Depression Subscale Scores Research Articles

MOOD STATES AND QUALITY OF LIFE IN PARALYMPIC BOCCIA ATHLETES IN THE COVID-19 PANDEMIC

ABSTRACT Introduction: Although studies have been conducted in the athlete population during the pandemic, its impacts on Paralympic athletes are still unknown. Objective: To evaluate the mood and quality of life of Paralympic boccia players during the COVID-19 pandemic period. Method: Questionnaires assessing mood, quality of life, and demographic data were sent electronically via social media. The study included 43 athletes from all functional classes (BC1 = 8, BC2 = 12, BC3 = 11, and BC4 = 11) and four regions of Brazil (Northeast = 12, Southeast = 12, Central-West = 3, and South = 17). ANOVA, t test, and similar non-parametric tests were used, with the respective effect sizes (ES). Results: Regarding mood states, BC4 athletes differed from BC1 athletes in the depression subscale score (25.5 vs. 14.5, p = 0.026, ES=1.47). The fatigue subscale score differed between BC4 and BC1 athletes (17.8 vs. 10.4, p = 0.023, ES=1.38) and between BC4 and BC2 athletes (17.8 vs 10.3, p = 0.008, ES=1.32). BC4 athletes had higher total mood disturbance (TMD) values than BC1 (175 vs. 141, p = 0.025, ES=1.35) and BC2 (175 vs.141, p = 0.025, ES=0.97) athletes. Lower stress (18.5 vs.21.8, p = 0.027, ES=0.64) and TMD (148.0 vs 162.0; p = 0.044; ES= 0.53) values were observed among the national level athletes. In terms of quality of life, differences were found between BC4 and BC2 athletes in the psychological health domain (3.73 vs. 4.49, p = 0.024, ES=0.89) and between athletes from the Northeast and South in the environment domain (3.39 vs. 4.18, p=0.030, ES=0.44). Conclusion: BC4 athletes are more susceptible to negative mood and quality-of-life perceptions. Additionally, athletes from the Northeast region may have poorer perceptions of quality of life related to the environment in which they live. Level of evidence III; Retrospective study.

The Attention Training Technique Reduces Anxiety and Depression in Patients With Coronary Heart Disease: A Pilot Feasibility Study.

Background and ObjectivesDepression and anxiety symptoms are highly prevalent in coronary heart disease (CHD) patients and associated with poor outcome. Most psychological treatments have shown limited effectiveness on anxiety and depression in these patients. This study evaluates the feasibility of the attention training technique (ATT) in CHD patients with symptoms of anxiety and/or depression.MethodsFive consecutive CHD patients with significant depression and anxiety symptoms with Hospital Anxiety and Depression rating scale (HADS) -anxiety or -depression subscale score > 8 received 6 weekly group-sessions of ATT in an open trial. Outcomes included feasibility and symptoms measured by HADS, at baseline, post-treatment and at 6 months follow-up. We also assessed psychiatric diagnoses, type D personality, insomnia, worry, and rumination.ResultsThe sample comprised five men with a mean age of 59.9 (SD 4.4) years. Four of the patients attended all six sessions, and one patient attended all but one session. Mean HADS-A scores at baseline, post-treatment, and follow-up were 9.4 (SD 3.0), 4.2 (SD 3.0), and 4.0 (SD 2.5), and for HADS-D 8.6 (SD 3.3), 3.0 (SD 3.7), and 1.6 (SD 1.5), respectively. The results showed clinically significant changes in anxiety, depression, psychiatric disorders, insomnia, worry, and rumination. Statistically significant changes were found from pre- to post-treatment scores for HADS-A and worry, which were maintained at follow-up, and HADS-D scores significantly decreased from pre-treatment to 6-months follow-up.ConclusionsATT in a group format appears to be a feasible stand-alone metacognitive treatment for CHD patients. An adequately powered randomized controlled trial is warranted.

