Background Anxiety Research Articles

The influence of anxiety-related emotional disorders and self-esteem on obesity among Chinese children

Background Anxiety and obesity can have negative impacts on the health of children. Understanding the relationship between obesity and mental disorders in children and adolescents will help develop effective prevention and intervention strategies. This research investigates the impact of anxiety-related emotional disorders and self-esteem on obesity among Chinese children aged 6-12 in Anhui Province. Methods Utilizing a non-experimental, cross-sectional study design, data were from 136 participants collected through standardized instrument measures from Chinese children: the “Chinese screening for overweight and obesity among school-age children and adolescents” in the “Health Industry Standards of the People’s Republic of China” as the standard for identifying obesity, the Screen for Anxiety-Related Emotional Disorders (SCARED) for assessing anxiety disorder, and the Children’s Self-Esteem Scale (CSES) for evaluating self-esteem. Statistical analysis, including descriptive statistics, Pearson correlation analysis, and multiple regression analyses was performed using SPSS version 26 to determine the predictive relationships between the variables. Results The analysis revealed that anxiety-related emotional disorders and self-esteem contribute significantly to the prediction of obesity among Chinese children, accounting for a 13.7% variance. The study highlights the critical roles of anxiety-related emotional disorders and self-esteem in determining children’s obesity. It suggests that underscores the necessity for comprehensive interventions that address both physical and mental health aspects to combat childhood obesity effectively. The study concludes that addressing anxiety and self-esteem is essential for developing effective strategies to reduce obesity rates among Chinese children, meeting the research objectives, and contributing to the development of holistic health programs for children’s well-being.

Research on mood monitoring and intervention for anxiety disorder patients based on deep learning wearable devices

Background Anxiety disorders are common mental health issues that have a significant effect on people's quality of life. Conventional techniques for tracking emotional states frequently lack the accuracy and sensitivity needed for successful intervention. Objectives This project aims to create a sophisticated monitoring system that uses deep learning methods to evaluate physiological data from wearables, emphasizing heart rate variability (HRV), to forecast patients’ emotional states who suffer from anxiety disorders. Methods Wearable equipment monitors physiological characteristics, which we used to obtain patient HRV data. We processed the data using a Bidirectional Long-Short-Term Memory (Bi-LSTM) network to evaluate time-dependent variables and enhance the precision of emotional state predictions. The physiological signals were used to teach the model to recognize different emotional states, such as neutral, happy, and sad. Results Outperforming conventional machine learning models, the Bi-LSTM model showed a high accuracy rate of up to 97% in predicting emotional states. The findings suggest that ongoing HRV monitoring can accurately track shifts in emotional states and enable prompt responses. Conclusion This work emphasizes the possibility of real-time emotional state monitoring in patients with anxiety disorders with wearable technology and deep learning. The results point to the potential benefits of this strategy for improving emotional regulation and improving anxiety sufferers’ quality of life, opening new avenues for investigation and advancement in the field of mental health therapies.

A Cross-sectional Study on Utilization of Herbal Medications for Anxiety in the Lebanese Population: Usage Patterns and Implications for Harmonizing Mental Health

Background Anxiety is a highly prevalent mental health issue worldwide, but it is also notably prevalent in Lebanon, where herbal medications and plants are commonly used as complementary or alternative treatments to manage anxiety. Lebanese citizens have undergone various disasters, starting with the economic crisis in 2019, the Beirut port explosion in 2020, and the COVID-19 pandemic, which led to several mental disorders such as anxiety, unipolar depression, and insomnia. Objective This study aimed to measure the prevalence and patterns of herbal medications and plant usage for anxiety among the Lebanese population, as well as to explore the factors influencing the decision to use herbal remedies, patient perspectives, and potential implications for mental health support. Methods A cross-sectional study was conducted to assess the prevalence of anxiety and the usage of herbal medications and plants among 501 Lebanese outpatients (General Population) aged 20 years and older at Lebanese community pharmacies within Beirut, Mount Lebanon, South, North, Beqaa. Data was collected through personal face-to-face and online structured interviews and surveys, capturing information on herbal medications and plants usage, sources of recommendations, patient perspectives, and perceived efficacy and safety of herbal medications and plants for anxiety. Results The study revealed that anxiety was a prevalent medical condition among Lebanese outpatients, with more than 50% reporting anxiety through various symptoms. Furthermore, 27.34% of Lebanese patients had consumed herbal medications, with a notable proportion advising others to use herbal remedies for anxiety. The sources of recommendations for herbal medication usage included mass media, pharmacists, and personal reading/internet. Additionally, a considerable percentage of patients expressed beliefs in the effectiveness and safety of herbal remedies for anxiety while also indicating a lack of awareness regarding potential side effects. Conclusion The findings of this study underscore the need for increased awareness, education, and regulatory oversight in Lebanese pharmacists regarding anxiety management using herbal medications and plant-based treatments. This includes public education campaigns, healthcare provider training, and regulatory oversight. Prioritizing patient counseling and further research is essential to assess the efficacy and safety of these treatments within the Lebanese context. This integrative approach, blending traditional practices with evidence-based mental health care, could drive policy changes and improve mental health outcomes in Lebanon.

