Higher Anxiety Scores Research Articles

Connective Tissue Dysplasia As A Predictor Of Premature Skin Aging

Background — One of the manifestations of connective tissue dysplasia (CTD) is premature skin aging. The latter can have different etiological factors. The objective of our study was to investigate the effect of predictors of premature skin aging, especially CTD, on the severity of involutional changes in the skin, as well as to develop the approach for the management of patients with premature aging. Material and Methods — We included in our study 78 women 35-45 years of age with no substantial anti-aging treatment procedures in their anamneses. We considered genealogical and cosmetological anamneses, and life history (including somatic pathology), physical examination; determined prevailing type of facial skin aging; identified predictors of CTD, assessed psychoemotional state of the patient, and performed sonography of the skin and biochemical examination of patient serum. At a clinical stage, we conducted a randomized comparative study of biorevitalizant efficacy in patients with normal and premature patterns of skin aging. Results — Our study established the role of CTD in assessing the risk of premature skin aging. In addition to the presence of CTD, the importance of identifying isolated phenotypic manifestations of CTD (such as arachnodactyly, hypermobility syndrome, low relative weight of the patient, and skin manifestations of CTD) was shown. Other predictors were also analyzed; their identification can help assessing the risk of premature skin aging. Among them, somatic pathology (varicose veins, herniated discs, visceroptosis, autonomic vascular dystonia) and physical examination data (such as pallor of the facial skin, swelling, skin hyperelasticity) were noted. When assessing the clinical efficacy of biorevitalization, the greatest satisfaction of patients with premature skin aging regarding its results was characteristic for the group of patients after 7% collagen treatment. The clinical efficacy according to sonography and histological examination in patients with premature skin aging was significantly higher after the use of collagen or a complex hyaluronic acid (HA) preparation, compared with native HA. Patients with premature skin aging exhibited high level of anxiety and/or depression, which in turn increased the risk of underestimating the outcome of procedures. Conclusion — The presented study confirmed the role of CTD in assessing the risk of premature skin aging. Predictors were revealed (somatic pathology, type of facial aging, physical examination data of the patient, etc.) that could be used to assess the risk of premature skin aging. In patients with premature aging, preparation with native HA (as a biorevitalizant) had a low clinical efficacy comparable to using placebo. A collagen-based preparation and a complex HA-based preparation exhibited high clinical efficacy. Also, patients with premature aging of the skin had a higher score of anxiety and depression, while patients with high levels of anxiety and depression were more likely to underestimate the satisfaction with the results of their aesthetic treatment.

Relationship between anxiety and depression with smoking cessation treatments: a follow-up study

ABSTRACT Background Smoking is known to be closely associated with stress levels and anxiety. In this study, the effects of smoking cessation treatments were investigated on anxiety/depression. Methods Socio-demographic characteristics, The Fagerström/Test/Nicotine/Dependence and the Hospital Anxiety/Depression-Scale, were applied for the first time. The first group received “varenicline+counseling,” second group “bupropion+counseling,” and third group “counseling only.” The Hospital Anxiety/Depression-Scale was recorded in quit smokers. Anxiety and depression scores were compared between groups and between smokers and ex-smokers in the first and sixth months. Results Firstly, The Hospital Anxiety/Depression-scale revealed that anxiety was noted in 46.8%, depression in 11.2%, and anxiety and/or depression in 48.9%. A significant decrease in both anxiety and depression scores was observed in quit smokers at 6 months (47.9%, 37.4% respectively) (p < .001). In the sixth month, there was a significant decrease in anxiety scores in the varenicline and bupropion groups. In addition, a significant decrease in the depression score of was observed in the varenicline group. In the bupropion group, the smoking cessation rate was higher in those with high anxiety and/or depression scores (66.7%). Conclusions Varenicline decreased anxiety/or depression scores in both smokers and quit smokers, whereas quit smoking rate increased in those with anxiety/depression in the bupropion.

