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Importance: This report details a case of effectively managing severe panic attacks in a panic disorder (PD) patient with agoraphobia by acupuncture treatment. Case presentation: A 38-year-old Japanese woman suffering from PD with agoraphobia presented at our acupuncture clinic with complaints of repeated panic attacks and anxiety. Initially starting to experience symptoms in her late teens, she avoided psychiatric consultation due to reluctance toward psychotropic medications. An unbiased psychiatrist used the Panic Disorder Severity Scale (PDSS) to assess her PD severity. The PDSS score decreased from 21 on the first to 12 points on the sixth visit. The patient experienced reduced frequency and severity of panic attacks, with restored confidence to go into public despite agoraphobia. Conclusions and Relevance: This is the first report to demonstrate the effectiveness of acupuncture on PD with agoraphobia using PDSS, suggesting its potential as a nonpharmacological treatment for patients with PD and agoraphobia. [ABSTRACT FROM AUTHOR]

Evaluation of a team-based intervention in primary care that includes cognitive behavioural therapy elements and case management and was supported by eHealth components in patients with panic disorder with or without agoraphobia (PD ± AG) and/or depression. In a two-armed cluster-randomised controlled trial (cRCT), mental health conditions were assessed by the Mental Health Index (MHI-5), Patient Health Questionnaire (PHQ-9), Overall Anxiety Severity and Impairment Scale (OASIS), Panic and Agoraphobia Scale (PAS), Mobility Inventory for Agoraphobia (MIA), and Patient Assessment of Chronic Illness Care (PACIC) at baseline (T0), after 6 months (T1), and after 12 months (T2). Scores were analysed as differences from baseline using a mixed linear model with general practitioner (GP) as a random intercept and treatment, time point, and respective baseline value as fixed factors. The majority of participants (mean age 54 years, SD 12.8 years) were women (n = 40, 67.8%). We found consistent mean effects in favour of the intervention group (MHI-5 index, 6.66 [−7.38; 20.70]; PACIC, 15.92 [4.58; 27.26]; PHQ-9, −3.43 [−5.71; −1.14]; OASIS, −2.89 [−5.41; −0.37]). A cautious interpretation indicates promising effects of the intervention. Obstacles to recruitment included the workload for GPs and medical assistants (MAs), potential reservations regarding eHealth, and the onset of the COVID-19 pandemic. Trial registration: The study was registered at the German Clinical Trials Register (DRKS00016622) on February 22nd, 2019. https://drks.de/search/de/trial/DRKS00016622. [ABSTRACT FROM AUTHOR]

