Depression Subscale Research Articles

Stress and Anxiety in Neurosurgical Patients before Surgery

Introduction. Stress is an inevitable part of everyone’s life. It is the body’s response to unfamiliar and unpredictable situations that people often have to face. Hospitalisation and surgery are among the factors that contribute to stress and anxiety.
 Aim. The aim of this study was to assess the severity of stress, anxiety and depression in neurosurgical patients before surgery and the factors affecting them.
 Material and Methods. The study included 100 patients residing in the Department of Neurosurgery of the 10th Military Research Hospital with Polyclinic IP HCC in Bydgoszcz, who were qualified for surgery. The study was conducted using the author’s questionnaire, the PSS-10 scale, the anxiety and depression subscales of the HADS-M questionnaire.
 Results. In the study group, the mean stress score was 6.07±1.31 points, anxiety 9.73±2.84 points and depression 4.76±3.15 points. An increase in stress levels resulted in an increase in anxiety and depression levels (p<0.001). Talking to hospital ward staff about the planned surgery reduced depression levels (p=0.045), but had no effect on levels of perceived stress and anxiety. Anxiety and depressive disorders increased with the age of the subjects.
 Conclusions. Preoperative assessment of stress, anxiety and depression can help to identify patients with high levels of these disorders and take appropriate measures to reduce them. (JNNN 2023;12(2):55–62)

Psychological distress of inmates at a women's prison in Lima after the first wave of COVID-19 in November 2020.

A descriptive study was carried out to establish the levels of psychological distress amongst female inmates at a high-security prison in Lima in November 2020, after the first wave of COVID-19. The Brief Symptoms Inventory-18 (BSI-18) was applied to a representative sample of 314 female inmates who agreed to participate in the study. Results showed that 34.6% of the inmates could be considered as cases of psychological distress. Moreover, the depression subscale had the highest score, followed by the anxiety and the somatisation subscales. The most prevalent symptom was "feeling blue". The prevalence of distress symptoms was analyzed, taking into account the effects of the first wave of COVID-19, the suspension of family visits, the restriction of treatment and leisure activities, etc. Gender aspects were also taken into consideration.

Microstructural changes precede depression in patients with relapsing-remitting Multiple Sclerosis

BackgroundMultiple Sclerosis lesions in the brain and spinal cord can lead to different symptoms, including cognitive and mood changes. In this study we explore the temporal relationship between early microstructural changes in subcortical volumes and cognitive and emotional function in a longitudinal cohort study of patients with relapsing-remitting Multiple Sclerosis.MethodsIn vivo imaging in forty-six patients with relapsing-remitting Multiple Sclerosis was performed annually over 3 years magnetic resonance imaging. Microstructural changes were estimated in subcortical structures using the free water fraction, a diffusion-based MRI metric. In parallel, patients were assessed with the Hospital Anxiety and Depression Scale amongst other tests. Predictive structural equation modeling was set up to further explore the relationship between imaging and the assessment scores. In a general linear model analysis, the cohort was split into patients with higher and lower depression scores.ResultsNearly all subcortical diffusion microstructure estimates at the baseline visit correlate with the depression score at the 2 years follow-up. The predictive nature of baseline free water estimates and depression subscores after 2 years are confirmed in the predictive structural equation modeling analysis with the thalamus showing the greatest effect size. The general linear model analysis shows patterns of MRI free water differences in the thalamus and amygdala/hippocampus area between participants with high and low depression score.ConclusionsOur data suggests a relationship between higher levels of free-water in the subcortical structures in an early stage of Multiple Sclerosis and depression symptoms at a later stage of the disease.

French Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q).

