Anxiety-related Symptoms Research Articles

(313) Is anxiety sensitivity related to threat-enhanced pain responses?

Anxiety sensitivity refers to a general sense of fear about anxiety-related symptoms (e.g., racing heart, sweating) and can amplify the perception of somatic sensations. Past research has shown that anxiety sensitivity is related to heightened response to pain; however, this work has primarily focused on static measures of pain sensitivity (e.g., pain threshold/tolerance). The present study examined the relationship between anxiety sensitivity and a dynamic measure of pain modulation, i.e., threat-enhanced pain and the nociceptive flexion reflex (NFR; a physiological measure of spinal nociception).

Group Cognitive Behavioural Therapy Program Shows Potential in Reducing Symptoms of Depression and Stress Among Young People with ASD

We examined the efficacy of cognitive behavioural therapy (CBT) delivered in groups on the reduction of symptoms of depression, anxiety and stress in young people on the autism spectrum. Utilising a quasi-experimental design, comparisons were made between individuals allocated to a group intervention program and individuals allocated to a waitlist. Following the intervention program, participants who were initially symptomatic reported significantly lower depression and stress scores on the Depression Anxiety Stress Scales in comparison to individuals on the waitlist. There was no significant change in anxiety related symptoms. The benefits were maintained at 3 and 9month follow-up. Our findings demonstrate the potential of CBT in a small group setting for assisting young people with ASD who have symptoms of depression and stress.

The lived experiences of single mothers in Swaziland of their son's aggressive behaviour

The study explored and described the lived experiences of single mothers and described guidelines for psychiatric nurses to facilitate the mental health of single mothers subjected to aggression by their adolescent sons. Participants were a purposive sample of 8 (single mothers, aged between 40 and 50 years, 7 mothers were employed and 3 were professionally trained, 4 mothers were domestic workers and 1 earned living by selling vegetables). The mothers attended the outpatient department at the National Psychiatric Hospital in Swaziland because of being exposed to aggression by their adolescent sons and had adolescent sons living with them 6 months prior to as well as during the study. Data were collected using individual in-depth phenomenological interviews, direct observation and field notes. Analyses used thematic coding. Results reflected that single mothers experienced their adolescent sons as disrespectful and violent, they had negative experiences about their adolescent sons which resulted in anxiety related symptoms, they had negative experiences of self and experienced poor relationships with their neighbours. Guidelines concerning intra- and interpersonal challenges were formulated for the psychiatric nurse to facilitate the mental health of these mothers.

