Anxiety Symptomatology Research Articles

Psychiatric symptoms, associated pharmacological treatments and cognitive function: A population-based study of men

BackgroundPsychiatric symptomatology and medications used in their treatment may be modifiable risk factors associated with cognitive function, although findings from population-based studies spanning the full adult age range are lacking. This study aimed to investigate associations between psychiatric symptomatology, psychotropic medication use and cognitive function in a population-based sample of men. MethodsData for 537 men were drawn from the Geelong Osteoporosis Study. Cognitive function (psychomotor function, attention, working memory and visual learning) was determined using the Cog-State Brief Battery. Current depressive and anxiety symptomatology was determined using the Hospital Anxiety and Depression Scale, and psychotropic medication use was self-reported. Linear regression models were developed to determine associations between psychiatric symptomatology and psychotropic medication use with each cognitive measure. ResultsDepressive symptomatology was associated with lower overall cognitive function (b-0.037 ± 0.010, η2 = 0.025, p < 0.001), psychomotor function (b 0.006 ± 0.002, η2 = 0.028 p < 0.001) and attention (b 0.004 ± 0.001, η2 = 0.021, p < 0.001), whereas psychotropic use was associated with lower overall cognitive function (b − 0.174 ± 0.075, η2 = 0.010, p = 0.021), attention (b 0.017 ± 0.008, η2 = 0.008, p = 0.038 and working memory (b 0.031 ± 0.012, η2 = 0.010, p = 0.010). Anticonvulsant use was associated with lower overall cognitive function (b − 0.723 ± 0.172, η2 = 0.032, p < 0.001), attention (b 0.065 ± 0.018, η2 = 0.029, p < 0.001) and working memory (b 0.088 ± 0.026, η2 = 0.022, p < 0.001). All relationships were found to have a small effect. There were no significant associations between anxiety symptomatology and antidepressant and anxiolytic use with any of the cognitive domains. ConclusionDepressive symptomatology and anticonvulsant use were associated with lower cognitive function. Understanding the underlying mechanisms involved in these relationships can advance knowledge on the heterogeneity in cognitive ageing and aid in prevention initiatives.

Dispositional factors in the explanation of symptoms of depression, anxiety, health anxiety and COVID-19 Phobia.

Maladaptive personality, the motivational systems, and intolerance of uncertainty play important roles in the statistical explanation of depression and anxiety. Here, we notably examined for the first time whether symptoms of depression, anxiety, health anxiety, and fear of COVID-19 share similar associations (e.g., variance explained) with these important dispositional dimensions. For this cross-sectional study, data from 1001 participants recruited in Germany (50% women; mean age = 47.26) were collected. In separate models, we examined the cross-sectional associations of the symptoms of depression, anxiety, health anxiety, and fear of COVID-19 with the Personality Inventory for DSM Short Form Plus scales, the Behavioral Inhibition System / Flight-Fight-Freeze System / Behavioral Activation System scales, and Intolerance of Uncertainty scales. Relative weight analyses were used to determine the within-model importance of the different scales in the prediction of the symptoms. All in all, our study showed that maladaptive personality and intolerance of uncertainty dimensions are more important sets of predictors of the studied outcomes (with which depressive and anxious symptomatology feature very similar associations) than are the motivational system dimensions. Within predictor sets, the scales with the most important predictors were: Negative Affectivity, the Behavioral Inhibition System, and Burden due to Intolerance of Uncertainty. Our findings highlight the relevance of focusing behavioral targets of psychotherapy on these within-set traits and identify potential research priorities (maladaptive personality and intolerance of uncertainty) in relation to the symptoms of interest.

Centering Agency: Examining the Relationship Between Acts of Resistance, Anxiety, and Depression Among Undocumented College Students

Research has established that legal vulnerability has detrimental consequences for the mental health of undocumented individuals. The purpose of our study is to consider how practicing agency is associated with mental health in the face of such structural marginalization. To meet this goal, we conceptualize actions taken to resist structural inequality as acts of resistance to center immigrants’ agency in navigating and contesting their marginalization. Drawing on survey data with California undocumented college students, we examine to what extent engaging in three acts of resistance is associated with depression and anxiety symptomatology. We find that students with higher rates of political engagement and critical consciousness raising report higher depression and anxiety symptomatology. Findings suggest that structural approaches to studying mental health must also consider immigrants’ agency and efforts to navigate, respond to, and challenge their marginalization.

