Hamilton Anxiety Rating Scale Scale Research Articles

Impulsivity and Its Association with Depression and Anxiety in the Normal Egyptian Population Post COVID-19 Pandemic.

Background and Objectives: It is well known that depression, anxiety, and impulsiveness are interrelated; however, studies that have assessed their association with the coronavirus outbreak are scarce. Hence, our study aimed to evaluate the impulsivity incidence and its correlation with anxiety and depression following COVID-19 infection between November 2022 and June 2023. Materials and Methods: The 201 participants completed the Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HAM-A), Sheehan Disability Scale (SDS), and short UPPS-P scales (urgency, premeditation, perseverance, sensation seeking, and positive urgency) to allow us to determine their anxiety and depression symptoms, functional impairment, and impulsivity, respectively. Results: Among our respondents, 22%, and 26.7% had moderate to severe anxiety and depression. The short UPPS-P scale significantly correlated with the HAM-A and HDRS scales. Participants with positive COVID-19 infection showed significantly higher functional impairment scores, especially in the work/study domain (mean (SD): 3.12 (2.2) vs. 2.43 (2.3); p = 0.037). COVID-19-related disruption significantly correlated with negative and positive urgency, HAM-A, HDRS, and the SDS total and subscales. Conclusions: Our findings showed a notable increase in anxiety, depression, and functional impairment among the population following COVID-19 infection. Our research highlights the correlation between impulsivity and the psychological distress experienced following the pandemic.

Is intravenous valproate more efficacious than oral valproate for inpatients with bipolar I disorder with a manic or depressive episode and concomitant symptoms of opposite polarity?

Valproic acid (VPA) is a commonly prescribed mood stabilizer, available in both oral (OS) and intravenous (IV) formulations. However, few studies have compared their safety and efficacy. This retrospective study aimed to investigate the safety and efficacy of and IV-VPA in patients with Bipolar Disorder. Fifty patients with Bipolar Disorder experiencing a manic or depressive episode, with concomitant symptoms of opposite polarity, admitted to our inpatient unit and treated with IV-VPA were included in a retrospective, single-centre, non-randomized, open-label, parallel-group comparative study. Fifty patients experiencing a manic or depressive episode, with concomitant symptoms of opposite polarity, treated with oral-VPA and selected among those who were admitted to the inpatient unit prior to the introduction of IV-VPA in our clinical practice, were included as the control group (matched based on age, gender and clinical scales score at baseline). The Clinical Global Impression (CGI), Young Mania Rating Scale (YMRS), Montgomery-Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Rating Scale (HAM-A) scores were recorded at baseline, after 3 days of treatment and discharge from the inpatient unit. Patients were asked to respond on the basis of the symptoms present on the day the scale was administered. Response rate and the presence of adverse effects were also recorded. Both patients treated with oral and IV-VPA demonstrated significant improvements in all psychometric scales (p < 0.001). However, the IV group exhibited superior efficacy, with significantly lower scores on the CGI, YMRS, MADRS and HAM-A scales on Day 3 and at discharge from the inpatient unit. The IV-VPA treatment showed higher response rates on all psychometric scales, and no adverse effects were reported in either group. This retrospective study supports the use of IV-VPA as a more efficacious treatment option for patients with Bipolar Disorder, particularly in acute settings where rapid symptom improvement is crucial. Both oral and IV-VPA were found to be safe and well-tolerated.

Clinical Effectiveness of Hawthorn, Lemon Balm and Magnesium on Patients with Distress Disorders: Preliminary Data by a Survey of Italian Gastroenterologists

