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Chronic Anxiety


Presentation

  • Here we present a case of 56-year-old female with a history of chronic anxiety who presented with retrosternal chest pain after her partner threatened to leave her. Her EKG showed diffuse T-wave changes with prolonged QT intervals.[ncbi.nlm.nih.gov]
  • Abstract This report presents results from an international multicenter trial of the safety of buspirone in the treatment of anxiety disorders for periods up to one year, if needed; 424 patients were treated for six months, and 264 patients completed[ncbi.nlm.nih.gov]
  • Using an experimental approach with healthy participants, specific fear and chronic anxiety were operationalized in a within-subjects fear-potentiated startle paradigm by, respectively, conditioning to a cue by presenting predictable shocks and conditioning[ncbi.nlm.nih.gov]
  • The present study aimed to explore CA in chronic anxiety. METHODS: Subjects with Hamilton anxiety scale scores 14 were enrolled and the dynamic changes of CBFV in response to an orthostatic challenge were investigated using TCD.[ncbi.nlm.nih.gov]
  • Hospital, Payne-Whitney Clinic "The volume has many strengths, including a list of prominent contributors, and the presentation of results from unpublished data sets.[amazon.com]
Localized Pain
  • Symptoms include persistent aches or stiffness anywhere along the spine; sharp, localized pain in the neck, upper back, or lower back, especially after lifting heavy objects or engaging in strenuous activity; and chronic ache in the middle or lower back[adaa.org]
Abdominal Tenderness
  • I had had abdominal tenderness for 2 mos straight and then saw my gastro who said it was just IBS, next day I felt completely FINE! After two straight months of having pain![steadyhealth.com]
Retrosternal Chest Pain
  • Here we present a case of 56-year-old female with a history of chronic anxiety who presented with retrosternal chest pain after her partner threatened to leave her. Her EKG showed diffuse T-wave changes with prolonged QT intervals.[ncbi.nlm.nih.gov]
Stupor
  • I don't actually like alcohol, but I forced myself into a drunken stupor by chugging each twelve ounce beer. Within a month, I was drinking up to twelve beers a night, and this went on for over a year. I finally had enough.[rxmarijuana.com]

Workup

  • […] reported in individuals with depression. 88, 89 Fatigue There is now good evidence to show not only that fatigue can be a symptom of CD, but also that it is a common clinical presentation. 90 – 93 Serological screening for CD is now recommended in the workup[doi.org]
Prolonged QT Interval
  • Her EKG showed diffuse T-wave changes with prolonged QT intervals. She also had modest elevation of cardiac enzymes.[ncbi.nlm.nih.gov]

Treatment

  • BACKGROUND: Despite the availability of highly efficacious treatments, many individuals with anxiety disorders never receive adequate treatment.[ncbi.nlm.nih.gov]
  • However there was no significant difference between the 3 treatments and no preference by either patients or doctor for any one treatment could be detected.[ncbi.nlm.nih.gov]
  • […] a full year of treatment.[ncbi.nlm.nih.gov]
  • There were no differences between treatments with respect to treatment efficacy, onset of symptom amelioration, or maintenance of therapeutic gains.[ncbi.nlm.nih.gov]
  • Lesser degrees of pathology responded better to treatment. Psychological factors in treatment showed themselves to be important in moderating pharmacological response.[ncbi.nlm.nih.gov]

Prognosis

  • Locus of control may be of importance in the formulation of therapy and prognosis in patients with anxiety disorders.[ncbi.nlm.nih.gov]
  • The current state of research regarding the prognosis of the various disorders will be reviewed as well as the clinical implications for older adults.[doi.org]
  • The expected prognosis for patients with comorbid anxiety and depressive disorders is poorer than that for either disorder alone.[web.archive.org]
  • Discussion Optimising the long term prognosis should be an over-riding priority when treating patients with anxiety disorders, because relapse and chronicity are common.[doi.org]
  • Prognosis When properly treated, most patients with generalized anxiety disorder experience improvement in their symptoms.[medical-dictionary.thefreedictionary.com]

