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Hoang-Dang B, Halavi SE, Rotstein NM, Spivak NM, Dang NH, Cvijanovic L, Hiller SH, Vallejo-Martelo M, Rosenberg BM, Swenson A, Becerra S, Sun M, Revett ME, Kronemyer D, Berlow R, Craske MG, Suthana N, Monti MM, Zbozinek TD, Bookheimer SY, Kuhn TP. Transcranial Focused Ultrasound Targeting the Amygdala May Increase Psychophysiological and Subjective Negative Emotional Reactivity in Healthy Older Adults. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:100342. [PMID: 39092138 PMCID: PMC11293512 DOI: 10.1016/j.bpsgos.2024.100342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 05/22/2024] [Accepted: 05/27/2024] [Indexed: 08/04/2024] Open
Abstract
Background The amygdala is highly implicated in an array of psychiatric disorders but is not accessible using currently available noninvasive neuromodulatory techniques. Low-intensity transcranial focused ultrasound (TFUS) is a neuromodulatory technique that has the capability of reaching subcortical regions noninvasively. Methods We studied healthy older adult participants (N = 21, ages 48-79 years) who received TFUS targeting the right amygdala and left entorhinal cortex (active control region) using a 2-visit within-participant crossover design. Before and after TFUS, behavioral measures were collected via the State-Trait Anxiety Inventory and an emotional reactivity and regulation task utilizing neutral and negatively valenced images from the International Affective Picture System. Heart rate and self-reported emotional valence and arousal were measured during the emotional reactivity and regulation task to investigate subjective and physiological responses to the task. Results Significant increases in both self-reported arousal in response to negative images and heart rate during emotional reactivity and regulation task intertrial intervals were observed when TFUS targeted the amygdala; these changes were not evident when the entorhinal cortex was targeted. No significant changes were found for state anxiety, self-reported valence to the negative images, cardiac response to the negative images, or emotion regulation. Conclusions The results of this study provide preliminary evidence that a single session of TFUS targeting the amygdala may alter psychophysiological and subjective emotional responses, indicating some potential for future neuropsychiatric applications. However, more work on TFUS parameters and targeting optimization is necessary to determine how to elicit changes in a more clinically advantageous way.
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Affiliation(s)
- Bianca Hoang-Dang
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Sabrina E. Halavi
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Natalie M. Rotstein
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Norman M. Spivak
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles, Los Angeles, California
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California
- UCLA David Geffen School of Medicine Medical Scientist Training Program, University of California, Los Angeles, Los Angeles, California
| | - Nolan H. Dang
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles, Los Angeles, California
- Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado
| | - Luka Cvijanovic
- Neuroscience Interdepartmental Program, University of California, Los Angeles, Los Angeles, California
| | - Sonja H. Hiller
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Mauricio Vallejo-Martelo
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles, Los Angeles, California
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California
| | - Benjamin M. Rosenberg
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Andrew Swenson
- Neuroscience Interdepartmental Program, University of California, Los Angeles, Los Angeles, California
| | - Sergio Becerra
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Michael Sun
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire
| | - Malina E. Revett
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - David Kronemyer
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Rustin Berlow
- American Brain Stimulation Clinic, Del Mar, California
| | - Michelle G. Craske
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Nanthia Suthana
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles, Los Angeles, California
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Martin M. Monti
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles, Los Angeles, California
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Tomislav D. Zbozinek
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles, Los Angeles, California
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Susan Y. Bookheimer
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Taylor P. Kuhn
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles, Los Angeles, California
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Kirk PA, Robinson OJ. Neuroanatomical Subtyping of Phobias: Implications for Function and Development. Am J Psychiatry 2024; 181:693-695. [PMID: 39086286 DOI: 10.1176/appi.ajp.20240502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Affiliation(s)
- Peter A Kirk
- Emotion and Development Branch, NIMH, Bethesda, Md. (Kirk); Institute of Cognitive Neuroscience and Department of Clinical, Educational, and Health Psychology, University College London (Robinson)
| | - Oliver J Robinson
- Emotion and Development Branch, NIMH, Bethesda, Md. (Kirk); Institute of Cognitive Neuroscience and Department of Clinical, Educational, and Health Psychology, University College London (Robinson)
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Suzuki K, Okamatsu Y, Uchida R, Sasahara I, Takeshita M, Sato W, Kitahara Y, Murakami H. Effect of whey protein-derived decapeptide on mood status and blood variables in healthy adults: a randomized, double-blind, placebo-controlled cross-over trial. Eur J Nutr 2024:10.1007/s00394-024-03464-1. [PMID: 39085724 DOI: 10.1007/s00394-024-03464-1] [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: 12/25/2023] [Accepted: 07/01/2024] [Indexed: 08/02/2024]
Abstract
PURPOSE The importance of maintaining good mental health with overall well-being has recently drawn attention from various fields. Functional peptides found from various protein sources reportedly reduce mental health problems. We found a new decapeptide (AJI-801) from whey proteins, which can possibly improve mood status and increase blood acetyl-L-carnitine (ALC) and fibroblast growth factor 21 (FGF21) levels. In this study, we assessed the effects of a single intake of whey protein hydrolysate containing a high amount of AJI-801 (WPH) on blood variables and mood status. METHODS A randomized, double-blind, placebo-controlled cross-over trial of two doses of WPH (100 and 500 mg) was conducted. Participants, aged between 20 and 59 years with fatigue were allocated to two groups based on the WPH doses received, and set first test food in each study. The blood ALC and FGF21 levels at baseline and after 60, 120, and 180 min of test food intake were analyzed and the responses to the questionnaire items for mood status were obtained at baseline and after 60 and 180 min of test food intake. RESULTS There were no significant differences in the blood ALC and FGF21 levels between the two groups. As mood status, intake of 500-mg WPH (including 2.5-mg AJI-801) showed significant improvement in Depression/Dejection of the Profile of Mood States Questionnaire second edition and visual analog scale score for depression, as compared to the placebo. CONCLUSIONS Intake of AJI-801 500-mg WPH (including 2.5-mg AJI-801) contributes to the improvement of feeling down in healthy persons with fatigue. TRIAL REGISTRATION University Hospital Medical Information Network Clinical Trial Registry (UMIN 000046829).
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Affiliation(s)
- Katsuya Suzuki
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc, Kanagawa, 210-8681, Japan.
| | - Yoriko Okamatsu
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc, Kanagawa, 210-8681, Japan
| | - Ryo Uchida
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc, Kanagawa, 210-8681, Japan
| | - Ikuko Sasahara
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc, Kanagawa, 210-8681, Japan
| | - Masamichi Takeshita
- Research Institute for Bioscience Products and Fine Chemicals, Ajinomoto Co., Inc, Kanagawa, 210-8681, Japan
| | - Wataru Sato
- Research Institute for Bioscience Products and Fine Chemicals, Ajinomoto Co., Inc, Kanagawa, 210-8681, Japan
| | - Yoshiro Kitahara
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc, Kanagawa, 210-8681, Japan
| | - Hitoshi Murakami
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc, Kanagawa, 210-8681, Japan
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Kordon A, Carroll AJ, Fu E, Rosenthal LJ, Rado JT, Jordan N, Brown CH, Smith JD. Multilevel perspectives on the implementation of the collaborative care model for depression and anxiety in primary care. BMC Psychiatry 2024; 24:519. [PMID: 39039458 PMCID: PMC11265029 DOI: 10.1186/s12888-024-05930-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/24/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND The Collaborative Care Model (CoCM) is an evidence-based mental health treatment in primary care. A greater understanding of the determinants of successful CoCM implementation, particularly the characteristics of multi-level implementers, is needed. METHODS This study was a process evaluation of the Collaborative Behavioral Health Program (CBHP) study (NCT04321876) in which CoCM was implemented in 11 primary care practices. CBHP implementation included screening for depression and anxiety, referral to CBHP, and treatment with behavioral care managers (BCMs). Interviews were conducted 4- and 15-months post-implementation with BCMs, practice managers, and practice champions (primary care clinicians). We used framework-guided rapid qualitative analysis with the Consolidated Framework for Implementation Research, Version 2.0, focused on the Individuals domain, to analyze response data. These data represented the roles of Mid-Level Leaders (practice managers), Implementation Team Members (clinicians, support staff), Innovation Deliverers (BCMs), and Innovation Recipients (primary care/CBHP patients) and their characteristics (i.e., Need, Capability, Opportunity, Motivation). RESULTS Mid-level leaders (practice managers) were enthusiastic about CBHP (Motivation), appreciated integrating mental health services into primary care (Need), and had time to assist clinicians (Opportunity). Although CBHP lessened the burden for implementation team members (clinicians, staff; Need), some were hesitant to reallocate patient care (Motivation). Innovation deliverers (BCMs) were eager to deliver CBHP (Motivation) and confident in assisting patients (Capability); their opportunity to deliver CBHP could be limited by clinician referrals (Opportunity). Although CBHP alleviated barriers for innovation recipients (patients; Need), it was difficult to secure services for those with severe conditions (Capability) and certain insurance types (Opportunity). CONCLUSIONS Overall, respondents favored sustaining CoCM and highlighted the positive impacts on the practice, health care team, and patients. Participants emphasized the benefits of integrating mental health services into primary care and how CBHP lessened the burden on clinicians while providing patients with comprehensive care. Barriers to CBHP implementation included ensuring appropriate patient referrals, providing treatment for patients with higher-level needs, and incentivizing clinician engagement. Future CoCM implementation should include strategies focused on education and training, encouraging clinician buy-in, and preparing referral paths for patients with more severe conditions or diverse needs. TRIAL REGISTRATION ClinicalTrials.gov(NCT04321876). Registered: March 25,2020. Retrospectively registered.
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Affiliation(s)
- Avram Kordon
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Allison J Carroll
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Emily Fu
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lisa J Rosenthal
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jeffrey T Rado
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Neil Jordan
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center of Innovation for Complex Chronic Healthcare, Hines VA Hospital, Hines, IL, USA
| | - C Hendricks Brown
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Justin D Smith
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA
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Bisby MA, Jones MP, Staples L, Dear B, Titov N. Measurement of Daily Actions Associated With Mental Health Using the Things You Do Questionnaire-15-Item: Questionnaire Development and Validation Study. JMIR Form Res 2024; 8:e57804. [PMID: 39038286 DOI: 10.2196/57804] [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: 02/27/2024] [Revised: 04/25/2024] [Accepted: 05/02/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND A large number of modifiable and measurable daily actions are thought to impact mental health. The "Things You Do" refers to 5 types of daily actions that have been associated with mental health: healthy thinking, meaningful activities, goals and plans, healthy habits, and social connections. Previous studies have reported the psychometric properties of the Things You Do Questionnaire (TYDQ)-21-item (TYDQ21). The 21-item version, however, has an uneven distribution of items across the 5 aforementioned factors and may be lengthy to administer on a regular basis. OBJECTIVE This study aimed to develop and evaluate a brief version of the TYDQ. To accomplish this, we identified the top 10 and 15 items on the TYDQ21 and then evaluated the performance of the 10-item and 15-item versions of the TYDQ in community and treatment-seeking samples. METHODS Using confirmatory factor analysis, the top 2 or 3 items were used to develop the 10-item and 15-item versions, respectively. Model fit, reliability, and validity were examined for both versions in 2 samples: a survey of community adults (n=6070) and adults who completed an assessment at a digital psychology service (n=14,878). Treatment responsivity was examined in a subgroup of participants (n=448). RESULTS Parallel analysis supported the 5-factor structure of the TYDQ. The brief (10-item and 15-item) versions were associated with better model fit than the 21-item version, as revealed by its comparative fit index, root-mean-square error of approximation, and Tucker-Lewis index. Configural, metric, and scalar invariance were supported. The 15-item version explained more variance in the 21-item scores than the 10-item version. Internal consistency was appropriate (eg, the 15-item version had a Cronbach α of >0.90 in both samples) and there were no marked differences between how the brief versions correlated with validated measures of depression or anxiety symptoms. The measure was responsive to treatment. CONCLUSIONS The 15-item version is appropriate for use as a brief measure of daily actions associated with mental health while balancing brevity and clinical utility. Further research is encouraged to replicate our psychometric evaluation in other settings (eg, face-to-face services). TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12613000407796; https://tinyurl.com/2s67a6ps.
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Affiliation(s)
- Madelyne A Bisby
- MindSpot Clinic, MQ Health, Macquarie University, Macquarie Park, Australia
- School of Psychological Sciences, Macquarie University, Macquarie Park, Australia
| | - Michael P Jones
- School of Psychological Sciences, Macquarie University, Macquarie Park, Australia
| | - Lauren Staples
- MindSpot Clinic, MQ Health, Macquarie University, Macquarie Park, Australia
| | - Blake Dear
- MindSpot Clinic, MQ Health, Macquarie University, Macquarie Park, Australia
- School of Psychological Sciences, Macquarie University, Macquarie Park, Australia
| | - Nickolai Titov
- MindSpot Clinic, MQ Health, Macquarie University, Macquarie Park, Australia
- School of Psychological Sciences, Macquarie University, Macquarie Park, Australia
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Yu FF, Luo KT, Wang GQ, Zhao CY, Wang M, Li Q, Sha TT, Dong ZC, Zhou GY, Ba Y, Wang S, Pan D. Association between fluoride exposure and psychiatric disorders in adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-10. [PMID: 39022824 DOI: 10.1080/09603123.2024.2378950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 07/08/2024] [Indexed: 07/20/2024]
Abstract
To explore the association between fluoride exposure and depression / anxiety in adults, the 1,169 participants were recruited. The demographic information of participants was obtained through questionnaire survey and physical measurements. Morning urine samples were collected, and urinary fluoride (UF) level was determined. Changes in depression and anxiety levels were evaluated using the Patient Health Questionnaire-2 and General Anxiety Disorder-2 scales. The association between psychiatric disorders and UF levels was analyzed. In the total population, the prevalence of depression and anxiety were 3.17% and 4.19%, respectively. These results showed no significant association between depression / anxiety scale scores and UF levels. Logistic regression suggested no significant association between depression / anxiety levels, and UF levels, but there was an interaction between UF and income on depression. Our findings highlighted the interaction between fluoride exposure and monthly income, which may affect depression in adults.