Autistic camouflaging is a collection of strategies used to hide autistic characteristics. It can have serious consequences on autistic people's mental health and needs to be addressed and measured in clinical practice. The purpose of this study is to evaluate the psychometric properties of the French adaptation of the Camouflaging Autistic Traits Questionnaire. 1227 participants (744 autistic, 483 non-autistic) answered the French version of the CAT-Q in an online survey or on paper. Confirmatory factor analysis, measurement invariance testing, internal consistency analysis (McDonald's ω), and convergent validity with the DASS-21 depression subscale were conducted. Test-rest reliability was assessed on a sample of 22 autistic volunteers using intraclass correlation coefficient. A good fit was found for the original three-factor structure as well as a good internal consistency, excellent test-retest reliability and highly significant convergent validity. Measurement invariance testing indicates however that the meaning behind items is different for autistic vs. non-autistic people. The French version of the CAT-Q can be used in clinical settings to assess camouflaging behaviors and intent to camouflage. Further research is needed to clarify the camouflage construct and whether reported measurement noninvariance are due to cultural differences or a true difference in what camouflaging might mean for non-autistic people.

Effects of successful parathyroidectomy on neuropsychological and cognitive status in patients with asymptomatic primary hyperparathyroidism.

Besides typical clinical symptoms, primary hyperparathyroidism (pHPT) is associated with impaired quality of life and cognitive status. The aim of this study was to evaluate the quality of life and cognitive impairment in patients with pHPT, before and after parathyroidectomy. We conducted a panel study, which included asymptomatic pHPT patients scheduled for parathyroidectomy. Besides demographic and clinical data, patients' quality of life and cognitive capacity were recorded before, 1 month, and 6 months following parathyroidectomy using the Short Form 36 questionnaire (RAND-36), Beck Depression Inventory (BDI), Depression Anxiety Stress Scales (DASS), Mini-Mental State Examination (MMSE), and Symptom Check List 90-revised version (SCL90R). During a 2-year follow-up, 101 patients entered the study (88 women), with an average age of 60.7 years. The Global score of RAND-36 test ameliorated by almost 50% 6 months after parathyroidectomy. The most sustained subscores of the RAND-36 test were role functioning/physical and health change, with an improvement of more than 125%. According to the BDI, DASS depression subscore, and SCL90R depression subscore, the extent of depressive symptoms reduction was approximately 60% 6 months postoperatively. The level of anxiety was reduced by 62.4%, measured by both the DASS and SCL90R anxiety subscores. The stress level was almost halved according to the DASS stress subscore (from 10.7 to 5.6 points). The results of the MMSE test showed a significant improvement postoperatively, for 1.2 points (4.4%). A worse preoperative score of each tool was related to the higher magnitude of improvement 6 months after parathyroidectomy. A considerable number of pHPT patients, even without other typical symptoms, show signs of impaired quality of life and neurocognitive status preoperatively. After a successful parathyroidectomy, there is an improvement in quality of life, declined levels of depression, anxiety, and stress, as well as amelioration of cognitive status. Patients with more impaired quality of life and pronounced neurocognitive symptoms may expect more benefits from the surgery.

Chronic post-thoracotomy pain after lung cancer surgery: a prospective study of preoperative risk factors.

The objective of this longitudinal cohort study was to investigate if preoperative pain mechanisms, anxiety, and depression increase risk of developing chronic post-thoracotomy pain (CPTP) after lung cancer surgery. Patients with suspected or confirmed lung cancer undergoing surgery by either video-assisted thoracoscopic surgery or anterior thoracotomy were recruited consecutively. Preoperative assessments were conducted by: quantitative sensory testing (QST) (brush, pinprick, cuff pressure pain detection threshold, cuff pressure tolerance pain threshold, temporal summation and conditioned pain modulation), neuropathic pain symptom inventory (NPSI), and the Hospital Anxiety and Depression Scale (HADS). Clinical parameters in relation to surgery were also collected. Presence of CPTP was determined after six months and defined as pain of any intensity in relation to the operation area on a numeric rating scale form 0 (no pain) to 10 (worst pain imaginable). A total of 121 patients (60.2 %) completed follow-up and 56 patients (46.3 %) reported CPTP. Development of CPTP was associated with higher preoperative HADS score (p=0.025), higher preoperative NPSI score (p=0.009) and acute postoperative pain (p=0.042). No differences were observed in relation to preoperative QST assessment by cuff algometry and HADS anxiety and depression sub-scores. High preoperative HADS score preoperative pain, acute postoperative pain intensity, and preoperative neuropathic symptoms were was associated with CPTP after lung cancer surgery. No differences in values of preoperative QST assessments were found. Preoperative assessment and identification of patients at higher risk of postoperative pain will offer opportunity for further exploration and development of preventive measures and individualised pain management depending on patient risk profile.

