7-item Generalized Anxiety Disorder Research Articles

A digital therapy targeting anxiety in pulmonary fibrosis: A decentralized randomized controlled trial.

Pulmonary fibrosis, a manifestation of interstitial lung disease, is frequently associated with anxiety. The objective of this study, COMPANION, was to assess the anxiolytic efficacy of Almee, a digital cognitive behavioural therapy for patients with pulmonary fibrosis, compared to treatment as usual. COMPANION was a randomized, controlled, open-label and partly reader-blinded, decentralized, clinical trial conducted in the United States. Eligible patients had radiology-confirmed pulmonary fibrosis and a Generalized Anxiety Disorder 7-item (GAD-7) score of ≥5 (possible range 0-21). Participants were randomized 1:1 to Almee or no intervention for 9 weeks, with block stratification by anxiety severity. The primary endpoint was change in GAD-7 score from baseline to week 9. Between 20 December 2022 and 14 August 2023, 108 participants were randomized, 54 to Almee and 54 to treatment as usual. In each arm, 46 participants completed the study; 108 cases were analysed as intention-to-treat. By week 9, average GAD-7 score had improved by 1.8 points (SEM = 2.1) in the Almee group (n = 54) and deteriorated by 0.9 points (SEM = 2.2) in the control group (n = 54), a 2.7-point difference (95% confidence interval: 1.2-4.2, p = 0.0006). Treatment with Almee was well-tolerated and showed clinically meaningful improvement in pulmonary fibrosis-related anxiety. Almee shows promise as a personalized intervention for management of the psychological burden related to living with pulmonary fibrosis.

Intention to Seek Mental Health Services During the 2022 Shanghai COVID-19 City-Wide Lockdown: Web-Based Cross-Sectional Study

Background The implementation of COVID-19 lockdown measures had immediate and delayed psychological effects. From March 27, 2022, to June 1, 2022, the Shanghai government enforced a city-wide lockdown that affected 25 million residents. During this period, mental health services were predominantly provided through digital platforms. However, limited knowledge exists regarding the general population’s intention to use mental health services during this time. Objective This study aimed to assess the intention of Shanghai residents to use mental health services during the 2022 Shanghai lockdown and identify factors associated with the intention to use mobile mental health services. Methods An online survey was distributed from April 29 to June 1, 2022, using a purposive sampling approach across 16 districts in Shanghai. Eligible participants were adults over 18 years of age who were physically present in Shanghai during the lockdown. Multivariable logistic regression was used to estimate the associations between demographic factors, lockdown-related stressors and experiences, physical and mental health status, and study outcomes–mobile mental health service use intention (mobile applications and WeChat Mini Programs [Tencent Holdings Limited]). Results The analytical sample comprised 3230 respondents, among whom 29.7% (weighted percentage; n=1030) screened positive for depression or anxiety based on the 9-item Patient Health Questionnaire or the 7-item Generalized Anxiety Disorder Scale. Less than one-fourth of the respondents (24.4%, n=914) expressed an intention to use any form of mental health services, with mobile mental health service being the most considered option (19.3%, n=728). Only 10.9% (n=440) used digital mental health services during the lockdown. Factors associated with increased odds of mobile mental health service use intention included being female, being employed, being a permanent resident, experiencing COVID-19–related stressors (such as loss of income, food insecurity, and potentially traumatic experiences), and having social and financial support. Individuals with moderate or severe anxiety, as well as those with comorbid anxiety and depression, demonstrated a higher intention to use mobile mental health services. However, individuals with depression alone did not exhibit a significantly higher intention compared with those without common mental disorders. Conclusions Despite a high prevalence of common mental disorders among Shanghai residents, less than one-fourth of the study respondents expressed an intention to use any form of mental health services during the lockdown. Mobile apps or WeChat Mini Programs were the most considered mental health service formats. The study provided insights for developing more person-centered mobile mental health services to meet the diverse needs of different populations.

Physical Activity Self-Efficacy Among Pregnant Women at High Risk for Gestational Diabetes Mellitus in China: A Cross-Sectional Study.

