Biomedical subjects

Renee D Goodwin

Publications and source records attributed to Renee D Goodwin.

68 records · Page 4Linked to original sources

PubMedDate not supplied

Alcohol use disorders in relatives of patients with panic disorder.

OBJECTIVE: The aim of this study was to use data from a family study of anxiety disorders to examine the familial association between alcohol use disorders and panic disorder (PD), controlling for alcohol use disorders in the proband. METHOD: Data from a family study of anxiety disorders were used to compare rates of alcohol use disorders in the relatives of 3 proband groups (PD with lifetime alcohol use disorders, PD without lifetime alcohol use disorders, and not-ill controls). RESULTS: There was a significantly higher rate (12%) of alcohol use disorders among the relatives of PD probands compared with relatives of controls (5%), even in the absence of alcohol use disorders in the proband and after adjusting for differences in sociodemographic characteristics and lifetime drug use disorders (chi2 = 5.4; df = 1; P = .02). Anxiety symptoms were more frequent among the male relatives of panic probands who received an alcohol diagnosis, compared with those who did not have alcohol use disorders (10/25 vs 22/111; chi2 = 4.6; df = 1; P = .03). A similar pattern was found in women (8/11 vs 63/156; chi2 = 4.4; df = 1; P = .036). CONCLUSIONS: These findings suggest a familial association between PD and alcohol use disorders. Future studies with more refined alcohol diagnoses are needed to replicate and investigate the mechanism of this association.

Alcoholism↗

PubMedDate not supplied

Association between anxiety disorders and substance use disorders among young persons: results of a 21-year longitudinal study.

OBJECTIVE: To examine the linkages between anxiety disorders and the development of substance use disorders in a birth cohort of young people studied to young adulthood. METHOD: Data were gathered over the course of a longitudinal study of a birth cohort of over 1000 New Zealand born young people. Over the course of the study, data were gathered on: (a) anxiety disorders and substance use disorders at ages 16-18 and 18-21; (b) a range of potential confounding factors including measures of childhood, social, and family factors. RESULTS: Young people with anxiety disorders had odds of substance dependence that were between 1.3 and 3.9 times higher than young people without anxiety disorders. These associations were largely explained by a series of covariate factors relating to: (a) childhood and family factors; (b) prior substance dependence; (c) comorbid depression; (d) peer affiliations. After adjustment for these factors, anxiety disorder was unrelated to all measures of substance use. CONCLUSIONS: Young people with anxiety disorders are at increased risk of substance dependence. However, this association appears to be largely or wholly non causal and reflects the associations between childhood factors, prior substance dependence, comorbid depression, peer affiliations and the development of anxiety disorders.

Adolescent↗

PubMedDate not supplied

Asthma and mental disorders in primary care.

This study examines relationships between asthma and likelihood of current mental disorders and suicidal ideation in an urban primary care population. A systematic waiting room sample of 998 adult patients was screened for mental disorders using the PRIME-MD PHQ. Asthma diagnoses were provided by primary care physicians. Multivariate logistic regression analyses were used to determine the odds of current major depression, panic attacks, generalized anxiety disorder, alcohol and drug use disorder, and suicidal ideation among patients with a diagnosis of asthma, as compared to those without asthma. After controlling for differences in sociodemographic characteristics and comorbid mental disorders, asthma was associated with increased likelihood of panic attack (OR=1.7 (1.1, 2.6)) and suicidal ideation (OR=1.9 (1.03, 3.4)). There was no statistically significant association between asthma and major depression, generalized anxiety disorder, alcohol, or drug use disorders after adjustment. Results suggest that physician-diagnosed asthma is associated with self-reported panic attacks and suicidal ideation in a systematic sample of primary care patients. Physicians who treat patients with asthma should remain vigilant for the presence of comorbid psychiatric problems and carefully evaluate whether there is a clinical need to treat each condition.

Academic Medical Centers↗

PubMedDate not supplied

Early-onset fearful panic attack: a possible prodrome of early-onset severe psychopathology.

To determine whether early-onset panic attack (< or =20 years) with fear at onset represents a possible prodrome of early-onset severe psychopathology, we drew data from the National Comorbidity Survey (N = 8,098), a probability sample drawn from respondents age 18 to 54 in the 48 contiguous United States. Multivariate logistic regression analyses were used to determine differences in age of onset of comorbid mental disorders, familial psychopathology, and lethality of suicide attempts between those with early-onset panic attacks with fear at onset compared with individuals with panic attacks that do not meet this criteria. Logistic regression analyses revealed that respondents with early-onset panic attack with fear at onset (n = 86) had significantly earlier onset of almost every comorbid mental disorder, higher rates of familial psychopathology, and increased risk and lethality of suicide attempt compared with those with other panic attacks (n = 336). These findings provide preliminary evidence to suggest that early-onset fearful panic attack may be a marker of risk of a lengthy course of severe psychopathology, which is predicted by familial mental illness, and is characterized by early onset and increased risk of serious suicidal behavior. Replication of these findings in other epidemiologic and clinical samples is needed.