Study Finds Great Increase in Stroke Risk With Anxiety

The more anxious you are, the greater your chances of an incident stroke, results from a prospective analysis demonstrated. The association was independent of other known risk factors including depression, researchers led by Maya J. Lambiase, PhD, reported in the journal Stroke. “Results indicated a dose-response relation between anxiety and stroke,” according to Dr. Lambiase, a cardiovascular behavioral medicine researcher in the department of psychiatry at the University of Pittsburgh, and her associates. “Exploratory analyses suggest that behavioral factors, particularly smoking and physical activity, may be important pathways to consider.” Over a period of 22 years, the researchers studied a nationally representative sample of 6,019 people aged 25-74 years from the first National Health and Nutrition Examination Survey (NHANES I), which was conducted from 1971-1975. At baseline, all study participants underwent an in–person structured interview, physical exam, and blood draw, and they completed psychological questionnaires including the General Well–Being Schedule (GWB), a four–item tool that asks respondents to rate the severity of their anxiety–related symptoms during the past month. Strokes were identified through hospital or nursing home reports and death certificates. Covariates were accounted for, including use of blood medications, diagnosis of diabetes by a physician, total serum cholesterol, body mass index, and depressive symptoms as measured by the GWB's depressed mood subscale and by the Center for Epidemiologic Studies of Depression scale. During a mean 16–year follow–up, the researchers identified 419 cases of incident strokes (221 in men and 198 in women). They observed that every one standard deviation increase in anxiety was associated with a 17% increase in stroke risk following adjustment for demographic factors. Men and women in the highest tertile of anxiety symptoms had a 33% higher risk of stroke compared with those in the lowest tertile, following adjustment for other cardiovascular risk factors. “Poor health behaviors may be one pathway linking anxiety with stroke risk,” the researchers wrote in an article that appeared online. “In the present study, behaviors (particularly smoking and physi-cal activity) had the most sizable attenuating effect on the relationship between anxiety and incident stroke. However, since these behaviors did not account fully for the association between anxiety and incident stroke, direct biologic effects of anxiety should also be considered. Chronic anxiety could lead to excess activation of the hypothalamic–pituitary–adrenal axis and sympathetic nervous system, which may increase the risk for stroke. Anxiety could also contribute to stroke or other cardiovascular disease by lowering the threshold for arrhythmia or by reducing heart rate variability.” The researchers acknowledged certain limitations of the study, including the fact that baseline history of stroke and coronary heart disease were self–reported and that bias “may have occurred due to excluding individuals lost to follow–up or with missing data. We could not formally test mediation due to insufficiencies in temporal ordering of data collection. Stroke cases were identified based on discharge reports/death certificates and were not confirmed by imaging or a neurologist. Additionally, we may not have accurately captured silent strokes -(resulting in an underestimate of cases in the population), although such misclassification would likely bias results toward the null.” The study was funded by the National Heart, Lung, and Blood Institute and by the National Institute of Mental Health. The researchers stated that they had no financial conflict of interest.

Chapter Fifteen - Involvement of Adenosine A2A Receptors in Depression and Anxiety

When administered to normal healthy patients, a nonselective adenosine A1/A2A antagonist, caffeine, tended to improve anxiety and depression at low doses and to exacerbate anxiety at high doses. Caffeine also appears to enhance anxiety-related symptoms in patients with panic disorder, and A2A receptor-deficient mice have been reported to exhibit higher anxiety-like behaviors, as well as a lower incidence of depression-like behaviors. Some selective A2A antagonists were reported to ameliorate anxiety-like behaviors in rodents, while others did not affect these behaviors. In addition, most A2A antagonists showed inhibitory effects on depression-like behaviors. The mechanisms underlying the relationship between A2A receptor antagonists and anxiety and depression remain unclear at the present time, although many studies have produced hypotheses. Given that a selective A2A receptor antagonist has recently become available for use in humans, research on the role of A2A receptors in the treatment of mental illness should progress in the near future.

Cigarette Smoking and Mental Illness: A Study of Nicotine Withdrawal

We compared prevalence, severity, and specific symptom profiles for nicotine withdrawal across categories of mental illness. We also examined the influence of nicotine withdrawal on efforts to quit smoking among those with mental illness. We analyzed data from 2 sources: wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions, limiting the sample to current smokers (2001-2002; n = 9913); and a 2-wave cohort telephone survey of a national sample of adult smokers (2004-2006; n = 751). Mental illness was associated with a substantially greater likelihood of nicotine withdrawal syndrome; approximately 44% of nicotine withdrawal syndrome diagnoses were attributable to mental illness. Symptom profiles were highly comparable between mental illness categories, although anxiety-related symptoms were better markers of withdrawal for those with an internalizing disorder. Smokers with mental illness were motivated to quit but were less likely to be successful in their quit attempts, and both dependence and withdrawal independently accounted for this lower likelihood of success. Nicotine withdrawal may be a particularly important target for intervention among those with mental illness who smoke cigarettes.

