Anxiety Symptoms Research Articles

62 Outcomes from a randomized controlled trial of a brief virtual group intervention for adolescents with mild to moderate suicidal ideation and their caregivers: The BRAVA study

Abstract Background Building Resilience and Attachment in Vulnerable Adolescents (BRAVA) is a brief virtual group intervention designed for adolescents with mild to moderate suicidal ideation (SI) and their caregivers. The goal of BRAVA is to reduce SI in adolescents and increase family connection. The intervention consists of six independent, 90 minute modules that are delivered in a group setting on a weekly basis. Independent modules allow for rolling admission thereby reducing wait time to start the intervention. The modules include components of Dialectical Behaviour Therapy. Attachment Based Family Therapy, Cognitive Behavioral Therapy, Collaborative Problem Solving and psychoeducation. Adolescents and their parents attend separate groups. Adolescents focus on emotional regulation, coping skills, managing crisis situations and caregivers focus on connecting with their teen, validation and crisis management Objectives This randomized controlled trial (RCT) assessed the efficacy of BRAVA in reducing symptoms of SI, depression and anxiety in adolescents, and improving life stress and competency in caregivers. Design/Methods Ninety-nine eligible youth (13-17.5 years) presenting with mild to moderate SI (rated 1 on the suicide item of HEADS-ED MH screening tool) and their caregivers were recruited from hospital and community services. Families were randomized to BRAVA (n=50) or the control group (n=49). The control group intervention consisted of weekly text messages and the opportunity to join the BRAVA group post-exit assessment). Outcome measures were administered at intake and exit for adolescents (Suicidal Ideation Questionnaire-Junior, SIQ-JR; Revised Children’s Anxiety and Depression Scale, RCADS) and caregivers (Perceived Stress Scale, PSS; Parent Sense of Competency Scale, PSOC). Outcomes were analyzed using repeated measures of multivariable analysis of variance (MANOVA). Results Preliminary analyses showed no significant differences between groups at intake for any demographic or clinical variables. Most adolescents and caregivers completed their exit assessment (nBRAVA=37; nControl=39). Adolescents and caregivers attended a median of six and five groups, respectively. Comparing to the control group, BRAVA was superior in reducing SI (p = 0.05) and depression (p = 0.005) in adolescents and caregiver life stress (p = 0.026). Preliminary MANOVA of adolescent outcomes were significant for time [p <0.01, Effect size (ES) = 0.98] and between groups (p = 0.03, ES = 0.11). Caregiver outcomes were significant for time (p=0.051, ES=0.70). Conclusion This study demonstrates that a brief virtual group intervention can have a significant impact on adolescent SI and depression compared to an enhanced treatment as usual control group. In addition, BRAVA can reduce caregiver perceived stress, helping them view their lives as less unpredictable, uncontrollable and overloaded.

Social Anxiety in Adolescents: An Analysis of the Psychological Influence Mechanism of Social Media Use

With the rapid progress of Internet technology, social media has become an indispensable part of the daily life of contemporary teenagers, which has a profound impact on their social habits, information acquisition methods and psychological development tracks. This paper explores the psychological mechanism of social anxiety in adolescents using social media, aiming to reveal how social media exerts a profound influence on social behavior, psychological cognition and emotional state of adolescents through various complex ways.The features of social media, such as convenience, interaction, anonymity and visualization, together constitute the basic environment for teenagers to use social media. They have many impacts on teenagers, including positive aspects such as the expansion of social circle, the convenience of information acquisition and the realization of self-expression, and may also bring negative impacts, especially social anxiety. This paper makes an in-depth analysis from multiple dimensions. On the one hand, the phenomenon of social comparison on social media is widespread, and teenagers are prone to inappropriate self-evaluation and feelings of inferiority when browsing the life fragments carefully selected and displayed by others, which will trigger social anxiety. On the other hand, there is also the ever-present threat of cyberbullying and harassment, and these negative experiences pose a serious threat to adolescents' mental health and exacerbate their symptoms of social anxiety. In addition, the increase of information overload and cognitive burden, addiction and dependence on social media are also important factors leading to social anxiety among adolescents. From the family, school and social level, it is necessary to strengthen the education and guidance of young people, help them establish the correct concept of social media use, set a reasonable time to use, encourage physical social activities, and cultivate self-esteem and self-confidence. At the same time, for adolescents with social anxiety symptoms, professional psychological help should be sought in time to alleviate their anxiety and promote their mental health development.

