7-item Generalized Anxiety Disorder Research Articles

Prevalence and Factors Associated with Generalized Anxiety Disorder During Covid19 Pandemic among Healthcare Workers in a Tertiary Facility in Edo State, Nigeria

Background: The potential risk of the Coronavirus disease-2019 (COVID-19) pandemic and the psychological challenges that accompanied the pandemic posed a major threat and evoked high levels of anxiety among healthcare workers (HCWs) in Nigeria. Thus, this study aimed to assess healthcare workers' perceived threat of COVID-19, determine the prevalence of generalized anxiety disorder (GAD) among respondents and elucidate the factors associated with GAD.
 Methods: A cross-sectional study that used the 7-item Generalized Anxiety Disorder (GAD-7) Scale, 8-item Perceived Threat Scale, and a socio-demographic data collection sheet was used to obtain information from eligible healthcare workers who were selected using a convenience sampling technique. Data analysis was done using SPSS version 21, at a statistical significance level of p <0.05.
 Results: Two hundred and thirteen HCWs participated in the study. COVID-19 posed moderatesevere threats to 57.3% of the participants, and the prevalence of GAD among respondents was 25.4%. Having a moderate-severe perception of threat by COVID-19 (p=0.039), being unmarried (p= .026), being previously suspected to have COVID-19 (p=0.018) and being directly involved in the care of COVID-19 patients (p=0.031) were significantly associated with anxiety disorder after adjusting for other variables.
 Conclusion: COVID-19 posed a substantial threat to HCWs and the prevalence of GAD among the study group was high. Government, public health institutions and non-governmental organizations have the responsibility to practically demonstrate concern for the mental well-being of HCWs by investing in mental health resources and providing adequate physical, material and psychological support for HCWs to guarantee their well-being.

Efficacy of Telephone-Based Cognitive Behavioral Therapy for Weight Loss, Disordered Eating, and Psychological Distress After Bariatric Surgery

Weight regain after bariatric surgery is associated with recurrence of obesity-related medical comorbidities and deterioration in quality of life. Developing efficacious psychosocial interventions that target risk factors, prevent weight regain, and improve mental health is imperative. To determine the efficacy of a telephone-based cognitive behavioral therapy (tele-CBT) intervention at 1 year after bariatric surgery in improving weight loss, disordered eating, and psychological distress. This multisite randomized clinical trial was conducted at 3 hospital-based bariatric surgery programs, with recruitment between February 2018 and December 2021. Eligibility for participation was assessed among 314 adults at 1 year after bariatric surgery who were fluent in English and had access to a telephone and the internet. Patients with active suicidal ideation or poorly controlled severe psychiatric illness were excluded. Primary and secondary outcome measures were assessed at baseline (1 year after surgery), after the intervention (approximately 15 months after surgery), and at 3-month follow-up (approximately 18 months after surgery). Data were analyzed from January to February 2023. The tele-CBT intervention consisted of 6 weekly 1-hour sessions and a seventh booster session 1 month later. The control group received standard postoperative bariatric care. The primary outcome was postoperative percentage total weight loss. Secondary outcomes were disordered eating (Binge Eating Scale [BES] and Emotional Eating Scale [EES]) and psychological distress (Patient Health Questionnaire-9 item scale [PHQ-9] and Generalized Anxiety Disorder-7 item scale [GAD-7]). The hypotheses and data-analytic plan were developed prior to data collection. Among 306 patients 1 year after bariatric surgery (255 females [83.3%]; mean [SD] age, 47.55 [9.98] years), there were 152 patients in the tele-CBT group and 154 patients in the control group. The group by time interaction for percentage total weight loss was not significant (F1,160.61 = 2.09; P = .15). However, there were significant interactions for mean BES (F2,527.32 = 18.73; P < .001), EES total (F2,530.67 = 10.83; P < .001), PHQ-9 (F2,529.93 = 17.74; P < .001), and GAD-7 (F2,535.16 = 15.29; P < .001) scores between the tele-CBT group and control group across all times. This study found that tele-CBT delivered at 1 year after surgery resulted in no change in short-term weight outcomes but improved disordered eating and psychological distress. The impact of these psychosocial improvements on longer-term weight outcomes is currently being examined as part of this longitudinal multisite randomized clinical trial. ClinicalTrials.gov Identifier: NCT03315247.

