1
|
Kim E, Jung S, Lee MY, Park CH, Cho SJ. Exploring the Association between Elevated Anxiety Symptoms and Low Skeletal Muscle Mass among Asymptomatic Adults: A Population-Based Study in Republic of Korea. Brain Sci 2024; 14:438. [PMID: 38790417 PMCID: PMC11119912 DOI: 10.3390/brainsci14050438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/17/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024] Open
Abstract
Individuals with mental health problems are at higher risk of musculoskeletal diseases. However, the association between low muscle mass (LMM) and anxiety symptoms remains uninvestigated. This cross-sectional study enrolled 174,262 adults (73,833 women, 100,429 men), aged 18 to 89, who completed the anxiety scale and body composition analyses. Using bio-electrical impedance analysis, skeletal muscle mass index (SMI) was calculated based on appendicular skeletal muscle mass (ASM) (kg)/height (m2). LMM was defined as SMI < 7.0 kg/m2 in men and <5.4 kg/m2 in women. Anxiety symptoms were screened using the Clinical Useful Anxiety Outcome Scale (CUXOS) with cut-off scores of 20, 30, and 40. Multivariable logistic regression analyses were performed. LMM prevalence was 20.17% in women, 3.86% in men (p < 0.001). The prevalence of anxiety symptoms in LMM group decreased from mild (CUXOS > 20: women, 32.74%, men, 21.17%) to moderate (CUXOS > 30: 13.34%, 7.32%), to severe anxiety symptoms (CUXOS > 40: 4.00%, 1.73%). In multivariable-adjusted models, LMM was associated with mild (aOR (95% confidence interval)), women, 1.13 (1.08-1.17); men, 1.17 (1.08-1.27)), moderate (1.17 (1.11-1.24); 1.35 (1.19-1.53) and severe anxiety symptoms (1.18 (1.07-1.3), 1.36 (1.06-1.74)), demonstrating an increased risk of ORs with escalating anxiety severity. LMM was independently associated with a higher prevalence of anxiety symptoms.
Collapse
Affiliation(s)
- Eunsoo Kim
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea;
| | - Sra Jung
- Department of Psychiatry, Cha University Ilsan Medical Center, Goyang 10223, Republic of Korea;
| | - Mi Yeon Lee
- Division of Biostatistics, Department of Academic Research, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea;
| | - Chul-Hyun Park
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
| | - Sung Joon Cho
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea;
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Seoul 03181, Republic of Korea
| |
Collapse
|
2
|
Jafari A, Moshki M, Mokhtari AM, Naddafi F, Nejatian M. Validity and reliability of anxiety literacy (A-Lit) and its relationship with demographic variables in the Iranian general population. Front Public Health 2024; 12:1359146. [PMID: 38694985 PMCID: PMC11061481 DOI: 10.3389/fpubh.2024.1359146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/25/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction Anxiety disorder is one of the most common mental disorders. This cross-sectional research aimed to determine anxiety literacy (A-Lit) psychometric properties among the Iranian population in 2022. Methods This research was conducted on 690 people in Iran in 2022. In this study, people were selected by proportional stratified sampling, and the validity and reliability of the A-Lit designed by Griffiths were assessed. Validity of A-Lit was assessed by face validity, content validity, and confirmatory factor analysis. Reliability of A-Lit was evaluated by the McDonald's omega coefficient, Cronbach's alpha coefficient, and test- retest. In analytical sections, the tests of One-way ANOVA, Chi-squared test, and independent samples t-test were used. Results The rates of S-CVI/Ave and CVR for A-Lit were 0.922 and 0.774, respectively. In confirmatory factor analysis, three items were deleted because the factor loading was less than 0.4, and goodness-of-fit indexes (Some of goodness-of-fit indexes: χ2/df = 4.175, GFI: 0.909, RMSEA = 0.068, PCFI = 0.745, AGFI = 0.883) were confirmed as the final model with 19 items. For all items, the Cronbach's alpha coefficient was 0.832, the McDonald's omega coefficient was 0.835, and the intraclass correlation coefficient was 0.874. According to the results of this study, 1.3% (n = 9) did not answer any questions correctly and 8.4% (n = 58) were able to answer 1-6 questions correctly. Approximately 72% (n = 495) were able to answer 7-12 questions, and eventually only 18.6% (n = 128) were able to answer 13 questions and more. There was a significant relationship between sex, age group, occupation status, marital status, and get information related to mental illness with A-Lit level (p < 0.05). Conclusion The Persian version of A-Lit was confirmed with 19 items, and this scale is a reliable tool for measuring A-Lit in the general population. The results also showed that a few people have a higher level of anxiety literacy and that educational and intervention programs need to be designed and implemented for the public population.
Collapse
Affiliation(s)
- Alireza Jafari
- Department of Health Education and Health Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mahdi Moshki
- Department of Health Education and Health Promotion, School of Health, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Ali Mohammad Mokhtari
- Department of Epidemiology and Biostatistics, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Fatemehzahra Naddafi
- Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mahbobeh Nejatian
- Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| |
Collapse
|
3
|
Guzick A, Storch EA, Smárason O, Minhajuddin A, Drummond K, Riddle D, Hettema JM, Mayes TL, Pitts S, Dodd C, Trivedi MH. Psychometric properties of the GAD-7 and PROMIS-Anxiety-4a among youth with depression and suicidality: Results from the Texas youth depression and suicide research network. J Psychiatr Res 2024; 170:237-244. [PMID: 38169247 DOI: 10.1016/j.jpsychires.2023.12.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024]
Abstract
There is a tremendous need for brief, valid, and free assessments of anxiety in child mental healthcare. The goal of this study was to determine the psychometric properties of two such measures, the GAD-7 and PROMIS-Anxiety-4a, in 1000 children, adolescents, and young adults (8-20 years-old) with depression and/or suicidality. The GAD-7, the PROMIS-Anxiety-4a, and other validated assessments of anxiety, physical functioning, and psychiatric diagnoses were completed. Confirmatory factor analyses showed an acceptable fit for a single factor in both measures via all indices but the RMSEA. They demonstrated measurement invariance across pre-adolescents (8-12 years-old) and adolescents and emerging adults (13-20 years-old), though scalar invariance was not observed for the GAD-7. Both measures showed strong convergent validity, GAD-7: r = 0.68; PROMIS-Anxiety-4a: r = 0.75, divergent validity with a measure of physical function, GAD-7: r = -0.24; PROMIS-Anxiety-4a: r = -0.28, good internal consistency, ω = 0.89 for both, and high test-retest reliability, GAD-7: r = 0.69; PROMIS-Anxiety-4a: r = 0.71. Both measures also showed acceptable sensitivity and specificity in detecting the presence of any anxiety disorder, GAD-7 cut-off score of 10: AUC = 0.75; PROMIS-Anxiety-4a cutoff score of 12: AUC = 0.79. The GAD-7 correlated similarly with the Screen for Child Anxiety Related Disorders total score and generalized anxiety subscale, and also showed similar diagnostic sensitivity and specificity when used to detect the presence of any anxiety disorder vs. generalized anxiety disorder specifically. Results suggest that both of these brief, publicly available instruments are valid and reliable assessments of anxiety among youth in treatment for depression and/or suicidality.
Collapse
Affiliation(s)
- Andrew Guzick
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Orri Smárason
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Faculty of Psychology, University of Iceland, Reykjavik, Iceland
| | - Abu Minhajuddin
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA; Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kendall Drummond
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - David Riddle
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - John M Hettema
- Department of Psychiatry, Texas A&M University School of Medicine, Bryan, TX, USA
| | - Taryn L Mayes
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Shamari Pitts
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Cody Dodd
- Department of Psychiatry and Behavioral Sciences, University of Texas-Medical Branch, Galveston, TX, USA
| | - Madhukar H Trivedi
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| |
Collapse
|
4
|
Chen CYC. Roles of physical functioning and comorbid mental illness of chronically ill parents and their spouses' health status in adolescent functioning. J Adolesc 2024; 96:381-393. [PMID: 38050767 DOI: 10.1002/jad.12282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/06/2023]
Abstract
INTRODUCTION Emerging research suggests that physically ill parents' psychological adjustment to illness and emotional well-being may affect adolescents' psychosocial functioning. As people with chronic medical conditions often develop mental disorders, it is important to examine the influence of comorbidity of parental physical and mental health conditions on adolescents' functioning. In addition, the physical and mental health status of the spouses/partners of chronically ill parents needs to be explored to further understand the potential impact of parental chronic illness on adolescents' psychological distress and academic performance. METHODS Cross-sectional data from 164 parent-adolescent pairs were collected through online surveys in the United States between 2018 and 2019. Parent participants (Mage = 42.69, SD = 5.96) included parents who had been diagnosed with a chronic physical illness (e.g., multiple sclerosis, diabetes, chronic pain, cancer). Adolescent participants were middle- and high-school-aged children who lived with their physically ill parents (Mage = 14.34, SD = 2.07). RESULTS Hierarchical regression analyses indicated that comorbid mental illness of parental chronic illness and spousal mental health status were associated with adolescents' distress. The level of physical functioning of chronically ill parents was related to adolescents' academic performance. CONCLUSION Parental chronic illness appears to affect adolescents' psychological and academic outcomes through distinct pathways. It is important to examine the comorbid mental health status of chronically ill parents and their spouses'/partners' mental health conditions to better understand the impact of parental chronic illness on adolescents' psychological adjustment.
Collapse
Affiliation(s)
- Cliff Yung-Chi Chen
- Educational and Community Programs, Queens College of the City University of New York, Flushing, New York, USA
| |
Collapse
|
5
|
Mishkin AD, Prince EJ, Leimbach EJ, Mapara MY, Carroll CP. Psychiatric comorbidities in adults with sickle cell disease: A narrative review. Br J Haematol 2023; 203:747-759. [PMID: 37455514 DOI: 10.1111/bjh.18981] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/21/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
Although descriptions of quality of life and patient reports of mood in sickle cell disease (SCD) have become more common in the literature, less is known about psychiatric illness prevalence, presentation, and treatment, particularly for adults. We provide a narrative review of what is known about common and debilitating psychiatric conditions such as depression, anxiety, and cognitive impairment, specifically for adults with SCD. We discuss the limitations of the current evidence, make provisional recommendations, and identify opportunities for research and improved care.
Collapse
Affiliation(s)
- Adrienne D Mishkin
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- Blood and Marrow Transplantation Program, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Elizabeth J Prince
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Elizabeth J Leimbach
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Markus Y Mapara
- Blood and Marrow Transplantation Program, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - C Patrick Carroll
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
6
|
Cheng AL, Agarwal M, Armbrecht MA, Abraham J, Calfee RP, Goss CW. Behavioral Mechanisms That Mediate Mental and Physical Health Improvements in People With Chronic Pain Who Receive a Digital Health Intervention: Prospective Cohort Pilot Study. JMIR Form Res 2023; 7:e51422. [PMID: 37976097 PMCID: PMC10692879 DOI: 10.2196/51422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/03/2023] [Accepted: 11/05/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Preliminary evidence suggests that digital mental health intervention (Wysa for Chronic Pain) can improve mental and physical health in people with chronic musculoskeletal pain and coexisting symptoms of depression or anxiety. However, the behavioral mechanisms through which this intervention acts are not fully understood. OBJECTIVE The purpose of this study was to identify behavioral mechanisms that may mediate changes in mental and physical health associated with use of Wysa for Chronic Pain during orthopedic management of chronic musculoskeletal pain. We hypothesized that improved behavioral activation, pain acceptance, and sleep quality mediate improvements in self-reported mental and physical health. METHODS In this prospective cohort, pilot mediation analysis, adults with chronic (≥3 months) neck or back pain received the Wysa for Chronic Pain digital intervention, which uses a conversational agent and text-based access to human counselors to deliver cognitive behavioral therapy and related therapeutic content. Patient-reported outcomes and proposed mediators were collected at baseline and 1 month. The exposure of interest was participants' engagement (ie, total interactions) with the digital intervention. Proposed mediators were assessed using the Behavioral Activation for Depression Scale-Short Form, Chronic Pain Acceptance Questionnaire, and Athens Insomnia Scale. Outcomes included Patient-Reported Outcomes Measurement Information System Anxiety, Depression, Pain Interference, and Physical Function scores. A mediation analysis was conducted using the Baron and Kenny method, adjusting for age, sex, and baseline mediators and outcome values. P<.20 was considered significant for this pilot study. RESULTS Among 30 patients (mean age 59, SD 14, years; 21 [70%] female), the mediation effect of behavioral activation on the relationship between increased intervention engagement and improved anxiety symptoms met predefined statistical significance thresholds (indirect effect -0.4, 80% CI -0.7 to -0.1; P=.13, 45% of the total effect). The direction of mediation effect was generally consistent with our hypothesis for all other proposed mediator or outcome relationships, as well. CONCLUSIONS In a full-sized randomized controlled trial of patients with chronic musculoskeletal pain, behavioral activation, pain acceptance, and sleep quality may play an important role in mediating the relationship between use of a digital mental health intervention (Wysa for Chronic Pain) and improved mental and physical health. TRIAL REGISTRATION ClinicalTrials.gov NCT05194722; https://clinicaltrials.gov/ct2/show/NCT05194722.
