Prevalence of Anxiety Disorders among Men & Women

INTRODUCTION

Anxiety disorders are the most common mental disorders collectively, with an expected lifetime pervasiveness of 28.8%and an expected year commonness of 18.1% in the general population.1-2 The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) orders generalized anxiety disorder (GAD), alarm disorder, agoraphobia, social anxiety disorder (SAD), obsessive-compulsive disorder (OCD), explicit fears, and post-horrible pressure disorder (PTSD) as anxiety disorders.3 Only as of late have scientists directed their concentration toward the event of anxiety disorders in women. Information from ongoing India local area studies has uncovered that women have an altogether higher danger than men of fostering an anxiety disorder during their lifetime. Hence, it is basic to research the qualities and expected reasons for anxiety disorders in this particular populace. As per India local area reviews, women are altogether more probable than men to foster frenzy disorder (7.7% versus 2.9%), GAD (6.6% versus 3.6%), or PTSD (12.5% versus 6.2%) during their lifetime. Though less articulated, these reviews likewise recommend a distinction in sexual orientation in the danger for creating lifetime OCD (3.1% of women versus 2.0% of men) and SAD (15.5% of women versus 11.1% of men). The reason for the expanded danger in women for fostering a lifetime anxiety disorder isn't perceived. Somewhat couple of concentrates up to this point have researched whether the qualities of women with anxiety disorders contrast from those in men with similar disorders. Investigations of female twin libraries have given significant knowledge with regards to the variables associated with the improvement of anxiety disorders in women. Information from these overviews recommends the possible job of hereditary versus environmental elements in the advancement of anxiety disorders. Information likewise proposes the expected job of female conceptive chemicals and related cycles in the turn of events, course, and result of anxiety disorders in women. Published information has shown a distinction in sexual orientation in the ingestion, bioavailability, and dispersion of psychotropic medicine, which will assume a significant part in the fate of conceivable treatment techniques for women with anxiety disorders. At last, ongoing discoveries from imaging studies have recommended that a more dynamic and bigger front cingulated cortex might exist among women with a particular dread reaction and high mischief aversion scores when contrasted with men with comparable qualities. Albeit such discoveries have women to anxiety disorders. This article endeavors to audit these issues involving the accessible proof in regards to anxiety disorders in women.

The National Comorbidity Survey (NCS) gauges a 5.7% lifetime pervasiveness rate for GAD.2 This study showed that women are around two times as prone to have GAD as their male partners, with absolute lifetime commonness paces of 6.6% and 3.6%, individually .The predominance rate expanded to 10.3% for women matured 45 years, however was unaltered for men matured 45 years (3.6%GAD is portrayed by exorbitant anxiety and stress happening a larger number of days than not for something like a half year, about various occasions or activities.3 The symptomatology related with this disorder incorporates fretfulness, being effectively exhausted, trouble concentrating, peevishness, muscle pressure, or potentially rest unsettling influence. Women with GAD seem to have a few distinctive clinical elements from men with GAD. Women determined to have GAD will quite often have a previous period of beginning than men with GAD. Women with GAD give off an impression of being bound to have comorbid mental disorders, specifically burdensome disorders, than men with GAD. Data gathered from three huge family tests propose that women with GAD might be bound to create comorbid dysthymia. Comorbid GAD, instead of unadulterated GAD, is related with expanded inability and brokenness, and has a more terrible anticipation and debilitation Analysis of populace based twin information base has recommended that in women, GAD has a nearby hereditary relationship to significant burdensome disorder (MDD).It is guessed that somewhat unmistakable environmental variables influence the statement of a GAD aggregate or a MDD aggregate. Accordingly, women with GAD might be bound to create comorbid conditions, like wretchedness, hence influencing the course and seriousness of their disease. Proof from different investigations has uncovered that women with GAD regularly report premenstrual deteriorating in GAD indications. A concentrate by McLeod et al contrasted women and GAD, GAD and premenstrual disorder (PMS), and women controls and announced that women with GAD and PMS had a greater number of side effects than the controls during the two periods of the monthly cycle and during the premenstrual period .They didn't report a huge change in manifestation seriousness during the monthly cycle in the women with GAD alone. Outline and the study of disease transmission Data from enormous scope epidemiologic examinations like the NCS and NCS Replication (NCS-R) studies assessed the lifetime pervasiveness of GAD somewhere in the range of 5% and 6%. Later expanded pace of GAD in contrast with men In essential consideration settings, GAD is allegedly the second most normal mental disorder after melancholy. Patients with GAD show deficiencies in friendly and job working, general wellbeing, and real torment consequently prompting greater handicap days and a more prominent number of doctor visits than patients without GAD. Around 90% of people with GAD have comorbid mental conditions. Temperament disorders were the most widely recognized lifetime comorbid disorder in those gathering measures for GAD, with unipolar sadness (67%) allegedly multiple times bound to happen than bipolar disorder (17%) in the NCS study . Stray is likewise regularly comorbid with other anxiety disorders like PD and SAD.

