Generalized Anxiety Disorder 7-item Scale Research Articles

Intervention Treatment for Anxiety and Depression-Induced Emotional Disorders in College Students: Mindfulness-Based Stress Reduction

Abstract The objective of this study was to investigate the effects of mindfulness-based stress reduction (MBSR) on relieving symptoms of emotional disorders caused by anxiety and depression in college students. Fifty college students with generalized anxiety disorder 7-item (GAD-7) scale scores >7 and self-rating depression scale (SDS) scores ≥50 were randomly divided into a blank group and an MBSR group. The MBSR group completed an eight-week training program, which included activities such as breath awareness and body scanning. The GAD-7 scale, SDS, Pittsburgh sleep quality index (PSQI), and five-facet mindfulness questionnaire (FFMQ) scores were compared between the two groups before and after the experiment. After the experiment, the MBSR group showed a significant improvement in mindfulness levels as it had a FFMQ score of 124.64±10.72 (p < 0.05 compared to the pre-experiment and blank group). The GAD-7 scale score was 5.46±2.98, and the SDS score was 45.32 ± 6.01, indicating that both anxiety and depression symptoms were relieved. The sleep quality improved as the PSQI score decreased to 5.26 ± 1.88 (p < 0.05 compared to the pre-experiment and blank group). MBSR is beneficial in reducing anxiety and depression among college students, improving sleep quality, and has a certain effect on symptoms of emotional disorders. It can be promoted and applied in practice.

Prevalence and predictors of depression and anxiety among workers at two points of entry in Botswana during the COVID-19 pandemic.

points of entry (POE) staff are particularly prone to depression and anxiety during outbreaks. The study aimed to determine the prevalence and predictors of depression and anxiety among POE staff in Botswana. this was a cross sectional study at Sir Seretse Khama International Airport (SSKIA) and Tlokweng border from 02/12/2021 to 24/02/2022 during the COVID-19 outbreak. The Patient Health Questionnaire-9 (PHQ-9) and the General Anxiety Disorder-7 item scale (GAD-7) were used to screen for depression and anxiety respectively. Logistic regression was used to determine predictors of depression (PHQ-9≥10) and anxiety (GAD-7 ≥10). a total of 276 POE workers participated in the study of which 60 (21.7%) had an abnormal PHQ-9 score (had depression). Anxiety levels were abnormal in 31 (11.2%) participants. The predictors of depression were working at SSKIA (Adjusted odds ratio (AOR) 0.22, 95% Confidence interval (CI) 0.08-0.65), age >39 years (AOR 0.15, 95% CI 0.03-0.68), having a diploma (AOR 0.27, 95% CI 0.008-0.89), having a degree or higher (AOR 0.23, 95% CI 0.07-0.80), history of asthma (AOR 4.43, 95% CI 1.17-16.72), experience of stigma and discrimination (AOR 2.93, 95% CI 1.01-8.55) and having older people (>65 years) in the household (AOR 4.61, 95% CI 1.64-12.99). The predictors of anxiety were having chronic medical conditions (AOR 5.76, 95% CI 1.34-24.78) and experience of stigma and discrimination (AOR 6.82, 95% CI 1.42-32.46). depression and anxiety were detected in a significant number of participants. Multiple risk factors were identified. Public health interventions should target these risk factors.

Bilateral rTMS Shows No Advantage in Depression nor in Comorbid Depression and Anxiety: A Naturalistic Study.

The objective was to determine if adding low-frequency right-sided rTMS treatment to the standard high-frequency left-sided treatment (LUL), referred to as sequential bilateral treatment (SBT), confers additional benefit for depression or anxiety outcomes. A retrospective chart review from January 2015 through December 2018 yielded 275 patients, all of whom were treated with a figure-8 coil for a major depressive episode. Their protocol was either LUL or SBL. Outcome measures were the Generalized Anxiety Disorder 7-item scale (GAD-7) and the Patient Health Questionnaire (PHQ-9). There was no significant difference in GAD-7 change scores between patients who had LUL or SBL (4.2 vs 4.8). This was also true when the sample was restricted to only patients who started with high GAD-7 scores. There was likewise no significant difference in PHQ-9 change scores between patients who had LUL or SBL (6.8 vs 5.1). Patients switching from LUL to SBL mid-course had poorer overall outcomes as compared to patients who stayed with the same protocol throughout treatment. This large naturalistic study shows no advantage for SBL treatment any group or condition examined. The results of this study have clinical applicability and sound a cautionary note regarding the use of combination rTMS protocols.