Stress, Anxiety and Depression Among Family Caregivers of COVID-19 Patients in Northwest Iran: A Cross-sectional Study

Background: Taking care of a patient with COVID-19 can have a significant psychological burden. This study aimed at determining the levels of stress, anxiety and depression symptoms among family caregivers of Covid-19 patients.
 Methods: This cross-sectional study was conducted on 236 main caregivers of coronavirus patients in Zanjan, Iran in 2020. The data measurement tool was the DASS-21 electronic questionnaire which was designed using the Porsline platform and was sent to the participants via SMS and WhatsApp messages. Descriptive statistics and Pearson’s R, Student’s T test and analysis of variance were performed to analyze the data in SPSS version 25.Results: The mean age of participants was 34.72±9.52 years. Of the participants, 57.21, 70.77 and 55.09% had symptoms of depression, anxiety and stress, respectively. Females experienced higher levels of stress than males (p=0.049). Additionally, the mean score of depression sub-scale was significantly different between categories of employment status (p=0.029), as self-employed workers had significantly higher depression sub-scale scores (10.97±10.85) compared to the other two groups. No significant associations were found between age and depression, anxiety, and stress of the participants. Moreover, the mean scores of depressions, anxiety, and stress sub-scales were not significantly different between categories of marital status and levels of education.
 Conclusion: The majority of family caregivers experienced depression, anxiety, and stress symptoms. This significant prevalence of psychological burden among these individuals underscores the need for supportive measures by policy makers and communities to prevent further severe consequences and help them reduce these symptoms.

Psychological Distress and Drug Provocation Test-Related Anxiety Levels of Pediatric Patients and Their Parents.

Background: Drug provocation tests (DPTs) are the gold standard for the diagnosis of drug hypersensitivity reaction (DHR). To the best of our knowledge, there is no previous study reporting DPT-related anxiety levels in children and their parents. This study aimed to determine the difference in pre- and post-DPT anxiety levels of parents and children who were informed of the possibility of another DHR during the DPT, and to evaluate the relationship between parental psychological distress and anxiety levels. Methods: The study included children who underwent DPT in our clinic between July 1, 2019, and February 29, 2020, and accompanying parents who consented to participate. Age-appropriate State-Trait Anxiety Inventory scales were used to assess levels of state and trait anxiety in the patients and parents. The Symptom Checklist-90-Revised (SCL-90-R) was used to screen for psychological symptoms in parents. Results: Data were collected from the parents of 69 children who underwent DPTs. The patients' median age was 7.28 (interquartile range: 4.52-10.06) and their parents' mean age was 35.28 ± 5.38 years. Anxiety-related data were collected from 21 pediatric patients. The children and parents had higher state anxiety scores before DPT compared to after DPT. There was a positive correlation between the parents' trait anxiety and pre-DPT state anxiety scores. In addition, parental pre-DPT state anxiety scores were positively correlated with SCL-90-R general severity index, somatization, anxiety, obsessive-compulsive, and depression subscale scores. Conclusion: The risk of allergic reaction in DPT may cause anxiety. A high level of parental anxiety before DPT, which gradually decreased after negative test results, was associated with history of drug-induced anaphylaxis in their children and high trait anxiety. Appropriate evaluation of patients and parents before DPT and providing detailed information may be important to reduce this anxiety.

Benson Relaxation Technique Combined With Music Therapy for Fatigue, Anxiety, and Depression in Hemodialysis Patients: A Randomized Controlled Trial.

This study aimed to investigate the effects of the Benson relaxation technique combined with music therapy on fatigue, anxiety, and depression levels of patients undergoing hemodialysis. This randomized controlled study was conducted with 61 patients (30 patients in the intervention group, 31 patients in the control group) in a province located in Turkey. This 8-week, randomized, clinical trial was carried out in 2 hemodialysis units. After the patients in both groups were informed about the study, the Piper Fatigue Scale and the Hospital Anxiety and Depression Scale were administered to the patients. All subdomain scores of the Piper Fatigue Scale in the intervention group were significantly lower at weeks 4, 8, and 10 than those of the control group (P < .05). The intervention group had significantly lower Anxiety subscale scores than those of the control group at week 10 (P < .05). Similarly, Depression subscale scores were significantly lower in the intervention group at weeks 8 and 10 than those in the control group (P < .05). The findings suggest that Benson relaxation technique combined with music therapy is an effective approach to manage fatigue, anxiety, and depression symptoms related to hemodialysis.