A case series on the use of lavendula oil capsules in patients suffering from major depressive disorder and symptoms of psychomotor agitation, insomnia and anxiety

Symptoms of agitation, anxiety and insomnia are frequent among patients with major depressive disorder (MDD) during the first weeks of psychiatric care. But a substantial number of patients declines taking pharmaceutical medication to avoid side effects. Therefore, an alternative herbal medication is needed. Clinical studies demonstrated that lavender oil capsules, termed Lasea®, have an anxiolytic effect comparable to Lorazepam and significantly reduce insomnia and agitation in non-depressed patients. Therefore, the aim of this retrospective case series was to analyze the effectiveness of Lasea® for patients with MDD and symptoms of anxiety, insomnia and psychomotor agitation. Eight cases were analyzed retrospectively regarding the dosage, length of treatment, possible side effects and effectiveness of Lasea®. All cases were treated at the Department of Psychiatry at Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin in a naturalistic setting. Effectiveness was measured by a change in the Hamilton Rating Scale for Depression (HAMD-17) total score and subscores. In 6 cases, the combination of Lasea® and an antidepressant resulted in a reduction of MDD. Lasea® also reduced agitation in 6 cases. Psychological anxiety was reduced in 5, somatic anxiety in 4 cases whereas sleep-onset and sleep-maintenance insomnia improved in 3 cases each. The results demonstrate that Lasea® reduces some of the anxiety related symptoms and sleep disturbances in MDD patients. Furthermore Lasea® significantly reduces psychomotor agitation. Additionally, the results indicate a significant global improvement stemming from the combinational therapy of Lasea® and antidepressant medication.

Accuracy in non-verbal emotional processing in children of parents diagnosed with bipolar disorder – preliminary results

Background: Children of parents diagnosed with bipolar disorder are at greater risk of developing bipolar disorder as well other axis I conditions. This increased risk is associated with deficits in frontal top-down regulatory pathways, involved with emotional processing and regulation. Previous research has also shown that depressive and anxiety-related symptoms in children at-risk have been linked to greater likelihood of developing bipolar disorder later on. Better understanding the deficits involved in this pathway during the progression of the disorder will help further our understanding of risk and the core psychopathology underlying bipolar disorder. The goal of our study is to compare performance during a nonverbal emotional labeling task between symptomatic high-risk bipolar offspring and children of healthy control parents. Methods: We plan to compare a total of 45 high-risk bipolar offspring with 15 healthy control participants during the well-validated Diagnostic Analysis of Nonverbal Accuracy (DANVA) task. To date, 14 high-risk partially-affected offspring (average age = 13.7(2.9) years, 6 females) and 12 healthy control offspring (average age = 13.2(2.7) years, 8 females) have participated. Overall accuracy and type of error, including intensity and emotion, have been compared between groups using Mann-Whitney U tests. Similarly, we performed a secondary analysis using diagnosis of depression and anxiety-related disorders in high-risk offspring to compare performance on this task using Kruskal-Wallis rank sum test. Results: High-risk offspring were shown to have significant increase in total number of errors on both child and adult face subsections of the DANVA (p b 0.0001 for both). High-risk offspring performed worse when the emotional intensity of the face shown was low for both child and adult faces and interestingly, for high intensity faces in adults. High-risk offspring were also more likely to inaccurately label angry faces as well as fearful adult faces. During a secondary analysis, we compared high-risk offspring with depression (n = 7), anxiety-related disorders (n = 6) and healthy controls (n = 12) and found the labeling accuracy difference between the three groups during the identification of low intensity emotion in adult faces (p = 0.04) as well as when adults faces were expressing anger (p = 0.008). Conclusions: Our results provide further evidence that the DANVA can be used to examine the emotional labeling deficits in offspring at high risk to develop bipolar disorder. Such deficits may be part of the core psychopathology in bipolar disorder.

