Search PubMed⌕ Search

Biomedical subjects

Renee D Goodwin

Publications and source records attributed to Renee D Goodwin.

At least 55 records · Page 3Linked to original sources
PubMed2003

Suicide attempts in the United States: the role of physical illness.

The study aimed to determine the relationship between physical illness, mental disorder, and the likelihood of suicide attempt among adults aged 15-54 in the United States. Data were drawn from the National Comorbidity Survey (N=8,098), a national probability sample of adults in the United States. Multivariate logistic regression analyses were used to determine the relationship between self-reported physical illness and the likelihood of suicide attempt. Lung disease (OR=1.8 (1.1, 2.7)), ulcer (OR=2.1 (1.3, 3.4)), and AIDS (OR=44.1 (10.5, 185.6)) were each associated with a significantly increased likelihood of suicide attempt, independent of the effects of mental disorders. Consistent with previous studies, the number of physical illnesses was linearly related to an increased odds of suicide attempt (OR=1.3 (1.2, 1.5)). Possible mechanisms for these associations are discussed. These findings call for the inclusion of a range of physical health problems, especially chronic illnesses, in future research on suicide attempts in the population.

Adolescent↗
PubMed2003

The prevalence of panic attacks in the United States: 1980 to 1995.

OBJECTIVE: The purpose of this study was to determine the difference in the prevalence of panic attacks among adults in the US population between 1980 and 1995. METHODS: Data were drawn from the Epidemiologic Catchment Area Program study (1980) and the Midlife Development in the United States Survey (1996), which are epidemiologic survey studies with samples representative of the US adult population. A chi-square test was used to determine the difference between the prevalence of panic attack in 1980 and 1995. RESULTS: There was a statistically significant increase in the prevalence of panic attacks among adults 25 to 74 years of age from 1980 to 1995 in the United States (12.7% versus 5.3%; chi(2)=135.2, df=1, P<.0001). CONCLUSIONS: These data suggest that there may have been an increase in the prevalence of panic attacks among adults 25 to 74 years of age in the general US population over the past two decades.

Adult↗
PubMed2003

Asthma and the risk of panic attacks among adults in the community.

OBJECTIVE: The study was designed to determine the association between self-reported asthma and the risk, persistence and severity of panic attacks among adults in the community. METHOD: Data were drawn from waves 1 and 2 of the Baltimore site of the Epidemiologic Catchment Area (ECA) Study (N = 2768), which included self-report information on asthma, treatment for asthma and panic attacks in 1981 and 1982. Multiple logistic regression analyses were used to calculate odds ratios comparing the prevalence of panic attack at baseline and follow-up by asthma status at baseline. Linear regression analyses were used to examine the relationship between self-reported asthma status and the number of panic symptoms during a panic attack. RESULTS: Self-report asthma was associated with significantly increased likelihood of having panic attacks at baseline (1981) (12.1% v. 7.3%, P < 0.05) and of having panic attacks at both baseline and follow-up (15.9% v. 7.3%, P < 0.05), compared to those without asthma at baseline. Adults receiving treatment for asthma at baseline had an increased risk of incident panic attacks at follow-up (OR = 2.65 (1.11, 6.34)) and at baseline and follow-up (OR = 5.88 (2.21, 15.62)), though untreated asthma did not appear to increase risk of incident panic at follow-up. Similarly, the risk of panic at follow-up was not increased among those with asthma at baseline who did not report asthma at follow-up, compared with those without asthma at baseline. Treated asthma was associated with having more panic symptoms during panic attacks, compared to those without asthma (P < 0.001). CONCLUSION: These findings are consistent with and extend previous results suggesting that self-reported asthma is associated with an increased risk of panic attacks among adults in the general population, and that there is a consistent relation between severity and persistence of asthma and panic attacks. The lack of association between remitted asthma and panic attack may reveal a need for further research to determine whether asthma may be a causal risk factor for panic attacks, or whether a third factor (genetic or environmental) may be associated with increased risk of the cooccurrence of asthma and panic attacks. Replication of these results using alternative methodology with corroborative data on asthma and panic attacks is needed next.

Adult↗
PubMed2003

Asthma and panic attacks among youth in the community.

