Anxiety-depression Comorbidity Research Articles

Chronic pregabalin treatment reduced anxiety, and acute pregabalin treatment increased depression-like behaviors in rats

BackgroundPregabalin is an antiepileptic drug that binds to the alpha-2/delta unit at presynaptic voltage-dependent calcium channels. We aimed to investigate the effect of acute and chronic pregabalin administration on anxiety and depression-like behaviors.MethodsFifty-six male Wistar albino rats were divided into seven groups: control, vehicle, and five different dose groups (5, 10, 30, 60, and 100 mg/kg). Pregabalin was administered for two weeks. Depression-like behaviors were evaluated by Forced swimming test. Anxiety-like behavior (ALB) was evaluated by Open field test (OFT), Elevated Plus Maze (EPM), and light-dark box. Subjects underwent the forced swimming test (FST) after the first dose, while the open field test (OFT), elevated plus maze (EPM), and light-dark box (LDB) were performed after two weeks of treatment. Further sucrose preference test was conducted to evaluate anhedonia until the end of the experiment.ResultsIn the forced swimming test, depression-like behaviors increased after acute single-dose administration of 10, 30, 60, 100 mg/kg pregabalin. According to OFT results, chronic 100 mg/kg pregabalin showed anxiolytic effects by decreasing grooming, and freezing behaviors. In addition, 100 mg/kg chronic pregabalin administration significantly increased the time spent in the central region, the number of entries to the center, and the unsupported rearing number without causing any change in locomotor activity. According to EPM results, both chronic 60 and 100 mg/kg pregabalin treatments showed anxiolytic effects by increasing open arm time and head dipping behavior. In addition, 60 and 100 mg/kg chronic pregabalin administration significantly decreased stretch attend posture. All pregabalin administrations between 5 and 100 mg/kg displayed anxiolytic effects in the LDB. Sucrose preference was above 65% for the duration of all experiments and subjects did not show anhedonia.ConclusionAcute pregabalin treatment triggered depression-like behaviors. Anhedonia, which may be associated with depression, was not observed during chronic treatment. Moreover, chronic treatment with pregabalin revealed potent anxiolytic effects in different behavior patterns and doses for all tests of unconditional anxiety. In particular, 100 mg/kg chronic pregabalin administration decreased anxiety-like behaviors in all experiment setups. Although the anxiolytic effect was demonstrated in chronic treatment, acute treatment of pregabalin induced depression-like behaviors, and thus in clinical practice should be done with caution, especially in patients with anxiety-depression comorbidity.

Clinician’s Opinion on Depression and Role of Escitalopram in the Management of Depression

Background: Depression is an emerging severe disorder and a serious public health problem, which can often go undetected. It is associated with many disease conditions. Increase in non-communicable diseases, suicide rate, has made its incidence to increase. These will have a negative impact on patient’s quality of life and will increase the burden of morbidity and mortality. Objective: The aim of this study was to gain a deeper understanding of the role of escitalopram in the management of depression by collecting clinical insights and expert opinion from Indian clinicians through a set of questionnaire. Methodology: A cross sectional, questionnaire based study was conducted to collect opinion among doctors in the major Indian cities, about experience and satisfaction with current pharmacotherapy and role of escitalopram in the management of depression across India between June to October 2017. Convenient sampling method was used. The pretested questionnaire booklet titled CHEER (Clinicians Opinions on Depression and role of Escitalopram) study was sent to the doctors who were willing to participate. For this, physicians were requested to complete this survey and express their opinion towards the various aspect of managing depression. Results: Totally, 177 out of 200 clinicians shared their experiences and opinion from all over India. As per survey data, 58.19% of clinicians reported that in their clinical practice, on an average, more than 15 patients were diagnosed with depression in a month. Around 75% of clinicians say that incidence of depression was more common in the female when compared to the male patients. Reports showed that incidence of depression was more common in urban educated patients (47.11%). Depression was seen more commonly in the age group of 31-40 years. About 58% of clinicians reported that counselling was as important as pharmacotherapy. The survey report suggested that more than 90% of clinicians prefer escitalopram as a first-line therapeutic agent for treating depression. More than 87% of clinicians prefer escitalopram in combination with clonazepam to treat co-morbidity of anxiety depression in their clinical practise. Conclusion: The present survey report suggested that majority of clinicians (85%) preferred escitalopram to treat depression among the SSRIs and other antidepressants agents. Survey also showed that escitalopram has better efficacy and lesser adverse effects.