Assessing the impact of implantable loop recorder placement on anxiety level

Abstract Background Anxiety is a prolonged state of apprehension or worry that can be an independent predictor of cardiovascular events, associated with a 48% increased risk of cardiac death. About one-third of patients with arrhythmias present with high anxiety levels, and subsequently worse quality of life. In our experience of patient care, many patients feel anxious about the possibility of an arrhythmia that could lead to their demise, especially if their symptoms are undiagnosed. Purpose Our project aims to explore the change in patients’ anxiety levels following implantable loop recorder (ILR) placement. Methods This is a survey-based observational study that was performed in an outpatient clinic and hospital using validated General Anxiety Disorder-7 (GAD-7) questionnaires. Individuals who met indications to undergo ILR implantation including palpitations, syncope, subclinical atrial fibrillation, and cryptogenic stroke underwent baseline assessment of anxiety prior to implantation. Individuals had repeat assessments at 6 weeks and 12 weeks post-implantation to evaluate the effect of ILR placement. Results Our study included 50 individuals. Out of the initial subjects, 10/25 females and 11/25 males were lost to follow-up. The average initial GAD-7 score was 3.3 (Range 0, 15), average 6-week score was 1.6 (Range 0, 14), and average 12-week score was 0.9 (Range 0, 10). Total decrease in GAD-7 score after 6 weeks of having ILR was 50%. Total decrease in GAD-7 score after 12 weeks of ILR was statistically significant at 73% (P=0.03). Females showed greater improvement of GAD-7 scores in comparison to males at 6 weeks (67% vs 36%) and 12 weeks (81% vs 66%). Conclusion Studies have suggested an overall decreased level of anxiety in patients receiving implantable devices that have the potential to treat arrhythmias such as implantable cardiac defibrillators and pacemakers. Our results suggest that the benefit may extend to implantable devices that seek to provide further diagnostic information and aid in the prognostication of disease burden. As seen in our study population, GAD-7 scores showed dramatic improvement with greater percentage in female than male population. After the placement of loop recorders, many patients experience a sense of security with having a device that monitors them. Our study is the first to address the association between ILR and anxiety. Future studies evaluating this association would help increase the power of the study.Figure 1:Bar graph of GAD-7 Scores

