Moving to Beat Anxiety: Epidemiology and Therapeutic Issues with Physical Activity for Anxiety

Longitudinal description and prediction of physical inactivity among patients with borderline personality disorder and personality-disordered comparison subjects

BACKGROUND

The physical and psychological benefits of physical activity are well-known, and physical activity has been proven to be a helpful adjunct to psychotherapeutic treatment for many symptomatic disorders, including mood and anxiety disorders. The current study explores physical inactivity levels in patients with borderline personality disorder (BPD). The first aim of this study is to describe the 12-year course of physical inactivity in patients with BPD. The second aim is to examine predictors of physical inactivity, including adversity experiences, comorbid symptomatic (formerly axis I) disorders, medical disorders, and demographic factors.

METHODS

Two hundred and forty-five patients with BPD were interviewed seven times over 12-years of prospective follow-up as part of the McLean Study of Adult Development (MSAD). Patients were categorized as ever-recovered (i.e., patient had experienced a symptomatic and psychosocial recovery from BPD) or never-recovered. At each follow-up, patients reported physical activity levels (minutes of exercise per week) via a semi-structured interview- the Medical History and Services Utilization Interview (MHSUI). Data was collected from June 1992 to December 2018.

RESULTS

Never-recovered patients with BPD were significantly more inactive than their ever-recovered counterparts (p < 0.001). These rates of inactivity remained stable over time for both groups. Two significant multivariate predictors of inactivity were found: obesity (p = 0.003) and PTSD (p < 0.001).

CONCLUSIONS

Non-recovered BPD patients are more likely to be inactive than patients who have recovered. Both clinical and medical factors appear to contribute to inactivity levels in patients with BPD.

Anxiety, Sleep Problems, and Vigorous Physical Activity: Bidirectional Associations from Early Adolescence to Early Adulthood in Swedish Adolescents

Anxiety symptoms and sleep problems typically emerge during adolescence and are frequently intertwined. However, there is a dearth of knowledge concerning their reciprocal influence and whether physical activity might play a protective role in this relationship. The present study aims at filling this gap exploring also the moderating role of sex. 915 13-year-old Swedish adolescents (56% girls) answered a survey conducted four times: at ages 13 (T1), 16 (T2), 19 (T3), and 22 (T4). A random intercept cross-lagged panel model was used. At within-levels, sleep problems and anxiety symptoms had a bidirectional positive association in middle adolescence. Vigorous physical activity and anxiety symptoms showed a reciprocal negative association from middle adolescence. Vigorous physical activity and sleep problems were reciprocally associated only in late adolescence. Associations were the same for girls and boys. This study demonstrated that the relations between anxiety symptoms, sleep problems, and vigorous physical activity cannot be understood without adopting a developmental perspective and that middle adolescence is a crucial period to plan interventions to reduce anxiety symptoms and sleep problems.

Vibration-reduced anxiety-like behavior relies on ameliorating abnormalities of the somatosensory cortex and medial prefrontal cortex

JOURNAL/nrgr/04.03/01300535-202406000-00040/inline-graphic1/v/2023-10-30T152229Z/r/image-tiff

Tibetan singing bowls emit low-frequency sounds and produce perceptible harmonic tones and vibrations through manual tapping. The sounds the singing bowls produce have been shown to enhance relaxation and reduce anxiety. However, the underlying mechanism remains unclear. In this study, we used chronic restraint stress or sleep deprivation to establish mouse models of anxiety that exhibit anxiety-like behaviors. We then supplied treatment with singing bowls in a bottomless cage placed on the top of a cushion. We found that unlike in humans, the combination of harmonic tones and vibrations did not improve anxiety-like behaviors in mice, while individual vibration components did. Additionally, the vibration of singing bowls increased the level of N-methyl-D-aspartate receptor 1 in the somatosensory cortex and prefrontal cortex of the mice, decreased the level of γ-aminobutyric acid A (GABA) receptor α 1 subtype, reduced the level of CaMKII in the prefrontal cortex, and increased the number of GABAergic interneurons. At the same time, electrophysiological tests showed that the vibration of singing bowls significantly reduced the abnormal low-frequency gamma oscillation peak frequency in the medial prefrontal cortex caused by stress restraint pressure and sleep deprivation. Results from this study indicate that the vibration of singing bowls can alleviate anxiety-like behaviors by reducing abnormal molecular and electrophysiological events in somatosensory and medial prefrontal cortex.

Physical Activity for Anxiety for Autistic People: A Systematic Review

Clinical anxiety is a common comorbidity in autistic people. Due to the prevalence of anxiety in the autism population and the adverse effects it causes, there is a critical need to develop effective interventions which address anxiety symptoms for autistic people. Therefore, the purpose of this systematic review was to examine the effectiveness of the use of physical activity as an intervention to reduce anxiety in autistic people. Three databases PubMed, PsychInfo, and Cochrane RCTs, were searched utilizing key terms. PRISMA systematic search procedures identified 44 studies meeting predetermined inclusion criteria. Participant characteristics, the type of physical activity performed, the nature of the physical activity program/delivery, anxiety-related outcomes, and research methodology was evaluated for each study. Each paper included was appraised and scored for risk of bias using Cochrane Handbook for Systematic Reviews of Interventions risk of bias tool. Titles and abstracts of 44 articles were reviewed and 8 articles met inclusion criteria which evaluated interventions. Evidence from 8 studies suggests that yoga, a community-based football program, an app-assisted walking program, group exercise programs, and horseback riding interventions reduced anxiety for autistic people. The studies included in this systematic review provide strong-to-moderate evidence that physical activity can reduce anxiety for autistic children and adults. However, additional research is needed to identify which mode of physical activity is most beneficial for anxiety reduction. Further, future research should evaluate frequency, duration, and intensity and their effects on anxiety for autistic people.

Study Protocol for the Residents' Mental Health Investigation, a Dynamic Longitudinal Study in Italy (ReMInDIt)

Medical residents constitute a vulnerable population susceptible to mental health disorders. In Italy, this was evident during the COVID-19 pandemic, when medical residents served on the front line and provided significant support to healthcare services. Therefore, the working group on "Public Mental Health" of the Medical Residents' Council of the Italian Society of Hygiene, Preventive Medicine, and Public Health (S.It.I.) designed the "Residents' mental health investigation, a dynamic longitudinal study in Italy" (ReMInDIt). This longitudinal study aims to assess the mental status of medical residents and to explore potential cause-effect relationships between risk/protective factors (identified among sociodemographic, residency program, and lifestyle characteristics) and mental health outcomes (anxiety and depressive symptoms). Data will be collected from a study population of 3615 residents enrolled in Italian residency programs in public health, occupational medicine, and forensic medicine through an online questionnaire that includes validated tools, requires 10 min for completion, and is disseminated by the residents' Councils. It will be followed by a follow-up administration after 12 months. The ReMInDIt study will play a significant role in generating evidence crucial for enhancing mental health services and promoting protective factors for the mental well-being of this important segment of healthcare professionals.

The effect of physical activity on anxiety symptoms among children and adolescents with mental health disorders: a research brief

Background

Anxiety is prevalent among children and adolescents (termed youths), and leads to reduced quality of life, disability, loss of education and reduced life-span. Physical activity has shown promising effects on symptoms of anxiety in adult populations, and an increasing amount of research has also demonstrated some effect in youth. However, physical activity is not widely used in youth mental health care, and research is very limited.

Methods/design

This single arm, pre-post study explores the effect of a manualized physical activity-based 14-session intervention termed Confident, Active and Happy Youth. Participants are youth attending specialized mental health care (N=51, M age = 13.4, SD = 2.2). Changes in anxiety symptoms are examined using mixed models with residual maximum likelihood (REML). The potential effect of anxiety subtype differences, participant age, comorbidity, and time spent in out-patient care are explored.

Results

Youths did not report any effect on anxiety symptoms after participation in CAHY, however, their parents report a significant reduction in youth's anxiety symptoms in general (b = -0.11, 95%, CI: -0.21 to -0.01) and specifically for social phobia (b = -0.19, 95% CI: -0.35 to -0.03). Age and comorbidity showed no significant effect on anxiety symptoms post treatment. Prior treatment time in youth mental health care demonstrated inconclusive results.

Conclusion

The study finds initial evidence of symptomatic change in a clinical population of youth's receiving a physical activity-based intervention. Our research provides preliminary support for physical activity as a supplementary treatment method for mental health disorders among youths.

Clinical Trial Registration

clinicaltrials.gov, NCT05049759.

Gender differences in learning and study strategies impact medical students' preclinical and USMLE step 1 examination performance

BACKGROUND

Evaluation of students' learning strategies can enhance academic support. Few studies have investigated differences in learning strategies between male and female students as well as their impact on United States Medical Licensing Examination® (USMLE) Step 1 and preclinical performance.

