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Journal of Clinical Rheumatology :... Dec 2017Psychiatric comorbidities, such as depression and anxiety, are very common in persons with rheumatoid arthritis (RA) and can lead to adverse outcomes. By appropriately... (Review)
Review
BACKGROUND
Psychiatric comorbidities, such as depression and anxiety, are very common in persons with rheumatoid arthritis (RA) and can lead to adverse outcomes. By appropriately treating these comorbidities, disease-specific outcomes and quality of life may be improved.
OBJECTIVE
The aim of this study was to systematically review the literature from controlled trials of treatments for depression and anxiety in persons with RA.
METHODS
We searched multiple online databases from inception until March 25, 2015, without restrictions on language, date, or location of publication. We included controlled trials conducted in persons with RA and depression or anxiety. Two independent reviewers extracted information including trial and participant characteristics. The standardized mean differences (SMDs) of depression or anxiety scores at postassessment were pooled between treatment and comparison groups, stratified by active versus inactive comparators.
RESULTS
From 1291 unique abstracts, we included 8 RA trials of depression interventions (6 pharmacological, 1 psychological, 1 both). Pharmacological interventions for depression with inactive comparators (n = 3 trials, 143 participants) did not reduce depressive symptoms (SMD, -0.21; 95% confidence interval [CI], -1.27 to 0.85), although interventions with active comparators (n = 3 trials, 190 participants) did improve depressive symptoms (SMD, -0.79; 95% CI, -1.34 to -0.25). The single psychological trial of depression treatment in RA did not improve depressive symptoms (SMD, -0.44; 95% CI, -0.96 to 0.08). Seven of the trials had an unclear risk of bias.
CONCLUSIONS
Few trials examining interventions for depression or anxiety in adults with RA exist, and the level of evidence is low to moderate because of the risk of bias and small number of trials.
Topics: Anxiety; Arthritis, Rheumatoid; Depression; Humans; Psychological Techniques; Quality of Life
PubMed: 28221313
DOI: 10.1097/RHU.0000000000000489 -
Multiple Sclerosis and Related Disorders Nov 2016Multiple Sclerosis (MS) is a chronic neurological disease, which poses significant psychological challenges. The purpose of this systematic review was to identify... (Review)
Review
BACKGROUND
Multiple Sclerosis (MS) is a chronic neurological disease, which poses significant psychological challenges. The purpose of this systematic review was to identify factors that are associated with anxiety in people with MS (PwMS). It aimed to examine the strength of evidence for factors associated with anxiety symptoms and identify limitations of existing studies.
METHOD AND RESULTS
One hundred and thirty one studies met inclusion criteria and were included in the review. A narrative synthesis was then conducted. Anxiety was found to be associated with a variety of demographic, physical, psychological, cognitive and social factors. A consistent finding was that anxiety was strongly associated with both high level of disability and low quality of life. A strong association between anxiety and depression was also found.
CONCLUSION
Implications for these results are discussed and a preliminary model of understanding anxiety in the context of MS is outlined. Given the overlap between anxiety and depression, a transdiagnostic treatment approach is suggested. In light of the shortcomings of extant studies, suggestions for future research are offered.
Topics: Anxiety; Depression; Humans; Multiple Sclerosis
PubMed: 27919483
DOI: 10.1016/j.msard.2016.10.003 -
Journal of Affective Disorders Jun 2023To assess whether working memory training will relieve anxiety in participants. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To assess whether working memory training will relieve anxiety in participants.
METHODS
The PubMed, PsycINFO, Web of Science, and ProQuest databases were searched up to January 25, 2022. We included random controlled trials with low to moderate risk of bias in comparing working memory training with control condition as the only intervention in treating anxiety (PROSPERO ID: CRD42022300404). The language was restricted to English. Data extraction was independently carried out by two authors, following the PRISMA guideline for systematic reviews.
RESULTS
Of the 477 records identified, 19 studies (n = 1051) were included in the meta-analysis. The results showed that the post-training anxiety was reduced with a small but significant value (Hedge's g = -0.392, p = .009) by working memory training. Subgroup analyses confirmed that the moderating effect of anxiety type, anxiety measurement and training environment were significant.
