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Luo X, Zhou B, Fang J, Cherif-Riahi Y, Li G, Shen X. Integrating EEG and Ensemble Learning for Accurate Grading and Quantification of Generalized Anxiety Disorder: A Novel Diagnostic Approach. Diagnostics (Basel) 2024; 14:1122. [PMID: 38893648 PMCID: PMC11172130 DOI: 10.3390/diagnostics14111122] [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: 04/06/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
Current assessments for generalized anxiety disorder (GAD) are often subjective and do not rely on a standardized measure to evaluate the GAD across its severity levels. The lack of objective and multi-level quantitative diagnostic criteria poses as a significant challenge for individualized treatment strategies. To address this need, this study aims to establish a GAD grading and quantification diagnostic model by integrating an electroencephalogram (EEG) and ensemble learning. In this context, a total of 39 normal subjects and 80 GAD patients were recruited and divided into four groups: normal control, mild GAD, moderate GAD, and severe GAD. Ten minutes resting state EEG data were collected for every subject. Functional connectivity features were extracted from each EEG segment with different time windows. Then, ensemble learning was employed for GAD classification studies and brain mechanism analysis. Hence, the results showed that the Catboost model with a 10 s time window achieved an impressive 98.1% accuracy for four-level classification. Particularly, it was found that those functional connections situated between the frontal and temporal lobes were significantly more abundant than in other regions, with the beta rhythm being the most prominent. The analysis framework and findings of this study provide substantial evidence for the applications of artificial intelligence in the clinical diagnosis of GAD.
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Affiliation(s)
- Xiaodong Luo
- The Second Hospital of Jinhua, Jinhua 321016, China;
| | - Bin Zhou
- College of Mathematical Medicine, Zhejiang Normal University, Jinhua 321004, China;
| | - Jiaqi Fang
- College of Engineering, Zhejiang Normal University, Jinhua 321004, China;
| | - Yassine Cherif-Riahi
- College of Computer Science and Technology, Zhejiang Normal University, Jinhua 321004, China;
| | - Gang Li
- College of Mathematical Medicine, Zhejiang Normal University, Jinhua 321004, China;
| | - Xueqian Shen
- The Second Hospital of Jinhua, Jinhua 321016, China;
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2
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Ma Z, Zhao M, Zhao H, Qu N. Causal role of immune cells in generalized anxiety disorder: Mendelian randomization study. Front Immunol 2024; 14:1338083. [PMID: 38264647 PMCID: PMC10803460 DOI: 10.3389/fimmu.2023.1338083] [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: 11/14/2023] [Accepted: 12/21/2023] [Indexed: 01/25/2024] Open
Abstract
Background Generalized anxiety disorder (GAD) is a prevalent emotional disorder that has received relatively little attention regarding its immunological basis. Recent years have seen the widespread use of high-density genetic markers such as SNPs or CNVs for genotyping, as well as the advancement of genome-wide association studies (GWAS) technologies, which have facilitated the understanding of immunological mechanisms underlying several major psychiatric disorders. Despite these advancements, the immunological basis of GAD remains poorly understood. In light of this, we aimed to explore the causal relationship between immune cells and the disease through a Mendelian randomization study. Methods The summary information for GAD (Ncase=4,666, Ncontrol=337,577) was obtained from the FinnGen dataset. Summary statistics for the characterization of 731 immune cells, including morphological parameters (MP=32), median fluorescence intensity (MFI=389), absolute cells (AC=118), and relative cells (RC=192), were derived from the GWAS catalog. The study involved both forward MR analysis, with immune cell traits as the exposure and GAD as the outcome, and reverse MR analysis, with GAD as the exposure and immune cell traits as the outcome. We performed extensive sensitivity analyses to confirm the robustness, heterogeneity, and potential multi-biological effects of the study results. Also, to control for false positive results during multiple hypothesis testing, we adopted a false discovery rate (FDR) to control for statistical bias due to multiple comparisons. Results After FDR correction, GAD had no statistically significant effect on immunophenotypes. Several phenotypes with unadjusted low P-values are worth mentioning, including decreased PB/PC levels on B cells(β=-0.289, 95%CI=0.044~0.194, P=0.002), reduced PB/PC AC in GAD patients (β=-0.270, 95% CI=0.77~0.92, P=0.000), and diminished PB/PC on lymphocytes (β=-0.315, 95% CI=0.77~0.93, P=0.001). GAD also exerted a causal effect on CD27 on IgD-CD38br (β=-0.155,95%CI=0.78~0.94,P=0.002), CD20-%B cell (β= -0.105,95% CI=0.77~0.94, P=0.002), IgD-CD38br%lymphocyte(β=-0.305, 95%CI=0.79~0.95, P=0.002), FSC-A level on granulocytes (β=0.200, 95%CI=0.75~0.91, P=8.35×10-5), and CD4RA on TD CD4+(β=-0.150, 95% CI=0.82~1.02, P=0.099). Furthermore, Two lymphocyte subsets were identified to be significantly associated with GAD risk: CD24+ CD27+ B cell (OR=1.066,95%CI=1.04~1.10,P=1.237×10-5),CD28+CD4+T cell (OR=0.927, 95%CI=0.89~0.96, P=8.085×10-5). Conclusion The study has shown the close association between immune cells and GAD through genetic methods, thereby offering direction for future clinical research.
