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Yalçın T, Ayyıldız F, Yılmaz MV, Asil E. Relationship of perceived depression, stress, anxiety levels and hedonic hunger. Int J Obes (Lond) 2023; 47:717-723. [PMID: 37100876 DOI: 10.1038/s41366-023-01315-3] [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] [Received: 02/20/2023] [Revised: 04/08/2023] [Accepted: 04/17/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND This study was designed to explore relationship of perceived depression, anxiety and stress (DAS) levels and hedonic hunger in adults. METHODS A cross-sectional survey included questions about some socio-demographic characteristics, Power of Food Scale (PFS-Tr) and Depression Anxiety Stress Scales (DASS-21) was sent via an online platform. Self-reported weight and height were also questioned. A total of 4112 adult volunteers between the ages of 18-65 years participated in this study. 72.3% of them were female. RESULTS The prevalence of moderate to extremely severe depression, anxiety, and stress was reported as 31%, 34% and 13% respectively. Hedonic hunger and perceived DAS levels were higher in females (p < 0.001). Hedonic hunger was positively correlated with perceived DAS (p < 0.001). While body mass index (BMI) was positively associated with PFS-Tr total score, food available and food present; negatively associated with food tasted. Body mass index was negatively correlated with perceived DAS. Hedonic hunger and perceived DAS levels decreased with increasing age. Females were more prone to both hedonic hunger and perceived DAS. About one in three participants reported moderate to extremely severe levels of depression and anxiety. Greater perceived DAS levels are associated with hedonic hunger. Underweight individuals had higher levels of perceived DAS. CONCLUSION To our knowledge, this is the first study to examine the prevalence and predictors of perceived DAS levels and hedonic hunger in the Turkish adult population. The findings of the study suggest that the predictors such as age, sex and BMI are a part of psychological well-being and hedonic hunger.
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Affiliation(s)
- Tuba Yalçın
- İzmir Katip Çelebi University Faculty of Health Sciences Department of Nutrition and Dietetics, İzmir, Türkiye.
| | - Feride Ayyıldız
- Gazi University Faculty of Health Sciences Department of Nutrition and Dietetics, Ankara, Türkiye
| | - Mustafa Volkan Yılmaz
- Ankara University Faculty of Health Sciences Department of Nutrition and Dietetics, Ankara, Türkiye
| | - Esma Asil
- Ankara University Faculty of Health Sciences Department of Nutrition and Dietetics, Ankara, Türkiye
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Frankenthal D, Keinan-Boker L, Bromberg M. Rise in depression and anxiety during the COVID-19 pandemic: results from a cross-sectional national survey. PSYCHOL HEALTH MED 2023; 28:139-147. [PMID: 35388716 DOI: 10.1080/13548506.2022.2057558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic has introduced many mental stressors. This study aimed to evaluate the prevalence of depression and anxiety during the pandemic and characterize those at higher risk. We conducted a national cross-sectional telephone interview survey among Israeli adults from May to September 2020, between the first two national lockdowns. Mental health status was measured using the 5-item Mental Health Inventory (MHI-5). A score of ≤60 was defined as poor mental health with moderate to high anxiety and depression symptoms. Multivariate analysis was used to identify demographic, health-related, and COVID-19-related risk factors associated with poor mental health. From 4,712 households that were eligible for inclusion in this study, 2,634 participants (55.9%) completed the survey. Levels of anxiety and depression symptoms increased significantly throughout the pandemic (from 12.9% to 20.3%, P < 0.001). Loneliness also increased over time (from 48.8% to 58.8%, P < 0.001), and fear of the pandemic remained high (66.5%) throughout the study. According to the multivariate analysis, poor mental health was associated with younger age, female gender, lower education, Arab ethnicity, decrease in household income during the pandemic, having a pre-existing chronic illness, obesity, smoking, ever being quarantined, feeling lonely and fear of the pandemic. Our findings show an increase in anxiety and depression over time among the Israeli population during the COVID-19 pandemic. These findings highlight the need for strengthened mental health services and the flexibility of reallocation of funds and health resources to support the growing mental health needs during the health crisis.
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Affiliation(s)
- Dvora Frankenthal
- Israel Center for Disease Control (ICDC), Ministry of Health, Ramat-Gan, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control (ICDC), Ministry of Health, Ramat-Gan, Israel.,School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Michal Bromberg
- Israel Center for Disease Control (ICDC), Ministry of Health, Ramat-Gan, Israel.,School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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ALİOĞULLARI A, ÖNAL SÖNMEZ A, ERDOĞAN A. Effect of Sociodemographic Variables on Health Anxiety and Death Anxiety Levels in COVID-19 Pandemic. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2022. [DOI: 10.18863/pgy.1009121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The aim of this study was to evaluate health anxiety and death anxiety levels in adult cases during the COVID-19 pandemic and to evaluate the effect of sociodemographic variables. In this online study, 334 patients over the age of 18 were included. Health Anxiety Scale, Death Anxiety Scale and Sociodemographic Data Form were used in the research. The subscales of health anxiety showed a meaningful correlation between hypersensitivity to bodily findings and negative consequences of the disease and death anxiety. Death anxiety and health anxiety were found to be higher in women. It is statistically significant that health anxiety is more common in individuals aged 20-30 years and women with primary education degrees. Death anxiety was found to be associated with low socioeconomic status and health anxiety was associated with average socioeconomic status. Death anxiety was found to be associated with two of the health anxiety subscales. Sociodemographic variables such as age, gender, educational status and socioeconomic status are thought to be effective in both death anxiety and health anxiety.
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Affiliation(s)
| | | | - Ayten ERDOĞAN
- ISTANBUL GELISIM UNIVERSITY, INSTITUTE OF SOCIAL SCIENCES
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Wang Q, Zhang J, Yao H, Jin P, Zhao F, Zhang P. Prevalence and associated factors of anxiety among the population in an urban area of China: a cross-sectional study. BMJ Open 2022; 12:e062431. [PMID: 36351738 PMCID: PMC9644322 DOI: 10.1136/bmjopen-2022-062431] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE This study was conducted to explore the prevalence and associated factors of anxiety disorder among the population in an urban area of China. DESIGN A cross-sectional study. SETTING The study was conducted in Shanghai, China. PARTICIPANTS Residents aged 30-70 years who have lived for over 6 months in Shanghai from December 2018 to April 2019 were included in the study. OUTCOME MEASURES The main study outcome was the prevalence of anxiety. The association of demographic information, medical expenses, living habits and sleep conditions with anxiety was also evaluated based on the collected data using structured questionnaires. RESULTS Among 5063 participants, 498 (9.84%, 95% CI: 9.02% to 10.66%) suffered from anxiety. The female sex, age 60-70 years old, lower educational level, partly self-expenses, higher family medical expenses in the past year, stroke history, hypertension history, dyslipidaemia history, diabetes history, drinking, sleeping on average <6 hours per day and waking up suffocating during sleep were associated with a higher prevalence of anxiety (p<0.05). Multivariate logistic regression analysis showed that age, gender, type of medical expenses, family medical expenses, hours of sleep and waking up suffocating were related to anxiety (p<0.05). CONCLUSIONS Our findings showed an alarmingly high prevalence of anxiety in the population living in an urban area of China. Sleep time <6 hours and waking up suffocating had a significant association with anxiety. These findings suggest that future anxiety prevention programmes in urban areas should incorporate interventions targeted at these factors, such as improving residents' sleep quality.
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Affiliation(s)
- Qingqing Wang
- Clinical Trial Center; National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Science; Beijing Key Laboratory of Drug Clinical Risk and Personalized Medication Evaluation, Beijing Hospital, Beijing, People's Republic of China
| | - Juhua Zhang
- Department of Integrated Traditional Chinese and Western Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Huiqing Yao
- Clinical Trial Center; National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Science; Beijing Key Laboratory of Drug Clinical Risk and Personalized Medication Evaluation, Beijing Hospital, Beijing, People's Republic of China
| | - Pengfei Jin
- Department of Pharmacy; National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Science; Beijing Key Laboratory of Drug Clinical Risk and Personalized Medication Evaluation, Beijing Hospital, Beijing, People's Republic of China
| | - Fei Zhao
- Department of Pharmacy; National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Science; Beijing Key Laboratory of Drug Clinical Risk and Personalized Medication Evaluation, Beijing Hospital, Beijing, People's Republic of China
| | - Peng Zhang
- School of Clinical Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
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Iglesias Martínez E, Roces García J, Jiménez Arberas E, Llosa JA. Difference between Impacts of COVID-19 on Women and Men's Psychological, Social, Vulnerable Work Situations, and Economic Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8849. [PMID: 35886699 PMCID: PMC9320173 DOI: 10.3390/ijerph19148849] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/17/2022] [Accepted: 07/18/2022] [Indexed: 01/27/2023]
Abstract
The SARS-CoV-2 virus changed social reality worldwide, affecting people's health and work life, particularly their anxiety levels. The purpose of this study is to verify the situation of women in terms of anxiety and social determinants in Spain during the pandemic. The sample consisted of 4686 people (3500 women and 1186 men). The tools used were the State-Trait Anxiety Inventory (STAI) and an ad hoc questionnaire to assess the work and mental situation of the participants. The results indicate a higher rate of anxiety among women than among men and reveal a relationship between higher levels of anxiety and more vulnerable work situations in terms of higher unemployment rates, contract changes, etc. Furthermore, there was a higher percentage of women than men in the sectors where the health crisis has had a greater impact and presence, with repercussions on the physical, mental, and social health of the entire population and especially on women. It is necessary to take into account the social determinants of health, not only at the structural level, in terms of the socio-economic and political contexts, to avoid and limit the axes of inequality such as gender.
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Affiliation(s)
| | - Jorge Roces García
- Polytechnic School of Engineering of Gijón, University of Oviedo, 33204 Gijón, Spain
| | | | - José Antonio Llosa
- Social Education, Faculty Padre Ossó, University of Oviedo, 33008 Oviedo, Spain; (E.I.M.); (J.A.L.)