The Relationship Between Primary Caregivers’ Psychosocial Factors and Self Esteem in Children and Adolescents with ADHD: An Exploratory Crosssectional Study

Objective: This study examined the correlation between primary caregivers’ psychosocial factors and self-esteem in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Materials and Methods: A cross-sectional study involving primary caregivers and their children with ADHD, aged 8-15, was conducted from September 2022 to February 2023. The children’s self-esteem was assessed using the Five-Scale Test of Self-Esteem for Children. Primary caregivers’ psychosocial factors were assessed using the Attitude of Parenting Questionnaire, Parenting Style and Dimension Questionnaire, Patient Health Questionnaire-9, and Generalized Anxiety Disorder 7-item. Descriptive statistics and multivariable linear regression were used to determine the associations among variables. Results: The study included 66 pairs of children and adolescents with ADHD and their primary caregivers. The study found 53% of caregivers screened positive for depression, while 16.7% screened positive for anxiety. Almost all caregivers (90.9%) adopted an authoritative parenting. The mean self-esteem score in participants with ADHD was 39.23±8.99. Younger caregivers, those with an education level below a bachelor’s degree, higher monthly income, positive screening for depression, and lower attitudes toward parenting scores were significantly associated with low self-esteem scores in their children. Conclusion: Age, education level of caregivers, and monthly family income were significantly correlated with the self-esteem of children and adolescents with ADHD. The attitudes of caregivers towards parenting and depression in caregivers also impacted self-esteem of children with ADHD under their care. Thus, strategies aimed at promoting positive caregiving attitudes, regular screening of caregivers for depression, and providing appropriate treatment are recommended to enhance self-esteem in children and adolescents with ADHD.

The effect of Baduanjin Qigong combined with five-elements music on anxiety and quality of sleep in asymptomatic patients with COVID-19 infection: A randomised controlled trial

BackgroundInfections of Coronavirus Disease-2019 (COVID-19) and the subsequent quarantine can culminate in anxious mood and sleep disturbances. The objective of this clinical trial was to investigate the effect of traditional Qigong with music therapy on relieving anxiety and improving the quality of sleep in Chinese adults with COVID-19 infection. MethodsA total of 200 asymptomatic COVID-19 infected patients were randomly assigned into two groups during their quarantine period in Chongming Island, Shanghai. The patients in the treatment group daily received Baduanjin Qigong, five-elements music therapy and routine care, while the patients in the control group only took the routine care. The primary outcome was anxiety levels measured by the 7-item Generalized Anxiety Disorder scale (GAD-7). Secondary outcomes included the quality of sleep measured by the Jenkins Sleep Scale (JSS), the degree of depression measured by the Patient Health Questionnaire (PHQ-9), as well as the self-efficacy in the Perceived Health Competence Scale (PHCS). An online questionnaire was given to all participants on the day of arrival to determine the baseline for all outcomes and then given again on the day of discharge. A one-way analysis of covariance was used to analyze the differences between the two groups after intervention. ResultsAt the end of the intervention, 177 (88.5%) patients finished the questionnaire. Patients in the treatment group had clearly decreased GAD-7 scores (MD = 2.7, 95% CI = 2.3, 3.2) after the daily exercise and music. Patients in the control group had little changes in the GAD-7 (MD = −0.2, 95%CI = −0.7, 0.3, P = 0.07), as well as the PHQ-9 (MD = 0.1, 95%CI = −0.5, 0.6, P = 0.66) after the routine care, when compared to their baseline scores. There were statistical between-group differences in GAD-7 (MD = 2.9, 95% CI = 2.2, 3.6, P < 0.001）and in the PHQ-9 scores (MD = 3.6, 95% CI = 2.9, 4.4, P < 0.001) at the post-treatment. Compared with the control group, patients had significantly lower scores on the JSS (MD = 2.7, 95% CI = 2.0, 3.3, P < 0.001), and higher scores on the PHCS (MD = −5.0, 95% CI = −6.1, −3.9, P < 0.001) after receiving Qigong and the music therapy. ConclusionTraditional Baduanjin Qigong and five-elements music therapy help to relieve anxiety and depression, and improve the sleep quality in patients with COVID-19 infection. Trial registrationChinese Clinical Trial Registry ChiCTR2200059800.

A network analysis of the long-term quality of life and mental distress of COVID-19 survivors 1 year after hospital discharge.