Beta-blocker prescriptions for patients with anxiety increased substantially between 2003 and 2018, yet there is no clinical guidance concerning their use. A previous review of propranolol – a beta-blocker – in the treatment of anxiety concluded there was insufficient evidence to support its use. Additional data have been published in the eight years since that review including some evidence for other beta-blockers. We aimed to synthesise all available data on the effectiveness of beta-blockers in the treatment of anxiety disorders in adults. We searched Medline, Embase, PsycINFO, Web of Science, and Trial Registries (September 2023), including randomised controlled trials (RCT), non-randomised control group comparative studies and cross-over trials reporting self- or clinician-reported anxiety symptoms. Study quality was assessed using Cochrane's Risk of Bias tool, with meta-analyses conducted by comparator group using random-effects models. Searches produced 3068 records, with 10 studies included, of which five were included in meta-analyses (n = 179). There was no evidence for a beneficial effect of beta-blockers compared with either placebo or benzodiazepines in patients with social phobia or panic disorder with/without agoraphobia (p -value for all meta-analyses ≥0.54). Many of the included studies had small sample sizes, missing data and high or unclear risk of bias. Beta-blockers are increasingly prescribed for anxiety, yet there is a lack of robust evidence of effectiveness. There is a need to understand when and why practitioners are using these drugs, and to undertake a large RCT to provide definitive evidence of whether beta-blockers are an effective and safe treatment for anxiety. • There was no evidence for a beneficial effect of beta-blockers. • Many studies had small sample sizes, missing data and high/unclear risk of bias. • Beta-blockers are increasingly prescribed for anxiety, yet there is a lack of robust evidence of effectiveness. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to assess the prevalence of psychiatric disorders among the women between 32-week gestation & two week postpartum. Methods: The study was conducted in the Post Graduate Department of Obstetrics and Gynaecology over a period of one year i.e. November 2016 to October 2017, after approval from the Ethical Committee. Subjects included 150 antenatal women from 32-week period of gestation till delivery and 150 postpartum women from delivery till 2 weeks postpartum. Psychiatric disorder was calculated using Mini Neuropsychiatric Inventory. Other sociodemographic, obstetric, and psychiatric variables were recorded. Results: Overall, 150 antenatal and 150 postnatal women were studied, 28 women (18.7%) in antenatal and 21(14%) women in postnatal group had psychiatric disorder. The overall prevalence of psychiatric disorders in the present study was found to be 16.4%. This prevalence in pregnancy ranges from 15- 29% worldwide. Among 28 antenatal patients diagnosed as having Psychiatric Disorder 13 (8.7%) had Depression. One patient (0.7%) had Dysthymia, 2 (1.3%) had panic disorder. 2 (1.3%) had obsessive compulsive disorder. 10 (6.7%) had Generalized Anxiety Disorder. None of the patients had Depression with Melancholic features, Suicidality, Hypomania, Agoraphobia, Social Phobia, Bipolar Disorder, Alcohol Dependence and abuse, Post-Traumatic Stress Disorder, Psychotic Disorder, Anorexia Nervosa, and Bulimia Nervosa. 21 Postnatal patients were diagnosed as having Psychiatric Disorder, out of which 12 (8.0%) had Depression. None had Dysthymia, 3(2%) had panic disorder. 1 (0.7%) had obsessive compulsive disorder. 1 (0.7%) had Post Traumatic Stress Disorder. 1 (0.7) had Psychotic Disorder and Mood disorder with Psychotic features. 3 (2%) had Generalized Anxiety Disorder. None of the patients had Depression with Melancholic features, Suicidality, Hypomania, Agoraphobia, Social Phobia, Bipolar Disorder, Alcohol Dependence and abuse, Anorexia Nervosa, and Bulimia Nervosa. 21.3% antenatal females had antenatal risk questionnaire score ≥23 with mean score 17.5±8.57 and 26.7% postnatal females had postnatal risk questionnaire score ≥24. Conclusion: Pregnancy-related psychiatric disorders are frequent. The outcomes for pregnant women, infants, and women's health are all improved by proper diagnosis and treatment of psychiatric problems. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic skin disease associated with lower quality of life and higher risk of anxiety and depression in adults. We investigate whether adolescents with psoriasis also experience poorer mental health than their peers. In this cross-sectional study, we included questionnaire data on psoriasis and mental health from the 18-year follow-up of the Danish National Birth Cohort. We estimated odds ratios (OR) and 95 % confidence intervals (CI) using a logistic regression with inverse probability weighting to account for potential selection bias, adjusted for potential confounders identified a priori. We estimated associations between self-reported psoriasis and multiple aspects of mental health (self-rated health, life satisfaction, mental well-being, loneliness, overall and internalizing behavioral difficulties, depressive symptoms, and anxiety symptoms). In sensitivity analyses, we examined doctor-diagnosed psoriasis and psoriasis with and without joint pain. Of the 44,838 included in this study, 1147 (2.6 %) reported psoriasis. Adolescents with psoriasis had a higher risk of nearly all outcomes, including depressive symptoms (OR 1.38; 1.19–1.58) and panic/agoraphobia among both males (OR 1.72; 1.33–2.19) and females (OR 1.60; 1.33–1.92). Associations attenuated when restricted to doctor-diagnosed psoriasis. Associations with poor mental health were mainly observed for adolescents with psoriasis also reporting joint pain. We could not establish temporality and lacked data on joint pain in referents. Psoriasis is associated with poor mental health in adolescents. This appears to be driven by adolescents with psoriasis also reporting joint pain and is less evident in those with a doctor-confirmed diagnosis. • Psoriasis is associated with poor mental health in adolescents. • Even milder forms of psoriasis can impact young people's mental health. • Joint pain has a negative impact on the mental health of adolescents with psoriasis. [ABSTRACT FROM AUTHOR]