Aims: distress disorders (DD) include psychological symptoms such as sleep disorders, fatigue and psychophysical exhaustion that are common to many mental diseases. DD is often associated with somatic symptoms such as abdominal pain or bowel dysfunction. The aim of this study was to evaluate in patients with DD the effectiveness of a nutraceutical containing Hawthorn, Lemon Balm, and Magnesium (Vagostabil®) on psychological and abdominal symptoms. For this purpose, a clinical survey was conducted by 7 Italian gastroenterologists.&#x0D; Methodology: 85 patients with DD (60 F, mean age 51,6 yrs), identified by a score &gt; 18 based on the Hamilton Anxiety Rating Scale (HAM-A), were included in the study. All patients assumed Vagostabil®, three tablets a day for two months. The same HAM-A score and a VAS score for abdominal pain were used to measure clinical results.&#x0D; Results: the mean score of the HAM-A scale decreased from 28.61 to 18.22 after 1 month and to 11.46 after 2 months of treatment respectively (P = .001 for all comparisons). An overall reduction of HAM-A score by 59.94 % was observed at the end of the treatment (P = .001). Similarly, VAS score for abdominal pain decreased from 7.59 to 4.86 after 1 month, and to 2.41 at the end of the treatment (P = .001 for both comparisons). A global reduction of 68.25% in the VAS score was observed at the end of the survey (P = .001).&#x0D; Conclusion: this clinical survey showed that Vagostabil® can ameliorate psychological symptoms and associated abdominal pain in patients with DD. These preliminary data suggest that Vagostabil® could be utilized by gastroenterologists in functional gastrointestinal disorders. However, further studies are needed to confirm these data.

A voxel-based morphometry investigation of brain structure variations in late-life depression with insomnia.

Late-life depression (LLD) is linked to various medical conditions and influenced by aging-related processes. Sleep disturbances and insomnia symptoms may be early indicators or risk factors for depression. Neuroimaging studies have attempted to understand the neural mechanisms underlying LLD, focusing on different brain networks. This study aims to further delineate discriminative brain structural profiles for LLD with insomnia using MRI. We analyzed 24 cases in the LLD with insomnia group, 26 cases in the LLD group, and 26 in the healthy control (HC) group. Patients were evaluated using the Hamilton Depression Rating Scale (HAMD-17), Hamilton Anxiety Rating Scale (HAMA), Mini-Mental State Examination (MMSE), and Pittsburgh Sleep Quality Index (PSQI). Structural MRI data were gathered and analyzed using voxel-based morphometry (VBM) to identify differences in gray matter volume (GMV) among the groups. Correlation analyses were conducted to explore the relationships between GMV and clinical characteristics. Significant difference in sex distribution was observed across the groups (p = 0.029). However, no significant differences were detected in age and MMSE scores among the groups. LLD with insomnia group exhibited significantly higher HAMA (p = 0.041) and PSQI scores (p < 0.05) compared to the LLD group. ANOVA identified significant difference in GMV of anterior lobe of cerebellum (peak MNI coordinate: x = 52, y = -40, z = -30) among HC, LLD, and LLD with insomnia. Post-hoc two-sample t-tests revealed that the significant difference in GMV was only found between the LLD group and the HC group (p < 0.05). The mean GMV in the cerebellum was positively correlated with HAMA scale in LLD patients (r = 0.47, p < 0.05). There is significant difference in GMV in the LLD group, the association between late-life depression and insomnia may be linked to anxiety. This study provides insights into the discriminative brain structural profiles of LLD and LLD with insomnia, advancing the understanding of the underlying neural mechanisms and potential targets for intervention.

Prevalence and clinical correlates of abnormal glucose metabolism in young, first- episode and medication-naïve outpatients with major depressive disorder

BackgroundsThe high co-morbidity of abnormal glucose metabolism in depressed patients has been extensively studied, but few studies have explored abnormal glucose metabolism in young patients with major depressive disorder (MDD). This study aimed to examine the prevalence and clinical correlates of abnormal glucose metabolism in young patients with first-episode medication-naïve (FEMN) MDD. MethodsA cross-sectional study was conducted on 1289 young Chinese outpatients with FEMN MDD. All subjects were assessed on the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale (HAMA), Positive and Negative Syndrome Scale, and their sociodemographic information was collected, and blood pressure, blood glucose, lipid and thyroid hormone levels were measured. ResultsThe prevalence of abnormal glucose metabolism was 12.57% in young FEMN MDD outpatients. Thyroid stimulating hormone (TSH) levels and HAMA scale scores were associated with fasting blood glucose levels in patients with FEMN MDD (P<0.05), and TSH could differentiate patients with abnormal normal glucose metabolism from those without abnormal glucose metabolism (Area Under Curve of 0.774). ConclusionsOur study showed a high prevalence of comorbid glucose metabolism abnormalities in young FEMN MDD outpatients. TSH may be a promising biomarker of abnormal glucose metabolism in young patients with FEMN MDD.