IRRATIONAL FALL RISK APPRAISAL GROUP CHARACTERISTICS IN COMMUNITY-DWELLING OLDER ADULTS

Abstract Approximately 43% of older adults are affected by fear of falling (FOF). A portion of those affected by FOF have irrational fall risk appraisal (FRA) which means they have a high FOF despite normal balance. This secondary analysis aimed to examine the 18% of the 124 study participants living with irrational FRA from the RO3AG06799-0 data source. Descriptive statistics were used to examine characteristics of older adults with Irrational FRA. Spearman Rho and linear regression were used to evaluate factors (age, sex, race, education, financial status, living situation, fall history, depression symptoms, anxiety, hand grip strength, balance, and fear of falling) associated with Irrational FRA in older adults. Of the 22 participants with irrational FRA, 20 were female, 70% were aged 70 or above (average age 74), and 72% were white (25% Asian, AA, and Hispanic). 77% had anxiety symptoms, with 50% having high anxiety scores, and 32% had depression symptoms. 40% lived alone, 45% had no prior falls, and 70% had low hand grip strength. 23% had inadequate financial means, and 72% had a college education or higher. Statistically significant correlations were found between the FES score and age (p=.044), who the participant lived with (p=.033), and balance (p=.042). Regression analysis showed predictors of FES score in this group to be anxiety (p=.042) and who they live with (p=.024). This study provides valuable insights into the demographic and clinical characteristics of older adults with irrational FRA and highlights the role of anxiety and living status in predicting FOF.

Mediating factors explain anxiety experienced by women with obesity during the Covid-19 pandemic.

The Covid-19 pandemic could be a source of great anxiety, especially for those at higher risk, such as women experiencing obesity. The aim of this study was to measure how some personal characteristics such as BMI (from underweight to class 3 obesity), bariatric surgery (yes or no), comorbidities, or age (as antecedent variables), and mediating factors impacted state anxiety during the Covid-19 Pandemic. Mediating factors were related to subjective knowledge or attitudes (e.g. interest or beliefs and practices around Covid-19, subjective health perception, and confidence in the government). French women (N = 532) were invited to take part in a voluntary online health survey during lockdown in Paris and its suburbs. Results showed that women with higher BMI had higher anxiety scores, primarily because they feel less healthy than other people. Secondly, the larger the body size of the participants was (BMI), the less they reported that information about Covid-19 held their attention. This lack of interest resulted in feelings of anxiety not being generated. Thirdly, the larger their body size was, the less confidence they had in the effectiveness of the proposed measures by the government and therefore, the more anxious they were. Finally, older age predicted higher interest in the pandemic, higher subjective health, and higher confidence in the government. Identifying obesity as a potential risk factor for anxiety disorders is crucial, but measuring the relationship between state anxiety and personal characteristics (e.g. BMI) requires considering mediating variables (e.g. subjective health perception). To reduce anxiety in women with obesity, it appears necessary to focus on psychological programs that can help them improve their perception of their health, as well as the confidence they may have in institutions, especially for younger women.

Instruments for anxiety analysis and the utility of its assessment in oral surgical interventions under local anesthesia in patients undergoing four operative procedures

Introduction: Fear of intervention in the oral cavity is declared as dental fear and is defined as a specific form of anxiety. The reaction to oral-surgical intervention will also depend on the feeling the patient acquires about the operator, but the positive experience also plays an important role.Aim: The aim is to evaluate differences between the sexes and the influence of experience from a previous oral surgical intervention on a similar subsequent intervention.Material and methods: In the research, anxiety was assessed using Corah's Dental Anxiety Scale (DASR) and Spielberger's State-Trait Anxiety Inventory (X1 and X2). The study included adult patients of both sexes with an indication for surgical extraction of impacted third permanent molars. Preoperative and postoperative anxiety was assessed: 1st measurement (day of examination) - DASR, and STAI (X1 and X2); 2nd measurement (immediately before the intervention) – STAI (X1 and X2); 3rd measurement (day after the intervention) – STAI (X1 and X2).Results: Preoperatively determined high levels of general, immediate, and dental anxiety decreased before the surgical procedure itself and were significantly reduced in the postoperative period. The downward trend continued in line with the positive experience. Women had higher anxiety scores than men for all monitored parameters. The use of the STAI scales to assess anxiety by dental practitioners is on par with other well-known anxiety assessment instruments, such as the DASR. Conclusion: In order to increase patient satisfaction and to prevent possible complications in such oral-surgical procedures, it would be useful to consider adequate therapy for high anxiety.

Alcohol and cannabis use among women with infertility: associations with psychiatric symptoms, attempts to conceive, and engagement in fertility treatment.

