Disorders - anxiety disorders
Dobson, E. T., Bloch, M. H., Strawn, J. R.
Objective: To evaluate the efficacy and tolerability of pharmacotherapy in pediatric anxiety disorders using network meta-analysis. Data Sources: PubMed, Cochrane Database, Web of Science, PsycNET, and ClinicalTrials.gov were searched for double-blind, controlled pharmacotherapy trials in youth with anxiety disorders from 1966 to September 2017. Data Selection: All double-blind, placebo-controlled trials of pharmacotherapy in the treatment of pediatric patients with generalized, social, and/or separation anxiety disorders were included. Data Extraction: We extracted demographic, symptom severity, global improvement, discontinuation, and suicidality data. Risk of bias was assessed with the Cochrane risk-of-bias tool, and a network metaanalysis comparing the efficacy and tolerability of medications and medication classes was performed using the gemtc package (R). Result(s): We identified 20 citations (22 RCTs, 24 treatment arms) with 2, 623 patients. Selective serotonin reuptake inhibitors (SSRIs) were the only class that was superior in reducing anxiety (standardized mean difference: 5.2; credible interval [CrI]: [2.8 to 8.8]) and in likelihood of treatment response compared to placebo (odds ratio [OR]: 4.6; CrI: [3.1 to 7.5]). Serotonin-norepinephrine reuptake inhibitor (SNRI) and a2 agonist treatment were associated with more frequent treatment response compared to placebo. The likelihood of treatment response was greater for SSRIs compared to SNRIs (OR: 1.9; CrI: [1.1 to 3.5]). Allcause discontinuation and treatment-emergent suicidality significantly differed among medications but not medication class. Conclusion(s): Although multiple medications reduce anxiety in children and adolescents, treatment response, tolerability, and treatmentemergent suicidality differ among these medications and medication classes. Determining whether efficacy and tolerability differences represent true differences (or reflect differences in trial design) requires additional head-to-head medication trials and-to exclude the impact of missing treatment interventions-requires trials of medications that successfully treat anxiety in adults but that have not been evaluated in youth. © Copyright 2019 Physicians Postgraduate Press, Inc.
Journal of Clinical Psychiatry, 80(1) : E1-E15
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
Eather, N., Riley, N., Miller, A., Smith, V., Poole, A., Vincze, L., Morgan, P. J., Lubans, D. R.
OBJECTIVES: The primary aim of this study was to evaluate the preliminary efficacy and feasibility of an 8-week high-intensity interval training program (Uni-HIIT) for young adult students in a university setting.
DESIGN: Randomised controlled trial.
METHOD: Uni-HIIT was conducted at the University of Newcastle, Australia (February-June, 2017). Participants were university students 18-25yrs (n=53; 20.38+/-1.88yrs) randomized into the Uni HIIT program (n=26) or wait-list control (n=27) condition. Participants were required to attend up to three HIIT sessions/week for 8-weeks which included a variety of aerobic and muscular fitness exercise combinations lasting 8-12minutes (using 30:30sec rest:work intervals). The primary outcome was cardio-respiratory fitness (CRF) (20mSRT), and secondary outcomes included muscular fitness (standing jump, push-ups), body composition (InBody), executive function (Trail Making Test), anxiety levels (State Trait Anxiety Inventory) and perceived stress (Perceived Stress Scale). Linear mixed models were used to analyse outcomes and Cohen's d effect sizes were calculated. Process evaluation measures of recruitment, retention, attendance and satisfaction were conducted.
RESULTS: A large significant group-by-time effect resulted for CRF [8.4 shuttles (95% CI(2.9-13.9), P=0.004,d=1.08] and muscular fitness [4.0 repetitions (95% CI(1.2-6.8), P=0.006,d=0.99], and moderate effect size was observed for Trail B [-5.9seconds (95% CI(-11.8-0.1.0), P=0.052, d=0.63]. No significant intervention effects were found for body composition, standing jump, anxiety or perceived stress (P >0.05). High ratings of participant satisfaction (4.73), enjoyment (4.54) and perceived value (4.54) were observed.
CONCLUSION: This study demonstrates the efficacy and feasibility of delivering a novel HIIT program in the university setting.
