Hospital Anxiety And Depression Scale Scores Research Articles

Poor sleep quality is associated with fatigue and depression in early Parkinson's disease: A longitudinal study in the PALS cohort.

BackgroundSleep disorders are common in Parkinson's disease (PD). However, the longitudinal relationship between sleep quality and the other non-motor symptoms of PD has not been well characterized, especially in early PD.ObjectiveTo explore the value of baseline sleep quality in predicting the progression of other non-motor symptoms in early PD.Methods109 early PD patients were recruited to the study. Patients were stratified into good and poor sleepers using the Pittsburgh Sleep Quality Index (PSQI). Assessments performed at baseline and 1 year follow-up included the Epworth Sleepiness Scale, Fatigue Severity Scale, Non-Motor Symptom Scale, Geriatric Depression Scale, Hospital Anxiety and Depression Scale, Apathy Scale, Montreal Cognitive Assessment and detailed neuropsychological assessments. Multivariable linear regression was performed at baseline to investigate differences in clinical scores between poor and good sleepers, while multivariable regression models were used to investigate associations between sleep quality and progression of test scores at 1 year follow-up.Results59 poor sleepers and 50 good sleepers were identified. At baseline, poor sleepers had greater HADS anxiety scores (p = 0.013) [2.99 (95% CI 2.26, 3.73)] than good sleepers [1.59 (95% CI 0.75, 2.42)]. After 1 year, poor sleepers had greater fatigue (FSS scores +3.60 as compared to −2.93 in good sleepers, p = 0.007) and depression (GDS scores +0.42 as compared to −0.70, p = 0.006).ConclusionThis study shows a longitudinal association between sleep quality, fatigue, and depression in early PD patients, independent of medication effect and disease severity, this may support the hypothesis that a common serotonergic pathway is implicated in these non-motor symptoms.

33006 Long-term improvement of patient-reported outcomes in adult patients with atopic dermatitis treated with baricitinib in the US and Canada

Objective: To evaluate long-term patient-reported outcome (PRO) improvements in patients with atopic dermatitis (AD) treated with baricitinib, a Janus kinase (JAK)1/JAK2 inhibitor. Methods: Data were derived from 2 phase 3 studies: double-blind placebo-controlled BREEZE-AD5 (NCT03435081) and long-term open-label extension BREEZE-AD6 (NCT03559270) through 52 weeks of treatment. Low-potency topical corticosteroids were permitted after Week 16 in BREEZE-AD5 and throughout BREEZE-AD6. PROs [Dermatology Life Quality Index (DLQI), Patient-Oriented Eczema Measure (POEM), and Hospital Anxiety Depression Scale (HADS-anxiety and HADS-depression)] were assessed to Week 52 using descriptive statistics with missing data imputed by last observation carried forward. Results: In 146 patients receiving baricitinib 2 mg, the quality of life measure DLQI (mean ± standard deviation at baseline 15.0 ± 7.6) showed a mean change from baseline of −7.0 ± 8.2 at Weeks 48-52. Patient-reported improvements in skin symptoms as measured by POEM were −7.3 ± 8.8 at Weeks 48-52 from mean baseline value of 21.7 ± 5.4. By Weeks 48-52, 68.9% and 57.6% of patients had achieved a clinically meaningful ≥4-point improvement in DLQI and POEM, respectively. HADS-anxiety and HADS-depression scores were 7.0 ± 4.4 and 5.2 ± 4.3 at baseline, respectively, with patients reporting a change from baseline of −1.9 ± 3.7 and −1.8 ± 3.3 at Weeks 48-52. Conclusion: Patients with moderate to severe AD treated with baricitinib 2 mg experienced clinically meaningful PRO improvements in skin symptoms, quality of life, and anxiety and depression over 52 weeks.

Anxiety level and COVID-19 awareness of patients in a non-COVID-19 outpatient clinic of a pandemic hospital

