely than comparison participants to endorse this lifetime history. College students with ADHD are more likely to have a lifetime history of an anxiety disorder and are at greater risk for some anxiety symptoms and associated features.

  5. Anxiety sensitivity predicts increased perceived exertion during a 1-mile walk test among treatment-seeking smokers.

    Science.gov (United States)

    Farris, Samantha G; Uebelacker, Lisa A; Brown, Richard A; Price, Lawrence H; Desaulniers, Julie; Abrantes, Ana M

    2017-12-01

    Smoking increases risk of early morbidity and mortality, and risk is compounded by physical inactivity. Anxiety sensitivity (fear of anxiety-relevant somatic sensations) is a cognitive factor that may amplify the subjective experience of exertion (effort) during exercise, subsequently resulting in lower engagement in physical activity. We examined the effect of anxiety sensitivity on ratings of perceived exertion (RPE) and physiological arousal (heart rate) during a bout of exercise among low-active treatment-seeking smokers. Adult daily smokers (n = 157; M age  = 44.9, SD = 11.13; 69.4% female) completed the Rockport 1.0 mile submaximal treadmill walk test. RPE and heart rate were assessed during the walk test. Multi-level modeling was used to examine the interactive effect of anxiety sensitivity × time on RPE and on heart rate at five time points during the walk test. There were significant linear and cubic time × anxiety sensitivity effects for RPE. High anxiety sensitivity was associated with greater initial increases in RPE during the walk test, with stabilized ratings towards the last 5 min, whereas low anxiety sensitivity was associated with lower initial increase in RPE which stabilized more quickly. The linear time × anxiety sensitivity effect for heart rate was not significant. Anxiety sensitivity is associated with increasing RPE during moderate-intensity exercise. Persistently rising RPE observed for smokers with high anxiety sensitivity may contribute to the negative experience of exercise, resulting in early termination of bouts of prolonged activity and/or decreased likelihood of future engagement in physical activity.

  6. A study of statistics anxiety levels of graduate dental hygiene students.

    Science.gov (United States)

    Welch, Paul S; Jacks, Mary E; Smiley, Lynn A; Walden, Carolyn E; Clark, William D; Nguyen, Carol A

    2015-02-01

    In light of increased emphasis on evidence-based practice in the profession of dental hygiene, it is important that today's dental hygienist comprehend statistical measures to fully understand research articles, and thereby apply scientific evidence to practice. Therefore, the purpose of this study was to investigate statistics anxiety among graduate dental hygiene students in the U.S. A web-based self-report, anonymous survey was emailed to directors of 17 MSDH programs in the U.S. with a request to distribute to graduate students. The survey collected data on statistics anxiety, sociodemographic characteristics and evidence-based practice. Statistic anxiety was assessed using the Statistical Anxiety Rating Scale. Study significance level was α=0.05. Only 8 of the 17 invited programs participated in the study. Statistical Anxiety Rating Scale data revealed graduate dental hygiene students experience low to moderate levels of statistics anxiety. Specifically, the level of anxiety on the Interpretation Anxiety factor indicated this population could struggle with making sense of scientific research. A decisive majority (92%) of students indicated statistics is essential for evidence-based practice and should be a required course for all dental hygienists. This study served to identify statistics anxiety in a previously unexplored population. The findings should be useful in both theory building and in practical applications. Furthermore, the results can be used to direct future research. Copyright © 2015 The American Dental Hygienists’ Association.

  7. Disability profile/clinician-rated: validity for Brazilian university students with social anxiety disorder.

    Science.gov (United States)

    Vaccaro de Morais Abumusse, Luciene; Osório, Flávia L; Crippa, José Alexandre S; Loureiro, Sonia Regina

    2013-01-01

    Functional impairment scales are important to assess Social Anxiety Disorder (SAD) patients. The present study aims to evaluate the reliability, internal consistency, validity and factorial structure of the Disability Profile/Clinician-Rate (DP) scale, as well as to present an interview-guide to support its application by clinicians. University students (n = 173) of both genders participated in the study (SAD = 84 and Non-SAD = 89), with ages ranging between 17 and 35 years, systematically diagnosed. The SAD group presented more difficulties when compared to the Non-SAD group. The DP presented, for the SAD group, internal consistency of 0.68 (lifetime) and 0.67 (last two weeks). Inter-rater reliability varied from 0.75 to 0.93. Two factors were extracted and the correlation among such factors and the Social Phobia Inventory subscales presented association between fear and avoidance symptoms and the functional impairments. The scale presents good psychometric properties and can contribute to the assessment of functional impairments.

  8. Anxiety and depression in women and men from early pregnancy to 3-months postpartum.

    Science.gov (United States)

    Figueiredo, Bárbara; Conde, Ana

    2011-06-01

    To investigate high-anxiety and depression in women and men from early pregnancy to 3-months postpartum, 260 Portuguese couples (N = 520) filled in the State-Anxiety Inventory (STAI-S) and the Edinburgh Post-Natal Depression Scale (EPDS) at the first, second, and third pregnancy trimesters, childbirth, and 3-months postpartum. Rates for high-anxiety (STAI-S ≥ 45) in women (13.1%; 12.2%; 18.2%; 18.6%; 4.7%) and men (10.1%; 8.0%, 7.8%; 8.5%; 4.4%) and for depression (EPDS ≥ 10) in women (20.0%, 19.6%, 17.4%, 17.6%; 11.1%) and men (11.3%; 6.6%; 5.5%; 7.5%; 7.2%) were high. Rates for depression were higher than rates for high-anxiety only in women during early pregnancy and the postpartum, but not at the third pregnancy trimester and childbirth. Rates for high-anxiety and depression were higher in women than in men during pregnancy/childbirth, but not at 3-months postpartum. Rates for high-anxiety but not rates for depression were higher during pregnancy/childbirth compared to 3-months postpartum and only in women. Considering that 15.9% of the parents-to-be were highly anxious and/or depressed during pregnancy-comparing to 9.3% at 3-months postpartum-particular attention should be drawn to both women's and men's mental health early in pregnancy.

  9. The nocturnal panic attacks: polysomnographic features and comorbidities

    Directory of Open Access Journals (Sweden)

    LI Yan-lin

    2013-05-01

    Full Text Available Background Panic disorder refers to the repeated or unexpected anxiety or panic attacks. It makes patients feel extreme pain. Although the episodes of most patients with panic disorder happen at daytime, the nocturnal panic attacks (NPA are quite common. Paients pay more attention to NPA. Insomnia is more serious in patients with NPA than those patients with panic disorder attack at daytime. Many patients may occur anxiety and avoidance behavior after NPA. Patients are often afraid of sleeping, or even do not sleep. The aim of this study is to analyze polysomnographic (PSG parameter changes and clinical concomitant symptoms of patietns with NPA, to explore the characteristics of sleep, in order to provide better diagnosis, differential diagnosis and treatment for these patients. Methods The features of sleep of 20 NPA patients and 23 healthy controls were monitored by video-PSG. Hamilton Anxiety Rating Scale (HAMA and Hamilton Depression Rating Scale (HAMD were used to assess the state of anxiety, depression, and dyssomnia of the patients. Results In comparison with normal control group, the NPA group showed shortened total sleep time (TST, decreased sleep efficiency (SE and sleep maintenance rate, delayed arousal time, increased number of arousal and number of arousal episode longer than 5 minutes, increased percentage of non-rapid eye movement (NREM sleep stage Ⅰ, decreased percentage of NREM sleep stageⅢ and percentage of rapid eye movement (REM sleep (P 0.05, for all. In NPA group, there were 13 cases (13/20 with anxiety, 17 (17/20 with depression, 13 cases/times (13/20 with difficulty of falling asleep, 17 cases/times (17/20 with difficulties in maintaining sleep (frequent arousals and difficult to fall asleep again and 7 cases/times (7/20 with wake up early. Conclusion NPA patients present decreased deep sleep, increased shallow sleep and poor sleep quality, and are mostly accompanied with mild or moderate depression and (or anxiety

  10. Prevalence of depressive and anxiety disorders in Chinese gastroenterological outpatients

    Institute of Scientific and Technical Information of China (English)

    Xiao-Jing Li; Yan-Ling He; Hong Ma; Zhe-Ning Liu; Fu-Jun Jia; Ling Zhang; Lan Zhang

    2012-01-01

    AIM:To investigate the prevalence and physicians'detection rate of depressive and anxiety disorders in gastrointestinal (GI) outpatients across China.METHODS:A hospital-based cross-sectional survey was conducted in the GI outpatient departments of 13general hospitals.A total of 1995 GI outpatients were recruited and screened with the Hospital Anxiety and Depression Scale (HADS).The physicians of the GI departments performed routine clinical diagnosis and management without knowing the HADS score results.SubJects with HADS scores ≥ 8 were subsequently interviewed by psychiatrists using the Mini International Neuropsychiatric Interview (MINI) to make further diagnoses.RESULTS:There were 1059 patients with HADS score ≥ 8 and 674 (63.64%) of them undertook the MINI interview by psychiatrists.Based on the criteria of Diagnostic and Statistical Manual of Mental Disorders (4th edition),the adjusted current prevalence for depressive disorders,anxiety disorders,and comorbidity of both disorders in the GI outpatients was 14.39%,9.42% and 4.66%,respectively.Prevalence of depressive disorders with suicidal problems [suicide attempt or suicide-related ideation prior or current; module C (suicide) of MINI score ≥ 1] was 5.84% in women and 1.64% in men.The GI physicians' detection rate of depressive and anxiety disorders accounted for 4.14%.CONCLUSION:While the prevalence of depressive and anxiety disorders is high in Chinese GI outpatients,the detection rate of depressive and anxiety disorders by physicians is low.

  11. Audiovisual aid viewing immediately before pediatric induction moderates the accompanying parents' anxiety.

    Science.gov (United States)

    Berghmans, Johan; Weber, Frank; van Akoleyen, Candyce; Utens, Elisabeth; Adriaenssens, Peter; Klein, Jan; Himpe, Dirk

    2012-04-01

    Parents accompanying their child during induction of anesthesia experience stress. The impact of audiovisual aid (AVA) on parental state anxiety and assessment of the child's anxiety at induction have been studied previously but need closer scrutiny. One hundred and twenty parents whose children were scheduled for day-care surgery entered this randomized, controlled study. The intervention group (n = 60) was exposed to an AVA in the holding area. Parental anxiety was measured with the Spielberger State-Trait Anxiety Inventory and the Amsterdam Preoperative Anxiety and Information Scale (APAIS) at three time points: (i) on admission [T1]; (ii) in the holding area just before entering the operating theater [T2]; and (iii) after leaving [T3]. Additionally, at [T3], both parent and attending anesthetist evaluated the child's anxiety using a visual analogue scale. The anesthetist also filled out the Induction Compliance Checklist. On the state anxiety subscale, APAIS parental anxiety at T2 (P = 0.015) and T3 (P = 0.009) was lower in the AVA intervention group than in the control group. After induction, the child's anxiety rating by the anesthetist was significantly lower than by the parent, in both intervention and control groups. Preoperative AVA shown to parents immediately before induction moderates the increase in anxiety associated with the anesthetic induction of their child. Present results suggest that behavioral characteristics seem better predictors of child's anxiety during induction than anxiety ratings per se and that anesthetists are better than parents in predicting child's anxiety during induction. © 2011 Blackwell Publishing Ltd.

