Hamilton Anxiety Rating Scale Research Articles

Prevalence and risk factors for psychotic symptoms in young, first-episode and drug-naïve patients with major depressive disorder

BackgroundMajor depressive disorder (MDD) is a common psychiatric disorder worldwide. Psychotic depression has been reported to be frequently under-diagnosed due to poor recognition of psychotic features. Therefore, the purpose of this study was to reveal the rate and risk factors of psychotic symptoms in young, drug-naïve patients with major depressive disorder at the time of their first episode.MethodsA total of 917 patients were recruited and divided into psychotic and non-psychotic subgroups based on the Positive and Negative Syndrome Scale (PANSS) positive subscale score. Anxiety symptoms and depressive symptoms were measured by the Hamilton Anxiety Rating Scale (HAMA) and the 17-item Hamilton Depression Rating Scale (HAMD-17), respectively. Several biochemical indicators such as total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) were also measured.ResultsThe rate of psychotic symptoms among young adult MDD patients was 9.1%. There were significant differences in TSH (p<0.001), FBG (p<0.001), TC (p<0.0001), TG (p = 0.001), HDL-C (p = 0.049), LDL-C (p = 0.010), diastolic blood pressure (DP) (p<0.001), systolic blood pressure (SP) (p<0.001), and HAMD total score (p<0.001) between young MDD patients with and without psychotic depression. HAMD, TSH, TC, and severe anxiety were independently associated with psychotic symptoms in young adult MDD patients. In addition, among young MDD patients, the rate of suicide attempts in the psychotic subgroup was much higher than in the non-psychotic subgroup (45.8% vs. 16.9%).ConclusionsOur findings suggest that psychotic symptoms are common in young MDD patients. Several clinical variables and biochemical indicators are associated with the occurrence of psychotic symptoms in young MDD patients.

A Comparison of the Anxiolytic Properties of Tofisopam and Diazepam: A Double-Blind, Randomized, Crossover, Placebo-Controlled Pilot Study.

New clinical reports have recently been published on tofisopam-an anxiolytic drug currently registered as a benzodiazepine-after a long break in this research area. Neurobiological studies concerning its properties, which differ from those of benzodiazepines, are underway. The analyses presented in this study aimed to compare the effects of tofisopam, diazepam, and a placebo in the treatment of anxiety symptoms. A total of 66 outpatients (43 women and 23 men) with generalized anxiety disorder aged 19 to 74 years (M = 41.4; SD = 13.2) were randomized in three groups receiving (1) tofisopam (50 mg three times a day), (2) diazepam (5 mg three times a day), or (3) a placebo for 2 weeks. Then, throughout a 2-week washout period, the patients were monitored for withdrawal symptoms. During the last 2 weeks, the effects of tofisopam (50 mg three times a day) and diazepam (5 mg three times a day) were compared (crossover design). The mean improvement on the Hamilton Anxiety Rating Scale was significantly higher in both the tofisopam and diazepam groups compared to the placebo group. There were no significant differences between the effects of diazepam and tofisopam, whereas adverse effects and withdrawal symptoms occurred less frequently in the tofisopam group. Tofisopam did not impair cognitive abilities, and related withdrawal symptoms resembled those of the placebo. If larger future studies corroborate these findings, tofisopam should be classified as a homophtalazine.

Effectiveness of Mindfulness Yoga and Progressive Resistance Exercises on Anxiety and Depression among Parkinson’s Disease

