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    Anxiety: When to Seek Help

    10 October is World Mental Health Day​. With the ongoing COVID-19 pandemic and gloomy economic outlook, it’s absolutely normal to feel anxious. But how can you tell if you’re not just being overly worried and suffering from an anxiety disorder instead? Associate Professor Leslie Lim, Senior Consultant from the Department of Psychiatry at Singapore General Hospital (SGH), a member of the SingHealth group, answers.

    What are anxiety disorders?

    Anxiety disorders refer to a range of mental conditions characterised by fearfulness, worry and uncertainty which interfere with the person’s life. “About 10 per cent of the population in Singapore suffer from anxiety and depressive disorders. Out of this, six per cent have depression, 0.9 per cent have generalised anxiety disorder (GAD), and three per cent have obsessive-compulsive disorder (OCD),” shares Assoc Prof Lim.

    Anxiety disorder conditions include:

    1.Generalised anxiety disorder (GAD)

    Characterised by excessive worry excessively about health, money, family or work even if there is no reasonable cause. Symptoms include:

    These symptoms are usually accompanied by headaches, muscle tension, irritability, sweating and fatigue.

    Read more: Is it depression or just feeling sad? How to tell the difference

    2. Obsessive-compulsive disorder (OCD)

    Characterised by:

    3. Panic disorder

    Characterised by sudden attacks of fear, usually accompanied by breathlessness, a choking sensation, shortness of breath, a pounding heart and fears of losing control or going crazy.

    It can occur anytime, even while watching television or sleeping, and typically lasts about 10-20 minutes each time.

    4. Social anxiety disorder (social phobia)

    Those with social phobia are excessively anxious and self-conscious in everyday social situations. They fear being watched and judged by others, and may be overly worried for days or weeks before a social event.

    Symptoms include profuse sweating, trembling and nausea.

    5. Phobias

    Phobias arouse an intense and irrational fear of something that may not actually be dangerous, such as animals, heights and thunder. Sometimes just thinking about the trigger can bring on a panic attack.

    Read more: Eating disorders – Types and how to know if you have it

    6. Post-traumatic stress disorder (PTSD)

    This condition usually affects victims of violent crime, accidents, war veterans and survivors of natural disasters, or even to an observer, such as someone who witnessed a loved one being harmed.

    Sufferers are easily startled, emotionally numbed, irritable or aggressive and experience frequent flashbacks.

    How to tell if anxiety becomes a problem

    In its mild form, an anxiety disorder will not affect normal life. “A person with a job will still be able to show up at work, although he or she may be less productive than usual,” explains Assoc Prof Lim.

    Only severe forms of anxiety disorders can disrupt daily activities. For example, making it impossible for the sufferer to go to work.”

    If the anxiety is disruptive, you should consult a doctor.

    “Your doctor will take some blood tests to rule out physical issues like hyperthyroidism, as well as use a diagnostic tool like an electrocardiogram (ECG) to exclude cardiac conditions.”

    How are anxiety disorders treated?

    Fortunately, anxiety disorders are highly treatable. Depending on the specific type of anxiety disorder, doctors may prescribe several classes of medications (such as anti-depressants for GAD).

    Psychotherapy can also help. This includes cognitive behaviour therapy which helps you to recognise and control your fears, modify your way of thinking, or desensitise you to anxiety triggers.

    Read more: 20 Stress-busting tips psychiatrists recommend

    Articles on HealthXchange.sg are meant for informational purposes only and cannot replace professional surgical, medical or health advice, examination, diagnosis or treatment. Photo courtesy of iStock.

    Mental Illness Awareness Week: Research on anxiety, depression, PTSD, OCD and more

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    The National Alliance on Mental Illness has designated this week as Mental Illness Awareness Week.

    In conjunction with this observance, Healio Psychiatry has compiled a list of most-read articles this year related to seven common mental health conditions: anxiety disorder, major depressive disorder, PTSD, bipolar disorder, borderline personality disorder, obsessive compulsive disorder and schizophrenia.

    Children with less sleep experience increased depression, anxiety, decreased cognitive performance

    Shorter sleep duration among children was associated with increased risk for depression, anxiety, impulsive behavior and poor cognitive performance, according to study findings published in Molecular Psychiatry. Read more.

    Botox injections may reduce depression

    Individuals who received Botox injections were significantly less likely to report depression vs. those who received different treatments, according to study results published in Scientific Reports. Read more.

