Prevalence, Diagnosis, and Treatment of Depression and Generalized Anxiety Disorder in a Diverse Urban Community

Letter to the editor. Healthcare workers on the edge of sanity due to COVID-19: Rapid review of the results of systematic reviews and meta-analyzes

The COVID-19 pandemic has impacted the well-being of millions of people around the globe. The evidence has shown that during the COVID-19 pandemic, the mental health of the population was affected, which means that there is an extra demand to implement different actions to mitigate and treat mental health disorders result of the pandemic. According to the literature it was expected that the prevalence of mental health disorders, such as anxiety and depression increased by 25 per cent worldwide, and Colombia was not the exception. However, there is not clear evidence on how much this increase might be. This study aims to estimate the prevalence of anxiety and depression for female and male adolescents and adults in Colombia before and during the COVID-19 pandemic. It estimated the potential increase of the prevalence in each group as a result of the COVID-19 pandemic in 2020. We used the Individual Registry of Health Services Delivery data from 2015-2021 to estimate the observed prevalence of anxiety and depression in Colombia for female and male adults. In addition, using the National Mental Health Survey 2015, we simulated the prevalence of anxiety and depression for adolescents (12 to 17 years) and adults (18 or older) in 2015 and using a static Monte Carlo simulation process we estimated the expected prevalence of depression and anxiety for each group from 2016 to 2021. The results of the analysis using revealed an important increase in the observed prevalence of depression and anxiety for adults and adolescents and men and women between 2015 and February 2020. When we simulated different scenarios using as a base line the National Mental Health Survey and estimated the prevalence of depression and anxiety for female and male adults and adolescents, we found that the prevalence of depression and anxiety has had an important increase in the last five years for all groups and had an important increase during 2020. This increase was greater for women compared to men, and adolescents than adults. Our results show the number of people who need potential attention from the health system in Colombia and highlight the importance to think about how to avoid and detect potential cases of anxiety and depression especially in female adolescents.

An epidemic of coronavirus pneumonia (COVID-19) throughout China has been occurring between 2019 and 2020. To combat the contagion, the Chinese government has implemented community-wide containment strategies such as home quarantine, business and public transportation shutdown, and class suspension for all schools. Psychological assistance has been offered to patients with COVID-19 infection and health professionals in Wuhan1. The effects of the COVID-19 epidemic and state-imposed massive quarantine on public mental health at the general population level have not been evaluated systematically. Our study aimed to examine the prevalence of anxiety and depression among China's adult population at the peak of the COVID-19 epidemic and identify the stressors associated with these disorders. We performed a nationally representative online survey of Chinese residents aged ≥18 years through Wenjuanxing, a web-based survey company. A stratified sampling method was used, and the sample population was randomly distributed in all Chi­na's provinces and municipalities. Subjects with pre-existing psy­chiatric disorders were excluded. A standardized questionnaire collected information on socio-demographic characteristics, time spent on news related to COVID-19 per day, and perceived sources of stress. The severity of anxiety and depression was assessed using the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9), respectively. A cut-off total score of 8 was used for both GAD-7 and PHQ-9 to obtain the optimal sensitivity and specificity2, 3. The protocols were approved by the Ethical Committee of Changzhi Medical College. The sample size was calculated by assuming that the prevalence of anxiety and depression would be 4% in China4. This would require the sample size to be roughly 4,100 to achieve the margin of error of 15%. The survey was conducted between February 9 and February 16, 2020. We used descriptive statistics and Mann-Whitney tests or χ2 tests for bivariate analysis. The associations between the above-mentioned variables and the occurrence of anxiety and depression were determined by multinomial logistic regression. All analyses were performed in Prism 8.3. A total of 5,033 individuals (1,676 men and 3,357 women; 40.9% living in provinces with at least 220 coronavirus cases) completed the questionnaire (response rate: 78.1%). The prevalence of anxiety or depression or both was 20.4% (1,029 of 5,033). The median total score on GAD-7 was 10 (interquartile range, IQR: 9-14). The median total score on PHQ-9 was 9 (IQR: 8-13). The occurrence of anxiety and/or depression was significantly associated with time spent on COVID-19 related news per day (odds ratio, OR=1.61, 95% CI: 1.42-1.84, p<0.001). The prevalence of depression and/or anxiety was 17.8% among those spending less than 5 min per day on COVID-19 related news, and 27.9% among those who spent more than one hour. Three psychosocial stressors were significantly associated with the development of both anxiety and depression: "I worry about myself and my loved ones being infected by COVID-19" (OR=1.95, 95% CI: 1.54-2.49 for anxiety; OR=1.24, 95% CI: 1.04-1.50 for depression), "I worry about my income, job, study or ability to pay the loan being affected" (OR=1.38, 95% CI: 1.13-1.68 for anxiety; OR=1.58, 95% CI: 1.35-1.86 for depression), and "Home quarantine causes great inconvenience to my daily life" (OR=1.31, 95% CI: 1.04-1.64 for anxiety; OR=1.42, 95% CI: 1.18-1.70 for depression). In summary, our study revealed that the COVID-19 epidemic caused a sharp increase in the prevalence of anxiety and depression among the general adult population in China, compared to the prevalence of 4% in 20194. The amount of time spent on news related to COVID-19 was significantly associated with the occurrence of these mental health problems, which is likely explained by excessive media coverage5. The financial burden caused by massive quarantine was one of the primary stressors related to both anxiety and depression. Besides psychological interventions, financial aid such as wage subsidy, tax exemption, and extended loan repayment may help reduce the anxiety and depression in the general population. Our study was conducted around the peak of the COVID-19 epidemic6. A longitudinal follow-up would be helpful to track the changes in anxiety and depression levels at different stages of the epidemic.