Network analysis of anxiety and depressive symptoms during the COVID-19 pandemic in older adults in the United Kingdom

The health crisis caused by COVID-19 in the United Kingdom and the confinement measures that were subsequently implemented had unprecedented effects on the mental health of older adults, leading to the emergence and exacerbation of different comorbid symptoms including depression and anxiety. This study examined and compared depression and anxiety symptom networks in two specific quarantine periods (June–July and November–December) in the older adult population in the United Kingdom. We used the database of the English Longitudinal Study of Aging COVID-19 Substudy, consisting of 5797 participants in the first stage (54% women) and 6512 participants in the second stage (56% women), all over 50 years of age. The symptoms with the highest centrality in both times were: “Nervousness (A1)” and “Inability to relax (A4)” in expected influence and predictability, and “depressed mood (D1”; bridging expected influence). The latter measure along with "Irritability (A6)" overlapped in both depression and anxiety clusters in both networks. In addition, a the cross-lagged panel network model was examined in which a more significant influence on the direction of the symptom "Nervousness (A1)" by the depressive symptoms of "Anhedonia (D6)", "Hopelessness (D7)", and "Sleep problems (D3)" was observed; the latter measure has the highest predictive capability of the network. The results report which symptoms had a higher degree of centrality and transdiagnostic overlap in the cross-sectional networks (invariants) and the cross-lagged panel network model of anxious and depressive symptomatology.

Use of monthly extended-release risperidone injection in schizophrenia: clinical experience

IntroductionMonthly extended-release injectable risperidone is the new antipsychotic formulation of risperidone available in doses of 75 mg and 100 mg, approved for the treatment of schizophrenia. It contains microcrystals of risperidone that are deposited following intramuscular injection. A fraction of the active ingredient of risperidone is already solubilized and rapidly enters the bloodstream, providing plasma levels similar to oral risperidone on the first day. The microcrystals continue to release risperidone steadily over a period of 4 weeks. No oral supplementation or loading doses are required.ObjectivesThe objective of this study is to demonstrate the effectiveness of treatment with monthly extended-release injectable risperidone in patients with schizophrenia who are followed up as outpatients from the Mental Health Center. The study aims to show that this treatment improves symptoms associated with schizophrenia, leading to an enhancement in the quality of life for these patients.MethodsAnalysis and evaluation were conducted on 9 patients diagnosed with Paranoid Schizophrenia and treated with monthly extended-release injectable risperidone from a Mental Health Unit and the Hospital Emergency System during the months of January to April 2023. Among the nine patients, six were previously on oral risperidone treatment exceeding 4 mg, and three were on doses less than 4 mg. The first group received a monthly injectable dose of 100 mg of risperidone, while the second group received 75 mg.ResultsAll nine patients showed improvement in positive and anxious symptomatology. Seven of them exhibited improvement in affective and cognitive profiles. None of the patients experienced significant metabolic alterations, and only one of them reported akathisia as a side effect. Furthermore, all patients improved their sleep patterns, and the seven who had behavioral disturbances with a tendency towards aggression no longer exhibited these behaviors.ConclusionsMonthly extended-release injectable risperidone is beneficial in reducing positive and affective symptoms in patients with schizophrenia. It also improves anxious, cognitive, and behavioral symptomatology. It is considered effective, safe, and well-tolerated for long-term treatment of this disease, regardless of its initial severity. Therefore, it is advisable to consider it as the first therapeutic option in patients with schizophrenia who have responded well to oral risperidone previously.Disclosure of InterestNone Declared

Transcranial magnetic stimulation for obsessive-compulsive disorder - preliminary results of an observational study