Prevalence and predictors of depression, anxiety, and stress among recovered COVID-19 patients in Vietnam.

During the COVID-19 pandemic, a high prevalence of mental health distress has been reported among people who have recovered from the disease. To assess the prevalence of depression, anxiety, and stress as well as identify predictors among recovered COVID-19 patients after more than six months of being discharged in Dong Thap Province, Vietnam. The cross-sectional study was conducted among 549 eligible participants recruited by stratified sampling. Data was collected using the depression, anxiety and stress scale - 21 items had Content Validity Index = 0.9, and Cronbach's alpha for depression, anxiety and stress sub-scales were 0.95, 0.81, and 0.86, respectively. Descriptive statistics were used to measure the prevalence levels and distribution of characteristics of the participant, while factors influencing depression, anxiety, and stress were predicted using binary logistic regression. The overall prevalence of depression, anxiety, and stress were 24.8% (95% CI: 21.2-28.6), 41.5% (95% CI: 37.4-45.8), and 25.3% (95% CI: 21.7-29.2), respectively. The predictors of depression were living in urban area (OR = 1.97; 95% CI: 1.27-3.08), holding a bachelor's degree (OR:3.51; 95% CI: 1.13-10.8), having a high monthly income (OR: 2.57; 95% CI: 1.03-6.38), diabetes (OR: 2.21; 95% CI: 1.04-4.68), heart disease (OR: 3.83; 95% CI: 1.79-8.17), respiratory disease (OR: 3.49; 95% CI: 1.24-9.84), and diarrhea (OR: 4.07; 95% CI: 1.06-15.6). Living in the urban area (OR: 1.57; 95% CI: 1.07-2.29), having sleep disturbance (OR: 2.32; 95% CI: 1.56-3.46), and fatigue (OR: 1.57; 95% CI: 1.03-2.39) were predictors for anxiety. Having respiratory disease (OR: 3.75; 95% CI: 1.47-9.60) or diarrhea (OR: 4.34; 95% CI: 1.18-15.9) were predictors of stress. People who have recovered from COVID-19 should be assessed for symptoms of depression, anxiety, and stress. Primary healthcare providers should develop interventions to support their recovery.

Drug Use, Family Support, and Depressive Symptoms Among Latinx Sexual Minority Men: A Longitudinal Analysis.

Family rejection has negative health consequences for Latinx sexual minority men(LSMM). However, LSMM often reconcile with their families, a phenomenon cross-sectional studies miss. We analyzed longitudinal data from the Healthy Young Men's Study in Los Angeles. We used individual fixed-effects Poisson regression to model changes over time in the associations among family support, drug use, and depressive symptoms. We found that (1) the initiation of drug use was associated with a 7.2% (Ratio=1.072, 95% CI 1.006 - 1.142, p = 0.03) increase in family support among LSMM who reported high depressive symptoms (depression subscale T-score ≥ 63) in at least one data wave; (2) a 1-unit increase in family support was associated with a 4.7% (RR = ;0.953, 95% CI 0.931 - 0.976, p < 0.001) decrease in the probability of high depressive symptoms; and (3) no significant association between a change in drug use and a change in high depressive symptoms. Over time, LSMM appear to benefit from the health effects of family support associated with Latinx family structures.