    30% of injury survivors experience moderate-to-severe PTSD symptoms

    More than 30% of civilian-related injury survivors who are treated in EDs exhibited moderate-to-severe PTSD symptoms during the first year after the initial incident, according to study results published in Psychological Medicine. Read more.

    Fatty acid diet intervention may stabilize mood among patients with bipolar disorder

    A nutrition intervention focused on fatty acids may stabilize mood, energy, irritability and pain among individuals with bipolar disorder, according to data presented at the American Society of Clinical Psychopharmacology Annual Meeting. Read more.

    Childhood sleep problems linked to adolescent psychosis, borderline personality disorder

    Sleep problems during early childhood may be associated with the onset of psychosis and borderline personality disorder, or BPD, in adolescence, according to results of a cohort study published in JAMA Psychiatry. Read more.

    OCD more common among women vs. men

    Women appeared to have a greater lifetime risk for obsessive-compulsive disorder than men, according to results of a meta-analysis published in Journal of Clinical Psychiatry. Read more.

    BMI linked to major psychiatric disorders

    Findings of a genome-wide association study published in JAMA Psychiatry suggest that many overlapping genetic risk variants exist between BMI and schizophrenia, bipolar disorder and major depression. Read more.

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    How to help an employee with an anxiety disorder

    “You’ve identified that something isn’t right, but you can’t put your finger on it.”

    Read more: Proving the ROI on wellbeing programs

    For Dr Brockis, it is then time to just step in and inquire ‘how are you?’ and ‘is everything alright?’

    In other words, it’s about asking those open-ended questions and acknowledging that it is a difficult time.

    “If you show genuine interest in the person, they are much more likely to feel safe to open up and say, ‘actually I am finding it hard at the moment’.”

    How to tell if your child has OCD and how to find the best treatment option – Insider

    • OCD in children is relatively uncommon, but boys are often more affected than girls.
    • Some of the obsessions that children with OCD may display are an extreme fear of dirt and germs, obsession with details, and excessive disgust over bodily waste.
    • Children may also have compulsions like repetitive handwashing, asking incessant questions, and hoarding objects with little or no value. 
    • This article was medically reviewed by Zlatin Ivanov, MD, who is certified in psychiatry and addiction psychiatry by the American Board of Psychiatry and Neurology at Psychiatrist NYC.
    • Visit Insider’s Health Reference library for more advice.

    Most people are diagnosed with OCD around age 19, but roughly 1-3% of children are diagnosed with it.

    Obsessive-compulsive disorder (OCD) — for both adults and children — is a mental condition characterized by intrusive, repetitive thoughts or fears that trigger irrational, compulsive behaviors.

    OCD in children is usually diagnosed between the ages of 7 and 12. Here’s what you need to know about the symptoms and treatment options for children with OCD. 

    How OCD manifests in children

    “In kids, OCD is slightly more common in boys, than in girls, but women tend to catch up later on in life,” says Michael Wheaton, PsyD, an assistant professor of psychology at Barnard College of Columbia University. 

    Symptoms of OCD in children 

    A child with OCD will experience symptoms of obsession and compulsion. Symptoms vary from child to child, however, the most common obsessions children experience include

    • Aggressive thoughts about self-harm and harm to others
    • Thoughts about doing offensive sexual acts or taboo behaviors 
    • Thoughts that may be against religious beliefs they hold 
    • An extreme fear of dirt and germs 
    • Fear of losing things 
    • An obsessive need to know or remember things that may be minor 
    • Excessive fears about getting ill or being infected with a disease 
    • Fear of saying certain things, or not saying the right things 
    • Excessive disgust over bodily waste or secretions
    • Obsession with details

    Children also engage in compulsive behaviors and repetitive rituals in response to obsessive thoughts. However, the relief from engaging in these compulsions is temporary because performing compulsions ultimately reinforces the obsessions. Therefore, these behaviors can be disruptive and time-consuming. Some of them include:

    • Repetitive hand washing or shower routine
    • Excessive cleaning of items like tabletops and clothes 
    • Needing to repeat routine activities like walking out of a door 
    • Having an obsessive need for things to be symmetrical 
    • Having checking compulsions such as checking and rechecking several times to make sure they lock a door 
    • Hoarding things that don’t have any value 
    • Spending an unhealthy amount of time counting and recounting things 
    • Asking questions repeatedly 

    OCD symptoms in children peak and dwindle and sometimes change from one form of the disorder to another. For example, compulsion symptoms might change from repetitive washing to checking. There is usually no evident reason for the change, but in some cases, a trigger may be identified.

