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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 -
Nature Reviews. Neuroscience Jul 2013Uncertainty about a possible future threat disrupts our ability to avoid it or to mitigate its negative impact and thus results in anxiety. Here, we focus the broad... (Review)
Review
Uncertainty about a possible future threat disrupts our ability to avoid it or to mitigate its negative impact and thus results in anxiety. Here, we focus the broad literature on the neurobiology of anxiety through the lens of uncertainty. We identify five processes that are essential for adaptive anticipatory responses to future threat uncertainty and propose that alterations in the neural instantiation of these processes result in maladaptive responses to uncertainty in pathological anxiety. This framework has the potential to advance the classification, diagnosis and treatment of clinical anxiety.
Topics: Adaptation, Psychological; Anxiety; Attention; Brain; Decision Making; Humans; Neurobiology; Uncertainty
PubMed: 23783199
DOI: 10.1038/nrn3524 -
Dialogues in Clinical Neuroscience Jun 2015A sizable proportion of psychiatric patients will seek clinical evaluation and treatment for anxiety symptoms reportedly refractory to treatment. This apparent lack of... (Review)
Review
A sizable proportion of psychiatric patients will seek clinical evaluation and treatment for anxiety symptoms reportedly refractory to treatment. This apparent lack of response is either due to "pseudo-resistance" (a failure to have received and adhered to a recognized and effective treatment or treatments for their condition) or to true "treatment resistance." Pseudo-resistance can be due to clinician errors in selecting and delivering an appropriate treatment effectively, or to patient nonadherence to a course of treatment. True treatment resistance can be due to unrecognized exogenous anxiogenic factors (eg, caffeine overuse, sleep deprivation, use of alcohol or marijuana) or an incorrect diagnosis (eg, atypical bipolar illness, occult substance abuse, attention deficit-hyperactivity disorder). Once the above factors are eliminated, treatment should focus on combining effective medications and cognitive behavioral therapy, combining several medications (augmentation), or employing novel medications or psychotherapies not typically indicated as first-line evidence-based anxiety treatments.
Topics: Anti-Anxiety Agents; Anxiety; Cognitive Behavioral Therapy; Databases, Bibliographic; Humans; Treatment Outcome
PubMed: 26246793
DOI: 10.31887/DCNS.2015.17.2/proybyrne -
CNS Neuroscience & Therapeutics Apr 2012This review aims to examine the volume and quality of the evidence base which supports the use of acupuncture in the treatment of anxiety disorders. A literature review... (Review)
Review
This review aims to examine the volume and quality of the evidence base which supports the use of acupuncture in the treatment of anxiety disorders. A literature review was conducted using Pubmed, Google scholar, AMED, BMJ, Embase, Psychinfo, Cochrane library, Ingenta connect, and Cinahl databases. Keywords were "anxiety,""anxious,""panic,""stress,""phobia," and "acupuncture" limited to year 2000 onwards and English language where available. The quality of research examining the use of acupuncture in the treatment of anxiety disorders is extremely variable. There is enormous variety regarding points used, number of points used in a session, duration of sessions, frequency of treatment and duration of treatment programme. While the generally poor methodological quality, combined with the wide range of outcome measures used, number and variety of points, frequency of sessions, and duration of treatment makes firm conclusions difficult. Against this, the volume of literature, consistency of statistically significant results, wide range of conditions treated and use of animal test subjects suggests very real, positive outcomes using a treatment method preferred by a population of individuals who tend to be resistant to conventional medicine.
Topics: Acupuncture Therapy; Animals; Anxiety; Anxiety Disorders; Humans
PubMed: 22070429
DOI: 10.1111/j.1755-5949.2011.00254.x -
BMC Pediatrics Mar 2016Hospitalization is a stressful and threatening experience, which can be emotionally devastating to children. Hospital play interventions have been widely used to prepare...
BACKGROUND
Hospitalization is a stressful and threatening experience, which can be emotionally devastating to children. Hospital play interventions have been widely used to prepare children for invasive medical procedures and hospitalization. Nevertheless, there is an imperative need for rigorous empirical scrutiny of the effectiveness of hospital play interventions, in particular, using play activities to ease the psychological burden of hospitalized children. This study tested the effectiveness of play interventions to reduce anxiety and negative emotions in hospitalized children.
METHODS
A non-equivalent control group pre-test and post-test, between subjects design was conducted in the two largest acute-care public hospitals in Hong Kong. A total of 304 Chinese children (ages 3-12) admitted for treatments in these two hospitals were invited to participate in the study. Of the 304 paediatric patients, 154 received hospital play interventions and 150 received usual care.
RESULTS
Children who received the hospital play interventions exhibited fewer negative emotions and experienced lower levels of anxiety than those children who received usual care.
