Abnormal Depression Scores Research Articles

Use of the Hospital Anxiety and Depression Scale in Patients with Oral Lichen Planus: An Institutional Experience.

Background Oral lichen planus (OLP) is a chronic inflammatory disorder affecting the oral mucosa. It commonly appears in reticular and erosive forms, among other variants that include bullous, papular, and plaque types. This condition can greatly diminish a patient's quality of life due to prevailing discomfort and anxiety. Materials and methodology A retrospective study was conducted involving patients with OLP in the Department of Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Chennai, India, measuring their anxiety and depression levels using the Hospital Anxiety and Depression Scale (HADS). Patient data were extracted from the private institution's electronic data recording system from June 1, 2023, to June 30, 2024. The retrieved data also included parameters such as age, gender, chief complaint, associated comorbidities, habit history, type of clinical variant, and previous medication history. SPSS Version 26.0 (IBM Corp., Armonk, NY) was employed for data analysis, utilizing Fisher's exact tests, chi-square tests, and Mann-Whitney U tests for comparisons, with a p-value of <0.05 considered as significant. To compare proportions between groups, the chi-square test was applied, and when the expected cell frequency was less than 5, Fisher's exact test was used. Results Out of 1,500 outpatients in the department, 367 were diagnosed with OLP and 212 met the diagnostic criteria for inclusion in a one-year study (June 1, 2023, to June 30, 2024). The most frequently reported age group was 51-60 years, representing 27.4% (n = 58) of the total population, with a female predominance of around 62.7% (n = 133). Patients' associated comorbidities revealed the prevalence of Grinspan syndrome in around 9.4% (n = 20). Additionally, the habit history indicated no significant history in 92% (n = 198) of cases. The majority of the study population was symptomatic, reporting a chief complaint of burning sensation (46.2%) (n = 98). The most common clinical variant reported was reticular (53.8%) (n = 114), followed by the erosive variant (36.8%) (n = 78). Medication history revealed that triamcinolone acetonide 0.1% (42.9%) (n = 91) was the most commonly prescribed medicine, followed by prednisolone 5 mg (32.5%) (n = 69). The HADS score indicated that 48.58% (n = 103) of patients had abnormal anxiety scores (mean of 15.8 ± 2.02), while 42.4% (n = 90) exhibited abnormal depression scores (mean of 16.3 ± 2.07). Notably, patients with the erosive variant showed higher anxiety scores compared to those with the reticular variant, with an average score of 9.3 ± 1.07, with a p-value of 0.041. Conclusion The findings underscore the substantial psychological burden associated with OLP, which affects patient's emotional well-being and treatment adherence. Addressing these psychological concerns through regular assessments and supportive interventions is crucial for improving the standard of living.

Effectiveness of a specific follow up program for the management of the mental components of post-intensive care syndrome and chronic pain after COVID-19: results from the PAIN-COVID randomized clinical trial

BackgroundCritical COVID-19 survivors are at risk of developing Post-intensive Care Syndrome (PICS) and Chronic ICU-Related Pain (CIRP). We determined whether a specific care program improves the quality of life (QoL) of patients at risk of developing PICS and CIRP after COVID-19. MethodsThe PAIN-COVID trial was a parallel-group, single-centre, single-blinded, randomized controlled trial. The intervention consisted of a follow up program, patient education on PICS and pain, and a psychological intervention based on Rehm’s self-control model in patients with abnormal depression scores (≥8) in the Hospital Anxiety and Depression Scale (HADS) at the baseline visit. QoL was evaluated with the 5-level EQ 5D (EQ 5D 5 L), mood disorders with the HADS, post-traumatic stress disorder (PTSD) with the PCL-5 checklist, and pain with the Brief Pain Inventory short form, the Douleur Neuropathique 4 questionnaire, and the Pain Catastrophizing Scale. The primary outcome was to determine if the program was superior to standard-of-care on the EQ visual analogue scale (VAS) at 6 months after the baseline visit. The secondary outcomes were EQ VAS at 3 months, and EQ index, CIRP incidence and characteristics, and anxiety, depression, and PTSD at 3 and 6 months after baseline visits. ConclusionsThis program was not superior to standard care in improving QoL in critical COVID-19 survivors as measured by the EQ VAS. However, our data can help establish better strategies for the study and management of PICS and CIRP in this population. Trial registration# NCT04394169, registered on 5/19/2020.