IntroductionObsessive-compulsive disorder (OCD) has a high prevalence and causes a significative reduction in functionality and quality of life.First and second line treatment is ineffective in a variable percentage of patients. In such cases transcranial magnetic stimulation (TMS) may be considered.ObjectivesThe goal of this study is to evaluate the impact of TMS treatment on obsessive-compulsive, anxious and depressive symptomatology in patients with OCD.MethodsA prospective observational study was conducted, including all patients diagnosed with OCD who underwent TMS in the Psychiatry department of Centro Hospitalar Universitário de São João since March 2023.Symptomatology was assessed using the Yale Brown Obsessive-Compulsive Scale (Y-BOCS), the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Depression Rating Scale (HAM-D) before and after treatment.Statistical analysis was performed using the SPSS-Statistics program. A significance level of 0.05 was considered.ResultsAs of October 31, 2023, nine individuals with OCD completed treatment with TMS, 33% male and with a median age of 40 years (range 33-57).The median Y-BOCS score pre-TMS was 30 (range 20-33) and post-TMS 28 (range 16-34). The median difference was 2.5 (range -5-14) and was not statistically significant (p=0.128). The median score on the HAM-A pre-TMS was 21 (range 9-41) and post-TMS 18 (range 11-24). The median difference was 0 points (range -4-21) and was not statistically significant (p=0.345).The median HAM-D score pre-TMS was 26 (range 14-40) and post-TMS 19 (range 10-32). The median difference was 2.5 (range -3-20) and was not statistically significant (p=0.225).Conclusions Preliminary findings suggest that the impact of TMS on obsessive-compulsive, anxious, and depressive symptomatology in patients with OCD does not appear to be clinically or statistically significant.Further results are necessary to confirm this trend.Disclosure of InterestNone Declared

Level of personality functioning among outpatients with predominant anxiety symptoms

IntroductionDimensional diagnosis of personality disorders has as its main criterion the assessment of the level of functionality. And in patients with other diagnostic categories, there is a difference in the degree of functioning, as well as a difference in the course and prognosis of the disorder. The reason for such a different course may be the existence of a certain degree of personality dysfunctionality.ObjectivesThe aim of the study is to determine the prevalence of personality disorder in patients with neurotic disorder and predominantly anxiety symptomatology.MethodsA descriptive cross-sectional study was made to determine personality disorder in patients with neurotic disorder (F40-F48, excluding those where the disorder is related to stress F43) and predominantly anxiety symptomatology. The HAM-A scale was used to assess anxiety, and the LPFS-BF-2.0 was used to assess the level of personality functioning. The results were processed by descriptive statistical analysis.ResultsThe study included 25 individuals (N 25, 64% women), aged between 18 and 65 years (mean age 44.16, SD 13.20) with a diagnosed neurotic disorder. All subjects had elevated anxiety symptomatology, mean HAM-A score was 35.36 (SD 7.76). The assessment of the level of personality functioning with the LPFS-BF-2.0 gave the following results: 20% of people have a personality difficulty, 12% have a mild personality disorder, 32% have a moderate and 4% have a severe personality disorder.Conclusions According to the obtained results, 68% of people with a neurotic disorder and a high degree of anxiety have a certain degree of personality dysfunction. The prevalence of personality disorder in individuals with neurotic disorder is high (48%). These results lead to the conclusion that people with pronounced anxiety often have a disruption in personality. In people with a high level of anxiety, an assessment should be made for the level of functioning of the person, as well as for the existence of a personality disorder, and the treatment should be adjusted according to the results obtained. In addition to the treatment of the emerging symptoms, the personality dysfunctions should also be treated.Disclosure of InterestNone Declared

