Anxiety sensitivity and cannabis use

Anxiety sensitivity can be defined as being anxious about being anxious. People with anxiety sensitivity are anxious about the physical symptoms of being anxious (an upset tummy, sweaty palms, pounding heart), mental incapacitation (losing control and not being able to think properly) and social concerns such as other people seeing them with a red face or in a panic. Some researchers think anxiety sensitivity plays a part in cannabis use and a team of researchers led by Julia D. Buckner from Louisiana State University looked into this in a study of 49 current cannabis users who were asked to fill in assessments about their mood at random times over a two-week period. The researchers found that at the start of the study fears about mental incapacitation were significantly related to more severe cannabis problems. Over the course of the study fears about mental incapacitation and social concerns were linked to subsequent cannabis use.

Buckner, Julia D. ... [et al] - Anxiety sensitivity and marijuana use: an analysis from ecological momentary assessment Depression and Anxiety DOI 10.1002/da.20816

Which drugs work best for anxiety?

A team of researchers led by David Baldwin from the University of Southampton have been reviewing trials into drug therapy for generalised anxiety disorder. They reviewed 27 trials comparing nine drugs: duloxetine, escitalopram, fluoxetine, lorazepam, paroxetine, pregabalin, sertraline, tiagabine and venlafaxine. They found that fluoxetine was the most effective and sertraline was the best tolerated i.e. had fewer side effects. Among treatments currently licensed in the UK duloxetine had the best response, escitalopram was ranked first for depression and pregabalin had the fewest side effects.

Baldwin, David ... [et al] - Efficacy of drug treatments for generalised anxiety disorder: systematic review and meta-analysis British Medical Journal BMJ 2011; 342:d1199

Panic attacks and other problems

There is an increasing amount of evidence to suggest that people who suffer from panic attacks are also more likely to suffer from other physical and mental-health problems. Researchers from the University of Manitoba in Winnipeg, Canada used information from the huge U.S. National Epidemioligic Survey on Alcohol and Related Conditions. They studied 34,653 people who were asked about their health in 2001-2 and 2004-5. The study found that those people who had panic attacks in 2001-2 were more likely to have generalised anxiety disorder, panic disorder, social phobia, depression and mania in 2004-5.

Kinley, D. Jolene ... [et al] - Panic attacks as a risk for later psychopathology: results from a nationally representative survey Depression and Anxiety DOI 10.1002/da.20809

NICE updates anxiety guidelines

The U.K.'s National Institute for Clinical Excellence (NICE) has updated its guidance on the treatment of generalised anxiety disorder (GAD). It says that patients should not be offered benzodiazepines or antipsychotics but should be educated about their condition and actively monitored. If this does not work patients should be offered low-intensity psychological interventions such as self-help groups or books and the chance to join psychoeducational groups. Patients who do not respond to this should be considered for cognitive behaviour therapy (CBT), applied relaxation or drug treatment while those most at risk of self-harm should be offered a specialist assessment of their needs and risks.

Survey shows mental-health problems in menopausal women

Compared to men women go through a number of hormonal changes throughout their life which can also affect their mental health. Menopause is associated with depression, sleep disturbances, anxiety and irritability and researchers from Selcuk University in Turkey studied mood and anxiety disorders in a sample of 269 post-menopausal women attending a gynaecology outpatient clinic. They found that 34.2% of them had at least one mood or anxiety disorder, the most common of which was generalised anxiety disorder which was suffered by 15.6% of the women. The less well-off the women were the more likely they were to suffer from mood and anxiety disorders.

Sahingoz, Mine,  Uguz, Faruk and Gezginc, Karim - Prevalence and Related Factors of Mood and Anxiety

Disorders in a Clinical Sample of Postmenopausal Women Perspectives in Psychiatric Care
doi: 10.1111/j.1744-6163.2010.00296.x

Acceptance and anxiety

When James Dean's character in Rebel Without a Cause is asked 'What are you rebelling against?' he replies 'What have you got?' and people with generalized anxiety disorder (GAD) feel much the same about worry. Acceptance-based behavioural therapy (ABBT) promotes the acceptance rather than the avoidance of uncomfortable emotions, persuades people that they can usefully channel these emotions and gets them to confront the situations that make them fearful. A team of researchers from the University of Massachusetts studied 31 people, half of whom were put on a waiting list and half of whom received ABBT. The people who received ABBT had significantly fewer difficulties in regulating their emotions and felt less fear about their emotional responses as well as being less bothered by uncertainty; improvements that were maintained when they were followed up after three and nine months.