COVID-19 survivors suffer from persistent mental distress and impaired quality of life (QOL) after recovery from the infection. However, the symptom-symptom interaction between these psychological variables remained unexplored. The present study aimed to determine the symptom network of mental distress (depression, anxiety, sleep disturbance, fatigue, and post-traumatic stress disorder) and their association with QOL among 535 COVID-19 survivors 1 year after hospital discharge. 9-item Patient Health Questionnaire, 7-item Generalized Anxiety Disorder Scale, Chalder fatigue scale, Impact of Event Scale-Revised, Pittsburgh Sleep Quality Index, and 36-Item Short-Form Health Survey were applied to measure depression, anxiety, fatigue, PTSD, sleep disturbances, and QOL, respectively. Two networks were estimated using Gaussian graphical model. Network 1 consisted of mental symptoms to determine the central and bridge symptoms. Network 2 additionally included QOL to determine which mental symptoms were mostly related to QOL. 60% of the COVID-19 survivors experienced mental distress 1 year after hospital discharge. Uncontrollable and excessive worry, psychomotor symptoms, intrusion, and daytime dysfunction were the most central symptoms. Daytime dysfunction and fatigue (especially mental fatigue and loss of energy) served as the bridge symptoms across the mental distress network and exhibited the most substantial association with QOL. Our study demonstrated several key symptoms that played a vital role in mental distress and QOL among COVID-19 survivors. Prompt screening and targeted interventions for these symptoms might hold great promise in preventing mental distress and improving QOL in COVID-19 survivors.

Multi-dimensional influence of pediatric epilepsy on children and their families: A cross-sectional study

ObjectiveIn this study, we aimed to evaluate the effects of pediatric epilepsy on family burden, parental anxiety, depression states, and quality of life of both parents and children. MethodsThe study was undertaken between March and December 2021 using an online questionnaire that included the Family Burden Scale of Disease, the 7-item Generalized Anxiety Disorder scale, the 9-item Patient Health Questionnaire, the WHO Quality of Life Scale (WHOQOL-BREF), and the PedsQL 4.0 Generic Core Scales (parent-proxy report). ResultsA total of 288 parents of children aged 2–18 years were included. Overall, 94.8% of the participating families experienced high levels of disease burden, 67.0% of parents suffered from anxiety states, 57.0% suffered from depression states, and 56.2% of children with epilepsy suffered from comorbid neuropsychiatric symptoms. The mean WHOQOL-BREF score for parental quality of life was 53.7 ± 12.8, while the median PedsQL score for children's quality of life was 65.4 (49.6–81.7). Parental depression states contributed the most to family burden and parental quality of life, whereas comorbidities of epilepsy contributed the most to children's quality of life. Seizure frequency significantly influenced parental anxiety states, and family burden was the most significant predictor of parental depression states. ConclusionHeavy disease burden, anxiety states, and depression states are prevalent in families with children suffering from epilepsy, and most have a poor quality of life. There is a need for greater focus on the quality of life of this patient population and their caregivers, as well as increased resources to help combat anxiety, depression, and poor quality of life.

Leptin, but not ghrelin, is associated with food addiction scores in a population-based subject sample.

Ghrelin and leptin are both peptide hormones and act as opposing players in the regulation of hunger, satiety and energy expenditure. Leptin reduces appetite and feelings of hunger and is secreted mainly by adipocytes, while ghrelin increases appetite and food intake and reduces metabolic rate. Both hormones have been implicated in addictive disorders. Ghrelin was shown to have pro-addictive effects while leptin's role in addiction yields more conflicting results. Their involvement in the regulation of both food intake and addictive behaviors make them interesting candidates when investigating the regulation of food addiction. However, only few human studies have been performed and large-scale studies are lacking to date. We aimed to investigate the association between total ghrelin and leptin serum levels with scores in the Yale Food Addiction Scale (YFAS). Subjects were recruited in the LIFE Adult cohort. 909 subjects were included in the analysis and we performed univariate multiple linear regression models, adjusted for age, sex (in total group analyses only), alcohol consumption, smoking status, BMI scores, cortisol concentrations, Center for Epidemiological Studies Depression Scale (CES-D) and the 7-item Generalized Anxiety Disorder Scale (GAD-7) sum scores. The dependent variable was the YFAS score. In men, leptin serum levels showed a significant positive association (standardized β = 0.146; p = 0.012) with the YFAS score. This finding was confirmed in an extreme-group comparison: men in the highest quartile of leptin levels had significantly higher YFAS sum scores than men in the lowest quartile (1.55 vs. 1.18; p = 0.00014). There was no association with YFAS sum score in the total group (standardized β = -0.002; p = 0.974) or in women (standardized β = -0.034; p = 0.674). Total serum ghrelin showed no association with YFAS sum score neither in the total group (standardized β = -0.043; p = 0.196) nor in men (n = 530; standardized β = -0.063; p = 0.135) or women (n = 379; standardized β = -0.035; p = 0.494). Our findings are in line with previous literature and suggest that total ghrelin serum levels are not associated with food addiction scores. Leptin had been previously shown to be associated with food addiction and we confirmed this finding for men in a large, population-based approach.

The Clinical Characteristics and Related Factors of Centrally Mediated Abdominal Pain Syndrome.