1. To review in Obsessive-Compulsive Disorder. 2. To review in Social Anxiety Disorder. Sex differences in GAD Women are 2-to 3-times more probable than men to meet lifetime rules for GAD Contrasts are additionally noted in the indications showed in the two genders, with women underwriting more physical grumblings, weariness, and muscle strain than men. McLean et al., hypothesized that the expanded substantial grumblings might mirror the impact of social and sex-explicit elements, as women are more inclined to disguising disorders contrasted with men. Females may likewise be almost certain than guys to have negative effect and neuroticism, and such characteristics have additionally been involved as hazard factors in the advancement of anxiety, by and large, just as GAD, specifically While epidemiological investigations have not distinguished a distinction in period of beginning, course or chronicity of GAD between the two genders reports from clinical examples have found a before onset of GAD in females than in guys. Women in the imminent HARP study were noted to have lower paces of reduction than men and abatement additionally happened later. Rodriguez et al., directed in an example of essential consideration patients observed comparable outcomes in that men were fundamentally more probable than women to accomplish an incomplete recuperation from GAD. Related Conditions (NESARC) study, an enormous get sectional overview of north of 43,000 members in the U.S., uncovered that men meeting measures for GAD had altogether higher paces of comorbid liquor and medication use disorders, nicotine reliance, and total disregard for other people than women with GAD. Women meeting GAD measures in contrast with men had essentially higher paces of comorbid mind-

liquor and medications to assist with soothing GAD side effects, while women with GAD were bound to report a family background of discouragement and more prominent degrees of handicap. Albeit somewhat scarcely any looked for treatment in similar report, men were even more outlandish than women to seek after treatment for GAD Co morbidity with wretchedness has been related with expanded utilitarian weakness and a more serious danger of self-destruction. Considering that women are bound to have GAD with comorbid gloom, this probably adds to the observing that women are almost certain than men to have a more persistent course of GAD and more noteworthy indication seriousness. Information from vicariate female twin sets with GAD proposes that hereditary elements represented roughly 30% of the danger of GAD advancement, with environmental variables clarifying the rest of the change there is restricted information accessible concerning the possible effect of sex on treatment reaction in GAD. There was no proof of sex contrasts in GAD treatment reaction in a twofold visually impaired, fake treatment controlled preliminary of sertraline. in any case, another review uncovered that females with GAD were less inclined to react to SSRIs than guys Although benzodiazepines are not viewed as first-line pharmacotherapy in anxiety disorders, results from a study in the Netherlands finished by in excess of 60,000 patients found overall practice settings uncovered that women in contrast with men were two times as prone to get a first solution for benzodiazepines and were additionally found to have an essentially higher pace of rehash benzodiazepine remedies.

