The social costs of anxiety disorders
|
|
- Johnathan Harris
- 6 years ago
- Views:
Transcription
1 The social costs of anxiety disorders Experience and Evidence in Psychiatry: Symposium on Somatics and Anxiety Disorders,, Madrid, 19th April 2006 Frank Jacobi & Hans-Ulrich Wittchen Technische Universität t Dresden Institute of Clinical Psychology and Psychotherapy Overview 1. The spectrum of anxiety disorders 2. What is special in anxiety disorders? high prevalence early onset persistence comorbidity low treatment rates 3. Indicators of social cost 4. The social costs of anxiety disorders in the context of all disorders of the brain 1
2 The spectrum of anxiety disorders (DSM-IV) panic disorder (with and without agoraphobia) agoraphobia (without panic disorder) social phobia specific phobias generalized anxiety disorder (GAD) obsessive-compulsive disorder (OCD) posttraumatic stress disorder (PTSD) anxiety disorder NOS Special features: partly different risk factors and correlates and consequences, various degree of within anxiety disorders overlap To understand the burden we need epidemiological studies: Research and reference populations Total general population Epidemiology is able to provide a more complete picture of patterns of morbidity and supplement findings from clinical research Subjects with a diagnosis in lifetime (lifetime prevalence/risk) High risk subjects (current subsyndromal, partial remission) Subjects with current disorders but not in treatment (undiagnosed, untreated) Patients in treatment services (treated prevalence) research 2
3 What is special in anxiety disorders? prevalence onset persistence Increasingly higher prevalence estimates for anxiety disorders in 3 decades (due to broader and more specific coverage no evidence for real increase ) 12month prevalence (%) 20 S % S9 Studies: S1 Marks review S2 Wittchen review % S7 S8 S10 S3 ECA S4 MFS S5 Edmonton % S1 S2 S3 S4 S5 S6 NCS S7 NEMESIS S8 OHS S9 EDSP S10 GHS-MHS 0 pre 1980 studies in the 80ies studies in the 90ies Wittchen & Jacobi, ECNP
4 First onset of anxiety disorders is predominantly before age of cumulative % "specific phobias" social phobia OCD panic disorder GAD Within anxiety disorders: PD, GAD later than phobias and OCD Age of onset (years) EDSP, 2005 Persistence: 12-month / lifetime prevalence Any anxiety disorder PTSD OCD Specific phobia Unlike to depression if you have a lifetime anxiety disorder you are very likely to also have an anxiety disorder currently! Social phobia GAD Agoraphobia 12-month lifetime Panic disorder NCS-R, % 4
5 Where is the position of anxiety disorder within all disorders of the brain? Size and Burden of Mental Disorders in Europe : Material and methods Standardized search for EU-publications (N=212 studies all languages) Iterative data collection process (114 country-specific experts) Inclusion of unpublished material (additional 19 studies) Agreement on definition and conventions (DSM-III-R/IV-diagnoses & criteria, 12-month, etc.) Original data for standardized reanalyses (7 EU-countries, N = , mean, 95% CI) Data compilation by country, age, gender and diagnoses for experts review Preparation of peer review state of the art papers by diagnostic domains Circulation to all country- and topic-specific experts (over 100 experts) Linkage with Health-Economic panel (collaboration with European Brain Council, EBC) Reanalyses and statistical modelling of data The collaborative EBC-ECNP ECNP network: Contributing core experts Panel members and review authors (mental disorders): Carlo Altamura, IT Jules Angst, CH Eni Becker, NL Claudine Berr, FR Terry Brugha, UK Ron de Graaf, NL Carlo Faravelli, IT Lydia Fehm, DE Tom Fryers, UK Tomas Furmark, SE Renee Goodwin, US Frank Jacobi, DE Ludwig Kraus, DE Roselind Lieb, DE Eugene Paykel, UK Antoine Pelissolo, FR Lukas Pezawas, US Stefano Pini, IT Jürgen Rehm, CH, CA Anita Riecher-Rössler, CH Karen Ritchie, FR Wulf Rössler, CH Robin Room, SE Hans Joachim Salize, DE Wim van den Brink, NL Jim van Os, NL Johannes Wancata, AT Hans-Ulrich Wittchen, DE Panel members and review authors (COI-reviews): Patrik Andlin-Sobocki, SE Jenny Berg, SE Mattias Ekman, SE Lars Forsgren, SE Bengt Jönsson, SE Linus Jönsson, SE Gisela Kobelt, FR Peter Lindgren, SE Mickael Löthgren, UK Jes Olesen, DK Country specific epidemiol. experts (mental disorders): Christer Allgulander, SE Jordi Alonso, ES Jules Angst, CH Terry Brugha, UK Ron de Graaf, NL Eva Dragomirecka, CZ Carlo Faravelli, IT Erkki Isometsä, FI Heinz Katschnig, AT Jean-Pierre Lèpine, FR Jouko Lönnqvist, FI Julien Mendlewicz, BE Povl Munk-Jörgensen, DK Bozena Pietrzykowska, PL Zoltan Rihmer, HU Inger Sandanger, NO Jon G. Stefánsson, IS Miguel Xavier, PT Panel members (neurological): Ettore Beghi, IT Karin Berger, DE Gudrun Boysen, DK Sonja v. Campenhausen, DE Richard Dodel, DE Lars Forsgren, SE W.H. Oertel, DE Jes Olesen, DK Maura Pugliatti, IT Franco Servadei, IT Uwe Siebert, DE Lars Stovner, NO Thomas Truelsen, SE Manfred Westphal, DE Coordinator of data collection: Frank Jacobi DE Steering committee members are underlined 5
