• Title/Summary/Keyword: Anxiety Disorder

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Heart Rate Variability in Patients with Anxiety Disorder and Effects of Selective Serotonin Reuptake Inhibitor (불안장애 환자에서의 심박변이도와 세로토닌재흡수억제제투여 후의 치료효과)

  • Lee, Kang-Joon;Kim, Hyun;Lee, Seung-Hwan;Park, Young-Min;Chung, Young-Cho
    • Korean Journal of Psychosomatic Medicine
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    • v.14 no.2
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    • pp.94-101
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    • 2006
  • Objectives : A variety of symptoms are typically reported during anxiety period, several of which are clearly linked to the autonomic nervous system(ANS), such as palpitations, chest pain and shortness of breath. Using spectral analysis of heart rate, several studies have shown that patients with anxiety disorder are characterized by a reduced heart rate variability(HRV), indicative of abnormalities in ANS fuction. To further evaluate the effect of anxiety and medication on autonomic function, 30 patients and 30 matched control subjects were assessed. Methods : Using spectral analysis of heart rate, which consisted of standardised measurements of HRV, we compared ANS between 30 patients with DSM-IV diagnosed anxiety disorder and 30 healthy controls, and investigated the autonomic effects of SSRI treatment. Five-minute HRV recordings were obtained before and after SSRI treatment and were analysed. Results : Five-minute HRV recordings in anxiety disorder patients revealed that a significant reduction in HRV was shown compared to controls. There was no significant changes in HRV between before and after SSRI treatment. Conclusion: Anxiety disorder patients showed a significant reduction in HRV compared to controls. SSRIs do not affect HRV influenced by ANS function. Further study is needed to confirm these things. Patients with anxiety disorder may suffer from functional disturbances in the interaction between the sympathetic and parasympathetic autonomic tree.

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Anxiety Hastened Depressive Recurrence in Bipolar Disorder : An Interim Analysis of Prospective Follow-Up Study (양극성 장애 환자에서 불안이 질병 경과에 미치는 영향 : 전향적 추적관찰에 대한 중간분석)

  • Kim, Soojeong;Kim, So Jeong;Song, Hye Hyun;Lee, Wonhye;Chon, Myong-Wuk;Nam, Yoon Young;Park, Dong Yeon
    • Korean Journal of Biological Psychiatry
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    • v.28 no.1
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    • pp.13-22
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    • 2021
  • Objectives Despite growing attention to anxiety in bipolar disorder (BD), little research has assessed anxiety symptoms in the course of BD. The current prospective follow-up study examines the influence of subjectively and objectively measured anxiety symptoms on the course of BD. Methods A total of 49 patients with BD were followed-up prospectively for average of one year at an average of four months interval. The Korean version of the Beck Anxiety Inventory (K-BAI), the Hamilton Anxiety Rating Scale, heart rate variability (HRV) were used to measure anxiety subjectively, objectively and physiologically. Participants were divided into high and low anxiety groups based on their K-BAI scores. Kaplan-Meier survival analysis was performed to compare the recurrence of mood episode, suicide attempt, emergency room visit, and psychiatric hospitalization between two groups. Mediators were investigated with Cox proportional hazards models. Results Compared to the low anxiety group, the high anxiety group reported significantly higher impulsiveness (p = 0.016) and lower high frequency component on HRV (p = 0.007) after controlling for severity of BD. Regarding survival analysis, the high anxiety group showed hastened depressive episode recurrence (p = 0.048) and suicidal ideation was the mediator of the hazard ratio (HR) 1.089 (p = 0.029) in the Cox model. Moreover, the high anxiety group showed a tendency of accelerated suicide attempt (p = 0.12) and impulsivity was the risk factor of suicide attempt (HR = 1.089, p = 0.036). Conclusions This interim analysis of prospective study suggests that high anxiety level in BD may anticipate unfavorable course. Further studies are needed to understand the multifactorial mechanism of anxious bipolar patients.

Emotion Recognition and Regulation Mechanism in Panic Disorder (공황장애의 감정 인식 및 조절 메커니즘)

  • Kim, Yoo-Ra;Lee, Kyoung-Uk
    • Anxiety and mood
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    • v.7 no.1
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    • pp.3-8
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    • 2011
  • Cognitive models of panic disorder have emphasized cognitive distortions' roles in the maintenance and treatment of panic disorder (PD). However, the patient's difficulty with identifying and managing emotional experiences might contribute to an enduring vulnerability to panic attacks. Numerous researchers, employing emotion processing paradigms and neuroimaging techniques, have investigated the empirical evidence for poor emotion processing in PD. For years, researchers considered that abnormal emotion processing in PD might reflect a dysfunction of the frontal-temporal-limbic circuits. Although neuropsychological studies have not provided consistent results regarding this model, a few studies have tried to find the biological basis of dysfunctional emotion processing in PD. In this article, we examine the possibility of dysregulation of emotion processing in PD. Specifically we discuss the neural basis of emotion processing and the manner in which such neurocognitive impairments may help clarify PD's core symptoms.

