HADS Scores Research Articles

The Prevalence of Depression and Anxiety in Heart Failure Patients in Saudi Arabia: An Original Study.

Background Depression is a severe comorbidity that is often detected in patients with chronic diseases. Poor prognosis may eventuate high mortality risk. Up to 30% of heart failure patients have been documented with depression and the majority upholds depression-related symptoms that may have serious clinical implications, such as hospital readmissions and fatalities. To mitigate depression-induced harms among heart failure patients, studies are being conducted to determine the prevalence, risk factors, and interventions. Objectives The current investigation is envisioned to examine the prevalence of depression and anxiety among the Saudi heart failure population. Also, it will help to explore the risk factors that will subsequently facilitate the analysis of preventive measures. Methodology The cross-sectional epidemiologic research was conducted at King Khalid University, Hospital with the recruitment of 205 participants. Each participant underwent a 30-question screening for depression, anxiety, and related risk factors. The "Hospital, Anxiety, and Depression Scale" (HADSscore) was used to score subjects for the assessment of both comorbidities. The data points were subsequently analyzed by descriptive statistics and regression analysis. Results Among 205 participants, 137 (66.82%) were male and 68 (33.17%) were female with a mean age of 59.71 years. Our sample reflects a prevalence of 52.7% depression and 56.9% anxiety in Saudi heart failure patients. High depression scores were positively related to age, female gender, hospital readmissions, and pre-existing comorbidities in heart failure patients. Conclusion The study manifested high depression scores among the Saudi heart failure cohort compared to the previous survey. In addition, a substantial interrelationship of depression and categorical variables has been identified that accentuates predominating risks that can potentially promote depression and anxiety in heart failure patients.

Journal Digest: CBT With Cardiac Rehab, PMDD Neurochemistry, and More

Journal Digest: CBT With Cardiac Rehab, PMDD Neurochemistry, and More

Length of Disease More than Therapy Impacts Anxiety and Depression in Multiple Sclerosis

Persons with multiple sclerosis (PwMS) often report a reduced quality of life related to their anxiety and depression associated with the biological unknowns of MS. The COVID-19 pandemic increased the risk of anxiety due to the uncertainties related to vaccine efficacy and immune-suppressing disease-modifying therapies. PwMS were recruited from the Neurology Clinic of the Penn State Hershey Medical Center and asked to complete a demographic questionnaire and surveys on depression (MS-Beck Depression Inventory, MS-BDI) and the Hospital Anxiety and Depression Scale (HADS). The rationale for the study is to determine whether treatment modalities, age, and length of disease impacted anxiety and/or depression in PwMS. Data from 150 participants were included in the analyses. The overall mean age was 54.6 years with a 3.7:1 female:male ratio and mean length of disease of approximately 17 years. Mean scores of the HADS-D, and high scores (> 8) were 4.68 ± 0.3 and 10.0 ± 0.32, respectively, with no differences between males and females. The mean HADS-A score was 6.15 ± 0.36 with significant differences recorded between male and females. The mean high HADS-A score was 10.77 ± 0.40, with no differences between sexes. The mean MS-BDI score was 4.15 ± 0.7 with no differences between males and females. Analyses of anxiety scores in relationship to length of disease revealed no differences between males and females. Anxiety scores did not differ for PwMS on different disease-modifying therapies. In conclusion, the number of years that PwMS had the disease impacted anxiety levels more than the age or treatment regimen..

Features of the upper gastrointestinal tract mucous membrane state in patients with atherosclerosis of the mesenteric arteries

