Generalised Anxiety Disorder Assessment Research Articles

Long COVID in Pakistan: a cross-sectional analysis of health and psychosocial outcomes

ABSTRACT According to the World Health Organization-led Delphi consensus, long COVID corresponds to the occurrence of symptoms beyond twelve weeks after the onset of acute COVID-19 illness that cannot be explained by alternate diagnosis. This cross-sectional study aimed to analyse the impacts of long COVID on general health and psychosocial well-being. For this study, the participants were interviewed either face to face or via telephone, and their responses were recorded on a questionnaire capturing information on demographics, COVID-19 status, duration of symptoms and long COVID symptoms. The psychosocial impacts of the pandemic were assessed using scales like Short Mood and feeling questionnaire (sMFQ), Warwick-Edinburgh Mental Well-being Scale (WEMWBS), Generalized Anxiety Disorder Assessment (GAD-7) and Perceived Stress Scale (PSS). Regression analysis was conducted to analyse the predictors of long COVID. A total of 300 participants were interviewed, of which 155 (52%) had COVID-19 illness. Of these 54 (35%) had persistent symptoms for a period of more than 12 weeks classified as long COVID. Muscle problems and fatigue were the most frequent (14.7%) symptoms encountered, followed by breathing problems (12.6%) and cognitive issues (12.6%). The symptoms of decrease in appetite and confusion or disorientation during the initial phase of the infection were associated with long COVID. The majority of the participants (83.3%) had moderate level of perceived stress, while moderate to severe levels of stress were observed in 17.3% of the individuals. Moreover, a high level of positive mental well-being was also observed. This study highlights the need for further research into the clinical aspects and implications of long COVID in Pakistan and emphasizes the importance of ongoing support for affected individuals.

Machine learning analyses reveal circadian clock features predictive of anxiety among UK biobank participants

Mood disorders, including depression and anxiety, affect almost one-fifth of the world’s adult population and are becoming increasingly prevalent. Mutations in circadian clock genes have previously been associated with mood disorders both directly and indirectly through alterations in circadian phase, suggesting that the circadian clock influences multiple molecular pathways involved in mood. By targeting previously identified single nucleotide polymorphisms (SNPs) that have been implicated in anxiety and depressive disorders, we use a combination of statistical and machine learning techniques to investigate associations with the generalized anxiety disorder assessment (GAD-7) scores in a UK Biobank sample of 90,882 individuals. As in previous studies, we observed that females exhibited higher GAD-7 scores than males regardless of genotype. Interestingly, we found no significant effects on anxiety from individual circadian gene variants; only circadian genotypes with multiple SNP variants showed significant associations with anxiety. For both sexes, severe anxiety is associated with a 120-fold increase in odds for individuals with CRY2_AG(rs1083852)/ZBTB20_TT(rs1394593) genotypes and is associated with a near 40-fold reduction in odds for individuals with PER3-A_CG(rs228697)/ZBTB20_TT(rs1394593) genotypes. We also report several sex-specific associations with anxiety. In females, the CRY2/ZBTB20 genotype combination showed a > 200-fold increase in odds of anxiety and PER3/ZBTB20 and CRY1 /PER3-A genotype combinations also appeared as female risk factors. In males, CRY1/PER3-A and PER3-B/ZBTB20 genotype combinations were associated with anxiety risk. Mediation analysis revealed direct associations of CRY2/ZBTB20 variant genotypes with moderate anxiety in females and CRY1/PER3-A variant genotypes with severe anxiety in males. The association of CRY1/PER3-A variant genotypes with severe anxiety in females was partially mediated by extreme evening chronotype. Our results reinforce existing findings that females exhibit stronger anxiety outcomes than males, and provide evidence for circadian gene associations with anxiety, particularly in females. Our analyses only identified significant associations using two-gene combinations, underscoring the importance of combined gene effects on anxiety risk. We describe novel, robust associations between gene combinations involving the ZBTB20 SNP (rs1394593) and risk of anxiety symptoms in a large population sample. Our findings also support previous findings that the ZBTB20 SNP is an important factor in mood disorders, including seasonal affective disorder. Our results suggest that reduced expression of this gene significantly modulates the risk of anxiety symptoms through direct influences on mood-related pathways. Together, these observations provide novel links between the circadian clockwork and anxiety symptoms and identify potential molecular pathways through which clock genes may influence anxiety risk.

Prevalence of Body Dysmorphic Disorder (BDD) among the Lebanese University students: associated risk factors and repercussion on mental health.