  12. Psychological benefits 2 and 4 weeks after a single treatment with near infrared light to the forehead: a pilot study of 10 patients with major depression and anxiety

    Directory of Open Access Journals (Sweden)

    Teicher Martin H

    2009-12-01

    Full Text Available Abstract Background Many studies have reported beneficial effects from the application of near-infrared (NIR light photobiomodulation (PBM to the body, and one group has reported beneficial effects applying it to the brain in stroke patients. We have reported that the measurement of a patient's left and right hemispheric emotional valence (HEV may clarify data and guide lateralized treatments. We sought to test whether a NIR treatment could 1. improve the psychological status of patients, 2. show a relationship between immediate psychological improvements when HEV was taken into account, and 3. show an increase in frontal pole regional cerebral blood flow (rCBF, and 4. be applied without side effects. Methods We gave 10 patients, (5 M/5 F with major depression, including 9 with anxiety, 7 with a past history of substance abuse (6 with an opiate abuse and 1 with an alcohol abuse history, and 3 with post traumatic stress disorder, a baseline standard diagnostic interview, a Hamilton Depression Rating Scale (HAM-D, a Hamilton Anxiety Rating Scale (HAM-A, and a Positive and Negative Affect Scale (PANAS. We then gave four 4-minute treatments in a random order: NIR to left forehead at F3, to right forehead at F4, and placebo treatments (light off at the same sites. Immediately following each treatment we repeated the PANAS, and at 2-weeks and at 4-weeks post treatment we repeated all 3 rating scales. During all treatments we recorded total hemoglobin (cHb, as a measure of rCBF with a commercial NIR spectroscopy device over the left and the right frontal poles of the brain. Results At 2-weeks post treatment 6 of 10 patients had a remission (a score ≤ 10 on the HAM-D and 7 of 10 achieved this on the HAM-A. Patients experienced highly significant reductions in both HAM-D and HAM-A scores following treatment, with the greatest reductions occurring at 2 weeks. Mean rCBF across hemispheres increased from 0.011 units in the off condition to 0.043 units in

  13. Anxiety and depression in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): Examining the incidence of health anxiety in CFS/ME.

    Science.gov (United States)

    Daniels, Jo; Brigden, Amberly; Kacorova, Adela

    2017-09-01

    There is a lack of research examining the incidence of health anxiety in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), despite this being an important research area with potentially significant clinical implications. This preliminary study aimed to determine the incidence of anxiety and depression, more specifically health anxiety, in a sample of CFS/ME patients over a 3-month period. The research was a cross-sectional questionnaire-based study, using a consecutive sample of patients who were assessed in a CFS/ME service. Data were taken from the Short Health Anxiety Inventory and the Hospital Anxiety and Depression Scale to identify incidence of anxiety, depression, and health anxiety. Data were collected from 45 CFS/ME patients over the sampling period. Thirty-one patients (68.9%) scored above the normal range but within the subclinical range of health anxiety, and 19 patients (42.2%) scored within the clinically significant health anxiety range. Anxiety and depression were common, with prevalence rates of 42.2% and 33.3% respectively, which is comparable to data found in a recent large-scale trial. Health anxiety in CFS/ME patients is likely to be common and warrants further investigation to provide a better insight into how this may influence treatment and symptom management. Anxiety and depression were common in a sample of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) patients, with a high proportion meeting criteria for severe health anxiety. While CFS/ME and health anxiety are distinct and separate conditions, it is unsurprising that patients with CFS/ME, who commonly report feeling 'delegitimized', may experience high levels of anxiety relating to their physical symptoms. Clinicians should consider screening for health anxiety due to the possible clinical implications for treatment; mutual maintenance may negatively influence treatment success in a complex condition such as CFS/ME. Health anxiety has been found to be common

  14. Welcome to My House: African American and European American Students' Responses to Virginia Hamilton's "House of Dies Drear."

    Science.gov (United States)

    Spears-Bunton, Linda A.

    1990-01-01

    Addresses the relationship between reader response and culture. Presents portraits of a teacher and her Black students and White students as they studied a series of African American literary texts, including Virginia Hamilton's "House of Dies Drear" (1968). The reading of this text marked a turning point for the teacher and students.…

  15. A Korean validation study of the Clinically Useful Anxiety Outcome Scale: Comorbidity and differentiation of anxiety and depressive disorders

    Science.gov (United States)

    Jeon, Sang Won; Ko, Young-Hoon; Yoon, Seoyoung; Pae, Chi-Un; Choi, Joonho; Kim, Jae-Min; Yoon, Ho-Kyoung; Lee, Hoseon; Patkar, Ashwin A.; Zimmerman, Mark

    2017-01-01

    Background This study aimed to evaluate the psychometric properties of the Korean version of the Clinically Useful Anxiety Outcome Scale (CUXOS) and to examine the current diagnostic comorbidity and differential severity of anxiety symptoms between major depressive disorder (MDD) and anxiety disorders. Methodology In total, 838 psychiatric outpatients were analyzed at their intake appointment. Diagnostic characteristics were examined using the structured clinical interview from the DSM-IV because the DSM5 was not available at the start of the study. The CUXOS score was measured and compared with that of 3 clinician rating scales and 4 self-report scales. Principal findings The CUXOS showed excellent results for internal consistency (Cronbach’s α = 0.90), test–retest reliability (r = 0.74), and discriminant and convergent validity. The CUXOS significantly discriminated between different levels of anxiety severity, and the measure was sensitive to change after treatment. Approximately 45% of patients with MDD were additionally diagnosed with anxiety disorders while 55% of patients with anxiety disorders additionally reported an MDD. There was a significant difference in CUXOS scores between diagnostic categories (MDD only, anxiety only, both disorders, and no MDD or anxiety disorder). The CUXOS scores differed significantly between all categories of depression (major, minor, and non-depression) except for the comparison between minor depression and non-depression groups. Conclusions The Korean version of the CUXOS is a reliable and valid measure of the severity of anxiety symptoms. The use of the CUXOS could broaden the understanding of coexisting and differentiating characteristics of anxiety and depression. PMID:28604808

  16. A Korean validation study of the Clinically Useful Anxiety Outcome Scale: Comorbidity and differentiation of anxiety and depressive disorders.

    Directory of Open Access Journals (Sweden)

    Sang Won Jeon

    Full Text Available This study aimed to evaluate the psychometric properties of the Korean version of the Clinically Useful Anxiety Outcome Scale (CUXOS and to examine the current diagnostic comorbidity and differential severity of anxiety symptoms between major depressive disorder (MDD and anxiety disorders.In total, 838 psychiatric outpatients were analyzed at their intake appointment. Diagnostic characteristics were examined using the structured clinical interview from the DSM-IV because the DSM5 was not available at the start of the study. The CUXOS score was measured and compared with that of 3 clinician rating scales and 4 self-report scales.The CUXOS showed excellent results for internal consistency (Cronbach's α = 0.90, test-retest reliability (r = 0.74, and discriminant and convergent validity. The CUXOS significantly discriminated between different levels of anxiety severity, and the measure was sensitive to change after treatment. Approximately 45% of patients with MDD were additionally diagnosed with anxiety disorders while 55% of patients with anxiety disorders additionally reported an MDD. There was a significant difference in CUXOS scores between diagnostic categories (MDD only, anxiety only, both disorders, and no MDD or anxiety disorder. The CUXOS scores differed significantly between all categories of depression (major, minor, and non-depression except for the comparison between minor depression and non-depression groups.The Korean version of the CUXOS is a reliable and valid measure of the severity of anxiety symptoms. The use of the CUXOS could broaden the understanding of coexisting and differentiating characteristics of anxiety and depression.

  17. Clinical impact of depression and anxiety in patients with idiopathic pulmonary fibrosis.

    Directory of Open Access Journals (Sweden)

    Ye Jin Lee

    Full Text Available Although depression and anxiety represent significant yet treatable comorbidities in patients with idiopathic pulmonary fibrosis (IPF, their impact on the clinical course and prognosis of IPF remain unclear.We investigated the prevalence and clinical significance of depression and anxiety in patients with IPF.The present study included a prospective cohort comprising 112 Korean patients with IPF who had completed the Hospital Anxiety and Depression Scale (HADS questionnaire.Symptoms of depression and anxiety were present in 25.9% and 21.4% of patients with IPF, respectively (HADS scores ≥8. No significant differences in demographic data, age, sex, smoking status, Modified Medical Research Council Dyspnea Scale (MMRC scores, pulmonary function tests, or Gender-Age-Physiology Index for IPF were observed between patients with depression or anxiety and those without. However, in patients with anxiety, St. George's Respiratory Questionnaire (SGRQ scores were significantly higher than those of patients without anxiety (40.5 versus 23.5; p = 0.003. The survival rate and total number of hospital admissions did not significantly differ between patients with depression/anxiety and those without.Our findings indicate that depression and anxiety are relatively common in patients with IPF. Although no significant differences were noted with regard to survival rate and hospitalization, the present study suggests that depression and anxiety significantly influence quality of life in patients with IPF.

  18. Validation of the 17-item Hamilton Depression Rating Scale definition of response for adults with major depressive disorder using equipercentile linking to Clinical Global Impression scale ratings: analysis of Pharmacogenomic Research Network Antidepressant Medication Pharmacogenomic Study (PGRN-AMPS) data.

    Science.gov (United States)

    Bobo, William V; Angleró, Gabriela C; Jenkins, Gregory; Hall-Flavin, Daniel K; Weinshilboum, Richard; Biernacka, Joanna M

    2016-05-01

    The study aimed to define thresholds of clinically significant change in 17-item Hamilton Depression Rating Scale (HDRS-17) scores using the Clinical Global Impression-Improvement (CGI-I) Scale as a gold standard. We conducted a secondary analysis of individual patient data from the Pharmacogenomic Research Network Antidepressant Medication Pharmacogenomic Study, an 8-week, single-arm clinical trial of citalopram or escitalopram treatment of adults with major depression. We used equipercentile linking to identify levels of absolute and percent change in HDRS-17 scores that equated with scores on the CGI-I at 4 and 8 weeks. Additional analyses equated changes in the HDRS-7 and Bech-6 scale scores with CGI-I scores. A CGI-I score of 2 (much improved) corresponded to an absolute decrease (improvement) in HDRS-17 total score of 11 points and a percent decrease of 50-57%, from baseline values. Similar results were observed for percent change in HDRS-7 and Bech-6 scores. Larger absolute (but not percent) decreases in HDRS-17 scores equated with CGI-I scores of 2 in persons with higher baseline depression severity. Our results support the consensus definition of response based on HDRS-17 scores (>50% decrease from baseline). A similar definition of response may apply to the HDRS-7 and Bech-6. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  19. Regional climate change trends and uncertainty analysis using extreme indices: A case study of Hamilton, Canada

    OpenAIRE

    Razavi, Tara; Switzman, Harris; Arain, Altaf; Coulibaly, Paulin

    2016-01-01

    This study aims to provide a deeper understanding of the level of uncertainty associated with the development of extreme weather frequency and intensity indices at the local scale. Several different global climate models, downscaling methods, and emission scenarios were used to develop extreme temperature and precipitation indices at the local scale in the Hamilton region, Ontario, Canada. Uncertainty associated with historical and future trends in extreme indices and future climate projectio...

