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Advances in Experimental Medicine and... 2020Anxiety disorders are a group of highly prevalent mental health conditions that can have a debilitating impact on daily functioning and well-being. They can co-occur... (Review)
Review
Anxiety disorders are a group of highly prevalent mental health conditions that can have a debilitating impact on daily functioning and well-being. They can co-occur with other mental health disorders, such as depression. People with anxiety disorders are also at an elevated risk of cardiovascular disease and premature mortality. Physical activity appears to be protective against anxiety disorders in clinical and nonclinical populations. Exercise, a subset of physical activity, has been shown to significantly reduce the symptoms of anxiety. The mechanisms through which exercise produces these effects are likely to involve a combination of biological and psychological factors. Physical activity may also be useful in reducing the symptoms of comorbid mental health conditions and the risk of physical health complications over time. Promoting physical activity could be a method of preventing or treating anxiety disorders with a wide range of benefits. However, further research will be necessary to address important gaps in the literature before these approaches can be fully implemented in mental health services.
Topics: Anxiety; Anxiety Disorders; Depression; Exercise; Humans; Mental Health
PubMed: 32342469
DOI: 10.1007/978-981-15-1792-1_23 -
Advances in Experimental Medicine and... 2020Recent data has linked anxiety and its disorders in late life to increased morbidity and mortality, especially related to a higher cardiovascular burden and an increased... (Review)
Review
Recent data has linked anxiety and its disorders in late life to increased morbidity and mortality, especially related to a higher cardiovascular burden and an increased cognitive decline. Clinically, anxiety symptoms may be more difficult to elicit in older adults who are less accurate in identifying anxiety symptoms and tend to minimize symptoms and to attribute symptoms to physical illness. Although SSRIs have proven more effective than psychotherapy in late-life anxiety, many elderly anxious subjects prefer psychotherapeutic interventions. These interventions appear to work best when tailored for the needs, expectations, and cultural background of older anxious subjects.
Topics: Aged; Anti-Anxiety Agents; Anxiety; Anxiety Disorders; Cardiovascular Diseases; Comorbidity; Humans; Psychotherapy; Selective Serotonin Reuptake Inhibitors
PubMed: 32002946
DOI: 10.1007/978-981-32-9705-0_28 -
Nature Reviews. Neuroscience Nov 2021Epidemiological sex differences in anxiety disorders and major depression are well characterized. Yet the circuits and mechanisms that contribute to these differences... (Review)
Review
Epidemiological sex differences in anxiety disorders and major depression are well characterized. Yet the circuits and mechanisms that contribute to these differences are understudied, because preclinical studies have historically excluded female rodents. This oversight is beginning to be addressed, and recent studies that include male and female rodents are identifying sex differences in neurobiological processes that underlie features of these disorders, including conflict anxiety, fear processing, arousal, social avoidance, learned helplessness and anhedonia. These findings allow us to conceptualize various types of sex differences in the brain, which in turn have broader implications for considering sex as a biological variable. Importantly, comparing the sexes could aid in the discovery of novel therapeutics.
Topics: Animals; Anxiety; Brain; Depression; Female; Humans; Male; Nerve Net; Sex Characteristics
PubMed: 34545241
DOI: 10.1038/s41583-021-00513-0 -
The Psychiatric Clinics of North America Sep 2021Athletes may first seek counsel from mental health professionals with concerns of performance anxiety. The mental health professional must carefully explore the context... (Review)
Review
Athletes may first seek counsel from mental health professionals with concerns of performance anxiety. The mental health professional must carefully explore the context and origins of the athlete's anxiety in order to identify and address the root cause. A detailed history and physical examination will help avoid missing comorbid conditions presenting with anxiety symptoms. This chapter highlights the importance of recognizing the circumstances in which anxiety symptoms may arise in athletes; identifying stressors that are exclusive to the athlete experience; determining how those symptoms can affect their performance and general livelihood; and developing a treatment strategy that maximizes the athlete's performance.
