Depression And Anxiety Research Articles

Social Cognitive Predictors of Health Promotion Self-Efficacy Among Older Adults During the COVID-19 Pandemic.

To examine the relative importance of social cognitive predictors (ie, performance accomplishment, vicarious learning, verbal persuasion, affective state) on health promotion self-efficacy among older adults during COVID-19. Cross-sectional. Data collected online from participants in British Columbia (BC), Canada. Seventy-five adults (n = 75) aged ≥65years. Health promotion self-efficacy was measured using the Self-Rated Abilities for Health Practices Scale. Performance accomplishment was assessed using the health directed behavior subscale of the Health Education Impact Questionnaire; vicarious learning was measured using the positive social interaction subscale of the Medical Outcomes Survey - Social Support Scale (MOS-SSS); verbal persuasion was assessed using the informational support subscale from the MOS-SSS; and affective state was assessed using the depression subscale from the Depression Anxiety Stress Scale (DASS-21). Multiple linear regression was used to investigate the relative importance of each social cognitive predictor on self-efficacy, after controlling for age. Our analyses revealed statistically significant associations between self-efficacy and performance accomplishment (health-directed behavior; β = .20), verbal persuasion (informational support; β = .41), and affective state (depressive symptoms; β = -.44) at P < .05. Vicarious learning (β = -.15) did not significantly predict self-efficacy. The model was statistically significant (P < .001) explaining 43% of the self-efficacy variance. Performance accomplishment experiences, verbal persuasion strategies, and affective states may be the target of interventions to modify health promotion self-efficacy among older adults, in environments that require physical and social distancing.

Transcranial Direct Current Stimulation Reduces Pressure Pain Sensitivity in Patients With Noncancer Chronic Pain

Objectives: Noncancer chronic pain is a clinical challenge because pharmacological treatment often fails to relieve pain. Transcranial direct current stimulation (tDCS) is a treatment that could have the potential for pain relief and improvement in quality of life. However, there is a lack of clinical trials evaluating the effects of tDCS on the pain system. The aim of the present study was to evaluate the effect of 5 days of anodal tDCS treatment on the pain system in patients with chronic noncancer pain using quantitative sensory testing and quality of life questionnaires: (1) Brief Pain Inventory-short form, (2) European Organization for Research and Treatment of Life Questionnaire-C30, and (3) Hospital Anxiety Depression Scale. Methods: Eleven patients with noncancer chronic pain (51 ± 13.6 y old, 5M) participated in the study. Anodal tDCS was applied for 5 consecutive days, followed by sham stimulation after a washout period of at least 2 weeks. Pressure pain thresholds and pain tolerance thresholds (PTT) were assessed in different body regions on days 1 and 5. Results: Anodal tDCS appeared to maintain PTT at C5 (clavicle) on day 5, but sham stimulation decreased PTT (P = 0.007). In addition, anodal tDCS increased PTT compared with sham at day 5 at Th10 ventral dermatomes (P = 0.014). Both anodal and sham tDCS decreased the Brief Pain Inventory-short form total and interference scores, and the European Organization for Research and Treatment of Life Questionnaire-C30 fatigue score, but no interaction effect was observed. Conclusion: This study adds to the evidence in the literature that tDCS may be a potential therapeutic tool for the management of noncancer chronic pain.

Evaluation of a probiotic blend on psychosocial health and biomarkers of inflammatory, immune and stress response in adults with subthreshold depression: a double-blind, randomised, placebo-controlled trial.

