GAD-7 Scores Research Articles

Mental health conditions, physical functioning, and health-related quality of life in adults with a skeletal dysplasia: a cross-sectional multinational study

BackgroundThis cross-sectional study investigated mental health conditions, physical functioning, and health-related quality of life (HRQOL) in adults with short-statured skeletal dysplasia conditions across three centres; in New York, Newcastle-upon-Tyne and Norway.MethodsQuestionnaires were sent to patients registered at the centres or distributed to adults attending clinics. The questionnaires included demographics, medical history, depression (PHQ-8), anxiety (GAD-7), pain catastrophizing, activities of daily living (HAQ), and HRQOL (SF 36/RAND-36 and PROMIS-29).ResultsOf the 142 participants, 62 (44%) had achondroplasia (n = 59) or hypochondroplasia (n = 3), and 80 (56%) had other skeletal dysplasia conditions (OSD), the largest groups being multiple epiphyseal dysplasia (n = 14), diastrophic dysplasia (n = 9), spondyloepiphyseal dysplasia congenita (n = 9) and pseudoachondroplasia (n = 8). Mean age was 41 (range 18–80) years. A prior psychiatric diagnosis was reported by 36%. Clinically significant symptoms of depression (PHQ-8 score ≥ 10) and anxiety (GAD-7 score ≥ 10) were reported by 23% and 13%. Almost all (99%) reported pain, while 9% had clinically significant levels of pain catastrophizing. For daily activities, the most affected domains were activities, reach and walking. The prevalence of current depression and anxiety symptoms was considerably higher in the study population than in the general US population. Participants with OSD reported more psychiatric diagnoses, depression and anxiety symptoms, more pain and challenges in performing daily activities, and lower HRQOL compared to participants with achondroplasia/hypochondroplasia.ConclusionAdults with skeletal dysplasia appear to have an increased risk for mental health issues and reduced physical functioning, which may impact HRQOL. These findings underscore the importance of including a formal assessment of mental health, pain and daily activities as part of regular medical follow-up across the lifespan in these patients.

Screening for depression, anxiety, and suicidality in outpatients of a tertiary epilepsy center: How frequent are increased scores and what is recommended?

Screening for depression, anxiety, and suicidality in outpatients of a tertiary epilepsy center: How frequent are increased scores and what is recommended?

Effect of e-cigarettes for smoking cessation on depressive and anxiety symptoms: Secondary analysis of a randomized controlled trial.

This study aims to assess differences in depressive and anxiety symptoms at 6-month follow-up in a smoking cessation trial using e-cigarettes as quitting aids. We conducted a secondary analysis of the Swiss multicentre ESTxENDS smoking cessation randomized controlled trial (RCT) assessing differences in depressive (Patient Health Questionnaire-9, PHQ-9, range: 0-27) and anxiety symptoms (General Anxiety Disorder-7, GAD-7, range: 0-21) at 6-month follow-up comparing participants who received e-cigarettes to those who received smoking cessation counseling alone. Of 1244 participants 913 completed the PHQ-9 and 884 the GAD-7 at 6-month follow-up. Mean PHQ-9 scores (SD) at 6months for the intervention group were 3.7 (3.9), control group: 4.0 (4.2); mean GAD-7 scores (SD) at 6months for the intervention group were 4.6 (4.3), control group: 4.6 (4.4). Multivariable analyses showed no evidence of a clinically relevant intervention effect on the PHQ-9 [coefficient-0.101, 95% CI -0.182 to -0.019, p=.016, corresponding to a 0.9 decrease of the original PHQ-9 score] and the GAD-7 scores [coefficient-0.056, 95% CI -0.135 to 0.022, p=.160] in the main adjusted models. Among smokers who participated in the ESTxENDS smoking cessation trial, we found distribution of e-cigarettes for smoking cessation in addition to standard counseling compared to counseling alone had no clinically relevant effect on depressive or anxiety symptoms at 6-month follow-up. ClinicalTrials NCT03603340.

The Moderated Mediating Effects of Social Media Identity and Loneliness on the Relationship Between Problematic Internet Use and Mental Health in China: Nationwide Cross-Sectional Questionnaire Study.

