Inter-informant agreement on diagnoses and prevalence estimates of anxiety disorders: direct interview versus family history method.

The aims of the present study were to: (1) assess agreement for diagnoses of specific anxiety disorders between direct interviews and the family history method; (2) compare prevalence estimates according to direct interviews and family history information; (3) test strategies to approximate prevalence estimates according to family history reports to those based on direct interviews; (4) test covariates of inter-informant agreement; and (5) test the likelihood of reporting disorders by informants. Analyses were based on family study data which included 1625 distinct informant (first-degree relatives and spouses)-index subject pairs. Our main findings were: (1) inter-informant agreement was satisfactory for panic disorder, agoraphobia, social phobia and obsessive-compulsive disorder; (2) the family history method provided lower prevalence estimates for all anxiety disorders (except for generalized anxiety disorder and obsessive-compulsive disorder) than direct interviews; (3) the lowering of diagnostic thresholds and the combination of multiple family history reports increased the accuracy of prevalence estimates according to the family history method; (4) female gender of index subjects was associated with poor agreement; and (5) informants, who themselves had a history of an anxiety disorder, were more likely to detect this disorder in their relatives which entails the risk of overestimation of the size of familial aggregation.

["Epinephrine-addiction" and risk-seeking behaviour in athletes: what realities?]. / "Adrénaline-addiction" et comportements de prises de risques chez les sportifs: quelles réalités?

This article resumes the psychobiologic mechanisms involved in risk-seeking behaviour. The question is discussed whether some forms of high risk sports meet the diagnostic criteria of dependency. The intensive activation of the adrenocorticotropic pathway may yield to addiction: according to the model of emotion-focussed coping of stress, unpleasant emotion is "overwritten" by intense stress and hence better tolerated emotionally, leading to an addictive repetition of risk-seeking behaviour. In addition, pharmacologic mimicry seems possible as the perception of effects of catecholamines may imitate some of the effects of stimulating drugs. Finally, the current concept of risk and harm reduction is transferred to sports. This would mean to apply appropriate preventive interventions for a large variety of possibly dangerous activities.