Collapse
Affiliation(s)
- Abby L Cheng
- Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, MO, United States
| | - Mansi Agarwal
- Institute for Informatics, Data Science and Biostatistics, Washington University School of Medicine, St Louis, MO, United States
| | - Melissa A Armbrecht
- Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, MO, United States
| | - Joanna Abraham
- Department of Anesthesiology and Institute for Informatics, Washington University School of Medicine, St Louis, MO, United States
| | - Ryan P Calfee
- Division of Hand and Wrist, Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, MO, United States
| | - Charles W Goss
- Institute for Informatics, Data Science and Biostatistics, Washington University School of Medicine, St Louis, MO, United States
| |
Collapse
|
7
|
Roca M, Villamor AT, Molinera VG, Gili M. Characteristics of patients with panic disorder attended in primary care during the COVID-19 pandemic: A cross-sectional multicenter study. Aten Primaria 2023; 55:102703. [PMID: 37422988 PMCID: PMC10272946 DOI: 10.1016/j.aprim.2023.102703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 07/11/2023] Open
Abstract
OBJECTIVE To assess the prevalence of panic disorder during the second and third waves of the COVID-19 pandemic. DESIGN Cross-sectional multicenter study. SETTING Primary care. PARTICIPANTS Participating primary care physicians selected patients visiting their primary care centers for any reason over a 16-month period. MAIN OUTCOME MEASURE Diagnosis of panic disorder was established using The Primary Care Evaluation of Mental Disorders (PRIME-MD) instrument. RESULTS Of a total of 678 patients who met the inclusion criteria, 36 presented with panic disorder, with a prevalence of 5.3% (95% confidence interval 3.6-7.0). A total of 63.9% of cases occurred in women. The mean age was 46.7±17.1 years. Socioeconomic difficulties, such as very low monthly income rate, unemployment, and financial constraints to make housing payments and to make ends meet were more frequent in patients with panic disorders as compared to patients without panic disorder. A high level of stress (Holmes-Rahe scale>300), concomitant chronic fatigue syndrome and irritable bowel disease, and having financial difficulties in the past 6 months were associated with factors of panic disorder. DISCUSSION This study characterizes patients with panic disorder diagnosed with a validated instrument during the COVID-19 pandemic and identified risk factors for this disease. CONCLUSIONS In non-selected consecutive primary care attendees in real-world conditions during the COVID-19 pandemic, the prevalence of panic disorder was 5.3%, being more frequent in women. There is a need to enhance primary care resources for mental health care during the duration of the pandemic and beyond.
Collapse
Affiliation(s)
- Miquel Roca
- Department of Medicine, Institut Universitari d'Investigació en Ciències de la Salut, IDISBA, Universitat de les Illes Balears, Palma de Mallorca, Spain.
| | | | | | - Margarita Gili
- Department of Psychology, Institut Universitari d'Investigació en Ciències de la Salut, IDISBA, Universitat de les Illes Balears, Palma de Mallorca, Spain
| |
Collapse
|
8
|
Spratt J, Adkins Z, Warda D, Smith M, Bruggers J, Weiss P, Becher S. Illicit drug and alcohol use and measures of musculoskeletal function and mental health in orthopaedic trauma patients. OTA Int 2023; 6:e270. [PMID: 37719314 PMCID: PMC10503674 DOI: 10.1097/oi9.0000000000000270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 02/28/2023] [Indexed: 09/19/2023]
Abstract
Objectives The objective of this study was to describe the relationship between positive toxicology screens and measures of preinjury mental health and physical function in an orthopaedic trauma population. Design This was a cross-sectional study. Setting Urban Level 1 trauma center. Patients A total of 125 trauma patients gave written consent for this study. Main Outcome Measurements Questionnaires such as, Patient Health Questionnaire-9, General Anxiety Disorder-7, PCL-5, and Short Musculoskeletal Function Assessment, were used to survey patients after surgical intervention. Results Patient Health Questionnaire-9 (P = 0.05) and PCL-5 (P = 0.04) were not found to have significant differences between positive and negative toxicology screens. Both General Anxiety Disorder-7 (P = 0.004) and Short Musculoskeletal Function Assessment function (P = 0.006) were significantly higher in patients with positive toxicology screens. Conclusions Positive toxicology seems to be associated with preinjury anxiety. Patient reported preinjury function was not adversely affected by the presence of illicit substances or alcohol, nor were levels of post-traumatic stress disorder and depression found to be higher in patients with positive toxicology screens. Level of Evidence Level IV Cross-Sectional Study.
Collapse
Affiliation(s)
| | | | - Danny Warda
- Wellstar Atlanta Medical Center, Atlanta, GA
| | | | | | - Paul Weiss
- Wellstar Atlanta Medical Center, Atlanta, GA
| | | |
Collapse
|
9
|
Mobile Phone Addiction and Sleep Quality: The Mediating Role of Anxiety and the Moderating Role of Emotion Regulation. Behav Sci (Basel) 2023; 13:bs13030250. [PMID: 36975275 PMCID: PMC10045665 DOI: 10.3390/bs13030250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023] Open
Abstract
Smartphones have become a fundamental tool in the daily life of mankind, but its excessive use seriously impairs people’s quality of sleep. A specific state of emotion has been shown to play a crucial role in the relationship between mobile phone addiction (MPA) and the sleep quality of college students. However, studies have rarely considered top-down emotion regulation. This study is the first to examine the effects of MPA on the sleep quality of Chinese college students from a top-down emotion regulation perspective. The survey sample comprised 1559 university students (40.73% male; M (SD) age = 19.11 (1.22) years) who completed questionnaires on MPA, sleep quality, anxiety and emotion regulation. The results revealed that (1) Anxiety mediated the relationship between MPA and sleep quality; (2) Cognitive reappraisal (CR) negatively moderated the relationship between MPA and anxiety; and (3) Expressive suppression (ES) positively moderated the relationship between MPA and anxiety. These findings reveal the mechanism of sleep problems in Chinese college students. We provide research ideas and method guidance for the follow-up intervention and treatment of college students’ sleep problems.
Collapse
|
10
|
Systematic review to explore the effect of yoga on anxiety in adults. Ment Health (Lond) 2023. [DOI: 10.56508/mhgcj.v6i1.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
Introduction: The National Health Service cannot chronically sustain the overwhelming demands being placed on it due to financial cuts, staff numbers and recent presence of Covid-19. As a result, anxiety levels are on the rise thus increasing the need for effective first-line treatment.
Purpose: The purpose of this systematic review was to examine the efficacy of yoga as a first-line treatment for anxiety. Previous systematic reviews have produced mixed results.
Methodology: The inclusion criteria followed the PICO research statement. The population (P) were either healthy or diagnosed with anxiety and the intervention (I) was yoga. The comparison (C) was a control group, or CBT, or used a pre-and post-intervention design. The outcome (O) was the change in the level of anxiety post-intervention.
Results and Discussion: After the review of 64 studies, 7 studies fit the inclusion criteria: four randomized controlled studies, one longitudinal study, and two pre- and post-intervention comparisons. All the studies included provided statistically significant results for the beneficial effect of yoga on anxiety.
Conclusion: This study adds to preceding literature on the current anxiety levels of adults and the potential utility of yoga as a first-line treatment for self-management of anxiety levels. This review stresses the issue of heterogeneity, mode of yoga and calls for more robust randomised controlled trials to pioneer the subject matter to help, if not prevent, to slow down the rising cases of anxiety and ill mental health worldwide.
Collapse
|
11
|
Mason JE, Asmundson GJG. Cognitive behavioural techniques reduce exercise anxiety and improve adherence to a resistance training program for people with anxiety-related disorders: A randomized controlled trial. J Anxiety Disord 2023; 95:102693. [PMID: 36905851 DOI: 10.1016/j.janxdis.2023.102693] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 12/06/2022] [Accepted: 01/25/2023] [Indexed: 03/13/2023]
Abstract
Exercise is a cost-efficient alternative to other interventions for anxiety-related disorders (ARDs; e.g., psychotherapy, pharmaceutical) that is also associated with health benefits. Several exercise modalities, including resistance training (RT), have demonstrated efficacy at reducing symptoms of ARDs; however, there are challenges associated with effectively implementing such protocols, most notably, exercise avoidance or early discontinuation. Researchers have identified exercise anxiety as a contributor to exercise avoidance for people with ARDs. Exercise-based interventions for people with ARDs may need to include strategies for helping these individuals cope with exercise anxiety to facilitate long-term exercise engagement; however, research in this area is lacking. The primary purpose of this randomized controlled trial (RCT) was to examine the effects of combining cognitive behavioural techniques (CBT) with a RT program on changes in exercise anxiety, exercise frequency, disorder-specific anxiety symptoms, and physical activity for people with ARDs. A secondary purpose was to explore group differences in exercise motivation and exercise self-efficacy across time. A total of 59 physically inactive individuals with ARDs were randomized into either RT + CBT, RT, or waitlist (WL). Primary measures were assessed at baseline, weekly during the 4-week active phase, and at 1-week, 1-month, and 3-month follow-ups. Findings indicate both RT and RT + CBT can reduce exercise anxiety; however, the addition of CBT techniques may help facilitate improvements in exercise self-efficacy, reductions in disorder-specific anxiety, and increases in long-term exercise behaviour and vigorous physical activity. These techniques may be useful for researchers and clinicians alike in supporting individuals with ARDs interested in using exercise to cope with elevated anxiety.
Collapse
Affiliation(s)
- Julia E Mason
- Department of Psychology, University of Regina, Canada
| | | |
Collapse
|
12
|
Phimphasone-Brady P, Page CE, Ali DA, Haller HC, Duffy KA. Racial and ethnic disparities in women's mental health: a narrative synthesis of systematic reviews and meta-analyses of the US-based samples. Fertil Steril 2023; 119:364-374. [PMID: 36702342 PMCID: PMC10754063 DOI: 10.1016/j.fertnstert.2023.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023]
Abstract
Over 2 decades of research indicate the significance of racial or ethnic disparities in mental illness in the United States. However, minoritized racial or ethnic groups tend to report overall lower prevalence rates of psychiatric disorders than White adults, although this varies depending on gender and race or ethnicity. We conducted a rigorous and systematic narrative synthesis on the differences in the prevalence rates and symptoms that differ across racial or ethnic women in depression, anxiety, eating disorders, and premenstrual syndrome or premenstrual dysphoric disorder. Seven systematic reviews and meta-analyses that examined racial/ethnic differences in depression and eating disorders were included. No review that examined racial/ethnic differences in anxiety or premenstrual syndrome or premenstrual dysphoric disorder met inclusion criteria. Methodological quality of the reviews, which was determined by the Assessment of Multiple Systematic Reviews criteria, revealed that the results of 5 reviews were rated as critically low confidence, one review was rated as low confidence, and one review was rated as high confidence. Findings were inconsistent across systematic reviews and meta-analyses because of the methodological differences in the original studies. Overall, racially or ethnically minoritized women generally report lower prevalence rates in depressive and eating disorders than the White women; however, they exhibit different or greater symptom presentation that could influence prevalence estimates depending on the diagnostic criteria followed. Methodological considerations are provided to strengthen the literature on racial or ethnic mental health disparities in women.
Collapse
Affiliation(s)
- Phoutdavone Phimphasone-Brady
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado; Department of Family Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado.
| | - Chloe E Page
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado
| | - Diab A Ali
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado
| | - Heinrich C Haller
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado
| | - Korrina A Duffy
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado
| |
Collapse
|
13
|
Singer A, Kosowan L, Muthumuni D, Katz A, Zafari H, Zulkernine F, Richardson JD, Price M, Williamson T, Queenan J, Sareen J. Characterizing primary care patients with posttraumatic stress disorder using electronic medical records: a retrospective cross-sectional study. Fam Pract 2022:cmac139. [PMID: 36490368 DOI: 10.1093/fampra/cmac139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) has significant morbidity and economic costs. This study describes the prevalence and characteristics of patients with PTSD using primary care electronic medical record (EMR) data. METHODS This retrospective cross-sectional study used EMR data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). This study included 1,574 primary care providers located in 7 Canadian provinces. There were 689,301 patients that visited a CPCSSN provider between 1 January 2017 and 31 December 2019. We describe associations between PTSD and patient characteristics using descriptive statistics, chi-square, and multiple logistic regression models. RESULTS Among the 689,301 patients included, 8,817 (1.3%, 95% CI 1.2-1.3) had a diagnosis of PTSD. On multiple logistic regression analysis, patients with depression (OR 4.4, 95% CI 4.2-4.7, P < 0.001), alcohol abuse/dependence (OR 1.7, 95% CI 1.6-1.9, P < 0.001), and/or drug abuse/dependence (OR 2.6, 95% CI 2.5-2.8, P < 0.001) had significantly higher odds of PTSD compared with patients without those conditions. Patients residing in community areas considered the most material deprived (OR 2.1, 95% CI 1.5-2.1, P < 0.001) or the most socially deprived (OR 2.8, 95% CI 2.7-5.3, P < 0.001) had higher odds of being diagnosed with PTSD compared with patients in the least deprived areas. CONCLUSIONS The prevalence of PTSD in Canadian primary care is 1.3% (95% CI 1.25-1.31). Using EMR records we confirmed the co-occurrence of PTSD with other mental health conditions within primary care settings suggesting benefit for improved screening and evidence-based resources to manage PTSD.