LIMITATIONS
These results should be considered with caution for the heterogeneity of training paradigms, participant population and types of anxiety assessed between studies. Further research is required to support these results.
CONCLUSIONS
Working memory training is a promising intervention to relieve anxiety symptoms.
Topics: Humans; Cognitive Training; Anxiety Disorders; Anxiety
PubMed: 36958492
DOI: 10.1016/j.jad.2023.03.045 -
BMC Psychiatry Oct 2023Historically, religion has had a central role in shaping the psychosocial and moral development of young people. While religiosity and spirituality have been linked to... (Meta-Analysis)
Meta-Analysis
Historically, religion has had a central role in shaping the psychosocial and moral development of young people. While religiosity and spirituality have been linked to positive mental health outcomes in adults, their role during the developmental context of adolescence, and the mechanisms through which such beliefs might operate, is less well understood. Moreover, there is some evidence that negative aspects of religiosity are associated with poor mental health outcomes. Guided by lived experience consultants, we undertook a systematic review and quality appraisal of 45 longitudinal studies and 29 intervention studies identified from three electronic databases (Medline, PsycINFO and Scopus) exploring the role of religiosity and spiritual involvement (formal and informal) in prevention and management of depression and anxiety in young people aged 10 to 24 years. Most studies were from high-income countries and of low to moderate quality. Meta-analysis of high-quality longitudinal studies (assessed using Joanna Briggs Institute critical appraisal tools, n = 25) showed a trend towards association of negative religious coping (i.e., feeling abandoned by or blaming God) with greater depressive symptoms over time (Pearson's r = 0.09, 95% confidence interval (CI) -0.009, 0.188) whereas spiritual wellbeing was protective against depression (Pearson's r = -0.153, CI -0.187, -0.118). Personal importance of religion was not associated with depressive symptoms overall (Pearson's r = -0.024, CI-0.053, 0.004). Interventions that involved religious and spiritual practices for depression and anxiety in young people were mostly effective, although the study quality was typically low and the heterogeneity in study designs did not allow for a meta-analysis. The lived experience consultants described spirituality and religious involvement as central to their way of life and greatly valued feeling watched over during difficult times. While we require more evidence from low- and middle-income countries, in younger adolescents and for anxiety disorders, the review provides insight into how spirituality and religious involvement could be harnessed to design novel psychological interventions for depression and anxiety in young people.Review RegistrationThe systematic review was funded by Wellcome Trust Mental Health Priority Area 'Active Ingredients' 2021 commission and registered with PROSPERO 2021 (CRD42021281912).
Topics: Adult; Adolescent; Humans; Spirituality; Depression; Religion; Anxiety; Anxiety Disorders; Adaptation, Psychological
PubMed: 37817143
DOI: 10.1186/s12888-023-05091-2 -
Environmental Research Dec 2020Exposure to transportation noise is hypothesized to contribute to anxiety, but consistent associations have not been established. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Exposure to transportation noise is hypothesized to contribute to anxiety, but consistent associations have not been established.
OBJECTIVE
To provide a comprehensive synthesis of the literature by examining associations between traffic-related noise (i.e., road traffic noise, railway noise, aircraft noise and mixed traffic noise) and anxiety.
METHODS
We systematically searched Web of Science, Scopus, Embase, PubMed, and PsycINFO for English-language observational studies published up to February 2020 reporting on the traffic noise-anxiety association. We appraised the risk of bias using an assessment tool and the quality of evidence following established guidelines. A random-effects meta-analysis was performed for pooled and separated traffic-related noise sources.
RESULTS
Of the 3575 studies identified, 11 fulfilled the inclusion criteria and 9 studies were appropriate for meta-analysis. For the pooled overall effect size between transport noise and anxiety, we found 9% higher odds of anxiety associated with a 10 dB(A) increase in day-evening-night noise level (L), with moderate heterogeneity (OR = 1.09, 95% CI: [0.97; 1.23], I = 70%). The association was more likely to be significant with more severe anxiety (OR = 1.08, 95% CI: [1.01; 1.15], I = 48%). Sub-group analysis revealed that the effects of different noise sources on anxiety were inconsistent and insignificant. The quality of evidence was rated as very low to low.