Mental health disorders are a major public health challenge, and problematic internet use (PIU) may play an important role in this issue. However, the underlying mechanisms of PIU and its effects on mental health have not yet been elucidated. This study examines the mediating effect of loneliness on the relationship between PIU and mental health, as well as the moderating effect of social media identity on the relationships among PIU, loneliness, and mental health. A cross-sectional questionnaire survey was conducted on 21,292 participants recruited using a multistage stratified sampling strategy from 31 provinces/regions in mainland China from June 20 to August 31, 2022. This study assesses PIU (PIU questionnaire-short form-6), depression (9-item Patient Health Questionnaire [PHQ-9]), anxiety (7-item Generalized Anxiety Disorder scale [GAD-7]), loneliness (3-item loneliness scale), and social media identity (identity bubble reinforcement scale). Additionally, we collected the sociodemographic characteristics of the participants. Participants whose total score of PHQ-9≥15 or total score of GAD-7≥10 were considered to have moderate or severe symptoms of depression or anxiety, respectively. A moderated mediation model was established to examine the mediating effect of loneliness on the association between PIU and mental health outcomes (depression and anxiety), moderated by social media identity. Approximately 22.80% (4854/21,292) and 14.20% (3023/21,292) of the respondents reported moderate or severe symptoms of depression and anxiety, respectively. Loneliness significantly mediated the association between PIU and mental health outcomes, explaining 42.53% and 45.48% of the total effect of PIU on depression and anxiety, respectively. Social media identity significantly moderated the associations between PIU and depression (β=0.002, 95% CI 0.001-0.002), PIU and anxiety (β=0.001, 95% CI 0.000-0.002), loneliness and depression (β=0.010, 95% CI 0.007-0.013), and loneliness and anxiety (β=0.007, 95% CI 0.004-0.010), but not between PIU and loneliness (β=0.000, 95% CI -0.003 to 0.003). Higher levels of social media identity were significantly associated with lower levels of loneliness (β=-0.018, 95% CI -0.020 to -0.016). Addressing loneliness may serve as a valuable approach to mitigate the impact of PIU on mental health outcomes. However, social media identity poses a significant challenge in addressing health issues linked to PIU.

17 LONG-TERM EFFECTS OF PIANO MUSIC THERAPY ON THE MENTAL HEALTH OF ADOLESCENTS WITH ANXIETY DISORDERS

Abstract Background Anxiety disorder is a common psychological disorder among adolescents, manifested as excessive tension, anxiety and physical symptoms. Long-term anxiety may have a profound impact on mental health and social function. Music therapy has received attention in the field of mental health in recent years due to its non-invasive and soothing effects. Piano music therapy, by combining the dual modes of playing and listening, can not only directly relieve anxiety, but also have a positive impact on long-term mental health by activating brain neural networks. Methods The study recruited 60 adolescent patients diagnosed with anxiety disorders and randomly divided them into an intervention group and a control group, with 30 people in each group. The intervention group received piano music therapy for 16 weeks, three times a week, each time including 30 minutes of piano playing training and 30 minutes of music listening. The repertoire was selected by the therapist according to the individual needs of the patients. The control group received a standard mental health education course once a week, 60 minutes each time. Anxiety symptoms were assessed by the Generalized Anxiety Disorder 7 Item Scale (GAD-7), depression levels were measured using the Self-Rating Depression Scale (SDS), and psychological resilience was measured using the Connor-Davidson Resilience Scale (CD-RISC). All scales were measured once before the intervention, after the intervention, and one year after the intervention. Results The improvement in anxiety, depression and psychological resilience scores of the intervention group was significantly better than that of the control group (P<0.01). After the intervention, the GAD-7 score of the intervention group dropped from an average of 16.4 ± 3.2 points to 9.1 ± 2.6 points, while that of the control group only dropped from 16.2 ± 3.1 points to 13.5 points. The SDS score showed that the intervention group dropped from 54.7 ± 5.3 points to 42.3 ± 4.7 points, while the control group dropped from 54.1 ± 5.1 points to 49.6 ± 4.9 points. In terms of psychological flexibility, the CD-RISC score showed that the intervention group improved from 55.2 ± 6.4 points before the intervention to 70.8 ± 5.7 points, while the control group only improved from 54.8 ± 6.1 points to 61.4 ± 5.8 points. One year after the intervention, the GAD-7 score of the intervention group was maintained at 9.5 ± 2.7 points, the SDS score was 43.1 ± 4.5 points, and the CD-RISC score was 69.6 ± 5.9 points, showing significant long-term effects, while the control group’s The scores were close to the pre-intervention levels, which were 15.1 ± 3.0 points, 51.8 ± 5.0 points and 58.3 ± 6.2 points respectively. Discussion Piano music therapy significantly improved the anxiety and depressive symptoms of adolescent patients with anxiety disorder, while significantly improving psychological flexibility, and the effect was still maintained one year after the intervention ended. As a comprehensive intervention model, piano music therapy provides a new idea for the long-term treatment of anxiety disorders.