01 Vaping, mental and physical health in adolescents in a COMPASS-Quebec cohort

Abstract Background Better knowledge of the association between vaping and youth’s health would help raise awareness among adolescents, parents, professionals and decision-makers on the likely threat it represents. Objectives Our objective is to examine the association between vaping, its frequency, and adolescent health. Design/Methods This observational study is based on data from the 2022-23 survey round of COMPASS-Quebec school cohorts through self-reported measures. It includes 45,203 respondents aged from 12 to 18 years old from 99 schools of Eastern Quebec. A four-modality variable depicts the vaping frequency in the last twelve months (abstinence, < once/month, ≥ once/month, ≥ once/week, daily). The measurement of health states is based on 5 dichotomous indicators: (i) good vs poor physical health (excellent, very good, good, vs fair, poor), (ii) maximum oxygen consumption considered at risk for health vs not (estimated VO2max, calculated using Léger’s equation); (iii) good vs poor mental health (excellent, very good, good, vs fair, poor); (iv) the presence vs absence of moderate to severe anxiety (GAD7, score ≥10/30) and; (v) the presence vs absence of significant depressive symptoms (CESD-R, score ≥10/21). Sex, age and family material deprivation level are taken into account as confounding factors. Results The proportion of adolescents who have vaped in the last 12 months is 26.8%. After adjustment, daily vaping is associated with poor physical health, a VO2max considered at risk for health, poor mental health, moderate to severe anxiety and significant depressive symptoms, compared to abstinence (adjusted relative risk [aRR] 2,46 [95%CI: 2,05-2,88]; 1,66 [95%CI: 1,44-1,89]; 1,88 [95%CI: 1,66-2,11]; 1,75 [95%CI: 1,53-1,97]; 1,55 [95%CI: 1,40-1,70]). A gradient in the associations between vaping frequency and lower mental health indicators has been observed. Adolescents who have vaped <once/month, ≥once/month, ≥once/week and daily have more risk of presenting moderate to severe anxiety (aRR 1,21 [95%CI: 1,09-1,33]; 1,44 [95%CI: 1,27-1,61]; 1,54 [95%CI: 1,37-1,72]; 1,75 [95%CI: 1,53-1,97]). Regarding significant depressive symptoms, aRR are 1,23 [95%CI: 1,14-1,32], 1,39 [95%CI: 1,27-1,51], 1,49 [95%CI: 1,36-1,62], 1,55 [95%CI: 1,40-1,70]. Regarding poor mental health, aRR are 1,29 [95%CI: 1,17-1,42], 1,61 [95%CI : 1,43-1,79], 1,63 [95%CI : 1,45-1,81], 1,88 [95%CI: 1,66-2,11]. Conclusion This study suggests a consistent association between health, both physical and mental, and use of electronic cigarettes in adolescents. Longitudinal studies would help clarify possible causal influence of vaping on youth's health.

Dating violence, mental health symptoms, and life satisfaction in same-sex and opposite-sex relationships in Spain: A gender analysis

Intimate partner violence has become a major social and public health problem. Thus, this study examines dating violence perpetration and victimization in opposite-sex and same-sex couples in Spain. The sample was non-probabilistic and consisted of 240 men and 288 women, half of each gender group had a same-sex partner while the other half had an opposite-sex partner. Participants were assessed using six scales and questionnaires. The results showed that 60.8% of men and 59% of women in same-sex relationships and 67.5% of men and 48.6% of women in opposite-sex relationships reported experiencing some – mostly psychological – violence from their partner. 21.7% of men and 11.1% of women with a same-sex partner and 25.8% of men and 9.7% of women with an opposite-sex partner reported experiencing physical violence, and 10% of men and 9% of women with a same-sex partner and 7.5% men and 6.3% women with an opposite sex partner reported sexual violence. The results showed that 60.8% of men and 59% of women in same-sex relationships and 67.5% of men and 48.6% of women in opposite-sex relationships reported experiencing some – mostly psychological – violence from their partner: 21.7% of men and 11.1%. Perpetration and victimization were associated: 47.5% of men and 46.5% of women with a same-sex partner and 53.3% of men and 38.9% of women with an opposite-sex partner reported being both victims and perpetrators of dating violence. In all groups, being a victim of violence was linked to increased anxiety and insomnia symptoms, and in some groups, it was also linked to severe depressive symptoms and low self-esteem. Despite differences depending on gender and whether the relationship is between same-sex or opposite-sex partners, dating violence is common in all relationships and represents a serious threat to mental health and well-being.