NETWORK ANALYSIS OF ANXIETY AND DEPRESSIVE SYMPTOMS AMONG OLDER ADULTS WITH DIFFERENTIAL MENTAL HEALTH RISKS

Abstract Anxiety and depressive symptoms are common in older people, and network analysis may provide deeper characterization of symptom-symptom interactions to inform personalized care. The aim of this study was to elucidate characteristics of anxiety and depressive symptom networks of older adults with differential risks for depression and anxiety. A total of 4184 older adults (mean age = 77.3±8.8 years, 3245 women) were recruited from the community. Their anxiety and depressive symptom were measured using the Generalized Anxiety Disorder Scale 7-item (GAD-7) and Patient Health Questionnaire 9-item (PHQ-9), respectively. A cut-off score of 5 was used for both scales to differentiate people with mild or above anxiety/depressive symptoms; by this criterion, 1067 (25.5%) of the sample had no anxiety/depressive symptoms, 1690 (40.4%) had symptoms in one domain, and 1427 (34.1%) had symptoms in both domains. Central symptoms and bridge symptoms were identified via centrality indices and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedure. Overall, Restlessness (GAD-7 item 5), Depressed mood (PHQ-9 item 2), and Fear (GAD-7 item 7) had the highest centrality values; two bridge symptoms, Restlessness and Psychomotor disturbances (PHQ-9 item 8), were also identified. Higher risks for depression and/or anxiety were positively associated with global strength; Restlessness and Depressed mood remained to be central symptoms, but in those with both depression and anxiety risks, Restlessness and Guilt/Self-blame (PHQ-9 item 6) bridged the two domains. Interventions designed to target central symptoms and bridge symptoms may be effective in alleviating co-occurring experiences of anxiety and depression.

Anxiety symptoms and associated factors among school students after 2 years of the COVID-19 pandemic: a cross-sectional study in Zhejiang Province, China

ObjectivesTo ascertain the prevalence and associated factors of anxiety symptoms among middle and high school students in Zhejiang after 2 years of the COVID-19 pandemic.DesignA school-based cross-sectional study.Setting30 counties/districts in...

Implementing Affordable Virtual Reality Interventions for Older Adults in Latin America: A Feasibility Study

Introduction:Virtual Reality (VR)-based meditation has shown to help reduce, stress, anxiety, sadness, and anger in younger adults. However, this has not been extensively studied in older adults. Furthermore, there are no standard guidelines on how VR mindfulness interventions should be implemented to ensure successful outcomes in different cultures and languages. The availability of affordable hardware raises the possibility of VR being used in low-income countries. The goal of this study is to describe and highlight some key considerations and challenges when implementing low-cost VR mindfulness interventions with older adults in Quito, Ecuador.Methods:We created a guided mindfulness intervention using low-cost VR (smartphones and Destek V5 headsets) for older adults with anxiety in Quito, Ecuador. This project is a collaboration between the Technology and Aging Lab at McLean Hospital and the Universidad San Francisco de Quito in Ecuador. Our goal was to recruit 20 older adults with anxiety from various outpatient settings in Quito. We used the free “Sites in VR” app and selected different nature scenes for each intervention. The intervention consists of a total of 10 sessions each lasting 30 minutes. We assessed depression using the Geriatric Depression Scale (GDS), and anxiety with the Generalized Anxiety Disorder 7-item scale (GAD-7). In addition, we also administered the Mindfulness Attention Awareness Scale (MAAS) and the Behavior Activation for Depression scale (BADS).Results:At the time of writing, we have reached 100% of our recruitment goal and anticipate completing data analysis by January 2023. Qualitatively, our intervention revealed barriers to designing scalable VR Spanish language interventions in Latin America. Some of the main difficulties we encountered are described below: (i) There are very few virtual reality videos (360° videos) that are available for use with the DesTeK VS VR Headset in Spanish. We therefore, used a standardized Spanish narration to guide the mindfulness practice based on a script used in the United States. (ii) We found that majority of the available content is not suitable for mindfulness. Using the application Sites in VR remedied this concern, as it provides static 360° images, suitable for mindfulness. (iii) Not all technology necessary for VR interventions is readily available in Latin America: smartphones sold in Latin America do not always have a gyroscope sensor.Conclusion:Mindfulness interventions using virtual reality may be an effective way to address stress and mood symptoms in older adults across cultures. However, there are many culture-specific aspects that must be addressed before applying these interventions in different cultures. This study, conducted in Latin America, is an initial step toward the establishment of best practices and standardized low-cost VR mindfulness intervention in older adults, and many aspects addressed here may be generalizable to other cultures, settings, and countries.

Experiential avoidance and obsessive-compulsive symptoms in University students

Experiential avoidance is functional diagnostic dimension which refers to the unwillingness to engage with distressing thoughts, feelings, memories, and other internal experiences, despite the subsequent impairment it may cause. The spectrum of obsessive-compulsive symptoms (OCS) is often associated with anxiety and avoidant behaviors. It is still unknown the relation of each OCD dimension with experiential avoidance. This study aims to examine the relationship between dimensions of obsessive-compulsive symptoms and experiential avoidance in a college student sample. A total of 390 undergraduate students participated in this investigation, completing online surveys including DYBOC-short version and the Brief Experiential Avoidance Questionnaire (BEAQ), alongside assessments of anxiety (Generalized Anxiety Disorder 7-Item Scale) and depressive symptoms (Patient Health Questionnaire-9). The findings indicated a significant correlation between experiential avoidance, obsessive-compulsive symptom scores, and depression scores within a non-clinical sample.