Little is known about substance use among women with infertility, yet substance use has implications for fertility and pregnancy. The purpose was to estimate the prevalence of substance use among women with infertility and examine whether substance use was associated with psychiatric symptoms, active attempts to conceive, and engagement in fertility treatments. Eligible patients were from a single healthcare system who received a female infertility diagnosis within the past 2years. Participants (n = 188) completed an online questionnaire regarding substance use, psychiatric symptoms, attempts to conceive, and fertility treatments. The prevalence of hazardous alcohol use, any cannabis use, and hazardous cannabis use were 30.3%, 30.9%, and 8.5%, respectively. Hazardous alcohol use was not associated with psychiatric symptoms (p > .05). Those with any cannabis use were more likely to have higher depression scores than those without (p = .02). Those with hazardous cannabis use were more likely to have higher depression scores (p = .001) and higher anxiety scores (p = .03). Substance use was not associated with actively trying to conceive. Those pursuing fertility treatments had a lower percentage engaging in hazardous alcohol use compared to those not pursuing fertility treatments (19.0% vs. 36.3%, p = .02). Substance use among women with infertility is common. Hazardous cannabis use was associated with greater psychiatric symptoms, suggesting that cannabis may be used to cope with distress. Pursuing fertility treatments may serve as a protective factor for hazardous alcohol use. Clinicians treating patients with infertility may want to screen for substance use.

PRKCA and TCF4 Genetic Variants in Anxiety Symptoms and Generalized Anxiety Disorder in a Sample of Colombian Subjects Selected on the Basis of High Anxiety Scores

Objective: There are several anxiety disorders leading to a high burden of disease around the world, including Generalized Anxiety Disorder (GAD). The heritability of GAD suggests that genetic factors play an important role in its development; however, further research in this area is needed in Latin America. This study aimed to analyze the possible association between two single nucleotide polymorphisms (SNPs), rs2244497 and rs1452789, located in the PRKCA and TCF4 genes with anxiety symptoms and GAD based on high anxiety scores in a sample of selected Colombian subjects. Methods: We evaluated 303 participants using the Hospital Anxiety and Depression Scale (HADS) and Zung’s Self-Rating Anxiety Scale (ZSAS). Subjects with high scores in both scales (according to established cut-off points) participated in a psychiatric evaluation for the diagnosis of GAD. TaqMan assays were employed to genotype the SNPs, and statistical analyses were performed using logistic and linear regression. Results: In a sample of Colombian subjects selected on the basis of high anxiety scores, we found a significant association between the rs2244497 SNP in the PRKCA gene and higher scores in anxiety symptoms, where people carrying the T/T genotype had the highest scores for HADS scale. However, we did not observe this association in people diagnosed with GAD. In addition, the SNP in TCF4 (rs1452789) did not have an association with anxiety symptoms or GAD diagnosis. Conclusion: This study contributes to the analysis of the molecular basis of anxiety disorders in selected Latin American samples. However, further studies are necessary to understand the role of rs2244497 SNP in the PRKCA gene and the risk for higher scores in anxiety symptoms.

Effects of preoperative anxiety level on pain level and joint functions after total knee arthroplasty

This study examined the effect of preoperative anxiety level on postoperative pain, opioid and nonopioid analgesic use requirements and joint function in patients undergoing primary knee arthroplasty for knee osteoarthritis. 106 patients were included in the study. Situational anxiety score (STAI-S) and trait anxiety score (STAI-T) were divided into two groups as below and above 40. Visual analog scale (VAS), Lysholm scores, and anxiety levels were assessed preoperatively, at the third and sixth month postoperatively to investigate their effects on the use of opioid and non-opioid drugs during the postoperative period. For those with low situational and trait anxiety scores, the median duration of hospital stays was significantly shorter compared to those with high anxiety scores. In groups where anxiety levels were initially low, the median anxiety levels at the postoperative 3rd month were also observed to be lower compared to the other group. In the same groups, the median VAS values and the median Lysholm knee scores were significantly better both preoperatively and at the postoperative 3rd month compared to the other group. There was no significant difference in Lysholm score between the two groups at the 6th postoperative month. Similarly, in the preoperative period, groups with low anxiety levels had a significantly lower median usage of both opioids and non-opioids compared to the other group. These findings suggest that high preoperative anxiety may have a negative effect on functional outcomes in the early postoperative period, but this effect disappeared at 6 months. It can be concluded that reducing preoperative anxiety may have a positive effect on early outcomes. We believe that preoperative psychological evaluation and treatment can increase the satisfaction level in patients undergoing total knee arthroplasty (TKA).