6 Coverage and Definitions Mental disorders (DSM-IIR-DSM-IV) Affective disorders: Bipolar disorders, major depression, dysthymia Anxiety disorders: panic disorder, agoraphobia, GAD, social phobia, specific phobia, OCD, PTSD Dementia Psychotic disorders (focus on schizophrenia) Somatoform disorders: hypochondriasis, pain disorders, Somatisation disorder Substance use disorders: Alcohol abuse and dependence, Illegal drug abuse and dependence, nicotine dependence Eating disorders: anorexia nervosa, bulimia Other disorders of the brain: Parkinson s disease, Migraine and other headaches Stroke, Epilepsy, Brain trauma, Brain tumour, Multiple Sclerosis Geographical Scope EU member countries (EU-25) and Iceland, Norway and Switzerland Latest findings: Anxiety accounts for a large proportion of all mental disorders! 12-month prevalence (%, 95% CI) and estimated number of subjects affected in the EU eating disorders ill. subst. dep. OCD psychotic disorders bipolar disorder agoraphobia GAD panic disorder 1,1 Mio (0,9-1,7) 2,0 Mio (1,4-2,1) 2,6 Mio (2,4-3,0) 3,6 Mio (2,8-5,3 2,4 Mio (1,7-2,4) 3,9 Mio (3,3-4,7) 5,8 Mio (5,2-6,1) 5,2 Mio (4,3-5,3) social phobia alcohol dependence 6,6 Mio (5,4-9,2) 7,1 Mio (5,8-8,6) somatof. disorders specific phobias 18.9 Mio. ( ) 18.4 Mio. ( ) major depression 18.5 Mio. ( ) Note: Numbers add up to more than 27% and 82 million subjects because subjects can have more than one disorder (comorbidity) Wittchen & Jacobi (2005), Neuropsychopharmacology 6
7 Are these 12-month prevalence EU estimates suprisingly high? Yes if you consider that some of the previous epidemiological studies revealed somewhat lower estimates, because of + A restricted range of disorders covered + Narrower time window (e.g. restricted the prevalence period to 2 weeks) + Additional so-called clinical significance criteria Are those 12-month prevalence EU estimates surprisingly high? Yes if you consider that some of the previous epidemiological studies revealed somewhat lower estimates, because of + A restricted range of disorders covered + Narrower time window (e.g. restricted the prevalence period to 2 weeks) + Additional so-called clinical significance criteria Not however if you account in previous studies for the above mentioned methodological differences Not in comparison to somatic disorders: In this age range, over 70% of the general population has at least one somatic disorder ( Why should the brain less frequently affected? ) 7
8 What is special in anxiety disorders? (cont.) comorbidity Comorbidity is a fundamental characteristic of mental disorders (and the way they are defined in current classification systems) and increases by age OR Anxiety with: Suds: 2.6 Depression: 6.9 Somatoform: 3.4 OR Depression: Anxiety: 7.0 Suds: 2.7 Somatoform: % of all anxiety disorders are comorbid 60,2% of the mood disorders proportion comorbid ,2% of substance use disorders OR Substance with: Anxiety: 2.5 Depression: 2.7 Somatoform: ,2% of the somatoform disorders OR Somatoform: Anxiety: 3.5 Suds: 2.1 Depression: Age group 8
9 .. And might have important etiological implications, for example Symptom progression models: Sequential comorbidity in anxiety disorders Onset of cascade Precursors: Behavioral inhibition/separation anxiety, (trauma) Increased neurobiological, cognitive, behavioral sensitization Specific and social phobia panic attacks, agoraphobia, panic disorder GAD Secondary depression Increased impairment/disability Suicidality Substance use disorders age Cumulative risk of cases with primary anxiety disorder by age of onset of secondary depressive disorder Cumulative % of Cum. risk (%) depression no anxiety dx By age of onset EDSP,
10 Cumulative risk of cases with primary anxiety disorder by age of onset of secondary depressive disorder Cumulative % of depression PD GAD AG SPP SoP no anxiety dx By age of onset EDSP, 2001 Anxiety disorders are also associated with increased somatic morbidity: Comorbidity with selected physical conditions Physical Conditions No Anxiety Disorder n (%) Anxiety Disorder n (%) AOR (95% CI) significant reduction of health related QoL (SF-36) Cardiac diseases 88 (2.3) 18 (3.7) 1.79 ( ) Respiratory diseases 191 (5.4) 43 (10.5) 1.71 ( )** X Gastrointestinal diseases 113 (2.9) 29 (7.4) 2.10 ( )** X Arthritic conditions 956 (24.6) 138 (32.0) 1.66 ( )** X Metabolic syndromes 279 (7.6) 38 (9.9) 1.56 ( )* X Allergic conditions 461 (12.3) 75 (18.1) 1.39 ( )* X Migraine headaches 271 (6.2) 72 (17.0) 2.12 ( )** X Thyroid diseases 340 (8.4) 68 (15.9) 1.59 ( )** Any past month physical condition 2295 (59.6) 315 (74.2) 1.70 ( )** X AOR: Odds Ratio adjusted for sociodemographic variables and comorbid depression and SUD Sareen et al. (subm.) 10
11 What is special in anxiety disorders? (cont.) treatment rates Treatment rates are extremely low in almost all mental disorders increase by degree of comorbidity By type of disorder anxiety By comorbidity 100% 100% 90% 90% 80% 80% 70% 60% 50% no treatment both only psychological only drug no consultation 70% 60% 50% 40% 40% 30% 30% 20% 20% 10% 10% 0% any mood disorder any anxiety disorder any alcohol disorder psychotic disorder 0% just one disorder more than one disorder ECNP-Task Force Report 2005 : Size and burden of Mental Disorders in the EU 11
12 and if treatment occurs it occurs predominantly very late! Cumulative lifetime probability of treatment contact in anxiety disorders Wang et al. (2005), Archives of General Psychiatry Summary (1): Special features of anxiety disorders High prevalence Early onset and persistence High comorbidity rates (with secondary mental disorders and with somatic disorders) Low rates of treatment Wittchen & Jacobi (2005), Neuropsychopharmacology Goodwin et al. (2005), Neuropsychopharmacology Fehm et al. (2005), Neuropsychopharmacology Lieb et al. (2005), Neuropsychopharmacology ESEMeD/MHEDEA 2000 Investigators (2004), Acta Psychiatrica Scandinavica 12