Effect of S-ketamine on Postoperative Quality of Recovery in Patients Undergoing Video-Assisted Thoracic Surgery

S-ketamine is associated with effective postoperative analgesia and enhanced quality of recovery (QoR). The study aimed to investigate the effect of perioperative S-ketamine on postoperative quality of recovery in patients undergoing video-assisted thoracic surgery (VATS). A prospective, randomized, double-blinded, placebo-controlled trial. Single institution, tertiary university hospital. Eighty adult patients aged 18-to-65 undergoing VATS were eligible for participation. Patients enrolled in this study were randomized to receive either S-ketamine (a bolus of 0.25 mg/kg, followed by an infusion of 0.125 mg/kg/h until 15 minutes before the end of the surgical procedure), or identical volumes and rates of 0.9% saline. Postoperative quality of recovery was measured with QoR-40 score 48 hours after surgery. The postoperative pain was assessed postoperatively using the numeric rating scale at 0.5, 6, 24, and 48 hours. Hospital Anxiety and Depression Scale Depression subscale (HADS-D) scores and other secondary outcomes also were recorded. The final analysis included 77 patients. The global QoR-40 score at 48 hours postoperatively was higher in the S-ketamine group compared with the saline group (median [interquartile range]: 181.5 [178-184] v 174.5 [169-177]), estimated median difference 7 (95% confidence interval 5-10, p < 0.001). Patients who received S-ketamine treatment had lower pain scores at rest (p=0.017 and p=0.006, respectively) and coughing (p < 0.001 and p=0.007, respectively) at 24 and 48 hours postoperatively than those who received saline treatment. The requirement and consumption of opioid for rescue analgesic were lower in the S-ketamine (p=0.045 and p=0.047, respectively). Compared with the saline group, S-ketamine reduced HADS-D scores (p=0.003) at 48 hours after surgery. The present study's findings suggested that perioperative S-ketamine enhanced the quality of recovery in patients undergoing VATS. S-ketamine also improved postoperative analgesia and postoperative depression.

Screening patients with metastatic breast cancer for psychiatric disease: a cross sectional study

Background: Cancer patients are at risk of developing some level of psychological dysregulation, depending on a series of variables related to the tumor, the environment, and the patient. In this context, it becomes important to define the difference between psychological and psychiatric disorder and to study its prevalence. The primary endpoint of this study is to evaluate the prevalence of psychiatric disorders in a sample of Portuguese patients with metastatic breast cancer and assess the relationship between these disorders and the characteristics of the oncological disease. Methods: Cross-sectional, single-center study with female patients diagnosed with metastatic breast carcinoma and under palliative treatment between November 2020 and May 2021. Psychiatric disorders were screened by applying and filling-out the MMSE, HADS, BSI, and WHOQoL-Bref instruments at the outpatient daycare unit when patients were present for treatmen. Results: A total of 91 female patients were included, median age 59.79 years. None of the patients had cognitive impairment (MMSE). HADS scale: 18.7% of the patients scored for anxiety and 17.6% for depression. The anxiety subscale score of &gt; 8 (HADS) was related to ovarian function suppression (p&lt;0.001), neoadjuvant therapy (p&lt;0.001), and type of second-line of palliative treatment (p=0.024). The depression subscale score &gt;8 (HADS) was related to the type of surgery performed (p= 0.022), molecular subtype of the tumor (p=0.020), and occurrence of grade 3-4 toxicities in the first (p=0.018), and third-line treatments (p=0.031). Conclusion: The screening of psychiatric disorders through the application of these scales by the medical oncology team may be able to aid in diagnosis and potentially lead to psychiatric referral and intervention at an earlier stage.