Assessment and correlation of anxiety, depression and serum cortisol levels in patients with oral submucous fibrosis and leukoplakia: A clinicohematological study.

Potentially malignant disorders (PMDs) of the oral cavity like oral submucous fibrosis (OSMF) and leukoplakia are known to be caused due to addictive habits, while serum cortisol is accepted to be a stress hormone. The present study was aimed to assess and correlate the anxiety, depression and serum cortisol levels in habit-associated PMDs such as OSMF and leukoplakia and compare it with healthy subjects. Ninety patients were included in the study and were divided into three Groups, namely Group I (OSMF), Group II (leukoplakia) and Group III (control group). Serum cortisol levels and severity of anxiety and depression using the Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D) were recorded and correlated. A significant correlation existed between serum cortisol level and levels of both anxiety and depression between Group I and II as compared to the control group. There exists a definite correlation between serum cortisol levels and the levels of anxiety and depression in patients with leukoplakia and OSMF, with increasing levels of serum cortisol and higher values in both the HAM-A and HAM-D scales in patients with both OSMF and leukoplakia. PMDs such as leukoplakia and OSMF have an established cancer-causing potential. Anxiety and depression although prevalent are underdiagnosed and poorly understood. Hence, a holistic approach in the treatment of such pathologies including hematological investigations and psychological evaluation should be mandatorily made a part of the workup and treatment plan.

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Treatment of Psoriasis Vulgaris with Medicated Thread Moxibustion of Zhuang Medicine: A Multicenter Randomized, Parallel Controlled Trial.

To explore the efficacy and safety of Zhuang medicine medicated thread moxibustion (ZMTM) on psoriasis vulgaris. A multicenter, randomized, parallel controlled clinical trial was designed. A total of 241 outpatients with psoriasis vulgaris were randomly divided into a control group (120 cases) and a treatment group (121 cases) using a central block randomization from June 2015 to May 2018. The control group was treated with Western medicines alone including pidotimod dispersible tablets, vitamin B compound tablets, and compound cod liver oil-zinc oxide ointment. The treatment group was treated with ZMTM every 2 days combined with Western medicines. The two groups received continuous intervention for 30 days. The primary outcome was Psoriasis Area and Severity Index (PASI), and the secondary outcomes included Itch Rating Scale, Dermatology Quality of Life Index (DLQI), Hamilton Anxiety Rating Scale (HAMA), as well as PASI response rate. Meanwhile, adverse events were evaluated during the whole clinical trial. Follow-up was carried out 30 days after treatment. There were 5 cases of shedding in this trial. In intention-to-treat analysis, 236 cases were included and each group contained 118 cases. On the 30th and 60th days, PASI scores of patients in each group were significantly lower than that at baseline (P<0.01) and the PASI score reduction of the treatment group was greater than that of the control group (P<0.01). Itch Rating Scale, DLQI, and HAMA scale were decreased in both groups after treatment, and the treatment group showed a better therapeutic effect (P<0.01). The response rates of PASI 50 and 75 were significantly higher than those in the control group [81.4% (96/118), 43.2% (51/118) vs. 41.5% (49/118), 11.0% (13/118), respectively, P<0.05]. During follow-up, the improvements in scores of PASI, Itch Rating Scale, DLQI, and HAMA of the treatment group were significantly greater than those of the control group (P<0.01). The response rates of PASI 50 and 75 in the treatment group were significantly higher than those in the control group, respectively (both P<0.05). No obvious adverse reaction was found in either group. ZMTM combined with Western medicines showed a better therapeutic effect in the treatment of psoriasis vulgaris without obvious adverse reaction. (Trial Registration No. ChiCTR-IOR-16008159).