Combined EEG-tDCS approach in resting state to reduce comorbid anxiety and depressive symptoms in affective disorders: A sham-controlled pilot study

Continuous challenges have been imposed on mental health science by Anxiety and Depression disorders as the most prevalent and debilitating psychiatric conditions worldwide. Pharmacologic and cognitive behavioral therapies, either alone or in combination, have been considered as the first-line therapies, however, resistant symptomatology is prevalent in comorbid conditions with symptoms remaining after interventions. The demand for new therapeutic solutions has given space to the development of non-invasive brain stimulation techniques (NIBS), and the transmagnetic direct current stimulation (tDCS) has been reported as a safe and well-tolerated technique for the treatment of several mental health conditions, including Anxiety and Depression disorders. Relying on quantitative electroencephalography(qEEG)- tDCS approach, the current study aims to inspect the effect of tDCS intervention on patients who suffer from anxiety-depression comorbidity, in particular, the impact of tDCS intervention on qEEG spectral power activity and resting-state connectivity organization during eyes closed and eyes open protocols. QEEG data were acquired from eight patients suffering from moderate to severe anxiety-depression comorbid symptoms along with poor coping skills to manage stress and negative affect. Twelve control subjects allocated in the control group exhibiting low to moderate symptoms in both anxiety and depression conditions went also through the qEEG data acquisition. In addition, a sham-controlled study was conducted, and the patient group went through resting-state qEEG-tDCS neuromodulation once a week for ten weeks. Various-stage qEEG recordings were performed to inspect the efficacy of tDCS treatment during the modulation of brain regions involved in the regulation of affective responses. Our results demonstrated that after tDCS neuromodulation, the patients' groups exhibited decreased absolute power abnormalities over the left anterior cingulate cortex and reduced abnormal activity in the alpha band over posterior regions; improved functional connectivity indexes; decreased anxiety and depressive scores while positive affect score was improved. Besides the promising improvements, our study did not find a significant tDCS effect on perceived stress and negative affect scores. Consistently, significant differences in absolute spectral power over the left anterior cingulate cortex were detected among the patient group, as compared to the controls, as expected. Therefore, our study offers preliminary data to understand the neuroplasticity changes that potentially result from the manipulation of cortical excitability during affective regulation protocols followed by the consequent decrease of comorbid anxiety and depressive symptomatology. The pilot study was followed by prospective registration with ChiCTR2200062142.

Prevalence and coping of depression and anxiety among college students during COVID-19 lockdowns in China

BackgroundThis study sought to investigate the prevalence of anxiety, depression and mixed anxiety-depression disorder among college students during COVID-19 shelter-in-place lockdowns in China. MethodsParticipants (N = 2818) were selected from 8 provincial regions across the country in areas that were under lockdown mandates. The dependent variables were anxiety and depression. Multiple regression models were tested using anxiety and depression as the respective outcome variables, and binary logistic regression was conducted with anxiety-depression comorbidity as the dependent variable. Explanatory variables were changes in (social) media use and communication behaviors, perceived effectiveness of daily activity involvements as well as a number of demographic and environmental factors. ResultsBeing a college senior, prior anxiety/depression history, having family members and residents in neighborhood tested positive with COVID were all important predictors of elevated anxiety, depression and their comorbidity. Increased face-to-face family communication and reading more e-books were associated with reduced anxiety, depression and their comorbidity. Listening to music and playing video games were correlated with lower anxiety but not depression. ConclusionsDraconian shelter-in-place lockdowns as strictly enforced in China within a short notice could be detrimental to individual mental health and psychological well-being. Findings in this research can provide practical guidance for college counselors and health professionals in targeting particular segments of the student population in providing tailored psychological, therapeutic and material services during disruptive moments and public health crises. The central role of family communication in the emotional and social support process deserves critical contemplation.

Exploring Comorbidity Between Anxiety and Depression in Spanish-Speaking School-Aged Children: A Network Analysis Approach.

Anxiety and depression are highly prevalent and comorbid problems in childhood, which deserve greater understanding for effective prevention and treatment. The main aim of the present study was to explore the comorbidity between anxiety and depression symptoms using a novel and valuable approach to study comorbidity, such as network analysis. Specifically, the connectivity between symptoms and possible relevant symptoms was examined through comorbidity estimation and shortest pathway networks, as well as bridge symptoms. This study comprised 281 Spanish-speaking children aged 8-12 years (45.2% girls), whose anxiety and depression symptoms were assessed through specific brief parent-report measures. Analyses revealed that in the comorbidity network, the most central symptoms were related to depression ("No good anymore," "Could never be as good," "Hated self," "Did everything wrong," "Nobody loved him/her") or anxiety ("Suddenly feels really scared"). Furthermore, it was found that the most central bridge symptoms, whose activation would play a key role in the activation of other domain symptoms, were anxiety symptoms such as "Trouble going to school" and "Suddenly feels really scared" and depression symptoms, such as "Could never be as good" and "Hated self." Additionally, the shortest path network suggested the existence of different possible pathways of connection between anxiety and depression symptoms. Overall, these findings help to understand the complexity of the anxiety-depression comorbidity. It suggests the existence of central and bridge symptoms that complement previous studies, which may be potential targets for interventions to prevent and treat childhood anxiety and depression.