  20. Parental anxiety and quality of life of epileptic children.

    Science.gov (United States)

    Li, Yong; Ji, Cheng-Ye; Qin, Jiong; Zhang, Zhi-Xiang

    2008-06-01

    To investigate the prevalence of parental anxiety associated with epileptic children, and to explore whether and how this specific condition affects children's quality of life (QOL), and what are the significant determinants for parental anxiety. Three hundred and forty parents whose children were affected with known epilepsy were enrolled in the study. Questionnaires for quality of life in childhood epilepsy (QOLCE), and hospital anxiety and depression (HAD) of parents were used to collect demographic data of both children and their parents, as well as clinical manifestations of epilepsy and family status. Parental anxiety (of any severity) was observed in 191 subjects at interview, giving a prevalence rate of 56.2%. Of the 191 subjects, 18.5% reported mild anxiety, 24.4% moderate anxiety, and 13.2% severe anxiety. Factors associated with parental anxiety included frequency of seizure in children, average monthly income per person and parents' knowledge about epilepsy (P < 0.05). Parental anxiety significantly (P = 0.000) correlated with quality of life of children with epilepsy. Parents of children with epilepsy are at high risk of having anxiety. Factors associated with parental anxiety originate both from children and from parents. Parental anxiety is significantly related with children's QOL. It is important for experts concerned to recognize such a relationship to improve the QOL of children and their parents.

  1. Factors associated with social anxiety disorder in a group

    Science.gov (United States)

    Özşahin, Akatlı Kürşad; Altıntaş, Ebru

    2018-04-30

    Background/aim: Mental disorders may accompany obesity. This study aims to evaluate the association between social anxiety disorder (SAD) and obesity and the risk factors for SAD in obese female patients. Materials and methods: A total of 114 obese patients and 110 healthy controls were included. The Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), State and Trait Anxiety Inventory (STAI I-II), and Liebowitz Social Anxiety Scale (LSAS) were administered to assess anxiety, depression, and social anxiety levels. Scale scores were analyzed statistically. Results: The rate of SAD in obese female patients was found to be 8.8%. Anxiety, depression, and social anxiety levels were significantly higher in the obesity group compared to the control group (P < 0.05). According to linear regression analyses, a significant association between LSAS anxiety level and age, prior surgery, social support, history of being teased, BDI, and BAI was found. Conclusion: The present study shows that many factors are related to obesity and SAD in obese female patients. The clinical implications of these findings should be considered. Interventions for these factors may help prevent SAD in obese female patients.

  2. Biased Perception and Interpretation of Bodily Anxiety Symptoms in Childhood Social Anxiety

    Science.gov (United States)

    Schmitz, Julian; Blechert, Jens; Kramer, Martina; Asbrand, Julia; Tuschen-Caffier, Brunna

    2012-01-01

    Cognitive models of social phobia (SP) and empirical evidence in adults suggest that affected individuals overestimate arousal symptoms such as heart rate (HR) during social stress and worry about their visibility in public. To date, little is known about these aspects in childhood social anxiety, an important precursor of the disorder. We…

  3. Prevalence, structure and correlates of anxiety-depression in boys with an autism spectrum disorder.

    Science.gov (United States)

    Bitsika, Vicki; Sharpley, Christopher F; Andronicos, Nicholas M; Agnew, Linda L

    2016-01-01

    Comorbidity of anxiety and depression predicts impaired treatment outcomes, poor quality of life and increased suicide risk. No study has reported on a combined measure of anxiety-depression in boys with an Autism Spectrum Disorder. To explore the prevalence, underlying factor structure and relationships between anxiety-depression, physiological stress and symptoms of Autism Spectrum Disorder (ASD). 150 boys (aged 6-18 years; IQ M=94.9, range=73-132) with an ASD plus their parents (135 mothers, 15 fathers) completed scales about the boys' anxiety and depression, and the boys provided samples of their saliva in the morning and afternoon. Parents also completed the ASD Behaviour Checklist about the boys' ASD symptoms. The two sources of ratings were not significantly different for prevalence of anxiety-depression but the factor structures varied between the parents' and boys' responses, with a four-factor solution for the boys' ratings and a three-factor solution for the parents' ratings. There were also differences in the correlations between cortisol and anxiety-depression and between ASD symptoms and anxiety depression across the boys' and parents' data. Assessment of anxiety and depression comorbidity from parents and from children with an ASD themselves could provide a valuable adjunct datum when diagnosing ASD. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Symptom overlap in anxiety and multiple sclerosis.

    LENUS (Irish Health Repository)

    O Donnchadha, Seán

    2013-02-14

    BACKGROUND: The validity of self-rated anxiety inventories in people with multiple sclerosis (pwMS) is unclear. However, the appropriateness of self-reported depression scales has been widely examined. Given somatic symptom overlap between depression and MS, research emphasises caution when using such scales. OBJECTIVE: This study evaluates symptom overlap between anxiety and MS in a group of 33 individuals with MS, using the Beck Anxiety Inventory (BAI). METHODS: Participants underwent a neurological examination and completed the BAI. RESULTS: A novel procedure using hierarchical cluster analysis revealed three distinct symptom clusters. Cluster one (\\'wobbliness\\' and \\'unsteady\\') grouped separately from all other BAI items. These symptoms are well-recognised MS-related symptoms and we question whether their endorsement in pwMS can be considered to reflect anxiety. A modified 19-item BAI (mBAI) was created which excludes cluster one items. This removal reduced the number of MS participants considered \\'anxious\\' by 21.21% (low threshold) and altered the level of anxiety severity for a further 27.27%. CONCLUSION: Based on these data, it is suggested that, as with depression measures, researchers and clinicians should exercise caution when using brief screening measures for anxiety in pwMS.

  5. On the Connection between the Hamilton-Jacobi-Bellman and the Fokker-Planck Control Frameworks

    KAUST Repository

    Annunziato, Mario

    2014-09-01

    In the framework of stochastic processes, the connection between the dynamic programming scheme given by the Hamilton-Jacobi-Bellman equation and a recently proposed control approach based on the Fokker-Planck equation is discussed. Under appropriate assumptions it is shown that the two strategies are equivalent in the case of expected cost functionals, while the FokkerPlanck formalism allows considering a larger class of objectives. To illustrate the connection between the two control strategies, the cases of an Itō stochastic process and of a piecewise-deterministic process are considered.

  6. Probabilistic formulation of estimation problems for a class of Hamilton-Jacobi equations

    KAUST Repository

    Hofleitner, Aude; Claudel, Christian G.; Bayen, Alexandre M.

    2012-01-01

    This article presents a method for deriving the probability distribution of the solution to a Hamilton-Jacobi partial differential equation for which the value conditions are random. The derivations lead to analytical or semi-analytical expressions of the probability distribution function at any point in the domain in which the solution is defined. The characterization of the distribution of the solution at any point is a first step towards the estimation of the parameters defining the random value conditions. This work has important applications for estimation in flow networks in which value conditions are noisy. In particular, we illustrate our derivations on a road segment with random capacity reductions. © 2012 IEEE.

  7. Code Red: Explaining Average Age of Death in the City of Hamilton

    Directory of Open Access Journals (Sweden)

    Patrick F. DeLuca

    2015-11-01

    Full Text Available The aim of this study is to identify the underlying factors that explain the average age of death in the City of Hamilton, Ontario, Canada, as identified in the Code Red Series of articles that were published in the city's local newspaper in 2010. Using a combination of data from the Canadian Census, the Government of Ontario and the Canadian Institute for Health Information, factor analysis was performed yielding three factors relating to poverty, working class, and health and aging. In a regression analysis these factors account for 42% of the total variability in the average ages of death observed at the census tract level of geography within the city.

  8. Probabilistic formulation of estimation problems for a class of Hamilton-Jacobi equations

    KAUST Repository

    Hofleitner, Aude

    2012-12-01

    This article presents a method for deriving the probability distribution of the solution to a Hamilton-Jacobi partial differential equation for which the value conditions are random. The derivations lead to analytical or semi-analytical expressions of the probability distribution function at any point in the domain in which the solution is defined. The characterization of the distribution of the solution at any point is a first step towards the estimation of the parameters defining the random value conditions. This work has important applications for estimation in flow networks in which value conditions are noisy. In particular, we illustrate our derivations on a road segment with random capacity reductions. © 2012 IEEE.

  9. Effect of aerobic and anaerobic exercise on anxiety and, blood cortisol secretion rate of young wrestlers

    Directory of Open Access Journals (Sweden)

    bahram Delfan

    2013-09-01

    Conclusion: Regarding the results of the research it can be said that one session of aerobic exercise was effective in decreasing anxiety of wrestlers and also a long-term continuation of these exercises reduces anxiety and the cortisol hormone level which leads to mental and emotional balance of athletes.

  10. An Experiential Learning Activity Demonstrating Normal and Phobic Anxiety

    Science.gov (United States)

    Canu, Will H.

    2008-01-01

    This article describes an activity for an undergraduate abnormal psychology course that used student-generated data to illustrate normal versus clinically significant anxiety responses related to specific phobias. Students (N = 37) viewed 14 images of low- or high-anxiety valence and rated their subjective response to each. Discussion in a…

  11. Statistics Anxiety, Trait Anxiety, Learning Behavior, and Academic Performance

    Science.gov (United States)

    Macher, Daniel; Paechter, Manuela; Papousek, Ilona; Ruggeri, Kai

    2012-01-01

    The present study investigated the relationship between statistics anxiety, individual characteristics (e.g., trait anxiety and learning strategies), and academic performance. Students enrolled in a statistics course in psychology (N = 147) filled in a questionnaire on statistics anxiety, trait anxiety, interest in statistics, mathematical…

  12. Phonemic verbal fluency and severity of anxiety disorders in young children

    Directory of Open Access Journals (Sweden)

    Rudineia Toazza

    Full Text Available Abstract Introduction: Previous studies have implicated impaired verbal fluency as being associated with anxiety disorders in adolescents. Objectives: To replicate and extend previously reported evidence by investigating whether performance in phonemic verbal fluency tasks is related to severity of anxiety symptoms in young children with anxiety disorders. We also aim to investigate whether putative associations are independent from co-occurring attention deficit hyperactivity disorder (ADHD symptoms. Methods: Sixty children (6-12 years old with primary diagnoses of anxiety disorders participated in this study. Severity of symptoms was measured using clinician-based, parent-rated and self-rated validated scales. Verbal fluency was assessed using a simple task that measures the number of words evoked in 1-minute with the letter F, from which we quantified the number of isolated words, number of clusters (groups of similar words and number of switches (transitions between clusters and/or between isolated words. Results: There was a significant association between the number of clusters and anxiety scores. Further analysis revealed associations were independent from co-occurring ADHD symptoms. Conclusion: We replicate and extend previous findings showing that verbal fluency is consistently associated with severity in anxiety disorders in children. Further studies should explore the potential effect of cognitive training on symptoms of anxiety disorders.

