Generalized Anxiety Research Articles

The long-term effect of surf therapy on posttraumatic stress, depression, and anxiety symptomology among current and former australian defence force members - A nonrandomised controlled longitudinal study in a community setting

BackgroundSurf therapy programs have demonstrated engagement among military samples, showing promising concurrent short-term reductions in symptoms of posttraumatic stress disorder, major depressive disorder, and generalised anxiety disorder; however, the long-term retained benefits of such programs have not been studied beyond three months. MethodsThis nonrandomised controlled longitudinal study recruited current and former Australian Defence Force personnel (N = 116) to examine the effect of a ten-session surf therapy program (n = 88) compared to a control group (no intervention; n = 28). Validated self-assessment measures of post-traumatic stress, depression and anxiety symptoms were recorded at pre and post intervention, and at one month, four months, and seven months follow up. ResultsLinear mixed model results reveal statistically significant post-program reductions in symptoms of posttraumatic stress (PCL-M; ß = −11.92, 95% CI [-17.44, −6.36]), depression (MDI; ß = −7.87, 95% CI [-12.35, −3.38]) and anxiety (GAD-7; ß = −4.02, 95% CI [-6.42, −1.57]), which were retained at 7-months follow-up. Clinically significant changes were also observed on all three outcomes. No changes were observed in the control group. Additional statistically significant beneficial effects for each model outcome were recorded for leisure surfing following the program. Most surf therapy participants continued surfing post program, indicating effective lifestyle change. ConclusionsThis is the largest quantitative surf therapy study among adults to date, and the first to follow up seven months post program. It confirms previous surf therapy findings of high engagement and transdiagnostic effects, and provides new clinically relevant knowledge by demonstrating retained beneficial effects regardless of continued surfing post program.

Examining the influence of anxiety and depression on medication adherence among patients diagnosed with acute myocardial infarction

BackgroundEffective medication adherence is vital for managing acute myocardial infarction (AMI) and enhancing patient well-being. This study aimed to evaluate medication adherence levels and associated factors among AMI patients using standardized assessment tools.MethodsEmploying a cross-sectional descriptive design, the study involved 210 patients diagnosed with acute myocardial infarction. Participants completed the General Medication Adherence Scale (GMAS), Hospital Anxiety and Depression Scale (HADS), and provided socio-demographic details.ResultsThe study revealed partial adherence to medications among AMI patients, with mean scores of 24.89 (± 3.64) out of 33. Notably, good adherence was observed in non-adherence due to patient behavior (mean ± SD = 11.8 ± 2.3 out of 15) and additional disease burden (mean ± SD = 8.65 ± 2.21 out of 12), while partial adherence was noted in non-adherence due to financial constraints (mean ± SD = 4.44 ± 1.34 out of 6). Patients reported mild anxiety (mean ± SD = 8.38 ± 2.81) and no depressive symptoms (mean ± SD = 7.43 ± 2.42). Multiple linear regression analysis indicated that employed status, younger age, shorter duration of MI, lower anxiety, and depression levels were associated with higher medication adherence. However, factors such as monthly income, gender, educational level, and marital status did not predict medication adherence.ConclusionThe study highlights the significance of addressing anxiety and depression levels and considering socio-demographic factors when designing interventions to enhance medication adherence among AMI patients. Further research is needed to explore additional determinants of medication adherence and develop tailored interventions to improve patient outcomes post-AMI.