EFFECT OF PAROXETINE IN ANXIETY DISORDER AMONG SCHOOL DROPOUT TEENAGER IN SOUTH INDIAN POPULATION

Objective: Anxiety disorders are the most common group of psychiatric illnesses in children. This study is to observe the effectiveness of Paroxetine in anxiety disorder among teenagers in South India population using Hamilton Anxiety Rating Scale (HAM-A) and to screen the possible risk for paroxetine in anxiety disorder among teenagers.&#x0D; Methods: This study is a prospective observational study that was conducted for a period of 6 mo. Of 84 teenage patients with anxiety disorder assessed using Hamilton Anxiety Rating Scale (HAM-A) were followed-up in an outpatient psychiatric ward. Study population includes both sexes, age group between 13 to 19 y, Teenage patient receiving paroxetine for anxiety disorder were included and patients unwilling to give written informed consent or assent form were excluded.&#x0D; Results: Out of 84 patients the prevalence of symptoms before the drug treatment, 65 patients were falling in very severe category, which was assessed by HAM-A scale. Then reassessed with drug Paroxetine at week 4 and week 8. There was a drastic reduction in the prevalence of symptoms in week 8 than compared to week 4. A significant reduction in body weight was also observed during the study period. Among various side effects, nausea was the prominent risk found during the study.&#x0D; Conclusion: The present study demonstrated that paroxetine is effective and well-tolerated for the treatment of various types of anxiety disorder in teenagers with few side effects.

Effect of Dance Therapy on Stress and Anxiety in Working Women

Objective: To find out the effect of dance therapy on stress and anxiety in working women. Method: A total of 41 women between age group 25 to 40 years were randomly selected to receive aerobic dance therapy. The program was conducted for 4 weeks, scheduled three days in a week, with a session of 10-20 minutes each day. Outcome assessment included perceived stress scale (PSS) and Hamilton anxiety rating scale (HAMA) which was recorded before and after completion of sessions. Result: There was a reduction in levels of stress and anxiety after 4 weeks of aerobic dance therapy (p value < 0.0001) which was found to be statistically significant; whereas correlation between working hours and scores of PSS (r value -0.16) and HAMA (r value -0.06) Scales were statistically insignificant. Conclusion: On the basis of results of our study we concluded that aerobic dance therapy was effective in reducing stress and anxiety in working women.

Treatment of multiple sclerosis patients with sleep disorders associated with anxiety

Sleep disorders (SD) have a crucial impact on enhancement of disability and decreasing quality of life alongside with motor, cognitive and psycho-emotional disorders in patients suffering from multiple sclerosis (MS). The aim of our study was to determine efficiency of treatment of MS patients suffering from sleep disorders associated with anxiety and evaluation of possible medication’s effect on fatigue severity, cognitive impairment and asthenia features among participants. Twenty patients enrolled in the current study were suffering from MS with relapsing-remitting and secondary-progressive types (mean age 43,7 ± 8,9; disease duration 11,3 ± 7,6) and had sleep disorders of different severity associated with anxiety. The following questionnaires were applied in the study: The Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Rating Scale (HAM-A), The Montreal Cognitive Assessment (MoCA), Modified Fatigue Impact Scale (MFIS), Asthenic State Scale (ШАС). According to results of the Pittsburgh Sleep Quality Index 10% of participants had mild sleep disorders, 35% had moderate and 55% had severe. Based on HAM-A results 30% had mild, 25% had mild and 45% had severe anxiety. A drug Valeo-Dorm Duo (kryzin, melatonin) was applied for treatment. The dynamics of sleep quality, anxiety, cognitive impairment and asthenia indicators during the treatment were evaluated with the use of corresponding scales. A significant improvement of sleep quality was found in 70% of patients after treatment, as well as decreased level of anxiety in 45% to mild and in 55% to moderate according to HAM-A scale. Applying of Valeo-Dorm Duo proved to be effective in cases of treatment of patients suffering from a combination of sleep disorders with anxiety. It prompted sleep normalization and decreasing of anxiety and asthenia symptoms, thus the treatment improved quality of life of these patients.

Aplikasi Pengukuran Tingkat Kecemasan Berdasarkan Skala Hars Berbasis Android

Abstract - The development of technology that getting increasingly has an impact on a mobile device. In this era, mobile phone is a communication tool that is flexible, easy to carry anywhere, and its function is almost the same as the computer. The operating system that mobile phone has got increasingly. One of them is that Android operating system has grown rapidly and almost dominates the mobile market. The development of technology and the increase of necessities life make people have to work harder to sufficient their life. People compete to sufficient the needs and keep up the development that exists, but not everyone is able to sufficient it. It makes people want to do crimes like theft, corruption, murder, etc. This happens because someone is too obsessed with their desire. so they are afraid and anxious if they cannot sufficient and achieve their desire. Anxiety can be interpreted as an uncertain fear with a feeling of uncertainty and helplessness that can cause an uncomfortable feeling. So, it triggers their self to do bad things. In this phenomenon is needed an application that can be used to determine the level of anxiety because knowing the level of anxiety early can prevent people to do bad things. The measurement applications of anxiety levels with HARS scale are made based on the Hamilton Anxiety Rating Scale (HARS).