Anxiety or depression in heart failure across the ejection fraction spectrum

Abstract Background Anxiety or depression are commonly described in patients with heart failure (HF) but few data exist on characteristics and clinical outcomes associated with anxiety or depression across the different HF phenotypes. Purpose To assess the prevalence of patient characteristics and clinical outcomes associated with anxiety or depression in patients with HF with preserved, mildly reduced and reduced ejection fraction (HFpEF, HFmrEF, and HFrEF). Methods Patients enrolled in the Swedish Heart Failure Registry between 2000-2021 were included. Self-reported anxiety or depression was collected using EuroQoL 5-dimensional questionnaire (EQ-5D) at baseline and follow-up visits. Anxiety or depression was categorized as "not anxious or depressed", "moderately anxious or depressed" or "severe anxious or depressed". The independent associations between baseline characteristics and presence of anxiety or depression were assessed by a multivariable multinominal regression analysis. Cox proportional hazards regressions were performed to model the time to first event according to levels of anxiety or depression. Outcomes included all-cause death and all-cause hospitalizations. Results A total of 45,247 patients were included among whom 58% reported none, 38% moderate and 5% severe anxious or depressed with similar distribution across the HF phenotypes (Figure). Several characteristics were associated with anxiety or depression with the strongest ones for severe versus none being higher NYHA class (OR 3.10 (2.77-3.47)), liver disease (OR 1.99 (1.56-2.55)), in-patient setting (OR 1.62 (1.43-1.84)), smoking (OR 1.75 (1.52-2.00)) while others were inversely related including male sex (OR 0.51 (0.46-0.56)), higher age (OR 0.60 (0.53-0.67)), referral to HF nurse clinic (OR 0.82 (0.72-0.94)) and higher income level (OR 0.68 (0.62-0.76)). The risk of all-cause death and all-cause hospitalizations increased with increasing levels of anxiety or depression across all HF phenotypes during 12 months of follow up. Severe anxiety or depression had a stronger association with all-cause death in hospitalized patients and all-cause hospitalizations in out-patients. Conclusion In this large contemporary cohort of patients with HF in a real-world setting, anxiety or depression was frequently and similarly distributed across all HF phenotypes. Higher NYHA class, liver disease and in-patient setting were strongly associated with the anxiety or depression while male sex, higher age, and higher income were inversely related with anxiety or depression. Anxiety or depression was significantly associated with worse outcomes at 12 months follow up.Proportion anxiety or depression

Prevalence and social determinants of anxiety and depression among adults in Ghana systematic review

Abstract Background Anxiety and depression are major public health concerns, yet their prevalence and social determinants contributing to mental health disparities remain underexplored. This review, to our knowledge, is the first of its kind, aiming to examine the prevalence of anxiety and depression symptoms and disorders among adults in Ghana, along with social determinants associated with their occurrence. Methods A search of nine electronic databases and seven grey literature sources was conducted up to September 25, 2023. Two reviewers independently screened and appraised the studies. Forty-six studies were included. Prevalence estimates were pooled using a random-effects model. Subgroup analysis and meta-regression explored potential moderators. A narrative synthesis explored social determinants associated with anxiety and depression. Results Preliminary results showed a high prevalence of anxiety (43.7%, 95% CI: 35.6-54.4%) and depression (37.8%, 95% CI; 32.5% to 46%), with regional variations. There were significant differences in the prevalence of anxiety and depression across chronic physical conditions and method of condition assessment. Meta-regression showed significant association between average age and anxiety prevalence. Social determinants associated with anxiety included being female, non-Christian, low income, self-employed, limited social support, and basic education, while that for depression included being young (< 25yr), low income, government employed, childhood physical and sexual abuse, gender-based violence and urban residence. Protective factors for both were male gender, strong social support and higher education. Conclusions Preliminary results indicate a high prevalence of anxiety and depression linked to social determinants. While methodological limitations exist (eg, study heterogeneity), findings highlight a need for evidence-based interventions targeting social determinants to reduce the burden of anxiety and depression among adults in Ghana. Key messages • Our review suggests addressing the social determinants of mental health, aligned with sustainable developmental goals, may reduce the burden of anxiety and depression. • While Ghana is working towards improving mental health via its revised 12year Mental Health Policy launched in 2021, this review can facilitate planning and resource allocation for mental healthcare.

Videonystamography Findings in Dizziness Patients with Background Anxiety Disorder

Videonystamography Findings in Dizziness Patients with Background Anxiety Disorder

Therapeutics Effects of the Genus Citrus in Anxiety Disorder

Background Anxiety and mood disorders are among the mental health diseases that have exponentially increased in prevalence owing to the hectic and stressful lifestyle. In addition to negatively impacting people’s physical health, this has resulted in a major psychological, social, and financial burden. A lot of emphasis has been placed on dietary and lifestyle modifications in the ongoing search for medication-free treatments. Investigating the connection between the consumption of specific fruits and vegetables and mental health issues such as depression has produced some intriguing and occasionally encouraging results. The genus Citrus with over 1300 species of plants is enriched with a plethora of polyphenolic compounds on the one hand and multicomponent volatile oil content on the other hand. Purpose The current work is centered on examining the range of phytoconstituents found in various citrus species—both underutilized and utilized—as promising avenues for future anxiolytic research. The work also details the proposed pharmacological mechanisms of isolated components and clinical trial advancements of selected citrus species. Methodology Various databases, including PubMed and ScienceDirect, were used to search and collect relevant literature published in the past 10 years (2014–2024). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) criteria recommended for drafting methodical reviews were followed. Results Initially, 1791 articles were collected through an electronic database search, irrelevant titles/abstracts (1449) and other types of articles (05) were excluded. Out of 342 assessed reports, 187 duplicate articles were excluded. Finally, list of 67 articles was included in this narrative review. Conclusion Although research and development, as well as the commercial use of several citrus varieties, have attracted some interest recently, analyzing neglected citrus species closely can help to improve their processing into well-known anxiolytic leads by revealing their untapped potential. The work emphasizes the extensive exploration of underutilized citrus species, which have a rich bioactive pro file and enormous potential in pharmaceutical research and development.