Background and Aims: The aim of this study is to investigate the COVID-19 awareness and anxiety levels of patients who visited the outpatient department in a hospital. Methods: A questionnaire for socio-demographic data and COVID-19 awareness, Beck Anxiety Scale (BAS), and Hospital Anxiety and Depression Scale (HADS) data were collected from patients who volunteered to participate in the study. Counts, percentages, independent groups t-test, and correlation analysis were used during statistical data analysis. Those patients who were over 18 years of age, literate, having no psychiatric disorder and from whom informed consent was obtained were included in the study. Patients younger than 18 years of age, patients who had psychiatric disorders, and illiterate patients were excluded. Results: The questionnaire form and scales were distributed to 254 patients, while 210 patients were included in the study. Therefore, the response rate from the patients was 82.7%. The mean age of the patients participating in this study was 44.41 years ±16.9 SD. The BAS scores of patients over 65 years of age were significantly higher than the patients at younger ages (p<0.001). The percentage of female patients was 42.6% (n=89) and that of males was 57.4% (n=120). Both the BAS scores (p<0.001) and HADS scores (p<0.01) of the female patients were significantly higher than those of the male patients. Conclusion: The BAS and HADS scores of females were found to be significantly higher than those of the males. Although the mean of the BAS scores of the patients was low, the BAS scores of those women who were at an age of 65 years or above, and those who had secondary school education or below, were significantly higher. Therefore, related research focusing on these groups should be conducted in the future.

Assessing Changes in Fear of Movement in Patients attending Cardiac Rehabilitation: Responsiveness of the TSK-NL Heart Questionnaire.

ObjectivesThe primary objective was to determine the responsiveness of the Dutch version of the 13-item Tampa Scale for Kinesiophobia for cardiac patients (TSK-NL Heart). The secondary objective was to assess changes in kinesiophobia during cardiac rehabilitation.MethodsKinesiophobia was measured pre- and post-cardiac rehabilitation using the TSK-NL Heart questionnaire in 109 cardiac patients (61 years; 76% men). The effect size of kinesiophobia score changes was calculated for the full population. A measure that is responsive to change should produce higher effects sizes in patients in whom kinesiophobia improves. Therefore, effect sizes were also calculated for patients who did or did not improve on selected external measures. For this step, the Cardiac Anxiety Questionnaire (CAQ) and the Hospital Anxiety and Depression Scale (HADS) were completed as external measures in a subsample of 58 patients.ResultsThe effect size of the TSK-NL Heart for the full study population was small (0.29). In line with the study hypothesis the effect size was higher (moderate) for patients with improved CAQ (0.52) and HADS scores (0.54). Prevalence of high kinesiophobia levels decreased from 40% pre-cardiac rehabilitation to 26% post-cardiac rehabilitation (p = 0.004).ConclusionThe TSK-NL Heart has moderate responsiveness and can be used to measure changes in kinesiophobia. Improvements in kinesiophobia were observed during cardiac rehabilitation. Nevertheless, high levels of kinesiophobia were still highly prevalent post-cardiac rehabilitation.LAY ABSTRACTFear of movement (kinesiophobia) is common in patients referred for cardiac rehabilitation. Before interventions can be designed to target kinesiophobia, the impact of current cardiac rehabilitation programmes on kinesiophobia should be studied. Kinesiophobia is measured with the Tampa Scale for kinesiophobia (TSK-Heart). In order to measure the effect of cardiac rehabilitation on kinesiophobia, the TSK-Heart should be able to detect changes in the level of kinesiophobia (responsiveness). This study determined the responsiveness of the TSK-Heart and assessed changes in the level of kinesiophobia during cardiac rehabilitation, and shows that the TSK-Heart has moderate responsiveness. In addition, it was found that the prevalence of high levels of kinesiophobia, decreased from 40% before cardiac rehabilitation to 26% after cardiac rehabilitation.

Emotional Burden among Pharmacists and Pharmacy Technicians during the COVID-19 Lockdown: A Cross Sectional Study.

This study aims to investigate the prevalence of depression and anxiety symptoms among Spanish community pharmacists and pharmacy technicians during the coronavirus disease 2019 (COVID-19) lockdown. A descriptive cross-sectional quantitative study was designed. An online survey was administered to participants from 4 to 21 April 2020 using a questionnaire assessing sociodemographic information and the Spanish version of the Hospital Anxiety and Depression Scale (HADS). Informed consent to participate was requested. Participants comprised 1162 pharmacy staff from Spain with an average age of 39.15 ± 9.718, from 20 to 65 years old, of whom 83% were women, and 50.6% were married. More than half of the participants expressed symptoms of depression (62.7%) and anxiety (70.9%). An important prevalence of anxiety and depression symptoms has been detected among Spanish pharmacists and pharmacy technicians during the COVID-19 lockdown. Being a woman, smoking, feeling fear, feeling stress and believing that pharmacists/pharmacy technicians are very exposed to COVID-19 seem to be associated with higher HADS scores.