METHODS

The Learning and Study Strategies Inventory (LASSI) was administered to the classes of 2019-2024 (female (n = 350) and male (n = 262)). Students' performance on preclinical first-year (M1) courses, preclinical second-year (M2) courses, and USMLE Step 1 was recorded. An independent t-test evaluated differences between females and males on each LASSI scale. A Pearson product moment correlation determined which LASSI scales correlated with preclinical performance and USMLE Step 1 examinations.

RESULTS

Of the 10 LASSI scales, Anxiety, Attention, Information Processing, Selecting Main Idea, Test Strategies and Using Academic Resources showed significant differences between genders. Females reported higher levels of Anxiety (p < 0.001), which significantly influenced their performance. While males and females scored similarly in Concentration, Motivation, and Time Management, these scales were significant predictors of performance variation in females. Test Strategies was the largest contributor to performance variation for all students, regardless of gender.

CONCLUSION

Gender differences in learning influence performance on STEP1. Consideration of this study's results will allow for targeted interventions for academic success.

Influence of physical activity level and perceived social support on mental health and psychological distress in women with menopause problems

Perceived Social Support (PSS) and Physical Activity (PA) could have an important role in reducing psychological distress in women with problems in the menopausal period. The aim was to analyze the associations between a) Self-Perceived Health (SPH), prevalence of self-reported depression and anxiety, and mental health and its subscales, through the Goldberg General Health Questionnaire (GHQ-12) with b) the Physical Activity Level (PAL) and c) the PSS, through the Duke-UNC-11 functional social support questionnaire in Spanish women with problems in the menopausal period. This document uses data from the Spanish National Health Survey of 2017, focusing on women between 40 and 69 years of age with problems in the menopausal period. Dependency relationships were found between the prevalence of depression and PAL, anxiety and PAL, and SPH with PAL (p < 0.001). Weak inverse correlations were found between PAL and mental health, Coping Success, Self-confidence, and Stress (rho: - 0.214 to - 0.258; p < 0.001). Also, weak and very weak significant inverse correlations were found between PAL and all items of the GHQ-12. Weak inverse correlations were found between PSS scores and mental health, Coping, and Stress (r: -0.201 to - 0.304; p < 0.001). Likewise, weak and very weak inverse correlations, although statistically significant, were found between the PSS scores and the responses to the GHQ-12 items. Very active women with higher PSS have less psychological distress, higher self-esteem, and better prevalence of positive health.

Acupuncture for generalized anxiety disorder: a study protocol for a randomized controlled trial

During the COVID-19 outbreak, there was a sharp increase in generalized anxiety disorder (GAD). Acupuncture therapy has the advantages of accurate clinical efficacy, safety and reliability, few adverse reactions, and no dependence, and is gradually becoming one of the emerging therapies for treating GAD. We present a study protocol for a randomized clinical trial with the aim of exploring the mechanism of brain plasticity in patients with GAD and evaluate the effectiveness and reliability of acupuncture treatment. Transcranial magnetic stimulation (TMS) will be used to assess cortical excitability in GAD patients and healthy people. Sixty-six GAD patients meeting the inclusion criteria will be randomly divided into two groups: TA group, (treatment with acupuncture and basic western medicine treatment) and SA group (sham acupuncture and basic western medicine treatment). Twenty healthy people will be recruited as the control group (HC). The parameters that will be evaluated are amplitude of motor evoked potentials (MEPs), cortical resting period (CSP), resting motor threshold (RMT), and Hamilton Anxiety Scale (HAMA) score. Secondary results will include blood analysis of γ-aminobutyric acid (GABA), glutamate (Glu), glutamine (Gln), serotonin (5-HT), and brain-derived nerve growth factor (BDNF). Outcomes will be assessed at baseline and after the intervention (week 8). This study protocol is the first clinical trial designed to detect differences in cerebral cortical excitability between healthy subjects and patients with GAD, and the comparison of clinical efficacy and reliability before and after acupuncture intervention is also one of the main contents of the protocol. We hope to find a suitable non-pharmacological alternative treatment for patients with GAD.

Lifestyle factors and BMI attenuate relationships between biomarkers of inflammation and depressive symptoms and well-being: A cross-sectional study

Background

Mental disorders are a growing public health concern and evidence has linked chronic low-grade inflammation with depression and well-being. Research also suggests that certain modifiable lifestyle factors such as smoking, alcohol use, physical activity, diet quality and BMI are related to psychological health. These may modulate the relationship between low-grade inflammation and mental health conditions. In this study we examined inflammatory biomarker associations with two psychological health scores and investigated whether relationships are influenced by lifestyle factors and BMI.

Methods

This was a cross-sectional study of 1824 middle-to older-aged men and women randomly selected from a large primary care centre. Depressive symptoms and well-being were assessed using the 20-item Centre for Epidemiologic Studies Depression (CES-D) Scale and the World Health Organization-Five (WHO-5) Well-Being Index. Linear regression analyses were performed to examine depression and well-being score relationships with six inflammatory biomarkers, and a composite inflammatory biomarker score, adjusting for demographic characteristics, health conditions, lifestyle factors and BMI.

Results

Depression and well-being score associations with complement component 3 (CES-D only) c-reactive protein, interleukin 6, leptin, white blood cell counts, neutrophils and the inflammatory biomarker score were observed. These relationships survived adjustment for demographic variables and health conditions but were attenuated in models which included lifestyle factors and BMI. In final models, only leptin (β = 0.566, p = 0.018) and inflammatory score (β = 0.137, p = 0.004) associations with the CES-D score remained.

Conclusions

These findings suggest that the relationship between systemic low-grade inflammation and depressive symptoms and well-being may be largely explained by lifestyle factors and adiposity, highlighting the potential importance of promoting a healthy lifestyle in the treatment of depressive disorders.

Acupressure bladder meridian alleviates anxiety disorder in rats by regulating MAPK and BDNF signal pathway

The aim of this study was to investigate the effects of acupressure bladder meridian (ABM) on anxiety in rats. Chronic stress was induced rats to establish rat anxiety model. Shuttle experiment and open field experiments of were used to measure behaviors. The levels of cytokines in serum and hippocampus of rats were detected. Brain neurotransmitters (dopamine, 5- hydroxy tryptamine, norepinephrine) were detected by Enzyme linked immunosorbent assay (ELISA) kits. Immunohistochemistry and western blotting were used to detect MAPK and BDNF signal pathway in hippocampus of rats. ABM significantly improve behaviors, decreased cytokine levels in serum and hippocampus. ABM restored the changes of neurotransmitters and significantly decreased protein expressions of MAPK signal pathway and increased protein expressions of BDNF signal pathway in hippocampus of rats. The results shown that ABM significantly improved anxiety via inhibition of MAPK signal pathway and increased BDNF signal pathway.

Feasibility of a physical activity intervention for children and adolescents with anxiety and depression

BACKGROUND

Physical activity is identified as a key modifiable factor towards good short- and long-term mental health and has shown positive effects on anxiety and depression in children and adolescents. However, physical activity-based interventions are not a part of standard mental health care and evidence on the effect of such interventions is still lacking. A transdiagnostic, physical activity-based intervention was developed as a supplement to routine clinical care for youth in specialized child and adolescent mental health services.

METHODS

/design. The feasibility of the physical activity intervention (Confident, Active, and Happy Youth) was evaluated in an open-label study by assessing the recruitment process, acceptability, intervention suitability, contentment, and preliminary intervention effects in the form of youth and parent-rated anxiety and depressive symptoms. Physical activity levels were objectively measured using Actigraph™ physical activity sensors, and progression to a definitive study was evaluated in accordance with a priori criteria.

RESULTS

In total 21 of 25 eligible youth consented to participate, two dropped out of the intervention and 19 completed (76% of eligible participants). The retention rate among consenting participants was 89% and mean attendance to sessions was 83%. The suitability of the intervention was rated as good by the youth and their parents, and intervention contentment was rated high. Changes in youth and parent-rated symptom measures following the intervention were negligible, except for parent-rated anxiety symptoms assessed at 10-month follow-up. Accelerometer data indicated lower levels of moderate to vigorous activity during sessions than intended. No adverse effects were noted.

CONCLUSION

This feasibility study met the pre-determined progression criteria to a definitive study. Thus, a larger trial with longer follow-up should be conducted to explore the effect of the intervention.

TRIAL REGISTRATION

ClnicalTrials.gov, NCT05049759. Retrospectively registered, 20.09.2021.