Physical activity could decrease the odds of pregnant women at high risk for gestational diabetes mellitus (GDM) developing GDM. Physical activity self-efficacy was the key predictor of physical activity. This study aimed to examine physical activity self-efficacy and identify its predictors among pregnant women at high risk for GDM in mainland China. A cross-sectional study was conducted in Zhengzhou, China, from October 2021 to February 2022. Two hundred fifty-two pregnant women at high risk for GDM completed the Pregnancy Physical Activity Self-efficacy Scale, the Social Support for Physical Activity Scale, the Knowledge of Physical Activity Questionnaire, the 7-item Generalized Anxiety Disorder Scale, the Edinburgh Postnatal Depression Scale, and a socio-demographic data sheet. Multiple linear regression was used. Chinese pregnant women athigh risk for GDM reported a moderate level of physical activity self-efficacy. The best-fit regression analysis revealed four predictors. Social support for physical activity was the strongest predictor, followed by knowledge of physical activity, intention to do physical activity, and anxiety symptoms. The study found that Chinese pregnant women at high risk for GDM had a moderate level of physical activity self-efficacy, which had 4 predictors. Healthcare professionals should make efforts to enhance pregnant women's social support, knowledge, andintention to do physical activity and decrease their anxiety symptoms to improve their physical activity self-efficacy.

Virtual Reality Exposure Therapy Protocol for Post-Traumatic Stress Disorder Treatment in Military Veterans: Cross-Cultural Adaptation of Virtual Exposure Therapy in Ukraine

Introduction. The integration of virtual reality technologies into PTSD treatment in Ukraine presents new opportunities for enhancing the mental health of military personnel, veterans, and individuals affected by war-related trauma. During military operations, soldiers often experience intense stress, anxiety, and intrusive memories, which can lead to PTSD. VR therapy uses fully and partially immersive technologies to create a safe virtual environment where patients can explore and process traumatic experiences under the guidance of a qualified specialist. The use of VR technologies for PTSD treatment during the ongoing conflict in Ukraine may become a crucial tool for addressing and healing trauma in both military personnel and civilians. This method provides a structured setting that fosters emotional processing and therapeutic engagement, aiming to alleviate psychological burdens and improve mental health outcomes. Purpose: To conduct a cross-cultural adaptation of the physiologically facilitated Virtual Reality Exposure Therapy (VRET) protocol with gradually increasing exposure, develop a Ukrainian version of the protocol tailored to the specific needs of Ukrainian PTSD patients, create VR technology and content that reflect the unique aspects of the Ukrainian war experience, and pilot test this protocol with a focus group of Ukrainian war veterans diagnosed with PTSD and carrying war-related traumatic memories. Methodology: For the cross-cultural adaptation of the Virtual Reality Exposure Therapy (VRET) protocol, a physiologically facilitated version with gradually increasing exposure was selected. This protocol was translated by two independent translators, followed by synthesis into a single version, back-translation, analysis, and final approval by a working group. The finalized Ukrainian version was prepared for field studies with a focus group of Ukrainian war veterans (n=50). All veterans underwent diagnostic assessments both before and after the VRET intervention, using the following standardized scales: the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) for PTSD evaluation, the Generalized Anxiety Disorder 7-item (GAD-7) scale for anxiety disorders, the Patient Health Questionnaire-9 (PHQ-9) for depression, the Columbia-Suicide Severity Rating Scale (C-SSRS) for suicidal intentions, the Short Form Survey (SF-36) for quality of life, and the Alcohol Use Disorders Identification Test (AUDIT) for alcohol dependence. A series of VR scenarios were developed specifically to address the needs of Ukrainian war PTSD patients, designed to trigger common PTSD responses. A unique administrative panel was also created for therapists to adjust the presence and intensity of various triggers in real time, allowing for personalized tuning of the VR experience throughout the session. Results: Over a 6-month period, 50 Ukrainian war veterans participated in the study to assess the effectiveness of the adapted Ukrainian version of the VRET protocol for PTSD treatment. Comparison of baseline and post-intervention assessments showed significant improvements in clinical outcomes, including reductions in PTSD symptoms, anxiety, depression, and an overall improvement in quality of life. Conclusions: The cross-cultural adaptation and testing of the Virtual Reality Exposure Therapy protocol with a focus group of Ukrainian veterans with PTSD demonstrated reductions in PTSD symptoms, anxiety, and depression, alongside improvements in quality of life. Virtual reality allowed veterans to safely re-experience traumatic events under professional supervision, with gradually increased realism, enhancing the therapy's effectiveness. This method also reduces stigma by offering a confidential setting for therapist interaction, showing substantial promise in helping veterans manage their mental health more effectively

The Association Between Temporomandibular-Related Quality of Life and Oral Behaviours: A Cross-Sectional Study in Patients With Temporomandibular Disorders.

