James G. Barbee

Serum Cholesterol Levels in Patients with Generalized Anxiety Disorder (GAD) and with GAD and Comorbid Major Depression

Objective: To investigate risk for cardiovascular disease inpatients with GAD, as well as the effects of comorbid major depression (MD). Method: Predrug-trial serum cholesterol and triglyceride levels were assessed in 38 patients with pure GAD and compared with those of 21 patients with mixed GAD and comorbid (MD). Results: Significantly higher cholesterol and triglyceride levels were found in the GAD group. Conclusion: Increased noradrenergic activity may be responsible for elevations in lipid levels in patients with pure GAD.

A follow-up study of DSM-III-R generalized anxiety disorder with syndromal and subsyndromal major depression

OBJECTIVE The authors examined the long-term outcome of generalized anxiety disorder with depressive symptoms utilizing both categorical and dimensional analyses. METHOD Thirty-nine out-patients with a DSM-III-R diagnosis of generalized anxiety disorder (GAD) with depressive symptoms, both with (n=23) and without (n=16) syndromal major depression (MD) participated in an 11-week clinical trial. Approximately 18 months after initial screening, these individuals were once again evaluated using a structured diagnostic interview and a battery of rating scales. RESULTS Three distinct groups were discernible at follow-up. Twenty-three (60%) of the patients remained syndromal for GAD; 10 patients (43%) were in partial remission from GAD; six (15%) were asymptomatic. Of the 23 patients who were syndromal for MD at baseline, 13 (56%) remained syndromal for MD at follow-up. All of the patients who were syndromal for MD at follow-up remained syndromal for GAD as well. CONCLUSIONS Outcomes in this study were quite divergent, though they support the concept of GAD as a chronic illness in most patients, with or without MD. The presence or absence of MD versus subsyndromal depression at baseline appeared to have relatively little impact upon the outcome. Patients with subsyndromal anxiety and depressive symptoms may be at special risk for syndromal disorders over time.

Toward a New Alliance

In an attempt to assess the status of residency training in psychoeducational approaches for families of chronically ill patients, the authors conducted a national survey of U.S. residency training programs. Responses from 154 programs (75%) indicated a wide variation in time allotted, activities, and participants in such training among the respondents. Less than 50% of the programs indicated formal involvement of family support groups such as the National Alliance for the Mentally Ill (NAMI) and the National Depressive and Manie-Depressive Association (NDMDA). The authors describe a program they have initiated that incorporates organized family support groups in such training efforts.

EFFECT OF DIAZEPAM ON VISUOMOTOR REACTION TIME

20 male and 10 female adult, normal, healthy subjects, whose mean age was 26.34 yr., participated in a double-blind study of the effect of a single dose (0.2 mg./kg. of body weight) of diazepam on visuomotor reaction time. Reaction time was measured before drug administration, and 60 min., and 120 min. after administration. Separate reaction times for the dominant and nondominant hand were recorded. There were no significant differences between the diazepam and placebo group at each of the three time intervals. Diazepam in the single dose employed does not appear to affect adversely visuomotor reaction time of relatively young, normal, healthy adults. For both groups the difference in visuomotor reaction time between the dominant hand and the nondominant hand was statistically significant as expected.

Stability of worry content in GAD patients: a descriptive study

The stability of worry content was investigated in a sample of 27 individuals diagnosed with Generalized Anxiety Disorder. During an initial evaluation, participants were asked to describe the content of their current worries, and the examining psychiatrist rated the frequency and intensity of these topics. During the following year, the investigators interviewed the participants on a monthly basis assessing the intensity and frequency of original worries, intensity and frequency of new worries, overall worry level, and general anxiety level. Analysis of this longitudinal data indicated level of overall worry and anxiety remained fairly stable over a 12-month period. Although the intensity and frequency of original worries decreased over time, few original worry topics completely remitted. In fact, at the end of the 12-month monitoring period, worry content identified at baseline continued to account for over 65% of the overall worry variance. Most participants did identify new worry topics during the course of the 12-month period, and the frequency and intensity of the new worries were comparable to the decrease in frequency and intensity of the original worries.

Critical Stimulus Durations for Some Verbal and Nonverbal Stimuli

Durations of stimulus exposures in visual backward masking are determined with reference to critical stimulus durations. These are defined as the minimum, undisrupted, durations of exposure for 100% accuracy for a predetermined number of trials. These durations are shown to vary both within and between classes of stimuli for 10 normal adults with a mean age of 26.40 yr. The verbal stimuli employed (letters of the alphabet) were significantly easier to discern than the nonverbal stimuli (arrows). Although some letters were more readily identified than others, differences were not significant. The results suggest that type of stimuli, nature of response, and the ease with which stimuli can be discerned be considered in the selection of target stimuli for experiments using masking.