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Affiliation(s)
- Zhen Ma
- Department of Neurology, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
| | - Min Zhao
- Department of Neurology, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
| | - Huanghong Zhao
- Department of Neurology, Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou, China
| | - Nan Qu
- Department of Neurology, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
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Wheeler R, Lobley M. Anxiety and Associated Stressors Among Farm Women in England and Wales. J Agromedicine 2023; 28:769-783. [PMID: 37051849 DOI: 10.1080/1059924x.2023.2200421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
OBJECTIVES The findings presented here derive from a wider study that sought to establish a baseline understanding of mental health and wellbeing among the agricultural community in England and Wales. This paper focuses on selected questions that investigated levels of anxiety and associated stress factors among farm women, a group which has been relatively neglected within previous research on farming mental health in the United Kingdom. METHODS A questionnaire survey was widely distributed to members of the agricultural community in England and Wales (n = 15,296) in both paper and online formats. The survey included a number of standardised instruments to assess mental health and wellbeing, including the Generalised Anxiety Disorder-7 scale (GAD-7). Focusing on a sub-sample of female respondents (n = 3487), this paper details the findings from the GAD-7, alongside those from a selection of other questions investigating sources of stress, loneliness and perceived business viability. RESULTS A significant proportion of female respondents were experiencing anxiety at the time of survey completion, with 23.3% reaching the threshold for clinically relevant anxiety based on their GAD-7 scores (medium or severe anxiety, scores≥10). A further 34.6% were classified as experiencing mild anxiety (scores 5-9) whilst 42.1% were not suffering from anxiety (scores 0-4). Medium/severe anxiety was identified as being associated with a number of stress factors, feelings of loneliness and pessimistic perceptions of farm business viability. There were important age-based differences, with working-aged women identified as more likely to suffer from anxiety, loneliness and certain stressors than older women. CONCLUSION The findings reported here indicate concerning levels of anxiety among farming women and this should be seen as a call to action. There are clear associations between anxiety and a range of stressors and, although we cannot ascertain causality, these point to issues that demand attention in efforts to improve mental health within this social group. The factors contributing to anxiety are, however, multiple and complex and farm women may be affected by particular gender-based challenges that have not yet been explicitly explored in relation to mental health. Further research is needed to investigate and understand these issues in greater depth.