The effect of ketamine-assisted group therapy on treatment-resistant mental health conditions in firefighters: a prospective observational case series.

Firefighters display elevated risk for diagnoses of mental health illnesses. Psychedelic-assisted therapies show promise in the treatment of clinically challenging conditions. This observational case series analyzed data from firefighters with mental health diagnoses who participated in a 12-week ketamine-assisted group therapy treatment plan. Questionnaire scores (GAD-7; PHQ-9; PCL-5; B-IPF) collected throughout the program were scored and statistically analyzed for changes. Qualitative data were analyzed through thematic analysis. Significant decreases with large effect sizes were detected in GAD-7 and PCL-5 scores post-completion in the 12-week treatment plan, which persisted 6 months later. Participants noted it was beneficial being in a cohort with fellow firefighters. Statistically and clinically significant improvements to PTSD and anxiety diagnoses were detected in the cohort of firefighters after the RTT-KAT program, with results retained six months post treatment.

Living and neighborhood environments and anxiety symptoms among older adults in Anhui, China: evidence from a cross-sectional study

ObjectiveThis study aims to investigate the relationships between living and neighborhood environmental factors and anxiety symptoms among older adults residing in urban and rural areas of Anhui Province, China.MethodsData were collected from 5876 participants in a cross-sectional study carried out in four cities located in Anhui, China. Anxiety symptoms were evaluated via the Generalized Anxiety Disorder scale (GAD-7), and participants with scores of 5 and above were defined as having anxiety symptoms. The presence of dust and noise in the context of daily life was used to evaluate the living environment of the participants. The neighborhood environment was assessed by the availability of barrier-free facilities, proximity to facilities (supermarkets, restaurants, hospitals, and parks), and green and blue space near participants’ dwellings. Multilevel linear and logistic regression analyses were used to estimate the associations between these environmental factors and anxiety symptoms.ResultsThe participants who lived in dusty environments had elevated GAD-7 scores and higher odds of anxiety (dust: β = 0.754, 95% CI: 0.337, 1.171; OR = 1.451, 95% CI: 1.164, 1.809). Having barrier-free facilities and the existence of a neighboring park decreased the GAD-7 scores and the likelihood of having anxiety symptoms (barrier-free facilities: β=-0.503, 95% CI: -0.992, -0.085; OR = 0.768, 95% CI: 0.656, 0.899; park: β=-0.478, 95% CI: -0.830, -0.125; OR = 0.599, 95% CI: 0.440, 0.816). However, participants residing in close proximity to the hospital presented an increased likelihood of experiencing anxiety symptoms (OR = 1.377, 95% CI: 1.162, 1.631).ConclusionsParticipants who lived in dusty and noisy environments were more likely to suffer from anxiety, whereas those who lived near barrier-free facilities and parks were at lower risk. The findings emphasize the need for targeted interventions to create age-friendly communities, suggesting an integrated approach that combines environmental health strategies with mental health strategies for older adults.

Three-Month Durability of Bilateral Two-Level Stellate Ganglion Blocks in Patients with Generalized Anxiety Disorder: A Retrospective Analysis.

Purpose: Determine if performing ultrasound-guided, bilateral, two-level cervical sympathetic chain blocks (2LCSB) (performed on subsequent days) provides durable improvement in symptoms associated with anxiety. Methods: A retrospective chart review was conducted between January 2022 and November 2024. We identified 114 patients who received bilateral, 2LCSB for anxiety symptoms. Generalized Anxiety Disorder 7-Item Scale (GAD-7) outcome measure scores were collected at baseline and three-months post procedure in 71 males and 43 females. Results: Out of 114 patients, 99 patients (86.8%) showed a long-lasting improvement in their GAD-7 scores. Collected GAD-7 forms had a baseline average of 15.52 (14.99 for males and 16.40 for females), which decreased after three months to an average of 7.28 (6.96 for males and 7.81 for females). This represents a 52% average improvement in anxiety symptoms. Conclusions: In individuals treated with bilateral, 2LCSB, GAD-related symptoms were improved by 52% for at least 3 months regardless of initial anxiety severity.