Efectividad de un programa de seguimiento específico para el manejo de los componentes mentales del síndrome poscuidados intensivos y el dolor crónico tras la enfermedad por coronavirus de 2019: resultados del ensayo clínico aleatorizado “PAIN-COVID”

BackgroundCritical COVID-19 survivors are at risk of developing Post-intensive Care Syndrome (PICS) and Chronic ICU-Related Pain (CIRP). We determined whether a specific care program improves the quality of life (QoL) of patients at risk of developing PICS and CIRP after COVID-19 disease. MethodsThe PAIN-COVID trial was a parallel-group, single-centre, single-blinded, randomized controlled trial. The intervention consisted of a follow up program, patient education on PICS and pain, and a psychological intervention based on Rehm's self-control model in patients with abnormal depression scores (>=8) in the Hospital Anxiety and Depression Scale (HADS) at the baseline visit. QoL was evaluated with the 5-level EQ 5D (EQ 5D 5L), mood disorders with the HADS, post-traumatic stress disorder (PTSD) with the PCL-5 checklist, and pain with the Brief Pain Inventory short form, the Douleur Neuropathique 4 questionnaire, and the Pain Catastrophizing Scale. The primary outcome was to determine if the program was superior to standard-of-care on the EQ visual analogue scale (VAS) at 6 months after the baseline visit. The secondary outcomes were EQ VAS at 3 months, and EQ index, CIRP incidence and characteristics, and anxiety, depression, and PTSD at 3 and 6 months after baseline visits. ConclusionsThis program was not superior to standard care in improving QoL in critical COVID-19 survivors as measured by the EQ VAS. However, our data can help establish better strategies for the study and management of PICS and CIRP in this population.Trial registration: # NCT04394169, registered on 5/19/2020.

Influence of Weight-Control Attempts as Based on Self-Perception of Macronutrient Intake Among Young Females and Its Association with Mood Disorder.

There are a few studies on the association between macronutrients and mood, but none on weight control based on self-perception of specific macronutrients and mood. To assess the association between anxiety and depression levels and weight-control attempts among young females based on self-perception of diet that impacts weight by limiting or boosting a certain macronutrient. A cross-sectional survey conducted on young females (n=302) with an age range of 19 to 29. Dietary intake was measured using the Food frequency questionnaire (FFQ) and 24h-dietary recall. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS) questionnaire. Analysis of the data showed a significant and inverse association of macronutrients - carbohydrates (OR 0.86; 95% CI 0.77-0.95;p < 0.01), protein (OR 0.87; 95% CI 0.78-0.97;p < 0.05), and fat (OR 0.79; 95% CI 0.63-0.99;p < 0.05) - with the odds of abnormal anxiety was noted. In addition, lower omega-3 intake was significantly associated with abnormal anxiety score (OR 0.85; 95% CI 0.76-0.97;p < 0.05) and abnormal depression score (OR 0.31; 95% CI 0.14-0.68;p < 0.01). Increased calorie intake is associated with an increased risk of anxiety scores. This preliminary study found the importance of monitoring dietary intake, especially macronutrients, among the young population to screen for any onset of mood symptoms, especially for those who are following a specific diet without any supervision. Young people should be aware of the importance of following a balanced diet and seek dietitians' consultation.

Prevalence and impact of faecal incontinence among individuals with Rome IV irritable bowel syndrome.