Clinical factors associated with illness perception, worry and mental health in sclerosing cholangitis: A single centre prospective study

BackgroundA reduced quality of life and symptoms of depression and anxiety are reported in patients with primary sclerosing cholangitis (PSC), however specific risk factors and the effect of sclerosing cholangitis (SC) with autoimmune features are not known. ObjectiveTo integrate mental wellbeing assessment into routine clinical care for patients with SC, and evaluate factors associated with measures relating to quality of life, illness perception and mental health. MethodsA prospective study of adult non-transplant patients with SC attending the outpatient clinic over a 1 year period. Self-reported questionnaires were sent to patients electronically prior to clinic to assess worry, illness perception, depression and anxiety. Demographic and clinical information was collected. ResultsQuestionnaires were completed in 52/130 (40 %) patients with SC who attended clinic. Worry related to quality of life, mental and physical health, and future health were common. There was no difference in overall worry or illness perception in patients treated with ursodeoxycholic acid; whilst patients with PSC had a higher illness perception (P = 0.04) than those with SC and autoimmune features. Both worry (P = 0.047) and illness perception (P = 0.01) were higher in patients with elevated alkaline phosphatase, whilst there was no difference in patients with and without cirrhosis. There were high screening test scores for both depression (21.1 %) and anxiety (9.6 %), with no association with patient factors. ConclusionsWe integrated an electronic questionnaire for completion prior to clinic for patients with SC with good uptake. We identified a high prevalence of patient worries and symptoms of depression and anxiety, which may be more common in PSC with elevated alkaline phosphatase and without autoimmune features. We recommend the adoption of similar tools into routine clinical practice for patients with SC.

Brain signatures of chronic gut inflammation.

Gut inflammation is thought to modify brain activity and behaviour via modulation of the gut-brain axis. However, how relapsing and remitting exposure to peripheral inflammation over the natural history of inflammatory bowel disease (IBD) contributes to altered brain dynamics is poorly understood. Here, we used electroencephalography (EEG) to characterise changes in spontaneous spatiotemporal brain states in Crohn's Disease (CD) (n = 40) and Ulcerative Colitis (UC) (n = 30), compared to healthy individuals (n = 28). We first provide evidence of a significantly perturbed and heterogeneous microbial profile in CD, consistent with previous work showing enduring and long-standing dysbiosis in clinical remission. Results from our brain state assessment show that CD and UC exhibit alterations in the temporal properties of states implicating default-mode network, parietal, and visual regions, reflecting a shift in the predominance from externally to internally-oriented attentional modes. We investigated these dynamics at a finer sub-network resolution, showing a CD-specific and highly selective enhancement of connectivity between the insula and medial prefrontal cortex (mPFC), regions implicated in cognitive-interoceptive appraisal mechanisms. Alongside overall higher anxiety scores in CD, we also provide preliminary support to suggest that the strength of chronic interoceptive hyper-signalling in the brain co-occurs with disease duration. Together, our results demonstrate that a long-standing diagnosis of CD is, in itself, a key factor in determining the risk of developing altered brain network signatures.

Long-Term Maternal Mental Health after Spontaneous Preterm Birth.

The aim of this study is to investigate whether a history of spontaneous preterm birth (SPTB) is associated with maternal depressive and anxiety symptoms, or psychosocial distress in the fifth decade of life. This is a secondary analysis of the PreCaris-study, a prospective observational study in which we included 350 women with a history of SPTB between 220/7 and 366/7 weeks of gestation and compared them to 115 women who had a term birth. Primary outcomes were the Depression and Anxiety scores measured using the Hospital Anxiety Depression Scale and Psychosocial distress assessed with the Distress Thermometer for Parents. Secondary outcomes were self-reported impact of the birth in daily life and psychosocial support after delivery. After a median of 13 years after delivery, no significant differences were found in primary outcomes. Significantly more women with a history of SPTB reported that the birth still had impact in daily life; adjusted odds ratio: 2.46 (95% confidence interval: 1.35-4.48). A total of 57 (16.3%) women after SPTB reported to have needed professional psychosocial support after delivery but did not receive it. These women more often had a high Anxiety score (p = 0.030), psychosocial distress (p = 0.001), and influence of birth in daily life (p = 0.000). There are no long-term effects on depressive and anxiety symptoms and psychosocial distress in women who experienced SPTB compared with women who had a full-term pregnancy. A significant part of the women who delivered preterm needed psychosocial support but did not receive it and were at higher risk of anxiety, psychosocial distress, and impact in daily life. We therefore recommend offering all women after SPTB psychosocial support after delivery. · No long-term effects on depressive and anxiety symptoms and psychosocial distress after SPTB.. · A total of 16.3% of the cases needed professional psychosocial support after delivery but did not receive it.. · This subgroup was at higher risk of anxiety symptoms, psychosocial distress, and impact on daily life..