Fear of COVID-19 infection and its relation to depressive and anxiety symptoms among elderly population: online survey

BackgroundThe pandemic of COVID-19 is considered as one of the major threats that affected all age groups all over the world. Old age group has been highly affected with increased risk of severe health complications that may result in several mental health problems such as anxiety symptoms, depressive symptoms, sleep problems, or any other mental health disorder. Thus the aim of this study is to investigate the fear of COVID-19 infection and its relation to depressive and anxiety symptoms among elderly population during COVID-19 outbreak. A survey was distributed online through social media via a link to people who are 60 years old or above (N = 161).ResultsThe average score of fear of COVID-19 scale was 17.7 ± 5.4. There was a highly statistically significant correlation between anxiety subscale, depression subscale, and total score of hospital anxiety and depression scale with fear of COVID-19 score.ConclusionsParticipants who were more worried about having the disease developed more symptoms of anxiety and depression during the COVID-19 pandemic. It is necessary to screen the older people for the COVID-19-related fear and accompanying psychological disorders.

Prevalence of anxiety and depressive disorders in facial trauma patients: A cross-sectional study

Abstract Background To evaluate the prevalence of anxiety and depressive disorders in facial trauma patients admitted to the Ibn ROCHD University Hospital of Casablanca, we initiated this study. Indeed, facial trauma is damage that can have serious repercussions on the mental health of patients. However, there is little data in Morocco. Methods This was a cross-sectional study conducted at the Ibn Rochd University Hospital in Casablanca from January to April 2019 among facial trauma patients without a history of anxiety and depressive disorders, admitted to the Maxillofacial Surgery Department within 72 hours of the trauma. The patients' socio-demographic and clinical data were collected through a questionnaire, and then the Hospital Anxiety and Depression Scale (HADS) was applied to assess depression and anxiety. In addition to a descriptive analysis of the results, a multinomial regression analysis was performed to assess factors that might be associated with depression and anxiety. Results Among 50 facial trauma patients admitted to the Ibn Rochd University Hospital in Casablanca and included in our study, 11 had symptoms of anxiety (22%) and 12 had symptoms of depression (24%) according to the HADS classification. The mean HADS anxiety and depression subscale scores of the patients were 7.32±4.17 and 6.32±5.10, respectively. Although gender (OR = 2.28 [0.35; 5.70] females), marital status (OR = 3.30 [0.70; 12.70] singles), occupation (OR = 2.66 [0.58; 12.18] not employed), and circumstances of occurrence (OR = 3.66 [0.35; 15.70] public roads) increased the risk of anxiety in patients without anxiety (HADS score≤7); none of these factors was statistically associated with either anxiety or depression. Conclusions This cross-sectional study showed that the prevalence of anxiety and depression in victims of facial trauma is very high in Casablanca. Key messages The prevalence of anxiety and depression among facial trauma victims is very high. Gender, marital status, occupation, and circumstances of occurrence non-significantly increase the risk of anxiety and depression.

Validity and severity thresholds for the depression subscale of the affective self rating scale: An equipercentile equating study using classical test theory

Background: The Affective Symptoms Scale (ASRS) is a unique instrument designed to separately measure depressive and manic symptoms in mood disorders. We validated the ASRS against the Patient Health Questionnaire (PHQ-9) and the Quick Inventory of Depressive Symptomatology (QIDS-16).Methods: A retrospective study of 258 patients who completed the PHQ-9, QIDS-16 and ASRS as part of routine clinical care. To establish meaningful clinical thresholds for the depression subscale of the ASRS, it was equated with the QIDS and the PHQ-9.Results: The depression subscale of the ASRS had significant positive correlations with the QIDS-16 and the PHQ-9 (respectively, r= 0.8, t[253] = 19.8, p < 0.001, and r= 0.8, t[245] = 28.2, p < 0.001). The equipercentile equating method with the PHQ-9 indicated that the thresholds corresponded to ASRS depression subscale scores of 5.4, 10.6, 16.1, and 23. Equating with the QIDS indicated that thresholds corresponded to ASRS depression subscale scores of 5.1, 11, 18.4, and 27.5.Limitations: Limitations include a small sample size that did not allow more detailed statistical analysis, such as Item Response Theory. The population is a heterogenous population at a university outpatient setting.Conclusions: The ASRS depression subscale significantly correlated with the PHQ-9 and QIDS-16. Our proposed threshold scores for the ASRS are 5, 11, 16 and 23 to indicated mild, moderate, severe and very severe depression respectively.