The aim of this study was to explore the clinical characteristics and related factors of centrally mediated abdominal pain syndrome (CAPS). Our study included 73 patients with CAPS and 132 age-matched and gender-matched healthy controls. The general information of the participants was collected, and the questionnaires were completed including the 7-item Generalized Anxiety Disorder Scale, 9-item Patient Health Questionnaire, Hamilton Anxiety Scale, Hamilton Depression Scale Pittsburgh Sleep Quality Index, Visual Analog Scale, and Short-Form 36. Univariate and forward stepwise regression analyses were performed to explore the influencing factors of CAPS. Nonexercise (adjusted odds ration [AOR] 4.53; confidence interval [CI] 1.602-12.809), mild-to-moderate depression (AOR 7.931; CI 3.236-19.438), married status (AOR 3.656; CI 1.317-10.418), and drinking coffee (AOR 0.199; CI 0.051-0.775) were found to be related with centrally mediated abdominal syndrome. The Hamilton Anxiety Scale score (7-13) was significantly related to moderate-to-severe abdominal pain (AOR 7.043; CI 1.319-37.593). Higher Hamilton Depression Scale score was related to lower mental component scale score (β = -0.726, P < 0.01) and physical component scale score (β = -0.706, P < 0.01). Depression, married status, and nonexercise were the independent risk factors of CAPS. Conversely, coffee intake was an independent protective factor of CAPS. Anxiety was related to the severity of abdominal pain, while depression was related to low health-related quality of life.

Differential Associations Between Depressive Symptom-Domains With Anxiety, Loneliness, and Cognition in a Sample of Community Older Chinese Adults: A Multiple Indicators Multiple Causes Approach.

Depressive symptoms are common in older adults, and often co-occur with other mental health problems. However, knowledge about depressive symptom-domains and their associations with other conditions is limited. This study examined depressive symptom-domains and associations with anxiety, cognition, and loneliness. A sample of 3,795 participants aged 60 years and older were recruited from the community in Hong Kong. They were assessed for depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]), anxiety (Generalized Anxiety Disorder 7-item), loneliness (UCLA 3-item), and cognition (Montreal Cognitive Assessment 5-Minute Protocol). Summary descriptive statistics were calculated, followed by confirmatory factor analysis of PHQ-9. Multiple Indicators Multiple Causes analysis was used to examine the associations between mental health conditions in the general sample and subgroups based on depressive symptom severity. A 4-factor model based on the Research Domain Criteria showed the best model fit of PHQ-9 (χ2/df = 10.63, Root-Mean-Square Error of Approximation = 0.05, Comparative Fit Index = 0.96, Tucker-Lewis Index = 0.93). After adjusting for demographics, 4 depressive symptom-domains were differentially associated with anxiety, loneliness, and cognition across different depression severity groups. The Negative Valance Systems and Internalizing domain (NVS-I; guilt and self-harm) were consistently associated with anxiety (β = 0.45, 0.44) and loneliness (β = 0.11, 0.27) regardless of depression severity (at risk/mild vs moderate and more severe, respectively, all p < .001). The consistent associations between the NVS-I domain of depression with anxiety and loneliness warrant attention. Simultaneous considerations of depressive symptom-domains and symptom severity are needed for designing more personalized care. NCT03593889.

Depression and anxiety before and at the beginning of the COVID-19 pandemic and incident persistent symptoms: a prospective population-based cohort study.

Many patients affected by COVID-19 suffer from debilitating persistent symptoms whose risk factors remained poorly understood. This prospective study examined the association of depression and anxiety symptoms measured before and at the beginning of the COVID-19 pandemic with the incidence of persistent symptoms. Among 25,114 participants [mean (SD) age, 48.72 years (12.82); 51.1% women] from the SAPRIS and SAPRIS-Sérologie surveys nested in the French CONSTANCES population-based cohort, depression and anxiety symptoms were measured with the Center for Epidemiologic Studies-Depression scale and the 12-item General Health Questionnaire before the pandemic, and with the 9-item Patient Health Questionnaire and the 7-Item Generalized Anxiety Disorder scale at the beginning of the pandemic (i.e., between April 6, 2020 and May 4, 2020). Incident persistent symptoms were self-reported between December 2020 and January 2021. The following variables were also considered: gender, age, educational level, householdincome, smoking status,BMI, hypertension, diabetes, self-rated health, and SARS-CoV-2 infection according to serology/PCR test results. After a follow-up of seven to ten months, 2329 participants (9.3%) had been infected with SARS-CoV-2 and 4262 (17.0%) reported at least one incident persistent symptom that emerged from March 2020, regardless of SARS-CoV-2 infection. In multi-adjusted logistic regression models, participants in the highest (versus the lowest) quartile of depressive or anxiety symptom levels before or at the beginning of the pandemic were more likely to have at least one incident persistent symptom (versus none) at follow-up [OR (95%CI) ranging from 2.10 (1.89-2.32) to 3.01 (2.68-3.37)], with dose-response relationships (p for linear trend <0.001). Overall, these associations were significantly stronger in non-infected versus infected participants, except for depressive symptoms at the beginning of the pandemic. Depressive symptoms at the beginning of the pandemic were the strongest predictor of incident persistent symptoms in both infected and non-infected participants [OR (95%CI): 2.88 (2.01-4.14) and 3.03 (2.69-3.42), respectively]. In exploratory analyses, similar associations were found for each symptom taken separately in different models. Depression and anxiety symptoms should be tested as a potential target for preventive interventions against persistent symptoms after an infection with SARS-CoV-2.