OBJECTIVE: To determine the association between asthma and panic attacks among youth in the community. METHOD: Data were drawn from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study (n = 1285), a community-based sample of youth age 9-17 in the United States. Multivariate logistic regression analyses were used to determine the association between asthma and both panic attacks and panic disorder, adjusting for differences in sociodemographic characteristics and comorbid mental disorders. RESULTS: Asthma was associated with a significantly increased likelihood of panic attacks [OR= 1.5 (1.01, 2.2)]. This effect was specific and persisted after adjusting for differences in demographics and psychiatric comorbidity. Severe asthma was associated with an even greater likelihood of panic attacks [OR = 2.2 (1.3, 4.0)]. There was a dose-response relationship between number of panic symptoms during a panic attack and the likelihood of asthma [OR = 1.2 (1.1, 1.3)] and severe asthma [OR = 1.3 (1.1, 1.4)], which remained significant after adjusting for differences in sociodemographic characteristics and comorbid mental disorders. CONCLUSIONS: These data suggest a significant association between asthma, severe asthma, and panic attacks among youth in the community. Replication of these findings is needed, as are future studies that investigate the nature of these links. In light of the increasing prevalence of asthma and hospitalization for asthma among youth in the United States and worldwide, these associations may be worthwhile to consider in future investigations.

Adolescent↗
PubMed2003

Asthma and anxiety disorders.

In this chapter we have reviewed recent findings on the co-occurrence of asthma and anxiety disorders in youth and adults in clinical and community-based samples. We have not included a review of research on linkages between respiratory functioning and anxiety symptoms, or the linkages between asthma severity and anxiety symptoms, though several recent reviews of these areas are available [see 5, 12]. If possible, future research is needed to disentangle the relationship between asthma and anxiety disorders compared with that with other medical conditions. This may involve using samples that are unselected for either disorder of interest, including population samples where a range of severity is present. Studies that document a relationship between asthma and an increased use of emergency room services for asthma do not indicate that there is a link between asthma and anxiety disorders, but may simply reflect a relationship between mental disorders, which is well-documented, or an association being driven by a common third factor, such as low socioeconomic status, which is linked to both. There are also numerous studies that have investigated the relationship between anxiety symptoms and anxiety disorders and severity, use of treatment, and other clinical correlates of asthma and anxiety, especially panic [see 5 for a review], but a review of this literature is beyond the scope of this chapter. Results of studies to date suggest a link between asthma and anxiety disorders among both youth and adults, and in clinical and community-based samples. Still, many questions about this association remain unanswered. Future work is needed to determine the strength and specificity of the link between asthma and anxiety disorders. The temporal relationship between the onset of asthma and anxiety disorders, and relatedly, the mechanism of this association is also poorly understood. Furthermore, there is mounting evidence of a potential familial relationship between asthma and anxiety disorders, which warrants further investigation, and if replicated it will be important to uncover the mechanism of this association. Another unexplored area is common environmental factors, as emerging evidence suggests that there may be shared risk factors for both asthma and anxiety disorders in youth (e.g., urban residence, parental smoking), and future investigations into this link seem promising. In addition, studies that investigate the linkages between use of specific medications for asthma and the onset of anxiety symptoms and anxiety disorders are needed, both looking at the short- and long-term effects. As there is increasing data that use of specific medications are associated with brain changes, mood and psychotic disorders [41], and there is also emerging evidence of a link between asthma and respiratory disease and suicidal ideation and suicide attempts [42], further investigation into this area is important. Work is currently underway aimed at improving our understanding of the etiology and modifiable risk factors for onset and persistence of the co-occurrence of asthma and anxiety disorders, and the nature of the relationship between the two has the potential to lead to significant improvements in the understanding of etiology and effectiveness of treatment for both, as well as primary and secondary prevention efforts, among youth and adults in the community. The public health significance of both asthma and anxiety disorders, especially with a substantial increase in asthma, and possibly anxiety disorders [13], over the past two decades, highlights the potential import of work aimed at understanding these linkages.

Adolescent↗
PubMed2003

Feelings of inferiority and suicide ideation and suicide attempt among youth.

AIM: To determine the association between feelings of inferiority and suicidal ideation and suicide attempt among youth in the United States. METHODS: Data were drawn from the National Comorbidity Survey carried out among a representative sample of the 15-54 year old population (n=8,098) in the United States. The subsample analyzed in this study included 1,456 respondents aged 15-19. Multivariate logistic regression analyses were used to determine the relationship between feelings of inferiority and the likelihood of suicidal ideation and suicide attempt among youth them. RESULTS: Among the youth, 4.2% described themselves as having feelings of inferiority. Feelings of inferiority were associated with a significantly increased odds of suicidal ideation (odds ratio (OR)=3.2; 95% confidence interval (95%CI)=1.8-5.7) and suicide attempt (OR=2.2; 95%CI=1.0-4.8), which persisted after adjusting for differences in socio-demographic characteristics and comorbid mental disorders among youth in the community. There was evidence of interaction between feelings of inferiority and major depression in the likelihood of suicide attempt. CONCLUSIONS: This preliminary evidence suggests that feelings of inferiority are associated with a significantly increased likelihood of suicidal thoughts and suicidal behavior among youth in the community. Intervention and prevention strategies aimed at identifying and intervening with youth at risk may benefit from the assessment of feelings of inferiority.

