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Evidence-based Mental Health Nov 2021Around 40% of patients with bipolar disorder (BD) additionally have anxiety disorder. The prevalence of anxiety in patients with newly diagnosed BD and their... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Around 40% of patients with bipolar disorder (BD) additionally have anxiety disorder. The prevalence of anxiety in patients with newly diagnosed BD and their first-degree relatives (UR) has not been investigated.ObjectiveTo investigate (1) the prevalence of a comorbid anxiety diagnosis in patients with newly diagnosed BD and their UR, (2) sociodemographic and clinical differences between patients with and without a comorbid anxiety diagnosis and (3) the association between smartphone-based patient-reported anxiety and observer-based ratings of anxiety and functioning, respectively.
METHODS
We recruited 372 patients with BD and 116 of their UR. Daily smartphone-based data were provided from 125 patients. SCAN was used to assess comorbid anxiety diagnoses.
FINDINGS
In patients with BD, the prevalence of a comorbid anxiety disorder was 11.3% (N=42) and 10.3% and 5.9% in partial and full remission, respectively. In UR, the prevalence was 6.9%. Patients with a comorbid anxiety disorder had longer illness duration (p=0.016) and higher number of affective episodes (p=0.011). Smartphone-based patient-reported anxiety symptoms were associated with ratings of anxiety and impaired functioning (p<0.001).
LIMITATIONS
The SCAN interviews to diagnose comorbid anxiety disorder were carried out regardless of the participants' mood state.Clinical implicationsThe lower prevalence of anxiety in newly diagnosed BD than in later stages of BD indicates that anxiety increases with progression of BD. Comorbid anxiety seems associated with poorer clinical outcomes and functioning and smartphones are clinically useful for monitoring anxiety symptoms.
TRIAL REGISTRATION NUMBER
ClinicalTrials.gov Registry (NCT02888262).
Topics: Anxiety; Anxiety Disorders; Bipolar Disorder; Comorbidity; Humans; Prevalence; Self Report; Smartphone
PubMed: 34083204
DOI: 10.1136/ebmental-2021-300259 -
Computational and Mathematical Methods... 2022To explore the mechanism of intensive care of the heart after thoracoscopic surgery.
OBJECTIVE
To explore the mechanism of intensive care of the heart after thoracoscopic surgery.
METHODS
104 patients with severe cardiac disease were selected after thoracoscopic surgery in our hospital, received nursing care after surgery, and divided into control group ( = 53) and research group ( = 51) according to different nursing methods. Before nursing, the research group carried out targeted nursing and prevention of postoperative complications. The quality of life, complications, anxiety, depression and satisfaction scores, 6-minute walking distance, self-care ability scores, and cardiac function were compared between the two groups.
RESULTS
Patients' quality of life scores improved significantly in both groups after treatment, but the increase was greater in the study group than in the control group ( < 0.05); the incidence of complications was 18.9% and 5.9% in the study and control groups, respectively, and the incidence of complications was lower in the study group than in the control group ( < 0.05); and the incidence of complications was lower in the study group than in the control group ( < 0.05). After care, patients' anxiety and depression scores were significantly lower, and satisfaction scores were significantly higher in both groups, with a greater change in the study group than in the control group ( < 0.05); after care, patients' 6-minute walking distance was significantly higher in both groups, with a greater change in the study group than in the control group ( < 0.05); after care, LVEF indicators were significantly higher, and LVESD and LVED indicators were significantly higher, with a greater change in the study group than in the control group. After care, LVEF indexes increased significantly in both groups, while LVESD and LVED indexes decreased significantly in the study group, with a greater change than in the control group ( < 0.05); after care, systolic blood pressure and heart rate increased significantly in both groups, with a greater increase in the study group than in the control group ( < 0.05); after care, systolic blood pressure and heart rate increased significantly in both groups, with a more significant increase.
CONCLUSION
Targeted nursing for patients with severe cardiac disease after thoracoscopic surgery has a significant effect, which can improve patients' anxiety and depression, significantly improve patients' self-care ability and quality of life, and at the same time improve patients' cardiac function, heart rate, and blood pressure, with high patient satisfaction.