Body Dysmorphic Disorder (BDD) is a psychological illness characterized by persistent and intrusive preoccupation with an imagined or slight defect in appearance. This study aimed to determine the prevalence of BDD and investigate its association with mental health status (depression and anxiety), religiosity, eating disorder risk, and self-esteem among Lebanese University students. A cross-sectional study was conducted in March 2020, involving students from the Lebanese University. Data were collected using the dysmorphic concern questionnaire (DCQ), Rosenberg self-esteem scale (RSE), religiosity scale, patient health questionnaire (PHQ-9), generalized anxiety disorder assessment (GAD-7), Eating Attitude test-26 scale (EAT-26). A total of 6,448 participants were enrolled in our study. The overall prevalence of BDD among university students was (6.4%).Our results showed that Lebanese students with BDD were more likely to have anxiety ORadj 1.3 (95% CI: 1.2-1.7) p-value 0.001, depression ORadj 1.2 (95% CI: 1.15-1.5) p-value 0.007, and eating disorder (Bulimia & Food preoccupation ORadj 1.06 (95% CI: 1.03-1.2) p-value 0.0, and oral control ORadj 1.09 (95% CI: 1.05-1.1) p-value < 0.001) compared to those with no BDD. We also found that students with BDD had Lower Self-esteem ORadj 0.88 (95% CI: 0.78-0.9) p-value < 0.001), and less likely to be religious ORadj 0.88 (95% CI: 0.82-0.9) p-value 0.02) compared to those with no BDD. This pioneering study sheds light on the prevalence of BDD among Lebanese university students and its associated factors. Our findings underscore the importance of early detection of BDD during adolescence and young adulthood, necessitating timely psychological intervention to prevent chronicity and complications.

Assessing the Anxiety and Knowledge about Monkeypox Virus: A Cross-Sectional Cohort Study.

Introduction Recent cases of human monkeypox virus (MPXV) infections have raised global health concerns, as sporadic instances have occurred in various regions, prompting investigations into the potential for increased transmission. This underscores the importance of effective communication strategies in addressing the emerging challenges associated with this viral ailment. The study was conducted to understand public anxiety and knowledge related to MPXV infection, particularly in the context of emerging infectious diseases. Our aims included assessing anxiety levels and knowledge about monkeypox infection among the Saudi population, as well as their willingness to receive vaccinations if available. Methods A cross-sectional cohort study among the adult Saudi population was conducted. A questionnaire with four sections, including demographic data and disease knowledge, comprised optimized questions of the standard generalized anxiety disorder assessment (GAD-7) as well as questions related to acceptance of getting the vaccine if it could be afforded. Results Out of a total of 5298 participants, 927 (17.5%) showed different degrees of GAD-7 anxiety. Females showed a significantly higher rate of anxiety (487/2189, 22.2%) than males (440/3109, 14.2%). People aged 46 to 55 and >55 years old showed significantly higher rates of anxiety (30.7% and 27.2%). There is an overall decrease in knowledge and awareness about the MPXV. Interestingly, 59% of the participants admitted that they would get the MPXV vaccine if it were made available. There was a positive correlation between the anxiety level and the response of people toward the MPXV vaccine if it were available. Conclusion Our study underscores a significant level of anxiety and a notable lack of awareness concerning MPXV infection. Although a substantial number of participants expressed their willingness to receive an MPXV vaccine, our findings emphasize the pressing need for improved public education and awareness campaigns to alleviate anxiety levels and enhance understanding of this infectious disease. This effort is crucial for mitigating health concerns and facilitating well-informed decision-making among the Saudi population.

Seeking professional help for mental health issues in Slovenia: Prevalence and associated factors

Abstract Background The aim of the study was to examine the prevalence of seeking professional help for mental health issues and explore its association with sociodemographic factors, various aspects of mental health literacy, and symptom severity. Methods A cross-sectional survey was conducted from November 2021 to January 2022 using a probability sample of Slovenians aged 18-64 (prepared by The Statistical Office of the Republic of Slovenia). Of the 9000 participants invited, 2677 (52.2% males) completed the survey (30% response rate) either online (78.9%) or in paper format (21.1%). The prevalence of mental health issues and professional help-seeking was assessed using self-developed questions. Logistic regression was used to test the probability of seeking professional help, with predictor variables including sociodemographic, Depression literacy questionnaire (D-lit), Anxiety literacy questionnaire (A-lit), Inventory of Attitudes Toward Seeking Mental Health Services (IASMHS), General Help-Seeking Questionnaire (GHSQ), Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Assessment (GAD-7), General mental health (self-developed question). Results Among those who reported having mental health issues currently or in the past (44% of the sample), 46.6 % had never sought professional help. The logistic regression model was statistically significant (p &amp;lt; 0.001, χ2 (df)= 214,637(16)), revealing that women, older participants, those with higher score on A-lit, GHSQ, and those participants which reported worse general mental health were more likely to seek professional help. The variable D-lit, as well as PHQ-8, GAD-7, and subjective social status, were not significant predictors. For education and the variable IASMHS, only some of the predictors were statistically significant. Conclusions The study highlights the need for systematic approaches and targeted interventions at the national level to promote and enhance seeking professional help for mental health issues. Key messages • The study found a large help-seeking gap for mental health issues, with only specific aspects of mental health literacy (eg anxiety literacy) being significant predictors of seeking professional help.