Anxiety and depression following facial and dental trauma – A prospective study

ObjectiveThis prospective repeated measures design study was conducted to identify and analyze anxiety and depression in patients, sustaining traumatic facial and dental injuries along with other variables that may have a modifying effect on the psychological response of the patients. Methods241 patients were included in the study. 110 patients (Males - 87, Females - 23) suffered disfiguring injuries (DF). 131 patients (Males - 102, Females - 29) suffered non disfiguring injuries (NDF). Assessment was carried out using Hospital Anxiety and Depression scale (HADS) on the day of discharge (D.O.D) and at 1 month and 6 month. ResultsPatients with DF injuries had statistically significant higher mean scores of HADS for anxiety and depression when compared to patients with NDF injuries. Patients treated with maxillomandibular fixation, and patients aged 18–40 years had significantly higher scores then patients aged more than 40 years. ConclusionPatients with disfiguring facial injuries (DF) had significantly higher mean HADS scores in comparison with patients suffering non disfiguring facial injuries (NDF) at all 3 interval indicating higher anxiety and depression levels.

The potency of common proinflammatory cytokines measurement for revealing the risk and severity of anxiety and depression in psoriasis patients.

ObjectiveProinflammatory cytokines mediate anxiety and depression in various ways, such as immunity, inflammation, and the hypothalamic–pituitary–adrenal axis. This study intended to further explore the linkage of common proinflammatory cytokine levels with anxiety and depression in psoriasis patients.MethodsTotally, 150 psoriasis patients and 50 healthy controls (HCs) were included; the serum samples were collected, then common proinflammatory cytokines were measured by ELISA. Hospital Anxiety and Depression Scale (HADS) was assessed.ResultsHADS‐anxiety (HADS‐A) score, HADS‐depression (HADS‐D) score, TNF‐α, IL‐1β, IL‐6, IL‐12, IL‐17A, and IL‐23 were all increased in psoriasis patients compared to HCs (all p < 0.05). In psoriasis patients, TNF‐α (p = 0.001), IL‐12 (p = 0.035), and IL‐17A (p < 0.001), but not IL‐1β (p = 0.255), IL‐6 (p = 0.248), and IL‐23 (p = 0.216), were positively linked to HADS‐A score. Meanwhile, TNF‐α (p = 0.007) and IL‐17A (p = 0.007) were enhanced in psoriasis patients with anxiety in contrast to those without anxiety; whereas IL‐1β (p = 0.178), IL‐6 (p = 0.360), IL‐12 (p = 0.239), and IL‐23 (p = 0.450) were not different. TNF‐α (p < 0.001), IL‐1β (p = 0.013), Il‐17A (p < 0.001), and IL‐23 (p = 0.023), but not IL‐6 (p = 0.143) and IL‐12 (p = 0.158), were positively linked to HADS‐D score. Concurrently, TNF‐α (p = 0.015), IL‐17A (p < 0.001), and IL‐23 (p = 0.017) were climbed in psoriasis patients with depression by comparison to those without depression; whereas IL‐1β (p = 0.113), IL‐6 (p = 0.237), IL‐12 (p = 0.660) did not differ.ConclusionTNF‐α, IL‐17A, and IL‐23 increments reflect anabatic anxiety and depression in psoriasis patients, uncovering the potency of proinflammatory cytokines measurement for monitoring or even preventing psoriasis patients' anxiety and depression.

Effect of Nursing Model Based on Rosenthal Effect on Self-Efficacy and Cognition of Life Meaning in Patients with Non-Small-Cell Lung Cancer.

Objective To study the influence of nursing model based on Rosenthal effect on self-efficacy and cognition of life meaning in patients with non-small-cell lung cancer (NSCLC). Methods 120 patients with NSCLC treated in the hospital were selected from November 2020 to November 2021 and were randomly divided into the nursing group and the Rosenthal group, with 60 cases in each group. The nursing group received routine nursing intervention, while the Rosenthal group was intervened by nursing model based on the Rosenthal effect, and both groups were intervened for 1 month. The self-efficacy (General Self-Efficacy Scale (GSES)), negative emotions (Hospital Anxiety and Depression Scale (HADS)), self-burden (Self-Perceived Burden Scale for Cancer Patients (SPBS-CP)), meaning of life (Meaning of Life Scale for Advanced Cancer Patients (MiLS)), and quality of life (Functional Assessment of Cancer Therapy-Lung (FACT-L)) were compared between the two groups before and after intervention. Results After 1 month of intervention, the scores of GSES and MiLS of patients in the two groups were significantly higher than those before intervention, and the scores in the Rosenthal group were significantly higher than those in the nursing group (P < 0.05). The scores of HADS, SPBS-CP, and FACT-L in the two groups were significantly lower than those before intervention, and the scores were significantly lower in the Rosenthal group than those in the nursing group (P < 0.05). Conclusion Nursing model intervention based on Rosenthal effect enhances the self-efficacy and meaning of life and reduces the negative emotions and self-burden in patients with NSCLC.

