Preschool Behavioural Inhibition (BI) was found to be a temperamental risk factor of anxiety disorders in later life; especially in women. Similarly, previous research revealed that parental behaviour plays a major role in the development and maintenance of anxiety disorders. Gender differences in parental responses to child’s temperament may contribute to the stronger association between BI and anxiety disorders in females.

We aimed to examine the moderating effect of child’s gender in the association between child’s BI and parenting behaviour in a non-clinical sample of parents of preschool children.

A cross-sectional sample of parents (N=94) of preschool children (girls 47.4%) filled out the Behavioural Inhibition Questionnaire (BIQ) and the Multidimensional Assessment of Parenting Scale (MAPS).

Child’s gender was found to moderate the relationships between BIQ scores and MAPS Supportive Parenting (F(3,90)=4.350, p=.007, R2=.127), as well as Hostile Parenting (F(3,89)=3.478, p=.019, R2=.105). In boys, higher BIQ scores were associated with higher levels of Supporting Parenting (b=.005, p=.027), while in girls this association was reversed (b=-.004, p=.037). Furthermore, in boys, no association was found between BIQ scores and Hostile Parenting (b=.005, p=.835); however, higher BIQ scores were related to higher levels of Hostile Parenting in girls (b=.067, p<.001).

Our results suggest that parental responses to their preschool child’s Behavioural Inhibition may vary as a function of child’s gender. This may lead to gender differences in developmental pathways to anxiety disorders.

No significant relationships.

Generalized anxiety disorder (GAD) is associated with reduced attention, inhibition, decrease of processing speed. The impact of a new peptide antagonist of central cholecystokinin-1 receptors (GB-115) on cognitive processes in patients with GAD is reported.

To research the cognitive effects of GB-115 in patients with GAD.

25 patients with GAD in ICD-10 (mean age 35,76±8,55 years) treated with GB-115 in clinically relevant dose (6 mg/d) were enrolled to the study. The evaluation of cognitive functions was conducted at background, Day 3, Day 7, Day 14 and Day 21. The laboratory test toolkit included reaction time test, Shulte-Platonov tables, attention tests (using hardware and software complex “NeuroSoft-PsychoTest”). Statistical significance was ascertained by Wilcoxon signed-rank test.

Speed of reaction time increased on the Day 7 (418,17±61,49 msec, p≤0,01), the Day 14 (422,25±70,69 msec, p≤0,01) and the Day 21 of treatment (406,5±52,79 msec, p≤0,01) in comparison with background (449,19±64,91). Attention parameters improved on the Day 3 (305,95±45,31 msec, p≤0,05) and the Day 21 of treatment (300,14±47,74 msec, p≤0,05) in comparison with the background (316,41±42,35 msec). Decrease of time in performance of tables of Shulte-Platonov was also observed on the Day 7 (59,40±13,71 sec, p≤0,01), the Day 14 (57,88±12,82 sec, p≤0,01) and the Day 21 (53,40±13,19 sec, p≤0,01) in comparison with the background (68,84±16,78 sec).

GB-115 revealed cognitive effects such as an increase of processing speed and improvement of different aspects of attention (attentional resource allocation, attention span and switching) after the Day 7 of treatment.

No significant relationships.

The pilot clinical study of GB-115, a new peptide antagonist of central cholecystokinin-1 receptors, revealed that drug was clinically effective in patients with generalized anxiety disorder (GAD) at dose 6 mg daily. Here, we provide results of post-hoc analysis of changes of anxiety and fatigue symptoms to give characterization of its clinical effects in clinically relevant doses.

To research the changes of anxiety- and fatigue-related symptoms during GB-115 treatment in patients with generalized anxiety disorder (GAD).

Patients with GAD without somatic diseases aged 18-55 years were eligible in the study. Patients were prescribed with GB-115 6 mg daily for 21 days. Anxiety and fatigue symptoms were assessed with Hamilton Anxiety Rating Scale (HARS) and Multidimensional Fatigue Inventory (MFI-20). Variables are described as medians and interquartile range (IQR). Pre-post comparisons were performed using the Friedman ANOVA at 2-side p-value <0.05.