Secondary Trauma by Internet Content Moderation: a Case Report

Introduction In recent years, a global debate has emerged regarding the protection of Internet users from exposure to harmful content. Content moderation is defined as the organized practice of filtering user-generated content posted on internet, social networks, and media to determine the appropriateness of the content for a site, locality, or jurisdiction. The growing volume of this content along with the psychological impact of this activity have promoted the application of automated approaches based on artificial intelligence and machine-learning. However, the changing characteristics of content, as well as the cultural differences that influence its appropriateness, mean that human moderation of Internet content currently continues to exist. Psychological effects of this activity such as symptoms of post-traumatic stress disorder (PTSD) could represent an example of secondary trauma.Objectives Our aim is to describe a clinical case of post-traumatic stress disorder presenting with specific traumatic exposure idiosyncrasy that could lead to a better consequence characterization of a recent social phenomena such as internet content moderation.MethodsWe expose the clinical case of a woman with emotional distress who was reffered to our outpatient psychiatric unit in Barcelona in 2022 after five years working as an internet content moderator.ResultsWe describe the case of a 35-year-old woman without relevant medical, toxicologic or psychiatric record that presents to our out-patient psychiatric clinic with post-traumatic stress disorder after five years of working as an internet content moderator and being exposed to visual traumatic content such as sexual assault and paedophilia. The clinical presentation consisted with one year of recurrent daily panic attacks, intrusive images about the traumatic exposure, intrusive thoughts, insomnia, vivid nightmares, avoidance of exposure to her son, distrust of the environment and intense fear for her son security. The disorder interfered in her capacity to work. The patient received psychological treatment and ISRS (Sertraline) was prescribed, however only partial response was reached with persistence of the majority of symptoms.ConclusionsThe presented case suggests a temporal and symptom content relationship between the described work exposure and the appearance of emotional distress in a patient without PTSD history. Although previous evidence of secondary trauma in people exposed to indirect traumatic experiences has been reported, for example in healthcare professionals, the exposure to alien trauma through digital exposure as a workactivity is yet to be specifically examined. It is necessary to expand knowledge on the clinical expression of this phenomenon due to the observed recurrence of anxious and depressive symptomatology related to repeated exposure to traumatic content.Disclosure of InterestNone Declared

Evaluating alexithymia as a mediator of the relationship between sensory processing sensitivity and health anxiety

Highly sensitive individuals demonstrate heightened responses to environmental stimuli than their peers, often presenting with anxious and depressive symptomatology akin to those in alexithymic individuals. Alexithymia, referred to as difficulty in describing or identifying emotions, is of particular interest to use as a mediating variable between sensitivity to sensory processing and health anxiety. The present study aims to explore the relationship between sensory processing sensitivity (SPS) and alexithymia, and their collective impact on health anxiety, a correlation which, to the best of our knowledge, has not been previously examined, despite the common preoccupation with health among those affected. Health anxiety, defined by the fear of suffering from a serious and/or chronic illness, or of misinterpreting somatic symptoms as signs of illness, is the focal point of this investigation. The study recruited 814 adults (79.7% women and 20.3% men), with a mean age of 30 years old (standard deviation = 12.5 years), ranging from 18 to 76 years. Participants anonymously answered a questionnaire consisting of the French versions of the Highly Sensitive Person Scale (HSPS-FR), the Toronto Alexithymia Scale-20, and the Health Anxiety Questionnaire (HAQ). Statistical analyses, including correlations, ANOVA, linear regressions, and mediation analysis, were performed using SPSS and the SPSS macro PROCESS. Results revealed significant positive correlations among the three constructs (P &lt; 0.001). Furthermore, both SPS and alexithymia were found to be predictive of health anxiety (P &lt; 0.001). In addition, an indirect partial mediation effect between SPS and health anxiety through alexithymia was observed. This study highlights the intertwined relationship between sensitivity and alexithymia, shedding light on their collective impact on anxiety, particularly health anxiety. Moreover, it facilitates the examination of this relationship within a large population and amidst the specific context of COVID-19. Practical perspectives concerning support for highly sensitive people are discussed, taking into account their potential specific needs.

