The main objective of this thesis is to describe the epidemiology of long term BZD use as well as its long term consequences. This thesis is structured into three sections: In section one, the... Show moreThe main objective of this thesis is to describe the epidemiology of long term BZD use as well as its long term consequences. This thesis is structured into three sections: In section one, the correlates of BZD use, new use, chronic use, inappropriate use, and BZD dependence severity are investigated. The possible influence of the prescribing physicians on patient BZD use is also considered. In section two, the focus is on the physiological consequences of long-term BZDs use on the HPA axis and the ANS. In section three, cognitive effects of BZDs in long-term users are addressed Show less
The aim of this thesis was to clarify which aspects of depression and anxiety are related to an increased metabolic risk, and which factors contribute to these associations. Taken together, our... Show moreThe aim of this thesis was to clarify which aspects of depression and anxiety are related to an increased metabolic risk, and which factors contribute to these associations. Taken together, our findings indicate that people with more severe symptoms of depression and anxiety are at particular risk of progressive dyslipidemia and (abdominal) obesity. The higher rates of smoking and systemic inflammation among people with depression or anxiety partially accounted for their adverse metabolic profile. Dysregulations of the autonomic nervous system partly explained why users of tricyclic antidepressants displayed an increased risk of dyslipidemia and (abdominal) obesity as well, and also of hypertension. These important findings shed light on useful avenues for future research, and on preventive and therapeutic insights and directions. Show less
Jamal, M.; Does, A.J.W. van der; Cuijpers, P.; Penninx, B.W.J.H. 2012
There is a growing awareness that research of the etiology of depressive and anxiety disorders has been hampered by their strictly categorical definition in the Diagnostic and Statistical Manual ... Show moreThere is a growing awareness that research of the etiology of depressive and anxiety disorders has been hampered by their strictly categorical definition in the Diagnostic and Statistical Manual (DSM). The DSM uses a syndrome approach, which __ although beneficial for standardization - has inherent problems that make it suboptimal for research: high rates of (artificial) comorbidity, diagnostic heterogeneity and the unrealistic assumption of discontinuity between ill and healthy. A dimensional approach that focusses on the relative severity of continuous symptom domains could be more optimal but measurement and the added value of such dimensions has been debated. Therefore, this dissertation was aimed to investigate (1) the internal validity and possibility to measure dimensions and (2) their added value in etiological and clinical research. The results showed that measurement of dimensions can be optimized using self-report questionnaires. In addition, dimensions were shown to have added value in etiological and clinical research. Because of their specific and continuous nature, dimensions could be used to uncover symptom-specific and/or non-linear association. Together, the results suggest that dimensions of depression and anxiety have internal and external validity and have the potential to improve the psychiatric research. Show less