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Affiliation(s)
- Fang-Fang Yu
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Kang-Ting Luo
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Guo-Qing Wang
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Cheng-Yu Zhao
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Miao Wang
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Qian Li
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Tong-Tong Sha
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Zai-Chao Dong
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Guo-Yu Zhou
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Yue Ba
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Shuai Wang
- Department of Water Resources Monitoring, Institute of Natural Resources Monitoring and Comprehensive Land Improvement of Henan Province, Zhengzhou, China
- Key Laboratory of Protection and Restoration of Water and Soil Resources in the Middle and Lower Reaches of the Yellow River Basin, MNR
| | - Deng Pan
- Department of Water Resources Monitoring, Institute of Natural Resources Monitoring and Comprehensive Land Improvement of Henan Province, Zhengzhou, China
- Key Laboratory of Protection and Restoration of Water and Soil Resources in the Middle and Lower Reaches of the Yellow River Basin, MNR
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7
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Sun C, Zhu Z, Zhang P, Wang L, Zhang Q, Guo Y, Guo L, Li Y, Wang P, Hu B, Liu M, Duan J, Wang Y, Wang Z, Qin Y. Exploring the interconnections of anxiety, depression, sleep problems and health-promoting lifestyles among Chinese university students: a comprehensive network approach. Front Psychiatry 2024; 15:1402680. [PMID: 39077626 PMCID: PMC11284064 DOI: 10.3389/fpsyt.2024.1402680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/26/2024] [Indexed: 07/31/2024] Open
Abstract
Background Anxiety, depression, and sleep problems are prevalent comorbid mental disorders among university students. The World Health Organization (WHO) emphasized a mental health promotion objective, recommending the consideration of protective health-promoting factors in strategies aimed at preventing mental disorders. Integrating theoretically significant constructs (such as protective factors) enhances our comprehension of the intricate mechanisms that underpin mental disorders. This study employed network analysis to first identify core and bridge symptoms within comorbid mental disorders and then explore how health-promoting lifestyles (HPLs) were associated with these disorders. The ultimate goal is to offer health promotion recommendations to enhance students' quality of life. Methods A total of 3,896 qualified university students participated in this study. Anxiety, depression, sleep problems, and HPLs were assessed using the GAD-7, PHQ-9, PSQI, and HPLP-II scales. A Gaussian Graphical Model was used to construct the networks. The Network Comparison Test was applied to determine whether the associations between HPLs and comorbid symptoms vary by gender, educational level, family sibling, and mental health status. Results Low energy (PHQ4) had the highest strength centrality, followed by Daytime dysfunction (PSQI7) and Trouble relaxing (GAD4). Five bridge symptoms were identified: Daytime dysfunction (PSQI7), Self-harm even suicide (PHQ9), Sad mood (PHQ2), Low energy (PHQ4), and Feeling afraid (GAD7). Regarding protective HPLs, Physical activity, Spiritual growth, and Stress management generally emerged as the top three central mental health-promoting behaviors. Conclusion Targeting core and bridge symptoms with timely and appropriate interventions can alleviate anxiety, depression, and sleep problems in this population. Moreover, promoting physical activity, fostering spiritual growth, and managing stress are likely to significantly enhance the overall mental health of university students.
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Affiliation(s)
- Changqing Sun
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhengqi Zhu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Peijia Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Lianke Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Qiang Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yuanli Guo
- Department of Neurology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Lina Guo
- Department of Neurology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yang Li
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Panpan Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Bo Hu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Mengting Liu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Jingyi Duan
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yiwen Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Ziqi Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Ying Qin
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
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Rosenberg BM, Young KS, Nusslock R, Zinbarg RE, Craske MG. Anhedonia is associated with overgeneralization of conditioned fear during late adolescence and early adulthood. J Anxiety Disord 2024; 105:102880. [PMID: 38833961 DOI: 10.1016/j.janxdis.2024.102880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 04/24/2024] [Accepted: 05/22/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Pavlovian fear paradigms involve learning to associate cues with threat or safety. Aberrances in Pavlovian fear learning correlate with psychopathology, especially anxiety disorders. This study evaluated symptom dimensions of anxiety and depression in relation to Pavlovian fear acquisition and generalization. METHODS 256 participants (70.31 % female) completed a Pavlovian fear acquisition and generalization paradigm at ages 18-19 and 21-22 years. Analyses focused on indices of learning (self-reported US expectancy, skin conductance). Multilevel models tested associations with orthogonal symptom dimensions (Anhedonia-Apprehension, Fears, General Distress) at each timepoint. RESULTS All dimensions were associated with weaker acquisition of US expectancies at each timepoint. Fears was associated with overgeneralization only at age 21-22. General Distress was associated with overgeneralization only at age 18-19. Anhedonia-Apprehension was associated with overgeneralization at ages 18-19 and 21-22. CONCLUSIONS Anhedonia-Apprehension disrupts Pavlovian fear acquisition and increases overgeneralization of fear. These effects may emerge during adolescence and remain into young adulthood. General Distress and Fears also contribute to overgeneralization of fear, but these effects may vary as prefrontal mechanisms of fear inhibition continue to develop during late adolescence. Targeting specific symptom dimensions, particularly Anhedonia-Apprehension, may decrease fear generalization and augment interventions built on Pavlovian principles, such as exposure therapy.
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Affiliation(s)
- Benjamin M Rosenberg
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
| | - Katherine S Young
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Robin Nusslock
- Department of Psychology, Northwestern University, Evanston, IL, USA; Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - Richard E Zinbarg
- Department of Psychology, Northwestern University, Evanston, IL, USA; The Family Institute at Northwestern University, Evanston, IL, USA
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
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9
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Rezaee M, Darroudi H, Etemad L, Shad AN, Zardast Z, Kohansal H, Ghayour-Mobarhan M, Sadeghian F, Moohebati M, Esmaily H, Darroudi S, Ferns GA. Anxiety, a significant risk factor for coronary artery disease: what is the best index. BMC Psychiatry 2024; 24:443. [PMID: 38877499 PMCID: PMC11177367 DOI: 10.1186/s12888-024-05798-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 04/28/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Coronary artery disease (CAD) is known as the leading cause of disability and death globally. Anxiety disorders are also recognized as common types of mental disorders that substantially impact global health. Iran ranks among the countries with a high incidence of CAD and anxiety disorders. Therefore, the present study aims to determine the potential association and epidemiological aspects of anxiety and CAD within the population of Mashhad, the second most popoulos city in Iran. METHODS The present study is based on extracted data from the Mashhad stroke and heart atherosclerotic disorder (MASHAD) study which is a 10-year prospective cohort study intended to assess the effects of various CAD risk factors among Mashhad city residents. Anxiety scores were assessed at the baseline using Beck Anxiety Inventory and individuals were classified based on the BAI 4-factor structure model which included autonomic, cognitive, panic, and neuromotor components. Accordingly, the association between baseline anxiety scores and the BAI four-factor model with the risk of CAD events was analyzed using SPSS software version 21. RESULTS Based on the results, 60.4% of the sample were female, and 5.6% were classified as having severe forms of anxiety. Moreover, severe anxiety was more prevalent in females. Results showed a 1.7% risk of CAD (p-value < 0.001) over 10 years with one unit increase in anxiety score. Based on the 4-factor model structure, we found that only panic disorder could significantly increase the risk of CAD by 1.1% over the 10-year follow-up (p-value < 0.001). CONCLUSION Anxiety symptoms, particularly panic disorder, are independently and significantly associated with an increased overall risk of developing CAD over a 10-year period. Therefore, further studies are warranted to investigate the mechanisms through which anxiety may cause CAD, as well as possible interventions to mitigate these processes.
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Affiliation(s)
- Mojtaba Rezaee
- Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Leila Etemad
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of MedicalSciences, Mashhad, Iran
- Medical Toxicology Research Center, Faculty of Medicine. Mashhad University of Medical Sciences, Mashhad, Iran
| | - Arya Nasimi Shad
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Zardast
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Houra Kohansal
- Biochemistry Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Department of Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Metabolic Syndrome research center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Sadeghian
- Department of Biochemistry and Biophysics, Faculty of Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Mohsen Moohebati
- Department of Cardiovascular, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Susan Darroudi
- Metabolic Syndrome research center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Vascular and Endovascular Surgery Research Center, Mashhad University of medical sciences, Mashhad, Iran.
| | - Gordon A Ferns
- Brighton and Sussex Medical School, Division of Medical Education, Sussex BN1 9PH, U, Falmer, Brighton, UK
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Wang W, Wang Y, Wang F, Chen H, Qin X, Yang L, Yang X, Yang L. Notable dysthymia: evolving trends of major depressive disorders and dysthymia in China from 1990 to 2019, and projections until 2030. BMC Public Health 2024; 24:1585. [PMID: 38872130 PMCID: PMC11170895 DOI: 10.1186/s12889-024-18943-7] [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: 09/17/2023] [Accepted: 05/23/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Depressive disorders have been identified as a significant contributor to non-fatal health loss in China. Among the various subtypes of depressive disorders, dysthymia is gaining attention due to its similarity in clinical severity and disability to major depressive disorders (MDD). However, national epidemiological data on the burden of disease and risk factors of MDD and dysthymia in China are scarce. METHODS This study aimed to evaluate and compare the incidence, prevalence, and disability-adjusted life-years (DALYs) caused by MDD and dysthymia in China between 1990 and 2019. The temporal trends of the depressive disorder burden were evaluated using the average annual percentage change. The comparative risk assessment framework was used to estimate the proportion of DALYs attributed to risk factors, and a Bayesian age-period-cohort model was applied to project the burden of depressive disorders. RESULTS From 1990 to 2019, the overall age-standardized estimates of dysthymia in China remained stable, while MDD showed a decreasing trend. Since 2006, the raw prevalence of dysthymia exceeded that of MDD for the first time, and increased alternately with MDD in recent years. Moreover, while the prevalence and burden of MDD decreased in younger age groups, it increased in the aged population. In contrast, the prevalence and burden of dysthymia remained stable across different ages. In females, 11.34% of the DALYs attributable to depressive disorders in 2019 in China were caused by intimate partner violence, which has increasingly become prominent among older women. From 2020 to 2030, the age-standardized incidence, prevalence, and DALYs of dysthymia in China are projected to remain stable, while MDD is expected to continue declining. CONCLUSIONS To reduce the burden of depressive disorders in China, more attention and targeted strategies are needed for dysthymia. It's also urgent to control potential risk factors like intimate partner violence and develop intervention strategies for older women. These efforts are crucial for improving mental health outcomes in China.
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Affiliation(s)
- Wei Wang
- Department of Psychology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, Shandong, 250012, China
| | - Yihe Wang
- Department of Neurology, The Second Hospital of Shandong University, Jinan, China
| | - Feng Wang
- Department of Education, Guangxi Normal University, Guilin, China
| | - Hui Chen
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China
- Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiaqing Qin
- Department of Psychology, Shandong Normal University, Jinan, China
| | - Lexia Yang
- Nursing Department, The Third Hospital of Jinan, Jinan, Shandong, 250000, China
| | - Xiaorong Yang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.
- Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
| | - Lejin Yang
- Department of Psychology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, Shandong, 250012, China.
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11
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Chin P, Gorman F, Beck F, Russell BR, Stephan KE, Harrison OK. A systematic review of brief respiratory, embodiment, cognitive, and mindfulness interventions to reduce state anxiety. Front Psychol 2024; 15:1412928. [PMID: 38933581 PMCID: PMC11203600 DOI: 10.3389/fpsyg.2024.1412928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 05/13/2024] [Indexed: 06/28/2024] Open
Abstract
Introduction Anxiety is one of the most prevalent mental health conditions worldwide, and psychotherapeutic techniques can be employed to help manage and mitigate symptoms. While the available therapies are numerous, key strategies often involve cognitive and/or embodiment techniques. Within body-centered methods, breathing-oriented approaches are particularly prevalent, using either attention towards or active control of breathing. As the perception of body states (i.e., interoception) is thought to be an integral component of emotion generation, these embodiment and breathing techniques may be key in addressing the miscommunication between the brain and body that is thought to exist with anxiety. Therefore, we conducted a systematic review and meta-analysis to assess the effects of acute administration of psychological interventions for state anxiety. Results This systematic review was conducted in accordance with the PRISMA statement and registered prospectively in PROSPERO. A literature search for randomized controlled trials was conducted in PubMed, PsycINFO, and Scopus. We considered interventions that focused on cognitive, embodiment or breathing strategies, or a combination of these techniques. Twelve studies met our inclusion criteria, and study characteristics, quality and effect sizes were assessed. A single cognitive study was found to produce a moderate reduction in state anxiety, while moderate to large effects were found across studies assessing embodiment practices. In contrast, studies which utilized breathing-based interventions alone produced inconsistent results, with both attention towards and active control of breathing producing large to no effects depending on the technique employed. Finally, consistent moderate effects were found with combination techniques that involved passive attention (e.g., towards cognitions, body and/or breathing), with active combination techniques producing inconsistent results. Discussion While study numbers are limited regarding brief interventions, cognitive and embodiment techniques are consistently helpful for reducing state anxiety, while breathing-based exercises need to consider the specific technique employed, and how successful this may be for each individual. Furthermore, combined practices such as mindfulness can also be successful, although care must be taken when introducing an active change to one or more elements. PROSPERO Systematic Review Registration Number CRD42024507585 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024507585.
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Affiliation(s)
- Phoebe Chin
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Faye Gorman
- Department of Psychology, University of Otago, Dunedin, New Zealand
- Ngāpuhi, New Zealand
- Ngāti Kahu, New Zealand
| | - Fraser Beck
- Ngāi Tahu, New Zealand
- Optimal Health Model Ltd., Glenorchy, New Zealand
| | | | - Klaas E. Stephan
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Zurich, Switzerland
| | - Olivia K. Harrison
- Department of Psychology, University of Otago, Dunedin, New Zealand
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Zurich, Switzerland
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12
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Bendall RCA, Elton SN, Hughes ATL. Expressive suppression mediates the relationship between sleep quality and generalized anxiety symptomology. Sci Rep 2024; 14:13575. [PMID: 38866858 PMCID: PMC11169225 DOI: 10.1038/s41598-024-63939-3] [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] [Received: 10/13/2023] [Accepted: 06/03/2024] [Indexed: 06/14/2024] Open
Abstract
Anxiety disorders are the most prevalent worldwide mental health disorder, resulting in high societal costs. Emotion regulation and sleep quality are associated with the development of psychopathologies including anxiety. However, it is unknown whether habitual emotion regulation strategy use can mediate the influence of sleep quality on anxiety symptomology. An opportunity sample in a healthy population completed the Pittsburgh Sleep Quality Index to provide a measure of sleep quality, the Emotion Regulation Questionnaire to assess habitual use of emotion regulation strategies, and the Generalized Anxiety Disorder Scale to record anxiety symptomology. Data were analysed using correlation and regression-based mediation analyses. Improved sleep quality was predictive of reduced habitual use of expressive suppression and reduced anxiety symptomology. Additionally, increased use of expressive suppression was predictive of greater anxiety symptomology. Cognitive reappraisal was not associated with sleep quality or anxiety severity. Further, novel findings using mediation analyses show that expressive suppression partially mediated the relationship between sleep quality and anxiety. Whilst longitudinal and experimental research are needed to establish causality, these findings suggest that simultaneously targeting improvements in sleep quality and the use of specific emotion regulation strategies, including expressive suppression, may improve the efficacy of interventions focussed on reducing anxiety-related symptomology.
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Affiliation(s)
- Robert C A Bendall
- Directorate of Psychology and Sport, School of Health and Society, University of Salford, Salford, UK.