Variety ACEs and risk of developing anxiety, depression, or anxiety-depression co-morbidity: the 2006-2022 UK Biobank data.

Adverse childhood experiences (ACEs) and anxiety-depression co-morbidity are attracting widespread attention. Previous studies have shown the relationship between individual psychiatric disorders and ACEs. This study will analyze the correlation between anxiety-depression co-morbidity and different levels of ACEs. Seven categories of ACE and four classifications of psychiatric disorders were defined in a sample of 126,064 participants identified by the UK Biobank from 2006-2022, and correlations were investigated using logistic regression models. Then, to explore nonlinear relationships, restricted spline models were developed to examine differences in sex and age across cohorts (n = 126,064 for the full cohort and n = 121,934 for the European cohort). Finally, the impact of the category of ACEs on psychiatric disorders was examined. After controlling for confounders, ACEs scores showed dose-dependent relationships with depression, anxiety, anxiety-depression co-morbidity, and at least one (any of the first three outcomes) in all models. ACEs with different scores were significantly positively correlated with the four psychiatric disorders classifications, with the highest odds of anxiety-depression co-morbidity (odds ratio [OR] = 4.87, 95% confidence intervals [CI]: 4.37 ~ 5.43), p = 6.08 × 10-178. In the restricted cubic spline models, the risk was relatively flat for females at ACEs = 0-1 and males at ACEs = 0-2/3 (except in males, where ACEs were associated with a lower risk of anxiety, all other psychiatric disorders had an increased risk of morbidity after risk smoothing). In addition, the risk of having anxiety, depression, anxiety-depression co-morbidity, and at least one of these disorders varies with each category of ACEs. The prevalence of anxiety-depression comorbidity was highest across ACE scores after controlling for confounding factors and had a significant effect on each category of ACEs.

Association Between Comorbid Anxiety and Depression and Health Risk Behaviors Among Chinese Adolescents: Cross-Sectional Questionnaire Study.

Comorbidity of psychiatric disorders such as depression and anxiety is very common among children and adolescents. Few studies have examined how comorbid anxiety and depression are associated with health risk behaviors (HRBs) in adolescents, which could inform preventative approaches for mental health. We evaluated the association between HRBs and comorbid anxiety and depression in a large adolescent cohort. We used data from 22,868 adolescents in the National Youth Cohort (China). Anxiety and depression symptoms were assessed using the 9-item Patient Health Questionnaire scale and the 7-item Generalized Anxiety Disorder scale, respectively. Comorbidity was determined by the coexistence of anxiety and depression. HRBs including poor diet, smoking, physical inactivity, and poor sleep, as well as the above HRB scores, were added to obtain the total HRB score (HRB risk index). Based on single and total HRB scores, we divided participants into low-, medium-, and high-risk groups. Potential confounders included gender, presence of siblings, regional economic level, educational status, self-rated health, parental education level, self-reported family income, number of friends, learning burden, and family history of psychosis. Correlation analysis was used to explore associations between single risk behaviors. Binary logistic regression estimated the association between HRBs and anxiety-depression comorbidity before and after adjusting for potential confounders. The comorbidity rate of anxiety and depression among Chinese adolescents was 31.6% (7236/22,868). There was a statistically significant association between each HRB (P<.05), and HRBs were positively associated with comorbid anxiety and depression in the above population. For single HRBs, adolescents with poor diet, smoking, and poor sleep (medium-risk) were more prone to anxiety-depression comorbidity after adjusting for confounders compared to low-risk adolescents. However, adolescents with all high-risk HRBs were more likely to have comorbid anxiety and depression after adjusting for confounders (poor diet odds ratio [OR] 1.50, 95% CI 1.39-1.62; smoking OR 2.17, 95% CI 1.67-2.81; physical inactivity OR 1.16, 95% CI 1.06-1.28; poor sleep OR 1.84, 95% CI 1.70-2.01). Moreover, in both unadjusted (medium risk OR 1.79, 95% CI 1.56-2.05; high risk OR 3.09, 95% CI 2.72-3.52) and adjusted (medium risk OR 1.57, 95% CI 1.37-1.80; high risk OR 2.33, 95% CI 2.03-2.68) models, HRB risk index, like clustered HRBs, was positively associated with anxiety-depression comorbidity, and the strength of the association was stronger than for any single HRB. In addition, we found that compared to girls, the association between clustered HRBs and anxiety-depression comorbidity was stronger in boys after adjustment. We provide evidence that HRBs are related to comorbid anxiety and depression. Interventions that decrease HRBs may support mental health development in adolescence, with the potential to improve health and well-being through to adulthood.