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Villarim NLDS, Maciel PP, Cavalcanti YW, Ribeiro ILA, Perez DEDC, Martelli-Junior H, Machado RA, Bonan PRF. Impact of COVID-19 on dental practice and anxiety among increased risk group dentists: A cross-sectional study. Work 2022; 72:827-837. [DOI: 10.3233/wor-211035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND: The likelihood of infection with SARS-COV-2 (COVID-19) in the dental office is considered high. OBJECTIVES: Assessing the impact of the COVID-19 on dental practices and anxiety levels in risk group Brazilian dentists. METHODS: A cross-sectional study was performed using an online questionnaire. The data obtained were analyzed using the IBM SPSS 25.0 software (Pearson’s Chi-square association test, multivariate logistic regression, and Poisson multiple regression), with subsequent calculation of the odds ratio at a 95% confidence interval, with a significance level of 5%. RESULTS: Responses of 578 dentists distributed in all regions of Brazil were collected. Most of the dentists were female, with an average age of 35. Of the participants, 23.4% were part of the increased risk group for COVID-19. The professionals who belonged to the increased risk group had a greater chance of not feeling prepared to perform consultations (OR = 1.67) and were not performing any procedures during the pandemic (OR = 2.03). Belonging to the increased risk group did not influence anxiety levels among the dentists. The factors associated with increased anxiety were being female, being younger, working in the southeastern region of the country, being afraid of contracting COVID-19 while working, and being concerned for one’s professional future. CONCLUSIONS: The pandemic has had a negative impact on the professional practice of individuals at risk, but the level of anxiety was like professionals who were not part of the increased risk group for COVID-19.
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Affiliation(s)
| | | | | | | | | | - Hercílio Martelli-Junior
- Postgraduate Program in Health Sciences and Primary Health Care, State University of Montes Claros, MontesClaros, Brazil
| | - Renato Assis Machado
- Department of Oral Diagnosis, School of Dentistry, University of Campinas (FOP/UNICAMP), Piracicaba, São Paulo, Brazil
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Hasan MT, Hossain S, Safa F, Anjum A, Khan AH, Koly KN, Alam SF, Rafi MA, Podder V, Trisa TI, Nodi RN, Azad DT, Ashraf F, Akther SMQ, Ahmed HU, Rosenbaum S, Thornicroft G. Anxiety and depressive symptoms among physicians during the COVID-19 pandemic in Bangladesh: a cross-sectional study. Glob Ment Health (Camb) 2022; 9:285-297. [PMID: 36606239 PMCID: PMC9253439 DOI: 10.1017/gmh.2022.30] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 04/06/2022] [Accepted: 05/14/2022] [Indexed: 01/20/2023] Open
Abstract
Objectives In addition to risking their physical well-being, frontline physicians are enduring significant emotional burden both at work and home during the coronavirus disease 2019 (COVID-19) pandemic. This study aims to investigate the levels of anxiety and depressive symptoms and to identify associated factors among Bangladeshi physicians during the COVID-19 outbreak. Methods and design A cross-sectional study using an online survey following a convenience sampling technique was conducted between April 21 and May 10, 2020. Outcomes assessed included demographic questions, COVID-19 related questions, and the Hospital Anxiety and Depression Scale (HADS). Results The survey was completed by 412 Bangladeshi physicians. The findings revealed that, in terms of standardized HADS cut-off points, the prevalence of anxiety and depressive symptoms among physicians was 67.72% and 48.5% respectively. Risk factors for higher rates of anxiety or depressive symptoms were: being female, physicians who had experienced COVID-19 like symptoms during the pandemic, those who had not received incentives, those who used self-funded personal protective equipment (PPE), not received adequate training, lacking perceived self-efficacy to manage COVID-19 positive patients, greater perceived stress of being infected, fear of getting assaulted/humiliated, being more connected with social media, having lower income levels to support the family, feeling more agitated, less than 2 h of leisure activity per day and short sleep duration. All these factors were found to be positively associated with anxiety and depression in unadjusted and adjusted statistical models. Conclusions This study identifies a real concern about the prevalence of anxiety and depressive symptoms among Bangladeshi physicians and identifies several associated factors during the COVID-19 pandemic. Given the vulnerability of the physicians in this extraordinary period whilst they are putting their own lives at risk to help people infected by COVID-19, health authorities should address the psychological needs of medical staff and formulate effective strategies to support vital frontline health workers.
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Affiliation(s)
- M. Tasdik Hasan
- Public Health Foundation, Bangladesh (PHF, BD), Dhaka, Bangladesh
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- Action Lab, Department of Human Centred Computing, Faculty of Information Technology, Monash University, Melbourne, Australia
- Department of Public Health, State University of Bangladesh, Dhaka, Bangladesh
| | - Sahadat Hossain
- Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh
| | - Farhana Safa
- Department of Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Afifa Anjum
- Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh
| | - Abid Hasan Khan
- Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh
| | - Kamrun Nahar Koly
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | | | - Vivek Podder
- Tairunnessa Memorial Medical College and Hospital, Gazipur, Bangladesh
| | | | | | | | - Fatema Ashraf
- Public Health Foundation, Bangladesh (PHF, BD), Dhaka, Bangladesh
- Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh
| | | | - Helal Uddin Ahmed
- National Institute of Mental Health and Hospital, Sher-e-Bangla Nagar, Dhaka, Bangladesh
| | - Simon Rosenbaum
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Gerdes ME, Aistis LA, Sachs NA, Williams M, Roberts JD, Rosenberg Goldstein RE. Reducing Anxiety with Nature and Gardening (RANG): Evaluating the Impacts of Gardening and Outdoor Activities on Anxiety among U.S. Adults during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095121. [PMID: 35564513 PMCID: PMC9100102 DOI: 10.3390/ijerph19095121] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 02/05/2023]
Abstract
The COVID-19 pandemic impacted mental health. Growing research has identified the mental health benefits of nature contact, including gardening. We used a cross-sectional survey to investigate the association between gardening and other outdoor activities with anxiety among U.S. adults. The RANG (Reducing Anxiety with Nature and Gardening) survey was distributed online from June−September 2020 through social media (Twitter and Facebook) and a national Master Gardeners listserv. Survey questions captured demographics, COVID-19 experiences, gardening, outdoor activities, and anxiety using the Generalized Anxiety Disorder 7-item scale. Data were analyzed using chi-square, Fisher’s exact, and Kruskal−Wallis tests, as well as logistic regression. Among participants, 46% reported anxiety symptoms. Participants who had gardened ≥ 15 years and those gardening > 8 h over two weeks had lower anxiety scores. Spending more time outdoors on weekdays also decreased anxiety scores. After adjusting for covariates, lower odds of anxiety were identified for 50−69 and 70−89-year-olds vs. 18−29-year-olds; males vs. females; and Texas vs. Maryland residents. These findings confirm increased anxiety during the COVID-19 pandemic and suggest that sustained gardening and other outdoor activities could help reduce anxiety.
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Affiliation(s)
- Megan E. Gerdes
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD 20742, USA;
| | - Lucy A. Aistis
- Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD 20742, USA;
| | - Naomi A. Sachs
- Department of Plant Science and Landscape Architecture, University of Maryland, College Park, MD 20742, USA;
| | - Marcus Williams
- Baltimore City Extension, University of Maryland Extension, Baltimore, MD 21215, USA;
| | - Jennifer D. Roberts
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD 20742, USA;
| | - Rachel E. Rosenberg Goldstein
- Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD 20742, USA;
- Correspondence: ; Tel.: +1-301-314-1588
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Romm KF, Patterson B, Wysota CN, Wang Y, Berg CJ. Predictors of negative psychosocial and health behavior impact of COVID-19 among young adults. HEALTH EDUCATION RESEARCH 2022; 36:385-397. [PMID: 34196369 PMCID: PMC8344829 DOI: 10.1093/her/cyab026] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/19/2021] [Accepted: 06/07/2021] [Indexed: 05/05/2023]
Abstract
Given the global impact of coronavirus disease 2019 (COVID-19) on mental and physical health, we examined young adults' changes in mental health, intimate relationship quality, alcohol use and weight-related behaviors during COVID-19 and their correlates (depressive symptoms, resilience, social context and COVID-19-related factors). We analyzed data from a longitudinal study of 1082 young adults across six metropolitan areas (Mage = 24.76 ± 4.70; 51.8% female; 73.6% White and 12.5% Hispanic), using multivariate linear regressions for continuous outcomes (magnitude of mental health impact) and logistic regressions for categorical outcomes (decreased relationship quality, physical activity and nutrition and increased alcohol use and sedentary behavior). Of five negative mental health impacts assessed, participants reported experiencing an average of 3.54 (SD = 5.46), experiencing more correlated with increased childcare responsibilities and lower resilience. Additionally, 23.6% of those in relationships experienced negative relationship impact, 41.3% increased alcohol use, 47.2% decreased physical activity, 74.0% were more sedentary and 34.7% experienced poorer nutrition, all of which was predicted by greater depressive symptoms. Additionally, lower resilience predicted negative relationship impact and poorer nutrition and social context/roles correlated with various outcomes (e.g. relationships and alcohol use). Interventions to reduce negative health behaviors given societal stressors should address key psychosocial and situational factors, including depressive symptoms and resilience.
