Impact of Mental Health Treatment on Outcomes in Patients With Heart Failure and Ischemic Heart Disease.

Background: There is conflicting evidence as to the impact of mental health treatment on outcomes in patients with heart disease. The aim of this study was to examine whether individuals who received mental health treatment for anxiety or depression after being hospitalized for ischemic disorders or heart failure had a reduced frequency of rehospitalizations, emergency department visits, or mortality compared with those who did not receive treatment.

Methods And Results: A population-based, retrospective, cohort design was used to examine the association between psychotherapy or antidepressant medication prescription and health service utilization and mortality in patients with coronary artery disease or heart failure and comorbid anxiety or depression.

The relationship between sleep and anxiety in older adults.

Anxiety and sleep problems are major barriers to healthy aging and are frequently comorbid conditions in older adults. In the current review, we present recent advances in understanding the extensive overlap among older adults between anxiety and one specific related sleep problem, insomnia. These proposals suggest that anxiety and insomnia may share a common vulnerability to negative emotionality and at times may act as risk factors for each other in older adults.

Women and non-cardiac chest pain: gender differences in symptom presentation.

A substantial number of individuals evaluated for complaints of chest pain do not suffer from coronary heart disease (CHD). Studies show that many patients who complain of symptoms that might be caused by CHD, such as shortness of breath or chest pain, may actually have an anxiety disorder. Gender differences in how patients present with these symptoms have not been adequately explored.

Difference in treatment outcome in outpatients with anxious versus nonanxious depression: a STAR*D report.

Objective: About half of outpatients with major depressive disorder also have clinically meaningful levels of anxiety. The authors conducted a secondary data analysis to compare antidepressant treatment outcomes for patients with anxious and nonanxious major depression in Levels 1 and 2 of the STAR*D study.

Method: A total of 2,876 adult outpatients with major depressive disorder, enrolled from 18 primary and 23 psychiatric care sites, received citalopram in Level 1 of STAR*D.

Cardiac anxiety in people with and without coronary atherosclerosis.

Many studies have shown that cardiac anxiety when occurring in the absence of coronary artery disease is common and quite costly. The Cardiac Anxiety Questionnaire (CAQ) is an 18-item self-report measure that assesses anxiety related to cardiac symptoms. To better understand the construct of cardiac anxiety, a factor analysis was conducted on CAQ data from 658 individuals who were self or physician-referred for electron beam tomographic screening to determine whether clinically significant coronary atherosclerosis was present.

What clinical and symptom features and comorbid disorders characterize outpatients with anxious major depressive disorder: a replication and extension.

Objective: We previously found that 46% of the first 1450 outpatients with depression participating in the multicentre Sequenced Treatment Alternatives to Relieve Depression (STAR*D) project qualified for the designation of anxious depression. This study was designed to replicate and extend our initial findings in a subsequent, larger cohort of outpatient STAR*D participants with nonpsychotic major depressive disorder (MDD).

Methods: Baseline clinical and sociodemographic data were collected on 2337 consecutive STAR*D participants.

Jumping to interpretations: social anxiety disorder and the identification of emotional facial expressions.

A small body of research suggests that socially anxious individuals show biases in interpreting the facial expressions of others. The current study included a clinically anxious sample in a speeded emotional card-sorting task in two conditions (baseline and threat) to investigate several hypothesized biases in interpretation. Following the threat manipulation, participants with generalized social anxiety disorders (GSADs) sorted angry cards with greater accuracy, but also evidenced a greater rate of neutral cards misclassified as angry, as compared to nonanxious controls.

The role of cognitions in OCD treatment: toward rapprochement.

The authors of the papers in this special issue have underscored the efficacy of both psychological and pharmacological treatments for OCD. Despite the potency of these interventions, complete symptom remission rarely occurs. Furthermore, problems related to treatment drop-out, the persistence of residual symptoms despite adequate therapy, patients' vulnerability to relapse and recurrence, and the lack of a clear method for managing co-morbidity or treating OCD subtypes remain incompletely addressed.

Clinical correlates and symptom patterns of anxious depression among patients with major depressive disorder in STAR*D.

Background: Anxious depression, defined as Major Depressive Disorder (MDD) with high levels of anxiety symptoms, may represent a relatively common depressive subtype, with distinctive features.

Objective: The objective of this study was to determine the prevalence of anxious depression and to define its clinical correlates and symptom patterns.

Method: Baseline clinical and sociodemographic data were collected on 1450 subjects participating in the STAR*D study.

Cardiac anxiety in patients self-referred for electron beam tomography.

Studies have repeatedly shown that as many as 43% of patients undergoing coronary angiograms have no evidence of coronary heart disease (CHD). Fear of cardiac-related sensations has been posited as one explanation for complaints of chest pain in patients without CHD. The purpose of this study is to examine variables associated with cardiac anxiety in a sample of individuals self-referred for noninvasive coronary calcium screening.

Treatment of late-onset OCD following basal ganglia infarct.

Current consensus on the treatment of obsessive-compulsive disorder (OCD) includes cognitive behavior therapy (CBT) in the form of exposure and response prevention (ERP). However, the generalizability of these methods to elderly populations remains largely undocumented. This clinical case study examines the effectiveness of medications and intensive, inpatient ERP in an elderly patient with onset of OCD following basal ganglia infarcts.