Potentially Traumatic Events of Women of Color in an Urban Adult Basic Education Program

ABSTRACT Adult Basic Education (ABE) in the United States is an important tool for underrepresented and underserved communities to achieve the goal of high school graduation following noncompletion of K-12 education. Largely in urban settings, ABE centers serve millions of students annually, especially historically and contemporarily marginalized groups. ABE provides critical resources and skills to meet the educational needs of diverse peoples seeking to advance their station in life. ABE centers may serve students with potentially traumatic events (PTE), diagnosable trauma, and related poorer outcomes. Alarmingly, a paucity of research exists that examines the presence of PTEs for ABE students, particularly people and womgen of color. In the present research, the Patient Health Questionnaire 9-item and Generalized Anxiety Disorder 7-item measures were used to weigh depression and anxiety scores across the Life Events Checklist for the DSM-5 (LEC-5) trauma types in a sample (N = 170) of predominantly women of color. We examined three respondent groups based on proximity and frequency of PTEs: (1) denied; (2) witnessed/learned about; and (3) experienced. Results indicate that those experiencing higher levels of PTEs (namely, sexual assault, unwanted/uncomfortable sexual experience, and sudden accidental death) also experienced higher ratings of depression and anxiety. More research is indicated, as women of color within ABE settings could benefit from tailored resources for prevention, intervention, and treatment.

Association Between Comorbid Anxiety and Depression and Health Risk Behaviors Among Chinese Adolescents: Cross-Sectional Questionnaire Study.

Comorbidity of psychiatric disorders such as depression and anxiety is very common among children and adolescents. Few studies have examined how comorbid anxiety and depression are associated with health risk behaviors (HRBs) in adolescents, which could inform preventative approaches for mental health. We evaluated the association between HRBs and comorbid anxiety and depression in a large adolescent cohort. We used data from 22,868 adolescents in the National Youth Cohort (China). Anxiety and depression symptoms were assessed using the 9-item Patient Health Questionnaire scale and the 7-item Generalized Anxiety Disorder scale, respectively. Comorbidity was determined by the coexistence of anxiety and depression. HRBs including poor diet, smoking, physical inactivity, and poor sleep, as well as the above HRB scores, were added to obtain the total HRB score (HRB risk index). Based on single and total HRB scores, we divided participants into low-, medium-, and high-risk groups. Potential confounders included gender, presence of siblings, regional economic level, educational status, self-rated health, parental education level, self-reported family income, number of friends, learning burden, and family history of psychosis. Correlation analysis was used to explore associations between single risk behaviors. Binary logistic regression estimated the association between HRBs and anxiety-depression comorbidity before and after adjusting for potential confounders. The comorbidity rate of anxiety and depression among Chinese adolescents was 31.6% (7236/22,868). There was a statistically significant association between each HRB (P<.05), and HRBs were positively associated with comorbid anxiety and depression in the above population. For single HRBs, adolescents with poor diet, smoking, and poor sleep (medium-risk) were more prone to anxiety-depression comorbidity after adjusting for confounders compared to low-risk adolescents. However, adolescents with all high-risk HRBs were more likely to have comorbid anxiety and depression after adjusting for confounders (poor diet odds ratio [OR] 1.50, 95% CI 1.39-1.62; smoking OR 2.17, 95% CI 1.67-2.81; physical inactivity OR 1.16, 95% CI 1.06-1.28; poor sleep OR 1.84, 95% CI 1.70-2.01). Moreover, in both unadjusted (medium risk OR 1.79, 95% CI 1.56-2.05; high risk OR 3.09, 95% CI 2.72-3.52) and adjusted (medium risk OR 1.57, 95% CI 1.37-1.80; high risk OR 2.33, 95% CI 2.03-2.68) models, HRB risk index, like clustered HRBs, was positively associated with anxiety-depression comorbidity, and the strength of the association was stronger than for any single HRB. In addition, we found that compared to girls, the association between clustered HRBs and anxiety-depression comorbidity was stronger in boys after adjustment. We provide evidence that HRBs are related to comorbid anxiety and depression. Interventions that decrease HRBs may support mental health development in adolescence, with the potential to improve health and well-being through to adulthood.