  13. Childhood trauma, sexual functions, psychiatric comorbidity and sociodemographic data in obsessive-compulsive disorders with sexual obsessions

    Directory of Open Access Journals (Sweden)

    Burcu Göksan Yavuz

    2013-01-01

    Full Text Available Objective: We compared the childhood trauma, the severityof sexual functions, comorbidity of axis I psychiatricdisorder, the types and severity of obsessive-compulsivedisorder (OCD and sociodemographic data of patientswith or without sexual obsession in OCD.Methods: Eighty patients of OCD were recruited fromincluding consecutive admissions to an outpatient clinic.Primary OCD patients assessed each subject using theStructured Clinical Interview for DSM-IV Axis I Disorders(SCID-I. OCD symptoms and symptoms severity was assessedby the Yale-Brown Obsessive Compulsive Scale(YBOCS. Traumas were assessed by the ChildhoodTrauma Experiences Questionnaire. Sexual functions severitywas assessed by the Arizona Sexual ExperienceScale (ASEX. Current depressive and anxiety symptomsscore were assessed using the 17-item Hamilton RatingScale for Depression (HAM-D and the Hamilton AnxietyScale (HAM-A.Results: The frequency of sexual obsession was 15%in our clinical populations diagnosed with OCD. Historyof emotional abuse and incest were associated with asignificantly higher rate of OCD with sexual obsessions.Religious, aggressive, hoarding obsessions and hoardingcompulsions were associated with a significantly higherrate of OCD with sexual obsessions. Comorbidity of Somatoformdisorder was associated with a significantlyhigher rate of OCD with sexual obsessions. Subjects whohave OCD with sexual obsessions did not significantly differfrom those without sexual obsessions on any ASEX scores, Y-BOCS scores, HAM-D, HAM-A and demographicfeatures.Conclusion: Sexual obsessions were related to religious,aggressive, hoarding obsessions and hoarding compulsions,the emotional abuse, incest and a comorbidy ofsomatoform disorder.Key words: sexual obsessions, childhood trauma, comorbidity

  14. Statistics anxiety, state anxiety during an examination, and academic achievement.

    Science.gov (United States)

    Macher, Daniel; Paechter, Manuela; Papousek, Ilona; Ruggeri, Kai; Freudenthaler, H Harald; Arendasy, Martin

    2013-12-01

    A large proportion of students identify statistics courses as the most anxiety-inducing courses in their curriculum. Many students feel impaired by feelings of state anxiety in the examination and therefore probably show lower achievements. The study investigates how statistics anxiety, attitudes (e.g., interest, mathematical self-concept) and trait anxiety, as a general disposition to anxiety, influence experiences of anxiety as well as achievement in an examination. Participants were 284 undergraduate psychology students, 225 females and 59 males. Two weeks prior to the examination, participants completed a demographic questionnaire and measures of the STARS, the STAI, self-concept in mathematics, and interest in statistics. At the beginning of the statistics examination, students assessed their present state anxiety by the KUSTA scale. After 25 min, all examination participants gave another assessment of their anxiety at that moment. Students' examination scores were recorded. Structural equation modelling techniques were used to test relationships between the variables in a multivariate context. Statistics anxiety was the only variable related to state anxiety in the examination. Via state anxiety experienced before and during the examination, statistics anxiety had a negative influence on achievement. However, statistics anxiety also had a direct positive influence on achievement. This result may be explained by students' motivational goals in the specific educational setting. The results provide insight into the relationship between students' attitudes, dispositions, experiences of anxiety in the examination, and academic achievement, and give recommendations to instructors on how to support students prior to and in the examination. © 2012 The British Psychological Society.

  15. [College students social anxiety associated with stress and mental health].

    Science.gov (United States)

    Chen, Xuefeng; Wang, Zhen; Gao, Jing; Hu, Weipeng

    2007-03-01

    To explore the mediator effects of social anxiety on college students' life stress and mental health. 1430 college students were tested by revised Adolescent Self-Rating Life Events Check List (ASLEC), General Health Questionnaire (GHQ12) and social anxiety scale chose from Self-Consciousness Scale. 1. Social anxiety was the mediator variable between stress and mental health. 2. Female students were easily suffered from higher losing stress and human relationship stress in comparision with male. 3. Non-only child Students got a higher score in social anxiety and lower GHQ in comparision with only child. It may be helpful to improve the stress management and mental health of college students by testing and intervening their social anxiety perception.

  16. Depression, anxiety and stress in dental students

    OpenAIRE

    Basudan, Sumaya; Binanzan, Najla; Alhassan, Aseel

    2017-01-01

    Objectives To measure the occurrence and levels of depression, anxiety and stress in undergraduate dental students using the Depression, Anxiety and Stress Scale (DASS-21). Methods This cross-sectional study was conducted in November and December of 2014. A total of 289 dental students were invited to participate, and 277 responded, resulting in a response rate of 96%. The final sample included 247 participants. Eligible participants were surveyed via a self-reported questionnaire that includ...

  17. Anxiety and Death Anxiety in Egyptian and Spanish Nursing Students

    Science.gov (United States)

    Abdel-Khalek, Ahmed M.; Tomas-Sabado, Joaquin

    2005-01-01

    Two samples of female nursing undergraduates from Egypt (n=132) and Spain (n=126) responded to the Arabic Scale of Death Anxiety, the Spanish Death Anxiety Inventory, the Templer's Death Anxiety Scale, the Kuwait University Anxiety Scale, and the State-Trait Anxiety Inventory-Trait Subscale. Each sample answered the scales in their native…

  18. Examining the interrelationships between social anxiety, smoking to cope, and cigarette craving.

    Science.gov (United States)

    Watson, Noreen L; VanderVeen, Joseph W; Cohen, Lee M; DeMarree, Kenneth G; Morrell, Holly E R

    2012-08-01

    Smokers with symptoms of social anxiety often report smoking as a way to cope with negative affect. These individuals have lower success rates when attempting cessation compared with the general population. However, there is a paucity of research examining the role of social anxiety in nicotine dependence. The present study explored the relationships between symptoms of social anxiety, smoking to cope with these symptoms during social situations (STC), and cigarette craving. Thirty-eight participants completed measures of social anxiety and STC at baseline. Cigarette craving was subsequently assessed pre and post exposure to smoking-related images during periods of nicotine satiation and deprivation. Regression analyses revealed that greater symptoms of social anxiety predicted the frequency of STC behaviors and the number of cigarettes participants thought they would need in order to feel more comfortable in social situations. Symptoms of social anxiety and several behaviors associated with STC (e.g., avoiding social situations in which smoking is not permitted) predicted increases in craving during nicotine deprivation, but not satiation. These findings suggest that symptoms of social anxiety and STC behaviors may play a role in the maintenance of smoking behaviors. Further, targeting symptoms of social anxiety within the context of smoking cessation treatment may be particularly helpful and may improve the rates of smoking cessation among individuals with symptoms of social anxiety. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Feasibility, Reproducibility, and Clinical Validity of the Pediatric Anxiety Rating Scale--Revised for Fragile X Syndrome

    Science.gov (United States)

    Russo-Ponsaran, Nicole M.; Yesensky, Jessica; Hessl, David; Berry-Kravis Elizabeth

    2014-01-01

    Fragile X syndrome (FXS) is the most common inherited cause of intellectual disability and the most common known genetic cause of autism. FXS is associated with psychiatric impairments, including anxiety disorders. There is a paucity of well-developed measures to characterize anxiety in FXS. However, such scales are needed to measure therapeutic…

  20. [Impact of music therapy on anxiety and depression for patients with Alzheimer's disease and on the burden felt by the main caregiver (feasibility study)].

    Science.gov (United States)

    Guetin, S; Portet, F; Picot, M-C; Defez, C; Pose, C; Blayac, J-P; Touchon, J

    2009-02-01

    during the session and to stimulate the patient's cognitive functions by recalling memories and images from his past life experience. The main evaluation criterion was regular session attendance at the hospital. Secondary criteria were: anxiety score (Hamilton scale), depression score (Cornell scale) and the burden score felt by the main caregiver (Zarit scale). Evaluations took place at W1, W4 and W10. The score evolution on the Hamilton, Cornell and Zarit scales were tested using the Wilcoxon test on paired data. The significance threshold has conventionally been set at 5% for all tests used. The statistical analysis was done using the SAS software (8th version) (SAS Institute, Cary, N.C.; proc npar1way, proc univariate, proc freq). Alzheimer's disease is a recognized indication for music therapy. A simple oral consent was collected prior to the study inclusion. Five patients were included for a total of 44 sessions. The patients' regular attendance at the music therapy sessions showed its feasibility. Thanks to oral feedback, we were able to see that music therapy was very well-accepted both by patients and caregivers. After the sessions, all patients expressed a sensation of well-being and pleasure, such as: "Music made me feel better, I feel more relaxed", "I feel better", "I didn't know that music could have such an impact on me"... Other verbal comments were collected regarding the patients' previous life experience: "This music reminds me of my childhood", "I imagined myself dancing just like I used to in the old days", "This reminds me of my trip to Italy with my children"... The level of anxiety (Hamilton scale) dropped significantly from 9.4 (+/-2.2) to 3.4 (+/-2.6) between the first session and the fourth session (Pmusic therapy in terms of its impact on the overall care for patients suffering from Alzheimer's disease. This easily applicable technique can be useful in treating anxiety and depression in a patient with Alzheimer's disease and also in relieving

  1. Paediatric Anxiety Disorders

    Directory of Open Access Journals (Sweden)

    Beena Johnson

    2017-07-01

    Full Text Available Anxiety disorders are highly prevalent among children and are associated with serious morbidity. Lifetime prevalence of paediatric anxiety disorders is about fifteen percent. Social phobia, generalized anxiety disorder and separation anxiety disorder are included in the triad of paediatric anxiety disorders. Specific phobia, obsessive compulsive disorder and post-traumatic stress disorder are also commonly seen in children. Overprotection by parents, parental death or separation, female sex, low educational status, family history of anxiety disorder, financial stress in family and adverse childhood experiences are risk factors for the development of anxiety disorders. If not diagnosed and managed at the earliest, paediatric anxiety disorders can cause life threatening problems in the future. Hence early and scientific management of anxiety disorders is essential. Cognitive behavioural therapy is the effective evidence based treatment for paediatric anxiety disorders.

  2. Major depressive disorder and generalized anxiety disorder show different autonomic dysregulations revealed by heart-rate variability analysis in first-onset drug-naïve patients without comorbidity.

    Science.gov (United States)

    Shinba, Toshikazu

    2017-02-01

    The aim of the present study was to examine whether depression and anxiety disorder manifest different autonomic dysregulations using heart-rate variability (HRV) and heart rate (HR) measurements. HRV and HR were recorded both at rest and during task execution (random-number generation) in first-onset drug-naïve patients with major depressive disorder (MDD, n = 14) and generalized anxiety disorder (GAD, n = 11) as well as in healthy controls (n = 41). The patients showed no comorbidity of depression and anxiety disorder. GAD patients did not exhibit panic or phobic symptoms at the time of measurement. Following power spectrum analysis of HR trend, the high- (HF) and low-frequency (LF) components, the sum (LF + HF), and the LF/HF ratio were compared among the groups. In the MDD patients, as previously reported, HF was low and the LF/HF ratio was high during the initial-rest condition, and HF was less reactive to the task. In contrast, GAD patients showed significantly high HF, although autonomic reactivity was not impaired. The results indicate that baseline autonomic activity and its reactivity to behavioral changes are different between MDD and GAD in the early stage of illness. High parasympathetic tone in GAD may reflect responses of the parasympathetic system to anxiety. MDD is accompanied by an autonomic shift toward sympathetic activation and a reduced reactivity to task. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

  3. Prevalence of Intimate Partner Violence and Associated Factors

    Science.gov (United States)

    KARAKOÇ, Berna; GÜLSEREN, Leyla; ÇAM, Birmay; GÜLSEREN, Şeref; TENEKECİ, Nermin; METE, Levent

    2015-01-01

    Introduction The aim of the present cross-sectional study was to investigate the prevalence of intimate partner physical violence among depressive Turkish women, as well as the association of intimate partner physical violence with attachment patterns, childhood traumas, and socio-demographic factors. Methods The study included 100 women diagnosed with depressive disorder and 30 healthy women. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV axis I disorders, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Adult Attachment Style Questionnaire (AASQ), and Childhood Trauma Questionnaire (CTQ) were used for clinical assessment. Results It was found that 64% of the women diagnosed with depression were suffering from intimate partner physical violence. In these women, the severity of depression and anxiety symptoms was higher, suicidal ideation and suicide attempts were more common, and the diagnosis of double depression was more prevalent. These women also achieved higher scores in the avoidant and ambivalent subscales of AASQ and higher total scores and higher scores in the physical abuse subscale of CTQ. The partner’s and the woman’s experiences of physical violence in their families during their childhood predicted intimate partner physical violence for women suffering from depression. Conclusion The investigation of domestic violence contributes to the treatment of depression and also to the recognition and prevention of domestic violence that has profound effects on successive generations. PMID:28360734

  4. Effects of a music-creation programme on the anxiety, self-esteem, and quality of life of people with severe mental illness: A quasi-experimental design.