Topics: Anxiety; Anxiety Disorders; Athletes; Humans
PubMed: 34372994
DOI: 10.1016/j.psc.2021.04.005 -
JAMA Apr 2023
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Journal of Neurology, Neurosurgery, and... Dec 2019Anxiety is an adaptive response that promotes harm avoidance, but at the same time excessive anxiety constitutes the most common psychiatric complaint. Moreover, current... (Review)
Review
Anxiety is an adaptive response that promotes harm avoidance, but at the same time excessive anxiety constitutes the most common psychiatric complaint. Moreover, current treatments for anxiety-both psychological and pharmacological-hover at around 50% recovery rates. Improving treatment outcomes is nevertheless difficult, in part because contemporary interventions were developed without an understanding of the underlying neurobiological mechanisms that they modulate. Recent advances in experimental models of anxiety in humans, such as threat of unpredictable shock, have, however, enabled us to start translating the wealth of mechanistic animal work on defensive behaviour into humans. In this article, we discuss the distinction between fear and anxiety, before reviewing translational research on the neural circuitry of anxiety in animal models and how it relates to human neuroimaging studies across both healthy and clinical populations. We highlight the roles of subcortical regions (and their subunits) such as the bed nucleus of the stria terminalis, the amgydala, and the hippocampus, as well as their connectivity to cortical regions such as dorsal medial and lateral prefrontal/cingulate cortex and insula in maintaining anxiety responding. We discuss how this circuitry might be modulated by current treatments before finally highlighting areas for future research that might ultimately improve treatment outcomes for this common and debilitating transdiagnostic symptom.
Topics: Anxiety; Anxiety Disorders; Brain Mapping; Fear; Humans; Nerve Net
PubMed: 31256001
DOI: 10.1136/jnnp-2019-321400 -
Neuroscience Bulletin Apr 2023The Coronavirus Disease 2019 (COVID-19) pandemic has had an adverse impact on the physical and mental health of the public worldwide. In addition to illness in patients... (Review)
Review
The Coronavirus Disease 2019 (COVID-19) pandemic has had an adverse impact on the physical and mental health of the public worldwide. In addition to illness in patients with COVID-19, isolated people and the general population have experienced mental health problems due to social distancing policies, mandatory lockdown, and other psychosocial factors, and the prevalence of depression and anxiety significantly increased during the pandemic. The purpose of this review is to elucidate the epidemiology, contributing factors, and pathogenesis of depression and anxiety. during the pandemic. These findings indicate that physicians and psychiatrists should pay more attention to and identify those with a high risk for mental problems, such as females, younger people, unmarried people, and those with a low educational level. In addition, researchers should focus on identifying the neural and neuroimmune mechanisms involved in depression and anxiety, and assess the intestinal microbiome to identify effective biomarkers. We also provide an overview of various intervention methods, including pharmacological treatment, psychological therapy, and physiotherapy, to provide a reference for different populations to guide the development of optimized intervention methods.
Topics: Humans; Anxiety; Communicable Disease Control; COVID-19; Depression; Pandemics; Age Factors; Sex Factors; Socioeconomic Factors; Comorbidity
PubMed: 36411394
DOI: 10.1007/s12264-022-00970-2 -
Journal of Clinical Nursing Dec 2022Games are increasingly being used as a means of alleviating pain and anxiety in paediatric patients, in the view that this form of distraction is effective, non-invasive... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Games are increasingly being used as a means of alleviating pain and anxiety in paediatric patients, in the view that this form of distraction is effective, non-invasive and non-pharmacological.
AIMS
To determine whether a game-based intervention (via gamification or virtual reality) during the induction of anaesthesia reduces preoperative pain and anxiety in paediatric patients.
METHODS
A systematic review with meta-analysis of randomised controlled trials was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and using RevMan software. The review was based on a search of the EMBASE, CINAHL, Medline, SciELO and Scopus databases, conducted in July 2021. No restriction was placed on the year of publication.
RESULTS
26 studies were found, with a total study population of 2525 children. Regarding pain reduction, no significant differences were reported. For anxiety during anaesthesia induction, however, a mean difference of -10.62 (95% CI -13.85, -7.39) on the Modified Yale Preoperative Anxiety Scale, in favour of game-based intervention, was recorded.