P095 Factors associated with sleep and mental health problems following athletic retirement

Abstract Introduction Despite growing research on the sleep and mental health of athletes, there is limited literature on their sleep health following retirement from sport. The aim of this study was to investigate potential factors associated with symptoms of sleep and mental health disorders in former athletes. Methods Former athletes (N=173, 50% women) who retired from any sport or competition level ≤20 years ago completed an online survey, consisting of the Athlete Sleep Screening Questionnaire (ASSQ), Personal Wellbeing Index-Adult (PWI-A), Center for Epidemiologic Studies Depression Scale-Revised (CESD-R), and Generalised Anxiety Disorder Assessment (GAD-7). Results Self-disclosed lifetime diagnosis of sleep disorder(s) and mental health disorder(s) was reported by 28.3% and 45.1% of former athletes, respectively. Binary logistic regressions showed that age (OR=0.95[95% CI:0.92, 0.99], p=.007) and gender (OR=2.28[95% CI:1.09, 4.79], p=.029) were associated with anxiety symptoms, with women and younger ex-athletes presenting greater risk. Increased BMI was associated with risk for sleep disordered breathing (OR=1.20[95% CI:1.10, 1.30], p&amp;lt;.001), sleep difficulty (OR=1.13[95% CI:1.03, 1.23], p=.008), and poor wellbeing (OR=0.91[95% CI:0.85, 0.98], p=.010). Those who placed a lower priority on sport whilst competing had greater risk for sleep disordered breathing (OR=2.00[95% CI:1.05, 3.80], p=.035). Recency of retirement was not associated with any measures. Discussion Findings indicate that former athletes are not exempt from poor sleep and mental ill-health. Results provide preliminary insight into predictive factors for difficulty transitioning out of sport. Future longitudinal research should consider the interplay between sport reintegration and the timing of sleep and mental health problems.

Association between psychological vulnerability and glaucoma progression: Protocol for a multicenter prospective cohort study in South Korea.

Mental health is a significant concern for patients diagnosed with glaucoma, as visual impairment can have a profound impact on psychological well-being. Conversely, psychological vulnerability in glaucoma patients can negatively influence treatment adherence to ocular hypotensive therapy, thereby potentially exacerbating disease progression in a vicious cycle. The study protocol proposed herein aims to explore the impact of psychological states such as anxiety, depression, and stress on both medication adherence and progression of glaucoma. This study is to be a prospective multicenter study conducted at four tertiary medical centers. Patients recently diagnosed with glaucoma and not yet treated will be enrolled. Anxiety, depression, and stress scales will be administered at baseline, one year, and two years, along with glaucomatous assessments to be performed every six months. Validated questionnaires (Generalized Anxiety Disorder Assessment [GAD-7], Patient Health Questionnaire [PHQ-9], and Perceived Stress Scale-10 [PSS-10]) will assess anxiety, depression, and stress, respectively. The primary objective is to correlate post-diagnosis psychological status with medication adherence and disease progression. The effects of pre- and post-diagnosis changes in anxiety, depression, and stress on disease progression will be analyzed. Kaplan-Meier survival analysis and logistic regression will be performed to identify clinical characteristics associated with increased risk of developing anxiety, depression, and stress in glaucoma patients.

The high burden of erectile dysfunction among men living with HIV in northern Tanzania: a call for evidence-based interventions

BackgroundThe extent of the burden of erectile dysfunction and its associated factors remains unclear. The aim of this study was to investigate the factors associated with ED and its prevalence among MLHIV in northern Tanzania.MethodsA hospital-based, multi-center, cross-sectional study was conducted on MLHIV aged 18 years and above in northern Tanzania.OutcomeThe risk factors for ED and the prevalence of such risk factors among MLHIV was assessed and evaluated through a multivariate logistic regression analysis adjusted for depression symptoms using the Patient Health Questionnaire-9 (PHQ9) scale; anxiety disorders using the Generalized Anxiety Disorder Assessment (GAD-7); ART adherence; viral load; initial regimen date; ART regimen; and sexual risk behaviors.ResultsData for 366 participants with a median age of 50 years (IQR 38–57 years) were available for analysis. Approximately three in four (74.6%) MLHIV had ED (of any severity), whereas 37.7% had mild ED. The majority (96.5%) of the participants had low testosterone, two in three (66.7%) had depressive symptoms, and close to half of the participants (48.4%) had anxiety. Age, lack of engagement in vigorous physical activity, depression, and self-reported good adherence to antiretroviral therapy (ART) were associated with ED in a multivariate logistic regression analysis (p=0.004, p =0.006, p=0.07, p=0.006, and p=0.004, respectively).ConclusionThere is a high prevalence of ED among MLHIV in northern Tanzania. Erectile dysfunction should be regarded as one of the comorbidities associated with HIV and should be routinely screened for among MLHIV in CTC clinics.

