Z-Drug Use and Benzodiazepine Use and Misuse Among LGB Populations: The Role of Psychological Distress

BACKGROUND

Z-drugs (hypnotics such as zolpidem, zopiclone, and zaleplon) and benzodiazepines (BZDs) are sedative medications with misuse liability. The goals of this study are to report the (1) prevalence of past-year any Z-drug use, any BZD use, and any BZD misuse by sexual identity category and psychological distress; (2) associations among these 3 categories between sexual identity and past-year psychological distress; (3) associations among these 3 categories with sexual identity by past-year psychological distress status.

METHODS

Data were collected from the National Survey on Drug Use and Health (years 2015-2019 [n = 210,392]), a yearly representative national household survey of the American population. We report prevalences of any Z-drug use, any BZD use, and any BZD misuse by sexual identity and past-year psychological distress status. We ran logistic regressions with complex survey design with the 3 dichotomous variables described above as the dependent variables, stratified and not-stratified by psychological distress.

RESULTS

Prevalence of any Z-drug an BZD use and any BZD misuse were higher among LGB (lesbian/gay/bisexual) populations, especially gay men and bisexual women. Psychological distress was positively associated with any Z-drug and BZD use and any BZD misuse. Women were at higher risk of Z-drug (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.18-1.37) and BZD use (OR, 1.64; 95% CI, 1.55-1.73), but lower risk of BZD misuse (OR, 0.82; 95% CI, 0.76-0.88). When stratifying by psychological distress, differences between LGB and heterosexuals were more pronounced among those without past-year psychological distress, especially gay men and bisexual women.

CONCLUSIONS

The presence of psychological distress attenuates the disparities between LGB and heterosexual individuals in Z-drug use and BZD use and misuse.

Effectiveness of Karate in Oncology Patients: A Quasi-Experimental Study

Cancer is a global health concern and affects patient quality of life, anxiety, depression, and sleep. Physical exercise shows promise in alleviating these effects. Karate is a holistic intervention that could be used to improve several outcomes related to cancer disease, but to date its effect remains unexplored. This quasi-experimental pre-/poststudy evaluated the effects of a 6-month karate program conducted twice a week for 60 minutes each session on quality of life, anxiety, depression, sleep quality, and psychosomatic symptoms in 22 patients with posttherapy oncology. Significant improvements in quality of life (P = .006), anxiety (P < .001), depression (P < .001), and sleep quality (P = .011) were observed. Multidimensional psychophysical evaluation showed significant reductions in symptoms (P < .05). High participant satisfaction was reported across all dimensions. This pilot study shows the potential benefits in oncology patients, but more research is necessary to confirm these findings.

Immersive Technologies for Depression Care: Scoping Review

BACKGROUND

Depression significantly impacts quality of life, affecting approximately 280 million people worldwide. However, only 16.5% of those affected receive treatment, indicating a substantial treatment gap. Immersive technologies (IMTs) such as virtual reality (VR) and augmented reality offer new avenues for treating depression by creating immersive environments for therapeutic interventions. Despite their potential, significant gaps exist in the current evidence regarding the design, implementation, and use of IMTs for depression care.

OBJECTIVE

We aim to map the available evidence on IMT interventions targeting depression treatment.

METHODS

This scoping review followed a methodological framework, and we systematically searched databases for studies on IMTs and depression. The focus was on randomized clinical trials involving adults and using IMTs. The selection and charting process involved multiple reviewers to minimize bias.

RESULTS

The search identified 16 peer-reviewed articles, predominantly from Europe (n=10, 63%), with a notable emphasis on Poland (n=9, 56%), which contributed to more than half of the articles. Most of the studies (9/16, 56%) were conducted between 2020 and 2021. Regarding participant demographics, of the 16 articles, 5 (31%) exclusively involved female participants, and 7 (44%) featured participants whose mean or median age was >60 years. Regarding technical aspects, all studies focused on VR, with most using stand-alone VR headsets (14/16, 88%), and interventions typically ranging from 2 to 8 weeks, predominantly in hospital settings (11/16, 69%). Only 2 (13%) of the 16 studies mentioned using a specific VR design framework in planning their interventions. The most frequently used therapeutic approach was Ericksonian psychotherapy, used in 56% (9/16) of the studies. Notably, none of the articles reported using an implementation framework or identified barriers and enablers to implementation.

CONCLUSIONS

This scoping review highlights the growing interest in using IMTs, particularly VR, for depression treatment but emphasizes the need for more inclusive and comprehensive research. Future studies should explore varied therapeutic approaches and cost-effectiveness as well as the inclusion of augmented reality to fully realize the potential of IMTs in mental health care.