25 patients diagnosed with GAD (8 males, 17 females; median [IQR] age: 34 [29.75, 43.0]) included in the analysis. Median [IQR] HARS total score decreased from 22 [20, 24.5] to 19 [16, 20], 13 [10.5, 15.5], 9 [5.5, 11] and 5 [3.5, 8] on the Day 3,7,14 and 21, respectively (χ2=95.07, df=4, p<0.001). Median [IQR] MFI-20 score decreased from 70 [46, 75.5] to 59 [41, 74.5], 52 [37.5, 64.5], 37 [26.5, 63] and 28 [24, 48.5] on the Day 3, 7, 14 and 21, respectively (χ2= 55.41, df=4, p<0.001). None of patients had stimulation-related side effects.

GB-115 action in the treatment of GAD patients is characterized with anxiolytic action with mild psychostimulant properties.

No significant relationships.

Several previous studies have identified a continuity between childhood anxiety/withdrawal and anxiety disorder (AD) in later life. However, not all children with anxiety/withdrawal problems will experience an AD in later life. Previous studies have shown that the severity of childhood anxiety/withdrawal accounts for some of the variability in AD outcomes. However, no studies to date have investigated how variation in features of anxiety/withdrawal may relate to continuity prognoses. The present research addresses this gap.

Data were gathered as part of the Christchurch Health and Development Study, a 40-year population birth cohort of 1265 children born in Christchurch, New Zealand. Fifteen childhood anxiety/withdrawal items were measured at 7–9 years and AD outcomes were measured at various interviews from 15 to 40 years. Six network models were estimated. Two models estimated the network structure of childhood anxiety/withdrawal items independently for males and females. Four models estimated childhood anxiety/withdrawal items predicting adolescent AD (14–21 years) and adult AD (21–40 years) in both males and females.

Approximately 40% of participants met the diagnostic criteria for an AD during both the adolescent (14–21 years) and adult (21–40 years) outcome periods. Outcome networks showed that items measuring social and emotional anxious/withdrawn behaviours most frequently predicted AD outcomes. Items measuring situation-based fears and authority figure-specific anxious/withdrawn behaviour did not consistently predict AD outcomes. This applied across both the male and female subsamples.

Social and emotional anxious/withdrawn behaviours in middle childhood appear to carry increased risk for AD outcomes in both adolescence and adulthood.

Health care workers in emergency department and intensive care are usually exposed to stressful situations, which require an early intervention.

To assess the prevalence of anxiety among health care workers in emergency department and to determine its associated factors.

It was a cross-sectional, descriptive and analytical study including health care workers assigned to emergency ward and intensive care unit of Hedi Chaker and Habib Bourguiba hospitals in Sfax and the regional hospital of Kebili. Data was collected by an anonymous and confidential self- administered questionnaire. We used hospital anxiety and depression scale (HAD) to assess anxiety and depression.

The participation rate was 48.8% (n=240). The mean age was 37 years, 59.2% were female and 62% were married. Mean work experience was 11 years. 79.2% assured night shifts (average= 1.5 night shifts per week) and 71.7% benefited of compensatory rest. Our study revealed that 32.5 % of health care workers were suffering from anxiety. In univariate study, anxiety was significantly correlated with the female gender (p=0.004), the lack of practice of leisure activities (p=0.004), with absence of compensatory rest (p=0.001), with sleep disturbances (p=0.001) and with depression (p<10-3). Multivariate study pointed that anxiety was associated with lack of practice of leisure activities (OR=2.7[1.09-6.99]; p=0.006), absence of compensatory rest (OR=2.7[1.3-5.5]; p=0.004), depression (OR=3[1.5-6]; p= 0.001) and with sleep disturbances (OR=2.8[1.4-5.7]; p=0.004).

Anxiety affected one in three emergency caregivers. Stress management programs for emergency caregivers can be of great help in dealing with this problem.

The objective of this population-based register study was (1) to investigate the association between young adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) and subsequent labour market marginalisation (LMM) in two comparison groups, i.e. matched young adults from the general population without ADHD and unaffected siblings to persons with ADHD and (2) to assess the role of comorbid disorders.