Causal effects of various types of physical activities on psychiatric disorders: a Mendelian randomization study

Background

Psychiatric disorders (PD) pose a significant burden, with vast prevalence and mortality, inflicting substantial costs on individuals and society. Despite its widespread prevalence, the complex pathogenesis of PD remains elusive, leading to limited and challenging therapeutic development. An emerging risk factor for chronic diseases, prolonged sedentary behavior, contrasts with the therapeutic potential of exercise, regardless of its intensity, for various ailments, including PD. Yet, the diversity in exercise modalities and intensities may offer varied impacts on health. This study, leveraging Mendelian Randomization (MR), seeks to investigate the causal relationship between exercise and PD, aiming to elucidate the optimal exercise modality and intensity for PD mitigation while addressing potential confounders.

Methods

This study employed a Mendelian randomization analysis using the genome-wide association study (GWAS) database to investigate the causal relationship between types of physical activity and psychiatric disorders. Sensitivity analysis was conducted to demonstrate the reliability and robustness of the results.

Results

In the past 4 weeks, engaging in a substantial amount of DIY physical activity was found to have a causal relationship with psychiatric disorders (IVW: OR = 0.228, 95% CI: 0.113-0.461, P = 0.000038). As for the types of exercises, there may be a potential causal association between aerobic training (including swimming, cycling, fitness, and bowling) and psychiatric disorders (IVW: OR = 0.322, 95% CI = 0.148-0.704, P = 0.004). However, there was no causal relationship found between mild DIY physical activity and psychiatric disorders (IVW: OR = 0.918, 95% CI = 0.417-2.021, P = 0.831). Furthermore, it seems that there is no causal relationship between vigorous exercise and psychiatric disorders (IVW: OR = 2.705, 95% CI = 0.081-3.419, P = 0.578).

Conclusion

Our study confirms that only a certain level of training activity can have a protective effect on psychiatric disorders, while mild physical activity or vigorous training does not have an impact on psychiatric disorders.

Positive childhood experiences as predictors of anxiety and depression in a large sample from Turkey

BACKGROUND

Positive childhood experiences positively influence one's adult life, while the absence of such positive experiences can potentially yield mental health problems throughout the lifespan.

OBJECTIVE

This study aimed to investigate the role of positive childhood experiences on depression and anxiety levels.

PARTICIPANTS AND SETTING

3090 (2059 women) young adults participated in this research. They ranged in age between 18 and 68 years (M = 28.78, SD = 9.44) and completed the self-report measures including the Positive Childhood Experiences Scale, Beck Depression and Anxiety Scales and Personal Information Forms.

METHOD

A cross-sectional research design was used to collect the data through social media platforms. We conducted a regression analysis to examine how positive childhood experiences contribute to depression and anxiety.

RESULTS

The results of correlation analysis indicated that positive childhood experiences were significantly negatively related to depression and anxiety. Regression analysis revealed that positive childhood experiences explained a significant amount of variance in the prediction of depression (10 %) and anxiety (8 %) after controlling for demographic factors.

CONCLUSIONS

The results suggest that the frequency of positive experiences lived during childhood might significantly reduce anxiety and depression, and positive childhood experiences might positively affect them.

The Occurrence of Anxiety, Depression, and Distress among Professionals Working in Emergency Care

Maintaining mental health is essential for professions with higher stress levels and challenging environments, including emergency specializations. In this study, the occurrence of distress, anxiety, and depression among a group of ambulance and hospital emergency care professionals was assessed (n = 202). A cross-sectional, quantitative, descriptive online survey was conducted, including the internationally validated Beck depression inventory (BDI), the perceived stress scale (PSS-14), and the State-Trait Anxiety Inventory (STAI). Statistical analyses involved descriptive statistics, the χ2-test, Mann-Whitney U test, Kruskal-Wallis test, Dunn-Bonferroni test, logistic regression (LR), Cramer coefficient (Cramer's V), Kolmogorov-Smirnov test, and Spearman's rank correlation coefficient (rs). Based on the results, female professionals are more likely to have depressive symptoms (OR = 2.6, 95% CI = 1.3-5.1), perceived stress (OR = 1.2, 95% CI = 1.2-4.1), and anxiety (OR = 2.1, 95% CI = 1.0-4.1) than male professionals. Perceived stress levels decreased proportionally with increasing years spent working in healthcare (OR = 7.4, 95% CI = 7.1-8.3). Extended work shifts of 12 or 24 h increase the risk of perceived stress and anxiety in emergency care workers (p = 0.02). Customized stress management interventions are needed to mitigate the amplified mental strain associated with gender, working years, and longer shifts in the emergency care sector to sustain their mental health and well-being.

Leveraging Emerging Technologies to Expand Accessibility and Improve Precision in Rehabilitation and Exercise for People with Disabilities

Physical rehabilitation and exercise training have emerged as promising solutions for improving health, restoring function, and preserving quality of life in populations that face disparate health challenges related to disability. Despite the immense potential for rehabilitation and exercise to help people with disabilities live longer, healthier, and more independent lives, people with disabilities can experience physical, psychosocial, environmental, and economic barriers that limit their ability to participate in rehabilitation, exercise, and other physical activities. Together, these barriers contribute to health inequities in people with disabilities, by disproportionately limiting their ability to participate in health-promoting physical activities, relative to people without disabilities. Therefore, there is great need for research and innovation focusing on the development of strategies to expand accessibility and promote participation in rehabilitation and exercise programs for people with disabilities. Here, we discuss how cutting-edge technologies related to telecommunications, wearables, virtual and augmented reality, artificial intelligence, and cloud computing are providing new opportunities to improve accessibility in rehabilitation and exercise for people with disabilities. In addition, we highlight new frontiers in digital health technology and emerging lines of scientific research that will shape the future of precision care strategies for people with disabilities.

Health-related behaviors and symptoms of anxiety and depression in Spanish nursing students: an observational study

Background

Symptoms of anxiety and depression are prevalent among young adults and are a significant public health issue. College students are at a higher risk of experiencing poor mental health than other young people due to several factors, including moving away from home, financial pressures, heavy workload, poor time management skills, competitivity, new processes of socialization and insufficient coping mechanisms, among others. In addition, nursing students' mental and physical health may also be affected by unhealthy lifestyle habits and health-related behaviors.

Aim

To determine the prevalence of symptoms of depression and anxiety, and the association between these symptoms and health-related behaviors, in a population of Spanish student nurses.

Methods

Cross-sectional study on a sample of 339 nursing students. We used the Hospital Anxiety and Depression Scale, the International Physical Activity Questionnaire-Short form, the Spanish Healthy Eating Index and an "ad hoc" questionnaire for sociodemographic variables. The association between psychological symptoms and health-related behaviors was analyzed through binary logistic regression models.

Results

The prevalence of symptoms of depression and anxiety was 3.8% and 24.5%, respectively. Negative health-related behaviors were frequent, namely tobacco and alcohol consumption, suboptimal physical activity and diet. Moderate physical activity was associated with a lower probability of experiencing depressive symptoms. Symptoms of anxiety were related to a low level of physical activity, an unhealthy diet and alcohol consumption ≥2 times a week.

Conclusion

Student nurses could benefit from the implementation of both physical and mental health promotion initiatives.

Endocannabinoid and psychological responses to acute resistance exercise in trained and untrained adults

INTRODUCTION

This study examined the effects of acute resistance exercise on circulating endocannabinoid (eCB) and mood responses in trained and untrained healthy adults.

METHODS

Thirty-two healthy adults (22.1 ± 2.9 years) were recruited from trained (reporting resistance exercise at least twice per week for ≥ previous three months) and untrained (performing no resistance exercise for ≥ previous three months) groups. Participants (13 male, 19 female) completed three sets of resistance exercise (16 repetitions at 50% 1-repetition max, 12 repetitions at 70% 1-repetition max, 8 repetitions at 80% 1-repetition max). Resistance machines targeted the legs, chest, back, and abdominal muscles. Mood states, affect, and circulating eCB concentrations were evaluated before and after resistance exercise.

RESULTS

There were significant decreases in AEA, PEA, and OEA levels following acute resistance exercise (p <0.05; ds = -0.39, -0.48, -0.65, respectively), with no significant group differences or group by time interactions. 2-AG did not change significantly. Positive affect increased significantly following resistance exercise (p = 0.009), while negative affect decreased (p <0.001). Depressive symptoms, anger, confusion, and total mood disturbance decreased significantly (p <0.05), while vigor increased significantly following resistance exercise (p = 0.005). There were no significant group differences or group by time interactions for any psychological outcomes.

CONCLUSION

These results indicate that acute resistance exercise may reduce eCB and related lipid concentrations, which is opposite to the increase in lipids typically observed with acute aerobic exercise. Furthermore, psychological improvements occur after resistance exercise regardless of decreases in eCBs, supporting the notion that psychological changes with exercise likely occur through a wide variety of biological and environmental mechanisms.