Effects of health education during public health emergencies on the health literacy, emotion and coping style of Chinese junior middle school students: a randomized controlled trial

BackgroundSchools are high incidence places for public health emergencies. Good health literacy helps students cope with public health emergencies. Overall, the health literacy of young students is relatively low. Health education can promote health literacy, but the health education related to public health emergencies for Chinese junior middle school students needs to be improved. To design and implement health education courses related to public health emergencies for junior middle school students and examine the impact on their health literacy, emotions, and coping styles.MethodsFrom March to December 2022, 724 students in Grade 7 and Grade 8 of two junior middle schools in Changzhou were randomly divided into a course group (n = 359) and a control group (n = 365). The course group received an age-appropriate health education course that addressed public health emergencies; there were 12 classes, one per week. The control group received general health education. One week before and after the courses, the two groups of students were assessed with the Adolescent Health Literacy Evaluation Scale under Public Health Emergencies (AHLES-PHE), the Depression Self-Rating Scale for Children (DSRSC), the Generalized Anxiety Disorder 7-item scale (GAD-7), and the Simplified Coping Style Questionnaire (SCSQ).ResultsAfter the courses were completed, the scores of AHLES-PHE [156.0 (45.0,180.0) vs. 165.0 (54.0,180.0), P < 0. 05] in the course group increased significantly. The positive rate of DSRSC [81 (22.6%) vs. 57 (15.9%), P < 0.05] and GAD-7 [45 (12.5%) vs. 29 (8.1), P < 0.05]in the course group were significantly lower than those before courses. There was no significant difference in the above indices before and after courses in the control group (P > 0.05).ConclusionThis suggests that the health education courses related to public health emergencies designed in this study has an effect on improving health literacy, depression and anxiety in junior middle school students.

Digitally Enabled Peer Support Intervention to Address Loneliness and Mental Health: Prospective Cohort Analysis.

Social isolation and loneliness affect 61% of US adults and are associated with significant increases in excessive mental and physical morbidity and mortality. Annual health care spending is US $1643 higher for socially isolated individuals than for those not socially isolated. We prospectively evaluated the effects of participation with a digitally enabled peer support intervention on loneliness, depression, anxiety, and health-related quality of life among adults with loneliness. Adults aged 18 years and older living in Colorado were recruited to participate in a peer support program via social media campaigns. The intervention included peer support, group coaching, the ability to become a peer helper, and referral to other behavioral health resources. Participants were asked to complete surveys at baseline, 30, 60, and 90 days, which included questions from the validated University of California, Los Angeles Loneliness Scale, Patient Health Questionnaire 2-Item Scale, General Anxiety Disorder 7-Item Scale, and a 2-item measure assessing unhealthy days due to physical condition and mental condition. A growth curve modeling procedure using multilevel regression analyses was conducted to test for linear changes in the outcome variables from baseline to the end of the intervention. In total, 815 ethnically and socially diverse participants completed registration (mean age 38, SD 12.7; range 18-70 years; female: n=310, 38%; White: n=438, 53.7%; Hispanic: n=133, 16.3%; Black: n=51, 6.3%; n=263, 56.1% had a high social vulnerability score). Participants most commonly joined the following peer communities: loneliness (n=220, 27%), building self-esteem (n=187, 23%), coping with depression (n=179, 22%), and anxiety (n=114, 14%). Program engagement was high, with 90% (n=733) engaged with the platform at 60 days and 86% (n=701) at 90 days. There was a statistically (P<.001 for all outcomes) and clinically significant improvement in all clinical outcomes of interest: a 14.6% (mean 6.47) decrease in loneliness at 90 days; a 50.1% (mean 1.89) decline in depression symptoms at 90 days; a 29% (mean 1.42) reduction in anxiety symptoms at 90 days; and a 13% (mean 21.35) improvement in health-related quality of life at 90 days. Based on changes in health-related quality of life, we estimated a reduction in annual medical costs of US $615 per participant. The program was successful in referring participants to behavioral health educational resources, with 27% (n=217) of participants accessing a resource about how to best support those experiencing psychological distress and 15% (n=45) of women accessing a program about the risks of excessive alcohol use. Our results suggest that a digitally enabled peer support program can be effective in addressing loneliness, depression, anxiety, and health-related quality of life among a diverse population of adults with loneliness. Moreover, it holds promise as a tool for identifying and referring members to relevant behavioral health resources.