CONCLUSIONS
Our findings support the hypothesis of an association between traffic noise and more severe anxiety. More high-quality studies are needed to confirm associations between different noise types and anxiety, as well as to better understand underlying mechanisms.
Topics: Aircraft; Anxiety; Environmental Exposure; Noise, Transportation; Transportation
PubMed: 32835678
DOI: 10.1016/j.envres.2020.110118 -
Epilepsia May 2021Absence seizures (AS), presenting as short losses of consciousness with staring spells, are a common manifestation of childhood epilepsy that is associated with... (Meta-Analysis)
Meta-Analysis
Absence seizures (AS), presenting as short losses of consciousness with staring spells, are a common manifestation of childhood epilepsy that is associated with behavioral, emotional, and social impairments. It has also been suggested that patients with AS are more likely to suffer from mood disorders such as depression and anxiety. This systematic review and meta-analysis synthesizes human and animal models that investigated mood disorders and AS. Of the 1019 scientific publications identified, 35 articles met the inclusion criteria for this review. We found that patients with AS had greater odds of developing depression and anxiety when compared to controls (odds ratio = 4.93, 95% confidence interval = 2.91-8.35, p < .01). The included studies further suggest a strong correlation between AS and depression and anxiety in the form of a bidirectional relationship. The current literature emphasizes that these conditions likely share underlying mechanisms, such as genetic predisposition, neurophysiology, and anatomical pathways. Further research will clarify this relationship and ensure more effective treatment for AS and mood disorders.
Topics: Animals; Anxiety; Depression; Epilepsy, Absence; Humans; Seizures
PubMed: 33751566
DOI: 10.1111/epi.16862 -
Breast (Edinburgh, Scotland) Apr 2022Psychoeducation has emerged as an intervention for women with breast cancer (BC). This meta-analysis evaluated the effectiveness of psychoeducation on adherence to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Psychoeducation has emerged as an intervention for women with breast cancer (BC). This meta-analysis evaluated the effectiveness of psychoeducation on adherence to diagnostic procedures and medical treatment, anxiety, depression, quality of life (QoL), and BC knowledge among patients with BC symptoms or diagnosis and BC survivors.
METHODS
A systematic literature search (in PubMed, Embase, PsycINFO and Cochrane) for randomised controlled trials (RCTs) comparing the effects of psychoeducation to control among patients with BC symptoms or diagnosis and BC survivors. Effects were expressed as relative risks (RRs) and standardized mean differences (SMDs) with their 95% confidence intervals.
RESULTS
Twenty-seven RCTs (7742 participants; 3880 psychoeducation and 3862 controls) were included. Compared with controls, psychoeducation had no significant effect on adherence to diagnostic procedures and medical treatment (RR 1.553; 95% CI 0.733 to 3.290, p = .16), but it significantly decreased anxiety (SMD -0.710, 95% CI -1.395 to -0.027, p = .04) and improved QoL with (SMD 0.509; 95% CI 0.096 to 0.923, p < .01). No effects were found for psychoeducation on depression (SMD -0.243, 95% CI -0.580 to 0.091, p = .14), or BC knowledge (SMD 0.718, 95% CI -0.800 to 2.236, p = .23).
CONCLUSION
We demonstrated that psychoeducation did not improve adherence to diagnostic procedures and treatment, depression and BC knowledge but was valuable for reducing anxiety and improving QoL. Future studies may explore the effectiveness of psychoeducation in promoting adherence across various types of cancer.
Topics: Anxiety; Breast Neoplasms; Depression; Female; Humans; Quality of Life; Survivors
PubMed: 35121502
DOI: 10.1016/j.breast.2022.01.005 -
BMC Research Notes Aug 2016Depression and anxiety are common in inflammatory bowel disease (IBD) and can affect disease outcomes, including quality of life and success of disease treatment.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Depression and anxiety are common in inflammatory bowel disease (IBD) and can affect disease outcomes, including quality of life and success of disease treatment. Successful management of psychiatric comorbidities may improve outcomes, though the effectiveness of existing treatments in IBD is unknown.