This study examined the efficacy of a probiotic in reducing depressive symptom severity in people with subthreshold depression. In a double-blind, randomised, placebo-controlled trial, a probiotic (1 × 10^9 live cells per strain: Limosilactobacillus fermentum LF16 (DSM26956), Lacticaseibacillus rhamnosus LR06 (DSM21981), Lactiplantibacillus plantarum LP01 (LMG P-21021) and Bifidobacterium longum 04 (DSM23233)) or placebo was taken daily for 12 weeks. Data were collected at baseline, 6 and 12 weeks including psychological symptom severity (Beck Depression Inventory, BDI; Patient Health Questionnaire, PHQ; Hospital Anxiety Depression Scale, HADS; and Depression Anxiety and Stress Scale, DASS). Biomarkers of glycaemia, inflammation (high-sensitivity C-reactive protein, hs-CRP), antioxidant status (total glutathione (GSH)) and stress (cortisol awakening response, CAR) were also measured. Thirty-nine participants (nineteen probiotic;twenty placebo) were enrolled. There were no significant between-group differences in the examined psychological symptom severity scores, despite certain significant within-group changes observed in both groups from baseline to 6 and/or 12 weeks of follow-up. Regarding biomarkers, the probiotic group showed reduced hs-CRP (-1520; 95 % CI -273·7, -2766·2 ng/dl) and CAR (-0·28; 95 % CI -0·05, -0·51 μg/dl) at 12 weeks, but increased total GSH (3·9; 95 % CI 0·1, 7·5 ng/dl) at 6 weeks, compared with the placebo. The current study reported favourable decreases in depressive symptoms in both groups. Although the within-group changes observed in the probiotic group were supported by favourable inflammatory, antioxidant status and stress biomarker changes compared with the placebo, further research is required to shed more light on the role of gut microbiota modulation on emotional regulation.

Feasibility, acceptability, and initial outcomes of a psychological adjustment and reintegration program for transitioned military veterans

BackgroundReintegration and adjustment to civilian life after military service is crucial for veterans’ mental and physical health. However, there is a lack of evidence-based interventions in Australia that specifically address the psychological and cultural factors associated with improved adjustment and mental health in this group. The aim of this study was to evaluate the feasibility, acceptability, and initial outcomes of a novel group intervention program, developed to address this gap in supports and services for Australian veterans.MethodsA non-controlled, within-subjects longitudinal design was employed with a feasibility framework including assessment of demand, implementation, integration, experience, perceived effectiveness, and burden or discomfort. The program included eight weekly 2.5-hour group sessions using cognitive-behavioural and acceptance and commitment therapy techniques. Participants included 24 transitioned veterans who completed the Military-Civilian Adjustment and Reintegration Measure, Quality of Life Enjoyment and Satisfaction Questionnaire–Short Form, Depression Anxiety Stress Scale-21, and PTSD Checklist for DSM-5 at pre-intervention, post-intervention, and three-month follow-up.ResultsHigh participant ratings of engagement, experience and usefulness of the program were found, as well as perceived improvement in adjustment to civilian life as a result of the program. Sound program retention (82.8%), completion (87.5%), and manual adherence rates (89.6%) were also found. Significant improvements were found in adjustment and reintegration scores from pre-intervention to post-intervention (p = < 0.001) and from pre-intervention to follow-up (p = < 0.05), with large effect size (ηp2 = 0.344). All participants who completed the program reported they would recommend the program to another veteran.ConclusionThis study demonstrated the feasibility and acceptability of a novel group intervention program designed for military veterans in Australia. The program showed promising initial evidence of effectiveness in improving adjustment and reintegration to civilian life and provides an essential first step towards addressing a substantial gap in services for veterans struggling to adjust to civilian life. A randomised controlled trial may be an appropriate next step.ANZCTR registration numberACTRN12622000172707.Date of registration02/02/2022.Type of registrationRetrospectively registered.

Patterns of overeating in middle-aged Chinese from Hong Kong

Abstract Background Obesity is one of the most important risk factors for non-communicable diseases worldwide. Overweightness may be attributable to a wide spectrum of overeating behaviours. However, the various types of overeating behaviors are under-studied in Asia, particularly in non-adolescent age groups. This study aims to estimate the prevalence and factors associated with various overeating patterns among middle-aged Chinese adults. Methods A random telephone survey was conducted in 2023 on Hong Kong Chinese adults between 35 and 59 years or age (n = 785). An instrument composed of modified Positive-Negative Emotional Eating (EE) Scale, Night Eating Questionnaire-Chinese (NEQ), Binge Eating Disorder Screener (BED-7), Depression Anxiety and Stress Scales (DASS-21), demographic factors, BMI and number of reported gastrointestinal (GI) conditions was used. Multiple regression analyses were conducted to test the association of demographic factors, BMI, GI conditions as well as dysphoric mood with overeating behaviors. Results Hong Kong Chinese middle-aged adults reported the following past-month prevalence of overeating behaviors: positive EE (26.1%), general overeating (12.4%), negative EE (9.2%), binge eating (6.0%) and night eating behavior (1.8%). Nightshift work, mental stress, being single and younger age were common risk factors for the various overeating patterns among middle-aged men. Anxiety, high/low educational levels and younger age were common risk factors among middle-aged women. Obesity was associated with binge eating and positive EE in men (OR: 1.7-4.0) and associated with negative EE and general overeating (OR:2.3-2.7) in women. Conclusions This study noted that binge eating, night eating, positive/negative EE, and GOB were distinct eating patterns requiring different clinical approaches. The significant association between various overeating behaviors with BMI, indicates that these individuals should be prioritized to receive healthy eating interventions. Key messages • Adult overeating is not a singular behavior but represents an array of different eating patterns with different risk factors. • Like their Western counterparts, overeating behaviors in Chinese adults are often linked to dysphoric mood, therefore treatment of obesity may require psychological counseling.