The NCS gauges a 12.1% lifetime commonness rate for SAD.2 The NCS has exhibited that SAD is the most well-known anxiety disorder and the third most normal mental disorder, surpassed in lifetime predominance exclusively by significant wretchedness (16.6%) and liquor misuse (13.2%). A prior rendition of the NCS has exhibited that women are roughly 1.5 occasions more probable than men to have social anxiety, with complete lifetime predominance paces of 15.5% and 11.1%, respectively SAD, otherwise called social fear, is described by a checked and determined feeling of dread toward at least one social or execution circumstances in which the individual is presented to new individuals or to conceivable investigation by others. Two principle subtypes of the disorder have been ordered, generalized and non-generalized. The generalized subtype of SAD incorporates people with a wide scope of social feelings of dread, though the no generalized subtype essentially includes anxiety that is restricted to explicit circumstances. A review by Turk et al inspected explicit gender contrasts among patients with SADs. contrasts were obvious with respect to seriousness of dread in explicit circumstances. Women revealed fundamentally bigger dread than men while conversing with power, acting/performing/giving a discussion before a group of people, working while at the same time being noticed, going into a room when others are situated, being the focal point of consideration, making some noise at a gathering, communicating conflict or dissatisfaction to individuals they don't know quite well, giving a report to a gathering, and giving a party. Men revealed fundamentally more dread than women in regards to peeing in open washrooms and returning products to a store. This study didn't show proof of gender contrasts in the pervasiveness of the generalized versus no generalized sort of SAD, the event of comorbid disorders, or in the clinical course of the infection. Different examinations, be that as it may, have shown gender contrasts in the study of disease transmission of SAD. Yonkers et al analyzed information from the Indian Community Med 2019 Anxiety Disorders , announcing that overall, women with SAD had more comorbid mental diseases than men (2.4 comorbid mental sicknesses contrasted and 1.9; t = 2.05, df = 161, p < 0.4). They found that the ailments probably going to co-happen among women were alarm disorder with agoraphobia (50 % of women and 28% of men; p < 0.005) and straightforward fear (24% of women and 9% of men; p < 0.017). They likewise observed that a marginally bigger extent of women than men had generalized social fear (56% versus 47%) and that a more modest extent of women had the particular type of social fear (44% versus 53%); nonetheless, neither one of the distinctions was genuinely critical. These gender distinctions might clarify the more ongoing course, with expanded indication seriousness and more noteworthy utilitarian debilitation saw in women with SAD. There is generally little information accessible with respect to gender contrasts in treatment reaction in SAD. While women have been displayed to have a higher lifetime hazard for creating SAD, proof from two investigations have demonstrated that men are bound to look for treatment for the disorder. In a fake treatment controlled preliminary researching the viability of paroxetine in the treatment of SAD, Stein et al revealed that there was no proof of a gender contrast accordingly rates among people with SAD getting treatment with paroxetine. A similar gathering additionally distributed as of late a twofold visually impaired fake treatment controlled investigation of escitalopram for SAD, where the treatment impacts of escitalopram were free of gender. Regardless, the effect of female regenerative chemicals on the course and seriousness of social anxiety still can't seem to be entirely examined. for obsessive-compulsive disorder (OCD).2 However results from the Epidemiologic Catchment Area (ECA) study and the Cross-national OCD Collaborative Group Study gauge a somewhat higher lifetime predominance rate for OCD (2%-3%) in the United States. These same reviews show that women are 1.5 occasions more probable than men to foster OCD during their lifetime. In any case, the time of beginning seems to contrast among people, as information has proposed that prepubertal young men are multiple times bound to be determined to have OCD as prepubertal girls. The mean period of beginning of OCD in people is 20 years and 25 years, individually. After menarche the predominance pace of females with OCD significantly increments, proposing the likely job of female conceptive chemicals in the advancement of the disorder. OCD is described by fixation as characterized by intermittent and steady musings, motivations, or pictures that are capable, sooner or later during the unsettling influence, as nosy and unseemly and that cause checked anxiety or pain, just as by monotonous practices or mental demonstrations that the individual feels headed to act in light of a fixation, or as indicated by decides that should be applied unbendingly. There is some proof that the course of OCD might be more rambling and less serious in women than in men, and that women with OCD might have a more intense beginning of OCD than men. A few investigations have demonstrated that the path physiological instruments in OCD appear to vary by gender. Palace et al announced that females with OCD were bound to be hitched and to have kids than their male partners. They additionally observed that females were imperceptibly bound to have a previous history of a dietary problem or misery, while guys were bound to have a past filled with restless or careful character attributes. Lensi et al additionally tracked down gender contrasts in the introduction of the sickness. They detailed that women had higher paces of related fits of anxiety after the beginning of OCD and a higher recurrence of forceful fixations at the beginning of their ailment. Valleni-Basile et al have announced that in teenagers with OCD, indications in females with OCD are portrayed by compulsive ceremonies, while guys are bound to have obsessive considerations.