Temporal reciprocal relationships among anxiety, depression, and posttraumatic stress disorder for family surrogates from intensive care units over their first two bereavement years

Background/ObjectiveBereaved family surrogates from intensive care units (ICU) are at risk of comorbid anxiety, depression, and post-traumatic stress disorder (PTSD), but the temporal reciprocal relationships among them have only been examined once among veterans. This study aimed to longitudinally investigate these never-before-examined temporal reciprocal relationships for ICU family members over their first two bereavement years.MethodsIn this prospective, longitudinal, observational study, symptoms of anxiety, depression, and PTSD were assessed among 321 family surrogates of ICU decedents from 2 academically affiliated hospitals in Taiwan by the anxiety and depression subscales of the Hospital Anxiety and Depression Scale, and the Impact of Event Scale-Revised, respectively at 1, 3, 6, 13, 18, and 24 months postloss. Cross-lagged panel modeling was conducted to longitudinally examine the temporal reciprocal relationships among anxiety, depression, and PTSD.ResultsExamined psychological-distress levels were markedly stable over the first 2 bereavement years: autoregressive coefficients for symptoms of anxiety, depression, and PTSD were 0.585–0.770, 0.546–0.780, and 0.440–0.780, respectively. Cross-lag coefficients showed depressive symptoms predicted PTSD symptoms in the first bereavement year, whereas PTSD symptoms predicted depressive symptoms in the second bereavement year. Anxiety symptoms predicted symptoms of depression and PTSD at 13 and 24 months postloss, whereas depressive symptoms predicted anxiety symptoms at 3 and 6 months postloss while PTSD symptoms predicted anxiety symptoms during the second bereavement year.ConclusionsDifferent patterns of temporal relationships among symptoms of anxiety, depression, and PTSD over the first 2 bereavement years present important opportunities to target symptoms of specific psychological distress at different points during bereavement to prevent the onset, exacerbation, or maintenance of subsequent psychological distress.

Painful temporomandibular disorders in Confucian-heritage cultures: Their inter-relationship with bodily pain, psychological well-being and distress.

Temporomandibular disorders (TMDs) are common and affect individuals negatively. This study investigated the inter-relationship of painful TMDs with bodily pain, psychological well-being and distress in young people from a Confucian-heritage culture (CHC). Adolescents/young adults were recruited from a polytechnic in Singapore. While the presence/severity of painful TMDs and bodily pain were established with the DC/TMD Pain Screener (TPS) and Maciel's Pain Inventory, psychological well-being and distress were evaluated with the Scales of Psychological Well-being-18 (SPWB-18) and Patient Health Questionnaire-4 (PHQ-4). Statistical explorations were conducted using chi-square/Mann-Whitney U tests, Spearman's correlation and logistic regression analyses (α = .05). Among the 225 participants (mean age 20.1 ± 3.9 years) examined, 11.6% had painful TMDs and 68.9% experienced multisite bodily pain. Though painful TMDs were accompanied by a higher occurrence of multisite bodily pain, the overall/discrete number of bodily pain sites did not differ substantially between the 'no TMD pain' (NT) and 'with TMD pain' (WT) groups. Besides ear pain, differences in overall/discrete bodily pain scores were also insignificant. However, significant differences in environmental mastery, overall psychological distress, depression and anxiety subscale scores were discerned between the NT and WT groups. Psychological well-being and distress were moderately and negatively correlated (rs = -.56). Multivariate analysis indicated that ear pain and psychological distress increased the prospect of painful TMDs. The prevalence of multi-site bodily pain was high in young people from CHCs irrespective of the painful TMDs' presence of painful TMDs. Enhancing environmental mastery and relieving depression/anxiety may help manage TMD pain.