Oral behaviours (OB) are some oral overuse behaviours which could be observed in patients with temporomandibular disorders (TMD). This study aims to investigate the association between TMD-related quality of life and OB to enhance understanding of these behaviours. A total of 319 participants diagnosed with TMD were included in this research. According to the diagnostic criteria for TMD, patients were divided into three subgroups: pain-related TMD (PT, n = 71), intra-articular TMD (IT, n = 91) and combined TMD (CT, n = 157). Participants completed the oral behaviour checklist (OBC), the oral health impact profile for TMD (OHIP-TMD), the generalised anxiety disorder 7-item (GAD-7) and the patient health questionnaire 9-item (PHQ-9), and demographic characteristics were collected from medical records. TMD patients with high OBC scores (25-84 points) had higher scores in six of the seven OHIP-TMD domains (all p < 0.05). Logistic regression analysis indicated that OHIP-TMD scores (OR = 1.03), younger age (OR = 0.95), education (OR = 2.80-3.10), and PHQ-9 scores (OR = 1.14) were significantly positively correlated with OBC scores (p < 0.05). After adjusting for confounding factors, the psychological discomfort (OR = 1.09) and psychological disability (OR = 1.10) domains of the OHIP-TMD were identified as independent factors associated with higher OBC scores. Patients with more frequent OB exhibited a lower quality of life across nearly all OHIP-TMD domains. Higher OHIP-TMD scores and specific psychological domains were independently associated with a higher frequency of OB. The causal relationship between quality of life and OB in TMD patients requires further investigation.

Gout Flare Burden in the United States: A Multiyear Cross-Sectional Survey Study.

The objective of this study was to assess the burden of gout flares and examine associated patient characteristics and outcomes in a sample of US adults. Data were collected via an online survey of US adults ≥18 years using a random stratified sampling framework. Participants with gout completed questions about treatments, serum urate (SU) levels, severity, satisfaction with control, and gout flares. All participants completed the Veterans RAND 12-Item Health Survey, the Generalized Anxiety Disorder 7-Item Scale, and the Patient Health Questionnaire 9-Item Scale. Data were summarized using descriptive statistics. Multivariable-adjusted logistic regression analyses examined factors predictive of reporting gout flares to a physician. A total of 933 participants met the study criteria for having gout. Those with gout tended to be older (58.3 [SD 13.3] years vs 45.4 [SD 16.1] years; P < 0.001), male (76.3% vs 46.9%; P < 0.001), White (80.5% vs 76.8%; P = 0.01), and married or living with their partner (58.9% vs 52.8%; P < 0.001) compared with those without gout (n = 30,146). The total gout flare burden for those with gout was 6.6 gout flares per year. Nearly 72% of gout flares were either not reported to physicians or pretreated or prevented. Characteristics of those who were less likely to report gout flares included being younger, being less educated, having a lower Charlson Comorbidity Index score, not being diagnosed with gout by their doctor, and not taking a urate-lowering therapy. This study confirmed that gout flares are common in US adults with gout and found that gout flares are underreported. Reliance on clinical documentation of physician-reported gout flares is insufficient to assess the true patient burden of gout.

A Multisite, Longitudinal Study Assessing Prevalence of Anxiety in Student Pharmacists

ObjectiveConduct a multisite, survey-based study assessing rates of self-reported anxiety symptoms among student pharmacists enrolled in the first 3 professional years (PY1 to PY3) of a 4-year Doctor of Pharmacy (PharmD) curricula. MethodsThis study followed a cross-sectional observational design conducted at Washington State University, College of Pharmacy and Pharmaceutical Sciences (WSU) and the University of Arkansas for Medical Sciences, College of Pharmacy (UAMS). Student pharmacists in PY1 to PY3 of the PharmD curricula were invited to voluntarily complete the Generalized Anxiety Disorder 7-item (GAD-7) scale in order to self-report measures of anxiety. The GAD-7 is a validated 7-item instrument using a 4-point Likert scale. ResultsA total of 2022 surveys were evaluated from PY1-PY3 students at WSU and UAMS over a 5-year period (2019 to 2023). Overall, 882 (43.6%) completed surveys indicated the presence of moderate to severe anxiety according to the GAD-7. When asked about the difficulty of doing work, taking care of things at home, or getting along with other people, 487 (24.1%) respondents indicated “very” or “extremely” difficult using a 4-point Likert scale. ConclusionBehavioral and mental health support appears to be needed to support students living with symptoms of anxiety that are impacting life activities. Pharmacy educators should consider proactive approaches to improve mental well-being and support skill development related to anxiety management for student pharmacists. Future studies may include measuring change in student pharmacist anxiety over time with targeted interventions and studies to determine impact on reported levels of anxiety.