    How is OCD in children diagnosed?

    A child psychologist or a mental expert will need to examine your child. To be diagnosed with OCD, the child must exhibit obsessions and compulsions that are continuous and severe enough to be considered disruptive to their daily life. 

    Most medical professionals use the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) to diagnose OCD for children. The scale involves a checklist of common obsessions including ones about contamination, aggression, sexual obsession, superstition, and more.

    Children with OCD also frequently struggle with other mental health problems, such as clinical depression, Tourette’s Syndrome, ADHD, or other anxiety disorders. This can make an OCD diagnosis in children more difficult than in adults. 

    “Children, especially younger children, may present primarily on the compulsion side. They might engage more with repetitive behaviors like washing of hands or repetitive checking of things. They might also have a harder time articulating their obsessions,” says Wheaton

    What causes OCD in children? 

    OCD is a neurobiological disorder, meaning it’s caused by an imbalance of certain chemicals in the brain. It is important to know that OCD in children is never the fault of the children or their parents. 

    While stress doesn’t cause OCD, a stressful event like the death of a loved one, or parents getting divorced might trigger the condition. A stressful event might also worsen symptoms in a child who has already been diagnosed with OCD. 

    Some research shows that a strep infection may also trigger the sudden onset of OCD symptoms in children who are genetically predisposed to the condition. This type of OCD is called Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS) if it is triggered by a strep infection. 

    Treatment of OCD in children

    The treatments that are effective for treating adults with OCD also work for children. Medical experts often begin treatment with behavioral therapy and only include medication in more severe cases.

    Exposure and response prevention therapy (ERP)

    ERP is a form of cognitive behavior therapy that involves exposing children to their obsessions and simultaneously preventing them from engaging in the compulsions that would usually follow. It is typically the first line of treatment for children with OCD. 

    “In ERP, we help people with OCD understand that no real danger can occur as a result of their thoughts,” says Wheaton. “We encourage them to face their perceived fears … to overcome it and discourage them from engaging in compulsions in response to these fears. Over time, they’ll become less reliant on using compulsions to feel better,” Wheaton says.

    Medication

    If a child’s symptoms are severe, medication may be prescribed. Selective serotonin reuptake inhibitors (SSRIs) are traditionally the first line of medical treatments. 

    They help to ease OCD symptoms by raising serotonin levels in the brain, which can help limit obsessive thoughts and mental compulsions. 

    If your child’s OCD is linked to a strep infection, antibiotics will be prescribed to treat the infection. If the infection is treated properly, there’ll also be an improvement in OCD symptoms.

    The bottom line   

    OCD in children is rarer than in adolescents or adults, and it can sometimes be difficult to diagnose. But if you think your child has OCD, it’s important to see a medical professional for a diagnosis and proper treatment.

    “Parents need to see this as a real illness. But one that there are effective treatments for. They also need to get connected with a proper treatment provider, because it can be overwhelming for parents to take on OCD by themselves,” Wheaton says. 

    If you’re a parent with a child who has OCD, or you think they have OCD, the International OCD Foundation (IOCDF) offers services that can help you and your loved ones get the proper treatment, Wheaton says.

    What you need to know about intrusive thoughts and OCD

    Having ‘intrusive thoughts’ is a catch-all term for any thoughts that are unwelcome: graphic sexual or violent thoughts, thoughts of doing, saying or seeing something taboo, or generally unwelcome mental images or messages.

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    Intrusive thoughts in themselves are not a condition or symptom of anything. One 2014 study suggested that 94% of people thought they had experienced them. They’re unpleasant and uninvited, but in almost all cases they come and go without consequence.

    But in people with obsessive-compulsive disorder, the experience is starkly different. OCD is a chronic mental health condition, and (though perhaps underdiagnosed) it’s a lot less common than intrusive thoughts. Current estimates are that 1.2% of the population is affected by OCD over a 12-month period (not including their loved ones who might be impacted by supporting them). That means that at any one time, more than 750,000 people in the UK are living with OCD.

    Living with OCD and intrusive thoughts

    An OCD diagnosis comes from a combination of two symptoms: obsessive thoughts and compulsive behaviour. When a person with OCD experiences intrusive thoughts, they then have an urge to do something to cope with how the thoughts make them feel. The urge might be to do a verbal or physical task (asking for reassurance, or hand-washing) but it might also be going through a thought process (exhaustively thinking over an event).

