Panic disorder is a chronic illness that waxes and wanes, and the prognosis is worse with comorbid agoraphobia, depression, or personality disorder. Both medication and cognitive-behavioral therapy ...have been found helpful in acute treatment trials of panic disorder. However, recent studies suggest that therapeutic gains are lost in many instances when treatment is stopped after short-term medication or cognitive-behavioral therapy. Thus, maintenance treatment appears necessary for many panic patients. Patients appear relatively stable during medication maintenance, but studies of maintenance psychosocial treatment for panic disorder have not yet been reported. Whether combined medication and psychosocial treatment lead to more durable effects after treatment discontinuation than are seen with individual treatments also remains to be determined.
Imipramine in the treatment of social phobia Simpson, H B; Schneier, F R; Campeas, R B ...
Journal of clinical psychopharmacology,
04/1998, Letnik:
18, Številka:
2
Journal Article
Recenzirano
We report the results of an 8-week open trial of imipramine in 15 patients with social phobia. Nine patients completed the trial; six dropped out early because of adverse effects. The mean reduction ...in the Liebowitz Social Anxiety Scale was 15% and 18% for the intent-to-treat and completer groups, respectively; the overall response rate (based on the Clinical Global Impression Scale of 1 or 2, very much or much improved) was 20% (3/15) and 22% (2/9), respectively. The results from this open trial do not support the efficacy of imipramine as a treatment for social phobia.
Objective To determine whether prophylactic indomethacin (PINDO) has more or less morbidity than delayed conservative management of the moderate-to-large patent ductus arteriosus (PDA). Study design ...We performed a prospective double cohort controlled study of infants delivered at ≤276/7 weeks gestation (n = 397). From January 2005 through April 2011, all infants were treated with PINDO (n = 247). From May 2011 through August 2016, no infant was treated with indomethacin until at least 8 postnatal days (conservative epoch, n = 150). Echocardiograms were performed on day 7 and at planned intervals until the PDA was small or closed. A single neonatologist prospectively collected all data. Results The incidence of moderate-to-large PDA on day 7 and duration of exposure to moderate-to-large PDA were significantly less in the PINDO epoch (incidence = 10%, median = 2 days) than the conservative epoch (incidence = 67%, median = 14 days). Ligation rates were low in both epochs (PINDO = 14%, conservative = 5%). In multivariate analyses, PINDO infants had a significantly lower incidence of bronchopulmonary dysplasia (BPD) (risk ratio = 0.68, CI: 0.46-0.89) and BPD or death (risk ratio= 0.78, CI: 0.62-0.95) than conservative infants. There were no differences between the epochs in death, intraventricular hemorrhage grades 3 and 4, necrotizing enterocolitis, or retinopathy of prematurity receiving treatment. The effects of PINDO on BPD and BPD or death were no longer significant when analyses were adjusted for presence of a moderate-to-large PDA on day 7. The significant effects of PINDO were independent of whether or not a ligation was performed. Conclusions PINDO decreases BPD and BPD or death compared with delayed conservative PDA management. These effects are mediated by closure of the PDA.
Many investigators have shown that panic disorder patients and possibly social phobics are hypersensitive to the anxiogenic effects of inhaled carbon dioxide (CO2). In this study we administered ...double-breath inhalation of 35% CO2 and 65% oxygen (O2) to panic disorder patients, social phobics, and normal controls. At baseline, panic disorder patients were characterized by higher pulse, anxiety score, and evidence of hyperventilation. Panic patients and social phobics panicked more often to 35% CO2 than to room air; normal controls did not have a higher rate of panic to CO2 than to room air. However, we did not find significant group differences in anxiety level, physiological measures, or biochemical measures in response to CO2 breathing compared with room air breathing. These results confirm earlier reports of baseline hyperventilation in panic disorder patients. However, 35% CO2 may be too high a dose to differentiate respiratory responses of patients compared with normals.