- Centre for Applied Health Research, University of Salford, Salford, UK.
| | - Sophie N Elton
- Directorate of Psychology and Sport, School of Health and Society, University of Salford, Salford, UK
| | - Alun T L Hughes
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
- Institute of Health Research, Liverpool John Moores University, Liverpool, UK
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13
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Duncan Z, Ward B, Kippen R, Dietze P, Sutton K. A narrative systematic review of associations and temporality between use of methamphetamine, ecstasy/MDMA, or cocaine with anxiety or depressive symptoms. Addict Behav 2024; 153:107988. [PMID: 38394960 DOI: 10.1016/j.addbeh.2024.107988] [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] [Received: 11/29/2023] [Revised: 02/06/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE Anxiety and depression are prevalent mental health problems in people who use illicit stimulants. Improved understanding of the temporal relationship between methamphetamine, ecstasy/MDMA, or cocaine use with anxiety or depression informs public health interventions and treatment options for those experiencing this co-occurrence. This narrative systematic review sought to examine associations and temporality between the use of methamphetamine, ecstasy/MDMA, or cocaine, with anxiety or depressive symptoms. Method Systematic searches of 4 electronic databases were conducted up to August 2023. Study eligibility included the measurement of anxiety and/or depressive symptoms, and frequency of illicit stimulant use (methamphetamine, cocaine, or ecstasy/MDMA) at two separate time points, with data analysis of the association between these variables. The Joanna Briggs Critical Appraisal Checklist was utilised to assess quality. Data was extracted, and a narrative synthesis incorporating an eight-criteria framework to assess associations was conducted. Results 4432 studies were screened for eligibility; 11 studies (3 RCTs and 8 prospective cohort studies) were included. Evidence for an association between depressive symptoms and methamphetamine use was demonstrated in six studies, with temporal evidence in three studies supporting methamphetamine use preceding depressive symptoms. Three studies reported an association between cocaine use and depressive symptoms. Evidence for associations with any of the illicit stimulants and anxiety symptoms was lacking. CONCLUSIONS There was some evidence to support a case for temporality, particularly for methamphetamine use and depressive symptoms. Investing in longitudinal studies is pivotal to understanding the dynamic and reciprocal relationship between illicit stimulant use and anxiety or depressive symptoms. A limitation of the study was the variation in the measurement and analysis of outcomes.
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Affiliation(s)
- Zoe Duncan
- Monash Rural Health, Monash University, Melbourne, Australia.
| | - Bernadette Ward
- Monash Rural Health, Monash University, Melbourne, Australia; Behaviours and Health Risks Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Rebecca Kippen
- Monash Rural Health, Monash University, Melbourne, Australia
| | - Paul Dietze
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Victoria, Australia; National Drug Research Institute, Curtin University, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Keith Sutton
- Monash Rural Health, Monash University, Melbourne, Australia; National Drug Research Institute, Curtin University, Melbourne, Victoria, Australia
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14
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Merrill RM, Ashton MK. How Do Mental Disorders and Combinations of Disorders Affect the Odds of Injuries and Poisoning? J Nerv Ment Dis 2024; 212:303-311. [PMID: 38704650 DOI: 10.1097/nmd.0000000000001771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
ABSTRACT Injuries and poisoning are associated with mental disorders. The association may be stronger if comorbid mental illness is involved. This study explores whether selected mental disorders (stress, anxiety, depression, attention deficit hyperactivity disorder [ADHD], bipolar, obsessive-compulsive disorder [OCD], schizophrenia) are associated with injuries and poisoning and if the presence and frequency of comorbid mental illness affect these associations. Analyses utilize medical claims data for adult employees of a large corporation during 2017-2021. Approximately half or more of the index mental disorders experience comorbid mental illness. Odds of injury and poisoning are significantly greater for each mental disorder and tend to be significantly greater when comorbid mental illness exists ( vs . the mental disorder alone), especially for the associations involving poisoning. Schizophrenia alone and in combination with other mental illness has the strongest associations with injury and poisoning. OCD is only associated with injury and poisoning, and ADHD is only associated with poisoning, if accompanied by comorbid mental illness.
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Affiliation(s)
- Ray M Merrill
- Department of Public Health, College of Life Sciences, Brigham Young University, Provo, Utah
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15
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Casares MÁ, Díez-Gómez A, Pérez-Albéniz A, Lucas-Molina B, Fonseca-Pedrero E. Screening for anxiety in adolescents: Validation of the Generalized Anxiety Disorder Assessment-7 in a representative sample of adolescents. J Affect Disord 2024; 354:331-338. [PMID: 38490592 DOI: 10.1016/j.jad.2024.03.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/28/2024] [Accepted: 03/09/2024] [Indexed: 03/17/2024]
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16
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Bellaert N, Morreale K, Tseng WL. Peer functioning difficulties may exacerbate symptoms of attention-deficit/hyperactivity disorder and irritability over time: a temporal network analysis. J Child Psychol Psychiatry 2024; 65:809-821. [PMID: 37859512 PMCID: PMC11026298 DOI: 10.1111/jcpp.13911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/10/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Children with attention-deficit/hyperactivity disorder (ADHD) have been consistently found to experience impairments in peer functioning. Irritability is highly prevalent in children with ADHD and may worsen social impairments given the frequent temper outbursts and low frustration tolerance characterizing irritability. However, it is still unclear how ADHD and irritability symptoms interact with peer functioning difficulties over time. Assessing these temporal dynamics using a novel longitudinal approach (i.e., temporal network analysis) may reveal precise targets for intervention. METHODS This study investigates the dynamic associations between ADHD symptoms, irritability, and peer functioning in a community sample of 739 children (ages 8-11 years, Mage = 10.06 [SD = 0.59], 47.77% females) assessed at three timepoints, 6 months apart, in a school-based study. Parents reported their child's ADHD symptoms using the Swanson, Nolan, and Pelham Rating Scale (SNAP-IV), and irritability symptoms using the Child Behavior Checklist (CBCL) irritability items. Children's peer functioning (i.e., peer acceptance, peer rejection, number of friendships, and victimization) was measured via peer nomination. To estimate the longitudinal associations between the variables, we built a graphical vector autoregression model for panel data. RESULTS The longitudinal network highlighted that poor peer functioning contributed to increases in symptoms over time. Specifically, (1) physical victimization predicted increases in inattention, hyperactivity, and irritability; (2) peer rejection predicted increases in inattention, which in turn predicted increases in irritability; (3) peer acceptance predicted decreases in inattention and irritability; and (4) higher numbers of mutual friendships increased inattention. CONCLUSIONS These results suggest that a negative social environment involving physical bullying and rejection may aggravate ADHD and irritability symptoms. Conversely, positive social interactions, such as being liked by peers, may improve inattention and irritability symptoms. Fostering social-emotional skills and positive social interactions and environments in children with ADHD and irritability may be a promising target for future interventions to reduce symptoms.
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Affiliation(s)
- Nellia Bellaert
- Cognitive Psychology and Neuropsychology Department, University of Mons, Mons, Belgium
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, United States
| | - Kristina Morreale
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, United States
- University of New Haven, New Haven, CT, United States
| | - Wan-Ling Tseng
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, United States
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17
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Basso M, Zorzan I, Johnstone N, Barberis M, Cohen Kadosh K. Diet quality and anxiety: a critical overview with focus on the gut microbiome. Front Nutr 2024; 11:1346483. [PMID: 38812941 PMCID: PMC11133642 DOI: 10.3389/fnut.2024.1346483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/05/2024] [Indexed: 05/31/2024] Open
Abstract
Anxiety disorders disproportionally affect females and are frequently comorbid with eating disorders. With the emerging field of nutritional psychiatry, focus has been put on the impact of diet quality in anxiety pathophysiology and gut microbiome underlying mechanisms. While the relationship between diet and anxiety is bidirectional, improving dietary habits could better facilitate the actions of pharmacological and psychological therapies, or prevent their use. A better understanding of how gut bacteria mediate and moderate such relationship could further contribute to develop personalized programs and inform probiotics and prebiotics manufacturing. To date, studies that look simultaneously at diet, the gut microbiome, and anxiety are missing as only pairwise relationships among them have been investigated. Therefore, this study aims at summarizing and integrating the existing knowledge on the dietary effects on anxiety with focus on gut microbiome. Findings on the effects of diet on anxiety are critically summarized and reinterpreted in relation to findings on (i) the effects of diet on the gut microbiome composition, and (ii) the associations between the abundance of certain gut bacteria and anxiety. This novel interpretation suggests a theoretical model where the relationship between diet and anxiety is mediated and/or modulated by the gut microbiome through multiple mechanisms. In parallel, this study critically evaluates methodologies employed in the nutritional field to investigate the effects of diet on anxiety highlighting a lack of systematic operationalization and assessment strategies. Therefore, it ultimately proposes a novel evidence-based approach that can enhance studies validity, reliability, systematicity, and translation to clinical and community settings.
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Affiliation(s)
- Melissa Basso
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Irene Zorzan
- Molecular Systems Biology, School of Biosciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- Centre for Mathematical and Computational Biology, CMCB, University of Surrey, Guildford, United Kingdom
| | - Nicola Johnstone
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Matteo Barberis
- Molecular Systems Biology, School of Biosciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- Centre for Mathematical and Computational Biology, CMCB, University of Surrey, Guildford, United Kingdom
- Synthetic Systems Biology and Nuclear Organization, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Kathrin Cohen Kadosh
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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Liu XL, Chang LS. Deciphering the Genetic Links between Psychological Stress, Autophagy, and Dermatological Health: Insights from Bioinformatics, Single-Cell Analysis, and Machine Learning in Psoriasis and Anxiety Disorders. Int J Mol Sci 2024; 25:5387. [PMID: 38791423 PMCID: PMC11121097 DOI: 10.3390/ijms25105387] [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] [Received: 04/18/2024] [Revised: 05/08/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
The relationship between psychological stress, altered skin immunity, and autophagy-related genes (ATGs) is currently unclear. Psoriasis is a chronic skin inflammation of unclear etiology that is characterized by persistence and recurrence. Immune dysregulation and emotional disturbances are recognized as significant risk factors. Emerging clinical evidence suggests a possible connection between anxiety disorders, heightened immune system activation, and altered skin immunity, offering a fresh perspective on the initiation of psoriasis. The aim of this study was to explore the potential shared biological mechanisms underlying the comorbidity of psoriasis and anxiety disorders. Psoriasis and anxiety disorders data were obtained from the GEO database. A list of 3254 ATGs was obtained from the public database. Differentially expressed genes (DEGs) were obtained by taking the intersection of DEGs between psoriasis and anxiety disorder samples and the list of ATGs. Five machine learning algorithms used screening hub genes. The ROC curve was performed to evaluate diagnostic performance. Then, GSEA, immune infiltration analysis, and network analysis were carried out. The Seurat and Monocle algorithms were used to depict T-cell evolution. Cellchat was used to infer the signaling pathway between keratinocytes and immune cells. Four key hub genes were identified as diagnostic genes related to psoriasis autophagy. Enrichment analysis showed that these genes are indeed related to T cells, autophagy, and immune regulation, and have good diagnostic efficacy validated. Using single-cell RNA sequencing analysis, we expanded our understanding of key cellular participants, including inflammatory keratinocytes and their interactions with immune cells. We found that the CASP7 gene is involved in the T-cell development process, and correlated with γδ T cells, warranting further investigation. We found that anxiety disorders are related to increased autophagy regulation, immune dysregulation, and inflammatory response, and are reflected in the onset and exacerbation of skin inflammation. The hub gene is involved in the process of immune signaling and immune regulation. The CASP7 gene, which is related with the development and differentiation of T cells, deserves further study. Potential biomarkers between psoriasis and anxiety disorders were identified, which are expected to aid in the prediction of disease diagnosis and the development of personalized treatments.
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Affiliation(s)
| | - Long-Sen Chang
- Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung 804, Taiwan;
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19
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Hwang JS, Yeo JN, Hwang IC. Serum uric acid levels in people with anxiety: A Korean nationwide survey. J Affect Disord 2024; 352:138-139. [PMID: 38367496 DOI: 10.1016/j.jad.2024.02.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 02/19/2024]
Affiliation(s)
- Ju Sam Hwang
- Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Ji Na Yeo
- Division of Rheumatology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - In Cheol Hwang
- Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea.
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Wang Y, Timms F, Li J, Yu H. Benefits of nature-based intervention in combating the impact of urbanization on psychopathology in industrialized societies. Curr Opin Psychiatry 2024; 37:202-211. [PMID: 38415720 DOI: 10.1097/yco.0000000000000937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
PURPOSE OF REVIEW The assumption has been made that urbanization adversely affects mental health, primarily attributed to the lack of access to nature. Our objective is to examine whether nature-based interventions can reduce psychopathology within an urban setting. RECENT FINDINGS Nature-based interventions are generally categorized as either physical or virtual. Physical interventions engage participants in various activities like passive exposure, outdoor swimming, or physical activities in natural environments. On the other hand, virtual interventions expose participants to visual, auditory, or even olfactory stimuli to simulate natural environments. While most interventions achieved some degree of success in enhancing overall well being, not all demonstrated a significant reduction in depression and anxiety. SUMMARY The review identified a shortage of well designed and well implemented outdoor or virtual nature-based interventions. Longitudinal designs in physical nature-based interventions provided the strongest evidence for reducing anxiety and depression. Multisensory virtual nature-based interventions also show significant potential for alleviating anxiety and depression in urban dwellers. Conversely, brief nature-based interventions yielded inconsistent results in improving mental health. Urgent investment in high-quality interventions and research in this domain is imperative to inform policy and enhance overall mental health in urban settings.
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Affiliation(s)
- Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Franklin Timms
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Jiaqi Li
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Hui Yu
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
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Lakhtakia T, Smith SR, Mohr DC, Stamatis CA. Longitudinal associations of daily affective dynamics with depression, generalized anxiety, and social anxiety symptoms. J Affect Disord 2024; 352:437-444. [PMID: 38286236 DOI: 10.1016/j.jad.2024.01.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 01/22/2024] [Accepted: 01/26/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND Low average affect, measured using ecological momentary assessment (EMA), has been consistently linked with depression, generalized anxiety, and social anxiety, supporting trait-like negative affect as a shared underlying feature. However, while theoretical models of emotion regulation would also implicate greater variability in daily affect in these conditions, empirical evidence linking EMA of mood variability with affective disorders is mixed. We used multilevel modeling to test relationships of daily mood and mood variability with depression, generalized anxiety, and social anxiety symptoms. METHODS Participants (N = 1004; 72.31 % female; Mage = 40.85) responded to EMA of mood 2-3×/day and completed measures of depression (PHQ-8), generalized anxiety (GAD-7), and social anxiety (SPIN) every three weeks. RESULTS Lower mean affect predicted all symptoms at both the between-person (PHQ-8: β = -0.486, p < 0.001; GAD-7: β = -0.429, p < 0.001; SPIN: β = -0.284, p < 0.001) and within-person (PHQ-8: β = -0.219, p < 0.001; GAD-7: β = -0.196, p < 0.001; SPIN: β = -0.049, p < 0.001) levels. Similarly, at the between-person level, greater affective variability was linked with all three clinical symptoms (PHQ-8: β = 0.617, p < 0.001; GAD-7: β = 0.703, p < 0.001; SPIN: β = 0.449, p < 0.001). However, within-person, affective variability related to depression (β = 0.144, p < 0.001) and generalized anxiety (β = 0.150, p < 0.001), but not social anxiety (β = 0.006, p = 0.712). LIMITATIONS The COVID-19 pandemic lockdown period occurred midway through the study. CONCLUSION Findings point to common and specific emotion dynamics that characterize affective symptoms severity, with implications for affective monitoring in a clinical context.