    David Adam’s memoir of his experience of OCD, The Man Who Couldn’t Stop, became a Sunday Times bestseller after its publication in 2016. 

    In it, David tells the story of how he developed OCD. In the summer after his first year of university, he began to have intrusive thoughts about touching objects that might have come into contact with HIV-laden blood. After these thoughts, David began checking and re-checking objects he’d touched as a way of trying to reassure himself. (Note: HIV cannot be transmitted simply by touching a surface. In the UK most infections are caused by having unprotected sex with an HIV-positive person who is not using effective treatment.)

    Initially, David says, therapy he received for OCD was not much help. But after he went back into treatment, he received cognitive behavioural therapy (CBT) and was prescribed medication to treat the OCD.

    “What they taught me in CBT is that intrusive thoughts are really common, and almost everybody has them,” David says. “But the way you respond to these thoughts and process them is where OCD pathology lies.”

    What causes OCD?

    OCD usually appears in late adolescence (common for men) or early 20s (common for women), but can appear in children. OCD UK estimates that a quarter of cases start by the age of 14. Onset after the age of 35 years is unusual, but does occur – for example, in postnatal OCD

    Unlike diseases like type 2 diabetes or PTSD, OCD can’t be said to have a particular cause. Risk of developing OCD is influenced by both a genetic predisposition to anxiety, and environmental factors like stress or trauma, but isn’t directly caused by either factor.

    For David, OCD appeared out of nowhere.

    “It was the summer after my first year of university and I was really happy,” he recalls. “I was having a really good time and looking forward to getting back to university. I can’t place an incident, stressor or traumatic experience which was triggered at that time.

    “As I say in the book, that first intrusive thought was so out of place, it was as if a snowflake had fallen from the sky in the middle of summer. It was so weird and out of place.”

    Compulsive behaviour

    Compulsive behaviour in OCD can be so subtle as to appear invisible, even to people who have it. Compulsions might be physical (cleaning or touching) but they might also be mental (private thought, tasks or rituals). Compulsions might also include ‘checking’ or asking for reassurance.

    Compulsions feel ‘addictive’ because they temporarily relieve anxiety. But however well they appear to work at the time, compulsions do not resolve anxiety. People might seek help for OCD when the urge to check or do a certain action gets in the way of their work or school work, or worries their friends or family. NICE advises that people with OCD receive therapeutic interventions, and some patients also find that medication such as antidepressants also decreases symptoms.

    A couple of years ago, there was a debate around whether a type of OCD exists that is characterised as ‘purely’ an obsession with intrusive thoughts, without compulsions – commonly referred to as ‘pure O’.

    But clinicians are sceptical, and OCD-UK has published a position statement clarifying that the charity doesn’t consider it to be a form of OCD. In its ‘mythbuster‘ OCD-UK clarifies that some compulsive behaviours in OCD might be more subtle than others – for example, mental rituals, checking/reassurance, or avoiding people or places. Nevertheless, ‘invisible’ compulsions still dog the person’s intrusive thoughts.

    Living with intrusive thoughts

    David still considers himself to have OCD, but his symptoms are well managed. He lives in London and works as a science writer and editor for national newspapers.

    “When people ask me how I feel now, I always say that I have good days and bad days, and that’s a lot better than only having bad days,” he explains. “I still have weird thoughts about HIV and AIDS, but I am better at resisting the compulsion ‘loop’, which is what drives the OCD.”

    Dr Lynne Drummond is a psychiatrist with 35 years’ experience, and worked most recently as the lead clinician for the National OCD/BDD Service for the UK.

    In Dr Drummond’s book, Obsessive Compulsive Disorders, she explains that when people with OCD tell friends and family what they’re concerned about, their worries might seem overblown or hard to understand. At first, people might be tempted to use humour or play down the worries – missing the emotional reality that the person with OCD is facing.

    “These thoughts are profoundly disturbing to the individual with OCD,” Drummond writes, and are therefore extremely serious in their mind. Although they may realise their thoughts are either irrational or exaggerated, the fear accompanying these thoughts is very real and they are unable to ‘snap out of it’.”

    She urges people to seek further help for symptoms that don’t change after CBT or counselling.

