PTSD and Panic, Anxiety, and Obsessive-Compulsive Disorders

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PTSD and Panic, Anxiety, and Obsessive-Compulsive Disorders

NIH - Medical Encyclopedia: Post-traumatic stress disorder

"Post-traumatic stress disorder is a psychiatric illness that can occur following a traumatic event in which there was threat of injury or death to you or someone else. … (PTSD) may occur soon after a major trauma, or can be delayed for more than six months after the event. When it occurs soon after the trauma it usually resolves after three months, but some people experience a longer-term form of the condition, which can last for many years. … People with PTSD re-experience the event again and again in at least one of several ways. They may have recurrent distressing dreams and recollections of the event, a sense of reliving the experience (referred to as flashbacks), and/or become very distressed around the time of events that symbolize the event (such as anniversaries)."

Highlighted Article

Posttraumatic Stress Disorder and Health Status: The Veterans Health Study. (J Ambul Care Manage. 2006)

"The association of PTSD with health status was substantial, suggesting that the burden of PTSD is at least comparable to, and may be worse than, that of depression. Mental health treatment alleviated some of this burden. The potential impact of PTSD on health status should be more widely recognized."

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PTSD and Panic, Anxiety, and Obsessive-Compulsive Disorders

Daily Treatment Report

Cognitive Therapy-CBT-Psychotherapy

Mindfulness-based cognitive therapy for generalized anxiety disorder. (J Anxiety Disord. 2007)

[Cognitive-behavior therapy for obsessive-compulsive disorder: a systematic review of the last decade.] (Rev Bras Psiquiatr. 2007)

Treatment of Anxiety Disorders in Older Adults: A Meta-analytic Comparison of Behavioral and Pharmacological Interventions (Am J Geriatr Psychiatry 2007)

Psychological treatment of post-traumatic stress disorder (PTSD). (Cochrane Database Syst Rev. 2007)

Behavioral couples therapy for comorbid substance use disorders and combat-related posttraumatic stress disorder among male veterans: An initial evaluation. (Addict Behav. 2007)

Cognitive behaviour therapy for postnatal post-traumatic stress disorder: case studies. (J Psychosom Obstet Gynaecol. 2007)

A meta-analytic review of adult cognitive-behavioral treatment outcome across the anxiety disorders. (J Nerv Ment Dis. 2007)

Prognostic indices with brief and standard CBT for panic disorder: I. Predictors of outcome. (Psychol Med. 2007)

Prognostic indices with brief and standard CBT for panic disorder: II. Moderators of outcome. (Psychol Med. 2007)

Combination of psychotherapy and benzodiazepines versus either therapy alone for panic disorder: a systematic review. (BMC Psychiatry. 2007) "CONCLUSIONS: Unlike some narrative reviews in the literature, our systematic search established the paucity of high quality evidence for or against the combined psychotherapy plus benzodiazepine therapy for panic disorder. Based on limited available published and unpublished data, however, the combined therapy is probably to be recommended over benzodiazepine alone for panic disorder with agoraphobia. The combination might be superior to behaviour therapy alone during the acute phase, but afterwards this trend may be reversed. We know little from these trials about their adverse effects."

Psychological treatments versus treatment as usual for obsessive compulsive disorder (OCD). (Cochrane Database Syst Rev. 2007) "AUTHORS' CONCLUSIONS: The findings of this review suggest that psychological treatments derived from cognitive behavioural models are an effective treatment for adult patients with obsessive compulsive disorder. Larger high quality randomised controlled trials involving longer follow up periods are needed, to further test cognitive behavioural treatments, and other psychological approaches, in comparison to each other and control conditions. Future trials should examine the predictors of response to each treatment, and also conduct cost-effectiveness evaluations."

Talk therapy helpful in adults with OCD "People suffering with obsessive-compulsive disorder (OCD) may benefit from cognitive behavioral therapy, researchers from Australia report in the current issue of The Cochrane Library."

Which panic disorder patients benefit from which treatment: cognitive therapy or antidepressants? (Psychother Psychosom. 2007)

Cognitive Behavioral Therapy for Posttraumatic Stress Disorder in Women (JAMA 2007) "Prolonged exposure is an effective treatment for PTSD in female veterans and active-duty military personnel. It is feasible to implement prolonged exposure across a range of clinical settings."

Cognitive-Behavioral group treatment for panic disorder with agoraphobia. ( Clin Psychol. 2007)

Combined psychotherapy plus antidepressants for panic disorder with or without agoraphobia. (Cochrane Database Syst Rev. 2007) "AUTHORS' CONCLUSIONS: Either combined therapy or psychotherapy alone may be chosen as first line treatment for panic disorder with or without agoraphobia, depending on patient preference."

Psychological therapies for generalised anxiety disorder. (Cochrane Database Syst Rev. 2007) "AUTHORS' CONCLUSIONS: Psychological therapy based on CBT principles is effective in reducing anxiety symptoms for short-term treatment of GAD. The body of evidence comparing CBT with other psychological therapies is small and heterogeneous, which precludes drawing conclusions about which psychological therapy is more effective. Further studies examining non-CBT models are required to inform health care policy on the most appropriate forms of psychological therapy in treating GAD."