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Affiliation(s)
- Tanvi Lakhtakia
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, United States of America
| | - Shannon R Smith
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, United States of America
| | - David C Mohr
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, United States of America
| | - Caitlin A Stamatis
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, United States of America.
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22
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Martins EC, Teixeira TM. Correlation between psychological status, revised Müller AO classification and patient-reported outcomes: a prospective cohort analysis. Arch Orthop Trauma Surg 2024; 144:2149-2155. [PMID: 38554207 DOI: 10.1007/s00402-024-05288-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/14/2024] [Indexed: 04/01/2024]
Abstract
INTRODUCTION The impact of psychological status on clinical outcomes is valued in several medical conditions, but rare attention is given to it in orthopedic trauma. We aimed to assess the correlation between psychological status, fracture severity and patient-reported outcomes in fractured patients needing urgency surgical treatment. MATERIALS AND METHODS We prospectively followed 139 consecutive patients undergoing urgency surgical treatment of a lower/upper limb fracture. Before surgery, all patients were divided into grades of fracture severity according to the Revised AO Müller Classification (AO grades). On the 15th and the 120th days after surgery, all patients underwent a psychological status assessment through the Hospital Anxiety and Depression Score (HADS), in addition to a pain evaluation through VAS. One year after surgery, patient-reported outcomes were obtained by using specific scales depending on the site of fracture. RESULTS AO grades and VAS scores were significantly correlated to scores at HADS-A (anxiety component) and HADS-D (depression component), both on the 15th and the 120th. Patients presenting persistent HADS-A and HADS-D scores equal or greater than 8 points had a risk of more than 2.5 or 2.0 times of experiencing unsatisfactory surgical outcomes, respectively [HADS-A: RR = 2.8 (95% CI: 2.2-3.5)] [HADS-D: RR = 2.2 (95% CI: 1.7-3.1)]. AO grade C and the persistency of significant symptoms of anxiety or depression were independent predictors of unsatisfactory patient-reported outcomes (OR: 1.7, p = 0.03 // OR: 2.9, p < 0.01). Female gender, age, and BMI did not present any statistically significant utility in predicting unsatisfactory patient-reported outcomes. CONCLUSION In fractured patients needing urgency surgical treatment, the risk of presenting unsatisfactory outcomes is more than twice as high in patients that present significant persistent changes in psychological status. Changes in psychological status are more frequent in patients presenting more severe pain and more severe fractures. AO grades and HADS scores are independent predictors of unsatisfactory outcomes in these patients.
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Affiliation(s)
- Eduardo Campos Martins
- Department of Surgery, Polydoro Ernani de São Thiago University Hospital, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
- Fractures Institute, Baía Sul Medical Center, Florianópolis, Santa Catarina, Brazil.
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Gebreegziabher ZA, Eristu R, Molla A. Determinants of adolescents' depression, anxiety, and somatic symptoms in Northwest Ethiopia: A non-recursive structural equation modeling. PLoS One 2024; 19:e0281571. [PMID: 38598540 PMCID: PMC11006201 DOI: 10.1371/journal.pone.0281571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 01/16/2024] [Indexed: 04/12/2024] Open
Abstract
INTRODUCTION In low and middle-income countries, adolescent mental health is not only a major public health challenge but also a development concern. Depression and anxiety are the most common mental health disorders and somatic symptoms often co-exist with them. Adolescents with common mental health problems are associated with an increased risk of suicide, future unemployment, and poor quality of life. However, little is known about the mental health of adolescents in Ethiopia. Thus, this study aimed to assess the determinants of depression, anxiety, and somatic symptoms among adolescents in Northwest Ethiopia, in 2022. METHODS An institution-based cross-sectional study was conducted from June 8 to 24, 2022. Two-stage stratified random sampling was used to select 1407 adolescents in Northwest Ethiopia. Structured and standardized self-administered questionnaires were used to collect the data. Non-recursive structural equation modeling was employed to assess the direct, indirect, and total effects of predictors. Adjusted regression coefficients and corresponding 95% confidence intervals were used to interpret the strength of the association. RESULTS The prevalence of depression, anxiety, and somatic symptoms were 28.21% (95% CI: 25.8, 31%), 25.05% (95%CI: 22.8, 27.5), and 25.24(95% CI: 23, 27.6%) respectively. Alcohol use had a significant positive effect on depression [β = 0.14, 95% CI: 0.073, 0.201], anxiety [β = 0.11, 95% CI: 0.041, 0.188], and somatic symptoms [β = 0.12, 95% CI: 0.062, 0.211]. Stress had a significant positive effect on depression [β = 0.76, 95% CI: 0.642, 0.900], anxiety [β = 1.10, 95% CI: 0.955, 1.264], and somatic symptoms [β = 086, 95% C: 0.700, 1.025]. Depression had a direct positive effect on anxiety [β = 0.74, 95% CI: 0.508, 1.010]. CONCLUSION In this study, the prevalence of depression, anxiety, and somatic symptoms was moderate. Alcohol use and stress were significantly related to depression, anxiety, and somatic symptoms. The bidirectional relationship between anxiety and depression was significant. Therefore, public health interventions should focus on the bidirectional relationship between depression and anxiety, as well as on identified factors to reduce the burden of mental illness in adolescents.
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Affiliation(s)
- Zenebe Abebe Gebreegziabher
- Department of Epidemiology and Biostatistics, School of Public Health, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Rediet Eristu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ayenew Molla
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Hua Y, Jiang W, He Y, Zheng X, Huang C, Guo L, Guo Y, Guo L. Associations of recent stressful life events with anxiety symptoms among Chinese adolescents with a consideration of family functioning. Eur J Psychotraumatol 2024; 15:2337577. [PMID: 38597558 PMCID: PMC11008314 DOI: 10.1080/20008066.2024.2337577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/25/2024] [Indexed: 04/11/2024] Open
Abstract
Background: The association between stressful life events (SLEs) and adolescent anxiety symptoms has been extensively studied, but the specific impacts of different SLEs domains remain inconclusive. Moreover, limited research has examined the role of family functioning in these associations.Objective: This study aimed to investigate the associations between various recent SLEs and adolescent anxiety symptoms and explore the role of family functioning.Methods: Data were obtained from the second phase of the Longitudinal Study of Adolescents' Mental and Behavioral Well-being Research in Guangzhou, China. A total of 10,985 students (51.9% boys; mean [SD] age, 15.3 [1.5] years) from forty middle schools participated in the study in 2022 and completed a self-report questionnaire assessing anxiety symptoms, SLEs, and family functioning using the Generalized Anxiety Disorder-7 (GAD-7), Adolescent Self-rating Life Events Checklist (ASLEC; including five subscales: interpersonal stress, academic stress, punishment-related stress, loss-related stress, and adaptation-related stress), and the adapted Chinese version of the Family Assessment Device (FAD), respectively. Linear mixed-effects models were performed and the moderation role of family functioning was also examined.Results: The fully adjusted model revealed that a 1-SD increase in the overall ASLEC score was associated with higher levels of anxiety symptoms (β = 2.23, 95%CI: 2.15-2.32). Among various SLEs domains, the academic domain shows the most significant association (β = 2.25, 95%CI: 2.17-2.33). Family functioning exerted an independent protective influence on anxiety symptoms, with each 1-SD increase in FAD scores negatively associated with anxiety symptoms (β = -2.11, 95%CI: - 2.29 to - 1.93) in the adjusted model. Moreover, family functioning significantly buffered the impacts of overall SLEs and each domain, except for adaptation-related SLEs, on anxiety symptoms.Conclusion: Higher recent SLEs levels were associated with increased anxiety symptoms among adolescents, with academic SLEs showing the greatest association. Positive family functioning had both direct and buffering influences on anxiety symptoms.
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Affiliation(s)
- Yilin Hua
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Weiqing Jiang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Yitong He
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Xinyu Zheng
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Cuihong Huang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Liling Guo
- Department of Prevention and Treatment of Common Diseases among Students, Health Promotion Center for Primary and Secondary Schools in Guangzhou, Guangzhou, People's Republic of China
| | - Yangfeng Guo
- Department of Prevention and Treatment of Common Diseases among Students, Health Promotion Center for Primary and Secondary Schools in Guangzhou, Guangzhou, People's Republic of China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
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Jackson AD, Cohen JL, Phensy AJ, Chang EF, Dawes HE, Sohal VS. Amygdala-hippocampus somatostatin interneuron beta-synchrony underlies a cross-species biomarker of emotional state. Neuron 2024; 112:1182-1195.e5. [PMID: 38266646 PMCID: PMC10994747 DOI: 10.1016/j.neuron.2023.12.017] [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: 07/28/2022] [Revised: 03/20/2023] [Accepted: 12/22/2023] [Indexed: 01/26/2024]
Abstract
Emotional responses arise from limbic circuits including the hippocampus and amygdala. In the human brain, beta-frequency communication between these structures correlates with self-reported mood and anxiety. However, both the mechanism and significance of this biomarker as a readout vs. driver of emotional state remain unknown. Here, we show that beta-frequency communication between ventral hippocampus and basolateral amygdala also predicts anxiety-related behavior in mice, both on long timescales (∼30 min) and immediately preceding behavioral choices. Genetically encoded voltage indicators reveal that this biomarker reflects synchronization between somatostatin interneurons across both structures. Indeed, synchrony between these neurons dynamically predicts approach-avoidance decisions, and optogenetically shifting the phase of synchronization by just 25 ms is sufficient to bidirectionally modulate anxiety-related behaviors. Thus, back-translation establishes a human biomarker as a causal determinant (not just predictor) of emotional state, revealing a novel mechanism whereby interregional synchronization that is frequency, phase, and cell type specific controls emotional processing.
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Affiliation(s)
- Adam D Jackson
- Department of Psychiatry and Behavioral Sciences, Center for Integrative Neuroscience and Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA 94143-0444, USA; Weill Institute for Neurosciences, Center for Integrative Neuroscience and Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA 94143-0444, USA
| | - Joshua L Cohen
- Department of Psychiatry and Behavioral Sciences, Center for Integrative Neuroscience and Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA 94143-0444, USA; Weill Institute for Neurosciences, Center for Integrative Neuroscience and Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA 94143-0444, USA
| | - Aarron J Phensy
- Department of Psychiatry and Behavioral Sciences, Center for Integrative Neuroscience and Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA 94143-0444, USA; Weill Institute for Neurosciences, Center for Integrative Neuroscience and Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA 94143-0444, USA
| | - Edward F Chang
- Department of Neurological Surgery, Center for Integrative Neuroscience and Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA 94143-0444, USA; Weill Institute for Neurosciences, Center for Integrative Neuroscience and Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA 94143-0444, USA
| | - Heather E Dawes
- Department of Neurological Surgery, Center for Integrative Neuroscience and Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA 94143-0444, USA; Weill Institute for Neurosciences, Center for Integrative Neuroscience and Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA 94143-0444, USA
| | - Vikaas S Sohal
- Department of Psychiatry and Behavioral Sciences, Center for Integrative Neuroscience and Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA 94143-0444, USA; Weill Institute for Neurosciences, Center for Integrative Neuroscience and Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA 94143-0444, USA.
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26
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Liu X, Yang F, Huang N, Zhang S, Guo J. Thirty-year trends of anxiety disorders among adolescents based on the 2019 Global Burden of Disease Study. Gen Psychiatr 2024; 37:e101288. [PMID: 38595856 PMCID: PMC11002340 DOI: 10.1136/gpsych-2023-101288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/25/2024] [Indexed: 04/11/2024] Open
Abstract
Background Anxiety disorders are the most common psychiatric problems, affecting approximately 1 in 12 children and 1 in 4 adolescents. Understanding the incidence, burden and correlated risks of anxiety disorders among children and adolescents can help identify areas of success, stagnation and emerging threats, thereby facilitating effective improvement strategies. Aims To estimate the incidence and burden trends of anxiety disorders in children and adolescents from 1990 to 2019 in 204 countries and compare the incidence and disease burden in different countries. To examine the association between anxiety disorders and social indicators (healthcare access and quality of life). Methods Data were obtained from the Global Burden of Disease Study 2019. The age-standardised incidence rates (ASIRs) and disability-adjusted life years (DALYs) were reported to assess the burden of anxiety disorders, and the estimated annual percentage change was calculated to quantify the temporal trends. Pearson's correlation was used to investigate country-level risk factors for incidence and DALYs. Results Globally, there were 932 million incident cases of anxiety disorders in children and adolescents, 739.29 per 100 000 ASIRs and 380.62 million DALYs in 2019. From 1990 to 2019, the estimated annual percentage change of incidence of anxiety disorders decreased by 2.2%. Significant variations were observed in the age-standardised burden rate and the changing trend of anxiety disorders among countries. Portugal reported the highest ASIR of anxiety disorders, while Mexico had the largest increase rate of ASIR. In 2019, Portugal reported the highest number of DALYs (1001.71 million), and India (212.09 million) reported the lowest number of DALYs. The burden of anxiety disorders was positively correlated with the average number of psychiatrists, psychologists and nurses in the mental health sector (per 100 000), and quality of life and the correlation coefficients were 0.58, 0.67, 0.43 and 0.53, respectively. Conclusions The incidence and global burden of anxiety disorders in adolescents have continued to decrease over the past 30 years. However, the incidence and disease burden in developed countries are still increasing steadily. Policymakers should design and implement mental health strategies for adolescents based on their specific developmental status, as well as the cultural and regional characteristics of each country.
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Affiliation(s)
- Xiaohan Liu
- School of Public Health, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, China
| | - Fan Yang
- School of Public Health, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, China
| | - Ning Huang
- School of Public Health, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, China
| | - Shan Zhang
- School of Public Health, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, China
| | - Jing Guo
- School of Public Health, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, China
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27
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Drzewiecki CM, Fox AS. Understanding the heterogeneity of anxiety using a translational neuroscience approach. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2024; 24:228-245. [PMID: 38356013 PMCID: PMC11039504 DOI: 10.3758/s13415-024-01162-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/14/2024] [Indexed: 02/16/2024]
Abstract
Anxiety disorders affect millions of people worldwide and present a challenge in neuroscience research because of their substantial heterogeneity in clinical presentation. While a great deal of progress has been made in understanding the neurobiology of fear and anxiety, these insights have not led to effective treatments. Understanding the relationship between phenotypic heterogeneity and the underlying biology is a critical first step in solving this problem. We show translation, reverse translation, and computational modeling can contribute to a refined, cross-species understanding of fear and anxiety as well as anxiety disorders. More specifically, we outline how animal models can be leveraged to develop testable hypotheses in humans by using targeted, cross-species approaches and ethologically informed behavioral paradigms. We discuss reverse translational approaches that can guide and prioritize animal research in nontraditional research species. Finally, we advocate for the use of computational models to harmonize cross-species and cross-methodology research into anxiety. Together, this translational neuroscience approach will help to bridge the widening gap between how we currently conceptualize and diagnose anxiety disorders, as well as aid in the discovery of better treatments for these conditions.