Social phobia is increasingly recognized as a prevalent and socially impairing mental disorder. However, little data is available regarding the general and disease-specific impairments and ...disabilities associated with social phobia. Furthermore, most studies have not controlled for the confounding effects of comorbid conditions. This study investigates: (a) the generic quality of life; (b) work productivity; and, (c) various other disorder-specific social impairments in current cases with pure (n = 65), comorbid (n = 51) and subthreshold (n = 34) DSM-IV social phobia as compared to controls with no social phobia (subjects with a history of herpes infections). Social phobia cases reported a mean illness duration of 22.9 years with onset in childhood or adolescence. Current quality of life, as assessed by the SF-36, was significantly reduced in all social phobia groups, particularly in the scales measuring vitality, general health, mental health, role limitations due to emotional health, and social functioning. Comorbid cases revealed more severe reductions than pure and subthreshold social phobics. Findings from the Liebowitz self-rated disability scale indicated that: (a) social phobia affects most areas of life, but in particular education, career, and romantic relationship; (b) the presence of past and current comorbid conditions increases the frequency of disease-specific impairments; and, (c) subthreshold social phobia revealed slightly lower overall impairments than comorbid social phobics. Past week work productivity of social phobics was significantly diminished as indicated by: (a) a three-fold higher rate of unemployed cases; (b) elevated rates of work hours missed due to social phobia problems; and, (c) a reduced work performance. Overall, these findings underline that social phobia in our sample of adults, whether comorbid, subthreshold, or pure was a persisting and impairing condition, resulting in considerable subjective suffering and negative impact on work performance and social relationships. The current disabilities and impairments were usually less pronounced than in the past, presumably due to adaptive behaviors in life style of the respondents. Data also confirmed that social phobia is poorly recognized and rarely treated by the mental health system.
The little fire ant, Wasmannia auropunctata (Roger) (Hymenoptera: Formicidae), is a stinging invasive ant that can establish extremely large, dominating populations in tropical and subtropical ...regions. In Florida, it is well established in south and central Florida with a reported northern limit of Marion County, Florida, USA. However, in 2018 to 2019 overwintering populations were discovered farther north in Gainesville, Florida, USA. There is a need to develop effective management options suitable for the site uses of these recently discovered infestations. Most commercial imported fire ant baits are formulated on a corn grit carrier that, when exposed to moisture, is thought to compromise bait effectiveness. Due to the humid and rainy summer weather in this region, the objective of this study was to determine the acceptance and efficacy of water-soaked ant baits on W. auropunctata, some of which had purported moisture resistance. Bait acceptance tests conducted in the field with dry baits determined that baits containing the active ingredients spinosad and pyriproxyfen were accepted poorly, while W. auropunctata accepted both dry and wet baits containing hydramethylnon, metaflumizone, indoxacarb, and abamectin. Laboratory colonies given access to either dry or wet baits exhibited significant declines in workers, brood, and queens with several colonies being eliminated. The results of this study indicated that water-soaked imported fire ant baits could control W. auropunctata, and moisture exposure did not cause baits to become unpalatable. However, these results should be validated under field conditions, where precipitation may reduce the accessibility of baits to foraging ants. La pequeña hormiga de fuego, Wasmannia auropunctata (Roger) (Hymenoptera: Formicidae), es una hormiga invasora urticante que puede establecer poblaciones dominantes extremadamente grandes en regiones tropicales y subtropicales. En Florida, está bien establecida en el sur y el centro de la Florida con un límite norte hasta el condado de Marion, Florida, EE. UU. Sin embargo, entre el 2018 y 2019 se descubrieron poblaciones que hibernan más al norte, en Gainesville, Florida. Existe la necesidad de desarrollar opciones de manejo efectivas adecuadas para los usos del sitio de estas infestaciones descubiertas recientemente. La mayoría de los cebos comerciales importados para hormigas de fuego están formulados con grano de maíz como portador que cuando se expone a la humedad, se cree que compromete la eficacia del cebo. Debido al clima húmedo y lluvioso del verano en esta región, el objetivo de este estudio fue determinar la aceptación y eficacia de los cebos para hormigas empapados en agua sobre W. auropunctata, algunos de los cuales tenían supuesta resistencia a la humedad. Las pruebas de aceptación de cebos realizadas en el campo con cebos secos determinaron que los cebos que contenían los ingredientes activos spinosad y pyriproxyfen fueron mal aceptados, mientras que W. auropunctata aceptó cebos secos y húmedos que contenían hidrametilnon, metaflumizona, indoxacarb y abamectina. Las colonias de laboratorio a las que se les dio acceso a cebos secos o húmedos exhibieron disminuciones significativas de obreras, crías y reinas y con varias eliminadas. Los resultados de este estudio indicaron que los cebos para hormigas de fuego importados empapados en agua podrían controlar W. auropunctata, y la exposición a la humedad no hizo que los cebos se volvieran desagradables. Sin embargo, estos resultados deben validarse en condiciones de campo, donde la precipitación puede reducir la accesibilidad de los cebos para las hormigas en busca de alimento.