Chronic nandrolone administration induces dysfunction of the reward pathway in rats

Data in animal models and surveys in humans have revealed psychiatric complications of long-term anabolic androgenic steroid abuse. However, the neurobiochemical mechanisms behind the observed behavioral changes are poorly understood.The aim of the present study was to investigate the effects of nandrolone decanoate on emotional behavior and neurochemical brain alterations in gonadally intact male rats.The behavioral reactivity to the elevated plus maze and the social interaction test was used to assess anxiety-related symptoms, and the sucrose preference test was used to evaluate anhedonia. Dopaminergic, serotonergic and noradrenergic transmissions were also evaluated in selected brain areas.The chronic administration of nandrolone, at 5mgkg−1 injected daily for 4weeks, induced the loss of sweet taste preference, a sign of anhedonia and dysfunction of the reward pathway. The behavioral outcomes were accompanied by reductions in the dopamine, serotonin and noradrenaline contents in the nucleus accumbens. Alterations in the time spent in the open arms and in the social interaction test were not found, suggesting that nandrolone did not induce an anxiogenic profile. No differences were revealed between the experimental groups in the amygdala in terms of the neurotransmitters measured.Our data suggest that nandrolone-treated rats have a depressive, but not anxiogenic-like, profile, accompanied by brain region-dependent changes in dopaminergic, serotonergic and noradrenergic neurotransmission. As anabolic androgenic steroid dependence is plausibly the major form of worldwide substance dependence that remains largely unexplored, it should be highlighted that our data could contribute to a better understanding of the altered rewards induced by nandrolone treatment and to the development of appropriate treatments.

Intranasal infusion of melanocortin receptor four (MC4R) antagonist to rats ameliorates development of depression and anxiety related symptoms induced by single prolonged stress

Brain melanocortinergic systems and specifically melanocortin receptor four (MC4R) are implicated in modulation of anxiety- and depressive-like behavior induced by mild or moderate stress. Here we examine whether blockage of central MC4Rs with HS014 before severe traumatic stress may protect against development of anxiety and depression co-morbid with post-traumatic stress disorder (PTSD). Male rats were treated intranasally (IN) with vehicle or varied doses of HS014, 30min prior to single prolonged stress (SPS) animal model of PTSD.IN administration of 100μg HS014 pre-SPS improved despair behavior in forced swim (FS) immediately after immobilization stress part of SPS protocol. During all 4 intervals of 20min FS these rats spent less time immobile than rats given vehicle or 3.5ng HS014. This dose of HS014 also had a long-term beneficial effect manifested as reduction of immobility time in forced swim test performed after SPS. However, both HS014 doses were effective in ameliorating development of anxiety-like behavior after traumatic stress. Thus, rats given IN HS014 prior to SPS exhibited less open arms (OA) visits in elevated plus maze (EPM), spent longer time in OA and less in closed arms, had lower anxiety index, higher risk assessment and more head dips over borders in OA. They also spent longer time in the center of the open field and defecated less. Reduced grooming behavior in EPM was observed with 100μg HS014. This is the first study revealing pronounced resilience effects of HS014 on development of behavioral symptoms co-morbid with PTSD.

Mutation carriers’ perspectives on Lynch syndrome

Learning about hereditary cancer may influence an individual’s self-concept, which otherwise represents a complex but stable cognitive structure. Recently, a 20- statement self-concept scale, with subscales related to stigma-vulnerability and bowel symptom-related anxiety, was developed for Lynch syndrome. We compared the performance of this scale in 591 mutation carriers from Denmark, Sweden and Canada. Principal component analysis identified two sets of linked statements—the first related to feeling different, isolated and labeled, and the second to concern and worry about bowel changes. The scale performed consistently in the three countries. Minor differences were identified, with guilt about passing on a defective gene and feelings of losing one’s privacy being more pronounced among Canadians, whereas Danes more often expressed worries about cancer. Validation of the Lynch syndrome self-concept scale supports its basic structure, identifies dependence between the statements in the subscales and demonstrates its applicability in different Western populations.

Guided Self-Help for the Management of Worry in Parkinson's Disease: A Pilot Study

Anxiety disorder and anxiety symptomatology are common in Parkinson's disease (PD), with up to 25% patients experiencing significant worry. There is no systematic evidence base for the management of anxiety or anxiety related symptoms such as worry in PD. To investigate whether cognitive therapy, delivered as bibliotherapy, is an effective intervention for worry in PD. 54 participants were randomly allocated to a guided reading group and a control group. The guided reading group were given a CBT based self-help resource called What? Me Worry!?! to work through over eight weeks, with telephone support at two week intervals. Controls were given information about worry only, and one phone call. Measures of worry, intolerance of uncertainty, metacognitions and health status were taken at baseline and after 3 months. Analysable data were obtained for 15 controls and 17 from the guided reading group. Worry and intolerance of uncertainty were significantly reduced in the guided reading group. However, no significant differences were found for the follow up measures between the groups. Bibliotherapy has the potential to be useful and cost effective as a management strategy for the treatment of worry in people with PD.