This study included all young adults in Sweden, aged 19–29 years, with an incident diagnosis of ADHD 2006–2011 (n = 9718). Crude and multivariate sex-stratified hazard ratios (HRs) with 95% confidence intervals (CIs) were measured 5 years after the diagnosis of ADHD for the risk of disability pension, long-term sickness absence (SA) (>90 days), long-term unemployment (>180 days) and a combined measure of all three in young adults with ADHD compared to their siblings without ADHD and a matched comparison group.

In the adjusted analyses young adults with ADHD had a 10-fold higher risk of disability pension (HR = 10.2; CI 9.3–11.2), a nearly three-fold higher risk of long-term SA (HR = 2.7; CI 2.5–2.8) and a 70% higher risk of long-term unemployment (HR = 1.7; CI 1.6–1.8) compared to the matched comparison group. The risk estimates were lower compared to siblings for disability pension (HR = 9.0; CI 6.6–12.3) and long-term SA (HR = 2.5; CI 2.1–3.1) but higher in the long-term unemployed (HR = 1.9; CI 1.6–2.1). Comorbid disorders explained about one-third of the association between ADHD and disability pension, but less regarding SA and long-term unemployment.

Young adults with ADHD have a high risk for different measures of LMM and comorbidities explain only a small proportion of this relationship.

Whether smoking should be regarded as a risk factor for mental disorders remains unresolved. Prescribed psychotropic drugs can be used as indications for mental disorders. We investigated how smoking was prospectively related to prescription of antipsychotics, mood stabilizers, antidepressants, and anxiolytics.

Information about smoking, including the Fagerström Test for Nicotine Dependence, and relevant confounders, were obtained from the population-based Young in Norway Study (N = 2602), with four data collection waves between 1992 and 2006. These survey data were linked with information on prescriptions for psychotropic drugs from the comprehensive, nationwide Norwegian Prescription Database from 2007 to 2015.

Daily smoking with high dependence in 2006 at age 28.5 (s.d. = 2.0) was associated with filling prescriptions of antipsychotics (OR, 6.57, 95% CI 2.19–19.70, p = 0.001), mood stabilizers (OR, 7.11, 95% CI 2.51–20.15, p < 0.001) and antidepressants (OR, 1.91, 95% CI 1.13–3.23, p = 0.016) 1–9 years later. Associations remained significant after adjustment for a variety of potential confounders measured before the assessment of smoking, including sociodemographic background, conduct problems, cannabis use, mental distress, and previous prescriptions for psychotropic medications. The association between smoking and prescription of anxiolytics was weaker and more unstable.

In this study of young adults, daily smoking with high dependence was associated with later prescriptions of antipsychotics, mood stabilizers and antidepressants, indicating smoking as a risk factor for mental disorders treated with these drugs.

To evaluate the effect of a transdiagnostic cognitive behavioural therapy (tCBT) protocol in an individual delivery format, adapted from a protocol that has been extensively evaluated in a group delivery format.

tCBT was provided to a cohort (N = 18) of adults with a range of anxiety disorders (55.6% male; M age = 40.6, SD = 17.6), at a speciality anxiety disorder research clinic. A within-subjects repeated measures design was employed. Pre-to-post-treatment diagnostic assessments were analysed through repeated measures analysis of variance, and session-by-session self-reported measures of anxiety, depression, and quality of life were modelled through mixed-effect regression modelling (MRM) to maximise the sample of treatment initiators.

Significant and large reductions for clinician-rated primary diagnosis severity (Hedges g = 1.63), and overall clinical global impressions (g = 1.43) were observed, and self-reported anxiety and depression symptoms showed significant reductions over the course of treatment with medium-to-large effect sizes (g = 0.66 and 0.74, respectively). Significant improvement to quality of life was also observed with medium effect size (g = 0.53).

There is now preliminary support for the use of an adaptation of an established group-based tCBT protocol for use with individuals. Implications and recommendations for future investigations are provided.