Assessing depression, anxiety, stress and psychological impact of Covid-19 on general population of Karachi; A web survey based cross-sectional study

Introduction: An outbreak of pneumonia was observed in December, 2019 China which was named as Covid-19 (Corona virus disease 19) by WHO. The first case of Covid-19 appeared in Pakistan on Feb 26, 2020. Pakistan has responded well to the cause and had taken timely decisions. During Covid-19 depression, anxiety, sleep disturbances have been revealed among population of various countries. This study was carried out to determine the mental health status of general population in Karachi during Covid-19 pandemic. Materials and Methods: This was a web survey based cross sectional study. The data was collected through a self-administrated questionnaire which was developed on Google forms. The questionnaire collected information regarding participants demographics, their knowledge about Covid-19, their attitude and practices towards it and the last part was used to assess psychological impact and mental health status of the participants using IES-R (Impact of event revised) score and DASS-21 (Depression, anxiety and stress score). Multivariate analysis of variance (MANOVA) and independent t-test were used as tests of significance. Results: Majority 229(76.3%) of the participants were aged between 15-25 years. Social media was the main medium through which people 124(41.3%) learned about Covid-19. Evaluation of knowledge regarding Covid-19 infection showed that majority correctly knew about transmission sources and sign/symptoms of Covid-19 infection. Analysis revealed that majority of the people 167(55.7%) had normal depression subscale score (0-9), 196(65.3%) had anxiety scores within normal range and 198(66%) did not report stress and had normal scores. While assessing the psychological impact of Covid-19 we found that 221(73.7%) had normal IES-R score and had mild impact of Covid-19. Conclusion: Our study showed that people of Karachi were well aware about Covid-19. Majority of respondents did not report depression, anxiety, stress and serious impact of Covid-19 on their lives showing their optimism and great will to fight against the pandemic. Keywords: COVID-19, Psychological impact; Mental health.

Effects of the COVID-19 pandemic on psychology and disease activity in patients with ankylosing spondylitis and rheumatoid arthritis

Background/aim The COVID-19 outbreak is known to increase stress levels of most patients with chronic diseases. Patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA) are highly susceptible to environmental stress. In the current study, we aimed to determine how the COVID-19 pandemic psychologically affected patients with chronic progressive diseases such as AS and RA and the effects of these psychological factors on disease activity. Materials and methods Age and sex-matched patients with AS (n = 80), RA (n = 80), and healthy controls (n = 80) were included in the study. All participants were evaluated with the “Perceived COVID-19 Threat Form (PCTF)”, “Suicide-Ideation Scale (SIS)”, “Hospital Anxiety and Depression Scale (HADS)”, “The Ability to Cope with Trauma (PACT)”, and “Psychological General Well-Being Index (PGWB)” scales. BASDAI was used in patients with AS, and DAS28 was used in patients with RA to assess disease severity.Results Compared to healthy individuals, patients with RA and AS had lower PGWB scores and higher HADS depression and anxiety subscale scores. Almost all psychometric assessment test scores were worse in AS patients with high-disease activity compared to those in low-disease activity. PACT scores were higher in patients with moderate RA compared to patients with mild RA (p = 0.006). While a positive correlation was identified between BASDAI and most of the psychometric assessment test scores (r = 0 .36 for PCTF, r = 0.53 for depressive scores, r = 0.54 for anxiety scores, r = 0.57 for suicidal ideation), DAS28 scores were found to be associated only with PACT total and PACT perceived forward-focused subscale scores (r = –.26 and r = .33, respectively). Conclusion Psychologically, AS and RA patients were found to be worse off compared to healthy controls. The perceived COVID threat and psychological status were associated with disease activity in AS, but not RA patients. Patients with chronic illnesses may be more vulnerable to the psychological effects of the pandemic, which can worsen disease activity.