Predominant approaches to measuring pregnancy-related anxiety in Sub-saharan Africa: a scoping review

BackgroundPregnancy-related anxiety significantly impacts maternal and fetal health in low- and middle-income countries (LMICs), including those within Sub-Saharan Africa (SSA). Most studies conducted to evaluate pregnancy-related anxiety in LMICs have utilized scales developed in high-income countries, despite significant variations in pregnancy-related anxiety due to socioeconomic and cultural contexts. This review surveyed existing literature in order to identify which scales have been used to measure pregnancy-related anxiety in SSA.MethodsA systematic search was conducted in PubMed, Health and Psychosocial Instruments, and APA PsycNet for relevant studies published in the English language up to March 22, 2023. Eligible studies focused on anxiety in pregnant populations within SSA, using validated scales or tools. Screening followed PRIMSA guidelines, with blinded review at the abstract/title level and subsequent full-text review. Data was extracted and analyzed to identify trends and characteristics of the screening tools used.ResultsFrom 271 articles, 37 met inclusion criteria, identifying 24 different tools used to measure anxiety in pregnant women in SSA. The most common tools were the Generalized Anxiety Disorder 7-item scale (seven uses), State-Trait Anxiety Inventory (five uses), and the Self-Reporting Questionnaire 20 (five uses). Seven tools were pregnancy-specific, with only two designed specifically for SSA: the Risk Factor Assessment (RFA), and the 4-Item Screening Tool. Studies were most frequently conducted in South Africa, followed by Tanzania, Ethiopia, Nigeria, and Ghana.ConclusionsThis scoping review illustrates that only two tools (the RFA and 4-item Screening Tool) were created to assess pregnancy-related anxiety specifically in SSA. This highlights the need for more culturally sensitive tools tailored to the specific contexts of pregnant populations in SSA.

Acceptance and Commitment Teletherapy for Mixed Anxiety and Depressive Symptoms During the COVID-19 Pandemic: A case Study

The present case details a successful treatment response to 21 sessions of Acceptance and Commitment Therapy (ACT) delivered via teletherapy for mixed anxiety and depressive symptomology during the COVID-19 pandemic. The client (“Natalie”), a 19-year-old, White, cisgender female, presented to a university training clinic reporting primary problematic anxiety consistent with a diagnosis of Generalized Anxiety Disorder. The therapist conceptualized Natalie’s anxiety through the ACT psychological flexibility model, wherein Natalie’s challenges appeared to be maintained by experiential avoidance and lack of committed action. This case highlights (a) the unique challenges of treating someone with pervasive anxiety amid the uncertain context of the COVID-19 pandemic, (b) repeated assessment of transdiagnostic processes to inform intervention focus, and (c) the process of ACT teletherapy. Symptom, process, and outcome measures taken bi-weekly throughout therapy suggested theoretically consistent and reliable treatment responses. Clinical implications of the case are discussed.

Study of Gaming Disorder and Its Association with Depressive Disorder and Anxiety among Medical Students in India

Abstract Context: Internet gaming disorder (IGD) was included in the 5th edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Addiction to Internet gaming is prevalent among Indian medical students. This study aims to measure the severity and pattern of gaming behavior along with the impact and association of IGD on different psychological conditions such as depression and anxiety. Methods: A cross-sectional study was conducted through an online survey among 845 medical students at a tertiary care teaching hospital in India. The Internet GD Scale-Short Form (IGDS9-SF) was used to assess the intensity of gaming disorders, while patient health questionnaire-9 (PHQ-9) and generalized anxiety disorder assessment (GAD-7) were used to assess the severity of depression and anxiety, respectively. Results: A total of 194 students were identified as current gamers, out of which 36 had gaming disorders based on DSM-5 diagnostic criteria for IGD from the current study sample. Multiple regression was calculated for the following age (B = 0.85, P = 0.002), weight (B = 0.07, P = 0.02), average time spent on gaming/day in hours (B = 1.01, P < 0.0001), PHQ-9 scores (B = 0.35, P ≤ 0.0001), GAD-7 scores (B = −0.24, P = 0.01) - Model R 2 = 0.35, F = 19.41, P < 0.0001. Conclusions: Potentially problematic gaming was found to be associated with psychological symptoms, negative affectivity, and a preference for solitude. There is a need for other studies that can help in creating awareness about the prevalence of gaming disorders in medical students.