In research and clinical practice, familial risk for depression and anxiety is often constructed as a simple Yes/No dichotomous family history (FH) indicator. However, this measure may not fully capture the liability to these conditions. This study investigated whether a continuous familial loading score (FLS), incorporating family- and disorder-specific characteristics (e.g. family size, prevalence of depression/anxiety), (i) is associated with a polygenic risk score (PRS) for major depression and with clinical/psychosocial vulnerabilities and (ii) still captures variation in clinical/psychosocial vulnerabilities after information on FH has been taken into account.

Data came from 1425 participants with lifetime depression and/or anxiety from the Netherlands Study of Depression and Anxiety. The Family Tree Inventory was used to determine FLS/FH indicators for depression and/or anxiety.

Persons with higher FLS had higher PRS for major depression, more severe depression and anxiety symptoms, higher disease burden, younger age of onset, and more neuroticism, rumination, and childhood trauma. Among these variables, FH was not associated with PRS, severity of symptoms, and neuroticism. After regression out the effect of FH from the FLS, the resulting residualized measure of FLS was still associated with severity of symptoms of depression and anxiety, rumination, and childhood trauma.

Familial risk for depression and anxiety deserves clinical attention due to its associated genetic vulnerability and more unfavorable disease profile, and seems to be better captured by a continuous score that incorporates family- and disorder-specific characteristics than by a dichotomous FH measure.

The general understanding of the ‘vulnerability–stress model’ of mental disorders neglects the modifying impact of resilience-increasing factors such as coping ability.

Probing a conceptual framework integrating both adverse events and coping factors in an extended ‘vulnerability–stress–coping model’ of mental disorders, the effects of functional neuropeptide S receptor gene (NPSR1) variation (G), early adversity (E) and coping factors (C) on anxiety were addressed in a three-dimensional G × E × C model.

In two independent samples of healthy probands (discovery: n = 1403; replication: n = 630), the interaction of NPSR1 rs324981, childhood trauma (Childhood Trauma Questionnaire, CTQ) and general self-efficacy as a measure of coping ability (General Self-Efficacy Scale, GSE) on trait anxiety (State-Trait Anxiety Inventory) was investigated via hierarchical multiple regression analyses.

In both samples, trait anxiety differed as a function of NPSR1 genotype, CTQ and GSE score (discovery: β = 0.129, P = 3.938 × 10−8; replication: β = 0.102, P = 0.020). In A allele carriers, the relationship between childhood trauma and anxiety was moderated by general self-efficacy: higher self-efficacy and childhood trauma resulted in low anxiety scores, and lower self-efficacy and childhood trauma in higher anxiety levels. In turn, TT homozygotes displayed increased anxiety as a function of childhood adversity unaffected by general self-efficacy.

Functional NPSR1 variation and childhood trauma are suggested as prime moderators in the vulnerability–stress model of anxiety, further modified by the protective effect of self-efficacy. This G × E × C approach – introducing coping as an additional dimension further shaping a G × E risk constellation, thus suggesting a three-dimensional ‘vulnerability–stress–coping model’ of mental disorders – might inform targeted preventive or therapeutic interventions strengthening coping ability to promote resilient functioning.

Panic disorder (PD) is generally regarded as a chronic condition with considerable variation in severity of symptoms.

To describe the long-term outcome of naturalistically treated PD.

Fifty-five outpatients with PD, who participated in a placebo-controlled drug trial of the efficacy of alprazolam and imipramine 15 years ago were reassessed with the same instruments used in the original study.

Complete recovery (no panic attacks and no longer on medication during the last 10 years) was seen in 18% of patients, and an additional 13% recovered but were still on medication. Fifty-one percent experienced recurrent anxiety attacks whereas 18% still met diagnostic criteria for PD. The incidence of agoraphobia decreased from 69% to 20%. Patients with agoraphobia at admission tended to have a poorer long-term outcome according to daily functioning compared with patients without agoraphobia at admission, although both groups reported improved daily functioning at follow-up. Maintenance medication was common. No benzodiazepine abuse was reported.

PD has a favourable outcome in a substantial proportion of patients. However, the illness is chronic and needs treatment. The short-term treatment given in the drug trial had no influence on the long-term outcome.

There is insufficient knowledge of the long-term course of panic disorder (PD).