Adolescent↗
PubMed2002

The early-onset fearful panic attack as a predictor of severe psychopathology.

The objective of this study was to replicate previous findings indicating that early-onset panic attack (< or =20 years) with fear represents a possible prodrome of early-onset severe psychopathology. Data were drawn from the Epidemiologic Catchment Area Survey (ECA) (n=20 291), a household sample of adults aged 18 and older drawn from five cities in the United States. Multivariate logistic regression analyses were used to differentiate those with early-onset panic attacks with fear from those with other panic attacks (early-onset without fear, late-onset without fear, late-onset with fear) with regard to psychiatric comorbidity, age at onset of comorbid mental disorders, and suicidal ideation and suicide attempts. Results of statistical analyses revealed that early-onset fearful panic attack (n=368) was associated with increased likelihood of major affective and substance use disorders, significantly earlier onset of comorbid mental disorders, higher rates of suicidal ideation and suicide attempt, and higher rates of antisocial personality disorder compared with those with other subtypes of panic attacks. Multiple logistic regression analyses showed that early-onset fearful panic was independently associated with increased odds of major depression [OR=3.0 (2.6, 3.5)], bipolar disorder [OR=7.9 (5.7, 10.8)], antisocial personality disorder [OR=1.5 (1.3, 1.7)], agoraphobia [OR=1.2 (1.1, 1.4)], simple phobia [OR=1.6 (1.4, 1.8)], and alcohol dependence [OR=1.3 (1.2, 1.5)], compared with those with all other panic attacks. These findings are consistent with previous epidemiologic data and provide new evidence to suggest that early-onset fearful panic attack may be a marker of increased vulnerability to severe and persistent psychopathology and associated with high rates of suicidality.

Adolescent↗
PubMed2002

Generalizability and correlates of clinically derived panic subtypes in the population.

To determine the generalizability and population-based correlates of clinically derived panic attack subtypes among adults in the community. Data were drawn from the National Comorbidity Survey (n = 8,098), a representative sample of adults of age 18-54 years in the United States. Sociodemographic characteristics, psychiatric comorbidity, and panic symptomotology associated with three clinically derived panic subtypes (early-onset, agoraphobia, and dyspnea) were compared using two-way ANOVA and multivariate logistic regression analyses. Among those with panic attacks in the community, 51.2% had early-onset, 32.6% had agoraphobia, and 64.4% had dysthymia. Significant differences in sociodemographic characteristics, psychiatric comorbidity, and panic symptomotology emerged between the three groups. Early-onset panic was associated with significantly increased likelihood of bipolar disorder and substance dependence but was not distinguished from the other two subtypes by panic symptoms. Panic attack with agoraphobia was associated with significantly higher odds of several comorbid anxiety disorders, and panic with dyspnea was more common among married females with less education and high levels of comorbid alcohol and depressive disorders. These data suggest that clinically derived panic subtypes are generalizable and may be associated with several unique sociodemographic and psychiatric correlates in the general population. Observed differences between these subtypes may influence results from clinical samples.

Adolescent↗
PubMed2002

Social anxiety as a barrier to treatment for eating disorders.

BACKGROUND: The goal of this pilot investigation is to determine the relationship between social anxiety and treatment-seeking behavior for eating disorders in an outpatient psychiatric clinic. METHOD: Twenty-eight patients seeking treatment for anorexia or bulimia at an outpatient eating disorders clinic completed a battery of self-report measures on eating pathology, attachment style and functioning, and social anxiety at initial intake appointment. Levels of eating pathology and social anxiety at consult were compared with service utilization records on entry into treatment. RESULTS: Individuals who did not engage in treatment had significantly higher levels of social anxiety (F = 8.29, df = 1, p < .05) compared with those who did engage in treatment. There were no differences in demographic characteristics, diagnoses, or level of eating pathology at intake. CONCLUSIONS: Social anxiety may act as a barrier to effective help-seeking and utilization of mental health treatment among individuals with eating disorders. Replication of these findings in a larger sample and more in-depth study of the mechanism of the observed association between use of services and social anxiety may be useful in planning more effective outreach in the community to underserved populations in need of treatment for eating disorders.

