Prediction of transition from common adolescent bipolar experiences to bipolar disorder: 10-year study.

Background: Although (hypo)manic symptoms are common in adolescence, transition to adult bipolar disorder is infrequent.

Aims: To examine whether the risk of transition to bipolar disorder is conditional on the extent of persistence of subthreshold affective phenotypes.

Method: In a 10-year prospective community cohort study of 3021 adolescents and young adults, the association between persistence of affective symptoms over 3 years and the 10-year clinical outcomes of incident DSM-IV (hypo)manic episodes and incident use of mental healthcare was assessed.

Generalized worry disorder: a review of DSM-IV generalized anxiety disorder and options for DSM-V.

Background: Generalized anxiety disorder (GAD) has undergone a series of substantial classificatory changes since its first inclusion in DSM-III. The majority of these revisions have been in response to its poor inter-rater reliability and concerns that it may lack diagnostic validity. This article provides options for the revision of the DSM-IV GAD criteria for DSM-V.

Incidence and risk patterns of anxiety and depressive disorders and categorization of generalized anxiety disorder.

Context: Controversy surrounds the diagnostic categorization of generalized anxiety disorder (GAD).

Objectives: To examine the incidence, comorbidity, and risk patterns for anxiety and depressive disorders and to test whether developmental features of GAD more strongly support a view of this condition as a depressive as opposed to an anxiety disorder.

Design: Face-to-face, 10-year prospective longitudinal and family study with as many as 4 assessment waves.

Anxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V.

This review summarizes findings on the epidemiology and etiology of anxiety disorders among children and adolescents including separation anxiety disorder, specific phobia, social phobia, agoraphobia, panic disorder, and generalized anxiety disorder, also highlighting critical aspects of diagnosis, assessment, and treatment. Childhood and adolescence is the core risk phase for the development of anxiety symptoms and syndromes, ranging from transient mild symptoms to full-blown anxiety disorders. This article critically reviews epidemiological evidence covering prevalence, incidence, course, and risk factors.

The position of anxiety disorders in structural models of mental disorders.

It has been suggested that the relationship between mental disorders can be summarized by a 3-factor model consisting of "anxious-misery," "fear," and "externalizing." This article examines the assumptions and predictions of this model, with particular emphasis on the anxiety disorders. Results indicate that the 3-factor model is not robust when additional diagnoses are included or when developmental factors are considered.

Mood episodes and mood disorders: patterns of incidence and conversion in the first three decades of life.

Objectives: Significant questions remain regarding both the incidence patterns of mood episodes in adolescents and young adults from the community and the conversion rate from unipolar to bipolar disorders. We addressed these issues by examining data from a prospective longitudinal community study to (i) determine the cumulative incidence of mood episodes and disorders in the first three decades of life; (ii) determine the risk for first onset of depression among individuals with a previous history of hypomanic/manic episodes and vice versa; and (iii) determine the clinical and treatment characteristics of these subjects.

Methods: Using the Munich-Composite International Diagnostic Interview, clinically trained interviewers assessed mood episodes and mental disorders in 3,021 community subjects (aged 14-24 at baseline and 21-34 at third follow-up).

The short- and long-term effect of duloxetine on painful physical symptoms in patients with generalized anxiety disorder: results from three clinical trials.

Generalized anxiety disorder (GAD) is associated with painful physical symptoms (PPS). These post hoc analyses of previous trial data assessed PPS and their response to duloxetine treatment in GAD patients. Studies 1 and 2 (n=840) were 9- to 10-week efficacy trials; study 3 (n=887) was a relapse prevention trial comprising a 26-week open-label treatment phase and a 26-week double-blind, placebo-controlled treatment continuation phase.

Do parental psychopathology and unfavorable family environment predict the persistence of social phobia?

Parental psychopathology and unfavorable family environment are established risk factors for onset of offspring social phobia (SP), but their associations with the further course, e.g., persistence of the disorder, remain understudied.

A typology of cannabis-related problems among individuals with repeated illegal drug use in the first three decades of life: Evidence for heterogeneity and different treatment needs.

