Anxiety Disorder Patients Research Articles

Use of Quetiapine as a Coadjuvant to Benzodiazepines in General Anxiety Disorder in Patients Aged Over 20 Years at Hospital Naval Guayaquil

Generalized anxiety disorder is the most prevalent mental disorder worldwide. The use of quetiapine + benzodiazepines has been shown to reduce symptoms in patients with generalized anxiety disorder who do not respond adequately to the exclusive use of benzodiazepines. Despite the benefits shown in Ecuador, there are no published studies about its effectiveness. This is a prevalent, retrospective, cross-sectional, descriptive, and analytical study carried out at the Hospital Naval de Guayaquil, in patients aged over 20 years diagnosed with generalized anxiety disorder and had undergone treatment with quetiapine, benzodiazepines, or both during the years 2017–2020. The average age of diagnosis of generalized anxiety disorder is 45.12 years. It prevails in married male patients diagnosed at 39.95 years. Benzodiazepine is the drug that produces clinical improvement in 38% of patients. However, it does not present great variation before quetiapine + benzodiazepine, which produced an improvement in 27% of patients. The treatment time according to the type of drug used is shorter with quetiapine, lasting 4.32 months. However, the Kruskal-Wallis test established that the treatment time is shorter using the combination of quetiapine as a coadjuvant to benzodiazepine with a significance of >0.05. The improvement of the sleep disorder stood out with the use of benzodiazepine in 38.57%. The benzodiazepine produces clinical improvement in 38% and in turn improves the sleep disorder in 38.57%. The use of quetiapine as a coadjuvant to benzodiazepines decreases the treatment time.
 Keywords: Ecuador, anxiety disorder, benzodiazepines, quetiapine.
 Resumen
 El trastorno de ansiedad generalizada es el desorden mental más prevalente a nivel mundial. El uso de quetiapina + benzodiacepinas, ha demostrado disminuir la sintomatología en pacientes sin mejoría con el uso exclusivo de benzodiacepinas. Sin embargo, pese al beneficio demostrado en Ecuador, no existen estudios publicados sobre su efectividad. Materiales y métodos. Estudio de prevalencia, retrospectivo, transversal, descriptivo y analítico realizado en el Hospital Naval de Guayaquil, en pacientes mayores de 20 años que acudieron con diagnóstico de trastorno de ansiedad generalizada y que fueron sometidos a tratamiento con quetiapina , benzodiacepinas o ambas durante los años 2017-2020. Resultados. El trastorno de ansiedad generalizada se diagnostica a la edad promedio 45,12 años. Prevalece en los pacientes casados de sexo masculino diagnosticados a los 39,95 años. La benzodiacepina es el fármaco que produce mejoría clínica en un 38% de los pacientes. Sin embargo, no presenta gran variación ante la quetiapina + benzodiacepina que produjo la mejoría de 27% de los pacientes. El tiempo de tratamiento de acuerdo al tipo de fármaco utilizado es menor con quetiapina durando 4,32 meses. Sin embargo, el test de Kruskal-Wallis estableció que el tiempo de tratamiento es menor utilizando la combinacion de quetiapina mas benzodiacepina con una significacia menor que 0.05. La mejoría del trastorno del sueño destacó con el uso de benzodiacepina en 38,57%. Conclusión. La benzodiacepina produce mejoría clínica en un 38%, mejorando además el trastorno del sueño en un 38,57%. El uso de quetiapina más benzodiacepina disminye el tiempo de tratamiento.
 Palabras Clave: Ecuador,trastorno de ansiedad, benzodiacepinas, quetiapina.

