Anxiety neurosis

Hamilton Anxiety Scale. The Hamilton Anxiety (HAMA) scale was designed to be used in adult patients who already have a diagnosis of anxiety neurosis rather than for making a diagnosis of anxiety in patients who have other problems. The test contains 14 items, each with a five-point scale, and is completed by a physician or psychologist. The test emphasizes the patient s subjective state. The two subscales determined are somatic anxiety and psychic anxiety. 

Freud coined the term anxiety neurosis approximately 100 years ago, and all forms of anxiety would be subsumed under that collective diagnostic entity for decades to come. In 1980, based on an emerging literature DSM-111 classified anxiety disorders into several discrete syndromes including panic disorder, obsessive-compulsive disorder (OCD), and generalized anxiety disorder (GAD). 

As noted earlier, prior to the advent of DSM-IIl in 1980, the anxiety disorders were collectively subsumed under some variation of the single diagnostic entity, anxiety neurosis. Consequently, the history of pharmacological treatment for the discrete anxiety syndromes is relatively brief, only approximately 20 years. Prior to 1980, we can only speak in a general manner as to how well medicines relieved anxiety in the broad sense of the term. Consequently, weTl present the more extensive history of pharmacological treatment for anxiety in this broader sense before launching into a more detailed discussion of the treatment of the individual anxiety disorders. 

In the 1890s, Sigmund Freud defined anxiety-neurosis as a clinical condition that was rooted in a psychological problem. Thus, Freud suggested that the many physical symptoms we now know as anxiety, which had previously been treated as separate ailments, were actually the result of one psychological (subjective) cause, which he called anxiety-neurosis. ... 

Before 1980, the term anxiety neurosis was used to describe a syndrome that included both chronic generalized anxiety and panic attacks. GAD and panic were first listed as discrete diagnoses in the DSM-III, in part because of observed differences in their response to available drug treatments (i.e., the former to benzodiazepines, the latter to antidepressants for a more detailed discussion of panic disorder, see Chapter 13). 

Pitts FN, McClure JN. Lactate metabolism in anxiety neurosis. N Engi J Med 1967 277 132-136. 

Cloninger CR, Martin RL, Clayton P, Couze S. Follow-up and family study of anxiety neurosis. In Klein DF, Rabkin J, eds. Anxiety New Research and Changing Concepts. New York Raven Press, 1981. 

Crowe RR, Crowe RC, Pauls DL, et al. A family study of anxiety neurosis morbidity risk in families of patients with and without mitral valve prolapse. Arch Gen Psychiatry 1980 37 77-79. 

Damiana is believed to possess antidepressant, thymoleptic, mild purgative, stomachic, and aphrodisiac properties. It is used for depression, nervous dyspepsia, atonic constipation, coital inadequacy, and specifically for anxiety neurosis with a predominant sexual factor. 

Insomnia, anxiety, tachycardia, and tremor are among the symptoms most commonly reported with caffeine (11). Tenseness and irritability also occur and, with high intake, symptoms resembhng those of anxiety neurosis (12). A case of caffeine psychosis has also been reported (13). Dose-response associations have not been particularly well studied, but some are known (SEDA-7, 6). Paradoxically, six cases have been reported of pathological sleepiness induced by caffeine (14). Tonic-clonic seizures occurred postpartum in a woman who had... 

Loxapine is used to treat and control the psychotic symptoms of both acute and chronic schizophrenia. Other uses include treatment of dementia, anxiety neurosis, hostile/aggressive behavior, and psychotic depression. 

Thioxanthenes are used in the treatment of psychosis, including schizophrenia, senile psychosis, pathological jealousy, and borderline personality disorder. Other uses include the treatment of pain, postoperative neuralgia, sedation, anxiety neurosis, childhood behavior problems, and depression. The maximum therapeutic daily oral dose for chlorprothixene, flupenthixol, and thiothixene is 600, 224, and 60 mg respectively the maximum intramuscular dose of each is 200 mg day 100 mg weekly, and 30 mg dayrespectively. Some thioxanthenes and thioxanthenones have shown signs in mice and in vitro assays of possible human therapeutic potential against tumors, and some thioxanthenes have been shown to have cytotoxic and antimicrobial activities. 

Many of the examples quoted involve central nervous system drugs. This is very important, as gender-related prescription usage is heavily weighted in this area toward women. The FDA 1985 drug utilization report showed that for benzodiazepines, the increased usage in women outnumbers men by 2 1 (339 vs. 171 prescriptions/ 1000 women and men, respectively). Twice as many women are treated for depression and anxiety neurosis than men, first described by Raskin (1974), and confirmed by Weissman and Klerman (1977). It is by no means certain that this is solely due to biochemical differences, for women are more likely to seek help than men. Of importance from the prior discussion is that, if women are... 

Anxiety can be a reaction to major life events, such as moving house, changing jobs or bereavement. As such, it is a normal, but short-lived response to a potentially threatening event. Anxiety becomes a medical problem when it is excessive, long lasting or inappropriate and incapacitating. Then it can be called anxiety neurosis , or an anxiety syndrome. 

W 0 (X X w Caffeine Adenosine receptor antagonist. High dose T Ca++ permeability in sarcoplasmic reticulum and T cAMP by inhibiting phosphodiesterase. Stimulates CNS, constricts cerebral arterioles, induces diuresis, stimulates heart, bronchodilates. Prolonged apnea in pre-term infants (unlabeled use). Included in some over-the counter analgesic preps, particularly headache remedies. Insomnia, restlessness, anxiety neurosis, nausea, tachycardia, diuresis. 

Pharmacological Investigations - Pitts and McClure reported that patients with anxiety neurosis show increased levels of lactate in the blood when under conditions of physiological stress or physical exercise. Infusion of lactate in susceptible patients in a double blind study initiated anxiety symptoms. A proposal that over-production of adrenalin by these patients is the cause for increase of lactate was supported by reports that the P-blocker, propranolol, can reduce or eliminate anxiety symptoms. Grosz and Parmer in a critical evaluation of Pitts and McClure s work, feel that these auUors... 

For the majority, the reality of forced migration perseveres within their memories and remains greatly complex both in its content and in terms of their political personal response to it (Braito 1988 Bowling 1990). In old age, injuries and their side-effects may resurface and also take the form of various mental health conditions such as depression, (p. 415) anxiety, neurosis, or paranoia (dubbed the Polish disease ) (Bram 1983). As noted by Braito with reference to refugees from Eastern and Central Europe after the wan... 

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