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Affiliation(s)
- Rebecca Wheeler
- Centre for Rural Policy Research, University of Exeter, Exeter, UK
| | - Matt Lobley
- Centre for Rural Policy Research, University of Exeter, Exeter, UK
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Mashayekh-Amiri S, Jafarabadi MA, Davies SM, Silverio SA, Fallon V, Montazeri M, Mirghafourvand M. Psychometric evaluation of the postpartum specific anxiety scale - research short-form among iranian women (PSAS-IR-RSF). BMC Pregnancy Childbirth 2023; 23:531. [PMID: 37480013 PMCID: PMC10362772 DOI: 10.1186/s12884-023-05855-4] [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: 11/24/2022] [Accepted: 07/14/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND The increasing prevalence of postpartum anxiety as a common psychological problem affects a large part of women's lives. Despite the existence of tools in this field, but due to the lack of specificity in reflecting postpartum anxiety, it is necessary to have a specific tool to screen it. Since the psychometric evaluation of the Postpartum Specific Anxiety Scale-Research Short-Form (PSAS-RSF) among Iranian women has not been assessed in Iran until now, so we decided to conduct this study with the aim of psychometric evaluation of the PSAS-IR-RSF. METHODS We included 180 women (six weeks to six months postpartum) in the study by random sampling during the period from December 2021 to June 2022. We examined the validity of the PSAS-IR-RSF tool in terms of face, content and construct (through exploratory and confirmatory factor analyses). We used internal consistency and test-retest reliability to determine the reliability of the scale. RESULTS In the present study, content validity index (CVI) and content validity ratio (CVR) of the PSAS-IR-RSF tool were equal to 0.91 and 0.97, respectively. We extracted a four-factor structure through the process of exploratory factor analysis. The values of fitting indices confirmed the validity of the model. Cronbach's alpha coefficient was equal to 0.72 and intra-class correlation coefficient (with 95% confidence interval) was 0.97 (0.98 to 0.93). CONCLUSIONS The Persian version of the PSAS-IR-RSF is a valid and reliable tool for the specific evaluation of postpartum anxiety among Iranian women.
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Affiliation(s)
- Sepideh Mashayekh-Amiri
- Students Research Committee, Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Cabrini Research, Cabrini Health, Malvern, VIC, 3144, Australia
- School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, 3800, Australia
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Siân M Davies
- School of Psychology, Liverpool John Moores University, Byrom Street, Liverpool, Merseyside, L3 3AF, UK
| | - Sergio A Silverio
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, London, SE1 7EH, UK
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Maryam Montazeri
- Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
- Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Cortés H, Cariño-Calvo L, Reyes-Hernández OD, Rojas-Márquez M, Magaña JJ, Vizcaino-Dorado PA, Villegas-Vazquez EY, Quintas-Granados LI, Jiménez-Islas E, Cortés-Mollinedo VA, Leyva-Gómez G, González-Del Carmen M. High Levels of Anxiety, Depression, Risk of Suicide, and Implications for Treatment in Patients with Lamellar Ichthyosis. Healthcare (Basel) 2023; 11:2071. [PMID: 37510511 PMCID: PMC10380064 DOI: 10.3390/healthcare11142071] [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: 06/14/2023] [Revised: 07/18/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Lamellar ichthyosis (LI) is a genodermatosis that injures the structure and function of the skin, affecting the appearance and self-esteem of patients, which may seriously impair their mental health and quality of life. In the present study, we determined anxiety, depression, and suicidal risk levels in patients with LI through the Beck anxiety and depression inventories (BAI and DBI-II, respectively) and the SAD PERSONS scale (SPS). We observed that anxiety, depression, and suicidal ideation were strongly associated with the LI (Cramér's V = 0.429, 0.594, and 0.462, respectively). Furthermore, patients with LI showed a significant increase in the scores of anxiety, depression, and suicidal risk (p = 0.011, <0.001, and 0.001, respectively) compared to individuals without the disease. Additionally, the suicide risk increased even more in patients who presented comorbidity of anxiety and depression than in patients who presented only anxiety or depression (p = 0.02). Similarly, the increase in the BAI scores correlated with the score observed on the SPS. Our results indicate that patients with LI have higher levels of anxiety and depression compared to individuals without the disease, which could be associated with suicidal risk. Therefore, the collaborative involvement of skin and mental health professionals is necessary to manage patients with LI appropriately. We believe that psychiatric studies and individual evaluations must be performed in LI patients to determine a treatment that, in addition to reducing skin symptoms, focuses on reducing the levels of depression and anxiety and improving the quality of life to reduce the risk of suicide.