Network pharmacology analysis of a patented Chinese herbal medicine for alleviating anxiety disorder in in vitro fertilization-embryo transfer

ObjectiveQu's formula 3 (QUF3) is a patented Chinese herbal medicine used to alleviate anxiety disorders during in vitro fertilization-embryo transfer (IVF-ET). This study aimed to identify the potential active constituents and molecular mechanisms of action of QUF3 in alleviating anxiety disorders during IVF-ET. MethodsThe active constituents of QUF3 were identified from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform and literatures. Potential targets of anxiety disorder and IVF-ET were identified using GeneCards, Online Mendelian Inheritance in Man, and the UniProt Database. Protein-protein interaction (PPI) network, gene ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed to identify the potential mechanisms. Molecular docking and molecular dynamics (MD) simulations were performed to visualize and verify the results. ResultsQuercetin, sophoranol, luteolin, kaempferol, and neurotoxin inhibitors were identified as the TOP 5 active constituents of QUF3. Forty common targets were shared among QUF3, anxiety disorders, and IVF-ET. Tumour necrosis factor, interleukin-6, vascular endothelial growth factor A, epidermal growth factor, interleukin-1B, cellular tumour antigen p53, matrix metalloproteinase-9, and oestrogen receptor were identified as the TOP 8 potential targets through PPI analysis. A total of 697 biological processes, 20 cellular components, and 54 molecular functions were identified. Further, 91 KEGG pathways were revealed to be enriched. The TOP 5 active constituents were verified to have good binding activity with the TOP 8 potential targets using molecular docking and MD simulations. ConclusionsThe mechanism of QUF3 in alleviating anxiety disorders in patients undergoing IVF-ET may be related to the interleukin-17 and tumour necrosis factor signalling pathways, inhibiting inflammatory responses and antioxidants, which may provide a solid foundation for the clinical application and further study of QUF3.

Применение препарата Ньюрексан® в лечении тревожных расстройств у мультиморбидных пациентов. Резолюция Совета экспертов (27 октября 2023 г.)

Stress disorders are a global public health problem, having a significant impact on patients and society. Chronic stress can lead to long-term consequences, including mental and physical illness. The body's first response to acute stress is characterized by the appearance of anxiety, but beyond a certain level, anxiety becomes maladaptive. Anxiety worsens the quality of life and adaptation of patients, complicates the course of comorbid pathology and its diagnosis. In the review anxiety disorders in patients with multiple sclerosis, Parkinson's disease, and chronic pain syndromes discussed. A significant deterioration in the course and prognosis of the neurological disease in combination with anxiety disorders in multimorbid patients has been shown. Treatment of anxiety includes psychotherapy, the use of antidepressants, and short courses of benzodiazepines. Neurexan® as the safe and effective drug that does not interact with other drugs and has a favorable tolerability profile can be recommended to patients with multimorbid pathologies to correct emotional disorders, reduce anxiety and improve sleep.

Асоціація поліморфізму Т102C (rs6313) гена рецептора серотоніну HTR2A з розвитком тривожних, депресивних розладів у дітей з органічними та функціональними респіраторними патологіями

