Effects of Biperiden (Cholinergic Muscarinic m1/m4 Receptor Antagonist) on Craving Nicotine: A Proof-Of-Concept Clinical Study

Confirmatory factor analysis of the Beck Anxiety and Depression Inventories in patients with major depression

Insufficient response to treatment and declining quality of life illustrate the continuing need to find new treatment modalities for allergic rhinitis (AR). The purpose of this study was to assess how escitalopram affects symptoms and quality of life among AR patients. This study included 120 patients with AR, who were divided into four treatment groups of 30 patients each. Patients were assessed before treatment and at the end of the 3rd month based on nasal symptom scores, otorhinolaryngological examination, the Rhinoconjunctivitis Quality of Life Questionnaire, and the Beck Depression and Anxiety Inventory. All patients received standardized treatments. Group A patients with positive Beck Depression and Anxiety Inventory scores received escitalopram, and group B patients with positive Beck Depression and Anxiety Inventory scores received placebo. Group C patients with negative Beck Depression and Anxiety Inventory scores received escitalopram, and group D patients with negative Beck Depression and Anxiety Inventory scores received placebo. Anxiety scores pre- and posttreatment revealed a statistically significant reduction in groups A, C, and D. All four groups exhibited reduced posttreatment scores for sleep, nonnasal and noneye symptoms, eye symptoms, and emotions. A statistically significant difference appeared between groups A and B in terms of general complaints and nasal symptom scores. The positive effects of escitalopram on posttreatment quality of life in the Beck-positive patient group were a predictable outcome. Otolaryngologists should pay more attention to the moods of their patients with AR while they evaluate treatment during clinical follow-up visits.

Evaluation of the psychometric properties of a translated and culturally adapted questionnaire. Translating, culturally adapting, and validating the Italian version of the Tampa Scale of Kinesiophobia (TSK-I) to allow its use for Italian-speaking patients with low back pain. Increasing attention is being given to standardized outcome measures as a means of improving interventions for low back pain. A translated form of the TSK in patients with low back pain has never been validated in the Italian population. The development of the TSK-I questionnaire involved its translation and back-translation, a final review by an expert committee, and testing of the prefinal version to establish its correspondence to the original English version. Psychometric testing included factor analysis, reliability by internal consistency (Cronbach's alpha) and test-retest repeatability (Intraclass Coefficient Correlation), discriminant validity (Pearson correlation) by comparing TSK-I to a visual analogue scale, the Roland Morris Disability Questionnaire, Beck's Depression Inventory and Anxiety Inventory. It took the authors 5 months to achieve a shared version of the TSK-I, which proved to be satisfactorily acceptable when administered to 178 subjects. Factor analysis indicated a 2-factor 13-item solution (38% of explained variance). The questionnaire showed acceptable internal consistency (alpha = 0.772) and high test-retest reliability (ICC = 0.956). Discriminant validity showed moderate to low correlations with visual analogue scale (r = 0.345), the Roland Morris Disability (r = 0.337), and Beck's Depression Inventory and Anxiety Inventory (r = 0.258 and r = 283). The subscales were also psychometrically analyzed. The TSK was successfully translated into Italian, showing a good factorial structure and psychometric properties, and replicating the results of existing English versions of the questionnaire. Its use is recommended for research purposes.