Assessment of cognitive functions and psychiatric symptoms in hepatitis C patients receiving pegylated interferon alpha and ribavirin: A prospective cohort study.

Objective This study aimed to prospectively evaluate cognitive functioning in hepatitis C virus patients before, during, and after interferon alpha and to assess the psychiatric side effects of interferon alpha such as depression and anxiety. Methods A total of 100 chronic hepatitis C virus patients eligible for interferon therapy from the hepatitis outpatient clinic of Assiut University Hospital were included. A full medical and psychiatric assessment was done using the Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-A). Cognitive assessment was done using The Mini-Mental State Examination (MMSE), Memory Assessment Scales (MAS), and Wechsler Adult Intelligence Scale (WAIS). Medical, cognitive, and psychiatric assessments were conducted at the start of the study and after starting the treatment at two, four, and six months. Results There was a significant increase in the mean scores of HAM-D (t = 7.739, p &lt; 0.001; t = 5.707, p &lt; 0.001; t = 5.115, p &lt; 0.001) and HAM-A (t = 6.237, p &lt; 0.001; t = 4.154, p &lt; 0.001; t = 3.955, p &lt; 0.001) scales at the two, four, and six month follow-ups, respectively, in comparison to the baseline measurements. As regards to the MAS, repeated assessments after two, four, and six months showed no statistically significant difference from the baseline apart from deterioration in the verbal memory performance after six months in comparison to the baseline (t = −2.605, p = 0.011). As regards to MMSE, the verbal intelligence quotient (IQ), performance IQ, and total IQ, there was a significant improvement in the patients’ cognitive performance, in comparison to the baseline, after two months (t = 2.144, p = 0.035), four months (t = 2.868, p = 0.002), and six months (t = 3.505, p = 0.001), respectively. There was also a significant negative correlation between HAM-D mean scores and the MAS verbal mean scores of the patients (r = −.219, p = 0.039). Conclusion There were increases in symptoms of depression and anxiety during interferon alpha and ribavirin treatment, which do not correlate with the patients’ cognitive performance. There was a significant improvement in cognitive performance except in verbal memory with the progress of interferon alpha treatment. Years of education, socioeconomic status, and lower quantitative polymerase chain reaction are predictors for better cognitive performance.

