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Can J Psychiatry 2021 Jun 23:7067437211027319. Epub 2021 Jun 23.

Anxiety Treatment and Research Clinic, 25479St. Joseph's Healthcare, Hamilton, Ontario, Canada.

Objective: Telehealth is being increasingly incorporated into the delivery of mental health care and has received widespread attention during the COVID-19 pandemic for its ability to facilitate care during physical distancing restrictions. Videoconferencing is a common telehealth modality for delivering psychotherapy and has demonstrated similar outcomes to those of face-to-face therapy. Cognitive behavioural therapy (CBT) is the most common psychotherapy evaluated across various telehealth modalities; however, studies on CBT delivered via videoconference, particularly in a group therapy format, are lacking. Read More

Cognit Ther Res 2018 Oct 30;42(5):661-673. Epub 2018 Mar 30.

Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.

Anxiety sensitivity, a fear of arousal-related sensations, is prevalent in a number of disorders. We examined the relationship between internalizing symptoms and the anxiety sensitivity components of physical, social, and cognitive concerns in a sample of 165 patients seeking treatment in a clinic specializing in CBT for anxiety-related disorders. Social anxiety symptoms were associated with greater social concerns. Read More

Neurosci Biobehav Rev 2021 Jun 15;128:136-151. Epub 2021 Jun 15.

Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, via Savi, 10, 56126, Pisa, Italy.

Attentional biases to threat exist in panic disorder (PD), probably related to altered subliminal processing. We systematically reviewed studies investigating subliminal processing in PD. Studies were retrieved from MEDLINE and Scopus®. Read More

Eat Weight Disord 2021 Jun 16. Epub 2021 Jun 16.

Psychiatry 2 Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Via Savi 10, 56126, Pisa, Italia.

Purpose: We aimed at investigating the lifetime prevalence of mood, eating and panic disorders in a large sample of obese patients referred to bariatric surgery. We also explored the patterns of psychiatric comorbidity and their relationship with Body Mass Index (BMI).

Methods: The sample was composed of patients consecutively referred for pre-surgical evaluation to the Obesity Center of Pisa University Hospital between January 2004 and November 2016. Read More

Front Psychiatry 2021 31;12:667602. Epub 2021 May 31.

Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.

Mental health may affect the quality of life (QoL) in patients with pulmonary arterial hypertension (PAH). However, mental disorders have not been systematically assessed in these patients. We examined the prevalence of mental disorders using structured interviews and determined their impact on QoL in patients with PAH. Read More

Behav Ther 2021 07 1;52(4):956-969. Epub 2021 Jan 1.

Weill Cornell Medical College.

Although clinical intuitions influence psychotherapeutic practice and are a rich source of novel hypotheses for research, many remain to be empirically tested. This study evaluates whether clinicians' beliefs about barriers to progress in cognitive-behavioral therapy (CBT) for panic disorder are supported by data. Data from a randomized-controlled trial comparing CBT to panic-focused psychodynamic psychotherapy (PFPP) for adults with primary panic disorder (N = 161) were used to evaluate 15 factors endorsed by clinicians as impediments to CBT in a recent survey. Read More

Behav Ther 2021 07 20;52(4):917-931. Epub 2020 Nov 20.

Center for Anxiety and Related Disorders, Boston University. Electronic address:

A growing literature suggests robust associations between dimensions of emotion regulation and emotional disorder psychopathology. However, limited research has investigated associations of emotion regulation dimensions across several emotional disorders (transdiagnostic associations), or the incremental validity of emotion regulation versus the higher-order construct of neuroticism. The current study used exploratory structural equation modeling and a large clinical sample (N = 1,138) to: (a) develop a multidimensional emotion regulation measurement model, (b) evaluate the differential associations between latent emotion regulation dimensions and five latent emotional disorder symptom dimensions (social anxiety, depression, agoraphobia/panic, obsessions/compulsions, generalized worry), and (c) determine the incremental contribution of emotion regulation in predicting symptom dimensions beyond neuroticism. Read More

Behav Ther 2021 07 21;52(4):1008-1018. Epub 2021 Jan 21.

Center for Anxiety and Related Disorders at Boston University.