Prevalence of Depression and Generalized Anxiety Among LGBTQ+ Medical Students in Thailand.

This study evaluated the prevalence and associated factors of depression and generalized anxiety among LGBTQ+ in five medical schools in Thailand. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to assess major depressive disorder (MDD) and generalized anxiety disorder (GAD), respectively, and multivariable logistic regression was employed to identify associated factors. Of 1,322 students, 412 (31.16%) identified as LGBTQ+. The prevalence for MDD and GAD among LGBTQ+ students were 32.77% and 17.23%, respectively. Significant associated factors for both MDD and GAD were a history of psychiatric illness (AOR for MDD = 2.32, p = .020; AOR for GAD = 3.67, p < .001), educational problems (AOR for MDD = 6.62, p < .001; AOR for GAD = 5.12, p < .001), and dissatisfaction with gender identity or sexual orientation (AOR for MDD = 1.92, p = .019; AOR for GAD = 2.47, p = .005). Additional factors associated with MDD were preclinical years (AOR = 2.30, p = .023), financial struggles (AOR = 2.05, p = .021), and inadequate peer support (AOR = 2.57, p = .044). In conclusion, nearly one-third and one-fifth of Thai LGBTQ+ medical students suffer from MDD and GAD, respectively. Our findings suggest that Thai medical schools should promote LGBTQ+ inclusivity to enhance students' identity satisfaction. Peer support groups should be encouraged, especially for preclinical LGBTQ+ students who face educational and financial challenges.

The mitigating role of social capital on the association between food insecurity and psychological distress among Chinese adults.

Food insecurity, a pervasive global issue exacerbated by the COVID-19 pandemic, has been linked to adverse mental health outcomes. However, the role of social capital in mitigating this relationship remains understudied, particularly in the Chinese context. This study investigated the associations between food insecurity and psychological distress (depressive and anxiety symptoms) and examined the potential moderating effects of bonding and bridging social capital among Chinese adults in Shanghai. This cross-sectional study included 3,220 Chinese adults (mean age: 34.45; 51.5% male) in Shanghai. Food insecurity was assessed using the modified Household Food Insecurity Access Scale, psychological distress was measured using the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7, and social capital was evaluated using the Revised Personal Social Capital Scale. Multivariable linear regression analyses revealed that food insecurity was significantly positively associated with both depressive (β = 0.449, SE = 0.024) and anxiety symptoms (β = 0.391, SE = 0.022), after adjusting for sociodemographic characteristics, health status, and COVID-19-related factors. Higher levels of bonding and bridging social capital were significantly associated with fewer depressive and anxiety symptoms. Significant interactions (p < .001) between bonding social capital and food insecurity indicated that the associations between food insecurity and psychological distress were less pronounced among adults with higher bonding social capital. These findings highlight the critical role of food insecurity as a risk factor for psychological distress and the importance of bonding social capital in mitigating its impact on mental health. Policies and interventions targeting food insecurity prevention and bonding social capital enhancement may promote better mental health outcomes among Chinese adults.

Impact of Central Sensitization on Clinical and Functional Aspects of Psoriatic Arthritis.

Background/Objectives: Psoriatic arthritis (PsA) is an inflammatory rheumatic disease characterized by peripheral arthritis, enthesitis, spondylitis and psoriasis. The objective of this study was to examine the prevalence of central sensitization (CS) and its impact on the clinical and functional aspects of PsA. Methods: Adult patients with PsA according to the Classification of Psoriatic Arthritis (CASPAR) criteria were included in this cross-sectional observational study. The Central Sensitization Inventory (CSI) was used to assess the presence of CS. The study evaluated the impact of CS on individuals by analyzing many factors including demographic information, laboratory findings, clinical features, disease activity, quality of life, severity of sleeplessness, frequency of depression and anxiety. The patients were categorized into distinct groups based on the existence and intensity of CS, and a comparative analysis was conducted on their respective outcomes. Results: A total of 103 PsA patients with a mean age of 43.2 (SD: 6.7) years and including 42 (40.8%) males were included. The mean CSI score was 45.4 (SD: 15.1), and 67 (65.1%) patients had CS. The logistic regression analysis revealed that the variables Psoriasis Area Severity Index (PASI), General Anxiety Disorder-7 (GAD-7), and Insomnia Severity Index (ISI) exhibit considerable predictive power in relation to the outcome variable CS (p < 0.05). PASI was observed as the most important variable in predicting CS (OR 9.70 95% CI: 1.52-62.21). Conclusions: CS has demonstrable efficacy in influencing laboratory, clinical, and functional markers among individuals with PsA. When assessing pain sensitivity in these patients, it is important to take into account the presence of CS.