The numerous people who are presented to injury, one out of four will foster post-horrible pressure disorder (PTSD). The NCS gauges a 6.8% lifetime pervasiveness rate for PTSD in the United States.1 Data from such populace overviews have proposed that women are two times as possible as men to foster lifetime PTSD (12.5% lifetime commonness in women versus 6.2% lifetime predominance in men). PTSD is described by persevering re-encountering of a horrendous memory, industrious aversion of boosts related with the awful accident, desensitizing of that lead to the advancement of PTSD. While the most widely recognized reason for PTSD in men is battle openness, the most well-known reasons for PTSD in women are rape, sexual attack, or youth actual maltreatment. Proof has additionally shown the significance of "saw danger" in the arrangement of PTSD in women, or the insight inside the casualty that the horrendous mishap is hazardous or that break is impossible rather than more evenhanded or practical appraisals of dangerous events.19 Male military veterans are determined to have PTSD at a lot more prominent rate than female military veterans; nonetheless, a few examinations have demonstrated that this information might be deceiving. Pereira analyzed male and female veterans presented to comparable degrees of battle related pressure and observed that people were similarly prone to have PTSD side effects. Kimberling et al inspected PTSD in female Vietnam War-period veterans and observed that there was a critical connection between PTSD side effects and detailed medical conditions in the women with past injury openness, and it has been proposed that high paces of ongoing clinical disease might be one of the unfriendly outcomes of neglecting to recognize and analyze PTSD in military veterans. The outcomes from these investigations maybe demonstrate that women truth be told have a comparative danger for PTSD as men after battle related injury openness; they are essentially more averse to get a PTSD finding than men. A few examinations have likewise shown a gender contrast in the symptomatology of PTSD. Fullerton et al analyzed the event of PTSD in people after a genuine engine vehicle mishap, and observed that women were almost multiple times as prone to meet the general evasion/desensitizing measure and right multiple times as liable to meet the general excitement rule for PTSD. They additionally observed that dissociative side effects at the hour of the mishap were related with an essentially higher danger for intense PTSD in women than in men. Magdol et al observed that women defrauded by aggressive behavior at home are bound to foster anxiety indications, while men are bound to foster substance use disorders. Furthermore, women who experience repetitive or constant sexual maltreatment might be bound to have anxiety and phobic side effects and to foster an anxiety disorder. Proof from a few investigations has proposed that women with PTSD might have an expanded danger for specific pregnancy difficulties. Seng et al found that women with PTSD have essentially higher chances proportions for ectopic pregnancy, unconstrained early termination, hyperemesis, preterm withdrawals, and unnecessary fetal development contrasted and a correlation gathering of women. Right now, nonetheless, there is minimal

distinction in treatment reaction to PTSD. Sertraline and fluoxetine have been viewed as more powerful in treating the manifestations of aversion/desensitizing and hyperarousal contrasted and once again encountering symptoms. Since there is proof that women are bound to encounter evasion/desensitizing and hyperarousal indications than men,81 this might represent the gender impact saw in these multicenter preliminaries. A multicenter preliminary exploring paroxetine in the treatment of PTSD yielded no proof of gender contrasts or differential reaction of PTSD side effect groups.

Information was drawn from the CPES, which is a mix of three public reviews of mental wellbeing in inhabitants of the Apollo Medical Research Institute Hyderabad Information were gathered between May 2019 and November 2020. The CPES has been portrayed exhaustively somewhere else yet a contracted depiction of every one of the constituent datasets is talked about here.

The sampling procedure for every one of the three overviews included four phases: 1) centre sampling, in which essential sampling units (metropolitan measurable regions or district units) and auxiliary sampling units (persistent groupings of enumeration blocks) were chosen with likelihood proportionate to estimate; 2) high-density supplemental sampling to over-example evaluation block bunches with 5% or more noteworthy density of target parentage/racial gatherings; 3) screening of an irregular choice of lodging units (utilizing a pre-decided sampling rate) inside each assigned sampling unit to decide fulfilment of study qualification rules, trailed by arbitrary choice of one respondent from every family for the review meeting; and 4) second respondent sampling to enlist members from families in which one qualified part had effectively been talked with Weighting correlations were formed to consider the joint probabilities for choice under the 4 components of the example plan

The complete example (N = 20,013) inspected in this study comprised of 11,463 women and 8,550 men. The women analyzed in this study were more established (M = 43.74 versus 42.90, F = 12.54, p < 0.001) and had an altogether higher extent of male (34.4% versus 26.9%, χ2 = 136.08, p < 0.001) than their male partners. The male associate, then again, had an essentially higher extent of Indians (12.7% χ2 = 23.51, p < 0.001), and revealed a higher mean yearly family pay (Rs.57,061 versus Rs.45,330, F = 263.06, p < 0.001). Since every one of these segment factors were altogether unique between orientation gatherings, every one of the investigations were run with these factors as covariates in the calculated regression examinations to represent these distinctions across men and women.