To evaluate the clinical and endoscopic features of diseases of the upper gastrointestinal tract (GIT) in patients with atherosclerosis of the mesenteric arteries (MA). The study included 48 patients with atherosclerosis of MA and 43 patients without atherosclerosis of MA, who were hospitalized in the department of vascular surgery of the Chelyabinsk Regional Clinical Hospital in the period from 2019 to 2021. All patients underwent multispiral computed tomoangiography of the visceral and lower limb arteries, esophagogastroduodenoscopy. Assessment of lesions of the upper gastrointestinal tract revealed a higher incidence of erosive and ulcerative gastroduodenopathies among patients with atherosclerosis of MA (60.4%), compared with patients without atherosclerosis MA (39.5%); p=0.047. Signs of severe atrophy according to the data of histological examination were statistically significantly more frequent among patients with atherosclerosis of MA (29.2 and 11.6%; p=0.031). According to the results of logistic regression, the following predictors of erosions and ulcers of the upper gastrointestinal tract were revealed: the severity of stenosis of the superior mesenteric artery (SMA) is more than 35%, the body mass index (BMI) is less than 25.9 and the total score on the HADS scale is more than 6.5 points for depression (p=0.008). Erosive-ulcerative gastroduodenopathies and atrophy of the gastric mucosa are significantly more common in the group of patients with MA atherosclerosis. The main risk factors for erosions and ulcers of the upper gastrointestinal tract in patients with MA atherosclerosis are: the severity of SMA stenosis is more than 35%, a decrease in BMI is less than 25.9 and an increase in the HADS score is more than 6.5 points.

Salivary gland immunohistochemistry vs substantia nigra sonography: comparative analysis of diagnostic significance

Introduction. Parkinson's disease (PD) urges for new instrumental methods of diagnosis. Transcranial sonography of the substantia nigra (SN TCS) is an established method for early PD diagnosis but its application is limited. Recently, biopsies (primarily that of salivary gland) and test for abnormal α-synuclein are suggested to verify PD.
 Materials and methods. We assessed 12 individuals with PD, Hoehn–Yahr 2.3 ± 0.4. The assessments included: UPDRS, NMSQ, NMSS, RBDSQ, PDQ-8, MoCA, and HADS scoring; SN TCS; and sublingual gland immunohistochemistry for phosphorylated α-synuclein (PS-129) with automated morphometric analysis.
 Results. Substantia nigra hyperechogenicity was shown in 75% of patients whereas biopsy revealed PS-129 in 100% of patients. Echogenic area of the substantia nigra was 0.24 [0.21; 0.3] cm2. PS-129 inclusion area varied from 28.47 [27.55; 96.26] to 238.77 [234.13; 272.49] μm2, and PS-129 proportion varied from 13.4% to 93.4% of the nervous fiber area across the patients. We found relations between PS-129 and NMSQ (r = 0.8; p 0.001), NMSS (r = 0.9; p 0.001), PDQ-8 (r = 0.7; p = 0.003), UPDRS-I (r = 0.7; p = 0.009), UPDRS-II (r = 0.6; p = 0.03), and HADS (anxiety r = 0.8; p = 0.002; depression r = 0.6; p = 0.04) scores.
 Conclusion. The results demonstrate a higher biopsy sensitivity as compared to SN TCS. Automated morphometric analysis has been newly applied to assess PS-129 occurrence. Immunohistochemistry results are directly related to non-motor symptom severity, which may indicate high probability of PS-129 presence and diagnosis confirmation in early disease.

Predictors of chronic pain and disability in patients treated conservatively after distal radius fracture: a prospective cohort study.

To determine predictors of chronic pain and disability among patients with distal radius fractures (DRF) treated conservatively with closed reduction and cast immobilization. This was a prospective cohort study. Information on patient characteristics, post-reduction radiographic parameters, finger and wrist range of motion, psychological status (Hospital Anxiety and Depression Scale or HADS), pain (Numeric Rating Scale or NRS), and self-perceived disability (Disabilities of the Arm, Should, and Hand or DASH) were taken at baseline, cast removal, and 24weeks. Differences in outcomes between time points were determined using analysis of variance. Multiple linear regressions were used to determine predictors of pain and disability at 24weeks. One hundred forty patients with DRF (70% women, age: 67.0 ± 17.9) completed 24weeks of follow-up and were included in the analysis. NRS (off-cast), range of ulnar deviation (off-cast), and greater occupational demands were significant predictors of pain at week 24 (adjusted R2 = 0.331, p < 0.001). Significant predictors of perceived disability at week 24 were HADS (off cast), sex (female), dominant-hand injury, and range of ulnar deviation (off cast) (adjusted R2 = 0.265, p < 0.001). Off-cast NRS and HADS scores are important modifiable predictors of patient-reported pain and disability at 24weeks in patients with DRF. These factors should be targeted in the prevention of chronic pain and disability post-DRF.