Biofeedback training in PhD students’ mental health: A preliminary study

Background: Undertaking a PhD, which is a prestigious career, is however associated with stress-inducing situations. The demands of research and publication, along with other academic requirements, and the complexity of reconciling professional, personal and family activities, require psychophysiological strategies to help students successfully overcome academic challenges. Objective: The aim of this study is to investigate the perceptions of a small group of doctoral students who used biofeedback to control anxiety, and to obtain information that will enable the development of a biofeedback-based program for doctoral students, based on a randomized intervention protocol. Methods: The questionnaires Mental Health Inventory (MHI-5), Kessler Psychological Distress Scale (K-10) and Generalised Anxiety Disorder Assessment (GAD-7), were used for evaluation before and after the use of biofeedback. Focus-group, highlight positive perceptions of the use of biofeedback. Results: Highlights students’ opinions to report on the advantages and improvements achieved with the biofeedback experience, as well as to identify the necessary changes to be made in terms of time, duration, and contexts in which the program is carried out. Some implications for the use of biofeedback in reducing psychological distress and promoting the mental health of doctoral students are mentioned. Conclusion: The joint use of biofeedback complemented by processes based on artificial intelligence could contribute to greater effectiveness in promoting the health and well-being of doctoral students. Keywords: Biofeedback, PhD students, Distress, Anxiety, Training.

Psychological Toll of the COVID-19 Pandemic: An In-Depth Exploration of Anxiety, Depression, and Insomnia and the Influence of Quarantine Measures on Daily Life.

The COVID-19 pandemic, on a global scale, has prompted multifaceted challenges, including a notable psychological toll on the general population. This study uses mixed-method approach for a nuanced exploration of these experiences. Using a phenomenological strategy, qualitative responses from 999 participants were analyzed regarding their pandemic-induced anxiety and the influence of quarantine measures on their lives. Quantitative measures, including the revised Impact of Event Scale (IES-R), patient health questionnaire-9 (PHQ-9), the seven-item generalized anxiety disorder assessment (GAD-7), and Insomnia Severity Index (ISI), were used to quantify trauma, depression, anxiety, and insomnia attributed to COVID-19. Partial least squares structural equation modeling (PLS-SEM) was utilized for quantitative data analysis. The anxiety-related responses were mainly clustered into four themes: life threats, support shortage, economic consequences, and disruptions to family and social life. Subthemes that addressed the perceived effects encapsulated disruptions to academic and professional lives, familial and social relationships, psychopathological stress, and movement limitations. The findings from quantitative analysis revealed the significant associations between COVID-19-related trauma and symptoms of anxiety, depression, and insomnia, as indicated by coefficients exceeding 0.10 (all z-values > 1.96; p-values < 0.05). In conclusion, the findings underscore COVID-19's role in escalating anxiety, influenced by various factors, and its disruptive effects on daily life due to quarantine measures. The strong associations between the pandemic and the symptoms of depression, anxiety, and insomnia underscore the urgency of comprehensive psychological and public health interventions to alleviate these impacts.

Low-Dose Naltrexone Use in Postural Orthostatic Tachycardia Syndrome: A Case Series.

Introduction In recent years, low-dose naltrexone has emerged as a novel off-label therapy for many chronic conditions including postural orthostatic tachycardia syndrome (POTS), however, there is little evidence for its efficacy. Methods In this institutional review board (IRB)-approved case series, the charts of six tilt table-confirmed patients with POTS who underwent a trial of low-dose naltrexone (LDN) at our institution were reviewed. Medical history, subjective description of symptom severity, the continuation of therapy, tolerability, and scores on patient-reported outcome measures (Patient-Reported Outcomes Measurement Information System {PROMIS} Fatigue, PROMIS physicaland mental health, Generalized Anxiety Disorder Assessment {GAD}-7, Patient Health Questionnaire {PHQ}-9, and Composite Autonomic Symptom Score {COMPASS}) were collected at therapy initiation and six to 12 months after the start of LDN. Results Three out of six reviewed patients reported an improvement in their POTS after the initiation of LDN. Two patients discontinued the therapy due to a lack of perceived benefit. No side effects or adverse outcomes were reported. The patient-reported outcome measures of PROMIS Fatigue, PROMIS physical and mental health, GAD-7, PHQ-9, and COMPASS showed inconsistent changes over the course of therapy, with some patients showing improvement or stability and others showing worsening. The small sample size and incomplete response rate did not allow for extensive statistical analysis. Conclusion As seen in its use in other conditions, LDN appears to have a favorable safety and side effect profile in patients with POTS but has little evidence for efficacy. Although some patients noted benefit, patient-reported outcome measures show a variable response profile. High-quality randomized controlled trials are needed to determine if the treatment is efficacious and should be used outside of a trial basis.