BackgroundStress, anxiety, and depression are some of the most important research and practice challenges for psychologists, psychiatrists, and behavioral scientists. Due to the importance of issue and the lack of general statistics on these disorders among the Hospital staff treating the COVID-19 patients, this study aims to systematically review and determine the prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients.MethodsIn this research work, the systematic review, meta-analysis and meta-regression approaches are used to approximate the prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients. The keywords of prevalence, anxiety, stress, depression, psychopathy, mental illness, mental disorder, doctor, physician, nurse, hospital staff, 2019-nCoV, COVID-19, SARS-CoV-2 and Coronaviruses were used for searching the SID, MagIran, IranMedex, IranDoc, ScienceDirect, Embase, Scopus, PubMed, Web of Science (ISI) and Google Scholar databases. The search process was conducted in December 2019 to June 2020. In order to amalgamate and analyze the reported results within the collected studies, the random effects model is used. The heterogeneity of the studies is assessed using the I2 index. Lastly, the data analysis is performed within the Comprehensive Meta-Analysis software.ResultsOf the 29 studies with a total sample size of 22,380, 21 papers have reported the prevalence of depression, 23 have reported the prevalence of anxiety, and 9 studies have reported the prevalence of stress. The prevalence of depression is 24.3% (18% CI 18.2–31.6%), the prevalence of anxiety is 25.8% (95% CI 20.5–31.9%), and the prevalence of stress is 45% (95% CI 24.3–67.5%) among the hospitals’ Hospital staff caring for the COVID-19 patients. According to the results of meta-regression analysis, with increasing the sample size, the prevalence of depression and anxiety decreased, and this was statistically significant (P < 0.05), however, the prevalence of stress increased with increasing the sample size, yet this was not statistically significant (P = 0.829).ConclusionThe results of this study clearly demonstrate that the prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients is high. Therefore, the health policy-makers should take measures to control and prevent mental disorders in the Hospital staff.

Globally, mental disorders such as depression and anxiety are on the rise. While effective prevention and treatment interventions exist, access to these is influenced by, among other things, household socioeconomic status. However, there is a shortage of evidence that highlights the prevalence and inequalities of depressive and anxiety disorders, especially in low- and middle-income countries. Consequently, this study aimed to generate new knowledge by examining the prevalence, inequalities, and determinants of depression and anxiety in Kenya. This study utilized the 2022 Kenya Demographic and Health Survey data. Employing multilevel modeling techniques, this study examined the influence of communal settings, independent of household-specific factors, on the prevalence of depression, anxiety, or both. We used household wealth quintiles as a socioeconomic ranking variable, while the prevalence rates of depression and anxiety served as the primary health variables of interest. We used concentration indices and curves to examine the inequalities in the distribution of depression and anxiety in Kenya. There was a 3.6% prevalence of anxiety and/or depression, sexual violence was positively correlated with anxiety and/or depression (OR=2.70 [1.93-3.79], P<0.001, p<0.001). Chronic diseases tripled the odds of anxiety and/or depression disorders (OR=3.47 [2.96-4.08], P<0.001). Poorer self-health perception ratings escalated the risk of anxiety and/or depression (OR=6.72 [2.61-17.29], P<0.001). Marriage reduced odds of mental illness (OR=0.77 [0.65-0.91], P=0.002). Regional clustering was explained by the Intraclass correlation coefficient of 10.8-12.7% variance. Depression or anxiety scored a concentration index that indicated prevalence was more pronounced among the better-off wealth categories (CI=0.053 [0.002-0.104], P<0.041). Marriage reduces risks, but sexual violence, chronic illness, and geographical inequities have a significant impact on mental health. Strengthen social support networks, chronic care, regional mental health services, and violence prevention.