Evaluation of cognitive functions, emotional disturbances and acceptance of the disease in patients with cardiovascular disorders and type D personality

IntroductionThe majority of people with cardiovascular disorder meets the criteria of type D personality. Its prevalence, however, favours experiencing negative emotions and avoiding social connections [Kupper et al. Int J Cardiol. 2013;166(2) 327-33]. Cardiovascular disorders’ steady morbidity growth entitles to search for the factors, which have an impact on functioning, acceptance of the disorder and obeying doctor’s orders among patients with this diagnosis [Leu et al. J Formos Med Assoc. 2019;118(3) 721-729]. One of the factors, which largely determines mental efficiency, except for anxiety and depression symptoms, is cognitive functioning [Burkauskas et al. Cogn Behav Neurol.2016;29(2)91-9, Schiffer et al. Eur J Heart Fail. 2008;10(8) 802-10].ObjectivesEvaluation of cognitive functioning, acceptance of the disorder, intensifying of anxiety and depression symptoms among people who suffer from cardiovascular diseases with type D personality and seeking for relationships between those parameters.Methods102 people took part in the study, including 63 men and 39 women, the average age amounting to 65,471 (SD±10,567). Patients were divided according to the presence of type D personality, gender and cardiological diagnoses. The DS-14 scale was used to assess the type D personality, the HADS scale to assess the symptoms of anxiety and depression, and also the AIS scale to assess the acceptance of the disease and MoCA 7.2 scale for cognitive functions. The original questionnaire was used to collect the necessary sociodemographic data, data on the type and course of the main disease, comorbidities and medications taken.ResultsAbout 37% of respondents meet the criteria of type D personality. The AIS scores correlate negatively with age, disease duration, and with both components of the DS-14 scale (negative emotions-Ne and social inhibition-Hs). Both DS-14 subscales correlate positively with HADS-A and HADS-D, and the DS-14 (Ne) subscale is also positively associated with age. The results of the MoCA scale negatively correlate with age and duration of the disease. People without personality traits of type D have higher AIS scores, lower HADS-A (fig.1) and HADS-D scores (fig.2), and higher MoCA scores (fig.3) than those with type D personality. There were no differences between patients with ischemic heart disease and patients with ischemic heart disease and heart failure. In the subscale of social inhibition DS-14 (Hs), women obtained a higher result.Image:Image 2:Image 3:Conclusions1. People with D personality are more difficult to accept their illness, they are characterized by a higher level of depression and anxiety, and weaker cognitive functions.2. Women are characterized by stronger social inhibition.3. Younger people with a shorter medical history accept the disease more easily.4. Heart failure is not a factor differentiating the studied group of patients.Disclosure of InterestNone Declared

Organic and psychiatric symptoms of “Long COVID” among Tunisian patients: a cross sectional study

IntroductionLong COVID is a condition characterized by long-term health problems persisting or appearing after the typical recovery period of COVID-19. Physical symptoms such as respiratory, neurological and musculoskeletal complaints were initially described in the foreground. A little after, psychological disorders have been widely reported.ObjectivesThe aim of this study was to screen for somatic and anxio-depressive disorders of Long COVID.MethodsA cross sectional descriptive study included the patients consulting within a minimum of 1 month after a COVID-19 infection. It was conducted at Taher Sfar university hospital of Mahdia over a period of one year from March 2020 to March 2021. A questionnaire and physical examination were used to look for physical symptoms and the Hospital Anxiety and Depression scale (HAD) was used to screen for anxio-depressive disorders.ResultsWe recruited 137 patients. The median age was of 60 years with a sex ratio M/F at 0.073. Obesity was the most frequent comorbidity (36%) followed by diabetes (35%) and hypertension (32%). More than a quarter of patients was hospitalized (30%) during the acute phase, while the others (70%) were confined at home. The median stay duration at home or hospital was of 10 days with extremes ranging from 0 to 21 days. The most frequent post-COVID symptoms were dyspnea, mood disorders, myalgia, arthralgia, dry cough, sleep disorders and anorexia in 45%, 30%, 30%, 20%, 16%, 15% and 14% of cases, respectively. Pulmonary auscultation was normal in 86% of our patients, for the others we noted crackles, ronchi and wheezing among 9%, 1% and 1% of patients. The median oxygen saturation was 97% with a range from 93 to 99%. The majority of our patients (120) had saturation more than 95% in ambient air. The median HAD score was situated at 19 [8, 33]. Anxio-depressive disorders were present 61% of cases. A severe depression was noted among 24% of patients. and a severe anxiety among 28% of them.ConclusionsOur study highlighted a high prevalence of anxio-depressive disorders (62%) which exeeds the prevalence described in the literature. The systematic use of the HAD scale among consultants could be the explanation. Thus, psychological screening and support should be considered when managing patients having a history of COVID-19 infection. Citizens should comply with the relevant legal provisions making vaccination compulsory as it was found that COVID-19 vaccination reduced long COVID risk.Disclosure of InterestNone Declared