Predictors of long-term anxiety and depression in discharged COVID-19 patients: A follow-up study.

BACKGROUNDPatients who were hospitalized for coronavirus disease 2019 (COVID-19) faced an extremely stressful experience that challenged their mental health and the long-term effects are not definitely known yet.AIMTo identify both the course of mental symptoms (anxiety and depressive symptoms) and the related risk factors of recovered patients at the 20-22 mo follow-up.METHODSOne hundred and seventy-two patients were enrolled. The patients were evaluated with a telepsychiatry interview and the Hospital Anxiety and Depression Scale (HADS). Sociodemographic and clinical features were analyzed by regression analysis.RESULTSThe mean HADS-Anxiety (HADS-A) score was 9.08 ± 4.90, and the mean HADS-Depression (HADS-D) score was 8.55 ± 4.39. The mean HADS-A (P = 0.484) and HADS-D (P = 0.011) scores were increased compared to scores during hospitalization. Being over 50 years old, having lower financial status, and being vaccinated were associated with symptoms of depression (adjusted R2 = 0.168) while being over 50 years old, female sex, being vaccinated, and dyspnea were associated with higher anxiety (adjusted R2 = 0.245).CONCLUSIONTo prevent the deterioration of mental health, psychiatrists should play an active role in identifying emerging mental problems as soon as possible, more vulnerable groups should be characterized, and psychological support should be sustained after discharge.

Factors influencing hospital anxiety and depression among emergency department nurses during the COVID-19 pandemic: A multi-center cross-sectional study.

IntroductionThe emergency department (ED) is a highly stressful environment, which exposes nurses to infection. ED nurses handle life-threatening conditions, endure long working hours, and deal with anxious patients and their families.AimThis study aimed to examine factors, which may influence anxiety and depression levels among ED nurses during the coronavirus disease 2019 (COVID-19) pandemic.MethodsA cross-sectional design was used with 251 participants from six hospitals in Saudi Arabia (mean age = 32.7 ± 6.59, range = 21–54 years, 70.5% females). Data were collected using the Hospital Anxiety and Depression Scale (HADS), and the analysis was conducted using structural equation modeling (SEM).ResultsBased on the HADS scores, 29.1 and 25.5% of ED nurses were identified as doubtful cases for depression and anxiety, respectively. Additionally, 34.7 and 43.3% of ED nurses were identified as definite cases for depression and anxiety, respectively. Higher anxiety levels were observed among female nurses, nurses with lower physical activity levels, and nurses who worked in urban areas. Low physical activity levels and more than 6 years of work experience correlated with a higher level of depression. None of the hypothesized paths in the anxiety and depression models were significant, except for two observed variables—namely, work location and physical exercise in the anxiety model and physical exercise in the depression model.ConclusionEmergency department nurses expressed high levels of anxiety and depression during the COVID-19 pandemic, which may negatively affect their performance and reduce care quality. Therefore, health care leaders should implement specialized mental health education programs focused on nursing occupational safety and support to improve ED nurses’ psychological well-being. Specific attention should be paid to ED female nurses who work in urban areas, especially those with more than 6 years of experience.

Prepandemic Alzheimer Disease Biomarkers and Anxious-Depressive Symptoms During the COVID-19 Confinement in Cognitively Unimpaired Adults.