Adult↗
PubMed2002

Mental health service utilization in the United States. The role of personality factors.

BACKGROUND: The aim of this study was to determine the relationship between personality factors and the use of mental health services (past 12 months) among adults in the community. METHOD: Data were drawn from the Midlife Development in the United States Survey (MIDUS), a representative sample of 3,032 adults aged 25-74 in the United States population. Analyses of variance and logistic regression analyses were used to determine the relationship between personality factors and mental health service utilization, in the presence and absence of mental disorders, during the past 12 months. RESULTS: Neuroticism [OR = 1.5 (1.2, 1.9)] was associated with significantly increased likelihood of mental health service utilization among adults in the community. Conscientiousness [OR = 0.7 (0.5, 0.9)] and extraversion [OR = 0.7 (0.5, 0.98)], in contrast, were associated with decreased likelihood of use of mental health services. Among adults with mental disorders, conscientiousness [OR = 0.5 (0.3, 0.8)] was associated with decreased odds of mental health service utilization. Neuroticism [OR = 1.8 (1.3, 2.4)] was associated with increased likelihood of service use among those who did not meet criteria for common mental disorders. CONCLUSIONS: These findings are the first to document a significant association between personality factors and the use of mental health services among adults in the general population. Our results highlight new ways in which personality may influence mental health in the community. This information may be useful in identifying those with unmet need for mental health treatment and developing more effective interventions for those at risk for common mental disorders. Replication of these findings is needed.

Adult↗
PubMed2002

Bipolar-panic comorbidity in the general population: prevalence and associated morbidity.

BACKGROUND: The goal of this study was to determine the prevalence, psychiatric comorbidity, panic symptomotology and physical morbidity associated with the co-occurrence of bipolar disorder and panic attacks in the general population. METHOD: Data were drawn from the National Comorbidity Survey, a community-based household sample (n=8098) representative of the US adult population aged 15-54. F tests were used to determine differences in sociodemographic characteristics, panic symptoms, physical and psychiatric morbidity between individuals with bipolar disorder with and without co-occurring panic attacks (lifetime). Multiple logistic regression analyses were used to identify sociodemographic and psychiatric correlates of the co-occurrence of bipolar disorder and panic attacks. RESULT: The co-occurrence of bipolar disorder and panic attacks was associated with earlier onset of panic attack [17.1 (8.7) years vs. 22.0 (10.3) years, F=8.3, df=1, 429, P=0.004] and significantly greater panic symptomotology (P<0.0001). Comorbid substance dependence [OR=5.8 (2.6, 13.0)], specific phobia [OR=3.3 (1.4, 7.6)], and GAD [OR=2.9 (1.3, 6.8)] were each independent correlates of the co-occurrence bipolar disorder and panic attacks. CONCLUSIONS: These findings are consistent with, and extend, results from clinical studies showing that panic attacks are not uncommon, and are associated with significantly elevated rates of comorbid psychopathology, among individuals with bipolar disorder in the general population. Future studies that examine the relationship between panic attacks and bipolar disorder using a longitudinal design may be helpful in improving our understanding of the mechanism of this association.

Adolescent↗
PubMed2002

Self-reported hay fever and panic attacks in the community.

OBJECTIVE: The objective of this study was to determine the relationship between self-reported hay fever and common mental disorders among adults in the general population. METHODS: Data were drawn from the Midlife Development in the United States Survey, a representative household survey of the adult US population (25 to 74 years old; n = 3,032). Multivariate logistic regression analyses were used to determine the relationship between self-reported hay fever and current major depression, panic attacks, generalized anxiety disorder, and alcohol/substance use disorders. RESULTS: Self-reported hay fever was associated with a significantly increased odds of panic attack (odds ratio = 1.8 [1.2, 2.6]), which persisted after adjusting for differences in sociodemographic characteristics and comorbid mental disorders. Self-reported hay fever was not associated with a significantly increased likelihood of major depression, generalized anxiety disorder, or alcohol/substance use disorders. CONCLUSIONS: Consistent with previous findings, these data show a relationship between self-reported hay fever and increased likelihood of panic attacks among adults in the general population. The mechanism of the observed association remains unknown. Future work that examines the relationship between hay fever and panic attacks, as well as other mental disorders using both self-report and objective measurement of allergic response in prospective, longitudinal, epidemiologic data may be useful in improving our understanding of this observed link.