Topics: Anxiety; Critical Care; Heart Diseases; Humans; Quality of Life; Thoracoscopy
PubMed: 35401784
DOI: 10.1155/2022/2894755 -
Frontiers in Public Health 2022Incidences of social anxiety disorder (SAD), appearance anxiety, and eating disorders (ED) show an increased prevalence among young people. However, symptoms'...
Symptom association between social anxiety disorder, appearance anxiety, and eating disorders among Chinese University students: A network analysis to conceptualize comorbidity.
BACKGROUND
Incidences of social anxiety disorder (SAD), appearance anxiety, and eating disorders (ED) show an increased prevalence among young people. However, symptoms' associations between these disorders have not been investigated in depth. Network analysis is an approach that can be used to explain the relationship(s) between symptoms of different psychological disorders. Using network analysis, this study aimed to explore the association and potential interacting mechanisms between SAD, appearance anxiety, and ED.
METHODS
This study included 96,218 University students from Jilin Province, China. SAD, appearance anxiety and ED were assessed using the Social Anxiety Subscale of the Self-Consciousness Scale (SASS), the Appearance Anxiety Scale Brief Version (AASBV), and the Sick, Control, One, Fat, Food questionnaire (SCOFF), Chinese versions. Network analysis was employed to investigate the symptom associations, while the stability of the network model was analyzed using statistical measures.
RESULTS
The prevalence of ED among the total sample was 38% (95% CI: 38.1-38.8%), while this figure was 31.2% (95% CI: 30.7-31.6%) in males and 43.6% (95% CI: 43.2-44.0%) in females. Additionally, the total score of SAD was significantly higher in females (11.83 ± 5.37) than it in males (10.02 ± 5.46) ( < 0.001). While the total score of appearance anxiety was also different significantly in gender (39.21 ± 9.49 in females vs. 38 ± 9.42 in males) ( < 0.001). Results showed that ED was associated with all three aspects of appearance anxiety, including "appearance concern," "appearance satisfaction," and "wish for good looks." Appearance anxiety and SAD were also associated; specifically, symptoms of "appearance satisfaction" were significantly associated with the symptoms "easily talk to strangers" and "appearance concern", which was also significantly associated with "embarrassed". Compared with males, females showed significantly stronger associations with appearance anxiety symptoms, while ED symptoms were associated with "troubled by being watched" and "appearance concern".
CONCLUSION
Appearance anxiety was associated with both ED and SAD symptoms. ED may have a potential relationship with SAD, affecting appearance anxiety indirectly. Significant differences were found among males and females in symptom associations between appearance anxiety and SAD. This study therefore clarified that young people should have body-positive interventions and challenge the normative body image discourse, which may help alleviate symptoms of SAD and ED.
Topics: Male; Female; Humans; Adolescent; Phobia, Social; Universities; Anxiety; Comorbidity; Feeding and Eating Disorders; Students
PubMed: 36620231
DOI: 10.3389/fpubh.2022.1044081 -
Journal of Psychiatric Research Jan 2021Studies have documented the significant direct and indirect psychological, social, and economic consequences of the Coronavirus disease 2019 (COVID-19) in many countries...
OBJECTIVE
Studies have documented the significant direct and indirect psychological, social, and economic consequences of the Coronavirus disease 2019 (COVID-19) in many countries but little is known on its impact in low- and middle-income countries (LMICs) already facing difficult living conditions and having vulnerable health systems that create anxiety among the affected populations. Using a multinational convenience sample from four LMICs (DR Congo, Haiti, Rwanda, and Togo), this study aims to explore the prevalence of anxiety symptoms and associated risk and protective factors during the COVID-19 pandemic.
METHODS
A total of 1267 individuals (40.8% of women) completed a questionnaire assessing exposure and stigmatization related to COVID-19, anxiety, and resilience. Analyses were performed to examine the prevalence and predictors of anxiety.
