effect of treating generalized anxiety disorder on psychoactive substance abuse and dependency in Erbil city

Generalized anxiety disorder is a common psychiatric disorder; it may act as a risk factor for psychoactive substance abuse and dependency development. The objectives are to assess the degree of abuse and dependency in generalized anxiety disorder patients, and the effect of treating the disorder on substances abuse and dependency. 120 patients with generalized anxiety disorder, diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders [DSM-IV], were studied from January 2007 to June 2008 for the presence of psychoactive substance abuse and dependency according to DSM-IV. All cases were managed for six months by the tricyclic antidepressant imipramine [35-75mg/day], with counseling to decrease anxiety by reassurance and anxiety management including relaxation training, in addition to supporting and encouraging the patients with abuse to stop the used psychoactive substances by a tapering schedule over weeks. Substance abuse were presents in 32.5% of patients [tobacco 17.5%, benzodiazepines 13.3%, and alcohol 1.7%], this rate decreased to 13.3% [tobacco 11.7%, benzodiazepines 0.8%, and alcohol 0.8%] six months after starting treatment. The decrease in benzodiazepines abuse and dependency was greater than that in tobacco or alcohol. Generalized anxiety disorder appears to encourage abuse on psychoactive substances. Treating the disorder decreases abuse and using imipramine appears to have a good therapeutic effect on generalized anxiety disorder with low risk for abuse

Anxiety among patients undergoing major general surgery

It has been recognized for more than 40 years that patients experience different levels of anxiety when faced with impending surgery. The degree to which each patient manifests anxiety is related to many factors; this study aims to assess the level of anxiety among patients undergoing major general surgery and to identify the effect of gender on preoperative anxiety. A sample of 300 patients who were admitted from 5th April 2009 to the 10th November 2009; in general surgery units of teaching hospitals [Rezgari and Hawler] in Erbil city were interviewed to assess their level of anxiety before surgery. The instrument used for this purpose was a questionnaire that included socio-demographic information and the State-Trait Anxiety Inventory [STAI] of Spilberger. Most of the patients showed moderate to severe anxiety level; [moderate=50% and severe=38.3%] others showed mild anxiety level [11.7%]. A statistically significant relationship was seen between preoperative anxiety and gender; female patients showed high levels of anxiety [severe anxiety=46.9%] while male patients showed less severe anxiety level [severe anxiety=28.6%]. According to the results of the study patients undergoing major general surgery need to be assessed regarding level of anxiety before surgery. This anxiety should be reduced through appropriate interventions, especially in women who have been found to experience high levels of anxiety