Trajectories of work disability among individuals with anxiety-, mood/affective-, or stress-related disorders in a primary healthcare setting

Abstract Background Anxiety-, mood/affective-, or stress-related disorders affect up to one-third of individuals during their lives and often impact their ability to work. This study aimed to delineate trajectories of work disability (WD) among individuals diagnosed with anxiety-, mood/affective-, or stress-related disorder in primary healthcare and to examine associations between trajectory group membership and sociodemographic, clinical, and clinical-related factors. Methods The study population included working-age individuals, aged 22–62 years, living in Stockholm County, Sweden, who experienced a new episode of any anxiety-, mood/affective, or stress-related disorder in primary healthcare in 2017 (N = 11,304). Data were obtained from Swedish national and regional registers and were linked using pseudonymised unique personal identification numbers. The primary outcome was days with WD (sum of sickness absence and disability pension days) during the three years before and three years after a diagnosis of anxiety-, mood/affective-, or stress-related disorders in primary healthcare. A zero-inflated Poisson group-based trajectory model was used to identify groups of individuals with similar patterns of WD over the study period, with a multinomial logistic regression used to examine associations of sociodemographic, clinical, and clinical-related factors with trajectory group membership. Results Four distinct trajectory groups were found, high increasing (5.1%), with high levels, from 16 to 80 days of WD in six-monthly intervals during follow-up, peak (11.1%), with a peak in WD, up to 32 days of WD, around the time of the diagnosis, low increasing (12.8%), with an increase in days of WD from 4 to 22 during the study period, and constant low (71.1%), with almost no WD over the study period. In multinomial regression models, diagnostic category, psychotropic medication use, a diagnosis of a psychiatric disorder within secondary healthcare, age at diagnosis, and occupation were associated with WD trajectory groups. Conclusions Around two-thirds of individuals treated for a new episode of any anxiety-, mood/affective-, or stress-related disorder in primary healthcare have an excellent prognosis regarding WD. Several sociodemographic and clinical characteristics were associated with group membership; these factors could identify individuals at risk of long-term welfare dependency and who might benefit from interventions to promote a return to work.

Dynamic links between daily anxiety symptoms and young adults’ daily well-being

ABSTRACT Background Anxiety disorders are prevalent among youth and adults. Increasing studies examined the dynamic associations between momentary fluctuations of anxiety and well-being, primarily focusing on the severity of general anxiety. Scant research has explored the co-fluctuations between different anxiety symptoms and mental health outcomes. Method The current study evaluated the multi-level factor structure and assessed the subclinical symptoms of generalized anxiety disorder (GAD), social phobia (SP), and panic disorder (PD) in a sample of non-clinical young adults (N = 271, Mage = 18 years, 72% female, 68% non-White) who participated in a 30-day daily diary study. Results Between persons, GAD, SP, and PD were positively correlated with depressive symptoms, stress, as well as emotional and peer problems. Within persons, both SP and PD were positively associated with stress, peer and emotional problems on the same day. Across days, there was positive reciprocal relation between PD and stress, whereas negative reciprocal link was observed between SP and emotional problems. Conclusions Current findings showed dynamic and distinct patterns in the associations between different anxiety symptoms and several mental health outcomes, which emphasizes the need to disentangle between- and within-person variation of anxiety symptoms with intensive longitudinal designs.