CONCLUSIONS
Game-based interventions alleviate preoperative anxiety during the induction of anaesthesia in children. This innovative and pleasurable approach can be helpful in the care of paediatric surgical patients.
RELEVANCE TO CLINICAL PRACTICE
In children, preoperative management is a challenging task for healthcare professionals, and game-based strategies could enhance results, improving patients' emotional health and boosting post-surgery recovery. Distractive games-based procedures should be considered for incorporation in the pre-surgery clinical workflow in order to optimise healthcare.
Topics: Humans; Child; Anxiety; Anesthesia, General; Anxiety Disorders; Emotions; Pain
PubMed: 35075716
DOI: 10.1111/jocn.16227 -
European Journal of Anaesthesiology Jan 2022Virtual reality and hypnosis are little studied in complex contexts, such as intensive care, where patients need significant physical and psychological assistance. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Virtual reality and hypnosis are little studied in complex contexts, such as intensive care, where patients need significant physical and psychological assistance.
OBJECTIVES
To compare and combine hypnosis and virtual reality benefits on anxiety and pain on patients before and after cardiac surgery.
DESIGN
Prospective randomised controlled clinical trial.
SETTING
The study was conducted in the University Hospital of Liege (Belgium) from October 2018 to January 2020.
PATIENTS
One hundred patients (66 ± 11.5 years; 24 women, 76 men) were included. Participants were adults undergoing cardiac surgery. Exclusion criteria: psychiatric diseases, claustrophobia, acrophobia, hearing loss, visual impairment, extreme fatigue, confusion surgery cancelled.
INTERVENTIONS
Patients were randomly assigned to four arms (control; hypnosis; virtual reality; virtual reality hypnosis) and had 20 min of one of the techniques the day before and the day after surgery.
MAIN OUTCOMES MEASURES
Anxiety, pain, fatigue, relaxation, physiological parameters, and opioid use were evaluated before and after each session.
RESULTS
The main results did not show any significant differences between the groups. In all groups, anxiety decreased and pain increased from baseline to the postoperative day. Relaxation increased in all groups in the pre-operative (P < 0.0001) and postoperative period (P = 0.03). There were no significant differences for fatigue, physiological measures, or opioid use.
CONCLUSION
As there were no significant differences between groups for the measured variables, we cannot affirm that one technique is better than another. Additional studies are required to compare and evaluate the cost-effectiveness of these techniques for critical care patients and caregivers.
TRIAL REGISTRATION
ClinicalTrials.gov: NCT03820700. https://clinicaltrials.gov/ct2/show/NCT03820700. Retrospectively registered on 29 January 2019.
Topics: Adult; Anxiety; Cardiac Surgical Procedures; Female; Humans; Hypnosis; Intensive Care Units; Male; Pain Management; Phobic Disorders; Prospective Studies; Virtual Reality
PubMed: 34783683
DOI: 10.1097/EJA.0000000000001633 -
Critical Reviews in Oncology/hematology Aug 2022Examining and addressing unmet care needs is integral to improving the provision and quality of cancer services. This review explored the prevalence of unmet supportive... (Review)
Review
Examining and addressing unmet care needs is integral to improving the provision and quality of cancer services. This review explored the prevalence of unmet supportive care needs, and factors associated with unmet need, in adults with advanced cancers (solid and hematological malignancies) and their caregivers. Electronic databases (PubMed, CINAHL, EMBASE) were searched, producing 85 papers representing 81 included studies. People with advanced cancer reported the highest unmet needs in financial, health system and information, psychological, and physical and daily living domains, whereas caregivers reported the highest unmet needs in psychological, and patient care and support domains. Distress, depression, and anxiety were associated with higher unmet needs across all unmet need domains for people with advanced cancer and their caregivers. Substantial heterogeneity in study populations and methods was observed. Findings from this review can inform targeted strategies and interventions to address these unmet needs in people with advanced cancer.
Topics: Adult; Anxiety; Caregivers; Health Services Needs and Demand; Humans; Needs Assessment; Neoplasms; Social Support; Surveys and Questionnaires
PubMed: 35662585
DOI: 10.1016/j.critrevonc.2022.103728