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Nature Reviews. Gastroenterology &... Sep 2023Irritable bowel syndrome (IBS) affects 5-10% of the global population. Up to one-third of people with IBS also experience anxiety or depression. Gastrointestinal and... (Review)
Review
Irritable bowel syndrome (IBS) affects 5-10% of the global population. Up to one-third of people with IBS also experience anxiety or depression. Gastrointestinal and psychological symptoms both drive health-care use in people with IBS, but psychological comorbidity seems to be more important for long-term quality of life. An integrated care approach that addresses gastrointestinal symptoms with nutrition and brain-gut behaviour therapies is considered the gold standard. However, best practice for the treatment of individuals with IBS who have a comorbid psychological condition is unclear. Given the rising prevalence of mental health disorders, discussion of the challenges of implementing therapy for people with IBS and anxiety and depression is critical. In this Review, we draw upon our expertise in gastroenterology, nutrition science and psychology to highlight common challenges that arise when managing patients with IBS and co-occurring anxiety and depression, and provide recommendations for tailoring clinical assessment and treatment. We provide best practice recommendations, including dietary and behavioural interventions that could be applied by non-specialists and clinicians working outside an integrated care model.
Topics: Humans; Irritable Bowel Syndrome; Mental Health; Quality of Life; Comorbidity; Anxiety
PubMed: 37268741
DOI: 10.1038/s41575-023-00794-z -
Translational Psychiatry Jul 2023Neuropsychiatric abnormalities may be broadly divided in two categories: disorders of mood, affect, and behavior and abnormalities affecting cognition. Among these... (Review)
Review
Neuropsychiatric abnormalities may be broadly divided in two categories: disorders of mood, affect, and behavior and abnormalities affecting cognition. Among these conditions, clinical depression, anxiety and neurocognitive disorders are the most common in multiple sclerosis (MS), with a substantial impact on patients' quality of life and adherence to treatments. Such manifestations may occur from the earliest phases of the disease but become more frequent in MS patients with a progressive disease course and more severe clinical disability. Although the pathogenesis of these neuropsychiatric manifestations has not been fully defined yet, brain structural and functional abnormalities, consistently observed with magnetic resonance imaging (MRI), together with genetic and immunologic factors, have been suggested to be key players. Even though the detrimental clinical impact of such manifestations in MS patients is a matter of crucial importance, at present, they are often overlooked in the clinical setting. Moreover, the efficacy of pharmacologic and non-pharmacologic approaches for their amelioration has been poorly investigated, with the majority of studies showing marginal or no beneficial effect of different therapeutic approaches, possibly due to the presence of multiple and heterogeneous underlying pathological mechanisms and intrinsic methodological limitations. A better evaluation of these manifestations in the clinical setting and improvements in the understanding of their pathophysiology may offer the potential to develop tools for differentiating these mechanisms in individual patients and ultimately provide a principled basis for treatment selection. This review provides an updated overview regarding the pathophysiology of the most common neuropsychiatric symptoms in MS, the clinical and MRI characteristics that have been associated with mood disorders (i.e., depression and anxiety) and cognitive impairment, and the treatment approaches currently available or under investigation.
Topics: Humans; Depression; Multiple Sclerosis; Quality of Life; Anxiety; Cognitive Dysfunction
PubMed: 37468462
DOI: 10.1038/s41398-023-02555-7 -
JAMA Network Open Aug 2023Shift work may lead to adverse health outcomes. Whether shift work is associated with depression and anxiety, and to what extent lifestyle mediates the associations,...
IMPORTANCE
Shift work may lead to adverse health outcomes. Whether shift work is associated with depression and anxiety, and to what extent lifestyle mediates the associations, remains unknown.
OBJECTIVE
To explore the associations of shift work, its type, frequency, and working years with anxiety and depression and to examine the potential mediating role of lifestyles.
DESIGN, SETTING, AND PARTICIPANTS
This cohort study included 175 543 employed or self-employed workers who participated in the UK Biobank baseline survey (2006-2010). Data analysis was conducted from November 2022 to January 2023.
EXPOSURES
Employment and shift work status information was obtained from baseline. Lifestyles included smoking, physical activity, alcohol consumption, dietary characteristics, sleep duration, sedentary time, and body mass index (BMI).