Background and ObjectivesIncreased anxious-depressive symptomatology is observed in the preclinical stage of Alzheimer disease (AD), which may accelerate disease progression. We investigated whether β-amyloid, cortical thickness in medial temporal lobe structures, neuroinflammation, and sociodemographic factors were associated with greater anxious-depressive symptoms during the COVID-19 confinement.MethodsThis retrospective observational study included cognitively unimpaired older adults from the Alzheimer's and Families cohort, the majority with a family history of sporadic AD. Participants performed the Hospital Anxiety and Depression Scale (HADS) during the COVID-19 confinement. A subset had available retrospective (on average: 2.4 years before) HADS assessment, amyloid [18F] flutemetamol PET and structural MRI scans, and CSF markers of neuroinflammation (interleukin-6 [IL-6], triggering receptor expressed on myeloid cells 2, and glial fibrillary acidic protein levels). We performed multivariable linear regression models to investigate the associations of prepandemic AD-related biomarkers and sociodemographic factors with HADS scores during the confinement. We further performed an analysis of covariance to adjust by participants' prepandemic anxiety-depression levels. Finally, we explored the role of stress and lifestyle changes (sleep patterns, eating, drinking, smoking habits, and medication use) on the tested associations and performed sex-stratified analyses.ResultsWe included 921 (254 with AD biomarkers) participants. β-amyloid positivity (B = 3.73; 95% CI = 1.1 to 6.36; p = 0.006), caregiving (B = 1.37; 95% CI 0.24–2.5; p = 0.018), sex (women: B = 1.95; 95% CI 1.1–2.79; p < 0.001), younger age (B = −0.12; 95% CI −0.18 to −0.052; p < 0.001), and lower education (B = −0.16; 95% CI −0.28 to −0.042; p = 0.008) were associated with greater anxious-depressive symptoms during the confinement. Considering prepandemic anxiety-depression levels, we further observed an association between lower levels of CSF IL-6 (B = −5.11; 95% CI −10.1 to −0.13; p = 0.044) and greater HADS scores. The results were independent of stress-related variables and lifestyle changes. Stratified analysis revealed that the associations were mainly driven by women.DiscussionOur results link AD-related pathophysiology and neuroinflammation with greater anxious-depressive symptomatology during the COVID-19-related confinement, notably in women. AD pathophysiology may increase neuropsychiatric symptomatology in response to stressors. This association may imply a worse clinical prognosis in people at risk for AD after the pandemic and thus deserves to be considered by clinicians.Trial Registration InformationClinicalTrials.gov Identifier NCT02485730.

Characterizing cannabis use reduction and change in functioning during treatment: Initial steps on the path to new clinical endpoints.

Reduction-based cannabis use endpoints are needed to better evaluate treatments for cannabis use disorder (CUD). This exploratory, secondary analysis aimed to characterize cannabis frequency and quantity reduction patterns and corresponding changes in psychosocial functioning during treatment. We analyzed 16 weeks (4 prerandomization, 12 postrandomization) of data (n = 302) from both arms of a randomized clinical trial assessing pharmacotherapy for CUD. Cannabis consumption pattern classes were extracted with latent profile modeling using self-reported (a) past-week days used (i.e., frequency) and (b) past-week average grams used per using day (i.e., quantity). Changes in mean Marijuana Problem Scale (MPS) and Hospital Anxiety and Depression Scale (HADS) scores were examined among classes. Urine cannabinoid levels were examined in relation to self-reported consumption as a validity check. Two-, three-, four-, and five-class solutions each provided potentially useful conceptualizations of associations between frequency and quantity. Regardless of solution, reductions in MPS scores varied in magnitude across classes and closely tracked class-specific reductions in consumption (e.g., larger MPS reduction corresponded to larger frequency/quantity reductions). Changes in HADS scores were less pronounced and less consistent with consumption patterns. Urine cannabinoid levels closely matched class-specific self-reported consumption frequency. Findings illustrate that frequency and quantity can be used in tandem within mixture model frameworks to summarize heterogeneous cannabis use reduction patterns that may correspond to improved psychosocial functioning. Going forward, similar analytic strategies applied to alternative metrics of cannabis consumption may facilitate construction of useful reduction-based clinical endpoints. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Validity and Reliability of the Japanese Version of the Dyspnea-12 Questionnaire in Patients With Lung Cancer.

The Dyspnea-12 questionnaire is a simple tool to assess dyspnea using qualitative descriptors that include both physical and emotional domains. However, the reliability and validity of the Japanese version in patients with lung cancer have not been assessed. To determine the reliability and validity of the Japanese version of the Dyspnea-12 questionnaire in patients with lung cancer. The assessment was based on the numerical rating scale (NRS), cancer dyspnea scale (CDS), and hospital anxiety and depression scale (HADS). Spearman's correlation assessed the convergent validity of Dyspnea-12 using these three scales. Exploratory factor analysis examined the construct validity. The reliability was verified using Cronbach's alpha. Anxiety, depression, clinical dyspnea, presence of chronic obstructive pulmonary disease (COPD), and patient status were identified by discriminating performance. The analysis included 113 patients with lung cancer. A significant positive correlation was found between Dyspnea-12 and NRS, CDS, and HADS scores. Similar to the original version, factor analysis clearly classified Dyspnea-12 into two components (physical and emotional), thereby confirming its construct validity. Cronbach's alpha values for the total Dyspnea-12 and its physical and emotional components were 0.97, 0.95, and 0.96, respectively. Patients with anxiety, depression, and clinical dyspnea and those in the palliative phase had significantly higher Dyspnea-12 scores than their respective counterparts. The Dyspnea-12 scores of patients with and without COPD were similar. The Japanese version of the Dyspnea-12 questionnaire is a useful and reliable tool to assess the multi-dimensional aspects of dyspnea in patients with lung cancer.

