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Behavioral Sleep Medicine Jul 2024Sleep difficulties are common amongst university students and are associated with mental illness and reduced wellbeing. This paper reports a pilot study of Cognitive...
INTRODUCTION
Sleep difficulties are common amongst university students and are associated with mental illness and reduced wellbeing. This paper reports a pilot study of Cognitive Behavior Therapy for Insomnia (CBT-I) tailored specifically for university students. It was hypothesized that the intervention would be feasible, acceptable, and improve sleep, anxiety, depression, and wellbeing.
METHOD
Students aged 18-25 participated via videoconferencing small group sessions of CBT-I. Feasibility was assessed through sign-up, consent rates, and study attrition, while acceptability was assessed using intervention adherence and a measure of intervention acceptability. Outcome measures included sleep quality, insomnia, suicidal ideation, symptoms of depression, anxiety, and wellbeing, and were assessed at baseline and post-intervention.
RESULTS
Participants were 44 students ( = 21.8 years). Feasibility was confirmed by sign-up and consent rates (80% of the students who expressed interest agreed to participate); overall study attrition was 48%, comprised largely of participants not commencing treatment (27%). Participants perceived the program as effective and logical and made use of the skills suggested. In terms of adherence, 82% of the participants who engaged with treatment attended two or more sessions and 63% attended all four sessions; and 92% were either very satisfied or mostly satisfied. Sleep quality, insomnia, depression, anxiety, and wellbeing all significantly improved from pre- to post-intervention.
DISCUSSION
There was evidence that the CBT-I intervention tailored for university students was acceptable to participants and could be feasible to deliver. Sleep quality, depression, anxiety, and wellbeing improved significantly. These findings suggest that the intervention is suitable for evaluation in a fully powered randomized controlled trial.
PubMed: 38949071
DOI: 10.1080/15402002.2024.2374258 -
Clinical Psychology & Psychotherapy 2024In this study, we re-examined data from a previous randomized controlled trial investigating 'technology supported mindfulness' (TSM)-an 8-week treatment intervention... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
In this study, we re-examined data from a previous randomized controlled trial investigating 'technology supported mindfulness' (TSM)-an 8-week treatment intervention for individuals experiencing OCD. The current analysis involves an examination of the longitudinal relationships between rumination, worry and OCD symptom changes during mindfulness treatment, in comparison to a waitlist control.
METHODS
Participants experiencing OCD (n = 71) were randomly assigned to 8 weeks of (1) TSM or (2) waitlist control. We tested the extent to which rumination (using the Ruminative Response Scale) and worry (using the Penn State Worry Questionnaire) are associated with OCD symptom changes during the acute phase of treatment, concurrently (i.e., within the same longitudinal model).
RESULTS
Generalized linear model (GLM) results indicated a significant time (week 1 vs. week 8) by condition interaction involving decreased rumination in the TSM condition: F(1, 61) = 13.37, p = 0.001, partial η = 0.18 and observed power = 0.94. A second GLM demonstrated decreased worry in the TSM condition: F(1, 69) = 37.34, p = 0.001, partial η = 0.35 and observed power = 0.83. Longitudinal 'latent difference' structural equation analyses demonstrated a cross-lagged association between worry (but not rumination) and OCD symptom changes.
CONCLUSIONS
Individuals in the TSM condition experienced greater reductions in rumination and worry during 8 weeks of TSM treatment compared to the waitlist control, and reduced worry predicted subsequent OCD symptom reduction.
Topics: Humans; Female; Male; Mindfulness; Obsessive-Compulsive Disorder; Rumination, Cognitive; Adult; Treatment Outcome; Anxiety; Middle Aged; Surveys and Questionnaires
PubMed: 38948943
DOI: 10.1002/cpp.3018 -
BioRxiv : the Preprint Server For... Jun 2024Distinct basolateral amygdala (BLA) cell populations influence emotional responses in manners thought important for anxiety and anxiety disorders. The BLA contains...
