Anxiety Subscale Scores Research Articles

Fatherhood too soon. Anxiety, depression and quality of life in fathers of preterm and term babies: a longitudinal study

Introduction Fathers are increasingly recognized as playing a critical role in the family unit and emotional development of children. The birth of a preterm baby can be confronting, yet there is limited research that explores how preterm birth might impact on father’s emotional wellbeing and quality of life. The aim of the study was to monitor quality of life and psychological wellbeing in a group of fathers to explore if a preterm birth altered outcomes in these two domains. Methods Institutional ethics committee approval was obtained. Australian men (N = 1000) were recruited in the antenatal period via their pregnant partner, and completed the Hospital Anxiety and Depression Scale (HADS) and Satisfaction with Life Scale (SWLS) in the third trimester and again 6 weeks after the birth of their baby. Birth records were independently audited to determine which fathers experienced preterm birth. Results Data was available for 1000 and 950 fathers at each time point. Overall, 72 (7.2%) of fathers experienced preterm birth and 928 (92.8%) had a term birth. Fathers of preterm infants were significantly older (p = 0.002) and less likely to be married or in a defacto relationship (p = 0.043). Preterm babies were more likely to be delivered by cesarean section, have a low birthweight and require admission to a special care or neonatal intensive care unit (p < 0.001). There were no significant differences in HADS total, anxiety or depression subscale and SWLS scores in the antenatal period. Six weeks after the birth, fathers of preterm babies were significantly more likely to meet the case criteria for anxiety compared to fathers of term babies (25 vs. 12%, p = 0.02). This was due to persisting anxiety in preterm fathers (p < 0.001). They also reported significantly lower SWLS scores compared to fathers of term infants (27.31 vs. 27.88, p = 0.011). However, there were no differences in depression or HADS total scores. Conclusion Following birth of a preterm baby, persisting anxiety may affect quality of life of fathers. Routine screening of fathers of preterm babies may identify men who could benefit from referral for psychological intervention.

Predictors of long-term anxiety and depression in uveal melanoma survivors: A cross-lagged five-year analysis.

Cancer survivors commonly experience long-term anxiety and depression. Anxiety and depression might result from problems emerging during survivorship rather than illness and treatment. This study tested three potential causal paths: (a) concerns about physical symptoms and functional problems and fear of cancer recurrence (FCR) arising during survivorship directly cause anxiety and depression, (b) an indirect path whereby FCR mediates effects of concerns about physical symptoms and functional problems on anxiety and depression, and (c) a reciprocal path whereby anxiety and depression cause concerns about physical symptoms and functional problems and FCR, which exacerbate later anxiety and depression. Sample of 453 uveal melanoma survivors who completed observations 6-, 12-, 24-, 36-, 48- and 60-months post-diagnosis and did not miss two consecutive observations. Cross-lagged analyses were conducted to predict Hospital Anxiety and Depression Scale subscale scores. Symptoms and functional problems were measured using the EORTC OPT 30 scale, and FCR operationalised by the EORTC OPT 30 worry about recurrence scale. Covariates were age, gender, treatment modality, and visual acuity of the fellow eye and chromosome-3 status (which accurately predicts 10-year survival), worry and anxiety or depression. All paths received some support, although the indirect path emerged only for anxiety in females. Concerns about physical symptoms, functional problems, and FCR originated in survivorship and appeared to both influence and be influenced by anxiety and depression. Findings emphasise the importance of actively monitoring survivors to prevent, detect, and intervene in the development of anxiety and depression during survivorship.

COVID-19 Pandemic: Psycho-social Consequences During the Social Distancing Period Among Najran City Population.