13 Burden indicators and cost estimates social impairment high utilizers total and hidden costs Almost invariably marked social impairment and disability in anxiety disorders By diagnostic definition and criteria anxiety disorders always imply social role impairment and clinically significant suffering Unlike to episodic disorders like depression, persistent (anticipatory anxiety) and special (panic attacks) features are associated with a pronounced long-term burden in terms of subjective suffering and disruption in social roles However, research has been slow to incestigate this in greater detail! A crude indicator applied across the majority of studies is number of disability (sick leave) days Also reduced work productivity (when at work) important factor for high indirect costs (Greenberg et al., 2001; Simon et al., 2000) 13
14 Example: Proportion of subjects with days lost, days impaired (or both) due to mental health problems in pure and comorbid 12-month GAD % subjects having any lost/impaired days Days lost Days impaired Total lost/impaired 67,8 55,4 50,5 52,5 30,7 31, ,9 6,5 6,8 5,4 0,7 No GAD/No MDD GAD/No MDE MDD/No GAD GAD + MDD Diagnostic comparison groups Wittchen et al. (2002), International Clinical Psychopharmacology Total number of disability days in the past month in the population: Population attributable fraction of 12-month mental and anxiety disorders any somatic disorder 56% mental disorder other than anxiety 16% any anxiety disorder 25% PAF controlled for the presence of other types of disorder other 3% 14
15 High and overutilization Number of doctor visits in the past 12-months by diagnostic status: anxiety patients are high utilizers of health care resources no mental disorder 6,9 any anxiety disorder 12,4 any mental disorder 10,0 OCD 18,8 specific phobia 12,1 social phobia GAD agoraphobia 14,6 15,4 16,1 panic disorder 19, But only a small proportion of excess utilization rates can be explained by mental health care visits! The total estimated cost of brain disorders in Europe by disease area ( PPP billion) Andlin-Sobocki et al 2005, modified) All brain disorders: billion Health care costs: Direct non-medical Indirect costs: Mental disorders Health care costs: Direct non-medical Indirect costs: mental disorders billion neurological Neurological disorders Health care costs: Direct non-medical Indirect costs: Addiction Health care costs: Direct non-medical Indirect costs: Affective disorders Health care costs: Direct non-medical - NE- Indirect costs: Anxiety disorders Health care costs: Direct non-medical -NE- Indirect costs: Psychotic disorders Health care costs: Direct non-medical Indirect costs: - NE- neurosurgical billion Neurosurgical disorders Health care costs: Direct non-medical 269 Indirect costs: Note: under-estimation (especially indirect costs) 15
16 Despite past limitations and vast variation with regard to the relative contribution of cost components good concordance across studies Annual cost estimates for anxiety Rice & Miller (1996): 46 billion $ DuPont et al. (1996): 47 billion $ Greenberg et al. (1999): 42 billion $ (in 1998 costs: 63.1 billion $) Andlin-Sobocki et al. (2005): 41 billion Annual cost estimates for depression Rice & Miller (1996): 31 billion $ DuPont et al (1996): 44 billion $ Greenberg et al (1999): 53 billion $ Andlin-Sobocki et al. (2005): 105 billion (including bipolar disorders) The total health care and societal costs of anxiety disorders are roughly the same as for depression Additional effects of illness-related life course changes with adverse financial implications that have so far never been taken into account in cost studies! under-estimation of (especially indirect) costs / Further hidden costs of untreated anxiety disorders (e.g., Candilis & Pollack, 1997) Other indices not or only partially covered in these cost estimations: Subsequent unemployment (Etner et al., 1997; Leon et al., 1995; Yayakody et al., 1998) Work in under-payed jobs (Etner et al., 1997; Kessler & Greenberg, in press) Educational under-achievement (Kessler et al. 1995) Teen childbearing, marital timing and instability (Kessler et al. 1997, 1998) 16
17 Summary (2): The underestimated cost and burden of anxiety disorders burden as a function of prevalence x active time within an affected individual X cost per case Summary (2): The underestimated cost and burden of anxiety disorders prevalence: 1/4 of the population will suffer an anxiety disorder at least once in their lifetime, ~15% are affected in any given year active time within an affected individual: early onset, persistence cost: risk factor status, high degree of current and lifetime comorbidity cost (cont.): extremely high indirect costs and relatively low direct costs despite burden: large degree of unmet needs of patients with anxiety disorders (low treatment rates unless complex comorbid complications occur, considerably delayed treatment, particularly low treatment rates in adolescents and young adults) Limitations: incomplete data base with regard to prevalence/incidence in the elderly and in children, incomplete costs estimates, incomplete data for many countries, lack of data on sequential comorbidity, lack of data concerning burden 17
18 Summary (2): The underestimated cost and burden of anxiety disorders burden as a function of prevalence x active time within an affected individual x cost per case Avoidable burden? jacobi@psychologie.tu-dresden.de 18
Cost of Brain Disorders in Italy A Review
Maura Pugliatti, 1,2 Paola Cossu, 1 Patrik Sobocki 3 and Ettore Beghi 4 1. Department of Neuroscience, University of Sassari; 2. Department of Public Health and Primary Health Care, University of Bergen;
More informationCost of Disorders of the Brain in Europe Gustavsson et al. Cost of disorders of the brain in Europe Eur. Neuropsych. (2011) 21,
Cost of Disorders of the Brain in Europe 2010 Gustavsson et al. Cost of disorders of the brain in Europe 2010. Eur. Neuropsych. (2011) 21, 718-779 Steering Committee Prof Jes Olesen 1 Prof Bengt Jönsson