    “Both I and my colleagues in psychiatry notice that we rarely see people with OCD, despite it affecting 1-3% of the population,” she says. “I think people go to Improving Access to Psychological Therapies (IAPT) services, and if they don’t get better after that they tend to believe there’s nothing else for them.

    “OCD can be very serious. It can impact on the whole family and ruin lives. But there are effective treatments out there.”

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    COVID-19 pandemic taking toll on mental health, Alberta survey says

    An online survey of Albertans who reached out for help over COVID-19 suggests the pandemic is taking a toll on mental health, with increased signs of obsessive behaviour, stress and depression.

    Vincent Agyapong, a professor of psychiatry at the University of Alberta, has just published results of a survey he took of people who subscribed to Text-4-Hope, a government service that provides a daily reassuring text message.

    He found abut 60 per cent of respondents had become worried about dirt, germs and viruses since the COVID outbreak.

    About 54 per cent had begun washing their hands “very often or in a special way,” which could be considered a symptom of obsessive compulsive disorder.

    Nearly 50 per cent were considered likely candidates for anxiety disorders, and more than 40 per cent were likely clinically depressed.

    And almost 85 per cent of respondents reported moderate to high stress.

    Agyapong cautions the sample isn’t representative and that some level of stress and unusual behaviour is understandable in the current situation.

    But he says his findings suggest the pandemic is affecting the public’s mental health.

    COVID-19 causing stress, depression and obsessive behaviour: Alberta survey

    EDMONTON — An online survey of Albertans who have reached out for help during the COVID-19 crisis suggests the pandemic is taking a toll on mental health, with increased signs of obsessive behaviour, stress and depression.

    “We did not expect people to be experiencing this level of anxiety, depression or stress,” said Vincent Agyapong, a professor of psychiatry at the University of Alberta and co-author of a newly published paper.

    Agyapong’s research has focused on the lingering mental-health effects of public traumas such as the Fort McMurray wildfire. He and his colleagues have been asked by provincial and private agencies to help design a public mental-health response to COVID-19.

    The paper, published in Environmental Research and Public Health, is an attempt to assess those needs.

    “We thought it would be useful to collect baseline data,” Agyapong said.

    In late March, the researchers contacted about 33,000 Albertans who subscribed to Text4Hope — a government initiative that sends out a daily supportive text message written by mental health professionals. They asked subscribers to complete a survey that contained standard measures of anxiety, depression and obsessive behaviour.

    About 6,000 people responded.

    The survey, funded by a group of Alberta charitable health foundations, found that about 60 per cent of respondents had become worried about dirt, germs and viruses since the COVID-19 outbreak. About 54 per cent had begun washing their hands “very often or in a special way” that could be considered a symptom of obsessive compulsive disorder.

    Nearly 50 per cent were considered probable candidates for anxiety disorders and more than 40 per cent were likely to be clinically depressed. Almost 85 per cent of respondents reported moderate to high stress.

    The results were consistent between men and women. Symptoms and anxiety levels tended to increase with age and education levels.

    Agyapong is cautious about the results. The survey sample isn’t representative of the Alberta population. And some level of stress and unusual behaviour is understandable when people are losing their jobs and seeing society shut down around them.

    But something is going on, he said.

    “It’s not diagnostic, but it is indicative,” said Agyapong. “It doesn’t necessarily mean (the results) aren’t representative of what’s going on.”

    Although research suggests about one-quarter of the general population will show some obsessive compulsive symptoms at some point in life, the incidence of the actual condition is only about two per cent — much lower than the figure in Agyapong’s survey.

    Agyapong points out his findings are consistent with studies done in other countries such as China.

    He said simple measures can help — even the daily reassurance provided by Text4Hope. Preliminary results suggest that in six weeks, anxiety levels in subscribers fell by 20 per cent.

    “It may not work for everybody, but if you can get it to work for even half of those who are struggling, then it means that you don’t need more (expensive) resources at a population level,” Agyapong said.

    This report by The Canadian Press was first published Sept. 26, 2020

    Bob Weber, The Canadian Press

    Coronavirus

    COVID-19 causing stress, depression and obsessive behaviour: survey

    EDMONTON —
    An online survey of Albertans who have reached out for help during the COVID-19 crisis suggests the pandemic is taking a toll on mental health, with increased signs of obsessive behaviour, stress and depression.

    “We did not expect people to be experiencing this level of anxiety, depression or stress,” said Vincent Agyapong, a professor of psychiatry at the University of Alberta and co-author of a newly published paper.