The Association of Anxiety Severity With Health Risk Behaviors in a Large Representative Sample of Korean Adolescents

  • Woo, Kyung Soo;Ji, Yoonmi;Lee, Hye Jeong;Choi, Tae Young
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.32 no.4
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    • pp.144-153
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    • 2021
  • Objectives: Anxiety disorders are the most common psychiatric disorders in adolescents and seem to occur the earliest among all forms of psychopathology. The aim of this study was to investigate the association of anxiety severity with health risk behaviors and mental health in adolescents. Methods: Data from the 2020 Korean Youth Risk Behavior Web-Based Survey were analyzed. A total of 54948 adolescents responded to the 7-item Generalized Anxiety Disorder Scale (GAD-7) for the assessment of their anxiety severity as well as to the mental health and health risk behavior survey. Logistic regression analysis, t tests, and variance analysis of a complex sample general linear model were used to examine the association of anxiety severity with health behaviors and mental health. Results: After statistical adjustment for sociodemographic characteristics, the subjects in the severe anxiety group were significantly more likely to be current smokers (odds ratio [OR]: 2.08, 95% confidence interval [CI]: 1.72-2.50), current drinkers (OR: 1.91, 95% CI: 1.67-2.19), experience habitual substance use (OR: 10.89, 95% CI: 8.22-14.42), have sexual intercourse (OR: 2.10, 95% CI: 1.76-2.51), and have unprotected intercourse (OR: 2.21, 95% CI: 1.67-2.92) than those in the normal group. Anxiety severity negatively correlated with sleep satisfaction and happiness, but positively correlated with stress perception, loneliness, depressive symptoms, and suicidality. Conclusion: Adolescent anxiety is associated with health risk behaviors and poor mental health. Thus, early screening and intervention for anxiety in adolescents could contribute to the management and coping of youth health risk behaviors in the community.

Attentional Dysfunction in Major Psychiatric Disorders (주요 정신장애에서의 주의력 장애)

  • Ha, Kyoo-Seob
    • Sleep Medicine and Psychophysiology
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    • v.5 no.2
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    • pp.155-169
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    • 1998
  • Attentional dysfunction is considered as one of the core deficits in schizophrenic process. The findings, pathophysiological mechanisms, and their clinical implications of clinical and experimental neurocognitive tests for the attentional impairment in schizophrenics are reviewed. The influences of psychopathology, antipsychotic treatment, and chronic institutionalization are also included in the review. In contrast, there are only a few evidences that attentional dysfunction would be a core deficit of depressive, manic, and anxiety disorders. Some recent findings of attentional impairment in these disorders are reviewed.

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Neurobiology of Anxiety (불안의 신경생물학)

  • Ryu, Seong Gon;Han, Chang Whan
    • Korean Journal of Biological Psychiatry
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    • v.8 no.1
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    • pp.71-78
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    • 2001
  • The current understanding of the neurobiology of anxiety is generally based on experimental animal model, empirical effective psychopharmacological agents, chemical and naturalistic challenge paradigms, and psychoendocinological assessment. This article focuses on reviewing neuroanantomical, neuroendocinological and neurofunctional research of anxiety disorder. In the decade ahead, we anticipate that extension of current research and the new integrated approach promise novel insight into mechanism of anxiety.

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Automatic Nerve Activity to Physiologic Response in Adult With Psychiatric Disorder: A Systemic Review (성인 정신장애의 청각자극에 따른 생리학적 반응 측정에 대한 체계적 고찰)

  • Jung, Hye-Rim;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.9 no.1
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    • pp.45-52
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    • 2011
  • Objective : The aim of this study was to provide the method to measure physiologic response using equipments and auditory stimulation, and the physiologic response features of adult psychiatric disorders through a systemic review. Methods : The systemic review was executed using PubMed. The key words for search were "auditory stimulation, auditory startle, electromyograph, skin conductance, heart rate, psychiatric disorder, anxiety disorder, schizophrenia, depression". 8 studies were used for data analysis, and all of levels of evidence were level II. The substances of the review were subject(population), auditory stimulation, measure equipments and physiologic response features of psychiatric disorder. Results : 1. The subjects for the studies were anxiety disorder(4) and schizophrenia(4). 2. Auditory stimulation was used in 8 studies and visual stimulation with auditory stimulation was used in 2 studies to induce physiologic response. 3. Every study used electromyograph, and skin conductance was used in 2 studies and heart rate was used in 2 studies with electromyograph to measure physiologic response. 4. The subjects for the studies, schizophrenia and anxiety disorder(PTSD, OCD) have different physiologic response features with the normal control group. Conclusion : All studies used simple tones as an auditory stimulation and electromyograph to measure physiologic response. Psychiatric disorders indicated larger response, shorter and delayed habituation. The objective and systematic study using physiologic measure to investigate the sensory feature of psychologic disorders.