Effect of COVID-19 pandemic on health perception, depression, anxiety and stress levels in Turkish society

Aim: The purpose of this study was to evaluate the health perception, depression, anxiety and stress levels in Turkish society during the COVID-19 pandemic, and to examine the factors affecting. Material and Methods: In this study, which was planned as a cross-sectional analytical study, individuals were reached through social media using the snow-ball sampling method. Health Perception Scale (HPS), Depression, Anxiety and Stress Scale (DASS), Perceived Stress Scale (PSS) was applied. The study was completed with 440 people. Result: As the level of education increased, health perception scores also increased (p=0.049). There was a significant relationship between regular nutrition, exercise and self-devotion and perception of health (p<0.001, p<0.001, p=0.001). The total score of DASS was found to be statistically significantly higher in participants with COVID disease in the first degree (p=0.044). DASS depression subscale scores were statistically higher in singles than married. PSS levels were higher in the participants under the age of 40 (p=0.002), in women (p<0.001), in singles (p<0.001) and in those who did not have children (p<0.001). Discussion: In this study, during the COVID-19 outbreak in the society, it was found that the participants had high levels of depression, anxiety and stress and low perception of health. Priority might therefore be attached to these in future psychiatric planning. Psychological interventions for prevention and treatment are necessary to reduce the psychological effects of the pandemic.

Obesity and mental health issues among healthcare workers: a cross-sectional study in Sabah, Malaysia

PurposeThis study aims to determine the prevalence of obesity and its relationship with mental health issues among healthcare workers in Kota Kinabalu District Health Office, Sabah Borneo and its associating factors.Design/methodology/approachThis cross-sectional study was conducted among 387 healthcare workers working in the Kota Kinabalu District Health Office, Sabah. Sociodemographic data and anthropometric measurements were collected and DASS 21 questionnaire was used to assess mental health status.FindingsThe prevalence of obesity among healthcare workers was 29%, which is significantly associated with years of service (p = 0.016) and abnormal depression subscale scores (p = 0.012) at univariate analysis. The percentage of abnormal subscale score for depression, anxiety and stress was 16, 26 and 12%, respectively. Multivariable logistic regression revealed that more than five years of service years (OR 2.23, 95%CI 1.16–4.28) and high depressive subscale score (OR 2.09, 95%CI 1.18–3.71) were both significantly associated with obesity.Originality/valueThis study has affirmed the link between physical and mental health. Policies that tackle both issues should be put in place to promote wellness among healthcare workers.

The Association Between Psychological Factors and Outcomes After Distal Radius Fracture

The aim of this study was to identify psychological factors associated with pain intensity and disability following distal radius fracture. We prospectively followed 216 adult patients with distal radius fracture for 9 months. Demographics, injury and treatment details, and psychological measures (Hospital Anxiety and Depression Score [HADS], Pain Catastrophizing Scale, Posttraumatic Stress Disorder Checklist-Civilian, Tampa Scale for Kinesiophobia, Illness Perception Questionnaire Brief [IPQB], General Self-Efficacy Scale, and Recovery Locus of Control [RLOC]) were collected at enrollment. Multivariable linear regression was used to identify factors associated with Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and Likert pain scores. Higher 10-week DASH scores were associated with increased age, the presence of a nerve pathology, increased HADS Depression subscale scores, increased IPQB scores, and lower RLOC scores. Higher 9-month DASH scores were associated with increased age, increased deprivation scores, increased numbers of medical comorbidities, a greater degree of radial shortening, increased HADS Depression subscale scores, and lower RLOC scores. A higher 10-week pain score was associated with increased deprivation and IPQB scores. A higher pain score at 9 months was associated with an increased number of medical comorbidities. Psychosocial factors measured early after fracture are associated with pain and disability up to 9 months after distal radius fracture. Illness perception is a potentially modifiable psychological construct not previously studied in hand conditions. It may provide a suitable target for psychological interventions that could enhance recovery. Prognostic II.