Exploring the potential mechanism of Kaixinsan powder for the same pathogenesis of PTSD and anxiety based on network pharmacology and molecular docking: A review

BACKGROUND

Post-traumatic stress disorder (PTSD) and anxiety are common mental illnesses and there are many similar pathogenesis and clinical manifestations between PTSD and anxiety. Kaixinsan powder (KXS), a commonly used prescription in traditional Chinese medicine, has been widely used to treat PTSD and anxiety. This study aims to explore the potential mechanisms of KXS for the same pathogenesis of PTSD and anxiety using a network pharmacology approach.

METHODS

The bioactive components and relevant target genes of KXS were obtained from the database about Traditional Chinese Medicine. The key genes of PTSD and anxiety were derived from disease databases. Subsequently, the network of protein-protein interaction and a network of "drug-components-disease-targets" was constructed. In order to treat PTSD and anxiety, gene ontology enrichment and signaling pathway enrichment were analyzed by using R language and components-core targets associated were validated by molecular docking.

RESULTS

One hundred three targets of KXS in treating PTSD and anxiety were identified. The results of protein-protein interaction analysis and molecular docking indicated that AKT1 and IL-6 were crucial targets. Moreover, KEGG analysis has shown that neuroactive ligand-receptor interaction, calcium signaling pathway, and cAMP signaling pathway may play crucial roles in treating PTSD and anxiety. Ten biological process, 10 molecular function, and 10 cellular component were revealed via gene ontology analysis.

CONCLUSIONS

The network pharmacology study and molecular docking indicated that KXS treated anxiety and PTSD by multiple components, targets, and signaling pathways. These results provide an important reference for subsequent basic research on PTSD and anxiety.

Higher physical activity level and perceived social support is associated with less psychological distress in people with anxiety

Introduction

Anxiety is one of the most prevalent mental illnesses in first world societies, generating discomfort in the people who suffer from it, and high expenses and economic losses in the society. The physical activity (PA) performed, together with the perceived social support (PSS) by people with anxiety could be related to the psychological distress of people with anxiety.

Objectives

To study the relationships between mental health and its dimensions, through Golberg's General Health Questionnaire (GHQ12), and the level of PA (PAL) and the PSS in the Spanish adult population with anxiety.

Hypothesis

A higher PAL, and a higher PSS, is related to a lower psychological distress in this population.

Design and Methodology

This study included 1,661 adults with anxiety, residents in Spain. It was a cross-sectional study with data obtained from the Spanish National Health Survey. A Kolmogorov-Smirnov test was applied to examine the data distribution of the variables. The median and interquartile range were used to characterize the sample for continuous variables, and absolute and relative frequencies were used for categorical variables. The Mann-Whitney U test was used to examine the differences between sexes. Dependence between PAL and sex was studied using the chi-square statistic. A Krustal-Wallis test was used to evaluate the existence of differences in the baseline medians on the GHQ-12, according to PAL level. Finally, the correlations between mental health and its dimensions with PAL and the Duke-UNC-11 scores were analysed, obtaining Spearman's rho and Pearson's correlation coefficient.

Results

Moderate inverse correlations were found between the GHQ-12 and: PAL (rho: -0.219); PSS (r: -0.347). PAL and PSS presented moderate inverse correlations with successful coping (rho: -0.206 and r: -0.325), self-esteem (rho: -0.222 and r: -0.333) and stress (rho: -0.158 and r: -0.288).

Conclusions

Greater PAL and social support are associated with reduced psychological distress in people with anxiety.

Moderate physical activity is associated with lower depression, anxiety and stress in health-care workers during the COVID-19 pandemic

OBJECTIVE

Health-care workers are in high risk for COVID-19 and may experience associated mental health disturbances. Although physical activity (PA) has positive effects on mental disturbances, it has not been fully investigated in health-team during COVID-19 pandemic. Therefore, we analyzed depression, anxiety and stress in health-care workers, and their relationship with PA before and during a COVID-19 peak.

METHODS

Retrospective cohort study. PA (IPAQ short-form) evaluated and associated with depression, anxiety and stress (DAAS-21) at the beginning of COVID-19 first wave in Mexico (April 2020) in 1146 workers of a tertiary-care hospital, and in a subsequent occasion at the first wave peak (July-August/2020) in 311 workers (from the first ones). Data collected from routine surveillance.

RESULTS

Depression increased 9%, anxiety 15%, and stress 10% at the pandemic peak. Subjects with higher frequency of baseline moderate PA showed lower severity of depression, anxiety and stress at the peak (p < 0.05). At the pandemic peak, female sex (OR = 2.42, 95%CI 1.14-5.13), diabetes (OR = 21.9, 95%CI 2.09-221) and baseline depression (OR = 8.86, 95%CI 4.30-18.2) predicted depression; baseline anxiety (OR = 5.52, 95%CI 3.01-10.1), working in COVID-19 area (OR = 4.14, 95%CI 1.99-8.64), and baseline moderate PA (OR = 0.35, 95%CI 0.16-0.73) predicted anxiety; and baseline stress (OR = 8.64, 95%CI 4.11-18.2), and moderate PA (OR = 0.35, 95%CI 0.15-0.82) predicted stress.

CONCLUSION

Depression, stress, and particularly anxiety, increased in health-care workers from the beginning to the COVID-19 pandemic peak, and were predicted by the presence of the corresponding baseline mental alterations, and in the case of anxiety and stress, by the lower frequency of moderate PA.

Measurement Invariance and Psychometric Evaluation of the Tendency to Avoid Physical Activity and Sport Scale (TAPAS) Among Mainland Chinese University Students

Introduction

Preventative factors in young people's physical inactivity require further understanding, including related psychosocial factors (eg, body image and weight stigma). The Tendency to Avoid Physical Activity and Sport Scale (TAPAS) is a recently developed instrument to address this issue and the present study examined its psychometric properties among Chinese university students particularly in relation to patterns across sex, physical activity (PA) level, and weight status.

Methods

Using a convenience sample of 3142 students (mean age = 19.8 years; 56% female) in mainland China, data were collected using an online survey between August and October 2022. Psychometric instruments including the Weight Bias Internalization Scale, 21-item Depression, Anxiety and Stress Scale, and International Physical Activity Questionnaire Short Form were administered along with the TAPAS to assess convergent and discriminant validity. Multi-group confirmatory factor analysis (CFA) assessed the measurement invariance across specific groups.

Results

The unidimensional structure of the scale was confirmed through CFA (CFI=0.995; RMSEA=0.046). All configural, metric and scalar models of invariance indicated that the scale was invariant across sex, PA level, and weight status. Acceptable convergent and discriminant validity for the scale were found.

Conclusion

The TAPAS is a suitable instrument to assess body image and weight stigma concerns for avoiding physical activity and sport among Chinese university students.

Heart Rate Variability Biofeedback as Adjunctive Treatment of Generalized Anxiety Disorder: A Case Report

Introduction

Generalized anxiety disorder (GAD) is a common psychiatric disorder that can cause significant functional impairment to a patient's life. Mind body therapies (MBT) have increasingly been used as an intervention to manage symptoms of anxiety. Heart rate variability (HRV) biofeedback is a specific MBT that utilizes real-time feedback on autonomic functioning to train the physiological stress response through diaphragmatic breathing.

Case Presentation

A 39-year-old female was referred for a seven-week HRV biofeedback training protocol at Bastyr University Clinic for adjunctive treatment of GAD and depression. She had been taking citalopram for approximately four months prior to the first visit.

Discussion/Conclusion

After completing the seven-week protocol, the patient's anxiety improved from severe to mild, and her depression improved from mild to minimal. This improvement was maintained at a four-week follow-up, and eight weeks after the final visit she reported that her anxiety was no longer a concern to her. HRV biofeedback demonstrated to be an effective adjunctive treatment for GAD in this patient's case; however further research is needed to elucidate the effects of HRV biofeedback in patients with GAD.

The Effect of Acute Exercise on State Anxiety: A Systematic Review

Acute exercise has been shown to induce a small reduction in state anxiety, yet the most beneficial exercise stimulus is not clear. This review provides an update on the papers published since the last comprehensive review in 2015, with specific emphasis on whether study quality has improved. Randomised control trials, conducted in samples of healthy adults with non-clinical anxiety, were sourced from PubMed, PsycInfo, and Scopus. Study characteristics and study quality were assessed in nine studies comprising thirteen exercise conditions. Acute exercise significantly reduced anxiety in 53% (N = 7/13) of the exercise conditions. In comparison to a control condition, four showed exercising to be more effective, and one was as effective as the control. Two of the effective studies did not contain a control group. Six conditions were ineffective in reducing anxiety. There was no clear pattern of what combination of exercise mode, duration, and intensity was most effective, suggesting a variety may be effective in reducing anxiety. Methodological limitations still exist within the research, e.g., participant recruitment not considering baseline anxiety; variations in the control condition content. Future research should include participant samples exhibiting moderate-to-high levels of anxiety and examine self-selected exercise intensities.

