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Phongsaphakjarukorn N, Kanlayanaphotporn R, Jensen MP, Janwantanakul P. Responsiveness and clinically important differences of the PROMIS short form-depression 8a, anxiety 8a, and PASS-20 in individuals with chronic low back pain. Pain Rep 2024; 9:e1170. [PMID: 38910868 PMCID: PMC11191038 DOI: 10.1097/pr9.0000000000001170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/30/2024] [Accepted: 05/14/2024] [Indexed: 06/25/2024] Open
Abstract
Introduction Depression and anxiety are the most commonly reported mental health conditions. The Patient-Reported Outcomes Measurement Information System Short Form v1.0-Depression 8a (PROMIS-D-8a), Anxiety 8a (PROMIS-Anx8a), and Pain Anxiety Symptoms Scale-20 (PASS-20) measures were designed to assess depression, general anxiety, and pain-related anxiety, respectively. Objectives To examine the responsiveness and estimate the clinically important differences (CIDs) of the Thai version of these measures in individuals with chronic low back pain (CLBP). Methods The study sample comprised 144 participants with CLBP. Responsiveness was evaluated by calculating the change scores, effect sizes (ESs), standardized response means (SRMs), area under the curve (AUC), and correlations between the change scores and associated Global Perceived Effect (GPE). We also estimated CIDs by the difference in mean change score between improved and unchanged groups and standard error of measurement (SEM) for each measure. Results Statistically significant differences in the mean change scores, ESs, and SRMs supported the responsiveness of all measures. The AUCs achieved acceptable discriminatory ability (0.71-0.72) for moderate improvement but not for any improvement (0.65-0.68). The correlations between GPE and change scores on all measures were low (r ranging 0.28-0.33). The estimated CIDs for the PROMIS-D-8a, PROMIS-Anx8a, and PASS-20 were 3.64, 4.20, and 8.80, respectively. Conclusion The PROMIS-D-8a, PROMIS-Anx8a, and PASS-20 measures were sensitive for detecting clinical changes over time in individuals with CLBP. The CID values can be used as reference points for assessing meaningful improvements in the domains assessed by these scales in clinical and research practice.
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Affiliation(s)
| | - Rotsalai Kanlayanaphotporn
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Mark P. Jensen
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Prawit Janwantanakul
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
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Srinivasan R, Rodgers-Melnick SN, Rivard RL, Kaiser C, Vincent D, Adan F, Dusek JA. Implementing paper-based patient-reported outcome collection within outpatient integrative health and medicine. PLoS One 2024; 19:e0303985. [PMID: 38809886 PMCID: PMC11135778 DOI: 10.1371/journal.pone.0303985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 05/04/2024] [Indexed: 05/31/2024] Open
Abstract
OBJECTIVE To investigate the feasibility of pre- and post-encounter patient-reported outcome (PRO) measure collection within an outpatient integrative health and medicine (IHM) clinic and to characterize factors associated with successful completion. METHODS We conducted a retrospective review of 27,464 outpatient IHM encounters including 9,520 chiropractic; 8,237 acupuncture; 5,847 massage; 2,345 IHM consultation; and 1,515 osteopathic manipulation treatment encounters at four clinics offering IHM over 18 months. Patients were asked to complete paper questionnaires rating pain, anxiety, and stress from 0-10 immediately pre- and post-encounter. Generalized linear mixed effect regression models were used to examine the relationship between demographic, clinical, and operational covariates and completing (1) pre-encounter and (2) paired (i.e., pre and post) PROs. RESULTS Patients (N = 5587, mean age 49 years, 74% white, 77% female) generally presented for musculoskeletal conditions (81.7%), with a chief complaint of pain (55.1%). 21,852 (79.6%) encounters were among patients who completed pre-encounter PROs; 11,709/21,852 (53.6%) completed subsequent post-encounter PROs. Odds of PRO completion were more impacted by provider, operational, and clinical-level factors than patient factors. Covariates associated with increased odds of pre-encounter PRO completion included being female, having additional IHM encounters, and having a pain or anxiety complaint. Covariates associated with increased odds of paired PRO completion included being aged 31-40 vs. 51-60 years and having additional IHM encounters. CONCLUSION Implementing a paper-based PRO collection system in outpatient IHM is feasible; however, collecting post-encounter PROs was challenging. Future endeavors should leverage the electronic health record and patient portals to optimize PRO collection and engage patients and clinical providers.
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Affiliation(s)
- Roshini Srinivasan
- Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH, United States of America
- Duke University School of Medicine, Durham, NC, United States of America
| | - Samuel N. Rodgers-Melnick
- Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH, United States of America
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, United States of America
| | - Rachael L. Rivard
- Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH, United States of America
- Center for Evaluation Survey and Research, HealthPartners Institute, Minneapolis, MN, United States of America
| | - Christine Kaiser
- Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH, United States of America
| | - David Vincent
- Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH, United States of America
| | - Francoise Adan
- Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH, United States of America
- Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, United States of America
| | - Jeffery A. Dusek
- Susan Samueli Integrative Health Institute, University of California Irvine, Irvine, CA, United States of America
- Department of Medicine, University of California Irvine, Irvine, CA, United States of America
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Crosby S, Kwon C, Rodney T. Symptom Profile Characterization Using the Beck Anxiety Inventory Among Undergraduates in the United States. J Am Psychiatr Nurses Assoc 2024; 30:378-383. [PMID: 35927888 DOI: 10.1177/10783903221114334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Beck Anxiety Inventory (BAI) is widely used to measure the severity of anxiety. This tool may additionally allow for an in-depth analysis of symptom typology, as reported symptoms can be placed into four categories (subjective, neurophysiologic, autonomic, and panic-related). Although overall severity ratings in populations may be similar, the type of symptoms reported as severe may differ dependent on characteristics of the populations assessed. AIMS This study examines the variety of anxiety symptoms manifested among U.S. university students and the impact of symptom typology on seeking treatment. METHOD This was an online survey completed by undergraduate students in the United States, responding to questions including the BAI. RESULTS A multivariate logistic regression analysis model showed that the likelihood of students seeking treatment increased when they experienced more "subjective" anxiety symptoms, odds ratio (OR) = 2.443, 95% confidence interval (CI) = [1.462, 4.082], p = .001, as compared to symptoms in the other three categories. Students were also asked to report which symptoms were "most bothersome" to them. Many students reported difficulty sleeping and an inability to concentrate. These symptoms are not measured by the BAI. CONCLUSION The results of this study show the potential for the BAI to be used as a symptom categorization tool to be considered independently in identifying target areas for treatment. An understanding of the existence of these gaps may allow providers to better identify students with anxiety who present with symptoms not included in the BAI.
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Affiliation(s)
- Shae Crosby
- Shae Crosby, MSN, RN, Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Chloe Kwon
- Chloe Kwon, MSN, RN, Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Tamar Rodney
- Tamar Rodney, PhD, RN, PMHNP-BC, CNE, Johns Hopkins University School of Nursing, Baltimore, MD, USA
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4
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Fakes K, Boyes A, Hall A, Carey M, Leigh L, Brown S, Sanson-Fisher R. Trajectories and Predictors of Raised State Anxiety Among Outpatients Who Have Undergone Medical Imaging Procedures. J Am Coll Radiol 2024; 21:285-294. [PMID: 37453598 DOI: 10.1016/j.jacr.2023.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/23/2023] [Accepted: 06/09/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE The aim of this study was to examine the prevalence of raised state anxiety before and after medical imaging procedures, the prevalence of state anxiety trajectories, and factors associated with postprocedural raised state anxiety. METHODS A prospective survey was administered to outpatients undergoing elective medical imaging procedures (CT, radiography, MRI, ultrasound, angiography, or fluoroscopy) recruited from one center. Participants completed a self-report survey preprocedure (time 1) and postprocedure (time 2). State anxiety was measured using the six-item State-Trait Anxiety Inventory. The point prevalence of raised state anxiety (State-Trait Anxiety Inventory score ≥33.16) at time 1 and time 2 was calculated, as was the prevalence of four state anxiety trajectories over time: persistent low anxiety, decreasing anxiety, increasing anxiety, and persistent raised anxiety. Factors predictive of raised state anxiety at time 2 were examined using logistic regression analysis. RESULTS Three hundred fifteen participants completed both surveys. The prevalence of raised state anxiety at time 1 (50%) and time 2 (51%) was similar. Most patients reported persistent raised anxiety (36%) and persistent low anxiety (34%) over time. Fewer patients reported increasing anxiety (15%) and decreasing anxiety (14%). Raised state anxiety (odds ratio, 4.84; 95% confidence interval, 2.48-9.48) and lower reported health status (odds ratio, 2.48; 95% confidence interval, 1.11-5.51) at time 1 were significantly associated with greater odds of raised anxiety at time 2. CONCLUSIONS Raised state anxiety related to medical imaging procedures is common among outpatients. Half of patients either developed or continued to experience raised anxiety after their procedures. Outpatients may benefit from evidence-based methods of alleviating anxiety before their procedures.
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Affiliation(s)
- Kristy Fakes
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, New Lambton Heights, Australia.
| | - Allison Boyes
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Alix Hall
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Mariko Carey
- Hunter Medical Research Institute, New Lambton Heights, Australia; Centre for Women's Health Research, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Lucy Leigh
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Sandy Brown
- Hunter New England Imaging, John Hunter Hospital/Royal Newcastle Centre, New Lambton Heights, Australia
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5
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Ahmed I, Hazell CM, Edwards B, Glazebrook C, Davies EB. A systematic review and meta-analysis of studies exploring prevalence of non-specific anxiety in undergraduate university students. BMC Psychiatry 2023; 23:240. [PMID: 37041470 PMCID: PMC10088287 DOI: 10.1186/s12888-023-04645-8] [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] [Received: 06/09/2022] [Accepted: 02/28/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Anxiety is a common mental health problem in the general population, and is associated with functional impairment and negative impacts upon quality of life. There has been increased concern about university students' mental health in recent years, with a wide range of non-specific anxiety rates reported worldwide in undergraduate university students. We aimed to explore prevalence of non-specific anxiety in undergraduate university student populations. METHODS Four databases were searched to identify studies published between 1980 and 2020 which investigated prevalence of non-specific anxiety in undergraduate university students. Each study's quality was appraised using a checklist. Sub-analyses were undertaken reflecting outcome measure utilized, course of study, location of study, and whether study was before or during the COVID-19 pandemic. RESULTS A total of 89 studies - representing approx. 130,090 students-met inclusion criteria. Eighty-three were included in meta-analysis, calculating a weighted mean prevalence of 39.65% (95% CI: 35.72%-43.58%) for non-specific anxiety. Prevalence from diagnostic interview studies ranged from 0.3%-20.8% 12-month prevalence. Prevalence varied by outcome measure used to assess non-specific anxiety, the type of course studied by sample, and by study location. In half the studies, being female was associated with being more likely to have higher non-specific anxiety scores and/or screening above thresholds. Few of the included studies met all quality appraisal criteria. CONCLUSION The results suggest that approximately a third of undergraduate students are experiencing elevated levels of non-specific anxiety. Results from sub-analyses have identified some methodological issues that need consideration in appraising prevalence in this population.
