Trent Consultants News ANXIETY DISORDERS LINKED TO PHYSICAL CONDITIONS

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Their findings,published today in the October 23 issue of Archives of Internal Medicine,suggest that this co-occurrence of disorders may significantly increase therisk of disability and negatively affect quality of life. Although depression has long beenlinked to physical illness, evidence supporting an association between anxietydisorders and physical health problems is more recent. Anxiety disordersinclude panic disorder, agoraphobia (fear of being in a situation where panicor anxiety may occur and escape from the situation might be difficult), socialphobia and obsessive-compulsive disorder. Studies have found that those withphobic (fearful) anxiety may be more likely to experience sudden cardiac death,and rates of anxiety disorders are higher than expected in patients with thyroiddisease, cancer, hypertension and several other conditions. Dr. Jitender Sareen and hiscolleagues in the department of psychiatry studied the association betweenanxiety disorders and physical conditions in 4,181 adults who were part of theGerman Health Survey (GHS) conducted between 1997 and 1999. The survey assessedwhether participants had any physical illnesses through a questionnaire askingabout 44 particular conditions, a medical interview conducted by a primary carephysician, blood pressure measurements and blood and urine samples. Psychiatricinterviews were conducted by a psychologist or physician, who used criteriafrom the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition(DSM-IV) to detect anxiety disorders. A quality of life survey—which measuredfactors such as physical functioning, pain and general health—was alsoadministered, and to determine disability levels participants reported how manydays of the past 30 they were unable to perform their usual daily activities. Among the 1,913 men and 2,268women in the study, 429 (8.4 per cent) had an anxiety disorder within the pastmonth and 2,610 (60.8 per cent) had a physical condition within the past month.Having an anxiety disorder was associated with having any type of physicalcondition, and specifically with respiratory diseases, gastrointestinaldiseases, arthritis, allergies, thyroid diseases and migraine headaches. Mostindividuals with both an anxiety disorder and physical illness developed theanxiety disorder first, and tended to have a poorer quality of life than thosewith anxiety disorders or physical conditions alone. Those who had both typesof disorders also were more likely to have one or more days of disability thanthose with physical illnesses alone. "The mechanisms ofassociation between anxiety disorders and physical conditions remain unknown,although several possibilities should be considered," Sareen notes. Forexample, the presence of an illness may cause worry and anxiety that eventuallybecomes serious enough to qualify as an anxiety disorder, the presence of ananxiety disorders could trigger biological processes that contribute to illnessor a third condition, such as a substance abuse disorder, could be linked toboth. Sareen explains: "Thesefindings extend previous work in clinical and community samples that noted anassociation between anxiety disorders and physical illnesses but alsodemonstrate the unique association of this comorbidity with poor quality oflife and disability. Although there have been increased efforts to recognizeand treat depression in the medically ill, our findings underscore the need tocreate similar programs to recognize and treat anxiety disorders in themedically ill." This research was supported by aManitoba Health Research Council Award, by a U.S. National Institutes of Healthgrant and a Canada Research Chair award. For more information, pleasecontact: Dr. Jitender Sareen, psychiatry, 204-787-7078. For more information, contact:Chris Rutkowski, Media Relations Coordinator, Public Affairs rutkows@ms.umanitoba.ca , Phone: (204) 474-9514, Fax: (204) 474-7631   Trent Consultants Psychology Clinic. Dedicatedto the study, diagnosis, and treatment of mental, emotional and behavioraldisorders. Trent Consultants has a variety of programs for parents who want togive their children a headstart in life. Trent Consultants website www.trentconsultants.org Email: childcare@trentconsultants.org

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