Psychological and emotional outcomes after bariatric surgery: a cross-sectional comparison of sleeve gastrectomy and gastric bypass patients .

Why physically active people report lower anxiety than those who are inactive is not well understood. This study examined whether physical self-concept and self-esteem would mediate associations of self-reported physical activity with anxiety disorder symptoms in young women, a population with elevated risk for developing an anxiety disorder. College women (N = 1036, mean ± SD = 19.7 ± 2.9 yr) completed a physical activity recall, the Psychiatric Diagnostic Screening Questionnaire, and the Physical Self-Description Questionnaire. Structural equation modeling was used to test hypotheses. Physical activity had inverse, indirect associations with symptoms of social phobia, generalized anxiety disorder, and obsessive-compulsive disorder that were expressed through its positive association with specific and global physical self-concept and self-esteem. The results were independent of similar relations with symptoms of major depressive disorder as well as the estimates of body fatness and use of psychotropic medications. These correlational findings provide initial evidence to warrant experimental efficacy trials of whether physical activity will reduce the risk of anxiety disorders in young women by positive influences on physical self-concept and self-esteem.

Anxiety and Depressive Symptoms in Adolescents with Type 1 Diabetes

Mental health of surgeons during the COVID-19 pandemic: An urgent need for intervention

Background Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), can trigger the onset of depressive and anxiety symptoms. The evaluation of mental well-being in patients with a chronic medical condition is considered a good clinical practice and it is strongly recommended by the World Health Organization. Nevertheless, mental health is not routinely investigated in this context for several reasons, including lack of training by healthcare professionals, stigma associated to mental health and gender-relatedstereotypes. The objectives of our study were to assess the presence of depressive and anxiety symptoms inpatients affected by IBD using two simple validated questionnaires and to identify potential related factors, particularly gender differences. Methods We conducted a single center observational study evaluating anxiety and depressive symptoms in patients with IBD treated with biological therapy at the IBD Unit of Ospedale Policlinico of Milan during October 2022. We assessed depressive and anxiety symptoms using respectively the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) that are easy self-administered rating scales. Univariate analyses and regression models were applied for the purpose of the study. Results Among a total of 174 consecutive patients, 158 completed the questionnaires. The prevalence of moderate tosevere depression (PHQ-9 score > 9) in the total sample was 18.4%, and it was higher in CD than in UC (21% vs 9.7%). The prevalence of clinically significant anxiety symptoms (GAD-7 score > 9) was 24% (25.7% in CD and 19.3% in UC). Focusing on gender differences, similar prevalence of significant anxiety anddepression was observed between males (M) and females (F); respectively 18.6% M vs 17.6% F for depression (PHQ-9 > 9) and 22.2% M vs 25.4% F for anxiety (GAD-7 > 9). Of note, a relevant association was observed between younger age and higher GAD-7 (β =-0.639; p=0.021) and PHQ-9 (β =-0.604, p=0.055) scores. Conclusion Both males and females (especially younger) IBD patients in biological therapy are largely affected bysignificant depressive and anxiety symptoms. The administration of simple questionnaires like PHQ-9 andGAD-7 in routine clinical practice can facilitate early identification of patients requiring mental health support, this is crucial as psychiatric conditions can complicate the course of the disease and adherence to treatments.

The aim of this study was to screen for depression and anxiety and to assess well-being among women diagnosed with gynecologic malignancies, identify factors associated with elevated depressive or anxiety symptoms, and further characterize the needs of those with elevated anxiety or depressive symptoms. Women presenting for gynecologic cancer at an academic center during the course of 10 months were offered screening for depressive and anxiety symptoms. Patients were screened with the Primary Care Evaluation of Mental Disorders' Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7. The Functional Assessment of Cancer Therapy-General assessed well-being. Demographics, psychiatric history, and components about the cancer and treatment were collected. Those who screened positive with scores of 10 or higher on the Patient Health Questionnaire-9 or the Generalized Anxiety Disorder-7 were offered a meeting with the study psychiatrist for further evaluation both with the Structured Clinical Interview for Diagnosis as well as with an interview to discuss their experiences and to assess their desired needs. When family and social well-being was added to the logistic regression model, higher family and social well-being was the strongest factor associated with lower amounts of anxiety (odds ratio, 0.10; P = 0.001 for a cutoff of 10; odds ratio, 0.21; P = 0.012 for a cutoff of 8). Less than 30% who screened positive met with the study psychiatrist and were not receiving optimal treatment. Given that low family and social well-being and elevated anxiety symptoms were so highly correlated, those with anxiety symptoms would most benefit from social interventions. However, this study also found that patients with elevated depressive or anxiety symptoms were difficult to engage with a psychiatric provider. We need partnership between psychiatry and gynecology oncology to identify those with elevated depressive and anxiety symptoms and develop better ways to provide psychosocial supports.