Background: This study was designed to inspect the effectiveness of Mindfulness Yoga and Progressive resistanceexercise on anxiety and depression among Parkinson’s disease.Purpose: To compare the effectiveness of Mindfulness Yoga and Progressive resistance exercise on anxiety anddepression among Parkinson’s diseaseMaterials and Methods: The study was conducted with a sample size of 28 participants . The subjects were selectedfrom Sri Saga Physiotherapy Centre, according to inclusion and exclusion criteria. Patients were completelyexplained about the safety and simplicity of the procedure and informed consent were obtained from the patient.For all the subjects Pre-test outcome measure were assessed using Hamilton anxiety and Hamilton depressionscale. The subjects was divided into two groups based on concealed envelope method .Group A were givenmindfulness yoga for 4 weeks of duration of 30 mins and Group-B were given Progressive resistance exercise for4 weeks (10 reps*3 sets where 10RM=1kg) .At the end of 4th week post outcome measures were analyzed usingHamilton anxiety and Hamilton depression scale and statistically tabulated.Result: Statistical analysis of Hamilton anxiety and Hamilton depression scale examination post-test valuesrevealed the constantly significant differences, with P value of &lt; 0.0001.Conclusion: Mindfulness yoga was found to be more effective than progressive resistance exercise in reducinganxiety and depression symptoms among Parkinson’s patients.

Latent classes of symptom trajectories among major depressive disorder patients in China

ObjectiveThis study aimed to understand the long-term symptom trajectories of Chinese patients with major depressive disorder (MDD) using piecewise latent growth modeling and growth mixture modeling. The investigation also aimed to identify the baseline characteristics indicative of poorer treatment outcomes. MethodsA total of 558 outpatients with MDD were assessed using a sequence of surveys. The Hamilton Rating Scale for Depression (HRSD), Hamilton Anxiety Rating Scale (HAMA), and Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) were used to evaluate baseline depression, anxiety, and cognitive function. Depression symptom severity was subsequently measured at the 1-month, 2-month, 6-month, 1-year, and 2-year follow-ups. ResultsResults indicated three depressive symptomology trajectories, including (a) severe, improving class (12.72 %), (b) partially responding, later deteriorating class (6.09 %), and (c) moderate, improving class (81.18 %). Logistic regression analyses showed that a history of cardiovascular disease (CVD) increased the odds of belonging to the partially responding, later deteriorating class, whereas higher baseline depression increased the odds of belonging to the severe, improving class compared to the moderate, improving class. Patients who experienced less depression relief during the first month of treatment had a lower probability of belonging to the moderate, improving class. LimitationsParticipant attrition in this study may have inflated the estimated rate of treatment-resistant patients. ConclusionsThe burden of CVD and poorer initial treatment response are plausible risk factors for poorer treatment outcomes, highlighting targets for intervention in Chinese MDD patients.

A contribution to the French validation of the clinical anxiety scale amongst health care workers in Switzerland

BackgroundAnxiety disorders are frequent but remain often underdiagnosed and undertreated. Hence, valid screening instruments are needed to enhance the diagnostic process. The Clinical Anxiety Scale (CAS) is a 25-item anxiety screening tool derived from the Hamilton Anxiety Scale (HAM-A). However, this scale is not available in French. The General anxiety disorder − 7 (GAD-7) scale, which has been validated in French, is a 7-item instrument with good psychometric properties. This study contributes to the validation of an adapted French version of the CAS, using the GAD-7 as the reference.MethodsA forward-backward English-French-English translation of the CAS was performed according to standard practice. The French versions of the CAS and GAD-7 were completed by 127 French speaking healthcare professionals. CAS internal consistency was assessed using Crohnbach’s alpha, and test-retest reliability was tested after 15 days in a subsample of 30 subjects. Convergent validity with GAD-7 was assessed using Pearson’s correlation coefficient. Test-retest reliability was explored using one-way random effects model to calculate the intra-class correlation coefficient (ICC).ResultsFrench CAS showed excellent internal consistency (Cronbach’s alpha 0.97), high convergent validity with GAD-7 (Pearson’s R 0.81, p < 0.001), and very good test-retest reliability (ICC = 0.97, 95% CI 0.93–0.98).ConclusionThe proposed French version of the CAS showed high reliability and validity that need to be further investigated in different populations.