Association between changes in physical activity and comorbid symptoms of anxiety and depression in college students

To describe the prevalence of physical activity and comorbid symptoms of anxiety and depression in college students, and to explore the correlation strength between changes in physical activity and comorbid symptoms of anxiety and depression, so as to provide a reference for promoting college students&apos; mental health. From April to May 2019, 1179 freshmen majoring in public health, nursing, chemistry and physical education were randomly sampled from one university in Hefei City, Anhui Province, and Shangrao City, Jiangxi Province, respectively. A baseline questionnaire survey was conducted. A follow-up survey was conducted in May 2021, and a total of 1046 subjects were included, including 647 female and 399 male. The International Physical Activity Questionnaire-Short Form was used to evaluate the physical activity level of college students, and the Patient Health Questionnaire and Generalized Anxiety Disorder Scale were used to evaluate the anxiety and depression symptoms of college students during follow-up. Determining the coexistence of anxiety and depression symptoms in college students as anxiety-depression comorbid symptoms. In the follow-up survey, the detection rate of anxiety and depression comorbid symptoms of college students was 16.9%(n=177), and the detection rates of sufficient, decreased, increased, and insufficient physical activity changes were 72.5%(n=758), 13.8%(n=144), 9.2%(n=96), and 4.6%(n=48), respectively. The result of multiple Logistic regression model showed that, after controlling for confounding factors, compared with those with sustained high level of physical activity, i. e. , adequate physical activity, increased physical activity(OR=1.89, 95%CI 1.10-3.25), decreased physical activity(OR =2.80, 95% CI 1.72-4.57), and insufficient physical activity(OR = 3.66, 95% CI 1.85-7.23) increased the risk of anxiety-depression comorbidity symptoms of college students(P&lt;0.05). However, there was no significant increase in the risk of anxiety or depressive symptoms in those who increased, decreased, or insufficient physical activity compared with those who were sufficient physical activity(P&gt;0.05). The level of physical activity and its changes are related to mental health of college students. The continuous low level of physical activity is associated with the increased risk of comorbidity of anxiety and depression in college students.

Satisfaction with Life and Coping Strategies among Patients with Hidradenitis Suppurativa: A Cross-Sectional Study.

Hidradenitis suppurativa (HS) is a chronic recurrent inflammatory dermatosis with vast psychosocial burden. The objective of this study is to thoroughly analyze satisfaction with life (SWL) and coping strategies of HS patients in relation to the clinical and psychosocial factors. 114 HS patients (53.1% females; mean age 36.6 ± 13.1 years) were enrolled. Severity of the disease was measured using Hurley staging and International HS Score System (IHS4). Instruments utilized: Satisfaction with Life Scale (SWLS); Coping-Orientation to Problems-Experienced Inventory (Brief COPE); HS Quality of Life Scale (HiSQoL); Patient Health Questionnaire-9 (PHQ-9); Generalized Anxiety Disorder-7 (GAD-7); General Health Questionnaire (GHQ-28). SWL was low in 31.6% of HS patients. No relation was found between SWL and Hurley staging and IHS4. SWL correlated with GHQ-28 (r = -0.579 p < 0.001), PHQ-9 (r = -0.603 p < 0.001), GAD-7 (r = -0.579 p < 0.001), and HiSQoL (r = -0.449 p < 0.001). Problem-focused coping strategies were most commonly used, followed by emotion-focused coping and avoiding coping strategies. Significant differences were found between the following coping strategies and SWL: self-distraction (p = 0.013), behavioral-disengagement (p = 0.001), denial (p = 0.003), venting (p = 0.019), and self-blame (p = 0.001). HS patients present low SWL which correlates with psychosocial burden. Reducing anxiety-depression comorbidity and encouraging optimal coping strategies may be of great importance in holistic approach to HS patients.

A mental health survey among young front-line clinicians in high-risk areas during the COVID-19 sporadic epidemic in China.