Taijin-kyofu-sho (TKS) is thought to be a common, culture-bound disorder of social anxiety in Japan and Korea. Its phenomenology has been noted to overlap with that of social phobia. The "offensive ...type" of TKS, which has no direct parallel in Western classification, is characterized by a fear of offending others in social situations, which leads to social avoidance. There has been only one case of offensive-type TKS reported in the United States, and this case was not regarded as a variant of social phobia.
The phenomenology and treatment of six patients who presented to New York City anxiety disorders research clinic psychiatrists with the offensive type of TKS are described. Features of TKS are compared with those of social phobia, as described in Western countries. Treatment outcomes for four patients are discussed and compared with TKS treatment experience in Japan and Korea and with treatment outcome in social phobia.
In this anxiety clinic sample, features of the offensive type of TKS showed much overlap with symptoms of social phobia. Only two of four treated patients in this TKS sample received adequate trials of medication known to be effective for social phobia, and one of the two improved significantly.
The offensive type of TKS may not be as culture-bound as previously thought. Further study is needed to determine whether such cases respond to medications and to cognitive-behavioral approaches that are effective for social phobia. How to classify the offensive type of TKS is uncertain, but social phobia should be considered in the differential diagnosis.
One hundred and sixty patients with a primary diagnosis of obsessive-compulsive disorder were enrolled in a multicentre, randomized, double-blind, placebo-controlled study of fluvoxamine. After a ...placebo washout phase, patients were randomized to treatment with placebo or fluvoxamine (100-300 mg/day) for 10 weeks. Seventy-eight patients in each group were evaluable for efficacy. Fluvoxamine was significantly more effective than placebo as assessed by the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the National Institute of Mental Health Obsessive-Compulsive (NIMH-OC) scale and the Global Improvement item of the Clinical Global Impression (CGI) scale. The percentage of patients classified as "responders" (much or very much improved according to the Global Improvement item) was also significantly higher in the fluvoxamine group from Week 6 onwards, with 33.3% of fluvoxamine-treated patients and 9.0% of those given placebo classified as "responders" at endpoint. The "responders" to fluvoxamine experienced a substantial clinical benefit as reflected in decreases in their Y-BOCS and NIMH-OC scores. Fluvoxamine was well tolerated with the majority of adverse events considered mild or moderate.
Sixty patients with probable atypical depression--defined as meeting Research Diagnostic Criteria for depressive illness, having reactive mood, and having one of four associated symptoms ...(hyperphagia, hypersomnolence, leaden feeling, and sensitivity to rejection)--took part in a study contrasting phenelzine, imipramine, and placebo. Phenelzine was found to be superior to imipramine and placebo. These results were compared to results from a sample of 120 patients with identical characteristics, except that they had more than one associated atypical symptom (full atypical syndrome). The size of the drug effect was comparable in patients with full atypical and partial atypical syndromes.
The litle fre ant, Wasmannia auropunctata (Roger) (Hymenoptera: Formicidae), is a stinging invasive ant that can establish extremely large, dominating populations in tropical and subtropical regions. ...In Florida, it is well established in south and central Florida with a reported northern limit of Marion County, Florida, USA. However, in 2018 to 2019 overwintering populations were discovered farther north in Gainesville, Florida, USA. There is a need to develop effectve management options suitable for the site uses of these recently discovered infestations. Most commercial imported fre ant baits are formulated on a corn grit carrier that, when exposed to moisture, is thought to compromise bait effectveness. Due to the humid and rainy summer weather in this region, the objectve of this study was to determine the acceptance and eficacy of water-soaked ant baits on W. auropunctata, some of which had purported moisture resistance. Bait acceptance tests conducted in the feld with dry baits determined that baits containing the actve ingredients spinosad and pyriproxyfen were accepted poorly, while W. auropunctata accepted both dry and wet baits containing hydramethylnon, metafumizone, indoxacarb, and abamectn. Laboratory colonies given access to either dry or wet baits exhibited significant declines in workers, brood, and queens with several colonies being eliminated. The results of this study indicated that water-soaked imported fre ant baits could control W. auropunctata, and moisture exposure did not cause baits to become unpalatable. However, these results should be validated under feld conditions, where precipitation may reduce the accessibility of baits to foraging ants.
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