Journal of Science & Medicine in Sport, 22(5) : 596-601
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Physical activity, exercise
Sanchez, A. L., Comer, J. S., Coxe, S., Albano, A. M., Piacentini, J., Compton, S. N., Ginsburg, G. S., Rynn, M. A., Walkup, J. T., Sakolsky, D. J., Birmaher, B., Kendall, P. C.
Youth anxiety disorders are highly prevalent and are associated with considerable school impairment. Despite the identification of well-supported strategies for treating youth anxiety, research has yet to evaluate the differential effects of these treatments on anxiety-related school impairment. The present study leveraged data from the Child/Adolescent Anxiety Multimodal Study to examine differential treatment effects of CBT, sertraline, and their combination (COMB), relative to placebo (PBO), on anxiety-related school impairment among youth (N=488). Latent growth modeling revealed that all three active treatments demonstrated superiority over PBO in reducing anxiety-related school impairment over time, with COMB showing the most robust effects. According to parent report, medication strategies may have stronger effects on anxiety-related school impairment among males than among females. Results were discrepant across parents and youth. Findings are discussed in terms of clinical implications for anxious youth and the need for continued research to examine treatment effects on anxiety-related school impairment.
Child Psychiatry and Human Development, 50 : 940-949
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Antidepressants (any)
, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Song, C., Ikei, H., Kagawa, T., Miyazaki, Y.
The effects of forest activities on health promotion have received increasing attention. The aim of this study was to evaluate the physiological and psychological effects of brief walks in forests on young women. The experiments were conducted in 6 forests (test) and 6 city areas (control). Overall, 12 participants in each area (60 participants in total, mean age: 21.0 +/- 1.3 years) were instructed to walk in a forest and a city area for approximately 15 min; simultaneously, their heart rate variability, heart rate, blood pressure, and pulse rate were measured to quantify their physiological responses to walking. The modified semantic differential method, Profile of Mood States (POMS), and the State-Trait Anxiety Inventory (STAI) were used to determine their psychological responses. Walking in a forest was associated with significantly higher parasympathetic nervous activity and lower sympathetic nervous activity and heart rate. In addition, scores for the comfortable, relaxed, and natural parameters and vigor subscale of POMS were significantly higher, whereas scores for negative feelings, such as tension-anxiety, depression-dejection, anger-hostility, fatigue, and confusion, were significantly lower, as were the total mood disturbance of POMS and the anxiety dimension of the STAI. The subjective evaluations were generally in accordance with the physiological responses. A brief walk in a forest resulted in physiological and psychological relaxation effects in young women. Copyright © 2019 by the authors. Licensee MDPI, Basel, Switzerland.
International Journal of Environmental Research and Public Health, 16 (2) (no pagination)(229) :
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Physical activity, exercise
Balconi, M., Fronda, G., Crivelli, D.
Repeated exposure to stressors, even if mild, may alter the efficiency of optimal stress responses and hinder emotion regulation skills. Mindfulness meditation, by strengthening self-regulation and awareness, may optimize the efficiency of physiological, cognitive, and behavioral reactions to stressful events but typically requires notable commitment to practice, which often leads to disengagement. Recent research suggested that such practices may be made more accessible and that the potential for self-enhancement and stress management of meditation might be improved by supporting mental training with wearable neurofeedback devices able to inform the practicer on ongoing modulation of bodily and brain activity. This study aimed at testing the effect of such novel training approach based on the integration of mental training with brain-sensing wearable devices on physiological (heart rate and variability) and subjective markers of stress (perceived stress, anxiety, and mood states). Participants (N = 55) have been randomly divided into an active control (CONTg) and an experimental group (EXPg). Both groups completed a four-week training constituted by brief daily activities based on mindfulness practices. Experimental participants practiced with the support of dedicated brain-sensing devices. By analyzing pre- and post-training assessments, we observed relevantly decreased stress and anxiety measures in EXPg, as well as relevantly decreased mental fatigue and increased vigor. EXPg also showed improved physiological markers of vagal tone both at rest and during exposure to a cognitive stressor. Reported findings add to the limited available literature on potential effects of technology-supported mental training protocols for promoting subjective well-being and enhancing self-regulation skills. Copyright © 2019 Informa UK Limited, trading as Taylor & Francis Group.
Stress, 22(2) : 200-209
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Meditation
Turrini, G., Purgato, M., Acarturk, C., Anttila, M., Au, T., Ballette, F., Bird, M., Carswell, K., Churchill, R., Cuijpers, P., Hall, J., Hansen, L. J., Kosters, M., Lantta, T., Nose, M., Ostuzzi, G., Sijbrandij, M., Tedeschi, F., Valimaki, M., Wancata, J., White, R., Van Ommeren, M., Barbui, C.