2824 – Acute psychosis and buprenorphine withdrawal: abrupt vs. progressive could make a difference

Buprenorphine, a partial μ-opioid agonist and κ-opioid antagonist, is frequently used in the treatment of heroin dependence, and to prevent complications arising from intravenous injection and social consequences of heroin use. Psychosis occurring after discontinuation of buprenorphine or other opioids has been described, but is uncommon. We report the case of a 37-year-old man, suffering from opiates dependence, presenting acute and intense psychotic symptoms beginning after an abrupt discontinuation of buprenorphine, which he was taking for two years as substitution therapy for heroin dependence. The initial medication by risperidone, up to a dose of 8 mg/day was inefficient to control psychotic symptoms. Four weeks later, buprenorphine was finally restarted at 8 mg/day, which allowed a complete remission of psychotic and anxiety-related symptoms. The antipsychotic medication was gradually discontinued two months later, allowing the patient to remain symptom-free eighteen months later. We discuss the potential role of abrupt withdrawal syndrome in the apparition of the psychotic symptoms and the presence of a latent psychotic disorder. An interesting issue in our case report is that a correctly conducted antipsychotic treatment did not succeed in stopping symptoms of delusions, even after four weeks, while reintroducing buprenorphine did, showing in this context an antipsychotic effect. This case report highlights the importance of taking opiate dependence into account in patients with recent onset of psychotic symptoms, even several weeks after withdrawal.

Genetic and pharmacological manipulations of the serotonergic system in early life: neurodevelopmental underpinnings of autism-related behavior

Serotonin, in its function as neurotransmitter, is well-known for its role in depression, autism and other neuropsychiatric disorders, however, less known as a neurodevelopmental factor. The serotonergic system is one of the earliest to develop during embryogenesis and early changes in serotonin levels can have large consequences for the correct development of specific brain areas. The regulation and functioning of serotonin is influenced by genetic risk factors, such as the serotonin transporter polymorphism in humans. This polymorphism is associated with anxiety-related symptoms, changes in social behavior, and cortical gray and white matter changes also seen in patients suffering from autism spectrum disorders (ASD). The human polymorphism can be mimicked by the knockout of the serotonin transporter in rodents, which are as a model system therefore vital to explore the precise neurobiological mechanisms. Moreover, there are pharmacological challenges influencing serotonin in early life, like prenatal/neonatal exposure to selective serotonin reuptake inhibitors (SSRI) in depressed pregnant women. There is accumulating evidence that this dysregulation of serotonin during critical phases of brain development can lead to ASD-related symptoms in children, and reduced social behavior and increased anxiety in rodents. Furthermore, prenatal valproic acid (VPA) exposure, a mood stabilizing drug which is also thought to interfere with serotonin levels, has the potency to induce ASD-like symptoms and to affect the development of the serotonergic system. Here, we review and compare the neurodevelopmental and behavioral consequences of serotonin transporter gene variation, and prenatal SSRI and VPA exposure in the context of ASD.