Homework assignments are an integral part of cognitive behavioral therapy, providing patients with opportunities to practice skills between sessions. Generally, greater homework compliance is associated with better treatment outcomes. However, fewer studies have examined the effect of homework quality on treatment outcomes. Read More

Rev Psiquiatr Salud Ment (Engl Ed) 2021 Apr-Jun;14(2):90-105

Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium.

Introduction: Healthcare workers are vulnerable to adverse mental health impacts of the COVID-19 pandemic. We assessed prevalence of mental disorders and associated factors during the first wave of the pandemic among healthcare professionals in Spain.

Methods: All workers in 18 healthcare institutions (6 AACC) in Spain were invited to web-based surveys assessing individual characteristics, COVID-19 infection status and exposure, and mental health status (May 5 - September 7, 2020). Read More

CNS Spectr 2021 Apr;26(2):178-179

Western University of Health Sciences, Pomona, CA, USA.

Traumatic brain injury (TBI) is a complex phenomenon affecting multiple areas of the brain in multiple ways. Both right and left hemispheres are affected as well as supratentorial and infratentorial compartments. These multifocal injuries are caused by many factors including acute mechanical injury, focal intracranial hemorrhage, blunt and rotational forces, epidural and subdural hematoma, hypoxemia, hypotension, edema, axonal damage, neuronal death, gliosis and blood brain barrier disruption. Read More

J Psychiatr Res 2021 May 29;140:329-336. Epub 2021 May 29.

Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KULeuven, Belgium.

We examined the manifestation of major depressive disorder, generalized anxiety disorder, substance use disorder, post-traumatic stress disorder, and panic attacks among health care professionals during the first COVID-19 wave (n = 6409) by means of mental disorder screening instruments. Logistic regressions were used to gauge individual risk factors; population attributable risk proportions (PARP) were inferred to identify the most important risk factors at the societal level. Data were weighted to represent general profiles of Belgian health care professionals. Read More

Front Psychol 2021 26;12:684222. Epub 2021 May 26.

Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China.

The novel coronavirus disease 2019 (COVID-19) posed an unprecedented threat to Chinese healthcare professionals. Nevertheless, few studies notably focused on the mental health conditions of nurses and explored protective factors to prevent posttraumatic stress and psychological distress. This study aimed to explore the prevalence and the predictive factors especially defensive predictors associated with posttraumatic stress and psychological distress in nurses during the COVID-19 pandemic. Read More

Behav Brain Res 2021 Jun 9;412:113412. Epub 2021 Jun 9.

Institute of Systems Neuroscience, National Tsing Hua University, Hsihchu, 30013, Taiwan; Brain Research Center, National Tsing Hua University, Hsinchu, 30013, Taiwan. Electronic address:

Some anxiety-related disorders, such as panic disorder, specific phobia, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD), develop because of the poor regulation and inappropriate expression of fear-related behavior at the wrong place and wrong time. In clinical settings, exposure therapy, which consists of repeated presentation of trauma-related stimuli without real threats in the therapeutic context, is commonly used to treat these disorders. However, 30-50 % of patients suffer from the recurrence of anxiety symptoms after they leave the therapeutic context. Read More

Psychother Psychosom 2021 Jun 10:1-14. Epub 2021 Jun 10.

Research Unit for Psychotherapy and Psychopathology, Mental Health Service West, Copenhagen University Hospital, Psychiatry Region Zealand, Slagelse, Denmark.

Introduction: The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) delivered in a group format could facilitate the implementation of evidence-based psychological treatments.

Objective: This study compared the efficacy of group UP and diagnosis-specific cognitive behavioral therapy (dCBT) for anxiety and depression in outpatient mental health services.

Methods: In this pragmatic, multi-center, single-blinded, non-inferiority, randomized controlled trial (RCT), we assigned 291 patients with major depressive disorder, social anxiety disorder, panic disorder, or agoraphobia to 14 weekly sessions in mixed-diagnosis UP or single-diagnosis dCBT groups. Read More

Nat Sci Sleep 2021 31;13:683-693. Epub 2021 May 31.

Flinders Health and Medical Research Institute (Sleep Health)/Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia.

Purpose: We aimed to estimate the prevalence of probable shift work disorder (pSWD) in a representative sample of Australian workers and identify sleep, health and safety correlates.