AimThe aim of the study is to investigate if cognitive behavioral therapy given in a group setting affects anxiety and depression, stress, pain, coping strategies during daily life, and health‐related quality of life (HRQoL), among frequent attenders (FAs) in primary care.MethodsCognitive behavioral therapy was offered to 331 FAs between 18 and 65 years of age, of whom 89 accepted and 54 completed all steps in the protocol; patients were assigned to 1 of 3 groups: 0, 6, and 12‐month waiting time. The therapy consisted of 12 sessions administered in group format. Outcome measures were Beck's Anxiety Inventory (BAI), Beck's Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS), Everyday Life Stress (ELS), Coping Strategy Questionnaire, Multidimensional Pain Inventory‐Swedish version, and Short Form‐36.ResultsMean age among patients who completed cognitive behavioral therapy was 49.9 years, with a female majority (79.6%). Anxiety and depression scores were reduced after treatment (BAI 16.7 vs 13.6; BDI 16.3 vs 15.7; HADS‐Anxiety 8.41 vs 6.05; HADS‐Depression 7.09 vs 5.69). Because waiting time itself did not affect symptoms, differences reflect treatment effects. Stress ratings were not affected by treatment. Use of nonadaptive coping strategies like praying and hoping and catastrophizing decreased. Frequent attenders experienced a higher sense of life control. Frequent attenders reported significantly lower HRQoL than general Swedish population norms in all 8 Short Form‐36 domains including mental and physical component summary scores (MCS and PCS), and all domains were unaffected by treatment.ConclusionCognitive behavioral therapy exerts some beneficial effects in FAs. Content of treatment addressed musculoskeletal pain, stress, anxiety, and depression. This broad approach resulted in reduced anxiety, depression, and impact of pain because of enhanced life control.

ObjectiveTo study the impact of secondary mental disorders in patients affected with acromegaly and correlate them with quality of life (QoL) and disease status.DesignAn observational transversal descriptive and comparative study that evaluates QoL's impact due to secondary mental disorders in affected Mexicans with acromegaly using AcroQoL and SF‐36 instruments. Correlation of the results with the disease's biochemical status was performed. According to Beck's scales, anxiety and depression analyses evaluate QoL's impact, and its gender variability is described.ResultsEighty‐five patients with diagnoses of acromegaly were included. The mean age was 43.18 years, 47 being women (55.29%). The mean age at diagnosis was 37.95 years, with no difference between men and women. AcroQoL and SF‐36 global and sub‐domain scores differed significantly between men and women, the latter having lower global and individual sub‐domain scores. The mean score of QoL, according to AcroQoL, is 59.40. In women, the mean values are less (55.13) than men (64.68), p = 0.021. The sub‐domain analyses’ scores in physical, appearance and social relationships were less in women (53.21; 47.34; 62.32) than men (62.68; 56.76; 73.87) p = 0.044, 0.069 and 0.013, respectively. Higher Beck's Depression Inventory (BDI) and Beck's Anxiety Inventory (BAI) scores correlated with lower QoL as assessed by global and individual sub‐domain scores. Women presented significantly higher BDI and BAI mean scores when compared to men regardless of their biochemical status. Anxiety (p = 0.027) and depression (p < 0.001) severity were higher in women compared to men.ConclusionCorrelations between female gender, depression/anxiety scores and QoL require further validation. There is much to be routinely done to improve secondary psychopathology in patients affected by this disease. The need for mental status screening at diagnosis should be emphasized to identify secondary mental illnesses to improve QoL with its treatment.

The differentiation between depressive and anxious adolescent females and controls by behavioural self-rating scales

Accurate diagnosis is key to providing quality services in community mental health. This research examined the ability of the Beck Anxiety and Depression Inventories to identify anxiety and depression in community settings. The diagnostic accuracy of these instruments was compared with the Structured Clinical Interview for DSM-IV in a sample of 288 distressed women seeking treatment for their children. Operating characteristic curves indicated the Beck Anxiety and Depression Inventories hold utility as screens for panic and major depressive disorder, respectively. Deploying these instruments as initial screens in a tiered diagnostic system may improve diagnostic accuracy in community settings.