Investigating the Mental Health Outcomes and Treatment Gap Among Sexual Minorities in Czechia: A National Cross-Sectional Study

Abstract Aims This study aims to (1) estimate the prevalence and relative risk of mental disorders, (2) assess the severity of mental health symptoms, and (3) investigate the treatment gap for mental disorders within SM. Methods Data from a cross-sectional, nationally representative survey of 3,063 Czech adults (response rate = 58.6%) were utilized. The Mini-International Neuropsychiatric Interview was employed to screen for mental disorders. In those identified with mental disorders, help-seeking behaviors over the past 12 months were examined. The severity of mental health symptoms was evaluated using the 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder scale. Prevalence rates of mental disorders associated treatment gaps, and relative risks of mental disorders were calculated. Results The prevalence of mental disorders among heterosexual, gay or lesbian, bisexual, and more sexually diverse individuals was 18.9% (17.4-20.3), 52.3% (36.9-67.6), 33.3% (19.5-47.2), and 25.9% (13.9-38), respectively. Suicidal thoughts and behaviors were reported in 5.7% (4.9-6.6) of heterosexual individuals compared with 25.0% (11.7-38.3) in gay or lesbian, 22.9% (10.6-35.3) in bisexual, and 11.1% (2.5-19.8) in more sexually diverse individuals. After adjusting for confounders, gay or lesbian individuals demonstrated an increased risk of having at least one current mental disorder compared with heterosexual people (OR = 3.5 95% CI(1.8-6.8)). Bisexual and more sexually diverse individuals demonstrated risks consistent with a null effect. No substantial differences in treatment gap were detected between heterosexuals and SM who scored positively for at least one current mental disorder. Conclusions The findings underscore the urgent need for systemic changes to improve the mental health outcomes of Czech SM. Addressing structural stigma and ensuring sensitive care are imperative to mitigate the health disparities faced by Czech SM.

Rising Mental Health Issues from Remote Work Challenges in South Korea Amid COVID-19

Abstract The COVID-19 pandemic significantly increased remote work, raising concerns about its impact on mental health. This study assessed the relationship between the challenges of remote work during the pandemic and mental health outcomes such as anxiety, depression, and sleep disorders. An online survey was conducted among South Korean adults, with data from 507 participants analyzed using the Generalized Anxiety Disorder 7-Item Scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Insomnia Severity Index (ISI). Results indicated that participants in the ‘difficult’ remote work category experienced higher rates of anxiety (26.6%), sleep disorders (37.3%), and depressive symptoms (38.4%) compared to the ‘non-difficult’ category (14.1% anxiety, 24.8% sleep disorder, and 24.8% depressive symptoms), with all differences statistically significant (p ≤ 0.005). Logistic regression models adjusted for demographics and socio-economic factors revealed increased odds of mental health issues in the ‘difficult’ group (ORs ranging from 2.241 to 3.210). Sub-group analysis highlighted significant disparities, particularly among blue-collar workers and men. The findings underscore the need for organizational strategies to mitigate the mental health challenges of remote work. Interventions should include improving technological infrastructure, enhancing workspace ergonomics, and fostering robust communication channels to replace in-person interactions. Additionally, policies should address the differential impacts observed between genders and industries, tailoring support to diverse needs. On a personal level, promoting regular indoor exercise could help workers manage stress and enhance their well-being in remote work settings. This study calls for a comprehensive approach to managing the complex impacts of remote work on mental health. Key messages • This study calls for a comprehensive approach to managing the complex impacts of remote work on mental health. • The findings underscore the need for organizational strategies to mitigate the mental health challenges of remote work.

Quality of life, anxiety and mindfulness during the prevalence of COVID-19: a comparison between medical and non-medical students