Echocardiographic associates of impaired sleep quality in patients with anxiety and depression

Abstract Objective Sleep health, mental health and cardiovascular health are multidimensional constructs that are strongly associated with each other. Anxiety and depression are the most common psychiatric diseases in the community and frequently comorbid in routine clinical practice. This study sought to investigate whether there is an association between sleep quality and echocardiographic parameters in patients with anxiety and/or depression. Methods The clinical and instrumental find­ings of consecutive patients diagnosed with either of anxiety disorders and/or depressive disorders and underwent cardiac examination in our tertiary center on the same day were retrospectively reviewed. The diagnosis was made by a psychiatrist according to the criteria listed in the fifth edition of The Diagnostic and Statistical Manual of Mental Disorders. Afterwards, Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI) were applied to patients to assess symptom severity and sleep quality, respectively. Subsequent to psychiatric examination, the patients underwent echocardiographic examination that includes two-dimensional conventional echocardiography, tissue doppler imaging (TDI) echocardiography, atrial conduction times, and left atrium (LA) volumes and functions. Results The final study population consisted of 167 patients and divided into two groups according to their PSQI score: PSQI&amp;lt;5 (normal sleep quality) (n=32) and PSQI≥5 (impaired sleep quality) (n=135). Aortic diameter, left ventricular (LV) end-systolic diameter, LV end-diastolic and -systolic volume, LV stroke volume and LV stroke volume index, LV outflow tract velocity–time integral (LVOT-VTI), and LA conduit volume calculations were significantly lower in patients with impaired sleep quality compared to patients with normal sleep quality. The other echocardiographic parameters including LV systolic functions, doppler and TDI echocardiography indices, atrial conduction times, atrial mechanical functions including LA function index (LAFI) were similar among groups. Correlation analysis yielded a negative, weak but statistically significant correlation between LAFI and PSQI score (r=-0.17, p=.030) (Figure 1A). Left intra-AEMD positively and significantly correlated with PSQI score at a weak level (r=0.16, p=.043) (Figure 1B). Aortic diameter, LV stroke volume index, LVOT-VTI and conduit volume were determined as echocardiographic parameters significantly associated with impaired sleep quality in univariate analysis. Among these parameters, only conduit volume remained as significant and independent associate of impaired sleep quality in multivariate logistic regression analysis (Odds ratio:0.91, 95% Confidence interval:0.85-0.98, p=.018) (Table 1). Conclusion There is an independent association between LA conduit volume and impaired sleep quality in patients suffering from anxiety and/or depressive disorders.Figure 1Table 1

The Icehearts Europe Implementation Guide to promote a mentoring programme for youth mental health

Abstract Issue/problem In Europe, 9 million young people (10-19) suffer from mental disorders and 70% of children and adolescents with mental health problems do not receive appropriate interventions at a sufficiently early age. Moreover, during the Covid-19 pandemic a high prevalence of depressive symptoms, anxiety and sleep disorders was observed in the population aged 4-19 years. The Icehearts Europe project (funding: EU4Health 2022 Programme) aims to disseminate at EU level a long-term programme for supporting health and wellbeing of disadvantaged children and adolescents. It is inspired by the Finnish best practice Icehearts, a 12-year long mentoring programme. Five pilot countries (Italy, Denmark, Spain, Slovenia, Estonia) will test the model to raise European awareness of how it works and to get more countries and organisations involved. Description of the problem Icehearts Europe is a preventive mentoring programme based on team sports, recreation and school support activities, with a child-centred community approach. To facilitate its implementation, a practical guide has been developed for grassroots sport and social promotion organisations to help them implement the model in their own contexts. The guide is the result of both a multisectoral cooperation between grassroots sport, health, universities, NGOs, and qualitative study activities (bibliographic research, study visit, group work, analysis of the situation and needs of local contexts). Results From February 2024 the Icehearts Europe Implementation Guide is available in six languages at https://www.icehearts.eu/resources. It is now being adapted by the Icehearts Europe partners into an online training programme for managers. Lessons The guide has incorporated lessons learnt from the Finnish model, considered as an evidence-based approach. It contains several operational tools to implement Icehearts Europe and can be adopted using different approaches: there is no one-size-fits-all solution. Key messages • Developed as a support to the Icehearts Europe piloting partners and as a basis for a fully-fledged online training programme for future Icehearts Europe managers. • To facilitate the implementation of early interventions to promote health and wellbeing of children and adolescents and enable them to cope with disadvantaged conditions.