BackgroundDigital mental health interventions (DMHIs) may reduce treatment access issues for those experiencing depressive and/or anxiety symptoms. DMHIs that incorporate relational agents may offer unique ways to engage and respond to users and to potentially help reduce provider burden. This study tested Woebot for Mood & Anxiety (W-MA-02), a DMHI that employs Woebot, a relational agent that incorporates elements of several evidence-based psychotherapies, among those with baseline clinical levels of depressive or anxiety symptoms. Changes in self-reported depressive and anxiety symptoms over 8 weeks were measured, along with the association between each of these outcomes and demographic and clinical characteristics.MethodsThis exploratory, single-arm, 8-week study of 256 adults yielded non-mutually exclusive subsamples with either clinical levels of depressive or anxiety symptoms at baseline. Week 8 Patient Health Questionnaire-8 (PHQ-8) changes were measured in the depressive subsample (PHQ-8 ≥ 10). Week 8 Generalized Anxiety Disorder-7 (GAD-7) changes were measured in the anxiety subsample (GAD-7 ≥ 10). Demographic and clinical characteristics were examined in association with symptom changes via bivariate and multiple regression models adjusted for W-MA-02 utilization. Characteristics included age, sex at birth, race/ethnicity, marital status, education, sexual orientation, employment status, health insurance, baseline levels of depressive and anxiety symptoms, and concurrent psychotherapeutic or psychotropic medication treatments during the study.ResultsBoth the depressive and anxiety subsamples were predominantly female, educated, non-Hispanic white, and averaged 38 and 37 years of age, respectively. The depressive subsample had significant reductions in depressive symptoms at Week 8 (mean change =—7.28, SD = 5.91, Cohen’s d = -1.23, p < 0.01); the anxiety subsample had significant reductions in anxiety symptoms at Week 8 (mean change = -7.45, SD = 5.99, Cohen’s d = -1.24, p < 0.01). No significant associations were found between sex at birth, age, employment status, educational background and Week 8 symptom changes. Significant associations between depressive and anxiety symptom outcomes and sexual orientation, marital status, concurrent mental health treatment, and baseline symptom severity were found.ConclusionsThe present study suggests early promise for W-MA-02 as an intervention for depression and/or anxiety symptoms. Although exploratory in nature, this study revealed potential user characteristics associated with outcomes that can be investigated in future studies.Trial RegistrationThis study was retrospectively registered on ClinicalTrials.gov (#NCT05672745) on January 5th, 2023.

A Longitudinal Investigation of Anxiety and Depressive Symptomatology and Exercise Behaviour Among Adults With Type 2 Diabetes Mellitus.

Background In the field of psychotherapy, the exploration of non-pharmacological interventions has gained increasing attention. Visual art expression, as a core form of expressive art therapy, provides a non-verbal pathway for emotional regulation and self-exploration. Although its clinical applications have gradually increased, standardized intervention protocols for specific psychosomatic symptoms and quantifiable efficacy evidence remain insufficient. Currently, there is a lack of high-quality empirical evidence utilizing rigorous randomized controlled trials. Therefore, this study aims to develop a structured group visual art expression intervention program and evaluate its immediate and short-term sustained effects on improving anxiety and depressive symptoms in adults through randomized controlled trials. Methods The study enrolled 120 adult participants diagnosed with mild to moderate anxiety or depressive states, who were randomly assigned to an art intervention group (n = 60) or a waitlist control group (n = 60). The art intervention group received a structured group visual art expression intervention for 8 weeks, with weekly sessions of 90 minutes each, including emotional symbol drawing, narrative painting, and clay sculpting, all guided by a registered art therapist. The control group received no intervention during the study period. Assessments were conducted before intervention (T1), at the end of intervention (T2), and one month after intervention (T3) using the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Rosenberg Self-Esteem Scale (RSES). Data were analyzed using repeated measures ANOVA. Results The anxiety and depression symptoms in the art intervention group showed significant reduction after the intervention, with the effects maintained during the follow-up period. Specific data are presented in Table 1. Table 1 data analysis revealed that the anxiety (GAD-7) and depression (PHQ-9) symptoms in the art intervention group were significantly alleviated (p&amp;lt;.001), while the self-esteem level (RSES) showed a significant improvement, with all improvements remaining stable during the follow-up period. No significant changes were observed in any of the indicators in the waiting control group. Discussion Research demonstrates that structured group visual art expression interventions can effectively and sustainably alleviate mild to moderate anxiety and depressive symptoms, while simultaneously enhancing self-esteem levels. This supports the use of artistic expression as an effective adjunctive non-pharmacological intervention in psychotherapy. Future studies could validate the efficacy of this approach across a broader spectrum of mental disorders, and combine neuroimaging techniques to further explore the underlying neurobiological mechanisms by which artistic creation influences emotional and cognitive functions.