Adolescent↗

PubMedDate not supplied

The relationship between anxiety and substance use disorders among individuals with severe affective disorders.

We sought to determine the association between anxiety disorders and substance use disorders among patients with severe affective disorders in a community-based outpatient treatment program. Two hundred sixty participants in a supported socialization program were assessed using the Structured Clinical Interview for DSM-III-R (SCID). Multivariate logistic regression analyses were used to determine the relationship between anxiety disorders and alcohol and substance use disorders among patients with severe and persistent affective disorders (i.e., major depression and bipolar disorder). Among patients with severe and persistent affective disorders, cocaine (odds ratio [OR] = 5.9 [1.4, 24.6]), stimulant (OR = 5.1 [1.2, 20.9]), sedative (OR = 5.4 [1.2, 24.7]), and opioid use disorders (OR = 13.9 [1.4, 138.7]) were significantly more common among those with, compared with those without, anxiety disorders. This association persisted after adjusting for differences in sociodemographic characteristics and comorbid psychotic disorders. Significant associations between panic attacks, social phobia, specific phobia, and obsessive-compulsive disorder (OCD) and specific substance use disorders were also evident. These findings are consistent with and extend previous results by documenting an association between anxiety disorders and substance use disorders, independent of comorbid psychotic disorders among patients in a outpatient psychiatric rehabilitation program. These data highlight the prevalence of comorbid anxiety disorders, a potentially undetected and therefore undertreated problem, among patients with severe affective disorders and substance use comorbidity. Future work is needed to determine the nature of this association and to determine whether treatment of one prevents onset of the other.

Anxiety Disorders↗

PubMedDate not supplied

Generalized anxiety disorder and peptic ulcer disease among adults in the United States.

OBJECTIVE: Previous research has suggested a link between chronic anxiety and peptic ulcer disease, though recent evidence documenting an infectious cause (Helicobacter pylori) for ulcer has led to doubt about this association. The goal of the current study was to determine the relationship between generalized anxiety disorder (GAD) and self-reported peptic ulcer disease (PUD) among adults in the community. METHODS: Data were drawn from the National Comorbidity Survey, a representative household survey of the adult population of the United States (N = 8098). Multivariate logistic regression analyses were used to determine the relationship between GAD and self-reported ulcer, controlling for differences in sociodemographic characteristics and psychiatric and medical comorbidity. RESULTS: GAD was associated with a significantly increased risk of self-reported PUD (odds ratio = 2.8, 95% confidence interval = 1.4-5.7; p = .0002) after adjusting for differences in sociodemographic characteristics, comorbid mental disorders, and physical morbidity. Further analyses revealed a dose-response relationship between number of GAD symptoms (odds ratio = 1.2, 95% confidence interval = 1.1-1.4; p = .001) and increased risk of self-reported PUD. CONCLUSIONS: These findings are consistent with and extend previous clinical and epidemiologic data, providing evidence of a dose-response relationship between GAD and self-reported PUD among adults in the general population. The mechanism of this association remains unknown. Future work investigating the relationship between onset of GAD and development of PUD in prospective, longitudinal, epidemiologic data with objective measures of physical health status and mental health may be useful in improving our understanding of this link.

Adolescent↗

PubMedDate not supplied

Major depression, physical illness, and suicidal ideation in primary care.

OBJECTIVE: To determine the association between major depression and suicidal ideation and the role of physical illness in this link among primary care patients. METHOD: More than 3,000 randomly selected primary care patients at eight sites across the United States completed the PRIME-MD PHQ, a screen for mental disorders for use in primary care. Physicians independently diagnosed physical illnesses. Multiple logistic regression analyses were used to determine the relationship between PRIME-MD depression, physical illness, and suicidal ideation. RESULTS: Pulmonary disease was associated with an increased likelihood of suicidal ideation, even among patients without major depression [odds ratio = 1.9 (1.04, 3.4)]. There was evidence of statistical interaction between pulmonary disease and depression in increasing the odds of suicidal ideation. Specifically, patients with pulmonary disease without depression, those with depression without pulmonary disease, and patients with both pulmonary disease and depression had significantly increased odds of suicidal ideation with odd ratios of 1.9 (1.04, 3.4), 7.4 (5.6, 9.7), and 9.6 (5.1, 18.0), respectively. CONCLUSIONS: These data suggest that some physical disorders may be associated with increased suicidal ideation in primary care and may also play a role in the relationship between depression and suicidal ideation among primary care patients. Primary care physicians may wish to engage in an in-depth evaluation of psychiatric problems, especially current suicidal ideation, among patients with specific ongoing physical illnesses.