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Affiliation(s)
- Irtiqa Ahmed
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Cassie M Hazell
- Department of Psychological Interventions, University of Surrey, Guildford, UK.
| | - Bethany Edwards
- School of Social Sciences and Humanities, University of Westminster, London, UK
| | - Cris Glazebrook
- Clinical Neurosciences and Mental Health, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - E Bethan Davies
- Clinical Neurosciences and Mental Health, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
- NIHR MindTech MedTech Co-Operative, Institute of Mental Health, School of Medicine, The University of Nottingham, Nottingham, UK
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Almaazmi S, Simsekler MCE, Henschel A, Qazi A, Marbouh D, Luqman RAMA. Evaluating Drivers of the Patient Experience Triangle: Stress, Anxiety, and Frustration. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5384. [PMID: 37047998 PMCID: PMC10094497 DOI: 10.3390/ijerph20075384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 06/19/2023]
Abstract
Patient experience is a widely used indicator for assessing the quality-of-care process during a patient's journey in hospital. However, the literature rarely discusses three components: patient stress, anxiety, and frustration. Furthermore, little is known about what drives each component during hospital visits. In order to explore this, we utilized data from a patient experience survey, including patient- and provider-related determinants, that was administered at a local hospital in Abu Dhabi, UAE. A machine-learning-based random forest (RF) algorithm, along with its embedded importance analysis function feature, was used to explore and rank the drivers of patient stress, anxiety, and frustration throughout two stages of the patient journey: registration and consultation. The attribute 'age' was identified as the primary patient-related determinant driving patient stress, anxiety, and frustration throughout the registration and consultation stages. In the registration stage, 'total time taken for registration' was the key driver of patient stress, whereas 'courtesy demonstrated by the registration staff in meeting your needs' was the key driver of anxiety and frustration. In the consultation step, 'waiting time to see the doctor/physician' was the key driver of both patient stress and frustration, whereas 'the doctor/physician was able to explain your symptoms using language that was easy to understand' was the main driver of anxiety. The RF algorithm provided valuable insights, showing the relative importance of factors affecting patient stress, anxiety, and frustration throughout the registration and consultation stages. Healthcare managers can utilize and allocate resources to improve the overall patient experience during hospital visits based on the importance of patient- and provider-related determinants.
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Affiliation(s)
- Sumaya Almaazmi
- Department of Industrial and Systems Engineering, Khalifa University of Science and Technology, Abu Dhabi 127788, United Arab Emirates
| | - Mecit Can Emre Simsekler
- Department of Industrial and Systems Engineering, Khalifa University of Science and Technology, Abu Dhabi 127788, United Arab Emirates
| | - Andreas Henschel
- Department of Electrical Engineering and Computer Science, Khalifa University of Science and Technology, Abu Dhabi 127788, United Arab Emirates
| | - Abroon Qazi
- School of Business Administration, American University Sharjah, Sharjah 26666, United Arab Emirates
| | - Dounia Marbouh
- Department of Industrial and Systems Engineering, Khalifa University of Science and Technology, Abu Dhabi 127788, United Arab Emirates
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7
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Gribkoff VK, Kaczmarek LK. The Difficult Path to the Discovery of Novel Treatments in Psychiatric Disorders. ADVANCES IN NEUROBIOLOGY 2023; 30:255-285. [PMID: 36928854 PMCID: PMC10599454 DOI: 10.1007/978-3-031-21054-9_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
CNS diseases, including psychiatric disorders, represent a significant opportunity for the discovery and development of new drugs and therapeutic treatments with the potential to have a significant impact on human health. CNS diseases, however, present particular challenges to therapeutic discovery efforts, and psychiatric diseases/disorders may be among the most difficult. With specific exceptions such as psychostimulants for ADHD, a large number of psychiatric patients are resistant to existing treatments. In addition, clinicians have no way of knowing which psychiatric patients will respond to which drugs. By definition, psychiatric diagnoses are syndromal in nature; determinations of efficacy are often self-reported, and drug discovery is largely model-based. While such models of psychiatric disease are amenable to screening for new drugs, whether cellular or whole-animal based, they have only modest face validity and, more importantly, predictive validity. Multiple academic, pharmaceutical industry, and government agencies are dedicated to the translation of new findings about the neurobiology of major psychiatric disorders into the discovery and advancement of novel therapies. The collaboration of these agencies provide a pathway for developing new therapeutics. These efforts will be greatly helped by recent advances in understanding the genetic bases of psychiatric disorders, the ongoing search for diagnostic and therapy-responsive biomarkers, and the validation of new animal models.
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Affiliation(s)
- Valentin K Gribkoff
- Department of Internal Medicine, Section on Endocrinology, Yale University School of Medicine, New Haven, CT, USA.
| | - Leonard K Kaczmarek
- Department of Pharmacology, Yale University School of Medicine, New Haven, CT, USA.
- Department of Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, CT, USA.
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8
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Jacobson NC, Feng B. Digital phenotyping of generalized anxiety disorder: using artificial intelligence to accurately predict symptom severity using wearable sensors in daily life. Transl Psychiatry 2022; 12:336. [PMID: 35977932 PMCID: PMC9385727 DOI: 10.1038/s41398-022-02038-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 06/22/2022] [Accepted: 06/29/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is a highly prevalent condition. Monitoring GAD symptoms requires substantial time, effort, and cost. The development of digital phenotypes of GAD may enable new scalable, timely, and inexpensive assessments of GAD symptoms. METHOD The current study used passive movement data collected within a large national cohort (N = 264) to assess GAD symptom severity. RESULTS Using one week of movement data, machine learning models accurately predicted GAD symptoms across a continuum (r = 0.511) and accurately detected those individuals with elevated GAD symptoms (AUC = 0.892, 70.0% Sensitivity, 95.5% Specificity, Brier Score = 0.092). Those with a risk score at the 90th percentile or above had 21 times the odds of having elevated GAD symptoms compared to those with lower risk scores. The risk score was most strongly associated with irritability, worry controllability, and restlessness (individual rs > 0.5). The risk scores for GAD were also discriminant of major depressive disorder symptom severity (r = 0.190). LIMITATIONS The current study examined the detection of GAD symptom severity rather than the prediction of GAD symptom severity across time. Furthermore, the instant sample of data did not include nighttime actigraphy, as participants were not asked to wear the actigraphs at night. CONCLUSIONS These results suggest that artificial intelligence can effectively utilize wearable movement data collected in daily life to accurately infer risk of GAD symptoms.
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Affiliation(s)
- Nicholas C. Jacobson
- grid.254880.30000 0001 2179 2404Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, PA USA ,grid.254880.30000 0001 2179 2404Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, PA USA ,grid.254880.30000 0001 2179 2404Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Lebanon, PA USA
| | - Brandon Feng
- grid.254880.30000 0001 2179 2404Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, PA USA
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A Comparison of Anxiety Symptoms and Correlates of Anxiety in People with Progressive and Relapsing-Remitting Multiple Sclerosis. Mult Scler Relat Disord 2022; 63:103918. [DOI: 10.1016/j.msard.2022.103918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/26/2022] [Accepted: 05/26/2022] [Indexed: 11/18/2022]
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10
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Kirk PA, Holmes AJ, Robinson OJ. Threat vigilance and intrinsic amygdala connectivity. Hum Brain Mapp 2022; 43:3283-3292. [PMID: 35362645 PMCID: PMC9188965 DOI: 10.1002/hbm.25851] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 12/20/2022] Open
Abstract
A well‐documented amygdala‐dorsomedial prefrontal circuit is theorized to promote attention to threat (“threat vigilance”). Prior research has implicated a relationship between individual differences in trait anxiety/vigilance, engagement of this circuitry, and anxiogenic features of the environment (e.g., through threat‐of‐shock and movie‐watching). In the present study, we predicted that—for those scoring high in self‐reported anxiety and a behavioral measure of threat vigilance—this circuitry is chronically engaged, even in the absence of anxiogenic stimuli. Our analyses of resting‐state fMRI data (N = 639) did not, however, provide evidence for such a relationship. Nevertheless, in our planned exploratory analyses, we saw a relationship between threat vigilance behavior (but not self‐reported anxiety) and intrinsic amygdala‐periaqueductal gray connectivity. Here, we suggest this subcortical circuitry may be chronically engaged in hypervigilant individuals, but that amygdala‐prefrontal circuitry may only be engaged in response to anxiogenic stimuli.