    Agyapong’s research has focused on the lingering mental-health effects of public traumas such as the Fort McMurray wildfire. He and his colleagues have been asked by provincial and private agencies to help design a public mental-health response to COVID-19.

    The paper, published in Environmental Research and Public Health, is an attempt to assess those needs.

    “We thought it would be useful to collect baseline data,” Agyapong said.

    In late March, the researchers contacted about 33,000 Albertans who subscribed to Text4Hope — a government initiative that sends out a daily supportive text message written by mental health professionals. They asked subscribers to complete a survey that contained standard measures of anxiety, depression and obsessive behaviour.

    About 6,000 people responded.

    The survey, funded by a group of Alberta charitable health foundations, found that about 60 per cent of respondents had become worried about dirt, germs and viruses since the COVID-19 outbreak. About 54 per cent had begun washing their hands “very often or in a special way” that could be considered a symptom of obsessive compulsive disorder.

    Nearly 50 per cent were considered probable candidates for anxiety disorders and more than 40 per cent were likely to be clinically depressed. Almost 85 per cent of respondents reported moderate to high stress.

    The results were consistent between men and women. Symptoms and anxiety levels tended to increase with age and education levels.

    Agyapong is cautious about the results. The survey sample isn’t representative of the Alberta population. And some level of stress and unusual behaviour is understandable when people are losing their jobs and seeing society shut down around them.

    But something is going on, he said.

    “It’s not diagnostic, but it is indicative,” said Agyapong. “It doesn’t necessarily mean (the results) aren’t representative of what’s going on.”

    Although research suggests about one-quarter of the general population will show some obsessive compulsive symptoms at some point in life, the incidence of the actual condition is only about two per cent — much lower than the figure in Agyapong’s survey.

    Agyapong points out his findings are consistent with studies done in other countries such as China.

    He said simple measures can help — even the daily reassurance provided by Text4Hope. Preliminary results suggest that in six weeks, anxiety levels in subscribers fell by 20 per cent.

    “It may not work for everybody, but if you can get it to work for even half of those who are struggling, then it means that you don’t need more (expensive) resources at a population level,” Agyapong said.

    This report by The Canadian Press was first published Sept. 26, 2020

    OCD Patients With Increased Brain Activity May Respond Better to CBT

    In a recent study published in the American Journal of Psychiatry online, researchers found an association between brain activation and response to cognitive-behavioral therapy (CBT) in adolescents with obsessive compulsive disorder (OCD). The findings may help clinicians personalize OCD treatment.

    Psychological treatment for OCD typically includes CBT. However, about 30 to 50% of patients do not respond to treatment. To help find out why, study authors wanted to explore the neural mechanisms behind OCD and what happens in the brain during CBT as compared to a control therapy (stress management).

    Of the 87 patients included, 42 received CBT and 45 received stress management therapy (SMT). Researchers focused on two age ranges: 13-17 and 25-45. Participants had to have early-onset OCD (15 years) and moderate or greater symptoms at baseline.

    Patients received either 12 weeks of either CBT or SMT. For the task used to activate brain activity, participants pressed one of two buttons to identify a target letter (S, K, H, and C) surrounded by four “flankers” that either mapped the same button response or the opposite response. Cues indicated how much money participants stood to lose for a right or wrong response. Participants completed four rounds of this test, each consisting of 48 trials. Performance measures included reaction times and errors. An fMRI was used to evaluate brain activity.


    Continue Reading

    Both the CBT and SMT groups showed improvement over the 12-week period. The CBT group had a steeper reduction in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores compared to the SMT group (β=3.21, t=4.52, P=.001, 95% CI=4.61, 1.81)

    Pretreatment brain activation within the right temporal lobe (CBT group: β=3.96, P=.003; SMT group: β=5.09, P.001), the rACC (CBT group: β=2.68, P=.004; SMT group: β=2.94, P=0.01), and the left premotor cortex (CBT group: β=2.91, P=.002; SMT group: β=3.61, P=.008) was associated with better treatment response in CBT participants, while less activation was associated with better treatment response in the same regions in SMT participants.

    Significant voxel-activation was found within a large cluster incorporating the left and right ventromedial prefrontal cortex, orbitofrontal cortex, amygdala, inferior frontal gyrus, and dorsolateral prefrontal cortex. More pretreatment activation in this region was associated with better treatment response within the CBT group β=23.91, P.001) but a worse treatment response in the SMT group (β=5.62, P.0.001). a similar pattern was found in the left temporal lobe.