Little is known about faecal incontinence (FI) in individuals with irritable bowel syndrome (IBS). To compare characteristics of people with IBS reporting FI, compared with people with IBS who do not report FI. We collected demographic, gastrointestinal and psychological symptoms, healthcare usage, direct healthcare costs, impact on work and activities of daily living, and quality of life data from individuals with Rome IV-defined IBS. We asked participants about FI, assigning presence or absence according to Rome-IV criteria. Of 752 participants with Rome IV IBS, 202 (26.9%) met Rome IV criteria for FI. Individuals with FI were older (p< 0.001), more likely to have IBS-D (47.0% vs. 39.0%, p= 0.008), and less likely to have attained a university or postgraduate level of education (31.2% vs. 45.6%, p< 0.001), or to have an annual income of ≥£30,000 (18.2% vs. 32.9%, p< 0.001). They were more likely to report urgency (44.6% vs. 19.1%, p< 0.001) as their most troublesome symptom and a greater proportion had severe IBS symptom scores, abnormal depression scores, higher somatic symptom-reporting scores or higher gastrointestinal symptom-specific anxiety scores (p< 0.01 for trend for all analyses). Mean health-related quality of life scores were significantly lower among those with, compared with those without, FI (p< 0.001). Finally, FI was associated with higher IBS-related direct healthcare costs (p= 0.002). Among individuals with Rome IV IBS, one-in-four repo rted FI according to Rome IV criteria. Physicians should ask patients with IBS about FI routinely.

Factors associated with improvements in symptoms of anxiety and depression among gay, bisexual and other men who have sex with men (gbMSM) in Vancouver, Canada: A prospective cohort study

BackgroundDepression and anxiety are commonly experienced among gay, bisexual and other men-who-have-sex-with-men (gbMSM). We explored factors associated with improvements in mental health symptoms among gbMSM with abnormal depression and anxiety scores over a period of four years, in Vancouver, Canada. MethodsSexually active gbMSM ≥16 years of age were recruited using respondent-driven sampling from February 2012 to February 2015. Participants completed a computer-assisted questionnaire which included the Hospital Anxiety and Depression Scale (HADS), and psychometric scales to measure loneliness, self-esteem and social connectedness, every 6 months until July 2019. Generalized linear mixed models were used to assess factors associated with normal/borderline HADS scores (<11) following a previous abnormal score (≥11) for each of anxiety and depression subscales. ResultsWe recruited 694 participants, of whom 580 had at least one follow-up visit. Across all visits, 43.6 % of participants ever had abnormal anxiety scores and 16.2 % ever had abnormal depression scores. Among those with abnormal anxiety scores, 34.9 % of follow-up visits demonstrated reductions in anxiety scores. Among those with abnormal depression scores 51.0 % of follow-up visits demonstrated reductions in depression scores. Reductions in anxiety scores were associated with increased self-esteem, decreased loneliness and the number of gbMSM seen/spoken to in the previous month. Reductions in depression scores were associated with increased self-esteem, decreased loneliness and having a regular partner. ConclusionImprovements in mental health symptoms were frequently observed. Social connectedness was related with improved anxiety and depression symptoms. Interventions to improve social connectedness may help to improve mental health for gbMSM.

The Burden of Disease in Alopecia Areata: Canadian Online Survey of Patients and Caregivers.

Alopecia areata (AA) is associated with negative impacts on the quality of life (QoL). Data on this impact are lacking for Canadian patients and their caregivers. This study aims to investigate the burden of AA on Canadian patients and their caregivers. We created 4 online surveys for patients 5-11 years old, 12-17 years old, and ≥18 years old and for caregivers of children (<18 years old) with AA. These were disseminated through the Canadian Alopecia Areata Foundation (CANAAF) website and to dermatologists across Canada. In total, 115 adult patients (n=100, 87%, female), 14 pediatric patients (n=13, 92.9%, female), and 15 caregivers completed the surveys online. The majority (n=123, 95%) of patients felt uncomfortable or self-conscious about their appearance. Camouflaging hair loss with hats, scarves, and hairpieces was a common practice for 11 (78.6%) pediatric and 84 (73%) adult patients. Avoidance of social situations was reported by 8 (57.1%) pediatric and 75 (65.2%) adult patients. Constant worry about losing the achieved hair growth was a concern for 8 (57.1%) pediatric and 75 (65.2%) adult patients. On a scale of 1-5, the mean score of caregivers' own feelings of sadness or depression about their child's AA was 4.0 (SD 0.9) and of their feelings of guilt or helplessness was 4.2 (SD 1.2). The impact on the QoL was moderate for both children and adults. Based on the Adjustment Disorder New Module-20 (ADNM-20), 71 (61.7%) of 115 patients were at high risk of an adjustment disorder. Abnormal anxiety scores were recorded in 40 (34.8%) patients compared to abnormal depression scores in 20 (17.4%) patients. This study confirmed a significant burden of AA on Canadian patients' and caregivers' QoL.

