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3 results

  • Chapter 16 - Autism and autism spectrum disorders

  • Edited by John I. Nurnberger, Jr, Wade Berrettini, University of Pennsylvania School of Medicine
  • Book:
    Principles of Psychiatric Genetics
    Published online:
    05 October 2012
    Print publication:
    13 September 2012, pp 183-195

  • Summary

    Genetic epidemiology can address a number of questions of practical importance for a search for genes for phobic disorders. With the genetics of the phobic disorders established, studies are beginning to ask more specifically what constitutes the additive genetic component. Genome searches have been reported for agoraphobia, simple phobia, social phobia, and for a broad phenotype that includes these three phobias in addition to other anxiety disorders. Genetic epidemiology indicates that finding genes for the phobic disorders will require samples with considerable statistical power since the heritability's of these disorders are modest. Twin studies indicate that the familial transmission of generalized anxiety disorder (GAD) is due to genes. With regard to GAD, additive genes shared with panic disorder and agoraphobia accounted for 20% of the total variance of GAD; indeed, this shared variance component made up 87% of its additive genetic variance.

  • Anxiety in middle adulthood: effects of age and time on the 14-year course of panic disorder, social phobia and generalized anxiety disorder

  • H. J. Ramsawh, S. D. Raffa, M. Orlando Edelen, R. Rende, M. B. Keller
  • Journal:
    Psychological Medicine / Volume 39 / Issue 4 / April 2009
    Published online by Cambridge University Press:
    30 July 2008, pp. 615-624
  • Background

    Much about the long-term course of anxiety disorders is unknown. The present study utilizes a naturalistic, longitudinal, short-interval follow-up design to elucidate the course of anxiety disorders over 14 years in a largely middle-aged adult sample recruited from out-patient psychiatry and primary care facilities.

    Method

    The sample consisted of 453 participants with a diagnosis of panic disorder (PD), social phobia (SP) and/or generalized anxiety disorder (GAD). Anxiety symptom ratings were tracked using weekly psychiatric status ratings (PSRs). Controlling for demographic and clinical variables, the course of PD, GAD and SP were examined using longitudinal growth models, with the most severe PSR at each follow-up point as the main outcome variable.

    Results

    PSRs significantly decreased in severity over time in each of the three disorders. In the interaction effects models, age×time had a significant effect on course for PD and GAD, but not for SP, in that older age was associated with lower PSRs over time.

    Conclusions

    The present findings suggest that the severity of anxiety disorders declines over time, although this decline is modest and depends on the specific disorder being assessed. Older individuals with PD and GAD have a better prognosis than their younger counterparts, as their course is characterized by a steeper decline in severity. The present findings provide important information about the course of anxiety disorders in mid-life.

  • Vasovagal syncope and anaesthetic practice

  • L. Hosie, J. P. Wood, A. N. Thomas
  • Journal:
    European Journal of Anaesthesiology / Volume 18 / Issue 8 / August 2001
    Published online by Cambridge University Press:
    16 August 2006, pp. 554-557
    Print publication:
    August 2001

  • We surveyed anaesthetists working in North-West England and in North Wales concerning episodes of vasovagal syncope encountered in their practice. Eighty-eight anaesthetists described 109 such events occurring in either patients or their relatives and the estimated frequency of syncope was 1 in 5000 anaesthetic episodes. The patient syncopal episodes were triggered by venous cannulation in 16 instances and regional or local techniques in 20 instances. Thirty-three of the 53 patients were in the upright position when syncope occurred. Thirty-nine of the 56 relatives were male partners of female patients and four of these partners suffered some morbidity. The results of the survey are consistent with our current knowledge of the pathophysiology of vasovagal syncope, which is summarized, and also highlight the common anaesthetic scenarios where fainting is most likely to occur. Given this information anaesthetists will be in a better position to avoid such potentially harmful episodes in the future.