AimsIn the past few years, there has been an unprecedented increase in the number of forcibly displaced migrants worldwide, of which a substantial proportion is refugees and asylum seekers. Refugees and asylum seekers may experience high levels of psychological distress, and show high rates of mental health conditions. It is therefore timely and particularly relevant to assess whether current evidence supports the provision of psychosocial interventions for this population. We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) assessing the efficacy and acceptability of psychosocial interventions compared with control conditions (treatment as usual/no treatment, waiting list, psychological placebo) aimed at reducing mental health problems in distressed refugees and asylum seekers.MethodsWe used Cochrane procedures for conducting a systematic review and meta-analysis of RCTs. We searched for published and unpublished RCTs assessing the efficacy and acceptability of psychosocial interventions in adults and children asylum seekers and refugees with psychological distress. Post-traumatic stress disorder (PTSD), depressive and anxiety symptoms at post-intervention were the primary outcomes. Secondary outcomes include: PTSD, depressive and anxiety symptoms at follow-up, functioning, quality of life and dropouts due to any reason.ResultsWe included 26 studies with 1959 participants. Meta-analysis of RCTs revealed that psychosocial interventions have a clinically significant beneficial effect on PTSD (standardised mean difference [SMD] = ?irc;'0.71; 95% confidence interval [CI] ?irc;'1.01 to ?irc;'0.41; I2 = 83%; 95% CI 78-88; 20 studies, 1370 participants; moderate quality evidence), depression (SMD = ?irc;'1.02; 95% CI ?irc;'1.52 to ?irc;'0.51; I2 = 89%; 95% CI 82-93; 12 studies, 844 participants; moderate quality evidence) and anxiety outcomes (SMD = ?irc;'1.05; 95% CI ?irc;'1.55 to ?irc;'0.56; I2 = 87%; 95% CI 79-92; 11 studies, 815 participants; moderate quality evidence). This beneficial effect was maintained at 1 month or longer follow-up, which is extremely important for populations exposed to ongoing post-migration stressors. For the other secondary outcomes, we identified a non-significant trend in favour of psychosocial interventions. Most evidence supported interventions based on cognitive behavioural therapies with a trauma-focused component. Limitations of this review include the limited number of studies collected, with a relatively low total number of participants, and the limited available data for positive outcomes like functioning and quality of life.ConclusionsConsidering the epidemiological relevance of psychological distress and mental health conditions in refugees and asylum seekers, and in view of the existing data on the effectiveness of psychosocial interventions, these interventions should be routinely made available as part of the health care of distressed refugees and asylum seekers. Evidence-based guidelines and implementation packages should be developed accordingly. Copyright © Cambridge University Press 2019 This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Epidemiology and Psychiatric Sciences., :
- Year: 2019
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions, Narrative exposure therapy (NET)
Yang, L., Zhou, X., Pu, J., Liu, L., Cuijpers, P., Zhang, Y., Zhang, H., Yuan, S., Teng, T., Tian, L., Xie, P.
Social anxiety disorder (SAD) is highly prevalent and persistent in children and adolescents. However, evidence for the efficacy and acceptability of psychological interventions for SAD in children and adolescents remains unclear. Seven electronic databases (PubMed, CENTRAL, Embase, Web of Science, PsycINFO, CINAHL, and ProQuest) were searched. Randomized controlled trials (RCTs) that compared psychological interventions for SAD with control conditions in children and adolescents were included. Primary outcomes were the efficacy (mean change in anxiety symptom scores) and acceptability (dropouts for all reasons). Secondary outcomes were remission, quality of life/functional improvement, and depressive symptoms measures. Seventeen RCTs were included in this meta-analysis. Psychological interventions (including cognitive behavioral therapy and behavioral therapy) were significantly more effective than control conditions, with a standardized mean difference (SMD) of - 1.13, and remission with a risk ratio (RR) of 8.99, the number needed to treat was 3.3. There was no statistically significant difference between psychological interventions and control conditions for all-cause dropouts (RR = 1.00). Psychological interventions were superior to control conditions in improving quality of life/functioning (SMD = 0.79) and reducing depressive symptoms (SMD = - 0.39). Given considerable heterogeneity of primary efficacy outcome, a series of subgroup analyses of different variables were conducted. Psychological interventions are probably efficacious in the treatment of SAD among children and adolescents, and may markedly improve quality of life and functioning in this population. However, this finding should be interpreted with caution because of the high heterogeneity of trials and low literature quality.
