Sleep disturbance in generalized anxiety disorder and its treatment.

Sleep laboratory and epidemiological studies indicate that insomnia is a frequent finding in patients with psychiatric disorders. In this respect, insomnia associated with a major depression or an anxiety disorder, mainly generalized anxiety disorder (GAD), is the most prevalent diagnosis. According to available evidence, the sleep disturbance associated with mild-to-moderate GAD is a sleep-maintenance insomnia, and to a lesser extent a sleep-onset insomnia. Insomnia associated with mild-to-moderate GAD generally responds to psychological treatments and anxiolytic benzodiazepines. Moreover, concomitant administration of hypnotic medication can be contemplated in patients with severe GAD.

[1]  M. Lader The nature and duration of treatment for GAD , 1998, Acta psychiatrica Scandinavica. Supplementum.

[2]  D. Barlow,et al.  DSM‐IV and beyond: what is generalized anxiety disorder? , 1998, Acta psychiatrica Scandinavica. Supplementum.

[3]  J. Lépine,et al.  Epidemiology and Public Health Impact of Anxiety Disorders in Late Life , 1998 .

[4]  M. Ohayon Prevalence of DSM-IV diagnostic criteria of insomnia: distinguishing insomnia related to mental disorders from sleep disorders. , 1997, Journal of psychiatric research.

[5]  W. F. Waters,et al.  Generalized anxiety and sleep architecture: a polysomnographic investigation. , 1997, Sleep.

[6]  C. Morin,et al.  Sleep and psychopathology , 1996 .

[7]  T. Roth,et al.  Sleep disturbance and psychiatric disorders: A longitudinal epidemiological study of young Adults , 1996, Biological Psychiatry.

[8]  D. Monti,et al.  Pharmacological Treatment of Chronic Insomnia , 1995 .

[9]  M. Mavissakalian Long-term treatment of anxiety disorders , 1995, Biological Psychiatry.

[10]  Daniel J Buysse,et al.  Clinical diagnoses in 216 insomnia patients using the International Classification of Sleep Disorders (ICSD), DSM-IV and ICD-10 categories: a report from the APA/NIMH DSM-IV Field Trial. , 1994, Sleep.

[11]  M. Lader Benzodiazepines , 1994 .

[12]  R. Kessler,et al.  DSM-III-R generalized anxiety disorder in the National Comorbidity Survey. , 1994, Archives of general psychiatry.

[13]  K. Rickels,et al.  Antidepressants for the treatment of generalized anxiety disorder. A placebo-controlled comparison of imipramine, trazodone, and diazepam. , 1993, Archives of general psychiatry.

[14]  T. Borkovec,et al.  Efficacy of applied relaxation and cognitive-behavioral therapy in the treatment of generalized anxiety disorder. , 1993, Journal of consulting and clinical psychology.

[15]  R. Durham,et al.  Psychological Treatment of Generalised Anxiety Disorder , 1993, British Journal of Psychiatry.

[16]  M. Fennell,et al.  Comparison of behavior therapy and cognitive behavior therapy in the treatment of generalized anxiety disorder. , 1991, Journal of consulting and clinical psychology.

[17]  D. Regier,et al.  Age at onset of selected mental disorders in five community populations. , 1990, Archives of general psychiatry.

[18]  D. Ford,et al.  Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? , 1989, JAMA.

[19]  K. Power,et al.  A Controlled Comparison of Cognitive—Behaviour Therapy, Diazepam and Placebo in the Management of Generalized Anxiety , 1989, Behavioural Psychotherapy.

[20]  G. Papadimitriou,et al.  EEG sleep studies in patients with generalized anxiety disorder , 1988, Psychiatry Research.

[21]  D S Rae,et al.  One-month prevalence of mental disorders in the United States. Based on five Epidemiologic Catchment Area sites. , 1988, Archives of general psychiatry.

[22]  A. Mathews,et al.  The effects of relaxation training with cognitive or nondirective therapy and the role of relaxation-induced anxiety in the treatment of generalized anxiety. , 1987, Journal of consulting and clinical psychology.

[23]  M. Gelder,et al.  Anxiety Management for Persistent Generalised Anxiety , 1987, British Journal of Psychiatry.

[24]  J. Copeland,et al.  Is There More Dementia, Depression and Neurosis in New York? , 1987, British Journal of Psychiatry.

[25]  N. Tarrier,et al.  Applied Relaxation Training for Generalised Anxiety and Panic Attacks: , 1986, British Journal of Psychiatry.

[26]  J. Price Anxiety Disorders and Phobias. A Cognitive Perspective . By Aaron T. Beck and Gary Emery. (Basic Books, New York, 1985.) , 1986, Journal of Biosocial Science.

[27]  O. Cameron,et al.  Ages of onset of DSM-III anxiety disorders. , 1985, Comprehensive psychiatry.

[28]  E. Uhlenhuth,et al.  Insomnia and its treatment. Prevalence and correlates. , 1985, Archives of general psychiatry.