Patients And Methods: In 2019, data were collected from working respondents as part of a cross-sectional national sleep health survey conducted online (n=964 total; n=448 individuals on non-standard work schedules). We established the prevalence of pSWD according to International Classification of Sleep Disorders criteria (ICSD-R, ICSD-2 and ICSD-3). Read More

Epidemiol Psychiatr Sci 2021 Jun 4;30:e42. Epub 2021 Jun 4.

Research Department of Clinical, Educational & Health Psychology, Centre for Outcomes Research and Effectiveness (CORE), University College London, 1-19 Torrington Place, LondonWC1E 7HB, UK.

Aims: To determine whether age, gender and marital status are associated with prognosis for adults with depression who sought treatment in primary care.

Methods: Medline, Embase, PsycINFO and Cochrane Central were searched from inception to 1st December 2020 for randomised controlled trials (RCTs) of adults seeking treatment for depression from their general practitioners, that used the Revised Clinical Interview Schedule so that there was uniformity in the measurement of clinical prognostic factors, and that reported on age, gender and marital status. Individual participant data were gathered from all nine eligible RCTs (N = 4864). Read More

Indian J Psychiatry 2021 Jan-Feb;63(1):70-73. Epub 2021 Feb 15.

Department of Psychiatry, IQ City Medical College, Durgapur, West Bengal, India.

Background: Dissociative experiences and health anxiety are frequently encountered in anxiety disorders and contribute to the burden of illness.

Aim: The aim was to assess and compare dissociative experiences and level of health anxiety in patients with panic disorder and normal individuals.

Materials And Methods: We recruited forty eligible patients with panic disorder and forty healthy volunteers without any psychiatric diagnoses. Read More

Psychol Rev 2021 Jun 3. Epub 2021 Jun 3.

Institute of Cognitive Sciences and Technologies.

We advance a novel computational model that characterizes formally the ways we perceive or misperceive bodily symptoms, in the context of panic attacks. The computational model is grounded within the formal framework of Active Inference, which considers top-down prediction and attention dynamics as key to perceptual inference and action selection. In a series of simulations, we use the computational model to reproduce key facets of adaptive and maladaptive symptom perception: the ways we infer our bodily state by integrating prior information and somatic afferents; the ways we decide whether or not to attend to somatic channels; the ways we use the symptom inference to make decisions about taking or not taking a medicine; and the ways all the above processes can go awry, determining symptom misperception and ensuing maladaptive behaviors, such as hypervigilance or excessive medicine use. Read More

Mol Psychiatry 2021 Jun 2. Epub 2021 Jun 2.

Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

Promotion of good mental health, prevention, and early intervention before/at the onset of mental disorders improve outcomes. However, the range and peak ages at onset for mental disorders are not fully established. To provide robust, global epidemiological estimates of age at onset for mental disorders, we conducted a PRISMA/MOOSE-compliant systematic review with meta-analysis of birth cohort/cross-sectional/cohort studies, representative of the general population, reporting age at onset for any ICD/DSM-mental disorders, identified in PubMed/Web of Science (up to 16/05/2020) (PROSPERO:CRD42019143015). Read More

J Clin Med 2021 May 25;10(11). Epub 2021 May 25.

2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy.

Mood and anxiety disorders are the most common neuropsychiatric syndromes associated with Parkinson's disease (PD). The aim of our study was to estimate the prevalence of lifetime and current anxiety disorders in patients with Parkinson's Disease (PD), to explore possible distinctive neurological and psychiatric features associated with such comorbidity. One hundred patients were consecutively recruited at the Movement Disorders Section of the Neurological Outpatient Clinic of the University of Pisa. Read More

Int J Environ Res Public Health 2021 05 17;18(10). Epub 2021 May 17.

Research Unit for Psychotherapy & Psychopathology, Psychiatry West, Region Zealand, 4200 Slagelse, Denmark.

Group cohesion refers to a sense of belonging, mutual support and identification with other group members. Group cohesion has been associated with better outcomes, lower drop-out rates, more interpersonal support and better participation in psychotherapy. Nevertheless, the role of group cohesion in CBT has not yet received much attention. Read More

Medicina (Kaunas) 2021 May 12;57(5). Epub 2021 May 12.