Objectives: Inequities in physical health outcomes exist for people with mental health and substance use conditions and for Indigenous populations (Māori in Aotearoa New Zealand). These inequities may be partly explained by poorer quality of physical healthcare services, including discrimination at systemic and individual levels. This study investigated the experiences of people with mental health and substance use conditions accessing physical healthcare and differences in service quality for non-Māori relative to Māori. Methods: A cross-sectional online survey of people with mental health and substance use conditions in New Zealand asked about four aspects of service quality in four healthcare settings: general practice, emergency department, hospital and pharmacy. The quality domains were: treated with respect; listened to; treated unfairly due to mental health and substance use conditions; mental health and substance use condition diagnoses distracting clinicians from physical healthcare (diagnostic and treatment overshadowing). Results: Across the four health services, pharmacy was rated highest for all quality measures and emergency department lowest. Participants rated general practice services highly for being treated with respect and listened to but reported relatively high levels of overshadowing in general practice, emergency department and hospital services. Experiences of unfair treatment were more common in emergency department and hospital than general practice and pharmacy. Compared to Māori, non-Māori reported higher levels of being treated with respect and listened to in most services and were more likely to report 'never' experiencing unfair treatment and overshadowing for all health services. Conclusion: Interventions to address discrimination and poor-quality health services to people with mental health and substance use conditions should be tailored to the physical healthcare setting. More needs to be done to address institutional racism in systems that privilege non-Māori. [ABSTRACT FROM AUTHOR]

This paper investigates the application of Virtual Reality Exposure Therapy (VRET) to treat agoraphobia, focusing on two pivotal research questions derived from identified gaps in current therapeutic approaches. The first question (RQ1) addresses the development of complex VR environments to enhance therapy's effectiveness by simulating real‐world anxiety triggers. The second question (RQ2) examines the differential impact of these VR environments on agoraphobic and nonagoraphobic participants through rigorous comparative analyses using t‐tests. Methodologies include advanced data processing techniques for electrodermal activity (EDA) and eye‐tracking metrics to assess the anxiety levels induced by these environments. Additionally, qualitative methods such as structured interviews and questionnaires complement these measurements, providing deeper insights into the subjective experiences of participants. Video recordings of sessions using Unity software offer a layer of data, enabling the study to replay and analyze interactions within the VR environment meticulously. The experimental results confirm the efficacy of VR settings in eliciting significant physiological and psychological responses from participants, substantiating the VR scenarios' potential as a therapeutic tool. This study contributes to the broader discourse on the viability and optimization of VR technologies in clinical settings, offering a methodologically sound approach to the practicality and accessibility of exposure therapies for anxiety disorders. [ABSTRACT FROM AUTHOR]

Background: Individuals with anxiety disorders (ADs) often display hypervigilance to threat information, although this response may be less pronounced following psychotherapy. This study aims to investigate the unconscious recognition performance of facial expressions in patients with panic disorder (PD) posttreatment, shedding light on alterations in their emotional processing biases. Methods: Patients with PD (n=34) after (exposure-based) cognitive behavior therapy and healthy controls (n=43) performed a subliminal affective recognition task. Emotional facial expressions (fearful, happy, or mirrored) were displayed for 33 ms and backwardly masked by a neutral face. Participants completed a forced choice task to discriminate the briefly presented facial stimulus and an uncovered condition where only the neutral mask was shown. We conducted a secondary analysis to compare groups based on their four possible response types under the four stimulus conditions and examined the correlation of the false alarm rate for fear responses to non-fearful (happy, mirrored, and uncovered) stimuli with clinical anxiety symptoms. Results: The patient group showed a unique selection pattern in response to happy expressions, with significantly more correct "happy" responses compared to controls. Additionally, lower severity of anxiety symptoms after psychotherapy was associated with a decreased false fear response rate with nonthreat presentations. Conclusion: These data suggest that patients with PD exhibited a "happy-face recognition advantage" after psychotherapy. Less symptoms after treatment were related to a reduced fear bias. Thus, a differential facial emotion detection task could be a suitable tool to monitor response patterns and biases in individuals with ADs in the context of psychotherapy. [ABSTRACT FROM AUTHOR]