COVID-19 is a global pandemic that endanger the health and enforced social distancing for the whole world. Social distancing may generate stress, anxiety, and depression. Understanding the psychosocial consequences of COVID19 during social distancing may help decision-makers to take suitable decisions that help in increasing awareness. Evaluate the psychosocial consequences of COVID-19 pandemic during the social distancing period and explore the relationship between social media use and psychological stress during COVID-19 outbreak among Najran city population. Research design is descriptive correlational research design. A snowball sampling technique, was used to recruit participants live in Najran city during the COVID-19 pandemic (1508 participant). A statistically significant differences (P<0.05) are observed between Saudi and non-Saudi participants in all social aspects assessed except for time spent on social media. In addition, a high mean of depression, stress, and anxiety subscale scores are observed in non-Saudi compared to the Saudi participants with statistically significant differences (p=0.000). As well as high DASS-21 total scores in non-Saudi compared to the Saudi participants. Also, there are positive statistically significant correlations (≤0.05) between participants' time spent in social media and their depression, stress, anxiety, and total DASS scores during the COVID-19 outbreak. The findings of the present study indicate that COVID-19 pandemic generates stress, anxiety and depression among Najran population especially, non-Saudi. This poor psychological condition is exaggerated with prolonged social media use. COVID-19 also has negative impact on social wellbeing and use of social media cannot replace direct contact with friends. The current study results may be utilized to formulate interventions that enhance psychosocial health and resilience during the COVID-19 outbreak.

Abnormal Functional Asymmetry in the Salience and Auditory Networks in First-episode, Drug-naive Somatization Disorder

Evidence of abnormal functional connectivity (FC) has been implicated in patients with somatization disorder (SD). Although the importance of damage to the functional asymmetry has been established, it remains unclear as to whether abnormal intra- and inter-hemispheric FCs are related to patients with SD. We applied resting-state functional magnetic resonance imaging to first-episode, medication-naive patients with SD (n = 25) and matched healthy controls (HCs) (n = 28). The data were analyzed using parameter of asymmetry (PAS) and support vector machine (SVM). Patients with SD showed significantly lower PAS values in the left inferior temporal gyrus (ITG) and higher PAS values in the right insula compared to HCs. A negative correlation was observed between the higher PAS values in the right insula and the Hamilton Depression Scale (HAMD) sleep subscale scores (r = −0.502, p = 0.011), and positive correlations were found between the lower PAS values in the left ITG and the Hamilton Anxiety Scale (HAMA) somatic anxiety subscale scores (r = 0.443, p = 0.027) and the HAMA total scores (r = 0.456, p = 0.022). Moreover, the increased PAS values in the right insula could distinguish patients with SD from HCs with acceptable accuracy (77.36%). First-episode, treatment-naive patients with SD show disrupted asymmetry of inter- and intra-hemispheric FCs. The pattern of disrupted functional asymmetry occurs early in the course of the disease and is independent of medication status, which suggests that disrupted functional asymmetry of salience and auditory networks may be applied as early biological markers for SD.

Exploring profiles of anxiety symptoms in male and female children on the autism spectrum

BackgroundIt is now recognised that children on the autism spectrum frequently experience co-occurring anxiety. Although a child’s sex is thought to impact the prevalence of anxiety in typically developing children, the relationship between sex and anxiety symptoms has not previously been established in children on the autism spectrum. This study compares the parent-reported anxiety symptoms of male and female children (aged 9–12 years) on the autism spectrum. Method24 male and 24 female children with a diagnosis of autism spectrum disorder were matched on age, VABS receptive language scores, and SCQ scores. Anxiety was measured using the ASC-ASD-P, a 24-item questionnaire designed to capture typical and atypical signs of anxiety in children on the autism spectrum. A combination of descriptive and inferential analyses was used to compare the total anxiety scores, anxiety subscale scores, and anxiety item scores of males and females. ResultsNo significant differences were found between the total anxiety scores of males and females, or the performance anxiety, separation anxiety, or uncertainty subscale scores. Females had significantly higher anxiety scores on the anxious arousal subscale which was due to significant differences on two individual anxiety items within that subscale. ConclusionOverall, male and female children on the autism spectrum, aged 9–12 years, had similar anxiety scores. The profiles of anxiety in male and female children on the autism spectrum may differ from those reported in typically developing children and warrant further investigation.