Post-Covid-19 mental health issues in Obstetrics &amp; Gynecology health care professionals of Lady Reading Hospital, Peshawar

Introduction: Pandemics and Epidemics are usually known for acute anxiety and even panic states, yet it has been documented that psychological effects remain in the post-pandemic period as well. These effects can impact not only the working capacity of individuals, but also their general and social wellbeing.&#x0D; Objective: To assess the mental health in terms of anxiety and depression in health care professionals (HCP) who have recovered from COVID 19.&#x0D; Materials &amp; Methods: A descriptive study was conducted in the department of Obstetrics &amp; Gynecology of Lady Reading Hospital, Peshawar from March to August 2020 on 34 health care workers who had confirmed COVID 19 (positive PCR on nasopharyngeal swab) and recovered by repeat negative PCR on nasopharyngeal swab, had joined their duties, and were 3 months post-covid. Persons with prior mental health issues and on psychiatric medication were excluded. After permission from Hospital Ethical Board, informed consent for inclusion in the study was taken from subjects. The Hospital Anxiety Depression Scale (HADS), was filled by all subjects; they were categorized as either suffering from anxiety/depression or normal based on the inbuilt scoring system. Data were analyzed using SPSS version 20 for descriptive statistics.&#x0D; Results: Anxiety and depression scores based on HADS questionnaire were calculated and following are the percentages of participants with borderline anxiety score (32.5%), abnormal anxiety score (23.4%), borderline depression score (26.5%), and abnormal depression scores (32.4%).&#x0D; Conclusion: Post-covid mental health assessment is likely to reveal a sizeable number of health care workers showing long term effects of Covid-19, who could be candidates for rehabilitation psychotherapy.

Willingness to accept risk with medication in return for cure of symptoms among patients with Rome IV irritable bowel syndrome.

SummaryBackgroundSome drugs for irritable bowel syndrome (IBS) have serious side effects.AimsTo examine the willingness of individuals with IBS to accept risks with medication in return for symptom cure.MethodsWe collected demographic, gastrointestinal symptoms, psychological health, quality of life and impact on work and daily activities data from 752 adults with Rome IV‐defined IBS. We examined median willingness to accept death in return for cure with a hypothetical medication using a standard gamble, according to these variables.ResultsParticipants would accept a median 2.0% (IQR 0.0%‐9.0%) risk of death in return for a 98.0% (IQR 91.0%‐100.0%) chance of permanent symptom cure. The median accepted risk of death was higher in men (5.0% vs 2.0%, P < 0.001), those with continuous abdominal pain (4.0% vs 1.0%, P < 0.001), more severe symptoms (P = 0.005 for trend), abnormal depression scores (P < 0.001 for trend), higher gastrointestinal symptom‐specific anxiety (P < 0.001 for trend), and lower IBS‐related quality of life (P < 0.001 for trend). Those willing to accept above median risk of death were more likely to be male (17.1% vs 9.1%, P < 0.001), take higher levels of risks in their daily life (P = 0.008 for trend), and report continuous abdominal pain (53.1% vs 39.4%, P < 0.001), and had higher depression (P = 0.004 for trend) and lower quality of life (P < 0.001 for trend) scores.ConclusionPatients are willing to accept significant risks in return for cure of their IBS symptoms.

Associations of Food Intolerance with Irritable Bowel Syndrome, Psychological Symptoms, and Quality of Life