Effect of alternate nostril breathing exercise on autonomic functions, ocular hypertension, and quality of life in elderly with systemic hypertension and high-tension primary open-angle glaucoma

Investigating the response of ocular hypertension and quality of life to a 4-week alternate-nostril breathing exercise (ANBE) in older adults with systemic hypertension (SH) and high-tension form of primary open-angle glaucoma (HTF-POAG) was our aim. Sixty older adults with SH and HTF-POAG were randomly assigned to the ANBE group (n=30, received morning and evening 30 min sessions of daily ANBE) or the control (waitlist) group (n=30). Right-eye intraocular pressure (IOP), left-eye IOP, blood pressure, short-form-36 survey (SF36S), rates of respiration and radial-artery pulsation, hospital anxiety and depression scale (depression subscale abbreviated as HADS-D and anxiety subscale abbreviated as HADS-A), and glaucoma quality-of-life 15-item questionnaire (GQoL-15) were assessed. All measurements were improved in the ANBE group only. In conclusion, a 4-week ANBE could be an adjunctive modality to improve HADS-D, rates of respiration and radial-artery pulsation, HADS-A, blood pressure, IOP, GQol-15, and SF36S in older adults SH and HTF-POAG.

Abnormalities in brain structure following childhood unpredictability: a mechanism underlying depressive and anxiety symptoms.

Childhood adversity is associated with abnormalities in brain structure, but this association has not been tested for childhood unpredictability, one form of adversity. We studied whether abnormalities in gray matter volume (GMV) could be a mechanism linking childhood unpredictability and psychopathology, over and above the effect of childhood trauma. Participants were 158 right-handed healthy young adults (aged 17-28 years, M = 22.07, s.d. = 2.08; 66.46% female) who underwent structural magnetic resonance imaging measurements and provided retrospective reports of childhood unpredictability. The anxiety and depression subscales of the self-report Brief Symptom Inventory-53 were used to index psychopathology. Whole-brain voxel-based morphometric analyses showed that after controlling for the effect of childhood trauma, childhood unpredictability was correlated with greater GMV in bilateral frontal pole, bilateral precuneus, bilateral postcentral gyrus, right hemisphere of fusiform, and lingual gyrus, and left hemisphere of ventrolateral prefrontal cortex as well as occipital gyrus. Greater GMV in bilateral frontal pole, bilateral precuneus, and bilateral postcentral gyrus mediated associations between unpredictability and symptoms of depression and anxiety. The findings suggest that childhood unpredictability could exact unique effects on neural development, over and above the effect of childhood trauma. These findings are relevant for understanding the occurrence of psychopathology following childhood unpredictability and have implications for intervention.

Telehealth-based psychological intervention for caregivers of patients with primary malignant brain tumors: A randomized controlled trial.

12008 Background: Caregivers of patients with primary malignant brain tumors (PMBT) face unique challenges caring for someone with a progressive neurological illness. In preliminary studies, we found that 50% or more of caregivers had clinically significant anxiety symptoms in the months following the patient’s PMBT diagnosis. However, few interventions have been developed to specifically target anxiety symptoms in this population. Methods: We conducted a randomized controlled trial evaluating the efficacy of NeuroCARE, a population-specific intervention addressing anxiety in caregivers of patients receiving treatment at two academic centers. Eligible caregivers were within six months of the patient’s PMBT diagnosis and had clinically significant anxiety symptoms (score ≥ 5 on the Generalized Anxiety Disorder-7 tool). Participants were randomized 1:1 to NeuroCARE or usual care. NeuroCARE consisted of six one-on-one telehealth sessions with a mental health clinician or trainee and incorporated evidence-based skills for 1) coping with worry, 2) using assertive communication techniques, 3) optimizing social support, and 4) promoting relaxation and healthy sleep. Participants completed questionnaires at baseline, 11 weeks (immediately post-intervention) and 16 weeks (1 month post-intervention). Our primary endpoint was anxiety symptoms at 11 weeks (Hospital Anxiety and Depression Scale (HADS) – Anxiety Subscale score). We also assessed depression symptoms (HADS – Depression Subscale), quality of life (QOL; Caregiver QOL survey), caregiver burden (Caregiver Reaction Assessment), self-efficacy (Lewis Cancer Self-Efficacy scale), coping (Measure of Current Status) and post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for DSM-5). We used analysis of covariance to evaluate the effect of NeuroCARE versus usual care on these outcomes. Results: We enrolled 120 caregivers (60 per arm, mean age = 53 years, 83% female), the majority of whom were caring for their spouse/long-term partner (70%), child (17%), or parent (7%). At 11 weeks, NeuroCARE participants reported significantly lower anxiety symptoms than those assigned to usual care (means: 8.87 vs 10.69, p = 0.008). NeuroCARE caregivers also reported significantly lower depression symptoms (6.08 vs 7.77, p = 0.004) and better self-efficacy (128.81 vs 111.17, p &lt; 0.001) and coping (32.25 vs 25.65, p &lt; 0.001) at 11 weeks. Study groups did not differ with respect to caregiver burden, PTSD symptoms, or QOL at 11 weeks. Conclusions: A population-specific telehealth-based psychological intervention (NeuroCARE) led to significantly lower anxiety and depression symptoms and better self-efficacy and coping among caregivers of patients with PMBT compared with usual supportive care. Clinical trial information: NCT04109209 .