The Associations Between Intimate Partner Violence and Mental Health Outcomes Among Sexual Minority Men: A Systematic Review and Meta-Analysis.

Sexual minority men (SMM) experience intimate partner violence (IPV) at a substantially high rate and also bear high burdens of adverse mental health outcomes. This systematic review and meta-analysis aimed to consolidate existing evidence on the associations between experiencing IPV and adverse mental health outcomes (depressive symptoms, anxiety, stress, etc.) among SMM. Following the Preferred Reporting Items For Systematic Reviews and Meta-Analyses guideline, we identified 22 published studies encompassing data from 18,454 individuals, all of which were cross-sectional in design and half of which were conducted in the U.S. We found that experiencing IPV was associated with an increased risk of depressive symptoms and anxiety with a pooled Adjusted Odds Ratios (AORs) of 1.71 (95% CI [1.43, 2.05]) and 1.89 (95% CI [1.46, 2.43]), respective. Studies also found that IPV was positively associated with suicide-related risk (AOR = 2.71, 95% CI [2.21, 3.32] and perceived loneliness. Studies varied in their IPV measures and recall periods and used diverse mental health measurement tools like PHQ-9/GAD-7, Perceived Stress Scale, and the Suicide Behaviors Questionnaire-Revised. This systematic review and meta-analysis revealed an urgent need to examine the effects of IPV on SMM's mental well-being in low- and middle-income countries using standardized IPV measurement tools. Future research should employ a longitudinal design to track the long-term effects of IPV on the mental well-being of SMM and explore potential interventions for mitigating these impacts over time. These insights are crucial for enhancing IPV screening within healthcare settings and identifying key intervention targets aimed at improving the mental health of SMM.

Type 2 diabetes risk is associated with poorer general health and mental health in women and men

Abstract Background Increasing evidence points to a relation between cardiometabolic and mental health, but population-based data are scarce. We investigated the association of type 2 diabetes (T2D) risk to general and mental health with a focus on potential differences between women and men. Methods The study population comprised 5,192 adults (18+ years) without known diabetes based on data of the German Health Update (GEDA) 2022. T2D risk was assessed by the German Diabetes Risk Score (GDRS), that estimates the 5-year probability of developing T2D and was categorized into low, still low, elevated, and high risk. Sex-specific Poisson regression analyses were conducted including self-rated health (SRH), self-rated mental health (SRMH), depressive symptoms (PHQ-2) and anxiety symptoms (GAD-2) as dichotomous dependent variables and age, educational level, living alone, region of residence, and social support as covariables. Results Women had a higher prevalence of low T2D risk (66.1%) and a lower prevalence of high T2D risk (9.4 %) than men (55.3% vs. 16.3%). Compared to those with low T2D risk, women and men with a high T2D risk were less likely to report very good/good SRH (women: prevalence ratio: 0.63; 95% confidence interval: 0.51-0.79; men: 0.69; 0.57-0.84) or excellent/very good SRMH (women: 0.53, 0.39-0.73; men: 0.85, 0.63-1.15). Further, those with a high T2D risk had a higher risk of depressive symptoms (women: 1.71, 1.05-2.81; men: 2.23, 1.22-4.05) and anxiety symptoms (women: 1.84, 1.03-3.29; men: 2.73, 1.09-6.81). No statistically significant interactions between sex and T2D risk were observed regarding the included health outcomes. Conclusions A high T2D risk is associated with a lower probability of a favourable SRH and SRMH and a higher risk of depressive and anxiety symptoms in men and women. The underlying mechanisms need further identification, in order to design synergistically beneficial health promotion for cardiometabolic and mental health. Key messages • No sex-specific differences in general and mental health were found in people at high T2D risk. • Further research is needed to identify the underlying mechanism to improve general and mental health.