The Effects of Exergaming on Fear of Falling and the Balance Function in Anxious and Non-Anxious Older Adults: A Pilot Study

ABSTRACT Background Anxiety can exacerbate fear of falling and balance issues, potentially affecting intervention efficacy. This study examines exergaming’s impact on fear of falling and balance in anxious and non-anxious older adults. Materials and Methods Twenty older adults (10 anxious, 10 non-anxious) participated in six weeks of balance-oriented gaming. Fear of falling was assessed using the Falls Efficacy Scale and the Activities-specific Balance Confidence Scale. Balance was measured with the Berg Balance Scale and the Timed Up and Go Test before, after, and six weeks post-intervention. Results Both groups showed significant improvements in balance and mobility, sustained during follow-up. However, only the non-anxious group exhibited significant reductions in fear of falling and increased balance confidence. Anxiety was linked to reduced enjoyment, lower efficacy perception, and heightened tension during the intervention. Conclusion Exergaming improves balance and reduces fear of falling in non-anxious older adults. Anxiety may diminish these benefits. Clinical implications Assessing anxiety levels is crucial when prescribing exergaming interventions. Tailoring treatments to address anxiety could enhance outcomes.

A study of association between early menarche and anxiety in undergraduate students

Background Anxiety has been reported to be one of the most common epidemics in recent years. The present study focused on understanding the association between early menarche and the prevalence of anxiety and anxiety symptoms among adult undergraduate students. Methods This was an observational, case-control study. The sample included 146 young female adults aged more than or equal to 18 years pursuing the Bachelor of Medicine and Bachelor of Surgery (MBBS) and Bachelor of Dental Sciences (BDS). Using an online questionnaire, participants were asked to recall and enter the age at which they attained menarche. We used the Generalized Anxiety Disorder 7- Item Questionnaire (GAD-7) to measure the severity of their present anxiety symptoms. Results The results showed a significant increase in anxiety symptoms in participants who had early menarche compared to those who did not have early menarche. The mean score on the GAD-7 Questionnaire for the cases was 9.93 and the control group was 6.89. The GAD-7 scores among the cases group were significantly higher in the GAD-7 scores than in the control group. Conclusions This study concluded that early menarche is associated with higher anxiety levels in young adults.

Anxiety Symptoms Influence Food Consumption Differently Depending on Nutritional Status During the COVID-19 Pandemic: A Longitudinal Study with University Students

Background Anxiety symptoms are factors that directly affect eating habits, but this interference can be heterogeneous depending on the nutritional status of the individuals. Objectives To analyze whether the presence of anxiety symptoms at the beginning of the pandemic influenced the change in food consumption according to its purpose and extent of processing during a one-year follow-up and whether this association occurs equally with excess weight and without excess weight university students. Methods This longitudinal study was carried out with 583 university students from a public Higher Education Institution (HEI) in Brazil. The Generalized Estimating Equation (GEE) was used to verify whether anxiety symptoms were associated with changes in food consumption over time. Results The results showed that previous moderate/severe anxiety symptoms were associated with an increased frequency of consumption of both fresh or minimally processed foods (β: 0.2 95%CI: 0.1; 0.7 p = 0.013) and ultra-processed foods (β: 5.6 95%CI: 1.8; 17.7 p = 0.003), but with different magnitudes. In university students who were not excess weight, previous moderate/severe anxiety symptoms were associated with a reduction in the frequency of consumption of fresh or minimally processed foods (β: −2.0 95%CI: −3.5; −0.5 p = 0.008), while in those who were excess weight, there was an increase in consumption of ultra-processed foods (β: 4.5 95%CI: 2.2; 6.8 p < 0.001). Conclusion This study confirms the influence of anxiety symptoms on food consumption according to the extent and purpose of processing. In addition, these results emphasize the role of psychological distress in the university population, and that this factor can affect excess weight and without excess weight individuals differently.