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Affiliation(s)
- Katelyn F Romm
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University Science & Engineering Hall, 800 22nd St NW, #7000C, Washington, DC 20052, USA
- George Washington Cancer Center, George Washington University
Science & Engineering Hall, 800 22nd St NW, #7000C, Washington, DC 20052, USA
| | - Brooke Patterson
- Department of Global Health, Milken Institute School of Public Health, George Washington University Science & Engineering Hall, 800 22nd St NW, #7000C, Washington, DC 20052, USA
| | - Christina N Wysota
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University Science & Engineering Hall, 800 22nd St NW, #7000C, Washington, DC 20052, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University Science & Engineering Hall, 800 22nd St NW, #7000C, Washington, DC 20052, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University Science & Engineering Hall, 800 22nd St NW, #7000C, Washington, DC 20052, USA
- George Washington Cancer Center, George Washington University
Science & Engineering Hall, 800 22nd St NW, #7000C, Washington, DC 20052, USA
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Kassahun EA, Kassie BA, Tilahun SY, Bizuneh AD. Depression, anxiety and stress, during COVID-19 pandemic among midwives in ethiopia: A nationwide cross-sectional survey. Front Psychiatry 2022; 13:867040. [PMID: 35958664 PMCID: PMC9360319 DOI: 10.3389/fpsyt.2022.867040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION COVID-19 has rapidly crossed borders, infecting people throughout the whole world, and has led to a wide range of psychological sequelae. Midwives who come close in contact with women while providing care are often left stricken with inadequate protection from contamination with COVID-19. Therefore, this study aimed to assess the level of depression, anxiety, and stress (DASS) among midwives in Ethiopia. METHODS A cross-sectional study was conducted from 20 June to 20 August 2020, among 1,691 practicing midwives in Ethiopia. A simple random sampling technique was used to select study participants. Data were collected through a structured telephone interview. A 21-item depression, anxiety, and stress scale (DASS-21) was used. Data were entered using the Google forms platform and were analyzed with SPSS version 24. Both bivariate and multivariable logistic regression analyses were employed. Variables with a p-value < 0.05 in the final model were declared statistically significant. Adjusted odds ratio (AOR) with the corresponding 95% confidence interval (95% CI) was used to determine independent predictors. RESULTS The prevalence of DASS among midwives in Ethiopia was 41.1, 29.6, and 19.0%, respectively. Being female [AOR = 1.35; 95% CI: 1.08, 1.69], working in rural areas [AOR = 1.39; 95% CI: 1.06, 1.82], having poor knowledge of COVID-19 [AOR = 1.40; 95% CI: 1.12, 1.75], having poor preventive practice [AOR = 1.83; 95% CI: 1.47, 2.28], and substance use [AOR = 0.31; 95% CI: 0.17, 0.56] were significantly associated with depression; while, working in the governmental health facility [AOR = 2.44; 95% CI: 1.24, 4.78], having poor preventive practice [AOR = 1,47; 95% CI: 1.16, 1.85], and having poor attitude [AOR = 2.22; 95% CI: 1.04, 1.66] were significantly associated with anxiety. Furthermore, working in rural areas [AOR = 0.57; 95% CI: 0.39, 0.83], substance use [AOR = 2.06; 95% CI: 1.51, 2.81], having poor knowledge [AOR = 1.44; 95% CI: 1.20, 1.90], and having poor preventive practice [AOR = 1.60; 95% CI: 1.23, 2.10] were associated with stress. CONCLUSION In this study, the overall magnitude of depression, anxiety, and stress were high. Addressing knowledge gaps through information, training, and safety protocols on COVID-19 and the provision of adequate personal protective equipment (PPE) is essential to preserve the mental health of Midwives during COVID-19.
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Affiliation(s)
| | - Belayneh Ayanaw Kassie
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sewbesew Yitayih Tilahun
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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11
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Asim SS, Ghani S, Ahmed M, Asim A, Qureshi AFK. Assessing Mental Health of Women Living in Karachi During the Covid-19 Pandemic. Front Glob Womens Health 2021; 1:594970. [PMID: 34816167 PMCID: PMC8594054 DOI: 10.3389/fgwh.2020.594970] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/09/2020] [Indexed: 12/04/2022] Open
Abstract
Introduction: Women are more susceptible to mental health disorders and have been reported to experience higher levels of depression and anxiety during previous large-scale disease outbreaks. Stressful events like the COVID-19 pandemic can add extra burdens to women's already multifaceted lives. Keeping the gender implications of COVID-19 in mind can assist health care workers to offer more effective management. In our study, we aimed to assess the impact of COVID-19 on the mental health of women in Karachi, Pakistan and investigate the possible risk factors. Methods: An online questionnaire was distributed to women on social media platforms in the month of June 2020. The questionnaire had two self-assessment scales, Patient Health Questionnaire (PHQ-9) scale which measures the symptoms of depression and General Anxiety Disorder (GAD-7) scale which measures anxiety. Results: Three hundred and ninety three individuals completed the questionnaire with the mean age calculated to be 27.6 ± 11.7 years. Age, education, marital status, number of children, financial issues, employment status, smoking, comorbidities and mental illnesses were significantly associated with participants' mean anxiety and depression scores. The depression scores were generally higher compared to anxiety scores in each category. As the age increased, their scores decreased, with women aged 18–30 having a significantly higher mean depression and anxiety scores compared to women who were above 50. Severe anxiety was identified in 21.9% women and severe depression was noted in 17.8% women. A frightening number of 148 (37.7%) was found of women who had self-destructive thoughts at one time or another. Out of these women, surprisingly 97 (65.5%) individuals were not previously diagnosed with any mental illnesses. Discussion: This study supports the existing literature regarding the disturbed psychological state of women close to the peak of the covid-19 pandemic. We noted increased percentage of depressive women as compared to studies conducted before the covid-19 era. This raises concern especially with our thought provoking finding of self-harm or suicidal thoughts among women. Most of our female population is also seen to be anxious. This study highlights the importance for help and support groups of mental health to effectively reach women during this period of social isolation.
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Affiliation(s)
- Shabnam Shamim Asim
- Department of Gynecology and Obstetrics, Karachi Medical and Dental College, Karachi, Pakistan
| | - Samrah Ghani
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Maheen Ahmed
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Anushae Asim
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
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Prevalence and Correlates of Likely Major Depressive Disorder among the Adult Population in Ghana during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137106. [PMID: 34281040 PMCID: PMC8297143 DOI: 10.3390/ijerph18137106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 01/08/2023]
Abstract
Background: Emerging research suggests that the novel coronavirus disease (COVID-19) pandemic and associated public health restrictions have caused psychological distress in many contexts. In order for public health authorities and policy makers to effectively address the psychological distress associated with the pandemic, it is important to determine the prevalence and correlates of mental disorders, including depression. Objectives: We aimed to determine the prevalence, and demographic, social, clinical and other COVID-19 related correlates of major depressive disorder symptoms among the general population in Ghana during the COVID-19 pandemic. Method: The study was a cross-sectional survey using online data collection methods. The survey assessed demographic, social and clinical variables as well as COVID-19 related variables. Major depressive disorder symptoms were assessed using the Patient Health Questionnaire-9. The survey link was distributed primarily through WhatsApp-based platforms. Data were analyzed using descriptive and inferential statistics. Results: The overall prevalence of likely MDD symptoms among the sample population was 12.3%. Variables such as employment, loss of jobs during the pandemic and rate of exposure to COVID-related news were independently and significantly associated with the likelihood that respondents had likely MDD. Variables such as gender, relationship, housing status and having a family member or friend who was sick from COVID-19 were not independently significantly associated with the likelihood that respondents had likely MDD, when all other factors in the model were controlled. Conclusion: This study has identified the prevalence and correlates of depression symptoms in Ghana during the COVID-19 pandemic. There is the urgent need for mental health policy makers and the government of Ghana to have policies in place to alleviate the potential threat to the mental health of the population.
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DENİZ ÖZTURAN D, KELEŞ ŞAHİN A. Levels of anxiety and coping with stress in healthcare workers during coronavirus disease 2019 (COVID-19) pandemic. FAMILY PRACTICE AND PALLIATIVE CARE 2021. [DOI: 10.22391/fppc.789890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Yildirim H, Işik K, Aylaz R. The effect of anxiety levels of elderly people in quarantine on depression during covid-19 pandemic. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:194-204. [PMID: 33413035 DOI: 10.1080/19371918.2020.1868372] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study aims to determine the effect on depression of elderly people's anxiety levels in quarantine during the COVID-19 pandemic. This is a descriptive study, in which data were collected using the online survey method, an introductory information form, a semistructured data form for COVID-19, the Trait Anxiety Inventory, and the Geriatric Depression Scale. Data were collected during the period when a curfew was imposed for the elderly. Data were analyzed using a structural equation model. According to the structural equation model, anxiety was determined as a predictor of depression. The anxiety levels of the elderly who were 65-74 years old, female, single; had insufficient knowledge about the pandemic; and had not encountered a similar outbreak before considered that family relationships were affected negatively so they became lonely and reported that they became bored, exhausted, and distressed during the pandemic, which increased their depression levels. Anxiety affects depression in the elderly. Therefore, it is recommended to provide them with appropriate psychological support interventions and understandable information about the pandemic so that their anxiety and depression levels can be reduced during the pandemic.
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Affiliation(s)
- Hilal Yildirim
- Department of Puplic Health Nursing, Faculty of Nursing, Inonu University, Malatya, Turkey
| | - Kevser Işik
- Department of Puplic Health Nursing, Faculty of Health Sciences, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Rukuye Aylaz
- Department of Puplic Health Nursing, Faculty of Nursing, Inonu University, Malatya, Turkey
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Hasan M, Hossain S, Safa F, Anjum A, Khan AH, Koly KN, Alam SF, Rafi MA, Podder V, Trisa TI, Nodi RN, Azad DT, Ashraf F, Akther SQ, Ahmed HU, Rosenbaum S, Thornicroft G. Prevalence of anxiety and depressive symptoms among physicians during the COVID-19 pandemic in Bangladesh: a cross-sectional study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.12.08.20245829. [PMID: 33330877 PMCID: PMC7743086 DOI: 10.1101/2020.12.08.20245829] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES In addition to risking their physical well-being, frontline physicians are enduring significant emotional burden both at work and home during the COVID-19 pandemic. This study aims to investigate the levels of anxiety and depressive symptoms and to identify associated factors among Bangladeshi physicians during the COVID-19 outbreak. METHODS AND DESIGN A cross-sectional study using an online survey was conducted between April 21 and May 10, 2020. Outcomes assessed included demographic questions, COVID-19 related questions, and the Hospital Anxiety and Depression Scale (HADS). RESULTS The survey was completed by 412 Bangladeshi physicians. The findings revealed that, in terms of standardized HADS cut-off points, the prevalence of anxiety and depressive symptoms among physicians was 67.72% and 48.5% respectively. Risk factors for higher rates of anxiety or depressive symptoms were: being female, physicians who had experienced COVID-19 like symptoms during the pandemic, those who had not received incentives, those who used self-funded PPE, not received adequate training, lacking perceived self-efficacy to manage COVID -19 positive patients, greater perceived stress of being infected, fear of getting assaulted/humiliated, being more connected with social media, having lower income levels to support the family, feeling more agitated, less than 2 hours of leisure activity per day and short sleep duration. All these factors were found to be positively associated with anxiety and depression in unadjusted and adjusted statistical models. CONCLUSIONS This study identifies a real concern about the prevalence of anxiety and depressive symptoms among Bangladeshi physicians and identifies several associated factors during the COVID-19 pandemic. Given the vulnerability of the physicians in this extraordinary period whilst they are putting their own lives at risk to help people infected by COVID-19, health authorities should address the psychological needs of medical staff and formulate effective strategies to support vital frontline health workers. STHRENGHTS & LIMITATIONS OF THE STUDY This study reports a novel and concerning findings on the prevalence of anxiety and depression symptoms with identification of several important associated factors among Bangladeshi physicians during the COVID-19 pandemic.The cross-sectional nature of the study design could not establish causal relationship between the dependent and independent variables.This study was carried out by conducting a web-based survey, which might generate sampling bias by excluding the physicians who do not have access to internet or inactive in social medias, and thus limit the generalizability of the findings.