BackgroundPsychotherapy patients are particularly vulnerable to the experience of eco-distress, often referred to as climate anxiety or eco-anxiety. Eco-distress can foster pro-environmental behavior, but its various symptoms might as well be functionally impairing and are negatively correlated with psychological well-being. The link between eco-distress and depressive and anxiety symptoms, as well as the use of dysfunctional emotion regulation strategies, may explain this vulnerability and suggest ways to promote resilience.MethodsPsychotherapy out-patients were screened at T1 (n = 203) and again five months later (T2; n = 79) for anxious (Generalized Anxiety Disorder Scale; GAD-7) and depressive symptoms (Patient Health Questionnaire; PHQ-9) and for eco-distress (Eco-Anxiety Questionnaire, EAQ-22; Generalized Anxiety Disorder Scale-Climate Version; GAD-7-C; Climate Change-Man-Made Disaster Distress Scale; CC-MMDS). Emotion regulation strategies were assessed at T1. Factorial validity was tested for eco-distress questionnaires. The relationship of eco-distress, depressive and anxious symptoms, and emotion regulation strategies was tested via multivariate models, multiple regression analysis, and mediation analysis.ResultsThe EAQ-22 and GAD-7-C showed good model fit, the factorial structure of the CC-MMDS had to be adapted. Participants who screened positive for a generalized anxiety disorder and/or a depressive disorder at T1 reported higher levels of eco-distress, but changes in anxious or depressive symptoms from T1 to T2 did not predict a change in eco-distress. At T1, Rumination and Catastrophizing predicted higher scores of eco-distress for all three questionnaires. However, emotion regulation strategies did not mediate the effect of depressive and anxious symptoms on eco-distress.ConclusionEco-distress is associated with the frequent use of the emotion regulation strategies Catastrophizing and Rumination and is higher in individuals with depressive and anxious symptoms. Addressing the use of these emotion regulation strategies in individuals could promote psychological resilience when facing the climate crisis.

Anxiety symptoms and depressive symptoms are observed in approximately 20%-50% and 30% of patients with psoriasis, respectively.1,2 To date, however, evidence for the association of these symptoms with patients' direct perception of their disease (called patient-reported outcomes [PROs]) remains limited. We assessed the association of anxiety symptoms and depressive symptoms with the severity of psoriasis, psoriatic symptoms, health-related quality of life (HRQoL), and satisfaction levels in Japanese patients with psoriasis using baseline data of participants from a single-arm, open-label, multicenter, prospective cohort study-ProLOGUE (Japan Registry of Clinical Trials identifier: jRCTs031180037).3 Patients (aged ≥18 years) who had plaque psoriasis without peripheral arthritis symptoms and were eligible for self-administration of brodalumab were enrolled at 15 facilities across Japan (study period, October 2017-March 2020).3.

COVID-19 infection survivors and the risk of depression and anxiety symptoms: A nationwide study of adults in the United States

Prevalence of Symptoms of Depression and Anxiety in Adults With Cystic Fibrosis Based on the PHQ-9 and GAD-7 Screening Questionnaires