Prevalence and Risk Factors for Anxiety Symptoms among Student Nurses in Gauteng Province of South Africa

Background: Globally, mental disorders are common among nursing students; therefore, effective prevention and early detection are urgently needed. However, the prevalence rate of anxiety symptoms has not been investigated in South African nursing colleges. Aim: The study aimed to assess the prevalence of anxiety symptoms and their sociodemographic risk factors among nursing students in Gauteng province, South Africa. Methods: This cross-sectional descriptive study was conducted at Chris Hani Baragwanath and SG Lourens nursing colleges in the first week of June 2022. A purposeful sampling technique selected the third- and fourth-year nursing students aged ≥ 18 years registered at the two nursing colleges. The seven-item Generalised Anxiety Disorder scale was used to assess anxiety symptoms. Results: The prevalence of anxiety symptoms was 74.7% (95% confidence interval: 69.9-78.9). Being a student at nursing college B, being in the fourth academic year of study and use of substances were identified as predictors of anxiety symptoms in these nursing students. Conclusions: The prevalence of anxiety symptoms in this study is relatively high, with predictors of developing anxiety being a student at nursing college B, in the fourth academic year and current use of psychoactive substances were predictors of anxiety symptoms. These findings highlight the need to develop interventions and strategies to promote mental health assessments and management to prevent and reduce the problem of mental disorders among nursing students.

Virtual reality in the management of stress and anxiety disorders: A retrospective analysis of 61 people treated in the metaverse

Mental health is the second largest group of health disorders associated with prolonged disability. Treating conditions such as stress and anxiety are a global health challenge due to inadequate funding and resources. Therefore, providing virtual treatment in the metaverse may provide a novel method of treatment for these conditions. We conducted a retrospective analysis of health records of people experiencing stress and anxiety who were treated principally in the metaverse using virtual reality. The main objective was to determine if virtual mental health treatment was achievable and safe, with measurable outcomes repeated at multiple time points. Here, 61 participants health records were evaluated (50% were female, 19% male, 31% identified as other). The cohort was 45.7 ± 15.7 years of age and reported no adverse effects with outcomes measured. Specifically, anxiety (via Generalized Anxiety Disorder Scale) decreased by 34% (p = 0.002) and stress (via Perceived Stress Scale) decreased by 32% (p < 0.001) after virtual intervention. The data suggests that this method of treatment was feasible, safe, and outcomes were obtainable over a range of time points. This early data suggest that management in the metaverse for these conditions may be beneficial, however, further prospective studies are necessary to better understand these clinical findings.

A Review of the Impact of Maternal Prenatal Stress on Offspring Microbiota and Metabolites

Maternal prenatal stress exposure affects the development of offspring. We searched for articles in the PubMed database and reviewed the evidence for how prenatal stress alters the composition of the microbiome, the production of microbial-derived metabolites, and regulates microbiome-induced behavioral changes in the offspring. The gut-brain signaling axis has gained considerable attention in recent years and provides insights into the microbial dysfunction in several metabolic disorders. Here, we reviewed evidence from human studies and animal models to discuss how maternal stress can modulate the offspring microbiome. We will discuss how probiotic supplementation has a profound effect on the stress response, the production of short chain fatty acids (SCFAs), and how psychobiotics are emerging as novel therapeutic targets. Finally, we highlight the potential molecular mechanisms by which the effects of stress are transmitted to the offspring and discuss how the mitigation of early-life stress as a risk factor can improve the birth outcomes.

MAPK Is a Mutual Pathway Targeted by Anxiety-Related miRNAs, and E2F5 Is a Putative Target for Anxiolytic miRNAs

Anxiety-related disorders (ARDs) are chronic neuropsychological diseases and the sixth leading cause of disability in the world. As dysregulation of microRNAs (miRs) are observed in the pathological course of neuropsychiatric disorders, the present study aimed to introduce miRs that underlie anxiety processing in the brain. First, we collected the experimentally confirmed anxiety-related miRNAs (ARmiRs), predicted their target transcripts, and introduced critical cellular pathways with key commune hub genes. As a result, we have found nine anxiolytic and ten anxiogenic ARmiRs. The anxiolytic miRs frequently target the mRNA of Acyl-CoA synthetase long-chain family member 4 (Acsl4), AFF4-AF4/FMR2 family member 4 (Aff4), and Krüppel like transcription factor 4 (Klf4) genes, where miR-34b-5p and miR-34c-5p interact with all of them. Moreover, the anxiogenic miRs frequently target the mRNA of nine genes; among them, only two miR (miR-142-5p and miR-218-5p) have no interaction with the mRNA of trinucleotide repeat-containing adaptor 6B (Tnrc6b), and miR-124-3p interacts with all of them where MAPK is the main signaling pathway affected by both anxiolytic and anxiogenic miR. In addition, the anxiolytic miR commonly target E2F transcription factor 5 (E2F5) in the TGF-β signaling pathway, and the anxiogenic miR commonly target Ataxin 1 (Atxn1), WASP-like actin nucleation promoting factor (Wasl), and Solute Carrier Family 17 Member 6 (Slc17a6) genes in the notch signaling, adherence junction, and synaptic vesicle cycle pathways, respectively. Taken together, we conclude that the most important anxiolytic (miR-34c, Let-7d, and miR-17) and anxiogenic (miR-19b, miR-92a, and 218) miR, as hub epigenetic modulators, potentially influence the pathophysiology of anxiety, primarily via interaction with the MAPK signaling pathway. Moreover, the role of E2F5 as a novel putative target for anxiolytic miRNAs in ARDs disorders deserves further exploration.

The effect of physical exercise on the anxiety of college students in the post-pandemic era: The mediating role of social support and proactive personality

In order to study the current situation of the anxiety of college students in the post-pandemic era and the effect of physical exercise on anxiety, this study explores the influence of social support and proactive personality as mediating variables on the anxiety of college students from the perspective of physical exercise. Firstly, anxiety symptoms and anxious emotions are defined. Secondly, a questionnaire survey is conducted for a well-known university in a certain city, and different questionnaire scales are developed from the physical exercise, anxiety, social support, and proactive personality assessment of college students. Finally, the results of the survey are statistically analyzed to explore the relieving effect of physical exercise on anxiety. The results reveal that there is a significant gender difference in the level of physical exercise, and the amount of physical exercise of the male students is generally higher than that of female students. In addition, the intensity, time, and frequency of exercise of male students are more than that of female students, but there is no obvious difference between them and whether they were only children. Physical exercise habits, social support, proactive personality traits, and anxiety of college students have a significant correlation. Through the analysis of the chain mediation effect, Ind2 (0.0140) is the largest coefficient among the three paths, indicating that the path of influencing social support through physical exercise habits, followed by affecting proactive personality traits, and then impacting anxiety has the strongest explanatory force. According to the results, strategies to relieve the anxiety of college students are given. This study can provide a reference for the research on the methods to alleviate their anxiety under the influence of the epidemic.

How perceived risk influences college students' preventive behavior: Novel data of COVID-19 campus lockdown from Wuhan, China

Following preventive behaviors is a key measure to protect people from infectious diseases. Protection motivation theory (PMT) suggests that perceived risk motivates individuals to take protective measures. The COVID-19 pandemic has posed unprecedented stress to the public, and changes in perceived risk may be more pronounced among college students than among other groups due to the related campus lockdown. With 1,119 college students recruited as research subjects, a quantitative research was conducted in Wuhan, China, to deduce the relationship between the perceived risk and preventive behavior of college students, as well as between the mediation effect of individual affect and the moderating effect of physical exercise. The results showed that the preventive behavior of college students was significantly affected by perceived risk, and both positive affect and negative affect played a mediating role between perceived risk and preventive behavior. Specifically, positive affect aided the relationship between perceived risk and preventive behavior, negative affect was detrimental to their relationship, and the mediation effect of positive affect is significantly higher than that of negative affect. Furthermore, physical exercise played a moderating role in the mediation effects of positive affect and negative affect. Therefore, appropriate measures should be taken to strengthen Chinese college students' perceived risk and provide them with corresponding guidance. The importance of physical exercise should also be emphasized to help college students with low perceived risk reduce negative affect, increase positive affect, and promote their preventive behavior.

Clinical Markers of Panic and Generalized Anxiety Disorder: Overlapping Symptoms, Different Course and Outcome

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.

Active and Happy? Physical Activity and Life Satisfaction among Young Educated Women

BACKGROUND

Physical activity belongs to the group of health-promoting behaviors. It also affects emotional well-being, which is linked to a higher quality of life. Individuals who participate in physical activity practice regardless of age reap several positive health benefits that affect both body and mind. The aim of this study was to assess the life satisfaction of young adults in the context of physical activity undertaken.