OBSESSIVE COMPULSIVE PERSONALITY AND FATIGUE IN PATIENTS WITH ANXIETY AND MOOD DISORDERS

Introduction Prior analysis has demonstrated executive dysfunction as a cardinal feature of fatigue in a post myocardial infarction population [1]. Executive problems have also been demonstrated in a group of subjects with obsessive compulsive personality disorder (OCPD) [2]. Traits of OCPD are commonly associated with depression, which has fatigue as an intrinsic element; however, so far no study has investigated the possibility of a specific association between fatigue and OCPD. Aim To investigate whether measures of fatigue and OCPD were associated, in a sample of patients with anxiety and mood disorders (AMD) demonstrating high levels of fatigue. Material and Methods A cross-sectional study of patients with AMD attending a Stress Disorders Clinic. Socio-demographic and clinical information including diagnosis (as defined by The Mini International Neuropsychiatric Interview), medication use, body mass index, and history of smoking were collected. The severity of OCPD traits was evaluated using the observer-rated Compulsive Personality Assessment Scale (CPAS) [2]. The Multidimensional Fatigue Inventory (MFI-20) was used to assess general, physical and mental fatigue, reduced activity and motivation. The Beck Depression Inventory-II (BDI-II) and the Hamilton Depression Rating Scale (HAM-D) were employed to measure subjective and objective symptoms of depression, while the Hamilton Anxiety Rating Scale (HAM-A) measured anxiety symptoms. Two-tailed Student’s t-test or Fisher’s χ2 test were applied to compare socio-demographic, clinical, fatigue, anxiety and depression characteristics in AMD patients with and without OCPD. Binary logistic regression analyses were performed to test associations between OCPD and fatigue, while controlling for possible confounders. Results Sixty-seven patients participated, 49 (73.1 %) females with a mean age of 39±13. In this group, 14 (20.9%) patients had one mood disorder, 17 (25.4%) had one anxiety disorder, and the remaining 36 (53.7%) patients suffered simultaneously from AMD. Nine patients (13.4%) fulfilled operational criteria for OCPD. The OCPD group had higher subjective depression scores on the BDI-II relative to patients without OCPD (35.1±14.1 vs. 23.5±11.1; p = 0.007). However, scores on the HAM-D and HAM-A scales did not show any difference between groups (p’s > 0.05). Measures of physical and mental fatigue were higher among OCPD patients than non-OCPD (respectively, 81.9±22.8 vs. 62.5±25.8, p = 0.037; 88.9±13.5 vs. 65.7±27.6, p = 0.017). Controlling for potential confounders i.e. depression scores (BDI-II), age, gender, medication use and reduced motivation, the association between mental fatigue and OCPD remained significant and was associated with a 1.072-fold increase (95% confidence, 1.002 to 1.147, p = 0.045) in risk for OCPD. There was no longer a significant effect of physical fatigue on OCPD. Conclusions Mental fatigue in patients with AMD is associated with OCPD traits even when depression and reduced motivation symptoms are taken into account. Thus, mental fatigue might represent a previously under-explored marker of OCPD. Further investigation of mental fatigue in diverse groups of patients is needed to confirm this finding.

Relationship of Apathy with Depressive Symptom Severity and Cognitive Functions in Geriatric Depression.

Apathy which is known as loss of primary motivation is observed more frequently in elderly depression in comparison with younger adults. It is put forth that apathy is related with depressive symptom severity and cognitive functions, that the existence of apathy may be a predictor of neurocognitive impairment. The objective of this study was to examine the apathy levels in elderly patients with major depression as well as the relationship between depressive symptom severity and cognitive functions. The study was carried out with 40 major depressive disorder patients (MDD) aged 60 and above, 40 healthy controls aged 60 and above. Sociodemographic data form, structured psychiatric interview (SCID-I), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Montgomery-Asberg Depression Rating Scale (MADRS), Standardized Mini Mental State Examination (SMMSE), Montreal Cognitive Assessment Scale (MoCA), Apathy Evaluation Scale (AES) and Sheehan Disability Scale (SDS) were applied to the participants. In our study, HAM-D, HAM-A and MADRS scale scores of MDD group was determined to be higher in comparison with those of the healthy control group. A positive correlation was determined in the MDD groups between the AES scores and depressive symptom severity, whereas a negative correlation was determined between the AES scores and cognitive functions. The SMMSE and MoCA scores of the geriatric MDD group were determined to be lower in comparison with healthy control group. Low performance was observed in the geriatric MDD group especially in the fields of orientation, visual/spatial functions, memory and language. Functionality was found to be lower in MDB group than in the control group, and functionality decreased as the level of apathy increased. Our results indicate that the apathy levels in geriatric depression are higher in comparison with the control group. Cognitive functions are affected adversely in geriatric patients in major depressive disorder, depressive symptom severity, impairment in cognitive functions and functionality are observed to be related with apathy level.

Association of yoga practice and serum cortisol levels in chronic periodontitis patients with stress-related anxiety and depression.

Aim:Reducing the psychosocial stress by various methods can improve overall health, and yoga is now considered as an easily available alternative method. The present cross-sectional pilot study was conducted mainly to find the association of yoga practice with periodontal disease by measuring serum cortisol levels.Materials and Methods:A total of 70 subjects with age range of 35–60 years suffering with chronic periodontitis were divided into group I (with stress), group II (without stress), and group III (practicing yoga). Psychological evaluation was carried out using Hamilton Anxiety Rating Scale (HAM-A) and Zung Self-rating Depression Scale (ZSDS). Periodontal parameters like plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) at 5–8 mm and >8 mm were recorded. Blood samples were collected and serum cortisol levels were measured.Results:Mean age, plaque scores, and number of teeth with PPD and CAL at 5–8 mm and >8 mm were similar in all the groups, except between group I and group III where a multiple comparison with Tukey's post-hoc test showed significant difference in plaque index (P < 0.038) and the number of teeth with CAL 5–8 mm (P < 0.016). Serum cortisol levels and HAM-A scale and ZSDS scores showed highly significant value (P < 0.001) in group I subjects when compared with group II and group III subjects.Conclusion:Cross-sectional observation done among three groups showed that individuals practicing yoga regularly had low serum cortisol levels, HAM-A scale and ZSDS scores, and better periodontal health.