50 Sex differences in psychological features in adolescents after concussion

Objective:Few concussion studies have investigated the psychological domain of concussions. Of the 22 postconcussion symptoms assessed on the Graded Symptom Checklist of the SCAT-5, five do not overlap with core symptoms of anxiety and depression. 43% of patients report at least one psychiatric symptom, the median is four after injury. Previous studies focus on total scores and not individual items; furthermore, few consider resilience as part of psychological factors that impact recovery. This research aims to describe general and specific characteristics of psychological functioning in males/females ages 12-18 after concussion to help guide treatment. We compared total scores for each measure between males/females and looked at the differences between the genders for individual items in each measure.Participants and Methods:Participants were evaluated at an outpatient concussion clinic participating in the North Texas Concussion Registry (ConTex; N=1238, 53% female, mean age=15.4 years, SD=1.16 years). The Generalized Anxiety Disorder 7-item Scale (GAD-7, the Patient Health Questionnaire-8 (PHQ-8), the Brief Resilience Scale (BRS), and the Pittsburgh Sleep Quality Index (PSQI) were used to determine levels of anxiety, depression, resilience, and sleep quality.Results:Utilizing Mann-Whitney U tests (median, interquartile range) to examine group distributions for the GAD-7, PHQ-8, and BRS, females had significantly higher scores than males for the GAD (p&lt;0.001; Female: 4, 1-9 v. Male: 2, 0-5) and PHQ (p&lt;0.001; Female: 5, 210 v. Male: 3, 1-7). For the BRS, total scores for females were significantly lower than males (p&lt;0.001; Female: 3.67, 3-4 v. Male: 3.83, 3.214.33). The PSQI media score was significantly different between males and females: item 2, p=.016 and item 4 p=.007 using an exact sampling distribution for U. Pearson Chi square tests were used to examine sex differences for each item of the psychological measures. Items 1-7 within the GAD-7 were significant between sexes (i.e. male or female). The seven items assess (1) Feelings of nervousness, (2) Inability to stop/control worry, (3) Worrying too much about different things, (4) Trouble relaxing, (5) Inability to sit still due to restlessness, (6) Irritability, and (7) Feeling afraid. Items 2-8 within the PHQ were significant between sexes. The items assess (2) Feeling down/depressed/hopeless, (3) Trouble falling/staying asleep, (4) Feeling tired/no energy, (5) Appetite changes, (6) Lowered/poor self-esteem, (7) Concentration issues, and (8) Feeling slowed down or unable to be still. There was a statistically significant difference between genders and Items 2 and 4 within the BRS were significant between sexes. The items assess (2) Difficulty surviving hard times and (4) Difficulty snapping back from something bad.Conclusions:Like other studies, this study found females have higher levels of negative affect (i.e., depressive and anxious symptoms). Females displayed lower resilience and reported poorer sleep. By analyzing psychiatric measures, treatment protocols can be tailored to address specific problems, and mental health difficulties can be mitigated by teaching specific coping techniques. These results suggest clinicians should consistently be providing education on depression, anxiety, sleep, and resilience, particularly to female patients, who appear at greater risk for psychological distress.

The Arabic Hospital Anxiety and Depression Scale: validation in a sample of Lebanese patients with cancer

BackgroundDepression and anxiety are common comorbid psychological disorders among patients with cancer. Despite the wide use of the Arabic Hospital and Anxiety Scale (HADS) in oncological settings, it has not been yet validated among Lebanese patients with cancer. We aimed to assess the reliability and validity of the HADS in a sample of Lebanese patients with cancer. One-hundred one Lebanese patients diagnosed with cancer presenting to the Ambulatory Care Center in the Hematology Oncology Department at the American University of Beirut Medial Center filled the Arabic version of the HADS. The Generalized Anxiety Disorder 7-Item Scale (GAD-7) and the Patient Health Questionnaire 9-Item Scale (PHQ-9) were used to assess its concurrent validity in capturing anxiety and depression, respectively.ResultsReliability analysis using Cronbach’s alpha (α) coefficient revealed good internal consistency for the Arabic HADS (α = 0.89) and both subscales (α = 0.86 for depression and α = 0.78 for anxiety). Correlations between HADS with both GAD-7 and PHQ-9 were statistically significant and strong for both depression (r = 0.795; p < 0.0001) and anxiety (r = 0.727; p < 0.0001). Confirmatory factor analysis revealed that the observed data fits the two-factor model of depression and anxiety (Kaiser–Meyer–Olkin = 0.86; Tucker Lewis Index = 0.879; root-mean-square error of approximation = 0.08). Depression and anxiety rates were approximately 52% and 25%, respectively.ConclusionWe conclude that the Arabic version of the HADS is a credible and valid tool for clinical assessment of psychological distress (anxious and depressive states) among Lebanese patients with cancer.