Double blind randomized placebo-controlled study of the efficacy and safety of proroxan in the complex therapy of generalized anxiety disorder

Introduction. The clinical picture of generalized anxiety disorder is characterized by diffuse anxiety, muscle tension and multiple symptoms of hyperactivity of the sympathetic part of the autonomic nervous system. As an alpha-adrenoblocker, proroxan can reduce the hyperactivity of the autonomic nervous system, thereby reducing the severity of anxiety and its somatic symptoms.Aim. To evaluate the efficacy of proroxan in the correction of autonomic disorders in patients with generalized anxiety disorder compared to placebo.Materials and methods. 100 people participated in the study: 50 – in the study group received the SSRI escitalopram, 50 – in the control group received SSRI + placebo. The diagnosis of generalized anxiety disorder was made on the basis of ICD-10 criteria. Psychometric assessment using the Montgomery-Asberg scale was performed (only at the screening visit). Weekly psychometric evaluation was performed using the Hamilton anxiety scale, the SCL-90-R scale to assess somatic manifestations of anxiety, and general clinical impression scales (CGI-S disease severity and CGI-I general improvement).Results. In the course of the study, statistically significant decrease in the mean value of CGI-S scale was observed in both groups, however, more pronounced in the proroxan group (p &gt; 0.05); in the CGI-I scale, more pronounced improvement was observed in the first week of treatment in the proroxan group (p &gt; 0.05). The HAM-A scale also showed a more significant reduction in anxiety in the proroxan group than in the placebo group (p &gt; 0.05). The SCL-90-R SOM scale showed a decrease in the mean value in both groups, more pronounced in the proroxan group, which confirms the effect of the drug on autonomic symptoms of anxiety (p &gt; 0.05).Conclusions. The obtained results confirm the superiority of combination therapy with escitalopram and proroxan in the treatment of generalized anxiety disorder compared to monotherapy. The advantages of proroxan were the absence of sedative effect and, in general, good tolerability, absence of withdrawal syndrome and control of vegetative manifestations of anxiety.

Instant and short-term effects of acupuncture for depression and anxiety in unstable angina pectoris patients with percutaneous coronary interventions.

Patients with unstable angina pectoris (UAP) usually present anxiety or depression during percutaneous coronary intervention (PCI). This study sought to investigate the instant and short-term effects of acupuncture for anxiety and depression in UAP patients with PCI. A total of 210 UAP patients who underwent PCI were recruited and randomly assigned (1:1:1) to acupuncture, placebo, or control groups. Enzyme-linked immunosorbent assay was used to detect the levels of fasting glucose, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), interleukin-6 (IL-6), high-sensitivity C-reactive protein (Hs-CRP), advanced oxidation protein products (AoPPs), and oxidized low-density lipoprotein (OX-LDL). Serial questionnaires with the Hamilton Anxiety (HAMA) scale and the Pittsburgh Sleep Quality Index were evaluated, and heart rate variability indicators were obtained. Primary end-point: low frequency/high frequency (HF) was lower in the electroacupuncture group (p = 0.014), while standard deviation of normal-to-normal intervals, average standard deviation of normal-to-normal intervals, percentage of successive intervals that differ more than 50 ms, and HF were increased with acupuncture (p = 0.018, p = 0.043, p = 0.016, and p = 0.002, respectively). Secondary end-point: significant improvements in anxiety levels (HAMA) were observed in the three groups (p < 0.001). The fasting insulin and HOMA-IR levels were similar between the control group and the acupuncture group (p = 0.285 and p = 0.165, respectively). The levels of IL-6 and AoPPs differed among the three groups (p = 0.021 and p < 0.001, respectively). However, no significant differences were found in fasting plasma glucose, fasting c-peptide, Hs-CRP, and OX-LDL levels among the three groups (p = 0.585, p = 0.611, p = 0.902, and p = 0.756, respectively). In this study, short-term acupuncture may potentially relieve clinical symptoms before PCI treatment. ClinicalTrials.gov, identifier (NCT03789344).

Prevalence and correlates of severe anxiety in patients with first hospitalization for major depressive disorder combined with dyslipidemia: a large sample cross-sectional study.