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Özdin S, Bayrak Özdin Ş. Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender. Int J Soc Psychiatry 2020; 66:504-511. [PMID: 32380879 PMCID: PMC7405629 DOI: 10.1177/0020764020927051] [Citation(s) in RCA: 655] [Impact Index Per Article: 163.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND The COVID-19 pandemic is having negative effects on societies' mental health. Both the pandemic and the measures taken to combat it can affect individuals' mental health. AIMS The purpose of this study was to evaluate the levels of depression, anxiety and health anxiety in Turkish society during the COVID-19 pandemic, and to examine the factors affecting these. METHOD The study was performed using an online questionnaire. Participants were asked to complete a sociodemographic data form, the Hospital Anxiety and Depression Scale (HADS) and the Health Anxiety Inventory (HAI). The effects on depression, anxiety and health anxiety levels of factors such as age, sex, marital status, living with an individual aged above 60, the presence of a new Coronavirus+ patient among friends or relatives, previous and current psychiatric illness and presence of accompanying chronic disease were then investigated. RESULTS In terms of HADS cut-off points, 23.6% (n = 81) of the population scored above the depression cut-off point, and 45.1% (n = 155) scored above the cut-off point for anxiety. In regression analysis, female gender, living in urban areas and previous psychiatric illness history were found as risk factors for anxiety; living in urban areas was found as risk factor for depression; and female gender, accompanying chronic disease and previous psychiatric history were found as risk factors for health anxiety. CONCLUSION The results of this cross-sectional study suggest that the groups most psychologically affected by the COVID-19 pandemic are women, individuals with previous psychiatric illness, individuals living in urban areas and those with an accompanying chronic disease. Priority might therefore be attached to these in future psychiatric planning.
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Affiliation(s)
- Selçuk Özdin
- Psychiatry Clinic, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
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Karacin C, Bilgetekin I, B Basal F, Oksuzoglu OB. How does COVID-19 fear and anxiety affect chemotherapy adherence in patients with cancer. Future Oncol 2020; 16:2283-2293. [PMID: 32677462 PMCID: PMC7367513 DOI: 10.2217/fon-2020-0592] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Aim: To investigate how COVID-19 fear and anxiety (COV-FA) affects chemotherapy adherence in patients with cancer. Materials & methods: The records of 3661 patients with chemotherapy (CT) appointments were retrospectively reviewed. Results: The CT postponement rates before and after COVID-19 were 11.6% and 14.2%, respectively (p = 0.017). The rate of COV-FA-related CT postponement after telemedicine was lower than that before (4.6% vs 17.4%, p = 0.012). The median time to come back to treatment of the COV-FA group was 47 days (range 19–72 days). Advanced age (≥60 years) was found to be the independent factor that was predictive of time to come back to treatment (p = 0.043). Conclusion: The CT postponement rate increased after COVID-19. COV-FA-related CT postponement decreased after telemedicine. Advanced age could be predictive of time to come back to treatment.
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Affiliation(s)
- Cengiz Karacin
- Department of Medical Oncology, HSU Dr Abdurrahman Yurtaslan Oncology Training & Research Hospital, Ankara 06200, Turkey
| | - Irem Bilgetekin
- Department of Medical Oncology, HSU Dr Abdurrahman Yurtaslan Oncology Training & Research Hospital, Ankara 06200, Turkey
| | - Fatma B Basal
- Department of Medical Oncology, HSU Dr Abdurrahman Yurtaslan Oncology Training & Research Hospital, Ankara 06200, Turkey
| | - Omur B Oksuzoglu
- Department of Medical Oncology, HSU Dr Abdurrahman Yurtaslan Oncology Training & Research Hospital, Ankara 06200, Turkey
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18
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Koksal E, Dost B, Terzi Ö, Ustun YB, Özdin S, Bilgin S. Evaluation of Depression and Anxiety Levels and Related Factors Among Operating Theater Workers During the Novel Coronavirus (COVID-19) Pandemic. J Perianesth Nurs 2020; 35:472-477. [PMID: 32855053 PMCID: PMC7303603 DOI: 10.1016/j.jopan.2020.06.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/08/2020] [Accepted: 06/08/2020] [Indexed: 01/15/2023]
Abstract
Purpose Tremendous physical and psychological pressure has been placed on health care workers because of the outbreak of novel coronavirus disease 2019. This study aimed to examine the anxiety and depression levels and related factors among health care professionals working in operating theaters (anesthetic technicians and nurses) during the coronavirus disease 2019 pandemic. Design The universe of this descriptive study consisted of health care professionals working in operating theaters in various health care institutions in Turkey. Methods Data were collected online between April 9, 2020 and April 12, 2020 using a SurveyMonkey Questionnaire (SurveyMonkey, San Mateo, CA) and health care workers who volunteered to participate in the study were contacted via the social media platforms Twitter, LinkedIn, and WhatsApp and asked to answer the questionnaire. Statistical analysis was performed using the SPSS version 22.0 software. Findings A total of 702 health care professionals working in operating theaters participated in the study. The mean depression and anxiety scores of the participants were found to be 9.4 ± 4.6 (min 0 to max 21) and 10.0 ± 4.5 (min 0 to max 21), respectively. Depression scores were statistically significantly higher among females, single individuals, those who had children, those living with a person aged 60 years or older (P < .05). Meanwhile, anxiety scores were statistically significantly higher among females, single individuals (including widowed and divorced), university graduates, those with at least one chronic disease, and those whose workload increased (P < .05). Conclusions The present study showed that anxiety and depression symptoms were high among health care professionals working in operating theaters. To reduce these symptoms, psychological conditions of health care professionals can be followed continuously and regularly via standard procedures, and necessary interventions can be provided in the early period.
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Affiliation(s)
- Ersin Koksal
- Department of Anesthesiology and Reanimation, Ondokuz Mayis University, Samsun, Turkey
| | - Burhan Dost
- Department of Anesthesiology and Reanimation, Ondokuz Mayis University, Samsun, Turkey.
| | - Özlem Terzi
- Department of Public Health, Ondokuz Mayis University, Samsun, Turkey
| | - Yasemin B Ustun
- Department of Anesthesiology and Reanimation, Ondokuz Mayis University, Samsun, Turkey
| | - Selçuk Özdin
- Department of Psychiatry, Ondokuz Mayis University, Samsun, Turkey
| | - Sezgin Bilgin
- Department of Anesthesiology and Reanimation, Ondokuz Mayis University, Samsun, Turkey
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Sepede G, Brunetti M, Di Giannantonio M. Comorbid Premenstrual Dysphoric Disorder in Women with Bipolar Disorder: Management Challenges. Neuropsychiatr Dis Treat 2020; 16:415-426. [PMID: 32103961 PMCID: PMC7020916 DOI: 10.2147/ndt.s202881] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 01/30/2020] [Indexed: 12/16/2022] Open
Abstract
Bipolar disorder (BD) and premenstrual dysphoric disorder (PMDD) are two cyclic mood illnesses, sometimes presenting together. Their comorbidity appears to be linked to common biological mechanisms and usually results in more severity of mood symptoms and a poorer long-term outcome. Nevertheless, the management of comorbid PMDD/BD has been scarcely studied. Therefore, the aim of the present paper was to review the published literature on the treatment of comorbid PMDD/BD and to provide point-by-point hypotheses to address these complex clinical cases. We searched PubMed to identify the studies focused on the treatment and management of comorbid PMDD/BD using the following search words, alone and in combination: premenstrual dysphoric disorder, bipolar disorder, comorbid, treatment, management, pharmacotherapy, psychotherapy. The search was conducted on the 1st of June 2019 and yielded 55 records. Four papers met our inclusion/exclusion criteria and were therefore included in our qualitative synthesis. Integrating the few data pertaining to the treatment of comorbid PMDD/BD with the large amount of published data on the two conditions separately, we can suggest that the management of comorbid PMDD/BD needs as a first step to stabilize the bipolar symptoms by means of optimal dosages of mood stabilizers. Then, in euthymic BD patients, the PMDD symptoms could be treated with estroprogestins (first-line treatment). On the contrary, during acute phases of BD, antidepressants (for major depressive episodes) and atypical antipsychotics/hormonal modulators (for manic episodes) could be considered as promising add-on treatments to mood stabilizers. In case of resistant PMDD/BD symptoms, combined strategies should be taken into account, as well as alternative treatments, such as lifestyle changes. In conclusion, RCTs on comorbid PMDD/BD are still lacking. The management of this complex condition is therefore challenging and it requires a tailored treatment.
