Anxiety Disorders ( Modern Trends in Pharmacopsychiatry )

Publication series : Modern Trends in Pharmacopsychiatry

Author: Baldwin D.S.; Leonard B.E.  

Publisher: S. Karger AG‎

Publication year: 2013

E-ISBN: 9783318024647

P-ISBN(Paperback): 9783318024630

Subject: R749.7 neurosis

Keyword: 神经病学与精神病学,预防医学、卫生学,药学,神经病学

Language: ENG

Access to resources Favorite

Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.

Description

Anxiety disorders are not uncommon and are often ‘comorbid’ with other forms of mental disorders. This publication provides an update on the origins and the causes of anxiety disorders and their related symptoms. Its focus is on neuroimaging and neuroinflammation and genetics as well as areas where an overlap may exist with abnormal cardiovascular physiology. Further it takes a closer look at the early phases of anxiety disorder and the potential effects of prolonged illness prior to diagnosis and also investigates recent research findings about the neuroimmunology of depression and the immunomodulatory effects of antidepressants. It also examines the neuroinflammatory hypothesis about anxiety disorders and concludes with the succinct but evidence-based and comprehensive reports on the value of pharmacological treatments used for generalized anxiety disorder, panic disorder, social anxiety disorder, posttraumatic stress disorder and obsessive-compulsive disorder. The topics covered in this publication will certainly make it essential reading for both novice and expert practitioners in psychiatric medicine, but its appeal should extend even further and include those researching the neuropsychobiology of anxiety or trying to improve our grasp of posttraumatic stress disorder or obsessive-compulsive disorder.

Chapter

On the Nature of Obsessions and Compulsions

Abstract

DSM Criteria

Historical Overview

Early Developments

Westphal

Janet and Von Gebsattel

Summary

Open Questions and Suggestions for Answers

Certainty and Trust

The Role of Reflection

Conclusion

References

The Origin of Anxiety Disorders – An Evolutionary Approach

Abstract

The Brain: Evolution and Complexity

Neurocircuitry of Anxiety Disorders

Posttraumatic Stress Disorder

Panic Disorder

Phobia

Generalized Anxiety Disorder

Obsessive-Compulsive Disorder

The Importance of Distance from a Threat

Conclusion

Acknowledgement

References

Genetic Factors in Anxiety Disorders

Abstract

Clinical Genetic Studies

Molecular Genetic Studies

Linkage Studies

Cytogenetic Studies

Association Studies

Serotonin/Norepinephrine System Genes

Dopamine System Genes

Cholecystokinin System Genes

Adenosine System Genes

GABAergic System Genes

Hypothalamus-Pituitary-Adrenal Axis-Related Genes

Other Candidate Genes

Gene-Gene Interaction Studies

Genome-Wide Association Studies

Gene-Environment Interaction Studies

Epigenetic Studies

Genetic Studies in Intermediate Phenotypes

Peripheral Sympathetic Activity

Carbon Dioxide Reactivity

Cholecystokinin Challenge

Startle Reflex

Neural Correlates of Emotional Processing

Pharmacogenetic and Psychotherapy-Genetic Studies

Discussion and Outlook

Acknowledgements

References

Neuroimaging in Anxiety Disorders

Abstract

Diagnosis and Prevalence

Etiology

Neuroimaging

Meta-Analysis of Anxiety Neuroimaging

Symptom Provocation and Fear Network Activity

Multiple Mechanisms Mediating Anxiety

References

Potential Neuroimmunological Targets in the Treatment of Anxiety Disorders

Abstract

The Pivotal Role of Cytokines

The Neuroimmunology of Depression

Immunomodulating Effects of Antidepressants

A Neuroimmunology of Anxiety Disorders?

Inflammatory Responses and the Anxious State

Inflammatory Responses in Anxiety Disorders

Post-Traumatic Stress Disorder

Panic Disorder

Obsessive-Compulsive Disorder

Generalized Anxiety Disorder

The Limitations of Current Knowledge

Recommendations for Future Research

Longitudinal Study Design

Standardized Measures of Inflammatory Biomarkers

Standardized Behavioural Assessments and Record of Inflammatory Events

Vulnerability Factors

Effects of Medications

Development of Novel Measurement Strategies

Genetic Polymorphism of Cytokines

Clinical and Pharmacotherapeutic Implications

Future Research

References

Anxiety and Cardiovascular Disease

Abstract

Anxiety and Hypertension

Association of Anxiety Disorders with Hypertension

Mechanisms in the Association of Hypertension and Panic Attacks/Panic Disorder

Other Putative Mechanisms

Anxiety and Coronary Heart Disease

Mechanisms in the Association of Coronary Heart Disease and Anxiety

Acknowledgement

References

The Early Phases of Anxiety Disorders: From Prevention to Treatment

Abstract

Application of the Early Intervention Model to Anxiety Disorders

New Concepts for Health Prevention

Predictors of Anxiety Disorders

Duration of Untreated Illness in Anxiety Disorders

The Early Stages of Anxiety Disorders

The ‘at Risk Asymptomatic’