BackgroundThe sporadic coronavirus disease (COVID-19) epidemic has placed enormous psychological stress on people, especially clinicians. The objective of this study was to examine depression, anxiety, quality of life (QOL), and related social psychological factors among young front-line clinicians in high-risk areas during the COVID-19 sporadic epidemic in China and to provide a reference for formulating reasonable countermeasures.MethodsIn this cross-sectional study, demographic information, COVID-19-related questions, anxiety (Generalized Anxiety Disorder-7, GAD-7), depression (Patient Health Questionnaire-9, PHQ-9), insomnia (Insomnia Severity Index, ISI), stress (Perceived Stress Scale-10, PSS-10), and QOL (World Health Organization Quality of Life-brief version, WHOQOL-BREF) were collected. Binary logistic regression analysis was used to test the relationships between anxiety and/or depression and other related problems. Multiple linear regression analysis was used to test the relationships among factors influencing QOL.ResultsA total of 146 young front-line clinicians were included. The prevalence rates of depression, anxiety, and anxiety-depression comorbidity were 37.7% (95% CI = 29.7–45.6%), 26.0% (95% CI = 18.8–33.2%), and 24.0% (95% CI = 17.0–31.0%), respectively. Severe stress (OR = 1.258, 95% CI = 1.098–1.442, P < 0.01) and insomnia (OR = 1.282, 95% CI = 1.135–1.447, P < 0.01) were positively correlated with depression. Severe stress (OR = 1.487, 95% CI = 1.213–1.823, P < 0.01) and insomnia (OR = 1.131, 95% CI = 1.003–1.274, P < 0.05) were positively correlated with anxiety. Severe stress (OR = 1.532, 95% CI = 1.228–1.912, P < 0.01) was positively correlated with anxiety-depression comorbidity. However, insomnia (OR = 1.081, 95% CI = 0.963–1.214, P > 0.05) was not correlated with anxiety-depression comorbidity. The belief that the vaccine will stop the COVID-19 pandemic (OR = 0.099, 95% CI = 0.014–0.715, P < 0.05) was negatively correlated with anxiety and anxiety-depression comorbidity (OR = 0.101, 95% CI = 0.014–0.744, P < 0.05). Severe stress (B = −0.068, 95% CI = −0.129 to −0.007, P < 0.05) and insomnia (B = −0.127, 95% CI = −0.188 to −0.067, P < 0.01) were negatively correlated with QOL. The belief that the vaccine could provide protection (B = 1.442, 95% CI = 0.253–2.631, P < 0.05) was positively correlated with QOL.ConclusionsThe prevalence of depression, anxiety, and even anxiety-depression comorbidity was high among young front-line clinicians in high-risk areas during the COVID-19 sporadic epidemic in China. Various biological and psychological factors as well as COVID-19-related factors were associated with mental health issues and QOL. Psychological intervention should evaluate these related factors and formulate measures for these high-risk groups.

Vigilance-Avoidance Toward Negative Faces in Social Anxiety With and Without Comorbid Depression.

Despite the growing evidence for the attentional bias toward emotional related stimuli in patients with social anxiety disorder (SAD), it remains unclear how the attentional bias manifests in normal individuals with SAD and/or depressive traits. To address this question, we recruited three groups of normal participants with different psychiatric traits—individuals with comorbid SAD and depression (SADd, N = 19), individuals with only SAD (SAD, N = 15), and healthy control individuals (HC, N = 19). In a dot-probe paradigm, participants view angry, disgusted, and sad face stimuli with durations ranging from very brief (i.e., 14ms) that renders stimuli completely intangible, to relatively long (i.e., 2000ms) that guarantees image visibility. We find significant early vigilance (i.e., on brief stimuli) and later avoidance (i.e., on long stimuli) toward angry faces in the SADd group. We also find vigilance toward angry and disgusted faces in the SAD group. To our best knowledge, this is the first study to unify both vigilance and avoidance within the same experimental paradigm, providing direct evidence for the “vigilance-avoidance” theory of comorbid SAD and depression. In sum, these results provide evidence for the potential behavioral differences induced by anxiety-depression comorbidity and a single trait in non-clinical populations, but the lack of a depression-only group cannot reveal the effects of high levels of depression on the results. The limitations are discussed.

Anxiety and depression predispose individuals to an autoimmune bullous diseases- bullous pemphigoid: A large-scale population-based cohort study