Investigating the prevalence of probable night eating syndrome among preclinical medical students and the mediating role of impulsivity in its relationship with chronotype

ABSTRACT The aim of the current study was to determine the prevalence of night eating syndrome (NES) among preclinical medical students. All participants were asked to complete a socio-demographic form, Night Eating Questionnaire (NEQ), Morningness-Eveningness Questionnaire (MEQ), Pittsburgh Sleep Quality Index (PSQI), Barratt Impulsiveness Scale-11 (BIS-11), Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales (PHQ-SADS), and the Adult Attention Deficit Hyperactivity Disorder Self-report Scale (ASRS). The participants were categorised according to their NEQ scores, and statistical analyses were carried out between the groups. The mean NEQ score of the participants was 16.31 ± 5.48, and 8.8% were diagnosed with probable NES. Those with probable NES had higher MEQ, PSQI, BIS-11, PHQ-15, GAD-7, PHQ-9, ASRS-A and ASRS-B scores. A moderate positive association was identified between the NEQ score and PSQI and PHQ-9. ASRS-B and BIS-11 were found to have a mediating role in the relationship between NES and MEQ. The findings of our study suggest that the prevalence of probable NES in preclinical medical students is higher than the general population, and that NES symptomatology is associated with many psychiatric clinical entities in addition to depressive and sleep disorders included in the diagnostic criteria.

Successful aging was negatively associated with depression and anxiety symptoms among adults aged 65 years and older in Ningbo, China

BackgroundDepression and anxiety are the emotional problems most frequently experienced by older adults. We aimed to investigate the associations between successful aging (SA) and depression and anxiety in older adults from Ningbo, China.MethodsA cross-sectional study of 6,672 community-dwelling adults aged 65 years or older was performed. SA, depression, and anxiety symptoms were self-reported and measured using the Successful Aging Inventory (SAI), Patient Health Questionnaire-9 item (PHQ-9), and the 7-item Generalized Anxiety Disorder scale (GAD-7), respectively. Linear and logistic regression analyses were used to estimate the associations of SA with depression and anxiety.ResultsAfter multivariate adjustment, we found that the SAI score was independently associated with the PHQ-9 and GAD-7 scores (β = −0.069 and − 0.048, respectively). Multivariate-adjusted spline regression models showed negative, nonlinear dose–response associations between the SAI score and both depression and anxiety symptoms (Pfor nonlinearity = 0.001 for both). With the highest quartile set as the reference, we determined that the lowest SAI score quartile was independently associated with both depression symptoms (OR = 16.131, 95% CI: 8.423, 30.892) and anxiety symptoms (odds ratio [OR] = 10.926, 95% confidence interval [CI]: 5.268, 22.664). In subgroup analyses, the association between the SAI score and depression symptoms was significantly higher in rural than in urban areas (Pfor interaction = 0.024).ConclusionAmong older adults in Ningbo, China, SA was found to play an important role in depression and anxiety symptoms, suggesting the need for effective and feasible interventions to promote SA in Chinese older adults.