Treanor, Michael ... [et al] - Acceptance-based behavioral therapy for GAD: effects on outcomes from three theoretical models Depression and anxiety doi: 10.1002/da.20766

Getting to the bottom of why people worry

Generalised anxiety disorder (GAD), or chronic worrying, is the most common anxiety disorder and, in any one year, is thought to affect around 2.7% of the population. Two thought processes that are believed to underly GAD are intolerance of uncertainty and what psychologists call negative metacognitive beliefs - worry about worry. Intolerance of uncertainty is a predisposition to react negatively to an uncertain event or situation - to assume that the worst is going to happen. People who are intolerant of uncertainty assess ambiguous situations as being stressful, disturbing and unacceptable and show increased perceptions of threat in situations that are relatively harmless. Worrying about worrying can lead to unhelpful behaviour and ways of controlling one's thoughts that actually lead to more worry in the long-term. Researchers from Swinburne University of Technology in Melbourne studied 119 people in an attempt to investigate these issues further. Their study also looked into the effects of 'parentification' - a situation in which children end up looking after people who are supposed to be looking after them. The idea behind this was that these children are asked to carry out tasks that they are not really capable of which makes them less confident, and more anxious about, their ability to handle difficult situations in the future. The researchers found that intolerance of uncertainty and negative metacognitive beliefs were both associated with an increase in GAD symptoms. However, once the researchers had taken into account the effects of depression parentification was not associated with an increased propensity to worry.

Tan, Shary ... [et al] (2010) Metacognitive, cognitive and developmental predictors of generalised anxiety disorder symptoms Clinical Psychologist 14 (3), 84 - 89

Smoking and anxiety

People with anxiety problems could be more likely to smoke and may have a harder time giving up when they do. Researchers from the University of Wisconsin studied 1,504 people taking part in a smoking-cessation programme in Madison and Milwaukee. 455 had had a panic attack in the past, 199 had social anxiety disorder and 99 had generalized anxiety disorder with some people having more than one condition. Other research has shown that up to a quarter of the smokers in the U.S. have had at least one anxiety disorder in their lifetime. The participants with anxiety disorders were much less likely to succeed on the programme, had higher levels of nicotine dependence and more withdrawal symptoms before quitting.

Anxiety and insomnia drugs linked to increased risk of death

Taking drugs to fight anxiety or insomnia could significantly increase people's risk of death. Researchers from the Universite Laval in Quebec analysed 12 years of data on over 14,000 Canadians from the National Population Health Survey. They found that respondents who said they had used drugs to treat insomnia or anxiety at least once in the month before the survey had a mortality rate about 50% higher than those who did not use them. After allowing for alcohol and tobacco consumption, physical health, exercise and depression the researchers concluded that the drugs were associated with a 36% increase in the risk of death. The increased risk of death could be due to a number of causes including: the drugs' effect on reaction times, alertness and concentration leading to more falls and accidents; their effect on people's breathing particularly during sleep and a possible increased risk of suicide after taking the drugs.

You can find out more about this research by clicking on the title of this post.

Anxiety does not affect effectiveness of duloxetine

Some studies have suggested that people who suffer from anxiety as well as depression respond less well to treatments with antidepressants. J. Craig Nelson from the University of California, San Francisco reviewed 11 studies into the effectiveness of duloxetine at treating depression. The studies covered a total of 2,841 people of whom 1,326 were classified as anxious. Duloxetine was found to be more effective than a placebo and have better response and remission rates, and the drug was just as effective for people with anxiety.