Anxiety symptoms and dyslipidemia are common co-morbidities in patients with major depressive disorder (MDD), and there are complex pathophysiologic as well as clinical mechanisms underlying the association between the three. In this study, we investigated the prevalence and associated factors of severe anxiety in first-time hospitalized patients with MDD with dyslipidemia. We included 708 patients with major depressive disorder with comorbid dyslipidemia and collected their sociodemographic and general clinical data as well as biochemical parameters such as lipids, thyroid function, and blood glucose. We also completed the Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Positive Symptom Scale (PSS), and Clinical General Impression Scale (CGI) to assess their clinical symptoms. The prevalence of severe anxiety disorder was 11.02% in patients with MDD with comorbid dyslipidemia. Suicidal history, female gender, body mass index (BMI), HAMD score, PSS score, and FT4 level were risk factors for the development of severe anxiety symptoms. Higher HAMD scores, higher PSS scores, and suicidal history were influential factors in exacerbating severe anxiety symptoms. This study reports and identifies the prevalence of severe anxiety symptoms in first-time hospitalized MDD patients with dyslipidemia, as well as risk factors for anxiety symptoms and factors influencing their severity, and these identified factors may be potentially helpful and informative in preventing and intervening in severe anxiety disorders in this target population.

Effects of STN-DBS on cognition and mood in young-onset Parkinson's disease: a two-year follow-up.

The effects of subthalamic nucleus deep brain stimulation (STN-DBS) on the cognition and mood of patients with PD are still not uniformly concluded, and young-onset Parkinson's disease (YOPD) is even less explored. To observe the effectiveness of STN-DBS on the cognition and mood of YOPD patients. A total of 27 subjects, with a mean age at onset of 39.48 ± 6.24 and age at surgery for STN-DBS of 48.44 ± 4.85, were followed up preoperatively and for 2 years postoperatively. Using the Unified Parkinson disease rating scale (UPDRS), H&Y(Hoehn and Yahr stage), 39-Item Parkinson's Disease Questionnaire (PDQ-39), Mini-mental state examination (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA) to assess motor, cognition, and mood. At the 2-year follow-up after STN-DBS, YOPD patients showed significant improvements in motor and quality of life (UPDRS III: p < 0.001, PDQ-39: p < 0.001); overall cognition was not significantly different from preoperative (MMSE: p = 0.275, MoCA: p = 0.913), although language function was significantly impaired compared to preoperative (MMSE: p = 0.004, MoCA: p = 0.009); depression and anxiety symptoms also improved significantly (HAMD: p < 0.001, HAMA: p < 0.001) and the depression score correlated significantly with motor (preoperative: r = 0.493, p = 0.009), disease duration (preoperative: r = 0.519, p = 0.006; postoperative: r = 0.406, p = 0.036) and H&Y (preoperative: r = 0.430, p = 0.025; postoperative: r = 0.387, p = 0.046); total anxiety scores were also significantly correlated with motor (preoperative: r = 0.553, p = 0.003; postoperative: r = 0.444, p = 0.020), disease duration (preoperative: r = 0.417, p = 0.031), PDQ-39 (preoperative: r = 0.464, p = 0.015) and H&Y (preoperative: r = 0.440, p = 0.022; postoperative: r = 0.526, p = 0.005). STN-DBS is a safe and effective treatment for YOPD. The mood improved significantly, and overall cognition was not impaired, were only verbal fluency decreased but did not affect the improvement in quality of life.

Use of cognitive-behavioral career coaching to reduce work anxiety and depression in public employees.

Public employees worldwide are increasingly concerned about work anxiety and depression. Cognitive-behavioral career coaching has emerged as a promising strategy for addressing these mental health disorders, which can negatively impact on a person's overall well-being and performance. To examine whether cognitive-behavioral career coaching reduces work anxiety and depression among Nigerian public employees. A total of 120 public employees (n = 60) suffering from severe anxiety and depression were randomly assigned to the treatment or control groups in this study. Cognitive behavioral coaching was provided twice a week to those in the treatment group, whereas no treatment was given to those in the control group. As part of the study, the Hamilton Anxiety Rating Scales and Beck Depression Inventory were used to collect data. Analysis of covariance of the data from participants indicates a significant effect of cognitive-behavioral career coaching on work anxiety and depression. Insights into the underlying mechanisms by which cognitive behavior career coaching exerts its effects have been gained from this study. Also, the study has gathered valuable data that can inform future practice and guide the development of strategies for supporting mental health at work.