MAIN OUTCOMES AND MEASURES
Depression and anxiety were identified based on electronic health records. Cox proportional hazard regression models were used to calculate the association of shift work with anxiety and depression, and cause mediation analyses we used to test the mediating role of lifestyle factors in this association.
RESULTS
Of the 175 543 included participants (mean [SD] age, 52.6 [7.1] years; 88 290 men [50.3%]; 167 495 White participants [95.4%]), 27 637 participants (16.2%) reported shift work. During a median (IQR) follow-up of 9.06 (8.35-9.75) years, 3956 workers (2.3%) developed depression and 2838 (1.7%) developed anxiety. In the fully adjusted model, individuals who reported engaging in shift work, or shift workers, had a higher risk of depression (HR, 1.22; 95% CI, 1.12-1.33; P < .001) and anxiety (HR, 1.16; 95% CI, 1.04-1.28; P < .001), and the risk was positively associated with shift frequency. Among shift workers, there was no significant difference between night shifts and nonnight shifts. In the dose-association analyses, years of shift work were negatively associated with the risk of depression and anxiety. Smoking, sedentary time, BMI, and sleep duration were identified as the main potentially modifiable mediators. These mediators together explained 31.3% of the association between shift work and depression and 21.2% of the association between shift work and anxiety.
CONCLUSIONS AND RELEVANCE
In this cohort study, shift work was significantly associated with a higher risk of depression and anxiety, and lifestyle factors partially mediated the associations. These findings not only support that shift work should be considered an occupational hazard, but also provide evidence for the urgent need for the development of public health interventions that promote healthy lifestyles aimed at improving the mental health of shift workers.
Topics: Male; Humans; Middle Aged; Cohort Studies; Shift Work Schedule; Depression; Life Style; Anxiety
PubMed: 37578795
DOI: 10.1001/jamanetworkopen.2023.28798 -
Neuron Apr 2024Physical exercise is known to reduce anxiety, but the underlying brain mechanisms remain unclear. Here, we explore a hypothalamo-cerebello-amygdalar circuit that may...
Physical exercise is known to reduce anxiety, but the underlying brain mechanisms remain unclear. Here, we explore a hypothalamo-cerebello-amygdalar circuit that may mediate motor-dependent alleviation of anxiety. This three-neuron loop, in which the cerebellar dentate nucleus takes center stage, bridges the motor system with the emotional system. Subjecting animals to a constant rotarod engages glutamatergic cerebellar dentate neurons that drive PKCδ amygdalar neurons to elicit an anxiolytic effect. Moreover, challenging animals on an accelerated rather than a constant rotarod engages hypothalamic neurons that provide a superimposed anxiolytic effect via an orexinergic projection to the dentate neurons that activate the amygdala. Our findings reveal a cerebello-limbic pathway that may contribute to motor-triggered alleviation of anxiety and that may be optimally exploited during challenging physical exercise.
Topics: Animals; Anti-Anxiety Agents; Anxiety; Hypothalamus; Cerebellum; Anxiety Disorders
PubMed: 38301648
DOI: 10.1016/j.neuron.2024.01.007 -
Psychiatria Danubina Oct 2023In the pandemic period due to the strong restrictions made necessary to deal with the spread of the Sars COVID-19 Virus, adolescents were the subjects who, most of all,...
In the pandemic period due to the strong restrictions made necessary to deal with the spread of the Sars COVID-19 Virus, adolescents were the subjects who, most of all, suffered from isolation and lack of sociality, due to social distancing. It was necessary to change their habits, their lifestyles, the way they live social relationships and relate to others. Furthermore, those of them who were facing health difficulties at the time were faced with the impossibility of the services to guarantee safety conditions, so that in most cases many medical, psychiatric and psychological activities were suspended, with hospitalizations postponed to a date to be defined, appointments canceled with a high risk of losing contact with the patient. Many authors agreed, right from the start, that the pandemic consequences would have focused above all on psychological problems. The scientific literature on past pandemics had shown the role of fear, anxiety, stress and depression and its negative psychosocial consequences on the quality of life of the population. Samantha Brooks and colleagues from King's College London reviewed 24 studies on the psychological impact of quarantine and highlighted negative psychological effects including symptoms of post-traumatic stress, confusion and anger. Today there are many contributions in the literature which unfortunately confirm what has been hypothesized.