Purpose - to establish the relationship between the polymorphism T102C (rs6313) of the HTR2A serotonin receptor gene and the risk of developing somatoform and comorbid anxiety and depressive disorders in children with respiratory pathologies. Materials and methods. The study involved 90 patients, whose average age was 11.6±3.3 years (M±σ), of whom 63.3% were boys (n=57) and 36.7% were girls (n=33). The patients were divided into three groups of 30 (33.3%) people in each: with bronchial asthma (BA), with pneumonia, and with somatoform autonomic dysfunction of the respiratory system (SАDRS). Also, 30 healthy children of the control group were examined. The Children’s depression inventory M. Kovacs (1992), questionnaire was used to detect depression, and the Spielberger-Hanin test-questionnaire was used to study anxiety. In all children, serotonin and gamma aminobutyric acid concentrations in blood serum were determined by the ELISA method. Genetic studies were carried out with the determination of the T102C (rs6313) serotonin receptor 5-HTR2A genetic polymorphism by polymerase chain reaction. Statistical analyses were performed to determine the absolute and attributable risk, odds ratio (OR) and relative risk, and the potential harm index. The significance of differences was assessed using the two-sample Student’s t-test and the construction of a 95% confidence interval (CI) for the difference in means, as well as Fisher’s exact test, χ2 with Yates’ correction, and Pearson's coefficient. Values with p<0.05 were considered significant. Results. In general, sick carriers of the T/T allele have the highest level of personal anxiety of 46.9±8.9 points, reaching the lowest level in sick carriers of the C/C allele of 41.6±8.5 points (95% CI: 0.13-10.47; p˂0.045). The highest level of personal anxiety was also observed in patients carrying the T/T allele with SАDRS (52.3±6.3 points), reaching the lowest level in patients carrying the C/C allele - 44.8±7.7 points (95% CI: 0.26-14.7; p˂0.05). The presence of the T/T allele increases, on average, the incidence of anxiety disorders in patients with SАDRS by 41.7±16.0%, while the OR is 7.00 (95% CI: 1.38-35.47) and anxiety disorders and SАDRS in patients with BA by 44.2±16.0%, while the OR is 8.10 (95% CI: 1.61-40.76). In general, the level of serotonin in patients with respiratory pathologies with the presence of the T/T allele was lower compared to the presence of the C/C allele (95% CI: 0.084-0.656 μmol; p˂0.012). Conclusions. The presence of the T/T polymorphism is a predictor of the development of SАDRS and anxiety disorders in children (p=0.021) and increases the incidence of SАDRS and anxiety disorders in patients with BA (p=0.010), probably due to disruption of serotonin metabolism. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Retinal changes in generalized anxiety disorder patients.

Optical coherence tomography (OCT) is a method that allows high-resolution cross-sectional imaging of biological tissues. It was suggested that changes in the cranial structure or functions would be reflected in the retina. OCT has been an important method in the diagnosis and follow-up of diseases via morphometric or quantitative retinal measurements. Free radicals, inflammatory processes, and neurotransmission disorders play a role in the etiology of generalized anxiety disorder (GAD). The study aimed to demonstrate the retinal changes in GAD patients due to neurodegeneration based on the comparison of the OCT data of the GAD patients and controls, and the differences between OCT findings of GAD patients and those of controls. The study group included 21 GAD patients. The control group included 21 individuals without any known psychiatric or organic disease, including eye diseases. There was a statistically significant difference between the macular volumes (MV) of the GAD and control groups, the macular volume was lower in the GAD group. There were positive correlations between BDI scores and MV, GCLT, RNFLT-i, RNFLT-n, between BAE scores and (RNFLT-n), and between the CGI severity scale scores and MV, RNFLT-n, and RNFLT-t. OCT analysis of the GAD patients demonstrated that MV values were lower when compared to the control group. Patients with GAD should be screened for these retinal changes. OCT, a simple, non-invasive, and relatively inexpensive method could be employed as a supplementary method in the follow-up of GAD patients.

The Impact of the COVID-19 Pandemic on the Assessment of Healthcare and Anxiety Disorders in Patients with Chronic Diseases.

(1) Background: We compared the impact of the COVID-19 pandemic on the functioning and mental health of chronically ill patients, namely those with hemodialysis (HD) and diabetes (DM). (2) Methods: We used a questionnaire to collect the medical data and the Generalized Anxiety Questionnaire (GAD-7) to measure the mood status. (3) Results: In both groups, a similar percentage of patients had a past COVID-19 infection and similar opinions about pandemic-related inconveniences. The most significant limitations of the study included mask wearing and the restriction of social contact. Mental disorders were significantly more frequently reported in the DM group. Sleep problems were found in approximately 30% of patients. Approximately 20% of patients in both groups declared that the pandemic had negatively affected the quality of their sleep. The mean score of the GAD-7 scale in the HD group did not differ according to gender. In the group of DM patients, a significant difference was observed between men and women, with women scoring higher compared to men. In both groups, the percentage of patients with GAD-7 scores > 5, > 10 and > 15 did not differ significantly. (4) Conclusions: In both groups, chronically ill patients reported anxiety disorders with similar frequency. In the DM group, more severe anxiety disorders were found in women. Mental disorders were significantly more prevalent in DM patients. It seems that HD patients coped better with the psychological aspects of pandemic-related stress and limitations.