Adult↗
PubMed2002

Anxiety disorders and the onset of depression among adults in the community.

OBJECTIVE: To determine the association between anxiety disorders, panic attack and the risk of major depression among adults in the community. METHOD: Data were drawn from the Epidemiologic Catchment Area Program survey waves 1 (N = 20291) and 2 (N = 15849). Multivariate logistic regression analyses were used to determine the risk of incident major depression at 12-month follow-up (wave 2) associated with each anxiety disorder and panic attacks assessed at wave 1, adjusting for differences in sociodemographic characteristics, and then controlling simultaneously for all anxiety disorders, and other psychiatric co-morbidity. RESULTS: Specific phobia (OR = 1.7 (1.6, 1.8)), agoraphobia (OR = 2.3 (2.2, 2.5)), obsessive-compulsive disorder (OR = 5.4 (5.0, 5.8)) and panic attack (OR = 1.9 (1.8, 2.1)) each made an independent contribution to the risk of major depression, which persisted after adjusting simultaneously for sociodemographic differences and other psychiatric co-morbidity. CONCLUSIONS: Each anxiety disorder and panic attacks appear to confer an independent risk for the onset of major depression within 12-months among adults in the community. Understanding the key role played by anxiety in depression onset is needed for prevention strategies.

Adult↗
PubMed2002

Sedative use and misuse in the United States.

OBJECTIVE: To determine the prevalence and correlates associated with sedative use and misuse in the general population. METHOD: Data were drawn from the National Comobidity Survey (n = 8098), a representative sample of adults in the community. Multivariate logistic regression analyses were used to identify correlates of sedative use, non-prescription use and self-perceived dependence. RESULTS: The life-time prevalence of self-perceived sedative dependence was 0.5%, 7.1% reported non-prescribed sedative use and 17.0% had been prescribed sedatives and denied misuse. Individuals who used sedatives without a prescription were more likely to be male (OR = 0.61 (0.44, 0.86)), have lower income (OR = 0.71 (0.54, 0.94)), more education (OR = 1.51 (1.17, 1.96)), major depression (OR = 1.47 (1.04, 2.08)), agoraphobia (OR = 1.59 (1.09, 2.32)), ASPD (OR = 5.29 (3.42, 8.20)) and suicide ideation (OR = 1.91 (1.23, 2.94)), compared with those who did not use sedatives. Individuals with self-perceived dependence on sedatives were older (OR = 1.05 (1.02, 1.08)), had less education (OR = 0.2 (0.1, 0.7)) and were more likely to have a parent who abused prescription medications (OR = 4.3 (1.03, 18.03)), compared with those without sedative dependence. CONCLUSIONS: Almost one in 10 adults report misuse of sedatives in their lifetime. Sedative use and misuse are associated with high levels of psychopathology and suicide risk, and show a specific association with parental abuse of prescription medications in the general population. Future work to understand more effectively the nature of these associations may ultimately lead to improved effectiveness of preventive interventions.

Adolescent↗
PubMed2002

Respiratory disease and panic attacks among adults in the United States.

OBJECTIVE: To determine the association between respiratory disease and panic attacks among adults in the US population. METHOD: Data were drawn from the Midlife Development in the United States Survey (n = 3,032), a representative sample of adults aged 25 to 74 years. Multivariate logistic regression analyses were used to determine the relationship between self-reported respiratory and other lung disease and panic attacks, major depression, generalized anxiety disorder, and alcohol/substance use disorders. RESULTS: After adjusting for demographic characteristics, comorbid mental disorders, and comorbid physical disorders, self-reported respiratory disease (ie, asthma, chronic bronchitis, or emphysema) was associated with a significantly increased likelihood of panic attacks (odds ratio, 1.7; confidence interval, 1.2 to 2.4). Other self-reported lung disease was also associated with a significantly increased odds of panic attacks (odds ratio, 2.3; confidence interval, 1.2 to 4.2), and having both self-reported respiratory disease and another lung disease was associated with increased likelihood of panic attacks (odds ratio, 4.1; confidence interval, 1.7, 9.9). These associations also persisted after adjusting for demographic characteristics, comorbid mental disorders, and physical comorbidity. CONCLUSION: These findings are consistent with and extend previous clinical and epidemiologic data by showing a specific association between self-reported respiratory disease and panic attacks among adults. Future studies that investigate the relationship between respiratory disease and panic attacks, and other mental disorders, using prospectively collected data on respiratory functioning, may help to improve our understanding of the mechanism of this association.

Adult↗