Clinical characteristics of 217 Chinese cases with depersonalization/derealization disorder

Depersonalization/derealization disorder (DPD) is a prevalent yet inadequately understood clinical condition characterized by a recurrent or persistent sense of unreality. This study aims to provide insight into DPD through descriptive and comparative analyses involving a large group of Chinese participants. The socio-demographic details (age, gender proportion, education, occupational status, marital status), depersonalized and dissociative symptom characteristics (symptomatic factors or subscales of the Cambridge Depersonalization Scale and the Dissociative Experiences Scale), development trajectory (age of onset, potential precipitating factors, course characteristics), treatment history (duration of delayed healthcare attendance, duration of delayed diagnosis, previous diagnoses), and adverse childhood experiences of the DPD patients are presented. Comparisons of anxiety and depressive symptoms, alongside psychosocial functioning, between DPD participants and those diagnosed with generalized anxiety disorder, bipolar disorders, and major depressive disorder were conducted. The analysis highlights a higher male preponderance and early onset of DPD, symptomatology marked by derealization, notable impairment in psychosocial functioning, and prolonged periods of delayed healthcare attendance and diagnosis associated with symptom severity. Furthermore, noteworthy relationships between adverse childhood experiences and symptom levels were identified. The findings substantiate the view that DPD is a serious but neglected mental disorder, urging initiatives to improve the current condition of DPD patients.

Staying Active, Minding Health: Does Exercise Influence Depression and Anxiety in Herat University's Education Students?

Mental health issues are a major concern for public health worldwide, affecting a large segment of the global population. This study aims to investigate the association between physical activity, depression, and anxiety among students in the Faculty of Education at Herat University. A cross-sectional study was conducted during the fourth quarter of 2023 (October-December) encompassing a 204 sample of male students enrolled in the Faculty of Education at Herat University. We used a 13-item self-administered questionnaire to collect information on the participants’ sociodemographic details and physical activities. We assessed depression and anxiety using the standardized Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder 7-item (GAD-7) questionnaire, respectively. The data was scored and categorized according to the guidelines set for each instrument. Statistical analyses were performed in IBM SPSS Statistics (version 27). Of all participants in this study, 86.3% suffered from various degrees of depression and 71.6% suffered from various degrees of anxiety. A lack of a regular and organized weekly plan involving sports activities was associated with depression (p=0.009) and anxiety (p=0.024). Lack of regular weekly exercise in the past due to physical problems was associated only with anxiety (p=0.023). This study explored how physical activity relates to depression and anxiety in students at Herat University's Faculty of Education. We found that being physically active was linked to both lower depression and anxiety levels. The higher rates of depression and anxiety in our study might be due to social and environmental factors that the other studies didn't account for.

