The Management of Anxiety and Depressive Disorders: A Review

Ohaeri, Jude U.

doi:10.1007/s11469-006-9016-x

Cited by 4 publications

(4 citation statements)

References 73 publications

(54 reference statements)

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“…With regard to the prevalence of abnormal test scores, our finding about the commonness of anxiety-depression co-morbidity is in line with the literature [ 49 , 50 ]. We found the following frequencies: about 14% for anxiety/depression, 17% for deviant behaviour, 16.6%–19.7% for poor adaptive behaviour, and 9.6% – 23.1% for poor family adjustment.…”

Section: Discussionsupporting

confidence: 90%

Psychopathological status, behavior problems, and family adjustment of Kuwaiti children whose fathers were involved in the first gulf war

Al-Turkait

Ohaeri²

2008

Child Adolesc Psychiatry Ment Health

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ObjectivesFollowing the end of the Gulf War that resulted in the liberation of Kuwait, there are no reports on the impact of veterans' traumatic exposure and posttraumatic stress disorder (PTSD) on their children. We compared the severity of anxiety, depression, deviant behavior and poor family adjustment among the children of a stratified random sample of four groups of Kuwaiti military men, viz: the retired; an active -in-the-army group (AIA) (involved in duties at the rear); an in-battle group (IB) (involved in combat); and a prisoners -of- war (POWs) group. Also, we assessed the association of father's PTSD/combat status and mother's characteristics with child psychosocial outcomes.MethodSubjects were interviewed at home, 6 years after the war, using: the Child Behavior Index to assess anxiety, depression, and adaptive behavior; Rutter Scale A2 for deviant behavior; and Family Adjustment Device for adjustment at home. Both parents were assessed for PTSD.ResultsThe 489 offspring (250 m, 239 f; mean age 13.8 yrs) belonged to 166 father-mother pairs. Children of POWs tended to have higher anxiety, depression, and abnormal behavior scores. Those whose fathers had PTSD had significantly higher depression scores. However, children of fathers with both PTSD and POW status (N = 43) did not have significantly different outcome scores than the other father PTSD/combat status groups. Mother's PTSD, anxiety, depression and social status were significantly associated with all the child outcome variables. Parental age, child's age and child's level of education were significant covariates. Although children with both parents having PTSD had significantly higher anxiety/depression scores, the mother's anxiety was the most frequent and important predictor of child outcome variables. The frequency of abnormal test scores was: 14% for anxiety/depression, and 17% for deviant behavior.ConclusionOur findings support the impression that child emotional experiences in vulnerable family situations transcend culture and are associated with the particular behavior of significant adults in the child's life. The primacy of the mother's influence has implications for interventions to improve the psychological functioning of children in such families. Mental health education for these families has the potential to help those in difficulty.

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Section: Discussionsupporting

confidence: 90%

Psychopathological status, behavior problems, and family adjustment of Kuwaiti children whose fathers were involved in the first gulf war

Al-Turkait

Ohaeri²

2008

Child Adolesc Psychiatry Ment Health

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“…To support this notion, borrowing from a discussion on the psychoses [97], the commonality in the efficacy of SSRIs/SNRIs for GAD and MDD [26,34] points to the possibility that these disorders and their comorbidity are dimensional.…”

Section: Discussionmentioning

confidence: 99%

“…Impressed by the evidence, Tyrer [32,33] has called for the introduction into psychiatric nosology of an entity called “cothymia”, consisting of comorbid threshold anxiety/depression. First, anxiety/depression comorbidity occurs more frequently than would be expected by the base rates of the corresponding “pure” disorders in the population [3,34]. Comorbidity occurs both for methodological reasons (ie, there are shared diagnostic criteria) and substantive reasons (ie, one disorder causes the other) [35,36].…”

Section: Introductionmentioning

confidence: 99%

Characteristics of subjects with comorbidity of symptoms of generalized anxiety and major depressive disorders and the corresponding threshold and subthreshold conditions in an Arab general population sample