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Affiliation(s)
- Peter A Kirk
- Institute of Cognitive Neuroscience, University College London, London, UK.,Experimental Psychology, University College London, London, UK.,Departments of Psychology and Psychiatry, Yale University, New Haven, Connecticut, USA
| | - Avram J Holmes
- Departments of Psychology and Psychiatry, Yale University, New Haven, Connecticut, USA.,Wu Tsai Institute, Yale University, New Haven, Connecticut, USA
| | - Oliver J Robinson
- Institute of Cognitive Neuroscience, University College London, London, UK.,Clinical, Educational and Health Psychology, University College London, London, UK
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Lai TL, Au CK, Chung HY, Lau CS. Depression in psoriatic arthritis: Related to socio-demographics, comorbid loads or disease activity? Int J Rheum Dis 2022; 25:474-480. [PMID: 35147299 DOI: 10.1111/1756-185x.14298] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 11/29/2022]
Abstract
AIM Psychological distress commonly occurs in patients with psoriatic arthritis (PsA). The primary objective of this study was to determine the prevalence of depression in PsA. The secondary objective was to explore its associated factors, including socio-demographics, disease activity data and comorbidities. METHODS Patients with PsA fulfilling the Classification Criteria for Psoriatic Arthritis were consecutively recruited from local rheumatology clinics. Depression was assessed by a self-administered Chinese-Cantonese version of the Hospital Anxiety and Depression Scale (HADS). RESULTS Two hundred and eight eligible patients with PsA were recruited, with 82 females and 126 males. Depression was found in 62 (29.8%) of them. The univariate model identified these associated factors: (1) Psoriasis Area and Severity Index score; (2) disease activity measurement, that is tender and swollen joint count, erythrocyte sedimentation rate, C-reactive protein, Disease Activity in Psoriatic Arthritis (DAPSA) score, Leeds Enthesitis Index and tender dactylitis count; (3) quality of life measurement, that is Health Assessment Questionnaire - Disability Index (HAQ-DI), pain and general health perception; (4) PsA duration; and (5) body mass index. The final regression model identified DAPSA and HAQ-DI were closely associated with depression, P = .007 and P = .02 respectively. Moderate and strong correlations with HADS score were found with DAPSA (Kendall's tau-b coefficient [τb] = 0.25) and HAQ-DI (τb = 0.4) respectively. No associations with depression were found between age, living and employment status, gender, demographics, inflammatory markers, disease duration, skin involvement and comorbidities, in term of Charlson's Comorbidity Index. CONCLUSION Depression was prevalent among PsA patients and it was closely correlated with disease activity and physical function impairment. Achieving low disease activity and maintaining physical function in patients with PsA may mitigate the psychological burden. The present study also highlighted the unmet needs of strategies to identify this common phenomenon.
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Affiliation(s)
- Tin Lok Lai
- Rheumatology Team, Department of Medicine, Tseung Kwan O Hospital, Hong Kong, Hong Kong
| | - Chi Kit Au
- Rheumatology Team, Department of Medicine, Tseung Kwan O Hospital, Hong Kong, Hong Kong
| | - Ho Yin Chung
- Rheumatology & Clinical Immunology Team, Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong
| | - Chak Sing Lau
- Rheumatology & Clinical Immunology Team, Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong
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Gutiérrez-Velilla E, Barrientos-Casarrubias V, Cruz-Maycott R, Perrusquia-Ortiz LE, Alvarado-de la Barrera C, Ávila-Ríos S, Caballero-Suárez NP. Assessment of anxiety in Mexican persons living with HIV using a culturally-adapted version of the GAD-7 test. J Health Psychol 2022; 27:2875-2886. [PMID: 35042393 DOI: 10.1177/13591053211072687] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Our aim was to assess the severity of anxiety in PLWHA in Mexico City and obtain the psychometric properties of the culturally-adapted Spanish version of GAD-7. Thirteen percent of participants presented moderate to severe symptoms. Reliability (α = 0.82) and construct validity (single-factor explained 48.9% of variance) were evaluated in 411 participants. Confirmatory Factor Analysis was performed in a second sample of 527 participants. Model fit adequately (CFI = 0.991; CMIN/DF = 1.924; RMSEA = 0.042; and SRMR = 0.026). The adapted version of GAD-7 was adequate for the assessment of anxiety in Mexican PLWHA.
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Affiliation(s)
- Ester Gutiérrez-Velilla
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico.,Universidad Nacional Autónoma de México (UNAM), Mexico
| | - Vania Barrientos-Casarrubias
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico
| | - Rosa Cruz-Maycott
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico
| | - Lydia E Perrusquia-Ortiz
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico
| | - Claudia Alvarado-de la Barrera
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico
| | - Santiago Ávila-Ríos
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico
| | - Nancy Patricia Caballero-Suárez
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico
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13
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Westwell-Roper C, To S, Andjelic G, Lu C, Lin B, Soller L, Chan ES, Stewart SE. Food-allergy-specific anxiety and distress in parents of children with food allergy: A systematic review. Pediatr Allergy Immunol 2022; 33:e13695. [PMID: 34779046 DOI: 10.1111/pai.13695] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 10/05/2021] [Accepted: 10/28/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Parenting a child with food allergy (FA) can lead to impaired quality of life and family functioning. Anxiety is a critical component of FA-associated distress and a potential target for therapeutic intervention. This systematic review aimed to clarify the concept of FA-specific anxiety (FAA) and its antecedents, consequences, and correlates and to determine the extent to which existing FA-specific outcome measures capture symptoms of parental distress and FAA. METHODS MEDLINE, EMBASE, PsycINFO, and CENTRAL were searched for qualitative and quantitative studies examining distress or anxiety in parents of children with FA through August 2020. This review was registered with PROSPERO (CRD42020208316) and conducted in accordance with PRISMA guidelines. RESULTS Ninety-eight studies were included in the final narrative synthesis. Most participants were mothers, and reporting of demographic data was limited. Parents identified anxiety as the most burdensome form of FA-specific emotional distress. Several allergy-related factors as well as medical and psychosocial interventions were associated with reduced parental anxiety and distress. However, affective, cognitive, and behavioral dimensions of FAA were only partially addressed by existing measures for general anxiety symptoms and FA-specific parental factors. CONCLUSIONS FAA contributes to distress and functional impairment among parents of children with FA. Current FA-specific parent measures fail to adequately capture dimensions of FAA, suggesting that further work is needed to improve the assessment and monitoring of FAA and its impacts. Characterization of this construct represents an initial step in developing standardized methods for assessing and monitoring FAA in clinical populations.
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Affiliation(s)
- Clara Westwell-Roper
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Division of Clinical and Behavioural Neurosciences, Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sharon To
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Gordan Andjelic
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Cynthia Lu
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Boyee Lin
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Lianne Soller
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Edmond S Chan
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - S Evelyn Stewart
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Division of Clinical and Behavioural Neurosciences, Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Mental Health and Substance Use Research Institute, Vancouver, British Columbia, Canada
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14
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de Beurs E, Boehnke JR, Fried EI. Common measures or common metrics? A plea to harmonize measurement results. Clin Psychol Psychother 2022; 29:1755-1767. [PMID: 35421265 PMCID: PMC9796399 DOI: 10.1002/cpp.2742] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/26/2022] [Accepted: 04/11/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE There is a great variety of measurement instruments to assess similar constructs in clinical research and practice. This complicates the interpretation of test results and hampers the implementation of measurement-based care. METHOD For reporting and discussing test results with patients, we suggest converting test results into universally applicable common metrics. Two well-established metrics are reviewed: T scores and percentile ranks. Their calculation is explained, their merits and drawbacks are discussed, and recommendations for the most convenient reference group are provided. RESULTS We propose to express test results as T scores with the general population as reference group. To elucidate test results to patients, T scores may be supplemented with percentile ranks, based on data from a clinical sample. The practical benefits are demonstrated using the published data of four frequently used instruments for measuring depression: the CES-D, PHQ-9, BDI-II and the PROMIS depression measure. DISCUSSION Recent initiatives have proposed to mandate a limited set of outcome measures to harmonize clinical measurement. However, the selected instruments are not without flaws and, potentially, this directive may hamper future instrument development. We recommend using common metrics as an alternative approach to harmonize test results in clinical practice, as this will facilitate the integration of measures in day-to-day practice.
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Affiliation(s)
- Edwin de Beurs
- Department of Clinical PsychologyLeiden University & Arkin GGZAmsterdamThe Netherlands
| | | | - Eiko I. Fried
- Department of Clinical PsychologyLeiden UniversityLeidenZuid‐HollandThe Netherlands
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15
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Shah NN, Schwandt ML, Hobden B, Baldwin DS, Sinclair J, Agabio R, Leggio L. The validity of the state-trait anxiety inventory and the brief scale for anxiety in an inpatient sample with alcohol use disorder. Addiction 2021; 116:3055-3068. [PMID: 33861887 DOI: 10.1111/add.15516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/11/2021] [Accepted: 03/31/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS The Brief Scale for Anxiety (BSA) and the State-Trait Anxiety Inventory Form Y-2 (STAI-Y-2) are self-report scales used to gauge anxiety symptoms in clinical settings. Co-occuring anxiety is common in alcohol use disorder (AUD); however, no studies have assessed the validity of the BSA and STAI-Y-2 compared with a clinical diagnostic tool of anxiety in alcohol treatment programs. We aimed to examine the validity of the BSA and STAI-Y-2 to predict a clinical diagnosis of an anxiety disorder (via the Structured Clinical Interview for DSM [SCID]) in AUD patients. DESIGN Participants were administered the BSA (n = 1005) on day 2 and the STAI-Y-2 (n = 483) between days 2 and 10 of the detoxification program. SCID-based clinical diagnoses of AUD and anxiety were made approximately on day 10. SETTING AND PARTICIPANTS Individuals seeking treatment for AUD admitted to an inpatient unit at the National Institutes of Health (NIH) Clinical Center in Bethesda, MD, USA (n = 1010). MEASUREMENTS Inclusion criteria included a current diagnosis of alcohol dependence (AD) according to DSM-IV-TR or moderate to severe AUD according to DSM-5-RV, as well as available baseline BSA and/or STAI Y-2 data. Empirical receiver operating characteristic (ROC) curves were generated using estimates of sensitivity, 1-specificity and positive and negative predictive values for each cut-point to determine the accuracy of scale outcomes in relation to SCID diagnoses. FINDINGS The BSA demonstrated low accuracy relative to a clinical diagnosis of anxiety with an area under the curve (AUC) of 0.67 at the optimal cut-point of ≥ 10. The STAI-Y-2 had moderate accuracy relative to a clinical diagnosis of anxiety with an AUC of 0.70 at the optimal cut-point of ≥ 51. The accuracy of the STAI-Y-2 increased (AUC = 0.74) when excluding post-traumatic stress disorder and obsessive-compulsive disorder from anxiety disorder classification. CONCLUSIONS Use of the Brief Scale for Anxiety (BSA) and/or State-Trait Anxiety Inventory Form Y-2 (STAI-Y-2) does not appear to be a reliable substitute for clinical diagnoses of anxiety disorder among inpatients with alcohol use disorder. The BSA and STAI-Y-2 could serve as a screening tool to reject the presence of anxiety disorders rather than for detecting an anxiety disorder.
