HADS Scores Research Articles

Depressive symptoms in the general population: The 7th Tromsø Study

• In an adult population (≥40 years), participants in the age groups 40–49 and 80+ reported the highest prevalence of depressive symptoms. • Measured by the Hospital Anxiety and Depression Scale (HADS), men reported higher prevalence of depressive symptoms than women, but the difference disappeared after controlling for other factors. • Low social support, low education and living without a spouse increased the risk for depressive symptoms. The prevalence of depressive symptoms may differ in various age groups. The aim of the study was to investigate the point-prevalence of depressive symptoms in the adult general population and in various age groups. The impact of sex, marital status, education, and social support on depressive symptoms was also explored. The population ≥40 years in the city of Tromsø, Norway, were invited to participate in the survey, of whom 64.7% (n=21,083) participated. All participants with a completed Hospital Anxiety and Depression Scale (HADS) were included in the study. A score ≥8 in the HADS depression subscale (HADS-D) was used to indicate caseness for depression. The caseness for depression was 7.5% for men and 6.3% for women, overall 6.9%. The age groups 40-49 years and 80+ years had highest caseness. The overall HADS-D score for the total population was 2.8 (SD 2.7). The mean HADS-D for men (3.1; SD 2.8) was higher than for women (2.6; SD 2,6) (p<0.001). Low social support, low education and not living with a spouse was associated with higher risk for depressive symptoms. The prevalence of depressive symptoms was based on a questionnaire, and represents only an estimate of depression in the population. Participants over 80 years were underrepresented, as fragile elderly and elderly living in nursing homes did not participate. Depressive symptoms were more prevalent in the youngest and oldest age groups. Participants reporting low social support, low education and not living with a spouse had higher risk for depressive symptoms.

Correlation between Indonesian Version of Montreal Cognitive Assessment Score and Hospital Anxiety and Depression Scale Scores for Post-Stroke Patients

Background: Cerebrovascular disease, with its complex anatomy, and various parts of the brain can cause neurological deficits. The Oxfordshire Community Stroke Project classification distinguishes a posterior circulation infarct (PCI) from an Anterior Circulation Infarction (ACI) by using radiological examination. Anxiety after stroke occurs in about 24% of patients and it is a problem with quality of life associated with poor health. In Post Stroke Anxiety (PSA), there are still few studies on prevention, risk factors and therapeutic interventions. More than 40% of stroke sufferers have cognitive impairment or post stroke cognitive impairment (PSCI). &#x0D; Objectives: To determine the correlation between Indonesian Version of Montreal Cognitive Assessment Score (MoCA-INA) and the Hospital Anxiety and Depression Scale Scores (HADS-A) for post-stroke patients in neurological road care installation in University of Sumatera Utara Hospital. &#x0D; Methods: This is a numerical correlation study with a cross-sectional approach.. The sampling method is non-probability sampling with consecutive sampling type. The research subjects were then examined for the total MOCAINA score. Then, the research subjects are examined for HADS-A. After all the results of the examination, the questionnaire and the subject's personal data are completely filled in, the questionnaire is collected. The analysis uses the Spearman correlation test &#x0D; Results: The results of the analysis using the Spearman correlation test for the correlation between MoCA-INA total score and HADS-A total score, the value of r is -0.602 with p value &lt;0.001 (the correlation is very significant with negative correlation direction and the strength of the correlation is strong). &#x0D; Conclusions and Suggestions: With the influence of MoCa-INA score on the HADS-A score in post-stroke patients, it can provide an input for health workers to immediately detect and anticipate events of cognitive decline and anxiety in post-stroke patients.

Does Surgical Treatment Affect the Degree of Anxiety or Depression in Patients With Degenerative Cervical Myelopathy?

