Investigation of anxiety of road construction and maintenance workers in plateau area with an altitude of above 4, 000 meters and analysis of treatment of repetitive transcranial magnetic stimulation and medication

Abstract

Objective To investigate the present situation of anxiety of the road workers in the plateau area, and analyze the effect of repetitive transcranial magnetic stimulation (repeat transcranial magnetic stimulation rTMS) combined with drug intervention on anxiety. Methods 920 road workers in the high-altitude area of Qinghai province from April 2015 to July 2016 were studied by using the Hamilton anxiety scale (HAMA) for screening anxiety and the levels of anxiety in road workers were recorded according to different altitude (2 000 to 3 000 m, 3 001 to 4 000 m, above 4 000 m). 285 cases of road workers in above 4 000 meters altitude with light, medium and severe anxiety were enrolled in a prospective randomized controlled study, and were randomly divided into rTMS group and drug intervention group (25 cases in each group). The drug intervention group was treated with oral buspirone hydrochloride 10 mg three times perday. The changes of HAMA scores before and after treatment in two groups were compared. Results The incidence of anxiety in workers of above 4 000 meters altitude was higher than that of workers in lower altitude area. The percent of HAMA scores of ≥14 points in high altitude group is 20.40% (58/285), and the incidence of severe anxiety with HAMA scores of ≥ 29 in this group is 10.88%(31/285)and is higher than that of two groups in lower altitude[10.88% (31/285) vs 3.49% (11/315), 10.88% (31/285) vs 5.31% (17/320), P<0.05]. The anxiety symptom in rTMS and drug intervention groups was improved significantly. Conclusions The altitude has an important effect on the incidence of anxiety in road workers. Inthe areas with altitude of >4 000 meters, the incidence of anxiety of the workers is significantly higher than that of the workers at the altitude of <4 000 meters. rTMS and drug intervention can significantly improve the patients’ condition.The curative effect of rTMS is significantly better than that of pure drug therapy, especially for severe anxiety. Key words: Plateau region; Anxiety; Road workers; Repeat transcranial magnetic stimulation treatment