AB0672 PSYCHOLOGIC STATE OF PATIENTS WITH RHEUMATIC DISEASES AFTER THE OUTBREAK OF SARS-COV2

Background:The ongoing Coronavirus-19 disease epidemic is a public health emergency of international concern which could pose a challenge to psychological resilience. This is mainly the case of patients with rheumatic diseases (RD).Objectives:The aim of this study was to establish the prevalence of psychiatric symptoms in patients with RD and to identify factors associated with psychological stress.Methods:A cross-sectional study was conducted among patients with RD. They were invited to respond to a survey designed to assess their psychological response after the outbreak of the SARS-COV2 pandemic. Mental health status after the Covid-19 was evaluated using the Depression and Anxiety Scale (DASS-21). The total depression subscale score was divided into normal (0–9), mild depression (10–12), moderate depression (13–20), severe depression (21–27), and extremely severe depression (28–42). The total anxiety subscale score was divided into normal (0–6), mild anxiety (7–9), moderate anxiety (10–14), severe anxiety (15–19), and extremely severe anxiety (20–42).The Impact of Event Scale-Revised (IES-R) is a 22-item self-administered questionnaire that assesses the post-traumatic state (PTS). A cut-off point of 33 provided the best diagnostic accuracy for PTS. The level of significance was fixed at 0.05.Results:Sixty patients were included (42 with rheumatoid arthritis and 18 with spondylarthritis) with a mean age of 51.3 ± 13.1 years [18-75]. The majority of patients were women (63.3%), married (81.7%), with a household size of 3–5 people (67.9%). The mean disease duration was 11.9 ±5.6 [1-23] years.According to DASS depression score almost half of the patients (47%) suffered from depression, which was classified as severe in 10% of cases. The mean DASS anxiety subscale was 12.6 ± 8.2 [1-35]. The level of anxiety was mild in 23% of cases, moderate in 25% of cases, and severe in 23.3% of cases. The mean ILES-R score was 20.4 ± 10.2 [20-38]. Women experienced more PTS than men (26.3% vs 22.7%) without reaching a statistically significant correlation (p=0.9). Patients with higher education had lower IES-R, depression, and anxiety subscale scores as compared to those who were illiterate without a statistically significant correlation (p=0.5, p=0.2, p=0.4 respectively). A positive correlation was found between anxiety score and IES-R (p=0.00). Other sociodemographic variables including disease duration, parental status, marital status, and household size were not associated with IES-R and DASS subscale scores (p&gt;0.05).Conclusion:Our study showed that many of our patients with RD experienced anxiety, depression, and PTS after the outbreak of Covid-19. Professional status as well as other sociodemographic data was not associated with psychological stress.Disclosure of Interests:None declared

Female Sexual Function During the COVID-19 Pandemic in the United States.

IntroductionInternational studies have demonstrated increasing rates of sexual dysfunction amidst the coronavirus disease 2019 (COVID-19) pandemic; however, the impact of the pandemic on female sexual function in the United States is unknown.AimTo assess the impact of the COVID-19 pandemic on female sexual function and frequency in the United States.MethodsA pre-pandemic survey containing the Female Sexual Function Index (FSFI) and demographic questions was completed by adult women in the United States from October 20, 2019 and March 1, 2020. The same women were sent a follow-up survey also containing the FSFI, as well as the Patient Health Questionnaire for Depression and Anxiety with 4 items (PHQ-4), and questions pertaining to mask wearing habits, job loss, and relationship changes. Risk for female sexual dysfunction (RFSD) was defined as FSFI < 26.55.Main Outcome MeasureDifferences in pre-pandemic and intra-pandemic female sexual function, measured by the FSFI, and sexual frequency.ResultsNinety-one women were included in this study. Overall FSFI significantly decreased during the pandemic (27.2 vs 28.8, P = .002), with domain-specific decreases in arousal (4.41 vs 4.86, P = .0002), lubrication (4.90 vs 5.22, P = .004), and satisfaction (4.40 vs 4.70, P = .04). There was no change in sexual frequency. Contingency table analysis of RFSD prior to and during the pandemic revealed significantly increased RFSD during the pandemic (P = .002). Women who developed RFSD during the pandemic had higher PHQ-4 anxiety subscale scores (3.74 vs 2.53, P = .01) and depression subscale scores (2.74 vs 1.43, P = .001) than those who did not. Development of FSD was not associated with age, home region, relationship status, mask wearing habits, knowing someone who tested positive for COVID-19, relationship change, or job loss and/or reduction during the pandemic.ConclusionIn this population of female cannabis users, risk for sexual dysfunction increased amidst the COVID-19 pandemic and is associated with depression and anxiety symptoms. Bhambhvani HP, Chen T, Wilson-King AM, et al. Female Sexual Function During the COVID-19 Pandemic in the United States. Sex Med 2021;9:100355.