Retrospective cohort study. Preoperative mental state has been reported as one of the factors affecting the surgical outcomes of spine surgery, but few studies have examined in detail how patients' mental state is affected by spine surgery. The purpose of this study was to investigate using the Hospital Anxiety and Depression Scale (HADS) whether surgery improves preoperative depression and anxiety in patients with degenerative cervical myelopathy. We investigated patient-reported outcomes (Mental Component Summary, Physical Component Summary of SF-12 Health Survey, and EQ-5D, Neck Disability Index, JOACMEQ, satisfaction with treatment) and HADS one year after surgery, comparing them before and after surgery between April 2017 and February 2020. Among the cases diagnosed as preoperative anxiety and depression, we additionally compared the patient-reported outcomes based on the presence or absence of postoperative improvement in mental state, having also investigated the correlation between patient-reported outcomes and HADS for sub-analysis. Among the 99 patients eligible for inclusion in the present study, we found that patient-reported outcomes and the HADS scores improved significantly after surgery. There was a moderate correlation between the amount of change in HADS-D score before and after surgery and the amount of change in NDI (moderate, r = .41), NRS of neck (moderate, r = .46), and JOACMEQ (cervical spine function; moderate, r = .43, upper extremity function; moderate, r = .41, QOL; moderate, r = .41). We found that surgical treatment for patients with degenerative cervical myelopathy may improve postoperative anxiety and depression as well as other patient-reported outcomes.

Health-related quality of life in patients with alopecia areata: Results of a Japanese survey with norm-based comparisons.

Alopecia areata (AA) is a non‐scarring hair loss disorder affecting approximately 2% of the global population. AA is reported to have a significant negative impact on the emotional and psychological well‐being of the patients. This study aimed to evaluate the health‐related quality of life (HRQoL) of Japanese patients with AA in comparison to the Japanese population norms (national standard values for Japanese) using Short Form Health Survey 36 Item Version 2.0 (SF‐36v2). The study also aimed to access the negative effect of AA on patients’ daily lives and the proportion of patients having anxiety and/or depression. This cross‐sectional, non‐interventional web‐based survey study included 400 participants aged 17–84 years currently suffering from medically diagnosed AA. The assessment tools integrated in the online questionnaire included SF‐36v2, the Dermatology Life Quality Index (DLQI), and the Hospital Anxiety and Depression Scale (HADS). All outcome measures from the tools were evaluated across the study population. SF‐36v2 subscale scores for patients with AA revealed lower scores specifically for mental health (45.7 ± 10.1 points), social functioning (45.8 ± 10.9 points), vitality (46.2 ± 9.8 points), and role emotional (46.9 ± 11.6 points) as compared to the Japanese population norms of 50 ± 10 points each. The DLQI questionnaire‐based analysis indicated that 32.1% of respondents showed a moderate to extremely large effect on their lives; and HADS‐A (anxiety) and HADS‐D (depression) scores categorized 46.0% and 41.8% respondents as doubtful‐to‐definite cases, respectively. Multivariate linear regression revealed that hair loss range, age, comorbidities, and depression significantly worsened DLQI scores. In conclusion, the results of this survey demonstrated that a significant decrease in the HRQoL scores was observed in Japanese patients with AA in comparison with the national norms. Hence, emphasis on mental health is crucial for AA management.

The efficacy of live music for adolescent and young adult patients during hematopoietic stem cell transplantation.

Music therapy can improve mood in patients undergoing hematopoietic stem cell transplantation (HSCT). However, live music (LM) delivered by professional music therapists is not common in developing countries owing to the shortage of professional music therapists. Thus, in this study, we explored the effects of a multidisciplinary collaborative intervention based on LM on physical and psychological well-being of adolescent and young adult (AYA) patients undergoing HSCT with a quasi-experimental design. A total of 62 AYA patients agreed to participate and were randomly assigned to the intervention group receiving 4-week LM therapy (n = 31) or control group receiving usual care (n = 31). Depression, salivary cortisol, fatigue, and quality of life were the main outcome indicators measured at baseline, immediately after the intervention, 1month, and 3months follow-up. The intervention effects were analyzed by generalized estimating equations. Significant decrease in HADS-D scores occurred in the intervention group compared with wait-list controls at immediately after intervention (p < 0.05). Participants in the LM group had greater improvement in quality of lifeand lower salivary cortisol level than those in the wait-list control group at immediately, 1month, and 3months after intervention (p < 0.05). However, the interaction effects of the BFI scores were not significant. LM therapy significantly alleviated depression and salivary cortisol levels as well as improved quality of life of AYA patients undergoing HSCT.

