Primary prevention of anxiety disorders in primary care: A systematic review

Garcı́a-Campayo, Javier; López‐Del‐Hoyo, Yolanda; Valero, Montserrat Salas; Yus, María Cruz Pérez; Esteban, Eva; Guedea, Marta Puebla; Botaya, Rosa Magallón

doi:10.1016/j.ypmed.2014.10.015

Cited by 15 publications

(6 citation statements)

References 30 publications

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Section: Discussionmentioning

confidence: 99%

“…Our findings have potential clinical implications and highlight the importance of identifying vulnerable individuals at risk of maladaptive but modifiable stress processing [ 96 ]. In the sense of primary prevention [ 96 ], they should be protected from high-stress situations (e.g. by personnel selection) or prepared to high-stress situations prior to exposure thereby preventing mental health problems or mental disorders [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

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The impact of pre-existing anxiety on affective and cognitive processing of a Virtual Reality analogue trauma

et al. 2017

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Dysfunctional processing of traumatic events may be in particular related to high trait anxiety as a pre-traumatic risk factor for the development of post-traumatic stress disorder (PTSD). However, as this has rarely been investigated in prospective, experimental studies, we aimed to analyse the association between high trait anxiety and affective as well as cognitive processing of stress using a new prospective Virtual Reality analogue trauma paradigm to overcome limitations of retrospective or current analogue designs. Individuals with high and low trait anxiety (N = 80) were exposed to a multi-sensory Virtual Reality emergency scenario while psychophysiological stress response, emotion regulation and intrusive memories were assessed. Our results showed that high trait anxiety individuals display increased (i) subjective stress responses, (ii) emotion dysregulation and (iii) intrusive memories upon VR analogue trauma exposure. In particular, our sample of high trait anxiety individuals displayed limited access to different emotion regulation strategies as well as increased worry and rumination regarding perceived intrusive memories. Considering the complex interplay of multiple risk factors, our findings suggests that peri-traumatic affective processing seems to mediate high trait anxiety and post-traumatic intrusive memories thereby pointing out the central role of peri-traumatic processes for intrusion development. In addition, HA as a modulating pre-traumatic risk factor might further increase the risk of later dysfunctional processing of an analogue trauma by interacting with factors of affective processing during analogue trauma exposure. Implications of these findings which may contribute to a higher risk to develop PTSD are discussed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The impact of pre-existing anxiety on affective and cognitive processing of a Virtual Reality analogue trauma

et al. 2017

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“…For the review of the prevention literature, we surveyed the reference lists of recent meta-analyses of the prevention of anxiety [40][41][42][43][44] and the prevention of depression. [45][46][47][48] We also searched the literature for RCTs of the prevention of depression or anxiety in youth, which yielded 63 depression prevention trials and 54 studies targeting anxiety or the reduction of internalizing problems (across anxiety and depression).…”

Section: Methodsmentioning

confidence: 99%

Treatment and Prevention of Depression and Anxiety in Youth: Test of Cross-Over Effects

et al. 2016

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Anxiety and depression are highly comorbid and share several common etiological processes. Therefore, it may be more efficient to develop interventions that treat or prevent these problems together rather than as separate entities. The present meta-analytic review examined whether interventions for children and adolescents that explicitly targeted either anxiety or depression showed treatment specificity or also impacted the other outcome (i.e., cross-over effects). We addressed this question both within the same type of study (i.e., treatment, prevention) and across study types. Only randomized controlled trials (RCTs) that assessed both constructs with dimensional measures were included in this review. For treatment studies, RCTs targeting anxiety (n=18) showed significant effects on both anxious and depressive symptoms, although more strongly on anxiety than depression; similarly, RCTs treating depression (n=9) yielded significant effects on both depressive and anxious symptoms, but stronger effects on depression than anxiety. Thus, there were cross-over effects in treatments purportedly targeting either anxiety or depression, and also treatment specificity, such that larger effects were seen for the target problem at which the treatment was aimed. Anxiety prevention studies (n=14) significantly affected anxious, but not depressive symptoms, indicating no cross-over effect of anxiety prevention trials on depression. For depression prevention studies (n=15), the effects were not significant for either depressive or anxiety symptoms, although the effect was significantly larger for depressive than for anxious symptoms. Post-hoc analyses revealed that the effect on depressive symptoms was significant in depression preventions trials of targeted but not universal samples. Implications for transdiagnostic interventions are discussed.

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“…8,9 To our knowledge, there are no interventions to prevent the onset of anxiety disorders in the adult population irrespective of individual risk levels (universal prevention) administered by GPs. 7,10 Anxiety and depression frequently occur together, 11 they share most of their risk factors, [12][13][14] and both respond to the same treatments 15 and preventive interventions. [16][17] Our research group developed a personalized and novel bio-psycho-social intervention, the predictD-intervention, based on the level of risk and risk profile of depression and implemented by GPs to prevent the onset of major depression.…”

Section: Introductionmentioning

confidence: 99%

Use of a personalised depression intervention in primary care to prevent anxiety: a secondary study of a cluster randomised trial

et al. 2020

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Background: In the predictD-intervention, general practitioners (GPs) used a personalized bio-psycho-social program to prevent depression. This reduced the incidence of major depression by 21% although it was not statistically significant. Aim: Was the predictD-intervention effective in preventing anxiety in non-depressive and non-anxious primary care patients? Design and Setting: Secondary study of a cluster randomized trial with practices randomly assigned to either the predictD-intervention or CAU. This study was conducted in seven Spanish cities from October 2010 to July 2012. Methods: In each city, we randomly selected 10 practices and 2 GPs per practice as well as 4-6 patients every recruiting day until there were 26-27 eligible patients for each GP. The endpoint was cumulative incidence of anxiety as measured by the PRIME-MD over 18 months. Results: A total of 3326 non-depressed patients and 140 GPs from 70 practices consented and were eligible to participate, and 328 were removed because they had an anxiety syndrome at baseline. Of the 2998 valid patients, 2597 (86.6%) were evaluated at the end of the study. At 18 months, 10.43% (95%C.I.: 8.73% to 12.13%) of the patients in the predictD-intervention group developed anxiety compared with 13.1% (11.4% to 14.79%) in the CAU group (difference, -2.67% [-5.05% to -0.28%]; P=0.029). Conclusion: A personalized intervention delivered by GPs for the prevention of depression provided a modest but statistically significant reduction in the incidence of anxiety.

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Primary prevention of anxiety disorders in primary care: A systematic review

Abstract: This study emphasizes the need for the development of high-quality clinical trials on the prevention of anxiety disorders in primary care.

Cited by 15 publications

References 30 publications

The impact of pre-existing anxiety on affective and cognitive processing of a Virtual Reality analogue trauma

The impact of pre-existing anxiety on affective and cognitive processing of a Virtual Reality analogue trauma

Treatment and Prevention of Depression and Anxiety in Youth: Test of Cross-Over Effects

Use of a personalised depression intervention in primary care to prevent anxiety: a secondary study of a cluster randomised trial

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