Psychiatric disorders stress-related

Clinicians will readily recognize in Table 3.7 the experiences reported by many of their patients when receiving treatment for depression or other related psychiatric disorders. By looking at the Function affected column, it is possible to understand why some medications (say, SSRIs) are effective in variable degrees in several conditions associated with serotonin dysfunction (depression, OCD, social anxiety disorder, posttraumatic stress disorder, generalized anxiety disorder, panic disorder, and bulimia nervosa). 

There is a firm consensus that physical symptomatology is related to stressful exposures in all sorts of circumstances, and going to war is no exception (Ford etal., 2001 Storzbach etal., 2000). We know that rates of formal psychiatric disorder, especially depression and anxiety disorders, have increased about two-fold in Gulf veterans (Stimpson et al, 2003). Likewise, post-traumatic stress disorder (PTSD), is elevated in UK and US Gulf veterans, but not to the extent that could explain the overall increase in ill-health (Ismail et al, 2002) - in other words most symptomatic Gulf War veterans did not have PTSD. 

It s common almost everywhere to find an inverse relation between psychiatric disorders and socioeconomic status. Does the stress of low socioeconomic status provoke psychiatric dysfunction or does the presence of psychiatric dysfunction drive the individual to a lower status The question is generally without an answer, although many studies suggest that the stress produced by low socioeconomic status has an impact on already susceptible individuals.43... 

The rapid progress in proteomics and peptidomics during the last decade offers us new possibilities to study clinical aspects of disorders and diseases related to the brain [1], These strategies also offer new tools to follow chemical modifications and altered metabolic disturbances that may be indicative of pathophysiological adaptations related to environmental and psychosocial prolonged stress. These techniques can contribute to developments in the diagnostic and therapeutic fields of psychiatric... 

Post traumatic stress disorder (PTSD) is the only psychiatric condition whose definition demands a particular stressor to precede its appearance. Unlike the other anxiety disorders, it is only in the past decade that the biology of PTSD has come under scrutiny. Furthermore, although PTSD can occur following various traumatic events (for example, sexual abuse, accidents and torture), most emphasis has been placed on combat-related disorders. 

The DSM-IV-TR manual (American Psychiatric Association 2000) uses anxiety as a general term for a range of more specific anxiety disorders, which includes panic attacks, generalized anxiety disorder, specific phobias, social phobias, obsessive compulsive disorder and post traumatic stress disorder. However there is currently no literature applying these criteria to work and career anxiety, and nothing in the DSM-IV-TR which relates these disorders specifically to the work situation. Thus, the present chapter extrapolates the existing classifications of anxiety to the workplace from other settings. 

Cross-situational anxiety differs from the situation-specific anxiety described in the previous chapter, in that it involves multiple anxieties and worries that affect performance across a wide range of work and non-work-related situations and tasks. Examples of cross-situational anxiety include disorders such as uncued panic attacks, agoraphobia, generalized social phobia and generalized anxiety disorder (American Psychiatric Association [APA] 2000). The treatment of panic attacks and phobias was discussed in the previous chapter. This chapter thus focuses on the formulation and treatment of generalized anxiety disorder (GAD). GAD warrants specific attention since it requires quite a different CBT treatment approach from the other forms of anxiety already mentioned. Two other anxiety syndromes which have been found to be particularly prevalent among health workers, namely post-traumatic stress disorder (PTSD) and health anxiety, are also discussed in this chapter. 

Leussis MP, Berry-Scott EM, Saito M, Jhuang H, de Haan G, Alkan O, et al. The ANK3 bipolar disorder gene regulates psychiatric-related behaviors that are modulated by lithium and stress. Biol Psychiatry 2013 73(7) 683-90. 

Symptoms of anxiety and panic are commonly associated with a dependency on life support, communication difficulties, and uncertainty regarding health status (2). Many patients meet the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-fV) criteria for diagnosis of an anxiety disorder or a panic disorder. Posttraumatic stress disorder is sometimes the result of being close to death as well as the subsequent ICU experiences (3). If unmanaged, such psychiatric conditions will have important clinical consequences on adherence to recommended care and participation in rehabilitation. They will undoubtedly also influence health-related quality of life. 

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