The Association of the COVID-19 Pandemic on Male Sexual Function in the United States: A Survey Study of Male Cannabis Users.

IntroductionInternational studies have suggested that social disruptions caused by the COVID-19 pandemic have led to sexual dysfunction, but the impact on males in the United States is less defined.AimTo examine changes in male sexual function during the COVID-19 pandemic and to evaluate associated demographic variables.MethodsPrepandemic survey data was collected between October 20, 2019 and March 1, 2020 on adult males in the United States. Follow-up survey data collected for comparison during the COVID-19 pandemic between August 1, 2020 and October 10, 2020 included International Index of Erectile Function (IIEF) scores, Patient Health Questionnaire for Depression and Anxiety with 4 items (PHQ-4) scores, and questions regarding sexual frequency. Questions were also asked about mask-wearing habits, job loss, relationship changes, and proximity to individuals who tested positive for COVID-19.Main Outcome MeasuresDifferences in prepandemic and pandemic male sexual function assessed by self-reported IIEF domain scores and sexual frequencyResultsSeventy six men completed both prepandemic and pandemic surveys with a mean age of 48.3 years. Overall, there were no differences in either overall IIEF score or any subdomain score when comparing men's pre-pandemic and pandemic survey data. There was an increase in sexual frequency during the pandemic with 45% of men reporting sex ten or more times per month during the pandemic compared to only 25% of men prior to the pandemic (P = .03). Among the subgroup of 36 men who reported a decrease in IIEF, the decrease was an average of 3.97, and significantly associated with higher PHQ-4 depression subscale scores (1.78 vs 1.03, P = .02).ConclusionThe COVID-19 pandemic is associated with increased sexual frequency and no change in overall sexual function in males in the United States. Interventions intended to promote male sexual health during the COVID-19 pandemic should include a focus on mental health. Chen T, Bhambhvani HP, Kasman AM, et al. The Association of the COVID-19 Pandemic on Male Sexual Function in the United States: A Survey Study of Male Cannabis Users. J Sex Med 2021;9:100340.

Specialist breast care nurses for support of women with breast cancer.

Specialist breast care nurses for support of women with breast cancer.

Associations between inflammatory markers and well-being during 12weeks of basic military training.

Stress, anxiety and physical exertion are all closely linked to well-being, and each can alter immune function. Diminished well-being has been observed during military training, however there is mixed evidence regarding whether concomitant changes in inflammatory markers occur, with these phenomena indicating potential maladaptive responses to imposed training loads. The aims of this project were (1) assess changes in inflammation and subjective well-being across a 12-week basic military training (BMT) program, and (2) evaluate relationships between circulating inflammatory markers and well-being. A total of 37 men and women undergoing 12weeks of BMT in Australia were recruited. Well-being was assessed via questionnaire (DASS-21), and plasma samples were collected for the analysis of inflammatory cytokines [interleukin (IL)-4, IL-6, IL-1β, IL-8, IL-10, and tumor necrosis factor (TNF)-α] at weeks 1, 4, 8 and 12. Data were analysed using general linear mixed models. Depression, anxiety and stress subscale scores all significantly improved (all P ≤ 0.001), and TNF-α decreased (P = 0.031) across time. Compared to baseline (week 1), significant decreases in associations between depression and IL-10, anxiety and IL-10, and stress and IL-10, IL-4 IL-6 and TNF-α (all P < 0.05), were detected across BMT. The BMT program appears to support improved well-being over the 12weeks, with minimal perturbation to inflammatory markers. Biomarkers and well-being displayed consistent associations and may have utility as psychophysiological indicators of health status in military research, however for now, subjective measures may represent more cost-effective proxies for ongoing monitoring of military personnel.