Anxiety in subjects with cardiovascular disease: Current diagnostic strategies and therapeutic options. A review

Anxiety and anxiety disorders are important modifiable risk factors for cardiovascular and other common chronic non-communicable diseases and complications. Anxiety disorders significantly reduce the motivation and adherence of patients to lifestyle changes and drug therapy, significantly worsen the quality of life, and increase the risk of disability and the costs of the health care system. The issues of diagnosis and therapy of anxiety are relevant for the practice of physicians and cardiologists due to the high incidence of anxiety disorders in patients with cardiovascular diseases, a decrease in the quality of life and an increase in adverse outcomes, and also due to the insufficient awareness of the risks associated with the psycho-emotional state of patients. Therapy of anxiety disorders includes both drug and non-drug methods. The first-line drugs in treating most anxiety disorders are selective serotonin reuptake inhibitors or selective serotonin-norepinephrine reuptake inhibitors. The risk of possible side effects of these agents in patients with cardiovascular diseases should be considered. Sedative and anti-anxiety drugs, including non-benzodiazepine tranquilizers, are more commonly used. The most studied drug from this class in therapeutic and cardiological practice is fabomotizole. The efficacy and safety of fabomotizole, including long-term use, have been studied in numerous studies in patients with cardiovascular diseases and a wide range of anxiety disorders.

Digital mental health interventions for anxiety and mood disorders patients: A 24-week follow-up

BackgroundDigital psychoeducational interventions have been used for self-monitoring symptoms and self-care for outpatients with affective and anxiety disorders associated with a history of adverse childhood experiences (ACEs). Outpatients with affective and anxiety disorders were recruited for digital mental health interventions (smartphone app and e-book) with treatment as usual. MethodsParticipants were evaluated at baseline and at 24-week follow-up with digital mental health interventions. Participants were assessed by questionnaire and scales (the 17-item Hamilton Depressive Rating Scale (HDRS17), Hamilton Anxiety Rating Scale (HAM-A), Adverse Childhood Questionnaire, Sheehan Disability Scale, Quality of Life, Perceived StressScale, and by anthropometric measures. Results153 participants were classified into two groups: (n = 110) participants reported having experienced at least three ACEs (<4ACEs) and (n = 43) reported having experienced four or more (≥4ACEs). At baseline, the ≥ 4ACEs group presented significantly more unstable relationship, lower quality of life, more functional impairment, more perceived stress, higher HAM-A and HDRS17 scores than < 4ACEs group. After 24 weeks, digital psychoeducational interventions improved the practice of physical activity in both groups. Digital technologies improved severity of depressive symptoms in the < 4ACEs group and decreased functional impairment in the ≥ 4ACEs group. Higher scores on HAM-A were associated with more ACEs, HDRS17 > 7 and lack of physical activities. ConclusionThese findings highlight the importance of screening for ACEs to use digital psychoeducational interventions for reducing depressive symptoms and improving physical activities in outpatients with mood and anxiety disorders.

Intervention effect of community humanistic management combined with psychological education on community anxiety disorder patients

BackgroundAnxiety disorder, also known as anxiety neurosis, is a neurological disorder caused by anxiety, such as fear, insomnia, and anxiety. This study explores the intervention and management effects of community humanistic management combined with psychological education on patients with depression and anxiety disorder.Subjects and MethodsBased on 84 patients with anxiety disorder, there were 42 males and 42 females, and both groups of patients took the same anti-anxiety medication. The control group of patients received psychological education intervention. Two groups of patients were scored using the Self-Rating Anxiety Scale before and after intervention. The Self-Rating Anxiety Scale includes 20 items, and the symptom situation was evaluated using a 4-level scoring method. The higher the score, the more severe the anxiety situation. The results were tested using SPSS24.0 statistical software.ResultsThe difference in results was statistically significant (P&lt;0.05). The scores of the two groups of patients before and after intervention were significantly lower than those before the intervention, and the scores of the observation group after intervention were significantly better than those of the control group. The difference between the two groups was statistically significant. A comparison of trust and satisfaction in nursing between the two groups of patients showed that the intervention group had significantly higher trust and satisfaction in nursing quality than the control group.ConclusionsBy combining community humanistic management with psychological education, experience, and reference are provided for the innovation of management models for social anxiety disorder patients. Community psychological intervention has improved the depression and anxiety symptoms of anxiety disorder patients and improved their quality of life.