Anxiety Symptoms Differ in Youth With and Without Tic Disorders.

We compared anxiety symptoms in youth with and without tic disorders by comparing scores on the Multidimensional Anxiety Scale for Children (MASC) in youth with tic disorders to those in a concurrent community control group and in a group of treatment-seeking anxious youth from the Child/Adolescent Anxiety Multimodal Study (CAMS). Data from 176 youth with tic disorders, 93 control subjects, and 488 CAMS participants were included. Compared to youth with tic disorders, controls had lower total MASC scores (p < 0.0001) and CAMS participants had similar total MASC scores (p = 0.13). Separation Anxiety (p = 0.0003) and Physical Symptom (p < 0.0001) subscale scores were higher in youth with tic disorders than in CAMS participants. We conclude that the anxiety symptom profile differs in youth with and without tic disorders, which may have important implications for targeting treatment of anxiety in youth with tic disorders.

Cerebrospinal fluid neuroplasticity-associated protein levels in patients with psychiatric disorders: a multiplex immunoassay study

To examine the role of neuroplasticity in the pathology of psychiatric disorders, we measured cerebrospinal fluid (CSF) neuroplasticity-associated protein levels. Participants were 94 patients with schizophrenia, 68 with bipolar disorder (BD), 104 with major depressive disorder (MDD), and 118 healthy controls, matched for age, sex, and ethnicity (Japanese). A multiplex immunoassay (22-plex assay) was performed to measure CSF neuroplasticity-associated protein levels. Among 22 proteins, 11 were successfully measured in the assay. CSF amyloid precursor protein (APP) and glial cell-derived neurotrophic factor (GDNF) levels were significantly lower in patients with schizophrenia, and CSF APP and neural cell adhesion molecule (NCAM)-1 levels were significantly lower in patients with BD, than in healthy controls (all p < 0.05). Positive and Negative Syndrome Scale total, positive, and general scores were significantly and positively correlated with CSF hepatocyte growth factor (HGF) (p < 0.01) and S100 calcium-binding protein B (S100B) (p < 0.05) levels in patients with schizophrenia. Young mania-rating scale score was significantly and positively correlated with CSF S100B level in patients with BD (p < 0.05). Hamilton Depression Rating Scale, core, sleep, activity, somatic anxiety, and delusion subscale scores were significantly and positively correlated with CSF HGF level, while sleep subscale score was positively correlated with CSF S100B and VEGF receptor 2 levels in patients with MDD (p < 0.05). Our results suggest that CSF APP, GDNF, and NCAM-1 levels are associated with psychiatric disorders, and that CSF HGF, S100B, and VEGF receptor 2 levels are related to psychiatric symptoms.

Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry

This study aimed to assess and compare the immediate stress and psychological impact experienced by people with and without psychiatric illnesses during the peak of 2019 coronavirus disease (COVID-19) epidemic with strict lockdown measures. Seventy-six psychiatric patients and 109 healthy control subjects were recruited from Chongqing, China and completed a survey on demographic data, physical symptoms during the past 14 days and a range of psychiatric symptoms using the Impact of Event Scale-Revised (IES-R), Depression, Anxiety and Stress Scale (DASS-21) and Insomnia Severity Index (ISI). IES-R measures PTSD symptoms in survivorship after an event. DASS-21 is based on tripartite model of psychopathology that comprise a general distress construct with distinct characteristics. The mean IES-R, DASS-21 anxiety, depression and stress subscale and ISI scores were higher in psychiatric patients than healthy controls (p < 0.001). Serious worries about their physical health, anger and impulsivity and intense suicidal ideation were significantly higher in psychiatric patients than healthy controls (p < 0.05). More than one-third of psychiatric patients might fulfil the diagnostic criteria post-traumatic stress disorder (PTSD). More than one-quarter of psychiatric patients suffered from moderately severe to severe insomnia. Respondents who reported no change, poor or worse physical health status and had a psychiatric illness were significantly more likely to have higher mean IES-R, DASS depression, anxiety and stress subscale scores and ISI scores (p < 0.05). This study confirms the severity of negative psychological impact on psychiatric patients during the COVID-19 epidemic with strict lockdown measures. Understanding the psychological impact on psychiatric patients during the COVID-19 pandemic has the potential to provide insight into how to develop a new immunopsychiatry service. Further research is required to compare pro-inflammatory cytokines between psychiatric patients and healthy controls during the pandemic.