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Affiliation(s)
- Navan N Shah
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD, USA
| | - Melanie L Schwandt
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Bethesda, MD, USA
| | - Breanne Hobden
- Health Behaviour Research Group, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre in Health Behaviour and Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia
| | - David S Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,University Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Julia Sinclair
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Roberta Agabio
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD, USA.,Medication Development Program, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA.,Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA.,Division of Addiction Medicine, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.,Department of Neuroscience, Georgetown University Medical Center, Washington, DC, USA
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16
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Burstyn I, Holt K. A Cross-Sectional Survey of the Workplace Factors Contributing to Symptoms of Anxiety and Depression Among Nurses and Physicians During the First Wave of COVID-19 Pandemic in Two US Healthcare Systems. Ann Work Expo Health 2021; 66:312-333. [PMID: 34590682 PMCID: PMC8500032 DOI: 10.1093/annweh/wxab085] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 08/19/2021] [Accepted: 09/15/2021] [Indexed: 12/24/2022] Open
Abstract
Background Anxiety and depression among physicians and nurses during the COVID-19 pandemic in the USA are not well described and their modifiable causes are poorly understood. Methods We conducted a cross-sectional survey of symptoms of anxiety and depression (Hospital Anxiety and Depression Scale) among physicians and nurses in two US healthcare systems in June through September 2020; participation rate was 5–10%. We described features of work as well as their perceptions and associated concerns in relation to the risk of anxiety and depression, while controlling for health history via regression and path analyses. Results About a third of 684 nurses and 185 physicians surveyed showed symptoms of anxiety or depression, and the excess of symptoms of mood disorders was particularly prominent in nurses. The belief that one was infected was a dominant correlate of both anxiety and depression. This belief was more associated with history of symptoms of pneumonia than the contact with COVID-19 diagnosed patients. Factors found to be associated with reduced anxiety and depression in this working environment were having confidence in the competent use of and access to personal protective equipment, maintaining usual working hours, being surrounded by colleagues who were both sufficient in numbers and not stressed, and the support of immediate family and religious communities. Involvement in aerosol-generating procedures with infected patients was linked with lower depression in nurses but higher among physicians. Likewise, the setting of recent patient encounters affected risk of anxiety and depression differently for physicians and nurses. Conclusions Our findings may help develop mitigation measures and underscore the need to help nurses and physicians bear the psychological burden of the COVID-19 pandemic and similar events in the future.
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Affiliation(s)
- Igor Burstyn
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Karyn Holt
- School of Nursing, the University of Nevada Las Vegas, Las Vegas, NV, USA
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17
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Vitale SG, Caruso S, Carugno J, Ciebiera M, Barra F, Ferrero S, Cianci A. Quality of life and sexuality of postmenopausal women with intrauterine pathologies: a recommended three-step multidisciplinary approach focusing on the role of hysteroscopy. MINIM INVASIV THER 2021; 30:317-325. [PMID: 34278934 DOI: 10.1080/13645706.2021.1910312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Intrauterine pathologies are common in postmenopausal women and clinicians must identify signs and symptoms accurately to provide the adequate diagnosis and treatment. The quality of life (QoL) and sexuality of women are important outcomes to be considered to provide adequate clinical management of the postmenopausal patient with gynecologic pathologies. The aim of this paper is to propose a simple and replicable three-step multidisciplinary approach to evaluate the psychological outcomes of postmenopausal women with intrauterine pathologies, focusing on the role of hysteroscopy. In particular, the article describes three evaluation steps of those psychological outcomes corresponding to three fundamental moments of the patient's diagnostic and therapeutic path: the initial symptoms, diagnosis, and treatment. In our viewpoint, the standard use of such a protocol might considerably improve the QoL of postmenopausal patients undergoing hysteroscopic procedures due to intrauterine pathologies.
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Affiliation(s)
- Salvatore Giovanni Vitale
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Salvatore Caruso
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Jose Carugno
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Michał Ciebiera
- Second Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Fabio Barra
- Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino - IST, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (Dinogmi), University of Genoa, Genoa, Italy
| | - Simone Ferrero
- Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino - IST, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (Dinogmi), University of Genoa, Genoa, Italy
| | - Antonio Cianci
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
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18
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Lara LF, Wastvedt S, Hodges JS, Witkowski P, Wijkstrom M, Walsh RM, Singh VK, Schwarzenberg SJ, Pruett TL, Posselt A, Naziruddin B, Nathan JD, Morgan KA, Mitchell R, Kirchner VA, Mokshagundam SL, Hatipoglu B, Gardner TB, Freeman ML, Chinnakotla S, Beilman GJ, Abu-El-Haija M, Conwell DL, Bellin MD. The Association of Smoking and Alcohol Abuse on Anxiety and Depression in Patients With Recurrent Acute or Chronic Pancreatitis Undergoing Total Pancreatectomy and Islet Autotransplantation: A Report From the Prospective Observational Study of TPIAT Cohort. Pancreas 2021; 50:852-858. [PMID: 34347725 PMCID: PMC8373657 DOI: 10.1097/mpa.0000000000001850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Smoking and alcohol use are risk factors for acute and chronic pancreatitis, and their role on anxiety, depression, and opioid use in patients who undergo total pancreatectomy and islet autotransplantation (TPIAT) is unknown. METHODS We included adults enrolled in the Prospective Observational Study of TPIAT (POST). Measured variables included smoking (never, former, current) and alcohol abuse or dependency history (yes vs no). Using univariable and multivariable analyses, we investigated the association of smoking and alcohol dependency history with anxiety and depression, opioid use, and postsurgical outcomes. RESULTS Of 195 adults studied, 25 were current smokers and 77 former smokers, whereas 18 had a history of alcohol dependency (of whom 10 were current smokers). A diagnosis of anxiety was associated with current smoking (P = 0.005), and depression was associated with history of alcohol abuse/dependency (P = 0.0001). However, active symptoms of anxiety and depression at the time of TPIAT were not associated with smoking or alcohol status. Opioid use in the past 14 days was associated with being a former smoker (P = 0.005). CONCLUSIONS Active smoking and alcohol abuse history were associated with a diagnosis of anxiety and depression, respectively; however, at the time of TPIAT, symptom scores suggested that they were being addressed.
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Affiliation(s)
- Luis F. Lara
- Department of Internal Medicine, Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Medical Center, Columbus, OH
| | - Solvejg Wastvedt
- School of Public Health, University of Minnesota Minneapolis, MN
| | - James S. Hodges
- School of Public Health, University of Minnesota Minneapolis, MN
| | | | - Martin Wijkstrom
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | - Vikesh K. Singh
- Department of Medicine, Division of Gastroenterology, John Hopkins Medical Institutions, Baltimore, MD
| | | | - Timothy L. Pruett
- Department of Surgery, University of Minnesota Medical School, Minneapolis, MN
| | - Andrew Posselt
- Department of Surgery, University of California San Francisco, San Francisco, CA
| | - Bashoo Naziruddin
- Department of Surgery, Islet Cell Processing Laboratory, Baylor Health, Dallas, TX
| | - Jaimie D. Nathan
- Division of Surgery, Cincinnati Children’s Hospital Medical Center
- Department of Surgery, University of Cincinnati, Cincinnati, OH
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH
| | - Katherine A. Morgan
- Department of Surgery, Division of GI and Laparoscopic Surgery, Medical University of South Carolina, Charleston, SC
| | - Rebecca Mitchell
- School of Public Health, University of Minnesota Minneapolis, MN
| | - Varvara A. Kirchner
- Department of Surgery, University of Minnesota Medical School, Minneapolis, MN
| | | | - Betul Hatipoglu
- Department of Medicine, Division of Clinical and Molecular Endocrinology, University Hospitals, Cleveland, OH
| | - Timothy B. Gardner
- Department of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Martin L. Freeman
- Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota Medical School, Minneapolis, MN
| | - Srinath Chinnakotla
- Department of Surgery, University of Minnesota Medical School, Minneapolis, MN
| | - Gregory J. Beilman
- Department of Surgery, University of Minnesota Medical School, Minneapolis, MN
| | - Maisam Abu-El-Haija
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH
- Division of Pediatric Gastroenterology, Cincinnati Children’s Hospital
| | - Darwin L. Conwell
- Department of Internal Medicine, Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Medical Center, Columbus, OH
| | - Melena D. Bellin
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Minnesota Medical School, Minneapolis, MN
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19
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O'Laughlin DJ, Strelow B, Fellows N, Kelsey E, Peters S, Stevens J, Tweedy J. Addressing Anxiety and Fear during the Female Pelvic Examination. J Prim Care Community Health 2021; 12:2150132721992195. [PMID: 33525968 PMCID: PMC7970676 DOI: 10.1177/2150132721992195] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
To review the anxiety and fear risk factors, pathophysiology, symptoms, screening and diagnosis while highlighting treatment considerations for women undergoing a pelvic examination.