Hypertension is the elevation in the blood pressure level, and it is responsible for cardiovascular diseases. Depression and anxiety diseases are the most common mental disorders globally. Depression is common among patients with chronic disorders, including hypertension, and there are conflicts regarding the correlation between hypertension and anxiety. To assess the prevalence of anxiety and depression among hypertensive patients. PubMed and Google Scholar databases were searched for articles on the current subject starting from 2017 to 2021. The included searching terms included \&amp;quot;Prevalence of depression and hypertension, Prevalence of anxiety and hypertension, Anxiety among hypertensive patients, Depression among hypertensive patients.\&amp;quot; The inclusion criteria included full original articles conducted on patients with hypertension and assessed the prevalence of anxiety, depression, or both. We obtained 70 articles; only 10 articles were eligible for the inclusion criteria. The 10 studies included a total number of 2,581 participants and covered 6 countries. The findings of this systematic review showed that the overall prevalence of depression and anxiety ranged from 57.3% to 77.8%. The most-reported factors associated with the prevalence of depression and anxiety among hypertensive patients included gender and educational level. The prevalence of depression and anxiety among hypertensive patients varied based on several factors and the stage of hypertension; however, they were highly prevalent in general. Adequate control of blood pressure is necessary.

Prevalence of Generalized Anxiety Disorder in General Practice in Denmark, Finland, Norway, and Sweden

Background and Objectives: Cancer is a life-threatening disease which can also lead to mental health issues such as depression and anxiety, which add to the burden of illness in cancer patients. This study aimed to describe the prevalence and risk factors of depression and anxiety among cancer patients during treatment. Materials and Methods: A total of 128 patients were included in the study. The prevalence of depression and anxiety in patients was assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 scale. A cutoff score of ten or more was set to diagnose depression and anxiety, respectively. Various risk factors associated with depression and anxiety were assessed. Results: The prevalence of depression and anxiety in cancer patients was 31.25% and 15.62%, respectively. The prevalence of depression was most common in head-and-neck cancer and ovarian cancer, while the prevalence of anxiety was most common in head-and-neck cancer and lung cancer. The prevalence of both depression and anxiety was higher in stage IV versus stage III, in males versus females, and in the age group of 41–50 years. The patients receiving chemotherapy had a higher prevalence compared to those receiving combination treatment. Conclusion: Our study demonstrated a high prevalence of depression and anxiety in cancer patients during cancer treatment which is affected by a variety of factors. It highlights the problem of psychiatric burden in cancer patients and the need to address this problem by improving means for the early detection and early administration of treatment.

Do Canada and the United States Differ in Prevalence of Depression and Utilization of Services?

Anxiety and depression are common in prostate cancer (PCa) patients and negatively impact the quality of life, treatment outcome, survival and overall well-being, thus, requiring interventions to meet the psychosocial needs of PCa patients across treatment stages. However, there is not enough information to guide the design of these interventions, as there are still areas of lack of clarity regarding the prevalence and predictors of anxiety and depression in PCa patients. Therefore, this review was conducted to examine the literature to identify the overall prevalence of anxiety and depression across treatment stages in PCa patients and to identify the predictors of anxiety and depression in this population. A literature search was conducted from the Cochrane library, Ovid Medline and APA PsycINFO databases. Eighteen eligible studies were included in the final review. The findings were analysed using a narrative synthesis. The study quality was assessed using the Joanna Briggs Institute critical appraisal checklist. The prevalence of anxiety and depression was found to be between 6% to 44.8% and 10% to 48%, respectively. Notably, the prevalence of depression was higher in the post-treatment phase than in the treatment phase. Finally, the result demonstrates that socio-economic/demographic, clinical and lifestyle factors determine patients' predisposition to anxiety and depression. These demonstrate that the prevalence of anxiety and depression is high across the PCa disease trajectory and that some patients are more likely to experience anxiety and depression than others. Therefore, we recommend periodic assessment to identify at risk patients and those with clinically significant or worsening levels of anxiety and depression for timely interventions to mitigate the risks or ameliorate the symptoms of anxiety and depression.

Prevalence of depression and anxiety in patients with chronic non-malignant pain–A Danish register-linkage cohort study

Perceived Effectiveness of Medications Among Mental Health Service Users With and Without Alcohol Dependence

Do Acetylcholinesterase Inhibitors Increase Anxiety and Depression in Elderly Adults with Dementia?

Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory disease that causes pain, stiffness and swelling in the joints. In addition to physical symptoms, RA is associated with considerable psychological burden including depression, anxiety and sleep disturbances. Previous research from Western countries has documented the high rates of co-morbid mental health conditions amongst RA patients. However, data from the Middle-eastern region remain limited. This study aimed to investigate the prevalence of depression, anxiety and sleep disorders and their association with RA among Saudi adults. It also assessed the impact of mental health symptoms on patients’ health-related quality of life (HRQoL). Methods: A cross-sectional design was utilised. A sample of 1584 adult RA patients from the rheumatology clinics in Saudi Arabia was recruited. Participants completed validated self-report questionnaires assessing depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), sleep quality (Pittsburgh Sleep Quality Index) and HRQoL (EQ-5D-5L). Sociodemographic and clinical information was also collected. The Chi-square tests analysed the associations between RA and mental health variables. Results: The sample consisted of 84.8% females, with a mean age of 34 years. Regarding clinical characteristics, 42.4% were diagnosed with RA 1–5 years ago and the mean symptom severity was 5.2. Regarding mental health, 42.4% and 72.7% reported depression symptoms including depressed mood and loss of interest, respectively. Anxiety symptoms such as excessive worry and restlessness were present in 36.4% and 60.6%, respectively. Over 63.6% experienced sleep difficulties. Significant associations were observed between RA and both depression (P &lt; 0.001) and anxiety (P &lt; 0.001). Mental health symptoms moderately to significantly interfere with daily functioning for 57.5%. Discussion: In this multi-centric cross-sectional study, researchers found in the literature review of previous studies high rates of mental health conditions; however, our research investigated the prevalence of mental health conditions and the association with RA disease. Our findings indicate significant association between RA and mental disorders, such as depression and anxiety. Finally, researchers of the study suggest to enhance the awareness level through RA patients to decrease the chance of developing mental health disorders and increase the HRQoL among RA patients. Conclusion: The study findings indicate a high prevalence of depression, anxiety and sleep disorders amongst adult Saudi RA patients. Strong associations were established between having RA and co-morbid depression as well as anxiety. A considerable proportion reported impaired HRQoL due to mental health symptoms. Integrating psychological screening and management into routine rheumatology care may help address the holistic needs of this patient group. Larger prospective studies are needed to provide further insight into the relationships between RA and co-morbid conditions.

Background Cancer can have a deleterious impact on the well-being of a patient and can affect the mental health. Cancer treatment is influenced by anxiety and depression and thereby recovery, quality of life, and survival may get hampered. Depression is the most common psychiatric syndrome that has received the most attention in individuals with cancer. It has an intense impact on lives of patients and it continues to be underdiagnosed and inadequately treated. Depression most commonly coexists with other syndromes such as panic disorder, generalized anxiety disorder, and post-traumatic stress disorder. Cancer is threatening and understandably many patients get anxious in response to that threat and anxiety appears to increase as the illness progresses. Depression and anxiety have impact on morbidity and mortality leading to worsening of quality of life. In patients with cancer on treatment, there is a greater degree of association between anxiety and depression with worsening of quality of life. In this study, we assessed prevalence of depression, anxiety, and the quality of life in patients undergoing cancer treatment. We tried to find out the correlation between prevalence of depression and anxiety. We also looked at the quality of life in patients undergoing cancer treatment. Materials and methods Our study was conducted on 50 patients who were undergoing cancer treatment. We used Hamilton depression rating (HAM-D) and Hamilton anxiety rating (HAM-A) scales, respectively, to assess the symptoms of depression and anxiety. The quality of life was assessed using quality of life-10 (QOL-10) questionnaire. Results In this study among subjects on chemotherapy, 46.7% had mild depression, 30% had moderate depression, 16.7% had severe depression, and 6.7% had very severe depression. Among subjects on radiotherapy, 53.3% had mild depression, 13.3% had moderate depression, 33.3% had severe depression, and 0% had very severe depression. Among subjects on chemotherapy along with radiotherapy, 20% had mild depression, 40% had moderate depression, 40% had severe depression, and 0% had very severe depression. In this study, 60% had mild anxiety, 38% had mild to moderate anxiety, and 2% had moderate to severe anxiety. Among those on chemotherapy, 66.7% had mild anxiety; among those on radiotherapy, 53.3% had mild anxiety; and among those on chemotherapy + radiotherapy, 60% had mild to moderate anxiety. In this study, there was positive correlation between HAM-A and HAM-D scores, that is, with an increase in HAM-A score, there was an increase in HAM-D score and vice versa. Conclusion In our study, patients with cancer had higher prevalence of anxiety and depression. Anxiety and depression often lead to poor quality of life. How to cite this article Sahoonja C, Chandok T, Bathla M, et al. Prevalence of Anxiety and Depression and Assessment of Quality of Life in Patients Undergoing Cancer Treatment. J Med Sci 2020;6(1):14–18.