More informationAnxiety disorders in the general population: prevalences, impairments, and associations with physical illness
Eurocertificate XIV Canterbury, UK, 29 June - 04 July 2002 Anxiety disorders in the general population: prevalences, impairments, and associations with physical illness Frank Jacobi, PhD Clinical Psychology
More informationEuropean Brain Council: Structure and activities. Jes Olesen President European Brain Council (EBC)
European Brain Council: Structure and activities Jes Olesen President European Brain Council (EBC) European Brain Council (EBC) membership EFNS European Federation of Neurological Societies FENS Federation
More informationHUMAN AND ECONOMIC BURDEN OF GENERALIZED ANXIETY DISORDER
DEPRESSION AND ANXIETY 25:72 90 (2008) Research Review HUMAN AND ECONOMIC BURDEN OF GENERALIZED ANXIETY DISORDER Deborah L. Hoffman, Ph.D., 1 Ellen M. Dukes, Ph.D., 2 and Hans-Ulrich Wittchen, Ph.D. 3
More informationConsecutive mental health patients of a family doctor in Shanghai 6 years experience
Consecutive mental health patients of a family doctor in Shanghai 6 years experience Date: 13 th January 2015 Time: 12:15 Location: UFH Presenter: Lincoln Miyasaka Introduction: The prevalence of generalized
More informationFAMILY AND ADOLESCENT MENTAL HEALTH: THE PEDIATRICIAN S ROLE
FAMILY AND ADOLESCENT MENTAL HEALTH: THE PEDIATRICIAN S ROLE Mark Cavitt, M.D. Medical Director, Pediatric Psychiatry All Children s Hospital/Johns Hopkins Medicine OBJECTIVES Review the prevalence of
More informationChanges to the Organization and Diagnostic Coverage of the SCID-5-RV
Changes to the Organization and Diagnostic Coverage of the SCID-5-RV Core vs. Enhanced SCID configuration A number of new disorders have been added to the SCID-5-RV. To try to reduce the length and complexity
More informationCost of disorders of the brain in Europe 2010
Cost of disorders of the brain in Europe 2010 Anders Gustavsson a, Mikael Svensson b, Frank Jacobi c, Christer Allgulander d, Jordi Alonso e, Ettore Beghi f, Richard Dodel g, Mattias Ekman a, Carlo Faravelli
More informationChallenges in identifying and treating bipolar depression: a guide
Challenges in identifying and treating bipolar depression: a guide Dr. Paul Stokes Clinical Senior Lecturer, Centre for Affective Disorders, Department of Psychological Medicine Overview Challenges in
More informationHypomania spectrum disorder in adolescence: a 15-year follow-up of non-mood morbidity in adulthood
Päären et al. BMC Psychiatry 2014, 14:9 RESEARCH ARTICLE Open Access Hypomania spectrum disorder in adolescence: a 15-year follow-up of non-mood morbidity in adulthood Aivar Päären 1*, Hannes Bohman 1,
More informationRutgers University Course Syllabus Abnormal Psychology 01: 830: 340H7 Summer 3 rd Session 2014
Rutgers University Course Syllabus Abnormal Psychology 01: 830: 340H7 Summer 3 rd Session 2014 Date & Time: Monday and Wednesday 6:00PM- 9:40PM Location: LSB rm B115 Livingston Campus Instructor: Stevie
More informationWhat is the DSM. Diagnostic and Statistical Manual of Mental Disorders Purpose
DSM 5 The Basics What is the DSM Diagnostic and Statistical Manual of Mental Disorders Purpose Standardize diagnosis criteria (objectivity) Assist in research Provide common terminology Public health statistics
More informationExpanding Behavioral Health Data Collection:
Expanding Behavioral Health Data Collection: ADULT MENTAL ILLNESS DIAGNOSES WITH FUNCTIONAL IMPAIRMENT Center for Behavioral Health Statistics and Quality Substance Abuse and Mental Health Services Administration
More informationMood Disorders-Major Depression
Mood Disorders Paula Gibbs, MD Assistant Professor Department of Psychiatry Medical Director of 5West Med-Psych University of Utah Hospitals and Clinics Mood Disorders-Major Depression Key Points for Major
More informationSocial anxiety disorder above and below the diagnostic threshold: prevalence, comorbidity and impairment in the general population
Soc Psychiatry Psychiatr Epidemiol (2008) 43:257 265 DOI 10.1007/s00127-007-0299-4 ORIGINAL PAPER Lydia Fehm Æ Katja Beesdo Æ Frank Jacobi Æ Agnes Fiedler Social anxiety disorder above and below the diagnostic
More informationABNORMAL PSYCHOLOGY. Psychological Disorders. Fast Track Chapter 11 (Bernstein Chapter 15)
ABNORMAL PSYCHOLOGY Psychological Disorders Fast Track Chapter 11 (Bernstein Chapter 15) Introduction to Abnormal Psychology PSYCHOPATHOLOGY the study of the causes, symptoms, and development of psychological
More informationDSM Comparison Chart DSM-5 (Revisions in bold)
317.0-318.2 DSM Comparison Chart DSM-IV-TR DSM-5 (Revisions in bold) Multi-axial system s Usually First Diagnosed in Infancy, Childhood and Adolescence Single line diagnosis with specifiers Neurodevelopmental
More informationUnmanaged Behavioral Health Puts Your Company At Risk. Presented by: Dr. Sam Mayhugh Integrated Behavioral Health
Unmanaged Behavioral Health Puts Your Company At Risk Presented by: Dr. Sam Mayhugh Integrated Behavioral Health Behavioral Health Management Webinar Overview History of BH management Prevalence of behavioral
More informationAssessment in Integrated Care. J. Patrick Mooney, Ph.D.
Assessment in Integrated Care J. Patrick Mooney, Ph.D. Purpose of assessment in integrated care: Assessment provides feedback to promote individual and group learning and change. Physicians Mental health
More informationPSYCHIATRIC CO-MORBIDITY STEVE SUGDEN MD MPH
PSYCHIATRIC CO-MORBIDITY STEVE SUGDEN MD MPH OVERVIEW: PSYCHIATRIC DISORDERS Mood Disorders Anxiety Disorders Psychotic Disorders Personality Disorders PTSD Eating Disorders EXAMPLE What is the diagnosis?