Psychometric Properties of DASS-21 and Predictive Model of Negative Affectivities in Individuals with Different Pain Conditions

The aims of this cross-sectional study were i) to evaluate the psychometric properties of the Depression Anxiety and Stress Scale (DASS-21) in adults with different temporal conditions of pain; ii) to compare the Depression, Anxiety and Stress subscale scores in different individuals; iii) to estimate the prevalence of negative affectivity; and iv) to elaborate a predictive model considering aspects related to the development of negative affectivity. A total of 1,150 individuals (mean age: 38.6, SD = 10.8 years; 78.9% women) participated. The fit of the model of DASS-21 to the data was estimated by confirmatory strategy. The Depression, Anxiety and Stress mean scores of participants with different temporal conditions of pain were compared. The association between Depression, Anxiety and Stress and the presence or absence of pain was assessed by the chi-square test and odds ratio (OR). A multiple logistic regression model was developed to estimate the probability of negative affectivity in the sample.

Anxiety, Depression, and Suicidal Ideation amongst Patients with Facial Dermatoses (Acne, Rosacea, Perioral Dermatitis, and Folliculitis) in Lithuania

Background/Objective: Skin diseases, especially those with visible manifestation, are considered to cause a major influence on global mental health. Therefore, we determined the prevalence and severity of anxiety, depression, and suicidal ideation in a large sample of patients with facial dermatoses, namely acne, rosacea, folliculitis, and perioral dermatitis. Methods: The mental health of patients with facial dermatoses and respective controls was assessed using the Hospital Anxiety and Depression Scale and questions concerning suicidal ideation. Results: The study included 543 patients with facial dermatoses and 497 healthy individuals. Anxiety was present in 37.6% of the patients (14.9% of controls), depression in 21.7% (6.8%), and suicidal thoughts in 9.8% (3.2%) (p < 0.001). Acne patients demonstrated the highest anxiety and depression subscale scores (mean ± standard deviation: 7.1 ± 0.25, 95% confidence interval (CI): 6.58–7.56; controls: 5 ± 0.23, 95% CI: 4.57–5.49). In rosacea 30% of the patients had depression symptoms (adjusted odds ratio (OR): 7.216, 95% CI: 4.122–12.632, p < 0.001), while in folliculitis patients 15.4% (OR: 3.138, 95% CI: 1.241–7.936, p = 0.016) had suicidal thoughts. Patients with anxiety symptoms and suicidal thoughts were on average younger than those without (28.3 ± 0.76 vs. 31.2 ± 0.66 years, p = 0.001 and 25.3 ± 0.98 vs. 30.5 ± 0.55 years, p = 0.007, respectively). Conclusion: Acne and rosacea are associated with anxiety, depression, and suicidal ideation in Lithuanian patients. Younger patients are more prone to report such symptoms than older ones.