Nelson, J. Craig - Anxiety does not predict response to duloxetine in major depression: results of a pooled analysis of individual patient data from 11 placebo-controlled trials Depression and Anxiety January 2010, 27(1), 12-18

The burden of depression and anxiety

Worldwide, mental-health problems accounted for 9.4% of the burden of illness in 2002, compared to 9.9% for cardiovascular disease and 5.1% for cancer. Within mental illness depression is thought to make up about 55% of the burden, with anxiety making up 30%. Tahany M. Gadalla, from the University of Toronto, used data from the 2005 Canadian Community Health Survey, covering 108,986 people to look at the impact of depression and anxiety in Canada. Her study found that there were higher rates of anxiety and depression among women, those between 30-69, those who were single, divorced or widowed, those born in Canada, those with a low income and those with a chronic physical illness. Having anxiety or depression was significantly associated with short-term disability, needing help with daily activities and a reduction/modification of work activitiy.

Gadalla, Tahany M. - Association between mood and anxiety disorders and self-reported disability: results from a nationally representative sample of Canadians Journal of Mental Health December 2009, 18(6), 495-503

Study backs U.K. government's talk-therapy initiative

The U.K. government has been trying to help more people with mental-health problems with its Improving Access to Psychological Therapies (IAPT) programme. Researchers from Exeter University looked at the effectiveness of the programme in Doncaster, South Yorkshire. They studied 2,017 people who had been treated for depression and anxiety. By the end of their treatment 76% of depression sufferers were either in recovery or remission and 74% of anxiety sufferers were. For all patients (including those who dropped out of treatment) the figures were 61% and 62% respectively. The average length of treatment was short (2hrs 45 mins) and most patients received low-intensity cognitive behaviour therapy (CBT), the majority of which was carried out over the telephone.

You can find out more about this research at

http://www.medicalnewstoday.com/articles/169515.php

Anxiety and birthweight

The list of drinks and substances that pregnant women have to worry about can seem endless and now researchers from the University of Pittsburgh Medical Centre have added another factor to the list: anxiety itself. The researchers studied a sample of low-income women half of whom were African-American and half of whom were white. The group already had a number of risk factors - including drinking and smoking - but the study showed that anxiety had an influence over and above this. Anxiety in the last third of pregnancy predicted women having significantly smaller babies whereas in the first and second thirds of pregnancy only those with the most severe anxiety had smaller babies.

You can find out more about this research at

http://www.sciencedaily.com/releases/2009/10/091027132253.htm

Black cohosh for menopausal anxiety

Some studies have shown that nearly 50% of women experience psychological problems as they go through the menopause. Benzodiazepines and antidepressants are often used to treat anxiety in women going through the menopause but benzodiazepines can cause withdrawal problems and antidepressants can cause sexual problems, weight gain and withdrawal. Some women look for alternative remedies for their anxiety and turn to black cohosh extract made from the roots of a plant in the same family as buttercups and anemones. Researchers from the University of Pennsylvania carried out a small-scale study of 28 people comparing the effectiveness of black cohosh to that of a placebo. They found that there was no significant difference between the black cohosh and a placebo over a 12=week study.

Amsterdam, Jay D. ... [et al] - Randomized, double-blind, placebo-controlled trial of Cimicifuga racemosa (Black Cohosh) in women with anxiety disorder due to menopause Journal of Clinical Psychopharmacology October 2009, 29(5), 478-483

Neurosis and asthma

People who are neurotic are at greater risk of developing asthma. Neurotic people tend to be more pessimistic, worry more and have more emotional ups and downs than other people. Researchers from Heidelberg University studied 5,114 people aged between 40 and 65 examining the links between neuroticism, stressful life events and asthma. Around 2% of the people who were free of asthma at the start of the study developed it during the eight-year follow up period. People who were highly neurotic were three times more likely to develop asthma than others. Divorce or separation increased the risk of asthma in women but not in men. Unemployment and the death of a loved one were not significantly associated with the development of asthma.

You can find out more about this research at

http://uk.reuters.com/article/idUKTRE59L57Q20091022?feedType=RSS&feedName=healthNews&pageNumber=1&virtualBrandChannel=0

Depression, anxiety and obesity

A 19-year survey of 4,363 British civil servants by researchers at University College London has found that those who suffered from anxiety and depression were more likely to become obese. The participants were screeened four times over the course of the study with each screening assessing them for common mental disorders and measuring their height and weight. Weight gain was more common in people with mental disorders at the start of the study. Those participants who showed signs of mental disorder in the first three screenings were twice as likely as symptom-free people to be obese by the end of the study. Those who experienced more incidences of common mental disorders had a greater risk of weight gain and obesity but there was no evidence of a relationship in the other direction i.e. people who were obese at the earlier checks were no more likely to develop depression and anxiety later than slimmer people.