Anxiety disorders are among the most common disorders in early childhood. Although many older children and adolescents with anxiety disorders recover and remain well, little is known about the continuity of early childhood anxiety and the factors that predict persistence/recurrence in later childhood and adolescence. We followed 129 children who met anxiety disorder criteria at age 3 and/or 6 and determined how many continued to experience an anxiety disorder between age 7 and 15, as well as the continuity of specific anxiety disorders. We explored whether biological sex, number of anxiety disorders, early childhood persistence (i.e., anxiety diagnosis at both age 3 and 6), childhood comorbidities, temperamental behavioral inhibition, a maternal history of anxiety, and authoritarian and overprotective parenting predicted persistence/recurrence of an anxiety disorder from age 7 to 15. Sixty-five (50.4%) of the adolescents with an early childhood anxiety disorder met anxiety disorder criteria during the age 7–15 interval. Homotypic continuity from early childhood to school-age/mid-adolescence was observed for social anxiety disorder, separation anxiety disorder, and generalized anxiety disorder (GAD). Early childhood agoraphobia predicted school-age/mid-adolescent GAD and early childhood GAD predicted school-age/mid-adolescent specific phobia. In bivariate analyses, number of anxiety disorders, persistence of anxiety from age 3 to 6, and having a mother with a history of anxiety predicted the persistence/recurrence of anxiety disorders from age 7 to 15. Only early childhood persistence of anxiety uniquely predicted the persistence/recurrence of an anxiety disorder over and above the other predictors. Early intervention efforts should focus on identifying and intervening with young children who demonstrate a protracted course of anxiety. [ABSTRACT FROM AUTHOR]

Cardiac arrest (CA)-induced cerebral ischemia remains challenging with high mortality and disability. Neural stem cell (NSC) engrafting is an emerging therapeutic strategy with considerable promise that, unfortunately, is severely compromised by limited cell functionality after in vivo transplantation. This groundbreaking report demonstrates that metabolic glycoengineering (MGE) using the "Ac5ManNTProp (TProp)" monosaccharide analog stimulates the Wnt/β-catenin pathway, improves cell adhesion, and enhances neuronal differentiation in human NSCs in vitro thereby substantially increasing the therapeutic potential of these cells. For the first time, MGE significantly enhances NSC efficacy for treating ischemic brain injury after asphyxia CA in rats. In particular, neurological deficit scores and neurobehavioral tests experience greater improvements when the therapeutic cells are pretreated with TProp than with "stand-alone" NSC therapy. Notably, the TProp-NSC group exhibits significantly stronger neuroprotective functions including enhanced differentiation, synaptic plasticity, and reduced microglia recruitment; furthermore, Wnt pathway agonists and inhibitors demonstrate a pivotal role for Wnt signaling in the process. These findings help establishMGE as a promising avenue for addressing current limitations associated with NSC transplantation via beneficially influencing neural regeneration and synaptic plasticity, thereby offering enhanced therapeutic options to boost brain recovery following global ischemia. [ABSTRACT FROM AUTHOR]

This study aimed to detect alterations in interhemispheric interactions in patients with panic disorder (PD), determine whether such alterations could serve as biomarkers for the diagnosis and prediction of therapeutic outcomes, and map dynamic changes in interhemispheric interactions in patients with PD after treatment. Fifty-four patients with PD and 54 healthy controls (HCs) were enrolled in this study. All participants underwent clinical assessment and a resting-state functional magnetic resonance imaging scan at (i) baseline and (ii) after paroxetine treatment for 4 weeks. A voxel-mirrored homotopic connectivity (VMHC) indicator, support vector machine (SVM), and support vector regression (SVR) were used in this study. Patients with PD showed reduced VMHC in the fusiform, middle temporal/occipital, and postcentral/precentral gyri, relative to those of HCs. After treatment, the patients exhibited enhanced VMHC in the lingual gyrus, relative to the baseline data. The VMHC of the fusiform and postcentral/precentral gyri contributed most to the classification (accuracy = 87.04%). The predicted changes were accessed from the SVR using the aberrant VMHC as features. Positive correlations (p < 0.001) were indicated between the actual and predicted changes in the severity of anxiety. These findings suggest that impaired interhemispheric coordination in the cognitive–sensory network characterized PD and that VMHC can serve as biomarkers and predictors of the efficiency of PD treatment. Enhanced VMHC in the lingual gyrus of patients with PD after treatment implied that pharmacotherapy recruited the visual network in the early stages. [ABSTRACT FROM AUTHOR]