Clinical and economic outcomes of adjunctive therapy with pregabalin or usual care in generalized anxiety disorder patients with partial response to selective serotonin reuptake inhibitors.

BackgroundThis study is done to compare the effect of adjunctive therapy with pregabalin versus usual care (UC) on health-care costs and clinical and patients consequences in generalized anxiety disorder (GAD) subjects with partial response (PR) to a previous selective serotonin reuptake inhibitor (SSRI) course in medical practice in Spain.MethodsPost hoc analysis of patients with PR to SSRI monotherapy enrolled in a prospective 6-month naturalistic study was done. PR was defined as a Clinical Global Impression (CGI) scale score ≥3 and insufficient response with persistence of anxiety symptoms ≥16 in the Hamilton Anxiety Rating Scale (HAM-A). Two groups were analyzed: 1) adjunctive therapy (AT) with pregabalin (150–600 mg/day) to existing therapy and 2) UC (switching to a different SSRI or adding another anxiolytic different than pregabalin). Costs included GAD-related health-care resources utilization. Consequences were a combination of psychiatrist-based measurements [HAM-A, CGI, and Montgomery-Asberg Depression Rating Scale (MADRS)] and patient-reported outcomes [Medical Outcomes Study Sleep (MOS-sleep) scale, disability (World Health Organization Disability Assessment Schedule II (WHO-DAS II) and quality-of-life (Euro Qol-5D (EQ-5D)]. Changes in both health-care costs and scale scores were compared separately at end-of-trial visit by a general linear model with covariates.ResultsFour hundred eighty-six newly prescribed pregabalin and 239 UC GAD patients [mean (SD) HAM-A 26.7 (6.9) and CGI 4.1 (0.5)] were analyzed. Adding pregabalin was associated with significantly higher mean (95% CI) score reductions vs. UC in HAM-A [−14.9 (−15.6; −14.2) vs. −11.2 (−12.2; −10.2), p < 0.001] and MADRS [−11.6 (−12.2; −10.9) vs. −7.8 (−8.7; −6.8), p < 0.001]. Changes in all patient-reported outcomes favored significantly patients receiving pregabalin, including quality-of-life gain; 26.4 (24.7; 28.1) vs. 19.4 (17.1; 21.6) in the EQ-VAS, p < 0.001. Health-care costs were significantly reduced in both cohorts yielding similar 6-month costs; €1,565 (1,426; 1,703) pregabalin and €1,406 (1,200; 1,611) UC, p = 0.777. The effect of sex on costs and consequences were negligible.ConclusionIn medical practice, GAD patients with PR to SSRI experienced greater consequence improvements with adjunctive therapy with pregabalin versus UC, without increasing health-care cost. The effect of pregabalin was independent of patient gender.

Assessment of health-related quality of life, anxiety and depression in patients with early rheumatoid arthritis

Aim of the workTo assess the effect of clinical manifestations, disease activity and medications on health-related quality of life (HRQoL) among patients with early rheumatoid arthritis (RA). Patients and methodsTwenty-six early RA patients (mean age 43.31±10.51years, disease duration: 16.5±5.2months) diagnosed according to the 2010 RA classification criteria were recruited from the outpatient clinic of the Rheumatology and Rehabilitation Department, Sohag University, and 22 age and sex matched healthy persons participated in a case control study. Demographic data were taken from all participants in the study. The 36-item short-form health survey (SF-36) and Hamilton Anxiety Rating Scale (HAM-A) were assessed as measures of HRQoL and psychiatric comorbidity for both patients and controls. Disease activity in RA was assessed using the disease activity score (DAS28). Scoring algorithms were applied to produce the physical and mental component scores (PCS and MCS). ResultsThere was statistically significant difference in the total SF36 score, anxiety and depression scores of HAM-A scale between patients and controls. The PCS showed the highest significant difference (p<0.0001), followed by SF36 (p=0.01) and MCS (p=0.024). There were no significant differences according to the age, gender, occupation or level of education of the patients. Anxiety and depression scores significantly correlated with the bodily pain and DAS28 scores and inversely with the PCS and MCS. The DAS28 strongly negatively correlated with the PCS and MCS. ConclusionRheumatoid arthritis has a major impact on many areas of an individual’s life and tends to have a profound impact on the health-related quality of life.