The association of bullous pemphigoid (BP) with anxiety and anxiety-depression comorbidity is yet to be established. We aimed to evaluate the bidirectional association of BP with anxiety, depression, and anxiety-depression comorbidity, and to delineate the epidemiological features of patients with BP and the aforementioned psychiatric comorbidities. A population-based cohort study was performed to assess the risk of anxiety, depression, and anxiety-depression comorbidity among patients with BP (n = 3924) relative to age-, sex- and ethnicity-matched control subjects (n = 19,280). A case-control design was additionally adopted to estimate the odds of BP in individuals with a preexisting diagnosis of these three psychiatric conditions. Adjusted hazard ratios (HRs) and adjusted odds ratios (ORs) were estimated by Cox regression and logistic regression, respectively. A history of anxiety (OR, 1.17; 95% CI, 1.04–1.31), depression (OR, 1.26; 95% CI, 1.15–1.38), and anxiety-depression comorbidity (OR, 1.19; 95% CI, 1.04–1.35) was associated with subsequent development of BP. In the cohort study design, patients with BP were found to be at an increased overall risk of depression (HR, 1.17; 95% CI, 1.01–1.35), while female BP patients had an increased risk of depression (HR, 1.19; 95% CI, 1.00–1.42) and anxiety (HR, 1.29; 95% CI, 1.00–1.67). Patients with comorbid BP and depression exhibited a 19% increased all-cause mortality rate (HR, 1.19; 95% CI, 1.08–1.31), whereas patients with BP and anxiety-depression comorbidity were less adherent to long-term topical corticosteroid treatment and less frequently managed by adjuvant agents. In conclusion, a history of anxiety, depression, and anxiety-depression comorbidity predisposes individuals to BP, whereas patients with BP are at an increased risk of depression. Clinicians managing patients with anxiety and depression should take the increased risk of BP into consideration, and patients with BP should be monitored for depression.

Anxiété et dépression associées à la prise en charge de la COVID-19 chez les personnels de santé au Cameroun

ObjectiveThe COVID-19 pandemic has had a significant impact worldwide, at different levels. The literature consulted indicates that healthcare workers, who are the first to respond, are generally the ones who pay the highest price. The present study assesses the extent of anxious and depressive symptoms among these actors responding to COVID-19, in the context of Cameroon. MethodThe Hospital Anxiety and Depression Scale (HADS) was used to assess anxious and depressive symptoms. Data collection involved the use of a web questionnaire for this purpose through the Google Forms virtual platform. The questionnaire link was sent to professional groups spread throughout Cameroon's ten regions. A total of 331 health professionals were interviewed over the period from April 5 to 19, 2020. ResultThe results show a high rate of anxiety (41.8%) and depression (42.8%). There is a higher susceptibility to depression in young people (30-39 years). Fear of contamination and fear of death are modulators of depression and anxiety. The anxiety-depression comorbidity in the sample is 14.73%. The prevalence rates of major depressive disorder and adjustment disorder in the sample were 8.2% and 3.3%, respectively. The data presented confirm the trends recorded in the literature regarding the impact of fatal epidemics on the mental health of healthcare workers. DiscussionThe results indicate, as is the case with most of the work consulted in the literature, that the Covid 19 pandemic is significantly affecting the mental health of healthcare workers. This underlines the urgency of setting up a specialized aid and/or support system, in the context of the current pandemic, such as that of similar health crises. Such a device does not exist in Cameroon, where the mental health response remains weak. ConclusionThese results suggest that the healthcare staff involved in the response to COVID-19 in Cameroon are significantly affected in their mental health. This underlines the need for specialized psychological help for nursing staff.

청소년의 불안-우울 공존 양상과 자살시도 : 부모의 낮은 정신건강 관심정도의 가중효과

본 연구의 목적은 청소년 불안-우울 공존 양상을 파악하고, 이에 따른 자살시도 위험에서 부모의 낮은 정신건강 관심정도의 가중효과를 검증하는 것이다. 이를 위해 한국청소년정책연구원이 2012년 수행한 ’아동·청소년 정신건강 증진 지원방안 연구Ⅱ’의 횡단데이터를 활용하였으며 연구대상은 초등학교 4학년부터 고등학교 3학년 총 1,942명이다. 주요 연구결과는 다음과 같다. 첫째, 불안-우울 공존 양상을 파악하기 위해 잠재프로파일분석을 실시한 결과, 불안과 우울의 공병률은 일정한 양상을 보이며 저수준(59.2%, n=1,210), 중수준(33.5%, n=686), 그리고 고수준 집단(7.5%, n=146)으로 구분되었다. 또한 저수준 집단에 비해 중수준 집단의 자살시도 위험은 2.19배, 고수준의 경우 7.82배 증가하였다. 둘째, 부모의 정신건강 관심정도가 낮을수록 자살시도 위험비는 최대 2.42배 까지 증가하는 양상을 보였다. 셋째, 불안-우울 공존 양상과 부모의 정신건강 관심정도에 따른 자살시도 위험비를 검증한 결과, 이론적인 최저 위험집단(저수준 집단×부모의 정신건강 관심정도 매우 높음)에 비해 타집단은 최소 2.53배에서 최대 21.51배까지 자살시도 위험이 높은 것으로 검증되었다. 이와 같은 연구 결과를 바탕으로 청소년 불안-우울 공존 양상 및 부모의 정신건강 관심정도에 따른 자살시도 위험을 완화하기 위한 임상적, 정책적 제언을 하였다.