Integrating EMDR Standard Treatment Protocol into Child Psychotherapy at a Primary School with a 5‐year‐old Boy Who Suffered Complex Trauma: A Single Case Study

Schools are making an important contribution to providing access to professional counselling for young people and their families. The population of children who access school counselling includes young people who have experienced severe and complex trauma in their early life, which presents itself as post‐traumatic stress disorder (PTSD). Eye movement desensitization and reprocessing (EMDR) therapy is a recommended method of intervention for PTSD, with effective results in a short time. However, school counsellors are rarely specifically trained to work with complex trauma or PTSD. This article presents a case study exploring the integration of the EMDR eight‐phase protocol into child psychotherapy in an English primary school setting with a 5‐year‐old boy who suffered complex trauma. Following treatment, the Strengths and Difficulties Questionnaire (SDQ) score and Generalized Anxiety Disorder Assessment (GAD‐7) score—filled in by the child's parent and schoolteacher because of the child's age—decreased to non‐clinical levels. The six‐month follow‐up assessment confirmed the improvement in the emotional well‐being of the client. The promising results suggest the value of having adequately qualified child psychotherapists linked to primary schools to support emotionally vulnerable pupils.

BH15 Efficacy and safety of baricitinib in the management of severe alopecia areata over a 6-month period: a real-world experience

Abstract Alopecia areata (AA) is an autoimmune condition that targets the hair follicles, causing nonscarring hair loss. It can manifest with different patterns, ranging from discrete bald patches on the scalp to complete loss of body hairs. Despite being considered a disease of purely aesthetic concern, recent data support its systemic nature. In June 2022, baricitinib, an oral selective inhibitor of Janus kinases 1 and 2, was the first US Food and Drug Administration-approved systemic treatment for adult patients with severe AA. Our objective was to present the efficacy and safety of baricitinib in the management of adult patients with severe AA in real practice at 24 weeks. All consecutive adult patients diagnosed with severe AA, who were started on baricitinib in our specialist hair clinic, and completed 24 weeks of treatment were eligible. Access to baricitinib was granted after approval by the national organization for the provision of health services on a case-by-case basis. Demographic data, disease history, previous treatments for AA and comorbidities were documented. Severity of Alopecia Tool (SALT) score, loss of eyebrows/eyelashes, hair loss in other parts of the body and nail involvement were also assessed. Patients completed the Dermatology Life Quality Index (DLQI), Patient Health Questionnaire (PHQ)-9 and Generalised Anxiety Disorder Assessment (GAD-7) at each visit. Safety profile was also assessed. Visits were performed at T1 (4 weeks), T2 (8 weeks), T3 (12 weeks) and T4 (24 weeks). Ten patients were included in the analysis. The male-to-female ratio was 3 : 2. Mean patient age was 34.8 years. All were White. Sixty per cent of patients had alopecia universalis/totalis, 30% had ophiasis and 10% had patchy alopecia. Mean disease duration was 6.1 years. The most common comorbidities were depression and anxiety. Baseline mean SALT score was 82, which decreased significantly at weeks 8, 12 and 24. Ninety per cent had eyebrow/eyelash regrowth. Patients with more recent disease onset responded quicker than those with a more chronic disease course. Nail involvement was noted in 30% of patients, which improved in all of them at week 24. There was a significant decrease in PHQ-9, GAD-7 and DLQI scores at weeks 8, 12 and 24. Forty per cent of patients developed an acneiform rash, 30% an upper respiratory infection, 10% a vaginal infection, 40% transient raised creatine kinase, 20% dyslipidaemia and 20% transient neutropenia and anaemia. Our real-world data showed a quick onset of action for baricitinib and encouraging results in terms of efficacy at week 24. Safety profile was acceptable, with many of the adverse events being transient and not requiring treatment. No severe adverse events were noted. Studies with a larger number of patients and longer duration of treatment are needed to assess the long-term efficacy and safety of baricitinib in everyday clinical practice. Finally, national registries for patients with AA could play a crucial role.