Distinct basolateral amygdala (BLA) cell populations influence emotional responses in manners thought important for anxiety and anxiety disorders. The BLA contains numerous cell types which can broadcast information into structures that may elicit changes in emotional states and behaviors. BLA excitatory neurons can be divided into two main classes, one of which expresses (encoding protein phosphatase 1 regulatory inhibitor subunit 1B) which is downstream of the genes encoding the D1 and D2 dopamine receptors ( and respectively). The role of or BLA neurons in learned and unlearned emotional responses is unknown. Here, we identified that the + and + BLA neuron populations form two parallel pathways for communication with the ventral striatum. These neurons arise from the basal nucleus of the BLA, innervate the entire space of the ventral striatum, and are capable of exciting ventral striatum neurons. Further, through three separate behavioral assays, we found that the + and + parallel pathways bidirectionally influence both learned and unlearned emotional states when they are activated or suppressed, and do so depending upon where they synapse in the ventral striatum - with unique contributions of + and + circuitry on negative emotional states. Overall, these results contribute to a model whereby parallel, genetically-distinct BLA to ventral striatum circuits inform emotional states in a projection-specific manner.
PubMed: 38948716
DOI: 10.1101/2024.06.19.599749 -
Journal of Family Medicine and Primary... May 2024Telephobia is a kind of anxiety disorder in which the individual is afraid of either answering or making telephone calls. This study was conducted to determine the...
BACKGROUND
Telephobia is a kind of anxiety disorder in which the individual is afraid of either answering or making telephone calls. This study was conducted to determine the prevalence of telephobia among medical students and to determine the association of socio-demographic and other factors with this disorder.
METHODS
A total of 320 undergraduate medical students were enrolled at a tertiary medical college in Western India, of which 300 (93.75%) responded to the survey. A stratified sampling strategy with the proportional allocation method was used in which 40 males and 20 females were selected from each year of students, spanning 5 years. A specially designed semi-structured questionnaire was used for the study, consisting of demographic data, purpose of using the internet, gadget used, and a 10-item telephobia questionnaire modified from the Severity Measure for Agoraphobia-Adult (SMA-A) Questionnaire to measure student's avoidance of telephone calling and receiving.
RESULTS
The mean age of the study participants was 21.91 (±1.84) years, and most of the students were urban residents (184, 61.3%). The prevalence of mild, moderate, and severe telephobia was 33.0%, 7.67%, and 1.33%, respectively, giving an overall prevalence of 42%. Univariate analysis revealed that male gender (χ = 9.822, df = 3, = 0.0201), higher duration of internet usage (χ = 41.15, df = 9, value < 0.000), and viewing porn (χ = 15.94, df = 3, = 0.0011) had significant association with higher severity of telephobia. Viewing of porn sites was reported by 65 (21.7%) medical students, exclusively among males.
CONCLUSION
A prevalence of 9% moderate to severe telephobia among medical students is much alarming, which may aggravate further as the students move from academic to clinical settings. The phenomenon of telephobia needs further exploration, to find its determinants and predictors, especially among vulnerable populations.
PubMed: 38948634
DOI: 10.4103/jfmpc.jfmpc_1673_23 -
Journal of Family Medicine and Primary... May 2024The COVID-19 pandemic changed people's lives. The majority had to adapt to working online including students. The shift to online learning caused serious sleep and...
BACKGROUND
The COVID-19 pandemic changed people's lives. The majority had to adapt to working online including students. The shift to online learning caused serious sleep and mental health issues among students. This study aimed to examine the variations between the prevalence of sleep and mental health problems among undergraduate students during the periods of online learning and on-campus learning.
METHOD
An online survey was distributed to medical students in Saudi Arabia.
RESULTS
A total of 110 participated in the study (age = 21 ± 1.4 years). The on-campus anxiety (8.2 ± 6.3) was significantly higher than online anxiety (5.5 ± 5.1). On-campus daytime sleepiness (8.5 ± 4) was significantly higher when compared to online daytime sleepiness (6.7 ± 4.6). Although not significant, the on-campus stress (7.7 ± 5.7) and insomnia (12 ± 7.3) were higher than online stress (6.9 ± 5.5) and insomnia (11.5 ± 6). The online depression (6.6 ± 5.7) was higher than the mean on-campus depression (5.8 ± 5.4). A significant strong positive correlation was found between on-campus anxiety and on-campus stress. A significant moderate positive correlation was detected between on-campus anxiety and on-campus daytime sleepiness. A weak but significant correlation was found between on-campus anxiety and on-campus insomnia. On-campus anxiety was significantly predicted by the following model, which included on-campus stress, insomnia, and daytime sleepiness ( < .001).
