Here are a series of assessment questionnaires and handouts for Generalized Anxiety Disorder:

GAD, 2 question screen - answering "yes" to either of the two screening questions on this sheet suggests it's worth checking for a diagnosis of full Generalized Anxiety Disorder (GAD) - for example by using the GADQ (see below).

GAD, questionnaire (GADQ) - a simple questionnaire for making a full diagnosis of GAD.

GAD, assessment (GADSS) and scoring - the GAD Severity Scale.  Useful, and pays more attention to GAD's associated physical symptoms than the more purely worry-focussed scales that are often used.

GAD, metacognitions (Wells) - GAD assessment scale developed by Wells.  Includes measures of safety behaviours and metacognitions.

I have already written an initial blog post about Barbara Fredrickson and colleagues' interesting recent research paper (Fredrickson, Cohn et al. 2008) on the effects of teaching people loving-kindness meditation.  So what are some possible implications of this research for people in general, for using forms of mind training (meditation, imagery, breathing techniques, self-hypnosis and relaxation) for ourselves, and for people who teach these approaches?

Five of these six studies are from last month's American Journal of Psychiatry.  Kendler et al discuss the many similarities and only occasional differences between bereavement-related and other life event-related depression - an issue explored further in Maj's editorial.  Li et al show that depression in pregnancy (exacerbated further by stressful life events and obesity) increases the risk of preterm delivery.  Miklowitz reviews research on the value of adjunctive psychotherapy for bipolar disorder sufferers (already taking medication) and discusses the various ways it can be helpful.  Oquendo et al (in a freely viewable editorial) argue that suicidal behaviour should be placed on a "separate axis" in the next version of the DSM diagnostic system.  Finally Vertanen et al, in an interesting study, demonstrate that increased hospital overcrowding - measured by bed occupancy rates - is associated with increased use of antidepressants by hospital staff.

Kendler, K. S., J. Myers, et al. (2008). "Does Bereavement-Related Major Depression Differ From Major Depression Associated With Other Stressful Life Events?" Am J Psychiatry 165(11): 1449-1455.  [Abstract/Full Text]  

Here are a collection of downloadable forms, questionnaires and handouts that I use when working with people struggling with obsessive compulsive disorder and body dysmorphic disorder.

Normal intrusions - a list of 52 "normal intrusive thoughts" with the percentage of 293 students (none of whom had been diagnosed with a mental health problem) who reported that they had experienced this thought.  I often hand out this leaflet to help people realize that experiencing occasional disturbing intrusive thoughts is totally normal.

OCD diagnosis & prevalence - leaflet giving DSM-IV diagnostic criteria for obsessive-compulsive disorder and some details of prevalence rates.

I've just been reading the recent paper by Barbara Fredrickson and colleagues "Open hearts build lives: Positive emotions, induced through loving kindness meditation, build consequential personal resources" (Fredrickson, Cohn et al.

Here are half a dozen recent studies on men & women.  Elliot & Niesta found that red, relative to other colours, lead men to view women as "more attractive and sexually desirable".  Holt-Lundstad & colleagues randomized couples to a "support enhancement intervention" involving shared gentle massage for 30 minutes three times weekly or a control group.  There were encouraging effects of the "warm touch" on multiple stress-sensitive systems including husbands' blood pressure.  Koo et al found that writing about how something good might not have happened (e.g. how one might never have met one's romantic partner) produced more satisfaction (with the relationship) than writing about how the positive event actually had happened (e.g.

Good stuff!  The British Medical Journal Group have just launched their Evidence Centre.  It's a fine evidence-based resource providing excellent information for doctors, patients and organizations.  Most of the services however seem to cost money to access.  The Best Health resource for patients, for example, costs £9.99 plus VAT for a 30 day subscription (or £3.00 plus VAT to look at information on a single condition).  The good news for searches to the Best Health resource from the UK and Republic of Ireland is that Boots have linked with the BMJ Group to give access to this service free of charge.  Visit Ask Boots to see how helpful this can be.  Key features include:

• In-depth information on more than 180 common conditions
• Evaluation of over 1500 treatments
• Assessment of 23 common operations and tests
• Decision-support guidelines to help patients assess their options
• Search tips to help them navigate to the right information
• Regular updates to include new evidence and drug guidelines

Here are a couple of studies on smoking, a couple on B vitamins, a couple on vitamin D, and an intriguing study on iron.  The smoking papers underline the varieties of damage this habit produces.  So the Pasco et al study shows that, for women, being a smoker is associated with double the risk of developing subsequent major depression.  The Strandberg research challenges any notion of "Eat, drink and be merry for tomorrow we die".  This study of 1658 men reports that "During the 26-year follow-up of this socioeconomically homogeneous male cohort, HRQoL (quality of life) deteriorated with an increase in daily cigarettes smoked in a dose-dependent manner.

Here are a series of forms, questionnaires and handouts that I use regularly in my work.  The problem solving diagram is a recurring theme - both at the start of therapy and as a sheet to return to when reviewing and considering additional therapeutic options.  Other sheets are classic variants on the tools used by many cognitive behavioural therapists - with occasional alternatives and additions, that I've come up with over the years, thrown in as well.

An article in one of this month's editions of the Journal of the American Medical Association celebrates the publication of the CAGE alcohol screening questionnaire by Charles Ewing 25 years ago.  CAGE is a mnemonic to help remember the four simple questions.  "Have you ever ...

1.) felt the need to cut down your drinking?
2.) felt annoyed by criticism of your drinking?
3.) had guilty feelings about drinking?
4.) taken a morning eye opener?

An affirmative answer to 2 or 3 of these questions makes an alcohol problem likely, while a score of 4 suggests a diagnosis of alcoholism is almost certain. 

The questions can be used in most clinical settings to identify people who need to be checked out more fully.  In the United States, 30% of primary care physicians report  regularly screening for substance abuse.  Of these physicians 55% use the CAGE.  See too the January blog posting on The demon drink.