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Affiliation(s)
- Gianna Sepede
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Marcella Brunetti
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy.,Department of Mental Health - Chieti, National Health Trust, Chieti, Italy
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Abdominal pain during the menopause transition and early postmenopause: observations from the Seattle Midlife Women's Health Study. Womens Midlife Health 2019; 5:2. [PMID: 31388434 PMCID: PMC6679532 DOI: 10.1186/s40695-019-0046-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 07/25/2019] [Indexed: 12/15/2022] Open
Abstract
Objective To assess the relationship between abdominal pain severity during the menopausal transition (MT) and age, MT stage, reproductive biomarkers, stress biomarkers, and stress perceptions. Methods Women ages 35-55 were recruited from multiethnic neighborhoods in the greater Seattle area from 1990 to 1992, for an original study cohort of 508. From 1990 to 2013, a subset of this cohort consented to ongoing annual data collection by annual health questionnaire, health diary, and daily menstrual calendar. Beginning in 1997, a portion of these women also provided a first morning voided urine specimen to be assayed for levels of estrone glucuronide (E1G), follicle stimulating hormone (FSH), testosterone, cortisol, norepinephrine, and epinephrine. To identify how changes in abdominal pain severity changed over time in relation to age, MT stage, reproductive biomarkers, stress-related biomarkers, and stress-related perceptions, mixed effects modeling was used. Results In a univariate model, E1G (p = 0.02) and testosterone (p = 0.02) were significantly and negatively related to abdominal pain severity, while perceived stress (p = 0.06), tension (p < 0.001), and anxiety (p < 0.001) were significantly and positively associated. In a multivariate model, increasing age (p = 0.001) and E1G (p = 0.04) were negatively associated with abdominal pain severity, and anxiety (p = 0.00) positively associated. Testosterone did not improve the fit to the final model, nor did tension or perceived stress. Conclusions These results suggest that age, anxiety, and E1G each show a significant association with abdominal pain severity in the MT. In contrast, stress perception, tension, testosterone, stress biomarkers, and MT stage do not. These factors should be evaluated further in research on abdominal pain experienced during the MT and early postmenopause years.
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Xu K, Li P, Miao Y, Dong N, Zhang J, Wei S, Li S, Cao F. Effects of ovarian hormones on emotional behaviors in dopamine D3 receptor knockout mice. Physiol Behav 2019; 198:11-17. [PMID: 30292827 DOI: 10.1016/j.physbeh.2018.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 09/19/2018] [Accepted: 10/02/2018] [Indexed: 11/18/2022]
Abstract
Ovarian hormones reportedly have beneficial effects on affective behaviors. However, the functions of ovarian hormones in neurotransmitter signaling must be identified to understand their role in anxiety and depression. Several studies have provided evidence of the relationship between ovarian hormones and the dopaminergic system, but the interaction between ovarian hormones and dopamine D3 receptor (DRD3) is poorly understood. The aim of the present study was to examine the role of DRD3 in the anxiety-like and depression-like behavioral changes induced by estrogen and progesterone. We subjected D3 receptor knockout (D3KO) and wild-type (WT) mice to a series of behavioral tests. Mice were ovariectomized 4 weeks before testing, and we randomly administered 17β-estradiol (E2, 0.2 mg/kg), progesterone (P4, 10 mg/kg), E2 (0.2 mg/kg) plus P4 (10 mg/kg) or vehicle (VEH, corn oil, 0.2 ml) subcutaneously daily for 9 consecutive days, starting 4 days before the testing day. On the testing day, the mice were injected 30 min prior to behavioral testing. Compared with WT mice in the same treatment group, D3KO mice displayed hyperactivity in the light-dark box test (LDBT) but lower activity in the open field test (OFT). In addition, D3KO mice but not their WT littermates showed behavioral changes after E2 treatment compared with those after VEH treatment in the LDBT only. In depression tests, D3KO-VEH mice displayed significantly longer immobility times than did WT-VEH mice. In addition, only D3KO mice exhibited an obvious decrease in immobility time after E2 and P4 administration. These results indicate that the anxiolytic and antidepressant effects of ovarian hormones can be influenced by DRD3 expression and that DRD3 knockout may induce varying sensitivities to ovarian hormones that depend on various factors, including test paradigms and experiences in animal models. Our research provides a novel insight, i.e., DRD3 may play a role in the efficacy of hormone therapy.
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Affiliation(s)
- Kedong Xu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Pingping Li
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Yi Miao
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Nan Dong
- College of Forensic Medicine, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Jianbo Zhang
- College of Forensic Medicine, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Shuguang Wei
- College of Forensic Medicine, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Shengbin Li
- College of Forensic Medicine, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Fang Cao
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
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Richter-Levin G, Stork O, Schmidt MV. Animal models of PTSD: a challenge to be met. Mol Psychiatry 2019; 24:1135-1156. [PMID: 30816289 PMCID: PMC6756084 DOI: 10.1038/s41380-018-0272-5] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 08/13/2018] [Accepted: 09/11/2018] [Indexed: 02/07/2023]
Abstract
Recent years have seen increased interest in psychopathologies related to trauma exposure. Specifically, there has been a growing awareness to posttraumatic stress disorder (PTSD) in part due to terrorism, climate change-associated natural disasters, the global refugee crisis, and increased violence in overpopulated urban areas. However, notwithstanding the increased awareness to the disorder, the increasing number of patients, and the devastating impact on the lives of patients and their families, the efficacy of available treatments remains limited and highly unsatisfactory. A major scientific effort is therefore devoted to unravel the neural mechanisms underlying PTSD with the aim of paving the way to developing novel or improved treatment approaches and drugs to treat PTSD. One of the major scientific tools used to gain insight into understanding physiological and neuronal mechanisms underlying diseases and for treatment development is the use of animal models of human diseases. While much progress has been made using these models in understanding mechanisms of conditioned fear and fear memory, the gained knowledge has not yet led to better treatment options for PTSD patients. This poor translational outcome has already led some scientists and pharmaceutical companies, who do not in general hold opinions against animal models, to propose that those models should be abandoned. Here, we critically examine aspects of animal models of PTSD that may have contributed to the relative lack of translatability, including the focus on the exposure to trauma, overlooking individual and sex differences, and the contribution of risk factors. Based on findings from recent years, we propose research-based modifications that we believe are required in order to overcome some of the shortcomings of previous practice. These modifications include the usage of animal models of PTSD which incorporate risk factors and of the behavioral profiling analysis of individuals in a sample. These modifications are aimed to address factors such as individual predisposition and resilience, thus taking into consideration the fact that only a fraction of individuals exposed to trauma develop PTSD. We suggest that with an appropriate shift of practice, animal models are not only a valuable tool to enhance our understanding of fear and memory processes, but could serve as effective platforms for understanding PTSD, for PTSD drug development and drug testing.
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Affiliation(s)
- Gal Richter-Levin
- Sagol Department of Neurobiology, University of Haifa, Haifa, Israel. .,The Integrated Brain and Behavior Research Center (IBBR), University of Haifa, Haifa, Israel. .,Psychology Department, University of Haifa, Haifa, Israel.
| | - Oliver Stork
- 0000 0001 1018 4307grid.5807.aDepartment of Genetics & Molecular Neurobiology, Institute of Biology, Otto-von-Guericke-University Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany ,grid.452320.2Center for Behavioral Brain Sciences, Universitätsplatz 2, 39106 Magdeburg, Germany
| | - Mathias V. Schmidt
- 0000 0000 9497 5095grid.419548.5Department of Stress Neurobiology and Neurogenetics, Max Planck Institute of Psychiatry, Munich, Germany
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Dornellas APS, Boldarine VT, Pedroso AP, Carvalho LOT, de Andrade IS, Vulcani-Freitas TM, dos Santos CCC, do Nascimento CMDPO, Oyama LM, Ribeiro EB. High-Fat Feeding Improves Anxiety-Type Behavior Induced by Ovariectomy in Rats. Front Neurosci 2018; 12:557. [PMID: 30233288 PMCID: PMC6129615 DOI: 10.3389/fnins.2018.00557] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 07/24/2018] [Indexed: 12/11/2022] Open
Abstract
Menopause-induced changes may include increased incidence of both depression/anxiety and obesity. We hypothesized that behavioral changes that may develop after ovarian failure could be related to neurochemical and metabolic aspects affected by this condition and that high-fat intake may influence these associations. The present study investigated in rats the effects of ovariectomy, either alone or combined with high-fat diets enriched with either lard or fish-oil, on metabolic, behavioral and monoaminergic statuses, and on gene expression of neuropeptides and receptors involved in energy balance and mood regulation. Female rats had their ovaries removed and received either standard chow (OvxC) or high-fat diets enriched with either lard (OvxL) or fish-oil (OvxF) for 8 weeks. The Sham group received only chow diet. Ovariectomy increased feed efficiency and body weight gain and impaired glucose homeostasis and serotonin-induced hypophagia, effects either maintained or even accentuated by the lard diet but counteracted by the fish diet. The OvxL group developed obesity and hyperleptinemia. Regarding components of hypothalamic serotonergic system, both ovariectomy alone or combined with the fish diet increased 5-HT2C expression while the lard diet reduced 5-HT1B mRNA. Ovariectomy increased the anxiety index, as derived from the elevated plus maze test, while both high-fat groups showed normalization of this index. In the forced swimming test, ovariectomy allied to high-lard diet, but not to fish-oil diet, reduced the latency to immobility, indicating vulnerability to a depressive-like state. Linear regression analysis showed hippocampal AgRP to be negatively associated with the anxiety index and hypothalamic AgRP to be positively associated with the latency to immobility. These AgRp gene expression associations are indicative of a beneficial involvement of this neuropeptide on both depression and anxiety measures. The present findings demonstrate metabolic, neurochemical and behavioral alterations after ovaries removal and highlight a positive effect of high-fat feeding on the anxiety-like behavior shown by ovariectomized animals. Since the polyunsaturated ômega-3 intake (fish diet), unlike the saturated fat intake (lard diet), failed to induce deleterious metabolic or neurochemical consequences, further studies are needed focusing on the potential of this dietary component as an adjuvant anxiolytic agent after menopause.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Eliane B. Ribeiro
- Physiology Department, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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Reduced Vesicular Acetylcholine Transporter favors antidepressant behaviors and modulates serotonin and dopamine in female mouse brain. Behav Brain Res 2017; 330:127-132. [DOI: 10.1016/j.bbr.2017.04.049] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 04/07/2017] [Accepted: 04/26/2017] [Indexed: 11/18/2022]
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Validation of the German version of the short form of the dysfunctional beliefs and attitudes about sleep scale (DBAS-16). Neurol Sci 2017; 38:1047-1058. [DOI: 10.1007/s10072-017-2921-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 03/14/2017] [Indexed: 12/22/2022]
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Liu C, Lai Y, Ouyang J, Yang T, Guo Y, Yang J, Huang S. Influence of nonylphenol and octylphenol exposure on 5-HT, 5-HT transporter, and 5-HT 2A receptor. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2017; 24:8279-8286. [PMID: 28160177 DOI: 10.1007/s11356-017-8487-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 01/19/2017] [Indexed: 05/20/2023]
Abstract
Nonylphenol (NP) and octylphenol (OP) are priority environmental contaminants that have a potential role as endocrine disruptors. They can be biomagnified in the food chain and pose an estrogenic health risk to human health. A 28-day oral toxicity study was performed to observe the impact of single and combined exposure to NP and OP on 5-HT transporter (SERT) as well as 5-HT2A receptor. Results showed that the 5-HT levels in rat plasma increased with exposure to middle-dose and high-dose NP, to high-dose OP, and to low, middle, and high doses of combined NP and OP (P < 0.05), while the 5-HT levels in rat platelets increased when exposed to NP/OP or combined NP and OP of middle or high dose (P < 0.05). The expression levels of SERT in rat platelets decreased when exposed to high-dose NP/OP or high dose of combined NP and OP (P < 0.05). Meanwhile, the expression levels of 5-HT2A in rat platelets decreased when exposed to high-dose NP/OP as well as combined NP and OP (P < 0.05). These findings suggested that exposure to NP and OP could influence the metabolic network of 5-hydroxytryptamine via transportation and receptor binding pathways.