Effectiveness of psychological therapies for depression and anxiety in atypical dementia.

People with dementia may benefit from psychological therapies for depression or anxiety, but evidence of their effectiveness in atypical dementia is limited. Using electronic health-care records of > 2 million people who attended psychological therapy services in England between 2012 and 2019, we examined pre-post therapy symptom changes and compared therapy outcomes among 523 people with atypical dementia, a matched cohort without dementia, and 1157 people with typical dementia. People with atypical dementia experienced reductions in depression (Cohen d=-0.92 [-1.05 to -0.79]) and anxiety (d=-0.85 [-0.98 to -0.73]) symptoms. They had similar odds of improvement than people with typical dementia (odds ratio [OR]=1.07, 95% confidence interval [CI]: 0.85 to 1.34), but lower odds than people living without dementia (OR=0.70, 95% CI: 0.53 to 0.91). Reasons for discharge were similar between all groups. People with atypical dementia may benefit from primary care psychological therapies, but further research is needed to explore necessary adaptations. Talking therapies for depression and anxiety may be beneficial for people with atypical dementia. Being younger and havinga lower socioeconomic background are associated with poorer outcomes. Receiving more treatment sessions and shorter waiting times are associated with better outcomes.

Urbanization, loneliness and mental health model - A cross-sectional network analysis with a representative sample

With increasing urbanization, more people are exposed to mental health risk factors stemming from the urban social or physical environment. However, research on the relationship between urbanization and mental health is lacking. This cross-sectional study aimed to explore the relationships of the physical environment (spatial cohesion and urban environment) and social factors (neighborhood cohesion) with mental health (stress, anxiety and depression symptoms) and physical health and the mediating role of loneliness based on the proposed theoretical model. The study was conducted in Metropolis GZM (Silesia, Poland) in a representative sample of 3296 residents (48% women). The measurements used were the PSS-10, GAD-7, PHQ-9, R-UCLA3 and neighborhood cohesion scale. ANOVA results showed that city residents had better mental health indices than residents of villages and small towns. The network approach revealed that urbanization was one of the most influential nodes and played the role of a bridge between all other nodes. The model was confirmed and showed that the relationships between the physical environment and mental health were consecutively mediated by neighborhood cohesion and loneliness. Spatial cohesion related to factors of the physical environment and physical health, while physical health was directly connected to sociodemographic factors and weakly to stress. Anxiety was the strongest risk factor. Mental health can be improved by social and architectural factors, such as strengthening neighborhood cohesion and improving neglected buildings.

Measurement-Based Care in a Remote Intensive Outpatient Program: Pilot Implementation Initiative.