BackgroundThe Covid-19 pandemic has affected all areas of society, including students. However, medical students have faced many challenges due to direct contact with patients. The present study was conducted with the aim of investigating and comparing the quality of life (QoL), anxiety and mindfulness between Iranian medical and non-medical students during the COVID-19 pandemic.MethodFive hundred and six students (both medical and non-medical students) participated in the study from August to October 2022 with a convenience sampling method. The data were collected using an online questionnaire including a demographic form, the QoL Questionnaire (WHOQOL- BREF), the Generalized Anxiety Disorder 7-item survey (GAD‐7) and the Relaxation/Meditation/Mindfulness Tracker t-Persian version survey (RMMt-P). Pearson correlation and independent t-test and multivariate linear regression were used to determine the relationship between the study variables.ResultsThe samples included 272 medical students and 234 non-medical students with a mean age of 21.99 ± 3.46 and 24.17 ± 6.54 years respectively. Most of the medical and non-medical students were female, single and had a bachelor’s degree. The mean scores of medical and non-medical students’ QoL during the COVID-19 pandemic were 57.86 ± 13.26 and 56.75 ± 14.42, respectively which indicates the higher quality of life of medical students. Anxiety and mindfulness predicted 29% of the variance of the QoL in the medical students, while anxiety and mindfulness and having a chronic disease predicted 30% of the variance of the QoL in the non-medical students. No significant difference existed in the QoL and its subscales during the COVID-19 pandemic between medical and non-medical students (p > 0.05). There was a significant difference in terms of anxiety (p = 0.02) and mindfulness (p = 0.03) between medical and non-medical students during the prevalence of COVID-19.Discussion and conclusionThe findings of the present study indicated that medical students exhibited lower levels of anxiety and higher levels of mindfulness. Therefore, interventions aimed at reducing anxiety and increasing mindfulness among non-medical students are necessary. It is recommended that preventive approaches and psychological interventions to improve students’ quality of life become an integral part of crisis response during the COVID-19 pandemic. Additionally, reducing anxiety and enhancing mindfulness can improve the quality of education and professional performance of medical students, while also contributing to their mental well-being and effective clinical communication.

Arabic translation and validation of the clinician administered Staden schizophrenia anxiety rating scale (S-SARS)

BackgroundResearch on anxiety in patients with schizophrenia of Arab origin is surprisingly scarce, particularly given that expressions of both psychotic disorders and anxiety disorders can be largely shaped by cultural factors. This study proposes to complement previous research by exploring the psychometric characteristics of an Arabic translation of the Staden Schizophrenia Anxiety Rating Scale (S-SARS) in chronic, remitted patients diagnosed with schizophrenia. As the Arabic version of the Generalized Anxiety Disorder 7-Item Scale (GAD-7) has not been previously validated in Arabic in patients with schizophrenia, this study had as a secondary aim to investigate the psychometric properties of this scale before its use. MethodThis cross-sectional study was performed over a period of three months (August–October 2023). A total of 177 chronic inpatients diagnosed with schizophrenia (63.3 % males) who were remitted and clinically stable participated in the study. ResultsConfirmatory factor analyses showed that all 10 items loaded onto a single factor and had high factor loading values between .53 and .81. The reliability of the S-SARS in its Arabic version was excellent as attested by a McDonald's omega and a Cronbach's alpha coefficients of .90 and .89, respectively. The score of Arabic S-SARS correlated positively with the GAD-7 scores (r = .55; p < .001), thus supporting good convergent validity. As for discriminant validity, findings showed positive correlations between S-SARS and depression scores as assessed using the Calgary Depressive Symptoms Scale. In addition, the Arabic S-SARS correlated negatively with general functioning, further supporting the good validity and clinical relevance of the scale. Finally, measurement invariance was established in the sex subsamples (males vs. females) at the scalar, metric and configural levels, with females showing more anxiety than males. ConclusionFindings suggest that the Arabic S-SARS holds good psychometric properties, and is suitable for use among Arabic-speaking people diagnosed with schizophrenia in both research and clinical practice. The Arabic version of S-SARS will hopefully be widely applied to provide useful and timely clinical information for monitoring and adequately treating patients with schizophrenia, in order to improve the course and prognosis of the disease.

Study of Rates and Factors Associated to Psychosomatic Syndromes Assessed Using the Diagnostic Criteria for Psychosomatic Research across Different Clinical Settings