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Affiliation(s)
- Chunhong Liu
- College of Food Science, South China Agricultural University, Guangzhou, 510642, China.
- Guangdong Provincial Key Laboratory of Food Quality and Safety, South China Agricultural University, Guangzhou, 510642, China.
- Laboratory of Quality and Safety Risk Assessment to Post-Harvested Product Storage, Ministry of Agriculture, Guangzhou, 510642, China.
| | - Yuting Lai
- College of Food Science, South China Agricultural University, Guangzhou, 510642, China
| | - Junyan Ouyang
- College of Food Science, South China Agricultural University, Guangzhou, 510642, China
| | - Tongwang Yang
- College of Food Science, South China Agricultural University, Guangzhou, 510642, China
| | - Youting Guo
- College of Food Science, South China Agricultural University, Guangzhou, 510642, China
| | - Jie Yang
- College of Food Science, South China Agricultural University, Guangzhou, 510642, China
| | - Shaowen Huang
- College of Food Science, South China Agricultural University, Guangzhou, 510642, China
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Anxiety and anger immediately prior to myocardial infarction and long-term mortality: Characteristics of high-risk patients. J Psychosom Res 2017; 93:19-27. [PMID: 28107888 PMCID: PMC5260840 DOI: 10.1016/j.jpsychores.2016.12.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 11/22/2016] [Accepted: 12/01/2016] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Acute high levels of anger and anxiety are associated with an elevated risk of myocardial infarction (MI) in the following two hours. MIs preceded by these acute negative emotions may also have a poor long-term prognosis, but information about high-risk patients is lacking. We examined whether young age and female sex are associated with MIs that are preceded by negative emotions and whether age and sex moderate the subsequent increased mortality risk following MI preceded by negative emotions. METHODS We conducted a secondary analysis of the Determinants of Myocardial Infarction Onset Study (N=2176, mean age=60.1±12.3years, 29.2% women). Anxiety and anger immediately prior to (0-2h) MI and the day before (24-26h) MI were assessed using a structured interview. Subsequent 10-year all-cause mortality was determined using the US National Death Index. RESULTS Anxiety during the 0-2h pre-MI period was associated with younger age (OR=0.98,95% CI=0.96-0.99 per year) and female sex (OR=1.50,95% CI=1.11-2.02). Anger in the 0-2h pre-MI period was also associated with younger age (OR=0.95,95% CI=0.94-0.96) but not with sex (OR=0.93,95% CI=0.67-1.28). During follow-up, 580 (26.7%) patients died. Mortality rate was higher if MI occurred immediately after high anxiety, particularly in patients ≥65years (HR=1.80,95% CI=1.28-2.54) vs. younger patients (HR=0.87,95% CI=0.55-1.40; p-interaction=0.015). Other interactions with sex or anger were not significant. CONCLUSIONS Patients with high anxiety or anger levels in the critical 2-hour period prior to MI are younger than those without such emotional precipitants. In addition, pre-MI anxiety is associated with an elevated 10-year mortality risk in patients aged ≥65years.
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Castañeda SF, Buelna C, Giacinto RE, Gallo LC, Sotres-Alvarez D, Gonzalez P, Fortmann AL, Wassertheil-Smoller S, Gellman MD, Giachello AL, Talavera GA. Cardiovascular disease risk factors and psychological distress among Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Prev Med 2016; 87:144-150. [PMID: 26921653 PMCID: PMC4884536 DOI: 10.1016/j.ypmed.2016.02.032] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 01/25/2016] [Accepted: 02/22/2016] [Indexed: 12/17/2022]
Abstract
Studies show that cardiovascular disease (CVD) risk factors are correlated with psychological distress, yet research examining these relationships among Hispanic/Latinos is lacking. The population-based Hispanic Community Health Study/Study of Latinos enrolled a cohort of Hispanic/Latino adults (N=16,415) 18-74years of age at the time of recruitment, from four US metropolitan areas, between March 2008 and June 2011. Psychological distress (i.e., 10-item Center for Epidemiological Studies Depression Scale, 10 item Spielberger Trait Anxiety Scale, and a combined depression/anxiety score), socio-demographics (i.e., age, education, income, insurance, sex, and Hispanic/Latino background), acculturation (i.e., country of birth and language preference), and traditional CVD risk factors (i.e., dyslipidemia, obesity, current cigarette smoking, diabetes, and hypertension) were assessed at baseline. Associations between CVD risk factors and psychological distress measures by sex were examined using multiple linear regression models, accounting for complex survey design and sampling weights and controlling for socio-demographic and acculturation covariates. In adjusted analyses, all three psychological distress measures were significantly related to smoking. For females, greater psychological distress was significantly related to obesity and current smoking. For males, diabetes and current smoking were associated with psychological distress. For males and females, dyslipidemia and hypertension were not associated with psychological distress after adjusting for other factors. Elevated depression and anxiety symptoms were associated with CVD risk factors for Hispanic/Latino men and women. However, these results were not consistent across Hispanic/Latino groups. As promoted by the integrative care model, psychosocial concerns should be considered in research on CVD risk and chronic disease prevention.
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Affiliation(s)
- Sheila F Castañeda
- Graduate School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA 92182, USA.
| | - Christina Buelna
- Graduate School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA 92182, USA
| | - Rebeca Espinoza Giacinto
- Graduate School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA 92182, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, 5500 Campanile Dr, San Diego, CA 92182, USA
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina, 137 E. Franklin Street, Suite 203, CB#8030, Chapel Hill, NC 27514, USA
| | - Patricia Gonzalez
- Graduate School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA 92182, USA
| | - Addie L Fortmann
- Scripps Whittier Diabetes Institute, 10140 Campus Point Drive, San Diego, CA 92121, USA
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Einstein College of Medicine, 1300 Morris Park Avenue, Belfer Building, Room 1312, Bronx, NY 10461, USA
| | - Marc D Gellman
- Behavioral Medicine Research Center, University of Miami, 1251 Stanford Dr, Coral Gables, FL 33146, USA
| | - Aida L Giachello
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Dr, Suite 1400, Chicago, IL 60611, USA
| | - Gregory A Talavera
- Graduate School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA 92182, USA
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Gerber M, Lang C, Lemola S, Colledge F, Kalak N, Holsboer-Trachsler E, Pühse U, Brand S. Validation of the German version of the insomnia severity index in adolescents, young adults and adult workers: results from three cross-sectional studies. BMC Psychiatry 2016; 16:174. [PMID: 27245844 PMCID: PMC4888604 DOI: 10.1186/s12888-016-0876-8] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 05/16/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND A variety of objective and subjective methods exist to assess insomnia. The Insomnia Severity Index (ISI) was developed to provide a brief self-report instrument useful to assess people's perception of sleep complaints. The ISI was developed in English, and has been translated into several languages including German. Surprisingly, the psychometric properties of the German version have not been evaluated, although the ISI is often used with German-speaking populations. METHODS The psychometric properties of the ISI are tested in three independent samples: 1475 adolescents, 862 university students, and 533 police and emergency response service officers. In all three studies, participants provide information about insomnia (ISI), sleep quality (Pittsburgh Sleep Quality Index), and psychological functioning (diverse instruments). Descriptive statistics, gender differences, homogeneity and internal consistency, convergent validity, and factorial validity (including measurement invariance across genders) are examined in each sample. RESULTS The findings show that the German version of the ISI has generally acceptable psychometric properties and sufficient concurrent validity. Confirmatory factor analyses show that a 1-factor solution achieves good model fit. Furthermore, measurement invariance across gender is supported in all three samples. CONCLUSIONS While the ISI has been widely used in German-speaking countries, this study is the first to provide empirical evidence that the German version of this instrument has good psychometric properties and satisfactory convergent and factorial validity across various age groups and both men and women. Thus, the German version of the ISI can be recommended as a brief screening measure in German-speaking populations.