Impulse phobias during pregnancy: a case report of a 37 year-old woman pregnant of her first child

IntroductionPregnancy and puerperium are two critical stages for women’s mental health due to the biological stress of pregnancy itself, as well as the emotional stress that surrounds this vital moment. (1) Debut and aggravation of psychiatric symptoms may occur, as well as relapse in women previously diagnosed with Severe Mental Disorder (SMD).Symptoms of the anxious spectrum are the most frequent within the perinatal mental pathology, being impulse phobias an entity that appears in about 25% of women previously diagnosed with OCD and up to 10-15% of women without previous psychopathology (2)ObjectivesExposing the importance of Perinatal Mental Health from the presentation of a clinical case.MethodsReview of the literature available in PubMed. Presentation of the pathobiography and evolution of the patient.ResultsOur case is about a 37-year-old woman, 30 weeks pregnant with her first child and history of having required admission to Psychiatry with subsequent follow-up in Mental Health for anxious-depressive symptoms with the presence of self-injurious ideas who, after two weeks with multiple life stressors, came to the Emergency Department for the presence of impulse phobias focused on pregnancy with significant internal anguish and ideas of death as a resolution to it, which is why it was decided to hospitalize her. During admission, and taking into account the patient’s gestational state, treatment was started with diluted Mirtazapine and Aripiprazole solution at minimal doses, which in this case were sufficient for symptom control.The latest guidelines addressing psychopharmacology during pregnancy and lactation point to sertraline among the antidepressants and Lorazepam among the benzodiazepines as the safest drugs during pregnancy (3).Conclusions-The exacerbation of anxious symptomatology and the presence of gestation-focused impulse phobias are frequent during pregnancy and their intensity increases as the time of delivery approaches.-Sertraline, Lorazepam, Mirtazapine and Aripiprazole are safe drugs during pregnancy.-In these women, a close and multidisciplinary follow-up by Psychiatry and Gynecology is advisable.Disclosure of InterestNone Declared

Precision computerised cognitive behavioural therapy (cCBT) for adolescents with depression: a pilot and feasibility randomised controlled trial protocol for SPARX-UK

BackgroundA serious game called SPARX (Smart, Positive, Active, Realistic, X-factor thoughts), originally developed in New Zealand and incorporating cognitive behavioural therapy (CBT) principles, has been shown to help reduce symptoms of depression and anxiety in adolescents with mild to moderate depression in studies undertaken in Australasia. However, SPARX has never been trialled in the United Kingdom (UK), and there have been issues relating to low engagement when it has been used in a real-world context.AimsTo conduct the first pilot and feasibility randomised controlled trial (RCT) in England to explore the use of SPARX in different settings. The trial will explore whether SPARX supported by an e-coach (assistant psychologists) improves adherence and engagement compared with self-directed (i.e. self-help) use. The trial results will be used to inform the optimal mode of delivery (SPARX supported vs. SPARX self-directed), to calculate an appropriate sample size for a full RCT, and to decide which setting is most suitable.MethodsFollowing consultation with young people to ensure study suitability/appropriateness, a total of 120 adolescents (11–19 years) will be recruited for this three-arm study. Adolescents recruited for the study across England will be randomised to receive either SPARX with human support (from an e-coach), self-directed SPARX, or a waitlist control group. Assessments will be conducted online at baseline, week 4, and 8–10-week post-randomisation. The assessments will include measures which capture demographic, depression (Patient Health Questionnaire modified for adolescents [PHQ-A]) and anxiety (Revised Child Anxiety and Depression Scale [RCADS]) symptomatology, and health-related quality-of-life data (EQ-5D-Y and proxy version). Analyses will be primarily descriptive. Qualitative interviews will be undertaken with a proportion of the participants and clinical staff as part of a process evaluation, and the qualitative data gathered will be thematically analysed. Finally, feasibility data will be collected on recruitment details, overall study uptake and engagement with SPARX, participant retention, and youth-reported acceptability of the intervention.DiscussionThe findings will inform the design of a future definitive RCT of SPARX in the UK. If the subsequent definitive RCT demonstrates that SPARX is effective, then an online serious game utilising CBT principles ultimately has the potential to improve the provision of care within the UK’s health services if delivered en masse.Trial registrationISRCTN: ISRCTN15124804. Registered on 16 January 2023, https://www.isrctn.com/ISRCTN15124804.