Food insecurity is associated with poor mental health and health risk behaviors in Czechia

Abstract Background Food insecurity (FI) is one of social determinants of health and a profound public health concern because it leads to malnutrition and hence poor health. COVID-19 impacted people disproportionately and exacerbated preexisting social and health inequalities. The aim of this study was to understand how socioeconomic and health conditions affected one’s FI in Czechia during the pandemic using a representative panel of Czech adults from a longitudinal survey, Life During the Pandemic collected in October 2022 as part of a Czech longitudinal survey. Methods A study sample of 1,499 respondents was included in our multiple logistic regression models. Depressive symptoms and anxiety symptoms were assessed using validated questionnaires PHQ-2 and DAG-2. Results Approximately one third of the study sample (32.4%) reported being food insecure. In the fully-adjusted model, adults with depressive symptoms (OR 2.37, CI 1.49, 5.02), problems with sleeping (OR 2.20, CI 1.64, 2.96), smoking habit (OR 2.27, CI 1.68, 3.07), lower fruit and vegetable consumption (OR 1.50, CI 1.04, 2.17) had greater odds of experiencing FI. The lowest income group was associated with 6.2 times greater odds of reporting FI as compared to the high-income group (CI 3.96, 9.67). Lower education attainment also had higher odds of experiencing FI (OR 2.15, CI 1.40, 3.31). Anxiety was not a significant predictor for FI. Conclusions Our study highlights that food insecurity is associated with depressive symptoms, poor quality of sleep and lower consumption of fruit and vegetables among adults. Food insecurity was also evident among lower income and lower education attainment. Funding source This study was supported by The Charles University Grant Agency (GA UK). Key messages • Our study suggests that adults with poor mental health and diet quality experience food insecurity. • Given the established link between a balanced diet and mental well-being, interventions should encompass not only food security but also the quality of dietary intake.

Exposure to firearm injury and suicide in a rural Pennsylvania county: implications for mental and behavioral health.

To evaluate the association between self-reported gun violence exposures and mental health and behavioral health indicators in a rural population. Using cross-sectional survey responses from 630 residents of a rural county in Pennsylvania, logistic regression models estimate the likelihood of residents indicating moderate or severe levels of health outcomes as a function of gun violence exposure. We control for a series of variables related to gun ownership, behavior, history with firearms and demographic characteristics. Personal firearm victimization was associated with self-reported depressive symptoms and interrupted sleep. Secondary exposure to firearm violence, particularly exposure to friends attempting or completing a suicide, was associated with higher odds of reporting severe levels (14days or more in the past month) of depressive symptoms, anxiety, and poor sleep. For firearm suicide involving a friend or family member, the odds of reporting severe levels of all three outcomes are 3 times greater (OR 2.984, 95% CI 1.457-6.108). For each additional firearm exposure, the odds of experiencing severe levels of mental health and sleep difficulties are 1.4 times greater (OR 1.384, 95% CI 1.115-1.720). Cumulative exposures also increase the odds of reporting binge drinking and drug use. Firearm violence exposure was associated with adverse health indicators in this rural population. Approaches to counter the effects of cumulative firearm exposure and firearm suicide exposure, including reinvigorating community spaces and strengthening social supports, may help to reduce mental health burden in rural communities.

Multidimensional assessment and analysis of the mental health of teachers and police officers

Abstract Background The years-long COVID-19 pandemic, the proximity of the Russian-Ukrainian war, high inflation, and the economic recession are significant stressors for the Hungarian people. Numerous domestic and international surveys are prepared every year, in which the most stressful professions are ranked. In recent years, based on Hungarian, American and European surveys, teachers and police officers have always been included in the 10 most stressful jobs. They also rank the most valued jobs and highest paid jobs every year. In this relation, police and teaching jobs never made it into the top 10, despite the fact that both professions are very important on a social level. Methods 20 male and 20 female teachers and police officers completed a complex quality of life and psychological assessment using international tests with ethics approval. We measured pain syndromes, such as headache, neck and back pain, joint pain, assessed depression, anxiety, sleep quality, and gastrointestinal symptoms. Results For police officers and teachers, gender differences were not verified with regard to any parameter. None of the parameters differed significantly for male police officers and teachers. Many significant differences were confirmed between female police officers and female teachers, in all of them the results of the teachers were worse: depression (9,4±10,3 vs 2,9±4,3; p = 0.02) anxiety(43,3±12,2 vs 33±4,6; p = 0.01), sleep disorders(32,7±8,2 vs 24,3±7,8; p = 0.01), gastrointestinal complaints(24,7±9,4 vs 17,6±2,3; p = 0.01). Conclusions The sleep quality, depression and anxiety levels of female teachers are worse than those of female police officers who live at least as stressful a life. There is no difference between the mental and psychological state of male teachers and police officers. It is important to pay attention to the mental support of female teachers. Key messages • We consider the assessment of the mental state of police officers and teachers and the creation of primary prevention programs and a mental support network to be an important public health task. • In particular, the mental state of female teachers should be monitored and supported.