680-P: Improvement in Anxiety and Depression in Patients with Type 2 Diabetes through Customized Lifestyle Intervention

Background: Type 2 diabetes (T2D) is a chronic metabolic disorder that has a significant impact on the mental health of an individual, which in turn results in increased morbidity and mortality. Objective: To evaluate the effect of holistic lifestyle intervention in improving mental health outcomes in patients with T2D. Materials and Methods: In this quasi-experimental study, baseline data (anthropometry and medical history) on 428 T2D patients enrolled in a one-year online holistic lifestyle intervention program at the Freedom from Diabetes Clinic (Pune, India) between May 2021 and Feb 2022 were collected. The validated Patient Health Questionnaire (PHQ-9) (scoring 0-27) and Generalized Anxiety Disorder Assessment (GAD-7) scale (scoring 0-21) were used to assess depression and anxiety, respectively. The intervention included a customized vegan diet and exercise protocol along with stress-relieving group sessions for diabetes management and one-on-one psychological counselling sessions (aimed specifically at people with anxiety and/or depression). After 6 months of intervention, the questionnaires were re-administered to assess the reduction in anxiety and depression. Results: The prevalence of depression, anxiety, and both was 7.9%, 7.2%, and 8.9% at baseline, respectively. Post-intervention, it reduced to 3.5%, 3.7%, and 4.9%, respectively. The absolute change (calculated as final score-initial score/initial score*100) was significantly higher for both depression and anxiety scores in those who received the intervention (group therapy or individual counselling) vs those who chose not to receive the intervention (p&amp;lt;0.05). Of the 72 and 69 patients who showed depression and anxiety at baseline, 43 and 40 shifted to the minimal to mild categories, respectively, indicating improvement. Conclusion: Our findings suggest that incorporating a psychological component into lifestyle interventions may help improve mental health in patients with T2D. Disclosure P.Tripathi: Board Member; Freedom from Diabetes Clinic. N.S.Kadam: Research Support; Freedom from Diabetes Clinic. B.Sharma: Research Support; Freedom From Diabetes clinic. A.R.Vyawahare: Research Support; Freedom From Diabetes. M.Das biswas: Employee; Freedom from Diabetes Clinic. M.H.Ganla: Employee; Freedom from Diabetes Clinic. B.D.Saboo: None.

The association between coffee consumption and risk of incident depression and anxiety: Exploring the benefits of moderate intake

Accumulating evidence has reported the associations of coffee consumption with physical conditions and mortality, but the associations with mental disorders were limited. The objective of this study was to examine the associations of coffee consumption with incident depression and anxiety, and to assess whether the associations differed by coffee subtypes (instant, ground, and decaffeinated coffee) or additives (milk, sugar-sweetened, and artificial-sweetened). In this prospective cohort study, we utilized data from the UK Biobank and included a total of 146,566 participants who completed the touchscreen questionnaire at baseline between 2006 and 2010. During the follow-up, incident depression and anxiety were measured in 2016 using the Patient Health Questionnaire (PHQ)-9 and the Generalised Anxiety Disorder Assessment (GAD)-7, respectively. Multivariable-adjusted logistic regression models and restricted cubic splines were used to assess the associations. Approximately 80.7% of participants reported consuming coffee, and most drank 2 to 3 cups per day (41.2%). We found J-shaped associations between coffee consumption and both incident depression and anxiety, with the lowest risk of the mental disorders occurring at around 2–3 cups per day. Results were similar for participants who drank 2–3 cups of ground coffee, milk-coffee, or unsweetened coffee. Our findings highlight that 2–3 cups of coffee consumption could be recommended as part of a healthy lifestyle to improve mental health.

A-48 Comparative Analysis of Adolescents With a Sport-Related Concussion Versus Non-Sport-Related Concussion During Initial Visit

Abstract [Outstanding Trainee Award Winner] Purpose To investigate differences in pre-injury risk factors and clinical outcomes in adolescents with a Sport-Related Concussion (SRC) versus non-Sport-Related Concussion (non-SRC). Methods Participants (n=136, aged 10-18) presented to a specialty concussion clinic 2-30 (M=9.25) days post-injury. They completed a clinical interview with a trained clinician and were administered the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), Post-Concussion Symptom Scale (PCSS), Concussion Clinical Profile Screening (CP Screen), Vestibular/Ocular-Motor Screening (VOMS), Screen for Child Related Anxiety Disorders - Child Version (SCARED-C), and the Generalized Anxiety Disorder Assessment (GAD-7). Data analyses utilized independent sample t-tests, chi-square tests, and descriptive statistics to compare clinical outcomes of both groups during initial visit. Alpha was set to p&amp;lt;.05 for all analyses. Results Adolescents with non-SRC took longer to seek specialty concussion care, were majority female, and were older than the SRC group. Non-SRC participants also reported a higher rate of migraine, depression, and anxiety history (i.e., SCARED-C Panic Disorder, SCARED-C Generalized Anxiety Disorder, and SCARED-C Anxiety Disorder). Additionally, non-SRC participants reported more symptoms on the PCSS Total score, and on most VOMS items, including Smooth Pursuits, Horizontal and Vertical Saccades, Horizontal and Vertical Vestibular-Ocular Reflex, Visual Motion Sensitivity, as well as VOMS Total. Non-SRC group also reported higher post-injury anxiety scores (i.e., GAD-7). All findings were below the p-value of .05. Conclusions The study findings suggest that mechanism of injury and individual risk factors play a significant role in determining the clinical presentation of a concussion in an SRC and non-SRC adolescent population.