Online social support based on the digital economy on anxiety disorder patients

BackgroundWith the development of the digital economy and the increasing popularity of internet technology, online social support as a new type of mental health intervention has gradually received attention. At the same time, the rapid development of society has led to a large number of people suffering from anxiety disorders. Given this, this study proposes to analyze the intervention effect of online social support based on the digital economy on anxiety disorder patients.Subjects and Methods200 patients diagnosed with anxiety disorder were randomly divided into an experimental group and a control group, with 100 patients in each group. The experimental group received online social support intervention for three months, while the control group maintained routine treatment. Evaluate the anxiety level of patients using the Self-Rating Anxiety Scale (SAS) and compare the changes before and after intervention between the two groups. The data was processed using SASV9.4 statistical software.ResultsAfter the experiment, compared with the control group, the anxiety level of the experimental group patients was significantly reduced (P&lt;0.05). Meanwhile, over 70% of patients in the experimental group expressed that online social support helped them better understand their emotions and gain connections with others.ConclusionsOnline social support based on the digital economy has significant benefits for patients with anxiety disorders, not only reducing their anxiety levels, but also enhancing their social connectivity and psychological resilience. It is recommended to incorporate online social support as an effective means of future mental health interventions.AcknowledgementThe Special Fund for Key Fields in Guangdong Province (2021ZDZX3013).

Cultural heritage-based creative design on social anxiety disorder patients’ mental health

Background Social anxiety disorder is a psychological disorder that refers to excessive nervousness, fear, and fear of being judged or shamed by others in social situations. Although traditional psychotherapy methods are effective, their effectiveness is not good. Intangible cultural heritage elements cultural design uses traditional cultural elements to create unique products and experiences, which can provide a bridge for patients to communicate with others.Subjects and Methods100 patients with social anxiety disorder were randomly assigned to the experimental and control groups. The experimental group received the intangible cultural design intervention, while the control group received conventional psychotherapy. The mental health status of the subjects was assessed by Stanford Acute Stress Response Questionnaire (SASRQ) and 3-Minute Delirium Diagnosis Scale (3D-CAM) scale scores before and after the intervention.Results The results showed that the social anxiety of the experimental group was significantly reduced and the mental health status was significantly improved after the intervention, while the intervention effect of the control group was relatively limited. It shows that intangible cultural and creative design has a positive impact on the mental health of patients with social anxiety disorder.ConclusionsThrough the cultural and creative design of intangible cultural heritage elements, patients can reduce anxiety by creating and appreciating works. At the same time, patients can understand and experience traditional culture to enhance their cultural identity and self-esteem. In addition, patients can share work and exchange creative experiences with others to improve social skills. This method provides a new approach to the psychological treatment of patients with social anxiety disorder.

The positive impact of ideological and political concepts in curriculum on anxiety disorder among college students

BackgroundAnxiety neurosis is a common type of neurosis characterized by anxiety. Genetic, biological, and psychological factors can all lead to the occurrence of anxiety disorder. In order to improve the treatment effect of anxiety disorder, the study integrates the educational concept of curriculum ideological and political education into the classroom education of college students, analyzes the positive impact of curriculum ideological and political education on the group of college anxiety disorder patients, and provides more treatment interventions for the treatment of anxiety disorder.Subjects and Methods160 college students with anxiety disorders were selected as experimental research subjects. The experimental group received psychological education on ideological and political concepts in the curriculum, while the control group received psychological education on traditional teaching concepts. The Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Symptom Checklist 90 (SCL90), and Self-Acceptance Questionnaire (SAQ) were used for evaluation.ResultsThe teaching integration of ideological and political courses has a positive impact on alleviating the anxiety and depression of college students (P&lt;0.05), and can effectively improve the patient’s self-acceptance level (P&lt;0.05). Compared with the control group, the effect on anxiety is more significant (P&lt;0.05).ConclusionsFrom the perspective of educational psychology, the integration of teaching and curriculum ideological and political education has a positive impact on the intervention of anxiety disorder in college students, and all scales have higher scores than the control group.