Objective: Few long‐term studies have examined the life‐time prevalence of comorbid psychiatric conditions in patients with obsessive‐compulsive disorder (OCD). We therefore studied the frequency of comorbid psychiatric disorders, and their relation to onset and prognosis, in patients with OCD who were followed for almost half a century. Methods: During 1947–1953, 285 OCD patients were admitted as inpatients to a university hospital in Gothenburg, Sweden. Among those, 251 (88%) accepted a structured comprehensive psychiatric examination in 1954–1956. In 1989–1993, 176 survivors were eligible and 144 (response rate 82%) were re‐examined. The same psychiatrist performed both examinations. OCD was diagnosed according to the Schneider criteria, and other mental disorders according to DSM‐IV. Mean follow‐up since onset was 47 years. Results: The lifetime frequency of depressive disorders was 84.7% (major depression 43.8%), generalized anxiety disorder (GAD) 71.5%, panic anxiety disorder 47.9%, agoraphobia 52.1%, specific phobias 64.6%, social phobia 47.9%, paranoid conditions 40.3% (29.1% paranoid ideation), psychotic disorders 15.3%, alcohol abuse 13.2% (men 39%, women 3%) and substance abuse 17.4%. Specific phobia most often started before OCD, while depression had a varied onset in relation to OCD. Social phobia, agoraphobia, GAD, alcohol and substance abuse, psychotic disorders and paranoid conditions most often started after OCD. Presence of GAD, psychotic disorder and substance abuse worsened prognosis of OCD. Conclusion: Comorbid psychiatric conditions are common in OCD patients, and have onset throughout the course. OCD signals vulnerability for other psychiatric conditions, which are important to detect in clinical practice as they negatively affect the outcome. [ABSTRACT FROM AUTHOR]

While referring specifically to Doina Cosman's exemplary The Orange Man and Other Therapeutic Stories, we have in view cognitive behavioural therapy, with its development of personal coping strategies to treat mental health disorders ranging from mood disorders and schizophrenia, through substance-related disorders and paraphilia, to rape and adultery. [ABSTRACT FROM AUTHOR]

Anxiety-related disorders feature elevated negative affect (NA), and in some cases, diminished positive affect (PA). It remains unclear how well extant psychotherapies for anxiety-related disorders improve PA versus NA. We systematically searched the Cochrane Central Register of Controlled Trials, PubMed, PsychInfo, and Web of Science databases. Records included studies involving (1) patients with a principal or co-principal diagnosis of at least one anxiety-related disorder (i.e., generalized anxiety, social anxiety, panic, agoraphobia, health anxiety, specific phobia, obsessive-compulsive disorder, or posttraumatic stress disorder), and (2) pre- and post-treatment PA and NA scores or a change index between pre- and post-treatment PA and NA scores. Effect sizes were calculated for meta-analyses. Fourteen studies with 1001 adults with an anxiety-related disorder were included. Psychotherapeutic interventions included cognitive behavioral, present-centered, and imagery-based approaches. Treatments reduced NA (g = −0.90; 95%CI [−1.19, −0.61]) to a greater extent than they improved PA (g = 0.27; 95%CI [0.05, 0.59]), Z = −5.26, p <.001. The limited number of studies available precluded analyses of the relationship between changes in affect and symptoms. Results should be considered with caution given the small number and heterogeneity of included studies. Current psychotherapeutic interventions for anxiety-related disorders may not improve PA and NA to comparable levels. • Systematic review and meta-analysis of the effect of psychotherapies on affective change for anxiety-related disorders. • There is a large effect of improvement in negative affect (g = −0.90). • There is a small effect of improvement in positive affect (g = 0.27). • Extant psychotherapies for anxiety-related disorders repair negative affect to a greater extent than positive affect. [ABSTRACT FROM AUTHOR]

Background: The ever-increasing spread of Internet-based systems for common mental disorders has generated the need for brief online screening methods. This study aims to test the psychometric properties of the Web Screening Questionnaire (WSQ) to examine its suitability for screening for common mental health problems among a community sample of Italian adults. Methods: A total of 1282 subjects (F = 819; mean age = 42.05) answered the WSQ. Its discriminant characteristics were examined with other validated selected scales for measuring mental health widely used in the Italian population using sensitivity, specificity, and area under the curve (AUC), as well as positive (PPV) and negative predictive values (NPV). Results: Most of the WSQ subscales exhibited moderate to high specificity values. Specifically, the scales of 'agoraphobia' (0.947; 95%CI [0.934, 0.960]), 'anxiety' (0.959; 95%CI [0.946, 0.970]), and 'panic disorder' (0.973; 95%CI [0.964, 0.981]) showed the highest values whilst the 'obsessive-compulsive' dimension had the lowest value at 0.838, 95%CI [0.815, 0.861]. With exceptions observed for 'depression' (0.716; 95%CI [642, 798]) and 'alcohol abuse' (0.760; 95%CI [560, 920]), instead, the WSQ demonstrated critical sensitivity values (<0.6) in all dimensions. Conclusions: The WSQ was appropriate for discriminating between people with and without a psychiatric condition, as it helps to confirm the absence of disorders. However, further diagnostic procedures are required, in case of a positive WSQ screening result. [ABSTRACT FROM AUTHOR]