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Affiliation(s)
- Carly M Drzewiecki
- California National Primate Research Center, University of California, Davis, CA, USA.
| | - Andrew S Fox
- California National Primate Research Center, University of California, Davis, CA, USA.
- Department of Psychology, University of California, Davis, CA, USA.
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28
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Chang J, Liu X, Xue S, Qiu J. An amygdala-centered effective connectivity network in trait anxiety. Brain Imaging Behav 2024; 18:324-330. [PMID: 38078980 DOI: 10.1007/s11682-023-00837-8] [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] [Accepted: 12/01/2023] [Indexed: 06/07/2024]
Abstract
Previous studies have established that the amygdala plays an important role in trait anxiety. However, there remains limited knowledge regarding the changes in amygdala-centered effective connectivity network associated with this trait. The current study employed the Granger Causal analysis to investigate the directional connectivity patterns involving the amygdala in relation to trait anxiety in a large cohort of young adults (N = 424). The results revealed a negative association between trait anxiety scores and the Granger causality from the left middle frontal gyrus and right superior frontal gyrus to the right amygdala. Conversely, higher trait anxiety levels were found to be associated with increased effective connectivity from the left amygdala to the left hippocampus. These results demonstrated the significance of the prefrontal cortex-amygdala-hippocampus neural circuitry in the neurobiological mechanisms underlying trait anxiety. Our findings advance the comprehension of this characteristic, holding promise for informing strategies in the prevention and treatment of related mental disorders.
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Affiliation(s)
- Jingjing Chang
- Institute of Psychology, School of Public Policy, Xiamen University, Xiamen, China
| | - Xin Liu
- Department of Neurology, Affiliated Hospital of Chengdu University, Chengdu, China
| | - Song Xue
- School of Psychology, Nanjing Normal University, Nanjing, 210097, China.
- Faculty of Psychology, Key Laboratory of Cognition and Personality, Southwest University, Ministry of Education, Chongqing, China.
| | - Jiang Qiu
- Faculty of Psychology, Key Laboratory of Cognition and Personality, Southwest University, Ministry of Education, Chongqing, China
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Dilmore AH, Kuplicki R, McDonald D, Kumar M, Estaki M, Youngblut N, Tyakht A, Ackermann G, Blach C, MahmoudianDehkordi S, Dunlop BW, Bhattacharyya S, Guinjoan S, Mandaviya P, Ley RE, Kaddaruh-Dauok R, Paulus MP, Knight R. Medication Use is Associated with Distinct Microbial Features in Anxiety and Depression. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.19.585820. [PMID: 38562901 PMCID: PMC10983923 DOI: 10.1101/2024.03.19.585820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
This study investigated the relationship between gut microbiota and neuropsychiatric disorders (NPDs), specifically anxiety disorder (ANXD) and/or major depressive disorder (MDD), as defined by DSM-IV or V criteria. The study also examined the influence of medication use, particularly antidepressants and/or anxiolytics, classified through the Anatomical Therapeutic Chemical (ATC) Classification System, on the gut microbiota. Both 16S rRNA gene amplicon sequencing and shallow shotgun sequencing were performed on DNA extracted from 666 fecal samples from the Tulsa-1000 and NeuroMAP CoBRE cohorts. The results highlight the significant influence of medication use; antidepressant use is associated with significant differences in gut microbiota beta diversity and has a larger effect size than NPD diagnosis. Next, specific microbes were associated with ANXD and MDD, highlighting their potential for non-pharmacological intervention. Finally, the study demonstrated the capability of Random Forest classifiers to predict diagnoses of NPD and medication use from microbial profiles, suggesting a promising direction for the use of gut microbiota as biomarkers for NPD. The findings suggest that future research on the gut microbiota's role in NPD and its interactions with pharmacological treatments are needed.
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Affiliation(s)
- Amanda Hazel Dilmore
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
- Biomedical Sciences Graduate Program, University of California San Diego, La Jolla, California, USA
| | - Rayus Kuplicki
- Laureate Institute for Brain Research, Tulsa, Oklahoma, USA
| | - Daniel McDonald
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Megha Kumar
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Mehrbod Estaki
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Nicholas Youngblut
- Department of Microbiome Science, Max Planck Institute for Biology, Tübingen, Germany
| | - Alexander Tyakht
- Department of Microbiome Science, Max Planck Institute for Biology, Tübingen, Germany
| | - Gail Ackermann
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Colette Blach
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
- Department of Medicine, Duke University, Durham, North Carolina, USA
- Duke Institute of Brain Sciences, Duke University, Durham, North Carolina, USA
| | | | - Boadie W. Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Sudeepa Bhattacharyya
- Department of Biological Sciences, Arkansas Biosciences Institute, Arkansas State University, Jonesboro, AR, USA
| | | | - Pooja Mandaviya
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ruth E. Ley
- Department of Microbiome Science, Max Planck Institute for Biology, Tübingen, Germany
| | - Rima Kaddaruh-Dauok
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
- Department of Medicine, Duke University, Durham, North Carolina, USA
- Duke Institute of Brain Sciences, Duke University, Durham, North Carolina, USA
| | | | - Rob Knight
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
- Department of Computer Science & Engineering, University of California San Diego, La Jolla, California, USA
- Department of Bioengineering, University of California San Diego, La Jolla, California, USA
- Center for Microbiome Innovation, University of California San Diego, La Jolla, California, USA
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Ridge LJ, Kennedy S, Davis M, McCullagh MC. How Depression and Anxiety Impact Adherence to COVID-19 Prevention Practices in Urban Liberia. West J Nurs Res 2024; 46:192-200. [PMID: 38343034 DOI: 10.1177/01939459241228687] [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] [Indexed: 02/29/2024]
Abstract
BACKGROUND Understanding the relationship between mental health and COVID-19 prevention practices is crucial but challenging considering COVID-19's impact on mental well-being. Liberia, a West African country, had well-documented rates of depression and anxiety prior to COVID-19. Liberia responded aggressively to COVID-19 while case counts remained low; thus, it is an ideal setting to study the relationship of mental health and COVID-19 prevention practices. METHODS A validated cross-sectional survey was administered to 250 randomly selected residents of Montserrado county, Liberia in June 2021, asking about their mental health and adherence to COVID-19 prevention practices. The survey included the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-9 to assess for anxiety and depression, respectively. Responses were analyzed using Spearman correlation and regression. RESULTS Scores indicative of depression were present in 43% (95% confidence interval [CI]: 37-49) of participants; scores indicative of anxiety were present in 41% (95% CI: 34-47). Self-reported adherence to COVID-19 prevention practices was middling and varied greatly by behavior. Higher scores for depression and anxiety were significantly associated with lower adherence to COVID-19 prevention practices. CONCLUSIONS Results indicate that while the spread of COVID-19 has certainly affected mental health, it is likely that pre-existing mental health conditions affected the spread of COVID-19 through lower adherence to prevention practices. Policymakers should consider investing in mental health services as an important step in managing future epidemics, and the needs of people with poor mental health when designing epidemic responses, particularly in low-income countries where the burdens of adherence are likely to be greater.
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Affiliation(s)
- Laura Jean Ridge
- Department of Systems, Populations and Leadership, University of Michigan, Ann Arbor, MI, USA
| | - Stephen Kennedy
- Pacific Institute for Research and Evaluation, University of Liberia, Monrovia, Liberia
| | - Matthew Davis
- Department of Systems, Populations and Leadership, University of Michigan, Ann Arbor, MI, USA
| | - Marjorie C McCullagh
- Department of Systems, Populations and Leadership, University of Michigan, Ann Arbor, MI, USA
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Dahlén E, Bardage C, Tuvendal P, Ljung R. New users of anxiolytics and sedatives in Sweden-Drug type, doses, prescribers' characteristics, and psychiatric comorbidity in more than 750,000 patients. Int J Methods Psychiatr Res 2024; 33:e1998. [PMID: 38351589 PMCID: PMC10903432 DOI: 10.1002/mpr.1998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 09/22/2023] [Accepted: 11/02/2023] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVES Anxiety and sleep disorders are common in the population and anxiolytics and sedatives are widely used. Our aim was to describe the drug utilization of new users of anxiolytics and sedatives in adults including type of drug, doses, prescribers' characteristics, and psychiatric comorbidity. METHODS A register-based cohort study of new users (18-64 years) of anxiolytics and sedatives in 2015-2019, free of any such drug 5 years prior to inclusion. The individuals were linked to national registers on dispensed drugs and recorded diagnoses. RESULTS In total, 764,432 new users of anxiolytics and sedatives were identified, which corresponds to an incidence of 26/1000 inhabitants and year. The proportion of new users of benzodiazepines (including both anxiolytics and sedatives) decreased, whereas the proportion of sedative antihistamines and melatonin increased. The most common drug dispensed was hydroxizin (33%) followed by benzodiazepine related drugs (zopiclone and zolpidem; 20%), propiomazine (14%) and benzodiazepines (13%). The majority (68%) of the prescriptions were from primary care. Most new users were prescribed 1-30DDDs and 52% among women and 49% among men were dispensed their drug only once during the first year. Half of the new users had a previous comorbid psychiatric disorder. CONCLUSIONS The findings are well reflecting the recommendations in national guidelines.
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Affiliation(s)
- Elin Dahlén
- The Swedish Medical Products AgencyUppsalaSweden
- Department of Clinical Science and EducationSödersjukhusetKarolinska InstitutetStockholmSweden
| | | | | | - Rickard Ljung
- The Swedish Medical Products AgencyUppsalaSweden
- Unit of EpidemiologyInstitute of Environmental MedicineKarolinska InstitutetStockholmSweden
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Albayrak T, Torun Göktaş A, Eyüpoğlu S, Muhtaroğlu A, Dulger AC. Patient Anxiety in Endoscopy: A Comparative Analysis of Single vs. Dual Procedure Effects. Cureus 2024; 16:e57237. [PMID: 38686224 PMCID: PMC11056767 DOI: 10.7759/cureus.57237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2024] [Indexed: 05/02/2024] Open
Abstract
AIM This study aimed to investigate the difference in anxiety levels between patients undergoing gastroscopy only and those subjected to both gastroscopy and colonoscopy. Despite known preoperative anxiety impacts, no prior research has compared these specific patient groups. MATERIALS AND METHODS A total of 150 patients were divided equally into two groups: Group I, undergoing gastroscopy only, and Group II, undergoing gastroscopy and colonoscopy. Inclusion criteria were patients in the age range 18-70 years and having an ASA (American Society of Anesthesiologists) physical status classification of I-III. Exclusion criteria were patients outside the age range, and patients with hearing disorders, psychiatric disorders, dementia, or recent anxiolytic drug use. Anxiety was analysed using the Beck Anxiety Inventory Scale before procedures, without any premedication. RESULTS Patients in Group II had significantly higher anxiety levels, with particular increases noted in symptoms such as leg weakness and tremors, inability to relax, and fears of adverse events and death. These results highlighted a considerable elevation in anxiety among patients anticipating or undergoing combined endoscopic procedures. DISCUSSION The findings revealed that undergoing combined gastroscopy and colonoscopy procedures significantly elevated patient anxiety levels compared to gastroscopy alone. This suggests a critical need for healthcare providers to implement more strong preoperative counselling and anxiety reduction strategies for patients facing multiple procedures. Addressing this increased anxiety could lead to better patient experiences, reduced procedural complications, and improved satisfaction and outcomes.
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Affiliation(s)
- Tuna Albayrak
- Department of Anesthesiology and Reanimation, Giresun University Faculty of Medicine, Giresun, TUR
| | - Ayşegül Torun Göktaş
- Department of Anesthesiology and Reanimation, Giresun İlhan Özdemir State Hospital, Giresun, TUR
| | - Selin Eyüpoğlu
- Department of Anesthesiology and Critical Care, Giresun Training and Research Hospital, Giresun, TUR
| | - Ali Muhtaroğlu
- Department of General Surgery, Giresun University Faculty of Medicine, Giresun, TUR
| | - Ahmet Cumhur Dulger
- Department of Gastroenterology, Giresun University Faculty of Medicine, Giresun, TUR
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Gómez-Gómez I, Barquero-Jiménez C, Johnson E, Conejo-Cerón S, Moreno-Peral P, Bellón JÁ, Motrico E. Effectiveness of multiple health behavior change interventions in reducing symptoms of anxiety in the adult population: A systematic review and meta-analysis of randomized controlled trials. Prev Med 2024; 180:107847. [PMID: 38199592 DOI: 10.1016/j.ypmed.2024.107847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 11/30/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
There is limited evidence regarding the effectiveness of preventive interventions for anxiety disorders. We aim to test the effectiveness of multiple health behavior change (MHBC) interventions in the reduction of symptoms of anxiety in the adult population. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted by searching the most relevant databases and registry platforms in the area. Reference lists of included articles and relevant systematic reviews and meta-analyses of MHBC interventions that examined anxiety or depression as outcomes were also manually searched. To identify RCTs that evaluated preventive interventions, we excluded studies in which the target population included only patients meeting the diagnostic criteria for anxiety disorders. To pool results, the standardized mean difference (SMD) was calculated using the random effects model. Sensitivity, subgroup and meta-regression analyses were performed. Forty-six RCTs were included in the qualitative synthesis, and 34 RCTs were included in the meta-analysis. Thirty RCTs were focused on promoting healthy diet and physical activity, whereas the other 16 studies also focused on smoking cessation. The pooled SMD was small (-0.183; 95% CI -0.276 to -0.091) but significant (p < 0.001). The effect became non-significant when only studies with a low risk of bias were included. There was substantial and significant heterogeneity between the studies. There is currently insufficient evidence regarding the effectiveness of MHBC interventions to reduce symptoms of anxiety in the adult population.
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Affiliation(s)
- Irene Gómez-Gómez
- Department of Psychology, Universidad Loyola Andalucía, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain
| | | | - Emma Johnson
- Centre for Applied Psychology, School of Psychology, University of Birmingham, UK
| | - Sonia Conejo-Cerón
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain; Research Unit of the Health District of Primary Care Málaga-Guadalhorce, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Spain
| | - Patricia Moreno-Peral
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain; Research Unit of the Health District of Primary Care Málaga-Guadalhorce, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Spain; Department of Personality, Assessment and Psychological Treatment, University of Malaga (UMA), Spain
| | - Juan Ángel Bellón
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain; Research Unit of the Health District of Primary Care Málaga-Guadalhorce, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Spain; El Palo Health Centre, Andalusian Health Service (SAS), Spain; Department of Public Health and Psychiatry, University of Málaga (UMA), Spain
| | - Emma Motrico
- Department of Psychology, Universidad Loyola Andalucía, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain.