    Both age groups showed similar symptom reduction.

    There were some limitations with this study. It was not possible for researchers to maintain blinded status. The researchers excluded participants with comorbidities — results may not carry over to these patients. The sample size was also moderate.

    “The present study advances the field by demonstrating that associations between brain activation and treatment response were treatment specific to CBT relative to a control psychotherapy and, moreover, that these associations were stable from adolescence to mature adulthood,” the researchers concluded.

    Reference

    Norman LJ, Mannella KA, Yang H, et al. Treatment-specific associations between brain activation and symptom reduction in OCD following CBT: A randomized fMRI trial [published online August 28, 2020]. Am J Psychiatry. 2020;appiajp202019080886. doi: 10.1176/appi.ajp.2020.19080886

    5 major types of OCD and their key symptoms

    People with this type of OCD have an obsessive fear of certain objects lacking symmetry. These people spend a lot of time in activities like folding clothes or stacking them. Even if one cloth from the stack is lurking out, they will do it all over again. If they get their one hand wet, they will intentionally wet their other hand too.

    Some common symptoms are

    -Checking the lock multiple times

    -Counting the steps when they walk

    -Counting the tiles on the wall

    -Perfectly arranging things with the same between each one of them.

    INSIGHT BEHAVIORAL HEALTH CENTERS ANNOUNCES NAME CHANGE TO PATHLIGHT MOOD & ANXIETY CENTER, RENEWS COMMITMENT TO PROVIDING EXPERT, SPECIALIZED TREATMENT OF MOOD, ANXIETY AND TRAUMA-RELATED DISORDERS

    Denver, Sept. 22, 2020 (GLOBE NEWSWIRE) — Across the United States, communities are experiencing an undeniable need for more comprehensive, specialized mental health services. Americans struggling with mood, anxiety and trauma-related disorders need intensive, personalized treatment to build their resilience and learn practical tools that empower them to thrive long term. To be sure their name better describes the company’s promise to answer that need, Insight Behavioral Health is now Pathlight Mood Anxiety Center. Under the leadership and guidance of nationally recognized experts in behavioral health, Pathlight illuminates each patient’s unique journey to lasting wellness by providing evidenced-based and state-of-the-science treatment; intensive family programs, including support, education and family therapy; and the ability to meet the needs of patients with complex medical and psychiatric conditions.

    With treatment center locations in six states across the country and virtual telebehavioral health options for nationwide access, Pathlight offers comprehensive treatment for anxiety disorders such as generalized anxiety disorder and obsessive compulsive disorder; mood disorders such as major depressive disorder; and trauma-related conditions including post-traumatic stress disorder. Pathlight bridges the gap between acute psychiatric treatment and weekly outpatient therapy by offering higher levels of care: Residential, Partial Hospitalization (PHP) and Intensive Outpatient (IOP) treatment. An all too common scenario for patients suffering from mental illness is having an emergency psychiatric event that brings them to the ER, followed by a short stay in an inpatient psychiatric stabilization setting, then being discharged back to outpatient therapy visits only to repeat the cycle again in the future. Pathlight interrupts that cycle of crisis care by providing evidence-based, individualized treatment that supports the patient and their family in building the skills and tools they need to make lasting change for the better.

    “At Pathlight, we often work with patients who weren’t able to get the help and support they needed elsewhere,” said Anne Marie O’Melia, MD, MS, FAAP, Chief Medical and Clinical Officer at Pathlight. “We embrace innovative, evidence-based treatment modalities that aim to educate and empower patients as well as their support systems to set them up for lasting recovery. As September is National Suicide Prevention Month, it’s important to spread the message that no one should have to go it alone when it comes to their mental health. Our individualized programs help create the best outcomes when both patients and their closest supporters have tools and strategies for a path forward.”

    Insight was founded in Chicago in 2006 by Susan McClanahan, PhD. After partnering with Eating Recovery Center in 2011, it expanded to treat patients in Texas, Colorado, Ohio, Maryland and Washington state. Now as Pathlight, the centers continue to be led by national thought leaders in behavioral health. Under the leadership of Dr. O’Melia, these experts include Charles Brady, PhD, who specializes in the treatment of anxiety disorders and obsessive-compulsive disorder in particular; Ellen Astrachan-Fletcher, PhD, a senior clinician and national thought leader in Radically Open Dialectic Behavior Therapy; and Elizabeth Easton, PsyD, an expert in Emotion-Focused Family Therapy.