Introduction: Diagnostic Criteria for Psychosomatic Research (DCPR) serve as an instrument for identifying and classifying specific psychosomatic syndromes that are not adequately encompassed in standard nosography. The present study aimed at measuring the prevalence of DCPR syndromes in different clinical settings and exploring factors associated to such diagnoses. Methods: A cross-sectional and nationwide study recruited 6,647 patients in different clinical settings: 306 were diagnosed with fibromyalgia (FM), 333 with irritable bowel syndrome, 1,109 with migraine, 2,550 with coronary heart disease (CHD), and 2,349 with type 2 diabetes (T2D). Participants underwent DCPR diagnostic interview and were assessed for depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder 7-Item Scale), and subjective well-being (World Health Organization-5 Well-Being Index). The PsychoSocial Index was used to evaluate global well-being, stress, and abnormal illness behavior. The prevalence of DCPR diagnoses was calculated, and factors associated to such diagnoses were analyzed by logistic regression. Results: Alexithymia (64.47%), irritable mood (20.55%), and demoralization (15.60%) were the most prevalent psychosomatic syndromes, with demoralization being most common in FM (49.02%). The factors associated to DCPR diagnoses encompassed high anxiety or abnormal illness behavior, and poor well-being. Notably, stress was found to be associated specifically to FM and T2D, with OR of 1.24 (95% CI: 1.06–1.46) and 1.26 (95% CI: 1.18–1.36), respectively. Conclusion: DCPR is a clinically helpful complementary assessment tool in need of being widely implemented in clinical settings in order to have a comprehensive picture of the patients.

How accurately can supervised machine learning model predict a targeted psychiatric disorder?

BackgroundHoarding disorder (HD) is characterized by a compulsion to collect belongings, and to experience significant distress when parting from them. HD is often misdiagnosed for several reasons. These include patient and family lack of recognition that it is a psychiatric disorder and professionals’ lack of relevant expertise with it. This study evaluates the ability of a supervised machine learning (ML) model to match the diagnostic skills of psychiatrists when presented with equivalent information pertinent to symptoms of HD.MethodsFive hundred online participants were randomly recruited and completed the Hoarding Rating Scale-Self Report (HRS-SR) and the Generalized Anxiety Disorder 7-item (GAD-7) scale. Responses to the questionnaires were read by an ML model. Responses to the HRS-SR were then converted into anonymized, random-equivalent texts. Each of these individual texts was presented in random order to two experienced psychiatrists who were independently asked for a provisional diagnosis - e.g.; the presence or absence of HD. In case of disagreement between the two assessors, a third psychiatrist broke the tie. A decision tree classification model was employed to predict clinical HD using self-report data from two psychological tests, the HRS-SR and GAD-7. The target variable was whether a participant had clinical HD, while the predictive variables were the continuous scores from the HRS-SR and GAD-7 tests. The model’s performance was evaluated using a confusion matrix, which compared the observed diagnoses with the predicted diagnoses to assess accuracy.ResultsAccording to the psychiatrists, approximately 10% of the participants fulfilled DSM-5 diagnostic criteria for HD. 93% of the clinician-identified cases were identified by the ML model based on HRS-SR and GAD-7 scores. A decision tree plot model demonstrated that about 60% of the cases could be detected by the HRS-SR alone while the rest required a combination of HRS-SR and GAD-7 scores. ML evaluation metrics showed satisfactory performance, with a Matthews Correlation Coefficient of 55%; Area Under Curve (AUC), 79%; a Negative Predictive Value of 76%; and a False Negative Rate of 24%.ConclusionsStudy findings strongly suggest that ML can, in the future, play a significant role in the risk assessment of psychiatric disorders prior to face-to-face consultation. By using AI to scan big data questionnaire responses, wait time for seriously ill patients can be substantially cut, and prognoses substantially improved.

Were there any missing mediators between visual impairment and anxiety symptoms? Results from Chinese Longitudinal Healthy Longevity Survey.

Visual impairment, encompassing low visual acuity and visual field loss, significantly impacts the older adult population worldwide, leading to increased disability and mortality risks. Recent studies suggest a strong association between visual impairment and anxiety, particularly among older adults. This study aims to explore the relationship between visual impairment and anxiety symptoms in older adult individuals in China, and to investigate potential mediating factors. Data for this study were derived from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), including 11,702 participants aged 65 and older. Visual impairment was assessed through self-reported visual function, while anxiety symptoms were measured using the 7-item Generalized Anxiety Disorder scale (GAD-7). Additional assessments included sleep quality and duration, exercise status, and dietary diversity. Logistic regression models and mediation analysis were employed to explore associations and mediating effects. The findings indicate that visual impairment is significantly associated with increased anxiety symptoms among the older adult (OR = 1.51, 95% CI: 1.32-1.72, p < 0.001). Mediation analysis revealed that sleep quality, dietary diversity score (DDS), and plant-based DDS significantly mediated the relationship between visual impairment and anxiety. In contrast, sleep duration, exercise, and animal-based DDS did not show significant mediating effects. Visual impairment is a crucial predictor of anxiety symptoms in the older adult. Improving sleep quality and promoting a diverse plant-based diet may mitigate anxiety symptoms in this population. Interventions targeting these areas could enhance the mental health and quality of life of older adult individuals with visual impairment.