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Yang X, Sun J, Zhang W. Global trends in burden of type 2 diabetes attributable to physical inactivity across 204 countries and territories, 1990-2019. Front Endocrinol (Lausanne) 2024; 15:1343002. [PMID: 38469145 PMCID: PMC10925666 DOI: 10.3389/fendo.2024.1343002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/08/2024] [Indexed: 03/13/2024] Open
Abstract
Background To promote a comprehensive understanding of global trends and burden of type 2 diabetes attributable to physical inactivity. Methods We utilized data regarding mortality, disability-adjusted life years (DALYs), as well as age-standardized mortality rates (ASMR) and DALYs rates (ASDR) derived from the global burden of disease study 2019 to evaluate the impact of physical inactivity on the prevalence of type 2 diabetes in 204 countries and territories over the period from 1990 to 2019. This method facilitated the analysis of the diabetes burden across different ages, genders, and regions. To determine the long-term progression of type 2 diabetes prevalence, we computed the estimated annual percentage change (EAPC) in burden rates. Results Globally, the number of deaths and DALYs from type 2 diabetes due to physical inactivity more than doubled between 1990 and 2019. Concurrently, there was an increase in the ASMR and ASDR, with EAPC of 0.26 (95% CI: 0.13-0.39) and 0.84 (95% CI: 0.78-0.89), respectively. As of 2019, the global ASMR and ASDR for physical inactivity stood at 1.6 (95% UI: 0.8-2.7) per 100 000 and 55.9 (95% UI: 27.2-97.6) per 100 000, respectively. Notable disparities were observed in the type 2 diabetes burden associated with physical inactivity worldwide, with higher sociodemographic index (SDI) countries experiencing lower ASDR and ASMR compared to lower SDI countries. Initially, females exhibited higher ASMR and ASDR than males, but this gender disparity in ASMR and ASDR has lessened in recent years. The mortality and DALYs rates associated with physical inactivity exhibit an inverted V-shaped pattern across various age groups, predominantly affecting the elderly population. Conclusion Between 1990 and 2019, there was a marked rise in the worldwide burden of type 2 diabetes associated with physical inactivity, underscoring the role of physical inactivity as a key changeable risk factor in the global landscape of this disease. This necessitates additional research to explore the variables contributing to the varying levels of disease burden across different countries and between sexes. Furthermore, it calls for the formulation of public health policies aimed at guiding prevention tactics, promoting early detection, and enhancing the management of type 2 diabetes.
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Affiliation(s)
| | | | - Wenjuan Zhang
- Department of Cardiovascular Medicine, Tianjin Medical University General Hospital, Tianjin, China
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Zhi Z, Yan S, Yijuan H, Jiahuan Z, Xiaohan J, Dandan C. Trends in the disease burden of anxiety disorders in middle-aged and older adults in China. BMC Psychol 2024; 12:83. [PMID: 38373999 PMCID: PMC10877872 DOI: 10.1186/s40359-024-01575-2] [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] [Received: 01/01/2024] [Accepted: 02/05/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Anxiety disorders in middle-aged and older adults are an important public health concern in China. Based on the data in the global disease burden (GDB) research database, this study evaluated and analyzed the trend of the disease burden of middle-aged and older patients living with anxiety in China in the past 30 years. METHODS The incidence and disability-adjusted life years (DALYs) data of anxiety disorders in China for individuals aged 45-89 years were collected from the Global Burden of Disease Study 2019, and the effects of age, period, and cohort on the incidence of and DALY rate for anxiety disorders were analysed using an age-period-cohort model. Because of the COVID-19 pandemic, the global disease burden research database has not been updated since 2019. However, this did not affect the analysis of future trends in this study, which combined data in the past three decades from 1990 to 2019. RESULTS (1) The overall age-standardised incidence rate (ASIR) and age-standardised DALY rate (ASDR) for anxiety disorders in middle-aged and older adults in China decreased by 4.0 and 7.7% from 1990 to 2019, respectively, and the ASIR and ASDR were always higher in women than in men. (2)Age-period-cohort analysis showed that the net drifts for incidence and DALY rate were - 0.27% and - 0.55% per year, respectively. For both genders, the local drifts for incidence were lower than zero in those aged 45-79 years and higher than zero in those aged 80-89 years; the local drifts for the DALY rate were lower than zero in all groups. (3) From the 1990-1994 to 2015-2019, the relative risks of anxiety disorder incidence and DALY decreased by 5.6 and 7.3% in men and 4.3 and 11.7% in women, respectively. CONCLUSION The disease burden of anxiety disorders in middle-aged and older adults in China has been relieved over the past 30 years; however, recent ASDR, ASDR, period, and cohort effects have shown adverse trends. The incidence and DALY rate decreased with age in women, while men showed a trend of increasing first and decreasing afterwards.
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Affiliation(s)
- Zeng Zhi
- School of Health and Economics Management, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
| | - Shi Yan
- Pukou Hospital of Traditional Chinese Medicine in Nanjing, Nanjing, 211899, China.
| | - He Yijuan
- School of Health and Economics Management, Nanjing University of Chinese Medicine, Nanjing, 210023, China
- Science and Education Department, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215400, Jiangsu Province, China
| | - Zheng Jiahuan
- School of Health and Economics Management, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Jiang Xiaohan
- School of Health and Economics Management, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Chen Dandan
- School of Health and Economics Management, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
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Cao L, Dayimu A, Guan X, Duan M, Zeng S, Wang H, Zong J, Sun C, Yang X, Yang X. Global evolving patterns and cross-country inequalities of inflammatory bowel disease burden from 1990 to 2019: a worldwide report. Inflamm Res 2024; 73:277-287. [PMID: 38184814 DOI: 10.1007/s00011-023-01836-7] [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: 08/02/2023] [Revised: 11/30/2023] [Accepted: 12/09/2023] [Indexed: 01/08/2024] Open
Abstract
AIMS Inflammatory bowel disease (IBD) is a global disease. We aim to summarize the latest epidemiological patterns of IBD at the national, regional and global levels to give well-deserved attention and outline facilitating measures to reduce the disease burden. METHODS We collected the incidence, prevalence, mortality and disability-adjusted life years (DALYs) of IBD in 204 countries and territories from 1990 to 2019 using data from the Global Burden of Disease Study 2019. We further calculated the estimated annual percentage change (EAPC) to qualify the temporal trends of IBD burden by sex, age and region over the past 30 years. RESULTS Globally, a total of 404.55 thousand incident cases, 4898.56 thousand prevalent cases, 41.00 thousand deaths and 1622.50 thousand DALYs of IBD were estimated in 2019. The age-standardized DALYs decreased from 27.2 in 1990 to 20.15 per 100,000 people in 2019, with an EAPC of -1.04. The high socio-demographic index regions presented pronounced age-standardized rates (ASRs) consistently over the last 30 years. The high-income North America had the highest ASRs in 2019, followed by Western Europe and Australasia. No gender difference was observed after being stratified by sex. CONCLUSIONS The accumulated IBD patients are expected to increase in the future due to the increased rate of IBD in developing countries, and social aging in developed countries. Understanding the changes in epidemiological patterns helps to provide evidence to mitigate the rising burden of IBD.
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Affiliation(s)
- Lina Cao
- Department of Health Management Center, Qilu Hospital of Shandong University, Jinan, China
| | - Alimu Dayimu
- Clinical Trial Unit, Department of Oncology, Univerisity of Cambridge, Cambridge, UK
| | - Xiao Guan
- Department of Health Management Center, Qilu Hospital of Shandong University, Jinan, China
| | - Miao Duan
- Department of Gastroenterology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China
| | - Shuyan Zeng
- Department of Gastroenterology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Digestive Disease, Qilu Hospital of Shandong University, Jinan, China
| | - Hui Wang
- Department of Gastroenterology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Digestive Disease, Qilu Hospital of Shandong University, Jinan, China
| | - Jiahao Zong
- Department of Gastroenterology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Digestive Disease, Qilu Hospital of Shandong University, Jinan, China
| | - Chunhua Sun
- Department of Health Management Center, Qilu Hospital of Shandong University, Jinan, China
| | - Xiaorong Yang
- Department of Gastroenterology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China.
- Shandong Provincial Clinical Research Center for Digestive Disease, Qilu Hospital of Shandong University, Jinan, China.
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, Shandong, China.
| | - Xiaoyun Yang
- Department of Gastroenterology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China.
- Shandong Provincial Clinical Research Center for Digestive Disease, Qilu Hospital of Shandong University, Jinan, China.
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, Shandong, China.
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Zhao H, Li L, Zhang X, Shi J, Lai W, Wang W, Guo L, Gong J, Lu C. Global, regional, and national burden of depressive disorders among young people aged 10-24 years, 2010-2019. J Psychiatr Res 2024; 170:47-57. [PMID: 38103449 DOI: 10.1016/j.jpsychires.2023.11.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 08/19/2023] [Accepted: 11/28/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE To describe the latest disease burden, temporal trends, and risk factors of depressive disorders among young people. METHODS Data from the Global Burden of Disease Study 2019 was utilized to analyze depressive disorders among individuals aged 10-24 years. The study focused on describing the incidence, prevalence, disability-adjusted life years (DALYs), and their attributable risk factors across 204 countries and territories from 2010 to 2019. The estimated annual percentage change (EAPC) was calculated to quantify the temporal trends. RESULTS Globally, the incidence, prevalence, and DALYs rate of depressive disorders per 100 000 young people increased from 3003.01, 2445.69, and 448.61 in 2010 to 3035.26, 2470.67, and 452.58 in 2019, indicating a slight upward trend (EAPC = 0.11 for incidence and prevalence; EAPC = 0.09 for DALYs rate). Notably, the percentage of DALYs of depressive disorders among young people increased substantially from 3.24% in 2010 to 3.66% in 2019, an increase of 13.06% (EAPC = 1.26, 95%CI: 1.08-1.44), and the burden of depressive disorders among young people rose from fouth to second in females, and from tenth to fifth in males. Social demographic index (SDI) and other indicators were positively correlated with the percentage of DALYs of depressive disorder and negatively correlated with the EAPC of DALYs. CONCLUSION The global burden of depressive disorders among young people is on the rise. The regional differences in depressive disorders among young people suggest the need for enhanced screening efforts in low-SDI areas, along with the adoption of more effective prevention and control measures.
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Affiliation(s)
- Hao Zhao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Li Li
- Maternity and Children Health Care Hospital of Luohu District, Shenzhen, China
| | - Xuening Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jingman Shi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Wenjian Lai
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Jianhua Gong
- Maternity and Children Health Care Hospital of Luohu District, Shenzhen, China.
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.
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Cheng Y, Fang Y, Zheng J, Guan S, Wang M, Hong W. The burden of depression, anxiety and schizophrenia among the older population in ageing and aged countries: an analysis of the Global Burden of Disease Study 2019. Gen Psychiatr 2024; 37:e101078. [PMID: 38274290 PMCID: PMC10806508 DOI: 10.1136/gpsych-2023-101078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 11/28/2023] [Indexed: 01/27/2024] Open
Abstract
Background Depression, anxiety and schizophrenia among older persons have become global public health challenges. However, the burden of these disorders in ageing and aged countries has not been analysed. Aims To investigate the burden of depression, anxiety and schizophrenia among older adults in ageing and aged countries. Methods Using data from the Global Burden of Disease Study 2019, we calculated the estimated annual percentage change (EAPC) in the age-standardised incidence rates (ASIR) and age-standardised disability-adjusted life years (DALYs) rates (ASDR) for depression, anxiety and schizophrenia of older people in ageing countries (China, India, Indonesia) and aged countries (Japan, Italy, Portugal) between 1990 and 2019. Trends in incidence and DALYs were analysed by gender and age. Results In 2019, the highest incidence of depression, anxiety and schizophrenia in the older population in aged countries was in Japan (927 271.3 (752 552.3-1 125 796.5), 51 498.2 (37 625.7-70 487.3) and 126.0 (61.0-223.2), respectively), while the highest incidence in ageing countries was in China (5 797 556.9 (4 599 403.4-7 133 006.5), 330 256.1 (246 448.9-445 987.4) and 1067.7 (556.2-1775.9), respectively). DALYs for these disorders were similar, with the highest in Japan and China. From 1990 to 2019, the ASIR for depressive disorders decreased in aged countries but increased in ageing countries; the ASIR for anxiety disorders and schizophrenia declined in both ageing and aged countries. The ASDR for depressive disorders was consistent with the ASIR but not for anxiety disorders and schizophrenia. The ASIR for depressive disorders was higher in older women, while the opposite was observed in anxiety disorders and schizophrenia. Notably, the conditions of burden of depressive disorders, anxiety disorders and schizophrenia in the 65-70-year-old age group were the most burdensome. Conclusions The incidence and DALYs of these three mental disorders increased while exhibiting differences between ageing and aged countries. Raising awareness about formulating health policies for preventing and treating mental disorders in the older population is necessary to reduce the future burden posed by the ageing challenge.
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Affiliation(s)
- Ying Cheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Fang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinxin Zheng
- Department of Nephrology, Ruijin Hospital, Institute of Nephrology, Institute of Nephrology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shiyang Guan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Meiti Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wu Hong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Apostolova Y, Stamm E, Cilla F, Durst AV, Büla C, D'Amelio P. A contribution to the French validation of the clinical anxiety scale amongst health care workers in Switzerland. BMC Psychol 2024; 12:42. [PMID: 38243345 PMCID: PMC10799402 DOI: 10.1186/s40359-024-01525-y] [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: 04/16/2023] [Accepted: 01/07/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Anxiety disorders are frequent but remain often underdiagnosed and undertreated. Hence, valid screening instruments are needed to enhance the diagnostic process. The Clinical Anxiety Scale (CAS) is a 25-item anxiety screening tool derived from the Hamilton Anxiety Scale (HAM-A). However, this scale is not available in French. The General anxiety disorder - 7 (GAD-7) scale, which has been validated in French, is a 7-item instrument with good psychometric properties. This study contributes to the validation of an adapted French version of the CAS, using the GAD-7 as the reference. METHODS A forward-backward English-French-English translation of the CAS was performed according to standard practice. The French versions of the CAS and GAD-7 were completed by 127 French speaking healthcare professionals. CAS internal consistency was assessed using Crohnbach's alpha, and test-retest reliability was tested after 15 days in a subsample of 30 subjects. Convergent validity with GAD-7 was assessed using Pearson's correlation coefficient. Test-retest reliability was explored using one-way random effects model to calculate the intra-class correlation coefficient (ICC). RESULTS French CAS showed excellent internal consistency (Cronbach's alpha 0.97), high convergent validity with GAD-7 (Pearson's R 0.81, p < 0.001), and very good test-retest reliability (ICC = 0.97, 95% CI 0.93-0.98). CONCLUSION The proposed French version of the CAS showed high reliability and validity that need to be further investigated in different populations.