A systematic review on the efficacy of virtual reality and gamification interventions for managing anxiety and depression

This systematic review aims to assess the effectiveness of virtual reality (VR) and gamification interventions in addressing anxiety and depression. The review also seeks to identify gaps in the current VR treatment landscape and provide guidelines for future research and development. A systematic literature search was conducted using Scopus, Web of Science, and PubMed databases, focusing on studies that utilized VR and gamification technology to address anxiety and depression disorders. A total of 2,664 studies were initially identified, 15 of those studies fulfilled the inclusion criteria for this systematic review. The efficacy of VR in addressing anxiety and depression was evident across all included studies. However, the diversity among VR interventions highlights the need for further investigation. It is advised to incorporate more diverse participant samples and larger cohorts and explore a broader spectrum of therapeutic approaches within VR interventions for addressing anxiety and depression to enhance the credibility of future research. Additionally, conducting studies in varying socioeconomic contexts would contribute to a more comprehensive understanding of their real-world applicability.

Effectiveness of immersive virtual reality on anxiety, fatigue and pain in patients with cancer undergoing chemotherapy: A systematic review and meta-analysis

PURPOSE

This Systematic review and meta-analysis aimed to assess the effectiveness of Virtual Reality on anxiety, fatigue and pain in patients with cancer during chemotherapy and provide evidence for decision-making in clinical practice.

METHODS

A systematic literature search was performed in the databases PubMed, Web of Science, Scopus, Cumulative Index of Nursing and Allied Health Literature and the Cochrane Library. Risk of Bias was used to assess the quality of individual studies, and Grading of Recommendations Assessment, Development and Evaluation was used to assess confidence for each individual outcome. A random-effects model was used to examine the overall effect.

RESULTS

Four randomized controlled trials and four crossover studies were included, with an overall sample of 459 patients. Results showed that Virtual Reality compared with standard care had a significant reduction of anxiety only (MD = -6.57, 95% CI: -11.59 to -1.54, p = 0.01) but with considerable heterogeneity (I² = 92%), while Virtual Reality was not significantly different from integrative interventions. The trials included showed small sample sizes, lack of statistical power, low methodological quality, high heterogeneity, and different Virtual Reality technology types, lengths and frequencies.

CONCLUSION

The quality of evidence is very low and the strength of recommendation is weak. Further research has large potential for reducing uncertainty about the effects of Virtual Reality in patients with cancer receiving chemotherapy. This study was registered with PROSPERO as CRD42020223375.

Virtual Reality for Addressing Depression and Anxiety: A Bibliometric Analysis

Virtual reality is an emerging field in mental health and has gained widespread acceptance due to its potential to treat various disorders, such as anxiety and depression. This paper presents a bibliometric analysis of virtual reality (VR) use in addressing depression and anxiety from 1995 to 2022. The study analysed 1872 documents using the Scopus database, identifying the field's most relevant journals and authors. The results indicate that using VR for addressing anxiety and depression is a multidisciplinary field with a wide variety of research topics, leading to significant collaborative research in this area. The Annual Review of Cybertherapy and Telemedicine was identified as the most relevant journal, while Behavior Research and Therapy was found to be the most cited journal. The analysis of keywords suggests that there is more research on using VR for anxiety and related disorders than for depression. Riva G. was identified as the top author in producing research outputs on VR-AD, and the University of Washington emerged as the leading institution in scientific outputs on VR-AD. Thematic and intellectual analyses helped identify the main themes within the research domain, providing valuable insight into the current and future directions of the field.

The effect of physical exercise on anxiety in people with parkinson’s disease: A systematic review of randomized control trials

BACKGROUND Anxiety is a prominent disabling non-motor neuropsychiatric complication of Parkinson’s disease (PD). Pharmacological treatments for PD and anxiety have drug interactions and negative side effects. Therefore, non-pharmacological interventions such as exercise has been proposed to reduce anxiety in people with PD (PwP). OBJECTIVE This systematic review aimed to explore the relationship between physical exercise and anxiety in PwP. METHOD Four databases (PubMed, Embase, Scopus, Ebscohost) were searched without date restrictions. English randomized control trials (RCT) including adults with PD, exposed to physical exercise interventions with anxiety as an outcome variable, were included. Quality was assessed by means of an adapted 9-point PEDro scale. RESULTS Five of the identified 5547 studies met the inclusion criteria. Sample size ranged between 11–152 participants, totaling 328 participants with majority being male. PD stage ranged from early to moderate, with disease duration ranged between 2.9 and 8.0 years. All studies measured anxiety at baseline and post-intervention. On average studies scored 7/9 (76%) on the PEDro scale. CONCLUSION There is insufficient evidence to support or refute the effect of exercise on anxiety in PwP due to noted limitations of included studies. There is an urgent need for high-quality RCTs on physical exercise and anxiety in PwP.