Oral health, stress and barriers accessing dental health care among war-affected Ukrainian refugees in Germany

BackgroundAfter Russian invasion many Ukrainians fled to European countries including Germany. In this context, the German health care system faced challenges delivering dental care to a displaced population. Recently surfaced obstacles as well as different cultural and medical traits need to be considered in order to deliver appropriate medical care. The aim of this study was to evaluate oral health and hygiene of Ukrainian refugees, identify barriers accessing dental health care and explore the relation to their mental health state.MethodsThis cross-sectional study was conducted using a self-assessment questionnaire, distributed via non-probability snowball sampling method among war-affected Ukrainians, who fled to Germany. The online form was distributed via web-based platforms, the printed version was hand-delivered across diverse local venues. Chi-Square Tests, T-Tests and Mann-Whitney-U Tests were performed. Analysis of variance and Spearman correlation coefficient analysis were also conducted.ResultsFrom 819 completed questionnaires, 724 questionnaires were included in the analysis with 78 males (10.8%) and 640 females (88.6%) and a mean age of 37.5 years (SD = 10.5). The majority of participants rated their state of teeth (77%) and gums (81%) as average or better. The main problems, caused by state of their teeth, were: “Have avoided smiling because of teeth” (23.6%) or “Felt embarrassed due to appearance of teeth” (22.2%). The most frequent limiting factors to access dental care were finances (82.6%), language (82.2%) and complicated health care system (74.1%). 45.8% of the participants scored 10 or more in the Patient Health Questionnaire and 37.4% in the Generalized Anxiety Disorder 7-item scale, respectively. These participants were more likely to report pain, poor state of teeth and gums and to fail a dental consultation. Overall, 59.6% participants reported not consulting a dentist, when needed. Failed consultations were associated with a poorer reported state of teeth and gums.ConclusionsUkrainian refugees reported barriers accessing dental health care in Germany. It is important to improve oral health literacy and dental services for displaced people and provide help and guidance in seeking dental care.

Relationship of widowhood with pulse pressure, fasting blood glucose, and mental health in older adults: a propensity matching score analysis

BackgroundTransitioning from marriage to widowhood presents inevitable and significant challenges for many older adults. This study explored the impact of widowhood on a range of mental health outcomes, including pulse pressure and fasting blood glucose levels, among older adults in nursing homes.MethodsThis cross-sectional study utilized cluster random sampling to recruit participants, with data analyzed from 388 older Chinese adults. Psychosocial traits were assessed using the Perceived Social Support from Family scale (PSS-Fa) for family support, the Generalized Anxiety Disorder 7-item scale (GAD-7) for anxiety symptoms, and the 9-item Patient Health Questionnaire (PHQ-9) for depressive symptoms and suicidal ideation. Propensity score matching (PSM) was employed to control for confounding factors. A multivariate linear regression analysis was performed to explore the relationship between widowhood, mental health outcomes, pulse pressure, and fasting blood glucose levels.ResultsAfter applying PSM, the sample size was refined to 268 (N = 134 for both married and widowed groups) from the initial 388, excluding 120 unmatched cases. Widowed older adults were found to have notably lower family support (β = −0.81, p = 0.002), increased depressive symptoms (β = 1.04, p = 0.043), elevated pulse pressure (β = 8.90, p &amp;lt; 0.001), and higher fasting blood glucose levels (β = 3.22, p = 0.027). These associations exhibited greater beta values compared to pre-matching analysis.ConclusionOur findings revealed that widowed participants had reduced family support, an increased risk of depressive symptoms, heightened pulse pressure, and elevated fasting blood glucose in comparison to their married counterparts. Interventions focusing on social support, mental health, and cardiovascular well-being could be advantageous for this at-risk group.

Dizziness Directly Influences Postconcussion Symptoms and Is Predictive of Poorer Mental Health in UK Military Personnel: A Retrospective Analysis.

To investigate the contribution of dizziness to postconcussion symptoms, depression, and anxiety symptoms. Mild traumatic brain injury (mTBI) service, Defence Medical Rehabilitation Centre, Stanford Hall. Two hundred eighty-three UK military personnel from the Royal Navy, Royal Airforce, Royal Marines, and British Army. A retrospective analysis of data from the Ministry of Defence medical records database. Sixteen-item Rivermead Post Concussion Symptoms Questionnaire, Generalized Anxiety Disorder 7-item scale, Patient Health Questionnaire-9, The Dizziness Handicap Inventory. Injuries from sports or falls were the most common mechanism of mTBI, accounting for 23%, respectively. Chi-square analysis indicated that individuals with dizziness and postconcussion symptoms (PCS) had greater severity of PCS, depression, and anxiety than those with PCS alone. Mediation analysis showed dizziness directly and independently influenced the severity of PCS, despite the indirect effects of mediating depression and anxiety symptoms. Comorbid dizziness and PCS were predictive of poorer mental health compared with PCS alone. In addition, dizziness directly influenced the severity of PCS irrespective of the indirect effects of mental health symptoms. These observations suggest that treating dizziness with vestibular rehabilitation may improve PCS and mental health.