The impact of different types of food intolerance on gastrointestinal symptoms and quality of life (QOL) is poorly understood. We aimed to investigate associations of food intolerance and type of intolerance with irritable bowel syndrome (IBS), health-related QOL, and psychological symptoms. We conducted an observational study of United States-based adults through an online survey. Demographics, culprit foods, symptoms, medical evaluation, Rome IV criteria for IBS, health-related QOL (Short-Form Health Survey 12), and anxiety and depression scores (Hospital Anxiety and Depression Scale) were collected in participants with self-reported food intolerance (lactose, non-lactose food, lactose plus food intolerance), and controls with no intolerance. Univariable associations of group with study endpoints were analyzed with the Kruskal-Wallis and Pearson χ2 or Fisher exact test. Multivariable comparisons were analyzed by logistic and linear regression. A total of 197 patients with (59 lactose, 61 non-lactose food, 77 lactose plus food intolerance) and 273 patients without intolerance participated. Lactose, wheat, and eggs were the most common food triggers. Gas (54.2%), abdominal pain (40.2%), and diarrhea (37.3%) were frequently reported symptoms of food intolerance. Reactions caused 57.8% to eliminate the food. Rates of IBS, abnormal anxiety scores, and abnormal depression scores were highest in lactose plus food intolerance; Short-Form Health Survey 12 scores were lowest in lactose plus food intolerance. Multivariable analyses revealed all intolerance subgroups were more likely to have IBS than controls. Food intolerance is associated with IBS, anxiety, depression, and decreased health-related QOL and frequently leads to food elimination. Adults with lactose and lactose plus food intolerance have higher rates of IBS, increased psychological symptoms, and poorer QOL.

Depression and anxiety among pregnant mothers in the initial stage of the Coronavirus Disease (COVID-19) pandemic in the southwest of Iran

‌BackgroundWomen are at a higher risk for depression progression, especially during pregnancy. The current study purposed to investigate depression, anxiety, and stress levels of pregnant mothers in the initial stage of the COVID-19 infection in the southwest of Iran.MethodsThis cross-sectional study was conducted during March and April, 2020, in Shiraz, Iran. Pregnant mothers registered in maternity clinics affiliated with Shiraz University of Medical Sciences were included. An online self-administered checklist was used. It included socio-demographic, obstetric and medical histories, and the short form of the Depression Anxiety Stress Scales (DASS-21) to evaluate depression, anxiety, and stress. A p-value < 0.05 was considered significant.ResultsIn total, 540 pregnant mothers answered the questionnaire. 83.5% had no comorbidity. Abnormal depression scores were significantly higher in those who had no insurance (OR = 2.5) and in those with poor self-rated health (SRH) (OR = 27.8). Pregnant mothers with lower SRH and two or more comorbidities had a higher chance of having an abnormal level of anxiety subscale (6.9, 3.7 times, retrospectively).ConclusionThe results revealed that an abnormal level of depression was associated with SRH and medical insurance status. Moreover, the number of comorbidities and poor SRH significantly increased the chance of achieving abnormal anxiety levels in pregnant mothers during the COVID-19 pandemic.

Prevalence of anxiety and depression during COVID-19 pandemic among healthcare students in Jordan and its effect on their learning process: A national survey.

During pandemics, including the most recent COVID-19 pandemic, the mental health of university healthcare students' is expected to be affected negatively, impacting the students' learning process. The aim of this study was to assess the level of anxiety and depression of healthcare students living in Jordan, and the effect on their learning process during the COVID-19 pandemic. This descriptive cross-sectional study was conducted via an online survey completed by students studying a healthcare-oriented degree in a university in Jordan. Participants were recruited through social media (Facebook and WhatsApp). The validated previously published Hospital Anxiety and Depression Scale (HADS) questionnaire was used as a part of the online survey to assess students' anxiety/depression scores. Students' responses regarding their learning process during the COVID-19 was also assessed. The mean age of participants was 21.62 (SD = 4.90), with the majority being females (67.1%). The HADs' assessment revealed that 43.8% and 40.0% of participants had normal anxiety and depression scores, while 22.4% showed borderline abnormal anxiety/depression scores (33.8%). Many students (33.8%) were classified to have abnormal anxiety scores, while a smaller proportion (26.2%) was classified to have abnormal depression scores. Smoking (p = 0.022), lower family income (p = 0.039), and use of medications (p = 0.032) were positively associated with higher (worse) anxiety scores. Ranking the learning process during COVID-19 showed that 45.8% of the participants believed it was a 'good/very good/excellent' process. Anxiety and depression levels amongst university healthcare students in Jordan were found to be high when assessed during the COVID-19 pandemic. In addition, the learning process during the pandemic was not accepted by more than half of the students. Implementing psychological interventions for healthcare students during pandemics is strongly recommended in order to optimize students' mental health and their learning process alike.