European Child & Adolescent Psychiatry, 28(1) : 79-89
- Year: 2019
- Problem: Anxiety Disorders (any), Social phobia (social anxiety disorder)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions
Dai, F., Chen, B.
Objectives : Serious incidents of college students due to sustained psychological stress leads to mental illness caused by frequent occurrence, darling serious psychological problems such as depression, anxiety, obsessive compulsive disorders such common college students mental illness. In response to these psychological characteristics, at home and abroad in recent years, researchers have advocated a more suitable way of this population movement - the movement of body and mind. Body- Mind Exercise is awareness campaigns, such as tai chi, yoga and qigong, the core of the movement is to train individuals with a sense of control activities of the various parts of the body to achieve the body and mind. Studies have shown that Body- Mind Exercise has the advantages of physical training and psychological training, and it can produce better physical and mental health benefits for patients with mental illness. Therefore, this study attempts to explore the effect of Body- Mind Exercise intervention on college students' stress response and psychological endurance. To provide effective and reasonable stress coping styles and develop good psychological endurance for undergraduates under pressure, thus improving their mental health. Methods : Among the 1000 college students (Wuchang Institute of Technology), 80 college students with higher stress scores (CPSS scale scores higher than the average score of 32) were selected as the experimental intervention group and the control group, 40 in the experimental group and the control group (There were 22 males and 18 female in the both groups, and the experimental group the average age of 20.81 +/- 1.34 years in the control group the average age of 20.35 +/- 1.61 years old). The students in the experimental group were intervened by yoga exercise, and the control group was operated according to the normal life trajectory, 3 times a week, 45 minutes each time, comparative efficacy after 12 weeks. Results : Experiment front set of scores on scale CPSS indicators have improved ( P < 0.05), lower than the score of the control group, which has a different degree in each dimension, the perceived reduced pressure, the difference statistically significant ( P < 0.01), compared with a small dimension of the tension decreases the amplitude, feeling out of control was not significant ( P > 0.05); while China endurance scale (CPPRS) measured before and after the significant difference ( P < 0.01), wherein The differences in willpower, problem solving, and interpersonal communication were statistically significant ( P < 0.05), but there was no significant difference in family support and optimistic self- confidence ( P > 0.05). Conclusion : Body- Mind Exercise can actively reduce various negative psychological consequences by adjusting mentality and emotions, and reduce the negative consequences of stress, and improve the psychological coping ability of college students and the psychological endurance in the face of stress, and the intervention effect is better.
Basic and Clinical Pharmacology and Toxicology, 124 (Supplement 3) : 209-210
- Year: 2019
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Mind-body exercises (e.g. yoga, tai chi, qigong)
Carsley, D., Heath, N. L.
OBJECTIVE: This study compared the effectiveness of mindfulness coloring (mandala), free drawing/coloring, and a noncoloring control activity for university students' test anxiety, and assessed the relationship of dispositional mindfulness and response to intervention on mindfulness and test anxiety states. PARTICIPANTS: University students (n=167; 81.4% female; Mage = 21.29years, SD=4.46) were randomly assigned to a mandala (n=57), free draw/coloring (n=58), or noncoloring condition (n=52). METHOD(S): Participants completed standardized measures assessing test anxiety and state mindfulness pre-postactivity before completing a test, and two dispositional mindfulness measures. RESULT(S): Participants in both coloring conditions reported significant decreases in test anxiety and significant increases in state mindfulness pre-postintervention, and participants in the control condition reported significant increases in test anxiety. Reports of preintervention state mindfulness and test anxiety fully mediated relations between dispositional mindfulness and postintervention state mindfulness and test anxiety. CONCLUSION(S): Implications for research and practice on mindfulness coloring and test anxiety are discussed.
Journal of American College Health, : 1-10
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Mindfulness based therapy, Creative expression: music, dance, drama, art
Noormohamadi, S. M., Arefi, M., Afshaini, K., Kakabaraee, K.