The impact of anxiety on heart rate variability at rest and under stress

Event Abstract Back to Event The impact of anxiety on heart rate variability at rest and under stress John Chalmers1*, Daniel S. Quintana1, 2, Maree J. Abbott1 and Andrew Kemp1, 3 1 University of Sydney, Australia 2 Brain and Mind Research Institute, Australia 3 Hospital Universitário, University of São Paulo, Brazil Aims: Anxiety increases the risk of developing cardiovascular disease (CVD), and is associated with poorer prognosis once CVD is diagnosed. Reduced heart rate variability (HRV) – indicative of reduced parasympathetic nervous system (PNS) activity – may be one mechanism underlying this relationship. Low HRV predicts CVD and all-cause mortality, and is associated with a number of anxiety disorders. However, it remains unclear whether anxious apprehension or arousal underpins HRV reductions. This is the goal of the present study, during rest, and stress conditions. Method: Eighty participants (55 controls) were recruited, and administered the Anxiety Disorders Interview Schedule IV and a semi-structured medical interview to assess psychiatric and medical history. Participants also completed measures (i.e. Penn State Worry Questionnaire, GAD-7, Anxiety Sensitivity Index, & Body Sensations Questionnaire) assessing anxiety related symptoms. Five laboratory tasks were administered (baseline rest, anticipation of shock, acute threat of shock, anticipation of serial subtraction, acute serial subtraction) during which electrocardiogram was collected from which indices of HRV were derived. Results: Participants with a primary anxiety disorder displayed significant reductions in HRV at baseline relative to controls (t = 2.58, p = .03) Multiple regression indicated that general apprehension and worry (Penn State Worry Questionnaire) predicted unique variance in HRV at rest. High worriers also exhibited significantly lower resting state HRV than low worriers. Conclusions: Decreased HRV is driven more by symptoms of worry and apprehension, than symptoms of panic and arousal. Keywords: Heart rate variability, Anxiety, Autonomic Nervous System, Parasympathetic Nervous System, Stress, Psychological Conference: ASP2013 - 23rd Annual meeting of the Australasian Society for Psychophysiology, Wollongong, Australia, 20 Nov - 22 Nov, 2013. Presentation Type: Oral Presentation Topic: Other... Citation: Chalmers J, Quintana DS, Abbott MJ and Kemp A (2013). The impact of anxiety on heart rate variability at rest and under stress. Conference Abstract: ASP2013 - 23rd Annual meeting of the Australasian Society for Psychophysiology. doi: 10.3389/conf.fnhum.2013.213.00020 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 05 Nov 2013; Published Online: 05 Nov 2013. * Correspondence: Mr. John Chalmers, University of Sydney, Sydney, Australia, john.chalmers313@gmail.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers John Chalmers Daniel S Quintana Maree J Abbott Andrew Kemp Google John Chalmers Daniel S Quintana Maree J Abbott Andrew Kemp Google Scholar John Chalmers Daniel S Quintana Maree J Abbott Andrew Kemp PubMed John Chalmers Daniel S Quintana Maree J Abbott Andrew Kemp Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Buspirone Ameliorates the Morphine Withdrawal-Induced Anxiety through Synaptic Ultrastructural Changes in Hippocampus of Rat

Morphine administration causes long-lasting neural changes in the brain that underpin the behavioral abnormalities, and the relationship between structural changes and behavioral symptoms is obscure. In present study, the elevated plus-maze and transmission electron microscope were applied to validate the anxiety-like behaviors and synaptic ultrastructural changes in the hippocampi of rats among the morphine group (morphine administration only), the buspirone group (morphine plus buspirone administration) and the vehicle (saline treated only). As compared with the vehicle group, lower values of OE (times of entering into the open arms), OE% (percentage of entries into the open arms), OT (time spent in the open arms), OT% (percentage of time stayed in the open arms), Ns (surface density (Sv)/numerical density (Nv)) and S (surface area) of synapses were observed in the morphine group , but significantly, behavior higher scores of RR (rearing), HD (head-dipping), FBA (flat back approach), and higher Nv, Sv, PSD (postsynaptic density), LPT (length of postsynaptic thickening), WCJ (widths in synaptic cleft on junctions) and CCR (curvature of the cleft region) of synapses appeared in the morphine group. However, no significant differences in values of most of those parameters above were detected between the vehicle group and the buspirone group. These results supported that anxiety-like symptoms of rats significantly occurred to the rats after acute morphine withdrawal, but buspirone administration could reverse these indexes. It also proved that the appearance/disappearance of anxiety-related symptoms was related to the ultrastructural changes/reversibility of synapses in the hippocampus with morphine and buspirone administrations. So, it suggested that anxiety-related symptoms were modified in rats subjected to the synaptic ultrastructural changes in hippocampus by morphine acute withdrawal and were further rehabilitated by buspirone administration. It is helpful to pursue the effective therapeutic methods of morphine addiction.