More informationRutgers University Course Syllabus Abnormal Psychology 01: 830: 340H6 Summer 3 rd Session 2015
Rutgers University Course Syllabus Abnormal Psychology 01: 830: 340H6 Summer 3 rd Session 2015 Date & Time: Monday and Wednesday 6:00PM- 9:40PM Location: Tillett bldg. room 253 Livingston Campus Instructor:
More informationOverview of Generalized Anxiety Disorder: Epidemiology, Presentation, and Course. Risa B. Weisberg, PhD
Risa B. Weisberg Overview of Generalized Anxiety Disorder: Epidemiology, Presentation, and Course Risa B. Weisberg, PhD Generalized anxiety disorder (GAD) was defined relatively recently, and the diagnostic
More informationPanic Attack as a Risk Factor for Severe Psychopathology
Article Panic Attack as a Risk Factor for Severe Psychopathology Renee D. Goodwin, Ph.D., M.P.H. Roselind Lieb, Ph.D. Michael Hoefler, Dipl.-Stat. Hildegard Pfister, Dipl.-Inf. Antje Bittner, Dipl.-Psych.
More informationResident Rotation: Collaborative Care Consultation Psychiatry
Resident Rotation: Collaborative Care Consultation Psychiatry Anna Ratzliff, MD, PhD James Basinski, MD With contributions from: Jurgen Unutzer, MD, MPH, MA Jennifer Sexton, MD, Catherine Howe, MD, PhD
More informationGenetics of psychiatric disorders Dr Radwan Banimustafa
Genetics of psychiatric disorders Dr Radwan Banimustafa Schizophrenia Is a chronic relapsing psychotic disorder which affects young population and interfere with: - Thoughts - Perception - Volition - Behavior
More informationPsychological Disorders
Chapter 12 Psychological 12-1 Abnormal Behavior The most commonly used criteria for distinguishing between normal and abnormal behaviors are: 12-2 Abnormal Behavior We can define behaviors as abnormal
More informationAnxiety disorders in mothers and their children: prospective longitudinal community study
Anxiety disorders in mothers and their children: prospective longitudinal community study Andrea Schreier, Hans-Ulrich Wittchen, Michael Höfler and Roselind Lieb Summary The relationship between DSM IV
More informationDiffusing the Stress in Financial Distress: The Intersection of Bankruptcy and Mental Health
Diffusing the Stress in Financial Distress: The Intersection of Bankruptcy and Mental Health Moderator: Hon. Laura Taylor Swain (S.D. N.Y.), New York, NY Panelists: Prof. Richard A. Friedman, M.D., Weill
More informationMENTAL ILLNESSES, CONSIDERATIONS FOR YOUTH AND AVAILABILITY OF PROGRAMS
MENTAL ILLNESSES, CONSIDERATIONS FOR YOUTH AND AVAILABILITY OF PROGRAMS Queen Elizabeth High School Parent Council May 15 2017 DR A G M B U L L O C H, D E P U T Y D I R E C T O R M A T H I S O N C E N
More informationHow to measure mental health in the general population? Reiner Rugulies
How to measure mental health in the general population? Reiner Rugulies National Research Centre for the Working Environment, Denmark Department of Public Health and Department of Psychology, University
More informationACBHCS Outpatient Included List DHCS ICD-10
12-19-17 ACBHCS Mental Health Outpatient (includes PES/CSU) Crosswalk Medi-Cal Included Dx List Numeric by Code (Crossed out diagnoses are not allowed. Always use the code) Instructions: Crossed out diagnoses
More informationNothing Explains Everything
Nothing Explains Everything NES: Psychiatric Comorbidities Diagnosis LaFrance 2005 Lifetime Current MDD 80% 47% Any Affective d/o 98% 64% PTSD 58% 49% Any anxiety d/o except PTSD 51% 47% Any Somatoform
More informationACBHCS Mental Health Outpatient (includes PES/CSU) Medi-Cal Included Diagnosis List - Alpha by Name
Instructions: DHCS publishes the list of diagnoses covered by Medi-Cal in format. The DSM is used because does not provide specific diagnostic criteria. Providers must always use DSM-5 first and whenever
More informationACBHCS Outpatient Included List DHCS ICD-10
12-19-17 ACBHCS Mental Health Outpatient (includes PES/CSU) Crosswalk Medi-Cal Included Dx List-Alpha by Name (Crossed out diagnoses are not allowed. Always use the code) Instructions: Crossed out diagnoses
More informationHow to Win Friends and Influence People Lesson 6 Psychological Patterns and Disorders
How to Win Friends and Influence People Lesson 6 Psychological Patterns and Disorders What are psychological disorders? Mental health workers view psychological disorders as ongoing patterns of thoughts,
More information4/29/2016. Psychosis A final common pathway. Early Intervention in Psychotic Disorders: Necessary, Effective, and Overdue
Early Intervention in Psychotic Disorders: Necessary, Effective, and Overdue Disclosures Financial relationships with commercial interests Douglas R. Robbins, M.D. Maine Medical Center Tufts University
More informationClassification of mood disorders
Classification of mood disorders Congress of Neuropsychiatry and Neuropsychology 2014 Poznań 27 November 2014 Jules Angst Department of Psychiatry, Psychotherapy and Psychosomatics Psychiatric Hospital,
More informationPsych Grand Rounds. Disclosure. My books
for Asperger Syndrome and Other Related Disorders Practical Strategies for Assessment Practical Strategies and for Treatment Assessment and Treatment Illustrated by Laura S. Kowalski A Simple Technique
More information9/12/2012 ALCOHOL AND DRUG USE, ASSOCIATED DISORDERS AND THEIR PSYCHIATRIC COMORBIDITIES IN U.S. ADULTS OBJECTIVES
ALCOHOL AND DRUG USE, ASSOCIATED DISORDERS AND THEIR PSYCHIATRIC COMORBIDITIES IN U.S. ADULTS Risë B. Goldstein, Ph.D., M.P.H., Staff Scientist Laboratory of Epidemiology and Biometry Division of Intramural
More informationEVOLUTION OF THE DSM 8/23/2013. The New DSM-5 : What Administrators Need to Know. American Psychiatric Association Copyright Statement
The New DSM-5 : What Administrators Need to Know Jason J. Washburn, PhD., ABPP Director, Center for Evidence-Based Practice American Psychiatric Association Copyright Statement DSM and DSM-5 are registered
More information1. Family aggregation and long-term outcome of psychopathology in children and adolescents in the Danish Three Generation Study (3GS)
Aalborg CAP research programme 2016 1. Family aggregation and long-term outcome of psychopathology in children and adolescents in the Danish Three Generation Study (3GS) Objectives: Study of the aggregation
More informationWebinar: How Do We Measure Mental Illness & Addictions at a Population Level?
