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The Lancet. Gastroenterology &... May 2021Inflammatory bowel disease (IBD) is a lifelong condition with no cure. Patients with IBD might experience symptoms of common mental disorders such as anxiety and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Inflammatory bowel disease (IBD) is a lifelong condition with no cure. Patients with IBD might experience symptoms of common mental disorders such as anxiety and depression because of bidirectional communication via the gut-brain axis and chronicity of symptoms, and because of impaired quality of life and reduced social functioning. However, uncertainties remain about the magnitude of this problem. We aimed to assess prevalence of symptoms of anxiety or depression in adult patients with IBD.
METHODS
In this systematic review and meta-analysis, we searched MEDLINE, Embase, Embase Classic, and PsycINFO for papers published from inception to Sept 30, 2020, reporting observational studies that recruited at least 100 adult patients with IBD and that reported prevalence of symptoms of anxiety or depression according to validated screening instruments. We excluded studies that only used a structured interview to assess for these symptoms and studies that did not provide extractable data. We extracted data from published study reports and calculated pooled prevalences of symptoms of anxiety and depression, odds ratios (OR), and 95% CIs.
FINDINGS
Of 5544 studies identified, 77 fulfilled the eligibility criteria, including 30 118 patients in total. Overall, pooled prevalence of anxiety symptoms was 32·1% (95% CI 28·3-36·0) in 58 studies (I=96·9%) and pooled prevalence of depression symptoms was 25·2% (22·0-28·5) in 75 studies (I=97·6%). In studies that reported prevalence of anxiety or depression in patients with Crohn's disease and ulcerative colitis within the same study population, patients with Crohn's disease had higher odds of anxiety symptoms (OR 1·2, 95% CI 1·1-1·4) and depression symptoms (1·2, 1·1-1·4) than patients with ulcerative colitis. Overall, women with IBD were more likely to have symptoms of anxiety than were men with IBD (pooled prevalence 33·8% [95% CI 26·5-41·5] for women vs 22·8% [18·7-27·2] for men; OR 1·7 [95% CI 1·2-2·3]). They were also more likely to have symptoms of depression than men were (pooled prevalence 21·2% [95% CI 15·4-27·6] for women vs 16·2% [12·6-20·3] for men; OR 1·3 [95% CI 1·0-1·8]). The prevalence of symptoms of anxiety (57·6% [95% CI 38·6-75·4]) or depression (38·9% [26·2-52·3]) was higher in patients with active IBD than in patients with inactive disease (38·1% [30·9-45·7] for anxiety symptoms and 24·2% [14·7-35·3] for depression symptoms; ORs 2·5 [95% CI 1·5-4·1] for anxiety and 3·1 [1·9-4·9] for depression).
INTERPRETATION
There is a high prevalence of symptoms of anxiety and depression in patients with IBD, with up to a third of patients affected by anxiety symptoms and a quarter affected by depression symptoms. Prevalence was also increased in patients with active disease: half of these patients met criteria for anxiety symptoms and a third met criteria for depression symptoms. Encouraging gastroenterologists to screen for and treat these disorders might improve outcomes for patients with IBD.
FUNDING
None.
Topics: Adult; Anxiety; Depression; Humans; Inflammatory Bowel Diseases; Prevalence; Risk Factors
PubMed: 33721557
DOI: 10.1016/S2468-1253(21)00014-5 -
The British Journal of General Practice... Feb 2020
Topics: Adolescent; Anxiety; Depression; Disease Management; Female; Humans; Male; Primary Health Care; Social Media; Young Adult
PubMed: 32001455
DOI: 10.3399/bjgp20X707765 -
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 -
PloS One 2020Vitiligo is an acquired depigmenting skin disease which is often accompanied by mental distress. There are numerous studies dedicated to local and global prevalence of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Vitiligo is an acquired depigmenting skin disease which is often accompanied by mental distress. There are numerous studies dedicated to local and global prevalence of depression in patients with vitiligo but anxiety has not been recognized as a major mental problem within named population. We aimed to evaluate the prevalence of anxiety among patients with vitiligo from different countries and to compare it with patients suffering from eczema, psoriasis, and acne.
METHODS
In November 2019, we conducted a systematic search for observational studies that examined the prevalence of anxiety in vitiligo patients. Fifteen studies comprising 1176 patients with vitiligo were included to our systematic review.
RESULTS
The general prevalence of anxiety among vitiligo patients was equal to 35.8%. Statistically significant difference in anxiety rates was found among female and male patients (47.32% vs 42.4%) (P = 0.03), but the clinical relevance of this issue remains arguable. In addition, the pooled odds ratio among vitiligo and non-vitiligo patients did not indicate a statistical significance among patients coming from different continents.