The ongoing mental health crisis, especially among youth, has led to a greater demand for intensive treatment at the intermediate level, such as intensive outpatient programs (IOPs). Defining best practices in remote IOPs more broadly is critical to understanding the impact of these offerings for individuals with high-acuity mental health service needs in the outpatient setting. Measurement-based care (MBC), or the routine and systematic collection of patient-reported data throughout the course of care to make meaningful changes to treatment, is one such practice that has been shown to improve patient outcomes in mental health treatment. Despite the literature linking MBC to beneficial clinical outcomes, the adoption of MBC in clinical practice has been slow and inconsistent, and more research is needed around MBC in youth-serving settings. The aim of this paper is to help bridge these gaps, illustrating the implementation of MBC within an organization that provides remote-first, youth-oriented IOP for individuals with high-acuity psychiatric needs. A series of 2 quality improvement pilot studies were conducted with select clinicians and their clients at Charlie Health, a remote IOP program that treats high-acuity teenagers and young adults who present with a range of mental health disorders. Both studies were carefully designed, including thorough preparation and planning, clinician training, feedback collection, and data analysis. Using process evaluation data, MBC deployment was repeatedly refined to enhance the clinical workflow and clinician experience. The survey completion rate was 80.08% (3216/4016) and 86.01% (4218/4904) for study 1 and study 2, respectively. Quantitative clinician feedback showed marked improvement from study 1 to study 2. Rates of successful treatment completion were 22% and 29% higher for MBC pilot clients in study 1 and study 2, respectively. Depression, anxiety, and psychological well-being symptom reduction were statistically significantly greater for MBC pilot clients (P<.05). Our findings support the feasibility and clinician acceptability of a rigorous MBC process in a real-world, youth-serving, remote-first, intermediate care setting. High survey completion data across both studies and improved clinician feedback over time suggest strong clinician buy-in. Client outcomes data suggest MBC is positively correlated with increased treatment completion and symptom reduction. This paper provides practical guidance for MBC implementation in IOPs and can extend to other mental health care settings.

Exploring reciprocal links between early adolescent coping and internalizing symptoms.

The rising prevalence of depression and anxiety among adolescents is a public health concern. Early adolescence is a key developmental period to reduce risks for internalizing symptoms through primary prevention programs, yet additional research is needed on modifiable factors, such as coping skills, to target to mitigate risk factors. Therefore, we investigated the reciprocal link between coping style and internalizing symptoms among a racially/ethnically diverse sample of early adolescents (n = 1273) from 12 middle schools over 1 year. We leveraged a longitudinal data set of a cluster, randomized trial of a preventive intervention from 12 middle schools in a large public-school district in the United States to test our hypotheses using multilevel modeling. The sample was 49% female and racially/ethnically diverse (39% Hispanic/Latinx, 23% Black/African American, 12% Asian or Pacific Islander, 11% other, 9% White, and 5% multiracial). Participants (ages 12-14) completed a baseline questionnaire in 7th grade (Spring 2018) and a 1-year follow-up questionnaire in 8th grade (Spring 2019). Depressive and anxious symptoms affected levels of active and avoidant coping skill use over the 1-year period of the study, indicating that symptoms can be an impetus for maladaptive coping. We also identified bidirectional links between active coping and depression in addition to avoidant coping and anxiety. Our findings have implications for augmenting coping psychoeducation within prevention programs to reduce internalizing symptoms among early adolescents and for future longitudinal and qualitative research exploring how coping skills reduce risks for internalizing symptoms throughout adolescence and into early adulthood.

Understanding depression, anxiety and stress in young people living with HIV in Ghana

Ghanaians with perinatally acquired human immunodeficiency virus (HIV) infection now live into adulthood. It is known that adolescents and young adults living with HIV have a high risk of mental health comorbidity. Despite increasing global attention on HIV–mental health interactions, the field remains understudied in Ghana, with an attendant lack of national integrated care solutions. This study aimed to measure the burden and explore the context of depression, anxiety and stress symptoms among young people living with HIV receiving care at a tertiary care hospital in Ghana. This was an explanatory sequential mixed-methods study. Depression, anxiety and stress symptoms were measured using the Depression, Anxiety and Stress Scale, and their associations with quality of life (QoL), socioeconomic status, internalised stigma, disease stage and HIV-related risk-taking behaviours were explored. After preliminary quantitative data analysis, semi-structured interviews were conducted for those who screened positive for depression and/or anxiety to explore their experience with this comorbidity. This study found a low prevalence of depression and anxiety symptoms, which were associated with higher stigma scores and lower QoL. We believe this low prevalence to be attributable to the effect of several psychosocial interventional programmes, which were previously piloted with the study cohort that have gradually normalised mental health discussions. Participants also showed marked resilience and knowledge about their condition. The results of this study present an opportunity to advocate and scale up effective locally adapted and strength-based solutions to address the mental illness–HIV syndemic in Ghanaian young people living with HIV.