Exploring the Novel Therapeutic Potential of N-acetylcysteine in Depression, Bipolar Disorders and Anxiety

Background Anxiety disorders, bipolar disorder, and depression are prevalent mental health issues that have a substantial impact on both individuals and the community. Many people continue to have symptoms and do not get the right kind of relief from their existing drugs, even after trying conventional therapy methods. Therefore, to enhance the current treatment modalities and patient results, new therapeutic alternatives are required. In recent years, there has been an increase in interest in N-acetylcysteine (NAC) because of its many biological benefits, including its ability to modulate glutamate levels and its antioxidant and anti-inflammatory properties. According to studies, NAC has encouraging anti-depressant properties and may help treat bipolar disease by stabilizing mood and reducing the risk of relapses. Furthermore, through lowering oxidative stress and modifying neurotransmitter networks, NAC has been shown to lessen the symptoms of anxiety. The preclinical and clinical research examining the efficacy of NAC in depression, bipolar disorders, and anxiety are thoroughly analyzed in this review. Methodology Books were reviewed and medical and scientific literature found in MEDLINE and PubMed were analyzed for an assessment of NAC’s therapeutic potential in psychiatric illnesses such as anxiety, depression, and bipolar disorder. Conclusion NAC exhibits potential as a therapeutic agent for psychiatric problems such as anxiety, bipolar disorder, and depression. Performing a thorough clinical study will facilitate proper understanding its efficacy, safety and mechanisms of action.

The effect of magnesium sulfate on memory and anxiety-like behavior in a rat model: an investigation of its neuronal molecular mechanisms

ABSTRACT Background Anxiety is an adaptive response to potentially threatening conditions. Excessive and uncontrolled anxiety responses become nonadaptive and cause anxiety disorders. To better understand the anxiety-modulating effects of Mg sulfate, behavioral test batteries in the assessment of anxiety and learning and memory functions were performed simultaneously over a time period. This study also examines the effects of Mg sulfate compared to diazepam, an anxiolytic drug with amnestic effects on anxiety-like behavior, as well as possible oxidative-nitrosative stress and hippocampal changes in male rats exposed to predator odor. Methods Young adult Sprague-Dawley male rats were used. The rats were assessed using a comprehensive neurobehavioral test battery consisting of novel object recognition, open field, and successive alleys tasks. Anxiety was induced by cat odor, and diazepam and Mg were used as study drugs. Of the frontal cortex and hippocampus, the state of total oxidant and antioxidant and NO levels and histological examination of hippocampal CA1, CA2, CA3, and DG regions were performed. Results Diazepam- and Mg-treated rats showed an improvement in anxiety-related behavior to predator odors. Furthermore, Mg treatment alleviated some of the increasing oxidative stress in the frontal cortex and hippocampus of rats, while diazepam treatment in particular enhanced hippocampal oxidant and antioxidant activity. In addition, brain NO increase induced by animal odor exposure or diazepam treatment was ameliorated by Mg administration. Conclusions Overall, our work suggests that Mg had a partial anxiolytic effect on anxiety-like behaviors, although not as much as diazepam, and this effect varied depending on the dose. Mg treatment might counteract increased oxidative stress and elevated NO levels in the brain.

Effects of oral dexmedetomidine on incidence of anxiety and emergence delirium in surgical and non-surgical anesthesia in preschool children

ABSTRACT Background Anxiety and emergence delirium (ED) are common complications of anesthesia in preschool children. Several causes had been attributed to them. Emergence delirium might be related to preoperative anxiety. We aimed to detect the incidence of anxiety and emergence delirium in anesthesia for surgical and non-surgical procedures, also to detect if oral dexmedetomidine as a premedication affects the incidence and severity of them in these procedures. Methods The study involved 180 children undergoing anesthesia who were randomly assigned to one of four groups, with each group containing 45 children. The study was clinical, controlled, comparative, and prospective. Groups A1&A2 had surgical intervention, while groups B1&B2 had MRI scanning. Groups A1&B1 were given 20 ml plain apple juice (Placebo) and groups A2&B2 received oral Dexmedetomidine (4 µg/kg) inserted in 20 ml apple juice 45 minutes prior to anesthesia induction. Anxiety was assessed pre-procedural, emergence delirium and pain at different intervals post-anesthesia. Results Incidence of anxiety and emergence delirium showed no difference between surgical and non-surgical procedures. Patients who received oral dexmedetomidine in groups A2 and B2 had significantly lower Parental Separation Anxiety scores than corresponding control groups A1 and B1 (p = 0.001). Occurrence of emergence delirium and severe pain were much decreased in groups received dexmedetomidine. PAED and FLACC exhibited significantly reduced scores in groups received dexmedetomidine than groups received Placebo drug (p < 0.05) in both surgical and non-surgical procedures. Rescue analgesia was needed more significantly for patients in groups A1 and B1 relative to other groups (p = 0.002). The incidence of complications revealed no statistical significance. Conclusion Anxiety and emergence delirium were similar in surgical and non-surgical procedures. Premedication of preschool children with oral dexmedetomidine lowered the frequency and intensity of anxiety, emergence delirium and severe pain. Emergence delirium was correlated to pain, especially in surgical procedures.