Webinar: How Do We Measure Mental Illness & Addictions at a Population Level? Jürgen Rehm Centre for Addiction and Mental Health, Toronto, Canada Dalla Lana School of Public Health and Department of Psychiatry,
More informationCauses of Treatment Failure
Causes of Treatment Failure 1. Misdiagnosis 2. Comorbidity 3. Non diagnosed Substance Abuse 4. Non adherence to prescribed medication Presenter has no conflict of interest to disclose Is Misdiagnosis the
More informationEstimates of Prevalence of Mental Health Conditions among Children and Adolescents in Texas. March 24, 2016
Estimates of Prevalence of Mental Health Conditions among Children and Adolescents in Texas March 24, 2016 MMHPI Page 2 Estimates of the Prevalence of Mental Health Conditions among Children and Adolescents
More information6/22/2012. Co-morbidity - when two or more conditions occur together. The two conditions may or may not be causally related.
Autism Spectrum Disorders and Co-existing Mental Health Issues By Dr. Karen Berkman Objective To present an overview of common psychiatric conditions that occur in persons with autism spectrum disorders
More informationComorbidities of Migraine
Comorbidities of Migraine Richard B. Lipton, MD Edwin S Lowe Professor and Vice Chair of Neurology Director, Montefiore Headache Center Albert Einstein College of Medicine Overview What is comorbidity?
More informationRutgers University Course Syllabus Atypical Child and Adolescent Development Fall 2016
Rutgers University Course Syllabus Atypical Child and Adolescent Development Fall 2016 Date & Time: Mon and Wedn. 1:40 3:00 pm Location: Pharm. Rm 111 Busch Campus Instructor: Stevie M. McKenna MA E-Mail:
More informationChapter 13 Learning Objectives with SubQuestions
Chapter 13 Learning Objectives with SubQuestions As you review the various theories in this chapter, you might want to make notes on the tables at the end of this document to use as study aids for comparing
More informationUnit 12 REVIEW. Name: Date:
Name: Date: 1. Which of the following disorders is classified as a mood disorder? A) antisocial personality disorder B) agoraphobia C) catatonia D) generalized anxiety disorder E) bipolar disorder 2. Mania
More informationThe relationship between migraine and mental disorders in a population-based sample
Available online at www.sciencedirect.com General Hospital Psychiatry 31 (2009) 14 19 The relationship between migraine and mental disorders in a population-based sample Gregory E. Ratcliffe, B.Sc. a,
More informationSerious Mental Illness (SMI) CRITERIA CHECKLIST
Serious Mental Illness (SMI) CRITERIA CHECKLIST BEHAVIORAL HEALTH COLLABORATIVE NEW MEXICO SMI determination is based on the age of the individual, functional impairment, duration of the disorder and the
More informationContinuity of Care for Florida Medicaid Primary Care Utilizers with Psychological Conditions
Continuity of Care for Florida Medicaid Primary Care Utilizers with Psychological Conditions Robert G. Frank, PhD Natalie C. Blevins February 23, 24 1 Primary care is the most frequent site for psychological
More informationUniversity of Groningen. Functional limitations associated with mental disorders Buist-Bouwman, Martine Albertine
University of Groningen Functional limitations associated with mental disorders Buist-Bouwman, Martine Albertine IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if
More informationPsychological Disorders. Schizophrenia Spectrum & Other Psychotic Disorders. Schizophrenia. Neurodevelopmental Disorders 4/12/2018
Psychological s Schizophrenia Spectrum & Other Psychotic s Schizophrenia Spectrum & Other Psychotic s 0Presence of delusions, hallucinations, disorganized thinking/speech, disorganized or abnormal motor
More informationThe burden of mental disorders, such as depression and anxiety, fall disproportionately on women of childbearing and childrearing age.
The burden of mental disorders, such as depression and anxiety, fall disproportionately on women of childbearing and childrearing age. Psychiatric Clinics of North America, 2007 Rates of severe mental
More informationACBHCS Mental Health Outpatient (includes PES/CSU) Medi-Cal Included Diagnosis List by ICD-10 Code
Instructions: DHCS publishes the list of diagnoses covered by Medi-Cal in format. The DSM is used because does not provide specific diagnostic criteria. Providers must always use DSM-5 first and whenever
More informationRutgers University Course Syllabus Atypical Child and Adolescent Development Spring 2017
Rutgers University Course Syllabus Atypical Child and Adolescent Development Spring 2017 Date & Time: Mon and Wedn. 5:00 6:20 pm Location: Tillett bldg. rm 232 Livingston Campus Instructor: Stevie M. McKenna
More informationDisclosure Information. Preparing for DSM-5. Program Outline. Rajiv Tandon, M.D. Professor Of Psychiatry University of Florida.
Preparing for DSM-5 Disclosure Information Rajiv Tandon, M.D. Professor Of Psychiatry University of Florida NO RELEVANT FINANCIAL CONFLICTS OF INTEREST MEMBER OF THE DSM-5 WORKGROUP ON PSYCHOTIC DISORDERS
More informationINPATIENT INCLUDED ICD-10 CODES
INPATIENT INCLUDED ICD-10 CODES MHSUDS IN 18-053 ICD-10 F01.51 Vascular Dementia With Behavioral Disturbance F10.14 Alcohol Abuse With Alcohol-Induced Mood Disorder F10.150 Alcohol Abuse With Alcohol-Induced
More informationANXIETY DISORDERS AND RISK FOR SUICIDE ATTEMPTS: FINDINGS FROM THE BALTIMORE EPIDEMIOLOGIC CATCHMENT AREA FOLLOW-UP STUDY
DEPRESSION AND ANXIETY 0:1 5 (2007) Research Article ANXIETY DISORDERS AND RISK FOR SUICIDE ATTEMPTS: FINDINGS FROM THE BALTIMORE EPIDEMIOLOGIC CATCHMENT AREA FOLLOW-UP STUDY James M. Bolton, M.D., 1 Brian
More informationAnxiety Disorders: First aid and when to refer on
Anxiety Disorders: First aid and when to refer on Presenter: Dr Roger Singh, Consultant Psychiatrist, ABT service, Hillingdon Educational resources from NICE, 2011 NICE clinical guideline 113 What is anxiety?