Mental health and quality of life among patients with chronic respiratory failure on domiciliary oxygen: a prospective cohort study from a tertiary care centre in India

ObjectivesThe study aims to assess the prevalence of anxiety, depression and the quality of life among patients with chronic respiratory failure and the changes in anxiety and depression scores after...

Prevalence of fear of hypoglycemia in adults with type 1 diabetes using a newly developed screener and clinician’s perspective on its implementation

IntroductionFear of hypoglycemia (FoH) affects quality of life, emotional well-being, and diabetes management among people with type 1 diabetes (PwT1D). American Diabetes Association’s (ADA) guidelines recommend assessing FoH in clinical...

Psychometric Properties of the 7-Item Generalized Anxiety Disorder (Gad-7) in Nigerian Pregnant Women Attending Primary Health Care

AimsMaternal mental health is an integral component of services that should be rendered to pregnant women in addition to their physical health during their antenatal care. Mental health conditions are screened for during these visits. There is a high prevalence of anxiety disorders among this group of women. A common questionnaire used to screen for anxiety is the 7-item generalized anxiety disorder (GAD-7). However, this instrument has not been validated among pregnant women in Nigeria. We conducted research among pregnant women in Southwest Nigeria to demonstrate the psychometric properties of GAD-7 using the anxiety modules of the Mini International Neuropsychiatric Interview (MINI) as a gold standard.MethodsWe administered both GAD-7 and the anxiety module of MINI among 203 pregnant women who attended 4 randomly selected primary health centres in Southwest Nigeria. The data collected from these questionnaires were analysed using the Statistical Package for Social Sciences (SPSS).The reliability of GAD-7 was assessed with Cronbach's alpha to estimate its internal consistency. The validity of GAD-7 was examined with an assessment of its concurrent validity, sensitivity, and specificity analysis and a receiver operator characteristic curve.Using Pearson correlations, we evaluated the concurrent validity of GAD-7 and the anxiety modules of the M.I.N.I. The sensitivity, specificity, positive predictive, and negative predictive values of GAD-7 were determined with the MINI as a gold standard. The predictive accuracy was further determined from receiver operating curve analysis using the area under the curve as a standard measure.ResultsThe internal consistency value measured by Cronbach's alpha for GAD-7 was 0.709. GAD-7 correlated minimally with the anxiety modules of MINI with a coefficient score (r) of 0.393 at a p-value of 0.01. GAD-7 has a low sensitivity &amp; negative predictive value of 14.1% and 57.8% respectively and a high specificity &amp; positive predictive value of 97.3% and 81.2% respectively. The area under the curve using receiver operating curve analysis was above the chance line of 0.5 with a value of 0.0557 at p &lt; 0.05.ConclusionGAD-7 is a reliable and moderately valid instrument to screen anxiety among pregnant women in Southwest Nigeria.

Sleep and its association with depressive and anxiety symptoms during the last weeks of pregnancy: A population-based study

ObjectiveTo evaluate the association between sleep characteristics and depressive and anxiety symptoms during the immediate postpartum period. MethodsPeople who had hospital births during 2019 in the municipality of Rio Grande (southern Brazil) were assessed with a standardized questionnaire concerning sociodemographic (eg, age and self-reported skin color) and health-related variables (eg, parity and stillbirth) (n = 2314) 24-48 hours after birth. We used the Munich Chronotype Questionnaire to assess sleep latency, inertia, duration, and chronotype; the Edinburgh Postpartum Depression Scale for depressive symptoms; and the General Anxiety Disorder 7-Item Scale to evaluate anxiety symptoms. We used logistic regression models to calculate odds ratios. ResultsThe prevalence of depressive symptoms was 13.7%, and of anxiety symptoms was 10.7%. Depressive symptoms were more likely in those with vespertine chronotype (odds ratios = 1.63; 95% CI: 1.14-2.35) and those with a sleep latency of more than 30 minutes (OR = 2.36; 95% CI: 1.68-3.32). The probability of depressive symptoms decreased by 16% for each additional hour of sleep (OR = 0.84; 95% CI: 0.77-0.92). Sleep inertia of 11-30 minutes increased the probability of anxiety on free days (OR = 1.73; 95% CI: 1.27-2.36) and increased the probability of depressive (OR = 2.68; 95% CI: 1.82-3.83) and anxiety symptoms (OR = 1.69; 95%CI: 1.16-2.44) on workdays. ConclusionParticipants with vespertine chronotype or shorter sleep duration were more likely to have depressive symptoms. Those who took more time to fall asleep or get out of bed were more likely to have both anxiety and depressive symptoms, but the association was stronger for depressive symptoms.