    Residential care offers 24-hour support seven days a week. The PHP level of care offers comprehensive services eight hours per day during the week and six hours per day on weekends. The IOP level of care includes three hours of programming per day, three to six days a week depending on the patient’s needs. Conveniently, all IOP patients are currently receiving their care virtually due to the pandemic.

    “Delivery of therapy, education and skill development is far more efficient in higher levels of care,” said Charles Brady, PhD. “The same behavior change achieved in just eight weeks of intensive, multidisciplinary treatment might take many months or years to deliver across weekly outpatient appointments. Given the mental health challenges facing all of us today – specifically a startling increase in suicide planning, attempts and deaths – families can’t afford to wait and hope for the best.”

    A survey conducted by the Centers for Disease Control and Prevention in August found that more than four in 10 Americans are struggling with mental health issues resulting from the COVID-19 pandemic. About a third of respondents said they were experiencing anxiety or depression symptoms, and 11 percent said they had seriously considered suicide in the prior 30 days.

    “I have found this program essential to meet the needs of our patients in the community dealing with mental health issues,” said Jacqueline Rhew, LCPC, Co-Founder, Center for Emotional Wellness of the Northwest Suburbs outside of Chicago. “I can say with confidence that Pathlight is a leader in the behavioral health field, not only in our community but nationwide. Our patients who have received treatment in their programs have thrived as a result. They have gained skills to manage their symptoms and return to a healthy level of functioning.”

    About Pathlight Mood Anxiety Center 

    Pathlight Mood Anxiety Center (Pathlight) is part of a leading national mental health care system dedicated to the treatment of primary mood, anxiety and trauma-related disorders. Pathlight specializes in treatment for mood and anxiety disorders such as generalized anxiety disorder, obsessive compulsive disorder, panic disorder, depression and mania, trauma-related disorders including post-traumatic stress disorder, as well as co-occurring substance use disorder. Pathlight provides evidence-based, innovative treatment programs tailored to patients of all ages, gender expressions and ethnicities. Working with patients and their families, Pathlight’s multi-disciplinary treatment programs are designed to help illuminate their unique paths forward and provide a foundation for resilience and long-lasting mental wellness. Pathlight offers Residential, Partial Hospitalization (PHP) and Intensive Outpatient (IOP) levels of care in centers across the country as well as Virtual PHP and IOP (video) telebehavioral health services. For more information, please visit pathlightbh.com

     

    Meg Mulcahy
    Pathlight Mood  Anxiety Center
    3037318913
    megan.mulcahy@ERCPathlight.com
    

    OCD: Dealing with compulsions during the coronavirus pandemic

    About one in 50 people suffer from obsessive-compulsive disorder, or OCD, repeatedly washing their hands or worrying that they’ve touched something or someone they shouldn’t have. It’s behavior that may be exacerbated by the coronavirus pandemic. Now, clinical trials are looking at new treatments and therapies to bring these deep-seated compulsions under control.

    Obsessively checking things, hoarding items, extreme fear of germs … symptoms of OCD. OCD sufferers want to stop, but find it difficult, if not impossible to do so.

    “For many folks, that level of distress is so intense that it motivates them to engage in these onerous behaviors, whether it be more ritualistic or avoidance to prevent that feared outcome from taking place. The problem with any sort of ritual, is that it’s temporary. It just doesn’t tend to stick for a while,” explained Eric Storch, PhD of the Baylor College of Medicine

    OCD therapies currently under study or clinical trials include deep brain stimulation to implant electrodes, anti-depressants known as serotonin reuptake inhibitors, and glutamate in the brain, which is a neurotransmitter that sends signals to other cells.

    “The best treatment for anxiety disorders are therapies like cognitive behavioral therapy or desensitization therapy,” added psychiatrist Harry A. Croft, MD.

    And, although COVID-19 has impacted some individuals with OCD, mental health experts say it’s useful for others to understand what it’s like to live under that cloak of anxiety … not just during a pandemic, but all of the time.

    The Centers for Disease Control has recommended that healthcare providers continue to serve patients with OCD during the pandemic by implementing telehealth appointments and services where possible. More COVID-19 resources are available on the website for the International OCD foundation here.

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