CONCLUSION
Medical students reported lower anxiety, daytime sleepiness, stress, and insomnia during their online learning compared to on-campus learning. Only depression was higher during online learning compared to on-campus learning.
PubMed: 38948610
DOI: 10.4103/jfmpc.jfmpc_1790_23 -
Journal of Family Medicine and Primary... May 2024Fear and anxiety related to dental and healthcare procedures are common among young adults and can negatively impact dental and healthcare consumership, resulting in...
BACKGROUND AND PURPOSE
Fear and anxiety related to dental and healthcare procedures are common among young adults and can negatively impact dental and healthcare consumership, resulting in poor health outcomes.
PURPOSE
This cross-sectional study aimed to examine young adults' experiences of fear related to dental and healthcare procedures and the potential relationships between the two forms of fear experiences and demographic factors.
METHODS
Young adults (252) were recruited from a large public university and completed a survey about their dental and healthcare fear/anxiety as well as their confidence in healthcare professionals. Descriptive and correlational analyses were completed to describe the experiences of young adults and the relationships between variables.
RESULTS
Ten types of fear/anxiety were identified related to healthcare procedures, with the most common being needles and pain. Nine fears/anxieties were identified for dental visits, of which pain and sensory experiences other than pain were most common. Female participants were significantly more likely to report fear/anxiety related to dental procedures, and there was a statistically significant relationship between fear/anxiety related to healthcare procedures and that related to dental procedures. There was also a significant negative relationship found between confidence in healthcare providers and fear/anxiety related to healthcare procedures.
CONCLUSIONS
Young adults experience fear/anxiety related to healthcare and dentist visits, and this fear/anxiety can impact their confidence in healthcare providers, such as primary physicians. The findings of the current study suggest primary care providers should be aware of potential fears/anxieties and offer patients appropriate supports.
PubMed: 38948590
DOI: 10.4103/jfmpc.jfmpc_961_23 -
Journal of Family Medicine and Primary... May 2024In the United States, access to evidence-based behavioral health treatment remains limited, contributing to inadequate treatment for individuals with depression and...
CONTEXT AND AIMS
In the United States, access to evidence-based behavioral health treatment remains limited, contributing to inadequate treatment for individuals with depression and anxiety disorders. The Collaborative care model (CoCM), the integration of behavioral healthcare into primary care, has been shown to be effective in addressing this issue, particularly when delivered virtually through telehealth platforms. While collaborative care has been shown to be effective, little has been studied to understand the impact of patient treatment factors on patient improvement. This study aims to analyze factors associated with patient improvement, measured by PHQ-9 and GAD-7 score changes, in patients with depression and anxiety disorders from Concert Health, a national behavioral medical group offering collaborative care across 18 states.
METHODS AND MATERIAL
Stepwise logistic regression models were utilized to identify factors influencing patient improvement in standardized symptom screener scores (PHQ-9 and GAD-7). Relevant patient-level data, including demographics, clinical engagement, insurance type, clinical touchpoints, and other variables, were analyzed. Results are presented as odds ratios (ORs).
RESULTS AND CONCLUSIONS
We find that increased clinical touchpoints were associated with improved outcomes in both depression (PHQ-9) and anxiety (GAD-7) populations. Commercial insurance was linked to a greater likelihood of improvement relative to Medicaid, and the use of C-SSRS suicide screeners had varied effects on patient outcomes depending on the diagnosis. The duration of time spent in appointments showed a nuanced impact, suggesting an optimal length for touchpoints. Psychiatric consults also impact patient outcomes in both populations. This study sheds light on factors influencing patient outcomes in virtual collaborative care for depression and anxiety disorders, which may be used to inform and motivate further research and allow providers to better optimize and understand the impacts of treatment choices in collaborative care settings.
PubMed: 38948587
DOI: 10.4103/jfmpc.jfmpc_1493_23 -
Journal of Family Medicine and Primary... May 2024Lichen planus is a chronic inflammatory disease of the skin and mucous membrane with higher predilection seen in the female population. Oral lichen planus (OLP) has been...
BACKGROUND
Lichen planus is a chronic inflammatory disease of the skin and mucous membrane with higher predilection seen in the female population. Oral lichen planus (OLP) has been associated with various etiological factors, such as stress, hormonal imbalance, and immunological variation. The purpose of this study was to assess serum and salivary estrogen (E2) levels in OLP patients and correlate them with stress levels.