The therapeutic effects of oxygen inhalation combined with relaxation training on generalized anxiety disorder

Objective To observe the therapeutic effects of oxygen inhalation combined with relaxation training on patients ,with generalized anxiety disorder （GAD）. Methods A total of 188 GAD patients were divided into the study group and the control group randomly. The two groups were treated with conventional antianxiety drugs （paroxetine） , in addition to conventional medical therapy. The study group was aided with oxygen inhalation and relaxation training, the control group was given henzodiazepine. The scores of Hamilton anxiety rating scale （HAMA） , global improvement（GI） [ a part of clinical global impression （CGI）], and treatment emergent symptom scale （TESS） were used to evaluate clinical effects and adverse reactions before and after 4-week treatment. The indexes of breathing, heart rate and blood pressure were evaluated before and after treatment. Results The scores of HAMA scale and GI in the two groups were significantly different after treatment（ P 〈 0.05 ） , and the study group changed significantly（ P 〈 0.05 or P 〈 0.01 ）. The adverse reactions of the two groups were slight, there was no significant difference of TESS before and after treatment （ P 〉 0. 05 ）. There was no significant difference in terms of breathing, heart rate and blood pressure between the two groups before treatment（ P 〉 0.05 ） , but were all lower after treatment the study group changed more apparently and significantly（ P 〈 0.01 ）. Conclusions Based on conventional drugs treatment oxygen inhalation combined with relaxation training could improve anxiety and somatization rapidly, there was no obvious adverse reaction and the patients compliance was good, so the treatment was worth to use in clinic. Key words: Oxygen inhalation; Relaxation training; Generalized anxiety disorder

L-Theanine Relieves Positive, Activation, and Anxiety Symptoms in Patients With Schizophrenia and Schizoaffective Disorder

L-theanine is a unique amino acid present almost exclusively in the tea plant. It possesses neuroprotective, mood-enhancing, and relaxation properties. This is a first study designed to evaluate the efficacy and tolerability of L-theanine augmentation of antipsychotic treatment of patients with chronic schizophrenia and schizoaffective disorder. 60 patients with DSM-IV schizophrenia or schizoaffective disorder participated in an 8-week, double-blind, randomized, placebo-controlled study. 400 mg/d of L-theanine was added to ongoing antipsychotic treatment from February 2006 until October 2008. The outcome measures were the Positive and Negative Syndrome Scale (PANSS), the Hamilton Anxiety Rating Scale (HARS), the Cambridge Neuropsychological Test Automated Battery (CANTAB) for neurocognitive functioning, and additional measures of general functioning, side effects, and quality of life. 40 patients completed the study protocol. Compared with placebo, L-theanine augmentation was associated with reduction of anxiety (P = .015; measured by the HARS scale) and positive (P = .009) and general psychopathology (P < .001) scores (measured by the PANSS 3-dimensional model). According to the 5-dimension model of psychopathology, L-theanine produced significant reductions on PANSS positive (P = .004) and activation factor (P = .006) scores compared to placebo. The effect sizes (Cohen d) for these differences ranged from modest to moderate (0.09-0.39). PANSS negative and CANTAB task scores, general functioning, side effect, and quality of life measures were not affected by L-theanine augmentation. L-theanine was found to be a safe and well-tolerated medication. L-theanine augmentation of antipsychotic therapy can ameliorate positive, activation, and anxiety symptoms in schizophrenia and schizoaffective disorder patients. Further long-term studies of L-theanine are needed to substantiate the clinically significant benefits of L-theanine augmentation.