Epidemiology of Social Anxiety Disorder (SAD) SAD (social anxiety disorder) (social anxiety disorder), also known as social phobia, is characterised by excessive fear of embarrassment or humiliation in social situations, which in turn leads to marked distress or avoidance of these situations and functional impairment as described in DSM-IV-TR. It is a common disorder with… Read More »
Current recommended treatment options for social anxiety disorder include pharmacotherapy and cognitive behavioural therapy (CBT). Although several randomised controlled trials (RCTs) have failed to show efficacy for beta-adrenoceptor antagonists in generalised social anxiety disorder (SAD), it has been suggested that these agents may be useful in non-generalised social anxiety disorder (SAD), patients with performance anxiety… Read More »
Etiology and Pathophysiology Minor depression is only a proposed diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and there are no International Classification of Diseases codes to categorize it. The proposed diagnostic category for minor depression in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition describes a depressive disorder that… Read More »
β-Adrenergic Blockers β-blockers, the most widely used class of drugs in prophylactic migraine treatment, are approximately 50% effective in producing a greater than 50% reduction in attack frequency. Rabkin et al. serendipitously discovered propranolol’s effectiveness in headache treatment in patients who were being treated for angina. The Agency for Healthcare Policy and Research (AHCPR) Technical… Read More »
Antidepressants consist of a number of different classes of drugs with different mechanisms of action. Only tricyclic antidepressants (TCAs) have proven efncacy in migraine; we cover the newer components for completeness and reader interest. Mechanism of Action TCAs, selective serotonin-reuptake inhibitors (SSRIs), and serotonin NE-reuptake inhibitors increase synaptic NE or serotonin (5-HT) by inhibiting high-affinity… Read More »
Social phobia was first described as a unique, diagnosable disorder in DSM-III (American Psychiatric Association 1980). From a historical perspective, the disorder has been recognized since the middle of the 19th century, when Casper described erythrophobia (Casper 1902). Marks (1970) separated social phobia from other types of anxiety, including agoraphobia and simple phobia; thus, he… Read More »
There is a consensus that antidepressant therapy is effective and should be recommended for the treatment of depression in the elderly. Because of the pharmacokinetic changes in the elderly, the tolerability of antidepressants, especially of the classic tricyclics, is reduced compared with younger populations. However, this problem can be managed by a careful dosing regime… Read More »
The initial approach to patients with refractory or chronic depression begins with a comprehensive assessment of Axis I psychiatric disorders, including information from the patient as well as collateral sources. Unrecognized syndromal or subsyndromal psychiatric conditions (e.g., bipolar disorder, atypical depression, anxiety disorders, psychosis, substance abuse) may be found in some patients with chronic or… Read More »
Treatment of anxiety disorders in the medically ill depends upon the relationship between anxiety symptoms and physical disease. Some patients have persisting symptoms or exacerbations of anxiety disorders that existed before the onset of physical disease. In that case, treatment should be similar to that given to patients without comorbid illness. Other patients, perhaps the… Read More »
In the management of stress-induced disorders one has to consider symptoms, severity, duration and social ramification of the trauma. It is particularly important for treatment planning to include co-occurring disorders. Psychological interventions are always required. Pharmacological treatments may be administered as adjuvants to psychological therapy or with the primary aim of suppressing stress-induced symptoms. Pharmacological… Read More »