RESULTS
Findings showed a pooled prevalence of 24.3% (9.4%, 29.2%, 28.5%, and 16.5% respectively for Togo, Haiti, RDC, and Rwanda, x = 32.6, p < .0001). For the pooled data, exposure to COVID-19 (β = 0.06, p = .005), stigmatization related to COVID-19 (β = 0.03, p < .001), and resilience (β = -0.06, p < .001) contributed to the prediction of anxiety scores. Stigmatization related to COVID-19 was significantly associated to anxiety symptoms in all countries (β = 0.02, p < .00; β = 0.05, p = .013; β = 0.03, p = .021; β = 0.04, p < .001, respectively for the RDC, Rwanda, Haiti, and Togo).
CONCLUSIONS
The findings highlight the need for health education programs in LMICs to decrease stigmatization and the related fears and anxieties, and increase observance of health instructions. Strength-based mental health programs based on cultural and contextual factors need to be developed to reinforce both individual and community resilience and to address the complexities of local eco-systems.
Topics: Adult; Anxiety; COVID-19; Congo; Developing Countries; Female; Haiti; Health Knowledge, Attitudes, Practice; Humans; Male; Middle Aged; Prevalence; Protective Factors; Resilience, Psychological; Risk Factors; Rwanda; Social Stigma; Togo
PubMed: 33035760
DOI: 10.1016/j.jpsychires.2020.09.031 -
Medicine Sep 2023Mindfulness-based stress reduction (MBSR) has been suggested as an effective mind-body approach for relieving stress in patients with chronic diseases. As of yet, there... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Mindfulness-based stress reduction (MBSR) has been suggested as an effective mind-body approach for relieving stress in patients with chronic diseases. As of yet, there is no conclusive research on MBSR's role in reducing affective disorders among cancer patients. A systematic review and meta-analysis was conducted to determine whether MBSR has an impact on loneliness, anxiety, and depression in cancer patients.
METHODS
Systematic searches were conducted in PubMed, Embase, and the Cochrane Library from the start of these databases to January 2nd, 2022 to identify relevant randomized controlled trials. Two authors independently conducted the literature search, collected the data, and performed the statistical analysis. In order to account for potential between-study heterogeneity, a random-effect model was used in the meta-analysis.
RESULTS
The meta-analysis included 16 studies with 2072 cancer patients. Among the 16 studies, 13 included patients with breast cancer, and the follow-up duration ranged from 6 to 53 weeks. Compared to controls receiving standard cancer care, interventions of MBSR with sessions for 6 to 8 weeks significantly improved loneliness (standard mean difference [SMD]: -0.35, 95% confidence interval [CI]: -0.59 to -0.12, P = .003, I2 = 46%), anxiety (SMD: -0.51, 95% CI: -0.73 to -0.30, P < .001, I2 = 77%), and depression (SMD: -0.61, 95% CI: -1.02 to -0.20, P = .004, I2 = 94%) in patients with cancer.
CONCLUSION
According to recent research, MBSR may be beneficial to patients diagnosed with cancer who are feeling lonely, anxious, or depressed.
Topics: Humans; Female; Loneliness; Depression; Mindfulness; Anxiety; Breast Neoplasms
PubMed: 37713902
DOI: 10.1097/MD.0000000000034917 -
Revista Da Associacao Medica Brasileira... 2023This study aims to examine the effect of telecounseling in reducing the anxiety and depression experienced by pregnant women. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
This study aims to examine the effect of telecounseling in reducing the anxiety and depression experienced by pregnant women.
METHOD
This randomized control trial was conducted on 100 pregnant women (50 in each intervention and control group). The intervention group received telecounseling with regard to the mother and the fetus as needed between 08:00 h and 20:00 h for 6 weeks at home. The control group received only routine care. Anxiety and depression levels were evaluated at the beginning and end of the study using the Hospital Anxiety Depression Scale.
RESULTS
Anxiety and depression levels were found to be lower in the intervention group than in the control group (p<0.001). In the control group, the anxiety score increased from 5.62 to 7.16, and the depression score increased from 4.92 to 5.76 without any intervention (p<0.001).
CONCLUSION
This study shows that telecounseling may have an effect on reducing the level of anxiety and depression of pregnant women.
Topics: Female; Pregnancy; Humans; Anxiety; Pregnant Women; Anxiety Disorders; Mothers
PubMed: 37194904
DOI: 10.1590/1806-9282.20221213 -
Health Psychology : Official Journal of... Dec 2022Anxiety is prevalent in pregnancy and predicts risk of adverse birth outcomes. Many instruments measure anxiety in pregnancy, some of which assess defined as maternal...