The effects of Tai Chi and Baduanjin on breast cancer patients: systematic review and meta-analysis of randomized controlled trials

BackgroundTai Chi and Baduanjin are nonpharmacological interventions that are widely applied among cancer patients.ObjectiveThis meta-analysis aimed to assess the effect of Tai Chi and Baduanjin on breast cancer patients by summarizing and pooling the results of previous studies.MethodsThe PubMed, Embase, Web of Science, Scopus and Cochrane Library and several databases were searched up to December 1, 2023, to identify high-quality RCTs. Relevant terms such as Tai Chi and Baduanjin were used as keywords. Stata 15.0 software and Review Manager (version 5.3; Cochrane Training) were used to screen the studies, extract the data, code the data, and perform the meta-analysis. The mean differences (MDs) and standardized mean differences (SMDs) with 95% CIs were used to calculate continuous variables. The Cochrane risk of bias assessment tool was used to evaluate the risk of bias. The PICOS framework was used to develop the following eligibility criteria: (i) population - breast cancer patients; (ii) intervention - Tai Chi and Baduanjin intervention; (iii) comparison - Tai Chi and Baduanjin group and different intervention (e.g., regular intervention, routine rehabilitation training, waiting list, sham Qigong, usual care, no intervention); (iv) outcomes - cognitive ability, shoulder joint function, anxiety, depression, fatigue, sleep quality, quality of life; and (v) study design - randomized controlled trial.ResultsFrom January 2013 to December 2023, we included a total of 16 RCTs involving 1247 patients. A total of 647 patients were in the experimental group and were treated with Tai Chi and Baduanjin, while 600 patients were in the control group and were treated with traditional methods. The results of our meta-analysis indicate that Tai Chi and Baduanjin yield outcomes that are comparable to those of traditional treatment methods. Specifically, Tai Chi and Baduanjin significantly increased cognitive function, increased shoulder joint function, improved sleep quality indicators and improved quality of life indicators. Furthermore, Tai Chi and Baduanjin significantly reduced anxiety symptoms, depression symptoms, and fatigue symptoms among breast cancer patients. Sensitivity analysis was performed, a funnel plot was constructed. No publication bias was indicated by Egger’s or Begg’s test.ConclusionOverall, Tai Chi and Baduanjin are viable and effective nonpharmacological approaches for treating breast cancer patients, as they yield better results than traditional treatment methods. However, these findings should be interpreted with caution due to the limited number of controlled trials, small sample sizes, and low quality of the evidence.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023469301.

Effectiveness of Mindfulness Therapy as a Complement to Pharmacological Treatment in the Control of Blood Pressure in Hypertensive Adults: A Quasi-Experimental Study in Lima, Peru.

To evaluate the effectiveness of mindfulness therapy as an adjunct to pharmacological treatment for improving blood pressure (BP) control in hypertensive adult patients at a health center in Lima, Peru. This study employed a quasi-experimental design with a quantitative and longitudinal cohort approach. The participants included 50 adults who were diagnosed with hypertension and who regularly attended the health center in the Villa El Salvador district of Lima, Peru. The data were collected using three instruments: the Depression Anxiety Stress Scale (DASS 21), validated in Peru; a sociodemographic questionnaire; and a BP recording sheet. The Wilcoxon test was utilized to assess the effectiveness of mindfulness therapy on BP control, while the nonparametric Friedman test was used to evaluate the effectiveness of mindfulness therapy considering confounding factors. Therapy resulted in favorable outcomes for BP control. After eight sessions, the average systolic BP decreased from 122.8 to 115.0mm Hg (a reduction of 7%), and the average diastolic BP decreased from 78.1 to 69.9mm Hg (a reduction of 11%). Mindfulness is an effective complementary therapy for controlling BP in hypertensive adults. It also helps reduce confounding factors such as stress, anxiety, and depression.