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Affiliation(s)
- Hernán Cortés
- Laboratorio de Medicina Genómica, Departamento de Genómica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México 14389, Mexico
| | | | - Octavio D Reyes-Hernández
- Laboratorio de Biología Molecular del Cáncer, UMIEZ, FES Zaragoza, Universidad Nacional Autónoma de México, Ciudad de México 09230, Mexico
| | - Martín Rojas-Márquez
- Hospital Psiquiátrico Infantil Dr. Juan N. Navarro, Secretaría de Salud, Ciudad de México 14080, Mexico
| | - Jonathan J Magaña
- Laboratorio de Medicina Genómica, Departamento de Genómica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México 14389, Mexico
| | - Pablo A Vizcaino-Dorado
- Laboratorio de Medicina Genómica, Departamento de Genómica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México 14389, Mexico
| | - Edgar Y Villegas-Vazquez
- Laboratorio de Farmacogenética, UMIEZ, FES Zaragoza, Universidad Nacional Autónoma de México, Ciudad de México 09230, Mexico
| | | | - Elizabeth Jiménez-Islas
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
| | | | - Gerardo Leyva-Gómez
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
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Warner EN, Ammerman RT, Glauser TA, Pestian JP, Agasthya G, Strawn JR. Developmental Epidemiology of Pediatric Anxiety Disorders. Child Adolesc Psychiatr Clin N Am 2023; 32:511-530. [PMID: 37201964 DOI: 10.1016/j.chc.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
This review summarizes the developmental epidemiology of childhood and adolescent anxiety disorders. It discusses the coronavirus disease of 2019 (COVID-19) pandemic, sex differences, longitudinal course, and stability of anxiety disorders in addition to recurrence and remission. The trajectory of anxiety disorders-whether homotypic (ie, the same anxiety disorder persists over time) or heterotypic (ie, an anxiety disorder shifts to a different diagnosis over time) is discussed with regard to social, generalized, and separation anxiety disorders as well as specific phobia, and panic disorder. Finally, strategies for early recognition, prevention, and treatment of disorders are discussed.
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Affiliation(s)
- Emily N Warner
- University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Environmental and Public Health Sciences, University of Cincinnati.
| | - Robert T Ammerman
- Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Tracy A Glauser
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - John P Pestian
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Greeshma Agasthya
- Oak Ridge National Laboratory, Computational Sciences and Engineering Division, Advanced Computing for Health Sciences Section
| | - Jeffrey R Strawn
- University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Psychiatry, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Division of Clinical Pharmacology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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7
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Niu Y, Li Z, Pettit JW, Buzzell GA, Zhao J. Context and domain matter: the error-related negativity in peer presence predicts fear of negative evaluation, not global social anxiety, in adolescents. Psychol Med 2023:1-11. [PMID: 37057809 DOI: 10.1017/s0033291723000466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
BACKGROUND Social anxiety symptoms are most likely to emerge during adolescence, a developmental window marked by heightened concern over peer evaluation. However, the neurocognitive mechanism(s) underlying adolescent social anxiety remain unclear. Emerging work points to the error-related negativity (ERN) as a potential neural marker of exaggerated self/error-monitoring in social anxiety, particularly for errors committed in front of peers. However, social anxiety symptoms are marked by heterogeneity and it remains unclear exactly what domain(s) of social anxiety symptoms are associated with ERN variation in peer presence, particularly within the adolescent period. METHODS To advance and deepen the mechanistic understanding of the ERN's putative role as a neural marker for social anxiety in adolescence, we leveraged a social manipulation procedure and assessed a developmentally salient domain of social anxiety during adolescence - fear of negative evaluation (FNE). Adolescents residing in Hanzhong, a small city in the southwestern region of mainland China, had EEG recorded while performing a flanker task, twice (peer presence/absence); FNE, as well as global social anxiety symptoms, was assessed. RESULTS Overall ERN increases in peer presence. FNE specifically, but not global levels of social anxiety symptoms, predicted ERN in peer presence. CONCLUSIONS These data are the first demonstration that the ERN relates to a specific domain of social anxiety in adolescents, as well as the first evidence of such relations within a non-WEIRD (Western, Educated, Industrialized, Rich and Democratic) sample. Results have important implications for theory and research into adolescent social anxiety.