Collapse
Affiliation(s)
- Alexander Singer
- Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Leanne Kosowan
- Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Dhasni Muthumuni
- Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Alan Katz
- Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Community Health Science, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Hasan Zafari
- School of Computing, Queen's University, Kingston, ON, Canada
| | | | - J Don Richardson
- Operational Stress Injury Clinic, Parkwood Institute, London, ON, Canada
| | - Morgan Price
- Department of Family Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Tyler Williamson
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - John Queenan
- Department of Family Medicine, Queens University, Kingston, ON, Canada
| | - Jitender Sareen
- Department of Psychiatry, Max Rady College of Medicine, Rady Faulty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| |
Collapse
|
14
|
Nunes JC, Carroll MK, Mahaffey KW, Califf RM, Doraiswamy PM, Short S, Shah SH, Swope S, Williams D, Hernandez AF, Hong DS. General Anxiety Disorder-7 Questionnaire as a marker of low socioeconomic status and inequity. J Affect Disord 2022; 317:287-297. [PMID: 36031002 DOI: 10.1016/j.jad.2022.08.085] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 08/14/2022] [Accepted: 08/22/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND The General Anxiety Disorder-7 (GAD-7) questionnaire is a standard tool used for screening and follow-up of patients with Generalized Anxiety Disorder (GAD). Although it is generally accepted that anxiety correlates with clinical and psychosocial stressors, precise quantitative data is limited on the relations among GAD-7, traditional biomarkers, and other measures of health. Further research is needed about how GAD-7 relates to race, ethnicity, and socioeconomic status (SES) as an assembly. We determined how multiple demographic and socioeconomic data correlate with the participants' GAD-7 results when compared with laboratory, physical function, clinical, and other biological markers. METHODS The Project Baseline Health Study (BHS) is a prospective cohort of adults representing several populations in the USA. We analyzed a deeply phenotyped group of 2502 participants from that study. Measures of interest included: clinical markers or history of medical diagnoses; physical function markers including gait, grip strength, balance time, daily steps, and echocardiographic parameters; psychometric measurements; activities of daily living; socioeconomic characteristics; and laboratory results. RESULTS Higher GAD-7 scores were associated with female sex, younger age, and Hispanic ethnicity. Measures of low SES were also associated with higher scores, including unemployment, income ≤$25,000, and ≤12 years of education. After adjustment for 158 demographic, clinical, laboratory, and symptom characteristics, unemployment and overall higher SES risk scores were highly correlated with anxiety scores. Protective factors included Black race and older age. LIMITATIONS Correlations identified in this cross-sectional study cannot be used to infer causal relationships; further, we were not able to account for possible use of anxiety treatments by study participants. CONCLUSIONS These findings highlight the importance of understanding anxiety as a biopsychosocial entity. Clinicians and provider organizations need to consider both the physical manifestations of the disorder and their patients' social determinants of health when considering treatment pathways and designing interventions.
Collapse
Affiliation(s)
- Julio C Nunes
- Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
| | | | - Kenneth W Mahaffey
- Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA, USA
| | | | - P Murali Doraiswamy
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Duke Institute for Brain Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Sarah Short
- Verily Life Sciences (Alphabet), San Francisco, CA, USA
| | - Svati H Shah
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA; Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Susan Swope
- Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA, USA
| | - Donna Williams
- Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA, USA
| | - Adrian F Hernandez
- Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
| | - David S Hong
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| |
Collapse
|
15
|
DHA/EPA supplementation decreases anxiety-like behaviour, but it does not ameliorate metabolic profile in obese male rats. Br J Nutr 2022; 128:964-974. [PMID: 34605386 DOI: 10.1017/s0007114521003998] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Obesity is a major public health problem that predisposes to several diseases and higher mortality in patients with COVID-19. Obesity also generates neuroinflammation, which predisposes to the development of neuropsychiatric diseases. Since there is a lack of effective treatments for obesity, the search for new strategies to reverse its consequences is urgent. In this perspective, the anti-inflammatory properties of omega-3 polyunsaturated fatty acids such as DHA/EPA might reduce the harmful effects of obesity. Here, we used the cafeteria diet (CAF) model to induce obesity in Wistar rats. Animals received ultra-processed food for 20 weeks, and DHA/EPA supplementation (500 mg/kg per d) was performed between the 16th and the 20th week. At the end of the experiment, it was evaluated: body weight, visceral fat deposition, plasma glucose, insulin and triglycerides, and it was also measured the levels of inflammatory cytokines TNF-α and IL-6 in plasma and liver, and TNF-α in the prefrontal cortex. The elevated plus maze test was performed to analyse anxiety-like behaviour. Our results demonstrated that DHA/EPA could not reverse weight and fat gain and did not modify plasma dosages. However, there was a decrease in IL-6 in the liver (DHA/EPA effect: P = 0.023) and TNF-α in the brain (CAF compared with CAF + DHA/EPA, P < 0.05). Also, there was a decrease in the anxiety index in CAF + DHA/EPA compared with the CAF group (P < 0.01). Thus, DHA/EPA supplementation is helpful to reverse the consequences of obesity in the brain.
Collapse
|
16
|
Parker MM, Dailey SF, Emmanuel AD, Campbell A. Psychological impact of coronavirus disease 2019 (COVID-19) social distancing mandates on trauma survivors. GLOBAL HEALTH JOURNAL 2022; 6:174-179. [PMID: 35847474 PMCID: PMC9270776 DOI: 10.1016/j.glohj.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 03/22/2022] [Accepted: 06/30/2022] [Indexed: 11/15/2022] Open
Abstract
Objective Despite recognition that coronavirus disease 2019 (COVID-19) pandemic created an unprecedented impact on global mental health, information on the psychological health among trauma survivors during the COVID-19 pandemic is rare. We sought to examine psychological outcomes among individuals with preexisting traumatic experiences during COVID-19. Methods We sampled 1 242 adults in the mid-Atlantic region of the United States under a state-issued Phase 1 stay-at-home mandate to examine associations between pre-pandemic trauma exposure as measured by the Brief Trauma Questionnaire (BTQ) and anxiety and depression, as measured by the Patient Reported Outcome Scale Anxiety and Depression (PROMIS-A and PROMIS-D). Results Pre-pandemic trauma exposure among the sample was reported, with 281 (22.6%) participants identifying as experiencing one trauma, 209 (16.8%) reporting two, and 468 (37.7%) reporting three or more. As reported experiences of trauma increased, so did participant anxiety and depressive symptomatology. One-way Analysis of Variance indicated that reported trauma was significantly positively correlated with anxiety (P < 0.01) and depressive symptomatology (P < 0.01). Conclusion Findings highlight the immense psychological toll of the COVID-19 pandemic, specifically with individuals who were previously exposed to trauma. Public health officials can encourage physicians, employers, and universities to screen patients, employees, and students to assess previous trauma, psychological functioning, and risk factors. Collaboration between physicians and mental health providers including psychiatrists, psychologists, counselors, and social workers to provide evidence informed rapid coordination of care can better meet the global mental health crisis that is arising as a result of this unprecedented global trauma.
Collapse
|
17
|
Nicholson J, Valentine A, Ledingham E, Reif S. Peer Support at the Intersection of Disability and Opioid (Mis)Use: Key Stakeholders Provide Essential Considerations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9664. [PMID: 35955019 PMCID: PMC9368223 DOI: 10.3390/ijerph19159664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/27/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
Individuals with disabilities may experience higher rates of opioid/substance use disorders (OUD/SUD) than other individuals and are likely vulnerable to unmet treatment needs. Peer support may be beneficial to these individuals, given the evidence of benefits in target populations with similar needs and the potential for overcoming barriers to treatment suggested in the available literature. The objective of this exploratory study was to specify essential considerations in adapting peer support for this population. Diverse key stakeholders (n = 16) were interviewed to explore the experiences, needs, and available supports for individuals with disabilities and OUD/SUD. A Peer Support Work Group including members with lived experience advised each component of the study. Semi-structured interview data were content analyzed and memos generated to summarize themes related to the research question. Participants reported extensive professional and personal experience in human services, disability, and recovery. Emergent themes included the importance of accessibility and model fit, the notion of "peerness" and peer match, and essential aspects of peer recruitment, training, and support. An accessible, acceptable, effective model of peer support requires particular attention to the needs of this diverse and varied population, and the contexts in which they are identified, referred, and engaged in services.
Collapse
Affiliation(s)
- Joanne Nicholson
- Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA 02453, USA
| | - Anne Valentine
- Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA 02453, USA
| | - Emily Ledingham
- Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA 02453, USA
| | - Sharon Reif
- Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA 02453, USA
| |
Collapse
|
18
|
Duko B, Pereira G, Tait RJ, Betts K, Newnham J, Alati R. Prenatal tobacco and alcohol exposures and the risk of anxiety symptoms in young adulthood: A population-based cohort study. Psychiatry Res 2022; 310:114466. [PMID: 35219268 DOI: 10.1016/j.psychres.2022.114466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/18/2022] [Accepted: 02/19/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Epidemiological studies have linked prenatal tobacco and alcohol exposures to internalizing behaviours in children and adolescents with inconsistent findings. Dearth of epidemiological studies have investigated the associations with the risk of experiencing symptoms of anxiety in young adulthood. METHODS Study participants (N = 1190) were from the Raine Study, a population-based prospective birth cohort based in Perth, Western Australia. Data on prenatal tobacco and alcohol exposures were available for the first and third trimesters of pregnancy. Experiencing symptoms of anxiety in young adulthood at age 20 years was measured by a short form of the Depression Anxiety Stress Scale (DASS 21). Relative risk (RR) of experiencing symptoms of anxiety in young adulthood for prenatal tobacco and alcohol exposures were estimated with log binomial regression. RESULTS After adjusting for potential confounders, we observed increased risks of experiencing symptoms of anxiety in young adults exposed to prenatal tobacco in the first trimester [RR = 1.52, 95% CI: 1.12-2.06, p-value < 0.01] and third trimester [RR = 1.53, 95% CI: 1.10-2.13, p-value = 0.02]. However, we found insufficient statistical evidence for an association between first trimester [RR = 1.01, 95% CI: 0.76-1.22, p-value = 0.90] and third trimester [RR = 1.03, 95% CI: 0.80-1.34, p-value = 0.91] prenatal exposure to alcohol and the risk of experiencing symptoms of anxiety in young adults. There was a dose response association between prenatal tobacco exposure and increasing anxiety symptoms in offspring. CONCLUSION The findings of this study suggest that an association between prenatal tobacco exposure and risk of anxiety symptoms remains apparent into young adulthood.
Collapse
Affiliation(s)
- Bereket Duko
- Curtin School of Population Health, Curtin University, Kent Street, Bentley WA 6102, Australia.
| | - Gavin Pereira
- Curtin School of Population Health, Curtin University, Kent Street, Bentley WA 6102, Australia; Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway; enAble Institute, Curtin University, Kent Street, Bentley, Western Australia 6102, Australia
| | - Robert J Tait
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, 7 Parker Place Building 609, Level 2 Technology Park, Bentley WA 6102, Australia
| | - Kim Betts
- Curtin School of Population Health, Curtin University, Kent Street, Bentley WA 6102, Australia
| | - John Newnham
- Division of Obstetrics and Gynaecology, Faculty of Health and Medical Sciences, The University of Western Australia, 17 Monash Ave, Nedlands WA 6009, Australia
| | - Rosa Alati
- Curtin School of Population Health, Curtin University, Kent Street, Bentley WA 6102, Australia; Institute for Social Sciences Research, The University of Queensland, 80 Meier's Rd, Indooroopilly, Queensland 4068 Australia
| |
Collapse
|
19
|
Reif S, Karriker-Jaffe KJ, Valentine A, Patterson D, Mericle AA, Adams RS, Greenfield TK. Substance use and misuse patterns and disability status in the 2020 US National Alcohol Survey: A contributing role for chronic pain. Disabil Health J 2022; 15:101290. [DOI: 10.1016/j.dhjo.2022.101290] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/02/2021] [Accepted: 07/15/2021] [Indexed: 11/15/2022]
|
20
|
Li Y, Wen Z, He Y, Huang J. Mental health status among prison officers in the process of enforcing the law during COVID-19epidemic: a cross-sectional survey from China. BMC Psychiatry 2022; 22:33. [PMID: 35016661 PMCID: PMC8749117 DOI: 10.1186/s12888-021-03679-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 12/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A global public health emergency triggered by the Coronavirus Disease 2019 (COVID-19) epidemic may have are markable psychological impact on the population. There is still limited psychological research on police officers, especially prison officers in the process of enforcing the law. The present study aims to identify prevalence and influencing factors on mental health status among frontline prison officers in China during the prevention and control of the COVID-19 epidemic. METHODS A cross-sectional survey with a sample of 981 frontline prison officers was conducted using snowball sampling approach. The self-administered questionnaire consisted of 4 parts: (i) informed consent form; (ii) socio-demographic section; (iii) work and life situations during the prevention and control of the COVID-19 epidemic; (iv) the Chinese version of the 12-item General Health Questionnaire (GHQ-12). Univariate analysis and multivariable logistic regression were performed to identify factors influencing mental health status. RESULTS The prevalence of being prone to mental health problems (GHQ-12 score ≥ 4) was 33.43% among frontline prison officers. The results of GHQ-12 factors analysis indicated that the prison officers suffered from psychological issues was related to anxiety and depression, which main symptoms were unhappy and depressed, lost sleep over worry and constantly under strain. Multivariate logistic regression analysis revealed that male (OR = 1.573, 95% CI:1.385-1.853), lockdown shift inside the prison(OR = 2.203, 95% CI:2.139-2.297), more night shifts (OR = 2.163, 95% CI:2.031-2.317; OR = 2.749, 95% CI:2.194-2.901), more smoking (OR = 1.100, 95% CI:1.037-2.168), poor self-reported physical condition (OR = 1.947, 95% CI:1.478-2.250), chronic or serious illness history(OR = 1.870, 95% CI:1.314-2.660; OR = 2.214, 95% CI:1.460-2.812) were risk factors for mental health among frontline prison officers, while regular diet (OR = 0.779, 95% CI:0.539-0.928), more physical exercise (OR = 0.702, 95% CI:0.548-0.899; OR = 0.641, 95% CI:0.316-0.887), more communication with family members (OR = 0.437, 95% CI:0.295-0.616) were protective factors. CONCLUSION Chinese frontline prison officers experienced different psychological stress coming from the prevention and control of this epidemic. Therefore, continued surveillance of psychological problems and targeted mental health care for frontline prison officers were urgent.