The Why to Bear Any How: Goal Self-Concordance, Meaning, and Depressive and Anxious Symptomatology

The Why to Bear Any How: Goal Self-Concordance, Meaning, and Depressive and Anxious Symptomatology

Anxiety in Turner syndrome: Engaging community to address barriers and facilitators to diagnosis and care.

Turner syndrome (TS), caused by complete or partial loss of the second sex chromosome, is associated with complex medical manifestations. The TS community identifies anxiety as a major contributor to reduced quality of life. The study aimed to improve understanding of anxiety symptomatology, diagnosis, and care in individuals with TS. A mixed methods design integrated community engagement, including community leaders as co-investigators and a community advisory board, an online survey (N = 135), and in-depth interviews (N = 10). The majority of respondents reported that anxiety symptoms occur two or more days per week, with self-advocates reporting more frequent symptoms than caregivers (p = 0.03). Self-advocates reported feeling anxious more often at school/work; both rater groups reported anxiety-related behaviors were most likely to be expressed at home. Insomnia was the most common symptom of anxiety endorsed across age and rater groups (>70%). Anxiety symptoms and triggers changed with age and often were undiagnosed or untreated during childhood. Therapy and medication were reported as helpful by most respondents who had tried these strategies. Qualitative themes included: 'Triggers for anxiety are related to TS', 'Anxiety impacts the whole family', and 'Opportunities for early identification and intervention'.

Acupressure: a possible therapeutic strategy for anxiety related to COVID-19: a meta-analysis of randomized controlled trials.

From the end of 2019 to December 2023, the world grappled with the COVID-19 pandemic. The scope and ultimate repercussions of the pandemic on global health and well-being remained uncertain, ushering in a wave of fear, anxiety, and worry. This resulted in many individuals succumbing to fear and despair. Acupoint massage emerged as a safe and effective alternative therapy for anxiety relief. However, its efficacy was yet to be extensively backed by evidence-based medicine. This study aimed to enhance the clinical effectiveness of acupoint massage and extend its benefits to a wider population. It undertakes a systematic review of the existing randomized controlled trials (RCTs) assessing the impact of acupoint massage on anxiety treatment, discussing its potential benefits and implications. This research aims to furnish robust evidence supporting anxiety treatment strategies for patients afflicted with COVID-19 disease and spark new approaches to anxiety management. This study evaluates the evidence derived from randomised controlled trials (RCTs), quantifies the impact of acupressure on anxiety manifestations within the general population, and proposes viable supplementary intervention strategies for managing COVID-19 related anxiety. This review included RCTs published between February 2014 and July 2023, that compared the effects of acupressure with sham control in alleviating anxiety symptomatology as the outcome measure. The studies were sourced from the multiple databases, including CINAHL, EBM Reviews, Embase, Medline, PsycINFO, Scopus and Web of Science. A meta-analysis was performed on the eligible studies, and an overall effect size was computed specifically for the anxiety outcome. The Cochrane Collaboration Bias Risk Assessment Tool (RevMan V5.4) was employed to assess bias risk, data integration, meta-analysis, and subgroup analysis. The mean difference, standard mean deviation, and binary data were used to represent continuous outcomes. Of 1,110 studies of potential relevance, 39 met the criteria for inclusion in the meta-analysis. The majority of the studies reported a positive effect of acupressure in assuaging anticipatory anxiety about treatment. Eighteen studies were evaluated using the STAI scale. The acupressure procedures were thoroughly documented, and studies exhibited a low risk of bias. The cumulative results of the 18 trials showcased a more substantial reduction in anxiety in the acupressure group compared to controls (SMD = -5.39, 95% CI -5.61 to -5.17, p < 0.01). A subsequent subgroup analysis, based on different interventions in the control group, demonstrated improvement in anxiety levels with sham acupressure in improving changes in anxiety levels (SMD -1.61, 95% CI: -2.34 to -0.87, p < 0.0001), and blank controls (SMD -0.92, 95% CI: -2.37 to 0.53, p = 0.22). In the clinical research of traditional Chinese medicine treatment of anxiety, acupressure demonstrated effectiveness in providing instant relief from anxiety related to multiple diseases with a medium effect size. Considering the increasing incidence of anxiety caused by long COVID, the widespread application of acupressure appears feasible. However, the results were inconsistent regarding improvements on physiological indicators, calling for more stringent reporting procedures, including allocation concealment, to solidify the findings.