Differentiating disordered affect in children and adolescents with type 1 diabetes

BackgroundThere is evidence for increased risk of affective disorders (AD) in adults with type 1 diabetes however, the prevalence and characteristics of AD in young people with the condition is unclear. Comorbid AD in type 1 diabetes is associated with deleterious self-management, sub-optimal clinical indicators, reduced quality of life, poorer physical health, increased complications, increased high risk behaviours in adolescence and young adulthood, and earlier mortality. The present study investigated the prevalence and character of AD in young people with type 1 diabetes. MethodsThe self-report PH-PANAS-C was employed in a cross-sectional, case-control design to identify and differentiate full-syndrome (FS) and subthreshold (St) levels of AD in 53 participants with type 1 diabetes (case) and 54 age-balanced controls (N=107; 7–18 yrs). ResultsCase participants reported greater AD than controls. When differentiated, only anxiety was significantly more prevalent. Case participants reported less positive affect, and greater negative affect and autonomic arousal. Further, 1:3 case participants presented with St symptoms of AD. LimitationsSelf-report measures are known to produce moderated responses therefore symptoms may be more severe than reported. There has been some suggestion that responses to somatic items in the PH-PANAS-C may relate to diabetes-specific states rather than affect-related symptoms however, recent evidence has refuted this argument. ConclusionsAD, particularly anxiety, represents a significant clinical concern in young people with type 1 diabetes both as a disorder in its own right and as a major impediment to primary care and management of the diabetes. The significant dominance of anxiety-related symptoms and prevalence of subthreshold presentation warrant further investigation.

A Novel BACHD Transgenic Rat Exhibits Characteristic Neuropathological Features of Huntington Disease

Huntington disease (HD) is an inherited progressive neurodegenerative disorder, characterized by motor, cognitive, and psychiatric deficits as well as neurodegeneration and brain atrophy beginning in the striatum and the cortex and extending to other subcortical brain regions. The genetic cause is an expansion of the CAG repeat stretch in the HTT gene encoding huntingtin protein (htt). Here, we generated an HD transgenic rat model using a human bacterial artificial chromosome (BAC), which contains the full-length HTT genomic sequence with 97 CAG/CAA repeats and all regulatory elements. BACHD transgenic rats display a robust, early onset and progressive HD-like phenotype including motor deficits and anxiety-related symptoms. In contrast to BAC and yeast artificial chromosome HD mouse models that express full-length mutant huntingtin, BACHD rats do not exhibit an increased body weight. Neuropathologically, the distribution of neuropil aggregates and nuclear accumulation of N-terminal mutant huntingtin in BACHD rats is similar to the observations in human HD brains. Aggregates occur more frequently in the cortex than in the striatum and neuropil aggregates appear earlier than mutant htt accumulation in the nucleus. Furthermore, we found an imbalance in the striatal striosome and matrix compartments in early stages of the disease. In addition, reduced dopamine receptor binding was detectable by in vivo imaging. Our data demonstrate that this transgenic BACHD rat line may be a valuable model for further understanding the disease mechanisms and for preclinical pharmacological studies.