Comparing the efficacy of duloxetine and nortriptyline in alleviating the symptoms of functional dyspepsia - a randomized clinical trial.

To compare the efficacy of Duloxetine and Nortriptyline in alleviating the symptoms of severity, anxiety, depression and quality of life in patients with functional dyspepsia (FD). We conducted a single-blinded 3-month trial of Duloxetine 20-30 mg daily in 20 patients and Nortriptyline 25 mg daily in 25 FD patients. The primary outcome measure was the severity of FD symptoms by Gastrointestinal symptoms rating scale. Secondary measures included Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and Nepean Dyspepsia Index. the patients were measured in 3 stages. 45 patients with FD with a mean age of 37.18 ± 10.62 years participated in the study. The severity of symptoms was significantly lower in the Nortriptyline group than in the Duloxetine group after three months (p = 0.031). The level of anxiety (p = 0.049), depression (p = 0.045) and quality of life (p = 0.046) improved significantly after three months in the Duloxetine group compared to Nortriptyline. Mediation analysis using linear regression revealed a significant mediator role for anxiety. This mediation analysis revealed a 21.13% reduction in anxiety in the Duloxetine group. While both medications demonstrated efficacy, Nortriptyline appeared to be superior in symptom reduction. Duloxetine exhibited more advantages compared to Nortriptyline in addressing anxiety and depression and enhancing the overall quality of life. Also, Duloxetine may have a noteworthy impact, contributing to a 20% reduction in FD symptoms by lowering anxiety levels. https://en.irct.ir/trial/65512.

A clinico-epidemiological study of breast eczema sparing nipple and areola from a tertiary care hospital in western Rajasthan

Nipple eczema can be a local manifestation of atopic dermatitis/eczema when it arises with classic age-related patterns of eczema on other body sites, or it can occur in isolation. In our study, breast eczema sparing nipple and areola, was observed in females of western Rajasthan. This study reports the demography, clinico-morphological patterns and factors causing it. After due informed consent, thirty consecutive female patients of breast eczema were undergone a detailed history, clinical examination and patch testing. Hamilton Anxiety Rating Scale was used for anxiety severity assessment. Most common site of breast eczema was the upper-outer quadrant (15/30) followed by upper-inner quadrant (9/30). The cell-phone was the most common object which was kept in close contact with the breast followed by purse (26/30) and money (11/30). Total 20 positive patch tests were seen in 17 patients. Fifteen patch tests were relevant to the current dermatitis. Mild anxiety cases were significantly more in acute type whereas moderate-severe type was more with chronic type (p value=0.021). Larger study is required to establish the exact cause of this type of breast eczema. Breast eczema seems to have diverse etiology, supplemented by various factors such as anxiety, perspiration in hot arid weather, traditional loosely-fit inner clothing of women in this region of western Rajasthan and friction produced by the objects (cell phones) that are kept in contact with breasts, work together to produce dermatitis.

A Study on the Impact of Psychosocial Factors on the Nature and Incidence of Suicide among Adolescent Students

ABSTRACT Adolescence is a time for existential confrontations and at this stage, the adolescent is philosophical, and often thinks of death in more abstract terms. This research is a study on the impact of psychosocial factors on the nature and incidence of suicide among adolescent students. The study was conducted using The Students Stress Inventory, Hamilton Anxiety Rating Scale (HAM-A), The Learned Helplessness Scale and The Suicide Behaviour Questionnaire Revised (SBQ-R) on a group of 10 male and female adolescent students whose age ranged from 13 to 17 years. The mixed research design was adopted using quantitative and qualitative analysis. The research findings reveal that all subjects of the group had moderate levels of stress, anxiety and helplessness. The students who participated in the study demonstrated suicidal ideation and behaviour. The correlation between stress and anxiety with suicide risk behaviour was high for the group of students. It is found that there was a low correlation between feelings of helplessness and suicide risk behaviour. The reports of the students who participated in the study throws light on social, economic and academic pressures which create stress and could make them contemplate attempting suicide.