Effects of Acupressure on Anxiety: A Systematic Review and Meta-Analysis

Objectives: The research aim was to perform a systematic review and meta-analysis evaluating the ability of acupressure to reduce anxiety. Design: Randomized controlled trials were obtained through a search of electronic medical databases (four in English and one in Chinese) from inception to October 5, 2020. Two authors searched the databases, evaluated studies' methodological quality, and performed data extraction independently. The final studies for analysis were identified after discussion with the third author. Results: We obtained 27 studies for our systematic review and meta-analysis. Eight studies had a low overall risk of bias, and 13 had some bias concerns with methodological quality. According to the results, acupressure significantly reduced patient anxiety (standardized mean difference = 1.152; 95% confidence interval: 0.847-1.459, p < 0.001), and the study heterogeneity was high (Q = 299.74, p < 0.001, I² = 91.333%). Two studies reported acupressure-associated adverse events. We also performed a sensitivity analysis by omitting one outlier study, which had the largest effect size; however, high heterogeneity remained (I² = 87.816%). A subgroup analysis revealed significant differences between participant types (Q = 46.573, p < 0.001), levels of methodological quality (Q = 6.228, p = 0.044), and massage equipment (Q = 4.642, p = 0.031). Conclusions: Our meta-analysis suggests that acupressure can alleviate anxiety. Acupressure was more effective for inpatients and preoperative patients when finger massage was applied. In individuals with anxiety and a stable hemodynamic status, acupressure could be a promising treatment option. However, the substantial heterogeneity across studies means that any inference from the results should be performed cautiously.

Screening of anxiolytic properties and analysis of structure-activity relationship of new derivatives of 6-(4-methoxy)-7H-[1,2,4]triazolo[3,4-a][2,3]benzodiazepine under the code RD

Introduction: Searching for new compounds with anti-anxiety activity resulting from the combination of privileged scaffolds is a promising direction in medicinal chemistry and in the development of new drugs. Anxiolytic potential and cytotoxic properties of previously synthesized molecules, containing fragments of 2,3-benzodiazepine and 1,2,4-triazole – 6-(4-methoxyphenyl)-7H-[1,2,4]triazolo[3,4-A][2,3]benzodiazepines under the generic code RD were studied.

Materials and methods: Screening for anxiolytic activity was performed on elevated plus maze (EPM) and open field (OF) test models. Structural and functional analysis of the anti-anxiety activity of the studied substances was carried out. A degree of muscle relaxant effect of the substances was assessed in the tests Grid, Wire, and Rotarod. A cytotoxicity study of RD compounds was carried out using an MTT assay on human hepatocellular carcinoma cells HepG2.

Results and discussion: For a number of novel triazolo[3,4-a][2,3]benzodiazepine derivatives, a prominent anxiolytic activity was manifested in terms of EPM test. The results of OF test were consistent with the obtained data and confirmed the presence of the sought activity in the leading compounds. There was no significant effect on muscle tone for the compounds under study. It was observed that RD compounds possessed no cytotoxic properties and were safe for further studies in vivo.

Conclusion: Among the new derivatives of 6-(4-methoxyphenyl)-7H-[1,2,4]triazolo[3,4-a][2,3]benzodiazepine under the code RD, substances (RD-4, 12, 13) with a high anxiolytic activity comparable to diazepam and tofisopam were found. The most promising compound is RD-4 due to its pronounced anxiolytic and low cytotoxic properties.

Virtual reality as a distraction technique for pain and anxiety among patients with breast cancer: A randomized control trial

Objective

The goal of this study was to assess the effectiveness of immersive virtual reality (VR) distraction technology in reducing pain and anxiety among female patients with breast cancer.

Method

A randomized control trial design was used with a sample of 80 female patients with breast cancer at a specialized cancer center in Jordan. Participants were randomly assigned into intervention and comparison groups.

Result

The study findings showed that one session of the immersive VR plus morphine made a significant reduction in pain and anxiety self-reported scores, compared with morphine alone, in breast cancer patients.