Preventable clinical and psychosocial factors predicted two out of three recurrent cardiovascular events in a coronary population

BackgroundThe relative importance of lifestyle, medical and psychosocial factors on the risk of recurrent major cardiovascular (CV) events (MACE) in coronary patients’ needs to be identified. The main objective of this study is to estimate the association between potentially preventable factors on MACE in an outpatient coronary population from routine clinical practice.MethodsThis prospective follow-up study of recurrent MACE, determine the predictive impact of risk factors and a wide range of relevant co-factors recorded at baseline. The baseline study included 1127 consecutive patients 2–36 months after myocardial infarction (MI) and/or revascularization procedure. The primary composite endpoint of recurrent MACE defined as CV death, hospitalization due to MI, revascularization, stroke/transitory ischemic attacks or heart failure was obtained from hospital records. Data were analysed using cox proportional hazard regression, stratified by prior coronary events before the index event.ResultsDuring a mean follow-up of 4.2 years from study inclusion (mean time from index event to end of study 5.7 years), 364 MACE occurred in 240 patients (21, 95% confidence interval: 19 to 24%), of which 39 were CV deaths. In multi-adjusted analyses, the strongest predictor of MACE was not taking statins (Relative risk [RR] 2.13), succeeded by physical inactivity (RR 1.73), peripheral artery disease (RR 1.73), chronic kidney failure (RR 1.52), former smoking (RR 1.46) and higher Hospital Anxiety and Depression Scale-Depression subscale score (RR 1.04 per unit increase). Preventable and potentially modifiable factors addressed accounted for 66% (95% confidence interval: 49 to 77%) of the risk for recurrent events. The major contributions were smoking, low physical activity, not taking statins, not participating in cardiac rehabilitation and diabetes.ConclusionsCoronary patients were at high risk of recurrent MACE. Potentially preventable clinical and psychosocial factors predicted two out of three MACE, which is why these factors should be targeted in coronary populations.Trial registrationRegistered at ClinicalTrials.gov: NCT02309255.Registered at December 5th, 2014, registered retrospectively.

Tailored, psychological intervention for anxiety or depression in people with chronic obstructive pulmonary disease (COPD), TANDEM (Tailored intervention for ANxiety and DEpression Management in COPD): protocol for a randomised controlled trial

BackgroundPeople with chronic obstructive pulmonary disease (COPD) are at increased risk of depression and anxiety, which greatly reduces their quality of life and is associated with worse outcomes; but these psychological co-morbidities are under-recognised and undertreated in COPD patients. Pulmonary rehabilitation (PR) improves mood for up to 6 months but health practitioners under-refer, and patients commonly fail to attend/complete PR. Research suggests that complex non-pharmacological interventions, including both psychological and exercise components, may reduce anxiety and depression in COPD.We have developed a tailored, cognitive behavioural approach (CBA) intervention for patients with COPD and co-morbid anxiety and/or depression (‘TANDEM’), which precedes and optimises the benefits of currently offered PR. We hypothesise that such a psychological intervention, delivered by supervised, trained respiratory healthcare professionals, will improve mood in patients with mild to moderate anxiety and/or depression and encourage uptake and completion of PR.MethodsWe will conduct a multi-centre, pragmatic, randomised controlled trial of the TANDEM intervention compared to usual care across the Midlands, London, the South East and Bristol, UK.We will train healthcare professionals familiar with COPD to deliver the manualised, tailored, face-to-face, one-to-one intervention weekly for 6–8 weeks.We will recruit 430 participants from primary, community and secondary care with confirmed COPD and moderate to very severe airflow limitation, who are eligible for assessment for PR, and who screen positive for symptoms of mild/moderate depression and/or anxiety using the Hospital Anxiety and Depression scale (HADS). Participants will be randomised 1.25:1 (intervention: usual care).The co-primary outcomes are the HADS anxiety and depression subscale scores at 6 months; participants will be followed up to 12 months. Secondary outcomes include uptake and completion of PR and healthcare resource use. There will be a parallel process evaluation and a health economic evaluation.DiscussionThe TANDEM intervention has the potential to optimise the unrealised synergy between a psychological intervention and PR. The CBA sessions will precede PR and target individuals’ cognitions, behaviours and symptoms associated with anxiety and depression to decrease psychological morbidity and increase effective self-management amongst patients with COPD.Trial registrationISRCTN, ID: ISRCTN59537391. Registered on 20 March 2017. Protocol version 6.0, 22 April 2018.