More informationBRONX COMMUNITY COLLEGE LIBRARY SUGGESTED FOR PSY 31 ABNORMAL PSYCHOLOGY
BRONX COMMUNITY COLLEGE LIBRARY SUGGESTED FOR PSY 31 (Text: : CURRENT PERSPECTIVES, 7 TH Ed.) ESSENTIALS OF IN A CHANGING WORLD,1 st Ed. Jeffrey S. Nevid & Beverly Greene Pretice Hall CODE NO. TITLE DIAGNOSIS
More informationBrief Notes on the Mental Health of Children and Adolescents
Brief Notes on the Mental Health of Children and Adolescents The future of our country depends on the mental health and strength of our young people. However, many children have mental health problems
More information8/23/2016. Chapter 34. Care of the Patient with a Psychiatric Disorder. Care of the Patient with a Psychiatric Disorder
Chapter 34 Care of the Patient with a Psychiatric Disorder All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Care of the Patient with a Psychiatric
More informationRutgers University Course Syllabus Abnormal Psychology 01: 830: 340 H6 Summer3 rd Session 2018
Rutgers University Course Syllabus Abnormal Psychology 01: 830: 340 H6 Summer3 rd Session 2018 Date & Time: Monday and Wednesday 6:00PM- 9:40PM Location: Lucy Stone Hall room B-112 Livingston Campus Instructor:
More informationDEPRESSION: THE INVISIBLE CULPRIT
DEPRESSION: THE INVISIBLE CULPRIT A depressive disorder 1 is an illness that involves the body, mood, and thoughts. It differs quantitatively and qualitatively from normal sadness or grief. Clinically,
More informationAgoraphobia. An anxiety disorder marked by fear of being in situations in which escape may be difficult or impossible.
Agoraphobia An anxiety disorder marked by fear of being in situations in which escape may be difficult or impossible. (See page 634) Antisocial personality disorder (APD) A personality disorder marked
More informationSome newer, investigational approaches to treating refractory major depression are being used.
CREATED EXCLUSIVELY FOR FINANCIAL PROFESSIONALS Rx FOR SUCCESS Depression and Anxiety Disorders Mood and anxiety disorders are common, and the mortality risk is due primarily to suicide, cardiovascular
More informationGOALS FOR THE PSCYHIATRY CLERKSHIP
GOALS FOR THE PSCYHIATRY CLERKSHIP GOALS - The aim of the core psychiatry clerkship is to expose students to patients with mental illness and to prepare them to provide psychiatric care at a basic level.
More informationResearch Studies workplacebullying.org. The WBI Website 2012 Instant Poll D - Impact of Workplace Bullying on Individuals Health
TM Research Studies workplacebullying.org The WBI Website 2012 Instant Poll D - Impact of Workplace Bullying on Individuals Health Gary Namie, PhD - Research Director Do not cite findings without crediting
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Age as factor in selective mutism, 623 as factor in social phobia, 623 Agoraphobia, 593 600 described, 594 596 DSM-V changes related to,
More informationIntro to Concurrent Disorders
CSAM-SCAM Fundamentals Intro to Concurrent Disorders Presentation provided by Jennifer Brasch, MD, FRCPC Psychiatrist, Concurrent Disorders Program, St. Joseph s Healthcare There are all kinds of addicts,
More informationANXIETY DISORDERS IN THE ELDERLY IMPACT OF LATE-LIFE ANXIETY CHANGES IN DSM-5 THE COSTS 6/4/2015 LATE-LIFE ANXIETY TOPICS TO BE COVERED
LATE-LIFE ANXIETY TOPICS TO BE COVERED ANXIETY DISORDERS IN THE ELDERLY Dr. Lisa Talbert Classes of Anxiety Disorders Diagnosis Comorbidities Pharmacologic Management Psychological Management LATE LIFE
More informationMental Illness and Disorders Notes
Mental Illness and Disorders Notes Stigma - is a negative and often unfair about mental illness and disorders can cause people with these to not seek help. Deny problem, feel shame and -feel as if they
More informationThe European Brain Council
The European Brain Council Dr C. Ian Ragan, Executive Director Dr Mary G. Baker MBE, Vice President Committee on Industry, Research and Energy Public Hearing on Mental Health Research: Scientific Progress
More informationICCAM platform. Introduction. David Nutt November 2011
ICCAM platform Introduction David Nutt November 2011 The ICCAM Platform New Drugs to Treat Addiction: Can a Knowledge of Brain Mechanisms Help? An MRC addiction cluster Imperial College London: David Nutt
More informationINTRODUCTION TO MENTAL HEALTH. PH150 Fall 2013 Carol S. Aneshensel, Ph.D.