28 Comorbid Psychological Factors in Emergency Department Patients With Low Risk Chest Pain Associated With Anxiety

Anxiety is thought to be a significant contributor to chest pain symptoms in approximately 40% of patients with low risk chest pain seen in the emergency department (ED). The validated Hospital Anxiety Depression Scale - Anxiety subscale (HADS-A) has been used as an anxiety screening tool in this population. These patients have been shown to have persistent anxiety symptoms at follow-up and significantly higher ED utilization. The objective of this study was to determine the prevalence of abnormal anxiety levels in a cohort of low-risk chest pain patients and characterize their comorbid psychological contributors. We hypothesized that those with abnormal anxiety scores would have worse concomitant depression, optimism and pain catastrophizing scores in addition to experiencing more life trauma. This was a pre-planned secondary analysis of a single-center, prospective observational cohort study of ED subjects with low risk chest pain. Eligible subjects between 18 and 70 years old with no history of acute coronary syndrome (ACS) and a physician-reported HEART score < 4, were enrolled. The HADS-A was used to stratify participants into 2 groups: Low Anxiety (score<8) and High Anxiety (score≥8). Outcomes assessed included concomitant depression via the Hospital Anxiety Depression Scale - Depression subscale (HADS-D), previous trauma (Traumatic Life Events Questionnaire), optimism (Life Optimism Test-Revised), and pain catastrophizing (Pain Catastrophizing Scale). These groups were analyzed and compared using t-tests for continuous data and chi-square for proportional/categorical data. Of 442 screened subjects, 304 met enrollment criteria and 163 (36.8%) gave informed consent. Seventy-six (47%) were stratified into the High Anxiety group with a score≥8. There were no differences in baseline demographics between groups. Overall, there was a moderate positive correlation between HADS-A and HADS-D scores with a Pearson’s R of 0.519. Thirty percent of all subjects had abnormal depression scores ≥8 on the HADS-D and 35 subjects (45%) had both abnormal anxiety as well as depression. Mean depression scores were significantly different between the low anxiety and high anxiety groups (3.64, 95% CI 2.17 to 5.10). Traumatic experiences of assault with a weapon (p=0.000), physical assault (p=0.012), sexual assault (p=0.046), witnessing fire (p=0.034), natural disaster (p=0.035) were all associated with abnormal levels of anxiety. However, only sexual assault (p=0.030) and other unwanted sexual encounters (p=0.040) were associated with abnormal levels of depression. Optimism was negatively correlated with both anxiety (R=-0.489) and depression (R=-0.504). Additionally, optimism was significantly lower for subjects with either abnormal anxiety (mean difference of 3.86, 95% CI 2.46 to 5.26) or abnormal depression (mean difference 4.32, 95% CI 2.80 to 5.83). Pain catastrophizing was also significantly higher in subjects with either abnormal anxiety or depression (p=0.000). The prevalence of abnormal levels of anxiety in our low risk chest pain cohort was 47%. These patients were more likely to have concurrent symptoms of depression, multiple traumatic exposures, a less optimistic outlook, and a pain catastrophizing phenotype. These data indicate there may be an opportunity to address these problems in many low risk chest pain patients as a best practice.

Thoughts about Suicide and Self-Harm in Patients with Tinnitus and Hyperacusis.