Health-Related Quality of Life in Patients with Inflammatory Bowel Disease in Clinical Remission: What Should We Look For?

Background and Objectives: Inflammatory bowel diseases (IBD) are chronic conditions with an unpredictable evolution that can have a negative impact on patients’ quality of life (QoL). Even though patients in remission have a better QoL compared to patients with active disease, they still have a lower QoL compared to healthy people. The aim of this study is to identify the factors that are associated with a lower QoL in patients with IBD in clinical remission, in a tertiary IBD center in Romania. Materials and Methods: Ninety-seven adult patients with a current diagnosis of IBD for over 3 months who were in clinical remission were enrolled in this study. Pregnant women, patients with ostomy, perianal disease, extraintestinal manifestations or other significant comorbidities were excluded. Out of the 97 patients, 63.9% were men. The median age was 39 years (IQR 29–47), and the median disease duration was 5 years (IQR 2–10). Disease activity was assessed using the SCCAI score for ulcerative colitis and HBI score for Crohn’s disease. Remission was defined for SCCAI score ≤ 1 and HBI score ≤ 4. The health-related quality of life (HR-QoL) was assessed using the IBDQ32 score. FACIT-Fatigue was used to evaluate the level of fatigue. Patients with symptoms of anxiety or depression were identified with the HADS score. Symptoms of anxiety were considered when HADS-A >7 points and symptoms of depression when HADS-D >7 points. Results: Sixty-five patients (67%) were diagnosed with CD and the remaining 32 (33%) with UC. Ninety-three patients (95.9%) were on biological therapy. The mean IBDQ score (total score) was 190.54 points (SD +/− 8.2). The mean FACIT Fatigue score was 42.5 (SD +/− 8.2), with 6.2% of patients suffering from severe fatigue (FACIT Fatigue < 30 points). A total of 33% of patients had symptoms of anxiety and 16.5% of depression. Exposure to more than one biologic therapy (p = 0.02), fatigue (p < 0.001) and symptoms of anxiety (p < 0.001) were associated with a lower HR-QoL in the multivariate analysis. Female patients, patients with Crohn’s disease, patients with anemia and patients with symptoms of depression also had a lower HR-QoL, but this did not reach statistical significance in our study. Conclusions: Exposure to a higher number of biological agents (patients that switched multiple biologics), the presence of fatigue and symptoms of anxiety impair the HR-QoL of patients with IBD in clinical remission. Further studies should assess in a prospective manner whether early identification of these factors with prompt clinical interventions could lead to a better HR-QoL in these patients.

Assessing the role of stressful life events in the induction and recurrence of alopecia areata: A case-control study

Assessing the role of stressful life events in the induction and recurrence of alopecia areata: A case-control study

Psychological Impact of Cancer Risk Assessment: Anxiety, Depression and Distress in an Italian Sample

Purpose: Evaluating whether and how anxious and depressive symptoms change from prior to Oncological Genetic Counseling (OGC) to one month following BRCA genetic test result. Short-term psychological impact of genetic test disclosure in an Italian sample was also assessed. Methods: 106 Italian natives completed Hospital Anxiety and Depression scale (HADs) both before accessing OGC (t1) and one month following their test result (t2). In t2 they also completed the Italian translation of Multidimensional Cancer Risk Assessment (MICRA). Results: An overall reduction of HADs scores over time in BRCA-carriers was observed. Higher distress median values (MICRA) were found in carriers than non-carriers. Discussion: In carriers, the simultaneous presence of both a reduction of anxiety/depression and a greater distress should be explained basing on Post- Traumatic-Growth studies in cancer patients. Being a carrier may represent an explanation for cancer disease, and allow patients to access specific riskreduction programs.