S24 * NEW DEVELOPMENTS IN THE TREATMENT OF ALCOHOL USE DISORDERS

BackgroundThe Sense of Coherence (SOC) scale is assumed to measure a distinct salutogenic construct separated from measures of anxiety and depression. Our aim was to challenge this concept.MethodsThe SOC-scale, Beck's Depression Inventory (BDI), Beck's Anxiety Inventory (BAI) , the emotional subscale of the Strengths and Difficulties Questionnaire (SDQ-em) and self-assessed health-related and physiological parameters were collected from a sample of non-clinical adolescent females (n = 66, mean age 16.5 years with a range of 15.9-17.7 years) and from female psychiatric patients (n = 73), mean age 16.8 years with a range of 14.5-18.4 years), with diagnoses of major depressive disorders (MDD) and anxiety disorders.ResultsThe SOC scores showed high inverse correlations to BDI, BAI and SDQ-em. In the non-clinical sample the correlation coefficient was -0.86 to -0.73 and in the clinical samples -0.74 to -0.53 (p < 0.001). Multiple regression models showed that BDI was the strongest predictor of SOC in the non-clinical (beta coefficient -0.47) and clinical sample (beta coefficient -0.52). The total degree of explanation of self assessed anxiety and depression on the SOC variance estimated by multiple R2 = 0.74, adjusted R2 = 0.73 in the non-clinical sample and multiple R2 = 0.66, adjusted R2 = 0.65 in the clinical sample.Multivariate analyses failed to isolate SOC as a separate construct and the SOC-scale, BDI, BAI and SDQ-em showed similar patterns of correlations to self-reported and physiological health parameters in both samples. The SOC-scale was the most stable measure over six months.ConclusionsThe SOC-scale did not appear to be a measure of a distinct salutogenic construct, but an inverse measure of persistent depressive symptoms and generalized social anxiety similar to the diagnostic criteria for major depressive disorder (MDD), dysthymic disorder, generalized anxiety disorder (GAD) or generalized social anxiety disorder (SAD) according to DSM-IV. These symptoms were better captured with SOC than by the specialized scales for anxiety and depression. Self-assessment scales that adequately identify MDD, dysthymic disorder, GAD and SAD need to be implemented. Comorbidity of these disorders is common in adolescent females and corresponds to a more severe symptomatology and impaired global function.

BackgroundFamilial Mediterranean Fever (FMF) is a systemic autoinflammatory disease requiring lifelong treatment, characterized by recurrent episodes of fever, arthritis, and serositis. Recent studies denote an association between FMF and behavioral...

BackgroundIn various studies in adults, caffeine may increase wakefulness and relieve pain, but caffeine overdose can cause many adverse serious effects on health. Caffeine intake has recently been increasing in adolescents. In spite of importance of caffeine effects on Korean adolescents, there are lack of scientific and systematic studies. The purpose of our study was to identify the relationship between caffeine consumption and effects on adolescents.MethodsWe performed study on 234 middle school students at one middle school in Daegu using a self-report questionnaire. We divided students to quartiles according to amount of caffeine intake. We used Beck Depression Inventory (BDI) to evaluate the degree of depression and Beck Anxiety Inventory (BAI) to evaluate the degree of anxiety. We also used Insomnia Severity Scale (ISI) to evaluate the degree of insomnia and Global Assessment of Recent Stress (GARS) to evaluate the stress in students. We used logistic regression analysis to identify the relationship between caffeine consumption and effects.ResultsHigher caffeine intake was associated with higher weight, height, lower academic achievement, and higher score in BDI, BAI, ISI, and GARS (P for trend <0.005). Higher caffeine intake quartile was associated with greater odds of having significant depression (BDI ≥10, P for trend=0.011), and insomnia (ISI ≥8, P for trend=0.015) after adjustment for factors that can affect the psychological status.ConclusionWe found that caffeine intake is associated weight, height, academic achievement, and higher score in BDI, BAI, ISI, and GARS. Caffeine intake was positively associated with the severity of depression and the severity of insomnia among adolescents in Korean.

Cannabis use, sleep and mood disturbances among persons with epilepsy - A clinical and polysomnography study from a Canadian tertiary care epilepsy center.