OBJECTIVES
Anxiety is prevalent in pregnancy and predicts risk of adverse birth outcomes. Many instruments measure anxiety in pregnancy, some of which assess defined as maternal concerns about a current pregnancy (e.g., baby, childbirth). The present study examined covariance among four anxiety or distress measures at two times in pregnancy and tested joint and individual effects on gestational length. We hypothesized that the common variance of the measures in each trimester would predict earlier delivery.
METHOD
Research staff interviewed 196 women in first and third trimester utilizing a clinical screener of anxiety severity/impairment, two instruments measuring pregnancy anxiety, and one on prenatal distress. Birth outcomes and medical risk factors were obtained from medical records after birth. Structural equation modeling fit latent factors for each trimester from the four measures. Subsequent models tested whether the latent factors predicted gestational length, and unique effects of each measure.
RESULTS
The third-trimester pregnancy anxiety latent factor predicted shorter gestational length adjusting for mother's age, education, parity, and obstetric risk. Scores on a four-item pregnancy-specific anxiety measure (PSAS) in third trimester added uniquely to prediction of gestational length. In first trimester, scores on the clinical screener (OASIS) uniquely predicted shorter gestational length whereas the latent factor did not.
CONCLUSION
These results support existing evidence indicating that pregnancy anxiety is a reliable risk factor for earlier birth. Findings point to possible screening for clinically significant anxiety symptoms in the first trimester, and pregnancy-specific anxiety thereafter to advance efforts to prevent earlier delivery. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Topics: Pregnancy; Infant; Female; Humans; Anxiety; Pregnancy Trimester, Third; Pregnancy Complications; Pregnancy Trimester, First; Anxiety Disorders
PubMed: 36154104
DOI: 10.1037/hea0001210 -
World Journal of Surgery Dec 2022Preoperative anxiety is associated with increased use of anesthetics and poorer postoperative outcomes. However, the prevalence of preoperative anxiety has not been...
BACKGROUND
Preoperative anxiety is associated with increased use of anesthetics and poorer postoperative outcomes. However, the prevalence of preoperative anxiety has not been characterized in Chinese patients. In this study, we aimed to estimate the overall prevalence of preoperative anxiety in Chinese adult patients and to explore the sociodemographic and clinical factors associated with preoperative anxiety in China.
METHODS
This study was a multicenter cross-sectional study conducted at 32 tertiary referral centers in China from September 1 to October 31, 2020. Adult patients scheduled for elective surgery were evaluated by the 7-item Perioperative Anxiety Scale (PAS-7) for preoperative anxiety after entrance to the operating zone.
RESULTS
A total of 5191 patients were recruited, and 5018 of them were analyzed. The prevalence of preoperative anxiety measured by PAS-7 was 15.8% (95% CI 14.8 to 16.9%). Multivariable analyses showed female sex, younger age, non-retired, first in a lifetime surgery, surgery of higher risk, and poorer preoperative sleep were associated with higher prevalence of preoperative anxiety.
CONCLUSIONS
Preoperative anxiety was relatively common (prevalence of 15.8%) among adult Chinese patients undergoing elective surgeries. Further studies are needed using suitable assessment tools to better characterize preoperative anxiety, and additional focus should be placed on perioperative education and intervention, especially in primary hospitals.
TRIAL REGISTRATION
This study was registered prospectively at www.chictr.org.cn (ChiCTR1900027639) on November 22, 2019.
Topics: Adult; Humans; Female; Cross-Sectional Studies; Anxiety; Elective Surgical Procedures; Prevalence; Postoperative Period
PubMed: 36070012
DOI: 10.1007/s00268-022-06720-9 -
Pain Research & Management 2023Chronic pelvic inflammatory disease (CPID) is a clinically common gynecological disease. Patients experience chronic pelvic pain and often accompany with emotional...
BACKGROUND
Chronic pelvic inflammatory disease (CPID) is a clinically common gynecological disease. Patients experience chronic pelvic pain and often accompany with emotional dysfunction. However, the impact and correlation of anxiety and depression on pain sensitization is not completely known.