Study on anxiety and depression in elderly patients with malignant liver tumor undergoing hepatectomy

BackgroundPatients with malignant tumors are more likely to have psychological problems due to their worries about their life expectancy. To understand the psychological status of elderly patients with malignant liver tumor undergoing hepatectomy better, the study was designed to investigate the current situation of anxiety and depression in elderly patients with malignant liver tumor undergoing hepatectomy and to analyze its related factors.MethodsA total of 126 elderly patients with malignant liver tumor undergoing hepatectomy were selected as the research objects. The anxiety and depression of all subjects were evaluated by HADS (Hosptial Anxiety and Depression Scale). The correlation factors affecting the psychological state of elderly patients with malignant liver tumor undergoing hepatectomy were analyzed by linear regression method.ResultsThe HADS-A score of elderly patients with malignant liver tumor undergoing hepatectomy was 8.79 ± 2.56, among which 37 patients were asymptomatic, 60 patients with suspicious symptoms, and 29 patients with definite symptoms. The HADS-D score was 8.40 ± 2.97, among which 61 patients were asymptomatic, 39 patients with suspicious symptoms, and 26 patients with definite symptoms. Multivariate analysis using linear regression method showed that FRAIL score, residence, and complication were significantly associated with anxiety and depression of elderly patients with malignant liver tumor undergoing hepatectomy.ConclusionsAnxiety and depression in elderly patients with malignant liver tumor undergoing hepatectomy were obvious. FRAIL score, regional differences, and the complication were the risk factors for anxiety and depression in elderly patients with malignant liver tumor undergoing hepatectomy. Improving frailty, reducing regional differences, and preventing complications is beneficial to alleviate the adverse mood of elderly patients with malignant liver tumor undergoing hepatectomy.

Prolonged Grief Disorder and Symptoms of Anxiety and Depression among Bereaved Family Caregivers in the Context of Palliative Home Care

Background: This study aimed to investigate the prevalence and the psychological comorbidity of PGD among bereaved family caregivers of palliative care cancer patients. We also examined the discriminant validity of two simple and reliable tools in correctly categorized individuals with PGD. Methods: A cross-sectional study was conducted with 157 bereaved participants (77.1% females, mean age = 43.50 ± 14.04 years, mean time since the loss = 3.59 years) recruited from three palliative home care services. These participants completed the Prolonged Grief Scale (PG-13) and the Hospital Anxiety and Depression Scale (HADS). Results: The prevalence of PGD within the sample was 4.46% (i.e., = 7/157). Participants scored higher than the cut-off on the PG-13 and the HADS-D. Symptoms of PGD were positively correlated with depression levels. The ROC curve analysis showed that the HADS-D was outstanding in categorizing individuals with prolonged grief disorder from those without PGD. A HADS-D score of ≥7.5 was able to categorize participants with a sensitivity of 0.90 and a specificity of 0.73. Conclusions: Overall, these results highlight the relationship between grief and depression symptoms and their exceptional discriminant validity among correctly identified individuals with PGD.