#5300 HUMANISTIC BURDEN OF RARE KIDNEY DISEASES: UNDERSTANDING THE IMPACT OF IGAN AND FSGS ON PATIENTS AND CARE-PARTNERS STUDY (HONUS): A US IGAN RESULTS UPDATE

Abstract Background and Aims While immunoglobulin A nephropathy (IgAN) has been shown to be associated with clinical and economic burden, the humanistic burden associated with IgAN is less understood. HONUS is a multi-national, cross-sectional survey study to evaluate the humanistic burden associated with rare kidney diseases, including IgAN, from the patient and caregiver perspectives in the US and Europe. Method The study recruited adult patients (≥18 years old) with their care-partners and parents/care-partners of youth (8-17 years old) with IgAN or focal segmental glomerulosclerosis (FSGS). Participants completed an online survey with questions on demographic and clinical characteristics, health-related quality of life (HRQoL) (ie, 12-Item Short Form Survey [SF-12]), anxiety and depression (ie, Generalized Anxiety Disorder Assessment [GAD-7], Patient Health Questionnaire [PHQ-9]), most burdensome symptoms, fear and uncertainty for the future, and disease impact on work productivity (ie, Work Productivity and Activity Impairment [WPAI]). The current analysis is based on information from adults with IgAN and their care-partners in the US before September 2022. Descriptive analyses were conducted, with continuous variables summarized using means, medians, and standard deviations (SD), and categorical variables summarized using frequency counts and percentages. Results A total of 96 pairs of adults with IgAN and their care-partners in the US were included in the analysis. The mean age of adult patients was 37.5 and the majority were Caucasian (86.5%) and female (53.1%). Median time since diagnosis was 5.6 years. More than half of patients (59.4%) were in chronic kidney disease stage 3 or 4, while 5.2% were in end-stage renal disease and had received a kidney transplant. Hypertension (31.3%), anemia (25.0%), and depression (18.8%) were the most common comorbidities. In terms of HRQoL, patient's mean (SD) SF-12 physical and mental component scores (PCS, MCS) were reported at 46.9 (7.4) and 41.1 (9.1), respectively, reflecting worse HRQoL (lower score) than previously published US general population scores (PCS and MCS of 50 [10]). Moderate and severe anxiety was reported by 28.1% and 1.0% of patients, respectively; moderate, moderately severe, and severe depression was reported by 51.0%, 2.1% and 1.0% of patients, respectively. The most burdensome symptoms reported by patients were constipation (82.3%), lower back pain (79.2%), and bone or joint pain (77.1%). Based on a 4-week recall period, 25.0% of adult patients reported being ‘very much bothered’ or ‘extremely bothered’ by bone or joint pain (22.9% for lower back pain, 10.4% for constipation). Most patients (96.9%) reported feeling fear and uncertainty for the future due to their disease, of which 52.1% reported the frequency of fear and uncertainty to be ‘often’. Among employed patients (72.9%), percent absenteeism was reported in 6.9%, presenteeism in 27.1%, overall work productivity loss in 31.4%, and activity impairment in 36.2% because of IgAN-related reasons. Most paired care-partners (87.5%) were partners of patients, with a mean age of 39.5 years. The mean SF-12 PCS and MCS of care-partners were 50.4 and 43.6, respectively. Moderate anxiety was reported in 13.5% of care-partners, with none reporting severe anxiety; moderate and moderately severe depression was reported in 35.4% and 5.2% of care-partners, respectively. Almost all care-partners (99.0%) reported feeling fear and uncertainty for the future due to the disease of their cared ones, of which 39.6% reported the frequency of this worry to be ‘often’. Among employed care-partners (93.8%), 9.8% reported absenteeism, 27.3% reported presenteeism, 33.2% reported overall work productivity loss, and 31.9% reported activity impairment due to IgAN-related reasons. Conclusion Patients with IgAN experience impaired HRQoL, depression, anxiety, and poor productivity, compared to previously reported US general population estimates. This also impacts the HRQoL, in terms of mental components, and productivity of care-partners. Both patients with IgAN and their care-partners also report widespread fear and uncertainty for the future.