[Evaluation of a Cognitive-Behavioral Therapy of Inpatients with DSM-IV Panic Disorder.] (Psychiatr Prax. 2007)

Treatment of acute posttraumatic stress disorder with brief cognitive behavioral therapy: a randomized controlled trial. (Am J Psychiatry. 2007) " CONCLUSIONS: Brief early cognitive behavioral therapy accelerated recovery from symptoms of acute PTSD but did not influence long-term results. Brief early cognitive behavioral therapy showed enhanced efficacy in patients with baseline comorbid depression and patients who were included within 1 month after their traumatic experience."

Online therapy may help people with panic attacks " Cyber-therapy may offer a new treatment option for people suffering from panic disorder who can't or won't go to a therapist's office, new research suggests. In a study of 60 adults who experienced panic attacks, researchers found that those who received education and counseling via the Internet and weekly phone calls had a lasting improvement in their symptoms."

Device Therapy

Drug Side-Effects and Interactions

Effects of gradual discontinuation of selective serotonin reuptake inhibitors in panic disorder with agoraphobia. (Int J Neuropsychopharmacol. 2007) "Discontinuation syndromes appeared to be fairly common even when performed with slow tapering and during clinical remission. In some cases disturbances persisted for months after discontinuation."

Drugs

Paroxetine treatment of compulsive hoarding. (J Psychiatr Res. 2007)

BP drug reduces nightmares in vets with PTSD "The blood pressure-lowering drug prazosin reduces trauma nightmares and sleep disturbances in combat veterans with post-traumatic stress disorder (PTSD), according to a study."

An update on the pharmacological treatment of obsessive-compulsive disorder. (Expert Opin Pharmacother. 2007)

Exercise

Physical activity protects male patients with post-traumatic stress disorder from developing severe fibromyalgia. (Clin Exp Rheumatol. 2007)

The effects of aerobic exercise on childhood PTSD, anxiety, and depression. (Int J Emerg Ment Health. 2007) "Results of this study provided support for the positive effects of aerobic exercise on reducing PTSD, depression, and anxiety. Fewer participants met full criteria for PTSD after exercising. This research is a starting point toward satisfying the essential need to establish efficacious methods to treat PTSD and associated symptoms in child/adolescent populations."

A pilot study of moderate-intensity aerobic exercise for obsessive compulsive disorder. (J Nerv Ment Dis. 2007)

General Information

Recognition and treatment of obsessive-compulsive disorder. (J Clin Psychiatry. 2007)

[Early detection and treatment of panic disorder with or without agoraphobia: update] (Can Fam Physician. 2007)

Report Shows Inadequate Effectiveness Data for Most Posttraumatic Stress Disorder Treatments "For instance, a high proportion of PTSD patients quit several studies. The committee also voiced concern that most of the drug studies were funded by the drugs' makers, and that there wasn’t enough research on certain groups, such as minorities, veterans with head injuries, and depressed or addicted PTSD patients."

[Diagnosis and treatment of tics] (MMW Fortschr Med. 2007)

Three-year medication prophylaxis in panic disorder: to continue or discontinue? A naturalistic study. (Compr Psychiatry. 2007)

Treating adults with acute stress disorder and post-traumatic stress disorder in general practice: a clinical update. (Med J Aust. 2007)

Motivation to change as a predictor of treatment response in obsessive compulsive disorder. (Ann Clin Psychiatry. 2007)

Issues in the pharmacological treatment of obsessive-compulsive disorder. (Int J Clin Pract. 2007) "Conclusion: OCD is a chronic and debilitating disorder. In responders, SRIs have to be continued in the same doses (if possible) for a minimum of 1-2 years and may be lifelong in those with persistent symptoms and in those with multiple relapses. CBT has to be offered in combination with SRIs wherever facilities for CBT exist."

Guidelines

NGC - Practice guideline for the treatment of patients with obsessive-compulsive disorder. (2007)

APA - Practice Guideline for the Treatment of Patients with Obsessive-Compulsive Disorder (2007)

Australian guidelines for the treatment of adults with acute stress disorder and post-traumatic stress disorder. (Aust N Z J Psychiatry. 2007)

[Is it time for revision of the section on OCD in the Guideline on anxiety disorders?] (Tijdschr Psychiatr. 2007)

Immunotherapy

Internet Sites

Treatment Information

DrugBank (drug structure)

FDA - MedWatch (Drug Alerts)

Drug-Food-Supplement Information

Drug Information Online

Drug Interaction Checker

DrugDigest (drug interactions)

FDA - Drug Interactions: What You Should Know

NIH - Botanical Dietary Supplements: Background Information

NIH - Drug, Supplements, and Herbal Information

NIH - Herbal Supplements: Consider Safety, Too

NIH - Medicines

NIH - Vitamin and Mineral Supplement Fact Sheets

Nutrition

Other

Other Treatments

Acupuncture for Posttraumatic Stress Disorder: A Randomized Controlled Pilot Trial. (J Nerv Ment Dis. 2007)

Experimental

Radiotherapy

Supplements-Vitamins-CAM

Omega-3 fatty acids as treatments for mental illness: which disorder and which fatty acid? (Lipids Health Dis. 2007) "CONCLUSIONS: While it is not currently possible to recommend omega-3 PUFA as either mono- or adjunctive-therapy in any mental illness, the available evidence is strong enough to justify continued study, especially with regard to attentional, anxiety and mood disorders."

Herbal and Dietary Supplements for Treatment of Anxiety Disorders (Am Fam Physician 2007)

Surgery

Transplantation

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