Associations Among Web-Based Civic Engagement and Discrimination, Web-Based Social Support, and Mental Health and Substance Use Risk Among LGBT Youth: Cross-Sectional Survey Study.

Social media use is ubiquitous among lesbian, gay, bisexual, and transgender or nonbinary (LGBT) adolescents. The time spent on LGBT sites and involvement in social justice-oriented web-based civic activities can increase exposure to heterosexist and transphobic posts, resulting in increases in depression, anxiety, and substance use. Collaborative social justice civic engagement may also increase LGBT adolescents' social support on the web, which may buffer the mental health and substance use risks associated with web-based discrimination. Drawing on the minority stress and stress-buffering hypotheses, this study aimed to test time spent on LGBT sites, involvement in web-based social justice activities, the mediating effect of web-based discrimination, and the moderating effect of web-based social support on mental health and substance use. An anonymous web-based survey conducted from October 20 to November 18, 2022, analyzed data from 571 respondents (mean age 16.4, SD 1.1 years): 125 cisgender lesbian girls, 186 cisgender gay boys, 111 cisgender bisexual adolescents, and 149 transgender or nonbinary adolescents. Measures included demographics, web-based LGBT identity disclosure, hours per week spent on LGBT social media sites, engagement in web-based social justice activities (Online Civic Engagement Behavior Construct), exposure to web-based discrimination (Online Victimization Scale), web-based social support (adapted from scales examining web-based interactions), depressive and anxiety symptoms, and substance use (the Patient Health Questionnaire modified for Adolescents; Generalized Anxiety Disorder 7-item; and Car, Relax, Alone, Forget, Friends, Trouble Screening Test). The time spent on LGBT social media sites was unrelated to web-based discrimination after civic engagement was accounted for (90% CI -0.007 to 0.004). Web-based social justice civic engagement was positively associated with social support (β=.4, 90% CI 0.2-0.4), exposure to discrimination (β=.6, 90% CI 0.5-0.7), and higher substance use risk (β=.2, 90% CI 0.2-0.6). Consistent with minority stress theory, exposure to web-based discrimination fully mediated the positive association between LGBT justice civic engagement and depressive (β=.3, 90% CI 0.2-0.4) and anxiety symptoms (β=.3, 90% CI 0.2-0.4). Web-based social support did not moderate the association between exposure to discrimination with depressive (90% CI -0.07 to 0.1) and anxiety symptoms (90% CI -0.06 to 0.1) and substance use (90% CI -0.04 to 0.01). This study highlights the importance of examining LGBT youth's specific web-based activities and the need for future research to focus on the intersectional experiences of LGBT adolescents from racial and ethnic minoritized groups through culturally sensitive questions. This study also calls for social media platforms to implement policies that mitigate the effects of algorithms that expose youth to heterosexist and transphobic messaging, such as adopting machine learning algorithms that can efficiently recognize and remove harmful content.

Impact of closed management on gastrointestinal function and mental health of Chinese university students during COVID-19

BackgroundThe innovative closed management of universities may have influenced the physical and mental health of students during the fourth stage of the COVID-19 pandemic in China. The study aimed to assess the gastrointestinal and mental health status of students in this stage and to explore the possible risk factors and mechanisms to provide a reference for future school responses to similar stressful events.MethodA multicenter, cross-sectional survey was administered to 598 college students from 10 Chinese universities. The study used the 7-item Generalized Anxiety Disorder Scale (GAD-7), 9-item Patient Health Questionnaire (PHQ-9), Fear of COVID-19 Scale (FCV-19 S), and the Diagnostic Tendency of Functional Bowel Disease Scale (DT-FBD) to evaluate anxiety, depression, fear of COVID-19 and likelihood of being diagnose diagnosed with functional bowel disease (FBD), respectively.ResultsA total of 516 college students completed the questionnaire. The proportions of students with more severe anxiety, more severe depression, greater fear of COVID-19, and a greater likelihood of being diagnosed with FBD were 49.8%, 57.0%, 49%, and 49%, respectively. These symptoms were significantly and positively correlated with the frequency of irregular sleep and eating (p < 0.05). Students in high-risk areas were more likely to experience anxiety and depression than students in areas with low/medium risk (odds ratio [OR] = 1.90, 95% confidence interval [CI]: 1.12–3.24, p = 0.017; OR = 2.14, 95% CI: 1.11–4.11, p = 0.022). A high likelihood of being diagnosed with FBD was positively associated with the severity of anxiety and depression symptoms and fear of COVID-19 (all p < 0.001). Moreover, mediation analysis revealed the following pathway in college students: fear of COVID-19 → depression and anxiety → poor diet → likelihood of being diagnosed with FBD.ConclusionCollege students generally exhibited higher more severe anxiety and depression symptoms and psychological symptoms with a greater higher propensity likelihood of being to be diagnosed with FBD. Good lifestyle habits, especially adequate sleep and a regular diet, can alleviate these problems. In addition, appropriate psychological intervention is very important.