Prevalence and risk factors for anxiety and depression among community dwelling patients with cervical spondylosis during the COVID-19 pandemic

BackgroundThe emergence of COVID-19 and its unfavorable consequences lead to disease fear and other related mental health problems for individuals worldwide. This study aimed to analyze the prevalence and relevant factors of anxiety and depression among community dwelling cervical spondylosis (CS) patients, and to explore the relationship between fear of COVID-19 and anxiety and depression, so as to provide scientific basis for improving their mental health. MethodsA community-based cross-sectional study was conducted among a cohort of 556 CS patients by using convenient sampling. These participants were asked to complete a demographic questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the Fear of COVID-19 Scale (FCV-19S). The Chi-square test was used to determine the differences among categorical variables. Binary stepwise logistic regression was used to determine predictors of anxiety and depression. ResultsThe median HADS-A score was 5 (interquartile interval 2–7), and the median HADS-D score was 4 (interquartile interval 2–8). In this study, the prevalence of anxiety and depression was 25.0% and 26.6%, respectively. Gender and comorbid chronic diseases were predictors of depressive symptoms. In addition, fear of COVID-19 was related to depression and anxiety among community dwelling CS patients. ConclusionApproximately one quarter of community dwelling CS patients were suffering depression or anxiety. Our findings could provide a basis for the development of psychological crisis intervention strategies for CS patients under public health emergencies in the future.

Influence of Care Burden-related Factors on Mental Health and Quality of Life of the Caregivers of Dementia Patients

Purpose: To evaluate the care burden of the caregivers of dementia patients and the relationship between anxiety-depression risk and quality of life.&#x0D; Methods: This study was conducted with 152 primary caregivers of dementia patients by using “Caregiver Burden Inventory”(CBI), “Hospital Anxiety-Depression Scale” (HADS) and “Short Version of the Quality of Life Assessment Instrument From the World Health Organization” (WHOQOL-BREF).&#x0D; Results: Mean age of the caregivers was 49.4±9.0 years; of them, 79.6% were females, 54.6% were graduates of elementary/secondary school. Mean age of dementia patients was 79.8±8.0 years; of them, 55.2% were females, 46.1% had advanced stage dementia and 30.9% had pressure ulcers. High care burden was detected in 101 (66.4%) caregivers, anxiety in 37 (24.3%) and depression in 109 (71.7%). The scores of HAD-A and HAD-D were significantly high (p=0.007, p=0.002) and WHOQOL-Bref score was significantly lower (p=0.001) in caregivers of the patients with pressure ulcers. Scores of CBI, HAD-A and HAD-D were found to significantly increase (p=0.005, p=0.042 and p=0.030, respectively) and WHOQOL-Bref score was found to significantly decrease (p=0.009) as stage of dementia increased. HAD-A and HAD-D scores were detected to increase (p=0.000, p=0.000) and WHOQOL-Bref score was detected to decrease (p=0.000) as CBI score increased. &#x0D; Conclusion: Dementia causes a high care burden for the caregivers. It is of vital importance to facilitate reaching professional support services for reducing care burden that increases with increasing stage, and establishing hospice care institutions for reducing the risk of mental disorders and for improving quality of life of the caregivers.

Prevalence of post-traumatic stress and tests of metacognition as a PTSD risk marker in patients with coronary heart disease and elevated HADS scores: analysis of data from the PATHWAY RCT's in UK cardiac rehabilitation.

Anxiety and depression in coronary heart disease (CHD) are associated with poorer health outcomes, greater healthcare use and reduced quality of life. Post-traumatic stress symptoms may be a particular concern as they are associated with increased mortality at follow-up. We examined prevalence of PTSD in patients with elevated anxiety/depression scores referred for cardiac rehabilitation (CR) across seven NHS sites in North-West England. We tested a possible mechanism (metacognition) linking CHD to PTSD symptom severity as implicated in the metacognitive model. Data was collected at baseline as part of the NIHR funded PATHWAY trial of metacognitive therapy for anxiety and depression in CHD. Patients (n = 572) with at least mild symptoms of anxiety and depression under routine screening (assessed with the Hospital Anxiety and Depression Scale) and attending CR were eligible for the study. A battery of questionnaires, including assessment of demographic variables, PTSD symptoms (using the IES-R) and metacognitive beliefs was administered prior to random allocation and intervention delivery. Rates of PTSD were high, with 48% of patients meeting threshold for PTSD and a further 15% partial PTSD. All five metacognition subscales were positively associated with PTSD vs. no PTSD, with beliefs about the uncontrollability and danger of worry and beliefs about need to control thoughts being most strongly related. For every unit increase in uncontrollability and danger metacognitions the odds of being in the PTSD group increased 30%, whilst the odds of partial PTSD increased 16%. Stepwise regression analysis using the metacognitive subscales along with demographic and health-related covariates found that uncontrollability/danger and need for control metacognitions explained unique variation in PTSD symptom severity, with unique contributions also for age, sex, and number of comorbidities. PTSD symptoms appeared highly prevalent in the current CR sample. Metacognitive beliefs were individually associated with symptom severity with the strongest positive relationship observed for beliefs about uncontrollability and dangerousness of worry, followed by need to control thoughts. The results highlight the importance in assessing PTSD in CR patients and add support to implementing metacognitive therapy in CHD to target particular metacognition risk factors in anxiety, depression and PTSD.