A Novel Animal Behavioral Model For Assessing Arousal and Anxiety States: Implications for Post-Traumatic Stress Disorder

Background: Post-traumatic stress disorder (PTSD) is a highly prevalent disorder with widespread impact on health co-morbidities, including cardiovascular disease (CVD). There is a pressing need to understand its underlying mechanisms. This study builds upon our previous published clinical and pre-clinical findings assessing cardiovascular and autonomic responses to stress. Using a recently developed behavioral model and lab-developed software for integrated behavioral and cardio-autonomic analysis, we sought to assess the impact of chronic unpredictable threat reminders on arousal and anxiety behavior as well as cardiovascular and autonomic function in pair-housed mice. Methods: Male and female C57bl/6J mice underwent Pavlovian auditory fear conditioning (n=10-16/group) and were returned to the home cage, equipped with speaker and top-down camera with infrared capabilities. Using a customized software to remotely deliver the conditioned stimulus (CS), pair-housed mice received 6 tones (30sec. 6kHz) throughout the light-dark (LD) cycle over a 24hr period (3 light, 3 dark), repeated for 14 days. The first CS during each LD cycle was recorded and freezing behavior was manually scored. Videos were used to train DeepLabCutTM (DLC) for automated behavioral analysis. On day 15, to evaluate whether evoked freezing is context-dependent, mice were placed into a novel context and CS-dependent freezing was measured. Mice then underwent elevated plus maze (EPM), uncued startle reactivity testing, and fear-potentiated startle (FPS) to assess locomotor, anxiety, and hyperarousal and heightened vigilant behaviors. Results: Following 14 days of chronic unpredictable conditioned threat reminders, fear-conditioned male and female mice exhibited strong CS-evoked freezing in the home cage. Circadian evaluation revealed enhanced freezing in the light versus the dark phase ( males, p&lt;0.01; females, p&lt;0.01). DLC analysis successfully and accurately quantified freezing of group-housed mice. Over 14 days, CS-dependent freezing declined, though this was context-dependent as freezing was significantly higher in a novel context on day 15 ( males, p&lt;0.01; females, p=0.02). While chronic threat reminders did not affect behavior in the EPM, males, but not females, displayed hyperarousal in both uncued (startle to 120dB, males, p&lt;0.01, females, p=0.62) and cued (FPS, males, p=0.04, females, p=0.60) startle testing, though neither males nor females had increased background anxiety during FPS ( males, p=0.77, females, p=0.77). Conclusions: Here we demonstrate, using lab-developed software, environment- and circadian-dependent conditioned freezing in the home cage of group-housed mice. These results further demonstrate that the delivery of chronic intermittent unpredictable conditioned threat reminders leads to an enhanced startle phenotype, that may be sex-dependent. Future studies are needed to assess direct measures of autonomic function in this model, which could provide novel insights into and potentially revealing new therapeutic and preventive strategies for mitigating PTSD-related autonomic dysfunction. (CDMRP) PR210574. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Anxiety and depression status in patients with idiopathic pulmonary fibrosis and outcomes of nintedanib treatment: an observational study