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Affiliation(s)
- Danielle J O'Laughlin
- Mayo Clinic Rochester - Community Internal Medicine.,Assistant professor in medicine, Mayo Clinic in Rochester, Rochester, MN, USA
| | - Brittany Strelow
- Mayo Clinic Rochester - Community Internal Medicine.,Assistant professor in medicine, Mayo Clinic in Rochester, Rochester, MN, USA
| | - Nicole Fellows
- Mayo Clinic Rochester - Community Internal Medicine.,Instructor in surgery and medicine, Mayo Clinic in Rochester, Rochester, MN, USA
| | - Elizabeth Kelsey
- Mayo Clinic Rochester - Community Internal Medicine.,Instructor in medicine, Mayo Clinic in Rochester, Rochester, MN, USA
| | - Sonya Peters
- Mayo Clinic Rochester - Community Internal Medicine.,Instructor in medicine, Mayo Clinic in Rochester, Rochester, MN, USA
| | - Joy Stevens
- Mayo Clinic Rochester - Community Internal Medicine.,Instructor in medicine, Mayo Clinic in Rochester, Rochester, MN, USA
| | - Johanna Tweedy
- Mayo Clinic Rochester - Community Internal Medicine.,Instructor in medicine, Mayo Clinic in Rochester, Rochester, MN, USA
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20
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Eugenicos MP, Ferreira NB. Psychological factors associated with inflammatory bowel disease. Br Med Bull 2021; 138:16-28. [PMID: 34057462 PMCID: PMC8361235 DOI: 10.1093/bmb/ldab010] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 04/07/2021] [Accepted: 04/13/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Both depression and anxiety are identified as significant experiences in inflammatory bowel disease (IBD); whether these are a consequence of the disease or an active contributor to the disease remains controversial. This review aimed to identify and critique recent evidence regarding mental health in IBD. SOURCES OF DATA PubmedⓇ, OvidⓇ, EmbaseⓇ, EBSCO PsychInfo and Google-Scholar were searched within the last 5 years (2016-2020). AREAS OF AGREEMENT Overall, both depression and anxiety affect disease activity, relapse and healthcare utilization. AREAS OF CONTROVERSY There is some controversy on whether depression and anxiety affect IBD outcomes differently depending on IBD subtype. GROWING POINTS The data support the need for depression and anxiety assessment to be incorporated in the routine management of IBD patients; prompt psychiatric and psychological management may ultimately reduce disease activity, relapses and healthcare costs. AREAS TIMELY FOR DEVELOPING RESEARCH More longitudinal research may further enlighten the role of depression and anxiety in IBD. Similarly, randomized controlled trials to investigate and clarify the effect of psychiatric/psychological management on IBD outcomes.
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Affiliation(s)
- M P Eugenicos
- Department of Gastroenterology, Western General Hospital, The Univesity of Edinburgh, Crewe Road South, Edinburgh EH4 2XU, UK
| | - N B Ferreira
- Department of Social Sciences, Clinical and Health Psychology, University of Nicosia, P.O. Box 24005, CY-1700, Cyprus
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21
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Tindall IK, Curtis GJ, Locke V. Dimensionality and Measurement Invariance of the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) and Validity Comparison With Measures of Negative Emotionality. Front Psychol 2021; 12:644889. [PMID: 34163400 PMCID: PMC8215200 DOI: 10.3389/fpsyg.2021.644889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 05/05/2021] [Indexed: 01/22/2023] Open
Abstract
This study explored the factor structure of the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) and measurement invariance between genders. We also measured concurrent and divergent validity of the STICSA as compared to the State-Trait Anxiety Inventory (STAI). A sample of 1064 (N Females = 855) participants completed questionnaires, including measures of anxiety, depression, stress, positive and negative affect. Confirmatory factor analyses supported the original factor structure of the STICSA, which was invariant between genders. Overall, the STICSA had superior concurrent and divergent validity as compared to the STAI. The somatic subscales were also significantly less correlated with depression, and positive and negative affect. Further, the somatic, as compared to cognitive anxiety STICSA subscales were less correlated with depression. This suggests that the STICSA, especially the somatic anxiety subscales, might hold the key to distinguishing between different types of anxiety, as well as between anxiety and depression.
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Affiliation(s)
- Isabeau K Tindall
- School of Psychological Science, The University of Western Australia, Perth, WA, Australia.,Discipline of Psychology, Murdoch University, Perth, WA, Australia
| | - Guy J Curtis
- School of Psychological Science, The University of Western Australia, Perth, WA, Australia.,Discipline of Psychology, Murdoch University, Perth, WA, Australia
| | - Vance Locke
- Discipline of Psychology, Murdoch University, Perth, WA, Australia
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22
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van Barneveld E, Manders J, van Osch FHM, van Poll M, Visser L, van Hanegem N, Lim AC, Bongers MY, Leue C. Depression, Anxiety, and Correlating Factors in Endometriosis: A Systematic Review and Meta-Analysis. J Womens Health (Larchmt) 2021; 31:219-230. [PMID: 34077695 DOI: 10.1089/jwh.2021.0021] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: Endometriosis stage is not directly related to the burden of symptoms, and recurrence of symptoms occurs frequently. It is suggested that symptoms are associated with psychological distress, as in depression and anxiety disorders. Our aim was to explore the strength of the associations between endometriosis and depression or anxiety and to review correlating factors. Materials and Methods: A literature search was carried out using the electronic databases Embase, PubMed, Web-of-science, and PsycINFO. Search terms related to depression, anxiety, and endometriosis were combined resulting in 1,837 records. Articles were included when describing an association between patients with endometriosis and symptoms of depression or anxiety assessed by validated tools, structured psychiatric interviews, or a documented diagnosis. With 47 articles a systematic qualitative review was performed. Seventeen studies were eligible for meta-analysis. Results: Endometriosis patients experienced significantly more symptoms of depression (standardized mean difference [SMD] of 0.71 (95% confidence interval [CI] 0.36-1.06)) and anxiety (SMD 0.60 (95% CI 0.35-0.84)) compared with healthy controls, but no differences were found comparing endometriosis patients with other chronic pelvic pain patients (SMD -0.01 [95% CI -0.17 to 0.15] for depression and SMD -0.02 [95% CI -0.22 to 0.18] for anxiety). Besides the effect of pain, other correlating factors included age, quality of life, quality of sleep, fatigue, sexual function, gastrointestinal symptoms, comorbidity, self-esteem, emotional self-efficacy, coping style, social adjustment, pain imagery, and pain sensitization. Conclusion: This systematic review supports the assumption that symptoms of depression and anxiety occur frequently in endometriosis patients and are related to chronic pain. Correlating factors should further be investigated.
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Affiliation(s)
- Esther van Barneveld
- Department of Gynaecology and Obstetrics, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jessica Manders
- Department of Gynaecology and Obstetrics, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Frits H M van Osch
- Department of Clinical Epidemiology, VieCuri Medical Centre, Venlo, The Netherlands
- Department of Complex Genetics, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Mikal van Poll
- Department of Gynaecology and Obstetrics, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Linda Visser
- Department of Psychiatry and Psychology, Zuyderland Hospital, Heerlen, The Netherlands
| | - Nehalennia van Hanegem
- Department of Gynaecology and Obstetrics, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Arianne C Lim
- Department of Gynaecology and Obstetrics, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marlies Y Bongers
- Department of Gynaecology and Obstetrics, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Carsten Leue
- Department of Psychiatry and Psychology, MeHNS School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
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23
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Construct and criterion validity of patient-reported outcomes (PROs) for depression: A clinimetric comparison. J Affect Disord 2021; 283:30-35. [PMID: 33516084 DOI: 10.1016/j.jad.2021.01.043] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 01/11/2021] [Accepted: 01/15/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND A number of patient-reported outcomes (PROs) have been developed but insufficient attention has been devoted to the assessment of their clinimetric properties. Clinimetrics, the science of clinical measurements, has been considered an emerging approach for evaluating reliability and validity of PROs. This is the first study using clinimetric principles to compare the construct and criterion validity of the Major Depression Inventory (MDI), the Beck Depression Inventory-II (BDI-II), the World Health Organization Well-Being Index (WHO-5), three of the most widely used PROs for the assessment of depression. METHODS Construct validity was evaluated via Item Response Theory (IRT) models (i.e., combining Rasch and Mokken analyses). Using the ICD-10 diagnostic algorithm for any depression as the gold standard, Receiver Operating Characteristic (ROC) curves were performed to examine the criterion validity of PROs. RESULTS One hundred healthy subjects (73% females, 32.6 ± 10.5 years) participated in the study, giving a response rate of 90.1%. When using IRT analyses, MDI and WHO-5 were found to be reliable and unidimensional, while BDI-II showed lack of unidimensionality. ROC analyses supported the diagnostic accuracy of MDI and the screening properties of WHO-5. LIMITATIONS The main limitations of the present study are that healthy subjects were assessed only via only self-reported measures and a cross-sectional design was used. CONCLUSIONS WHO-5 and MDI outperformed BDI-II in terms of construct and criterion validity. WHO-5 should be considered when screening for depression, while MDI should be used as a valid diagnostic instrument and as a unidimensional measure to assess depression severity.
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Effects of Microbiota Imbalance in Anxiety and Eating Disorders: Probiotics as Novel Therapeutic Approaches. Int J Mol Sci 2021; 22:ijms22052351. [PMID: 33652962 PMCID: PMC7956573 DOI: 10.3390/ijms22052351] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 02/22/2021] [Accepted: 02/22/2021] [Indexed: 02/06/2023] Open
Abstract
Anxiety and eating disorders produce a physiological imbalance that triggers alterations in the abundance and composition of gut microbiota. Moreover, the gut–brain axis can be altered by several factors such as diet, lifestyle, infections, and antibiotic treatment. Diet alterations generate gut dysbiosis, which affects immune system responses, inflammation mechanisms, the intestinal permeability, as well as the production of short chain fatty acids and neurotransmitters by gut microbiota, which are essential to the correct function of neurological processes. Recent studies indicated that patients with generalized anxiety or eating disorders (anorexia nervosa, bulimia nervosa, and binge-eating disorders) show a specific profile of gut microbiota, and this imbalance can be partially restored after a single or multi-strain probiotic supplementation. Following the PRISMA methodology, the current review addresses the main microbial signatures observed in patients with generalized anxiety and/or eating disorders as well as the importance of probiotics as a preventive or a therapeutic tool in these pathologies.
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Chapa O. An examination of the Beck Anxiety Inventory structure and psychometric properties: A study of American employees. INTERNATIONAL JOURNAL OF HUMAN RESOURCE MANAGEMENT 2021. [DOI: 10.1080/09585192.2020.1863246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Olga Chapa
- School of Business Administration, University of Houston Victoria, USA
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Wang YY, Yan JC, Li CY, Zhong L, Sun Y, Fu LL. Development and preliminary validation of a self-rating anxiety inventory for maintenance haemodialysis patients. PSYCHOL HEALTH MED 2021; 27:1482-1494. [PMID: 33602028 DOI: 10.1080/13548506.2021.1890159] [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: 10/22/2022]
Abstract
This study aimed to develop a self-rating anxiety inventory for maintenance haemodialysis patients (AI-MHD) and perform preliminary validation to provide a simple, effective, and highly specific practical tool for effective anxiety disorder screening in haemodialysis patients. Based on existing general anxiety disorder screening scales and common symptoms of MHD patients as a reference and after expert discussions and preliminary validation at a single dialysis centre, a self-rating AI-MHD containing 12 items was developed. Subsequently, the AI-MHD was applied in 4 dialysis centres and compared with GAD-7 and HADS-A. Further multicentre validation showed that Cronbach's alpha for the scale was 0.918; the AI-MHD score not only significantly differed between the anxiety disorders group and the non-anxiety disorders group (p<0.001) but also correlated with GAD-7 and HADS-A scores (p<0.001). In addition, the Kaiser-Meyer-Olkin (KMO) score was 0.847, and Bartlett's test of sphericity was significant (x2=849.45, p<0.001). The anxiety disorder detection rate was 93%, and the specificity was 90%, which were significantly better than the screening results using the GAD-7 and HADS-A scales in the same groups. Although there were limitations, such as the sample size and regionality, the AI-MHD showed good efficacy and reliability in rating anxiety in MHD patients.