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Affiliation(s)
- Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, St. Jakobsturm, Birsstrasse 320B, 4052, Basel, Switzerland.
| | - Christin Lang
- Department of Sport, Exercise and Health, University of Basel, St. Jakobsturm, Birsstrasse 320B, 4052 Basel, Switzerland
| | - Sakari Lemola
- Department of Psychology, University of Warwick, Coventry, UK
| | - Flora Colledge
- Department of Sport, Exercise and Health, University of Basel, St. Jakobsturm, Birsstrasse 320B, 4052 Basel, Switzerland
| | - Nadeem Kalak
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, Basel, Switzerland
| | - Edith Holsboer-Trachsler
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, Basel, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, St. Jakobsturm, Birsstrasse 320B, 4052 Basel, Switzerland
| | - Serge Brand
- Department of Sport, Exercise and Health, University of Basel, St. Jakobsturm, Birsstrasse 320B, 4052 Basel, Switzerland ,Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, Basel, Switzerland
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Santoro M, Nociti V, De Fino C, Caprara A, Giordano R, Palomba N, Losavio F, Marra C, Patanella AK, Mirabella M, Gainotti G, Quaranta D. Depression in multiple sclerosis: effect of brain derived neurotrophic factor Val66Met polymorphism and disease perception. Eur J Neurol 2016; 23:630-40. [PMID: 26756166 DOI: 10.1111/ene.12913] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 10/01/2015] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND PURPOSE Depression is common amongst subjects with multiple sclerosis (MS), and several investigations have explored different determinants of this condition, including physical disability, psychological and psychosocial factors. The brain derived neurotrophic factor (BDNF) Val66Met polymorphism has been associated with depression. The aim of this study was to analyze the influence of disease-related factors, BDNF Val66Met polymorphism and perception of disease on the severity of depression in MS. METHOD In total, 136 MS patients (88 women) were recruited and genotyped for BDNF rs6265 polymorphism at nucleotide 196 (G/A) using 'high resolution melting'. Depressive symptoms were assessed by the Multiple Sclerosis Depression Rating Scale. Perception of health status was assessed using the SF-36 questionnaire. RESULTS A multivariable linear regression model showed that the best predictors of depression were the SF-36 General health (β = -0.209; P = 0.013), Mental health (β = -0.410; P < 0.001) and Social activity (β = -0.195; P = 0.035) scores; physical disability (assessed by the Extended Disability Status Scale score) was directly correlated to depression severity on univariate analysis, but it was not a relevant predictor of depression on multivariate analysis; other variables directly related to the disease (treatment, annual relapsing rate) and the BDNF Val66Met polymorphism were not significantly associated with depression. CONCLUSION Perception of the health status is the principal predictor of depressive symptoms in our sample. This result supports the hypothesis that the subjective interpretation of the disease's consequences is one of the main factors in determining depression in MS.
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Affiliation(s)
- M Santoro
- Fondazione Don Gnocchi - ONLUS, Milan, Italy
| | - V Nociti
- Fondazione Don Gnocchi - ONLUS, Milan, Italy.,Institute of Neurology, Catholic University, Rome, Italy
| | - C De Fino
- Institute of Neurology, Catholic University, Rome, Italy
| | - A Caprara
- Institute of Neurology, Catholic University, Rome, Italy
| | - R Giordano
- Institute of Neurology, Catholic University, Rome, Italy
| | - N Palomba
- Institute of Neurology, Catholic University, Rome, Italy
| | - F Losavio
- Institute of Neurology, Catholic University, Rome, Italy
| | - C Marra
- Institute of Neurology, Catholic University, Rome, Italy.,Research Center for Neuropsychology, Institute of Neurology, Catholic University, Rome, Italy
| | - A K Patanella
- Institute of Neurology, Catholic University, Rome, Italy
| | - M Mirabella
- Institute of Neurology, Catholic University, Rome, Italy
| | - G Gainotti
- Institute of Neurology, Catholic University, Rome, Italy.,Research Center for Neuropsychology, Institute of Neurology, Catholic University, Rome, Italy
| | - D Quaranta
- Institute of Neurology, Catholic University, Rome, Italy.,Research Center for Neuropsychology, Institute of Neurology, Catholic University, Rome, Italy
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Kotan Z, Bican A, Kotan VO, Bora İ, Yalvac HD, Ozkaya G, Akkaya C. Sleep measurements in women with dysthymic disorder and insomnia. Sleep Biol Rhythms 2014. [DOI: 10.1111/sbr.12092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Zeynep Kotan
- Department of Psychiatry; Abdurrahman Yurtaslan Ankara Onkoloji Training and Research Hospital; Ankara Turkey
| | - Aylin Bican
- Department of Neurology Medicine; Uludag University, Medical Faculty; Bursa Turkey
| | - Vahap Ozan Kotan
- Department of Psychiatry; Ankara Numune Training and Research Hospital; Ankara Turkey
| | - İbrahim Bora
- Department of Neurology Medicine; Uludag University, Medical Faculty; Bursa Turkey
| | - Hayriye Dilek Yalvac
- Department of Psychiatry; Abdurrahman Yurtaslan Ankara Onkoloji Training and Research Hospital; Ankara Turkey
| | - Güven Ozkaya
- Department of Biostatistics; Uludag University, Medical Faculty; Bursa Turkey
| | - Cengiz Akkaya
- Department of Psychiatry; Uludag University, Medical Faculty; Bursa Turkey
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Passive Event-Related Potentials to a Single Tone in Treatment-Resistant Depression, Generalized Anxiety Disorder, and Borderline Personality Disorder Patients. J Clin Neurophysiol 2014; 31:488-92. [DOI: 10.1097/wnp.0000000000000091] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Patchev AV, Rodrigues AJ, Sousa N, Spengler D, Almeida OFX. The future is now: early life events preset adult behaviour. Acta Physiol (Oxf) 2014; 210:46-57. [PMID: 23790203 DOI: 10.1111/apha.12140] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Revised: 06/03/2013] [Accepted: 06/13/2013] [Indexed: 12/26/2022]
Abstract
To consider the evidence that human and animal behaviours are epigenetically programmed by lifetime experiences. Extensive PubMed searches were carried out to gain a broad view of the topic, in particular from the perspective of human psychopathologies such as mood and anxiety disorders. The selected literature cited is complemented by previously unpublished data from the authors' laboratories. Evidence that physiological and behavioural functions are particularly sensitive to the programming effects of environmental factors such as stress and nutrition during early life, and perhaps at later stages of life, is reviewed and extended. Definition of stimulus- and function-specific critical periods of programmability together with deeper understanding of the molecular basis of epigenetic regulation will deliver greater appreciation of the full potential of the brain's plasticity while providing evidence-based social, psychological and pharmacological interventions to promote lifetime well-being.
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Affiliation(s)
| | - A. J. Rodrigues
- Life and Health Sciences Research Institute; University of Minho; Braga Portugal
- ICVS/3B's - PT Government Associate Laboratory; Braga/Guimarães Portugal
| | - N. Sousa
- Life and Health Sciences Research Institute; University of Minho; Braga Portugal
- ICVS/3B's - PT Government Associate Laboratory; Braga/Guimarães Portugal
| | - D. Spengler
- Max Planck Institute of Psychiatry; Munich Germany
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Walter SA, Jones MP, Talley NJ, Kjellström L, Nyhlin H, Andreasson AN, Agréus L. Abdominal pain is associated with anxiety and depression scores in a sample of the general adult population with no signs of organic gastrointestinal disease. Neurogastroenterol Motil 2013; 25:741-e576. [PMID: 23692044 DOI: 10.1111/nmo.12155] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2012] [Accepted: 04/22/2013] [Indexed: 12/15/2022]
Abstract
BACKGROUND Abdominal pain is common in the community, but only a subset meet diagnostic criteria for irritable bowel syndrome (IBS). Although anxiety and depression have been linked to IBS, the role of mood disturbances in the remainder with symptoms remains unclear. We aimed to study the associations between abdominal pain, anxiety, depression, and quality of life in the general population who were free of organic colonic disease by colonoscopy. METHODS Two hundred and seventy-two randomly selected subjects from the general population, mean age 54 years (27-71), were clinically evaluated, had a colonoscopy and laboratory investigations to exclude organic gastrointestinal (GI) disease. All subjects completed GI symptom diaries for 1 week, the Rome II modular questionnaire, the Hospital Anxiety and Depression Scale, and Short Form 36. KEY RESULTS Twenty-two subjects were excluded due to organic disease; 1532 daily symptom records were available for analysis in the remainder. Thirty-four percent (n = 83) recorded at least one episode of abdominal pain on the diary. Twelve percent fulfilled Rome II criteria for IBS. Both anxiety and depression scores were higher in subjects who reported abdominal pain vs those who did not (P < 0.0005 and P < 0.0005). Anxiety and depression scores independently from IBS diagnosis (Rome II) predicted pain reporting and also correlated positively with pain burden. Quality of life scores were generally lower in subjects with abdominal pain. CONCLUSIONS & INFERENCES Anxiety and depression are linked to functional abdominal pain, not only in subjects with IBS but also in otherwise healthy people with milder, subtle GI symptoms.
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Affiliation(s)
- S A Walter
- Institution of Clinical and Experimental Medicine (IKE), Faculty of Health Sciences, Division of Gastroenterology, Linköping University, Linköping, Sweden.