Behçet's disease (BD) is a chronic, episodic disease with an often devastating course. The aim of this study was to evaluate the depression and anxiety levels in patients with BD and to compare them with those in patients with psoriasis. Patients were collected from the Dermatology Department, Faculty of Medicine, Gazi University, Ankara, Turkey. One hundred and twelve patients with BD and 95 patients with psoriasis were enrolled in the study. Patients were evaluated by Beck's depression inventory (BDI), Beck's anxiety inventory (BAI), automatic thoughts questionnaire (ATQ), and Beck's hopelessness scale (BHS). The group with BD had higher scores for BDI, BAI, ATQ, and BHS than the group with psoriasis (P < 0.05). Almost one-half of the patients with BD had depression. BAI only was higher in the younger BD group than in the corresponding psoriasis group, whereas all test scores were higher in the older BD group than in the corresponding psoriasis group. There was a strong correlation between the duration of BD and BDI, ATQ, and BHS scores, which was not observed in the psoriasis patients. BD increased the depression risk four-fold in this sample, and BD with a duration of over 3 years increased the depression risk 12-fold. In the present study, BD patients had higher levels of psychopathology than did psoriasis patients in terms of psychologic test scores. The duration of illness affected the severity of the psychiatric symptoms in the BD group, but not in the psoriasis group. The duration of illness was a major risk factor for the development of depression in BD. These findings indicate the need for early recognition of psychiatric symptoms in patients with BD.

AimsTo evaluate the effectiveness of Transcranial Direct Current Stimulation (tDCS) in treatment of post-laminectomy syndrome.MethodsTwenty-four patients were randomized in three groups to receive active or sham anodic stimulation (1.5 mA, 20 minutes for five consecutive days, with 25cm2 electrodes) in two different areas (primary motor cortex (M1) vs. dorsolateral prefrontal cortex (DLPFC), according to lateralization of pain. Brief Pain Inventory (BPI) and Visual Analogue Scale (VAS) were instruments used to assess pain, while Clinical Global Impression Scale (CGI) was applied to measure severity disease and clinical response. Additionally, the quality of life assessment was based on World Health Organization Quality-of-Life Scale (WHOQOL-BREF). In order to identify psychiatric comorbidities, Beck's Depression Inventory (BDI) and Beck's Anxiety Inventory (BAI) tests were applied. Comparisons between groups were performed using one-way ANOVA, ANOVA-Welch, Kruskal-Wallis, Man-Whitney, and Fisher's test.ResultsIt is observed that there was a statistically significant difference (difference 0,15† [95% CI, 7,07 ± 1,39]) in the way individuals assess their quality of life and the improvement in pain intensity by VAS, especially in M1. The assessment of quality of life among those who showed improvement was higher than those who did not improved.ConclusionApplication of tDCS in primary motor cortex (M1) produced an improvement in pain pattern in patients with post-laminectomy syndrome. Our data suggest that tDCS - a low-cost, technically simple and highly tolerable technique, is a promising technique for management chronic pain in disorders such as post-laminectomy syndrome.

Background and Objective: Burns injury is a major cause of anxiety and depression, contributing both as a risk factor and as an outcome process. This poses a great challenge in rehabilitation of burns patients. The main objective of this research is to understand better the frequency of anxiety and depression in burns victims and also assess the socio-demographic distribution of such cases. Materials and Methods:100 cases were selected among all the patients admitted to burns ward of McGann hospital Shimoga Institute of Medical sciences, during the two year period from January 2011 to December 2012, with 10% to 50% burns included through non-probable sampling technique. Testing protocol consisted of 21 points multiple choice questionnaire (Beck's Anxiety and Depression Inventory) including various socio- demographic variables and burn related variables. Standard statistical measures like mean with standard deviation and frequencies with proportions were calculated. Results:Of the 100 patients, 68% were females and 32% were males. The mean age of participants was 30.12 years. Majority of victims (68%) sustained burn injuries ranging from 25%-30%. Accidental stove burst was the most common factor in causation in 52% cases.Anxiety was seen amongst 78% cases, out of which 30% had mild, 32% had moderate and remaining 38% had severe anxiety scores. Depression was seen in 58 patients, out of which 20 had mild, 22 had moderate and rest 14 cases had severe depression symptoms. Conclusion:As anxiety and depression co-existed in majority of cases, it becomes highly prudent on the part of surgical team along with psychologist/psychiatrist, to simultaneously assess and manage both conditions in mild to moderate degree of burn related injuries.