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Affiliation(s)
- Yanbin Niu
- School of Psychology, Shaanxi Normal University, and Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, Shaanxi, China
| | - Zixuan Li
- School of Psychology, Shaanxi Normal University, and Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, Shaanxi, China
| | - Jeremy W Pettit
- Florida International University and the Center for Children and Families, Miami, FL, USA
| | - George A Buzzell
- Florida International University and the Center for Children and Families, Miami, FL, USA
| | - Jingjing Zhao
- School of Psychology, Shaanxi Normal University, and Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, Shaanxi, China
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Caldiroli A, Colzani L, Capuzzi E, Quitadamo C, La Tegola D, Surace T, Russo S, Capetti M, Leo S, Tringali A, Marcatili M, Zanelli Quarantini F, Colmegna F, Dakanalis A, Buoli M, Clerici M. Clinical Markers of Panic and Generalized Anxiety Disorder: Overlapping Symptoms, Different Course and Outcome. J Pers Med 2023; 13:jpm13030491. [PMID: 36983673 PMCID: PMC10052351 DOI: 10.3390/jpm13030491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 03/11/2023] Open
Abstract
Generalized Anxiety Disorder (GAD) and Panic Disorder (PD) share underlying neurobiological mechanisms and several clinical features which, with medical comorbidities, may increase misdiagnosis and delay proper treatment. The aim of the study was to evaluate the association between clinical/socio-demographic markers and GAD/PD diagnosis. Outpatients (N = 290) with PD or GAD were identified in mental health services in Monza and Milan (Italy). Descriptive analyses and a binary logistic regression model were performed. Post-onset psychiatric (p = 0.05) and medical (p = 0.02) multiple co-morbidities were associated with GAD; treatment with selective serotonin reuptake inhibitors (SSRIs) was associated with PD, while GAD diagnosis was associated with treatment with atypical antipsychotics or GABAergic drugs (p = 0.03), as well as psychodynamic psychotherapy (p < 0.01). Discontinuation of the last pharmacological treatment was associated with GAD diagnosis rather than the PD one (p = 0.02). GAD patients may have a worse prognosis than PD patients because of more frequent multiple co-morbidities, relapses and poorer treatment compliance. The different treatment approaches were consistent with the available literature, while the association between GAD and psychodynamic psychotherapy is an original finding of our study. Further studies on larger samples are necessary to better characterize clinical factors associated with GAD or PD.
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Affiliation(s)
- Alice Caldiroli
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
- Correspondence: ; Tel.: +39-0392336046
| | - Lia Colzani
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Enrico Capuzzi
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Cecilia Quitadamo
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Davide La Tegola
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Teresa Surace
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Stefania Russo
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Mauro Capetti
- Department of Medicine and Surgery, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy
| | - Silvia Leo
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Agnese Tringali
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Matteo Marcatili
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Francesco Zanelli Quarantini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Fabrizia Colmegna
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Antonios Dakanalis
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Massimo Clerici
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
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9
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Samuel B, Wang H, Shi C, Pan Y, Yu Y, Zhu W, Jing Z. The effects of coloring therapy on patients with generalized anxiety disorder. Animal Model Exp Med 2022; 5:502-512. [PMID: 35794728 PMCID: PMC9773305 DOI: 10.1002/ame2.12256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 05/13/2022] [Indexed: 02/05/2023] Open
Abstract
Generalized anxiety disorder (GAD) has harmful effects on physical and mental health and quality of life. Coloring therapy has been reported to have a positive effect on improving patient anxiety and depression. But there are no reported clinical trials examining their effectiveness as a treatment for GAD. This study was planned to evaluate the effectiveness of coloring therapy combined with conventional therapy in improving anxiety, depression, and positive and negative emotions with GAD. This randomized controlled study comprising 88 GAD patients was selected for intervention in different wards. The control group (n = 45) was given conventional antianxiety medication and physical therapy, and the experimental group (n = 43) received coloring therapy combined with conventional therapy. The Self-Rating Depression Scale, Self-Rating Anxiety Scale (SAS), Hamilton Depression Scale, Hamilton Anxiety Scale (HAMA), and Positive and Negative Affect Scale were assessed in both groups before and 3 weeks after the intervention. After the intervention, there were statistical differences in intra- and inter-group comparisons of anxiety, depression, and positive and negative mood scales in the experimental and control groups (p < .05). The minus in anxiety/positive emotions pre- and postintervention in the experimental group was statistically significant compared to that in anxiety/positive emotions pre- and postintervention in the control group (HAMA: d = 1.45, 95% confidence interval [CI] (0.34, 2.57), p = .011; SAS: d = 3.87, 95% CI (1.73,6.00), p = .001; positive: d = 1.76, 95% CI (0.17, 3.34), p = .030). The minus in depressive/negative emotions pre- and postintervention in the experimental group was not statistically significant compared with that in depressive/negative emotions pre- and postintervention in the control group (p > .05). For GAD patients, adding coloring therapy based on conventional drug therapy and physical therapy can not only reduce depression and negative emotions but also have better effects on reducing anxiety and improving positive emotions than conventional therapy.