There are conflicting reports with regard to the relationship between suicidal ideations and tinnitus and hyperacusis. Audiology departments play a major role in offering therapy and support for patients experiencing tinnitus and hyperacusis. If suicidal and self-harm ideations among patients seen in audiology clinics are high, then it would be important to screen for them to make onward referrals to mental health services. The aim of this study was to assess the prevalence of and factors related to suicidal and self-harm ideations in patients with tinnitus and hyperacusis seen at an audiology outpatient service. This study was a part of a service evaluation survey using a correlational design. All patients who sought help concerning their tinnitus or hyperacusis from an audiology clinic of the National Health Service in the United Kingdom in a 1-yr period were asked to complete the survey questionnaires (n = 402). The focus of this article is on analysis of the patients' responses about suicidal and self-harm ideations as measured via the Patient Health Questionnaire, item 9, and their associated factors. A total of 150/402 of patients answered the question about suicidal and self-harm ideations. Of these, 13% indicated that they had suicidal or self-harm ideations in the past 2 weeks. Suicidal and self-harm ideations were moderately correlated with scores on the anxiety and depression subscales of the hospital anxiety and depression scale. Suicidal and self-harm ideations decreased with increasing age. There were small statistically significant correlations between suicidal and self-harm ideations and tinnitus handicap, hyperacusis handicap, insomnia, and scores on the visual analog scale (VAS) of effect of tinnitus on life. The correlations between suicidal and self-harm ideations and gender, pure-tone average of the worse and better ears, uncomfortable loudness levels of the worse ears, and VAS of tinnitus loudness and annoyance were not statistically significant. A regression model showed that abnormal depression scores increased the chance of suicidal and self-harm ideations by a factor of 6.2 (95% confidence interval = 1.13-34.1, p = 0.036). Audiologists offering tinnitus and hyperacusis rehabilitation should screen for suicidal and self-harm ideations among patients, especially for those with comorbid depression, and make onward referral to appropriate services when needed.

Factors associated with decisional regret among patients undergoing major thoracic and abdominal operations

No study has specifically investigated patient attitudes on decisional regret concerning major operative procedures. The objective of the present study was to define the prevalence of regret among patients who had undergone a major abdominal or thoracic operative procedure and to identify factors associated with postoperative regret. Decisional regret was assessed using the validated Decision Regret Scale, which consisted of 5 items with Likert-scale responses. Data on preoperative decision-making preferences and postoperative regret, quality of life, and symptoms of anxiety and depression were collected and analyzed. Overall, 157 (68.9%) patients agreed to participate and completed the survey, while 12 (5.3%) patients declined citing lack of time or interest. The types of operative procedures varied, with 65 (41.7%) patients undergoing a thoracic operation, 59 (37.8%) resection of the pancreas, liver or bile duct, and 32 (20.5%) patients having a colorectal/enteric operation. Although most patients (n=98, 62.4%) expressed no degree of regret, a subset of patients did; specifically, 59 (37.6%) patients conveyed a varied degree of postoperative regret, with 20 (12.7%) patients expressing a moderate degree of regret, and 13 patients (8.3%) experiencing substantial regret. Postoperative regret was associated with a history of postoperative complications (odds ratio 4.7, 95% confidence interval 1.2-17.7, P<.01) and with discordance between a patient's preferred and actual perceived decision-making role (odds ratio 5.3, 95% confidence interval 1.6-17.4, P<.01). Patients experiencing regret were 5 times more likely than patients not experiencing regret to demonstrate borderline or abnormal depression scores (odds ratio 5.4, 95% confidence interval 1.6-18.0, P<.01); anxiety scores directly correlated with regret (rho 0.254, P<.01). Patient-reported decisional regret after major abdominal and thoracic operations was present in 37% of patients, with roughly 1 in 12 patients reporting substantial regret and distress over the decision to have undergone operation. Discordance between patients' preferred and actual involvement in operative decision-making was associated with postoperative regret, as was poor quality of life, anxiety, and depression.

AB0681 The assessment of the cognitive and behavioural profiles in primary sjogren’s syndrome

BackgroundSjogren’s syndrome (SS) is a multi-system autoimmune disorder known to affect the CNS. Studies have reported that 7%>100% patients experience neuropsychological manifestations including cognitive impairment, depression and anxiety (1,2). Depression...

Comprehensive Pulmonary Rehabilitation Results in Clinically Meaningful Improvements in Anxiety and Depression in Patients With Chronic Obstructive Pulmonary Disease