To determine the long-term course and prognostic variables in patients diagnosed with PD.

Patients who were diagnosed of anxiety states between 1950 and 1961, were examined using a structured clinical interview (SCID-DSM-III-R) between 1984 and 1988 (n = 144). A re-examination was performed in the period 1997–2001 (N = 125). Mean length of follow-up from onset was 47 years.

PD tends to be chronic. Among those who recovered, 93% had done so already by the 1980s. Lack of regular treatment compliance, progression to agoraphobia and number of episodes of panic disorder were associated with worse outcome. Agoraphobia without panic attacks and somatization symptoms were the most prevalent clinical status at follow-up.

After several decades, participants improve with regard to number of panic attacks, though most continue to have residual symptoms.

Cognitive functioning in anxiety disorders has received little investigation, particularly among young adults and in non-clinical samples. The present study examined cognitive functioning in a population-based sample of young adults with anxiety disorders in comparison to healthy peers.

A population-based sample of 21–35-year-olds with a lifetime history of anxiety disorders (n = 75) and a random sample of healthy controls (n = 71) derived from the same population were compared in terms of performance in neuropsychological tests measuring verbal and visual short-term memory, verbal long-term memory, attention, psychomotor processing speed, and executive functioning.

In general, young adults with anxiety disorders did not have major cognitive impairments when compared to healthy peers. When participants with anxiety disorder in remission were excluded, persons with current anxiety disorder scored lower in visual working memory tests. Current psychotropic medication use and low current psychosocial functioning associated with deficits in executive functioning, psychomotor processing speed, and visual short-term memory.

Lifetime history of anxiety disorders is not associated with cognitive impairment among young adults in the general population. However, among persons with anxiety disorders, current psychotropic medication use and low psychosocial functioning, indicating more severe symptoms, may associate with cognitive impairments.

Lifestyle is less favourable among individuals suffering from psychiatric disorders. We studied whether psychotherapy brings along changes in lifestyle and whether these changes differ between short-term and long-term psychodynamic psychotherapy (SPP and LPP) and solution-focused therapy (SFT).

A total of 326 outpatients, 20–46 years of age, with mood or anxiety disorder were randomly assigned to LPP, SPP and SFT. The lifestyle variables considered were alcohol consumption, smoking, body mass index (BMI), leisure time exercise and serum cholesterol. The patients were monitored for three years from the start of treatment.

During the three-year follow-up, BMI and serum cholesterol rose statistically significantly although no statistically significant trends were shown for alcohol consumption, smoking or exercise. SPP showed a disadvantage of increased alcohol consumption and serum cholesterol level when compared with LPP. SFT showed an advantage of reduced smoking in comparison with SPP.

Small therapy-specific changes in lifestyle may be a result from psychotherapy treatment. These lifestyle changes are apparently more common in short-term therapy. More studies are needed to verify these findings.

There is increasing interest in day-to-day affect fluctuations of patients with depressive and anxiety disorders. Few studies have compared repeated assessments of positive affect (PA) and negative affect (NA) across diagnostic groups, and fluctuation patterns were not uniformly defined. The aim of this study is to compare affect fluctuations in patients with a current episode of depressive or anxiety disorder, in remitted patients and in controls, using affect instability as a core concept but also describing other measures of variability and adjusting for possible confounders.

Ecological momentary assessment (EMA) data were obtained from 365 participants of the Netherlands Study of Depression and Anxiety with current (n = 95), remitted (n = 178) or no (n = 92) DSM-IV defined depression/anxiety disorder. For 2 weeks, five times per day, participants filled-out items on PA and NA. Affect instability was calculated as the root mean square of successive differences (RMSSD). Tests on group differences in RMSSD, within-person variance, and autocorrelation were performed, controlling for mean affect levels.

Current depression/anxiety patients had the highest affect instability in both PA and NA, followed by remitters and then controls. Instability differences between groups remained significant when controlling for mean affect levels, but differences between current and remitted were no longer significant.

Patients with a current disorder have higher instability of NA and PA than remitted patients and controls. Especially with regard to NA, this could be interpreted as patients with a current disorder being more sensitive to internal and external stressors and having suboptimal affect regulation.