METHODS
We searched multiple online databases from inception until March 25, 2015, without restrictions on language, date, or location of publication. We included controlled clinical trials conducted in persons with IBD and depression or anxiety. Two independent reviewers reviewed all abstracts and full-text articles and extracted information including trial and participant characteristics. We also assessed the risk of bias.
RESULTS
Of 768 unique abstracts, we included one trial of pharmacological anxiety treatment in IBD (48 participants), which found an improvement in anxiety symptoms (p < 0.001). There was a high risk of bias in this trial. We found no controlled clinical trials on the treatment of depression in persons with IBD and depression and no controlled clinical trials reporting on psychological interventions for anxiety or depression in IBD.
CONCLUSIONS
Only one trial examined an intervention for anxiety in adults with IBD and no trials studied depression in adults with IBD. The level of evidence is low because of the risk of bias and limited evidence.
Topics: Anxiety; Depression; Humans; Inflammatory Bowel Diseases; Publication Bias; Treatment Outcome
PubMed: 27514366
DOI: 10.1186/s13104-016-2204-2 -
Reproductive Biomedicine Online Jul 2022Patients undergoing IVF experience high levels of IVF-related state anxiety. Non-pharmacological interventions such as acupuncture may provide support, but its effect on... (Meta-Analysis)
Meta-Analysis Review
Patients undergoing IVF experience high levels of IVF-related state anxiety. Non-pharmacological interventions such as acupuncture may provide support, but its effect on IVF-related anxiety is unclear. This was a systematic review and meta-analysis to examine the effect of acupuncture on IVF-related state anxiety. The primary outcome was state anxiety after embryo transfer or oocyte retrieval as assessed by the State-Trait Anxiety Inventory, Hamilton Anxiety Scale, visual analogue scale or Standard Form 36. Eight trials with 2253 participants were reviewed, and 1785 participants completed an anxiety assessment. Using the random effects model, the meta-analysis found small but significant effects on state anxiety with acupuncture versus any control (standardized mean difference -0.21, 95% confidence interval -0.39 to -0.04, representing very low certainty evidence). Evidence was limited by the moderate number of included studies of an intermediate median sample size (n = 191). There was also a high risk of performance bias and substantial heterogeneity across trials. Acupuncture is a drug-free and safe treatment that may benefit those who are burdened with IVF-related anxiety, but more investigation is needed for confirmation.
Topics: Acupuncture Therapy; Anxiety; Embryo Transfer; Fertilization in Vitro; Humans; Oocyte Retrieval
PubMed: 35570176
DOI: 10.1016/j.rbmo.2022.02.002 -
Clinical Psychology Review Aug 2017Anxiety is common in the context of cancer, but there are few theoretical models that apply to people with cancer across the trajectory of their illness. The aims of... (Review)
Review
Anxiety is common in the context of cancer, but there are few theoretical models that apply to people with cancer across the trajectory of their illness. The aims of this review are to identify existing theories and to propose an integrated model of cancer-related anxiety. Using a systematic literature search of Medline, Premedline and PsycINFO databases, we identified nine theoretical models of anxiety in the context of cancer. We reviewed these for psychological concepts that fell under five themes: pre-existing schema, the inherent nature of cancer, cognitive factors, coping responses and contextual factors. From these themes, we integrated concepts from different models to develop a theoretical framework to explain the development and maintenance of anxiety in the context of cancer. The resulting model suggests that pre-existing schema, past experiences of cancer, an intolerance of uncertainty and meta-cognitive beliefs about worry interact with the inherent nature of cancer to produce overwhelming distress. The distress activates cognitive processes characterized by vigilance, worry and rumination. Attempts to cope by re-establishing control, and a pattern of vigilance to cancer-related cues and/or avoidance reinforce anxiety, in the context of a range of systemic factors that can either buffer against or worsen the anxiety.
Topics: Anxiety; Humans; Models, Psychological; Neoplasms
PubMed: 28686905
DOI: 10.1016/j.cpr.2017.06.003