Ohaeri¹,

Awadalla

2012

Med Sci Monit

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SummaryBackgroundThere is controversy about differential meaningfulness between comorbid generalized anxiety disorder (GAD)/ major depressive disorder (MDD), the corresponding “pure” disorders and subthreshold conditions. We compared subjects who met DSM-IVTR criteria of symptoms and functional impairment for comorbid GAD/MDD, versus those with GAD, MDD, subthreshold conditions, and without significant symptoms. The comparison measures were socio-demographics, clinical severity, and quality of life (QOL).Material/MethodsParticipants (N=3155: 55.1% female, aged 16–87 yrs) were a general population sample of Kuwaitis who self-completed DSM-IVTR criteria-based questionnaires and the WHOQOL-BREF in 2006/7. We scrutinized the questionnaires and classified them into categories.ResultsOf the 273 GAD and 210 MDD cases, the prevalence of comorbidity among cases with GAD was 30.8%, and 40% among MDD. Of the 398 subthreshold GAD and 194 subthreshold MDD cases, 58 had subthreshold anxiety/depression comorbidity. Comorbid threshold GAD/MDD cases were significantly older, and more likely to be women, divorced and unemployed, compared with GAD and MDD. In all measures, the threshold GAD/MDD comorbidity was the severest condition. There was a monotonic decrease in QOL with increasing anxiety-depression symptoms. For the predictors of subjective QOL, the GAD/MDD comorbidity group differed markedly from the others.ConclusionsThe high prevalence of comorbidity and subthreshold conditions supports the recommendation to assess them routinely, regardless of the primary reason for consultation. Our findings support a dimensional model with comorbid GAD/MDD at the higher end of a continuum, and differing from the “pure” conditions by a later onset and predictors of subjective wellbeing.

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“…Whether anxiety and depression were psychological reactions to PTSD or independently occurring phenomena [Thabet et al, 2004], the consensus of opinion is that these comorbidities are associated with poor outcome [Ohaeri, 2006;Tyrer, 2001]. The high level of comorbidity may have, therefore, been a contributory factor to the chronicity of PTSD among these Kuwaiti veterans, despite the social supports available to them.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and correlates of posttraumatic stress disorder among Kuwaiti military men according to level of involvement in the first Gulf War

Al-Turkait¹,

Ohaeri²

2008

Depress. Anxiety

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First, to compare the prevalence and intensity of posttraumatic stress disorder (PTSD) among Kuwaiti military men, divided into four groups (50 subjects each) according to degree of exposure to war trauma: (1) the retired (retired before the invasion); (2) an active-in-the-army group (AIA) (involved in duties at the rear only); (3) an in-battle (IB) group (involved in combat); and (4) prisoners of war (POWs-captured during combat). Second, to compare the severity of impact of event, comorbid depression, and anxiety among the groups. Third, to evaluate the contribution of self-esteem and locus of control (LOC). Subjects were interviewed once, 6 years after the war, using: the Clinician Administered PTSD Scale; the Impact of Event Scale (IES); the Hopkins Symptom Checklist-25; the Internal-External LOC; and The Self-Esteem Scale. Subjects were aged 24-71 years (mean 37.9). Sixty-three subjects (31.5%) fulfilled criteria for PTSD, with the rate significantly higher among the POWs (48%) than the retired (24%) and IB (22%), reflecting the severity of IES. Avoidance symptoms were the most pronounced. Self-esteem was significantly lowest among the POWs and those with PTSD. External LOC was associated with PTSD, anxiety, and depression. Self-esteem was the only covariate of PTSD scores. LOC was a significant covariate for anxiety. The characteristics of PTSD in these veterans showed similarity with those from elsewhere. The prominence of self-esteem and avoidance symptoms implies that they should be part of focus for interventions. Focus on LOC should be from the perspective of anxiety.

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The Management of Anxiety and Depressive Disorders: A Review

Cited by 4 publications

References 73 publications

Psychopathological status, behavior problems, and family adjustment of Kuwaiti children whose fathers were involved in the first gulf war

Psychopathological status, behavior problems, and family adjustment of Kuwaiti children whose fathers were involved in the first gulf war

Characteristics of subjects with comorbidity of symptoms of generalized anxiety and major depressive disorders and the corresponding threshold and subthreshold conditions in an Arab general population sample

Prevalence and correlates of posttraumatic stress disorder among Kuwaiti military men according to level of involvement in the first Gulf War

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