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Affiliation(s)
- Yun Yan Wang
- Department of Nephrology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jia Chuan Yan
- Neurology Center, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chun Yin Li
- Department of Nephrology, The Third People's Hospital of Chongqing, Chongqing, China
| | - Ling Zhong
- Department of Nephrology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Yan Sun
- Department of Nephrology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Li Fu
- Department of Nephrology, Daping Hospital, Third Military Medical University, Chongqing, China
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Commentary. Toward a core outcomes assessment set for clinical high risk. Schizophr Res 2021; 227:78-80. [PMID: 32414650 PMCID: PMC8215729 DOI: 10.1016/j.schres.2020.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/01/2020] [Accepted: 05/04/2020] [Indexed: 11/23/2022]
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Kwan A, Bingham K, Touma Z. Measures of Anxiety in Rheumatic Diseases. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:630-644. [PMID: 33091269 DOI: 10.1002/acr.24351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/05/2020] [Indexed: 12/30/2022]
Affiliation(s)
- Andrew Kwan
- University of Toronto, Toronto, Ontario, Canada
| | - Kathleen Bingham
- University of Toronto and University Health Network, Toronto, Ontario, Canada
| | - Zahi Touma
- University Health Network, Toronto, Ontario, Canada
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Horowitz RI, Freeman PR. Three novel prevention, diagnostic, and treatment options for COVID-19 urgently necessitating controlled randomized trials. Med Hypotheses 2020; 143:109851. [PMID: 32534175 PMCID: PMC7242962 DOI: 10.1016/j.mehy.2020.109851] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 05/17/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE Asymptomatic or minimally symptomatic infection with COVID-19 can result in silent transmission to large numbers of individuals, resulting in expansion of the pandemic with a global increase in morbidity and mortality. New ways of screening the general population for COVID-19 are urgently needed along with novel effective prevention and treatment strategies. HYPOTHESIS A hypothetical three-part prevention, diagnostic, and treatment approach based on an up-to-date scientific literature review for COVID-19 is proposed. Regarding diagnosis, a validated screening questionnaire and digital app for COVID-19 could help identify individuals who are at risk of transmitting the disease, as well as those at highest risk for poor clinical outcomes. Global implementation and online tracking of vital signs and scored questionnaires that are statistically validated would help health authorities properly allocate essential health care resources to test and isolate those at highest risk for transmission and poor outcomes. Second, regarding prevention, no validated protocols except for physical distancing, hand washing, and isolation exist, and recently ivermectin has been published to have anti-viral properties against COVID-19. A randomized trial of ivermectin, and/or nutraceuticals that have been published to support immune function including glutathione, vitamin C, zinc, and immunomodulatory supplements (3,6 Beta glucan) could be beneficial in preventing transmission or lessening symptomatology but requires statistical validation. Third, concerning treatment, COVID-19 induced inflammation and "cytokine storm syndrome" with hemophagocytic lymphohistiocytosis (HLH)/Macrophage Activation Syndrome (MAS) have resulted in extreme morbidity and mortality in those with certain comorbidities, secondary to "acute respiratory distress syndrome" (ARDS) and multiorgan dysfunction with disseminated intravascular coagulation (DIC). Deficiency in red blood cell, serum and alveolar glutathione has been published in the medical literature for ARDS, as well as viral and bacterial pneumonias, resulting from increased levels of free radical/oxidative stress. A randomized controlled trial of blocking NF-κB and cytokine formation using glutathione precursors (N-acetyl-cysteine [NAC] and alpha lipoic acid) and PO/IV glutathione with associated anti-viral effects should be performed, along with an evaluation of Nrf2 activators (curcumin, sulforaphane glucosinolate) which have been scientifically proven to lower inflammation. Since high mortality rates from sepsis induced DIC due to COVID-19 infection has also been associated with thrombotic events and elevated levels of D-dimer, randomized controlled trials of using anticoagulant therapy with heparin is urgently required. This is especially important in patients on ventilators who have met certain sepsis induced coagulopathy (SIC) criteria. The use of acetazolamide with or without sildenafil also needs to be explored with or without heparin, since increased oxygen delivery to vital organs through prevention of thrombosis/pulmonary emboli along with carbonic anhydrase inhibition may help increase oxygenation and prevent adverse clinical outcomes. CONCLUSION AND IMPLICATIONS A three-part prevention, diagnostic, and treatment plan is proposed for addressing the severe complications of COVID-19. Digital monitoring of symptoms to clinically diagnose early exposure and response to treatment; prevention with ivermectin as well as nutritional therapies that support a healthy immune response; treatment with anti-inflammatory therapies that block NF-κB and activate Nrf2 pathways, as well as novel therapies that address COVID-19 pneumonia and ARDS with DIC including anticoagulation and/or novel respiratory therapies with or without acetazolamide and sildenafil. These three broad-based interventions urgently need to be subjected to randomized, controlled trials.
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Affiliation(s)
- Richard I Horowitz
- HHS Babesia and Tickborne Pathogen Subcommittee, Washington, D.C. 20201, USA; Hudson Valley Healing Arts Center, 4232 Albany Post Road, Hyde Park, NY 12538, USA.
| | - Phyllis R Freeman
- Hudson Valley Healing Arts Center, 4232 Albany Post Road, Hyde Park, NY 12538, USA
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Stewart SL, Babcock SE, Li Y, Dave HP. A psychometric evaluation of the interRAI Child and Youth Mental Health instruments (ChYMH) anxiety scale in children with and without developmental disabilities. BMC Psychiatry 2020; 20:390. [PMID: 32727428 PMCID: PMC7390192 DOI: 10.1186/s12888-020-02785-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 07/10/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND With 10 to 20% of Canadian children suffering with mental illness, the importance of early identification and accurate assessment systems is clear. Unfortunately, many do not receive the mental health treatment necessary and wait-times for assessment can span up to a year. In response, the interRAI suite of assessments were designed to comprehensively assess early signs of mental health impairments in children from birth to 18 years. METHODS This study assesses the psychometric properties of the Anxiety Scale and addresses the identification of anxiety within children diagnosed with intellectual and developmental disabilities (IDD); a commonly underrepresented sample in mental health psychometric studies. Data was collected from children aged 4-18 years in three different samples. RESULTS Results indicated reliable internal consistency and factor structure, as well as moderate-to-strong convergent validity. CONCLUSIONS We conclude that the Anxiety Scale exhibits psychometric qualities which demonstrate its clinical utility for use within a child sample, as well as in children with IDD. The findings provide support to a larger body of research which show consistent psychometric rigour of the interRAI measures.
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Affiliation(s)
- S. L. Stewart
- grid.39381.300000 0004 1936 8884The University of Western Ontario, Faculty of Education, John George Althouse Building
- 1137 Western Road, London, Ontario N6G 1G7 Canada
| | - S. E. Babcock
- grid.39381.300000 0004 1936 8884Department of Psychology, The University of Western Ontario, Social Sciences Building
- 1151 Richmond St, London, Ontario N6A 3K7 Canada
| | - Y. Li
- grid.39381.300000 0004 1936 8884Department of Psychology, The University of Western Ontario, Social Sciences Building
- 1151 Richmond St, London, Ontario N6A 3K7 Canada
| | - H. P. Dave
- grid.39381.300000 0004 1936 8884Department of Psychology, The University of Western Ontario, Social Sciences Building
- 1151 Richmond St, London, Ontario N6A 3K7 Canada
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Donev IS, Ivanova MS, Conev NV. Fast time perception is associated with high levels of anxiety in cancer patients prior to starting chemotherapy. Biosci Trends 2020; 14:35-41. [PMID: 32023559 DOI: 10.5582/bst.2019.01296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Our study explored the potential relationship between time perception and the level of anxiety in cancer patients prior to starting chemotherapy. Time perception was assessed in 162 chemonaïve patients with solid tumors by evaluating each subject's prospective estimation of how fast one minute passed compared to the actual amount of time passed. The median value of time perception was used to stratify the patients into two categories of fast and slow time perception. We used the generalized anxiety disorder questionnaire (GAD-7) as a screening tool for detecting levels of anxiety. Scores ≥ 10 were considered high. In total, 45 (27.8%) patients had high levels of anxiety. The pattern of the time perception distributions significantly changed according to the reported levels on the GAD-7 scale. Scores ≥ 10 correlated with fast time perception and the female gender. Patients with a fast time perception had significantly higher levels of anxiety (8.44 ± 5.1) than patients with a slow time perception (3.49 ± 4.3). ROC analysis revealed that at the optimal cut-off value of time perception, clinically significant levels of anxiety can be discriminated with an AUC = 0.78 (95% CI: 0.70-0.85, p < 0.001), a sensitivity of 82.2% and a specificity of 64.1%. Moreover, in a multivariate logistic regression model, fast time perception was an independent predictor of clinically significant levels of anxiety (OR: 8.24; 95% CI: 3.16-21.41, p < 0.001). Time perception is a novel potent indicator for high levels of anxiety in cancer patients.