OBJECTIVE
To explore the differences and correlations among anxiety, depression, and pressure pain threshold (PPT) of acupoints in patients with CPID.
METHODS
One hundred and forty-seven patients with CPID were recruited. The Visual Analog Scale (VAS) and short-form McGill Pain Questionnaire (SF-MPQ) were used to assess pain. Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used to evaluate the emotional state of patients. The PPT of acupoints was collected using an electronic Von Frey by two licensed acupuncturists.
RESULTS
The CPID patients were divided into anxiety-depression group (group A) or nonanxiety-depression group (group B), according to the SAS and SDS scores. Finally, there were 73 patients in group A and 74 patients in group B. Group A had significantly higher SAS, SDS, VAS, and SF-MPQ scores than group B ( < 0.05). In addition, significant differences were observed in the PPTs of ST28 (R), ST29 (R), SP10 (R), SP9 (R), SP9 (L), ST36 (R), and LR3 (L) between the two groups ( < 0.05). No considerable differences in PPTs at the other acupoints were observed between the two groups. SAS scores showed a positive correlation with PPTs of ST29 (R), SP10 (R), SP9 (L), ST36 (R), and LR3 (L). No remarkable correlation was observed between the SDS scores and PPTs.
CONCLUSION
Anxiety and depression can affect the PPT of some acupoints in CPID patients, which may provide a reference for acupoint selection for acupuncture treatment of CPID with emotional disorders. This trial is registered with ChiCTR2100052632.
Topics: Female; Humans; Depression; Pain Threshold; Acupuncture Points; Pelvic Inflammatory Disease; Anxiety; Chronic Pain
PubMed: 38033371
DOI: 10.1155/2023/3315090 -
Journal of Hand Therapy : Official... 2022Patients with upper extremity conditions may also experience symptoms of depression, anxiety, and pain that limit functional recovery.
INTRODUCTION
Patients with upper extremity conditions may also experience symptoms of depression, anxiety, and pain that limit functional recovery.
PURPOSE OF THE STUDY
This study examined the impact of mental health and pain symptoms on referral rates to therapy and utilization of therapy services to achieve functional recovery among patients with common hand conditions.
STUDY DESIGN
This is a retrospective cohort study of patients from one orthopedic center.
METHODS
Data extraction provided demographics, the International Classification of Diseases, 10th revision diagnoses, therapy referral, therapy visit counts, treatment goal attainment, and Patient-Reported Outcomes Measurement Information System (PROMIS) Depression, Anxiety, and Pain Interference scores. The chi-square test, t-test, and logistic regression analyses assessed associations between baseline PROMIS depression, anxiety, and pain interference to therapy referral, the number of therapy visits, and goal attainment.
RESULTS
Forty-nine percent (172/351) of patients were referred to hand therapy. There was no relationship between three baseline PROMIS scores based on physician referral (t-test P values .32-.67) and no association between PROMIS scores and therapy utilization or goal attainment (Pearson correlation (r): 0.002 to 0.020, P > .05). Referral to therapy was most strongly associated with having a traumatic condition (P < .01). Patients with high depression, anxiety, and pain interference scores on average required one more therapy visit to achieve treatment goals (average visits: 3.7 vs 3.1; 4.1 vs 2.7; 3.4 vs 2.3, respectively). Fewer patients with high depression scores (50%) achieved their long-term goals than patients with low depression scores (69%, P = .20).
CONCLUSIONS
Patients' baseline level of depressive symptoms and anxiety do not predict referrals to hand therapy by orthopedic hand surgeons. There is some indication that patients with increased depressive symptoms, anxiety, and pain interference require more therapy with fewer achieving all goals, suggesting that mental health status may affect response to therapy. Therapists may address mental health needs in treatment plans. Future studies should examine if nonreferred patients with depressive symptoms achieve maximal functional recovery.
Topics: Anxiety; Depression; Humans; Pain; Patient Reported Outcome Measures; Referral and Consultation; Retrospective Studies
PubMed: 33250395
DOI: 10.1016/j.jht.2020.10.006