This study uses functional magnetic resonance imaging (fMRI) to learn how the brain functions in adolescents receiving fluoxetine (Prozac) or cognitive behavioral therapy (CBT) for anxiety or depression in children/adolescents. All participants will receive interviews to assess how they are doing in general, including his or her general mood, degree of nervousness and behavior. Each participant and one of his or her parents will be interviewed separately and together.
Age: 8 to 17
Consent: Can give consent/assent. (Parents will provide consent; minors will provide assent.)
IQ: All subjects will have IQ greater than 70 (Assessment relies on WASI)
SUBJECTS WITH AN ANXIETY DISORDER
Diagnosis: Current Diagnosis of Social Phobia, Separation Anxiety, or Generalized Anxiety Disorder (Based on K-SADS)
Symptom Severity: Score greater than 9 on PARS (This score was used to enroll subjects in previous trial demonstrating efficacy of an SSRI in pediatric anxiety.)
Clinical Impairment: CGAS less than 60
SUBJECTS WITH A MOOD DISORDER
Diagnosis: Current Diagnosis of Major Depression (Based on K-SADS (juveniles) or SCID (adults))
Clinical Impairment: CGAS less than 60 (juveniles) GAS less than 70 (adults)
Symptom Severity: CDRS Score greater than 39 (juveniles) (This score was used to enroll subjects in previous trials demonstrating efficacy of an SSRI in pediatric depression.)
Consent: Can give consent/assent.
IQ: All subjects will have IQ greater than 70. Assessment relies on WASI.
Any serious medical condition or condition that interferes with fMRI scanning, and for patients electing medication, any condition that increases risk of SSRI treatment. All patients will have complete physical examination. Healthy volunteer participants will be medication-free and have no current serious medical conditions, based on a review of their medical history.
Current use of any psychoactive substance; current suicidal ideation; current diagnosis of attention deficit hyperactivity disorder (ADHD) of sufficient severity to require pharmacotherapy. These factors could complicate treatment with an SSRI. No subject on medication will be accepted into the trial. Subjects will not be taken off of medications to enter the trial.
Current diagnoses: Tourette's, OCD, posttraumatic distress disorder, conduct disorder. These factors may be effected by SSRI treatment, influencing ability to detect effects on anxiety/depression
Past or current history of mania, psychosis, or pervasive developmental disorder. These factors may be effected by SSRI treatment, influencing ability to detect effects on anxiety/depression
Recent use of an SSRI: All subjects must have been free of any SSRI use for at least one month (fluoxetine six months) and must not have been treated with an SSRI for their current depressive episode. This is designed to exclude subjects who have failed a trial of an SSRI for their current episode of major depression.
HEALTHY ADULT SUBJECTS
Any current psychiatric diagnosis. Assessment relies on SCID.
SUBJECTS WITH AN ANXIETY DISORDER
Current Major Depressive Disorder
Out and About, or Stressed Out?
The holidays are an exciting time of good cheer, warm family traditions, and spending time with friends. Or, are they?
For many people, the idea of entering a crowded room and chatting up coworkers or strangers at a party, exchanging gifts with friends, traveling from home, or attending large family gatherings can produce intense anxiety, depression, or both.
Sex Differences in the Network Mediating Fear Learning and Extinction
With implications for anxiety disorders, substantial data indicate that structural, cellular, and molecular differences exist between the male and female brain regions, specifically the hippocampus, amygdala, and prefrontal cortex, important for cognition, memory, and affect. (Biology of Mood & Anxiety Disorders. 2012, 2:3) Read more.
Pregnant women with a history of anxiety or depression can face difficult and confusing choices about treating their symptoms with antidepressants and other medications.
Both anxiety disorders and depression are more likely to affect women than men, and women who are pregnant are not excluded. In fact, symptoms can develop or worsen during or after pregnancy, though in some cases women notice fewer symptoms while pregnant. Women can have an anxiety disorder and depression at the same time, too.
From the time a girl reaches puberty until about the age of 50, she is twice as likely to have an anxiety disorder as a man. Anxiety disorders also occur earlier in women than in men.
Women are also more likely to have multiple psychiatric disorders during their lifetime than men. The most common to co-occur with anxiety is depression.