The Prodrome

The First Episode

Incomplete Recovery, Relapse and Treatment Resistance after the First Episode

Objectives of Early Intervention in Anxiety Disorders

Prevention and Intervention in the Early Stages of Anxiety Disorders

Service Repercussions of Applying the Early Intervention Model to Anxiety and Obsessive Compulsive Disorders

References

Duration of Untreated Illness and Duration of Illness in Anxiety Disorders: Assessment and Influence on Outcome

Abstract

Anxiety Disorders, Duration of Untreated Illness and Duration of Illness

Duration of Untreated Illness

Duration of Illness

Duration of Untreated Illness, Epidemiology and Clinical Outcome in Anxiety Disorders

Conclusion

References

Pharmacotherapy of Generalized Anxiety Disorder

Abstract

Clinical Characteristics

Prevalence of Generalized Anxiety Disorder in Population Samples and in Primary Care

Somatic Comorbidity

Insomnia in Generalized Anxiety Disorder

Cost of Illness Studies

Evidence-Based Generalized Anxiety Disorder Treatments

Disclosure Statement

References

Pharmacological Treatment of Panic Disorder

Abstract

Selective Serotonin Reuptake Inhibitors

Serotonin-Noradrenaline Reuptake Inhibitors

Tricyclic Antidepressants

Benzodiazepines

Monoamine Oxidase Inhibitors

Other Medications

Long-Term Treatment

Comparisons between Drugs in the Treatment of Panic Disorder

Practical Guidelines for Treatment

Particular Patient Populations

Management of Treatment-Resistant Panic Disorder

References

Pharmacological Treatment of Social Anxiety Disorder

Abstract

Clinical Features

Recognition and Diagnosis

Social Anxiety and Psychosis

Presumed Neuropsychobiology

Acute Treatment

Longer-Term Treatment

Further Management after Non-Response to Initial Treatment

Treatment of Social Anxiety Symptoms in Psychosis

Potential Novel Pharmacological Treatments

Conclusions

Acknowledgements

References

Pharmacotherapy of Posttraumatic Stress Disorder

Abstract

Psychobiology of Posttraumatic Stress Disorder

Overview of the Pharmacotherapy of Posttraumatic Stress Disorder

Rationale for Pharmacotherapy

Evidence Base for Pharmacotherapy of Posttraumatic Stress Disorder

Determinants of Study Outcomes in Posttraumatic Stress Disorder

Brief Review of the Evidence of Pharmacotherapy in Posttraumatic Stress Disorder

Early Trials

Tricyclic Antidepressants

Monoamine Oxidase Inhibitors

Benzodiazepines

Selective Serotonin Reuptake Inhibitors

Paroxetine

Sertraline

Fluoxetine

Newer Agents

Venlafaxine Extended Release

Mirtazapine

Nefazodone

Prazosin

Anticonvulsants

Antipsychotics

Other Agents

Conclusion

References

Evidence-Based Treatment Pathways for Translational Studies in Obsessive-Compulsive Disorders

Abstract

Endophenotypes in Obsessive-Compulsive Disorder

Tools and Techniques for Measuring Clinical Response

Rating Scales

Criteria for Response, Remission, Relapse and Resistance

Evidence-Based Treatments for Obsessive-Compulsive Disorder: Current Knowledge and Practice

Cognitive Behaviour Therapy or Serotonin Reuptake Inhibitor?

Monotherapy or Combination Treatment?

Which Compound?

Which Dose?

Maintenance Treatment?

High-Dose SSRI or Adjunctive Antipsychotic in SSRI-Resistant Cases?

Novel Compounds?

In-Patient Intensive Cognitive Behaviour Therapy or Somatic Therapies?

Determining a Research-Focussed Treatment Algorithm

Calculating the Sample Size for Treatment Cells

Conclusion

Acknowledgement

References

Author Index

Subject Index

Cover

The users who browse this book also browse