Psychiatry 2 Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy.

: Emotional dysregulation is central to the problem of the overlap between attention-deficit/hyperactivity disorder (ADHD) and cyclothymia. The aim of the study was to evaluate comorbidity rates between ADHD and cyclothymic disorder and to explore demographic and clinical differences among the groups, focusing on affective temperament and emotional dysregulation. : One hundred sixty-five outpatients attending the Second Psychiatry Unit at the Santa Chiara University Hospital (Pisa) were consecutively recruited: 80 were diagnosed with ADHD, 60 with cyclothymic disorder, and 25 with both conditions. Read More

J Public Health Res 2021 May 31;10(s1). Epub 2021 May 31.

Department of Medical Surgical, Bachelor Nursing Programme, STIKes Santo Borromeus, Padalarang, West Java.

Background: Anxiety constitutes one of the most prevalent childhood mental health problems. It affects social functions, academic functions and increases the risk of mental health problems at the next stage of development among elementary school children. Besides, psychopathologic disorders in teenagers appear in form of emotional symptoms. Read More

J Dev Orig Health Dis 2021 May 31:1-11. Epub 2021 May 31.

College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, 5042, Australia.

While donor-conceived children have similar mental health outcomes compared to spontaneously conceived children, there is an inconsistency between studies investigating mental health outcomes of donor-conceived people in adulthood. This study is an online health survey that was completed by 272 donor sperm-conceived adults and 877 spontaneously conceived adults from around the world. Donor sperm-conceived adults had increased diagnoses of attention deficit disorder (P = 0. Read More

Psychol Med 2021 May 28:1-13. Epub 2021 May 28.

Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands.

Background: Digital interventions for anxiety disorders are a promising solution to address barriers to evidence-based treatment access. Precise and powerful estimates of digital intervention effectiveness for anxiety disorders are necessary for further adoption in practice. The present systematic review and meta-analysis examined the effectiveness of digital interventions across all anxiety disorders and specific to each disorder v. Read More

Biopsychosoc Med 2021 May 27;15(1):11. Epub 2021 May 27.

Department of Psychiatry, Jichi Medical University, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan.

Background: Graves' disease is characterized by hyperthyroidism and its symptoms often overlap with those of panic disorder, which may make it difficult to distinguish between the two conditions. In this report, we describe how proper diagnosis of thyroid disease in patients with mental illness can lead to appropriate treatment.

Case Presentation: We encountered a 34-year-old woman in whom thyroid crisis from Graves' disease was misdiagnosed as panic attack. Read More

J Nerv Ment Dis 2021 Jun;209(6):459-462

Treatment Resistant Depression Ambulatory, Psychiatry Institute, Federal University of Rio de Janeiro.

Abstract: The objective of this study was to investigate potential correlates of dispositional optimism and quality of life in patients with depression and panic disorder. The study used a cross-sectional design. The analyzed sample consisted of 77 participants with panic disorder and 75 participants with depression attending two outpatient clinics at the Psychiatry Institute of the Federal University of Rio de Janeiro. Read More

J Affect Disord 2021 Aug 14;291:110-117. Epub 2021 May 14.

University of South Florida, Department of Psychology.

Background: Although preliminary research has explored the possibility of optimal well-being after depression, it is unclear how rates compare to anxiety. Using Generalized Anxiety Disorder (GAD) and Panic Disorder (PD) as exemplars of anxiety, we tested the rates of optimal well-being one decade after being diagnosed with an anxiety disorder. Based on reward deficits in depression, we pre-registered our primary hypothesis that optimal well-being would be more prevalent after anxiety than depression as well as tested two exploratory hypotheses. Read More

Behav Res Ther 2021 Jul 12;142:103886. Epub 2021 May 12.

Department of Biological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald, Germany.

Further developments of exposure-based therapy (EBT) require more knowledge about transfer of treatment to non-trained everyday contexts. However, little is known about transfer effects of EBT. Using a standardized EBT protocol in 275 patients with panic disorder and agoraphobia we investigated the transfer of EBT to a highly standardized context during a Behavioral Avoidance Test (BAT; being entrapped in a small and dark test chamber) and not part of the exposure sessions. Read More