Síntomas de ansiedad y depresión en los trabajadores de la salud durante la pandemia por COVID-19 en un centro de salud en Barranquilla, Colombia

IntroductionThe spread of the pandemic in Colombian territory occurred heterogeneously, suggesting a potentially differential impact on the mental health of healthcare professionals who responded to the emergency. ObjectiveTo identify factors related to depressive and anxious symptoms in healthcare workers during the COVID-19 pandemic at a clinical center in the city of Barranquilla. MethodologyWe conducted a cross-sectional study involving 71 active healthcare workers in 2022. The Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder scale (GAD-7) were utilized to estimate the prevalence of these mental disorders. ResultsWe estimated a prevalence of depressive and anxious symptoms, mild or higher, at 18.3% (CI95% 10.1–29.3) and 21.1% (CI95% 12.3–33.4), respectively. Work experience, glove usage, gastrointestinal discomfort, and appetite disturbance were significantly associated with depressive symptoms, while loss of libido and appetite disturbance were linked to mild or higher anxious symptoms. ConclusionsDepressive and anxious symptoms are common in the mental health of healthcare workers in pandemic contexts. Factors associated with these symptoms, such as the use of personal protective equipment and work experience, could be addressed through organizational management.

The psychometric properties of the Swahili version of the Primary Care Post Traumatic Stress Disorder screen for DSM-5 among adults in Kenya.

The psychometric properties of the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) are undocumented in Kenya and sub-Saharan Africa (SSA) at large. This study aimed to evaluate the psychometric properties of the Swahili version of the tool, S-PC-PTSD-5, in a community sample of adults 18 years and older drawn from Nairobi, Mombasa and Kwale counties in Kenya. Analysis of cross-sectional data from 1431 adults from the community was conducted, examining the reliability, factorial structure, measurement invariance, and convergent and divergent validity of the interviewer-administered S-PC-PTSD-5. Out of 1431 adults who completed the S-PC-PTSD-5, 666 (46.5%) reported experiencing at least one traumatic event. Internal consistency of the S-PC-PTSD-5 was good overall, with alpha and omega values above 0.7. Confirmatory factor analysis (CFA) results indicated a one-factor structure of the S-PC-PTSD-5 for the overall sample. Multigroup CFA also demonstrated factorial invariance for sex for the one-factor structure of S-PC-PTSD-5. Scores for S-PC-PTSD-5 significantly correlated (positively) with those of generalized anxiety disorder (GAD7) and depressive symptoms (PHQ9), indicating convergent validity. S-PC-PTSD-5 scores also significantly correlated (negatively) with the WHO-5 wellbeing index, supporting divergent validity. The S-PC-PTSD-5 is a reliable and valid unidimensional measure. It appears to be a valuable screening measure for probable PTSD in both urban and rural community settings in Kenya. Nonetheless, to confidently identify those who may need treatment/additional support, further research on the reliability and validity of S-PC-PTSD-5 is required, especially its diagnostic accuracy at different cutoff scores.

Prevalence, Symptom Profiles, and Correlates of Mixed Anxiety-Depression in Male and Female Autistic Youth.

Relatively little attention has been given to mixed anxiety and depression in autistic youth, particularly how this differs between males and females. This study investigated sex-based differences in the prevalence and correlates of mixed anxiety and depression in a sample of 51 autistic males (M age = 10.16 yr, SD = 2.81 yr, and range = 6 yr to 17 yr) and 51 autistic females (M age = - 10.07 yr, SD = 2.76 yr, and range = 6 yr to 17 yr), matched for age, IQ, and autism severity. Self-reports on generalised anxiety disorder and major depressive disorder, morning salivary cortisol, ADOS-2 scores, and WASI-II full-scale scores were collected from these autistic youth, and data on the ASD-related symptoms of these youth were collected from their parents. The data were analysed for total anxiety-depression score levels, for the underlying components of this scale, and for the individual items used in the scale. The results indicate no significant sex differences for the prevalence of mixed anxiety and depression total scores or the underlying components of anxiety and depression or for the individual items of the mixed anxiety-depression scale. There were sex differences in the significant correlates of mixed anxiety and depression: morning cortisol and ASD-related difficulties in social interaction for females, and ASD-related behaviour for males. Males' feelings of being restless or edgy were correlated with their social interaction and repetitive and restricted behaviour. Females' difficulties in social interaction were correlated with their concerns about their abilities and their sleeping problems. Females' sleeping problems, their tendency to talk about dying, and feeling worthless, were correlated with their morning cortisol. These findings suggest that, while mixed anxiety and depression is experienced similarly by autistic males and females at the global, component, and individual item levels, specific aspects of the symptomatology of mixed anxiety and depression are differently associated with aspects of their ASD-related symptomatology and their levels of chronic physiological stress for males and females.