Postoperative complications and symptoms of anxiety and depression in patients with gastric and esophageal cancer: a retrospective cohort study

ABSTRACT Context. Gastric and oesophageal cancers are common. They are also expected to increase in incidence in the next few years and are characterized by poor prognosis. Surprisingly, whereas the incidence of severe anxiety and depression is high in patients with gastric and oesophageal cancers, the influence of symptoms of depression and anxiety on postoperative complications has barely been explored. Methods. In a retrospective study based on a prospectively collected database, 629 cancer patients were enrolled. Symptoms of depression and anxiety (Hospital Anxiety and Depression Scale scores) and sociodemographic and medical information were collected immediately after diagnosis and before any treatment. The surgical approach (i.e. gastrectomy or oesophagectomy) and postoperative complications according to the Clavien–Dindo classification were collected after surgery. Results. After controlling for known medical predictors (i.e. surgical strategy, alcohol and tobacco consumption, American Society of Anaesthesiologists classification physical status score) of postoperative complications, no effect of symptoms of depression or anxiety was detected. Discussion. The observed results are surprising given the literature. However, several potential arguments can be put forwards regarding methods and measures, controlling variables, and conceptual distinctions. Despite the absence of significant results, this topic should be more deeply investigated by applying methodological and conceptual adjustments.

How Can the Coping Strategies Mediate the Relationship Among COVID-19 Stress, Depression, and Anxiety?

The coronavirus disease-2019 (COVID-19) pandemic has had a severe impact on mental health. To explore the underlying mechanisms that influence mental health, a critical question is whether different types of coping strategies may mediate the relationships between COVID-19 related stress and mental health. Recruited between October 19 and 24, 2021, a total of 500 participants aged 20 to 69 years completed an online survey to evaluate the COVID-19 stress, coping orientation, depression and state anxiety. The period corresponded to the highest level of COVID-19 restrictions (level 4) immediately before the adjusted restriction to level 3. Parallel mediation analyses were conducted using structural equation modeling. Distinct mediation effects of the COVID-19 stress (i.e., fear of infection, difficulties of social distancing, anger toward others) through three types of coping strategies (i.e., functional, dysfunctional, seeking support) were found. Fear of infection was likely to be related to functional coping and dysfunctional coping. Social distancing model indicated dysfunctional coping and seeking support, while anger toward others model was associated with functional coping and seeking support. The results highlight the different relationships between COVID-19 stress and mental health coping strategies. The identification of these mediation pathways offers guidance for designing effective interventions and support systems to promote psychological well-being during challenging times like the COVID-19 pandemic.

Association Between Diet and Mental Health Outcomes in a Sample of 13,887 Adolescents in Canada.

The high prevalence of mental disorders among adolescents calls for community-based and population-level prevention strategies. Diet is an important intervention target for primary prevention of mental disorders among adolescents. We used data from a large longitudinal study of Canadian adolescents (aged 14-18 y) to examine prospective associations between diet and mental health outcomes. We estimated the effect of diet (ie, consumption of vegetables and fruit and sugar-sweetened beverages [SSBs]) at baseline on depressive symptoms, anxiety symptoms, and psychological well-being (measured by the Center for Epidemiologic Studies Depression Scale-Revised, Generalized Anxiety Disorder 7 scale, and Flourishing Scale, respectively) and at 1-year follow-up in a sample of 13,887 Canadian secondary school students who participated in the 2017-2018 and 2018-2019 cycles of the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary (COMPASS) behavior study. We applied linear mixed-effects methods informed by a directed acyclic graph. Sensitivity analyses assessed the robustness of the effect estimates to unmeasured confounding variables. Baseline SSB consumption was associated with greater severity of depressive (β = 0.04; 95% CI, 0.01-0.06) and anxiety (β = 0.02; 95% CI, 0-0.05) symptoms, particularly among male students, and poorer psychological well-being (β = -0.03; 95% CI, -0.05 to -0.01) at follow-up. Baseline vegetables and fruit consumption was positively associated with psychological well-being (β = 0.06; 95% CI, 0.03-0.10) but not other mental health outcomes at follow-up. Our results support the notion that diet should be part of comprehensive mental health prevention and promotion interventions to reduce the prevalence of mental health disorders among adolescents.