Anxiety and Depression in Parents of Children Undergoing Hematopoietic Stem Cell Transplant (HSCT).

In the present study were enrolled 100 parents of children who underwent HSCT. Data were collected by the completion of the "Hospital Anxiety and Depression Scale (HADs)," which also included parents' characteristics. The statistical significance level was p<0.05. Of the 100 participants, 81% and 64% of parents experienced anxiety and depression, respectively, based on HADs scores. A statistically significant association was observed between parental anxiety and gender (p=0.017), frequency of visiting the hospitalized child (p=0.023), whether they desired family members to remain in hospital (p=0.033), as well as with the need for participation in daily care (p=0.023), for help based on personal needs (p=0.026), for scheduled meetings with parents having same problems (p=0.006), for contact with hospital after discharge (p=0.035), and for written information (p=0.044). In terms of depression, a statistically significant association was observed with difficulties during the hospital stay (p=0.034), whether they desired other family members to remain in hospital (p=0.009), as well as with the need for opportunities or time for questions (p=0.004), for scheduled meetings with parents having the same problems (p=0.026), and for contact with hospital after discharge (p=0.038). Anxiety and depression were associated with possibility of family members to remain in the hospital as well as with the need for scheduled meetings with parents having the same problems and for contact after hospital discharge. Based on the findings presented, it is suggested that understanding parents' needs and perceptions is fundamental to the development of appropriate interventions that address their worries.

Tailoring STrAtegies for RelaTives for Black and South Asian dementia family carers in the United Kingdom: A mixed methods study.

We culturally adapted STrAtegies for RelaTives (START), a clinically and cost-effective intervention for dementia family carers, for Black and South Asian families. It had previously been delivered to family carers around the time of diagnosis, when most people with dementia had very mild, mild or moderate dementia. We interviewed a maximum variation sample of family carers (phase one; n=15 South Asian; n=11 Black) about what aspect of START, required cultural adaptation, then analysed it thematically using the Cultural Treatment Adaptation Framework then adapted it in English and into Urdu. Facilitators then delivered START individually to carers (phase two; n=13 South Asian; n=8 Black). We assessed acceptability and feasibility through the number of sessions attended, score for fidelity to the intervention and interviewing family carers about their experiences. We used the Hospital Anxiety and Depression Scale. to examine whether immediate changes in family carers' mental health were in line with previous studies. In phase one we made adaptations to peripheral elements of START, clarifying language, increasing illustrative vignettes numbers, emphasising privacy and the facilitator's cultural competence and making images ethnically diverse. In phase two 21 family carers consented to receive the adapted intervention; 12 completed ≥5/8 sessions; four completed fewer sessions and five never started. Baseline HADS score (n=21) was 14.4 (SD=9.8) but for those who we were able to follow up was 12.3 (SD 8.1) and immediately post-intervention was 11.3 (n=10; SD=6.1). Family carers were positive about the adapted START and continued to use elements after the intervention. Culturally adapted START was acceptable and feasible in South Asian and Black UK-based family carers and changes in mental health were in line with those in the original clinical trial. Our study shows that culturally inclusive START was also acceptable. Changes made in adaptations were relevant to all populations. We now use the adapted version for all family carers irrespective of ethnicity.

Quantitative EEG as a Biomarker in Evaluating Post-Stroke Depression.