Anxiety and depression among individuals with long COVID: Associations with social vulnerabilities

BackgroundWe examined the association between symptoms of anxiety and depression among individuals with long COVID and five social vulnerabilities (expenses, employment, food insufficiency, housing, and insurance). MethodsData from the Census Bureau's Household Pulse Survey (HPS) detailing COVID incidence, duration, and symptoms between June 1st and November 14th, 2022 contained versions of the Generalized Anxiety Disorder (GAD-2) and the Patient Health Questionnaire (PHQ-2) questionnaires. Associations between anxiety, depression, and the five social vulnerabilities among respondents from different racial and ethnic groups experiencing long COVID were evaluated using generalized binomial logistic regression. Structural equation models tested whether social vulnerabilities mediated the pathway between race/ethnicity and anxiety/depression. ResultsBlacks, Asians/others, and Hispanics with long COVID were significantly more likely to report anxiety and depression and various social vulnerabilities than Whites. Anxiety among Blacks was significantly associated with difficulty with expenses [Odds Ratio (OR) = 1.743, 95 % Confidence Interval (CI) = 1.739, 1.747], employment (OR = 1.519, 95 % CI = 1.516, 1.523), and housing (OR = 1.192, 95 % CI = 1.19, 1.194). Anxiety among Hispanics was significantly associated with food insufficiency (OR = 1.048, 95 % CI = 1.044, 1.052). Depression among Blacks was significantly associated with trouble with expenses (OR = 1.201, 95 % CI = 1.198, 1.205) and employment (OR = 1.129, 95 % CI = 1.127, 1.132). Mediation analysis showed that the number of social vulnerabilities partially mediated the association between race and anxiety. LimitationsThis retrospective study utilized secondary, observational, self-reported data from the HPS. Therefore, results may not be generalizable outside of the context in which they were collected. ConclusionsThe development of tailored programs for population health should address the differential associations of anxiety and depression with social difficulties among racial and ethnic groups.

Comparing network structures of depressive and anxiety symptoms between demographically-matched heart disease and heart disease free samples using propensity score matching: Findings from the Chinese Longitudinal Healthy Longevity Survey (CLHLS)

BackgroundOlder adults with heart disease often experience higher rates of comorbid anxiety and depression. This study examined depression and anxiety network structures among older adults with heart disease and their heart disease free peers. MethodsNetwork analyses of secondary cross-sectional data from the 2017 to 2018 wave of CLHLS were used to construct groups of older adults with and without heart disease using propensity score matching. Depression and anxiety symptoms were assessed using Center for Epidemiological Studies Depression Scale and Generalized Anxiety Disorder Scale, respectively. Central symptoms and bridge symptoms were identified using expected influence. Results1689 older adults with heart disease and matched control sample of 1689 older adults without heart disease were included. The prevalence and severity of depression and anxiety were significantly higher in older adults with heart disease compared to the control group. There was no significant difference in overall structures of depression and anxiety network models between two the groups. Key central symptoms and bridge symptoms within these groups were highly similar; GAD 2 “Uncontrollable worrying” and GAD 4 “Trouble relaxing” were identified as the most central symptoms, while GAD 1 “Nervousness” and CESD 1 “Feeling bothered” were identified as key bridge symptoms across both network models. ConclusionDepression and anxiety are more prevalent in older adults with heart disease than demographically-matched heart disease free controls. However, network structures of these symptoms do not differ between two groups. Accordingly, depression and anxiety psychosocial interventions developed for older adults without heart disease may also benefit older adults with heart disease.