A novel approach to ADHD classification based on severity and emotional impairment: Findings from artificial intelligence analysis

Attention Deficit Hyperactivity Disorder (ADHD) is a disorder characterized by symptoms of inattention and executive dysfunction, although there is not always agreement on the onset, course and long-term stability of the diagnosis. This study aims to detect differences in the cognitive profile according to the subtype of ADHD following a professional diagnosis and to propose an alternative classification. The scores obtained for each cognitive construct were compared using the Student’s t-test. In order to explore different diagnostic categories based on groupings made by Artificial Intelligence (AI) subjects were grouped based on their performance through the K-means clustering technique. The results obtained by Artificial Intelligence (AI) identified groups based on the severity of the cognitive profile and the presence of emotional impairment. Difficulties in perceived planning within family and school environments were highlighted as major risk factors in the severity of ADHD in children. Emotional disturbances perceived by both parents, such as depressive symptoms, anxiety, and somatization, were observed subsequently. In accordance with the results, an alternative way to classify ADHD is possible, involving categorization according to the presence or absence of emotional impairment, along with the severity of impairment in attentional and executive functions.

Do treatment responders maintain their gains following a randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder?

ABSTRACT To examine the maintenance effects of acceptance-based behavior therapy (ABBT) and applied relaxation (AR) for generalized anxiety disorder (GAD) 46 adults (69.6% female, 82.6% White) with high end-state functioning following an RCT comparing ABBT to AR were re-assessed at 12- and 24-month follow-up. End-state functioning was based on post-treatment scores within one standard deviation of the mean on three of five outcome measures [Clinician Severity Rating (CSR), Hamilton Anxiety, Penn State Worry Questionnaire (PSWQ), Depression Anxiety Stress Scale stress subscale (DASS-Stress), and State-Trait Anxiety Inventory (STAI)]. At 12 months, 93.8% of high endstate responders in ABBT and 95.5% in AR had maintained gains. At 24 months, 71.4% of responders from ABBT and 83.3% from AR maintained gains. Mixed-effects regression models revealed a significant effect for Time and Condition for DASS-Stress but not for Condition X Time. There was also a significant time effect for PSWQ, indicating PSWQ and DASS-Stress scores increased across follow-up. The rate of increase did not differ across conditions. Non-significant, small effects were found for all other outcomes indicating that symptoms did not significantly change across follow-up regardless of condition. While the results are limited by dropout rates, clients receiving ABBT or AR appear to maintain gains over long-term follow-up.

Drug utilization study of antidepressant drugs in psychiatric outdoor patients at a tertiary care hospital in Southern Rajasthan

Background: The World Health Organization (WHO) defines “Drug Utilization” as the marketing, distribution, prescription, and use of drugs in a society, with special emphasis on the resulting medical, social, and economic consequences. Antidepressants are used to treat depressive illnesses and anxiety disorders. However, these are also employed in the pharmacotherapy of several psychiatric disorders. Very few studies were found regarding the pattern of prescription of antidepressants in outdoor patients in southern Rajasthan. So, this study has been planned to learn about the prescription pattern of antidepressant drugs as per WHO Core Drugs Prescribing indicators at a tertiary care hospital in southern Rajasthan. Methods: A cross-sectional observational study was conducted among 375 patients by convenient sampling over one year duration, in the outdoor Department of Psychiatry at RNT Medical College, Udaipur, Rajasthan. Patient’s prescriptions were analyzed for drug utilisation pattern in OPD after relevant consent. All data was compiled in MS Excel and analyzed using statistical methods. Results: Out of 375 prescriptions analyzed, 48.8% were males and 51.2% were females. Most commonly, patients had a diagnosis of depressive disorder (42.93%), followed by bipolar affective disorder (14.4%). The most common drug class prescribed was SSRI (88.86%). Escitalopram (41.65%) was the most prescribed drug, followed by Sertraline (30.51%). Conclusions: Among the prescribed antidepressants SSRIs were the most common class of drug followed by TCA. Escitalopram was the most common drug to be prescribed followed by sertraline. More than half of the patients receiving antidepressants suffered from non-depressive disorders. Monotherapy was preferred over combination therapy. All patients were prescribed generic drugs.