Adolescence and youth are important periods in the growth and excellence of an individual. Given the importance of the study, its purpose was to determine the effect of rational-emotive behavior therapy (REBT) on anxiety and resilience in students. Students admitted to the counseling centers of Ilam University were randomly assigned to experimental and control groups. Using convenient sampling method, 30 subjects were selected and randomly assigned to either REBT tests or a control group (10 subjects in each). The 26 codes of ethics were observed in the study and the data were analyzed using SPSS17. Before the intervention, the anxiety score was 26.75 (4.43) and after the intervention it was 18 (4.403) (p < 0.05), but in the control group it was 31.34 (6.04) before the intervention and after the intervention it was 32.35 (5.17) (p > 0.05). Before the intervention, the anxiety score was 52.77 (13.37) and after the intervention it was 60.00 (14.31) (p < 0.05), but in the control group it was 47.00 (8.73) before the intervention and after the intervention it was 49.76 (9.10) (p > 0.05). REBT was effective in students as it reduced anxiety and increased resilience. Thus, it is suggested for use in students' care. Copyright © 2019 Walter de Gruyter GmbH, Berlin/Boston.
International Journal of Adolescent Medicine and Health., :
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Ahmadi, K., Hazrati, M., Ahmadizadeh, M., Noohi, S.
Objective: Not perceiving circadian shifts of sunlight due to living in enclosed environments may have deleterious effects on mental health and plasma parameters. This study aimed to determine the effect of dim regulation on the submarine personnel of Iranian Navy forces by radiating devices according to natural circadian sunlight shifts. Also, this study aimed to investigate the impact of mimicking sunlight circadian by artificial radiance luminating devices on the serological and psychological measures of submarine personnel. Method(s): Participants were randomly assigned to experimental and control groups in this non-randomized controlled trial. There were 26 participants in each group, and they were all male aged 21-29 years. Both groups were living in the submarine underground hall, with 120 meters 2 area with constant radiance with the same intensity. The experimental group had been given extra lighting devices with changing radiance intensity according to the natural sunlight circadian cycles. Plasma melatonin levels and depression and anxiety scores were determined before and after the experiment for both groups. Minnesota Multiphasic Personality Inventory (MMPI) and Cattell's Anxiety Scale Questionnaire (IPAT) were used to measure depression and anxiety, respectively. Result(s): Findings indicate that the plasma melatonin levels (-16.2+/-13.6 vs 8.0+/-9.3 mg/dL, respectively; p<0.001), depression scores (-6+/-6 vs 3.9+/-5.4, respectively; p<0.001), and anxiety scores (-1+/-1.2 vs 0.73+/-1.04, respectively; p<0.001) significantly reduced in the experimental group compared to the control group. Conclusion(s): Using radiance dimmers, with a radiance intensity regularity according to the sunlight, is effective in improving psychiatric and plasma parameters and can be used in closed occupational environments such as underground environments and submarine halls. Copyright © 2019 Tehran University of Medical Sciences. All rights reserved.
Iranian Journal of Psychiatry, 14(2) : 147-153
- Year: 2019
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Bright light therapy
Carpena, M. X., Tavares, P. D. S., Menezes, C. B.
Background: Evidence shows high prevalence of depression and anxiety symptoms among university students. This study investigated whether a meditation-based program would help reducing these symptoms in this population. Method(s): Non-randomized controlled trial investigating the effects of a six-week focused meditation training on depression (Beck Depression Inventory) and anxiety (Beck Anxiety Inventory) outcomes among university students. Participants were allocated into a meditation or waiting list control group. Assessment occurred pre and post intervention and only for the meditation group at 6 and 12 months follow-up. General linear model for repeated measures evaluated the intervention effect considering group and time factors, controlling for minor psychiatric disorders, gender and absence at meetings. Result(s): The meditation group presented a reduction in depression and anxiety symptoms after intervention compared to controls. Among the meditation group, depression (at 6 months follow-up) and anxiety (at 6 and 12 months follow-up) scores were lower for those who continued practicing. Limitation(s): Non-randomization and absence of daily practice record (precluding dose-response gradient evaluation). Conclusion(s): The meditation training was effective in reducing depression and anxiety symptoms, but the maintanance of these reductions only occurred for those who continued meditating. Permanent meditation programs may be an alternative for promoting mental health for university students. Copyright © 2018 Elsevier B.V.
Journal of Affective Disorders, 246 : 401-407
- Year: 2019
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Meditation