You can find out more about this research at

http://www.medicalnewstoday.com/articles/166566.php

Young, free and anxious

A YouGov poll of 2,000 adults has found that two-thirds of them feel stressed or anxious at least once a week. One in three young women suffered from frequent anxiety (most days or every day) compared to one in ten young men. Money worries were given as the main cause of worry by 45% of the respondents, followed by job prospects (33%) and pressure from school or university (29%). Some of the sample said that they would seek advice or support from a partner or friend but almost a third (31%) said that they kept anxiety and stress to themselves.

http://news.bbc.co.uk/1/hi/health/8286939.stm

Depression, anxiety and executive functioning

Executive functioning is made up of a broad range of capabilities including the ability to pay attention, the ability to transfer one's attention from one thing to another, the ability to hold information in one's working memory, and planning. People who suffer from anxiety and depression often have problems with their ability to concentrate and inhibit their impulses making some scientists think that they have problems with their executive functioning. However, it is not known whether these problems with executive functioning come before or after the onset of anxiety or depression i.e. whether they are a cause or a symptom of mental-health problems. Researchers from the Massachusetts General Hospital studied 147 children. Some of their parents had depression, others had anxiety and the rest formed an unaffected control group. The idea was that any genetic tendency towards poorer executive functioning in people at risk from depression and anxiety would be reflected in children whose parents suffered from these conditions. The study found that children whose parents suffered from anxiety, or depression did not have poorer executive functioning. However, those children who did have depression or anxiety themselves did show worse executive functioning. Children with depression had poorer performance on several executive functioning and processing speed measures. Children with anxiety had a poorer verbal memory and children with social phobia made more mistakes on a continuous performance task. The results of the study tend to support the idea that poorer executive functioning is a symptom of depression and anxiety rather than a cause.

Micco, Jaime A. ... [et al] - Executive functioning in offspring at risk for depression and anxiety Depression and Anxiety September 2009, 26(9), 780-790

Child abuse, teenage mums and mental-health problems

Around 270,000 girls under the age of 18 become pregnant each year in the U.S. Such girls are more likely to have experienced abuse from their parents and to suffer victimization (including domestic violence and sexual assault) later. Adolescent mothers are also more at risk of problems such as depression, anxiety, alcohol problems and drug abuse. However, little is known about the pathways between victimization in childhood, victimization later and other problems. Researchers from the University of Washington studied 229 teenage mothers to try and find out more about this. They found that parental child abuse had a negative effect on the teenage mums both in itself and by causing psychological distress and victimization, which in turn led to the girls suffering psychological distress at the end of the two-and-a-half year study. The psychological distress caused by the girls being abused as children was the most important factor leading to psychological distress and victimization at the end of the study rather than substance abuse problems developed in response to being abused by parents.

Lindhorst, Taryn ... [et al] - Mediating pathways explaining psychosocial functioning and revictimization as sequelae of parental violence among adolescent mothers American Journal of Orthopsychiatry 2009, 79(2), 181-190

Worrying oneself to death

Chronic worrying, anxiety and being prone to depression are important aspects of the personality trait known as neuroticism. Previous research has shown that high levels of neuroticism can lead to an early death and researchers from Purdue University in Indiana looked into this issue more closely in a study of 1,788 people between 1975 and 2005. They found that people with high levels of neuroticism were more likely to smoke, something that explained 25-40% of the association between high neuroticism and mortality. The researchers thought that neurotic people turned to cigarettes, and possibly alcohol and other drugs, to deal with their worry and anxiety. The other 60% of the excess mortality of neurotic people could not be explained by higher rates of smoking but could be due to biological factors or other environmental issues.

You can find out more about this research at

http://www.sciencedaily.com/releases/2009/08/090818130552.htm