Aims:The transition from adolescence to young adulthood, often referred to as ‘emerging adulthood’, is a challenging period in life, and mental health problems are common. Although a large number of studies have shown that social support is linked with fewer mental health problems, few longitudinal studies have examined these associations during this life phase. The aim of the current study was to examine the associations between perceived social support from different sources – family, friends and significant other – at age 17–18 and symptoms of depression and anxiety at age 20–21.Methods:Data were obtained from the cohort study Futura01 based on a Swedish national sample of adolescents attending grade 9 in 2016/2017. We used survey information from 2019 (age 17–18) and 2022 (age 20–21) and linked registry information (N=2722). Symptoms of depression and anxiety were measured by the Patient Health Questionnaire-4 (PHQ-4) at age 20–21. Perceived social support was measured by the Multidimensional Scale of Perceived Social Support (MSPSS) at age 17–18. Control variables included sociodemographic characteristics and indicators of mental health problems at age 17–18. Binary logistic regressions were performed.Results:When mutually adjusting for all sources of perceived social support, family support at age 17–18 had inverse associations with symptoms of both depression and anxiety at age 20–21. Perceived support from friends was associated with subsequent symptoms of anxiety only.Conclusions:Perceived social support can be a protective factor against mental health problems in emerging adulthood. The family serves a particularly important source of social support.

IntroductionStudies from the beginning of 2020 show that symptoms of depression and anxiety are increasing among health care workers. It is important to assess the dynamics of health care workers mental health.ObjectivesTo assess the dynamic of symptoms of depression and anxiety among health care workers over a 3-month period during the COVID-19 pandemia in Latvia.Methods A longitudinal cohort study of symptoms of depression and anxiety in the population of physicians, physician assistants and nurses in Latvia during the COVID-19 pandemia. Symptoms of depression were assessed using the Patient Health Questionnaire-9 (PHQ-9) scale, symptoms of anxiety were assessed using the General Anxiety Disorder (GAD-7) scale, cut-off score for both scales was 10. Initial data was collected on April-May 2020 with a 3 month follow-up.. Data was analyzed using SPSS- Related-Samples McNemar test.Results348 physicians were initially included (women 83,9%, mean age 45,17±14,02) and 376 physicians assistants and nurses (women 88,2%, mean age 39,99±12,97). After the 3-month follow up 189 physicians (women 88,40%, mean age 45,01±13,57) and 141 physicians assistants and nurses were left (women 88,00%, mean age 39,96 ±12,59). During the 3 months symptoms of depression among physicians rose from 26,80% (n=94) to 27,5% (n=52), symptoms of anxiety from 17,70% (n=62) to 20,6% (n=39). Depression symptoms among physician assistants and nurses dropped from 25,50% (n=96) to 23,9% (n=34), symptoms of anxiety stayed almost the same 18,20% (n=68) to 18,30% (n=26). Symptoms of depression among physicians changed from 26,80% (n=94) to 27,5% (n=52), symptoms of anxiety from 17,70% (n=62) to 20,6% (n=39), changes were not statistically significant (p=0,281; p=0,725). Symptoms of depression among physician assistants and nurses changed from 25,50% (n=96) to 23,9% (n=34), symptoms of anxiety from 18,20% (n=68) to 18,30% (n=26), changes were not statistically significant (p=0,405; p=0,664).ConclusionsNo change in the dynamics of symptoms of depression and anxiety among health care workers over a 3-month period during the COVID-19 pandemia in Latvia was observed.

Background: Mental health issues, particularly anxiety and depression, are increasingly concerning for university students. Pharmacy students are especially vulnerable to stress owing to high academic demands. This study is one of the first longitudinal analyses exploring the evolution of anxiety and depression symptoms among Indonesian pharmacy students. Objective: To observe the longitudinal patterns of depression and anxiety symptoms among pharmacy students using the Patient Health Questionnaire 9 (PHQ-9) and Generalized Anxiety Disorder 7 (GAD-7) over an academic year. Methods: This prospective cohort study involved 106 first-year pharmacy students (undergraduate and professional programs). Depression and anxiety symptoms were measured using the PHQ-9 and GAD-7 instruments at two time points: the beginning and the end of the academic year. Data were analyzed using descriptive statistics and the Wilcoxon Signed-Rank test. Results: The mean GAD-7 score slightly increased from 9.15 (SD=3.29) to 9.45 (SD=3.47), while the PHQ-9 score increased from 10.81 (SD=4.37) to 11.47 (SD=4.56). Wilcoxon tests showed that the increase in anxiety was not statistically significant (p=0.036), whereas the paired t-test indicated that the increase in depression was not statistically significant (p=0.079). However, a higher severity category was observed for depressive symptoms. Conclusion: Although changes in anxiety and depression scores were not statistically significant, a trend toward worsening depressive symptoms was observed during the academic year. These findings highlight the importance of continuous mental health monitoring and early supportive intervention among pharmacy students.