    Science.gov (United States)

    Chang, Beh-Huan; Chen, Bo-Wei; Beckstead, Jason W; Yang, Chiu-Yueh

    2018-06-01

    Many studies have shown that music therapy improves patients' symptoms. However, interventions using music creation as their core await further development for patients with severe mental illness (SMI). The current study investigated the effect of a music-creation programme on the anxiety, self-esteem, and quality of life of patients with SMI. A quasi-experimental design using convenience sampling was adopted to recruit patients with SMI from a psychiatric day care centre. Participants were grouped based on their willingness to undergo an intervention (26 patients in the experimental group and 23 patients in the control group). The control groups participated in conventional mental rehabilitation therapy activities. The experimental group participated in a music-creation session for 90 min every week over a 32-week period. The outcome indicators before and after the intervention were assessed using the Hamilton Anxiety Rating Scale (HAM-A), Rosenberg Self-Esteem Scale (RSES), and World Health Organization Quality of Life-BREF (WHOQOL-BREF). Finally, the intervention effect was determined using generalized estimating equations (GEEs). After 32 weeks of intervention activities, the experimental group showed significant improvements in their HAM-A total scores (P < 0.001) and RSES total scores (P = 0.005). Regarding quality of life, the improvements of the experimental group in terms of the psychological (P = 0.016) and social relationship domains (P = 0.033) were superior to those of the control group. Music-creation programmes are recommended for inclusion in the routine rehabilitation activities of patients with SMI. © 2017 Australian College of Mental Health Nurses Inc.

  5. Cognitive-Behavioral Therapy for Anxiety in Children With High-Functioning Autism: A Meta-analysis

    Science.gov (United States)

    Bloch, Michael H.; Panza, Kaitlyn E.; Reichow, Brian

    2013-01-01

    BACKGROUND Anxiety is a common and impairing problem in children and adolescents with autism spectrum disorder (ASD). There is emerging evidence that cognitive-behavioral therapy (CBT) could reduce anxiety in children with high-functioning ASD. OBJECTIVE: To systematically review the evidence of using CBT to treat anxiety in children and adolescents with ASD. Methods for this review were registered with PROSPERO (CRD42012002722). METHODS: We included randomized controlled trials published in English in peer-reviewed journals comparing CBT with another treatment, no treatment control, or waitlist control. Two authors independently screened 396 records obtained from database searches and hand searched relevant journals. Two authors independently extracted and reconciled all data used in analyses from study reports. RESULTS: Eight studies involving 469 participants (252 treatment, 217 comparison) met our inclusion criteria and were included in meta-analyses. Overall effect sizes for clinician- and parent-rated outcome measures of anxiety across all studies were d = 1.19 and d = 1.21, respectively. Five studies that included child self-report yielded an average d = 0.68 across self-reported anxiety. CONCLUSIONS: Parent ratings and clinician ratings of anxiety are sensitive to detecting treatment change with CBT for anxiety relative to waitlist and treatment-as-usual control conditions in children with high-functioning ASD. Clinical studies are needed to evaluate CBT for anxiety against attention control conditions in samples of children with ASD that are well characterized with regard to ASD diagnosis and co-occurring anxiety symptoms. PMID:24167175

  6. A case study: the initiative to improve RN scheduling at Hamilton Health Sciences.

    Science.gov (United States)

    Wallace, Laurel-Anne; Pierson, Sharon

    2008-01-01

    In 2003, Hamilton Health Sciences embarked on an initiative to improve and standardize nursing schedules and scheduling practices. The scheduling project was one of several initiatives undertaken by a corporate-wide Nursing Resource Group established to enhance the work environment and patient care and to ensure appropriate utilization of nursing resources across the organization's five hospitals. This article focuses on major activities undertaken in the scheduling initiative. The step-by-step approach described, plus examples of the scheduling resources developed and samples of extended-tour schedules, will all provide insight, potential strategies and practical help for nursing administrators, human resources (HR) personnel and others interested in improving nurse scheduling.

  7. Sex variations in youth anxiety symptoms: effects of pubertal development and gender role orientation.

    Science.gov (United States)

    Carter, Rona; Silverman, Wendy K; Jaccard, James

    2011-01-01

    This study evaluated whether pubertal development and gender role orientation (i.e., masculinity and femininity) can partially explain sex variations in youth anxiety symptoms among clinic-referred anxious youth (N = 175; ages 9-13 years; 74% Hispanic; 48% female). Using youth and parent ratings of youth anxiety symptoms, structural equation modeling results indicated that youth who reported being more advanced in their pubertal development reported high levels of femininity and anxiety symptoms. Youth who reported high levels of masculinity had low levels of anxiety symptoms as reported by both youths and parents. The estimated effects of pubertal development, femininity, and masculinity on youth and parent ratings of youth anxiety symptoms were not significantly moderated by biological sex. Pubertal development and gender role orientation appear to be important in explaining levels of youth anxiety symptoms among clinic-referred anxious youth.

  8. Prevalence of depression and anxiety in patients with chronic digestive system diseases: A multicenter epidemiological study.

    Science.gov (United States)

    Zhang, An-Zhong; Wang, Qing-Cai; Huang, Kun-Ming; Huang, Jia-Guo; Zhou, Chang-Hong; Sun, Fu-Qiang; Wang, Su-Wen; Wu, Feng-Ting

    2016-11-14

    To investigate the prevalence of depression and anxiety in patients with chronic digestive system diseases. A total of 1736 patients with chronic digestive system diseases were included in this cross-sectional study, including 871 outpatients and 865 in-patients. A self-designed General Information for Patients of the Department of Gastroenterology of General Hospitals questionnaire was used to collect each patient's general information, which included demographic data (including age, sex, marital status, and education) and disease characteristics (including major diseases, disease duration, principal symptoms, chronic pain, sleep disorder, and limited daily activities). The overall detection rate was 31.11% (540/1736) for depression symptoms alone, 27.02% (469/1736) for anxiety symptoms alone, 20.68% (359/1736) for both depression and anxiety symptoms, and 37.44% (650/1736) for either depression or anxiety symptoms. Subjects aged 70 years or above had the highest detection rate of depression (44.06%) and anxiety symptoms (33.33%). χ 2 trend test showed: the higher the body mass index (BMI), the lower the detection rate of depression and anxiety symptoms ( χ 2 trend = 13.697, P digestive system tumors had the highest detection rate of depression (57.55%) and anxiety (55.19%), followed by patients with liver cirrhosis (41.35% and 48.08%). Depression and anxiety symptoms were also high in subjects with comorbid hypertension and coronary heart disease. Depression and anxiety occur in patients with tumors, liver cirrhosis, functional dyspepsia, and chronic viral hepatitis. Elderly, divorced/widowed, poor sleep quality, and lower BMI are associated with higher risk of depression and anxiety.

  9. Association between joint hypermobility and anxiety in Brazilian university students: gender-related differences.

    Science.gov (United States)

    Sanches, S B; Osório, F L; Louzada-Junior, P; Moraes, D; Crippa, J A S; Martín-Santos, R

    2014-12-01

    Anxiety disorders may be associated with several non-psychiatric disorders. Current literature has been investigating the association between anxiety and joint hypermobility (JHM), with special interest in non-articular symptoms that may be related to autonomic dysfunction. This study investigated the association between anxiety and JHM in a sample of Brazilian university students. Data were cross-sectionally collected in two Brazilian universities (N=2600). Participants completed three validated self-rating anxiety scales: Beck Anxiety Inventory (BAI), Social Phobia Inventory (SPIN) and the brief-version of SPIN (Mini-SPIN). They also answered the self-rating screening questionnaire for JHM: the Five-part Questionnaire for Identifying Hypermobility. Hypermobile women showed significantly higher scores in all the anxiety scales, when compared with men: BAI total score (t=3.77; panxiety and JHM in women, showing specific gender-related features in this field. It also directs attention to non-articular symptoms that may be enrolled in this association. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Ketamine for Social Anxiety Disorder: A Randomized, Placebo-Controlled Crossover Trial.

    Science.gov (United States)

    Taylor, Jerome H; Landeros-Weisenberger, Angeli; Coughlin, Catherine; Mulqueen, Jilian; Johnson, Jessica A; Gabriel, Daniel; Reed, Margot O; Jakubovski, Ewgeni; Bloch, Michael H

    2018-01-01

    Many patients with social anxiety disorder (SAD) experience inadequate symptom relief from available treatments. Ketamine is a potent N-methyl-D-aspartate receptor antagonist with a potentially novel mechanism of action for the treatment of anxiety disorders. Therefore, we conducted a double-blind, randomized, placebo-controlled crossover trial in 18 adults with DSM-5 SAD and compared the effects between intravenous ketamine (0.5 mg/kg over 40 min) and placebo (normal saline) on social phobia symptoms. Ketamine and placebo infusions were administered in a random order with a 28-day washout period between infusions. Ratings of anxiety were assessed 3-h post-infusion and followed for 14 days. We used linear mixed models to assess the impact of ketamine and placebo on anxiety symptoms. Outcomes were blinded ratings on the Liebowitz Social Anxiety Scale (LSAS) and self-reported anxiety on a visual analog scale (VAS-Anxiety). We also used the Wilcoxon signed-rank test to compare the proportion of treatment responders. Based on prior studies, we defined response as a greater than 35% LSAS reduction and 50% VAS-Anxiety reduction. We found ketamine resulted in a significantly greater reduction in anxiety relative to placebo on the LSAS (Time × Treatment: F 9,115 =2.6, p=0.01) but not the VAS-Anxiety (Time × Treatment: F 10,141 =0.4, p=0.95). Participants were significantly more likely to exhibit a treatment response after ketamine infusion relative to placebo in the first 2 weeks following infusion measured on the LSAS (33.33% response ketamine vs 0% response placebo, Wilcoxon signed-rank test z=2.24, p=0.025) and VAS (88.89% response ketamine vs 52.94% response placebo, Wilcoxon signed-rank test z=2.12, p=0.034). In conclusion, this proof-of-concept trial provides initial evidence that ketamine may be effective in reducing anxiety.

  11. Marijuana Effect Expectancies: Relations to Social Anxiety and Marijuana Use Problems

    OpenAIRE

    Buckner, Julia D.; Schmidt, Norman B.

    2008-01-01

    High social anxiety is related to marijuana problems, yet the nature of this relation remains unclear. We examined relations between marijuana effect expectancies, social anxiety, and marijuana among undergraduates (N=337). Social anxiety was related positively to negative expectancies and negatively to Tension Reduction Expectancies. Among socially anxious individuals, greater belief that marijuana produces cognitive/behavioral impairment was associated with greater marijuana use rates. Nega...