Pulmonary rehabilitation (PR) improves anxiety and depression in patients with chronic obstructive pulmonary disease. However, little is known regarding its ability to produce clinically meaningful improvements in these outcomes. We retrospectively analyzed 366 patients who participated in our 8-week outpatient PR program. The Hospital Anxiety and Depression Scale was used to screen for anxiety and depression symptoms (HADA and HADD, respectively); for both, a score of ≥ 10 was considered abnormal, and a change of 1.5 units or greater in magnitude was considered the threshold for a minimal clinically important difference (MCID). Other outcomes included the Chronic Respiratory Disease Questionnaire and the 6-Minute Walk Test. Of the 366 patients, 257 (70%) completed the program and 235 (64%) completed final outcome evaluation. At program entry, 25% had abnormal anxiety scores and 17% had abnormal depression scores; these dropped to 9% and 6%, respectively, in those patients completing outcome analyses (P < .0001). Abnormal HADA and HADD scores predicted noncompletion of the program. Among patients who completed PR, there were significant improvements on all dimensions (increased walk distance, increased quality of life, and reduced symptoms of depression and anxiety). Of the total group, the MCID was exceeded in 41% and 46% for HADA and HADD, respectively. Of those with abnormal anxiety scores at baseline who completed outcome analysis (n = 44), 91% surpassed the MCID, while of those with abnormal depression scores at entry (n = 30), 93% surpassed the MCID. Pulmonary rehabilitation results in substantial and clinically meaningful changes in both anxiety and depression.

Prevalence and Clinical Factors of Anxiety and Depression in Neurally Mediated and Unexplained Syncope

PurposeSeveral studies have demonstrated that psychiatric disorders such as anxiety, depression and panic attack are associated with syncope, especially vasovagal and unexplained syncope (US). The aim of this study was to compare the prevalence of anxiety and depression between patients with neurally mediated syncope (NMS) and US and to investigate the clinical factors associated with anxiety and depression.Materials and MethodsBetween January 2009 and March 2010, 383 patients with syncopal episodes completed a Hospital Anxiety and Depression Scale questionnaire to assess symptoms of anxiety and depression. Inclusion criteria were NMS and US. Exclusion criteria were cardiac syncope, orthostatic hypotension and other disorders mimicking syncope. After exclusion, 199 patients were included.ResultsThere were 176 (88.4%) NMS patients and 23 (11.6%) US patients. The prevalence of abnormal anxiety and depression were not significantly different between the NMS and US groups (10.2% vs. 8.7%, p=0.99; 8.5% vs. 17.4%, p=0.24). Clinical factors associated with anxiety were female gender (p=0.01) and six or more recurrent syncopal episodes (p=0.01) by univariate analysis. The only factor associated with abnormal anxiety score (OR=20.26, 95% CI: 1.4-291.6, p=0.01) was more than six recurrent syncopal episodes, while a positive head-up tilt table testing response was inversely associated with abnormal depression score (OR=0.28, CI: 0.08-0.97, p=0.04) in the multiple logistic regression analysis.ConclusionAnxiety was associated with frequent syncopal episodes. Thus, anxiety might be considered in the management of syncope patients.

Increased Risk for Abnormal Depression Scores in Women With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Increased Risk for Abnormal Depression Scores in Women With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Increased Risk for Abnormal Depression Scores in Women With Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) and depression both have a high prevalence in reproductive-aged women. This study aimed to determine the prevalence of abnormal depression scores in women who meet currently recognized definitions of PCOS compared with women in a well-defined control group. The search was performed in MEDLINE, EMBASE Classic plus EMBASE, PsycINFO, Current Contents-Clinical Medicine and Current Contents-Life Sciences and Web of Science. Cochrane software Review Manager 5.0.24 was used to construct forest plots comparing risk of abnormal depression scores in those in the PCOS and control groups. Studies with well-defined criteria of women with PCOS and control groups of women without PCOS, with demographic information including age and body mass index (BMI), were included. Of 752 screened articles, 17 met the selection criteria for systematic review and 10 studies were included in the meta-analysis. Data were abstracted independently by three reviewers. All studies were cross-sectional and most used the Rotterdam criteria for the diagnosis of PCOS (n=10). The odds ratio (OR) for abnormal depression scores was 4.03 (95% confidence interval [CI] 2.96-5.5, P<.01) in women with PCOS (n=522) compared with those in the control groups (n=475). A subanalysis showed that the odds for abnormal depression scores was independent of BMI (OR 4.09, 95% CI 2.62-6.41). Several validated tools were used to screen for depression; the common tool used was the Beck Depression Inventory. The results of our study suggest the need to screen all women with PCOS for depression using validated screening tools. Women with PCOS are at an increased risk for abnormal depression scores independent of BMI.