Variations in objectively measured sleep parameters in patients with different premature ejaculation syndromes.

Poor sleep quality is now a cause of sexual dysfunction. To investigate variations in sleep quality among patients with different types of premature ejaculation (PE) and a control group. Patients with PE were categorized into groups according to 4 types: lifelong (LPE), acquired (APE), variable (VPE), and subjective (SPE). Basic demographic information about the participants was first collected, and then clinical data were obtained. Outcomes included the 5-item International Index of Erectile Function, Premature Ejaculation Diagnostic Tool, 7-item Generalized Anxiety Disorder, 9-item Patient Health Questionnaire, Pittsburgh Sleep Quality Index, self-estimated intravaginal ejaculation latency time (minutes), and sleep monitoring parameters obtained from a wearable device (Fitbit Charge 2). A total of 215 participants were enrolled in the study, of which 136 patients with PE were distributed as follows: LPE (31.62%), APE (42.65%), VPE (10.29%), and SPE (15.44%). Subjective scales showed that patients with APE were accompanied by a higher prevalence of erectile dysfunction, anxiety, and depression, as well as poorer sleep quality (assessed by the Pittsburgh Sleep Quality Index). The results of objective sleep parameters revealed that average durations of sleep onset latency (minutes) and wake after sleep onset (minutes) in patients with APE (mean ± SD; 20.03 ± 9.14, 55 ± 23.15) were significantly higher than those with LPE (15.07 ± 5.19, 45.09 ± 20.14), VPE (13.64 ± 3.73, 38.14 ± 11.53), and SPE (14.81 ± 4.33, 42.86 ± 13.14) and the control group (12.48 ± 3.45, 37.14 ± 15.01; P < .05). The average duration of rapid eye movement (REM; minutes) in patients with APE (71.34 ± 23.18) was significantly lower than that in patients with LPE (79.67 ± 21.53), VPE (85.93 ± 6.93), and SPE (80.86 ± 13.04) and the control group (86.56 ± 11.93; P < .05). Similarly, when compared with the control group, patients with LPE had significantly longer durations of sleep onset latency and wake after sleep onset and a significantly shorter duration of REM sleep. Our study suggests that clinicians should pay attention not only to male physical assessment but also to mental health and sleep quality. This study suggests that changes in sleep structure occur in patients with PE, which may provide some direction for future research. However, the cross-sectional study design does not allow us to conclude that sleep is a risk factor for PE. After controlling for traditional parameters such as age, erectile dysfunction, anxiety, and depression, sleep parameters are independently associated with PE. Patients with APE and LPE show significant alterations in sleep parameters, with patients with APE having notably poorer sleep quality, whereas patients with VPE and SPE have sleep parameters similar to controls.

A comparative study on hair cortisol concentration among generalized anxiety disorder patients with and without alcohol dependence syndrome presenting to a tertiary care center: A pilot study.

Generalized anxiety disorder (GAD) affects up to 6% of the population, which if not detected early and adequately treated will continue as a hidden impairment resulting in disability. The primary objective of the study is to assess the hair cortisol levels (HairF) in persons with GAD with and without alcohol dependence syndrome (ADS), and the secondary objective is to assess whether HairF can be used as a biomarker for assessment of GAD. This comparative study was done on 94 subjects (68 persons with GAD with or without ADS and 26 healthy controls) who were divided into three groups. Hamilton Anxiety Rating Scale (HAM-A) and Patient Health Questionnaire-4 (PHQ4) were also used to assess severity of anxiety symptoms. These scores were compared with HairF. Diagnostic accuracy of the HairF analysis test was done. Statistical analysis was done using SPSS version 20. The study found higher levels of HairF in persons with GAD (mean 189.4 ± 33.1) and GAD with ADS (164.2 ± 47.6) compared to healthy controls (mean 45.34 ± 40.7), which were statistically significant. Correlation of HAM-A and PHQ4 scores and HairF also showed positive correlation. The receiver operating characteristic curve suggested the best cutoff point at 88.4 pg/mg with a sensitivity of 98.5% and a specificity of 92.5%, clearly differentiating GAD from healthy controls. HairF were found to be higher in patients with GAD irrespective of ADS as comorbidity. The study supports the possibility of the HairF as a possible biomarker to detect GAD and play a complementary role in a multidimensional approach for management of chronic stress and anxiety.