Significance of results

Immersive VR is an effective distraction intervention for managing pain and anxiety among breast cancer patients. Using immersive VR as an adjuvant intervention is more effective than morphine alone in relieving pain and anxiety; furthermore, VR is a safe intervention more than pharmacological treatment.

Insight meditation and telomere biology: The effects of intensive retreat and the moderating role of personality

A growing body of evidence suggests that meditation training may have a range of salubrious effects, including improved telomere regulation. Telomeres and the enzyme telomerase interact with a variety of molecular components to regulate cell-cycle signaling cascades, and are implicated in pathways linking psychological stress to disease. We investigated the effects of intensive meditation practice on these biomarkers by measuring changes in telomere length (TL), telomerase activity (TA), and telomere-related gene (TRG) expression during a 1-month residential Insight meditation retreat. Multilevel analyses revealed an apparent TL increase in the retreat group, compared to a group of experienced meditators, similarly comprised in age and gender, who were not on retreat. Moreover, personality traits predicted changes in TL, such that retreat participants highest in neuroticism and lowest in agreeableness demonstrated the greatest increases in TL. Changes observed in TRGs further suggest retreat-related improvements in telomere maintenance, including increases in Gar1 and HnRNPA1, which encode proteins that bind telomerase RNA and telomeric DNA. Although no group-level changes were observed in TA, retreat participants' TA levels at post-assessment were inversely related to several indices of retreat engagement and prior meditation experience. Neuroticism also predicted variation in TA across retreat. These findings suggest that meditation training in a retreat setting may have positive effects on telomere regulation, which are moderated by individual differences in personality and meditation experience. (ClinicalTrials.gov #NCT03056105).

Acupuncture or Acupressure on Yintang (EX-HN 3) for Anxiety: A Preliminary Review

Background: Anxiety is a very common psychiatric symptom and can also occur in many physical conditions. Due to the limitations of conventional pharmacotherapy, the discovery of nonpharmacologic treatments that alleviate anxiety effectively is clinically important. Yintang (EX-HN 3), an acupoint located between the eyebrows, is known to have a mentally stabilizing effect in Traditional Chinese Medicine. Objectives: This preliminary review was conducted to investigate the current state of studies using acupressure or acupuncture on EX-HN 3 alone for anxiety, and to explore ways to apply this in clinical settings and future research, including systematic reviews and clinical trials. Materials and Methods: The authors searched 2 electronic medical databases, including PubMed and China National Knowledge Infrastructure, up to December 7, 2017, to collect clinical studies that used acupuncture or acupressure on EX-HN 3 only to relieve anxiety. Methodological qualities of included randomized controlled trials (RCTs) were assessed by the Cochrane risk-of-bias tool and a Jadad scale. Results: Five RCTs were included. Most of the RCTs were aimed at preoperative participants. In this population, the reduction of self-reported anxiety was consistently significant. Conclusions: Acupuncture or acupressure on EX-HN 3 was used mainly to reduce the anxiety of preoperative participants. The simplicity and economics of this intervention suggest the need for future rigorous clinical trials or systematic reviews on this topic. In addition, more experimental studies should be conducted to identify the underlying mechanisms of this anxiolytic effect.

Gray Matter and Functional Connectivity in Anterior Cingulate Cortex are Associated with the State of Mental Silence During Sahaja Yoga Meditation

Some meditation techniques teach the practitioner to achieve the state of mental silence. The aim of this study was to investigate brain regions that are associated with their volume and functional connectivity (FC) with the depth of mental silence in long-term practitioners of Sahaja Yoga Meditation. Twenty-three long-term practitioners of this meditation were scanned using Magnetic Resonance Imaging. In order to identify the neural correlates of the depth of mental silence, we tested which gray matter volumes (GMV) were correlated with the depth of mental silence and which regions these areas were functionally connected to under a meditation condition. GMV in medial prefrontal cortex including rostral anterior cingulate cortex were positively correlated with the subjective perception of the depth of mental silence inside the scanner. Furthermore, there was significantly increased FC between this area and bilateral anterior insula/putamen during a meditation-state specifically, while decreased connectivity with the right thalamus/parahippocampal gyrus was present during the meditation-state and the resting-state. The capacity of long-term meditators to establish a durable state of mental silence inside an MRI scanner was associated with larger gray matter volume in a medial frontal region that is crucial for top-down cognitive, emotion and attention control. This is furthermore corroborated by increased FC of this region during the meditation-state with bilateral anterior insula/putamen, which are important for interoception, emotion, and attention regulation. The findings hence suggest that the depth of mental silence is associated with medial fronto-insular-striatal networks that are crucial for top-down attention and emotional control.