A108 ASSESSING THE RELATIONSHIP BETWEEN MENTAL HEALTH, QUALITY OF LIFE, AND ACCESSING CARE IN PREGNANT IBD PATIENTS

Abstract Background Individuals with Inflammatory Bowel Disease (IBD) are at an increased risk of depression and anxiety, which are correlated with IBD disease activity and reduced quality of life. However, the impact of mental health on pregnant persons with IBD and the barriers to mental health care remain less clear. Aims To explore associations between mental health, quality of life, and barriers to addressing mental health concerns in pregnant persons with IBD. Methods We conducted an anonymous, cross-sectional survey of pregnant IBD patients. Data collected included demographics, IBD disease activity via modified Harvey Bradshaw Index (mHBI) for Crohn’s disease (CD) and the Partial Mayo Score 6 (pMayo6) for ulcerative colitis (UC), mental health scores (PHQ-9 and GAD-7), and IBD-related quality of life using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). We also explored patient perceptions of mental health stigma, barriers to accessing care, and comfort in discussing these concerns. Chi-square analysis and Fisher’s Exact Test were employed for categorical comparisons, and the Mann-Whitney U test was used to compare mental health scores with SIBDQ. Results Fifty-seven surveys were analyzed (52.6% CD, 47.4% UC). The mean age was 33.98 years (SD 3.734), and 22.7% had active disease (mHBI ≥ 5 or pMayo6 > 1). Elevated mental health scores (PHQ-9 and/or GAD-7 ≥ 5) were observed in 57.9% of participants, with 7% having high PHQ-9 scores, 12.3% having high GAD-7 scores, and 38.6% having both. The median SIBDQ score was 57 (IQR 12). A significant association was observed between lower SIBDQ scores and the presence of both an elevated PHQ-9 and GAD-7 score (p < 0.001), while neither score alone had a significant effect. 17.5% reported feeling stigmatized when discussing mental health, highlighting concerns of being perceived as weak, some in their role as maternal figures. A statistically significant association was observed between a clinical diagnosis of both depression and anxiety and feeling stigmatized. 12.3% reported cultural deterrents, noting language, negative cultural connotations, and lack of understanding within their communities. Ethnicity, education, and marital status did not significantly affect satisfaction with available supports, experiencing stigma or barriers to access. There was no significant association between Caucasian versus non-Caucasian patients’ preference for discussing these concerns with a physician (GP, IBD specialist, gastroenterologist, OBGYN, psychiatrist) or family/friends. Conclusions Pregnant IBD patients with both elevated PHQ-9 and GAD-7 scores may experience diminished quality of life, underscoring the need to address mental health concerns in disease management. Further research is needed to explore the influence of these factors on maternal-neonatal outcomes. Funding Agencies University of Toronto: UT GE-HEP NEW INVESTIGATOR PILOT AWARD

Effects of A Brief Resonance Frequency Breathing Exercise on Heart Rate Variability and Inhibitory Control in the Context of Generalised Anxiety Disorder.

Generalised anxiety disorder (GAD) is associated with cognitive and physiological symptoms including uncontrollable worry, inhibitory control deficits, and low heart rate variability (HRV). Literature linking HRV and inhibition in GAD is predominantly correlational. The present experiment investigated whether HRV has a causal role in maintaining inhibitory control. Participants (N = 135, 111 female) aged 18-37 reporting high levels of symptoms associated with GAD (GAD-7 scores ≥ 10; Penn State Worry Questionnaire scores ≥ 56) were assigned to an experimental or active control condition and completed baseline measures of HRV, respiration rate, and inhibitory control. The experimental condition completed resonance frequency breathing (RFB) training, and the control condition practiced breathing at their mean breathing rate before repeating the inhibitory control assessment. Participants also completed the breathing training before a behavioural worry task. The experimental condition was predicted to show increased HRV, alongside improved inhibitory control and better ability to stop worrying as compared to the control condition. HRV increased during the experimental condition, as compared to the control condition. However, there were no significant effects of RFB on inhibitory control or worry, or on HRV during the inhibitory control tasks. In conclusion, RFB can increase HRV in high GAD scorers, but further research is required to determine whether there is a relationship between increased HRV and symptoms of GAD in a single session experiment.

Clinical Effectiveness of a Functional Restoration Program Compared to Conventional Medical Management in Patients with Chronic Pain: A Multicenter, Retrospective Observational Analysis.

To determine clinical effectiveness of an 8-week functional restoration program (FRP) compared with conventional medical management (CMM) in patients with chronic pain following work-related injury in the workers' compensation system. Observational retrospective chart review of 485 patients treated between January 1, 2020, and December 31, 2022. Included patients with chronic pain following work-related injury who participated in a multidisciplinary evaluation and were considered appropriate for FRP. Outcomes were analyzed for two groups: FRP group completed an 8-week program, and CMM group did not receive FRP treatment. The ordinary least squares regression model was used to control confounding factors, and an independent t-test was performed to assess FRP effectiveness. FRP graduates demonstrated improvements in depression, anxiety, self-efficacy, and physical function; CES-D (< 0.001), GAD-7 (p < 0.01), PSEQ (p < 0.001), NDI (p < 0.001), and ODI (p < 0.001) scores were statistically significant compared to CMM. The LEFS and QuickDASH scores did not show statistically significant improvement with FRP. FRP offers a clinically effective treatment option to improve self-efficacy, anxiety, depression, and physical function in patients with chronic pain associated with work-related injury. Prospective, randomized control trials could be key in validating and identifying further variability in outcomes.