Assessment of Electromagnetic Hypersensitivity Syndrome in Subjects Lived Near Mobile Phone Base Station: Gender Based Study

Background: Electromagnetic hypersensitivity syndrome (EHS) is subjective clinical ‎signs and symptoms caused by exposure to the electromagnetic field.&#x0D; Objective: To show the gender distribution of each category of EHS in people who lived near the mobile ‎phone base station. ‎&#x0D; Patients and Methods: This cross-sectional study was performed in the College of Medicine, University of Diyala. A total number of 196 individuals (128 men and 68 women) ‎lived within a 1500 m distance away from the mobile phone base station in the Diyala ‎province in the North East of Baghdad-Iraq included in the study. The authors ‎interviewed the participants and completed the EHS questionnaires.&#x0D; Results: Participants reported high scores of sleep disturbances, anxiety, and mood ‎fluctuation compared with other complaints. Men had significantly higher scores of ‎transient deafness and migraine-like headache compared with women. There were no ‎significant differences between men and women with subjective signs and symptoms ‎related to the cardiovascular system or skin. Multi-variable linear regression data ‎revealed a significant correlation (R=0.253) between the total scores of EHS with the ‎age, distance from the base station, and the onset of the illnesses). ‎&#x0D; Conclusion: We conclude that men who lived in the vicinity of the mobile phone base ‎station are significantly vulnerable to sleep disorder, anxiety, and fluctuation of ‎mood induced by electromagnetic radiation.

Examining the link between impulse control disorder and antidepressant use in Parkinson's disease

IntroductionImpulse control disorders (ICD) in Parkinson's disease (PD) and hypomanic episodes of bipolar disorder show overlapping symptoms, suggesting a shared neurobiology. To explore this, the following hypotheses are tested: (1) larger changes in affective symptoms from OFF to ON medication states will be associated with ICD, (2) antidepressant exposure will be associated with larger OFF to ON affective symptom changes, and (3) antidepressant exposure will be associated with ICD. Methods200 participants (mean age 65, 61 % male) were evaluated in “off” and “on” dopamine states. Affective symptoms were captured using the Hamilton Anxiety and Depression Rating Scales. Differences in clinical outcomes were compared using two-sample Wilcoxon rank-sum tests and Pearson χ2 tests. We performed multivariable logistic regression to assess the association of antidepressant exposure on ICD. ResultsParticipants with an ICD had higher anxiety and depressive scores in “on” and “off” states and larger changes in depressive symptoms from OFF to ON states compared to those without an ICD. Participants on antidepressants had higher anxiety scores in “on” and “off” states, higher depressive scores in the “off” state, and larger changes in anxiety symptoms from OFF to ON states than those not on an antidepressant. Antidepressant use was associated with a higher odds of an ICD (OR 2.3, CI [1.0–4.5], p-value 0.04). ConclusionsAffective symptom severity in “on” and “off” dopamine states is associated with ICD. Antidepressant therapy may be associated with ICD. Future prospective studies clarifying temporal associations between antidepressant initiation and ICD emergence are needed.