OBJECTIVES
This study aimed to evaluate serum and salivary estrogen levels in female patients with OLP, along with the assessment of stress and its correlation with estrogen levels.
METHODS
A total of 78 females, 39 clinically diagnosed with OLP and 39 healthy females, were included in the study as the case and control groups, respectively. 2 ml each of salivary and serum samples was obtained from each participant to measure the estrogen levels. Stress levels in the study group patients were assessed using the Depression Anxiety Stress Scale (DASS-21) and the Perceived Stress Scale (PSS). The nonparametric Mann-Whitney test was used for intergroup comparisons.
RESULTS
Significantly higher serum estrogen levels with higher DASS-21 and PSS scores were noted in patients with OLP. Overall, significant positive correlations were observed between salivary E2 and serum E2 (r = 0.361, = 0.001). There was a positive correlation between salivary and serum E2 and DASS score (r = 0.410, < 0.001, and r = 0.768, < 0.001, respectively), serum/salivary E2 and PSS score (r = 0.745, < 0.001, and r = 0.410, < 0.001, respectively), and DASS score and PSS score (r = 0.878, < 0.001).
CONCLUSION
Estrogen can be used as a useful biomarker for OLP in the future. Salivary samples can prove to be an accurate and feasible alternative to serum estrogen level determination. We also suggest that OLP patients must be given supportive psychological treatment for improved life quality and disease management.
PubMed: 38948558
DOI: 10.4103/jfmpc.jfmpc_1332_23 -
F1000Research 2023Currently there are 1.3 billion adolescents worldwide, which makes up 16% of the world population. Over 20% of adolescents around the world are thought to have...
Currently there are 1.3 billion adolescents worldwide, which makes up 16% of the world population. Over 20% of adolescents around the world are thought to have behavioural or mental health issues. Addressing mental health issues is very important for the promotion of positive health in adolescents. The objective of our study was to estimate the prevalence of depression, anxiety, and stress among adolescents in urban and rural areas of Shivamogga. A cross-sectional study was conducted among 350 adolescents aged 16 to 19 years each from urban and rural areas of Shivamogga. Depression, anxiety and stress were found to be 23.1%, 29.4% and 26.6% in urban areas and 19.1%, 24% and 21.1% in rural areas respectively. About a quarter of the adolescent population suffers from depression anxiety and stress. Adopting and implementing better education and health policies are necessary to enhance adolescent mental health.
Topics: Humans; Adolescent; Male; Depression; Female; Rural Population; Stress, Psychological; Anxiety; Urban Population; Young Adult; Cross-Sectional Studies; India; Prevalence
PubMed: 38948506
DOI: 10.12688/f1000research.139603.2 -
Neurobiology of Stress Jul 2024Chronic pain can induce mood disorders and cognitive dysfunctions, such as anxiety, depression, and learning and memory impairment in humans. However, the specific...
Hyperexcitation of the glutamatergic neurons in lateral hypothalamus induced by chronic pain contributes to depression-like behavior and learning and memory impairment in male mice.
Chronic pain can induce mood disorders and cognitive dysfunctions, such as anxiety, depression, and learning and memory impairment in humans. However, the specific neural network involved in anxiety- and depression-like behaviors and learning and memory impairment caused by chronic pain remains poorly understood. In this study, behavioral test results showed that chronic pain induced anxiety- and depression-like behaviors, and learning and memory impairment in male mice. c-Fos immunofluorescence and fiber photometry recording showed that glutamatergic neurons in the LH of mice with chronic pain were selectively activated. Next, the glutamatergic neurons of LH in normal mice were activated using optogenetic and chemogenetic methods, which recapitulates some of the depressive-like behaviors, as well as memory impairment, but not anxiety-like behavior. Finally, inhibition of glutamatergic neurons in the LH of mice with chronic pain, effectively relieved anxiety- and depression-like behaviors and learning and memory impairment. Taken together, our findings suggest that hyperexcitation of glutamatergic neurons in the LH is involved in depression-like behavior and learning and memory impairment induced by chronic pain.
PubMed: 38948390
DOI: 10.1016/j.ynstr.2024.100654