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Affiliation(s)
| | - Martina Stoyanova Ivanova
- Clinic of Medical Oncology, UMHAT "St. Marina", Varna, Bulgaria.,Department of Nursing Care, Medical University of Varna, Bulgaria
| | - Nikolay Vladimirov Conev
- Clinic of Medical Oncology, UMHAT "St. Marina", Varna, Bulgaria.,Department of Propedeutics of Internal Diseases, Medical University of Varna, Bulgaria
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Torres OV, Estep JC, Gwin M, Villalta I. Gender Differences in Negative Mood, Emotional Intelligence and Tobacco Use among Young Adults. Subst Use Misuse 2020; 55:1881-1891. [PMID: 32532170 DOI: 10.1080/10826084.2020.1775649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background: Tobacco use is recognized as a form of addiction and remains a significant health concern. Despite this well accepted problem, the various components associated with tobacco use across gender remain relatively unknown. Objectives: The purpose of this study was to investigate the relationship between tobacco use and negative moods (anxiety, depression, stress) between men and women. The relationship between emotional intelligence (EI) and attitudes about smoking was also investigated. Methods: A questionnaire was used to determine sociodemographic characteristics, negative moods, EI, smoking behavior, and tobacco-related attitudes (N = 350). Results: Amongst individuals who used tobacco products, women reported greater disturbances in stress and anxiety compared to men. In addition, both men and women who used tobacco products reported higher depression scores compared to nonsmokers, however, no gender differences were observed. Hierarchical regression analyses revealed that higher EI scores explained negative attitudes about smoking in relation to health concerns. Lastly, women reported stronger attitudes for the restriction of cigarette sales and marketing of tobacco products. Conclusion: These findings support the literature by showing that mood dysregulation is an important factor associated with tobacco use among women. Additionally, we report that specific aspects of EI are psychological constructs closely linked with attitudes about smoking. Future studies elucidating the various components of tobacco use across gender might lead to more effective treatments for smoking.
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Affiliation(s)
- Oscar V Torres
- Department of Behavioral Sciences, San Diego Mesa College, San Diego, California, USA
| | - Justin C Estep
- Department of Behavioral Sciences, San Diego Mesa College, San Diego, California, USA
| | - Mary Gwin
- Department of Social Sciences, San Diego Mesa College, San Diego, California, USA
| | - Ian Villalta
- Department of Behavioral Sciences, San Diego Mesa College, San Diego, California, USA
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de Beurs E, Carlier IVE, van Hemert AM. Approaches to denote treatment outcome: Clinical significance and clinical global impression compared. Int J Methods Psychiatr Res 2019; 28:e1797. [PMID: 31597212 PMCID: PMC7649961 DOI: 10.1002/mpr.1797] [Citation(s) in RCA: 9] [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: 12/04/2018] [Revised: 04/18/2019] [Accepted: 07/02/2019] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES The authors of a previous study proposed a statistically based approach to denote treatment outcome, translating pretest and posttest scores into clinically relevant categories, such as recovery and reliable improvement. We assessed the convergent validity of the Jacobson-Truax (JT) approach, using T-score based cutoff values, with ratings by an independent evaluator. METHODS Pretest and retest scores on the Brief Symptom Inventory (BSI) and clinical global impression improvement (CGI-I) ratings were collected repeatedly through routine outcome monitoring from 5,900 outpatients with common mental disorders. Data were collected in everyday practice in a large mental health care provider. RESULTS Continuous pretest-to-retest BSI change scores had a stronger association with CGI-I than the categorical variable based on JT. However, JT categorization and improvement according to CGI converged substantially with association indices (Somers' D) ranging from D = .50 to .56. Discordance was predominantly due to a more positive outcome according to JT than on CGI-I ratings. CONCLUSION Converting continuous outcome variables into clinically meaningful categories comes at the price of somewhat diminished concurrent validity with CGI-I. Nevertheless, support was found for the proposed threshold values for reliable change and recovery, and the outcome denoted in these terms corresponded with CGI improvement for most patients.
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Affiliation(s)
- Edwin de Beurs
- Section Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Ingrid V E Carlier
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Albert M van Hemert
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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Scott R, Sherod M. A Clinical Case Demonstrating the Effectiveness of an Individualized Multimodal Intervention for Chronic Pain and Cognitive Sequelae Secondary to Traumatic Brain Injury. Clin Case Stud 2019. [DOI: 10.1177/1534650119855439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Chronic pain and cognitive difficulties are common secondary to traumatic brain injury (TBI); however, given the vast heterogeneity in TBI presentation, no empirically supported treatments specific to TBI exist. This case demonstrates the effectiveness of an empirically informed multimodal treatment, in which treatment components were selected based on the patient’s individual symptoms and delivered in a manner cognizant of the patient’s cognitive profile. Treatment incorporated components of cognitive behavioral therapy, physical intervention, mindfulness, sleep hygiene, distress tolerance, and cognitive rehabilitation. Pain, sleep, and therapy-related activities were logged daily. Treatment progress was further measured with the Beck Depression Inventory–II, Beck Anxiety Inventory, Satisfaction With Life Scale, and Insomnia Severity Index. The patient reported a significant reduction in pain (average pain rating reduced from 8.5-9 to 6.90 on the numerical rating scale [NRS]) and reported experiencing his least painful day in “years” (i.e., pain rating of 3). The patient reported improvements in mood and sleep, increased engagement in physical/other pleasant activities, and improved academic performance. The patient is currently not pursuing opioids or surgical intervention for pain. This case demonstrates the importance of utilization of neuropsychological data in the identification of treatment goals, appropriate treatment selection, and implementation of suitable techniques. This approach can provide neurologically atypical individuals with interventions that better address their symptom presentation and maximize prognosis.
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Swigris JJ, Brown KK, Abdulqawi R, Buch K, Dilling DF, Koschel D, Thavarajah K, Tomic R, Inoue Y. Patients' perceptions and patient-reported outcomes in progressive-fibrosing interstitial lung diseases. Eur Respir Rev 2018; 27:27/150/180075. [DOI: 10.1183/16000617.0075-2018] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 11/07/2018] [Indexed: 12/31/2022] Open
Abstract
The effects of interstitial lung disease (ILD) create a significant burden on patients, unsettling almost every domain of their lives, disrupting their physical and emotional well-being and impairing their quality of life (QoL). Because many ILDs are incurable, and there are limited reliably-effective, life-prolonging treatment options available, the focus of many therapeutic interventions has been on improving or maintaining how patients with ILD feel and function, and by extension, their QoL. Such patient-centred outcomes are best assessed by patients themselves through tools that capture their perceptions, which inherently incorporate their values and judgements. These patient-reported outcome measures (PROs) can be used to assess an array of constructs affected by a disease or the interventions implemented to treat it. Here, we review the impact of ILD that may present with a progressive-fibrosing phenotype on patients' lives and examine how PROs have been used to measure that impact and the effectiveness of therapeutic interventions.
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Braunsteiner NE, Vickers ER, Toole BM, Braunsteiner J. Psychosocial factors and addiction in chronic orofacial neuropathic pain. AUST ENDOD J 2018. [DOI: 10.1111/aej.12254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Natasha E. Braunsteiner
- Olympus Health Group; Sydney New South Wales Australia
- University of Queensland Dental School; Brisbane Queensland Australia
| | - E. Russell Vickers
- Olympus Health Group; Sydney New South Wales Australia
- University of Queensland Dental School; Brisbane Queensland Australia
- University of Sydney Medical School; Sydney New South Wales Australia
- Clinical Stem Cells Pty Ltd; Sydney New South Wales Australia
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Laufenberg-Feldmann R, Kappis B, Cámara RJA, Ferner M. Anxiety and its predictive value for pain and regular analgesic intake after lumbar disc surgery - a prospective observational longitudinal study. BMC Psychiatry 2018; 18:82. [PMID: 29587759 PMCID: PMC5870173 DOI: 10.1186/s12888-018-1652-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 03/07/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Ongoing pain after surgery is a major problem and influences recovery and the quality of life of the patient. Associations between anxiety and their impact on postoperative pain after herniated disc surgery have been reported, but the results are inconsistent. The aim of the present longitudinal study was to evaluate the predictive value of preoperative anxiety for postoperative ongoing pain and prolonged analgesic intake after herniated disc surgery. METHODS 106 patients with lumbar disc herniation were evaluated in the study. Anxiety was measured with the Generalized Anxiety Disorder 7-Item Scale (GAD-7) before surgery. Pain intensity was assessed on a numeric rating scale (NRS) at baseline, 6-weeks and 6-months after surgery. Regression analysis was performed to identify independent predictors of pain and regular utilization of analgesics up to 6 months after surgery while controlling for confounding variables. RESULTS 42.5% of the patients were rated as anxiety cases (sum scores GAD-7 > 5), mean scores of anxiety showed mild to moderate symptom severity, and 43% suffered from chronic pain before surgery. Six months after surgery, 55.6% of the patients indicated pain levels of 4/10 (NRS) or higher and about 40% still took pain medication on a regular basis, regardless of their preoperative classification as anxiety-case (37.7% and 41.5%). The preoperative pain level was statistically significant for ongoing postsurgical pain in all four analyses (p < 0.001). With binary logistic regression analyses, preoperative pain intensity, but neither demographic factors nor preoperative anxiety, was identified as predictor for postoperative pain and need for analgesic medication up to 6 months after lumbar disc surgery. CONCLUSION We found no evidence for the presence of anxiety before disc surgery being a prognostic factor for ongoing pain and regular postoperative intake of analgesics. Only preoperative pain intensity was predictive for increased pain and continued need for analgesic medication up to 6 months after lumbar disc surgery. TRIAL REGISTRATION Clinicaltrials.gov NCT01488617 . Registered 6 December 2011.