Topics: Adolescent; Humans; COVID-19; Quality of Life; SARS-CoV-2; Anxiety; Quarantine
PubMed: 37800238
DOI: No ID Found -
Journal of Medical Radiation Sciences Sep 2023Some patients experience mask-related anxiety and distress when undergoing radiation therapy for head and neck cancer. Building on the paper by Forbes et al...
Some patients experience mask-related anxiety and distress when undergoing radiation therapy for head and neck cancer. Building on the paper by Forbes et al (doi.org/10.1002/jmrs.658) this editorial discusses techniques to implement to improve the patient experience through education and support.
Topics: Humans; Anxiety; Head and Neck Neoplasms
PubMed: 37328435
DOI: 10.1002/jmrs.695 -
BMC Psychiatry Aug 2023Depressive and anxiety symptoms affect about one-fourth of Chinese secondary school students. However, the prevalence and correlates of mental distress among secondary...
BACKGROUND
Depressive and anxiety symptoms affect about one-fourth of Chinese secondary school students. However, the prevalence and correlates of mental distress among secondary school students from Western China remain largely unexplored. This study aimed to examine the prevalence and associations of depressive and anxiety symptoms with demographic, family, school, life, and behavior factors in a large, representative sample of secondary school students in Zigong, a city in Western China.
METHODS
Secondary school students were recruited using cluster sampling. The 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder Questionnaire, Multidimensional Peer-Victimization Scale, the Pittsburgh Sleep Quality Index, and Nine-Item Internet Gaming Disorder Scale-Short Form were used. Descriptive statistic was used to describe the sociodemographic characteristics of participants. The clustering effect was adjusted by the "survey" package of R to calculate weighted prevalence. Univariate and multivariate logistic regression were used to explore associated factors of depression and anxiety, respectively.
RESULTS
A total of 63,205 participants were involved, in which the weighted prevalence of depression in all subjects was 23.0% (95% CI: 19.6- 27.0%), and the weighted prevalence of anxiety was 13.9% (95% CI: 11.2- 17.0%). Logistic regression results showed girls, being single-child, non-nuclear family, peer bullying, sleep disturbance, and internet gaming disorder symptoms were positively associated with depressive and anxiety symptoms.
CONCLUSION
Depressive and anxiety symptoms were prevalent among secondary school students in Western China. Our results can guide policy strategies for the assessment, prevention, and intervention of psychological status among Chinese secondary school students.
Topics: Female; Humans; Depression; Prevalence; East Asian People; Anxiety; Students; Schools; China
PubMed: 37563573
DOI: 10.1186/s12888-023-05068-1 -
Journal of Affective Disorders Oct 2023College students are vulnerable to suffering from anxiety and depression. Moreover, mental disorders can contribute to drug consumption or inappropriate use of...
BACKGROUND
College students are vulnerable to suffering from anxiety and depression. Moreover, mental disorders can contribute to drug consumption or inappropriate use of prescribed drugs. Studies on this topic in Spanish college students are limited. This work analyses anxiety and depression and psychoactive drug intake pattern in the post-COVID era in college students.
METHODS
An online survey was conducted among college students from UCM (Spain). The survey collected data including demographic, academic student perception, GAD-7 and PHQ-9 scales, and psychoactive substances consumption.
RESULTS
A total of 6798 students were included; 44.1 % (CI95%: 42.9 to 45.3) showed symptoms of severe anxiety and 46.5 % (CI95%: 45.4 to 47.8) symptoms of severe or moderately severe depression. The perception of these symptoms did not change after returning to face-to-face university classes in the post-COVID19 era. Despite the high percentage of cases with clear symptoms of anxiety and depression, most students never had a diagnosis of mental illnesses [anxiety 69.2 % (CI95%: 68.1 to 70.3) and depression 78.1 % (CI95%: 77.1 to 79.1)]. Regarding psychoactive substances, valerian, melatonin, diazepam, and lorazepam were the most consumed. The most worrying issue was the consumption of diazepam, 10.8 % (CI95%: 9.8 to 11.8), and lorazepam, 7.7 % (CI95%: 6.9 to 8.6) without medical prescription. Among illicit drugs, cannabis is the most consumed.