Capacity to consent to treatment in severe eating disorders

Eating disorders represent a disabling, deadly and costly condition, whose principal treatment is constituted by weigh restoration and psychotherapy. Partial or total refuse of treatment is very common, leading some authors to question their decision-making capacity (DMC) to consent to treatment. However, very few studies have investigated treatment DMC, leading to contrasting results. Forty-five women were enrolled at the Psychiatric and Eating Disorders Unit of the University Hospital Policlinico Umberto I of Rome. Psychiatric symptoms severity (Brief Psychiatric Rating Scale Expanded, BPRS-E), treatment DMC (MacArthur Competence Assessment Tool for Treatment, MacCAT-T), depressive symptoms (Hamilton Depression Rating Scale, HAM-D), anxiety symptoms (Hamilton Anxiety Rating Scale, HAM-A), symptoms and psychological characteristics of eating disorders (Eating Disorder Inventory, EDI-3) and Metacognitive beliefs (Metacognitions Questionnaire 30, MCQ-30) were assessed. Sixty-seven percent of the total sample showed low treatment DMC; specifically, 70.4% of patients affected by Anorexia Nervosa, 72.7% of patients affected by Bulimia Nervosa, and 42.9% of patients affected by Binge Eating Disorder. Specific psychopathological symptoms enhance or hamper patients’ decisional capacities. Clinicians should be aware of the risk of impaired DMC in this vulnerable group of patients and pay attention at those factors suggesting the need of an in-depth evaluation.

Efficacy and safety of pregabalin vs carbamazepine in patients with central post-stroke pain

ABSTRACT Objective To compare the efficacy and safety of pregabalin and carbamazepine in patients with central post-stroke pain (CPSP). Methods Patients included in the study were randomly assigned to either flexible-dose pregabalin treatment group or carbamazepine treatment group. The primary efficacy variable was face visual analog scale (F-VAS), the second efficacy assessment was used to assess the effect of treatment on mental health by Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD). Results The mean baseline pain score F-VAS was 6.47 in the pregabalin group and 6.58 in carbamazepine treatment group. F-VAS was significantly lower in the pregabalin group (1.64) than (3.94) carbamazepine treatment group after treatment. Pregabalin was significantly superior to carbamazepine in endpoint assessments on the HAMA and HAMD after treatment. F-VAS and HAMD were showed efficacy as early as week 2 and maintained for whole duration of the study. The average pregabalin dose in the 12-week study was 214.6 (150–375) mg/day. The mean dose (range) of carbamazepine received by the patients was 275.0 (200–400) mg/day. Mild or moderate, typically transient, somnolence and dizziness were the most common adverse events (AES). The differences of the side effects between the two groups were not significant. Conclusions Pregabalin, but not carbamazepine, may be effective in improving F-VAS, HAMA and HAMD in patients with CPSP.

Prevalence and risk factors for abnormal glucose metabolism in first-episode and drug-naïve major depressive disorder outpatients with comorbid anxiety: A cross-sectional study from a large sample of the Chinese Han population

BackgroundBoth abnormal glucose metabolism and anxiety have been reported to be common in major depressive disorder (MDD). However, few studies have explored glucose disturbances in first-episode and drug-naive (FEDN) MDD patients with anxiety. The purpose of this study was to examine the prevalence and risk factors of glucose disturbance in FEND MDD patients comorbid with anxiety. Methods1718 FEDN MDD patients were included in this study. The positive subscale of the Positive and Negative Syndrome Scale (PANSS), Hamilton Anxiety Rating Scale (HAMA), and Hamilton Depression Rating Scale (HAMD) were used to measure psychotic, anxiety and depressive symptoms respectively. Sociodemographic and biochemical indicators were also collected. ResultsThe prevalence of glucose disorders in MDD patients combined with anxiety was 15.7 %, significantly higher than in MDD patients without anxiety symptoms (7.1 %). Glucose disturbances were associated with HAMD score, HAMA score, thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), anti-thyroglobulin (TGAb), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein (LDL-C), fasting blood glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), suicide attempts, and psychotic symptoms. Further logistic regression showed that illness duration, TSH, TGAb, and TPOAb levels were correlates of glucose disturbances in MDD patients with anxiety. LimitationsNo causal relationship could be drawn due to the cross-sectional design. ConclusionsOur findings suggest that TSH, TGAb and TPOAb may be promising biomarkers of glucose disturbances in MDD comorbid with anxiety, suggesting the importance of regular assessment of thyroid function parameters for abnormal glucose metabolism prevention.