We analyzed lifetime and past-year event of DSM-IV anxiety disorders (counting SAD, GAD, PD, AG, explicit fear, and PTSD) across gender. Auxiliary examinations researched the lifetime and past-year paces of comorbid disorders among those with somewhere around one anxiety disorder in every one of those time periods. We analyzed paces of comorbid state of mind disorders (i.e., significant burdensome disorder [MDD], bipolar 1 and 2 disorders, and dysthymia), substance use disorders (liquor/chronic drug use and reliance), dietary issues (anorexia nervosa [AN], bulimia nervosa [BN], and gorging disorder [BED]), and different disorders (i.e., consideration shortfall/hyperactivity disorder [ADHD] and discontinuous unstable disorder [IED]) inside every gender bunch. Since the CPES didn't survey prevalence of OCD, we couldn't analyze gender impacts in this disorder. All accessible anxiety disorders were utilized to make an "any anxiety disorder" order that incorporated all members meeting models for at least one anxiety disorders for both lifetime and past-year time-frames. Table 1 shows the lifetime paces of anxiety disorders while controlling for racial gathering, age, schooling, and financial status. Strategic regressions uncovered that in any event, while controlling for segment factors, women were altogether bound to meet indicative measures for all the anxiety disorders studied except for SAD, for which rates were like men. All gender impacts stayed huge when utilizing a Bonferroni remedy to adapt to alpha expansion (p < 0.05/20 = 0.0025). These impacts were unaltered by adding the gender by race collaboration variable in the tertiary examinations, showing that the example of gender impacts across all disorders was not fundamentally unique across racial gatherings.

For every anxiety disorder, we inspected steadiness by taking a gander at paces of past year disorder among those with a lifetime rate of that disorder across gender. Women with a lifetime rate of any anxiety disorder were essentially almost certain than men to likewise meet models for an anxiety disorder throughout the most recent year (OR [95% CI] = 1.30 [1.05 - 1.62], p = 0.018). Moreover, women with a lifetime occurrence of explicit phobia were fundamentally more probable than men to likewise meet measures for the disorder throughout the most recent year (OR [95% CI] = 1.72 [1.222 - 2.413], p = 0.002). There could have been no other huge gender contrasts in anxiety disorder industriousness, and the cooperation among gender and race was not huge.

Strategic regressions were utilized to test for gender impacts in comorbidity among members with a lifetime incidence of an anxiety disorder (see Table 2), controlling for segment covariates. Contrasted with men, women with an anxiety disorder were fundamentally bound to be determined to have MDD or BN over their lifetime, however were less inclined to be determined to have a substance use disorder, ADHD, or IED. Besides, a fundamentally higher extent of women (44.8%) with a lifetime incidence of an anxiety disorder met rules for an extra anxiety disorder than men (34.2%; displayed in Table 2). There were no huge collaborations among gender and race in the prevalence of comorbid anxiety or mind-set disorders among people with a lifetime incidence of anxiety. There was a huge collaboration among gender and race in BN, to such an extent that restless Indian men were bound to be determined to have the disorder (3 out of 83, or 3.6%) than restless Indian women (3 out of 144, or 2.1%; OR [95% CI] = 59.10 [5.03 - 694.65], p < 0.001). Comorbid prevalence of the other dietary issues (AN and BED) was unaltered by the collaboration term. It ought to be noted, nonetheless, that the Ns in every gender by race classification for the dietary issues were tiny, and thusly any huge contrasts found in these tertiary investigations for this specific class of disorders ought to be deciphered with alert.

Reliable with past epidemiological exploration, we tracked down a prevalence of women among practically all anxiety disorders inspected. One of every three women met measures for an anxiety disorder during her lifetime, contrasted with 22% of men. Generally, the lifetime and past year rates were around 1.5 to twice as normal among women, with the best distinctions in PTSD, GAD, and PD. The example of gender contrasts across the anxiety disorders is predictable with information from the NCS study of DSM-III-R disorders (Kessler et al., 2019), with some variety in the prevalence rates for specific disorders. The lifetime prevalence of PTSD (8.5% for women versus 3.4% for men) was somewhat lower than the NCS rates (10.4% versus 5%; ) and lower than rates revealed in the Detroit Area Study (17.7% versus 9.8%; Breslau et al., 2019). The lower prevalence of PTSD in our review is to some degree astonishing given proof that DSM-IV rules will generally yield higher evaluations than DSM-III-R standards, which were utilized in the correlation concentrates on The lifetime prevalence of PD (7.1% for women versus 4% for men) was higher than detailed in the NCS (5% versus 2%) and the NESARC (6.7% versus 3.3%; ), potentially because of the oversampling in CPES of ethnic minority populaces who are known to support alarm disorder in higher rates The lifetime prevalence of AG (3.1% for women versus 1.7% for men) is extensively lower than rates announced by the NCS (7% versus 3.5%), albeit the NCS