Association of fear assessment in inflammatory rheumatic diseases (FAIR) questionnaire with ankylosing spondylitis quality of life and disease activity in patients with ankylosing spondylitis

Background/Aim: Fear against disease course, treatment, and limitations in family, work, and social life are commonly seen but mostly overlooked by physicians of patients with chronic inflammatory rheumatic diseases. Ankylosing spondylitis (AS) is a chronic inflammatory disease in young adults characterized by limitations in spinal mobility. The Fear Assessment (FAIR) Questionnaire was designed especially for patients with rheumatoid arthritis and spondyloarthritis to assess the level of fear from the patient’s perspective. Here we evaluate the FAIR score in AS patients and its association with disease activity, AS quality of life (ASQoL), depression, anxiety, and fatigue levels.&#x0D; Methods: This cross-sectional study included 79 patients with AS, and disease activity was assessed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), AS-Disease Activity Score-C reactive protein, and functional status was assessed by Bath Ankylosing Spondylitis Functional Index (BASFI). Patient global assessment of disease and pain were scored on 0–10 cm visual analog scores. All patients completed FAIR and ASQoL questionnaires. The depression and anxiety were evaluated by Hospital Anxiety and Depression Scale (HADS), and fatigue was assessed by Fatigue Severity Scale (FSS).&#x0D; Results: The mean age of AS patients (62% male) was 41.7 (11.3) years. Most of the patients were on biological disease-modifying anti-rheumatic drugs (bDMARDs). The patients’ median BASDAI, ASDAS-CRP, and BASFI were 5.4 (range, 3.8–7.4), 3.83 (1.4), and 4.0 (range, 2.3–6.2), respectively. The overall FAIR, ASQoL, FSS, HADS-depression, and HADS-anxiety scores were 75 (range, 52–91), 9.6 (5.2), 5.4 (range, 4.1–7), 7.7 (4.4) and 9.6 (5.2), respectively. There were statistically significant correlations between disease activity indices and FAIR, ASQoL, FSS, and HADS scores. The FAIR scores significantly correlated with ASQoL, FSS, and HADS scores. The patients with active disease (BASDAI ≥ 4) had significantly higher levels of FAIR, ASQoL, FSS, and HADS. The best cut-off value for the FAIR score of AS patients with moderate to severe disease activity was 50 (AUC: 0.734, 95% CI [0.599–0.870], P = 0.002), with a sensitivity of 89.8%, specificity of 55%, positive likelihood ratio of 1.99, and Youden index of 0.45.&#x0D; Conclusion: This study shows that AS patients face a high level of fear which is associated with higher disease activity, higher risk of mood disorders, and lower quality of life. Physicians should not only focus on the physical improvement of the patient but also handle the fear of patients against their diseases and their treatment. This holistic approach will improve the dialogue between the physician and the patient, which will result in increased compliance with treatment and will raise the quality of care.

Reminiscence therapy is a feasible care program for improving cognitive function, anxiety, and depression in recurrent acute ischemic stroke patients: a randomized, controlled study.

Reminiscence therapy provides benefits among first-episode acute ischemic stroke (AIS) patients and their caregivers. This study intended to further compare the effect of reminiscence therapy plus usual care (RTUC) and usual care (UC) on cognitive function, anxiety, and depression among recurrent AIS patients. Totally, 160 recurrent AIS patients were enrolled and randomized in a 1:1 ratio into the RTUC group (N = 81) and UC group (N = 79), then a 12-month corresponding intervention was conducted in each group. Mini-Mental State Examination (MMSE) score and Hospital Anxiety and Depression Scale (HADS) were evaluated on discharge (M0), at month (M) 3, M6, M9, and M12 after discharge. MMSE scores at M6 (27.0 ± 1.6 vs. 26.3 ± 2.3, P = 0.031) and M12 (27.0 ± 1.7 vs. 26.1 ± 2.4, P = 0.009) were elevated, while cognitive impairment rate at M12 (29.2% vs. 45.7%, P = 0.042) and cognitive impairment severity at M12 (P = 0.029) were declined in RTUC group compared to UC group. Meanwhile, the HADS-anxiety scores at M9 (5.7 ± 3.1 vs. 6.9 ± 4.0, P = 0.046) and M12 (5.6 ± 2.7 vs. 7.0 ± 4.3, P = 0.024), anxiety rate at M12 (22.2% vs. 38.2%, P = 0.039) and anxiety severity at M12 (P = 0.018) were declined in RTUC group compared to UC group. Besides, the HADS-depression score at M12 (5.7 ± 3.1 vs. 6.8 ± 3.3, P = 0.043) was decreased in RTUC group compared to UC group, but depression rate and severity were not different between the two groups at each visit point (all P > 0.05). RTUC program elevates cognitive functions and alleviates mental problems in recurrent AIS patients.