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Affiliation(s)
- Yana Apostolova
- Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital and University of Lausanne, Route de Mont Paisible 16, 1011, Lausanne, Switzerland.
| | - Elisabeth Stamm
- Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital and University of Lausanne, Route de Mont Paisible 16, 1011, Lausanne, Switzerland
| | - Francesco Cilla
- Service of Geriatric Medicine, HFR Freiburg Kantonsspital, Freiburg, Switzerland
| | - Anne-Véronique Durst
- Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital and University of Lausanne, Route de Mont Paisible 16, 1011, Lausanne, Switzerland
| | - Christophe Büla
- Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital and University of Lausanne, Route de Mont Paisible 16, 1011, Lausanne, Switzerland
| | - Patrizia D'Amelio
- Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital and University of Lausanne, Route de Mont Paisible 16, 1011, Lausanne, Switzerland
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Gkrozou F, Tsonis O, Sorrentino F, Nappi L, Vatopoulou A, Skentou C, Pandey S, Paschopoulos M, Daniilidis A. Endometriosis Predictive Models Based on Self-Assessment Questionnaire, Evidence from Clinical Examination or Imaging Findings: A Narrative Review. J Clin Med 2024; 13:356. [PMID: 38256490 PMCID: PMC10816076 DOI: 10.3390/jcm13020356] [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: 12/05/2023] [Revised: 12/23/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
OBJECTIVE The aim of this narrative review is to evaluate existing questionnaires on predictive models for endometriosis. These symptom-based models have the potential to serve as screening tools for adult women to detect endometriosis. DATA SOURCES A comprehensive search of PubMed and Embase databases was conducted to identify studies on endometriosis screening. SELECTION OF STUDIES The search targeted predictive models for endometriosis localisation, bowel involvement, need for bowel surgery and fertility. Due to the heterogeneity identified, a systematic review was not possible. A total of 23 studies were identified. DATA EXTRACTION AND SYNTHESIS Among these studies, twelve included measures for general endometriosis, two targeted specific sites, four focused on deep infiltrating endometriosis (DIE), and three addressed the need for endometriosis-related bowel surgery. Many measures combined clinical, imaging and laboratory tests with patient questionnaires. Validation of these models as screening tools was lacking in all studies, as the focus was on diagnosis rather than screening. CONCLUSION This review did not identify any fully validated, symptom-based questionnaires for endometriosis screening in adult women. Substantial validation work remains to establish the efficacy of such tools.
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Affiliation(s)
- Fani Gkrozou
- Department of Obstetrics and Gynaecology, University Hospital of Ioannina, 451 10 Ioannina, Greece; (F.G.); (C.S.); (M.P.)
| | - Orestis Tsonis
- Assisted Conception Unit, Guy’s and St Thomas’ Hospital NHS Foundation Trust, London SE1 9RT, UK;
- Department of Gynaecology, St George’s University Hospitals NHS Foundation Trust, London WC1E 6BT, UK;
| | - Felice Sorrentino
- Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, 71121 Foggia, Italy;
| | - Luigi Nappi
- Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, 71121 Foggia, Italy;
| | - Anastasia Vatopoulou
- Department of Obstetrics and Gynaecology, University Hospital of Ioannina, 451 10 Ioannina, Greece; (F.G.); (C.S.); (M.P.)
| | - Chara Skentou
- Department of Obstetrics and Gynaecology, University Hospital of Ioannina, 451 10 Ioannina, Greece; (F.G.); (C.S.); (M.P.)
| | - Suruchi Pandey
- Department of Gynaecology, St George’s University Hospitals NHS Foundation Trust, London WC1E 6BT, UK;
| | - Minas Paschopoulos
- Department of Obstetrics and Gynaecology, University Hospital of Ioannina, 451 10 Ioannina, Greece; (F.G.); (C.S.); (M.P.)
| | - Angelos Daniilidis
- 2nd Department of Obstetrics and Gynaecology, Hippokration General Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
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Aggarwal N, Oler JA, Tromp DPM, Roseboom PH, Riedel MK, Elam VR, Brotman MA, Kalin NH. A preliminary study of the effects of an antimuscarinic agent on anxious behaviors and white matter microarchitecture in nonhuman primates. Neuropsychopharmacology 2024; 49:405-413. [PMID: 37516801 PMCID: PMC10724160 DOI: 10.1038/s41386-023-01686-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 07/31/2023]
Abstract
Myelination subserves efficient neuronal communication, and alterations in white matter (WM) microstructure have been implicated in numerous psychiatric disorders, including pathological anxiety. Recent work in rodents suggests that muscarinic antagonists may enhance myelination with behavioral benefits; however, the neural and behavioral effects of muscarinic antagonists have yet to be explored in non-human primates (NHP). Here, as a potentially translatable therapeutic strategy for human pathological anxiety, we present data from a first-in-primate study exploring the effects of the muscarinic receptor antagonist solifenacin on anxious behaviors and WM microstructure. 12 preadolescent rhesus macaques (6 vehicle control, 6 experimental; 8F, 4M) were included in a pre-test/post-test between-group study design. The experimental group received solifenacin succinate for ~60 days. Subjects underwent pre- and post-assessments of: 1) anxious temperament (AT)-related behaviors in the potentially threatening no-eye-contact (NEC) paradigm (30-min); and 2) WM and regional brain metabolism imaging metrics, including diffusion tensor imaging (DTI), quantitative relaxometry (QR), and FDG-PET. In relation to anxiety-related behaviors expressed during the NEC, significant Group (vehicle control vs. solifenacin) by Session (pre vs. post) interactions were found for freezing, cooing, and locomotion. Compared to vehicle controls, solifenacin-treated subjects exhibited effects consistent with reduced anxiety, specifically decreased freezing duration, increased locomotion duration, and increased cooing frequency. Furthermore, the Group-by-Session-by-Sex interaction indicated that these effects occurred predominantly in the males. Exploratory whole-brain voxelwise analyses of post-minus-pre differences in DTI, QR, and FDG-PET metrics revealed some solifenacin-related changes in WM microstructure and brain metabolism. These findings in NHPs support the further investigation of the utility of antimuscarinic agents in targeting WM microstructure as a means to treat pathological anxiety.
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Affiliation(s)
- Nakul Aggarwal
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, 53719, USA.
| | - Jonathan A Oler
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, 53719, USA
| | - Do P M Tromp
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, 53719, USA
| | - Patrick H Roseboom
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, 53719, USA
| | - Marissa K Riedel
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, 53719, USA
| | - Victoria R Elam
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, 53719, USA
| | - Melissa A Brotman
- Neuroscience and Novel Therapeutics Unit, National Institute of Mental Health, Bethesda, MD, 20892, USA
| | - Ned H Kalin
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, 53719, USA
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Wang H, Zhou Y, Dai P, Guan Y, Zhong J, Li N, Yu M. Anxiety symptoms and associated factors among school students after 2 years of the COVID-19 pandemic: a cross-sectional study in Zhejiang Province, China. BMJ Open 2023; 13:e079084. [PMID: 38154892 PMCID: PMC10759112 DOI: 10.1136/bmjopen-2023-079084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/30/2023] [Indexed: 12/30/2023] Open
Abstract
OBJECTIVES To ascertain the prevalence and associated factors of anxiety symptoms among middle and high school students in Zhejiang after 2 years of the COVID-19 pandemic. DESIGN A school-based cross-sectional study. SETTING 30 counties/districts in Zhejiang Province, China. PARTICIPANTS 27 019 students attending middle and high schools. OUTCOME MEASURES Anxiety symptoms were assessed using the Generalised Anxiety Disorder 7-item scale (GAD-7). A total score of 10 or more is considered indicative of anxiety symptoms. RESULTS The overall prevalence (95% CI) of anxiety symptoms was 14.2% (13.4 to 15.0), higher among girls (18.6%, 95% CI: 17.5 to 19.7) than boys (10.2%, 95% CI: 9.5 to 10.9) (p<0.001), higher among rural students (15.1%, 95% CI: 14.1 to 16.2) than urban students (12.5%, 95% CI: 11.6 to 13.4) (p<0.001). Older age (14-15 years, OR=1.25, 95% CI: 1.09 to 1.44; ≥16 years, OR=1.32, 95% CI: 1.07 to 1.63), being girls (OR=1.76, 95% CI: 1.58 to 1.96), living in rural areas (OR=1.14, 95%CI: 1.01 to 1.29), poor academic performance (OR=1.20, 95% CI: 1.03 to 1.41), alcohol drinking (OR=1.15, 95% CI: 1.01 to 1.30), inadequate fruits (OR=1.31, 95% CI: 1.19 to 1.45) and vegetables intake (OR=1.32, 95% CI: 1.10 to 1.57), insomnia (sometimes, OR=2.14, 95% CI: 1.93 to 2.38; often/always, OR=4.73, 95% CI: 4.03 to 5.56), loneliness (sometimes, OR=2.97, 95%CI: 2.59 to 3.41; often/always, OR=8.35, 95% CI: 7.20 to 9.69), sadness (OR=2.51, 95% CI: 2.25 to 2.79) and physical fight (OR=1.29, 95% CI: 1.13 to 1.48) were positively associated with anxiety symptoms, while studying at vocational high school (OR=0.61, 95% CI: 0.49 to 0.75), coming from family with middle income (OR=0.76, 95% CI: 0.64 to 0.89), being physically active 3-7 days weekly (OR=0.85, 95% CI: 0.75 to 0.95) were negatively associated with anxiety symptoms. CONCLUSION Anxiety symptoms prevailed among middle and high school students in China. A variety of factors, containing sociodemographic factors, lifestyle behaviours, mental health, academic performance and physical fight should be taken in consideration in addressing prevention and intervention of anxiety symptoms.
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Affiliation(s)
- Hao Wang
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yi Zhou
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Pinyuan Dai
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yunqi Guan
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - JieMing Zhong
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Na Li
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Min Yu
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
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Rhee TG, Davoudian PA, Sanacora G, Wilkinson ST. Psychedelic renaissance: Revitalized potential therapies for psychiatric disorders. Drug Discov Today 2023; 28:103818. [PMID: 37925136 DOI: 10.1016/j.drudis.2023.103818] [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] [Received: 08/08/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023]
Abstract
Psychiatric disorders represent the largest cause of disability worldwide. Global interests in psychedelic substances as potentially therapeutic agents for psychiatric disorders has recently re-emerged. Here, we review progress in the development of psychedelic compounds that have potential therapeutic effects as well as the safety concerns. We include psilocybin, N,N-dimethyltryptamine (DMT), lysergic acid diethylamide (LSD), and the entactogen 3,4-methyl-enedioxy-methamphetamine (MDMA). We also review the potential interactive effects these compounds can have with psychotherapeutic approaches. We provide a cutting-edge review of active and recently completed clinical trials based on the published literature (from MEDLINE), published abstracts at citable conferences, clinical trials from the US Clinical Trials registry (clinicaltrials.gov) and media press releases.
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Affiliation(s)
- Taeho Greg Rhee
- Yale Depression Research Program, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Pasha A Davoudian
- Medical Scientist Training Program, Yale School of Medicine, New Haven, CT, USA; Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT, USA
| | - Gerard Sanacora
- Yale Depression Research Program, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Samuel T Wilkinson
- Yale Depression Research Program, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
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Schröder D, Wrona KJ, Müller F, Heinemann S, Fischer F, Dockweiler C. Impact of virtual reality applications in the treatment of anxiety disorders: A systematic review and meta-analysis of randomized-controlled trials. J Behav Ther Exp Psychiatry 2023; 81:101893. [PMID: 37453405 DOI: 10.1016/j.jbtep.2023.101893] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/15/2023] [Accepted: 06/25/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND AND OBJECTIVES Anxiety disorders are the most prevalent mental disorders worldwide. Virtual reality (VR) treatment approaches have increasingly been studied. Before clinical implementation, it is necessary to evaluate the treatment effect of VR applications. The objective is to evaluate the treatment effect of virtual reality applications in the treatment of anxiety disorders compared to conventional therapy. METHODS A systematic literature review with meta-analysis was conducted. Four databases were used to identify randomized controlled trials published between April 2011 and April 2021 which compare VR applications with non-VR interventions or waiting lists. Study characteristics, pre- and post-treatment data were extracted. Hedges g was calculated as effect size. Primary outcome was anxiety symptoms. RESULTS Data from 17 studies from 827 participants was extracted. The studies examined specific phobia (n = 9), social anxiety disorder (n = 4), agoraphobia (n = 2) and panic disorder (n = 2). 16 out of 17 studies used head-mounted displays as VR application. A non-significant effect size with significant heterogeneity was observed in favor of the use of VR applications in anxiety symptoms (g, 0.33; 95%-CI, -0.20-0.87). Compared to passive control groups, VR applications are associated significant with lower anxiety symptoms (g, 1.29; 95%-CI, 0.68-1.90). LIMITATIONS The study and patient characteristics varied between the individual studies which is reflected in a high statistical heterogeneity of the effect sizes. CONCLUSIONS The added value of VR applications over waiting-list or psychoeducation only control groups is obvious. VR applications can be used as part of the treatment of anxiety disorders, especially when conventional therapy is unavailable.
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Affiliation(s)
- Dominik Schröder
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany.
| | - Kamil J Wrona
- Hochschule Bielefeld University of Applied Sciences and Arts, Bielefeld, Germany
| | - Frank Müller
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany; Department of Family Medicine, Michigan State University, Grand Rapids, Michigan, USA
| | - Stephanie Heinemann
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany; Department of Geriatrics, University Medical Center Göttingen, Göttingen, Germany
| | - Florian Fischer
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany; Bavarian Research Center for Digital Health and Social Care, Kempten University, Kempten, Germany
| | - Christoph Dockweiler
- Department Digital Biomedicine and Health Sciences, School of Life Sciences, University Siegen, Siegen, Germany; School of Public Health, Bielefeld University, Bielefeld, Germany
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Miller ML, McGuire JF. Targeting intolerance of uncertainty in treatment: A meta-analysis of therapeutic effects, treatment moderators, and underlying mechanisms. J Affect Disord 2023; 341:283-295. [PMID: 37657623 DOI: 10.1016/j.jad.2023.08.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE Anxiety-related disorders are among the most prevalent psychiatric conditions and cause significant impairment. Intolerance of uncertainty (IU) contributes to the emergence, maintenance, and symptom severity of anxiety-related disorders, yet information regarding treatment-related changes in IU is limited. This systematic review and meta-analysis examined the efficacy of evidence-based treatments for anxiety-related disorders on IU, explored factors moderating treatment effects of IU, and examined whether therapeutic improvement in IU corresponded with improvements in anxiety symptom severity. METHODS PubMED and PsycINFO were searched for randomized controlled trials (RCTs) using the terms "intolerance of uncertainty" AND "treatment" OR "therapy." Data for pre and post-treatment measures and patient, intervention, and trial-level characteristics were extracted from 28 RCTs. Separate random effects models examined the treatment efficacy of interventions on IU and symptom severity. Moderators of therapeutic effects were analyzed via method-of-moments meta-regression or an analog to the analysis of variance. RESULTS Across RCTs, interventions exhibited a large therapeutic effect on IU compared to control conditions (g = 0.89). Treatment effects on IU positively corresponded with improved symptom severity and accounted for 36 % of the variance. Interestingly, comorbid depression and certain treatment approaches were associated with larger improvements in IU. CONCLUSION Evidence-based treatments are effective in improving IU, highlighting the importance of IU in the treatment of anxiety-related disorders. Moderator analyses identified patient and intervention-level factors to inform approaches to improve therapeutic effects on IU. Future research is needed to optimize interventions targeting IU and evaluate long-term efficacy of interventions on IU for anxiety-related disorders.