Anxiety disorders and its risk factors among the Sichuan empty-nest older adults: A cross-sectional study

ObjectiveThe goal of this study was to determine the prevalence and correlates of anxiety disorders among empty-nest older adults in Sichuan Province, China. MethodsThe study population consisted of 352 subjects over the age of 60 who completed the Self-Rating Anxiety Scale (SAS), the Geriatric Depression Scale-Short Form (GDS-SF), the University of California, Los Angeles, Loneliness Scale (UCLA-LS), and the Mini-Mental State Examination (MMSE) questionnaires. The socio-demographic information, information on the subjects’ general health, and their level of concern about health problems were obtained from self-reports. ResultsIn the study population, 30.11% of the empty-nest older adults showed anxiety-related symptoms or anxiety disorders, with a standardized score of 44.53±11.01. The levels of anxiety were significantly different in terms of the patients’ gender, educational level, occupation, residence, marital status, and income, but not in terms of their age. Patient anxiety had a significantly positive association with depression and loneliness but had a significantly negative association with the MMSE scores. Multiple regression analysis revealed that patients with depression, loneliness, and cognitive impairment, as well as patients who were female, living in rural areas, or living alone were at risk for anxiety disorders. ConclusionsAnxiety prevails among the empty-nest older adults in Sichuan Province and is mainly associated with health-related characteristics. Physicians should give special attention to older adults with depression, loneliness, and cognitive impairments, especially to women who live alone in rural areas.

O-01 EMOTIONAL SUPPORT TO APHERESIS DONORS: EFFECTS AND IMPLICATIONS

It is known that intense anxiety can trigger fainting. It was observed that a psychological approach is able to reduce the onset of vasovagal reactions in first-time donors (FTDs). The aim of this survey is to study the relationship between anxiety, vasovagal reaction and emotional support during apheresis donations. A questionnaire was devised to investigate anxiety-related symptoms (ARSs) and vasovagal symptoms (VVSs) triggered by blood and apheresis donation. At the end of donation it was distributed to 600 donors. 300 of them were FTDs, 200 were repeated donors (RDs) and 100 were first-time platelet familiar donors (PltFDs). This last group was emotionally supported by the doctor during the whole procedure. All donors were asked what they felt during donation by choosing from a variety of symptoms related to anxiety and vasovagal reactions. They were also asked about discomfort in the arm of donation, pins and needles in the arm of donation and if they intended to donate again. Sweaty hands (36%) and accelerated heartbeats (34%) are the most frequent symptoms in FTDs. 17% of RDs had sweaty hands and 15.5% felt discomfort in the arm of donation. In the group of PltFDs 18% had dryness of mouth, 16% cold hands or feet, 14% pins and needles in the arm of donation and 10% sweaty hands. 58% of PltFDs, 56% of RDs and 33.3% of FTDs had no symptoms at all. 16.3% of FTDs, 21.5% of RDs and 31% of PltFDs had 1 or 2 symptoms. 24.3% of FTDs, 19% of RDs and 8% of PltFDs had from 3 to 5 symptoms. 25.9% of FTDs, 3.5% of RDs and 3% of PltFDs had from 6 to 11 symptoms. 63.3% of FTDs, 40.5% of RDs and 38% of PltFDs had ARSs or VVSs. 59% of FTDs, 36% of RDs and 42% of PltFDs had ARSs. 24.7% of FTDs, 14% of RDs and 4% of PltFDs had VVSs. 93 donors (37.3%) with ARSs and 40 donors (39.2%) with VVSs declared that they will not come to donate again. 99% of PltFDs declared the desire to donate again and 62% of them expressed the wish to become voluntary donors. Contrary to vasovagal reactions, not all anxiety-related symptoms are visible. It is possible to realize how much they are present only by talking to donors. Reducing anxiety is especially important as it may deter some first-time donors from becoming regular. PltFDs had fewer symptoms compared to the other groups and even if 42% of them admitted some ARSs only 4% developed VVSs and 62% expressed the desire to become voluntary donors. Moreover, apheresis procedures can evoke much more disturbing thoughts compared to blood donation (needle inside the vein for a longer time, the presence of a cell separator, extra-corporeal circulation). ARSs are the expression of an alarm reaction triggered by fears and they can snowball into VVSs. Only when donors’ discomfort is not too intense and when the doctor emotionally supports them in the critical moments of donation, are they able to manage their emotions.