FRI424 Allopregnanolone Levels Are Elevated in the Follicular Phase and Predict Premenstrual Depression and Anxiety Symptom Severity in Women with Menstrually Related Mood Disorder

Abstract Disclosure: A. Kimball: None. J. Bourassa: None. M. Chicote: None. A.V. Gerweck: None. L.E. Dichtel: Other; Self; Dr. Dichtel is a Mass General Brigham (MGB) Innovation Fellow hosted by Third Rock Ventures. Financial interests were reviewed and are managed by MGH and MGB in accordance with their COI policies. K.K. Miller: None. Menstrually related mood disorder (MRMD), which includes premenstrual dysphoric disorder (PMDD) and subthreshold PMDD, is marked by severe psychiatric impairment in the late luteal phase of the menstrual cycle, but little is known about the mechanisms responsible. Allopregnanolone is a neuroactive metabolite of progesterone and a potent GABAA receptor allosteric activator with antidepressant and anxiolytic properties. We have shown that allopregnanolone levels increase, while the allopregnanolone/progesterone ratio decreases, from the follicular to luteal phase in healthy women. We hypothesized that allopregnanolone levels would decrease in association with the increase in depression severity experienced in the late luteal phase by women with MRMD. We studied 23 women with regular menses [MRMD (n=9) and healthy controls with no premenstrual symptoms or psychiatric history (HC) (n=14)] in the mid-follicular (cycle day 6-10), mid-luteal (5-9 days after LH surge), and late luteal (9-13 days after LH surge) phases. No subjects took gonadal steroids or psychotropic medications. The Daily Record of Severity of Problems was used to diagnosed PMDD (≥5 symptoms) and subthreshold PMDD (1-4 symptoms). Depression and anxiety symptom severity were assessed using the Quick Inventory of Depressive Symptomatology and Generalized Anxiety Disorder 7-item Scale, respectively. Fasting plasma hormone levels were measured by GC/MS. Data are presented as median(95% CI). Normal ranges were calculated as the 95% CI of HC. Median age [30(28,33) years] and BMI [23.8(22.9,29.0) kg/m2] were similar between groups. Depression severity was greater in MRMD vs HC [7(3,13) vs 2(1,4), p=0.005) in the late luteal phase only, as expected. In the follicular phase, the median allopregnanolone level was higher in MRMD vs HC [86(40,148) vs 29(24,73) pg/mL, p=0.05] and frankly elevated in 6 of 9 (67%) MRMD women. The median allopregnanolone/progesterone ratio in the follicular phase was higher in MRMD vs HC [0.8(0.4,2.2) vs 0.4 (0.3,0.8), p=0.03] and elevated in 4 of 9 (44%) MRMD women. There were no differences in neuroactive steroid levels between groups during the luteal phase. Higher allopregnanolone levels in the follicular phase were associated with greater depression severity in the mid-luteal (r=0.51, p=0.01) and late luteal (r=0.54, p=0.007) phase and greater anxiety severity in the late luteal phase (r=0.41, p=0.05). Conclusion: Contrary to our hypothesis, we found that levels of neuroactive steroids, which have antidepressant effects, were higher in the follicular phase in women with MRMD – who experience depression in the late luteal phase – compared with HC. This suggests that increased conversion of progesterone to allopregnanolone in the follicular phase, resulting in elevated allopregnanolone levels, may be a compensatory response to premenstrual depression and anxiety in some women with MRMD. Presentation Date: Friday, June 16, 2023

FRI055 LYNC-LD: Prospective Multicenter Natural History Study Of Lipodystrophy Syndromes To Determine Prevalence, Incidence And Predictors Of Diabetes And Severe Hypertriglyceridemia, And Their Complications