Emotionally focused therapy and psychological distance research on consumers with social anxiety disorder

BackgroundSocial anxiety disorder is characterized by avoidance of interpersonal relationships and a generalized impairment of emotion recognition and regulation. Protecting the individual’s consumer rights can be difficult when this emotion is expressed in consumer relationships. Compared with other therapies, Emotionally Focused Therapy focuses more on the individual’s emotional processing. Therefore, the study proposes to use emotion-focused therapy and psychological distance theory to intervene in patients with social anxiety disorder and help them better control their emotional management.Subjects and Methods Consumers with social anxiety disorder were selected as research subjects and randomly divided into an experimental group (conventional psychological intervention) and a control group (emotion-focused therapy combined with psychological distance-related theory), respectively, to provide reasonable guidance for individual emotions. Before and after the experiment, the results were analyzed with the help of the Social Anxiety Subscale of the Self-Consciousness Scale and SPSS23.0.ResultsAfter the experimental intervention, it was found that there was a statistically significant difference between the social anxiety scale scores of the two groups of patients (P&lt;0.05), and the total scale scores of the experimental group and the control group were (12.34 ± 4.28) and (18.17 ± 2.13), respectively.Conclusions Emotional aggregation therapy can better enable social anxiety disorder patients to focus more on their own emotions, and psychological distance theory research can invariably draw closer to the degree of closeness between the intervener and the interviewees so that the efficacy of the treatment has a high degree of applicability and effectiveness.

Intervention of innovative reform in medical education on students’ anxiety disorders

BackgroundGeneralized Anxiety Disorder (GAD) is a common mental illness among adolescents, characterized by generalized and persistent anxiety, lack of clear targets, nervousness, and even involvement of the respiratory and digestive systems. Cognitive behavioral therapy has an improvement effect on anxiety disorders. This research was conducted to provide treatment interventions for students with anxiety disorders.Subjects and MethodsFirstly, 90 adolescent anxiety disorder patients aged 13-22 from a certain hospital were selected. Next, they were randomly divided into a control group and an observation group. The control group received routine drug treatment, while the observation group received cognitive behavioral therapy on this basis. The final treatment period was 16 weeks, with a round of treatment every 8 weeks. Statistical software SPSS23.0 was used for statistical description, and t-tests were used for measurement data.ResultsAfter a round of 8-week treatment, there was no statistically significant difference in the anxiety symptom scale scores between the two groups (P&gt;0.05). After the second round, the Hamilton Anxiety Scale scores of the observation group were significantly lower than those of the control group (P&lt;0.05); The difference in stress status scores at different times was significantly lower in the observation group than in the control group after the start of the second round (P&lt;0.05). In short, cognitive behavioral therapy has a relieving effect on students’ anxiety disorders.ConclusionsDrug therapy is mostly targeted at adult patients. However for adolescent patients, it is necessary to gradually combine cognitive behavioral therapy to promote the relief of anxiety disorders in students.