Using Smartphone Technology to Track Real-Time Changes in Anxiety/Depression Symptomatology Among Florida Cannabis Users.

Recent scientific attention has focused on the therapeutic effectiveness of cannabis use on a variety of physical and mental ailments. The present study uses smartphone technology to assess self-reported experiences of Florida cannabis users to understand how cannabis may impact anxiety and depression symptomatology. Several hundred Releaf App™ users from the state of Florida provided anonymous, real-time reports of their symptoms of anxiety and/or depression immediately before and after cannabis use sessions. Linear mixed-effects modeling was used to analyze the data at the symptom and user level. Results showed that for the majority of users, cannabis use was associated with a significant decrease in depression and anxiety symptomatology. While symptom type, doses per session, consumption method, and CBD levels were significant predictors of relief change, their effect sizes were small and should be interpreted with caution. At the user level, those who had positive relief outcomes in anxiety reported more doses and sessions, and those in the depression group reported more sessions. Our results generally support the therapeutic effectiveness of cannabis against depression/anxiety symptomatology. Future work should include standardized statistics and effect size estimates for a better understanding of each variable's practical contribution to this area of study.

Effects of physical activity on levels of anxiety, depression, and stress during the social isolation caused by COVID-19

COVID-19 is a disease caused by the SARS-CoV-2 virus, a new strain within the coronavirus family, which manifests itself in a varied and aggressive manner. The scenario of the COVID-19 pandemic has favored episodes of stress generated by prolonged isolation. Adherence to the practice of physical activity promotes beneficial effects on mental disorders, proving effective in this critical moment. The study's objective was to verify the effects of physical activity on levels of anxiety, stress, and depression during the period of social isolation. It is a cross-sectional study that identified the symptomatology of anxiety, stress, and depression, using the DASS-21. A total of 551 participants responded to the questionnaire online. The results showed that participants who did not engage in exercise before COVID-19 (n = 182) had higher levels of depression (p = .005), while those who engaged in physical activity (n = 323) showed lower indicators of anxiety (p = .010), stress (p = .021), and depression (p = .001). The study revealed that the frequent and continued practice of physical activity minimizes symptoms of anxiety, stress, and depression caused by the prolonged period of social isolation, favoring mental health benefits.

Clinical Symptomatology of Anxiety and Family Function in Adolescents-The Self-Esteem Mediator.

Family, the child's first environment, shapes their psycho-emotional balance. The literature links adolescent anxiety to family relationships, interactions, and dynamics. The self-esteem of adolescents appears to protect their mental health. This study examines whether family cohesion and adaptability affect adolescent anxiety symptoms. It also examines whether teen self-esteem mediates this relationship. This cross-sectional, descriptive study included 166 Attica youth aged 12-18 from schools and educational units. The adolescents completed Olson's FACES-III cohesion and adaptability scale, Spielberger's STAI-C, Rosenberg's self-esteem scale, and a socio-demographic questionnaire. Family cohesion, but not adaptability, was negatively correlated with state (rho = -0.25, p = 0.001) and trait (rho = -0.46, p < 0.001) anxiety in the adolescents. Teenagers from extreme families with the lowest cohesion and adaptability had higher trait anxiety (x2(2) = 6.91, p = 0.032) than those from moderately balanced/balanced families. Self-esteem mediated the relationship between the family cohesion functioning and adolescent's state anxiety (p = 0.005) and trait anxiety (p = 0.011). The findings show that family dysfunction negatively impacts adolescent anxiety, as well as their self-esteem, which protects mental balance.