Collapse
Affiliation(s)
- Yang Li
- School of Law, Minzu University of China, Beijing, 100081, People's Republic of China
| | - Zhen Wen
- Department of General Surgery, Chengdu Third People's Hospital, Chengdu, 610031, People's Republic of China
| | - Yimei He
- Dong Cheng Experimental Junior Middle School, Guangyuan, 628017, People's Republic of China
| | - Jingting Huang
- West China School of Medicine, Sichuan University, Chengdu, 610041, People's Republic of China.
| |
Collapse
|
21
|
Baghdadi LR, Alhassan MK, Alotaibi FH, AlSelaim KB, Alzahrani AA, AlMusaeed FF. Anxiety, Depression, and Common Chronic Diseases, and Their Association With Social Determinants in Saudi Primary Care. J Prim Care Community Health 2021; 12:21501327211054987. [PMID: 34814776 PMCID: PMC8673869 DOI: 10.1177/21501327211054987] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: Patients with chronic diseases can experience psychological conditions, including anxiety and depression. However, the association between chronic diseases and these psychological conditions remains unclear. This study aimed to identify the relationship between anxiety, depression, and common chronic diseases (hypertension, type 2 diabetes, dyslipidemia, and rheumatoid arthritis), and their association with social determinants at an outpatient primary care setting. Methods: The validated hospital anxiety and depression scale was administered electronically to eligible participants. For each condition (anxiety and depression), participants were categorized as normal, borderline abnormal, and abnormal, according to their score out of 21 (≤7 = normal, 8-10 = borderline abnormal, ≥11 = abnormal). The scores and numbers of participants in each category were analyzed and compared with their demographic characteristics and chronic diseases for associations and relationships. Results: We recruited 271 participants (mean age of 51.65 + 11.71 years) attending primary care clinics. Of these patients, 17.7% and 8.9% had borderline abnormal and abnormal depression, respectively, and 10.3% and 8.9% of patients had borderline abnormal anxiety and abnormal anxiety. Common social determinants and lifestyle factors were examined. Age, gender, and sugary drinks’ consumption significantly increased the odds of hypertension and type 2 diabetes; vigorous physical activity 3 times a week, decreased the odds of developing these chronic diseases. Adjusted regression models showed a statistically significant association between the hospital anxiety and depression scale score for borderline and abnormal anxiety and the presence of type 2 diabetes (OR 3.04 [95% CI 1.13, 8.19], P-value = .03 and OR 4.65 [95% CI 1.63,13.22], P-value <.03, respectively) and dyslipidemia (OR 5.93 [95% CI 1.54, 22.86], P-value = .01, and OR 4.70 [95% CI 0.78, 28.35], P-value = .09, respectively). The odds of developing depression were 4 times higher (P-value .04) in patients with rheumatoid arthritis. Conclusion: Among patients attending primary care outpatient clinics, anxiety, and depression were significantly associated with type 2 diabetes and rheumatoid arthritis, respectively. Social determinants and lifestyle factors play a major role in the development of common chronic diseases in Saudi Arabia. Primary care physicians should consider the patients’ psychological status, sociodemographic status, and lifestyle risks during the management of chronic diseases.
Collapse
|
22
|
Gibson E, LeBlanc J, Sabo MT. Prior mood disorder diagnoses do not relate to current mood disorder symptoms or patient-reported disease severity in rotator cuff patients. Shoulder Elbow 2021; 13:683-690. [PMID: 34804218 PMCID: PMC8600670 DOI: 10.1177/1758573220947025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 07/13/2020] [Accepted: 07/13/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Surgery for rotator cuff syndrome does not always produce symptom improvement. Biological factors may explain some symptoms, but mood disorder symptoms may also contribute. The purpose of this study is to examine the interaction between disease severity, prevalence of mood disorder diagnoses, and current mood disorder symptoms in preoperative rotator cuff patients. METHODS A prospective cohort of patients aged 35-75 years with unilateral rotator cuff disease awaiting surgery participated. Demographics, psychiatric history, the Hospital Anxiety & Depression Scale, and the Western Ontario Rotator Cuff index were collected. Descriptive and univariate statistical testing was performed. RESULTS Of 140 participants (75M:65W) aged 55 ± 8 years, 34 reported a prior diagnosis of a mood disorder. There was a moderate positive relationship between disease severity and current depression and anxiety scores. Women were more likely to carry a diagnosis of a mood disorder, but there were no differences in current symptom levels between genders. No differences were found in patient-reported outcome measure scores between patients with and without a mood disorder diagnosis. DISCUSSION Current mood disorder symptoms were associated with greater disease severity, whereas the presence of a past mood disorder diagnosis was not. Awareness of this relationship may reduce bias about past mood disorder diagnoses during decision-making.
Collapse
Affiliation(s)
- Eric Gibson
- Sport Injury Prevention Research Centre,
University of Calgary, Calgary, Canada,South Campus Research Unit for Bone and
Soft Tissue, University of Calgary, Calgary, Canada,Eric Gibson, Sport Injury Prevention
Research Centre, 2500 University Drive NW, Calgary, Alberta, Canada T2N 1N4.
| | - Justin LeBlanc
- South Campus Research Unit for Bone and
Soft Tissue, University of Calgary, Calgary, Canada,Section of Orthopaedic Surgery, Cumming
School of Medicine, University of Calgary, Calgary, Canada
| | - Marlis T Sabo
- South Campus Research Unit for Bone and
Soft Tissue, University of Calgary, Calgary, Canada,Section of Orthopaedic Surgery, Cumming
School of Medicine, University of Calgary, Calgary, Canada
| |
Collapse
|
23
|
Truong TH, Kim NT, Nguyen MNT, Do DL, Nguyen HT, Le TT, Le HA. Quality of life and health status of hospitalized adults with congenital heart disease in Vietnam: a cross-sectional study. BMC Cardiovasc Disord 2021; 21:229. [PMID: 33947343 PMCID: PMC8097946 DOI: 10.1186/s12872-021-02026-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/12/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Little is known about the quality of life (QOL) and health status of adults with congenital heart disease (CHD) in developing countries. Therefore, this study aimed to describe the QOL and health status of hospitalized adults with CHD in Vietnam and investigate the association between QOL and their biological-social characteristics. METHODS A cross-sectional study was conducted with 109 adults with CHD, hospitalized in the Vietnam National Heart Institute, between June and December 2019. Validated instruments to assess QOL and health status describing patient-reported outcomes were used, including the EuroQOL-5 Dimensions-5 Level, Satisfaction with Life Scale, and Hospital Anxiety and Depression Scale. RESULTS The mean scores on the EuroQOL-descriptive system (EQ-DS) and EuroQOL visual analogue scale (EQ-VAS) were 0.792 (SD = 0.122, 95% confidence interval [CI] 0.769-0.815) and 66.3 (SD = 12.5, 95% CI 63.9-68.7), respectively. A total of 9.2% (n = 9) patients experienced life dissatisfaction. The prevalence of anxiety and depression were 18.7% (n = 20) and 11% (n = 12), respectively. Scores of QOL in patients aged > 30 years were lower than in those aged ≤ 30 years. Stratified multivariate logistic regression revealed that poor QOL related to being unemployed/unstable employment (OR 4.43, 95% CI 1.71-11.47, p = 0.002), life dissatisfaction associated with unmarried status (OR 4.63, 95% CI 1.2-17.86, p = 0.026), anxiety regarding unemployment/unstable employment (OR 3.88, 95% CI 1.27-11.84, p = 0.017) and complex CHD/PAH (OR 4.84, 95% CI 1.33-17.54, p = 0.016), and depression regarding unemployment/unstable employment (OR 4.63, 95% CI 1.22-17.59, p = 0.003). CONCLUSIONS Reduced QOL and elevated psychological problems were common experiences among hospitalized adults with CHD in Vietnam. Biological-social characteristics such as unmarried status, unemployment/unstable employment, and complex CHD/PAH related to poor QOL, life dissatisfaction, anxiety, and depression.
Collapse
Affiliation(s)
- Thanh-Huong Truong
- Vietnam National Heart Institute, Bach Mai Hospital, 78 Giai Phong Road, Dong Da District, Hanoi, 100000 Vietnam
- Department of Cardiology, Hanoi Medical University, 1 Ton That Tung Street, Dong Da District, Hanoi, 100000 Vietnam
| | - Ngoc-Thanh Kim
- Vietnam National Heart Institute, Bach Mai Hospital, 78 Giai Phong Road, Dong Da District, Hanoi, 100000 Vietnam
- Department of Cardiology, Hanoi Medical University, 1 Ton That Tung Street, Dong Da District, Hanoi, 100000 Vietnam
| | - Mai-Ngoc Thi Nguyen
- Vietnam National Heart Institute, Bach Mai Hospital, 78 Giai Phong Road, Dong Da District, Hanoi, 100000 Vietnam
- Department of Cardiology, Hanoi Medical University, 1 Ton That Tung Street, Dong Da District, Hanoi, 100000 Vietnam
| | - Doan-Loi Do
- Vietnam National Heart Institute, Bach Mai Hospital, 78 Giai Phong Road, Dong Da District, Hanoi, 100000 Vietnam
- Department of Cardiology, Hanoi Medical University, 1 Ton That Tung Street, Dong Da District, Hanoi, 100000 Vietnam
| | - Hong Thi Nguyen
- Thanh Nhan Hospital, 42 Thanh Nhan Street, Hai Ba Trung District, Hanoi, 100000 Vietnam
| | - Thanh-Tung Le
- Vietnam National Heart Institute, Bach Mai Hospital, 78 Giai Phong Road, Dong Da District, Hanoi, 100000 Vietnam
| | - Hong-An Le
- School of Medicine and Pharmacy, Vietnam National University, 144 Xuan Thuy Road, Cau Giay District, Hanoi, 100000 Vietnam
| |
Collapse
|
24
|
von Känel R, Kasper S, Bondolfi G, Holsboer-Trachsler E, Hättenschwiler J, Hatzinger M, Imboden C, Heitlinger E, Seifritz E. Therapeutic effects of Silexan on somatic symptoms and physical health in patients with anxiety disorders: A meta-analysis. Brain Behav 2021; 11:e01997. [PMID: 33638614 PMCID: PMC8035468 DOI: 10.1002/brb3.1997] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 11/27/2020] [Accepted: 11/28/2020] [Indexed: 12/22/2022] Open
Abstract
A meta-analysis was performed to examine therapeutic effects of Silexan on somatic symptoms, including insomnia/fatigue, and physical health in patients with anxiety disorders. Five randomized, placebo-controlled trials were included in this analysis: The efficacy of Silexan (80 mg/day) was investigated in patients with subthreshold anxiety disorders (three trials) and in patients with generalized anxiety disorder (two trials). Silexan was superior to placebo in terms of the mean change from baseline in the Hamilton Anxiety Rating Scale (HAMA) subscore somatic anxiety at week 10 with a standardized mean difference of -0.31 [95% Cl: -0.52 to -0.10, p = .004]. Treatment effects of silexan on somatic anxiety were independent of gender and age. Statistically significant differences were also shown for single HAMA items somatic muscular, cardiovascular, respiratory, and genitourinary symptoms, indicating clinical relevance with small to medium effects of Silexan. Similar clinically meaningful effects of Silexan on SF-36 physical health, including reduced bodily pain and improved general health, and on insomnia complaints and fatigue, were demonstrated. In this meta-analysis including all placebo-controlled clinical trials in patients with anxiety disorders to date, statistically significant and clinically meaningful advantages of Silexan over placebo treatment were found in improving somatic symptoms and physical health.