Augmenting the efficacy of benzodiazepine taper with telehealth-delivered cognitive behavioral therapy for anxiety disorders in patients using prescription opioids: A pilot randomized controlled trial

The risks of concomitant benzodiazepine (BZ) and opioid use are significant. Despite the urgent need to reduce BZ use among patients taking opioids, no treatment intervention research to our knowledge has addressed treatment for this concurrent, high-risk use. The current study will evaluate the efficacy of augmenting BZ taper procedures with CBT for anxiety disorders that has been adapted specifically for patients with concomitant BZ and opioid use (either use as prescribed or misuse), a high-risk patient population. Research combining rapidly scalable behavioral interventions ancillary to pharmacological approaches delivered via telehealth in primary care settings is innovative and important given concerning trends in rising prevalence of BZ/opioid co-prescription, BZ-associated overdose deaths, and known barriers to implementation of behavioral health interventions in primary care. CBT delivery using telehealth has the potential to aid adherence and promote access and dissemination of procedures in primary care. Lastly, the current study will utilize an experimental therapeutics approach to preliminarily explore the mechanism of action for the proposed interventions. The overall aim of the present pilot randomized controlled trial is to examine the feasibility and preliminary efficacy of a BZ taper with CBT for anxiety disorders adapted for patients with concomitant BZ (BZT + CBT) and opioid use to a BZ taper with a control health education program (BZT + HE) in a sample of individuals (N = 54) who have been prescribed and are taking benzodiazepines and opioids for at least 3 months prior to baseline and experience anxious distress. Screening and outcome measures, methods, and implications are described.Trial Registration: ClinicalTrials.gov (NCT05573906).

Successful cessation of smoking among GAD patients during COVID-19 pandemic: A retrospective study in Eastern India

Tobacco use is one of the most significant causes of morbidity and mortality among patients suffering from psychiatric disorders. Even though the COVID-19 pandemic has been going on for two years, numerous researches have questioned the link between smoking and severe COVID-19.This paper aims to find out the outcomes of the pandemic fear intervention method in generalized anxiety disorder (GAD) patients with tobacco use.Only 48 patients were divided into two groups out of the total of 102 individuals. The only distinction between the two groups is the "pandemic fear intervention". These people were identified as heavy smokers seeking mental health treatment at the institution’s mental health + de-addition clinic.In comparison to the prior situation, counselling and cognitive behavioural therapy (CBT) resulted in significant improvements during the COVID-19 epidemic. All of the forty-eight patients were heavy smokers; the combination of COVID-19 anxiety and the lack of tobacco availability enhanced the ability of all forty-eight patients to stop smoking when rigorous psychotherapy health education and cognitive behavioural therapy (HE and CBT) was present. The COVID-19 fear factor's connection to the pandemic situation led to successful tobacco use cessation in 48 patients with chronic anxiety disorders, according to this study.Several tobacco use cessation sessions, as well as diverse technologies like CBT and health education counselling, are required for heavy smokers with general anxiety disorders. According to these models, the COVID-19 pandemic could be an important and counterintuitive motivator for quitting smoking. This study gives a fascinating fact and some data regarding COVID-19's impact on heavy smokers, in addition to the horrific misery it causes. We give an example of this by telling medical practitioners that they must use the "COVID-19 pandemic anxiety model" to extend patient lives, maintain environmental quality, and quit smoking.

The prevalence of major depression and generalized anxiety disorder in patients with multiple sclerosis in Saudi Arabia: a cross-sectional multicentered study.

Multiple sclerosis (MS) is an autoimmune disease characterized by chronic, progressive neurodegeneration of the central nervous system (CNS), and it is the most common inflammatory neurological disease affecting young adults. Given the chronic, progressive nature of the disease, psychiatric disorders are more prevalent among these patients, as reported in the literature; however, data in Saudi Arabia are limited. This study aimed to estimate the prevalence of major depression and generalized anxiety disorder in patients with MS and their association with different patient demographics. This was a cross-sectional, multicentered study that included adult patients with MS from 30 June 2021 to 30 June 2022. Participants were interviewed in person and asked to complete a survey that included general demographics, the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) questionnaire. Other variables related to the patients' conditions, such as MS type and Expanded Disability Status Scale (EDSS) score, were collected from the patient's electronic records. Descriptive statistics were performed, and associations were made using the chi-square, Fisher's exact, and analysis of variance tests, as appropriate. A total of 192 participants were included in this study. Based on a cutoff score of >10 on the GAD-7 and PHQ-9 scales, the prevalence of generalized anxiety disorder was 26.1% (50), with the majority of participants having minimal anxiety (40%); meanwhile, the prevalence of major depression was 42.7% (n = 82), and most of them had mild depression (30%). Female participants scored significantly higher compared to men on the GAD-7 scale (p = 0.0376), but not on the PHQ-9 scale (p = 0.1134). In addition, no statistically significant association was detected between functional disability (EDSS score) and prevalence of anxiety and depression. This study demonstrated a high prevalence of generalized anxiety disorder and major depression among patients with MS compared with that in the general population, with women being more affected. As these comorbid disorders could negatively affect the disease course, screening is of paramount significance.