LIMITATIONS
The study was based on an online survey.
CONCLUSIONS
The high prevalence of anxiety and depression aligned with poor medical diagnosis and high intake of psychoactive drugs should not be underestimated. University policies should be implemented to improve the well-being of students.
Topics: Humans; Mental Health; COVID-19; Lorazepam; Depression; Anxiety; Substance-Related Disorders; Students; Universities
PubMed: 37245551
DOI: 10.1016/j.jad.2023.05.080 -
Frontiers in Public Health 2023Symptoms of anxiety and depression are prevalent among young adults and are a significant public health issue. College students are at a higher risk of experiencing poor... (Observational Study)
Observational Study
BACKGROUND
Symptoms of anxiety and depression are prevalent among young adults and are a significant public health issue. College students are at a higher risk of experiencing poor mental health than other young people due to several factors, including moving away from home, financial pressures, heavy workload, poor time management skills, competitivity, new processes of socialization and insufficient coping mechanisms, among others. In addition, nursing students' mental and physical health may also be affected by unhealthy lifestyle habits and health-related behaviors.
AIM
To determine the prevalence of symptoms of depression and anxiety, and the association between these symptoms and health-related behaviors, in a population of Spanish student nurses.
METHODS
Cross-sectional study on a sample of 339 nursing students. We used the Hospital Anxiety and Depression Scale, the International Physical Activity Questionnaire-Short form, the Spanish Healthy Eating Index and an "" questionnaire for sociodemographic variables. The association between psychological symptoms and health-related behaviors was analyzed through binary logistic regression models.
RESULTS
The prevalence of symptoms of depression and anxiety was 3.8% and 24.5%, respectively. Negative health-related behaviors were frequent, namely tobacco and alcohol consumption, suboptimal physical activity and diet. Moderate physical activity was associated with a lower probability of experiencing depressive symptoms. Symptoms of anxiety were related to a low level of physical activity, an unhealthy diet and alcohol consumption ≥2 times a week.
CONCLUSION
Student nurses could benefit from the implementation of both physical and mental health promotion initiatives.
Topics: Young Adult; Humans; Adolescent; Depression; Students, Nursing; Cross-Sectional Studies; Anxiety; Health Behavior
PubMed: 38179570
DOI: 10.3389/fpubh.2023.1265775 -
Nature Communications Feb 2024Anxiety/stress-related disorders have been associated with multiple diseases, whereas a comprehensive assessment of the structure and interplay of subsequent associated...
Anxiety/stress-related disorders have been associated with multiple diseases, whereas a comprehensive assessment of the structure and interplay of subsequent associated diseases and their genetic underpinnings is lacking. Here, we first identify 136, out of 454 tested, medical conditions associated with incident anxiety/stress-related disorders attended in specialized care using a population-based cohort from the nationwide Swedish Patient Register, comprising 70,026 patients with anxiety/stress-related disorders and 1:10 birth year- and sex-matched unaffected individuals. By combining findings from the comorbidity network and disease trajectory analyses, we identify five robust disease clusters to be associated with a prior diagnosis of anxiety/stress-related disorders, featured by predominance of psychiatric disorders, eye diseases, ear diseases, cardiovascular diseases, and skin and genitourinary diseases. These five clusters and their featured diseases are largely validated in the UK Biobank. GWAS analyses based on the UK Biobank identify 3, 33, 40, 4, and 16 significantly independent single nucleotide polymorphisms for the link to the five disease clusters, respectively, which are mapped to several distinct risk genes and biological pathways. These findings motivate further mechanistic explorations and aid early risk assessment for cluster-based disease prevention among patients with newly diagnosed anxiety/stress-related disorders in specialized care.
Topics: Humans; Disease Hotspot; Anxiety Disorders; Anxiety; Comorbidity; Polymorphism, Single Nucleotide
PubMed: 38332132
DOI: 10.1038/s41467-024-45445-2