Improvement in symptoms of anxiety and depression in individuals with type 2 diabetes: retrospective analysis of an intensive lifestyle modification program

BackgroundType 2 diabetes (T2D) is a chronic metabolic disorder that has a notable influence on mental well-being, contributing to elevated morbidity and mortality rates. Depression and anxiety disorders are the most common mental health concerns among patients with T2D worldwide. Therefore, the present study aimed to assess the impact of an online intensive lifestyle intervention (ILI) on mental health outcomes (depression and anxiety) in patients with T2D in India.Materials and methodsThis retrospective pre-post analysis included adult patients (aged > 18 years) diagnosed with T2D who were enrolled in a diabetes management program in India between June 2021 and June 2023. The intervention consisted of lifestyle modifications such as a customized plant-based diet, regular physical activity, psychological support through group and individual therapy, and medical management. Data were extracted from the electronic database of the clinic, including anthropometry, medical history, biochemical parameters, symptoms of depression, and anxiety (assessed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorders-7 (GAD-7) scale) at the start and end of the six-month intervention period.ResultsOf the 1061 eligible patients (177 with prediabetes), 40.3% were female. The mean age, duration of diabetes, and HbA1c levels were 52 ± 10.4 years, 9.8 ± 7.8 years, and 8 ± 1.7%, respectively. The prevalence of symptoms of depression and anxiety (ranging from mild to severe) was 46% and 44.3%, respectively, which reduced to 28.7% and 29.2%, respectively, post-intervention.ConclusionIntegrated ILI successfully improved the symptoms of anxiety and depression, highlighting the importance of a multidisciplinary approach that includes diet, physical activity, psychological support, and medical management in enhancing mental health outcomes among patients with T2D. Future prospective studies are needed to explore the long-term effects of such interventions and develop effective strategies for promoting mental health in diverse populations.Trial registrationThe study was approved by the Freedom from Diabetes Research Foundation Institutional Ethics Committee (approval number FFDRF/IEC/2024/7) and registered in the Clinical Trials Registry of India (CTRI/2024/03/064596, registered on March 21, 2024).

Moderated mediation role of trust in authorities by the Kahramanmaras earthquake survivors

ABSTRACT This article examines the moderated mediation role of trust in authorities in the direct and indirect effects of earthquake exposure on psychological distress symptoms (depressive, anxiety and stress symptoms) through somatic fear (sleep loss and increased heart rates). Convenience and snowball sampling methods were used to collect survey data from 552 adult participants (221 men, 331 women) living in the earthquake zone. The independent variable is earthquake exposure, the mediating variable is somatic fear, and the moderating variable is trust in authorities (emergency plans and strategies, government policies, and media information). Factor analysis using structural equation modelling confirmed one factor for fear of earthquake and trust in authorities and three factors for symptoms of psychological distress. Regression results showed that disaster survivors had low trust in authorities in Turkiye. Mediation and moderated mediation results based on the bootstrap method showed that somatic fear mediated the effect of earthquake exposure on depressive symptoms, anxiety symptoms and stress symptoms, and trust in authorities moderated the indirect effects of earthquake exposure on stress symptoms through somatic fear. Increased trust in authorities in Turkiye would alleviate psychological distress symptoms among the Kahramanmaras earthquake survivors.

Maternal and paternal harsh parenting and anxiety symptoms in Chinese adolescents: examining a multiple mediation model

BackgroundHarsh parenting has been recognized as a risk factor for adolescent anxiety; however, the underlying mechanisms of this relationship remain unclear, and it is unknown whether this relationship is influenced by different parental roles and living arrangements. This study aimed to investigate the mediating mechanisms between harsh parenting and adolescent anxiety symptoms using a multiple mediation model and to further compare specific roles of harsh parenting and distinguish between the living arrangements.MethodsA total of 3505 adolescents completed this survey, and 3295 adolescents (54.7% girls, Mage = 14.97 years) were included in the study. Participants completed self-assessments measuring harsh parenting, self-efficacy, school connectedness, Internet addiction, sleep problems, and anxiety. They were categorized into three groups based on living arrangements: living with both parents, only with the mother, or only with the father.ResultsCorrelational analyses revealed that both maternal and paternal harsh parenting were associated with increased anxiety symptoms. Structural equation modeling (SEM) mediation analyses and multigroup analyses showed that the independent mediating effects of school connectedness, Internet addiction, and sleep problems, as well as the sequential mediating pathways involving self-efficacy → school connectedness, self-efficacy → Internet addiction, and self-efficacy → sleep problems, vary across the adolescents’ living arrangements in the association between maternal and paternal harsh parenting and adolescent anxiety symptoms.ConclusionsThis study elucidated the mechanisms linking harsh parenting to adolescent anxiety symptoms and validated the effects of different parental roles and living arrangements. The findings provide important insights for developing targeted interventions to address anxiety symptoms in adolescents exposed to harsh parenting.