Comparison of behavioral orthopedic and classical orthopedic rehabilitation : Aretrospective cohort study on the factors of mental comorbidity, gender and employment status

Mental comorbidity plays an increasingly important role in determining the specific rehabilitation needs of patients in Germany in the context of other personal, social and occupational factors. In order to make the DRV's list of criteria more meaningful when assigning patients to one type of rehabilitation, this retrospective analysis is intended to determine from which of the two rehabilitation concepts examined (orthopedic rehabilitation or healing procedures(HV)/behavioral-medical orthopedic rehabilitation (BMOR)) patients with mental comorbidity (taking into account gender, employment status of the main orthopedic diagnosis) benefit more. Using the screening questionnaires HADS‑A, HADS‑D, SIMBO and BPI as well as ahospital questionnaire at the beginning of rehabilitation, data from 913 subjects (529 m/384w) were collected and evaluated. Of these, 43% were assigned to HV and 57% to BMOR. Thus, in addition to the main orthopedic diagnosis, the frequency distribution of the factors psychological comorbidity, sex and, employment status (in the sense of unemployment) was determined. Using HADS, the benefit was determined at the end of the therapy by comparing the score medians. Frequency distributions and the development of HADS scores show that the prior classification according to psychological comorbidity was correct. Women were more often affected by mental comorbidity and women achieved greater success in BMOR. Regarding the main orthopedic diagnosis, ahigh prevalence of cervical and lumbar spine complaints was found. According to logistic regression with model decomposition, the variables gender, HADS‑A and -D at the beginning of rehabilitation and the psychological comorbidity (yes/no) are suitable to correctly allocate the patients with 76.86% to one of the two types of therapy. The presence of mental comorbidity appears to be auseful indicator that should be retained in the DRV's criteria catalog as one of the main criteria for allocation to BMOR. Female gender in connection with the presence of mental co-morbidity can also be considered aconclusive criterion. With regard to the main orthopedic diagnosis, cervical spine complaints may be particularly suitable as an allocation criterion.

Rotator cuff outcomes and mental health indices: Correlation or causation?

Psychological factors such as catastrophizing, anxiety, and depression influence clinical outcomes in many conditions. Our purpose was to examine trends and associations between these and outcomes of rotator cuff surgery. 148 patients (76 W:72 M, 55.1 ± 8.2 years) with unilateral symptomatic rotator cuff syndrome were followed for 1 year after surgery. The Western Ontario Rotator Cuff Score (WORC), the Pain Catastrophizing Score (PCS), and the Hospital Anxiety and Depression Score (HADS) were administered. Evolution and associations of WORC, HADS and PCS scores were examined using uni- and multivariate analyzes. At 1 year, PCS, HADS-A, and HADS-D scores negatively correlated with WORC score (R = -0.6, -0.61, -0.69). The strength of correlation was lower between baseline PCS, HADS-A, and HADS-D scores and 1-year WORC score (R = -0.38, -0.43, -0.42). Prior anxiety diagnosis was associated with higher HADS-A scores at 2- and 6- weeks post-op (p = 0.013, 0.011). 106 participants experienced an improving HADS-D over the year of follow-up. Worse pre-op pain, WORC, PCS, HADS-A, HADS-D, cardiovascular disease and current smoking were associated with non-improving HADS-D. Patient-reported outcomes of rotator cuff surgery are associated with patient-reported anxiety, depression, and pain catastrophizing. In many, all outcome scores improved over time suggesting a two-way association between shoulder condition and psychological parameters. II.

Correlation and Influencing Factors Between Laryngopharyngeal Reflux Disease and Sleep Status in Patients.