The link between apathy and depressive symptoms and healthy lifestyles in older community‐dwelling adults

AbstractBackgroundApathy (loss of motivation or goal‐directed behaviour) and depression each confer risk for dementia, cardiovascular disease and mortality in older adults. The mechanisms by which these neuropsychiatric symptoms are linked with health outcomes are not yet understood. Health behaviours may be one pathway, yet their potential links with apathy have received scant attention, whereas depression has been consistently associated with unhealthier behaviours including physical inactivity. Depression and apathy may be confounded, thus it is critical to determine their potential differential associations with health behaviours. This study thus aims to investigate whether apathy and depressive symptoms in older adults were associated with a broad battery of health behaviours.MethodCommunity‐dwelling participants from the Sydney Memory and Ageing Study (n = 1,030) aged 70‐90 without dementia completed assessments including the Geriatric Depression Scale, from which apathy (GDS‐3A) and depression (GDS‐12D) subscores were obtained. To investigate cross‐sectional associations with self‐reported physical activity, diet, current and lifetime alcohol consumption and smoking, linear or logistic regressions predicted the outcomes from apathy and depression, controlling for age, sex, education, global cognition and chronic conditions.ResultGreater apathy (but not depressive symptoms) was significantly associated with current physical inactivity (fewer hours/week weighted by intensity, p &lt; .001) and frequent alcohol consumption (&gt;2x weekly, p &lt;.05). Depressive symptoms alone predicted poorer current adherence to Australian Dietary Guidelines (ADG‐2013, p &lt;.05) and smoking (p &lt;.001). Higher levels of both apathy and depressive symptoms were significantly associated with a past period of “heavier” alcohol consumption (p &lt;.05); neither were related with lifetime history of smoking nor lifetime abstinence from alcohol.ConclusionApathy and depression were differentially associated with health behaviours. Presence of these symptoms in older adults may act as a barrier to engagement in healthier lifestyle activities, which are known to have numerous benefits for health and cognitive outcomes. These novel findings should be further examined longitudinally and with objective measures and alternative apathy assessment. Apathy should be considered along with depression as key determinants of health behaviours when designing health promotion interventions targeting older adults, and in models of dementia risk reduction.

Positive affect training to reduce mental health problems during the COVID-19 pandemic: a proof-of-concept randomised clinical trial

BackgroundThe social restrictions occurring during the pandemic contributed to loss of many sources of reward, which contributes to poor mental health.ObjectiveThis trial evaluated a brief positive affect training programme to...

Validation of Hospital Anxiety and Depression Scale in an Indonesian population: a scale adaptation study

ObjectiveThis study aims to adapt the English-language Hospital Anxiety and Depression Scale (HADS) to the Indonesian language and evaluate the validity and reliability of the adapted version (ie, HADS-Indonesia).DesignA cross-sectional...