Fear generalization predicts post-traumatic stress symptoms: A two-year follow-up study in Dutch fire fighters

IntroductionExcessive fear generalization has been associated with pathological anxiety, including posttraumatic stress disorder (PTSD). However, studies investigating the longitudinal relationship between generalization and the development of anxiety symptomatology are scarce. This study aims to test the predictive value of fear generalization for PTSD symptoms in a high-risk profession sample and to explore the relationship between generalization and neuroticism, which are both linked to PTSD. MethodLongitudinal data from a multi-wave study in 529 Dutch fire-fighters were used. Fear generalization, PTSD symptoms and neuroticism were assessed at baseline. PTSD symptoms were reevaluated at six, 12, 18, and 24 months. Generalization was assessed in a differential conditioning paradigm by measuring expectancies of an aversive outcome when presented with stimuli similar to previously conditioned stimuli. ResultsHigher expectancy ratings towards stimuli most similar to safety signals predicted PTSD symptoms at follow-up after controlling for baseline PTSD symptoms, whereas higher expectancy ratings towards stimuli most similar to danger signals was associated with neuroticism. Neuroticism weakened the predictive power of fear generalization when considered simultaneously. DiscussionThese findings suggest that heightened fear generalization is associated with the development of anxiety and trauma-related symptoms. Targeting problematic fear generalization may be a promising intervention approach.

Cost-Utility of Attachment-Based Compassion Therapy (ABCT) and Mindfulness-Based Stress Reduction (MBSR) in the Management of Depressive, Anxious, and Adjustment Disorders in Mental Health Settings: Economic Evaluation Alongside a Randomized Controlled Trial

ObjectivesThe main objective of this paper was to examine the cost-utility of attachment-based compassion therapy (ABCT) compared to Mindfulness-Based Stress Reduction (MBSR) and treatment-as-usual (TAU) on patients with depressive and/or anxious disorder, or adjustment disorder with depressive and/or anxious symptomatology in terms of effects on quality-adjusted life years (QALYs) as well as healthcare costs from a public healthcare system perspective.MethodA 6-month randomized controlled trial was conducted. Ninety Spanish patients with mental disorders (depressive, anxious, or adjustment disorders) received 8 weekly group sessions of TAU + ABCT, TAU + MBSR, or TAU alone. Data collection took place at pre- and 6-month follow-up. Cost-utility of the two treatment groups (ABCT vs MBSR vs TAU) was compared by examining treatment outcomes in terms of QALYs (obtained with the EQ-5D-3L) and healthcare costs (data about service use obtained with the Client Service Receipt Inventory).ResultsBoth MBSR and ABCT were more efficient than TAU alone, although the results did not reach statistical significance. Compared to ABCT, MBSR produced an increase both in terms of costs (€53.69, 95% CI [− 571.27 to 513.14]) and effects (0.004 QALYs, 95% CI [− 0.031 to 0.049]); ICUR = €13,422.50/QALY). Both interventions significantly reduced the number of visits to general practice compared to TAU.ConclusionsThis study has contributed to the evidence base of mindfulness- and compassion-based programs and provided promising information about the cost-utility of MBSR for patients with emotional disorders. However, the small sample size and short follow-up period limit the generalizability of the findings.PreregistrationClinicaltrials.gov; NCT03425487.

Caregiver and youth inter-rater assessment agreement in autism spectrum disorder, developmental coordination disorder, and typical development.

Youth diagnosed with autism spectrum disorder (ASD) and those with developmental coordination disorder (DCD) are at heightened risk for co-occurring mental health diagnoses, especially anxiety and attention-deficit/hyperactivity disorder (ADHD). However, caregiver-child agreement on presence of related symptoms in populations with neurodevelopmental conditions is not well understood. Here, we examine the extent to which 37 ASD, 26 DCD, and 40 typically developing children and their caregivers agree on the degree of the child's symptoms of anxiety and ADHD. All caregiver-child dyads completed the Screen for Child Anxiety Related Emotional Disorders and Conners 3 ADHD Index. Across groups, intraclass correlations indicated generally poor agreement on anxiety and ADHD symptomatology. Although youth generally reported greater internalizing symptoms (i.e., anxiety), caregivers tended to report more observable externalizing behaviors (i.e., ADHD). Together, the results of this study support the need for a multi-informant approach in assessments of anxiety and ADHD in youth with neurodevelopmental disorders.