ObjectiveTo observe the correlation between laryngopharyngeal reflux disease (LPRD) and patients' sleep status, and to explore the related factors of LPRD.MethodsFour hundred and sixteen patients who visited the otorhinolaryngology clinic in our hospital from June 2019 to June 2021 were selected as the research subjects. According to the scale of reflux symptom index, the subjects were divided into a patients group (120 patients) with an the reflux symptom index (RSI) > 13 and a control group (296 patients) with an RSI ≤ 13 according to the RSI scale score. General patient information was collected. The sleep state and emotional state of patients in the two groups were evaluated, and the related influencing factors for LPRD were also evaluated. The correlation between sleep state and depression in LPRD patients was analyzed.ResultsFour hundred and sixteen patients were divided into patients group and control group according to RSI score, the ratio of the two groups was 1:2.47. In the patients group, the common symptoms of RSI score and the top three of the total score were as follows: Foreign body sensation in throat in 112 patients, 438 points; Keep voice clear in 108 patients, 381 points; Excessive phlegm or nasal discharge reflux in 101 patients, 348 points. The PSQI and HADS scores in the patients group were higher than those in the control group (t = 19.990, 13.007, 14.690, P all <0.001). Logistic regression analysis showed that high-fat diet and high PSQI score were the risk factors for the development of LPRD (P = 0.012, P = 0.007). According to the PSQI score, the patients in the patients group were divided into 35 patients with abnormal PSQI score, 85 patients with normal PSQI score, and the HADS scores of those with abnormal PSQI score were all lower than those with normal PSQI score (P > 0.05). The PSQI score of the patients in the patients group was positively correlated with the HADS score (r = 0.714, P = 0.013).ConclusionSleep disorder may lead to the occurrence or aggravation of anxiety and depression in patients with LPRD, and it is an independent risk factor for the development of LPRD. Clinical attention to the treatment of sleep disorders in patients with LPRD may be conducive to improving the efficacy of LPRD.

Application of High-Quality Nursing Intervention Based on Humanistic Care Combined with the Project Teaching Method in Patients with Acute Leukemia Undergoing Chemotherapy.

Chemotherapy, the main treatment method of AL, can produce varying degrees of toxic and side effects on patients while killing tumor cells, resulting in decreased immune function of patients. We aim to explore the application effect of high-quality nursing intervention based on humanistic care combined with the project teaching method on patients with acute leukemia (AL) undergoing chemotherapy and its effect on their psychological state and satisfaction. 114 AL patients undergoing chemotherapy in the Department of Hematology of our hospital from July 2018 to July 2020 were chosen as the research objects and equally randomized into the experimental group (EG) and control group (CG). CG received routine nursing during chemotherapy, while EG received high-quality nursing intervention based on humanistic care combined with the project teaching method. Hospital Anxiety and Depression Scale (HAD) was adopted to evaluate the psychological state of patients in both groups after intervention, and the self-made nursing satisfaction questionnaire in our hospital was applied to evaluate the clinical nursing satisfaction. The HAD-A and HAD-D scores in the CG (P < 0.001) were significantly higher than the HAD-A and HAD-D scores in the EG after intervention. The scores of various coping styles in the EG after intervention were better than those in the CG (P < 0.05). Compared with the CG, the total nursing satisfaction after intervention was remarkably higher in the EG (P < 0.001), while the total incidence of adverse reactions during intervention was notably lower (P < 0.05). High-quality nursing intervention based on humanistic care combined with the project teaching method for AL patients undergoing chemotherapy can effectively relieve negative emotions, improve clinical nursing satisfaction, and reduce adverse reactions during chemotherapy.

Integrating healthcare for follow-up of adult COVID-19 patients in an outpatient clinic: A matter of cooperation.

Rationale, aims, and objectivesA large number of patients infected with SARS‐CoV‐2 (COVID‐19) need outpatient follow‐up after hospitalization. As these patients may experience a broad range of symptoms, as do patients infected with the related SARS‐CoV‐1 virus, we set up a multidisciplinary outpatient clinic involving pulmonologists, internists, and geriatricians. Patients were allocated to a specialist based on symptoms reported on a self‐developed questionnaire of expected symptoms of COVID‐19. This study aimed to evaluate the effectiveness of this outpatient clinic.MethodsIn this retrospective study, the medical records of patients who presented to the outpatient clinic for follow‐up after hospitalization for COVID‐19 up to 31 August 2020, were reviewed.ResultsIn total, 266 patients were seen at the outpatient clinic at least once. Overall, 100 patients were seen by a pulmonologist, 97 by an internist, and 65 by a geriatrician. A referral between these 3 medical specialists was needed for only 14 patients (5.3%). Fifty patients were seen by a psychologist, mostly those with a HADS score >10. Only 5 (2.2%) of the 221 patients who were not directly referred to a psychologist based on triage needed psychological support. Forty‐eight patients (18%) were also seen by a physiatrist.ConclusionIdentifying which medical specialist (pulmonologist, internist, and/or geriatrician) should see patients attending a post‐COVID outpatient clinic based on patient‐reported symptoms proved an effective approach to managing the flow of post‐COVID patients.