Assessment of Educational Environment and its Association with Burnout and Mental Health among the Dental Students of Majmaah University: A Pilot Study

Introduction: The educational environment is crucial to the wellbeing of students, particularly in high-stress fields like dentistry, where academic and clinical pressures can significantly affect mental health. In Saudi Arabia, the high prevalence of psychological distress among dental students necessitates an understanding of the underlying causes. Aim: To analyse dental students’ perceptions of their educational environment in the College of Dentistry, Saudi Arabia and its impact on mental health, particularly anxiety and burnout. Materials and Methods: This pilot study was conducted in September 2024, involving 50 undergraduate dental students from College of Dentistry, Majmaah University, Al Majmaah, Riyadh, Saudi Arabia. The Dundee Ready Education Environment Measure (DREEM) questionnaire assessed the perception of the educational environment. The Generalised Anxiety Disorder (GAD-7) scale and Maslach’s Burnout Inventory-Student Survey (MBI-SS) measured levels of anxiety and burnout. Statistical data were analysed using Statistical Package for Social Sciences (SPSS) version 29.0, with stratification based on gender and residence. One-way Analysis of Variance (ANOVA) and linear regression were applied to evaluate the relationship between the study variables. A p-value of &lt;0.05 was considered significant. Results: The average age of the participants was 22.96±2.9 years (range: 19-26 years). The overall mean DREEM score was 124.82/200, with Students’ Perception of Teachers (SPT) scoring the highest (71.59%). Female students had a significantly more positive perception of teachers than male students. No significant correlation was found between Professional Efficacy (PE) and GAD-7 scores (r=0.257), but other parameters, such as scores for DREEM domains, MBI dimensions and GAD-7, showed significant positive correlations. All the DREEM domains significantly predicted anxiety and burnout levels. Conclusion: Overall, the undergraduate dental students of Majmaah University, Saudi Arabia, had a generally favourable perception of their educational environment. However, addressing emotional stressors and enhancing peer relationships, curriculum design and the academic atmosphere may help reduce burnout and anxiety.

Hindi translation and validation of perinatal grief scale (short version): Assessing grief following stillbirth in bereaved mothers

Background: Perinatal grief is the experience or emotions of parents following the loss of an infant by miscarriage, stillbirth, neonatal loss, or elective termination for fetal anomalies. Aim: We aimed to translate and adapt the Perinatal Grief Scale (PGS) into Hindi and evaluate its psychometric properties in a sample of women who had recently experienced a stillbirth. Method: The PGS was translated and adapted into Hindi following the process of translation and adaptation recommended by the World Health Organization. Internal consistency reliability was assessed by calculating Cronbach’s alpha. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were carried out to assess discriminant validity and composite reliability. Additionally, the participants were assessed on four other questionnaires (State-Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale, Generalized Anxiety Disorder Scale, and Patient Health Questionnaire) to test the convergent validity. Results: The mean age of the participants was 27.57 years (SD = 4.42), and 7% of the mothers were of advanced age. The Cronbach’s alpha of the three subscales of PGS was more than 0.85, which confirms the reliability of PGS-H. A significant positive correlation was found between PGS-H and scores of STAI, EPDS, GAD7, and PHQ9 (P &lt; 0.05). EFA identified three domains of PGS. In CFA, the goodness of model fit was confirmed with a root mean square error of approximation of 0.06, a comparative fit index of 0.915, and a goodness of fit index of 0.812. Conclusion: The PGS-H has been demonstrated to be a reliable and valid instrument for assessing grief in women following pregnancy loss.

Binaural Pulse Modulation (BPM) as an Adjunctive Treatment for Anxiety: A Pilot Study.