[29]  D. Blazer,et al.  The NIMH Epidemiologic Catchment Area program. Historical context, major objectives, and study population characteristics. , 1984, Archives of general psychiatry.

[30]  R. Malcolm,et al.  Insomnia and its treatment. When are hypnotics justified? , 1984, Postgraduate medicine.

[31]  R. Noyes,et al.  A comparison of panic disorder and generalized anxiety disorder. , 1984, The American journal of psychiatry.

[32]  E. Uhlenhuth,et al.  Symptom checklist syndromes in the general population. Correlations with psychotherapeutic drug use. , 1983, Archives of general psychiatry.

[33]  R. Rosa,et al.  The relationship of sleep and anxiety in anxious subjects , 1983, Biological Psychology.

[34]  D J Kupfer,et al.  Sleep-wake disorders based on a polysomnographic diagnosis. A national cooperative study. , 1982, JAMA.

[35]  L. Robins,et al.  National Institute of Mental Health Diagnostic Interview Schedule. Its history, characteristics, and validity. , 1981, Archives of general psychiatry.

[36]  P. Howard Sleep Disorders Classification Committee, Association of Sleep Disorders Centers , 1979 .

[37]  E. Robins,et al.  Research diagnostic criteria: rationale and reliability. , 1978, Archives of general psychiatry.

[38]  J. Knott,et al.  A Comparison of EMG Feedback and Progressive Muscle Relaxation Training in Anxiety Neurosis , 1975, British Journal of Psychiatry.

[39]  R. E. Townsend,et al.  A comparison of biofeedback-mediated relaxation and group therapy in the treatment of chronic anxiety. , 1975, The American journal of psychiatry.

[40]  M. Hamilton The assessment of anxiety states by rating. , 1959, The British journal of medical psychology.

[41]  J. Wolpe,et al.  Psychotherapy by reciprocal inhibition , 1958, Conditional reflex.

[42]  P. Anderer,et al.  Nonorganic insomnia in generalized anxiety disorder. 1. Controlled studies on sleep, awakening and daytime vigilance utilizing polysomnography and EEG mapping. , 1997, Neuropsychobiology.

[43]  K. Rickels,et al.  The long-term management of generalized anxiety disorder: issues and dilemmas. , 1996, The Journal of clinical psychiatry.

[44]  K. Rickels,et al.  Maintenance treatment studies in anxiety disorders: some methodological notes. , 1995, Psychopharmacology bulletin.

[45]  G. Cassano,et al.  Pharmacological treatment of depression and comorbid anxiety disorders. , 1995, Advances in biochemical psychopharmacology.

[46]  Lépine,et al.  L'épidémiologie des troubles anxieux et dépressifs dans une population générale française. , 1994 .

[47]  Dc Washington Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .

[48]  P. Anderer,et al.  Insomnia in generalized anxiety disorder: polysomnographic, psychometric and clinical investigations before, during and after therapy with a long- versus a short-half-life benzodiazepine (quazepam versus triazolam). , 1994, Neuropsychobiology.

[49]  C. Soldatos Insomnia in relation to depression and anxiety: epidemiologic considerations. , 1994, Journal of psychosomatic research.

[50]  D H Barlow,et al.  Psychometric properties of the Penn State Worry Questionnaire in a clinical anxiety disorders sample. , 1992, Behaviour research and therapy.

[51]  T. Paiva,et al.  Clinical and EEG sleep changes in primary dysthymia and generalized anxiety: a comparison with normal controls. , 1990, Neuropsychobiology.

[52]  K. Power,et al.  A controlled comparison of cognitive- behaviour therapy, Diazepam, and placebo, alone and in combination, for the treatment of generalised anxiety disorder , 1990 .

[53]  D. Mcleod,et al.  Differential effects of alprazolam and imipramine in generalized anxiety disorder: somatic versus psychic symptoms. , 1988, The Journal of clinical psychiatry.

[54]  A. Mathews,et al.  Generalised anxiety: a controlled treatment study. , 1987, Behaviour research and therapy.

[55]  P. Lehrer,et al.  Progressive relaxation and meditation. A study of psychophysiological and therapeutic differences between two techniques. , 1983, Behaviour research and therapy.

[56]  R. Michels,et al.  Diagnostic and Statistical Manual of Mental Disorders, 3rd ed , 1981 .

[57]  M. Raskin,et al.  Muscle biofeedback and transcendental meditation. A controlled evaluation of efficacy in the treatment of chronic anxiety. , 1980, Archives of general psychiatry.

[58]  L. Covi,et al.  The Hopkins Symptom Checklist (HSCL). A measure of primary symptom dimensions. , 1974, Modern problems of pharmacopsychiatry.

[59]  A. Rechtschaffen,et al.  A manual of standardized terminology, technique and scoring system for sleep stages of human subjects , 1968 .

[60]  K. Colby A Primer For Psychotherapists , 1951 .