Effect of deep brain stimulation compared with drug therapy alone on the progression of Parkinson's disease.

Parkinson's disease (PD) symptoms deteriorate with disease progression. Although deep brain stimulation (DBS) can effectively improve the motor signs of PD patients, it is not yet known whether DBS surgery, which is an invasive treatment modality, may change the progression of PD. The aim of this work was to compare the effect of DBS with that of drug treatment on the progression of PD. A total of 77 patients with PD with the Hoehn and Yahr scale (HY) stage of 2.5 or 3 were included, and were divided into 34 in the drug therapy alone group (Drug-G) and 43 in the DBS therapy group (DBS-G). All patients were subjected to a follow-up of 2 years, and disease severity was assessed by the Unified Parkinson's Disease Rating Scale part III (UPDRS-III), the Montreal Cognitive Assessment (MOCA), the Hamilton Anxiety Scale (HAMA), and the Hamilton Depression Scale (HAMD) scores. In addition, the quality of life of patients and the burden on their family were assessed by the 39-item PD questionnaire (PDQ-39) scores, daily levodopa equivalent dose (LED), patient's annual treatment-related costs, and the Zarit Caregiver Burden Scale (ZCBS) score. The changes in relevant scale scores between the two groups were compared at each follow-up stage. The UPDRS-III score of the patients in the "off" state increased from year to year in both groups, and the degree of increase of this score was greater in the DBS-G than in the Drug-G group. The MOCA score in both groups began to decline in the 2nd year of follow-up, and the decline was greater in the Drug-G than in the DBS-G group. DBS treatment did not affect patients' psychiatric disorders. The PDQ39, LED, costs, and ZCBS were negatively correlated with the follow-up time in patients in the DBS-G group, and positively correlated with the follow-up time in patients in the Drug-G. PD is progressive regardless of treatment. The findings from this follow-up study suggest that the disease progression of patients in DBS-G may be slightly faster compared to the drug-G, but the advantages of DBS are also evident. Indeed, DBS better improves patient's motor signs and quality of life and reduces the family burden. In addition, DBS has less impact on patients in terms of cognitive and mental effects.

Clinical value of precise rehabilitation nursing in management of cerebral infarction.

Cerebral infarction, previously referred to as cerebral infarction or ischemic stroke, refers to the localized brain tissue experiencing ischemic necrosis or softening due to disorders in brain blood supply, ischemia, and hypoxia. The precision rehabilitation nursing model for chronic disease management is a continuous, fixed, orderly, and efficient nursing model aimed at standardizing the clinical nursing process, reducing the wastage of medical resources, and improving the quality of medical services. To analyze the value of a precise rehabilitation nursing model for chronic disease management in patients with cerebral infarction. Patients (n = 124) admitted to our hospital with cerebral infarction between November 2019 and November 2021 were enrolled as the study subjects. The random number table method was used to divide them into a conventional nursing intervention group (n = 61) and a model nursing intervention group (n = 63). Changes in the nursing index for the two groups were compared after conventional nursing intervention and precise rehabilitation intervention nursing for chronic disease management. Compared with the conventional intervention group, the model intervention group had a shorter time to clinical symptom relief (P < 0.05), lower Hamilton Anxiety Scale and Hamilton Depression Scale scores, a lower incidence of total complications (P < 0.05), a higher disease knowledge mastery rate, higher safety and quality, and a higher overall nursing satisfaction rate (P < 0.05). The precision rehabilitation nursing model for chronic disease management improves the clinical symptoms of patients with cerebral infarction, reducing the incidence of total complications and improving the clinical outcome of patients, and is worthy of application in clinical practice.