Background: Cannabis use (CU) and disorders (CUD) are highly prevalent among adolescents and young adults. We aim to identify clinically meaningful latent classes of users of cannabis and other illegal substances with distinct problem profiles.

Methods: N=3021 community subjects aged 14-24 at baseline were followed-up over a period ranging up to 10 years.

Pain associated with specific anxiety and depressive disorders in a nationally representative population sample.

Objective: To examine in a nationally representative sample (a) the differential association of specific anxiety and depressive disorders defined according to DSM-IV with pain disorder (PD) and pain symptoms, and (b) whether pain-associated anxiety and depressive disorders and their comorbidity have different implications in terms of impairment, disability, health care utilization, and substance use.

Method: A nationally representative community study was conducted in Germany. Symptoms, syndromes and diagnoses of mental disorders, and pain were assessed in N = 4,181 participants aged 18-65 years using the DSM-IV/M-CIDI.

Association between generalized anxiety levels and pain in a community sample: evidence for diagnostic specificity.

Background: It is unclear whether generalized anxiety disorder (GAD) has a specific relationship to pain syndromes, going beyond the established association of pain with anxiety syndromes in general.

Methods: Mental disorders were assessed in a community sample (N=4181; 18-65 years) using the DSM-IV/M-CIDI. Several threshold definitions were used to define GAD and medically unexplained pain.

Common and distinct amygdala-function perturbations in depressed vs anxious adolescents.

Context: Few studies directly compare amygdala function in depressive and anxiety disorders. Data from longitudinal research emphasize the need for such studies in adolescents.

Objective: To compare amygdala response to varying attention and emotion conditions among adolescents with major depressive disorder (MDD) or anxiety disorders, relative to adolescents with no psychopathology.

Worry exposure versus applied relaxation in the treatment of generalized anxiety disorder.

Background: Worry exposure (WE) is a core element of cognitive-behavioral treatment for generalized anxiety disorder (GAD). Its efficacy as a stand-alone treatment method (without further cognitive-behavioral therapy interventions) has never been tested.We aimed to examine whether WE alone is as efficacious as the empirically supported stand-alone treatment for GAD, applied relaxation (AR).

Posttraumatic stress disorder: diagnostic and epidemiological perspectives.

We reviewed epidemiological findings for the diagnosis of posttraumatic stress disorder (PTSD) and its core diagnostic features, focusing on whether epidemiology has been helpful in clarifying some of the critical diagnostic issues relevant to the revision of the Diagnostic and Statistical Manual of Mental Disorders and the International Statistical Classification of Diseases. Though epidemiology has provided increasingly rich data and knowledge regarding prevalence and incidence, patterns of onset and course, comorbidity, and risk factors for traumatic experiences and posttraumatic stress, little systematic research has been performed specifically addressing such critical diagnostic issues. Particularly, unresolved concerns remain regarding the definition of trauma, duration and impairment/distress criteria, the distinctiveness of the PTSD-syndrome, and even the position of PTSD in the classification system of mental disorders.

Associations of familial risk factors with social fears and social phobia: evidence for the continuum hypothesis in social anxiety disorder?

We examined parental psychopathology and family environment in subthreshold and DSM-IV threshold conditions of social anxiety disorder (SAD) in a representative cohort sample of 1,395 adolescents. Offspring and parental psychopathology was assessed using the DIA-X/M-CIDI; recalled parental rearing and family functioning via questionnaire. Diagnostic interviews in parents were supplemented by family history reports from offspring.

The role of parental psychopathology and family environment for social phobia in the first three decades of life.

Background: To examine the role of parental psychopathology and family environment for the risk of social phobia (SP) in offspring from childhood to early adulthood, encompassing the high risk period for SP.

Methods: A community sample of 1,395 adolescents was prospectively followed-up over 10 years. Offspring and parental psychopathology were assessed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) using the Munich Composite International Diagnostic Interview (M-CIDI), and direct diagnostic interviews in parents were supplemented by family history reports.

Risk and speed of transitions to first alcohol dependence symptoms in adolescents: a 10-year longitudinal community study in Germany.