  12. Impact of Music in Reducing Patient Anxiety During Pediatric Ultrasound

    OpenAIRE

    Kesselman, Andrew; Bergen, Michael; Stefanov, Dimitre; Goldfisher, Rachelle; Amodio, John

    2016-01-01

    The use of noninvasive ultrasound examinations can potentially result in significant anxiety in the pediatric population. The purpose of this study was to assess the influence of music during pediatric ultrasound examinations to reduce anxiety measured by heart rate. A total of 44 patients were recruited; 21 controls and 23 experimental. Each participant was randomized to either music or no music (control) after parental consent was obtained. Pulse oximeters were used to monitor heart rate at...

  13. Gender Differences in Anxiety Disorders: Prevalence, Course of Illness, Comorbidity and Burden of Illness

    Science.gov (United States)

    McLean, Carmen P.; Asnaani, Anu; Litz, Brett T.; Hofmann, Stefan G.

    2011-01-01

    Women have consistently higher prevalence rates of anxiety disorders, but less is known about how gender affects age of onset, chronicity, comorbidity, and burden of illness. Gender differences in DSM-IV anxiety disorders were examined in a large sample of adults (N = 20,013) in the United States using data from the Collaborative Psychiatric Epidemiology Studies (CPES). The lifetime and 12-month male:female prevalence ratios of any anxiety disorder were 1:1.7 and 1:1.79, respectively. Women had higher rates of lifetime diagnosis for each of the anxiety disorders examined, except for social anxiety disorder which showed no gender difference in prevalence. No gender differences were observed in the age of onset and chronicity of the illness. However, women with a lifetime diagnosis of an anxiety disorder were more likely than men to also be diagnosed with another anxiety disorder, bulimia nervosa, and major depressive disorder. Furthermore, anxiety disorders were associated with a greater illness burden in women than in men, particularly among European American women and to some extend also among Hispanic women. These results suggest that anxiety disorders are not only more prevalent but also more disabling in women than in men. PMID:21439576

  14. What are the Main Sources of Turkish EFL Students’ Anxiety in Oral Practice?

    Directory of Open Access Journals (Sweden)

    Gonca Subaşı

    2010-10-01

    Full Text Available This study was designed in order to investigate two potential sources of the anxiety of Turkish learners of English in oral practice:1 an individual student’s fear of negative evaluation, and 2 his/her self-perceived speaking ability. A total of 55 first year students enrolling in Anadolu University, Education Faculty, ELT Department participated in the study. A 55-item multiple-choice survey was administered to the participants in a regular classroom hour. The survey consisted of five parts: Fear of Negative Evaluation (FNE, Foreign Language Classroom Anxiety Scale (FLCAS, Self-Rating Can-Do Scale (SR-CDS, Self-Rating for the Current Level of Study (SR-CL, Self-Rating Perception by the English (SR-EPE. The Pearson correlation coefficients and multiple regression analyses were run for the statistical interpretation of the data. To achieve valid and reliable results, 15 students were also randomly chosen to conduct an interview in order to find out their reasons for being anxious in using English. The students’ responses given to the survey were probed to have a better understanding of sources leading to high anxiety. The results of the study indicated a positive correlation between an individual’s fear of negative evaluation and his/her anxiety level. Moreover, the findings of the current study revealed that there were significant negative relationships between anxiety and three of self-ratings; SR-CDS, SR-CL and SR-EPE. In addition, it was showed that among the FNE and the three self-ratings of English speaking ability, the combination of the FNE, the SR-CL and SR-CDS was the most appropriate model of predictors of anxiety level of this sample. Finally, the analysis of interview data provided valuable information about the main sources of the students’ anxiety in oral practice such as: personal reasons, teachers’ manners, teaching procedures, and previous experience.

  15. Anxiety, depression, and somatization in DSM-III hypochondriasis.

    Science.gov (United States)

    Kellner, R; Abbott, P; Winslow, W W; Pathak, D

    1989-01-01

    To assess the severity of distress and of somatization in hypochondriasis, the authors administered several validated self-rating scales of depression, anxiety, somatic symptoms, and anger/hostility to 21 psychiatric outpatients with the DSM-III diagnosis of hypochondriasis and to matched groups of other nonpsychotic psychiatric patients, family practice patients, and employees. Anxiety and somatic symptoms were highest in hypochondriacal patients; depression and anger/hostility did not differ from those of other psychiatric patients but were higher than in the other groups. The findings do not support the theory that hypochondriasis is a defense against anxiety or that it is a masked depression or depressive equivalent. The findings are consistent with the view that the interaction of severe anxiety and severe somatic symptoms is a common feature of the psychopathology of hypochondriasis.

  16. Lie-admissible structure of Hamilton's original equations with external terms

    International Nuclear Information System (INIS)

    Santilli, R.M.

    1991-09-01

    As a necessary additional step in preparation of our operator studies of closed nonhamiltonian systems, in this note we consider the algebraic structure of the original equations proposed by Lagrange and Hamilton, those with external terms representing precisely the contact nonpotential forces of the interior dynamical problem. We show that the brackets of the theory violate the conditions to characterize any algebra. Nevertheless, when properly written, they characterize a covering of the Lie-isotopic algebras called Lie-admissible algebras. It is indicated that a similar occurrence exists for conventional operator treatments, e.g. for nonconservative nuclear cases characterized by nonhermitean Hamiltonians. This occurrence then prevents a rigorous treatment of basic notions, such as that of angular momentum and spin spin, which are centrally dependent on the existence of a consistent algebraic structure. The emergence of the Lie-admissible algebras is therefore expected to be unavoidable for any rigorous operator treatment of open systems with nonlinear, nonlocal and nonhamiltonian external forces. (author). 14 refs, 1 fig

  17. Frailty index of deficit accumulation and falls: data from the Global Longitudinal Study of Osteoporosis in Women (GLOW) Hamilton cohort.

    Science.gov (United States)

    Li, Guowei; Ioannidis, George; Pickard, Laura; Kennedy, Courtney; Papaioannou, Alexandra; Thabane, Lehana; Adachi, Jonathan D

    2014-05-29

    To investigate the association between frailty index (FI) of deficit accumulation and risk of falls, fractures, death and overnight hospitalizations in women aged 55 years and older. The data were from the Global Longitudinal Study of Osteoporosis in Women (GLOW) Hamilton Cohort. In this 3-year longitudinal, observational cohort study, women (N=3,985) aged ≥ 55 years were enrolled between May 2008 and March 2009 in Hamilton, Canada. A FI including co-morbidities, activities of daily living, symptoms and signs, and healthcare utilization was constructed using 34 health deficits at baseline. Relationship between the FI and falls, fractures, death and overnight hospitalizations was examined. The FI was significantly associated with age, with a mean rate of deficit accumulation across baseline age of 0.004 or 0.021 (on a log scale) per year. During the third year of follow-up, 1,068 (31.89%) women reported at least one fall. Each increment of 0.01 on the FI was associated with a significantly increased risk of falls during the third year of follow-up (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.02-1.03). The area under the curve (AUC) of the predictive model was 0.69 (95% CI: 0.67-0.71). Results of subgroup and sensitivity analyses indicated the relationship between the FI and risk of falls was robust, while bootstrap analysis judged its internal validation. The FI was significantly related to fractures (hazard ratio [HR]: 1.02, 95% CI: 1.01-1.03), death (OR: 1.05, 95% CI: 1.03-1.06) during the 3-year follow-up period and overnight hospitalizations (incidence rate ratio [IRR]: 1.02, 95% CI: 1.02-1.03) for an increase of 0.01 on the FI during the third year of follow-up. Measured by per standard deviation (SD) increment of the FI, the ORs were 1.21 and 1.40 for falls and death respectively, while the HR was 1.17 for fractures and the IRR was 1.18 for overnight hospitalizations respectively. The FI of deficit accumulation increased with chronological age

  18. Hamilton-Jacobi approach for first order actions and theories with higher derivatives

    International Nuclear Information System (INIS)

    Bertin, M.C.; Pimentel, B.M.; Pompeia, P.J.

    2008-01-01

    In this work, we analyze systems described by Lagrangians with higher order derivatives in the context of the Hamilton-Jacobi formalism for first order actions. Two different approaches are studied here: the first one is analogous to the description of theories with higher derivatives in the hamiltonian formalism according to [D.M. Gitman, S.L. Lyakhovich, I.V. Tyutin, Soviet Phys. J. 26 (1983) 730; D.M. Gitman, I.V. Tyutin, Quantization of Fields with Constraints, Springer-Verlag, New York, Berlin, 1990] the second treats the case where degenerate coordinate are present, in an analogy to reference [D.M. Gitman, I.V. Tyutin, Nucl. Phys. B 630 (2002) 509]. Several examples are analyzed where a comparison between both approaches is made

  19. Assessment of social anxiety in first episode psychosis using the Liebowitz Social Anxiety scale as a self-report measure.

    Science.gov (United States)

    Romm, K L; Rossberg, J I; Berg, A O; Hansen, C F; Andreassen, O A; Melle, I

    2011-03-01

    Social anxiety is a common problem in psychotic disorders. The Liebowitz Social Anxiety Scale, Self-Rating version (LSAS-SR) is a widely used instrument to capture different aspects of social anxiety, but its psychometric properties have not been tested in this patient group. The aims of the present study were to evaluate the psychometric properties of the LSAS-SR in patients with first episode psychosis, to investigate whether it differentiated between active and passive social withdrawal and to test which clinical factors contributed to current level of social anxiety. A total of 144 first episode psychosis patients from the ongoing Thematically Organized Psychosis (TOP) study were included at the time of first treatment. Diagnoses were set according to the Structured Clinical Interview (SCID-1) for DSM-IV. A factor analysis was carried out and the relationship of social anxiety to psychotic and general symptomatology measured by the Positive and Negative Syndrome Scale (PANSS) was evaluated. Possible contributors to social anxiety were analyzed using multiple hierarchic regression analysis. The factor analysis identified three subscales: public performance, social interaction and observation. All three subscales showed satisfactory psychometric properties, acceptable convergent and discriminate properties, and confirmed previous findings in social anxiety samples. Self-esteem explained a significant amount of the variance in social anxiety, even after adjusting for the effects of delusions, suspiciousness and depression. The study shows that the LSAS-SR can be used in this patient group, that social anxiety is strongly related to both behavioral social avoidance and to self-esteem. The results support the use of this measure in assessment of social anxiety in both clinical settings and in research. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  20. Group anxiety management: effectiveness, perceived helpfulness and follow-up.

    Science.gov (United States)

    Cadbury, S; Childs-Clark, A; Sandhu, S

    1990-05-01

    An evaluation was conducted on out-patient cognitive-behavioural anxiety management groups. Twenty-nine clients assessed before and after the group and at three-month follow-up showed significant improvement on self-report measures. A further follow-up on 21 clients, conducted by an independent assessor at an average of 11 months, showed greater improvement with time. Clients also rated how helpful they had found non-specific therapeutic factors, and specific anxiety management techniques. 'Universality' was the most helpful non-specific factor, and 'the explanation of anxiety' was the most helpful technique.