Influence of psychiatric symptom profiles of parents on sleep bruxism intensity of their children

Objective The objective of this study was to evaluate the effects of parental anxiety, depression levels and psychiatric symptom profiles of parents on the occurrence of sleep bruxism in children. Material & Methods This cross-sectional study was carried out with a sample of 94 children aged 6 to 12 years, divided into two groups: with sleep bruxism (bruxism group-BG) and without sleep bruxism (control group-CG). Beck Depression Inventory (BDI), Symptom Checklist (SCL-90-R), Symptom Checklist and Screen for Child Anxiety Related Emotional Disorders-Parent (SCARED-P) scale were used to assess anxiety and depression levels of parents. All questionnaires were filled out by parents of children. Intraoral and extraoral examinations were carried out of children in the clinic and sleep bruxism was determined. All stress conditions were investigated by logistic regression analysis. In the comparison of the qualitative data, chi-square and Fisher exact tests were used. Results The data revealed that participants whose mothers had high anxiety and interpersonal sensitivity scores, and participants whose fathers had a medium level of obsessive-compulsive disorder were more likely to have an SB problem (p < 0.05). According to the results of BDI, the fathers’ results between the BG and the CG were not statistically significant (p > 0.05). However, the mothers’ results between the BG and the CG were statistically significant (p < 0.05) When all subscales of SCARED-P were evaluated, the separation anxiety disorder subscore was statistically significant in the bruxism group. Conclusion The psychological status of parents is a significant risk factor associated with SB development in school-age children.

Are anxiety and depression associated with cognition and cardiovascular function in young male and female adults?

The results of recent studies suggested that emotional disorders (such as anxiety and depression), cognitive impairments and cardiovascular disorders are related on the subclinical level. These major health issues are often concomitant and have complex, sex-dependent relationships; it is therefore important to study these issues concomitantly in the general population, in order to gain a better understanding of early-stage subclinical relationships between these conditions. The objective of this exploratory study was to assess correlations between anxiety, depression, cognition, and endothelial function in young adults from the general population. Endothelial function (via the reactive hyperaemia index (RHI) was assessed with a plethysmographic device. Depression and anxiety were self-reported via the Beck Disorder Inventory II and the State-Trait Anxiety Inventory, respectively. The Cambridge Neuropsychological Test Automated Battery was used to measure performances in visuospatial memory, visuospatial working memory, and sustained attention. Performances in inhibition and flexibility were evaluated with the Color Word Interference Test. Forty-four young adults (21 males; mean ± standard deviation age: 25.8 ± 1.1; 23 females; mean age: 25.6 ± 1.4) were included in the study. Anxiety was correlated with a low RHI (r = -0.40, p = 0.015, 95% CI [-0.64, -0.08]). In females, the depression score was positively correlated with the number of errors in the visuospatial memory task (r = 0.42, p = 0.049; 95% CI [-0.002, 0.70]) and visuospatial working memory (r = 0.57, p = 0.005; 95% CI [0.10, 0.79]). In males, high anxiety and depression scores were negatively correlated with the number of errors in visuospatial working memory task (anxiety: r = -0.77, p = 0.001; 95% CI [-0.91, -0.43]; depression r = -0.61, p = 0.004, 95% CI [-0.82, -0.22], respectively). However, the relationship between cognitive performance and RHI was not significant. Our data suggest that anxiety and depression could be differentially related to cognitive and endothelial functions in a non-clinical population of young adults. More research is needed to confirm these results, understand the pathophysiological mechanisms in more details, and assess the importance of a sex-specific approach.

OR17-01 Novel Provocation Test With MDMA (‘Ecstasy’) Reveals Oxytocin Deficiency As A New Pituitary Entity In Patients With Central Diabetes Insipidus - A Randomized Placebo-Controlled Trial

