International guidelines for the treatment of anxiety: does the real clinical practice in Ukraine correspond to them?

June 28, 2023
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УДК:  616.89-008.454
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Resume

Anxiety disorders are among the most common pathological conditions, have a direct positive correlations with external epidemiological and military risks, and are associated with a high economic burden. Its etiopathogenesis is complex and includes genetic, neurobiological, and psychosocial factors. According to current clinical guidelines, both psychotherapy (low- and high-intensity psychological interventions) and pharmacotherapy, mainly selective serotonin reuptake inhibitors, can be used in first-line treatment, and drugs of other groups, including calcium modulators, can be used for second-line treatment. Among the first-line drugs, escitalopram plays an important role, and pregabalin is the second-line drug.

References

  1. www.who.int/news-room/fact-sheets/detail/mental-disorders.
  2. vizhub.healthdata.org/gbd-results/.
  3. Javaid S.F., Hashim I.J., Hashim M.J. et al. (2023) Epidemiology of anxiety disorders: global burden and sociodemographic associations. Middl. East Curr. Psych., 30: 44.
  4. Yang X., Fang Y., Chen H. et al. (2021) Global, regional and national burden of anxiety disorders from 1990 to 2019: results from the Global Burden of Disease Study 2019. Epidemiol. Psychiatr. Sci., 30: e36.
  5. Bandelow B., Michaelis S. (2015) Epidemiology of anxiety disorders in the 21st century. Dialogues Clin. Neurosci., 17(3): 327–335.
  6. www.mentalhealth.org.uk/explore-mental-health/statistics/anxiety-statistics.
  7. www.statista.com/statistics/1132658/anxiety-symptoms-us-adults-by-date-past-week/.
  8. Charlson F., van Ommeren M., Flaxman A. et.al. (2019) New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis. Lancet, 394(10194): 240–248.
  9. Morina N., Akhtar A., Barth J., Schnyder U. (2018) Psychiatric Disorders in Refugees and Internally Displaced Persons After Forced Displacement: A Systematic Review. Front. Psychiatr., 9: 433.
  10. Carpiniello B. (2023) The Mental Health Costs of Armed Conflicts—A Review of Systematic Reviews Conducted on Refugees, Asylum-Seekers and People Living in War Zones. Int. J. Environ. Res. Public Health, 20: 2840.
  11. uifuture.org/publications/yak-zminyvsya-psyhoemoczijnyj-stan-ukrayincziv-presreliz-za-rezultatamy-prezentacziyi-doslidzhennya/.
  12. Feng C., Forthman K.L., Kuplicki R. et al. (2019) Neighborhood affluence is not associated with positive and negative valence processing in adults with mood and anxiety disorders: a Bayesian inference approach. Neuroimage Clin., 22: 101738.
  13. Bjorøy I., Jørgensen V.A., Pallesen S., Bjorvatn B. (2020) The Prevalence of Insomnia Subtypes in Relation to Demographic Characteristics, Anxiety, Depression, Alcohol Consumption and Use of Hypnotics. Front. Psychol., 11: 527.
  14. Haugan T., Muggleton S., Myhr A. (2021) Psychological distress in late adolescence: the role of inequalities in family affluence and municipal socioeconomic characteristics in Norway. PLoS One, 16: e0254033.
  15. Goldstein-Piekarski A.N., Williams L.M., Humphreys K. (2016) A trans-diagnostic review of anxiety disorder comorbidity and the impact of multiple exclusion criteria on studying clinical outcomes in anxiety disorders. Transl. Psychiatr., 6(6): e847.
  16. Wittchen H.U., Jacobi F., Rehm J. et al. (2011) The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur. Neuropsychopharmacol., 21: 655–679.
  17. National Institute for Health and Care Excellence (NICE) (2020) Generalised anxiety disorder and panic disorder in adults: management. Clinical guideline [CG113].
  18. www.nice.org.uk/guidance/cg159.
  19. Baldwin D.S., Anderson I.M., Nutt D.J. et al. (2014) Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: a revision of the 2005 guidelines from the British Association for Psychopharmacology. J. Psychopharmacol., 28(5): 403–439.
  20. Katzman M.A., Bleau P., Blier P. et al. (2014) the Canadian Anxiety Guidelines Initiative Group on behalf of the ADAC). Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessivecompulsive disorders. BMC Psychiatr., 14(Suppl. 1): S1.
  21. Bandelow B., Werner A.M., Kopp I. et al. (2022) The German Guidelines for the treatment of anxiety disorders: first revision. European Archives of Psychiatry and Clinical Neuroscience, 272: 571–582.
  22. Bandelow B., Allgulander Ch., Baldwin D.S. et al. (2022) World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders — Version 3. Part I: Anxiety disorders. World J. Biol. Psychiatr., 24(2): 79–117.
  23. zakon.rada.gov.ua/rada/show/v0059282-07#Text.
  24. www.mh4u.in.ua/wp-content/uploads/2021/11/poshyreni-psyhichni-rozlady-u-doroslogo-naselennya.-rekomendacziyi-dlya-ukrayiny-zhovten-2021.pdf.
  25. Bandelow B., Baldwin D., Abelli M. et al. (2016) Biological markers for anxiety disorders, OCD and PTSD — a consensus statement. Part I: Neuroimaging and genetics. World J. Biol. Psychiatr.,17(5): 321–365.
  26. National Institute for Health and Care Excellence (NICE) (2021) Anxiety disorders Quality standard (QS53). www.nice.org.uk/guidance/qs53.
  27. Slee A., Nazareth I., Bondaronek P. et al. (2019) Pharmacological treatments for generalised anxiety disorder: a systematic review and network meta-analysis. Lancet, 393(10173): 768–777.
  28. Kennedy S.H., Andersen H.F., Thase M.E. (2009) Escitalopram in the treatment of major depressive disorder: a meta-analysis. Curr. Med. Res. Opin., 25: 161–175.
  29. Eichentopf L., Hiemke C., Conca A. et al. (2022) Systematic review and meta-analysis on the therapeutic reference range for escitalopram: Blood concentrations, clinical effects and serotonin transporter occupancy. Front. Psychiatr., 13: 972141.
  30. Беар М.Ф., Коннорс Б.У., Парадизо М.А. (2021) Нейронауки. Исследования мозга. Т3. Мозг и поведение. Меняющийся мозг. 4-е изд. (Пер. с англ.). Діалектика, Київ, 640 с.
  31. Parsaik A.K., Mascarenhas S.S., Khosh-Chashm D. et al. (2016) Mortality associated with anxiolytic and hypnotic drugs. A systematic review and meta-analysis. Aust. NZ J. Psychiatr., 50(6): 520–533.
  32. Zhong G., Wang Y., Zhang Y., Zhao Y. (2015) Association between benzodiazepine use and dementia: a metaanalysis. PLoS One, 10(5): e0127836.
  33. Dodds T.J. (2017) Prescribed benzodiazepines and suicide risk: a review of the literature. Prim Care Companion CNS Disord., 19(2). doi: 10.4088/PCC.16r02037.
  34. Сартакова О.А. (2023) Поєднання тривоги та депресії: чому іноді лікування не допомагає? Укр. мед. часопис, 1(2)(153): 51–54.