  1. Influence of psychological and coronary parameters on coronary patient rehospitalization

    Directory of Open Access Journals (Sweden)

    Nikolić Gordana

    2010-01-01

    Full Text Available Introduction. Psychological reactions are often comorbid with coronary risk factors and could be important for a six-month outcome. Objective. Determination of anxiety level, depression and aggression, persistence of risk health behaviour, stress life events, and coronary risk factors after coronary event and a predictive value of those parameters for six-month rehospitalization. Methods. In the group with Angina Pectoris (E1=30 and the group with Acute Myocardial Infarction (E2=33, there were applied, at baseline and after 6 months, the following: Semistructured Clinical Interview based on ICD-10, for depressive episode and anxiety disorder, Hamilton Anxiety Scale (HAMA, Hamilton Depression Scale (HAMD, KON-6 sigma Scale for aggression, Holms-Rahe Scale (H-R for stress events and Questionnaire for risk behaviour: alcohol consumption, smoking, lack of physical activity. Group differences were assessed by t-test and chi-square test, p<0.05, regression analysis for assessing initial variables, a predictive value for six month rehospitalization. Results. After acute coronary event, the anxiety and depression levels were mild and aggression was low in E1 and mild in E2. Stress event score was significantly higher in E2 (H-R=115.18 than in E1 (H-R=72.20, p<0.05. After 6 months, the results were the same except for a significantly lower stress event score in E1 (H-R=49.48, and in E2 (H-R=91.65, but still significantly higher than in E1. Coronary parameters were reduced, smokers' rate was increased in E1. Alcohol consumption, hypercholesterolaemia and hereditary tendency were predictive for six- month rehospitalization. Conclusion. After acute cardiac event, hospitalized coronary patients had a mild anxiety, depression and aggression level as well as after six months. The infarct patients had experienced more stress life events in the previous year than the angina patients. Risk health behaviour did not change in the following six months, with the

  2. Childhood separation anxiety and the pathogenesis and treatment of adult anxiety.

    Science.gov (United States)

    Milrod, Barbara; Markowitz, John C; Gerber, Andrew J; Cyranowski, Jill; Altemus, Margaret; Shapiro, Theodore; Hofer, Myron; Glatt, Charles

    2014-01-01

    Clinically significant separation anxiety disorder in childhood leads to adult panic disorder and other anxiety disorders. The prevailing pathophysiological model of anxiety disorders, which emphasizes extinction deficits of fear-conditioned responses, does not fully consider the role of separation anxiety. Pathological early childhood attachments have far-reaching consequences for the later adult ability to experience and internalize positive relationships in order to develop mental capacities for self-soothing, anxiety tolerance, affect modulation, and individuation. Initially identified in attachment research, the phenomenon of separation anxiety is supported by animal model, neuroimaging, and genetic studies. A role of oxytocin is postulated. Adults, inured to their anxiety, often do not identify separation anxiety as problematic, but those who develop anxiety and mood disorders respond more poorly to both pharmacological and psychotherapeutic interventions. This poorer response may reflect patients' difficulty in forming and maintaining attachments, including therapeutic relationships. Psychotherapies that focus on relationships and separation anxiety may benefit patients with separation anxiety by using the dyadic therapist-patient relationship to recapture and better understand important elements of earlier pathological parent-child relationships.

  3. Impact of Tracheostomy Placement on Anxiety in Mechanically Ventilated Adult ICU Patients

    Science.gov (United States)

    Breckenridge, Stephanie J.; Chlan, Linda; Savik, Kay

    2014-01-01

    OBJECTIVE To determine if self-reported anxiety levels decreased after tracheostomy placement in a sample of mechanically ventilated intensive care unit patients. BACKGROUND There is limited research regarding the impact of a tracheostomy on patients’ anxiety. Elevated anxiety delays healing and contributes to long-term mental health complications. METHODS This was a secondary analysis of data from a large clinical trial conducted in urban Minnesota. Fifty-one of 116 patients received a tracheostomy. Anxiety scores were obtained daily using the Visual Analog Scale-Anxiety. Mixed model analysis was used to compare anxiety ratings pre- and post-tracheostomy. RESULTS There was no significant decrease in anxiety following tracheostomy after controlling for time and gender (all p>.16). Age was the only variable to impact anxiety levels: anxiety scores increased as age increased (p=.02). CONCLUSIONS Prospective studies are needed to more accurately assess the impact of tracheostomy placement on patient anxiety and salient outcomes. PMID:24559754

  4. Hubungan Tingkat Kecemasan dalam Menghadapi Objective Structured Clinical Examination (OSCE dengan Kelulusan OSCE pada Mahasiswa Fakultas Kedokteran Universitas Andalas

    Directory of Open Access Journals (Sweden)

    Dinda Putri Amir

    2016-01-01

    Full Text Available AbstrakKecemasan adalah normal terjadi dalam kehidupan, namun kecemasan dapat menjadi abnormal jika respons terhadap stimulus berlebihan. Pada mahasiswa, kecemasan berpengaruh terhadap proses pendidikan. OSCE merupakan salah satu bagian dari ujian komprehensif yang menguji keterampilan medis mahasiswa yang akan memasuki kepaniteraan klinik. Ujian ini hampir sama dengan ujian skills lab, tapi materi ujian lebih banyak dan setting ujian juga berbeda sehingga situasi tersebut menimbulkan kecemasan pada mahasiswa menjelang OSCE. Tujuan penelitian ini adalah menentukan hubungan tingkat kecemasan dalam menghadapi OSCE dengan kelulusan OSCE pada mahasiwa FK Unand. Jenis penelitian ini adalah deskriptif analitik dengan sampel sebanyak 34 orang. Data diperoleh melalui wawancara kepada peserta OSCE menggunakan kuesioner Hamilton Rating Scale for Anxiety (HRS-A dan Bagian Akademik FK Unand yang selanjutnya dianalisis melalui uji korelasi Gamma dan Somers’d. Hasil penelitian ini didapatkan nilai koefisien korelasi (r sebesar -0,106 dan nilai signifikansi p>0,05. Berdasarkan hasil penelitian dapat disimpulkan bahwa tidak terdapat hubungan yang bermakna antara tingkat kecemasan dalam menghadapi OSCE dengan kelulusan OSCE pada mahasiwa FK Unand.Kata kunci: kecemasan, ujian, OSCE, HRS-A AbstractAnxiety normally occurs in life, but anxiety can become abnormal if the response to the stimulus is excessive. In student, anxiety affects the educational process. OSCE is a part of comprehensive exam that examine medical skills of the students who will enter their clinical stage. Although this exam is similiar like skills lab exam but the matters of exam is more complex and the setting of exam is different too, so these situations cause anxiety in students toward OSCE. The objective of this study was to determine the correlation between anxiety level in facing OSCE to students’ graduation of OSCE in Faculty of Medicine Andalas University. This study was a

  5. Environmental Conservation Consciousness and Anxiety From the Persective of Personal Anxiety and Social Anxiety

    OpenAIRE

    保坂, 稔

    2014-01-01

    The system of lifetime employment tends to collapse recently, the rise of anxiety reduces some kinds of aspirations. This paper analyzes the relation between environmental conservation consciousness and anxiety by using the data of 260 university students in Nagasaki. Then I find that the affirmative side which anxiety brings to environmental protection.

  6. Orofacial esthetics and dental anxiety: associations with oral and psychological health.

    Science.gov (United States)

    Carlsson, Viktor; Hakeberg, Magnus; Blomkvist, Klas; Wide Boman, Ulla

    2014-11-01

    Severe dental anxiety (DA) is associated with both oral health and psychosocial consequences in what has been described as a vicious circle of DA. The aim of this study was to investigate self-rated orofacial esthetics in patients with DA and its relationship to psychological and oral health. A consecutive sample of 152 adult patients who were referred or self-referred to a specialized dental anxiety clinic filled out the Orofacial Esthetic Scale (OES) as well as measurements on DA, self-rated oral health and general anxiety and depression. Clinical measures of dental status were also obtained. Compared with the general population, patients with DA had lower ratings of satisfaction on all aspects of their orofacial esthetics, which included the teeth, gingiva, mouth and face, as well as a global orofacial assessment. Furthermore, the perception of the orofacial appearance was related both to dental status and self-rated oral health, as well as to general anxiety and depression. The level of dissatisfaction with the orofacial appearance was similar for both genders, but women reported more regular dental care and better dental status. The results of this study clearly show less satisfaction with dental and facial appearance in patients with DA, and that the self-rating of orofacial esthetics is related to both oral and psychological health. The OES can be used to assess orofacial esthetics in patients with DA.

  7. Anxiety and cerebral blood flow during behavioral challenge. Dissociation of central from peripheral and subjective measures

    International Nuclear Information System (INIS)

    Zohar, J.; Insel, T.R.; Berman, K.F.; Foa, E.B.; Hill, J.L.; Weinberger, D.R.

    1989-01-01

    To investigate the relationship between anxiety and regional cerebral blood flow, we administered behavioral challenges to 10 patients with obsessive-compulsive disorder while measuring regional cerebral blood flow with the xenon 133 inhalation technique. Each patient was studied under three conditions: relaxation, imaginal flooding, and in vivo (actual) exposure to the phobic stimulus. Subjective anxiety, obsessive-compulsive ratings, and autonomic measures (heart rate, blood pressure) increased significantly, but respiratory rate and PCO 2 did not change across the three conditions. Regional cerebral blood flow increased slightly (in the temporal region) during imaginal flooding, but decreased markedly in several cortical regions during in vivo exposure, when anxiety was highest by subjective and peripheral autonomic measures. These results demonstrate that intense anxiety can be associated with decreased rather than increased cortical perfusion and that ostensibly related states of anxiety (eg, anticipatory and obsessional anxiety) may be associated with opposite effects on regional cerebral blood flow

  8. Reducing the Sex Difference in Math Anxiety: The Role of Spatial Processing Ability

    Science.gov (United States)

    Maloney, Erin A.; Waechter, Stephanie; Risko, Evan F.; Fugelsang, Jonathan A.

    2012-01-01

    Decades of research have demonstrated that women experience higher rates of math anxiety--that is, negative affect when performing tasks involving numerical and mathematical skill--than men. Researchers have largely attributed this sex difference in math anxiety to factors such as social stereotypes and propensity to report anxiety. Here we…

  9. Reduced heart rate variability in pet dogs affected by anxiety-related behaviour problems.

    Science.gov (United States)

    Wormald, Dennis; Lawrence, Andrew J; Carter, Gabrielle; Fisher, Andrew D

    2017-01-01

    We present here the first evidence of correlation between canine anxiety-related behavioural problems and heart rate variability (HRV). HRV is known to be related to a range of mental disorders in humans; however this has not been explored in dogs. Behavioural problems in dogs can result in suffering, property destruction and human injury. Dog behaviour problems were assessed by owner questionnaire and the extreme high and low scoring dogs were recruited into either affected (n=10) or unaffected (n=20) groups. HRV was assessed in dogs at their homes, while being held in lateral recumbency for 5min using manual restraint. Salivary cortisol samples were taken before and after HRV testing. Dogs were assessed as either being reactive to the procedure (barking, growling, struggling or shaking) or unreactive. There was no effect of reactivity or behaviour problems on salivary cortisol levels at baseline or in response to the treatment. There was a significant effect of reactivity on HR (F 1,26 =5.54; P=0.026), and no effect of behaviour problems (F 1,26 =1.07; P=0.311). There was no effect of reactivity on any of the HRV measures. The presence of behaviour problems had a significant effect on a range of measures of HRV, with unaffected dogs having higher standard deviation of RR intervals (F 1,26 =6.39; P=0.018), higher high frequency spectrum (F 1,26 =5.23; P=0.031) and higher low frequency spectrum (F 1,26 =9.25; P=0.005) power. There was no effect of behaviour problems on very low frequency spectrum power (F 1,26 =1.40; P=0.248). Together these results provide evidence for a fundamental physiological difference between dogs affected or unaffected with behaviour problems. This study provides evidence for further investigation into the role of HRV in the pathophysiology of canine anxiety-related behaviour problems. Copyright © 2016. Published by Elsevier Inc.