Abstract Disclosure: C. Atila: None. F. Holze: None. R. Murugesu: None. N. Rommers: None. N. Hutter: None. N. Varghese: None. C.O. Sailer: None. A. Eckert: None. M. Heinrichs: None. M. Liechti: None. M. Christ-crain: None. Introduction: Despite adequate treatment, patients with arginine vasopressin deficiency (AVP-D), known as central diabetes insipidus (cDI), often report psychological symptoms such as heightened anxiety levels, difficulties describing emotions, and depressed mood. Given the anatomical proximity, disruptions of the hypothalamic-pituitary axis causing an AVP-D could also disturb the oxytocin (OXT) system. OXT regulates socio-emotional functioning, including fear reduction, attachment, emotion recognition, and empathy. Therefore, these psychological symptoms may be caused by an additional OXT deficiency. However, OXT deficiency has not been established as a pituitary entity, as no provocation test for OXT is currently available. Here, we aimed to investigate the OXT system stimulator 3,4-Methylenedioxymethamphetamine (MDMA, ‘ecstasy’) as a novel biochemical and psychoactive provocation test to reveal an OXT deficiency in patients with cDI. Methods: Randomized, placebo-controlled, double-blind, cross-over study in 15 patients with cDI and 15 matched healthy controls. Participants underwent a psychological baseline evaluation, including the assessment of anxiety levels using the State-Trait Anxiety Inventory (STAI), mood using the Beck’s Depression Inventory (BDI), and alexithymia using the Toronto Alexithymia Scale (TAS). Participants were randomized to receive either a single oral dose of MDMA (100 mg) or placebo first. OXT samples were collected at 0, 90, 120, 150, 180, and 300 minutes after drug intake. Subjective effects in response to MDMA were assessed throughout the experiment. The primary outcome was the area under the plasma OXT concentration curve (AUC) after MDMA intake. Results: Already at baseline, patients compared with healthy controls, showed significantly higher scores in anxiety (STAI: 41 points [IQR 34-48] vs. 28 points [24-31]; p=0.02), alexithymia (TAS: 47 points [38-59] vs. 30 points [29-37; p=0.04), and depression symptoms (BDI: 6 points [3-17] vs. 1 point [0-2]; p=0.04). In response to MDMA stimulation, in patients, there was only a minimal OXT change with 66 pg/ml [16-94], while in healthy controls, OXT increased by 658 pg/ml [355-914]. The AUC was 15.8 times (1485%), i.e., 85,678 pg/ml (95%-CI [-10,800 to -63,356], p&amp;lt;0.001), lower in patients compared with healthy controls. This lack of OXT in patients was associated with lower subjective effects such as ‘good drug effect,’ ‘feeling high,’ ‘satisfaction,’ ‘happy,’ ‘trust,’ ‘talkative,’ ‘openness,’ and ‘fear reduction’ compared with healthy controls. Conclusion: These results lay the groundwork for OXT deficiency as a hypothalamic-pituitary entity. In patients with cDI, this lack in OXT was associated with reduced pro-social, empathic, and anxiolytic effects. Presentation: Saturday, June 17, 2023

Tourism stimulus on anxiety and depression in college students

BackgroundThe prevalence of anxiety and depression continues to increase, becoming the most common mental health symptoms, with a higher proportion of these two mental illnesses among college students.Subjects and MethodsThe survey randomly selects 50 college students who suffer from both anxiety and depression at a certain university and divides them into two groups. One group consists of 25 people, and each group is treated with psychotherapy combined with tourism stimulus and psychotherapy. The treatment course lasts for one year, and a follow-up visit will be conducted one year later to score anxiety and depression.ResultsThe scoring results showed that among college students receiving combination therapy, the highest anxiety score was 8.6, which decreased to 3.7 after treatment. The highest depression score was 9.2, which decreased to 4.4 after combination therapy. Analysis of 25 people who received combined treatment found that the average score for depression and anxiety decreased to 4.1, and 5 of them were cured. Among college students who only received psychological treatment, the highest anxiety score was 9.1, which decreased to 5.3 after treatment. The highest depression score was 8.7, which decreased to 4.9 after psychological treatment. The average score for depression and anxiety reduction was 2.9.ConclusionsThe experimental results indicate that tourism stimulus combined with psychotherapy has a better therapeutic effect on college students with anxiety and depression than using psychotherapy alone.AcknowledgementThe Education Department of Hainan Province, No. Hnjg2021-116; 2022 Hainan Vocational University of Science and Technology Hainan Free Trade Port Business and Tourism Research Base Project, No. HKKY2022JD-06.

Dental Anxiety Assessment through the Drawings of Children and Influence of Art Therapy.