Introduction: Post-stroke depression (PSD) has complex pathophysiology determined by various biological and psychological factors. Although it is a long-term complication of stroke, PSD is often underdiagnosed. Given the diagnostic role of quantitative electroencephalography (qEEG) in depression, it was investigated whether a possible marker of PSD could be identified by observing the evolution of the (Delta + Theta)/(Alpha + Beta) Ratio (DTABR), respectively the Delta/Alpha Ratio (DAR) values in post-stroke depressed patients (evaluated through the HADS-D subscale). Methods: The current paper analyzed the data of 57 patients initially selected from a randomized control trial (RCT) that assessed the role of N-Pep 12 in stroke rehabilitation. EEG recordings from the original trial database were analyzed using signal processing techniques, respecting the conditions (eyes open, eyes closed), and several cognitive tasks. Results: We observed two significant associations between the DTABR values and the HADS-D scores of post-stroke depressed patients for each of the two visits (V1 and V2) of the N-Pep 12 trial. We recorded the relationships in the Global (V1 = 30 to 120 days after stroke) and Frontal Extended (V2 = 90 days after stroke) regions during cognitive tasks that trained attention and working memory. For the second visit, the association between the analyzed variables was negative. Conclusions: As both our relationships were described during the cognitive condition, we can state that the neural networks involved in processing attention and working memory might go through a reorganization process one to four months after the stroke onset. After a period longer than six months, the process could localize itself at the level of frontal regions, highlighting a possible divergence between the local frontal dynamics and the subjective well-being of stroke survivors. QEEG parameters linked to stroke progression evolution (like DAR or DTABR) can facilitate the identification of the most common neuropsychiatric complication in stroke survivors.

ACT-i, an insomnia intervention for autistic adults: a pilot study

Insomnia and disturbed sleep are more common in autistic adults compared with non-autistic adults, contributing to significant social, psychological and health burdens. However, sleep intervention research for autistic adults is lacking. The aim of the study was to implement an acceptance and commitment therapy group insomnia intervention (ACT-i) tailored for autistic adults to examine its impact on insomnia and co-occurring mental health symptoms. Eight individuals (6 male, 2 female) aged between 18 and 70 years, with a clinical diagnosis of autism spectrum disorder, and scores ranging from 9 to 26 on the Insomnia Severity Index (ISI) participated in the trial. Participants were assigned to one of two intervention groups (4 per group) within a multiple baseline over time design for group. Participants completed questionnaires pre-intervention, post-intervention, and at 2-month follow-up, actigraphy 1 week prior to intervention and 1 week post-intervention, and a daily sleep diary from baseline to 1 week post-intervention, and 1 week at follow-up. At a group level there were significant improvements in ISI (λ2=10.17, p=.006) and HADS-A (anxiety) (λ2=8.40, p=.015) scores across the three time points. Clinically reliable improvement occurred for ISI scores (n=5) and HADS-A scores (n=4) following intervention. Client satisfaction indicated that ACT-i was an acceptable intervention to the participants (median 4 out of 5). This pilot study with eight autistic adults indicates that ACT-i is both an efficacious and acceptable intervention for reducing self-reported insomnia and anxiety symptoms in autistic adults.

The Impact of Common Acne on the Well-Being of Young People Aged 15-35 Years and the Influence of Nutrition Knowledge and Diet on Acne Development.