MATERIAL AND METHODS

Study material was collected via anonymous questionnaire surveys among 328 young women (between the ages of 18 and 30 with secondary or higher education) in Poland. Satisfaction with life was assessed using The Satisfaction with Life Scale (SWLS). Statistical calculations were performed using the STATISTICA 13.3 program, Stat Soft Poland. Interdependence of unmeasured characteristics was assessed using the X2 test. Multivariate analysis for the direct effect of physical activity on life satisfaction (LS) and the influence of frequency of physical fitness on life satisfaction was performed based on regular OLS multiple regression.

RESULTS

The majority of respondents (74.7%) reported engaging in physical exercise. The mean level of life satisfaction was 4.5 ± 1.1 (on a scale of 1 to 7). Multivariate analysis showed no statistically significant relationship with life satisfaction in the physically active and inactive groups. It was observed that significantly higher levels of life satisfaction were found among respondents: married 5.1 ± 1.1, median = 5.2 (4.5-5.9) compared to single 4.4 ± 1.2, median = 4.6 (3.6-5.2) and in informal relationships 4.5 ± 1.0, median = 4.4 (3.8-5.2); p = 0.02; declaring rather good 4.5 ± 1.0, median = 4.6 (3.8-5.2) or very good health 4.8 ± 1.1, median = 5.0 (4.2-5.6) compared to rather poor 4.1 ± 1.0, median = 4.1 (3.4-4.8) and poor health 3.6 ± 1.4, median = 3.1 (2.6-4.4); p = 0.0006; rating their physical condition moderately 4.7 ± 1.1, median = 4.8 (4.0-5.6) or highly 4.9 ± 1.0, median = 5.0 (4.3-5.4) compared to rating their fitness low 4.2 ± 0.9, median = 4.2 (3.6-4.8); p < 0.0001. Multivariate analyses confirmed a significant effect of marital status and subjective assessment of physical condition on the average level of life satisfaction.

CONCLUSIONS

Physical activity does not differentiate the level of life satisfaction in the studied group of young women. Marital status and the subjective assessment of physical condition are factors that have a significant impact on the level of satisfaction with the life of young women. Given the beneficial effect of physical activity on the sense of satisfaction with life, which can lead to an increase in its quality, physical activity should be promoted, not only among children but also in the group of young adults.

Mental Health of Working Adults during the COVID-19 Pandemic: Does Physical Activity Level Matter?

The purpose of this study is to investigate the associations between physical activity levels and the psychological outcomes of depression and anxiety. In 2022, Hong Kong was still exercising strict measures to control the spread of COVID-19. In this connection, major events and almost all large-scale sports events were suspended. Most recreational facilities were closed and repurposed as vaccination venues. As a result, a reduction in physical activity was expected. A cross-sectional survey was conducted among 109 working adults in Hong Kong. The International Physical Activity Questionnaire-Short Form was adopted as it continues to be the most widely used scale to measure physical activity. Almost a quarter of respondents exercised regularly. On average, respondents engaged in less than an hour's physical activity per week. Findings showed that even low to moderate levels of physical activity were positively associated with perceived self-esteem and perceived mental well-being. More specifically, self-esteem and perceived mental well-being were negatively associated with depression and anxiety. A full mediation effect between engagement in low levels of physical activity and anxiety was found. Light exercises may ultimately lead to lower anxiety via an indirect effect, with perceived mental well-being acting as a mediator. There was no direct relationship between low levels of physical activity and anxiety. In a similar vein, moderate levels of physical activity may lead to amelioration of symptoms related to depression and anxiety through indirect effects, with self-esteem as a mediator. Apart from engagement in low levels of physical activity, moderate levels of physical activity, such as swimming, jogging, and dancing, which have associations with self-esteem and mental health, could also be considered for attention.

Keep Moving to Retain the Healthy Self: The Influence of Physical Exercise in Health Anxiety among Chinese Menopausal Women

Menopause is a period of high incidence of chronic diseases. Women experience various physical and psychological discomforts during menopause, and hormonal changes exacerbate mood swings in menopausal women and also cause them to begin to experience excessive worry and anxiety about their health problems. This study was a cross-sectional survey investigating the relationship between physical activity and women's health anxiety. Using cluster sampling, a valid sample of 455 females aged 45-50 was collected from 78 communities in five municipal districts in Changsha, China, and AMOS v.23 was adopted to construct a structural equation model to verify the hypotheses. The results indicate that interpersonal competence and emotional intelligence are negatively associated with health anxiety. Furthermore, interpersonal competence and emotional intelligence mediate the relationship between physical exercise and health anxiety, which means that menopausal women with more physical exercise, higher interpersonal competence, and higher emotional intelligence reported lower health anxiety. Finally, to alleviate menopausal women's health anxiety and reduce their risk of chronic diseases, the government, community, and family should create conditions and opportunities for women to participate in group physical activities.

Dissociation between physical capacity and daily physical activity in COPD patients. A population-based approach

BADKGROUND

Physical capacity (PC) and daily physical activity (PA) are two crucial factors in the clinical course of COPD, although they do not always maintain a close relationship. The objectives were to evaluate the frequency of PC-PA dissociation in patients with COPD and subjects without airflow limitation (AL) and to identify its risk factors.

METHODS

A sample of 319 COPD patients and 399 subjects without AL was consecutively obtained from a population-based sample of 9092 subjects evaluated in the EPISCAN II study. Baseline evaluation included clinical questionnaires, lung function testing, blood analysis and low-dose computed tomography (CT) scan with evaluation of lung density and airway wall thickness. A distance walked in 6 min > 70% predicted was considered an indicator of normal PC, while a Yale Physical Activity Survey summary index score <51 was used to identify with sedentary lifestyle.

RESULTS

166 COPD patients (52.0%) reported a sedentary lifestyle with evidence of preserved PC, while this phenomenon was present in 188 (47.1%) subjects without AL. In the COPD group, symptoms of chronic bronchitis, depression and elevated hematocrit and blood eosinophil count were identified as independent risk factors for PC-PA dissociation. In turn, in the subjects without AL, the risk factors for PC-PA dissociation were low fat-free mass, obesity and anxiety, as well as reduced levels of HDL-cholesterol and the absence of osteoporosis.

CONCLUSIONS

Almost half of COPD patients and subjects without airflow limitation with preserved PC maintain a sedentary lifestyle, with different risk factors for sedentarism between both groups.

Static magnetic field blocked alprazolam-induced behavior of Wistar rats in the elevated plus-maze test

Studies have shown that psychotropic drugs change rat behavior in the elevated plus-maze test (EPM). This study investigated whether static magnetic fields could alter alprazolam-induced rat behavior in the EPM. 66 male Wistar rats (270-300 g weight) were assigned to one of the following groups: Sham Magnetic + Saline (SMS), North Pole + Saline (NPS), South Pole + Saline (SPS), Sham magnetic + alprazolam (SMA), NP + alprazolam (NPA), and SP + alprazolam (SPA). After five days of static magnetic stimulation (3200 Gauss), they received alprazolam or saline (1 mg/kg), and their behavior was evaluated. Two-way ANOVA and Holm-Sidak post-hock were used, with a significant P value of <0.05. The SMA and NPA groups showed an increased number of entries and time in the open arms compared with the SMS group. SPA showed a decrease in these measures when compared to SMA [F(2,61) = 6.43 and F(2,61) = 3.72, respectively]. The SMA and NPA groups showed increased head dipping and end-arm activity compared with the SMS group. SPA showed a decrease in these measures when compared to SMA [F(2,61) = 3.37 and [F(2,61) = 4.72, respectively]. These results show that the south magnetic pole of a static magnetic field blocked the alprazolam effect in the space-time variables of the open arms and ethological anxiolytic-like behavior in the EPM.

Association between physical activity and comorbid anxiety/depression in 46 low- and middle-income countries

BACKGROUND

Evidence on the association of low physical activity (PA) with depression or anxiety is well established. Yet, evidence on the association between PA and comorbid anxiety/depression remains scarce, especially in low- and middle-income countries (LMICs). Thus, this study explored this relationship among adults aged ≥18 years from 46 LMICs.

METHODS

Cross-sectional, community-based data were analyzed from the World Health Survey (WHS). Multivariable multinomial logistic regression analysis was conducted to examine the association between low PA and comorbid anxiety/depression with no anxiety or depression as the base category.

RESULTS

237,023 participants [mean (SD) age = 38.4 (16.0) years; 50.8 % female] were included in the analysis. Low PA was significantly associated with depression alone (OR = 1.33; 95%CI = 1.12-1.57) and anxiety alone (OR = 1.37; 95%CI = 1.23-1.53), while the OR was highest among those with comorbid anxiety/depression (OR = 1.75; 95%CI = 1.52-2.01).