  10. Characteristics of social anxiety from virtual interpersonal interactions in patients with schizophrenia.

    Science.gov (United States)

    Park, Il Ho; Kim, Jae-Jin; Ku, Jeonghun; Jang, Hee Jeong; Park, Sung-Hyouk; Kim, Chan-Hyung; Kim, In Young; Kim, Sun I

    2009-01-01

    Dysfunctional emotional processing affects social functioning in patients with schizophrenia. However, the relationship between emotional perception and response in social interaction has not been elucidated. Twenty-seven patients with schizophrenia and 27 normal controls performed a virtual reality social encounter task in which they introduced themselves to avatars expressing happy, neutral, or angry emotions while verbal response duration and onset time were measured and perception of emotional valence and arousal, and state anxiety were rated afterwards. Self-reported trait-affective scale scores and the Positive and Negative Syndrome Scale (PANSS) ratings were also obtained. Patient group significantly underestimated the valence and arousal of angry emotions expressed by an avatar. While valence and arousal ratings of happy avatars were comparable between groups, patient group reported significantly higher state anxiety in response to happy avatars. State anxiety ratings significantly decreased from encounters with neutral to happy avatars in normal controls while no significant decrease was observed in the patient group. The Social Anhedonia Scale and PANSS negative symptom subscale scores (blunted affect, emotional withdrawal, and passive/ apathetic social withdrawal items) were significantly correlated with state anxiety ratings of the encounters with happy avatars. These results suggest that patients with schizophrenia have interference with the experience of pleasure in social interactions which may be associated with negative symptoms.

  11. Anxiety and anxiety disorders. Toward a conceptual reorientation.

    Science.gov (United States)

    Curtis, G C

    1985-03-01

    Traditionally, it has been assumed that there is only one type of anxiety; recent pharmacologic evidence suggests that there may be several. The psychoanalytic concept of "neurotic" symptoms as depressurizing mechanisms is out of keeping with most evidence now available. Spontaneous or "free-floating" anxiety may be partly biologic and genetic in origin. Anxiety symptoms evoked by specific stimuli behave in part like conditioned responses. Where conditioning theory has failed to propose a plausible unconditioned stimulus for pathologic anxiety, biology, ethology, and psychoanalysis may have been more successful.

  12. Non-destructive examination of a time capsule recovered from the Gore Park excavations, Hamilton, Ontario

    International Nuclear Information System (INIS)

    MacDonald, B.L.; Vanderstelt, J.

    2015-01-01

    Non-destructive analytical techniques are becoming increasingly important for the study of objects of cultural heritage interest. We present a study that applied two techniques: x-ray fluorescence (XRF) and neutron radiography, for the investigation of a time capsule recovered from an urban construction site in Gore Park, Hamilton. XRF analysis revealed the composition of the artifact, while n-radiography showed that its contents remained intact after being interred for 91 years. Results of this study demonstrate the value of non-destructive techniques for the analysis and preservation of cultural heritage. (author)

  13. Teachers' Knowledge of Anxiety and Identification of Excessive Anxiety in

    Science.gov (United States)

    Headley, Clea; Campbell, Marilyn A.

    2013-01-01

    This study examined primary school teachers' knowledge of anxiety and excessive anxiety symptoms in children. Three hundred and fifteen primary school teachers completed a questionnaire exploring their definitions of anxiety and the indications they associated with excessive anxiety in primary school children. Results showed that teachers had an…

  14. Enjoyment and anxiety in second language communication: An idiodynamic approach

    Directory of Open Access Journals (Sweden)

    Carmen Boudreau

    2018-03-01

    Full Text Available Emotions are a fleeting experience, sometimes lasting only moments before dissipating. Prior research in SLA has either ignored emotions, underestimated their relevance, or has studied them as a relatively stable individual difference variable. In contrast, the present study takes an idiodynamic approach to examine the rapidly changing relationship between enjoyment and anxiety in second language communication, on a moment-to-moment timescale. University students who speak French as a second language were recruited to complete oral tasks in their second language. Participants then rated their per-second fluctuations in each emotion while watching a video recording of their tasks. Immediately after this, they were interviewed about their attributions for fluctuations in their ratings. We found that the relationship between enjoyment and anxiety is highly dynamic, resulting in varying patterns of correlation ranging from negative to positive. Triangulation of ratings of anxiety and enjoyment with interview data produces a richer understanding of the role of emotions in second language communication.

  15. Comparison of Anxiety Management Training and Desensitization in Reducing Test and Other Anxieties.

    Science.gov (United States)

    Deffenbacher, Jerry L.; Shelton, John L.

    1978-01-01

    Effects of systematic desensitization and anxiety management training in reducing test anxiety and generalizing to other anxieties were compared. Both desensitization and anxiety management training produced significant reduction of text anxiety, but by follow-up, anxiety management training produced significantly more test-anxiety reduction on…

  16. Smelling Anxiety Chemosignals Impairs Clinical Performance of Dental Students.

    Science.gov (United States)

    Singh, Preet Bano; Young, Alix; Lind, Synnøve; Leegaard, Marie Cathinka; Capuozzo, Alessandra; Parma, Valentina

    2018-05-15

    Despite the fact that human body odors can transfer anxiety-related signals, the impact of such signals in real-life situations is scant. In this study, the effects of anxiety chemosignals on the performance of dental students operating on simulation units, wearing t-shirts imbued with human sweat and masked with eugenol were tested. Twenty-four 4th year dental students (17F) donated their body odors in two sessions (Anxiety and Rest). Twenty-four normosmic, sex- and age-matched test subjects who were3rd year dental students performed three dental procedures while smelling masked anxiety body odors, masked rest body odors or masker alone. The intensity and pleasantness ratings showed that the test subjects could not report perceptual differences between the odor conditions. When exposed to masked anxiety body odors the test subject's dental performance was significantly worse than when they were exposed to masked rest body odors and masker alone, indicating that their performance was modulated by exposure to the emotional tone of the odor. These findings call for a careful evaluation of the anxiety-inducing effects of body odors in performance-related tasks and provide the first ecological evaluation of human anxiety chemosignal communication.

  17. Anxiety disorders in young people: a population-based study

    Directory of Open Access Journals (Sweden)

    Thaíse Campos Mondin

    2013-12-01

    Full Text Available Objective: To assess the prevalence of anxiety disorders and associated factors in young adults. Methods: Cross-sectional population-based study of individuals between the ages of 18 and 24 years randomly selected from 89 census-based sectors to ensure an adequate sample size. Household selection within the sectors was performed according to a systematic sampling process. Anxiety disorders were assessed using the Mini International Neuropsychiatric Interview (MINI. The final sample comprised 1,560 young adults. Results: Of the participants who were diagnosed with anxiety disorders, 12.3% had agoraphobia, 9.7% had generalised anxiety disorder, 4.0% had social phobia, 3.3% had obsessive-compulsive disorder, 2.5% had panic disorder, and 2.1% had post-traumatic stress disorder; only 23.8% had received any previous treatment. Anxiety disorders were associated with sex, socioeconomic status, psychiatric problems in parents, alcohol abuse, and tobacco use. Conclusions: The identification of factors associated with anxiety disorders in young people enables us to develop intervention strategies. Anxiety disorders are not only highly prevalent but are also associated with significant functional impairment, significant reductions in quality of life, lower productivity, and higher rates of comorbidities.

  18. THE VALIDITY OF CLINICAL DIFFERENTIATION BETWEEN ANXIETY AND DEPRESSIVE NEUROSES BY FACTOR ANALYSIS

    OpenAIRE

    Singh, Gurmeet; Sharma, Ravinder Kumar

    1986-01-01

    SUMMARY Ninety subjects consisting of 30 patients of generalized anxiety disorder, 30 of dysthymic disorder (depressive neurosis) according to D. S. M. III criteria and 30 patients of mixed anxiety-depressive disorder were given a detailed psychiatric examination, in addition, they were administered the Humilton rating scales for anxiety and depression, and also the Taylor manifest anxiety scale and Amritsar depressive inventory. All the symptoms elicited were then subjected to factor analysi...

  19. Depression and anxiety among Grade 11 and 12 learners attending schools in central Bloemfontein

    Directory of Open Access Journals (Sweden)

    M A A Strydom

    2012-08-01

    Full Text Available Objectives. Anxiety disorders are the most common childhood psychiatric disorders. Previous research suggests that South African rates may be high. Our study examined the prevalence and severity of anxiety and depression among Grade 11 and 12 learners attending schools in central Bloemfontein. Learners’ perception of the important stressors as well as the most relevant coping strategies were investigated. Methods. A cross-sectional study was conducted by using self-assessment rating scales and questionnaires. The Hospital Anxiety and Depression Scale (HADS was used to screen for anxiety and depressive symptoms. Participants were provided with an additional list of possible stressors and coping skills, from which they identified those applicable to themselves. All students enrolled in Grades 11 and 12 at the selected schools during August 2009 were eligible for inclusion. Results. Five hundred and fifteen learners participated in the study, of whom 32.0% presented with moderate or severe anxiety and 5.3% with moderate or severe depressive symptoms. Mild symptoms were reported by an additional 29.0% on the anxiety subscale and 14% on the depression subscale of the HADS. Academic workload was reported as the main source of stress (81.4%. Conclusions. Although the study has limitations in terms of methodology and size, resulting in undetermined validity, it indicates possible higher prevalence rates for anxiety and depression than in previous South African studies and worldwide prevalence rates for adolescents. Pupils were generally hesitant to seek help from formal assistance structures provided by the schools, and preferred discussing problems with parents or friends.

  20. The greek translation of the symptoms rating scale for depression and anxiety: preliminary results of the validation study

    Directory of Open Access Journals (Sweden)

    Gougoulias Kyriakos

    2003-12-01

    Full Text Available Abstract Background The aim of the current study was to assess the reliability, validity and the psychometric properties of the Greek translation of the Symptoms Rating Scale For Depression and Anxiety. The scale consists of 42 items and permits the calculation of the scores of the Beck Depression Inventory (BDI-21, the BDI 13, the Melancholia Subscale, the Asthenia Subscale, the Anxiety Subscale and the Mania Subscale Methods 29 depressed patients 30.48 ± 9.83 years old, and 120 normal controls 27.45 ± 10.85 years old entered the study. In 20 of them (8 patients and 12 controls the instrument was re-applied 1–2 days later. Translation and Back Translation was made. Clinical Diagnosis was reached by consensus of two examiners with the use of the SCAN v.2.0 and the IPDE. CES-D and ZDRS were used for cross-validation purposes. The Statistical Analysis included ANOVA, the Spearman Correlation Coefficient, Principal Components Analysis and the calculation of Cronbach's alpha. Results The optimal cut-off points were: BDI-21: 14/15, BDI-13: 7/8, Melancholia: 8/9, Asthenia: 9/10, Anxiety: 10/11. Chronbach's alpha ranged between 0.86 and 0.92 for individual scales. Only the Mania subscale had very low alpha (0.12. The test-retest reliability was excellent for all scales with Spearman's Rho between 0.79 and 0.91. Conclusions The Greek translation of the SRSDA and the scales that consist it are both reliable and valid and are suitable for clinical and research use with satisfactory properties. Their properties are close to those reported in the international literature. However one should always have in mind the limitations inherent in the use of self-report scales.