Sensorineural Hearing Loss Negatively Impacts Cognition in Older Subjects with Normal Lateral Semi-Circular Canal Function

Plain Language SummaryWithin the current study, the authors aimed to explore the effect of hearing loss on cognitive functioning in older adults, considering the effects of vestibular function, anxiety and depression on cognitive performance. There is increasing evidence that hearing loss is a modifiable risk factor for cognitive decline but also vestibular dysfunction, depression and anxiety symptoms may play a role in this association. Cognitive functioning was evaluated in a group with moderate-to-severe hearing loss and a matched control group based on sex, age, education level, vestibular function, anxiety and depression rates. The patients with a hearing impairment performed significantly worse on cognitive testing and the differences were most pronounced for the cognitive subdomains of Attention and Visuospatial/Constructional memory. Results from this study confirm that hearing loss negatively impacts cognitive functioning, even in older adults with normal vestibular function.

Biopsychosocial Impact of Multiple Sclerosis in Omani Patients: A Multicenter Comparative Study.

Background/Objectives: Multiple sclerosis (MS) is a chronic neurological disorder characterized by various clinical presentations and manifestations that include biopsychosocial impediments. This study has three interrelated goals relevant to biopsychosocial functioning: (i) compare reasoning ability, neuropsychological functioning, affective range, and quality of life (QoL) between people with multiple sclerosis (PwMS) and healthy controls; (ii) explore gender differences in reasoning ability and neuropsychological functioning, affective symptoms, and QoL among PwMS; and (iii) examine the relationship between QoL and cognitive performance in PwMS, focusing on those with inadequate vs. adequate QoL. Methods: This multicenter study was carried out among clinically stable PwMS (no relapse in the last two months) at follow-up in two tertiary care units in urban Oman. Healthy controls, matched for age and sex, were also recruited as a comparison group. Data were collected using cognitive batteries sensitive to current reasoning ability and conventional neuropsychological batteries designed to measure verbal learning, visual-spatial ability, and processing speed. The affective range (anxiety and depressive symptoms) and quality of life (QoL) were also evaluated. Results: The PwMS group scored lower on current reasoning ability, verbal learning, visual-spatial ability, and processing speed compared to the control group. The incidence of anxiety was higher in the PwMS group, but there were no statistically significant differences in depressive symptoms. No significant differences were found in cognitive variables between the two sexes, except in visual-spatial ability, where women outperformed men. PwMS with low QoL scored lower on attention and concentration indices than those with adequate QoL. According to QoL, no significant differences were observed in reasoning, verbal learning, or visual-spatial ability. Conclusions: The present sentinel study suggests that the Omani cohort with MS tends to have lower indices of current reasoning ability, visual and spatial memory, and cognitive speed compared to control subjects. Gender differences are minimal, except for visual-spatial abilities, where women outperform men. Quality of life significantly affects cognitive functioning. In general, the biopsychosocial impediment appears to be significant, indicating the need for comprehensive evaluation and care in the management of MS.