The association between the socioeconomic status and anxiety-depression comorbidity in patients with psoriasis: a nationwide population-based study.

Numerous studies have indicated that comorbid anxiety and depression are associated with a more severe course of illness. Yet generally, the study of the effect of psoriasis on patients' mental health has considered anxiety and depression to be separate states. To measure the association between psoriasis and anxiety, depression and anxiety-depression co-occurrence among patients according to their socioeconomic statuses (SES). A nationwide population-based study of psoriasis patients and age and gender frequency-matched controls (n=255862) was designed. Diagnostic data were obtained from Clalit Health Services, the largest managed care organization in Israel. This database was established using continuous real-time input from healthcare providers, pharmacies, medical care facilities and administrative computerized operating systems. After controlling for demographic and clinical variables, psoriasis was associated with anxiety (OR 1.11, 95% CI 1.01-1.23, P<0.05), depression (OR 1.17, 95% CI 1.08-1.26, P<0.001), and anxiety and depression co-occurrence (OR 1.32, 95% CI 1.21-1.45, P<0.001) among patients with low SES, yet was associated only with anxiety (OR 1.15 95% CI 1.04-1.27, P<0.001) but not depression or comorbid anxiety-depression among patients with high SES. Survival analyses indicated that between the ages of 40 and 60, the cumulative probability of psoriasis patients with low SES to suffer from anxiety, depression and their co-occurrence inclined more sharply with age as compared to psoriasis patients with high SES. As psoriasis patients with low SES are prone to suffer from more severe courses of anxiety and depression, the choice of treatment of psoriasis should address the SES as well as the underlying psychiatric disease.

Psychometric Properties of the Response to Anxiety Questionnaire

Recent research highlights the importance of transdiagnostic factors of psychopathology, particularly in understanding comorbidity. Repetitive negative thinking (RNT) is one such factor, which may elucidate anxiety-depression comorbidity. The Response to Anxiety Questionnaire (RAQ) aims to evaluate repetitive negative thinking (RNT) related to anxiety-depression comorbidity, specifically hopelessness and rumination about anxiety symptoms. Anxious hopelessness is negative thoughts about the future due to anxiety symptoms, and anxious rumination includes negative evaluations of the meaning of anxiety symptoms, therefore the current study assessed the RAQ in three studies. We used exploratory and confirmatory factor analysis methodologies to examine the factor structure of the RAQ. In addition, we tested indirect effects of the two factors of RAQ (Rumination and Hopelessness) between anxiety and depression, and tested measure convergent validity. Results of the current study provide additional support for the psychometric properties of the RAQ, suggesting a two factor makeup (hopelessness, rumination), as well as its use in predicting anxiety and depressive symptoms.

Prevalence and predictors of anxiety in an African sample of recent stroke survivors.

Studies considering emotional disturbances in the setting of stroke have primarily focused on depression and been conducted in high-income countries. Anxiety in stroke survivors, which may be associated with its own unique sets of risk factors and clinical parameters, has been rarely investigated in sub-Saharan Africa (SSA). We assessthe characteristics of anxiety and anxiety-depression comorbidity in a SSA sample of recent stroke survivors. We assessed baseline data being collected as part of an intervention to improve one-year blood pressure control among recent (≤1month) stroke survivors in SSA.Anxiety in this patient population wasmeasured using the Hospital Anxiety and Depression Scale(HADS),while the community screening instrument for dementia was used to evaluate cognitive functioning. Independent associations were assessed using logistic regression analysis. Among391participants,clinically significant anxiety (HADS anxiety score≥11)was found in 77 (19.7%). Anxiety was comorbid with depression in 55 (14.1%). Femalestroke survivors were more likely than males to have anxiety(OR=2.4, 95% CI=1.5-4.0).Anxiety was significantly associated with the presence of cognitive impairment after adjusting for age, gender and education(OR=6.8, 95% CI=2.6-18.0). One in five recent stroke survivors in SSA has clinically significant anxiety, and well over 70% of those with anxiety also have depression. Future studies will need to determine what specific impact post-stroke anxiety may have on post-stroke clinical processes and outcomes.

Pathways to anxiety-depression comorbidity: A longitudinal examination of childhood anxiety disorders.

