Precordial catch.

The goal of the current work is to provide a comprehensive review and interpretation of the literature on the human and economic burden of generalized anxiety disorder (GAD) and how it compares with that of other mental disorders. The term "human burden" is used to describe quantified impairments in role functioning and quality of life (QOL). "Economic burden" describes costs related to health care resource utilization and lost work. A review of 34 studies reporting original quantitative data on associations between GAD and role functioning, QOL, and/or economic costs was undertaken. GAD was defined by DMS-III-R, DSM-IV, or ICD-10 DCR. Persons with GAD (both with and without a comorbid mental disorder) described significant impairments due to both physical and emotional problems. Studies typically showed that role and QOL impairments of GAD were at least comparable in magnitude to those of other anxiety disorders, somatoform disorders, and physical conditions, and greater than those of substance use disorders. Large representative studies showed that role impairments of pure GAD were similar in magnitude to those of pure MDD. Studies of DSM-IV disorders showed that QOL impairments of GAD were at least comparable in magnitude to those of MDD; studies of DSM-III-R disorders showed the opposite pattern. GAD was associated with considerable economic costs owing to lost work productivity and high medical resource use. Quality of care initiatives that have been implemented to increase recognition and improve treatment outcomes for persons with MDD should be extended to the effective management of GAD.

Anxiety Disorders↗

PubMed2007

Stress and anxiety associated with prenatal diagnosis.

Prior to any specific prenatal diagnostic procedure, the pregnant woman should be counselled about the indications for the procedure and how the diagnosis would inform care. In addition, the risks and limitations should be clearly spelt out. The availability of non-invasive prenatal diagnostic procedures such as sonography appears to have led to a higher rate of acceptance of such procedures, especially in younger patients. The expectations of pregnant women and their partners concerning prenatal diagnosis focus on reducing uncertainty in regard to the normality of the pregnancy. However, any prenatal diagnostic procedure can cause emotional stress in the pregnant woman. There are two different types of stress in this situation. There may be anxiety about the invasive nature of the procedure and the attendant risk of the loss of a wanted pregnancy. There may also be anxiety over the outcome of the investigation. Any unexpected finding, especially an abnormal one, often has an adverse impact on the pregnant woman and her partner. Imaging of the unborn child on sonography, and revealing fetal movements and heartbeat, are increasingly a common and key experience in a pregnancy. With the advent of this now commonly shared experience, the male partner also gives up his roll as a passive onlooker and becomes more actively involved in the pregnancy. Couples require multidisciplinary care if an abnormal fetus is found.

Anxiety Disorders↗