Epidemiologic heterogeneity of common mood and anxiety disorders over the lifecourse in the general population: a systematic review

Background Clinical evidence has long suggested there may be heterogeneity in the patterns and predictors of common mood and anxiety disorders; however, epidemiologic studies have generally treated these outcomes as homogenous entities. The objective of this study was to systematically review the epidemiologic evidence for potential patterns of heterogeneity of common mood and anxiety disorders over the lifecourse in the general population. Methods We reviewed epidemiologic studies examining heterogeneity in either the nature of symptoms experienced ( symptom syndromes ) or in patterns of symptoms over time ( symptom trajectories ). To be included, studies of syndromes were required to identify distinct symptom subtypes, and studies of trajectories were required to identify distinct longitudinal patterns of symptoms in at least three waves of follow-up. Studies based on clinical or patient populations were excluded. Results While research in this field is in its infancy, we found growing evidence that, not only can mood and anxiety disorders be differentiated by symptom syndromes and trajectories, but that the factors associated with these disorders may vary between these subtypes. Whether this reflects a causal pathway, where genetic or environmental factors influence the nature of the symptom or trajectory subtype experienced by an individual, or whether individuals with different subtypes differed in their susceptibility to different environmental factors, could not be determined. Few studies addressed issues of comorbidity or transitions in symptoms between common disorders. Conclusion Understanding the diversity of these conditions may help us identify preventable factors that are only associated with some subtypes of these common disorders

Mindfulness and Mantra Training for Disaster Mental Health Workers in the Philippines

Disaster mental health training programs have begun to include mindfulness instruction, though better understanding of providers’ mindfulness training expectancies and the differences that disaster exposure might make in their personal practice and clinical utilization of mindfulness is needed to support the feasibility and acceptability of this training in challenging disaster settings. This study examined training expectancies and utilization of a manualized mindfulness meditation and mantra program (Inner Resources for Stress) among N = 68 counselors and psychologists living in the Philippines beginning 12 weeks after Typhoon Haiyan. They attended a 4-h workshop conducted in Manila, Philippines, followed by an 8-week home study program. Following the workshop, a majority had high expectancies that the training would help with survivor and self-care. Higher disaster exposure (β = 0.32) and training expectancies (β = 0.25), but not baseline stress symptoms, were associated with higher perceived usefulness of the training for disaster work. Growth curve analyses demonstrated significantly different trajectories of weekly mindfulness practice for disaster-exposed versus nonexposed participants, with a flatter slope for disaster-exposed participants, though both groups had significant increases in practice time across the 8 weeks (d = 1.71). Higher total number of minutes of mindfulness practice was associated with lower depression severity (β = − 0.34), but not anxiety, at 8 weeks post-training. Participants perceived the training as credible and useful for disaster work and self-care and reported active personal and professional use of the techniques, suggesting that mindfulness training shows promise as a disaster intervention component