Acne is a disorder of sebaceous glands, and it most commonly develops on the face. The role of the diet in triggering and treating acne is controversial and has been widely debated in the literature. A knowledge of the environmental factors that contribute to acne could improve the patient's physical and emotional well-being, increase the efficacy of treatment, and minimize the risk of anxiety and depressive disorders. The aim of this study was to assess the impact of acne on the daily lives and well-being of people aged 15-30 years, to analyze young people's knowledge about the influence of various foods and other dietary factors on the prevalence, severity, and treatment of acne, as well as their adherence to an anti-acne diet. The study was conducted between April 2021 and May 2022. A total of 1329 respondents, including 963 women and 366 men, participated in the study. In 99% of men and women respondents, acne breakouts were typically located on the face. An analysis of HADS scores revealed moderate anxiety in 57% of women (F) and 22.5% of men (M) respondents. Acne breakouts located on the face were problematic for 81% of the study population (regardless of sex). More than ¾ of women and 2/3 of men claimed that acne made them feel less attractive. The impact of acne on the participants' emotional well-being and social life differed between genders. Women experienced psychological discomfort more frequently than men (p = 0.0023). More than 50% of the participants eliminated acne-triggering foods from their diets, and 2/3 of these respondents observed a marked improvement or disappearance of skin breakouts as a result. A significantly higher number of respondents with severe/moderate anxiety were convinced that acne breakouts were affected by diet (OR 1.56; 95% CI 1.23-1.87, p &lt; 0.001) and foods with a high glycemic index (OR 1.56; 95% CI 1.23-1.94, p &lt; 0.001). Acne affects the patients' emotional well-being. It can act as a barrier to social interactions and lead to mood disorders of varied severity. Persons with moderate/severe mood disorders associated with anxiety significantly more often recognized the role of dietary factors in acne aggravation, and the severity of mood disorders was directly correlated with more frequent consumption of sweets, sweetened beverages, and foods with a high glycemic index.

Effect of gender difference on psychiatric outcomes for hepatitis C virus patients receiving direct-acting antivirals in Egyptian population: a cohort study

Abstract Background Chronic liver disease is primarily caused by hepatitis C virus (HCV). HCV produces extrahepatic psychiatric problems. So, patients with CHC who received sofosbuvir-based direct-acting antiviral agents (DAAs) were evaluated for psychiatric manifestations, specifically depression and anxiety symptoms. Additionally, evaluate the impact of gender on psychiatric manifestations of sofosbuvir-based DAAs and identify their potential risk factors for psychiatric manifestations. In this prospective study, 170 CHC patients without prior treatment received DAA therapy who categorized into 2 groups, group 1 comprised male participants (Nb = 97), and group two comprised female participants (Nb = 73). All participants were evaluated with the five-factor model of personality (SIFFM), Hamilton Depression Rating Scale (HDS), and Hamilton Anxiety Rating Scale (HAS) at baseline and repeated follow up until 3 months after treatment end. Results Our findings indicated that, a progressive decline in the mean HADS-A and HADS-D scores between baseline (before treatment) and consequence follow-up (during and after treatment) measurements without significant difference regarding gender. No statistically significant difference between the groups regarding the mean values of SIFFM. High levels of extraversion were more likely to increase depression levels. Conclusions DAA treatment significantly improved anxiety and depression symptoms in CHC patients. Gender did not affect sofosbuvir-based DAA psychiatric symptoms. High extraversion increased depression risk.

Validation of an Instrument to Measure Family Engagement in Acute Cardiac Care

BackgroundEngaging families in care leads to improved patient- and family-centreed outcomes and is recommended by cardiovascular societies. However, no validated tools are currently available to measure family engagement in acute cardiac care. We previously described the development of the FAMily Engagement (FAME) instrument. The purpose of this study is to validate the FAME instrument in acute cardiac care. MethodsThe FAME questionnaire was administered to family members of patients in a cardiovascular intensive care unit and ward at an academic tertiary care hospital in Montreal, Canada. After hospital discharge, we assessed family satisfaction in the intensive care unit (FS-ICU) and mental health (using the Hospital Anxiety and Depression Scale [HADS]). Higher FAME scores indicate increased care engagement. Reliability was assessed using internal consistency testing. Predictive validity was evaluated by assessing the relationship between the FAME score and the FS-ICU score and whether the FAME score was correlated with the HADS score. Convergent validity was assessed by comparing the FAME score with engagement elements of the FS-ICU score. ResultsA total of 160 family participants were included (age 54.8 ± 14.8 years; 66% women; 36% non-White). The most common relationships to the patient were spouse/partner and adult child (both n = 62; 39%). The mean FAME score was 70.8 ± 16.0. The FAME instrument had high internal consistency (Cronbach’s a = 0.86). The FAME score was associated with family satisfaction in the multivariable analysis (P < 0.001). No correlation occurred between FAME and HADS anxiety or depression scores. ConclusionsThe FAME tool demonstrated reliability and convergent and predictive validity in the acute care cardiac population. Further research is needed to explore whether selected engagement interventions can impact the FAME score favourably.