This paper describes the anxiety evoked in a patient threatened by invasion or engulfment by his object on the one hand, and the fears of isolation and abandonment on the other. The author illustrates the patient's strugles to find a distance between himself and his object he can tolerate. The analyst has also to cope with the anxieties evoked by the patient's projections, and find a distance between himself and his patient that enables him to think and work. [ABSTRACT FROM AUTHOR]

Sleep and physical activity suggestions for panic disorder (PD) are critical but less surveyed. This two-year prospective cohort study aims to predict panic attacks (PA), state anxiety (SA), trait anxiety (TA) and panic disorder severity (PDS) in the upcoming week. We enrolled 114 PD patients from one general hospital. Data were collected using the DSM-5, the MINI, clinical app questionnaires (BDI, BAI, PDSS-SR, STAI) and wearable devices recording daily sleep, physical activity and heart rate from 16 June 2020 to 10 June 2022. Our teams applied RNN, LSTM, GRU deep learning and SHAP explainable methods to analyse the data. The 7-day prediction accuracies for PA, SA, TA, and PDS were 92.8 %, 83.6 %, 87.2 %, and 75.6 % from the LSTM model. Using the SHAP explainable model, higher initial BDI or BAI score and comorbidities with depressive disorder, generalized anxiety disorder or agoraphobia predict a higher chance of PA. However, PA decreased under the following conditions: daily average heart rate, 72–87 bpm; maximum heart rate, 100–145 bpm; resting heart rate, 55–60 bpm; daily climbing of more than nine floors; total sleep duration between 6 h 23 min and 10 h 50 min; deep sleep, >50 min; and awake duration, <53 min. Moderate sample size and self-report questionnaires were the limitations. Deep learning predicts recurrent PA and various anxiety domains with 75.6–92.8 % accuracy. Recurrent PA decreases under adequate daily sleep and physical activity. • LSTM deep learning achieves 75.6–92.8 % accuracy in PA prediction. • Optimal sleep and activity ranges for PA prevention identified via SHAP. • Baseline depression and anxiety impact PD prognosis negatively. • Common PA symptoms: chest tightness, dizziness, palpitations, breathlessness. [ABSTRACT FROM AUTHOR]

Background: This study was developed to determine the effectiveness of transcutaneous auricular vagus nerve stimulation and Jacobson relaxation technique on agoraphobia among subjects with post neurological ill-patients. Purpose: The purpose of the study is to compare and evaluate the effectiveness of two non-pharmacological methods of treatment for Agoraphobia patients with Post neurological ill-patients. Methods: The research project was conducted as a pilot study in a private hospital in Chennai. The experimental group (group A) received transcutaneous auricular vagus nerve stimulation for approximately 20 minutes (30 seconds ON and 5 minutes OFF) and a conventional Jacobson relaxation technique for 10 minutes. Group B got conventional cognitive behavioral therapy (20 minutes) and the Jacobson relaxation technique (10 minutes). Following the four-week treatment period, a post-test analysis was performed using the Severity measure of agoraphobia. Results: The study found that there is a positive impact of transcutaneous auricular vagus nerve stimulation and Jacobson relaxation technique on agoraphobia in post neurological ill patients. The analysis obtained a mean value of about 18 and an SD of 26 for group A, whereas group B revealed 24.8 ± 4.40, mean ± SD, and a significant P value of <0.001. Conclusion: When compared to group B, those in group A who received transcutaneous auricular vagus nerve stimulation improved more significantly when dealing with agoraphobia of post neurological ill patients. As a result, non-invasive transcutaneous auricular vagus nerve stimulation and Jacobson relaxation technique have been proven to be effective approaches for preventing agoraphobia. [ABSTRACT FROM AUTHOR]