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Affiliation(s)
- Bosomtwe Samuel
- School of MedicineHuzhou UniversityZhejiangChina,Department of NursingGregory Catholic HospitalBuduburamCentral RegionGhana
| | - Hongmei Wang
- Department of NursingWest China Hospital of Sichuan UniversitySichuanChina
| | - Chengdong Shi
- Department of NursingShenzhen Baoan Maternal and Child Health HospitalGuangdongChina
| | | | - Yuzi Yu
- School of MedicineHuzhou UniversityZhejiangChina
| | - Weiyu Zhu
- Department of Psychosomatic DiseasesHuzhou Third People's HospitalZhejiangChina
| | - Zhou Jing
- School of Teacher EducationHuzhou UniversityZhejiangChina
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10
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Khot SG, Tubaki BR, Gonugade VB. Efficacy of Brahmi vati in generalised anxiety disorder - Randomized double blind comparative clinical trial. J Ayurveda Integr Med 2022; 13:100552. [PMID: 35325682 PMCID: PMC8943402 DOI: 10.1016/j.jaim.2022.100552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background Generalized Anxiety Disorder (GAD) is the most common anxiety disorder. GAD has high comorbidities and it can affect social, professional and personal life. Ayurvedic medicine, Brahmi vati is explored for the possible role in management of GAD and is compared to Manasmitra vataka. Aim To evaluate the efficacy of B. vati on Generalized Anxiety Disorder. Methods A randomized double blind controlled trial, with total 56 patients meeting the DSM V criteria of GAD between 20–60 years of age and either sex participated in the study. Participants were randomly divided into two groups, Brahmi group received capsule B. vati 500 mg and Manasmitra group received capsule M. vataka 500 mg thrice a day with water for 45 days. Assessments were conducted through various clinical parameters such as Hamilton Anxiety Rating Scale (HARS), GAD 7 scale (GAD 7), Beck Depression Inventory scale (BDI), Epworth sleepiness scale (ESS), Pittsburgh Sleep Quality Index (PSQI), WHO Quality of Life- BREF (WHOQOL-BREF), Clinical Global Improvement scale (CGI). Blood variables including Haemoglobin, Erythrocyte Sedimentation Rate (ESR), Liver Function Test (LFT) and serum creatinine were assessed before and after the study. Assessments during intervention were conducted on every 15th day. Results Study results indicate that both B. vati and M. vataka were comparable and each produced significant improvement (p < 0.001) in HARS, GAD-7, BDI, ESS, PSQI, WHOQOL-BREF and CGI. Brahmi vati also produced significant decrease in systolic (p = 0.002) and diastolic (p < 0.001) blood pressure. Both groups showed good safety profile evaluated through the assessment of serum creatinine levels and LFT. Conclusion B. vati and M. vataka were effective, safe and comparable in the management of GAD. Warrants further studies.
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Affiliation(s)
- Siddhi G Khot
- Department of Kayachikitsa, Dr. N. A. Magadum Ayurvedic Medical College, Hospital & Research Centre, Ankali, Taluk-Chikodi, District-Belagavi, Karnataka, 591213, India
| | - Basavaraj R Tubaki
- Department of Kayachikitsa, Shri BMK Ayurveda Mahavidyalaya, A Constituent Unit of KLE Academy of Higher Education & Research, Belagavi, Karnataka, 590003, India.