Evaluation of retinal thickness measured by optical coherence tomography in patients with generalized anxiety disorder

PurposeTo compare the peripapillary retinal nerve fiber layer thickness, macular thickness, ganglion cell layer thickness, and inner plexiform layer thickness determined by Optic Coherence Tomography in the patient group diagnosed with a generalized anxiety disorder who did not receive any psychiatric medication with the healthy control group. MethodsForty newly diagnosed, drug-free Generalized Anxiety Disorder patients and 43 healthy age- and gender-matched control subjects were included in the study. Macular thickness, ganglion cell layer thickness, inner plexiform layer thickness, and peripapillary retinal nerve fiber layer thickness were measured using optical coherence tomography. Structured Clinical Interviews and a State-Trait Anxiety Scale were applied to both groups. ResultsGender distributions (P = 0.965) and mean ages were similar between the groups (P = 0.340). Retinal nerve fiber layer thickness measurements were not significantly different between the groups. We observed statistically significant thinning in the inner superior, inner nasal, inner temporal, inner inferior, and outer inferior quadrants of the macula in the patient group compared to the control group (P = 0.046, P = 0.046, P = 0.020, P = 0.007, P = 0.014). We found thinning at the Ganglion cell layer in the inner inferior and outer temporal quadrants (Respectively P = 0.018, P = 0.049), inner plexiform layer in the inner nasal, inner temporal, and inner inferior quadrants (Respectively P = 0.046, P = 0.044, P = 0.011) compared to the control group. ConclusionsThis is the first study to reveal thinning in the macula, ganglion cell layer, and inner plexiform layer in newly diagnosed, drug-free Generalized Anxiety Disorder patients compared to the control group.

Hypnotherapy for agoraphobia-Feasibility and efficacy investigated in a pilot study.

https://classic.clinicaltrials.gov/ct2/show/NCT03684577, identifier: NCT03684577.

Evaluation of anxiety disorder in patients with trigeminal neuralgia.

The aim of this cross-sectional study was to evaluate the relationship between anxiety levels and severity of trigeminal neuralgia (TN) disorder's chronic orofacial pain during 2019-2020 in Shiraz Dental Faculty. In this study, patients with TN disorder who were referred to the Oral Medicine Department of Shiraz Dental Faculty were evaluated. Individuals were selected based on convenience sampling. Finally, 47 patients with TN were recruited in this study. Satisfaction with treatment was recorded based on controlling the patient's pain, age, sex, and frequency of recurrence, and data were analyzed using SPSS18. The Chi-square test was used to compare the final results. A reliability of more than 95% was considered significant (P < 0.05). According to the results, the mean ages of participants with TN and control groups were 56.89 ± 10.93 and 37.12 ± 9.55, respectively. The mean value of participants' age was significantly different between the two evaluated groups (P < 0.0001). The anxiety of patients with TN was significantly higher than the healthy control group (P < 0.0001). The mean level of anxiety in patients with TN and also in healthy controls was not significantly different among men and women (P > 0.05). The mean level of anxiety of men and women in TN group was significantly higher than the healthy control women (P = 0.001). The mean levels of anxiety between different age ranges in patients with TN and healthy controls were not different in both evaluated groups (P > 0.05). Patients with TN in different age ranges had higher level of anxiety than healthy controls (P < 0.05). Patients with TN had significantly higher level of anxiety than healthy participants.