Background Anxiety and depression are common comorbidities in idiopathic pulmonary fibrosis (IPF) that impair health-related quality of life. However, there is a lack of studies focusing on the mental disorder of IPF after antifibrotic treatment and their related predictive factors. Methods Patients with an initial diagnosis of IPF were enrolled. Data on demographics, lung function, Generalized Anxiety Disorder-7 (GAD-7) Scale, Patient Health Questionnaire 9 (PHQ-9), Patient Health Questionnaire-15 (PHQ-15), and St. George's Respiratory Questionnaire total score(SGRQ-T) were collected. Changes in anxiety, depression, somatic symptoms, and quality of life scores before and after nintedanib treatment were compared, and the related predictive factors were analyzed. Results A total of 56 patients with a first diagnosis of IPF were enrolled, with 42 and 35 patients suffering from anxiety and depression, respectively. The GAD-7, PHQ-9, PHQ-15, and SGRQ scores were higher in the anxiety and depression groups. SGRQ total score (SGRQ-T) [OR = 1.075, 95%CI= (1.011, 1.142)] was an independent predictor of IPF combined with anxiety (p < 0.05); SGRQ-T [OR = 1.080, 95%CI= (1.001, 1.167)] was also an independent predictor of IPF combined with depression (p < 0.05). After treatment, GAD-7, PHQ-9, PHQ-15, and SGRQ scores decreased (p < 0.05). ΔSGRQ-T significantly affected ΔGAD-7 (β = 0.376, p = 0.009) and ΔPHQ-9 (β = 0.329, p = 0.022). Conclusion Anxiety and depression in IPF patients are closely related to somatic symptoms, pulmonary function, and quality of life. The SGRQ-T score is of great value for assessing anxiety and depression in patients with IPF. Short-term treatment with nintedanib antifibrotic therapy can alleviate anxiety and depression in IPF patients.

The feasibility and impact of a brief behavioural intervention for anxiety in later life: perceptions of general practice nurses

Background Anxiety is prevalent in older people and is associated with adverse health outcomes. Early detection and intervention are imperative, yet clinically significant anxiety in older people is often under-diagnosed. When diagnosed, pharmacotherapy is often the initial treatment, but resistance due to stigma, polypharmacy concerns, and side effects are common among the elderly. Non-pharmacological interventions such as deep breathing and progressive muscle relaxation may offer more acceptable and cost-effective options to managing anxiety. While primary care is ideal for addressing anxiety in older adults, it is important to assess the feasibility and acceptability of nurse-led interventions in general practice. Objective To explore the perspectives of General Practice Nurses (GPNs) on the feasibility and acceptability of implementing a guided relaxation intervention for older people living with symptoms of anxiety, in Australian metropolitan and regional settings. Methods GPNs were trained and then administered a guided relaxation intervention to older people at three metropolitan general practices and one large rural practice encompassing four sites. Subsequently, five GPNs participated in semi-structured interviews exploring the acceptability and feasibility of implementing the intervention. Interviews were recorded, transcribed and findings were mapped to four key domains of interest: “Screening”, “Training and Delivery”, “Perceived impact of the Intervention” and “Barriers to the intervention”. Results Overall, GPNs reported that the intervention was easy to implement, was well received, helped build relationships and enabled conversations about mental health and well-being. They noted broader applicability of acquired knowledge and skills with other clients. Conclusion The intervention shows promise in promoting and supporting healthcare capabilities in primary care. GPNs are ideally placed to detect clinical symptoms of anxiety among older people and deliver brief well-being initiatives. However, to sustain and scale well-being interventions structured skill development, commitment from general practices, and policy shifts such as government rebates for GPNs are required.

The longitudinal relationship between well-being comparisons and anxiety symptoms in the context of uncontrollability of worries and external locus of control: a two-wave study

ABSTRACT Background: Anxiety is a prevalent mental health condition. Comparisons of one’s own well-being to different aversive standards may contribute to the development and maintenance of anxiety symptoms. Objectives: Our primary goal was to investigate whether aversive well-being comparisons predict anxiety symptoms and vice versa. Additionally, we aimed at examining exploratorily whether well-being comparisons are reciprocally related to metacognitive beliefs about worrying and external control beliefs. Methods: In this two-wave longitudinal survey design, 922 participants completed measures of anxiety, metacognitions about the uncontrollability of worries, external locus of control, and the Comparison Standards Scale for Well-being (CSS-W) at two timepoints, three-months apart. The CSS-W assesses the frequency, perceived discrepancy, and affective impact of social, temporal, counterfactual, and criteria-based comparisons. Results: When autoregressive effects were adjusted for, aversive comparison frequency, comparison affective impact, and uncontrollability of worries at the first timepoint predicted subsequent anxiety symptoms. Furthermore, well-being comparison frequency and discrepancy at the second timepoint were predicted by baseline anxiety symptoms. External locus of control predicted comparison frequency and discrepancy. Conclusions: Well-being comparisons contribute distinct variance to anxiety symptoms and vice versa, pointing to a vicious cirlcle of symptom escalation. These findings have significant implications for future research.