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Severity of Musculoskeletal Pain and Its Effect on Psychosocial Factors in Veterans With Posttraumatic Stress Disorder

  • Kwon, Chun-suk;Kim, Suhn-yeop
    • Journal of the Korean Society of Physical Medicine
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    • v.10 no.3
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    • pp.29-37
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    • 2015
  • PURPOSE: The aim of this study is to investigate the relationship between psychosocial factors and the severity of musculoskeletal pain in veterans with posttraumatic stress disorder (PTSD). METHODS: A total of 60 subjects were recruited from among the veterans with musculoskeletal pain at D Veterans Hospital. PTSD was evaluated by using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; severity of pain was measured by using the short-form McGill Pain Questionnaire (SF-MPQ); depression and anxiety were measured by using the Symptom Checklist-90-Revision; and the quality of sleep was measured by using the Pittsburgh Sleep Quality Index. All data were analyzed using SPSS 18.0 software for Windows. RESULTS: The averages cores of pain intensity ($7.48{\pm}1.67$), SF-MPQ-sensory ($13.84{\pm}7.52$), SF-MPQ-affective ($4.41{\pm}3.79$), depression ($19.30{\pm}11.37$), anxiety ($13.39{\pm}7.99$), and quality of sleep ($10.05{\pm}5.89$) were obtained in veterans with PTSD. SF-MPQ-sensory measures sleep quality (r=0.346, p<0.01), SF-MPQ-affective measures depression (r=0.318, p<0.01) and anxiety (r=0.404, p<0.01), and these showed a statistically significant positive correlation in veterans with PTSD. Pain levels were observed to be higher in veterans with PTSD. Moreover, in these subjects, physical pain had a significant influence on the anxiety variable among the psychosocial factors. CONCLUSION: These findings suggest that musculoskeletal pain provides meaningful information about depression, anxiety, and sleep disorder in veterans with PTSD. Our data suggest that musculoskeletal pain may need to be addressed as part of the health management process of veterans.

Retrospective Drug Utilization Review Study on the Therapeutic Duplication in Patients with Anxiety Disorders (불안장애 환자에서의 치료약제 중복사용에 대한 후향적 의약품사용평가 연구)

  • Park, Chan-Hyun;Sohn, Hyun-Soon;Shin, Hyun-Taek;Choi, Kyung-Eob
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.1
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    • pp.39-49
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    • 2010
  • The present study was aimed to examine the occurrence and influencing factors therapeutic duplication (TD) of medications for anxiety disorders by analyzing the relevant prescription data. In this study, the prescription data issued on March 19, 2008 in domestic medical institutes were utilized. TD was defined as more than two medications under the same therapeutic classification per prescription based on the Anatomical Therapeutic Classification (ATC) code. The assessment of TD was performed based on the number of cases and on the ratio determined. To identify the influencing factor of TD, the variables related to the differences in the TD ratio were analyzed based on the results of the Chi-Square test conducted with the variables; patients, medical institutes, diseases, and treatments. The number and ratio of TD were determined to be 1,333 out of the total of 19,219 anxiety disorder cases, and 6.94%, most cases involving benzodiazepine derivatives, respectively. The TD ratio was found to be higher in relation to males than to females. Patients with national health insurance benefits have a higher TD ratio compared to the medical-aid beneficiaries. The TD ratios were highest in clinics, psychiatry divisions, and Gyeongsang district. The TD ratio of the cases with more than two anxiety disorders was found to be higher than that of the cases with only one anxiety disorder. As the number of medications per prescription increased, the TD ratio was shown to have become gradually higher. In conclusion, in order to prevent TD, the concurrent DUR system should be implemented. The prescribers and pharmacists must be educated regarding duplicated medications to promote the safe and effective use of medicines, without unnecessary TD.

Interpretation bias modification for social anxiety disorder: Development of computer based cognitive modification program (사회불안장애의 해석편향 연구: 컴퓨터 기반 해석편향 프로그램 개발 및 효과검증)

  • Yoon, Hyae-Young
    • Journal of the Korea Convergence Society
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    • v.8 no.4
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    • pp.111-122
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    • 2017
  • The purpose of this study was to develop a computer-based cognitive bias modification program (CBM-I) and to test the efficacy of CBM-I for college students with social anxiety. Forty socially anxious individuals were randomly assigned to the CBM-I(n=21) or a waiting list condition(n=19). Both groups were assessed at the beginning and the end of the program with interpretation bias and social anxiety symptoms(e.g. B=FNE=Brief-Fear of Negative Evaluation Scale, LSAS=Liebowitz Social Anxiety Scale). The CBM-I modified interpretation by providing positive feedback when participants made benign interpretations and negative feedback in response to threat interpretations. Participants in CBM-I completed three computer sessions over three weeks. The CBM-I successfully decreased social anxiety symptoms compared to the control condition(t=2.35, p<.05; t=4.70, p<.001). This result suggests that interpretation modification may have clinical utility when applied as a multi-session intervention.