Collapse
Affiliation(s)
- Roland von Känel
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Guido Bondolfi
- Department of Psychiatry, University Medical Centre, University of Geneva, Geneva, Switzerland
| | | | | | - Martin Hatzinger
- Psychiatric Services Solothurn and University of Basel, Solothurn, Switzerland
| | | | | | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| |
Collapse
|
25
|
Zsido AN, Varadi-Borbas B, Arato N. Psychometric properties of the social interaction anxiety scale and the social phobia scale in Hungarian adults and adolescents. BMC Psychiatry 2021; 21:171. [PMID: 33771109 PMCID: PMC7995698 DOI: 10.1186/s12888-021-03174-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although social anxiety disorder is one of the most frequent disorders, it often remained unrecognized. Utilizing brief, yet reliable screening tools, such as the Social Interaction Anxiety Scale (SIAS-6) and the Social Phobia Scale (SPS-6) are helping to solve this problem in parts of Western Europe and the US. Still some countries, like Hungary, lag behind. For this purpose, previous studies call for further evidence on the applicability of the scales in various populations and cultures, as well as the elaborative validity of the short forms. Here, we aimed to provide a thorough analysis of the scales in five studies. We employed item response theory (IRT) to explore the psychometric properties of the SIAS-6 and the SPS-6 in Hungarian adults (n = 3213, age range:19-80) and adolescents (n = 292, age range:14-18). RESULTS In both samples, IRT analyses demonstrated that the items of SIAS-6 and SPS-6 had high discriminative power and cover a wide range of the latent trait. Using various subsamples, we showed that (1) the scales had excellent convergent and divergent validity in relation to domains of anxiety, depression, and cognitive emotion regulation in both samples. Further, that (2) the scales discriminated those with a history of fainting or avoidance from those without such history. Lastly, (3) the questionnaires can discriminate people diagnosed with social anxiety disorder (n = 30, age range:13-71) and controls. CONCLUSIONS These findings suggest that the questionnaires are suitable for screening for SAD in adults and adolescents. Although the confirmation of the two-factor structure may be indicative of the validity of the "performance only" specifier of SAD in DSM-V, the high correlation between the factors and the similar patter of convergent validity might indicate that it is not a discrete entity but rather a part of SAD; and that SAD is latently continuous.
Collapse
Affiliation(s)
- Andras N. Zsido
- Institute of Psychology, University of Pécs, 6, Ifjusag street, Pécs, Baranya H-7624 Hungary
| | - Brigitta Varadi-Borbas
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Nikolett Arato
- Institute of Psychology, University of Pécs, 6, Ifjusag street, Pécs, Baranya H-7624 Hungary
| |
Collapse
|
26
|
Gårdvik KS, Rygg M, Torgersen T, Lydersen S, Indredavik MS. Psychiatric morbidity, somatic comorbidity and substance use in an adolescent psychiatric population at 3-year follow-up. Eur Child Adolesc Psychiatry 2021; 30:1095-1112. [PMID: 32671493 PMCID: PMC8295167 DOI: 10.1007/s00787-020-01602-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 07/08/2020] [Indexed: 12/28/2022]
Abstract
Knowledge is scarce on the course of psychiatric disorders in adolescence. We aimed to assess changes in the frequency of psychiatric disorders, somatic disorders, pain, and substance use in a clinical psychiatric cohort from adolescence to young adulthood. This study is part of the Health Survey in Department of Children and Youth, St. Olavs Hospital, Norway. At age 13-18 years, 717 (43.5% of eligible) participated in the first study visit (T1) in 2009-2011, 549 were reassessed 3 years later with telephone interview (T2), and 464 had diagnostic evaluation at both time points. Data included: ICD-10 diagnoses (T1), DSM-IV diagnoses (T2), self-reported pain and substance use (T1 and T2). The overall rate of psychiatric disorders decreased (T1 vs. T2: 94.8% vs. 72.2%, p < 0.001); while, an increased rate of anxiety disorders was marked among girls (37.5% vs. 55.9%, p < 0.001), with accompanying raised frequencies of psychiatric comorbidity (14.1% vs. 42.6%, p < 0.001), somatic comorbidity (9.4% vs. 19.5%, p = 0.001), chronic pain (31.6% vs. 49.4%, p < 0.001), smoking, alcohol use and trying illicit drugs. Chronic pain, smoking and trying illicit drugs were associated with persisting psychiatric disorders, with highest risk differences for girls (RD = 25.4%, p = 0.002, RD = 15.6%, p = 0.008, RD = 18.0%, p = 0.001, respectively). Three out of four adolescents still had a psychiatric disorder after 3 years. Unlike boys, girls had an increasing rate of anxiety disorders and comorbidities. Chronic pain, smoking and trying illicit drugs were associated with persisting psychiatric disorders. Despite methodological limitations, these findings emphasize the importance of early targeted intervention for adolescents with psychiatric disorders.
Collapse
Affiliation(s)
- Kari Skulstad Gårdvik
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway.
- Division of Mental Health Care, Department of Children and Youth, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Marite Rygg
- Department of Clinical and Molecular Medicine (IKOM), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Pediatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Terje Torgersen
- Division of Mental Health Care, Department of Østmarka, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Lydersen
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marit Sæbø Indredavik
- Department of Clinical and Molecular Medicine (IKOM), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
27
|
Golub Y, Stonawski V, Plank AC, Eichler A, Kratz O, Waltes R, von Hoersten S, Roessner V, Freitag CM. Anxiety Is Associated With DPPIV Alterations in Children With Selective Mutism and Social Anxiety Disorder: A Pilot Study. Front Psychiatry 2021; 12:644553. [PMID: 34267682 PMCID: PMC8275849 DOI: 10.3389/fpsyt.2021.644553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/31/2021] [Indexed: 12/25/2022] Open
Abstract
Background: Both selective mutism (SM) and social anxiety disorder (SAD) are severe pediatric anxiety disorders with the common trait of behavioral inhibition (BI). The underlying pathophysiology of these disorders remains poorly understood, however converging evidence suggests that alterations in several peripheral molecular pathways might be involved. In a pilot study, we investigated alterations in plasma molecular markers (dipeptidyl peptidase-4 [DPPIV], interleukin-6 [IL-6], tumor necrosis factor-β [TNF-β] and neuropeptide-Y [NPY]) in children with SM, SAD, and healthy controls, as well as the correlation of these markers to symptom severity. Methods: We included 51 children and adolescents (aged 5-18 years; n = 29 girls): n = 20 children in the SM-, n = 16 in the SAD- and n = 15 in the control-group (CG). Peripheral blood samples were analyzed for DPPIV, IL-6, TNF-β, and NPY concentrations. Diverse psychometric measures were used for BI, anxiety, and mutism symptoms. Results: Lower DPPIV-levels were correlated with more anxiety symptoms. However, we could not find a difference in any molecular marker between the patients with SAD and SM in comparison to the CG. Conclusion: DPPIV is proposed as relevant marker for child and adolescent anxiety. Investigating the pathophysiology of SM and SAD focusing on state and trait variables as anxiety or BI might help better understanding the underlying mechanisms of these disorders. Further studies with especially larger cohorts are needed to validate the current pilot-findings.
Collapse
Affiliation(s)
- Yulia Golub
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany.,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Valeska Stonawski
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Anne C Plank
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Anna Eichler
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Oliver Kratz
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Regina Waltes
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Stephan von Hoersten
- Department of Experimental Therapy and Preclinical Center, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| |
Collapse
|
28
|
Yonatan-Leus R, Strauss AY, Cooper-Kazaz R. Psychodynamic psychotherapy is associated with sustained reduction in health care utilization and cost. Clin Psychol Psychother 2020; 28:642-655. [PMID: 33142005 DOI: 10.1002/cpp.2527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 11/10/2022]
Abstract
Our objective was to examine the effectiveness and efficiency of psychodynamic psychotherapy on the reduction in health care utilization and cost while controlling for age, gender, and year. Health care utilization and cost were examined yearly in 1,675 patients from 2 years before outpatient psychotherapy (i.e., baseline) to three consecutive years after psychotherapy in a naturalistic longitudinal design. A multilevel analytic approach (LMLM) was applied to account for repeated measures effect and missing data. In the year prior to psychotherapy, there was a significant increase in total cost compared with baseline (14.8%) and in use of health care services (primary and specialist doctors' visits and outsourced referrals). In the first year following therapy, there was a significant decrease in total cost (10%) and in use of health care services (all doctors' visits, imaging, and outsourced referrals). The decrease was to baseline levels or lower and was maintained for two additional years. Psychiatric medication usage increased significantly after psychotherapy and remained so. The overall cumulative decrease in total cost per patient over 3 years after therapy was 3,665.92 NIS, equalling a 69% average cost of psychotherapy. Further cost saving can be expected due to the reduction in sick leave, disability, and psychiatric hospitalization. These findings support the notion that providing outpatient psychodynamic psychotherapy can be financially beneficial to health care systems, although further research is required for causal inferences. Also, an increase in health care utilization along with scarce physical findings may indicate unaddressed psychological distress and warrant referral for mental assessment and possible psychotherapy.
Collapse
Affiliation(s)
- Refael Yonatan-Leus
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel.,Mental Health Services (Talbiya), Clalit Health Services-Jerusalem, Affiliated with The Faculty of Medicine at The Hebrew University Jerusalem, Jerusalem, Israel
| | - Asher Y Strauss
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Rena Cooper-Kazaz
- Mental Health Services (Talbiya), Clalit Health Services-Jerusalem, Affiliated with The Faculty of Medicine at The Hebrew University Jerusalem, Jerusalem, Israel
| |
Collapse
|
29
|
Horenstein A, Heimberg RG. Anxiety disorders and healthcare utilization: A systematic review. Clin Psychol Rev 2020; 81:101894. [DOI: 10.1016/j.cpr.2020.101894] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 07/21/2020] [Accepted: 07/29/2020] [Indexed: 12/18/2022]
|
30
|
Correlates of symptoms of anxiety and depression and mental wellbeing associated with COVID-19: a cross-sectional study of UK-based respondents. Psychiatry Res 2020; 291:113138. [PMID: 32562931 PMCID: PMC7258801 DOI: 10.1016/j.psychres.2020.113138] [Citation(s) in RCA: 231] [Impact Index Per Article: 57.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/23/2020] [Accepted: 05/24/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The aim was to assess the impact of COVID-19 self-isolation/social distancing on mental health, and potential correlates, among a sample of the UK population. METHODS A cross-sectional study. Mental health was measured using the Beck Anxiety and Depression Inventory. Mental wellbeing was measured using The Short Warwick-Edinburgh Mental Well-being Scale. Data collected on predictors included sex, age, marital status, employment, annual income, region, current smoking, current alcohol consumption, physical multimorbidity, any physical symptoms experienced during self-isolation/social distancing, and the number of days of self-isolation/social distancing. The association between potential predictors and poor mental health was studied using a multivariable logistic regression. RESULTS 932 participants were included. Factors associated with poor mental health were sex (reference: male; female: OR=1.89, 95%CI=1.34-2.68), age (18-24 years: reference;45-54 years: OR=0.27, 95%CI=0.14-0.53; 55-64 years: OR=0.24, 95%CI=0.12-0.47; 65-74years: OR=0.10, 95% CI=0.05-0.22; and ≥75years: OR=0.08,95% CI=0.03-0.24),annual income (<£15,000: reference; £25,000-<£40,000: OR=0.54, 95% CI=0.31-0.93; £40,000-<£60,000: OR=0.39, 95% CI=0.22-0.69; and ≥£60,000: OR=0.38, 95% CI=0.21-0.67), current smoking (yes: OR=2.59, 95%CI=1.62-4.20), and physical multimorbidity (OR=2.35, 95%CI=1.61-3.46). CONCLUSIONS In this sample of UK adults self-isolating/social distancing females, younger age groups, those with a lower annual income, current smokers and those with physical multimorbidity were associated with higher levels of poor mental health.
Collapse
|
31
|
Battalio SL, Huffman SE, Jensen MP. Longitudinal associations between physical activity, anxiety, and depression in adults with long-term physical disabilities. Health Psychol 2020; 39:529-538. [PMID: 32202825 PMCID: PMC8439002 DOI: 10.1037/hea0000848] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate the longitudinal associations between self-reported physical activity and anxiety and depression symptom severity in adults with long-term physical disabilities. METHOD A secondary analysis of data from a United States-based longitudinal survey study of community-dwelling adults with 1 of 4 potential long-term physical disabilities (multiple sclerosis, muscular dystrophy, spinal cord injury, postpoliomyelitis syndrome). The first time point (T1) for the current study was completed by 1,594 participants. The second survey (T2) was sent 1 year later, and the third (T3) was sent 3 years later; each were completed by 1,380 and 1,218 participants, respectively. At each time point, participants completed a measure of physical activity (Godin Leisure Time Exercise Questionnaire) and Patient-Reported Outcomes Measurement System short forms evaluating depression and anxiety severity. RESULTS Mixed growth curve models showed greater quantities of physical activity were associated with decreases in both depression (χ2(2) = 84.01, p < .001) and anxiety (χ2(2) = 21.66, p < .001) symptom severity over the 4-year period. However, while greater quantities of moderate (anxiety z = -2.24, p < .05; depression z = -5.48, p < .001) and strenuous (anxiety z = -2.59, p < .05; depression z = -3.90, p < .001) physical activity were significantly associated with decreases in negative affect, mild physical activity was not. CONCLUSION The current study provides evidence that physical activity is longitudinally associated with anxious and depressive symptoms in adults with long-term physical disabilities. Future research should examine the quantities and intensities of physical activity necessary to impart psychological benefits. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
|
32
|
Abstract
OBJECTIVE Anxiety disorders are among the most frequent mental disorders and are associated with a range of short- and long-term impairments and disabilities. Relatively little is known about anxiety disorders in patients with somatic diseases, and the present literature review highlights the current research in this field, data about prevalences of anxiety disorders in patients with somatic diseases, and the effectiveness of interventions. This article also introduces a comprehensive model of inpatient treatment and summarizes the evidence pertinent to this approach. METHODS A narrative review is presented with regard to prevalence and treatment of anxiety disorders in patients with somatic diseases. The effects of inpatient treatment are illustrated based on a case report. RESULTS This review indicates that anxiety disorders are more common in patients with somatic diseases, with prevalence estimates ranging from 2.5% to 55%, than in the general population. Several outpatient treatment options exist, with substantial support for the effectiveness of cognitive behavioral therapy, psychodynamic therapy, and pharmacotherapy. We also provide evidence in support of psychosomatic inpatient treatment for patients with anxiety disorders that are comorbid with somatic diseases. CONCLUSIONS Anxiety disorders are common in patients with somatic diseases, and several effective treatment options exist, including cognitive behavioral therapy and pharmacological interventions. We also provide support for the effectiveness of inpatient treatment with unique opportunities for multidisciplinary psychosomatic treatment of anxiety disorders with comorbid somatic diseases.