Hyperintensities of middle frontal gyrus in patients with diabetic optic neuropathy: a dynamic amplitude of low-frequency fluctuation study.

Diabetic optic neuropathy (DON) is a diverse complication of diabetes and its pathogenesis has not been fully elucidated. The purpose of this study was to explore dynamic cerebral activity changes in DON patients using dynamic amplitude of low-frequency fluctuation (dALFF). In total, 22 DON patients and 22 healthy controls were enrolled. The dALFF approach was used in all participants to investigate dynamic intrinsic brain activity differences between the two groups. Compared with HCs, DON patients exhibited significantly increased dALFF variability in the right middle frontal gyrus (P < 0.01). Conversely, DON patients exhibited obviously decreased dALFF variability in the right precuneus (P < 0.01). We also found that there were significant negative correlations between HADS scores and dALFF values of the right middle frontal gyrus in the DON patients (r = -0.6404, P <0.01 for anxiety and r = -0.6346, P <0.01 for depression; HADS, Hospital Anxiety and Depression Scale). Abnormal variability of dALFF was observed in specific areas of the cerebrum in DON patients, which may contribute to distinguishing patients with DON from HCs and a better understanding of DON, hyperintensities of right middle frontal gyrus may be potential diagnostic marker for DON.

P392 To study the prevalence of depression and anxiety in patients of Inflammatory Bowel Disease (IBD) and the efficacy of psychopharmacotherapy in these patients: A pilot study

Abstract Background There is high prevalence of psychiatric disorders amongst IBD patients which independently affect quality of life. Studies have shown psychological stress leads to IBD flare. Non pharmacological psychotherapy has been studied in treatment of IBD, but not psychopharmacotherapy. We feel treatment for mental disorders in IBD patients may improve outcomes. Methods This is a prospective, observational single centre pilot study. After ethics committee approval, 200 patients were accrued between November, 2019 &amp; June, 2021, with, 1 year follow up for patients with anxiety or depression. All patients &amp;gt;18 years with Ulcerative Colitis (UC)/Crohn’s disease (CD) were enrolled. We excluded patients with IBD-Unclassified, post ileostomy/colostomy, on biologicals, malignancy. For assessing disease activity in UC we used UCEIS &amp; pMAYO scores; CDEIS &amp; Harvey-Bradshaw scores for CD. HADS-A &amp; HADS-D scores were used to determine anxiety and depression, respectively. Patient with HADS-A or HADS-D &amp;gt;, 7 were considered to have significant anxiety/depression, were given psychopharmacotherapy as per psychiatrist. All patients received IBD therapy as per standard of care. These patients were followed up at, 3, 6, 9 and, 12 months to assess the clinical parameters and HADS scores at each visit. Colonoscopy was repeated after a year to assess endoscopic activity. Results In our pilot study of, 200 patients CD was seen in, 84 (42.0%) &amp; UC in, 116 (58.0%). Prevalence of Anxiety was, 15%, Depression, 7% &amp; pooled prevalence, 22%., 86 patients (43.0%) received only IBD therapy., 66 (33.0%) received, 1 antipsychotic drug, 33 received, 2 (16.5%), 15 (7.5%) were prescribed, 3. Patients receiving psychopharmacotherapy, showed significant improvement in HADS-A or HADS-D scores at, 3, 6,9 and, 12 months. Amongst patients with UC, there was a significant improvement in UCEIS score (4.73 to, 2.36) in patients who received psychopharmacotherapy in addition to IBD standard of care after, 1 year (p&amp;lt;0.05). Similarly, the mean p-MAYO score dropped from, 4.91 to, 2.17 in patients receiving psychopharmacotherapy (p&amp;lt;0.05). The same pattern was observed in patients with Crohn’s disease receiving psychopharmacotherapy, in whom the mean CDEIS score dropped from, 5.43 to, 2.16 after, 1 year. Also, the mean Harvey-Bradshaw score dropped from, 5.57 to, 2.86. Both in UC &amp; CD; clinical, endoscopic scores significantly improved in patients who were given psychopharmacotherapy in addition to SOC. Conclusion Our study confirmed the high prevalence of anxiety and depression amongst Indian IBD patients. IBD patients with significant anxiety or depression benefit from Psychopharmacotherapy in addition to standard of care treatment, showed improvement in clinical as well as endoscopic disease activity.