Introduction: The role of catechol-O-methyltransferase (COMT) in catecholamine neurotransmitter metabolism has led to the investigation of variants of the corresponding gene in the etiology of different psychiatric disorders, but the results are inconclusive. Methods: We have examined the relationship between COMT Val158Met single nucleotide polymorphism (rs4680) and the occurrence of psychiatric disorders in a highly representative birth cohort sample of young adults in the Estonian Children Personality Behaviour and Health Study (original n = 1,238). The lifetime occurrence of psychiatric disorders at the age of 25 years was assessed with the Mini-International Neuropsychiatric Interview. Results: Both Val- and Met-alleles of the COMT Val158Met were associated with specific psychiatric disorders. Met-allele carriers had a significantly higher occurrence of agoraphobia (3.2% vs. 0.5%; χ2 = 4.10; p < 0.05) compared to Val/Val homozygotes. Also, the occurrence of panic disorder was significantly higher in female Met-allele carriers than in Val/Val homozygote females (10.2% vs. 3.6%; χ2 = 4.62 p = 0.03). In contrast, the occurrence of generalized anxiety disorder was higher in Val/Val females when compared to Met-allele carriers (12.7% vs. 6.8%; χ2 = 4.16; p = 0.04). Also, female Val/Val homozygotes (15.5%) had a higher occurrence of eating disorders than Met-allele carriers (6.1%) of the COMT Val158Met polymorphism (χ2 = 10.39; p = 0.002). In the whole sample, Met-allele homozygotes had a higher occurrence of alcohol use and substance use disorders than Val-allele carriers (χ2 = 3.62 and 3.68, respectively; p < 0.05). Conclusion: In a regional highly birth cohort representative sample, either COMT rs4680 variant was observed in association with specific psychiatric disorders. [ABSTRACT FROM AUTHOR]

Virtual reality (VR) has become a widely used tool in neuroscience, with applications in enhancing spatial memory. VR can simulate real-world environments, helping individuals with navigation difficulties such as neurodegenerative disorders, brain damage, and psychological diseases. It can also be used in educational settings to improve spatial memory and learning. The use of VR in healthcare, architecture, education, and entertainment has extensive benefits, improving spatial memory and cognitive skills. This special issue includes studies on VR and spatial memory, investigating factors that affect spatial navigation and the use of VR in diagnosing and treating agoraphobia. [Extracted from the article]

Although panic disorder has been frequently associated with increased suicidal ideation and behaviors, there are multiple explanations for this association in the literature. For example, some research has demonstrated panic disorder symptoms to mediate agoraphobia and suicidal ideation, while other researchers have hypothesized that comorbid depression symptoms contribute to suicidal ideation across anxiety disorders. Of note, none of these studies were completed in veterans, a population at higher risk for suicide relative to civilian samples. The present study investigated relations between the symptoms of panic, agoraphobia, depression, and suicidal ideation in 58 veterans diagnosed with panic disorder via correlations, hierarchical regression, and exploratory path analyses. Multiple models were investigated based on prior research. The final path model demonstrated that symptoms of panic disorder predicted agoraphobia symptoms, with agoraphobia predicting symptoms of depression. Symptoms of depression, then, predicted suicidal ideation. Discussion of the findings related to comorbid depressive symptoms highlight considerations for the assessment and treatment practices for panic disorder, with a particular focus on veterans receiving care within Veterans Affairs Healthcare System. [ABSTRACT FROM AUTHOR]

The current conceptualization of anxiety in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)—which includes 11 anxiety disorders plus additional anxiety-related conditions—does not align with accumulating evidence that anxiety is transdiagnostic and dimensional in nature. Transdiagnostic dimensional anxiety models have been proposed, yet they measure anxiety at either a very broad (e.g., "anxiety") or very narrow (e.g., "performance anxiety") level, overlooking intermediate properties of anxiety that cut across DSM disorders. Using indicators from a well-validated semistructured interview of anxiety-related disorders, we constructed intermediate-level transdiagnostic dimensions representing the intensity, avoidance, pervasiveness, and onset of anxiety. We captured these content-agnostic dimensions in a sample representing varying levels and forms of anxiety (N = 268), including individuals with generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, specific phobia, separation anxiety disorder, posttraumatic stress disorder, and obsessive–compulsive disorder (n = 205) and individuals with no psychopathology (n = 63). In preregistered analyses, our dimensional anxiety model showed noninferiority to DSM-5 diagnoses in predicting concurrent and prospective measures of anxiety-related impairment, anxiety vulnerabilities, comorbid depression, and suicidal ideation. These results held regardless of whether the dimensions were combined into a single composite or retained as separate components. Our transdiagnostic dimensional model offers meaningful gains in parsimony over DSM, with no loss of predictive power. This project provides a methodological framework for the empirical evaluation of other transdiagnostic dimensional models of psychopathology that have been proposed as alternatives to the DSM. General Scientific Summary: The current classification of anxiety is cumbersome; does not align with evidence that anxiety problems cut across disorder categories; and fails to acknowledge that the severity of anxiety matters, even at low levels. We developed a new classification that distills key features of anxiety—intensity, avoidance, pervasiveness, and onset—across disorders, allowing any individual to be located along a gradient from none to severe for each feature. This transdiagnostic dimensional approach is much simpler than the current Diagnostic and Statistical Manual of Mental Disorders (DSM) approach to anxiety, incorporates information about severity, and performs just as well as DSM diagnoses in predicting important clinical outcomes. [ABSTRACT FROM AUTHOR]