Changes in stress, burnout, and resilience associated with an 8-week intervention with relational agent “Woebot”

BackgroundResearch investigating the potential for digital mental health interventions with integrated relational agents to improve mental health outcomes is in its infancy. By delivering evidence-based mental health interventions through tailored, empathic conversations, relational agents have the potential to help individuals manage their stress and mood, and increase positive mental health. AimsThe aims of this study were twofold: 1) to assess whether a smartphone app delivering mental health support through a relational agent, Woebot, is associated with changes in stress, burnout, and resilience over 8 weeks, and 2) to identify demographic and clinical factors associated with changes in these outcomes. MethodThis exploratory, non-randomized, single-armed, open-labeled trial was conducted from May to July 2022. A total of 256 adults (mean age 39 ± 13.35; 72 % females) recruited through social media advertising enrolled in the study. Participants completed an 8-week intervention period during which they were invited to use a smartphone app called Woebot-LIFE that delivers cognitive behavioral therapy through a relational agent called “Woebot”. Participant-reported measures of stress, burnout, and resilience were collected at Baseline, and Week 8. Changes in these outcomes during the study period were assessed. Bivariate and stepwise multiple regression modeling was used to identify sociodemographic and clinical factors associated with observed changes over the 8-week study period. ResultsExposure to Woebot-LIFE was associated with significant reductions in perceived stress and burnout and significantly increased resilience over the 8-week study period. A greater reduction in stress was observed among those with clinically elevated mood symptoms (i.e., Patient Health Questionnaire-8 or Generalized Anxiety Disorder 7-item scores ≥10) at baseline compared to those without; however, the differences in the improvements in resilience scores and burnout between the two groups were not statistically significant. Although a difference in the magnitude of change in stress was observed for participants with and without clinically elevated mood symptoms at baseline, significant improvements in stress, burnout, and resilience over the 8-week study period were observed for both groups. Bivariate analyses showed that race, insurance type, and baseline level of resilience were associated with changes in each of the outcomes, though baseline resilience was the only factor that remained significantly associated with changes in the outcomes in the stepwise multiple regression analyses. ConclusionResults of this single-arm, exploratory study suggest that conversational agent-guided mental health interventions such as Woebot-LIFE may be associated with reduced stress and burnout and increased resilience in both clinical and non-clinical populations.

Association of Plant-Based Diet Indices and Abdominal Obesity with Mental Disorders among Older Chinese Adults.

We aimed to explore the correlation between plant-based diet indices and abdominal obesity with depression and anxiety among older Chinese adults. This study used a cross-sectional design using data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). We used a simplified food frequency questionnaire to evaluate the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI) separately, based on the potential health effects of the foods. Waist circumference (WC) was used to define abdominal obesity. The 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) and the 7-item Generalized Anxiety Disorder Scale (GAD-7) were applied to estimate depression symptoms and anxiety symptoms, respectively. Multi-adjusted binary logistic regression models were conducted to explore the effects of the three plant-based diet indices, abdominal obesity status, and their interaction on depression and anxiety. We enrolled a total of 11,623 participants aged 83.21 ± 10.98 years, of which 3140 (27.0%) participants had depression and 1361 (11.7%) had anxiety. The trend in the prevalence of depression/anxiety across increasing quartiles of the plant-based diet indices was statistically significant after controlling for potential confounders (p-trend < 0.05). Abdominal obesity was related to a lower prevalence of depression (OR = 0.86, 95% CI: 0.77-0.95) and anxiety (OR = 0.79, 95% CI: 0.69-0.90) compared with non-abdominal obesity. The protective effects of the PDI and hPDI against depression (OR = 0.52, 95% CI: 0.41-0.64; OR = 0.59, 95% CI: 0.48-0.73, respectively) and anxiety (OR = 0.75, 95% CI: 0.57-1.00; OR = 0.52, 95% CI: 0.39-0.70, respectively) were more pronounced in non-abdominally obese participants. The harmful effects of the uPDI against depression (OR = 1.78, 95% CI: 1.42-2.23) and anxiety (OR = 1.56, 95% CI: 1.16-2.10) were more pronounced in non-abdominally obese participants. In addition, a significant interaction between the plant-based diet indices and abdominal obesity was observed in terms of causing the prevalence of depression and anxiety. Consuming more of a healthful plant-based diet and less of an animal-based diet is related to a lower prevalence of depression and anxiety. A healthful plant-based diet plays a vital role in non-abdominally obese individuals.