The prevalence of depressive and anxiety symptoms among first-year and fifth-year medical students during the COVID-19 pandemic: a cross-sectional study

BackgroundMedical students have higher risk of psychological disorders due to the relatively stressful environment. Educators are becoming increasingly aware of the impact of stresses on the students general well-being. The objective of the current study was to examine the prevalence of and risk factors for depressive and anxiety symptoms among first-year and fifth-year medical students. Additionally, we aimed to determine whether the COVID-19 pandemic has affected students’ mental well-being.MethodsA cross-sectional study was performed at the College of Medicine at King Saud University between September 2020 and January 2021. The target population was first-year and fifth-year medical students. Depressive symptoms were screened using the 9-item Patient Health Questionnaire (PHQ-9), while anxiety symptoms were screened using the 7-item Generalized Anxiety Disorder assessment (GAD-7). Students were also directly asked about the effect of the COVID-19 pandemic on their mental well-being. Outcomes were compared between groups using the chi-squared test and Student’s t test. Multivariate logistic regression analysis was performed to identify factors associated with depressive and anxiety symptoms.ResultsA total of 182 medical students were included. Depressive symptoms (52.9% versus 35.8%, p = 0.020) and anxiety symptoms (35.6% versus 26.3%, p = 0.176) were higher in the first-year students than in the fifth-year students. Approximately 19.2% of the students were worried about acquiring COVID-19, 49.4% were worried about academic performance, and 30.8% were feeling sad, depressed or anxious during the COVID-19 pandemic. Independent risk factors for depressive symptoms included having concomitant anxiety, being worried about acquiring COVID-19, being worried about academic performance, and feeling sad, depressed or anxious. Independent risk factors for anxiety included having a lower grade point average and having concomitant depressive symptoms.ConclusionMedical students have an alarmingly high prevalence of depressive and anxiety symptoms, which might have been negatively impacted by the COVID-19 pandemic. There is a need for a special mental health program targeting new and current medical students.

Association between recent COVID-19 diagnosis, depression and anxiety symptoms among slum residents in Kampala, Uganda.

Despite the known link between poor living conditions and mental health, there has been little research on the mental health of slum dwellers worldwide. Although the Coronavirus disease 2019 (COVID-19) pandemic has led to an increase in mental health issues, little focus has been given to the impact on slum dwellers. The study aimed to investigate the association between recent COVID-19 diagnosis and the risk of depression and anxiety symptoms among people living in an urban slum in Uganda. A cross-sectional study was conducted among 284 adults (at least 18 years of age) in a slum settlement in Kampala, Uganda between April and May 2022. We assessed depression symptoms and anxiety using validated Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder assessment tool (GAD-7) questionnaires respectively. We collected data on sociodemographic characteristics, and self-reported recent COVID-19 diagnosis (in the previous 30 days). Using a modified Poisson regression, adjusted for age, sex, gender and household income, we separately provided prevalence ratios and 95% confidence intervals for the associations between recent COVID-19 diagnosis and depressive and anxiety symptoms. Overall, 33.8% and 13.4% of the participants met the depression and generalized anxiety screening criteria respectively and 11.3% were reportedly diagnosed with COVID-19 in the previous 30 days. People with recent COVID-19 diagnosis were more likely to be depressed (53.1%) than those with no recent diagnosis (31.4%) (p<0.001). Participants who were recently diagnosed with COVID-19 reported higher prevalence of anxiety (34.4%) compared to those with no recent diagnosis of COVID-19 (10.7%) (p = 0.014). After adjusting for confounding, recent diagnosis with COVID-19 was associated with depression (PR = 1.60, 95% CI 1.09-2.34) and anxiety (PR = 2.83, 95% CI 1.50-5.31). This study suggests an increased risk of depressive symptoms and GAD in adults following a COVID-19 diagnosis. We recommend additional mental health support for recently diagnosed persons. The long-term of COVID-19 on mental health effects also need to be investigated.

Mental Health and Feeding Styles in Parents of Formula-Fed Infants.

Background: Nonresponsive feeding styles can contribute to rapid weight gain in infancy and subsequent obesity in childhood. There is a need to investigate factors such as parental mental health symptoms (stress, depression, and anxiety) that may contribute to nonresponsive feeding styles. The purpose of this study was to investigate the relationship between parental mental health symptoms and feeding styles in parents of healthy, term formula-fed infants during the first year of life. Methods: A cross-sectional, descriptive correlational design was employed using online surveys. We recruited participants through Facebook groups and pediatricians' offices. Instruments included a demographic questionnaire, the Perceived Stress Scale-10, Patient Health Questionnaire-Depression Module-9, 7-item Generalized Anxiety Disorder Assessment, and Infant Feeding Style Questionnaire. Results: Participants were 306 parents of formula-fed infants. Greater depressive symptoms was the strongest predictor of the pressuring style (β = 0.54), while greater symptoms of stress (β = -0.13) and anxiety (β = -0.28) were associated with lower pressuring scores. Greater depressive symptoms was the strongest predictor of the laissez-faire style (β = 0.48), while greater symptoms of stress (β = -0.17) and anxiety (β = -0.23) were associated with lower laissez-faire scores. Engaging in ≤50% of the infant's feeds was the strongest control variable predictor for the pressuring and laissez-faire styles. None of the mental health variables were significantly related to the restrictive style. Conclusions: We recommend increased screening for depressive symptoms in parents of infants and responsive feeding support, especially for those experiencing depressive symptoms.