INTRODUCTION TO MENTAL HEALTH PH150 Fall 2013 Carol S. Aneshensel, Ph.D. Topics Subjective Experience: From the perspective of mentally ill persons Context Public attitudes toward the mentally ill Definition
More informationDecember 2014 MRC2.CORP.D.00011
This program is paid for by Otsuka America Pharmaceutical, Inc. and Lundbeck, LLC. The speaker is a paid contractor of Otsuka America Pharmaceutical, Inc. advice or professional diagnosis. Users seeking
More informationPreventing the onset of new cases of depressive disorders Possibilities and challenges
Prof. Pim Cuijpers Preventing the onset of new cases of depressive disorders Possibilities and challenges 6 th European conference on mental Health Berlin, October 6 th, 2017 JAMA 2012;307:1033-1034 2
More informationThe Economics of Mental Health
The Economics of Mental Health Garrett Hill Spring 2016 1 Note from the Author Throughout this paper there will be multiple references to common mental illnesses and serious mental illnesses. The author
More information2013 Virtual AD/HD Conference 1
Medication for & Coexisting Conditions Part 2 Dr. Kenny Handelman Child, Adolescent & Adult Psychiatrist Halton Healthcare Adjunct Professor of Psychiatry, University of Western Ontario www.drkenny.com
More informationAnxiety Disorders. Phenomenology. Phenomenology. Dr. Boland: Anxiety Disorders. Mental Status Exam. General appearance Physical symptoms of anxiety
Anxiety Disorders Phenomenology Phenomenology Mental Status Exam General appearance Physical symptoms of anxiety Emotional symptoms Thoughts Cognitive symptoms 1 Phenomenology Anxiety as Warning Signal
More informationICD-10 and DSM-5: Making Sense in the Clinical Environment. Mehul Mankad, MD Assistant Professor Duke University Medical Center
ICD-10 and DSM-5: Making Sense in the Clinical Environment Mehul Mankad, MD Assistant Professor Duke University Medical Center 1 GSK Foundation Disclosures 2 Specific Aims Review of pertinent differences
More information2) Percentage of adult patients (aged 18 years or older) with a diagnosis of major depression or dysthymia and an
Quality ID #370 (NQF 0710): Depression Remission at Twelve Months National Quality Strategy Domain: Effective Clinical Care Meaningful Measure Area: Prevention, Treatment, and Management of Mental Health
More informationPanic Disorder Prepared by Stephanie Gilbert Summary
Panic Disorder Prepared by Stephanie Gilbert Summary The Diagnostic and Statistical Manual of Mental Disorders, IV, classifies the most prominent feature of Panic Disorder as being the sudden repetition
More informationPreventing the onset of depressive disorders
Preventing the onset of depressive disorders Pim Cuijpers 30 November 2009 Canberra Overview What is prevention? Why is prevention important? Is it possible to prevent new incident cases? How can depression
More informationTerminology. ECA Study. Studies on Co morbidity Most widely cited studies: Dual dx MICA CAMI Co Morbid Disorders Co Occurring Disorders
Psychiatric Co Morbidities Jeffrey Selzer, MD, FASAM Associate Professor of Psychiatry Hofstra North Shore LIJ School of Medicine Albert Einstein College of Medicine Medical Director, NYS Committee for
More informationTe Rau Hinengaro: The New Zealand Mental Health Survey
Te Rau Hinengaro: The New Zealand Mental Health Survey Executive Summary Mark A Oakley Browne, J Elisabeth Wells, Kate M Scott Citation: Oakley Browne MA, Wells JE, Scott KM. 2006. Executive summary. In:
More informationProfile of PAES Recipients and Factors That Influence PAES Outcomes
` San Francisco Department of Human Services County Adult Assistance Programs Personal Assisted Employment Services Program Profile of PAES Recipients and Factors That Influence PAES Outcomes Analysis
More informationHealth Care Agency, Behavioral Health Service, AQIS CYBH Support
Health Care Agency, Behavioral Health Service, AQIS CYBH Support DX Code F20.0 Paranoid schizophrenia F20.1 Disorganized schizophrenia F20.2 Catatonic schizophrenia F20.3 Undifferentiated schizophrenia
More informationName: Period: Chapter 14 Reading Guide Psychological Disorders
Name: Period: Chapter 14 Reading Guide Psychological Disorders Introduction to Psychological Disorders (pg. 593-600) 1. List AND describe the 3 definitions of abnormal. A. Understanding Psychological Disorders
More informationWorld Mental Health Surveys: A Global Perspective of the Burdens of Mental Disorders
EUROPEAN COMMISSION. HEALTH AND CONSUMERS DIRECTORATE-GENERAL Governmental Experts on Mental Health and Well-being Luxembourg, 3-4 December 2014 World Mental Health Surveys: A Global Perspective of the
More information10. Psychological Disorders & Health
10. Psychological Disorders & Health We will now study different psychological disorders and theories for treating psychopathology. We will also cover health, stress and how to cope with them. The sections
More informationMood Disorders and Addictions: A shared biology?
Mood Disorders and Addictions: A shared biology? Dr. Paul Stokes Clinical Senior Lecturer, Centre for Affective Disorders, Department of Psychological Medicine Disclosures No relevant disclosures: No paid
More informationPsychiatric Morbidity in Patients With Chronic Whiplash-Associated Disorder
Page 1 of 6 www.medscape.com To Print: Click your browser's PRINT button. NOTE: To view the article with Web enhancements, go to: http://www.medscape.com/viewarticle/479857 Psychiatric Morbidity in Patients
More informationConcurrent Disorders
Concurrent Disorders Dr. Christy Sutherland MD CCFP dipabam Medical Director, PHS Community Services Methadone/Buprenorphine 101 Workshop April 1, 2017 Overview Introduction Epidemiology Treatment Principles
More informationAnxiety. DISORDERs? What ARE ANXIETY. What Are Anxiety Disorders? Physical Symptoms. Psychological Symptoms
PRESENTS What ARE Anxiety s? w orry stress payments headache ANXIETY work bills What Are Anxiety Disorders? Individuals with an anxiety disorder can experience psychological or physical symptoms, or both.
More informationTrue or False? Chapter 14 Psychological Disorders. What is Abnormal Behavior? 12/9/10. Characteristics of Abnormal Behavior
Chapter 14 Psychological Disorders Defining Abnormality Classifying Psychological Disorders Origins of Psychological Disorders True or False? Abnormal behaviors are always bizarre. A clear distinction
More informationManagement Of Depression And Anxiety
Management Of Depression And Anxiety CME Financial Disclosure Statement I, or an immediate family member including spouse/partner, have at present and/or have had within the last 12 months, or anticipate
More information