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Affiliation(s)
- Rita Laufenberg-Feldmann
- Department of Anesthesiology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, D-55131, Mainz, Germany.
| | - Bernd Kappis
- grid.410607.4Department of Anesthesiology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, D-55131 Mainz, Germany
| | - Rafael J. A. Cámara
- grid.410607.4Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Marion Ferner
- grid.410607.4Department of Anesthesiology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, D-55131 Mainz, Germany
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Anxiety as a risk factor for menopausal hot flashes: evidence from the Penn Ovarian Aging cohort. Menopause 2018; 23:942-9. [PMID: 27433864 DOI: 10.1097/gme.0000000000000662] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to identify temporal associations of anxiety dimensions with menopausal hot flashes in women progressing through the menopausal transition. We hypothesized that associations of both somatic and affective dimensions of anxiety with hot flashes increased in the menopausal transition, and that somatic anxiety was an independent risk factor for menopausal hot flashes. METHODS Hot flashes, anxiety symptoms, hormone levels, and other psychosocial variables were assessed annually for 14 years of follow-up. The 233 women were premenopausal at baseline and continued through 1 year or more after the final menstrual period. Anxiety dimensions were assessed with the Zung Anxiety Scale, a validated measure of affective anxiety and somatic anxiety. Summed item scores were divided by the number of items rated, so that ranges of the two dimensions were comparable. RESULTS Seventy-two percent of the sample reported moderate/severe hot flashes during the 14-year interval. There was no significant interaction between anxiety dimensions and menopausal stages. When adjusted for menopausal stage, the magnitude of association between somatic anxiety and hot flashes, however, dramatically increased (odds ratio [OR], 3.03; 95% CI, 2.12-4.32; P < 0.001), whereas the association between affective anxiety and hot flashes increased to a lesser extent (OR, 1.27; 95% CI, 1.03-1.57; P = 0.024). Women with high levels of somatic anxiety (top third of the sample) had the greatest risk of hot flashes (P < 0.001). When the anxiety dimensions were considered in combination, the additive effect of high affective anxiety symptoms was minimal, with no significant difference between the group with high affective/low somatic symptoms and the low symptom group in incident hot flashes at each menopausal stage (P = 0.54). In multivariable analysis, somatic anxiety increased the risk of hot flashes more than three times (OR, 3.13; 95% CI, 2.16-4.53; P < 0.001), but affective anxiety was not significantly associated with hot flashes after adjustment for other study variables (OR, 1.19; 95% CI, 0.96-1.48; P = 0.117). Time-lagged somatic anxiety scores significantly predicted hot flashes, with a 71% increase in risk (OR, 1.71; 95% CI, 1.21-2.41; P = 0.002). Time-lagged affective anxiety scores did not predict hot flashes (OR, 1.06; 95% CI, 0.87-1.31; P = 0.58). CONCLUSIONS This study showed a strong predictive association of somatic anxiety with the risk of menopausal hot flashes. The temporal associations suggest that somatic anxiety is not simply a redundant measure of hot flashes but predicts the risk of menopausal hot flashes and may be a potential target in clinical management of perimenopausal women.
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Is exercise helpful for women aged 50 and over with mental health problems and what are the barriers to exercise? QUALITY IN AGEING AND OLDER ADULTS 2017. [DOI: 10.1108/qaoa-08-2016-0031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to examine the influence of exercise on the mental health problems of older women.
Design/methodology/approach
The paper is based on information from academic literature, government publications and publications from other relevant bodies. It is a scoping study and is not a systematic review because of the constraints of the resources.
Findings
There is growing evidence about the value of exercise for the mental health of older women but few evaluated examples of how this can be achieved.
Research limitations/implications
There is a gap in the literature about this topic with few evaluated examples of how more older women can be encouraged to take more exercise.
Practical implications
Policy makers, practitioners and older people themselves would gain from a greater emphasis on exercise as a means of improving quality of life and for reducing healthcare budgets through fewer referrals to services.
Social implications
Greater emphasis on exercise for older women would increase their quality of life through a reduction in mental health problems.
Originality/value
There is limited research which links mental health, exercise and older women, especially regarding the barriers to exercise that older women with diagnosed mental health problems may face.
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Dimitrova NG, van Hooft EAJ, van Dyck C, Groenewegen P. Behind the wheel: What drives the effects of error handling? The Journal of Social Psychology 2016; 157:658-672. [PMID: 27967717 DOI: 10.1080/00224545.2016.1270891] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Existing research comparing error management (a strategy focusing on increasing the positive and decreasing the negative consequences of errors) to error prevention (a strategy focusing on working faultlessly), has identified error management as beneficial for multiple outcomes. Yet, due to various methodological limitations, it is unclear whether the effects previously found are due to error prevention, error management, or both. We examine this in an experimental study with a 2 (error prevention: yes vs. no) × 2 (error management: yes vs. no) factorial design. Error prevention had negative effects on cognition and adaptive transfer performance. Error management alleviated worry and boosted one's perceived self-efficacy. Overall, the results show that error prevention and error management have unique outcomes on negative affect, self-efficacy, cognition, and performance.
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A systematic review of anxiety amongst people with Multiple Sclerosis. Mult Scler Relat Disord 2016; 10:145-168. [PMID: 27919483 DOI: 10.1016/j.msard.2016.10.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/05/2016] [Accepted: 10/10/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Multiple Sclerosis (MS) is a chronic neurological disease, which poses significant psychological challenges. The purpose of this systematic review was to identify factors that are associated with anxiety in people with MS (PwMS). It aimed to examine the strength of evidence for factors associated with anxiety symptoms and identify limitations of existing studies. METHOD AND RESULTS One hundred and thirty one studies met inclusion criteria and were included in the review. A narrative synthesis was then conducted. Anxiety was found to be associated with a variety of demographic, physical, psychological, cognitive and social factors. A consistent finding was that anxiety was strongly associated with both high level of disability and low quality of life. A strong association between anxiety and depression was also found. CONCLUSION Implications for these results are discussed and a preliminary model of understanding anxiety in the context of MS is outlined. Given the overlap between anxiety and depression, a transdiagnostic treatment approach is suggested. In light of the shortcomings of extant studies, suggestions for future research are offered.
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Le J, Dorstyn D. Anxiety prevalence following spinal cord injury: a meta-analysis. Spinal Cord 2016; 54:570-8. [PMID: 26951738 DOI: 10.1038/sc.2016.15] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 01/12/2016] [Accepted: 01/14/2016] [Indexed: 01/06/2023]
Abstract
STUDY DESIGN Meta-analysis. OBJECTIVES Prevalence estimates indicate that anxiety following spinal cord injury (SCI) is a common problem. However, methodological differences between studies may impact the clinical interpretation of these data. METHODS Data from 18 independent studies (Nparticipants=3158), which reported the prevalence of an anxiety disorder or associated symptoms, were identified from the Embase, PubMed and PsycInfo databases. Proportions were the primary effect size estimate. Confidence intervals, fail-safe Ns and the I(2) statistic were additionally calculated to identify the extent to which findings were robust and consistent across studies. RESULTS Five per cent of participants met the criteria for either GAD or panic disorder, with Agoraphobia identified in 2.5%. These diagnostic data were, however, limited to two studies. Higher rates were noted for self-reported 'caseness' of anxiety, with 27% reporting clinically significant symptoms. Anxiety prevalence estimates varied across the individual self-report measures (range: 15-32%). Method of administration (range: 26-32%) did not impact significantly on these estimates nor did recruitment source, with similarly high anxiety levels reported by hospital (27%) and community (29%) samples. CONCLUSIONS Early identification and treatment of anxiety are important in SCI rehabilitation, with a subgroup of individuals experiencing chronic symptoms. Further research is needed to establish guidelines for the interpretation of self-report data, including the use of clinical cutoffs.
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Affiliation(s)
- J Le
- School of Psychology, Faculty of Health Sciences, University of Adelaide, Adelaide, SA, Australia
| | - D Dorstyn
- School of Psychology, Faculty of Health Sciences, University of Adelaide, Adelaide, SA, Australia
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Dougherty CM, Fairbanks AM, Eaton LH, Morrison ML, Kim MS, Thompson EA. Comparison of patient and partner quality of life and health outcomes in the first year after an implantable cardioverter defibrillator (ICD). J Behav Med 2015; 39:94-106. [PMID: 26345262 DOI: 10.1007/s10865-015-9671-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 08/13/2015] [Indexed: 02/04/2023]
Abstract
Recovery following an implantable cardioverter defibrillator (ICD) impacts both the patient and partner, often in divergent ways. Patients may have had a cardiac arrest or cardiac arrhythmias, whereas partners may have to perform CPR and manage the ongoing challenges of heart disease therapy. Currently, support for post-ICD care focuses primarily on restoring patient functioning with few interventions available to partners who serve as primary support. This descriptive study examined and compared patterns of change for both patients and partners during the first year post-ICD implantation. For this longitudinal study, the sample included 42 of 55 (76.4 %) patient-partner dyads who participated in the 'usual care' group of a larger intervention RCT with patients following ICD implant for secondary prevention of cardiac arrest. Measures taken at across five time points (at hospital discharge and at 1, 3, 6 and 12 months follow up) tracked physical function (SF-12 PCS, symptoms); psychological adjustment (SF-12 MCS; State-Trait Anxiety Inventory; CES-D); relationship impact (Family Functioning, DOII; Mutuality and Interpersonal Sensitivity, MIS); and healthcare utilization (ED visits, outpatient visits, hospitalizations). Repeated measures analysis of variance was used to characterize and compare outcome trends for patients and partners across the first 12 months of recovery. Patients were 66.5 ± 11.3 (mean + SD) years old, predominately Caucasian male (91 %), with Charlson co-morbidities of 4.4 ± 2.4. Partners were 62.5 ± 11.1 years old, predominantly female (91 %) with Charlson co-morbidities of 2.9 ± 3.0. Patient versus partner differences were observed in the pattern of physical health (F = 10.8, p < 0.0001); patient physical health improved while partner health showed few changes. For partners compared to patients, anxiety, depression, and illness demands on family functioning tended to be higher. Patient mutuality was stable, while partner mutuality increased steadily (F = 2.5, p = 0.05). Patient sensitivity was highest at discharge and declined; partner sensitivity increased (F = 10.2, p < 0.0001) across the 12-month recovery. Outpatient visits for patients versus partners differed (F = 5.0, p = 0.008) due most likely to the number of required patient ICD visits. Total hospitalizations and ED visits were higher for patients versus partners, but not significantly. The findings highlight the potential reciprocal influences of patient and partner responses to the ICD experience on health outcomes. Warranted are new, sound and feasible strategies to counterbalance partner needs while simultaneously optimizing patient recovery outcomes.
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Affiliation(s)
- Cynthia M Dougherty
- Biobehavioral Nursing and Health Systems, University of Washington School of Nursing, 1959 NE Pacific Street, HSB T615A, Box 357266, Seattle, WA, 98195-7266, USA.
| | | | - Linda H Eaton
- University of Washington School of Nursing, Seattle, WA, USA
| | | | - Mi Sun Kim
- University of Washington School of Nursing, Seattle, WA, USA
| | - Elaine A Thompson
- Psychosocial and Community Health, University of Washington School of Nursing, Seattle, WA, USA
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