Anxiety faintly and depression remarkably correlate with recurrence in acute ischemic stroke patients: A study with 3-year longitude evaluation and follow-up.

Clinical value of anxiety and depression in acute ischemic stroke (AIS) is rarely studied. Thus, the aim of this study was to explore longitudinal changes of anxiety and depression, as well as their correlation with recurrence in AIS.A total of 120 AIS patients and 120 controls were enrolled in the study. Furthermore, comparison of the hospital anxiety and depression scale (HADS) score or rate between AIS and controls was determined by Mann–Whitney U test or Chi-square test. In AIS patients, change of HADS scores or linear trend of anxiety and depression rate over time were determined by Friedman test or Mantel-Haenszel Chi-square test. Moreover, correlation of anxiety and depression with the recurrence rate was analyzed by log-rank test.HADS for anxiety score, anxiety rate, HADS for depression score and depression rate were all elevated in AIS patients compared with controls (all P < .001). In AIS patients, HADS for anxiety score was elevated from discharged from hospital (M0) to month (M) 36 (P = .027), while anxiety rate was not (P = .107). Besides, HADS-D score and rate were both increased from M0 to M36 (both P < .001). Moreover, accumulating recurrence rate was 6.7%, 11.7%, and 17.5% at 1 year, 2 years, and 3 years, respectively. Additionally, anxiety at M24 (P = .033), depression at M0, M12, M24, and M36 (all P < .05) were all correlated with increased accumulating recurrence rate.Continuous monitoring of anxiety and depression might be beneficial for the management of AIS prognosis.

The bidirectional temporal relationship between headache and affective disorders: longitudinal data from the HUNT studies

BackgroundFew prospective population-based studies have evaluated the bidirectional relationship between headache and affective disorder. The aim of this large-scale population-based follow-up study was to investigate whether tension-type headache (TTH) and migraine had increased risk of developing anxiety and depression after 11 years, and vice-versa.MethodsData from the Trøndelag Health Study (HUNT) conducted in 2006-2008 (baseline) and 2017-2019 (follow-up) were used to evaluate the bidirectional relationship between migraine and TTH and anxiety and depression measured by Hospital Anxiety and depression Scale (HADS). The population at risk at baseline consisted of respectively 18,380 persons with HADS score ≤ 7 and 13,893 without headache, and the prospective data was analyzed by Poisson regression.ResultsIn the multi-adjusted model, individuals with HADS anxiety (HADS-A) and depression scores (HADS-D) of ≥8 at baseline nearly doubled the risk of migraine (Risk rations (RR) between 1.8 and 2.2) at follow-up whereas a 40% increased risk (RR 1.4) was found for TTH. Vice versa, the risk of having HADS-A and HADS-D scores of ≥8 at follow-up were increased for TTH (RR 1.3) and migraine (RR 1.3-1.6) at baseline. Migraine with aura was associated with 81% (RR 1.81, 95% 1.52-2.14) increased risk of HADS-A score of ≥8.ConclusionsIn this large-scale population-based follow-up study we found a bidirectional relationship between anxiety and depression and migraine and TTH. For anxiety, this bidirectional association was slightly more evident for migraine than TTH.

Voice-related quality of life and emotional symptoms before and after thyroidectomy.