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Affiliation(s)
- Michelle L Miller
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Joseph F McGuire
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America.
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Song JW, Lee KH, Seong H, Shin DM, Shon WJ. Taste receptor type 1 member 3 enables western diet-induced anxiety in mice. BMC Biol 2023; 21:243. [PMID: 37926812 PMCID: PMC10626698 DOI: 10.1186/s12915-023-01723-x] [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: 12/10/2022] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Accumulating evidence supports that the Western diet (WD), a diet high in saturated fat and sugary drinks, contributes to the pathogenesis of anxiety disorders, which are the most prevalent mental disorders worldwide. However, the underlying mechanisms by which WD causes anxiety remain unclear. Abundant expression of taste receptor type 1 member 3 (TAS1R3) has been identified in the hypothalamus, a key brain area involved in sensing peripheral nutritional signals and regulating anxiety. Thus, we investigated the influence of excessive WD intake on anxiety and mechanisms by which WD intake affects anxiety development using wild-type (WT) and Tas1r3 deficient (Tas1r3-/-) mice fed a normal diet (ND) or WD for 12 weeks. RESULTS WD increased anxiety in male WT mice, whereas male Tas1r3-/- mice were protected from WD-induced anxiety, as assessed by open field (OF), elevated plus maze (EPM), light-dark box (LDB), and novelty-suppressed feeding (NSF) tests. Analyzing the hypothalamic transcriptome of WD-fed WT and Tas1r3-/- mice, we found 1,432 genes significantly up- or down-regulated as a result of Tas1r3 deficiency. Furthermore, bioinformatic analysis revealed that the CREB/BDNF signaling-mediated maintenance of neuronal regeneration, which can prevent anxiety development, was enhanced in WD-fed Tas1r3-/- mice compared with WD-fed WT mice. Additionally, in vitro studies further confirmed that Tas1r3 knockdown prevents the suppression of Creb1 and of CREB-mediated BDNF expression caused by high levels of glucose, fructose, and palmitic acid in hypothalamic neuronal cells. CONCLUSIONS Our results imply that TAS1R3 may play a key role in WD-induced alterations in hypothalamic functions, and that inhibition of TAS1R3 overactivation in the hypothalamus could offer therapeutic targets to alleviate the effects of WD on anxiety.
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Affiliation(s)
- Jae Won Song
- Department of Food and Nutrition, Seoul National University College of Human Ecology, Gwanak-Gu, Seoul, 08826, Republic of Korea
| | - Keon-Hee Lee
- Department of Food and Nutrition, Seoul National University College of Human Ecology, Gwanak-Gu, Seoul, 08826, Republic of Korea
| | - Hobin Seong
- Department of Food and Nutrition, Seoul National University College of Human Ecology, Gwanak-Gu, Seoul, 08826, Republic of Korea
| | - Dong-Mi Shin
- Department of Food and Nutrition, Seoul National University College of Human Ecology, Gwanak-Gu, Seoul, 08826, Republic of Korea.
- Research Institute of Human Ecology, Seoul National University, Gwanak-Gu, Seoul, 08826, Republic of Korea.
| | - Woo-Jeong Shon
- Department of Food and Nutrition, Seoul National University College of Human Ecology, Gwanak-Gu, Seoul, 08826, Republic of Korea.
- Research Institute of Human Ecology, Seoul National University, Gwanak-Gu, Seoul, 08826, Republic of Korea.
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Sanchez-Ruiz JA, Leibman NI, Larson NB, Jenkins GD, Ahmed AT, Nunez NA, Biernacka JM, Winham SJ, Weinshilboum RM, Wang L, Frye MA, Ozerdem A. Age-Dependent Sex Differences in the Prevalence of Selective Serotonin Reuptake Inhibitor Treatment: A Retrospective Cohort Analysis. J Womens Health (Larchmt) 2023; 32:1229-1240. [PMID: 37856151 PMCID: PMC10621660 DOI: 10.1089/jwh.2022.0484] [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: 10/20/2023] Open
Abstract
Background: Antidepressants are among the most prescribed medications in the United States. The aim of this study was to explore the prevalence of antidepressant prescriptions and investigate sex differences and age-sex interactions in adults enrolled in the Right Drug, Right Dose, Right Time: Using Genomic Data to Individualize Treatment (RIGHT) study. Materials and Methods: We conducted a retrospective analysis of the RIGHT study. Using electronic prescriptions, we assessed 12-month prevalence of antidepressant treatment. Sex differences and age-sex interactions were evaluated using multivariable logistic regression and flexible recursive smoothing splines. Results: The sample consisted of 11,087 participants (60% women). Antidepressant prescription prevalence was 22.24% (27.96% women, 13.58% men). After adjusting for age and enrollment year, women had significantly greater odds of antidepressant prescription (odds ratio = 2.29; 95% confidence interval = 2.07, 2.54). Furthermore, selective serotonin reuptake inhibitors (SSRIs) had a significant age-sex interaction. While SSRI prescriptions in men showed a sustained decrease with age, there was no such decline for women until after reaching ∼50 years of age. There are important limitations to consider in this study. Electronic prescription data were cross-sectional; information on treatment duration or adherence was not collected; this cohort is not nationally representative; and enrollment occurred over a broad period, introducing confounding by changes in temporal prescribing practices. Conclusions: Underscored by the significant interaction between age and sex on odds of SSRI prescription, our results warrant age to be incorporated as a mediator when investigating sex differences in mental illness, especially mood disorders and their treatment.
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Affiliation(s)
| | - Nicole I. Leibman
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Nicholas B. Larson
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Gregory D. Jenkins
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Ahmed T. Ahmed
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Nicolas A. Nunez
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Joanna M. Biernacka
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Stacey J. Winham
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Richard M. Weinshilboum
- Department of Molecular Pharmacology & Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA
| | - Liewei Wang
- Department of Molecular Pharmacology & Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA
| | - Mark A. Frye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Aysegul Ozerdem
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota, USA
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48
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Azargoonjahromi A. The role of epigenetics in anxiety disorders. Mol Biol Rep 2023; 50:9625-9636. [PMID: 37804465 DOI: 10.1007/s11033-023-08787-6] [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] [Received: 06/22/2023] [Accepted: 08/30/2023] [Indexed: 10/09/2023]
Abstract
Anxiety disorders (ADs) are extremely common psychiatric conditions that frequently co-occur with other physical and mental disorders. The pathophysiology of ADs is multifaceted and involves intricate connections among biological elements, environmental stimuli, and psychological mechanisms. Recent discoveries have highlighted the significance of epigenetics in bridging the gap between multiple risk factors that contribute to ADs and expanding our understanding of the pathomechanisms underlying ADs. Epigenetics is the study of how changes in the environment and behavior can have an impact on gene function. Indeed, researchers have found that epigenetic mechanisms can affect how genes are activated or inactivated, as well as whether they are expressed. Such mechanisms may also affect how ADs form and are protected. That is, the bulk of pharmacological trials evaluating epigenetic treatments for the treatment of ADs have used histone deacetylase inhibitors (HDACi), yielding promising outcomes in both preclinical and clinical studies. This review will provide an outline of how epigenetic pathways can be used to treat ADs or lessen their risk. It will also present the findings from preclinical and clinical trials that are currently available on the use of epigenetic drugs to treat ADs.
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Wright EC, Luo PX, Zakharenkov HC, Serna Godoy A, Lake AA, Prince ZD, Sekar S, Culkin HI, Ramirez AV, Dwyer T, Kapoor A, Corbett C, Tian L, Fox AS, Trainor BC. Sexual differentiation of neural mechanisms of stress sensitivity during puberty. Proc Natl Acad Sci U S A 2023; 120:e2306475120. [PMID: 37847733 PMCID: PMC10614610 DOI: 10.1073/pnas.2306475120] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/12/2023] [Indexed: 10/19/2023] Open
Abstract
Anxiety disorders are a major public health concern and current treatments are inadequate for many individuals. Anxiety is more common in women than men and this difference arises during puberty. Sex differences in physiological stress responses may contribute to this variability. During puberty, gonadal hormones shape brain structure and function, but the extent to which these changes affect stress sensitivity is unknown. We examined how pubertal androgens shape behavioral and neural responses to social stress in California mice (Peromyscus californicus), a model species for studying sex differences in stress responses. In adults, social defeat reduces social approach and increases social vigilance in females but not males. We show this sex difference is absent in juveniles, and that prepubertal castration sensitizes adult males to social defeat. Adult gonadectomy does not alter behavioral responses to defeat, indicating that gonadal hormones act during puberty to program behavioral responses to stress in adulthood. Calcium imaging in the medioventral bed nucleus of the stria terminalis (BNST) showed that social threats increased neural activity and that prepubertal castration generalized these responses to less threatening social contexts. These results support recent hypotheses that the BNST responds to immediate threats. Prepubertal treatment with the nonaromatizable androgen dihydrotestosterone acts in males and females to reduce the effects of defeat on social approach and vigilance in adults. These data indicate that activation of androgen receptors during puberty is critical for programming behavioral responses to stress in adulthood.
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Affiliation(s)
- Emily C. Wright
- Department of Psychology, University of California, Davis, CA95616
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, CA95616
| | - Pei X. Luo
- Department of Psychology, University of California, Davis, CA95616
| | | | | | - Alyssa A. Lake
- Department of Psychology, University of California, Davis, CA95616
| | - Zhana D. Prince
- Department of Psychology, University of California, Davis, CA95616
| | - Shwetha Sekar
- Department of Psychology, University of California, Davis, CA95616
| | - Hannah I. Culkin
- Department of Psychology, University of California, Davis, CA95616
| | | | - Tjien Dwyer
- Department of Psychology, University of California, Davis, CA95616
| | - Amita Kapoor
- Wisconsin National Primate Research Center, University of Wisconsin, Madison, WI53715
| | - Cody Corbett
- Wisconsin National Primate Research Center, University of Wisconsin, Madison, WI53715
| | - Lin Tian
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, CA95616
| | - Andrew S. Fox
- Department of Psychology, University of California, Davis, CA95616
- California National Primate Research Center, University of California, Davis, CA95616
| | - Brian C. Trainor
- Department of Psychology, University of California, Davis, CA95616
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50
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Scott OFT, Bubna M, Boyko E, Hunt C, Kristman VL, Gargaro J, Khodadadi M, Chandra T, Kabir US, Kenrick-Rochon S, Cowle S, Burke MJ, Zabjek KF, Dosaj A, Mushtaque A, Baker AJ, Bayley MT, Tartaglia MC. Characterizing the profiles of patients with acute concussion versus prolonged post-concussion symptoms in Ontario. Sci Rep 2023; 13:17955. [PMID: 37863954 PMCID: PMC10589269 DOI: 10.1038/s41598-023-44095-6] [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: 05/18/2023] [Accepted: 10/03/2023] [Indexed: 10/22/2023] Open
Abstract
Identifying vulnerability factors for developing persisting concussion symptoms is imperative for determining which patients may require specialized treatment. Using cross-sectional questionnaire data from an Ontario-wide observational concussion study, we compared patients with acute concussion (≤ 14 days) and prolonged post-concussion symptoms (PPCS) (≥ 90 days) on four factors of interest: sex, history of mental health disorders, history of headaches/migraines, and past concussions. Differences in profile between the two groups were also explored. 110 patients with acute concussion and 96 patients with PPCS were included in our study. The groups did not differ on the four factors of interest. Interestingly, both groups had greater proportions of females (acute concussion: 61.1% F; PPCS: 66.3% F). Patient profiles, however, differed wherein patients with PPCS were significantly older, more symptomatic, more likely to have been injured in a transportation-related incident, and more likely to live outside a Metropolitan city. These novel risk factors for persisting concussion symptoms require replication and highlight the need to re-evaluate previously identified risk factors as more and more concussions occur in non-athletes and different risk factors may be at play.
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Affiliation(s)
- Olivia F T Scott
- Canadian Concussion Centre, University Health Network, Toronto, ON, Canada
| | | | - Emily Boyko
- EPID@Work Research Institute, Lakehead University, Thunder Bay, ON, Canada
| | - Cindy Hunt
- Head Injury Clinic, Department of Trauma and Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Concussion Ontario Network: Neuroinformatics to Enhance Clinical Care and Translation, Toronto, ON, Canada
| | - Vicki L Kristman
- EPID@Work Research Institute, Lakehead University, Thunder Bay, ON, Canada
- Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada
| | - Judith Gargaro
- Neurotrauma Care Pathways Project, KITE Research Institute, University Health Network, Toronto, ON, Canada
| | - Mozhgan Khodadadi
- Canadian Concussion Centre, University Health Network, Toronto, ON, Canada
| | - Tharshini Chandra
- Hull-Ellis Concussion Clinic, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Umme Saika Kabir
- EPID@Work Research Institute, Lakehead University, Thunder Bay, ON, Canada
- Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada
| | - Shannon Kenrick-Rochon
- Northern Ontario School of Medicine University, Thunder Bay, ON, Canada
- Health Sciences North Research Institute, Sudbury, ON, Canada
| | | | - Matthew J Burke
- Neuropsychiatry Program, Division of Neurology, Department of Psychiatry, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Karl F Zabjek
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- KITE Research Institute, University Health Network, Toronto, ON, Canada
| | - Anil Dosaj
- Head Injury Clinic, Department of Trauma and Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada
| | - Asma Mushtaque
- Canadian Concussion Centre, University Health Network, Toronto, ON, Canada
| | - Andrew J Baker
- Brain Health and Wellness Research Program, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia, University of Toronto, Toronto, ON, Canada
| | - Mark T Bayley
- Hull-Ellis Concussion Clinic, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Division of Physical Medicine and Rehabilitation, Temerty Medicine, University of Toronto, Toronto, ON, Canada
| | - Maria Carmela Tartaglia
- Canadian Concussion Centre, University Health Network, Toronto, ON, Canada.
- Division of Neurology, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada.
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