Adult↗

PubMedDate not supplied

Respiratory symptoms and mental disorders among youth: results from a prospective, longitudinal study.

OBJECTIVE: To determine the relationship between respiratory symptoms and mental disorders among youth in the community, and to investigate possible mechanisms of these linkages. METHODS: Data were drawn from the Oregon Adolescent Depression Project (n = 1,709), a longitudinal study of adolescents in the community. Multiple logistic regression analyses were used to examine the cross-sectional and longitudinal associations between respiratory symptoms and mental disorders at baseline, and linkages between respiratory symptoms at baseline and the onset of specific mental disorders at follow-up. Additional analyses were performed to examine the strength and specificity of the relationship between respiratory symptoms and mental disorders. The potential roles of hypochondriasis, functional impairment, and cigarette smoking in the associations between respiratory symptoms and mental disorders were investigated. RESULTS: Respiratory symptoms were associated with a significantly increased odds of any mental disorder (odds ratio (OR) = 1.9), specifically any depressive disorder (OR = 1.9), major depression (OR = 1.9), any substance use disorders (OR = 1.6), panic attacks (OR = 3.1), and attention deficit/hyperactivity disorder (ADHD) (OR = 5.8) at baseline. Respiratory symptoms at between 1987 and 1989 (Time 1) were associated with significantly increased risk of the onset of any mental disorder a year later (Time 2) (OR = 2.1). While demographic differences, hypochondriasis, functional impairment, and cigarette smoking contributed to the relationships between respiratory symptoms and mental disorders, these associations persisted after adjusting for these factors. CONCLUSIONS: The results suggest evidence of an association between respiratory symptoms and mental disorders among youth in the community. While demographic differences, hypochondriasis, functional impairment, and cigarette smoking may contribute to the linkage, these factors do not appear to completely explain the association. Future studies that can replicate these findings and include an examination of other possible mechanisms for these patterns of comorbidity, such as shared familial vulnerability or other environmental risk factors (e.g., childhood behavioral risk factors), are needed next.

Adolescent↗

PubMedDate not supplied

Major depression and allergy: does neuroticism explain the relationship?

OBJECTIVE: To determine the association between major depression, neuroticism, and self-reported allergy among adults in the community. METHODS: Data were drawn from the Midlife Development in the United States Survey, a nationally representative sample of 3,032 adults age 25 to 74. ANOVA and multiple logistic regression analyses were used to determine the association between depression and allergy and the role of neuroticism in these relationships. These links were also examined by gender. RESULTS: Among adults in the community, major depression was associated with a significantly increased likelihood of allergy (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.14-1.98). Higher levels of neuroticism were also significantly associated with increased likelihood of allergy (OR, 1.22; 95% CI, 1.04-1.43). Among women, major depression was associated with a significantly increased likelihood of allergy (OR, 1.67; 95% CI, 1.15-2.41), and this relationship persisted after adjusting for demographic characteristics and neuroticism. Among men, there was no significant relationship between allergy and depression, yet neuroticism was related to allergy (OR, 1.42; 95% CI, 1.42-1.82), which persisted after adjustment for depression. CONCLUSION: These data are consistent with results of previous studies showing an association between major depression and allergy among adults and extend these data by providing preliminary evidence suggesting that this association is specific to women and independent of the effects of neuroticism among women. In addition, the data provide preliminary evidence that neuroticism may be related to allergy among men, though no link between depression and allergy was found among men. Future research with prospective, longitudinal studies is needed next to understand the possible biological underpinnings of these associations.

Adult↗

PubMedDate not supplied

Peptic ulcer disease and neuroticism in the United States adult population.

BACKGROUND: The goal of the current study was to determine the association between personality factors and peptic ulcer disease (PUD) among adults in the general population. METHOD: Data were drawn from the Midlife Development in the United States Survey (MIDUS), a representative household survey of the adult population (ages 25-74; n = 3,032) of the United States. Multiple logistic regression analyses were used to determine the association between the big five personality factors and PUD, adjusting for differences in sociodemographic characteristics, psychiatric and physical comorbidity. RESULTS: Neuroticism was associated with significantly increased odds of PUD [OR = 1.5 (95% CI: 1.03, 2.4)], which persisted after controlling for differences in sociodemographic characteristics, cigarette smoking, perception of poor health, comorbid mental disorders and physical illnesses. This relationship was specific to neuroticism. CONCLUSIONS: These findings are consistent with and extend previous clinical and epidemiologic data by providing evidence of an independent association between neuroticism and PUD among adults in the general population. Future work investigating the relationship between neuroticism and the development of PUD in prospective data, including objective measures of physical and mental health status, may contribute to our understanding of this association.