CONCLUSION
This study addressed a gap in the literature by providing empirical evidence to support the effectiveness of play interventions in reducing anxiety and negative emotions in hospitalized children. Findings from this study emphasize the significance of incorporating hospital play interventions to provide holistic and quality care to ease the psychological burden of hospitalized children.
TRIAL REGISTRATION
ClinicalTrials.gov NCT02665403 . Registered 22 January 2016.
Topics: Anxiety; Child; Child, Hospitalized; Child, Preschool; Emotions; Female; Hong Kong; Humans; Male; Patient Satisfaction; Play Therapy; Treatment Outcome
PubMed: 26969158
DOI: 10.1186/s12887-016-0570-5 -
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 -
Genes, Brain, and Behavior Mar 2018The pathogenesis of anxiety disorders is multifactorial, involving complex interactions between biological factors, environmental influences and psychological... (Review)
Review
The pathogenesis of anxiety disorders is multifactorial, involving complex interactions between biological factors, environmental influences and psychological mechanisms. Recent advances have highlighted the role of epigenetics in bridging the gap between multiple contributing risk factors toward an increased understanding of the pathomechanisms underlying anxiety. In this review, we present an overview of the current state of knowledge regarding putative risk mechanisms in the pathogenesis of anxiety disorders, placing a particular focus on the role of protective factors serving to buffer a risk factor constellation and the role of epigenetic processes functioning as a potent turnstile changing passage direction toward disorder risk or resilience. We discuss promising future directions in epigenetic research regarding the prediction, prevention and personalized treatment of anxiety disorders.
Topics: Animals; Anxiety; Anxiety Disorders; DNA Methylation; Epigenesis, Genetic; Gene-Environment Interaction; Histones; Humans; Resilience, Psychological; Risk Factors
PubMed: 28873274
DOI: 10.1111/gbb.12423 -
The Primary Care Companion For CNS... Oct 2016
Topics: Aged; Anxiety; Anxiety Disorders; Humans
PubMed: 27835726
DOI: 10.4088/PCC.16f02039 -
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 -
European Journal of Medical Research Sep 2018Preoperative anxiety is one of the most important problems for the patients, because it causes emotional and psychiatric problems as well as physical problems. It is...
BACKGROUND
Preoperative anxiety is one of the most important problems for the patients, because it causes emotional and psychiatric problems as well as physical problems. It is crucial to detect the patient's existing anxiety to assist patients. Our primary aim in this study is to investigate how the patient's age, gender, the operation, surgical briefing, type of anesthesia recommended for the operation ahead, and patient's prior anesthesia experience affect the patient's anxieties. Our secondary aim is to reveal the causes of the patient's anxieties regarding anesthesia.
METHODS
Our study was conducted as a prospective cohort study between May 2016-2017. Interviews with the patients were performed in the anesthesia clinic for preoperative examination. For the study, The Amsterdam Preoperative Anxiety and Information Scale (APAIS) has been used. The answers were evaluated in two scales: the anxiety score and the desire for information score. Answers to the statements were evaluated with Likert Scale. In addition, our patients were asked whether they had received prior anesthesia, if so, the type of anesthesia, whether they received surgical briefing and anesthetic method we recommended. We also asked our patients about the cause of their anxiety regarding the anesthesia.
RESULTS
A total of 637 patients were recruited to the study, after excluding the patients who do not meet the criteria for inclusion, and 499 patients were included. Between the age and desire for information sub-scores, a negative significant correlation was detected (r: - 0.241; p = 0.001). We found that the scores of graduates of university and higher were statistically significant than the primary school graduates (p = 0.003) and secondary school graduates (p = 0.034). Anxiety sub-scores of the patients who underwent general anesthesia were found to be significantly higher than the patients who underwent regional anesthesia (p = 0.029). Anxiety sub-scores of females were found to be significantly higher than the males (p = 0.001).
CONCLUSIONS
We think that being aware of the patients' anxiety and finding appropriate approaches for their anxieties can be valuable. APAIS is an effective method to measure patient anxiety and it might be beneficial to use during preoperative visits. Patient satisfaction and superior outcomes can be achieved in this way. Trial registration ISRCTN43960422. Registered 19/02/2018-Retrospectively registered. http://www.isrctn.com/ISRCTN43960422.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anesthesia; Anxiety; Fear; Female; Humans; Male; Middle Aged; Models, Statistical; Patient Satisfaction; Preoperative Care; Prevalence; Prospective Studies; Retrospective Studies; Surgical Procedures, Operative; Surveys and Questionnaires; Turkey; Young Adult
PubMed: 30205837
DOI: 10.1186/s40001-018-0339-4