Collapse
Affiliation(s)
- Michaela Henning
- From the Department of Psychosomatic Medicine and Psychotherapy (Henning, Subic-Wrana, Wiltink, Beutel), University Medical Center, Mainz; and Department of Psychosomatics and Psychotherapy (Henning), University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | | | | |
Collapse
|
33
|
Fancourt D, Baxter L, Lorencatto F. Barriers and enablers to engagement in participatory arts activities amongst individuals with depression and anxiety: quantitative analyses using a behaviour change framework. BMC Public Health 2020; 20:272. [PMID: 32106843 PMCID: PMC7045421 DOI: 10.1186/s12889-020-8337-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 02/07/2020] [Indexed: 01/03/2023] Open
Abstract
Background There is a large literature on the health benefits of engagement with the arts. However, there are also well-recognised challenges in ensuring equity of engagement with these activities. Specifically, it remains unclear whether individuals with poor mental health experience more barriers to participation. This study used a behaviour change framework to explore barriers to engagement in participatory arts activities amongst people with either depression or anxiety. Methods Data were drawn from a large citizen science experiment focused on participation in creative activities. Participants who reported engaging infrequently in performing arts, visual arts, design and crafts, literature-related activities, and online, digital and electronic arts were included and categorised into no mental health problems (n = 1851), depression but not anxiety (n = 873) and anxiety but not depression (n = 808). Barriers and enablers to engagement were measured using an 18-item scale based on the COM-B Self-Evaluation Questionnaire, with subscales assessing psychological and physical capabilities, social and physical opportunities, and automatic and reflective motivations. Logistic regression analyses were used to identify whether individuals with either depression or anxiety reported greater barriers across any of the six domains than individuals without any mental health problems. Where differences were found, we calculated the percentage of protective association explained by various demographic, socio-economic, social, physical or geographical factors. Results Individuals with depression and anxiety felt they would be more likely to engage in arts activities if they had greater psychological and physical capabilities, more social opportunities, and stronger automatic and reflective motivations to engage. However, they did not feel that more physical opportunities would affect their engagement. Covariates explained only 8–37% of the difference in response amongst those with and without anxiety and depression. Conclusions Findings suggest that for individuals with poor mental health, there are certain barriers to participation that are not felt as strongly by those without any mental health problems. Mapping the behaviour change domains to potential interventions, activities that focus on increasing perceived capabilities, providing social opportunities, and reinforcing both automatic and reflective motivations to engage has the potential to help to redress the imbalance in arts participation amongst those with poor mental health.
Collapse
Affiliation(s)
- Daisy Fancourt
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Louise Baxter
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | | |
Collapse
|
34
|
Buhagiar K, Templeton G, Osborn DPJ. Recent physical conditions and health service utilization in people with common mental disorders and severe mental illness in England: Comparative cross-sectional data from a nationally representative sample. Eur Psychiatry 2020; 63:e19. [PMID: 32093805 PMCID: PMC7315885 DOI: 10.1192/j.eurpsy.2020.22] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background. Policies addressing the physical health of people with mental disorders have historically focused on those with severe mental illness (SMI), giving less prominence to the more prevalent common mental disorders (CMDs). Little is known about the comparative physical health outcomes of these patient groups. We aimed to first compare the: (a) number of past-year chronic physical conditions and (b) recent physical health service utilization between CMDs vs. SMI, and secondly compare these outcomes between people with CMDs vs. people without mental disorders. Methods. We analyzed cross-sectional data from the third Adult Psychiatric Morbidity Survey, a representative sample of the English population. We determined the presence of physical conditions and health service utilization by self-report and performed logistic regression models to examine associations of these outcomes between participant groups. Results. Past-year physical conditions were reported by the majority of participants (CMDs, n = 815, 62.1%; SMI = 27, 63.1%) with no variation in the adjusted odds of at least one physical condition between diagnoses (odds ratio [OR] = 0.96, 95% confidence intervals [CI] 0.42–1.98, p = 0.784). People with CMDs were significantly more likely to be recently hospitalized relative to with those with SMI (OR = 6.33, 95% CI 5.50–9.01, p < 0.05). Having a CMD was associated with significantly higher odds of past-year physical conditions and recent health service utilization (all p < 0.001) compared with the general population. Conclusions. People with CMDs experience excess physical health morbidities in a similar pattern to those found among people with SMI, while their somatic hospitalization rates are even more elevated. Findings highlight the importance of recalibrating existing public health strategies to bring equity to the physical health needs of this patient group.
Collapse
Affiliation(s)
- Kurt Buhagiar
- Department of Research, Innovation & Medical Education, East London NHS Foundation Trust, London, United Kingdom
| | - Georgia Templeton
- Department of Research, Innovation & Medical Education, East London NHS Foundation Trust, London, United Kingdom
| | - David P J Osborn
- Division of Psychiatry, University College London, London, United Kingdom
| |
Collapse
|
35
|
Ethosuximide improves chronic pain-induced anxiety- and depression-like behaviors. Eur Neuropsychopharmacol 2019; 29:1419-1432. [PMID: 31767519 DOI: 10.1016/j.euroneuro.2019.10.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 08/30/2019] [Accepted: 10/29/2019] [Indexed: 02/06/2023]
Abstract
Chronic pain is a heavy burden disease. Current treatments are generally weakly effective or associated with adverse effects. New therapeutic approaches are therefore needed. Recent studies have suggested T-type calcium channels as an attractive target for the treatment of chronic pain. In this perspective, it was decided to perform a preclinical evaluation of the efficacy of ethosuximide, a T-type channel blocker used clinically as an antiepileptic, as a novel pharmacological treatment for chronic pain. Assessment of the effect of ethosuximide was thus made in both nociception and pain-related comorbidities as anxiety and depression are frequently encountered in chronic pain patients. Our results show that such symptoms occurred in three animal models of chronic pain designed to reflect traumatic neuropathic, chemotherapy-induced neuropathic and inflammatory pain conditions. Administration of ethosuximide reduced both chronic pain and comorbidities with a marked intensity ranging from partial reduction to a complete suppression of symptoms. These results make ethosuximide, and more broadly the inhibition of T-type calcium channels, a new strategy for the management of uncontrolled chronic pain, likely to improve not only pain but also the accompanying anxiety and depression.
Collapse
|
36
|
Pass LE, Kennelty K, Carter BL. Self-identified barriers to rural mental health services in Iowa by older adults with multiple comorbidities: qualitative interview study. BMJ Open 2019; 9:e029976. [PMID: 31685497 PMCID: PMC6858190 DOI: 10.1136/bmjopen-2019-029976] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 08/01/2019] [Accepted: 09/13/2019] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Individuals in rural areas face critical health disparities, including limited access to mental healthcare services and elevated burden of chronic illnesses. While disease outcomes are often worse in individuals who have both physical and mental comorbidities, few studies have examined rural, chronically-ill older adults' experiences accessing mental health services. The aim of the study was to determine barriers to finding, receiving and adhering to mental health treatments in this population to inform future interventions delivering services. DESIGN We conducted a qualitative study of barriers and facilitators to mental healthcare access. 19 interviews were analysed deductively for barriers using a modified version of Penchansky and Thomas's theory of access as an analytical framework. SETTING This study was conducted remotely using telephonic interviews. Patients were located in various rural Iowa towns and cities. PARTICIPANTS 15 rural Iowan older adults with multiple physical comorbidities as well as anxiety and/or depression. RESULTS We found that while patients in this study often felt that their mental health was important to address, they experienced multiple, but overlapping, barriers to services that delayed care or broke their continuity of receiving care, including limited knowledge of extant services and how to find them, difficulties obtaining referrals and unsatisfactory relationships with mental health service providers. CONCLUSIONS Our findings indicate that intervention across multiple domains of access is necessary for successful long-term management of mental health disorders for patients with multiple chronic comorbidities in Iowa.
Collapse
Affiliation(s)
- Lauren Elizabeth Pass
- Pharmacy Practice and Science, University of Iowa College of Pharmacy, Iowa City, Iowa, USA
| | - Korey Kennelty
- Pharmacy Practice and Science, University of Iowa College of Pharmacy, Iowa City, Iowa, USA
- Family Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
| | - Barry L Carter
- Pharmacy Practice and Science, University of Iowa College of Pharmacy, Iowa City, Iowa, USA
- Family Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
| |
Collapse
|
37
|
Abstract
OBJECTIVE Positive psychology interventions, which involve systematic completion of activities designed to promote well-being, are being increasingly studied in medically ill patients. However, the extent to which these interventions ameliorate patient anxiety remains unclear. Therefore, the aim of the study was to conduct a meta-analysis to determine the efficacy of positive psychology interventions in reducing anxiety in medical patients. METHODS Electronic databases Medline, PsycINFO, SciELO, Cochrane (Central), and ClinicalTrials.gov were searched from inception to June 18, 2018, to identify studies of positive psychology interventions that included a validated measure of anxiety as an outcome measure. RESULTS The search generated a total of 1024 studies. Twelve randomized controlled trials (n = 1131) delivered to medical patients were included in the review, and a further 11 nonrandomized trials (n = 300) were included in a secondary analysis. Positive psychology interventions were effective at reducing patient anxiety relative to a control with a small to medium effect size (g = -0.34, 95% confidence interval = -0.50 to -0.18), and results were maintained at a mean of 8-week follow-up (g = -0.31, 95% confidence interval = -0.54 to -0.08). Clinician-led interventions seemed to be more effective than self-administered interventions, and longer interventions were more effective than shorter interventions. Secondary analysis of nonrandomized trials also found that positive psychology interventions are associated with reduced anxiety. CONCLUSIONS Positive psychology interventions seem to be effective at reducing medical patient anxiety. Future research is needed to determine optimal intervention characteristics, including dose and intervention content, that maximize the observed treatment effects.
Collapse
|
38
|
Anderson R, Capobianco L, Fisher P, Reeves D, Heal C, Faija CL, Gaffney H, Wells A. Testing relationships between metacognitive beliefs, anxiety and depression in cardiac and cancer patients: Are they transdiagnostic? J Psychosom Res 2019; 124:109738. [PMID: 31443817 DOI: 10.1016/j.jpsychores.2019.109738] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 05/29/2019] [Accepted: 06/09/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Anxiety and depression symptoms are common in patients with physical health conditions. In the metacognitive model, beliefs about cognition (metacognitions) are a key factor in the development and maintenance of anxiety and depression. The current study evaluated if metacognitions predict anxiety and/or depression symptoms and if differential or common patterns of relationships exist across cardiac and cancer patients. METHOD A secondary data analysis with 102 cardiac patients and 105 patients with breast or prostate cancer were included. Participants were drawn from two studies, Wells et al. [1] and Cook et al. [2]. All patients reported at least mild anxiety or depression symptoms. Patients completed the Metacognitions Questionnaire 30 (MCQ-30) and the Hospital Anxiety and Depression Scale (HADS). Hierarchical linear regressions evaluated metacognitive predictors of anxiety and depression across the groups. RESULTS The results of regression analyses controlling for a range of demographics and testing for effect of illness type showed that uncontrollability and danger and positive beliefs were common and independent predictors of anxiety in both groups. There was one positive bi-variate association between metacognitive beliefs (uncontrollability and danger) and depressive symptoms. CONCLUSIONS Findings support the metacognitive model, suggesting that a common set of metacognitive factors contribute to psychological distress, particularly anxiety. Uncontrollability and danger metacognitions and positive beliefs about worry appear to make independent contributions to anxiety irrespective of type of physical illness. While metacognitive beliefs were not reliably associated with depressive symptoms this may be because the current sample exhibited low depression scores.