CONCLUSIONS
The pooled prevalence of anxiety among vitiligo patients worldwide was comparable to other severe skin disorders. This finding accentuates the necessity of anxiety awareness in management of patients with skin diseases.
Topics: Adult; Anxiety; Female; Humans; Male; Prevalence; Vitiligo
PubMed: 33170870
DOI: 10.1371/journal.pone.0241445 -
BMC Psychiatry Mar 2020Preoperative anxiety comprising anesthesia and surgery related anxiety is common and perceived by many patients as the worst aspect of the surgical episode. The aim of...
BACKGROUND
Preoperative anxiety comprising anesthesia and surgery related anxiety is common and perceived by many patients as the worst aspect of the surgical episode. The aim of this study was to identify independent predictors of these three anxieties dimensions and to quantify the relevance of specific fears particularly associated with anesthesia.
METHODS
This study was part of a cross-sectional survey in patients scheduled to undergo elective surgery. Anxiety levels were measured with the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Modified numeric rating scales (mNRS, range 0-10) were used to assess the severity of eight selected specific fears which were predominantly analyzed descriptively. Multivariate stepwise linear regression was applied to determine independent predictors of all three anxiety dimensions (APAIS anxiety subscales).
RESULTS
3087 of the 3200 enrolled patients were analyzed. Mean (SD) total preoperative anxiety (APAIS-A-T, range 4-20) was 9.9 (3.6). High anxiety (APAIS-A-T > 10) was reported by 40.5% of subjects. Mean (SD) levels of concern regarding the eight studied specific fears ranged from 3.9 (3.08) concerning "Anesthesiologist error" to 2.4 (2.29) concerning "Fatigue and drowsiness" with an average of 3.2 (2.84) concerning all specific fears. Ranking of all specific fears according to mean mNRS scores was almost identical in patients with high versus those with low anxiety. Among nine independent predictors of anxiety, only 3 variables (female gender, negative and positive anesthetic experience) independently predicted all three APAIS anxiety subscales. Other variables had a selective impact on one or two APAIS anxiety subscales only. Female gender had the strongest impact on all three APAIS anxiety subscales. Adjusted r values of the three models were all below 13%.
CONCLUSIONS
The high variability of importance assigned to all specific fears suggests an individualized approach is advisable when support of anxious patients is intended. Considering independent predictors of anxiety to estimate each patient's anxiety level is of limited use given the very low predictive capacity of all three models. The clinical benefit of dividing patients into those with high and low anxiety is questionable.
TRIAL REGISTRATION
German Registry of Clinical Trials (DRKS00016725), retrospectively registered.
Topics: Adult; Anesthesia; Anxiety; Cross-Sectional Studies; Elective Surgical Procedures; Fatigue; Fear; Female; Humans; Linear Models; Male; Middle Aged; Preoperative Period; Psychiatric Status Rating Scales; Registries; Risk Factors
PubMed: 32228525
DOI: 10.1186/s12888-020-02552-w -
Experimental Biology and Medicine... Jan 2020Mindfulness-based art therapy (MBAT) combines mindfulness practices with art therapy to promote health, wellness, and adaptive responses to stress. Mindfulness-based... (Review)
Review
UNLABELLED
Mindfulness-based art therapy (MBAT) combines mindfulness practices with art therapy to promote health, wellness, and adaptive responses to stress. Mindfulness-based stress reduction programs have been demonstrated to reduce anxiety symptoms in people with generalized anxiety disorder and serious medical conditions such as cancer. However, the benefits of MBAT specifically—not just in clinical anxiety disorders, but also for routine day-to-day anxiousness—have received little attention until recently. In this mini-review, we summarize how several established mindfulness-based interventions affect mental health with a specific focus on MBAT. We also describe and evaluate data indicating involvement of specific neural circuits and neuroendocrine markers of stress and/or anxiety. Lastly, we suggest areas of focus for future rigorous research on MBAT interventions and propose multiple biobehavioral and physiological mechanisms through which therapeutic benefits may be achieved.
IMPACT STATEMENT
Recent studies demonstrate the therapeutic potential of intensive MBAT and other mindfulness-based interventions for severe health conditions including cancer, heart disease, and anxiety, with effectiveness that rivals and sometimes even exceeds cognitive behavior therapy. MBAT-based approaches appear to be poised to mature into large-scale, cost-effective therapies for mental health disorders and symptoms comorbid with other serious health issues. However, the field currently suffers from inconsistent deployment protocols and needs additional validation data—at the behavioral, neuroendocrine, and neural levels—in order to establish best practices.