Treating psychiatric illnesses or influencing mental states with neurofeedback is challenging, likely due to the limited spatial specificity of EEG and the complications arising from the inadequate signal-to-noise ratio reduction of single-trial EEG. This pilot study aimed to investigate the feasibility of employing a binaural pulse mode-modulation (BPM) device to reduce anxiety by self-regulation. We desired to determine whether anxiety could be significantly reduced or regulated using BPM-type systems. Sixty adult participants were examined with self-reported anxiety tests (COVID Stress Scale, Generalized Anxiety Disorder 7, Beck Depression Inventory-II), which were completed before treatment, after four weeks, and after 12 weeks post-treatment. This BPM device produced two frequencies which combined to create a binaural pulse through differential auditory tone presentations. The participant calibrated the suitable target tone for optimal treatment efficacy. Each participant adjusted the binaural pulse to enhance the emotional intensity felt when envisioning an experience with comparable emotional significance or while performing a cognitive task while concurrently listening to music. The "treatment" relied on the individual's regulation of binaural pulses to obtain the desired state. The training concentrated on particular facets of their psychological challenges while listening to an auditory tone, adjusting a knob until the sound amplified the intended emotional state. Another knob was turned to intensify the emotional state associated with distress reduction. On the self-reported measures, the BPM treatment group was significantly better than the sham treatment (control) groups (p < 0.01). These findings indicate that over the four-week intervention period, BPM was similarly effective. On the GAD-7, the significant difference over time was noted before treatment and at the end of treatment for the experimental group, with the average GAD-7 score at the end of treatment being significantly lower (p < 0.01). BPM seems to induce a short-term alteration in self-reported distress levels during therapy. This study's limitations are examined, and recommendations for future research are provided.

Testing the Feasibility, Acceptability, and Potential Efficacy of an Innovative Digital Mental Health Care Delivery Model Designed to Increase Access to Care: Open Trial of the Digital Clinic.

Mental health concerns have become increasingly prevalent; however, care remains inaccessible to many. While digital mental health interventions offer a promising solution, self-help and even coached apps have not fully addressed the challenge. There is now a growing interest in hybrid, or blended, care approaches that use apps as tools to augment, rather than to entirely guide, care. The Digital Clinic is one such model, designed to increase access to high-quality mental health services. To assess the feasibility, acceptability, and potential efficacy of the Digital Clinic model, this study aims to conduct a nonrandomized open trial with participants experiencing depression, anxiety, or both, at various levels of clinical severity. Clinicians were trained in conducting brief transdiagnostic evidence-based treatment augmented by a mental health app (mindLAMP); digital navigators were trained in supporting participants' app engagement and digital literacy while also sharing app data with both patients and clinicians. Feasibility and acceptability of this 8-week program were assessed against a range of benchmarks. Potential efficacy was assessed by calculating pre-post change in symptoms of depression (Patient Health Questionnaire-9; PHQ-9), anxiety (7-item Generalized Anxiety Disorder; GAD-7), and comorbid depression and anxiety (Patient Health Questionnaire Anxiety and Depression Scale; PHQ-ADS), as well as rates of clinically meaningful improvement and remission. Secondary outcomes included change in functional impairment, self-efficacy in managing emotions, and flourishing. Of the 258 enrolled participants, 215 (83.3%) completed the 8-week program. Most were White (n=151, 70.2%) and identified as cisgender women (n=136, 63.3%), with a mean age of 41 (SD 14) years. Feasibility and acceptability were good to excellent across a range of domains. The program demonstrated potential efficacy: the average PHQ-9 score was moderate to moderately severe at baseline (mean 13.39, SD 4.53) and decreased to subclinical (mean 7.79, SD 4.61) by the end of the intervention (t126=12.50, P<.001, Cohen d=1.11). Similarly, the average GAD-7 score decreased from moderate at baseline (mean 12.93, SD 3.67) to subclinical (mean 7.35, SD 4.19) by the end of the intervention (t113=13, P<.001, Cohen d=1.22). Participation in the program was also associated with high rates of clinically significant improvement and remission. Results suggest that the Digital Clinic model is feasible, acceptable, and potentially efficacious, warranting a future randomized controlled trial to establish the efficacy of this innovative model of care.

The Johns Hopkins Hope at Hopkins Clinic: supporting the comprehensive needs of individuals with metastatic breast cancer.

Individuals with metastatic breast cancer (MBC) may live with their disease for many years. We initiated the Johns Hopkins Hope at Hopkins Clinic to assess the needs and optimize the care of these patients. Patients with MBC who agreed to participate in the Clinic in addition to usual care completed patient-reported outcome (PRO) surveys. They met with a navigator and underwent core consults (cancer rehabilitation, integrative medicine, supportive and palliative care, social work, and nutrition), clinical trial eligibility assessment, and optional services based on PRO responses and selection from a Clinic Menu. A medical oncologist provided a Care Plan during a final consult. Participants were asked to complete 3- and 6-month follow-up PRO surveys. We report on initial Clinic implementation, participant characteristics, and baseline PROs. From 11/2020 to 6/2022, 45 patients completed baseline surveys and participated in the Clinic. Median age was 58 (32-86); the majority (71%) were white and had estrogen receptor-positive (84%) tumors. Baseline physical and mental health were not good for ≥ 14days of the past month for 22 and 10%, respectively. PROMIS measure scores were > 1 standard deviation worse than average for 32% for Physical Health, 16% for Mental Health, and 23% for Physical Function. PHQ-8 and GAD-7 scores suggested depression and anxiety for 22 and 7%, respectively. More than 80% of participants received specific recommendations from the core consultants. Only 20% of participants completed follow-up surveys. Patients living with MBC have multiple needs. We used our results to implement routine PRO assessments and to expand services for patients with MBC. Our experience can serve as a model for coordinated care in other systems.