Network analysis of resilience, anxiety and depression in clinical nurses

BackgroundResilience is a protective feature against anxiety and depression disorders. However, the precise relationship and structure of resilience and anxiety and depression remain poorly understood. This study sought to investigate the link among resilience’ components and anxiety as well as depression.Methods1,279 clinical nurses were recruited. 10-item Connor-Davidson Resilience Scale, Generalized Anxiety Disorder 7, and Patient Health Questionnaire 9 were employed to evaluate resilience, anxiety, and depression, respectively. The regularized partial-correlation network was generated utilizing data from cross-sectional survey and the bridge expected influence index was utilized to quantify bridge components.ResultsThe rates of anxiety and depression within clinical nurses were 67.3% and 67.2%, accordingly. Four strongest bridge edges appeared in the resilience-anxiety network, like “Adapt to change”- “Fear that something might happen”, and “Stay focused under pressure”- “Uncontrollable worry”. Two strongest bridge edges appeared in the resilience-depression network, like “Adapt to change”- “Concentration difficulties” and “Stay focused under pressure”- “Fatigue”. “Adapt to change” was recognized as bridging nodes in both the resilience-anxiety network and the resilience-depression network.ConclusionsInterventions targeting the bridge component “Adapt to change” within resilience, may mitigate the intensity of anxiety and depression symptoms among clinical nurses.

Evaluation of efficacy and safety of low-intensity pulsed ultrasound in patients with concurrent erectile dysfunction and chronic prostatitis/chronic pelvic pain syndrome: a prospective, randomized controlled study

ObjectiveThe primary objective of this clinical trial is to investigate the effect of low-intensity pulsed ultrasound (LIPUS) on patients suffering from comorbid erectile dysfunction (ED) and chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS).MethodsThe clinical trial was conducted in the andrology outpatient treatment room of the Department of Urology, Xiangya Hospital, Central South University from August to November 2022 A total of 60 patients who met the research criteria for comorbid ED combined with CP/CPPS were recruited and randomly assigned to three treatment groups. They were treated with LIPUS (Group A), drug therapy(Group B), and LIPUS combined with drug therapy (Group C), respectively. Each group comprised 20 patients. Statistical analysis was performed on the five-item version of International Index of Erectile Function (IIEF-5), Erection Hardness Score (EHS), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), the nine-item Patient Health Questionnaire (PHQ-9), the seven-item Generalized Anxiety Disorder Scale (GAD-7), and the incidence of adverse events to comprehensively evaluate the efficacy and safety of LIPUS.ResultsThe positive response rate of ED and CP/CPPS treatment in Group A is 40%(8/20) and 45%(9/20), while those in Group B is 55%(11/20) and 60%(12/20), and those in Group C is 85%(17/20) and 85%(17/20). A notable increase in IIEF-5 scores was observed across the three groups post-treatment (10.45 ± 2.50 vs. 13.65 ± 3.03, P = 0.008; 11.80 ± 3.21 vs. 16.40 ± 3.20, P = 0.011; 12.90 ± 3.92 vs. 19.40 ± 2.35, P = 0.042) with a concomitant significant decrease in NIH-CPSI scores (16.75 ± 4.53 vs. 14.65 ± 4.51, P = 0.016; 16.35 ± 4.32 vs. 12.20 ± 4.74, P = 0.007; 16.00 ± 4.40 vs. 8.15 ± 4.28, P = 0.021). Notably, the most pronounced changes were seen in the group receiving LIPUS combined with tadalafil and doxazosin. Additionally, all groups exhibited marked improvements in anxiety and depression symptoms post-treatment. No adverse events were observed during treatment.ConclusionLIPUS can improve erectile function and CP/CPPS symptoms with good safety, and LIPUS combined with tadalafil and doxazosin is more effective during the treatment. However, its long-term efficacy remains to be seen.Trial RegistrationChinese Clinical Trial Registry; approval number: ChiCTR2200063038 (https://www.chictr.org.cn/) on August 29, 2022.

Physical Exercise and Mental Health in Adolescents: Scoping Review

Objective. To identify the most implemented exercises and their prescription, in addition to the effects of exercise on mental health in adolescents. Methods. A scoping review was performed from search of electronic databases: PubMed, Science Direct, Scopus, Springer, Google Scholar, from 23/08/2023 to 01/01/2024 in English, Spanish, and Portuguese language, including randomized clinical trial and cohort type studies. Results. A total of 7 articles were included: 57.14% controlled clinical trials, 100% in English. The number of participants was 85,637 aged 12 to 16 years. Intervention time ranged from 8 to 43 weeks, 2 to 5 times per week, 1 session per day, duration per session 10 to 120 minutes. The most used type of training was Programmed Physical Education followed by High Intensity Interval Training. Conclusions. Exercises such as Programmed Physical Education, High Intensity Interval Training, Moderate to Vigorous Physical Activity are included, which show positive effects on the increase in psychological well-being, quality of life and a significant decrease in anxiety and stress symptoms.