Collapse
Affiliation(s)
- Rebecca Anderson
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Lora Capobianco
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | - David Reeves
- NIHR School for Primary Care Research, Division of Population of Health, Health Services Research and Primary Care, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Calvin Heal
- Centre for Biostatistics, Division of Population of Health, Health Services Research and Primary Care, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Cintia L Faija
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Hannah Gaffney
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK; Centre for Biostatistics, Division of Population of Health, Health Services Research and Primary Care, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Adrian Wells
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK; School of Psychological Sciences, The University of Manchester, UK.
| |
Collapse
|
39
|
Depression and anxiety in patients with different rare chronic diseases: A cross-sectional study. PLoS One 2019; 14:e0211343. [PMID: 30785907 PMCID: PMC6382125 DOI: 10.1371/journal.pone.0211343] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 01/13/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Empirical evidence on depression and anxiety in patients with rare diseases is scarce but can help improve comprehensive treatment. The objectives of this study were to investigate the frequency of depression and anxiety in this heterogeneous population and to examine aspects associated with increased psychopathology. METHODS N = 300 patients with 79 different rare diseases (female:80%, age:M = 44.3(12.8), range:16-74 years) participated in a cross-sectional online study. We determined the percentages of patients reporting elevated depression (PHQ-9) and anxiety (GAD-7) scores. We calculated two linear regressions with depression and anxiety as outcomes. Predictor variables were diagnosis-related aspects (diagnosis assigned to ICD-10 chapter, visibility of symptoms, time since diagnosis, comorbid diseases), perceived somatic-symptom-severity (PHQ-15), illness-perceptions (consequences, control, identity, concern, understanding and treatment control; B-IPQ-R), coping mechanisms (constructive attitudes, active engagement in life) and social support (heiQ). We controlled for gender, age and depression or anxiety depending on the outcome. RESULTS 42% of the patients (95%CI [36.41%,47.59%]) reported depression scores indicating moderately or severely elevated symptom levels. Regarding anxiety, this applies to 23% (95%CI [18.54%,28.06%]). Variables significantly associated with depression were higher perceived somatic-symptom-severity (B = 0.41,p < .001), less control (B = .17,p < .05), lower levels of concern (B = -0.32,p < .01) and less constructive attitudes (B = -1.40,p < .001). No diagnosis-related variables were associated with depression. Variables significantly associated with anxiety were diseases of the circulatory system compared to congenital malformations (B = 1.88,p < .05), less consequences (B = -0.32,p < .05) and more concern (B = -0.32,p < .01). CONCLUSION The data reveal first insights into depression and anxiety in patients with different rare diseases. High percentages of patients showed clinically relevant symptom burden. No diagnosis-related differences were found in depression while anxiety seems to be particularly frequent in patients with rare diseases of the circulatory system. Besides perceived somatic symptom severity, cognitive appraisal seems to be linked to depression. Supporting patients in coping with their disease may help reduce psychopathology and therefore improve overall health.
Collapse
|
40
|
Özyurt G, Binici NC. The neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in adolescent obsessive-compulsive disorder: Does comorbid anxiety disorder affect inflammatory response? Psychiatry Res 2019; 272:311-315. [PMID: 30597382 DOI: 10.1016/j.psychres.2018.12.131] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 12/21/2018] [Accepted: 12/23/2018] [Indexed: 12/27/2022]
Abstract
Recent adult etiologic studies indicated evidence linking increased inflammatory parameters with psychiatric disorders. The neutrophil-lymphocyte ratio and platelet-lymphocyte ratio are easily obtainable clinical markers of inflammation and have been found to be increased in various medical and mental disorders. In this study, we aimed to investigate the neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in adolescents with obsessive-compulsive disorder (OCD). Secondarily, the effect of comorbid anxiety disorder with OCD on the inflammatory response was investigated. Sixty drug-naïve adolescents with OCD aged 12 to 18 years were enrolled in the patient group. Twenty-three of the OCD group had comorbid anxiety disorder (AD) and 37 had no comorbidities. One hundred twenty-eight adolescents in the same age range with no psychiatric disorders were recruited as the healthy control group. The severity of OCD symptoms was evaluated using the Children's Yale-Brown Obsessive Compulsive Scale. There were statistically significant differences in the neutrophil-lymphocyte ratio, white blood cell, neutrophil, and platelet counts among the three groups, even after adjusting for age and sex. The adolescents with OCD and AD had the highest neutrophil-lymphocyte ratio and white blood cell counts. A comorbid anxiety disorder diagnosis in addition to obsessive-compulsive disorder may increase the inflammatory response.
Collapse
Affiliation(s)
- Gonca Özyurt
- Child and Adolescent Psychiatry Department, Medical School, İzmir Katip Çelebi University, İzmir, Turkey.
| | - Nagihan Cevher Binici
- Child and Adolescent Psychiatry Specialist, Child and Adolescent Psychiatry Unit, Behçet Uz Children's Hospital, İzmir, Turkey.
| |
Collapse
|
41
|
Farris SG, Zvolensky MJ. Cognitive Processes in Anxiety and Comorbid Physical Illness and Health Behavior: Introduction to the Special Issue. COGNITIVE THERAPY AND RESEARCH 2018; 43:1-5. [PMID: 31462838 DOI: 10.1007/s10608-018-9988-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Anxiety symptoms and disorders are the most common psychiatric problems world-wide and are vastly overrepresented among individuals with chronic illness and poor health behavior. The purpose of the current special series is to bolster attention and highlight new research on cognitive processes as a basic element that may undergird the association between anxiety and chronic illness and health behavior. Findings in this issue highlight cognitive-based risk and resilience factors related to anxiety in individuals with various chronic conditions problematic health behaviors.
Collapse
Affiliation(s)
| | - Michael J Zvolensky
- University of Houston, Houston, Texas.,The University of Texas MD Anderson Cancer Centers, Houston, Texas.,HEALTH Institute, Houston, Texas
| |
Collapse
|
42
|
Gherasim A, Dao A, Bernstein JA. Confounders of severe asthma: diagnoses to consider when asthma symptoms persist despite optimal therapy. World Allergy Organ J 2018; 11:29. [PMID: 30459928 PMCID: PMC6234696 DOI: 10.1186/s40413-018-0207-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 09/18/2018] [Indexed: 12/30/2022] Open
Abstract
Asthma can often be challenging to diagnose especially when patients present with atypical symptoms. Therefore, it is important to have a broad differential diagnosis for asthma to ensure that other conditions are not missed. Clinicians must maintain a high index of suspicion for asthma mimickers, especially when patients fail to respond to conventional therapy. The purpose of this review is to briefly review some of the more common causes of asthma mimickers that clinicians should consider when the diagnosis of asthma is unclear.
Collapse
Affiliation(s)
- Alina Gherasim
- Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Ahn Dao
- University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Jonathan A Bernstein
- University of Cincinnati College of Medicine, Cincinnati, OH USA
- Department of Internal Medicine, Division of Immunology Rheumatology and Allergy, University of Cincinnati, 231 Albert Sabin Way ML#563, Cincinnati, OH 45267-0563 USA
| |
Collapse
|
43
|
Saracutu M, Edwards DJ, Davies H, Rance J. Protocol for a feasibility and acceptability study using a brief ACT-based intervention for people from Southwest Wales who live with persistent pain. BMJ Open 2018; 8:e021866. [PMID: 30389758 PMCID: PMC6224746 DOI: 10.1136/bmjopen-2018-021866] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Persistent pain affects a large percentage of the UK population and its burden has wide ramifications that affect physical, psychological, socioeconomic and occupational status. Pain has a significant impact on people's well-being and quality of life. Some of the most common comorbidities found in this population are depression and anxiety and also maladaptive behaviours such as fear avoidance and catastrophising. METHODS AND ANALYSIS This is a protocol for a study assessing the feasibility and acceptability of a novel Acceptance and Commitment Therapy (ACT)-based intervention for people from Southwest Wales who live with persistent pain. A group of 12 participants will be recruited through the Health and Wellbeing Academy (Swansea University). After being referred by an Osteopath, and attending a brief meeting with the researcher, the participants will take part in six sessions over six consecutive weeks. 'A Mindful Act' is an ACT-based group programme aiming to teach people how to develop more acceptance and self-compassion, be more mindful and clarify personal values in order to live a more rich and meaningful life. The main outcomes will include the feasibility of the recruitment process and the measurement tools, the acceptability of the intervention for both the participants and the Osteopaths and the adherence to the programme. In order to measure acceptability of the intervention, qualitative interviews will be conducted to provide an insight into peoples' experiences of taking part. Data will be analysed using Thematic Analysis, with the use of NVIVO 10. In addition, quantitative data will be collected at baseline, on completion of the programme and at 1 month and 3 months follow-up to reveal any differences in psychological flexibility, depression, anxiety, fear avoidance and general health status. The findings will help enhance the intervention by making appropriate modifications to the processes and procedures involved, following the recommendations made by the Medical Research Council framework. A larger scale study is envisaged to follow, in order to investigate the full effectiveness and cost-effectiveness of 'A Mindful Act'. ETHICS AND DISSEMINATION This study was approved by the College of Human and Health Sciences Research Ethics Committee at Swansea University in December 2017. The findings will be disseminated through various means including: the first author's PhD thesis, peer-reviewed journals as well as well as national and international conferences and public events.
Collapse
Affiliation(s)
- Madalina Saracutu
- College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Darren J Edwards
- College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Helen Davies
- College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Jaynie Rance
- College of Human and Health Sciences, Swansea University, Swansea, UK
| |
Collapse
|
44
|
Asmundson GJG, Thorisdottir AS, Roden-Foreman JW, Baird SO, Witcraft SM, Stein AT, Smits JAJ, Powers MB. A meta-analytic review of cognitive processing therapy for adults with posttraumatic stress disorder. Cogn Behav Ther 2018; 48:1-14. [PMID: 30332919 DOI: 10.1080/16506073.2018.1522371] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Numerous studies have demonstrated the efficacy of cognitive processing therapy (CPT) for treating posttraumatic stress disorder (PTSD). Two prior meta-analyses of studies are available but used approaches that limit conclusions that can be drawn regarding the impact of CPT on PTSD outcomes. The current meta-analysis reviewed outcomes of trials that tested the efficacy of CPT for PTSD in adults and evaluated potential moderators of outcomes. All published trials comparing CPT against an inactive control condition (i.e. psychological placebo or wait-list) or other active treatment for PTSD in adults were included, resulting in 11 studies with a total of 1130 participants. CPT outperformed inactive control conditions on PTSD outcome measures at posttreatment (mean Hedges' g = 1.24) and follow-up (mean Hedges' g = 0.90). The average CPT-treated participant fared better than 89% of those in inactive control conditions at posttreatment and 82% at follow-up. Results also showed that CPT outperformed inactive control conditions on non-PTSD outcome measures at posttreatment and follow-up and that CPT outperformed other active treatments at posttreatment but not at follow-up. Effect sizes of CPT on PTSD symptoms were not significantly moderated by participant age, number of treatment sessions, total sample size, length of follow-up, or group versus individual treatment; but, older studies had larger effect sizes and percent female sex moderated the effect of CPT on non-PTSD outcomes. These meta-analytic findings indicate that CPT is an effective PTSD treatment with lasting benefits across a range of outcomes.
Collapse
Affiliation(s)
- Gordon J G Asmundson
- a Department of Psychology , University of Regina , Regina , Saskatchewan , Canada
| | - Audur S Thorisdottir
- a Department of Psychology , University of Regina , Regina , Saskatchewan , Canada
| | - Jacob W Roden-Foreman
- b Division of Trauma, Critical Care, Acute Care Surgery , Baylor University Medical Center at Dallas , Dallas , TX , USA
| | - Scarlett O Baird
- c Department of Psychology , University of Texas at Austin , Austin , TX , USA
| | - Sara M Witcraft
- d Department of Psychology , The University of Mississippi , University , MS , USA
| | - Aliza T Stein
- c Department of Psychology , University of Texas at Austin , Austin , TX , USA
| | - Jasper A J Smits
- c Department of Psychology , University of Texas at Austin , Austin , TX , USA
| | - Mark B Powers
- b Division of Trauma, Critical Care, Acute Care Surgery , Baylor University Medical Center at Dallas , Dallas , TX , USA.,c Department of Psychology , University of Texas at Austin , Austin , TX , USA
| |
Collapse
|
45
|
Vun E, Turner S, Sareen J, Mota N, Afifi TO, El-Gabalawy R. Prevalence of comorbid chronic pain and mental health conditions in Canadian Armed Forces active personnel: analysis of a cross-sectional survey. CMAJ Open 2018; 6:E528-E536. [PMID: 30389752 PMCID: PMC6221807 DOI: 10.9778/cmajo.20180093] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Chronic pain conditions and mental disorders have high prevalence rates in military populations. However, few investigations have examined the comorbidity between chronic pain conditions and specific mental disorders among Canadian active military personnel. METHODS We conducted a secondary analysis of data from the 2013 Canadian Forces Mental Health Survey (CFMHS) concerning the population of regular members. Diagnostic interviews assessed the presence of mental disorders, and participants self-reported chronic pain conditions (i.e., arthritis, back problems, musculoskeletal conditions, migraines) and indicators of pain severity. We used multiple logistic regressions to assess associations between chronic pain conditions and mental disorders. We used cross-tabulations to assess the prevalence of pain severity indicators in comorbid relationships compared with the chronic pain condition alone. We used moderation analyses to examine the interactions between pain condition by pain severity, and pain condition by activity limitation, respectively, on mental disorders. RESULTS The CFMHS included data from 6696 regular members and had a response rate of 79.8%. About one-quarter (n = 1761) of military personnel reported having chronic pain. In the fully adjusted model, all assessed pain conditions were significantly associated with posttraumatic stress disorder (PTSD) (odds ratio [OR] range 1.86-2.55), and several pain conditions were associated with major depressive episode, generalized anxiety disorder and panic disorder. Back problems were significantly associated with all mental disorders apart from alcohol use disorders (OR range 1.40-2.17). Cross-tabulations showed higher prevalence estimates of endorsement for pain severity indicators among pain conditions and comorbid mental disorders, compared with pain conditions alone. Formal moderation analyses showed a significant relationship between migraine and activity limitation on PTSD. INTERPRETATION Chronic pain conditions are prevalent and co-occur with mental disorders among Canadian regular force members. Greater understanding of these chronic pain conditions and mental disorders and their impact on people's abilities to adapt to both military and civilian life is needed.