Adverse events following immunization and psychological distress among cancer patients/survivors following vaccination against SARS-CoV-2 infection.

PurposeThis study aims to describe the adverse events following immunization (AEFIs) of SARS-CoV-2 vaccination in cancer patients/survivors associated with their psychological distress.MethodsA cross-sectional study was conducted to assess AEFIs after the receipt of SARS-CoV-2 vaccines in cancer patients/survivors attending a university hospital in Malaysia. Psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS) before and after the first and second doses of COVID-19 vaccine.ResultsA total of 217 complete responses were received. Compared with before vaccination, both HADS Anxiety (HADS-A) and HADS Depression (HADS-D) scores were significantly reduced after the first and second dose of the SARS-CoV-2 vaccine. Most of the participants had mild-or-moderate systemic and local AEFIs, with the most common being pain at the injection site, tiredness, and headache for both the first and second doses of the vaccine. Positive correlations between the total AEFI score and HADS-A (r = 0.309, p < 0.001) and HADS-D (r = 0.214, p = 0.001) scores were observed after the first dose of the SARS-CoV-2 vaccine. Similarly, positive associations were observed between the total AEFI score and HADS-A (r = 0.305, p < 0.001) and HADS-D (r = 0.235, p < 0.001) scores after the second dose of the SARS-CoV-2 vaccine.ConclusionMild-to-moderate AEFIs found in this study help address vaccine hesitancy in cancer patients/survivors. Receiving the SARS-CoV-2 vaccine had a positive effect on decreasing psychological distress in cancer patients/survivors. High severity of an AEFI was associated with higher anxiety and depressive symptoms.

Serum interleukin-23 levels: relation to depression, anxiety, and disease activity in psoriatic arthritis patients

ObjectivesAssessment of serum levels of IL-23 in PsA patients and its correlation with depression, anxiety, and disease activity.MethodsEighty psoriatic arthritis (PsA) patients and eighty healthy volunteers matched for age and gender were included in this observational case–control study. All participants suspected to detailed history, clinical assessment, PsA activity using Disease Activity Index for Psoriatic Arthritis (DAPSA) score, the severity and extent of psoriasis was assessed by the Psoriasis Area and Severity Index (PASI), and ultrasonographic assessments of the entheses were examined according to the Madrid Sonographic Enthesitis Index (MASEI). Depression and anxiety were assessed by Hospital Anxiety and Depression Scale (HADS). Serum IL-23 was measured and correlated with disease activity, depression, and anxiety.ResultsThere was no significant difference between patients and controls regarding demographic data. Thirty-six PsA patients (45%) had anxiety and 28 patients (35%) had depression, while in the control group, 16 persons (20%) had anxiety and 12 (15%) had depression, with significant differences between the 2 groups (p < 0.0001). There were significant differences in HADS anxiety and depression scores between patients and controls with significant positive correlations between HADS depression, anxiety scores and IL-23, DAPSA, PASI, and MASEI scores (p < 0.05). IL-23 was positively correlated with DAPSA, PASI, and HADS scores; we observed that interleukin 23, higher DAPSA, and PASI were independently associated with depression and anxiety.ConclusionSerum interleukin-23 levels were elevated in PsA patients and were found to be correlated with depression, anxiety, and disease activity.Key Points• Psoriatic arthritis is a multidimensional disorder with psychiatric drawbacks.• Interleukin-23 is a proinflammatory cytokines that was correlated with depression and anxiety in PsA patients.• Interleukin-23 was correlated with disease activity in PsA.• Depression and anxiety were positively correlated with disease activity in PsA.

Long-term Neurologic Safety in Patients With B-Cell Lymphoma Treated With Anti-CD19 Chimeric Antigen Receptor T-Cell Therapy.