The aftermath of COVID-19: generalized anxiety disorder and burnout among radiology practitioners and interns in Saudi Arabia.

The coronavirus disease (COVID-19) pandemic has presented unprecedented stressors and difficulties for healthcare professionals. This study explored the prevalence of generalized anxiety disorders and burnout among radiology practitioners and interns in various hospitals in Saudi Arabia after the end of the COVID-19 global public health emergency. A cross-sectional survey of 230 radiology practitioners and interns was conducted between October and November 2023. This study utilized the Generalized Anxiety Disorder 7-item (GAD-7) scale and Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS-MP) 22-item questionnaire, employing a non-probability convenience sampling method. The average scores of the individual components constituting the GAD-7 scale and each burnout scale were calculated, and statistical analyses were conducted using the Mann-Whitney U and Kruskal-Wallis H nonparametric tests. Of 382 radiology practitioners and interns, 230 (60.2%) responded to the survey. Notably, 42.6% of the participants reported experiencing GAD. Regarding burnout, 82.3% were at moderate-to-high risk for emotional exhaustion, 93.5% for depersonalization, and 52.1% for personal achievement. The 31-40 years age group showed significantly higher burnout rates (p = 0.001) compared with the other age groups. Those with more than three years of experience had notably higher emotional exhaustion scores (p = 0.002) and a nearly significant increase in depersonalization scores (p = 0.051) than those with less experience. Our study revealed that 42.6% of radiology practitioners and interns experienced GAD, with the majority facing significant burnout. Furthermore, our research indicates a decline in GAD levels among radiology practitioners and interns compared with the peak COVID-19 pandemic period. It also showed a significant increase in both the incidence and severity of burnout, surpassing pre-pandemic levels in a comparable cohort. These findings emphasize the pressing challenges of GAD and burnout among healthcare workers, especially radiology professionals.

Antioxidant intake and its relationship with generalized anxiety disorder among adults

ABSTRACT Antioxidant intake may contribute to the prevention of numerous diseases, particularly those related to stress-induced psychiatric and stress disorders. The current study aimed to assess the relationship between daily antioxidant intake (DAI) and Generalized Anxiety Disorder (GAD) in adults. It also sought to investigate the correlation between the type of diet in conjunction with DAI and the scores on GAD 7-Item Scale in adults. A cross-sectional design was used to examine if DAI was lower in individuals with GAD; followed by an interventional study of 40 adults with severe GAD, who were exposed to higher DAI for a period of 6 weeks. The results indicated that participants with severe GAD had significantly lower levels of DAI compared to healthy controls (p < 0.001). After 6 weeks of antioxidant supplementation, a significant decrease in GAD-7 scores of participants was observed (p < 0.001). The study found a significant negative relationship between DAI and GAD.

Impacts and Pathways of Behavioral Activation on Psychological Distress Among Patients Diagnosed With Esophageal and Gastric Cancer in China: A Randomized Controlled Trial.

The objective of this study is to investigate the efficacy of behavioral activation (BA), a novel psychological intervention, in ameliorating psychological distress and anxiety symptoms among patients diagnosed with esophageal and gastric cancer, as well as the mediating role of self-efficacy between BA and psychological distress. A total of 139 patients diagnosed with esophageal and gastric cancer were recruited in China from March 2023 to October 2023 and randomly assigned to either the BA plus care as usual group (BA+CAU group) or the care as usual group (CAU group). Pre- and post-intervention questionnaires, including the Psychological Distress Thermometer (DT), Generalized anxiety disorder 7-item (GAD-7) Scale, General Self-Efficacy Scale (GSES) and the activation subscale of Behavioral Activation for Depression Scale (BADS-A), were administered. Generalized estimating equation analyses revealed that, compared to usual care alone, combining BA with usual care significantly ameliorated psychological distress, anxiety as well as improved self-efficacy and activation. The mediation analysis revealed that self-efficacy served as a mediator in the relationship between activation and psychological distress. BA primarily based on telephone or WeChat can not only directly ameliorates psychological distress and anxiety symptoms in patients with esophageal cancer and gastric cancer but also indirectly alleviates psychological distress by enhancing self-efficacy. The study also demonstrates the potential of BA in cancer patients, a skill that can be effectively acquired by primary care workers without specialized training and implemented more flexible. NCT06348940.

Sex Differences in Risk Factors for Generalized Anxiety Disorder in Korean Adolescents.