Sex-based disparities in the association between uric acid levels and anxiety: a cross-sectional analysis of nationwide data in Korea

BackgroundUric acid has antioxidant properties, and several studies have suggested its neuroprotective effects. Despite reports of increased oxidative damage and decreased antioxidants in anxiety disorders, findings remain inconclusive. This study investigated the association between serum uric acid levels and anxiety symptoms, stratified by sex, using nationwide data from South Korea.MethodsData were derived from the Korea National Health and Nutrition Examination Survey, which included 2,228 males and 2,805 females. Presence of anxiety symptoms was defined as a Generalized Anxiety Disorder 7-item scale (GAD-7) score of ≥ 10. Study participants were categorized into three groups based on serum uric acid levels: 1 (lowest) to 3 (highest). Multivariable logistic regression analyzed the association between uric acid levels and anxiety symptoms, stratified by sex.ResultsCompared to reference group 2, females in group 1 had increased anxiety symptoms (odds ratio (OR) 2.28, 95% confidence interval (CI) 1.48–3.49). When anxiety symptoms were defined as a GAD-7 score of ≥ 5, females in groups 1 (OR 1.68, 95% CI 1.30–2.16) and 3 (OR 1.35, 95% CI 1.04–1.74) both showed more anxiety symptoms than group 2, with a U-shaped relationship between uric acid levels and anxiety symptoms. In males, uric acid levels weren't significantly linked to anxiety symptoms.ConclusionsThis study indicates that low serum uric acid levels are associated with a higher prevalence of anxiety symptoms only in females, suggesting involvement of oxidative stress in anxiety disorders and its sex-based variation.

P1255 Impact of depression on health related quality of life in Ulcerative Colitis patients-are we doing enough? A single tertiary center experience

Abstract Background Ulcerative colitis (UC) is a chronic inflammatory bowel disease that significantly impacts patient’s health-related quality of life (HRQOL). Psychological factors such as anxiety, depression, and alexithymia may exacerbate these effects. This study aims to evaluate: HRQOL and possible factors affecting it, prevalence of anxiety, depression and alexytimia in patients with UC. Methods A cross-sectional study included 248 UC patients (117 males, mean age 44,7±14,6, 21 with proctitis, 63 with left sided and 164 with extensive colitis) Data were collected using standardized self-administered questionnaires (socio-demographic, GAD-7, PHQ-9, TAS-20 and SIBDQ-10). Clinical data on remission status, extraintestinal manifestations (EIM), comorbidities and use of advanced therapies were also collected. Hierarchical regression analysis of variables predicting SIBDQ-10 score in UC was done. Results In our patients average disease duration was 9.3 ± 7.4 years (range 0-49). 198 patients (79.8%) were treated with advanced therapies. Clinical and laboratory remission was present in 237 (95.6%) patients. Prevalence of depression, anxiety and alexithymia were 44.7%, 34.3% and 30.2% respectively. There were no differences in PHQ-9, GAD-7 and TAS-20 scores in relation to remission status (p&amp;gt;0.05). Average SIBDQ score was 56.5 ± 10.9. Patients in remission reported better SIBDQ-10 compared to those experiencing active symptoms (p=0.002). Results of hierarchical regresion analysis showed that remission of disease and higher depression score are the main factors influencing HRQOL in UC patients. Conclusion Prevalence of depression, anxiety and alexithymia in UC patients is high, even if disease is in remission. Remission of disease and high depression score are the main factors related to HRQOL. Depression adversely affects HRQOL in UC patients, highlighting the need for psychological screening and integrated mental health support in all UC patients. Strategies aimed at enhancing emotional well-being may improve overall quality of life and disease management in UC.