ANGSTST RUNGEN

1. ANGSTSTÖRUNGEN Epidemiologie

3. Epidemiologie Einfluss auf die Lebensqualität

4. To measure the extent to which anxiety disorders interfere with various domains of functioning, the Illness Intrusiveness Ratings Scale (IIRS) Although the three groups did not differ on total IIRS scores, group differences did emerge for particular domains of functioning. Patients with OCD reported significantly more interference with respect to passive recreation (e.g., reading) than did SP patients and with respect to religious expression compared with both PD and SP patients. Patients with SP reported more impairment with respect to social relationships and self-expression/self-improvement, compared with the other two groups. When compared with populations with a variety of other chronic illnesses, patients in the present study reported much higher levels of illness intrusiveness. Individuals with SP reported being significantly more impaired than the other two groups in the domains of "other social relations" and "self-expression/improvement." These findings are consistent with the fact that people with social phobia often report excessive concerns about performance and interacting with others and therefore find it difficult to meet new people, enjoy social contact, and express their opinions openly. Compared with patients with bipolar disorder and a variety of medical conditions (see Table 3) all three anxiety disorder groups reported more illness intrusiveness, as measured by the IIRS To measure the extent to which anxiety disorders interfere with various domains of functioning, the Illness Intrusiveness Ratings Scale (IIRS) Although the three groups did not differ on total IIRS scores, group differences did emerge for particular domains of functioning. Patients with OCD reported significantly more interference with respect to passive recreation (e.g., reading) than did SP patients and with respect to religious expression compared with both PD and SP patients. Patients with SP reported more impairment with respect to social relationships and self-expression/self-improvement, compared with the other two groups. When compared with populations with a variety of other chronic illnesses, patients in the present study reported much higher levels of illness intrusiveness. Individuals with SP reported being significantly more impaired than the other two groups in the domains of "other social relations" and "self-expression/improvement." These findings are consistent with the fact that people with social phobia often report excessive concerns about performance and interacting with others and therefore find it difficult to meet new people, enjoy social contact, and express their opinions openly. Compared with patients with bipolar disorder and a variety of medical conditions (see Table 3) all three anxiety disorder groups reported more illness intrusiveness, as measured by the IIRS

5.  Epidemiologie Einfluss auf die Lebensqualität  Kosten: 42,3 Billion $ pro Jahr (Costa et al. 1998) Epidemiologische Studie in die letzte Dekaden: NIHM NCS (National Comorbidity Survey) in USA Munich follow-up Study in Europa [Wittchen 1992] WHO (World Health Organization) Study

6. Grenze der epidemiologische Studie Diagnostische Instrumente Prozeduren der Stichprobenentnahme Definitionen Zeitspanne der Diagnose

7. Prävalenz Angststörungen (25%) Depressionen (17%) Lebenszeit Prävalenz-rate für alle Angststörungen: 19,2% für Männer 30,5% für Frauen.

8. Komorbidität zwischen Angst- und Depressiven Störungen zwischen Angst-Störungen und physiologischem Zustand

9. Panikattacke und Panikstörung PA und PD: Kriterien für Diagnose ? DSM IV Lebenszeit Prävalenz (Pelissolo and Lepine 1998): PA: 7-9 % PD: zwischen 1.5% und 2.5%

10. Agoraphobie Koexistenz mit PD NCS Studie: 50% von PD Patienten ohne AGO (Eaton et al. 1994) Aber ? Klinische Evidenzen Post-hoc Studie: Horwarth et al 1993, Wittchen et al. 1998

11. Panikstörung und Agoraphobie Demographische Faktoren: Mann-Frau: 1 : 1,5-2 Beginn: mittel 20-Jähre Risiko-Faktoren: Ehestand Ausbildungsniveau Lebensereignisse Rauchen (inkonsistent) Atemwegserkrankungen

12. Komorbidität Mit anderen Angststörungen: 20-75% Soziale Phobie 20% GAD 14% OCD 6% PTSD Mit Depressiver Störung: 30-60% Mit Suchterkrankungen (Alkohol, Drogen, Medikament): 36% (selbst-medikamentös?)

13. Spezifische Phobie Was ist? Heterogenität ? 4 Subtypen: Tierphobie Situationsphobie Blut-Spritzen-Verletzung Phobie Umweltphobie

14. Distinguishing Characteristics of Three Specific Phobia Subtypes Blood injury phobics have a distinct biphasic physiological response to exposure that differs from that seen in other types of phobia patients. An initial rise in heart rate and blood pressure is followed by precipitous onset of bradycardia and hypotension. +/- A subset of situational phobics are sensitive to the panicogenic effects of carbon dioxide, Blood injury phobics have a distinct biphasic physiological response to exposure that differs from that seen in other types of phobia patients. An initial rise in heart rate and blood pressure is followed by precipitous onset of bradycardia and hypotension. +/- A subset of situational phobics are sensitive to the panicogenic effects of carbon dioxide,

15.  Spezifische PhobieWas ist?Heterogenität ? 4 Subtypen Lebenszeit Prävalenz: Mann-Frau: 1 : 2,3 (6,7% vs 15,7%) Verlauf

16. Soziale Phobie Was ist? 2 Subtypen: Generalisierte Nicht-Generalisierte

17. As shown in Table 1, most patients with a lifetime diagnosis of social phobia reported one, two or three specific social fears and very few of them feared 4 or 5 different social situations. As shown in Table 1, most patients with a lifetime diagnosis of social phobia reported one, two or three specific social fears and very few of them feared 4 or 5 different social situations.

18. Soziale Phobie Definition 2 Subtype Lebenszeit Prävalenz

19. Lifetime Prevalence of SP

20. Soziale Phobie Was ist? 2 Subtype Lebenszeit Prävalenz: Mann-Frau: 1: 1,5 (Männer = 11,1% Frauen = 15,5% ) Risiko-Faktoren Ausbildung, Zivilstand sozioökonomisch Klasse

22. Epidemiology is the study of factors affecting the health and illness of populations serves as the foundation and logic of interventions made in the interest of public health and preventive medicine. It is considered a cornerstone methodology of public health research is highly regarded in evidence-based medicine for identifying risk factors for disease and determining optimal treatment approaches to clinical practice.

23. a clinical trial is a comparison test of a medication or other medical treatment (such as a medical device), versus a placebo (inactive look-a-like), other medications/devices, or the standard medical treatment for a patient's condition. Clinical trials vary greatly in size: from a single researcher in one hospital/clinic to an international multicenter study funded by a pharmaceutical company with over 100 participating hospitals on several continents. The number of patients tested can range from fewer than 50 to thousands.

24. the prevalence of a disease in a statistical population is defined as the total number of cases of the disease in the population at a given time, or the total number of cases in the population, divided by the number of individuals in the population.

25. Lifetime prevalence (LTP) is the number of individuals in a statistical population that at some point in their life (up to the time of assessment) have experienced a "case" (e.g., a disorder), compared to the total number of individuals (i.e. it is expressed as a ratio or percentage).