Topics: Anxiety; Art Therapy; Behavior; Humans; Mental Health; Mindfulness; Stress, Psychological
PubMed: 31635490
DOI: 10.1177/1535370219883634 -
Anesthesia and Analgesia Mar 2021Perioperative pediatric anxiety is common and can have a negative psychological impact on children undergoing surgery and anesthesia. Studies have shown an incidence of...
BACKGROUND
Perioperative pediatric anxiety is common and can have a negative psychological impact on children undergoing surgery and anesthesia. Studies have shown an incidence of anxiety at induction of up to 50%. Audiovisual distraction, including virtual reality (VR), is a noninvasive, nonpharmacological modality that may reduce perioperative anxiety. The goal of this study was to determine whether immersive audiovisual distraction with a VR headset during induction of general anesthesia (GA) in pediatric patients reduced preoperative anxiety.
METHODS
In this randomized-controlled, parallel-group study, 71 children 5-12 years of age scheduled for elective surgery with GA were randomly allocated to a VR group or a non-VR (No VR) control group. VR group patients underwent audiovisual distraction with a VR headset during induction in the operating room, whereas the control group received no audiovisual distraction. The primary outcome was the Modified Yale Preoperative Anxiety Scale (mYPAS), which was measured at 3 time points to assess patient anxiety: in the preoperative holding area before randomization, on entering the operating room, and during induction of GA. The primary outcome was analyzed using univariate analysis and a linear mixed-effects model. Secondary outcomes included postinduction parental anxiety measured by the State-Trait Anxiety Inventory, pediatric induction compliance, and parental satisfaction.
RESULTS
Average patient age was 8.0 ± 2.3 years (mean ± standard deviation [SD]), and 51.4% of patients were female. Baseline variables were not substantially different between the VR group (33 patients) and the No VR group (37 patients). No patients received preoperative anxiolytic medication. Baseline mYPAS scores were not different between the groups, with scores of 28.3 (23.3-28.3) (median [interquartile range {IQR}]) in both. The change in mYPAS scores from baseline to time of induction was significantly lower in the VR group versus control group (0.0 [0.0-5.0] vs 13.3 [5.0-26.7]; P < .0001). In the mixed-effects model, the VR group had an estimated 6.0-point lower mYPAS score (95% confidence interval [CI], 0.7-11.3; P = .03) at room entry than the No VR group, and 14.5-point lower score (95% CI, 9.3-19.8; P < .0001) at induction versus control. Randomization to VR did not alter parental anxiety (0 [-2 to 2]), pediatric induction compliance (0 [0-0]), or parental satisfaction (-3 [-8 to 2]) (difference in medians [95% CI]).
CONCLUSIONS
This study demonstrates a reduction in pediatric preoperative anxiety with the use of VR. Preoperative VR may be an effective noninvasive modality for anxiolysis during induction of anesthesia in children.
Topics: Age Factors; Anesthesia, General; Anxiety; Child; Child Behavior; Child, Preschool; Female; Humans; Male; Preoperative Care; Prospective Studies; San Francisco; Time Factors; Treatment Outcome; Virtual Reality
PubMed: 32618627
DOI: 10.1213/ANE.0000000000005004 -
Anesthesia Progress Apr 2022This study aimed to determine the effect of music as an intervention on relieving preoperative anxiety in patients with dental fear in an outpatient operating room (OR)... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
This study aimed to determine the effect of music as an intervention on relieving preoperative anxiety in patients with dental fear in an outpatient operating room (OR) before intravenous sedation (IVS).
METHODS
Sixty adult patients with dental fear undergoing dental surgery under IVS were divided into 2 groups (music and nonmusic). The music group listened to music in the waiting room until immediately before the initiation of IVS whereas the nonmusic group did not. Patient anxiety was objectively measured using heart rate variability (HRV) analysis to assess the low-frequency/high-frequency ratio as an indication of sympathetic or parasympathetic nervous system activity. Subjective preoperative anxiety was evaluated with a visual analog scale (VAS).
RESULTS
Heart rate variability analysis failed to demonstrate any significant difference between the 2 groups from baseline to start of IVS. There were also no significant differences between the 2 groups regarding changes in VAS scores.
CONCLUSION
Music intervention was not found to reduce preoperative anxiety in patients with dental fear before IVS in the dental outpatient OR as determined by HRV analysis or VAS scores.
Topics: Adult; Anxiety; Humans; Music; Music Therapy; Operating Rooms; Single-Blind Method
PubMed: 35377929
DOI: 10.2344/anpr-68-03-06