Anti-CD19 chimeric antigen receptor (CAR) T-cell therapy is a promising treatment in relapsing B-cell lymphoma but is frequently associated with acute neurotoxicity. Neurologic long-term safety has not been thoroughly assessed. All patients with consecutive refractory lymphoma admitted in our center for CAR T-cell therapy underwent neurologic examination, extensive neuropsychological assessment, and brain MRI (except 1 patient) and completed self-administrated questionnaires at baseline. The patients who remained disease-free at 2 years were re-evaluated similarly. All neurologic assessments were conducted by senior neurologists. None of the 19 disease-free patients developed new neurologic deficits or MRI changes when compared with baseline. There was no difference in cognitive performances before and 2 years after, even for the 11 patients who had developed acute neurotoxicity after CAR T cells. In self-questionnaire assessments, cognitive complaint was stable, reported by 32% of the patients at 2 years. We observed a reduction in HADS anxiety scores 2 years after treatment when compared with baseline (median score: 7/21 vs 4/21, p = 0.01). In conclusion, no significant neurocognitive or neurologic disorders were observed in this cohort of patients, 2 years after treatment with anti-CD19 CAR T cells.

Reminiscence therapy-based care program serves as an optional nursing modality in alleviating anxiety and depression, improving quality of life in surgical prostate cancer patients

PurposeReminiscence therapy is reported to attenuate the psychological disorders in cancer patients, such as colorectal and lung cancer patients. However, relevant report on surgical prostate cancer patients is scarce. This study put forward a reminiscence therapy-based care program (RTCP + UC) combing reminiscence therapy with usual care (UC), and aimed to evaluate the impact of RTCP + UC on anxiety, depression, quality of life and survival in surgical prostate cancer patients.MethodsTotally, 108 prostate cancer patients receiving surgical resection were enrolled, who were subsequently randomized and allocated to the RTCP + UC group (N = 55) and UC group (N = 53) at a 1:1 ratio. Hospital Anxiety and Depression Scale (HADS) and QLQ-C30 were assessed at month M0, M3, M6, M9 and M12 during the intervention period. After intervention, patients were followed up for another 24 months to calculate disease-free survival (DFS) and overall survival (OS).ResultsRTCP + UC decreased HADS-anxiety score at M9 and M12, declined HADS-depression score at M6, M9 and M12, reduced depression rate and the severity level of depression at M12, while did not affect these issues at other time points. Meanwhile, RTCP + UC enhanced the QLQ-C30 global health status score at M3, M6, M9 and M12, but did not influence the QLQ-C30 function score and QLQ-C30 symptom score at any time points. Meanwhile, RTCP + UC had no effect on the accumulating DFS and OS of surgical prostate cancer patients.ConclusionRTCP + UC serves as an optional nursing modality in alleviating anxiety and depression, improving quality of life in surgical prostate cancer patients.

Effect of vitamin B6 on pain, disease severity, and psychological profile of fibromyalgia patients; a randomized, double-blinded clinical trial

BackgroundGiven the role of vitamin B6 on pronociceptive/antinociceptive neurotransmitters balance, metabolic reactions, and inflammation, it is important to clarify the effect of vitamin B6 on pain and psychological disturbance in fibromyalgia (FM). This study aimed to evaluate whether an 80-mg daily dose of vitamin B6 improves pain, disease severity and psychological symptoms of FM compared to a placebo.MethodsThis randomized, double-blinded, placebo-controlled trial was performed on the FM patients whose diagnosis was confirmed by a rheumatologist based on the 2016 American College of Rheumatology (ACR). 90 Patients were randomized to receive either vitamin B6 (80 mg daily) or placebo in a 1:1 ratio, with a permuted block size of 30 stratified by disease severity. Primary outcomes included the Revised Fibromyalgia Impact Questionnaire (FIQR), Hospital Anxiety and Depression Scale (HADS), 12-item short-form health survey (SF-12), and pain visual analog scale (pain-VAS)). The mean differences in outcomes (before and after treatment) were compared between the vitamin B6 and placebo groups using an independent T-test. An ANCOVA model adjusted for baseline outcome value was also provided to compare the outcomes between the two groups.ResultsOf 90 eligible patients, 60 patients (31 patients in vitamin B6 and 29 in the placebo group) completed the trial. Overall, the FIQR, pain-VAS, and HADS-anxiety scores improved after treatment in both vitamin B6 and placebo groups; However, there was no statistically significant intergroup difference regarding primary outcomes. ANCOVA model also showed no difference in the treatment effects.ConclusionsOur results showed no priority for vitamin B6 over placebo in FM patients. Considering the potential ameliorating role of vitamin B6 on pain and psychological symptoms, acknowledgment of vitamin B6 as a relatively safe adjuvant treatment needs larger future studies.Trial registrationIranian Registry of Clinical Trials: IRCT20200920048782N2 on 2021/10/04.