Dysfunction of circulating endothelial progenitor cells in major depressive disorder.

Despite mounting evidence demonstrates circulating endothelial progenitor cells (cEPCs) quantitative changes in depression, no study has investigated cEPC functions in major depressive disorder (MDD). We investigated the role of cEPC adhesive and apoptotic functions in MDD. We recruited 68 patients with MDD and 56 healthy controls (HCs). The depression symptoms, anxiety, psychosomatic symptoms, subjective cognitive dysfunction, quality of life, and functional disability were evaluated using the Hamilton Depression Rating Scale and Montgomery-Åsberg Depression Rating Scale, Hamilton Anxiety Rating Scale, Depression and Somatic Symptoms Scale (DSSS), Perceived Deficits Questionnaire-Depression, 12-Item Short Form Health Survey (SF-12), and Sheehan Disability Scale (SDS), respectively. Working memory and executive function were assessed using a 2-back task and Wisconsin Card Sorting Test (WCST). Inflammatory marker (soluble interleukin-6 receptor, C-reactive protein, and tumor necrosis factor-α receptor-1), cEPC adhesive, and apoptotic levels were measured using in vitro assays. The MDD patients showed significantly lower cEPC adhesive levels than the HCs, and this difference in adhesive function remained statistically significant even after adjusting for inflammatory marker levels. The cEPC adhesion levels were in inverse correlations with commission and omission errors in 2-back task, the percent perseverative response and percent perseverative errors in WCST, and the DSSS and SDS scores, but in positive correlations with SF-12 physical and mental component scores. cEPC apoptotic levels did not differ significantly between the groups. The findings indicate that cEPC adhesive function is diminished in MDD and impacts various aspects of cognitive and psychosocial functions associated with the disorder.

Psychological status of women with miscarriage

Introduction. During pregnancy, a woman becomes vulnerable to develop symptoms of depression and anxiety, which in turn are associated with increased risk of perinatal complications, postpartum depression as well as behavioral problems in children.Aim: to assess the prevalence of symptoms related to depression and anxiety in pregnant women with threatened abortion (ТА), non-developing pregnancy (NP) as well as those with physiological course of pregnancy (РР) in the first trimester of pregnancy; to reveal major predictors of psycho-emotional disorders in pregnant women.Materials and Methods. Three groups of pregnant women were stratified: 62 patients with TA, 60 patients with NP and 57 women with PP. Clinical history and physical examination were performed in all subjects. All pregnant women were assessed by Hamilton Anxiety Rating Scale and the Beck Depression Inventory.Results. It was found that the mean Beck’s score was significantly higher in NP vs. TA and PP groups (p &lt; 0.05). Moreover, significant differences were also observed while comparing TA and PP groups (p = 0.037). Clinically important depression was found in 3.3 % NP women and in 1.6 % TA women. Preclinical depression was found in 13 % and 6.5 % women with NP and TA, respectively. The mean Hamilton scale score was significantly higher in NP vs. PP group (p &lt; 0.05), but was comparable with that in TA group (p &gt; 0.05). The mean score on the anxiety scale was significantly higher in TA vs. PP group (p = 0.001). Clinically significant mild to moderate anxiety was found in 4.9 % and 1.6 % TA and NP women, respectively. Mild anxiety symptoms were noted in 35.5 % of women with TA, 38.3 % of women with NP, and 15.7 % of women with PP. Multiple linear regression analysis revealed that a burdened obstetric history and the duration of the patient hospital stay had the strongest association with symptoms of depression and anxiety.Conclusion. Symptoms of prenatal anxiety and depression are widespread and should be identified in a timely manner. Psychological counseling and testing of pregnant women should be included into recommendations for pregnancy management.