Abstract Disclosure: M.C. Foss de Freitas: Advisory Board Member; Self; PTC Therapeutics. D.S. Rosenberg: None. M. Celik Guler: None. M. Yosef: None. S. Khalatbari: None. R. Carman: None. A. DillGomes: None. M. Ashmus: None. C. Spino: None. B. Akinci: Advisory Board Member; Self; Aegerion Pharmaceuticals, Regeneron Pharmaceuticals. Consulting Fee; Self; Aegerion Pharmaceuticals, Regeneron Pharmaceuticals, AstraZeneca, Lilly USA, LLC, Merck &amp; Co., Novartis Pharmaceuticals, Novo Nordisk, Boehringer Ingelheim, Sanofi, Servier. R.J. Brown: Grant Recipient; Self; Regeneron Pharmaceuticals. E.A. Oral: Consulting Fee; Self; Regeneron Pharmaceuticals, Aegerion Pharmaceuticals, Ionis Pharmaceuticals Inc., Third Rock Ventures, Rejuvenate Inc. Grant Recipient; Self; Regeneron Pharmaceuticals, Aegerion Pharmaceuticals, Ionis Pharmaceuticals Inc., Novo Nordisk, Rhythm pharmaceuticals, Fractyl Laboratories, GID Dynamics. Other; Self; Aegerion Pharmaceuticals. Background: Lipodystrophy syndromes are rare disorders characterized by selective deficiency of adipose tissue leading to insulin resistance, diabetes mellitus, dyslipidemia and hepatic steatosis. We are conducting a comprehensive, multicenter and international observational registry study to document the natural history and prevalence of lipodystrophy syndromes in the contemporary era. Methods: All participants clinically diagnosed with a lipodystrophy syndrome, excluding HIV-associated lipodystrophy, at the participating centers may be enrolled. Once enrolled, demographic information and detailed medical history are obtained by the study team and from the participant. Patients are followed with reevaluations every 12 months. Participant questionnaires include the Patient Health Questionnaire (PHQ-9), the generalized anxiety disorder 7-item scale (GAD-7), the RAND SF-36 quality of life questionnaire, and a brief pain inventory (BPI). Univariable and multivariable repeated measure analyses were performed. Results: 148 individuals were enrolled from March 2018 to March 2022 (data-cut) with baseline age: 42 ± 15 years, 82% female, and BMI: 27.6 ± 6.5 kg/m2. Familial partial lipodystrophy is the most prevalent diagnosis (n=93, 65%), followed by congenital generalized lipodystrophy (n=13, 9.1%). There was a high prevalence of diabetes mellitus (77%), hypertriglyceridemia (82%), and hepatic steatosis (69%). 25% had at least one pancreatitis episode reported, with first episode of pancreatitis reported at age 30 ± 13 years. Cirrhosis was observed in 10% of the participants, with age of onset 39 ± 13 years. We observed a high incidence of depression and anxiety (47 and 45%) from medical history evaluation. The pain severity score (PSS) calculated from the BPI was positively associated with depression (PHQ9; p&amp;lt;0.0001) and anxiety (GAD-7; p=0.0003) adjusted for follow-up time. Patients with mild/moderate pain (PSS ≤4) showed a significant positive association with several Quality of Life (QoL) scores, such as physical functioning, limitation to physical health, limitation with emotional problems, and lack of energy/fatigue, social functioning, and general health (p&amp;lt;0.001 for all associations). During follow-up, we observed a decrease in triglyceride levels (from 585 ± 802 at baseline to 480 ± 486 mg/dL at year 3 (n=28)), while HbA1c increased from 7.4 ± 1.9 at baseline to 8.2 ± 2.1 % at year 3 (n=28). We observed 6 (4%) deaths during the 4-year follow-up. Conclusion: Our data may help clinicians, scientists, and patients with medical evaluation and decision-making in the clinical environment and provide insight into natural history as regulators evaluate new drugs. Presentation: Friday, June 16, 2023

Prevalence and factors associated with general anxiety symptoms severity among older adults registered with the Primary Healthcare Corporation during the COVID-19 pandemic: A cross-sectional study.

Primary care-based studies examining the prevalence of anxiety symptoms severity and associated factors among older adults during the COVID-19 pandemic are scarce. The study aims to determine the prevalence of general anxiety symptoms severity and associated sociodemographic and physical health characteristics, including SARS-CoV-2 infection history, among older adults in primary care in Qatar during the COVID-19 pandemic. A cross-sectional study was conducted using a random sample of older adults aged 60 years and above (n = 337) from all primary health care centers (n = 28) of Qatar's Primary Health Care Corporation. Participants were interviewed via telephone by family physicians between June and August 2020. General anxiety symptoms severity was assessed using the Generalized Anxiety Disorder 7-item Scale (GAD-7). Descriptive statistics and ordinal regression were used to analyse the data. The mean age of participants was 65 years (ranging from 60 to 89 years), standard deviation = 4.8. About 49.0% and 32.0% of participants were females and of Qatari nationality, respectively. The prevalence of minimal, mild, moderate, and severe general anxiety symptoms was 82.5%, 13.9%, 3.0%, and 0.6%, respectively. Around 33.5%, 63.5%, and 3.0% of participants had unknown, negative, or positive SARS-CoV-2 infection histories, respectively. Females had greater odds of higher levels of anxiety symptoms severity (odds ratio (OR) 2.34; 95% confidence interval (CI) 1.22, 4.50; p = 0.011). As compared to participants with unknown SARS-CoV-2 infection status, those with a negative and positive SARS-CoV-2 infection history had increased odds of higher levels of general anxiety symptoms severity by 2.48 (95% CI 1.17, 5.24; p = 0.017) and 7.21 (95% CI 1.67, 31.25; p = 0.008), respectively. Age, marital status, living arrangements, nationality, and the number of medical conditions had no statistically significant associations with general anxiety symptoms severity. Most older adults experience minimal to mild anxiety symptoms during the COVID-19 pandemic. Female gender and confirmed or suspected SARS-CoV-2 infection history are independent predictors of more severe anxiety symptoms among older adults.