Etiology

  • Discussions focus on anxiety and stress, observations of anxiety in men under stress, etiology of psychosomatic disorders, emotional disturbance, and activation.[books.google.de]
  • The interplay and etiological continuity of neuroticism, difficulties, and life events in the etiology of major and subsyndromal, first and recurrent depressive episodes in later life. American Journal of Psychiatry 158, 885 – 891.[dx.doi.org]
  • A second possibility is that the disorders are etiologically different, but symptom episodes are provoked by related environmental events (ie, stressors), such as threat (anxiety) and loss (depression). 14 The third possibility is that the underlying[web.archive.org]
  • Etiology/Causes of Anxiety Psychological. Anxiety can result when a combination of increased internal and external stresses overwhelm ones normal coping abilities or when ones ability to cope normally is lessened for some reason.[web.archive.org]

Epidemiology

  • "The dual burden of chronic physical conditions and mood and anxiety disorders is a significant and growing problem," said Silvia Martins, MD, PhD, associate professor of Epidemiology at the Mailman School of Public Health, and senior author.[sciencedaily.com]
  • ., associate professor of Epidemiology at the Mailman School of Public Health, and senior author.[psychcentral.com]
  • The primary search terms were anxiety , anxiety disorders , depression , depressive disorders , comorbidity , epidemiology , benzodiazepines , antidepressants , pharmacology , clinical trials , and pharmacotherapy .[doi.org]
  • The primary search terms were anxiety, anxiety disorders, depression, depressive disorders, comorbidity, epidemiology, benzodiazepines, antidepressants, pharmacology, clinical trials, and pharmacotherapy.[dx.doi.org]
Sex distribution
Age distribution

Pathophysiology

  • Menezes Falcão, Takotsubo cardiomyopathy systematic review: Pathophysiologic process, clinical presentation and diagnostic approach to Takotsubo cardiomyopathy, International Journal of Cardiology, 209, (196), (2016).[doi.org]
  • Advances in the pathophysiology of tension-type headache: from stress to central sensitization. Current Pain and Headache Reports, 13 , 484-494. 7. Blackburn-Munro, G., & Blackburn-Munro, R. E. (2001).[instituteforchronicpain.org]
  • Advances in the pathophysiology of tension-type headache: from stress to central sensitization. Current Pain and Headache Reports, 13, 484-494. 7. Blackburn-Munro, G., & Blackburn-Munro, R. E. (2001).[instituteforchronicpain.org]
  • Abstract Depression, anxiety and apathy are common mood disturbances in Parkinson's disease (PD) but their pathophysiology is unclear. Advanced neuroimaging has been increasingly used to unravel neural substrates linked to these disturbances.[doi.org]
  • […] sexual performance anxiety can contribute to retarded ejaculation. 18,27 Anxiety disorders and pain disorders High levels of anxiety have been found in women with dyspareunia, 28-30 who seem to experience severe pain during sexual intercourse. 31 The pathophysiological[web.archive.org]

Prevention

  • Given the fact that anxiety and impaired CA are associated with cardiovascular disease, early ascertainment of compromised cerebrovascular modulation using TCD might suggest interventional therapies in the anxious population, and improve the primary prevention[ncbi.nlm.nih.gov]
  • ICD patients anxious at implantation should be closely monitored and offered adjunctive psychosocial intervention if symptoms do not remit spontaneously in order to prevent adverse health outcomes. Copyright 2009 Elsevier Ireland Ltd.[ncbi.nlm.nih.gov]
  • "Chronic disease coupled with a psychiatric disorder is a pressing issue that health providers should consider when designing preventive interventions and treatment services -- especially the heavy mental health burden experienced by those with two or[sciencedaily.com]
  • Thus, there has recently been increasing interest in preventing these illnesses.[doi.org]
  • Based on the review, the following points are recommended for inclusion in group programs for the prevention of mental maladjustment by SCSs in Japan: (1) content based on cognitive-behavioral therapy, (2) a focus on the prevention of depression or anxiety[hdl.handle.net]

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