Discharge Education Intervention to Reduce Anxiety and Depression in Cardiac Surgery Patients: A Randomized Controlled Study

PurposeThis study aimed to determine possible effects of a discharge education intervention on anxiety and depression among cardiac surgery patients in a private hospital in the city of Ordu, Turkey. DesignA randomized controlled trial. MethodsThirty-three patients were placed in standard care group and 33 into standard care plus discharge education group. Patients in the discharge education group were provided an individual training from the first day of the hospital admission until the day of the discharge. The standard care group received usual discharge instructions. FindingsThe Hospital Anxiety and Depression Scale—anxiety subscale scores were not significantly different between patients in the discharge and standard care groups (group: F = 1.58; P > .05). There was a significant difference for depression, indicating that the discharge education group had significantly lower depression than the standard care group (group: F = 19.23; P < .01). ConclusionsOur findings supported that the discharge education intervention reduced depression in cardiac surgery patients.

The Longitudinal Impact of Excessive Daytime Somnolence on Motor and Nonmotor Symptoms of Parkinson's Disease in a Southeast Asian Cohort.

Sleep-wake disturbances, such as excessive daytime somnolence (EDS), are nonmotor symptoms of Parkinson's disease (PD) and significantly affect the quality of life. This study aimed to examine the relationship between EDS and motor and nonmotor symptoms of PD. Eighty-two patients with idiopathic mild PD were followed up twice a year for 2 years and assessed on sleep, mood, anxiety, cognition, function, and disease severity. Data were analyzed retrospectively, comparing motor and nonmotor outcomes between those with EDS and those without. At baseline, 27.9% had EDS and were similar in demographic and clinical characteristics to those without; 10% had persistent EDS during the first year of follow-up. Excessive daytime somnolence had a significant main effect on mood and anxiety as shown by consistently higher scores on the Geriatric Depression Scale (P = .022) and Hospital Anxiety and Depression Scale-Anxiety subscale scores (P = .011) throughout duration of follow-up. The group with persistent EDS showed greater rate of worsening Frontal Assessment Battery scores by the end of first-year follow-up (P = .025) and greater rate of worsening Apathy Scale scores by the end of 2-year follow-up (P = .002). No significant effects of EDS on motor symptoms and disease severity were found. In a Southeast Asian cohort of patients with PD, EDS had a negative longitudinal impact on mood, anxiety, apathy, and cognitive function but no impact on motor symptoms and disease severity. Excessive daytime somnolence is thus a potential therapeutic target to improve nonmotor outcomes.

Spatiotemporal brain activation pattern following acute citalopram challenge is dose dependent and associated with neuroticism: A human phMRI study

BackgroundThe initial effects of selective serotonin reuptake inhibitors (SSRIs) in the human living brain are poorly understood. We carried out a 3T resting state fMRI study with pharmacological challenge to determine the brain activation changes over time following different dosages of citalopram. MethodsDuring the study, 7.5 mg i.v. citalopram was administered to 32 healthy subjects. In addition, 11.25 mg citalopram was administered to a subset of 9 subjects to investigate the dose-response. Associations with neuroticism (assessed by the NEO PI-R) of the emerging brain activation to citalopram was also investigated. ResultsCitalopram challenge evoked significant activation in brain regions that are part of the default mode network, the visual network and the sensorimotor network, extending to the thalamus, and midbrain. Most effects appeared to be dose-dependent and this was statistically significant in the middle cingulate gyrus. Individual citalopram-induced brain responses were positively correlated with neuroticism scores and its subscales in specific brain areas; anxiety subscale scores in thalamus and midbrain and self-consciousness scores in middle cingulate gyrus. There were no sex differences. LimitationsWe investigated only healthy subjects and we used a relatively low sample size in the 11.25 mg citalopram analysis. DiscussionOur results suggest that SSRIs acutely induce an increased arousal-like state of distributed cortical and subcortical systems that is mediated by enhanced serotonin neurotransmission according to levels of neuroticism and underpins trait sensitivity to environmental stimuli and stressors. Studies in depression are needed to determine how therapeutic effects eventually emerge.This article is part of the special issue entitled ‘Serotonin Research: Crossing Scales and Boundaries’.

