New Research on Anxiety Disorders

Effects of caffeine on anxiety and panic attacks in patients with panic disorder: A systematic review and meta-analysis

Klevebrant, L., & Frick, A. (2021). Effects of caffeine on anxiety and panic attacks in patients with panic disorder: A systematic review and meta-analysis. General hospital psychiatry, 74, 22–31. Advance online publication. https://doi.org/10.1016/j.genhosppsych.2021.11.005

• “Caffeine has been purported to have anxiogenic and panicogenic properties, specifically salient in patients with panic disorder (PD). However, compilations of the magnitude of the effect of caffeine on anxiety and panic attacks are lacking and potential dose-response relationships have not been examined.”
• “In the present systematic review and meta-analysis, we aimed to examine the acute effects of placebo-controlled caffeine challenge on occurrence of panic attacks and subjective anxiety in patients with PD and healthy controls (HC), including dose-response relationships.”
• “The results confirm that caffeine at doses roughly equivalent to 5 cups of coffee induces panic attacks in a large proportion of PD patients and highly discriminates this population from healthy adults.”
• “Caffeine also increases anxiety in PD patients as well as among healthy adults at these doses although the exact relationship between caffeine-induced anxiety and panic attacks remains uncertain.”
• “Future studies should employ a wider range of caffeine doses and investigate contributions of biological and psychological mechanisms underlying the anxiogenic and panicogenic effects of caffeine. In the clinic, patients with PD should be informed about the panicogenic and anxiogenic effects of caffeine, with the caveat that little is known regarding smaller doses than 480 mg.”

Symptom fluctuation over the menstrual cycle in anxiety disorders, PTSD, and OCD: a systematic review

Green, S. A., & Graham, B. M. (2021). Symptom fluctuation over the menstrual cycle in anxiety disorders, PTSD, and OCD: a systematic review. Archives of women’s mental health, 10.1007/s00737–021–01187–4. Advance online publication. https://doi.org/10.1007/s00737-021-01187-4

• “Anxiety disorders are more prevalent and severe in women than men. Extant research suggests that the menstrual cycle modulates the severity and expression of anxiety symptoms across a range of disorders.”
• “The aims of this systematic review were to synthesise the existing literature investigating menstrual phase-related fluctuations in symptoms of anxiety disorders, and related conditions PTSD and OCD, in menstruating women, and to evaluate the methodologies used.”
• “The review revealed evidence for exacerbation of a broad range of symptoms in panic disorder, PTSD, social anxiety disorder, and generalised anxiety disorder, around the weeks prior to and post menses onset, coincident with elevated but declining ovarian hormones, and low hormone levels, respectively. “
• “Menstrual fluctuations in anxiety symptoms appear to be a feature of anxiety disorders, PTSD, and OCD, but likely only occur in a subset of women. Future research in this field could better manage and account for such heterogeneity by using group-based trajectory modelling in larger sample sizes and using pre-screening to recruit women with known histories of menstrual fluctuation in anxiety symptoms.”

The prevalence of anxiety in general hospital inpatients: A systematic review and meta-analysis

Walker, J., van Niekerk, M., Hobbs, H., Toynbee, M., Magill, N., Bold, R., Hampsey, E., Harriss, E., Frost, C., & Sharpe, M. (2021). The prevalence of anxiety in general hospital inpatients: A systematic review and meta-analysis. General hospital psychiatry, 72, 131–140. https://doi.org/10.1016/j.genhosppsych.2021.08.004

• “Objective: To determine the prevalence of anxiety in general hospital inpatients by conducting a systematic review and meta-analysis of all relevant published studies.”
• “Results: We included 32 studies. Pooled prevalence estimates in random-effects meta-analyses were: anxiety symptoms 28% (95% CI 19% to 38%, 95% prediction interval 5% to 72%), any anxiety disorder 8% (95% CI 5% to 12%, 95% prediction interval 2% to 33%), panic disorder 3% (95% CI 2% to 4%, 95% prediction interval 1% to 8%), generalized anxiety disorder 5% (95% CI 3% to 8%, 95% prediction interval 1% to 23%). There was high heterogeneity in prevalence, little of which was explained in exploratory analyses of a limited number of potential determinants.”
• “Conclusion: Anxiety symptoms of clinically significant severity affect more than one in four inpatients and anxiety disorders affect nearly one in ten.”

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