Case-series Evaluating a Transdiagnostic Cognitive-behavioral Treatment For Co-occurring Anxiety Disorders.

Background. Patients with anxiety disorder diagnoses commonly have more than one anxiety diagnosis. While cognitive-behavioral interventions have proven efficacy in treating single anxiety disorder diagnoses, there has been little investigation of their efficacy in treating cooccurring anxiety disorders. Aims. To evaluate the efficacy of a transdiagnostic cognitive-behavioral intervention for treating co-occurring anxiety disorders. Methods. An A-B single case study design (N = 6) was used to evaluate the efficacy of a 12 to 13 session modular transdiagnostic cognitive-behavioral intervention for treating co-occurring anxiety disorders across patients with at least two of the following diagnoses: GAD, Social Phobia, Panic Disorder and/or OCD. Results. Five of the six participants completed treatment. At post-treatment assessment the five treatment completers achieved diagnostic and symptomatic change with three participants being diagnosis free. All participants who completed treatment no longer met criteria for any DSM-IV-TR Axis-I diagnosis at the three-month follow-up assessment, and demonstrated reliable and clinically-significant improvements in symptoms. Across the participants, statistically significant improvements from pre- to post-intervention were found on measures of anxiety, depression and general well-being, and all improvements were maintained at three-month follow-up. Conclusions. Results suggest that transdiagnostic cognitive behavioral interventions can be of benefit to patients with co-occurring anxiety disorders.

Lessons Learnt From Ragweed and Birch Studies

Here we review some of the most important aspects of recent work on Ragweed (Ambrosia) and birch (Betula) concerning: 1) sources, 2) trends & phenology and 3) dispersion and transformation. Sources: At Northern latitudes the birch fraction in forests usually exceeds 50% of all broadleaved trees and the abundance of birch decreases with latitude from 5%-20% in many mid-latitude regions and down to 0%-2% in more southern areas. Birches are also commonly found in small woodlands or planted as ornamental trees in urban areas. Ragweeds are herbaceous weed species that are associated with areas of disturbance. Ragweed is native to North America, but considered an invasive species in Europe, Australia and China. In Europe, the four main centres are: The Pannonian Plain, Ukraine, The Po Valley (Italy) and the Rhone Valley (France). Trends & Phenology: Birch pollen seasons have started earlier during the last decades. This trend appears have decreased during recent years despite increasing spring temperatures. Ragweed tends to experience less change in flowering date as ragweed flowering depends on photoperiod. Ragweed is increasing its distribution in Europe, but airborne concentrations of ragweed pollen are not universally increasing, e.g. due to control measures or pest attacks. Dispersion & transformation: The beginning of the birch pollen season is often heralded by episodes of Long Distance Transport (LDT) from the south. Similar LDT episodes are intermittently seen for ragweed, which can reach as far north as Scandinavia. Humidity and air pollution can modify pollen grains during atmospheric transport. This can cause a change in allergenic potential of the pollen grain and is a direction for future research including the effect of co-exposure of air pollution and the transformation of aeroallergens.