This study aimed to examine sex differences in the risk factors associated with generalized anxiety disorder (GAD) among Korean adolescents to provide insights for drafting more effective prevention strategies. Data from 51845 middle and high school students in the 18th Korea Youth Risk Behavior Web-based Survey were analyzed. GAD was assessed using the 7-item Generalized Anxiety Disorder tool, and factors such as grade, academic performance, economic status, living arrangements, smoking, drinking, sexual experience, and physical activity were included. The prevalence of GAD and its association with these factors were compared between male and female students using chi-square tests and logistic regression. Odds ratios were compared statistically to identify sex-specific differences. GAD prevalence was higher among girls (42.1%) than boys (30.1%). Both sexes showed increased GAD risk with lower academic performance, lower economic status, smoking, drinking, and sexual experience. Boys living apart from their families had a higher GAD risk, but this was not significant for girls. Additionally, smoking and drinking were associated with a higher increase in GAD risk in girls than in boys. This study underscores the importance of considering sex differences in the prevention of GAD among adolescents. Tailored sex-specific interventions are crucial for effective prevention and management of GAD in Korean adolescents.

A CROSS-SECTIONAL STUDY TO FIND THE ASSOCIATION OF MIGRATION ON DEPRESSIVE AND ANXIETY DISORDERS AMONG NURSING STUDENTS IN A TERTIARY CARE HOSPITAL IN BANGALORE

Objectives:To determine the prevalence of depression and anxiety disorders among Nursing students and their association with migration. Methodology: A cross-sectional study was conducted at Sapthagiri Institute of Medical Sciences from December 2023 to January 2024. The study included 60 BSc nursing students, using Generalised Anxiety Disorder-7 Item Score and Zung Self Rating Scales to assess anxiety and depression. Migrant students were compared with local students to explore the impact of migration. Results: Out of 75 students, 60 participated, with 62% female and 48% male. The majority (73%) were from Kerala, with 87% being migrants. The prevalence of depressive disorders was 11.7%, with a higher proportion (87.5%) among migrants. Anxiety disorders affected 57.5% of the participants, with 78% being migrants. Migrants had a significantly higher prevalence of mild to moderate anxiety symptoms compared to non-migrants. Statistical analysis showed a positive correlation between migration and Generalised Anxiety Disorder-7 Item Score, and it was indicated that migrants had a 3.63 times higher likelihood of developing depressive or anxiety disorders. Conclusion: Migration significantly impacts the mental health of nursing students, with a notable increase in anxiety disorders among migrants. Depression rates were lower than expected. Further research with larger sample sizes and longer study periods is needed to validate these findings.

Pain, Function and Quality of Life in Temporomandibular Disorder Patients With Different Disc Positions.

Whether pain, jaw function and quality of life are correlated with disc positions is controversial, and similar studies evaluating disc positions by magnetic resonance imaging (MRI) are very limited. This study evaluated the pain, mandibular function and quality of life of the temporomandibular disorders (TMDs) patients with different disc positions according to MRI, and the relationship among them. Three hundred and thirty-five participants were included. Patients completed questionnaires included the Numeric Rating Scale (NRS), Jaw Functional Limitation Scale 8-item (JFLS-8), the Generalised Anxiety Disorder 7-item (GAD-7), Patient Health Questionnaire 9-item (PHQ-9) and Oral Health Impact Profile for TMD (OHIP-TMD). MRI was conducted to evaluate these diagnoses, resulting in the identification of three distinct categories: normal positioning (NP), disc displacement with reduction (DDwR) and disc displacement without reduction (DDwoR). Participants had the mean age of 28.55 ± 11.10 years (80.90% women). DDwR and DDwoR had a higher percentage of females compared with NP. Significant differences existed among patients in all questionnaires. The DDwoR group had significantly the highest pain, functional limitation and the worst quality of life. Moreover, they experienced the most difficulties in chewing tough foods, yawning, experiencing pain and psychological discomfort. Moreover, the multivariate regression showed that age, female gender, diagnosis as DDwoR, GAD-7 and PHQ-9 were significantly linked to higher functional limitation. Worse quality of life was associated with age, diagnosis as DDwoR, GAD-7 and PHQ-9. Among patients with different disc positions, DDwoR showed the highest pain, functional limitation and the worst quality of life. Also, NP showed a proportion of chronic pain. Physical pain, psychological discomfort and chewing tough food were regarded as the most impaired. Women who experience anxiety and depression tended to have a higher propotion of dysfunction and a lower quality of life.