The relationship between perception of well-being and depression among adolescents in Jordan: using PERMA model as a theoretical framework

Purpose Adolescence is a developmental stage of transition that is marked by multiple biopsychosocial changes that affect their well- and ill-being. This study aims to examine the multidimensional of well- and ill-being among adolescents, and to understand the relationship between well-being and depression using the PERMA model among school-age adolescents. Design/methodology/approach A descriptive, cross-sectional design was used to recruit 625 school-age adolescents (343 males and 282 females), using convenience sampling technique from the central district of Jordan. Self-administered questionnaire was used to collect data in relation to depression and well-being. Findings The analysis revealed that 32% had a well-being score below the median and 19% had severe depressive symptoms. Depression and well-being were moderately correlated, with the connectedness dimension being the most correlated to depression, whereas the engagement dimension was the least correlated. Females had higher scores on all subscales of depression and a significantly higher score on depression than males, whereas males had higher scores on all well-being dimensions and significantly higher scores on overall well-being than females. Research limitations/implications Adolescents’ mental health is compromised and affected by their perception of well-being, and a comprehensive psychoeducation for adolescents on how to enhance well-being might combat development of depressive symptoms. Originality/value This study used all PERMA model components to provide an in-depth description of adolescents’ well-being, which is a crucial initial phase in better understanding how this age group experiences well-being and how it connects to their ill-being, as indicated by their depressive symptoms. The in-depth description of adolescents’ well-being will aid in planning early intervention and prevention programs for mental illness.

Health-related quality of life in patients with newly diagnosed inflammatory bowel disease: an observational prospective cohort study (IBSEN III)

PurposeThis unselected, population-based cohort study aimed to determine the level of health-related quality of life (HRQoL) in patients with Crohn’s disease (CD) and ulcerative colitis (UC) at the time of diagnosis compared with a reference population and identify the demographic factors, psychosocial measures, and disease activity markers associated with HRQoL.MethodsAdult patients newly diagnosed with CD or UC were prospectively enrolled. HRQoL was measured using the Short Form 36 (SF-36) and Norwegian Inflammatory Bowel Disease Questionnaires. Clinical significance was assessed using Cohen’s d effect size and further compared with a Norwegian reference population. Associations between HRQoL and symptom scores, demographic factors, psychosocial measures, and disease activity markers were analyzed.ResultsCompared with the Norwegian reference population, patients with CD and UC reported significantly lower scores in all SF-36 dimensions, except for physical functioning. Cohen’s d effect sizes for men and women in all SF-36 dimensions were at least moderate, except for bodily pain and emotional role for men with UC and physical functioning for both sexes and diagnoses. In the multivariate regression analysis, depression subscale scores ≥ 8 on the Hospital Anxiety and Depression Scale, substantial fatigue, and high symptom scores were associated with reduced HRQoL.ConclusionPatients newly diagnosed with CD and UC reported statistically and clinically significantly lower scores in seven of the eight SF-36 dimensions than the reference population. Symptoms of depression, fatigue, and elevated symptom scores were associated with poorer HRQoL.

(019) Longitudinal Observation on the Prevalence and Impact of Psychological Distress Among Patients Treated for Erectile Dysfunction During the COVID Pandemic