Assessment of dental anxiety in children is difficult because of their immature cognitive and emotional development. Drawings are well well-established emotion assessment tool. These can be used as nonverbal methods of communication for expressing the children's anxiety and emotions. Art therapy utilizes creative therapy interventions to deal with children suffering from emotional problems. The aim of the study is (1) To assess the drawings of children for the presence of dental anxiety. (2) To study the effectiveness of art therapy on dental anxiety in children. One hundred and twenty children within the age group of 6-12 years were part of this study. The pretest assessment of dental anxiety was done using Frankl and Five facial anxiety scales. All the participants received local anesthesia during their first treatment session. At the end of the treatment session, all the participants were asked to draw a picture of their experience. The drawn figures were assessed by a psychologist. The children were allotted randomly into the study group (n = 60) and control group (n = 60). Art therapy was given to 60 children in the study group for three consecutive appointments. The posttest assessment of dental anxiety was done using Frankl and Five facial anxiety scales after completion of the entire dental treatment. The pretest scores revealed very high level of dental anxiety in 33 (55%) children in study group and 34 (56.67%) children in control group. The posttest scores of study group, who received the art therapy, revealed that 24 (40%) children had little anxiety and 32 (53.33%) children had some anxiety. Whereas in the control group, the posttest scores showed 20 (33.33%) children had high anxiety and 39 (65%) children had very high anxiety scores. There was a significant correlation between the objective score of dental anxiety and the subjective scores of CD: H. Drawings can be used as an assessment tool for the detection of dental anxiety and art therapy effectively reduces the anxiety in pediatric patients undergoing dental treatment.

Sleep Quality and Its Relationship to Anxiety and Hardiness in a Cohort of Frontline Italian Nurses during the First Wave of the COVID-19 Pandemic.

The COVID-19 pandemic has had a considerable impact on the psychological and psychopathological status of the population and health care workers in terms of insomnia, anxiety, depression, and post-traumatic stress disorder. The primary aim of this study was to describe and evaluate the impact of the pandemic on insomnia levels of a cohort of Italian nurses, particularly those involved in the care of COVID-19 patients. The secondary aim was to identify the interaction between insomnia and hardiness, anxiety, and sleep disturbances. A descriptive-exploratory study was conducted using an online survey during the first wave of the COVID-19 pandemic (March to July 2020). The questionnaire consisted of multiple-choice, open-ended, closed, and semi-closed questions. The psychometric tools administered were the Dispositional Resilience Scale (DRS-15), the State-Trait Anxiety Inventory (STAI-Y), and the Insomnia Severity Index (ISI). a cohort of 1167 nurses fully completed the questionnaire (86.2% of total respondents). The insomnia scale survey showed an increase in post-pandemic scores compared to those before the pandemic, implying that insomnia levels increased after the first pandemic wave. Insomnia scores were directly correlated with anxiety levels (r = 0.571; p ≤ 0.05) and inversely correlated with hardiness levels (r = -0.324; p < 0.001). Multivariate analysis revealed the following protective factors: not having worked in COVID-19 wards, high levels of hardiness (commitment), and the presence of high pre-pandemic insomnia disorder. The main risk factor for insomnia reported in the analysis was a high anxiety score. Anxiety represented the main risk factor for insomnia severity in our sample, while hardiness was confirmed as a protective factor. Thus, it is necessary to design further studies to identify additional risk factors for poor sleep quality and to develop educational courses and strategies aimed at enhancing rest and sleep quality, especially for frontline nurses.

Preoperative Anxiety and Its Postoperative Associated Factors in Patients Receiving Post Anesthetic Recovery Care at Surgical Intensive Care Unit

Objectives: This study determined the postoperative associated factors with preoperative anxiety in patients receiving post anesthetic recovery care at surgical intensive care unit. Methods: In this cross-sectional correlational study, 84 postoperative patients were admitted to a surgical intensive care unit for post anesthetic recovery care. Participants completed questionnaires on anxiety, pain, stress, and sleep disturbance on the preoperative day and on the morning of postoperative day 1. Data were analyzed with χ 2 -test, unpaired t-test, Pearson correlation analysis and logistic regression. Results: Forty patients (47.6%) had a high preoperative anxiety score of ≥ 18. Higher preoperative anxiety was associated with greater postoperative anxiety (r = 0.24, &lt;i&gt;p&lt;/i&gt; = 0.026), higher postoperative stress (r = 0.24, &lt;i&gt;p&lt;/i&gt; = 0.026), and poorer postoperative sleep (r = 0.39, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). High preoperative anxiety was associated with postoperative physical restraint (B = 1.72, OR: 5.59, 95% CI: 1.19-21.32). High preoperative anxiety was associated with postoperative sleep disturbance (B = 0.29, OR: 1.34, 95% CI: 1.08-1.65). Conclusions: High preoperative anxiety is associated with poorer sleep during the first postoperative night among surgical intensive care unit patients.