| | - Varsha B Gonugade
- Department of Kayachikitsa, Shri BMK Ayurveda Mahavidyalaya, A Constituent Unit of KLE Academy of Higher Education & Research, Belagavi, Karnataka, 590003, India
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Millan MJ. Agomelatine for the treatment of generalized anxiety disorder: focus on its distinctive mechanism of action. Ther Adv Psychopharmacol 2022; 12:20451253221105128. [PMID: 35795687 PMCID: PMC9251978 DOI: 10.1177/20451253221105128] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/04/2022] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Generalized anxiety disorder (GAD), the most frequently diagnosed form of anxiety, is usually treated by cognitive-behavioural approaches or medication; in particular, benzodiazepines (acutely) and serotonin or serotonin/noradrenaline reuptake inhibitors (long term). Efficacy, compliance, and acceptability are, however, far from ideal, reinforcing interest in alternative options. Agomelatine, clinically employed in the treatment of major depression, expresses anxiolytic properties in rodents and was effective in the treatment of GAD (including severely ill patients) in several double-blind, short-term (12 weeks) and relapse-prevention (6 months) studies. At active doses, the incidence of adverse effects was no higher than for placebo. Agomelatine possesses a unique binding profile, behaving as a melatonin (MT1/MT2) receptor agonist and 5-HT2C receptor antagonist, yet recognizing neither monoamine transporters nor GABAA receptors. Extensive evidence supports a role for 5-HT2C receptors in the induction of anxious states, and their blockade likely plays a primary role in mediating the anxiolytic actions of agomelatine, including populations in the amygdala and bed nucleus of stria terminalis, as well as the hippocampus. Recruitment of MT receptors in the suprachiasmatic nucleus, thalamic reticular nucleus, and hippocampus appears to fulfil a complimentary role. Downstream of 5-HT2C and MT receptors, modulation of stress-sensitive glutamatergic circuits and altered release of the anxiogenic neuropeptides, corticotrophin-releasing factor, and vasopressin, may be implicated in the actions of agomelatine. To summarize, agomelatine exerts its anxiolytic actions by mechanisms clearly distinct from those of other agents currently employed for the management of GAD. PLAIN LANGUAGE SUMMARY How agomelatine helps in the treatment of anxiety disorders. INTRODUCTION • Anxiety disorders have a significant negative impact on quality of life.• The most common type of anxiety disorder, called generalized anxiety disorder (GAD), is associated with nervousness and excessive worry.• These symptoms can lead to additional symptoms like tiredness, sleeplessness, irritability, and poor attention.• GAD is generally treated through either cognitive-behavioural therapy or medication. However, widely used drugs like benzodiazepines and serotonin reuptake inhibitors have adverse effects.• Agomelatine, a well-established antidepressant drug, has shown anxiety-lowering ('anxiolytic') properties in rats and has been shown to effectively treat GAD with minimal side effects.• However, exactly how it acts on the brain to manage GAD is not yet clear.• Thus, this review aims to shed light on agomelatine's mechanism of action in treating GAD. METHODS • The authors reviewed studies on how agomelatine treats anxiety in animals.• They also looked at clinical studies on the effects of agomelatine in people with GAD. RESULTS • The study showed that agomelatine 'blocks' a receptor in nerve cells, which plays a role in causing anxiety, called the 5-HT2C receptor.• Blocking this receptor, especially in specific brain regions such as nerve cells of the amygdala, bed nucleus of stria terminalis, and hippocampus, produced the anxiety reduction seen during agomelatine treatment.• Agomelatine also activates the melatonin (MT) receptor, which is known to keep anxiety in check, promote sleep, and maintain the sleep cycle.• Agomelatine should thus tackle sleep disturbances commonly seen in patients with GAD.• Beyond 5-HT2C and MT receptors, signalling molecules in nerve cells that are known to be involved in anxiety disorders (called 'neurotransmitters' and 'neuropeptides') are also affected by agomelatine. CONCLUSION • Agomelatine's anxiolytic effects are caused by mechanisms that are distinct from those of other medications currently used to treat GAD.• This explains its therapeutic success and minimal adverse side effects.
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Affiliation(s)
- Mark J Millan
- Institute of Neuroscience and Psychology, College of Medicine, Vet and Life Sciences, Glasgow University, 28 Hillhead Street, Glasgow G12 8QB, UK
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GAD: Over-reactive and unstable mood. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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