Abstract Introduction The COVID global pandemic has significantly affected the delivery of the healthcare system with valued resources diverted to cope with more urgent clinical services. Erectile dysfunction (ED) is considered a non-urgent medical condition and hence, males with ED were not prioritised and invariably faced long delays in clinical management including postponement in surgical waitlist during this pandemic. Objective To assess the prevalence and impact of psychological distress among males with ED during the COVID pandemic based on changes in the outcomes of validated questionnaires such as the International Index of Erectile Function (IIEF), Depression and Anxiety Stress Scales (DASS-21), Sexual Distress Scale (SDS) and Decisional Engagement Scale (DES-10), as well as perceived availability of medical support. Methods Following ethics approval, this prospective longitudinal study tracked males with ED at a tertiary medical centre between June 2020 and June 2022. Inclusion criteria included males aged 20 to 70 years, who have pre-existing ED (greater than 6 months), receiving medical therapies for ED, and had enrolled in the prospective database at the time of the study. Exclusion criteria were those who have undergone penile prosthesis implantation or received major abdominopelvic surgery during the study period that may preclude sexual activity. All patients completed validated questionnaires at 0, 6, 12, 18 and 24 months with additional data collected during the peak periods of local COVID social measure lockdown. Results A total of 80 patients were identified during the 24 months and 20 patients dropped out due to surgery (15 patients) and incomplete follow-up (5 patients). The mean age of males was 46.8 (21-69) years, and the duration of ED was 14.5 (6-33) months. Almost one-third of the patients showed increased DASS scores on depression (38 patients) and anxiety (42 patients) subscales and one-quarter on stress (29 patients) subscales, with worse DASS scores during the peak periods of social measures. On the SDS questionnaire, higher concerns were registered across all domains apart from the question on regrets about your sexuality. The analyses showed a worsening of the IIEF scores (p&amp;lt;0.021), anxiety and stress (DASS score with p=0.045 and p=0.038, respectively) as well as SDS score (p=0.048) during this pandemic. However, the DES-10 scores were more positive with most patients reporting a score above 7 out of 10 in terms of items on accepting current arrangement (75%) and confidence in clinician decision-making about the treatment (80%) although most patients (92%) indicated the desire to be kept updated and provided with more detailed information on their clinical care. Conclusions The COVID pandemic has caused an adverse psychosexual impact on many patients’ erectile function and mental well-being, and social measures lockdown invariably heightened patient psychosexual distress. Our study showed regular clinical contact and medical reassurance coupled with an explanation of reasons for clinical delays in the non-urgent medical condition resulted in a high level of confidence in clinicians and potentially minimised emotional adjustment in the patients. Disclosure No

COVID-19 government measures and their impact on mental health: a cross-sectional study of older primary care patients in Germany.

With the outbreak of COVID-19, government measures including social distancing and restrictions of social contacts were imposed to slow the spread of the virus. Since older adults are at increased risk of severe disease, they were particularly affected by these restrictions. These may negatively affect mental health by loneliness and social isolation, which constitute risk factors for depressiveness. We aimed to analyse the impact of perceived restriction due to government measures on depressive symptoms and investigated stress as mediator in an at-risk-population in Germany. Data were collected in April 2020 from the population of the AgeWell.de-study, including individuals with a Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score ≥9, using the depression subscale of the Brief Symptom Inventory (BSI-18) and the Perceived Stress Scale (PSS-4). Feeling restricted due to COVID-19 government measures was surveyed with a standardized questionnaire. Stepwise multivariate regressions using zero-inflated negative binomial models were applied to analyse depressive symptoms, followed by a general structural equation model to assess stress as mediator. Analysis were controlled for sociodemographic factors as well as social support. We analysed data from 810 older adults (mean age = 69.9, SD = 5). Feeling restricted due to COVID-19 government measures was linked to increased depressiveness (b = 0.19; p < 0.001). The association was no longer significant when adding stress and covariates (b = 0.04; p = 0.43), while stress was linked to increased depressive symptoms (b = 0.22; p < 0.001). A final model confirms the assumption that the feeling of restriction is mediated by stress (total effect: b = 0.26; p < 0.001). We found evidence that feeling restricted due to COVID-19 government measures is associated with higher levels of depressive symptoms in older adults at increased risk for dementia. The association is mediated by perceived stress. Furthermore, social support was significantly associated with less depressive symptoms. Thus, it is of high relevance to consider possible adverse effects of government measures related to COVID-19 on mental health of older people.