Adult↗

PubMedDate not supplied

Panic attacks and the risk of depression among young adults in the community.

OBJECTIVES: To determine the association between panic attacks and the risk of major depression among young adults in the community. METHODS: Data were drawn from a 21-year longitudinal birth cohort study (n = 1, 265). Multiple logistic regression analyses were used to determine the association between panic attacks in adolescence (age 15-21 years) and the risk of current major depression (past month). RESULTS: Having a panic attack in the preceding 3 years was significantly associated with elevated risk of current major depression (past month) at the ages of 18 and 21. This association persisted after adjusting for a range of fixed social, family and individual risk factors for psychopathology, history of major depression, comorbid psychiatric disorder and life adversity among both males (OR = 8.9; 95% CI = 3.9-20.4) and females (OR = 2.3; 95% CI = 1.2-4.2). CONCLUSIONS: These data are consistent with and extend previous work by showing that panic attack increases the risk of current major depression, independent of the effects of psychiatric comorbidity and other early risk factors for psychopathology, though much of this relationship appears to be explained by common risk factors and comorbidity. These data show new evidence of interaction between gender and panic attacks in the risk of depression among young persons. Replication of these findings is needed, as are future studies that further investigate the underlying mechanism of this association.

Adolescent↗

PubMedDate not supplied

Cancer and mental disorders in a national community sample: findings from the national comorbidity survey.

OBJECTIVE: To determine the association between cancer (past 12 months) and mental disorders (past 12 months) among community-dwelling adults. METHODS: Data were drawn from the National Comorbidity Survey (n = 5,877), a representative household sample of adults aged 15-54 years in the United States. Multiple logistic regression analyses were used to determine the association between cancer and mental disorders, adjusting for differences in sociodemographic characteristics. RESULTS: Cancer was significantly associated with increased rates of major depression [odds ratio (OR) = 3.6, 95% confidence interval (CI) = 1.4-8.8], drug dependence (OR = 3.6, 95% CI = 1.3-9.8), simple phobia (OR = 2.5, 95% CI = 1.0-6.2) and agoraphobia (OR = 3.3, 95% CI = 1.0-10.4). These associations persisted after adjusting for major sociodemographic factors, and sex plays a significant role in the association between cancer diagnosis and mental disorder, with cancer diagnosis having a stronger influence on major depression and drug dependence in men than in women. CONCLUSIONS: Clinicians and community health workers working with cancer survivors need to be not only alert for signs of clinical depression but also of co-occurring drug dependence and certain anxiety disorders so that appropriate referrals to mental health professionals can be made.

Adolescent↗

PubMedDate not supplied

Comorbidity of asthma and anxiety and depression in Puerto Rican children.

Studies have reported that childhood asthma is associated with internalizing disorders, but most of these studies have used global measures of depressive and anxiety symptoms. The Diagnostic Interview Schedule for Children was administered to a group of 1891 youth ages 4 to 17 and their caregivers in Puerto Rico to determine DSM-IV symptoms and diagnoses. Asthma diagnosis and having had an asthma attack were assessed by parental report. A diagnosis of asthma was associated with having any depressive disorder and one symptom of separation anxiety. An asthma attack was associated with any depressive disorder and any anxiety disorder and, more specifically, with separation anxiety disorder, major depressive disorder, and symptoms of depression, separation anxiety, and generalized anxiety. Possible explanations for the findings are discussed.

Adolescent↗

PubMedDate not supplied

Parental mental health, childhood psychiatric disorders, and asthma attacks in island Puerto Rican youth.

OBJECTIVE: Previous research documents an association of poor parental mental health with asthma in children. This study aims to determine whether the associations between parental mental health problems and childhood asthma attacks persist after controlling for childhood anxiety and depression and other confounding factors. DESIGN/METHODS: A community household sample of youth ages 4 to 17 years and their primary caregivers from the US Commonwealth of Puerto Rico was studied to determine the associations between parental mental health and childhood asthma attacks. Regression models that predicted asthma attacks in youth controlled for parental mental health problems, childhood anxiety and depression, zone of residence, and parents' age, education, and perception of poverty. RESULTS: After adjusting for children's depressive and anxiety disorders as well as other important confounders, associations between parental depression, suicide attempts, ataque de nervios, and history of mental health treatment and asthma attacks in offspring, by parental report, persisted. Additionally, the frequency of parental mental health problems was associated with children's asthma attacks. CONCLUSION: Parents with mental health problems were more likely to report histories of asthma attacks in their children compared with parents without mental health problems in Puerto Rico. These associations were not attributable to internalizing disorders in youth but persisted independent of childhood psychopathology and other confounding factors. Clinicians and researchers should recognize the relations between poor parental mental health and childhood asthma and explore the potential role of family psychosocial and behavioral factors related to the manifestation of the disease.

Adolescent↗