Mindfulness and mental health: the importance of a clinical intervention to prevent the effects of a traumatic event. A pilot study.

Numerous research studies show that mindfulness can mitigate the negative impact of trauma on mental health by reducing symptoms of anxiety, mediating the relationship between trauma exposure and mental health, and treating symptoms resulting from traumatic events. During the COVID-19 pandemic, which was considered a traumatic event, the wellbeing of adults and children was severely compromised. Although children seem less vulnerable to the physical effects of the virus, this does not seem to be true for the psychological effects. Indeed, a prolonged period of loss of family activities and routines can have a negative impact on the mental health of children and adolescents. To investigate how mindfulness can help preschool children cope with the effects of COVID-19, a study was conducted on 46 children aged 4-5 years. The programme, based on the work of Jon Kabat-Zinn and adapted to the age of the participants, consisted of eight weekly 45-min sessions. Qualitative and quantitative results showed positive feedback, indicating that mindfulness helps children make sense of their experiences and achieve functional post-traumatic growth. This approach is seen as a challenge to guide children toward the restoration of psychological wellbeing, which is essential for good psychological balance.

Prevalence and associations of insomnia after COVID-19 infection.

Sleep disturbances in "long COVID" are common, but the associations between the severity of sleep problems and the severity of COVID infection are unclear. We evaluated the prevalence, persistence, comorbidities, and clinical effects of insomnia following recovery from acute COVID-19 infection in a COVID-specific clinic. Inpatients discharged after COVID infection and outpatients referred for persistent post-COVID symptoms were surveyed on insomnia severity (Insomnia Severity Index, ISI), other neuropsychological symptoms, cardiopulmonary symptoms and physiological functions (6 minute walk distance and others), and functional outcome and quality of life (QOL). Multivariable regression models evaluated the severity of ISI against independent variables. A total of 280 patients met criteria at the initial visit. The prevalence of significant insomnia at the initial visit was 50% and 42% at the subsequent visit (obtained in 78 of the 280 patients). Lower age, female sex, non-white race, and non-Hispanic ethnicity were significantly associated with worse initial ISI scores. More severe symptoms of anxiety and depression were strong correlates with worse ISI scores. Interval improvements in insomnia severity correlated with improvements in anxiety and post-traumatic stress disorder (PTSD) scores. Physiological sequelae of infection did not correlate with insomnia at any stage. Initial and persistent insomnia is common in long COVID. Treatment for insomnia with the use of evidence based approaches (such as cognitive behavioral therapy for insomnia) may best suit this particular post-COVID symptom.

Functional excitation-inhibition ratio for social anxiety analysis and severity assessment.

Social anxiety disorder (SAD) is a prevalent psychiatric condition characterized by an intense fear of and avoidance of social situations. Traditional assessment methods for SAD primarily rely on subjective self-report questionnaires and clinical interviews, which can be prone to biases and inaccuracies. This study aims to explore the functional excitation-inhibition (fEI) ratio derived from EEG data as a potential objective biomarker for assessing SAD severity. Resting-state EEG data were collected from 20 control subjects and 60 individuals with varying degrees of SAD severity (mild, moderate, and severe). The fEI ratio was estimated across different EEG bands and analyzed, focusing on differences between control subjects and SAD groups. Significantly higher fEI ratios were observed in the alpha and low beta EEG bands in individuals with SAD compared to controls, especially within the prefrontal cortex. Additionally, a positive correlation was found between the fEI ratio and the severity of social anxiety symptoms across SAD severity levels. The findings indicate that the fEI ratio in the alpha and low beta bands may serve as a promising biomarker for assessing SAD severity. These results contribute to a deeper understanding of the neural mechanisms underlying social anxiety, offering a potentially more objective approach to SAD assessment compared to traditional methods.