Chilliness in Japanese middle-aged women is associated with anxiety and low n-3 fatty acid intake

Objective: This cross-sectional study investigated chilliness, which is the most prevalent sexual-vasomotor symptom in middle-aged Japanese women.Methods: First-visit records of 475 Japanese women (age 40–65 years) enrolled in the health and nutrition education program at a menopause clinic were analyzed. Chilliness was estimated based on responses to the Menopausal Symptom Scale. Effects of age, menopausal status, body composition, cardiovascular parameters, resting energy expenditure, physical fitness, menopausal symptoms, lifestyle, and estimated daily intake of nutrients were assessed using a multivariate logistic regression analysis.Results: Severe chilliness was found in 28.4% of women. It was not related to age, menopausal status, body mass index, or body fat percentage. The anxiety subscale score of the Hospital Anxiety and Depression Scale was the sole background characteristic independently associated with severe chilliness (adjusted odds ratio, 1.09; 95% confidence interval, 1.04–1.15 per point). Daily intakes of vitamin D and n-3 fatty acids were significantly lower in women with severe chilliness. Daily intake of n-3 fatty acids was negatively associated with severe chilliness after adjustment (odds ratio, 0.54; 95% confidence interval, 0.29–0.95 per g/1000 kcal intake).Conclusions: Chilliness is associated with anxiety and low intake of n-3 fatty acids.

The long-term effects of microvascular decompression on social phobia and health-related quality of life in patients with hemifacial spasm: a 3-year prospective study.

Although not a life-threatening condition, hemifacial spasm (HFS) frequently leads to social phobia because it causes significant facial disfigurement and consequently reduces health-related quality of life (HRQoL). The purpose of the current study was to examine the long-term effects of MVD on psychological aspects and HRQoL in HFS patients with social anxiety over a 36-month follow-up. Thirty patients with HFS who underwent MVD from January 2015 to May 2015 were included in this prospective study. Clinical data, including standardized measures of general anxiety and depression (Hospital Anxiety Depression Scale (HADS)), social anxiety (Liebowitz Social Anxiety Scale (LSAS)), and the severity of HFS, were collected postoperatively, and 6months and 36months after MVD. Likewise, data on HRQoL were collected at baseline, and 6months and 36months after MVD using the Korean version of the Short Form 36 (SF-36). Twenty-two patients who completed the 36-month follow-up were classified into social phobia group and non-social phobia group based on the LSAS total scores of 60. Repeated measures analysis of variance demonstrated significant differences between the two groups over time for the total LSAS score (p < 0.001), anxiety subscale score of the HADS (p = 0.002), and the Mental Component Summary (MCS) (p = 0.046) of the SF-36. A comparison of these two groups in terms of differences observed in their scales at 6months after MVD has shown that the improvements of the social phobia group in HADS anxiety subscale (p = 0.010), LSAS total score (p = 0.008), and MCS (p = 0.040) were significantly more improved than the those of non-social phobia group. And at 36months after surgery, the improvement of the scales mentioned above was maintained, and additionally Vitality (p = 0.040) and Mental Health (p = 0.040) dimensions showed a statistically significant improvement. The improvements previously observed in psychological aspects and HRQoL over a short-term follow-up after MVD in HFS patients with social phobia were maintained for at least 36months after MVD.

Association between orthorexia nervosa, eating attitudes and anxiety among medical students in Lebanese universities: results of a cross-sectional study.