Psychometric properties of the Polish version of the Generalized Anxiety Disorder Scale (GAD-7) in a non-clinical sample of employees during pandemic crisis.

The COVID-19 outbreak is an example of a crisis that triggered an increase in generalized anxiety disorder. The study aims to validate the Polish version of the Generalized Anxiety Disorder 7-item scale (GAD-7) by Spitzer et al. among a non-clinical sample of employees and examine the invariance depending on the gender and age of working adults. For assessing factor structure of the Polish version of the GAD-7, the data were collected from a sample of 821 adults employed in 4 economic sectors (health care, education, IT, public administration) during the initial phase of the COVID-19 pandemic in Poland (April 10-May 24, 2020). Due to differences in the severity of GAD symptoms across gender and age groups, the measurement invariance in these groups was tested. The results of a series of confirmatory factor analyses confirmed the unidimensionality of the GAD-7. The values of the composite reliability index and Cronbach's α showed that it is a reliable tool. The GAD levels demonstrated strong relationships with professional burnout, psychological distress, and psychological complaints. These relationships were stronger than the relationships between these factors and job satisfaction. Construct, metric and scalar invariance across gender and age groups were documented. Women experienced more severe symptoms of generalized anxiety disorder than men. Generalized anxiety disorder affected 28% of respondents. This study contributes evidence of the validation of the GAD among employees and also confirms the invariance depending on gender and age. The Polish version of the GAD-7 has good psychometric properties in a group of professionals and can be recommended for research and to be used in an occupational medicine practice, especially during crisis periods associated with the risk of developing a generalized anxiety disorder. Int J Occup Med Environ Health. 2023;36(4):493-504.

Evaluation of Patients Diagnosed with Generalized Anxiety Disorder in Terms of Early Maladaptive Schemas

Aim: It has been reported that individuals with generalized anxiety have many interpersonal problems and these problems occur through schemas such as emotional inhibition, shyness, subjugation, self-sacrifice and intervention. In light of this information, the purpose of this study was to compare individuals with generalized anxiety disorder (GAD) and healthy controls in terms of early maladaptive schemas (EMSs).&#x0D; Material and Methods: This research involved 92 participants aged 18 to 55, including 48 GAD patients and 44 healthy controls. Sociodemographic data form, Young Schema Questionnaire-Short Form-3 (YSQ-S3), Generalized Anxiety Disorder 7-item scale (GAD-7), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were administered to the participants. The study was approved by the ethics committee (KÜTF KAEK NO:2023.02.16).&#x0D; Results: The patients' average age was 38.19±11.29, and 83.3% of them (n=40) were women. The average age of healthy controls was significantly lower, however, neither group differed significantly in terms of education or marital status. The mean GAD-7 score of the patients was 6.26±6.81. Emotional deprivation (p=0.024), pessimism (p

The impact of reduced worry on general functioning: Amediation analysis from a randomized trial.

Previous lab findings have indicated that excessive worry may impair cognitive performance and problem solving capabilities but it is unclear if excessive worry also leads to broader impairments in general functioning. We report a secondary process data analysis of a large randomized waitlist-controlled trial (N=670) of a self-guided online psychological intervention for dysfunctional worry related to the Covid-19 pandemic. Specific aims were to investigate (1) if improvements in general functioning were mediated by reductions in worry related to Covid-19 during the acute intervention phase, and (2) if reduced worry related to Covid-19 during acute intervention phase had a positive long-term impact on general functioning up to 1year after the end of the intervention. To address aim 1, we used a mediation analysis framework where outcome (general functioning measured with an adapted version of the Work and Social Adjustment Scale) and the hypothesized mediator (worry measured with an adapted version of the Generalised Anxiety Disorder 7-Item Scale) were administered weekly during the controlled phase of the trial of 3weeks. To address aim 2, we investigated if reductions in worry during the 3-week treatment period predicted improved general functioning at 1- and 12months after treatment completion. Results showed that improvements in general functioning at week 3 were mediated by reductions in worry during the first 2weeks of treatment (indirect effect estimate -0.08; 95% CI -0.15, -0.02). A sensitivity analysis indicated that the mediation effects dropped significantly when the residual correlation values between the mediator and the outcome exceeded r=0. A reversed causation model was not significant. Additionally, reductions in worry during treatment predicted subsequent improvements in general functioning at both 1- and 12-month follow-ups (p<.05, -.001). Altogether, these results provide further support of the importance of targeting worry as a way to improve functioning among the large population of individuals with high levels of worry.