CONCLUSION

Low PA is associated with particularly increased odds for comorbid anxiety/depression. Increasing PA may have a beneficial effect on the prevention of comorbid anxiety/depression. However, future longitudinal research establishing the direction of this relationship is warranted.

Restraint stress induced anxiety and sleep in mice

In humans and animals, exposure to changes in internal or external environments causes acute stress, which changes sleep and enhances neurochemical, neuroendocrine, and sympathetic activities. Repeated stress responses play an essential role in the pathogenesis of psychiatric diseases and sleep disorders. However, the underlying mechanism of sleep changes and anxiety disorders in response to acute stress is not well established. In the current study, the effects of restraint stress (RS) on anxiety and sleep-wake cycles in mice were investigated. We found that after RS, the mice showed anxiety-like behavior after RS manipulation and increased the amounts of both non-rapid eye movement (NREM) and rapid eye movement (REM) sleep in the dark period. The increase in sleep time was mainly due to the increased number of episodes of NREM and REM sleep during the dark period. In addition, the mice showed an elevation of the EEG power spectrum of both NREM and REM sleep 2 h after RS manipulation. There was a significant reduction in the EEG power spectrum of both NREM and REM sleep during the darkperiod in the RS condition. The expression of the c-Fos protein was significantly increased in the parabrachial nucleus, bed nucleus of the stria terminalis, central amygdala, and paraventricular hypothalamus by RS manipulation. Altogether, the findings from the present study indicated that neural circuits from the parabrachial nucleus might regulate anxiety and sleep responses to acute stress, and suggest a potential therapeutic target for RS induced anxiety and sleep alterations.

A 'health message' on sustainable physical and mental health for the prolonged COVID-19 and other pandemics

The world has been living with another pandemic physical inactivity (PI) and sedentary behavior (SB) and of other nature for years. As social measures to prevent the spread of COVID-19 have been strengthened, the physical activity (PA) barrier has been hit and the PI/SB pandemic has been exacerbated, and in the current situation, triggered by its prolonged period, it is emerging as a problem to be considered in order to combat the PI/SB pandemic through PA and to maintain continuous physical and mental health. This review aims to summarize existing and recent studies on the effects of PA/SB on physical and mental health in preparation for the context of prolonged COVID-19 and provides an easy and fun way to motivate, access PA, and PA recommendations for maintaining physical and mental health. We performed search strategies on PubMed, Medline, Scopus, and Google Scholar databases, and used a literature review of the current available literature on the COVID-19 and the effects of PI, SB, and PA on physical and mental health. The clinical relevance of this review shows that integrating PA into daily life and reducing prolonged sitting time is an important strategy for continuing a healthy life physically and mentally. As a result, for those who have not yet incorporated exercise as part of their daily routine, fun and easy access to PA suggests that in the long run, may be an opportunity to implement newer habits. In addition, in an emergency such as the COVID-19 quarantine period or other pandemics, it is essential for one to maintain health through PA at home, and underscore the 'health message' of the current review that reducing SB, progressively increasing PA, and doing more PA regularly in the current context prolonged COVID-19 can bring significant benefits to long-term habits and physical and mental health.

Accelerometer-Measured Physical Activity, Inactivity, and Related Factors in Family Caregivers of Patients with Terminal Cancer

The physical activity (PA) and inactivity of family caregivers of cancer patients were investigated and related to burden and quality of life through a cross-sectional multicentre study. A total of 75 caregivers were recruited from June 2020 to March 2021. The levels of PA and inactivity were estimated with a wrist accelerometer, 24 h a day, for 7 consecutive days. The Quality of Life Family Version, the Caregiver Strain Index, the total duration of care, the average number of hours spent in care, and the assistance received were registered. Our results showed that moderate-to-vigorous PA was 96.40 ± 46.93 min/day, with 90.7% of participants performing more than 150 min/week of physical activity, and this was significantly associated with age (r = −0.237). Daily inactivity was 665.78 ± 94.92 min, and inactivity for 20−30 min was significantly associated with caregiver burden (r = 0.232) and quality of life (r = −0.322). Compliance with the World Health Organization recommendations was significantly associated with a lower quality of life (r = −0.269). The strength of these associations was limited (r ~0.2). In conclusion, the PA performed by most caregivers met the established recommendations, although older caregivers (>65 years old) performed lower moderate-to-vigorous PA than younger ones. In addition, the mean inactive time was high (11 h/day), showing slight relationships with the burden and quality of life of caregivers.

Key characteristics including sex, sexual orientation and internet use associated with worse mental health among university students in Brazil and implications

BACKGROUND

The symptoms of anxiety and depression disorders are multifactorial and can trigger a series of problems especially among university students. The aim of this study was to assess the prevalence and associated factors with anxiety and depression symptoms among first-semester university students at a Federal University in Brazil given the paucity of such data and the first semester is the most stressfultime.

METHODS

Cross-sectional study with first-semester university students. The questionnaire included socio-demographic variables, lifestyles, health conditions and the Depression Anxiety Stress Scales. Descriptive analysis was performed, followed by bivariate analysis and Poisson regression analysis.

RESULTS

Three hundred and fifty-six students (65.2%) across a range of courses in their first semester participated. The prevalence of anxiety was 42.5% and depression 33.2%. Regarding symptoms of anxiety and depression disorders, a positive association was observed among females, non-heterosexual, non-white skin color, excessive internet use, lack of physical activity, not attending university parties, having psychological counseling, history of anxiety in first- or second-degree relatives, poor self-rated health and use of psychotropic medicines.

CONCLUSIONS

Due to the high prevalence of anxiety and depression symptoms, the importance of developing programs to promote mental and physical health of university students is highlighted.

Experiences of an Equine-Assisted Therapy Intervention among Children and Adolescents with Mental Illness in Sweden - A Nursing Perspective

Mental illness among children and adolescents is increasing globally, and prescription of psychiatric drugs for children and adolescents with mental illness is increasing worldwide, including Sweden. Holistic health-promoting interventions have shown promising long-lasting significant health benefits in young individuals with mental illness, but holistic health-promoting mental health interventions are often disregarded due to a lack of systematic theory-based knowledge. Consequently, the lack of scientific knowledge thwarts implementation of equine-assisted therapy as an established intervention in mental health nursing for children and adolescents with mental illness. The purpose of the study was to better understand experiences of equine-assisted therapy among children and adolescents with mental illness. The study adopted an inductive approach and data was collected using photovoice methodology. Six young persons, 7-18 years of age, referred by a psychologist to the equine-assisted intervention due to mental health issues, were included in the study. Data was analyzed using qualitative content analysis. The results could be summarized by an overarching theme, a physical, emotional, and social milieu for growth, consisting of three subcategories: feeling relief from everyday stress and anxiety; nurturing self-esteem in a mutual friendship; and strengthening self-reliance through synchronized interplay. The results indicate that equine-assisted therapy has essential values closely related to the goals of mental health nursing. Further research should strive to attain even gender distribution in study samples and focus on how equine-assisted therapy could be thoroughly integrated into established nursing intervention for children and adolescents with mental illness.

Effect of Aerobic Exercise on the Levels of Pain, Quality of Life, and Alexithymia in Alexithymic Individuals With Chronic Pain: A Single-Blinded Randomized Controlled Trial

OBJECTIVE

This study aimed to investigate the effects of aerobic exercise on pain, degree of alexithymia, and quality of life in individuals with alexithymia and chronic pain.

METHODS

A total of 40 participants who scored 61 or higher on the Toronto Alexithymia Scale-20 (TAS-20) were included in the study. The sample was subdivided into 2 groups using a computerized randomization program: an aerobic exercise group (n = 20) and a control group (n = 20). Participants in the aerobic exercise group underwent a 30-minute jogging protocol at 60% to 90% of maximum heart rate 3 days per week for 8 weeks under the supervision of a physiotherapist. Participants in the control group continued their daily physical activities. Outcome measures were the TAS-20, visual analog scale, Graded Chronic Pain Scale, and 36-Item Short Form Health Survey.

RESULTS

There was no statistically significant difference between the demographics of the 2 groups (P > .05). There was a statistically significant improvement in TAS-20, Graded Chronic Pain Scale, visual analog scale, and 36-Item Short Form Health Survey scores of the participants in the aerobic exercise group compared to the control group (P ˂ .05).

CONCLUSION

Aerobic exercise had a positive effect on pain, quality of life, and degree of alexithymia in individuals with alexithymia and chronic pain.