Background: Although in many western countries alcohol use (AU) and symptoms of alcohol dependence (AD) are frequent in adolescence, temporal patterns and trajectories remain understudied. It is unclear whether early onset of AU is associated with the speed of transition to first AD symptoms and whether specific first AD symptoms and their timing are associated with AD.

Aims: To examine (i) the incidence patterns of self-reported first AD symptoms; (ii) whether early AU is associated with the risk and speed of transition to first AD symptoms; and (iii) whether first AD symptoms and their timing are associated with AD.

Psychometric properties of the Retrospective Self Report of Inhibition (RSRI) in a representative German sample.

The present study examined the internal consistency, factorial structure, and construct validity of the German version of the Retrospective Self Report of Inhibition (RSRI), a questionnaire measure of behavioral inhibition. The research was based on data from a German prospective-longitudinal community study of 3021 adolescents and young adults (aged 14-24 years at baseline). Diagnostic assessment was based on the DSM-IV/M-CIDI and general psychopathological distress was assessed with SCL-90-R.

Agoraphobia and panic. Prospective-longitudinal relations suggest a rethinking of diagnostic concepts.

Background: The relationship of panic attacks (PA), panic disorder (PD) and agoraphobia (AG) is controversial. The aim of the current study is to prospectively examine the 10-year natural course of PA, PD and AG in the first three decades of life, their stability and their reciprocal transitions.

Methods: DSM-IV syndromes were assessed via Composite International Diagnostic Interview - Munich version in a 10-year prospective-longitudinal community study of 3,021 subjects aged 14-24 years at baseline.

The natural course of cannabis use, abuse and dependence during the first decades of life.

Aims: There has been little available information on the long-term natural course, persistence and remission of cannabis use, abuse and dependence. The current study estimated rates and risk factors associated with stability and variation in cannabis use patterns, cannabis abuse and cannabis dependence in a community sample over a 10-year period.

Design, Setting And Participants: Prospective longitudinal, epidemiological study with a 4- and 10-year follow-up of a community sample (n = 3021) aged 14-24 years at baseline in Munich, Germany.

Social anxiety disorder above and below the diagnostic threshold: prevalence, comorbidity and impairment in the general population.

Background: There is a lack of data systematically describing subthreshold expressions of social anxiety disorder (SAD) with regard to prevalence, comorbidity, and impairment.

Methods: This analysis was based on data from the German Health Survey (GHS) and its Mental Health Supplement (GHS-MHS). Social anxiety disorder and its syndromes as well as other mental disorders were assessed with a standardized diagnostic interview (M-CIDI) in 4,174 adults.

[Diagnosing mental disorders: gold or tin standard?--Critical comments on standardized diagnostic interviews and clinical routine diagnoses].

In a convenience sample of psychosomatic inpatients, Becker et al. reported poor diagnostic congruence between clinical diagnoses from routine examinations and DSM-IV diagnoses derived from the use of a computer-assisted standardized diagnostic interview (CIDI). The authors conclude that there is insufficient validity of such interviews in psychosomatic settings.

The interplay of familial depression liability and adverse events in predicting the first onset of depression during a 10-year follow-up.

Background: The aim of the present article is to explore interaction and correlation effects between familial depression liability and selected adverse (separation and traumatic) events in predicting the first onset of a major depressive episode (MDE) in a 10-year prospective longitudinal community survey.

Methods: Analyses are based on 1982 subjects (14 to 24 years at baseline) without baseline MDE who participated during the whole study period and for whom diagnostic information about psychopathology in both parents was available. The offspring's familial depression liability was determined by aggregating information on parental depressive symptoms obtained from family history data and direct interviews with parents.

Supplementary dimensional assessment in anxiety disorders.

Anxiety disorders, as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), comprise a relatively heterogeneous group of clinical conditions that range from specific phobias to obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). The grouping under one heading refers to the fact that these seemingly heterogeneous disorders share a number of common psychopathological features and also share at least some common principles in treatment. Among the shared elements are broadly defined prototypical anxiety reactions, panic attacks, anticipatory anxiety, avoidance behaviour, a predominantly early onset, and relatively high persistence rates over time.