Collapse
Affiliation(s)
- Everett Vun
- Max Rady College of Medicine, University of Manitoba (Vun); Departments of Community Health Sciences (Turner, Afifi), Psychiatry (Sareen, Afifi, Mota, El-Gabalawy), Clinical Health Psychology (Mota, El-Gabalawy), Anesthesiology, Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, University of Manitoba, Winnipeg, Man
| | - Sarah Turner
- Max Rady College of Medicine, University of Manitoba (Vun); Departments of Community Health Sciences (Turner, Afifi), Psychiatry (Sareen, Afifi, Mota, El-Gabalawy), Clinical Health Psychology (Mota, El-Gabalawy), Anesthesiology, Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, University of Manitoba, Winnipeg, Man
| | - Jitender Sareen
- Max Rady College of Medicine, University of Manitoba (Vun); Departments of Community Health Sciences (Turner, Afifi), Psychiatry (Sareen, Afifi, Mota, El-Gabalawy), Clinical Health Psychology (Mota, El-Gabalawy), Anesthesiology, Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, University of Manitoba, Winnipeg, Man
| | - Natalie Mota
- Max Rady College of Medicine, University of Manitoba (Vun); Departments of Community Health Sciences (Turner, Afifi), Psychiatry (Sareen, Afifi, Mota, El-Gabalawy), Clinical Health Psychology (Mota, El-Gabalawy), Anesthesiology, Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, University of Manitoba, Winnipeg, Man
| | - Tracie O Afifi
- Max Rady College of Medicine, University of Manitoba (Vun); Departments of Community Health Sciences (Turner, Afifi), Psychiatry (Sareen, Afifi, Mota, El-Gabalawy), Clinical Health Psychology (Mota, El-Gabalawy), Anesthesiology, Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, University of Manitoba, Winnipeg, Man
| | - Renée El-Gabalawy
- Max Rady College of Medicine, University of Manitoba (Vun); Departments of Community Health Sciences (Turner, Afifi), Psychiatry (Sareen, Afifi, Mota, El-Gabalawy), Clinical Health Psychology (Mota, El-Gabalawy), Anesthesiology, Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.
| |
Collapse
|
46
|
Balázs J, Miklósi M, Keresztény A, Hoven CW, Carli V, Wasserman C, Hadlaczky G, Apter A, Bobes J, Brunner R, Corcoran P, Cosman D, Haring C, Kahn JP, Postuvan V, Kaess M, Varnik A, Sarchiapone M, Wasserman D. Comorbidity of Physical and Anxiety Symptoms in Adolescent: Functional Impairment, Self-Rated Health and Subjective Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081698. [PMID: 30096890 PMCID: PMC6121583 DOI: 10.3390/ijerph15081698] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 08/03/2018] [Accepted: 08/07/2018] [Indexed: 12/17/2022]
Abstract
Physical disorders and anxiety are frequently comorbid. This study investigates the characteristics of physical disorders, self-rated heath, subjective well-being and anxiety in adolescents. Data were drawn from the Saving and Empowering Young Lives in Europe cohort study. From 11 countries 11,230 adolescents, aged 14–16 years were included. Zung Self-Rating Anxiety Scale (SAS), WHO-5 Well-Being Index and five questions prepared for this study to evaluate physical illnesses and self-rated heath were administered. Anxiety levels were significantly higher in adolescents who reported having physical disability (p < 0.001, Cohen’s d = 0.40), suffering from chronic illnesses (p < 0.001, Cohen’s d = 0.40), impairments associated to health conditions (p < 0.001, Cohen’s d = 0.61), or reported poor to very poor self-rated health (p < 0.001, Cohen’s d = 1.11). Mediational analyses revealed no direct effect of having a chronic illness/physical disability on subjective well-being, but the indirect effects through higher levels of anxiety were significant. Functional impairment related to health conditions was both directly and indirectly (through higher levels of anxiety) associated with lower well-being. The co-occurrence of anxiety and physical disorders may confer a greater level of disability and lower levels of subjective well-being. Clinicians have to screen anxiety, even in a subthreshold level in patients with choric physical illness or with medically unexplained physical symptoms.
Collapse
Affiliation(s)
- Judit Balázs
- Vadaskert Child and Adolescent Psychiatric Hospital, 1021 Budapest, Hungary.
- Institute of Psychology, Eötvös Loránd University, 1064 Budapest, Hungary.
| | - Mónika Miklósi
- Institute of Psychology, Eötvös Loránd University, 1064 Budapest, Hungary.
- Heim Pál National Pediatric Institute, 1131 Budapest, Hungary.
| | - Agnes Keresztény
- Institute of Psychology, Eötvös Loránd University, 1064 Budapest, Hungary.
- School of Ph.D. Studies, Semmelweis University, 1085 Budapest, Hungary.
| | - Christina W Hoven
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA.
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, SE-171 77 Stockholm, Sweden.
| | - Camilla Wasserman
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA.
- Department of Health Sciences, University of Molise, 86100 Campobasso, Italy.
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, SE-171 77 Stockholm, Sweden.
| | - Alan Apter
- Feinberg Child Study Center, Schneider Children's Medical Center, Tel Aviv University, Tel Aviv 6997801, Israel.
| | - Julio Bobes
- Department of Psychiatry, School of Medicine, University of Oviedo; Centro de InvestigaciónBiomédica en Red de Salud Mental, CIBERSAM, 33006 Oviedo, Spain.
| | - Romuald Brunner
- Section Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, University of Heidelberg, 69117 Heidelberg, Germany.
- Department of Child and Adolescent Psychiatry, University of Regensburg, 93053 Regensburg, Germany.
| | - Paul Corcoran
- National Suicide Research Foundation, Cork, Ireland.
| | - Doina Cosman
- Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
| | - Christian Haring
- Research Division for Mental Health, University for Medical Information Technology (UMIT), 6060 Hall in Tirol, Austria.
| | - Jean-Pierre Kahn
- Department of Psychiatry, Centre Hospitalo-Universitaire (CHU) de NANCY, Université H. Poincaré, 54003 Nancy, France.
| | - Vita Postuvan
- Mental Health Department, PINT, University of Primorska, 6000 Koper, Slovenia.
| | - Michael Kaess
- Section Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, University of Heidelberg, 69117 Heidelberg, Germany.
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, 3012 Bern, Switzerland.
| | - Airi Varnik
- Estonian-Swedish Mental Health & Suicidology Institute, Ctr. Behav & Hlth Sci, Tallinn University, 10120 Tallinn, Estonia.
| | - Marco Sarchiapone
- Department of Health Sciences, University of Molise, 86100 Campobasso, Italy.
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, SE-171 77 Stockholm, Sweden.
| |
Collapse
|
47
|
Mason JE, LeBouthillier DM, Asmundson GJ. Relationships between health behaviors, posttraumatic stress disorder, and comorbid general anxiety and depression. Cogn Behav Ther 2018; 48:184-199. [DOI: 10.1080/16506073.2018.1498119] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Julia Elizabeth Mason
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, Canada
| | - Daniel Marc LeBouthillier
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, Canada
| | - Gordon J.G Asmundson
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, Canada
| |
Collapse
|
48
|
Lee KM, Jung D, Hwang H, Son KL, Kim TY, Im SA, Lee KH, Hahm BJ. Pre-treatment anxiety is associated with persistent chemotherapy-induced peripheral neuropathy in women treated with neoadjuvant chemotherapy for breast cancer. J Psychosom Res 2018; 108:14-19. [PMID: 29602320 DOI: 10.1016/j.jpsychores.2018.02.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 02/19/2018] [Accepted: 02/21/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent adverse reaction caused by chemotherapeutic agents, especially the taxanes. CIPN can persist from months to years after completion of chemotherapy, decreasing quality of life for cancer survivors. The aim of this study was to explore the incidence and risk factors of persistent CIPN among women with breast cancer receiving neoadjuvant chemotherapy. METHODS In this prospective study, we recruited women with breast cancer receiving neoadjuvant chemotherapy, including four cycles of docetaxel. Participants reported neuropathic symptoms of tingling/numbness at baseline, at the end of chemotherapy treatment, and at 8 months after completion of chemotherapy. Candidate factors associated with CIPN were assessed before chemotherapy. RESULTS Among 111 participants, 50 (45.0%) experienced CIPN during chemotherapy, and 21 (18.9%) reported persistent CIPN after chemotherapy. Univariate logistic regression analysis revealed that development of CIPN was significantly associated with pre-treatment numbness (odds ratio [OR], 4.02; 95% confidence interval [CI], 1.09-7.40; p = .033), and persistent CIPN was significantly associated with pre-treatment numbness (OR, 3.60; 95% CI, 1.12-11.61; p = .032) and pre-treatment anxiety (OR, 5.02; 95% CI, 1.84-13.70; p = .002). Multivariate analysis indicated that pre-treatment anxiety remained significantly associated with persistent CIPN (OR, 4.01; 95% CI, 1.25-12.87; p = .020). CONCLUSION Our results suggested that pre-treatment anxiety might be related to a patient's risk for persistent CIPN in women with breast cancer undergoing neoadjuvant chemotherapy. Further research is required to investigate if interventions targeting pre-treatment anxiety could provide prevention and management for persistent CIPN.
Collapse
Affiliation(s)
- Kwang-Min Lee
- Public Health Medical Service, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry, Gyeonggi Provincial Medical Center Uijeongbu Hospital, Uijeongbu, Republic of Korea
| | - Dooyoung Jung
- Department of Human Factors Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Heesung Hwang
- Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyung-Lak Son
- Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Tae-Yong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Bong-Jin Hahm
- Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
| |
Collapse
|
49
|
Geva N, Defrin R. Opposite Effects of Stress on Pain Modulation Depend on the Magnitude of Individual Stress Response. THE JOURNAL OF PAIN 2018; 19:360-371. [DOI: 10.1016/j.jpain.2017.11.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 10/17/2017] [Accepted: 11/14/2017] [Indexed: 12/29/2022]
|
50
|
van Eck van der Sluijs JF, Castelijns H, Eijsbroek V, Rijnders CAT, van Marwijk HWJ, van der Feltz-Cornelis CM. Illness burden and physical outcomes associated with collaborative care in patients with comorbid depressive disorder in chronic medical conditions: A systematic review and meta-analysis. Gen Hosp Psychiatry 2018; 50:1-14. [PMID: 28957682 DOI: 10.1016/j.genhosppsych.2017.08.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 08/24/2017] [Accepted: 08/25/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Collaborative care (CC) improves depressive symptoms in people with comorbid depressive disorder in chronic medical conditions, but its effect on physical symptoms has not yet systematically been reviewed. This study aims to do so. METHODS Systematic review and meta-analysis was conducted using PubMed, the Cochrane Library, and the European and US Clinical Trial Registers. Eligible studies included randomized controlled trials (RCTs) of CC compared to care as usual (CAU), in primary care and general hospital setting, reporting on physical and depressive symptoms as outcomes. Overall treatment effects were estimated for illness burden, physical outcomes and depression, respectively. RESULTS Twenty RCTs were included, with N=4774 patients. The overall effect size of CC versus CAU for illness burden was OR 1.64 (95%CI 1.47;1.83), d=0.27 (95%CI 0.21;0.33). Best physical outcomes in CC were found for hypertension with comorbiddepression. Overall, depression outcomes were better for CC than for CAU. Moderator analyses did not yield statistically significant differences. CONCLUSIONS CC is more effective than CAU in terms of illness burden, physical outcomes and depression, in patients with comorbid depression in chronic medical conditions. More research covering multiple medical conditions is needed. PROTOCOL REGISTRATION NUMBER The protocol for this systematic review and meta-analysis has been registered at the International Prospective Register of Systematic Reviews (PROSPERO) on February 19th 2016: http://www.crd.york.ac.uk/PROSPERO/DisplayPDF.php?ID=CRD42016035553.
Collapse
Affiliation(s)
- Jonna F van Eck van der Sluijs
- Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, The Netherlands; Tranzo Department, Tilburg University, Tilburg, The Netherlands; Department of Residency Training, GGz Breburg, Tilburg, The Netherlands
| | - Hilde Castelijns
- Centre for Mental Health Care, PsyQ Tilburg-Parnassia Groep, Tilburg, The Netherlands
| | - Vera Eijsbroek
- Department of Residency Training, GGz Breburg, Tilburg, The Netherlands
| | | | - Harm W J van Marwijk
- Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, United Kingdom; Department of General Practice & Elderly Care Medicine and the EMGO+, Institute for Health and Care Research of VU University Medical Centre (VUmc), Amsterdam, The Netherlands
| | - Christina M van der Feltz-Cornelis
- Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, The Netherlands; Tranzo Department, Tilburg University, Tilburg, The Netherlands.
| |
Collapse
|