The case for eliminating excessive worry as a requirement for generalized anxiety disorder: a cross-national investigation.

Around the world, people living in objectively difficult circumstances who experience symptoms of generalized anxiety disorder (GAD) do not qualify for a diagnosis because their worry is not 'excessive' relative to the context. We carried out the first large-scale, cross-national study to explore the implications of removing this excessiveness requirement. Data come from the World Health Organization World Mental Health Survey Initiative. A total of 133 614 adults from 12 surveys in Low- or Middle-Income Countries (LMICs) and 16 surveys in High-Income Countries (HICs) were assessed with the Composite International Diagnostic Interview. Non-excessive worriers meeting all other DSM-5 criteria for GAD were compared to respondents meeting all criteria for GAD, and to respondents without GAD, on clinically-relevant correlates. Removing the excessiveness requirement increases the global lifetime prevalence of GAD from 2.6% to 4.0%, with larger increases in LMICs than HICs. Non-excessive and excessive GAD cases worry about many of the same things, although non-excessive cases worry more about health/welfare of loved ones, and less about personal or non-specific concerns, than excessive cases. Non-excessive cases closely resemble excessive cases in socio-demographic characteristics, family history of GAD, and risk of temporally secondary comorbidity and suicidality. Although non-excessive cases are less severe on average, they report impairment comparable to excessive cases and often seek treatment for GAD symptoms. Individuals with non-excessive worry who meet all other DSM-5 criteria for GAD are clinically significant cases. Eliminating the excessiveness requirement would lead to a more defensible GAD diagnosis.

Predictive models of post-traumatic stress disorder, complex post-traumatic stress disorder, depression, and anxiety in children and adolescents following a single-event trauma.

This study examined the power of theory-derived models to account for the development of PTSD, Complex PTSD (CPTSD), depression, and anxiety in children and adolescents who had experienced a single-event trauma. Children (n = 234, aged 8-17 years) recruited from local Emergency Departments were assessed at two and nine weeks post-trauma. Data obtained from self-report questionnaires completed by the child, telephone interviews with parents, and hospital data were used to develop four predictive models of risk factors for PTSD, CPTSD, depression, and Generalized Anxiety Disorder (GAD). ICD-11 proposed diagnostic criteria were used to generate measures for CPTSD and PTSD to assess for risk factors and identify the sample prevalence of these disorders. At nine weeks post-trauma, 64% did not meet criteria for any disorder, 23.5% met criteria for PTSD, and 5.2% met criteria for CPTSD. 23.9% and 10.7% had developed clinically significant symptoms of depression and GAD, respectively. A cognitive model was the most powerful predictive model, a psychosocial model was weak, and subjective markers of event severity were more powerful than objective measures. Youth exposed to single-incident trauma may develop different forms of psychopathology, and PTSD and CPTSD are frequently experienced alongside other conditions. The cognitive model of PTSD shows utility in identifying predictors of PTSD, CPTSD, depression, and GAD, particularly the role of trauma-related negative appraisals. This supports the application of cognitive interventions which focus upon re-appraising trauma-related beliefs in youth.

Cross-sectional analysis of healthcare worker mental health and utilisation of a digital mental health platform from 2020 to 2023

BackgroundHealthcare worker (HCW) anxiety and depression worsened during the pandemic, prompting the expansion of digital mental health platforms as potential solutions offering online assessments, access to resources and counselling. The...