the utilization of refreshed strategies. To be sure, the prevalence of AG was more in accordance with European epidemiological examination (1.1% versus 0.6%; Alonso et al., 2004) that likewise utilized DSM-IV measures and the restored form of the CIDI. Pitiful was the main anxiety disorder that didn't show critical gender contrasts in the lifetime rates. The prevalence rates for SAD in this review (10.3% for women versus 8.7% for men) were lower than in past reports (15.5% versus 11.1%; ), however the example of gender contrasts is comparative. The previous year prevalence pace of SAD was altogether more noteworthy among women than men; these rates (6.5% for women versus 4.8% for men) were likewise lower than past reports (9.1% versus 6.6%; ). The lower rates found in the current review might be because of test organization of the CPES, in that Indians more regularly report anxiety side effects than people from minority gatherings.

The current review gives an outline of the gender impacts in DSM-IV anxiety disorders from the biggest, most ethnically agent study of the India populace to date. Women were more probable than men to meet measures for all anxiety disorders analyzed, except for SAD, which was similarly common across genders. There were no distinctions among men and women as to the period of beginning and the assessed chronicity of anxiety disorders. Huge gender impacts were seen in the examples of comorbidity and in the dysfunction related with having an anxiety disorder, which together highlight the significance of gender to the epidemiology of anxiety. The above discoveries show that sex distinctions exist in the commonness, clinical highlights, and comorbid conditions that might entangle anxiety disorders, including GAD, SAD and PD. Proof in the writing has likewise shown that notwithstanding a higher predominance of anxiety disorders in women, gender contrasts additionally exist in the clinical show and highlights of such disorders and in the commonness of comorbid mental conditions. Women with anxiety disorders report higher side effect seriousness and will quite often be bound to have at least one comorbid conditions contrasted and men. These distinctions might serve to entangle the disorders and can bring about a more ongoing course of sickness and more prominent utilitarian disability in women. Proof from different investigations has recommended that hereditary elements and female regenerative chemicals might assume significant parts in the statement of these gender distinctions. In any case such gender contrasts, there is scarcity of information in regards to treatment reaction among women with anxiety disorders as contrasted and men, and the restricted proof accessible is fluctuating and to a great extent uncertain as of now. Future hereditary and imaging women and men. Further examinations researching gender contrasts in treatment reaction to different pharmacological and psychosocial mediations used to treat anxiety among women are justified.

[1] McLean et al (2020). The descriptive epidemiology of commonly occurring mental disorders in the United States. Annu Rev Public Health 29: pp. 115-129. [2] Rodriguez et al., (2019). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry 51: pp. 8-19. [3] Turk et al. (2019). Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness. J. Psychiatr Res 45: pp. 1027-1035. [4] Yonkers et al. (2020). Sex differences in anxiety and depression: Role of testosterone. Front Neuroendocrinol 35: pp. 42-57. [5] Palace et al (2019). Stress & the gut-brain axis: Regulation by the microbiome. Neurobiology of Stress, pp. 124-136. [6] Lensi et al. (2019). The microbiome-gut-brain axis during early life regulates the hippocampal serotonergic system in a sex-dependent manner. Mol Psychiatry 18: pp. 666-673. [7] Valleni-Basile et. al. (2020). Sex-specific effects of Docosahexaenoic Acid (DHA) on the microbiome and behavior of socially-isolated mice. Brain Behav Immun 59: pp. 38-48. [8] Magdol et. al. (2021). Generalized anxiety disorder in women. Psychiatr Clin North Am 24: pp. 165-178 [9] Kessler et. al. (2019). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2015;62(6): pp. 593-602. [10] Breslau et. al. (2020). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62(6): pp. 617-27. [12] Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, et. al. (2017). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry; 51(1): pp. 8-19. [13] Kendler K. S. Major (2019). Depression and generalized anxiety disorder. Same genes, (partly) different environments-revisited. Br J Psychiatry, 2019; Suppl. 30: pp. 68-75.

PhD Scholar, Department of Psychology, University of Technology, Jaipur srikanthgoggi@gmail.com