To correlate voice-related quality of life, anxiety, and depression symptoms pre- and post-thyroidectomy. Observational, longitudinal, prospective, and quantitative study. Twenty patients participated in the study, with a mean age of 54 years, who underwent thyroidectomy, laryngeal visual examination, and the Voice-Related Quality of Life and Hospital Anxiety and Depression Scale questionnaires at different times: preoperative, 1 week and 3 months post-thyroidectomy, with a higher prevalence of females (85%; n=17) and partial thyroidectomy (70%; n=14). There was no statistical difference in voice quality of life between the moments, but lower preoperative scores were observed, especially in the physical domain. We observed a slight trace of anxiety in the preoperative period, with a reduction after 1 week and an increase after 3 months. There was a moderate negative correlation between the physical domain of QVV and the anxiety subscale and the total HADS score after 1 week and between the total domain of QVV with the total HADS score after 1 week, weak negative correlation between the total domain of QVV and the HADS anxiety subscale after 1 week and the total HADS score after 3 months. The patients evaluated in this study self-perceived their voice-related quality of life as positive. Mild anxiety traits were identified, with a reduction after one week postoperatively and an increase after three months. The self-perception of better voice-related quality of life in the postoperative period is weakly related to the reduction of anxiety levels.

Effects of expressive art therapy on health status of patients with chronic obstructive pulmonary disease: a community-based cluster randomized controlled trial.

Background and objective:This study was performed to investigate the effect of expressive art therapy (EAT) on the health status of patients with chronic obstructive pulmonary disease (COPD).Methods:This community-based cluster randomized controlled trial involved patients with COPD from 16 communities in China. Participants received either EAT plus usual care (UC) or UC only. General practitioners were trained in EAT before the intervention. The primary outcomes were depression and anxiety symptoms, measured with the Hospital Anxiety and Depression Scale (HADS) and expressed as the HADS score for depression or anxiety (HADS-D or HADS-A, respectively). The secondary outcomes were the quality of life and dyspnoea, measured with the COPD assessment test (CAT). Dyspnoea was assessed using the modified Medical Research Council (mMRC) dyspnoea scale. Lung function was expressed as the forced expiratory volume in 1 s as a percentage of the predicted value [FEV1 (% pred)]. Outcome data were collected from all participants at baseline, 2 and 6 months.Results:In total, 360 participants with COPD and comorbid depression were included in the analysis with the control group of 181 receiving UC only and the intervention group of 179 receiving EAT plus UC. The EAT group showed significantly greater improvement in the HADS-D and HADS-A scores than the UC group at 2 months (p < 0.0001 and p < 0.001, respectively) and 6 months (p < 0.001 for both). The CAT and mMRC scores were significantly lower in the EAT group than in the UC group at 2 and 6 months (p < 0.001 for all). The FEV1 (% pred) was significantly higher in the EAT group than in the UC group at 6 months (p < 0.01).Conclusion:General practitioners can deliver EAT interventions. EAT can effectively reduce anxiety and depression symptoms and dyspnoea, improve quality of life and improve the pulmonary function of patients with COPD.

Prof K C Dube Poster Award

Background:Mucormycosis (previously : zygomycosis) is a rare and serious fungal infection caused by a group of molds called mucormycetes. There are five major clinical forms of Mucormycosis; gastrointestinal, disseminated, rhinocerebral , cutaneous and pulmonary, of which the latter 3 are the most common.There have been no studies conducted on the association of anxiety and depression with Mucormycosis.Materials and Methods :50 sample size. Conducted in the special Mucormycosis ward at DY Patil Hospital. Scales used were HADS and GSQS. Assessment done on Day5 and Day15 of admission.Results:50 post-Covid-19 Mucormycosis patients were analysed. 31 patients were males, whereas 19 patients were females. The age group was 18-70.Out of the 50 patients, 32 had Cutaneous type of Mucormycosis; 15 had Pulmonary type of Mucormycosis and 3 had Rhinocerebral type of Mucormycosis. HADS Score was significantly higher on Day 15 (21.02 ± 8.35; P = 0.0000) as compared to Day 5 (17.0 ± 7.69; P = 0.0000) in all patients. GSQS Score was significantly higher on Day 15 (7.10 ± 3.04; P = 0.0000) as compared to Day 5 (4.34 ± 2.80; P = 0.0000) in all patients.Conclusion:Anxiety and Depressive symptoms , along with sleep quality impairment was observed in patients of post-Covid-19 Mucormycosis.