Background: High resistance-to-treatment rates in obsessive-compulsive disorder (OCD) and various treatments remain significant obstacles to psychiatric disorder treatments. Objectives: The current study used network analysis to predict treatment response by psychiatric symptoms in the contamination/cleaning and danger/checking OCD subtypes. Methods: We evaluated 136 patients (mean age: 30.50 ± 5.25) who finished a 12-week selective serotonin reuptake inhibitor (SSRI) course. We used the convenience sampling method. All patients completed structured clinical interviews for the diagnostic and statistical manual of mental disorders, fifth edition research version (SCID-5-RV) at baseline and post-test. After treatment completion, the patients were categorized as responders and resistant according to their OCD severity scores (at the post-test). We used a network approach to determine the network structure of patients before and after the treatment. Network analysis was used by "the Rprogramming language" to compare patterns of psychiatric symptoms. Additionally, we contrasted treatment-responsive patients' network structure with treatment-resistant OCD patients in each subtype. Results: In baseline, dysthymia, insomnia, binge eating, agoraphobia, and panic were the most central (important) nodes in the danger/checking subtype. However, hoarding, ADHD, insomnia, depression, and panic were the most central nodes in the contamination/cleaning group at baseline. Also, global strength and symptom connectivity were higher in the contamination/cleaning subtype than in the danger/check subtype (P < 0.05). In the contamination/cleaning subtype, "insomnia" was the most significant predictor for categorizing patients as resistant at the post-test. For contamination/cleaning, panic and binge eating played similar roles in treatment outcomes. Conclusions: Psychiatric symptoms can predict treatment responses in OCD subtypes. So, it is necessary to consider psychiatric comorbidities regarding OCD subtypes. [ABSTRACT FROM AUTHOR]

Background: Anxiety disorders are commonly diagnosed and cause substantial functional impairment. A mixture of pharmaco)logic and psychosocial treatments currently exists, but these treatments are not always tolerable and effective. For patients with anxiety resistant to standard therapy, psychedelics may be a promising alternative. This review assesses the therapeutic benefits and safety of psychedelics in treating anxiety disorders. Methods: We searched PubMed, Embase, PsycInfo, and CINAHL for clinical trials investigating psychedelics in patients with clinician-diagnosed generalized anxiety disorder, social anxiety disorder, specific phobia, separation anxiety disorder, selective mutism, panic disorder, agoraphobia, and anxiety attributable to another medical condition. We analyzed data from 9 indepen)dent psychedelic-assisted trials testing ayahuasca (1 study), ketamine (4 studies), lysergic acid diethylamide (LSD) (2 studies), 3,4- methylenedioxymethamphetamine (MDMA) (1 study), and psilocybin (1 study). Efficacy was assessed by measuring the change in outcome measures and the quality of life from baseline. Results: The reviewed studies demonstrated encouraging efficacy in reducing anxiety symptoms, increasing self-perception, and increasing social function in patients with generalized anxiety disorder, social anxiety disorder, or anxiety attributable to another medical condition while establishing feasibility and evidence of safety. For many patients, the therapeutic effects of the psychedelic treatment lasted weeks, and no severe adverse events were reported. Conclusion: Based on the evidence of symptom reduction and safety, the current literature (2011 to 2021) shows that psychedelics could be considered for treating clinician-diagnosed anxiety disorders. Psychedelics may provide an alternative therapeutic option for patients resistant to current standard treatments. [ABSTRACT FROM AUTHOR]