Precision-based exercise in people with anxiety and stress related disorders: Are there interindividual differences in anxiolytic effects? An ancillary meta-analysis of randomized controlled trials

Interest in the individualized responses to exercise has been growing within mental health care and psychiatry. This meta-analysis examined if true interindividual differences (IIDs) in anxiolytic effects of exercise exist among adults with anxiety- and stress-related disorders. Data were extracted from a previous meta-analysis of randomized controlled trials (RCTs) and searches in CINAHL, Embase and Medline were updated (8 arms from 7 original studies, n participants=322). Change outcome standard deviations treated as point estimates for anxiety were extracted to calculate true IIDs. Inverse variance heterogeneity and restricted maximum likelihood models were used. Aerobic exercise and resistance training showed significant anxiolytic effects. No significant pooled IIDs were found for aerobic exercise nor resistance training demonstrating that there is currently a lack of convincing evidence to support the notion that true IIDs exist for the anxiolytic effects of exercise among adults with anxiety- and stress-related disorders. Consequently, clinical practice can focus on general population physical activity guidelines for patients with anxiety- and stress-related disorders rather than aiming for highly specific, individualized recommendations. Future research could prioritize investigating how to motivate patients with anxiety- and stress-related disorders to meet general population physical activity guidelines.

Anxiolytic effect of YangshenDingzhi granules: Integrated network pharmacology and hippocampal metabolomics

Anxiety disorder is one of the most common mental diseases. It is mainly characterized by a sudden, recurring but indescribable panic, fear, tension and/or anxiety. Yangshendingzhi granules (YSDZ) are widely used in the treatment of anxiety disorders, but its active ingredients and underlying mechanisms are not yet clear. This study integrates network pharmacology and metabolomics to investigate the potential mechanism of action of YSDZ in a rat model of anxiety. First, potential active ingredients and targets were screened by network pharmacology. Then, predictions were verified by molecular docking, molecular dynamics and western blotting. Metabolomics was used to identify differential metabolites and metabolic pathways. All results were integrated for a comprehensive analysis. Network pharmacology analysis found that Carotene, β-sitosterol, quercetin, Stigmasterol, and kaempferol in YSDZ exert anxiolytic effects mainly by acting on IL1β, GABRA1, PTGS1, ESR1, and TNF targets. Molecular docking results showed that all the affinities were lower than -5 kcal/mol, and the average affinities were -7.7764 kcal/mol. Molecular dynamics simulation results showed that RMSD was lower than 2.5 A, and the overall conformational changes of proteins were small, indicating that the small molecules formed stable complexes with proteins. The results of animal experiments showed that YSDZ exerts anxiolytic effects by regulating GABRA1 and TNF-α, ameliorating pathological damage in hippocampal CA1, and regulating metabolic pathways such as thiamine, cysteine and methionine metabolism, lysine biosynthesis and degradation. Altogether, we reveal multiple mechanisms through which YSDZ exerts its anti-anxiety effects, which may provide a reference for its clinical application and drug development.

Device-measured sedentary behaviour and anxiety symptoms during adolescence: a 6-year prospective cohort study

BACKGROUND

Sedentary behaviour is potentially a modifiable risk factor for anxiety disorders, a major source of global disability that typically starts during adolescence. This is the first prospective study of associations between repeated, device-based measures of sedentary behaviour and anxiety symptoms in adolescents.

METHODS

A UK cohort with 4257 adolescents aged 12 at baseline (56% female). Main exposures were sedentary behaviour and physical activity measured using accelerometers for 7-days at ages 12, 14, and 16. Primary outcome was anxiety symptom scores at age 18 from a Clinical Interview Schedule-Revised. We used adjusted negative binomial regression and iso-temporal substitution methods to analyse the data.

RESULTS

We found a positive association between sedentary behaviour at ages 12, 14, and 16, with anxiety symptoms at age 18, independent of total physical activity volume. Theoretically replacing an hour of daily sedentary behaviour for light activity at ages 12, 14, and 16, was associated with lower anxiety symptoms by age 18 by 15.9% (95% CI 8.7-22.4), 12.1% (95% CI 3.4-20.1), and 14.7% (95% CI 4-24.2), respectively. Whereas, theoretically replacing an hour of sedentary behaviour with moderate-to-vigorous physical activity was not associated with differences in anxiety symptoms. These results were robust to a series of sensitivity analyses.

CONCLUSION

Sedentary behaviour is a possible risk factor for increasing anxiety symptoms during adolescence, independent of total physical activity volume. Instead of focusing on moderate-to-vigorous activity, replacing daily sedentary behaviour with light activity during adolescence could be a more suitable method of reducing future anxiety symptoms.

Climbing as an Add-On Treatment Option for Patients with Severe Anxiety Disorders and PTSD: Feasibility Analysis and First Results of a Randomized Controlled Longitudinal Clinical Pilot Trial

BACKGROUND

Exercise has considerable effects on physical and psychological health. Anxiolytic effects of climbing exercise have been found in people suffering from depression. However, there are no studies on patients with severe anxiety disorders or post-traumatic stress disorder (PTSD) practicing climbing as add-on treatment. Additionally, many studies on physical therapy fail to use adequate active control groups. Therefore, this study aimed to investigate the feasibility of a four-week climbing exercise program for patients with anxiety disorders or PTSD in comparison to a standard exercise treatment and a social control group.

METHODS

Outpatients diagnosed with anxiety disorders or PTSD (F 40, F 41, F 43.1 according to ICD-10) were randomly assigned to (a) climbing exercise (n = 27), (b) Nordic walking exercise (n = 23), or (c) control condition (n = 23) providing the same amount of social contact for eight sessions of 90 minutes each. Psychological parameters (symptom severity, worry symptoms, self-efficacy, quality of life) and biological parameters were assessed at the beginning and at the end of the four-week program. Additionally, follow-up assessments were conducted three and six months after the program ended.

RESULTS

Sixty outpatients (75% female) aged 18-65 years with a longstanding history of a mental disorder (>10 years) and classified as treatment-resistant (95%) and with averaging 3.8 psychiatric comorbidities completed the pilot trial. After participation, symptoms of anxiety disorders were significantly reduced (p = 0.003), and health-related characteristics significantly improved (depression symptoms: p < 0.001, worry symptoms: p < 0.001, self-efficacy: p < 0.001, quality of life-physical health: p = 0.002, quality of life-psychological health: p = 0.006) in all groups. The feasibility of conducting climbing exercises for the patient groups could be demonstrated, and a general acceptance in the groups was recorded. No significant time-by-group interactions were found. At the completion of the program, psychological parameters improved, while biological parameters remained the same in all three groups.

CONCLUSIONS

Participation in the climbing group as well as in Nordic walking and social contact groups demonstrated beneficial results in patients with anxiety disorders and PTSD with severe mental burden. Nevertheless, climbing did not show any additional clinically relevant benefits compared to Nordic walking or social contact. Studies with larger sample sizes and qualitative insights are needed to further evaluate the possible benefits of climbing in this population.

The Role of Physical Activity in the Reduction of Generalised Anxiety Disorder in Young Adults in the Context of COVID-19 Pandemic

Physical activity is critically important not only for physical but also for mental health. Exercise may be a beneficial form of therapy for young adults with anxiety disorders. The global outbreak of the COVID-19 pandemic adversely affected the public, including young adults, in terms of their mental well-being and opportunities for physical activity. The study aimed to identify the influence of physical activity (PA) on generalised anxiety in young adults. It also assessed the changes which occurred in the level of PA and in generalised anxiety in young adults as a result of COVID-19 pandemic. A cross-sectional survey was carried out online with 506 young adults aged 18 to 34 years (=24.67 years ± 4.23 years). Respondents provided two answers to each question, i.e., information relating to the last 7 days during the pandemic (first hard lockdown), and to a period of 7 days before the pandemic (retrospective). The levels of physical activity were measured using 7-item International Physical Activity Questionnaire-Short Form (IPAQ-SF), whereas the level of generalised anxiety was assessed using the Generalised Anxiety Disorder 7 (GAD-7) questionnaire. During the pandemic there was a significant correlation between the level of generalised anxiety and the level of physical activity reported by the respondents (p = 0.048). A higher level of physical activity corresponded to lower level of generalized anxiety in young adults. During the pandemic, young adults spent significantly less time performing physical activity (8752.5 vs. 6174.6 metabolic equivalents (MET) min/week, p < 0.001), they spent more time engaging in sedentary behaviours (Me = 240 vs. Me = 300 min/day, p < 0.001), and they walked much less (from Me = 6930.0 (MET) min/week vs. 3861.0 (MET) min/week (44.29% decrease). Furthermore, after the outbreak of the pandemic the level of perceived generalised anxiety increased significantly (p < 0.001). Physical activity may play an important role in reducing anxiety disorder in young adults. During the COVID-19 pandemic young adults were significantly less involved in PA, which adversely affected their physical and mental condition. The importance of sufficient PA should be emphasised during this specific period, particularly among young adults.