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Švob Štrac D, Muck-Šeler D, Pivac N. The involvement of noradrenergic mechanisms in the suppressive effects of diazepam on the hypothalamic-pituitary-adrenal axis activity in female rats. Croat Med J 2012; 53:214-23. [PMID: 22661134 PMCID: PMC3368292 DOI: 10.3325/cmj.2012.53.214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Aim To elucidate the involvement of noradrenergic system in the mechanism by which diazepam suppresses basal hypothalamic-pituitary-adrenal (HPA) axis activity. Methods Plasma corticosterone and adrenocorticotropic hormone (ACTH) levels were determined in female rats treated with diazepam alone, as well as with diazepam in combination with clonidine (α2-adrenoreceptor agonist), yohimbine (α2-adrenoreceptor antagonist), alpha-methyl-p-tyrosine (α-MPT, an inhibitor of catecholamine synthesis), or reserpine (a catecholamine depleting drug) and yohimbine. Results Diazepam administered in a dose of 2.0 mg/kg suppressed basal HPA axis activity, ie, decreased plasma corticosterone and ACTH levels. Pretreatment with clonidine or yohimbine failed to affect basal plasma corticosterone and ACTH concentrations, but abolished diazepam-induced inhibition of the HPA axis activity. Pretreatment with α-MPT, or with a combination of reserpine and yohimbine, increased plasma corticosterone and ACTH levels and prevented diazepam-induced inhibition of the HPA axis activity. Conclusion The results suggest that α2-adrenoreceptors activity, as well as intact presynaptic noradrenergic function, are required for the suppressive effect of diazepam on the HPA axis activity.
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Sanders MJ, Stevens S, Boeh H. Stress enhancement of fear learning in mice is dependent upon stressor type: Effects of sex and ovarian hormones. Neurobiol Learn Mem 2010; 94:254-62. [PMID: 20601029 DOI: 10.1016/j.nlm.2010.06.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Revised: 06/02/2010] [Accepted: 06/08/2010] [Indexed: 11/25/2022]
Abstract
In three experiments, chronic stress enhancement of subsequent fear learning was investigated in C57Bl/6 mice. The first experiment focused on the influence of stressor type on subsequent Pavlovian fear learning. Male mice were subjected to 7d of either repeated restraint stress or chronic variable stress before undergoing a fear conditioning procedure with three tone-shock trials. Subsequent tests were conducted of contextual and tone fear, through measures of the freezing response. Repeated restraint altered pre-training activity and the unconditional response to shock, but was ineffective in influencing conditional fear. Chronic variable stress significantly inflated contextual fear without altering tone fear. In a second experiment, investigating potential sex differences in the fear-enhancing effects of stress, female mice were subjected to the very same procedures. Among females, chronic variable stress selectively altered tone fear, rather than contextual fear. A final experiment investigated the potential role of ovarian hormones by subjecting female mice to either ovariectomy or sham surgery before the stress procedures. Ovariectomy had no significant effect on the ability of stress to enhance fear in females. In sum, the experiments indicate that stressor type significantly influences subsequent fear learning, that males and females are differentially sensitive to fear enhancement by stress, and that the mechanisms mediating these sex differences lie outside of the immediate influence of ovarian hormones. The findings should allow for refinement of animal models of human psychiatric disorders and for further investigations into the genetic and molecular substrates of significant gender differences in fear and anxiety.
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Affiliation(s)
- Matthew J Sanders
- Department of Psychology, Marquette University, Milwaukee, WI 53201, United States.
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Kohrt BA, Worthman CM. Gender and anxiety in Nepal: the role of social support, stressful life events, and structural violence. CNS Neurosci Ther 2010; 15:237-48. [PMID: 19691543 DOI: 10.1111/j.1755-5949.2009.00096.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Throughout the world, anxiety disorders are 1.5-2 times more prevalent among women than men but the reasons for this gender disparity remain elusive. Despite frequent attribution to cultural roles of men and women, data regarding gendered risk factors in non-Western settings are scant. AIMS This study evaluated the role of gender as a moderator (effect modifier) of stressful life events (SLEs) and social support on the risk of anxiety in Nepal. A cross-sectional random sampling design was employed to recruit 316 persons in a rural community. The participants completed the Beck Anxiety Inventory (BAI), Stressful Life Events Rating Scale (SLERS), and a measure of social support. RESULTS The prevalence of anxiety differed by gender: 36.9% of women versus 20.4% of men endorsed anxiety symptoms above the validated cutoff for intervention (odds ratio [OR]= 2.3, 95% confidence interval [CI]= 1.4-3.8). The number of SLEs and levels of social support did not differ by gender, nor did gender moderate the relationship between SLEs and anxiety. Gender did moderate the relationship of social support with anxiety. Men who reported low social support had 3.5 times greater odds (95% CI = 1.4-10.7) of endorsing anxiety relative to men reporting high social support. Women exhibited no association of anxiety with social support. CONCLUSION Women are at a greater risk of anxiety in Nepal. Social support moderates the risk of anxiety among men but not among women. Ethnography and mixed-methods research are needed to identify other forms of support that may be protective for women and such factors should be promoted in gender-focused mental health interventions.
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Affiliation(s)
- Brandon A Kohrt
- Department of Anthropology, Emory University, Atlanta, GA 30322, USA.
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Histories of major depression and premenstrual dysphoric disorder: Evidence for phenotypic differences. Biol Psychol 2010; 84:235-47. [PMID: 20138113 DOI: 10.1016/j.biopsycho.2010.01.018] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2009] [Revised: 01/20/2010] [Accepted: 01/28/2010] [Indexed: 11/21/2022]
Abstract
This study examined unique versus shared stress and pain-related phenotypes associated with premenstrual dysphoric disorder (PMDD) and prior major depressive disorder (MDD). Sympathetic nervous system (SNS) and hypothalamic-pituitary-adrenal (HPA)-axis measures were assessed at rest and during mental stress, as well as sensitivity to cold pressor and tourniquet ischemic pain tasks in four groups of women: (1) non-PMDD with no prior MDD (N=18); (2) non-PMDD with prior MDD (N=9); (3) PMDD with no prior MDD (N=17); (4) PMDD with prior MDD (N=10). PMDD women showed blunted SNS responses to stress compared to non-PMDD women, irrespective of prior MDD; while women with prior MDD showed exaggerated diastolic blood pressure responses to stress versus never depressed women, irrespective of PMDD. However, only in women with histories of MDD did PMDD women have lower cortisol concentrations than non-PMDD women, and only in non-PMDD women was MDD associated with reduced cold pressor pain sensitivity. These results suggest both unique phenotypic differences between women with PMDD and those with a history of MDD, but also indicate that histories of MDD may have special relevance for PMDD.
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Calkins AW, Otto MW, Cohen LS, Soares CN, Vitonis AF, Hearon BA, Harlow BL. Psychosocial predictors of the onset of anxiety disorders in women: results from a prospective 3-year longitudinal study. J Anxiety Disord 2009; 23:1165-9. [PMID: 19699609 PMCID: PMC2760601 DOI: 10.1016/j.janxdis.2009.07.022] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2009] [Revised: 07/22/2009] [Accepted: 07/23/2009] [Indexed: 11/26/2022]
Abstract
In a prospective, longitudinal, population-based study of 643 women participating in the Harvard Study of Moods and Cycles we examined whether psychosocial variables predicted a new or recurrent onset of an anxiety disorder. Presence of anxiety disorders was assessed every 6 months over 3 years via structured clinical interviews. Among individuals who had a new episode of anxiety, we confirmed previous findings that history of anxiety, increased anxiety sensitivity (the fear of anxiety related sensations), and increased neuroticism were significant predictors. We also found trend level support for assertiveness as a predictor of anxiety onset. However, of these variables, only history of anxiety and anxiety sensitivity provided unique prediction. We did not find evidence for negative life events as a predictor of onset of anxiety either alone or in interaction with other variables in a diathesis-stress model. These findings from a prospective longitudinal study are discussed in relation to the potential role of such predictors in primary or relapse prevention efforts.
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de Chaves G, Moretti M, Castro A, Dagostin W, da Silva G, Boeck C, Quevedo J, Gavioli E. Effects of long-term ovariectomy on anxiety and behavioral despair in rats. Physiol Behav 2009; 97:420-5. [DOI: 10.1016/j.physbeh.2009.03.016] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2008] [Revised: 03/14/2009] [Accepted: 03/16/2009] [Indexed: 11/24/2022]
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Potter J, Bouyer J, Trussell J, Moreau C. Premenstrual syndrome prevalence and fluctuation over time: results from a French population-based survey. J Womens Health (Larchmt) 2009; 18:31-9. [PMID: 19105683 DOI: 10.1089/jwh.2008.0932] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To explore the experience of reproductive-age women in the French population with premenstrual syndrome (PMS) by estimating perceived symptom prevalence, identifying risk factors, and quantifying the burden of symptoms. This study also assesses the stability of the PMS diagnosis over a 1-year period of follow-up. METHODS The prevalence of reported PMS was estimated from a population-based cohort of 2863 French women interviewed in 2003 and 2004. Multivariate logistic regressions were used to identify risk factors associated with PMS. PMS fluctuation was studied by comparing women's responses in 2003 and 2004. RESULTS Results show that 4.1% of women qualified for severe PMS (six symptoms) and 8.1% qualified for moderate PMS (one to five symptoms), resulting in 12.2% of women who reported PMS symptoms that impacted their daily lives. Risk factors for PMS fell into three categories: hormonal, psychosocial, and physiological, with life stressors and exogenous hormonal exposure exerting the most substantial impact. Results also indicate a high level of intraindividual variation in PMS status over time; among women who qualified for PMS during 1 or both years of the study, 72% demonstrated fluctuation in their PMS status. CONCLUSIONS More women report suffering from distressing premenstrual symptoms than are captured by strict premenstrual dysphoric disorder (PMDD) diagnostic criteria. The impact of PMS symptoms on women appears to fluctuate over time, however, producing greater variability in the syndrome than previously recognized. Clinicians should be mindful of high intraindividual variability in the syndrome when advising patients about long-term management.
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Affiliation(s)
- Julia Potter
- Institut National de la Santé et de la Recherche Médical, Department of Epidemiology, Demography, and Social Sciences, Le Kremlin-Bicetre, France
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Jorgensen RS, Smyth JM. Psychosocial distress predicts diabetes: is additional research warranted? Diabet Med 2009; 26:191-2. [PMID: 19236628 DOI: 10.1111/j.1464-5491.2008.02657.x] [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] [Indexed: 10/21/2022]
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Olvey EL, Skrepnek GH. The cost-effectiveness of sertraline in the treatment of depression. Expert Opin Pharmacother 2008; 9:2497-508. [DOI: 10.1517/14656566.9.14.2497] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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