The objective of the study was to evaluate the association between orthorexia nervosa (ON) tendencies and behaviors, eating attitudes (EAT) and anxiety among a representative sample of medical students in the Lebanese universities. This cross-sectional study, conducted between May 2018 and January 2019, enrolled 627 medical students using a proportionate random sample from all seven faculties of medicine in Lebanon. The ORTO-15 scale was used to evaluate ON tendencies and behaviors among participants. Scores below 40 indicate the presence of ON. The Eating Attitude Test-26 and the Hamilton Anxiety Rating A (HAM-A) scales (yielding a psychic and a somatic subscale scores) were used to assess eating attitudes and anxiety, respectively. It is noteworthy that the sum of the EAT items 6, 7, 16 and 17 responses yielded the EAT score that would predict ON. The results of a linear regression, taking the ORTO-15 score (15 items) as the dependent variable and the EAT total score, the summated score of the EAT items that predict ON and the psychic and somatic anxiety subscales scores as independent variables, showed that a higher EAT score (β = - 0.094) was significantly associated with lower ORTO-15 scores (more orthorexia tendencies and behaviors); whereas, a higher psychic anxiety subscale score (β = 0.117) was significantly associated with higher ORTO-15 scores (lower orthorexia tendencies and behaviors). This suggests a link between eating disorders and ON which is beyond ON tendencies observed in eating disorders but ON individuals simultaneously have lesser psychological distress and anxiety. Level 5, cross-sectional descriptive study.

A sense of dread: affect and risk perception in people with schizophrenia during an influenza pandemic.

To explore the role of affect in risk perception and intention to adopt protective measures against pandemic swine influenza in people with schizophrenia. A cross-sectional study was conducted exploring the responses of 71 adults with schizophrenia and 238 adults attending general practice settings without schizophrenia. Participants completed a questionnaire that included items relating to: self-predicted affect (affective forecast) were they to contract swine influenza; perceived risk from swine influenza; and willingness to adopt protective measures against swine influenza. The 10-item Kessler Psychological Distress Scale (K10) and a single-item Self-Rated Health Question (SRHQ) were also included as measures. In people with schizophrenia, higher levels of predicted fear were associated with increased likelihood of perceived substantive risk from swine influenza and self-reported willingness to adopt protective measures against it. However, higher K10 anxiety subscale scores, reflecting greater concurrent anxiety, were associated with reduced likelihood of perceived substantive risk from swine influenza in people with schizophrenia. Affect appears to play a role in risk perception of influenza and willingness to take protective measures against it in people with schizophrenia.

Interleukin-6 and interleukin-17 are related to depression in patients with rheumatoid arthritis.

Mood disorders are a serious issue for patients with rheumatoid arthritis (RA) because poor mental health can exacerbate the disease course. This study aimed to identify the effect of proinflammatory cytokines on the mood of patients with RA. This study was conducted at a rheumatology clinic in Northern Taiwan. In total, 113 patients with RA and 42 healthy controls were assessed for anxiety and depression symptoms using Hospital Anxiety and Depression Scale (HADS). RA was assessed using the Disease Activity Score of 28 joints (DAS28). Serum proinflammatory cytokine levels, including interleukin (IL)-1β, IL-6, IL-17 and tumor necrosis factor alpha (TNF-α) were measured and compared between different patient groups according to disease activity and pain level. Serum IL-1β, IL-6, IL-17 and TNF-α levels were significantly higher in patients with RA than in healthy controls, as were the mean anxiety and depression subscale scores. In patients with RA who had different disease activities, pain severity correlated with both anxiety and depression symptoms. When HADS scores were analyzed according to pain levels, age was correlated with depression in the severe pain group. In the mild pain group, patients with higher IL-6 or higher IL-17 had a higher risk of depression. There was no correlation between mood symptoms and cytokine levels in healthy controls. Elevated serum IL-6 and IL-17 levels in patients with RA induce arthritis and cause mood symptoms, especially depression symptoms.