Anxiety Disorders: Burt VK

Burt VK. · Department of Psychiatry and Biobehavioral Sciences, the David Geffen School of Medicine at UCLA and Women's Life Center at UCLA, USA. · J Clin Psychiatry. · Pubmed #15315474 No free full text.

Abstract: Depression includes a wide range of symptoms that can impair a person's psychosocial and physical functioning. This impairment can lead to decreased productivity, increased health care utilization, alcohol and substance abuse, and an increased risk of suicide. While the treatment of depression has significantly advanced over the past 30 years, there is still room for improvement. Full remission of depressive symptoms is often elusive, and many patients never achieve full relief from their depression despite being regarded as responders to antidepressant treatment. Current treatments for depression tend to focus on emotional symptoms, not the physical and anxious symptoms also associated with depression. However, the physical and anxious symptoms of depression can be serious and sometimes more prominent than the emotional symptoms of depression, especially among special populations such as women. New treatment strategies, such as dual-acting agents and the combination of pharmacotherapy and psychotherapy, target the emotional and anxious symptoms of depression as well as symptoms associated with pain. In order to increase response and remission, depression should be seen as an illness comprising not only emotional symptoms but physical and anxious symptoms as well.

Suri R, Altshuler L, Hellemann G, Burt VK, Aquino A, Mintz J. · Mood Disorders Research Program, Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90095, USA. · Am J Psychiatry. · Pubmed #17671283 links to  free full text

Abstract: OBJECTIVE: The authors evaluated the effects of prenatal antidepressant exposure and maternal depression on infant gestational age at birth and risk of preterm birth. METHOD: Ninety women were followed in a prospective, naturalistic design through pregnancy with monthly assessments of symptoms of depression and anxiety using the Structured Clinical Interview for DSM-IV mood module for depression, the Hamilton Depression Rating Scale, the Beck Depression Inventory, and the Perceived Stress Scale. Participants included 49 women with major depressive disorder who were treated with antidepressants during pregnancy (group 1), 22 women with major depressive disorder who were either not treated with antidepressants or had limited exposure to them during pregnancy (group 2), and 19 healthy comparison subjects (group 3). The primary outcome variables were the infants' gestational age at birth, birth weight, 1- and 5-minute Apgar scores, and admission to the special care nursery. RESULTS: Groups 1, 2, and 3 differed significantly in gestational age at birth (38.5 weeks, 39.4 weeks, 39.7 weeks, respectively), rates of preterm birth (14.3%, 0%, 5.3%, respectively), and rates of admission to the special care nursery (21%, 9%, 0%, respectively). Birth weight and Apgar scores did not differ significantly between groups. Mild to moderate depression during pregnancy did not affect outcome measures. CONCLUSIONS: Prenatal antidepressant use was associated with lower gestational age at birth and an increased risk of preterm birth. Presence of depressive symptoms was not associated with this risk. These results suggest that medication status, rather than depression, is a predictor of gestational age at birth.

Burt VK, Rudolph M. · UCLA Neuropsychiatric Institute, 300 UCLA Medical Plaza, Los Angeles, CA 90095-6968, USA. · Am J Psychiatry. · Pubmed #10739423 links to  free full text

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