Anxiety disorders are prevalent in youth and associated with later depressive disorders. A recent model posits three distinct anxiety-depression pathways. Pathway 1 represents youth with a diathesis to anxiety that increases risk for depressive disorders; Pathway 2 describes youth with a shared anxiety-depression diathesis; and Pathway 3 consists of youth with a diathesis for depression who develop anxiety as a consequence of depression impairment. This is the first partial test of this model following cognitive-behavioral treatment (CBT) for child anxiety. The present study included individuals (N = 66; M age = 27.23 years, SD = 3.54) treated with CBT for childhood anxiety disorders 7-19 years (M = 16.24; SD = 3.56) earlier. Information regarding anxiety (i.e., social phobia (SoP), separation anxiety disorder (SAD), generalized anxiety disorder (GAD)) and mood disorders (i.e., major depressive disorder (MDD) and dysthymic disorders) was obtained at pretreatment, posttreatment, and one or more follow-up intervals via interviews and self-reports. Evidence of pathways from SoP, SAD, and GAD to later depressive disorders was not observed. Treatment responders evidenced reduced GAD and SoP over time, although SoP was observed to have a more chronic and enduring pattern. Evidence for typically observed pathways from childhood anxiety disorders was not observed. Future research should prospectively examine if CBT treatment response disrupts commonly observed pathways.

Estrés, síntomas psicopatológicos y riesgo de clicking en estudiantes universitarios: un estudio de casos y controles

Introducción: la evidencia científica sugiere que el estrés y los síntomas psicológicosdesempeñan un papel importante en las enfermedades. El objetivo del estudio fue investigar el clicking en individuos con estrés y diferentes síntomas psicopatológicos. Métodos: se compararon 30 estudiantes universitarios que experimentaron clicking con 60 voluntarios sanos como controles. Los participantes recibieron el pss-10 y scl-90-r en versiones españolas. Se calcularon los odds ratios (or) e ic al 95% para determinar el riesgo de estas variables para la presencia de clicking mediante regresión logística. Resultados: el estrés fue débilmente asociado con la ocurrencia de clicking(or = 1,35, ic al 95%: 0,46-3,95, p = 0,57). Ser un individuo con estrés y depresión (or = 2,92, ic al 95%: 0,61-14,0, p = 0,16) y ansiedad (or = 2,80, ic al 95%: 0,69-11,31, p = 0,13) pudieran aumentar el riesgo de presentar clicking. Además, la depresión (or = 7,00, ic al 95%: 0,66-74,28, p = 0,07) y la ansiedad (or = 4,90, ic al 95%: 0,78-30,80, p = 0,07) ajustadas por síntomas de dolor parecen importantes para unos sujetos. El riesgo de clicking en estudiantes con comorbilidad de depresión y ansiedad y estrés fue más alto (or = 2,11, ic al 95%: 0,40-11,15, p = 0,37). Por otra parte, existió un riesgo diferente cuando esta comorbilidad, estrés y el síntoma de dolor estuvieron presentes(or= 4,30, ic al 95%: 0,35-51,90, p = 0,21).Conclusión: la depresión, la ansiedad, el estrés y el dolor pudieran ser factores predictivos para el desarrollo de tdm como el clicking. En este sentido, la medición de esas condiciones debe ser una prioridad en estos pacientes.

Comorbidity of anxiety and depression in children and adolescents: 20 years after.

Brady and Kendall (1992) concluded that although anxiety and depression in youths are meaningfully linked, there are important distinctions, and additional research is needed. Since then, studies of anxiety-depression comorbidity in youths have increased exponentially. Following a discussion of comorbidity, we review existing conceptual models and propose a multiple pathways model to anxiety-depression comorbidity. Pathway 1 describes youths with a diathesis for anxiety, with subsequent comorbid depression resulting from anxiety-related impairment. Pathway 2 refers to youths with a shared diathesis for anxiety and depression, who may experience both disorders simultaneously. Pathway 3 describes youths with a diathesis for depression, with subsequent comorbid anxiety resulting from depression-related impairment. Additionally, shared and stratified risk factors contribute to the development of the comorbid disorder, either by interacting with disorder-related impairment or by predicting the simultaneous development of the disorders. Our review addresses descriptive and developmental factors, gender differences, suicidality, assessments, and treatment-outcome research as they relate to comorbid anxiety and depression and to our proposed pathways. Research since 1992 indicates that comorbidity varies depending on the specific anxiety disorder, with Pathway 1 describing youths with either social phobia or separation anxiety disorder and subsequent depression, Pathway 2 applying to youths with coprimary generalized anxiety disorder and depression, and Pathway 3 including depressed youths with subsequent social phobia. The need to test the proposed multiple pathways model and to examine (a) developmental change and (b) specific anxiety disorders is highlighted.