Hospital Anxiety And Depression Depression Scores Research Articles

Symptoms of Anxiety, Depression, and Stress among Families of Critically Ill patients with COVID-19: A Longitudinal Study.

Families of critically ill patients with COVID-19 may be at particularly high risk for anxiety, depression, and post-traumatic stress disorder after hospital discharge. To assess symptoms of anxiety, depression, and stress among families of patients with COVID-19 during and after an intensive care unit (ICU) admission and to use qualitative methods to determine the sources of emotional distress. Families of patients with COVID-19 who participated in an ICU study were approached for participation in this post-hospital discharge study. Participants completed the Hospital Anxiety and Depression (HADS) and Impact of Events-Revised (IES-R) measures at up to three points during the ICU stay and once after the ICU stay. Mixed effects models were used to compare trajectories HADS and IES-R scores over the ICU and post-ICU periods. Telephone interviews with participants were evaluated using thematic content analysis. Of the 90 families who participated from September 2020 to April 2021, there were 47 respective patients who were alive and 43 who were deceased. Average HADS-anxiety, HADS-depression, and IES-R scores after hospital discharge were significantly higher (greater symptom burden) among families of deceased vs. surviving patients: 9.2 (95% CI 7.8 - 10.6) vs. 6.3 (95% CI 4.9 - 7.6), p<0.01; 7.1 (95% CI 5.7 - 8.6) vs. 3.2 (95% CI 2.3 - 4.1), p<0.001; and 36.1 (95% CI 31.0 - 41.2) vs. 20.4 (95% CI 16.1 - 24.8) , p<0.001, respectively. HADS-anxiety and HADS depression scores began to diverge during the ICU stay whereas IES-R scores diverged after the stay. Qualitative analysis confirmed higher burden of psychological symptoms among families of deceased patients. Memories from the ICU stay became a focal point for participants who lost their loved ones, whereas families of surviving patients were able to look positively toward the future. In addition, families of deceased patients often viewed friends and family as sources of stress, whereas families of surviving patients typically viewed their community as a source of support. Patient death was associated with symptoms of anxiety, depression, and PTSD among families of ICU patients with COVID-19. Psychological support interventions may be most beneficial for families of patients who died from COVID-19. Clinical trial registered with ClinicalTrials.gov (NCT04501445).

Predicting return to work after acute myocardial infarction: Socio-occupational factors overcome clinical conditions.

ObjectivesReturn to work after acute myocardial infarction (AMI), a leading cause of death globally, is a multidimensional process influenced by clinical, psychological, social and occupational factors, the single impact of which, however, is still not well defined. The objective of this study was to investigate these 4 factors on return to work (RTW) within 365 days after AMI in a homogeneous cohort of patients who had undergone an urgent coronary angioplasty.ParticipantsWe studied 102 patients, in employment at the time of AMI (88.24% of men), admitted to the Department of Cardiology of the University-Hospital of Ferrara between March 2015 to December 2016. Demographical and clinical characteristics were obtained from the cardiological records. After completing an interview on social and occupational variables and the Hospital Anxiety and Depression (HADS) questionnaire, patients underwent exercise capacity measurement and spirometry.ResultsOf the 102 patients, only 12 (12.76%) held a university degree, 68.63% were employees and 31.37% self-employed. The median number of sick-leave days was 44 (IQR 33–88). At day 30, 78.5% of all subjects had not returned to work, at day 60, 40.8% and at day 365 only 7.3% had not resumed working. At univariate analyses, educational degree (p = 0.026), self-employment status (p = 0.0005), white collar professional category (p = 0.020) and HADS depression score were significant for earlier return to work. The multivariate analysis confirms that having a university degree, being self-employed and presenting a lower value of HADS depression score increase the probability of a quicker return to work.ConclusionsThese findings suggest that the strongest predictors of returning to work within 1 year after discharge for an acute myocardial infarction are related more to socio-occupational than to clinical parameters.

Randomised crossover trial of telemonitoring in chronic respiratory patients (TeleCRAFT trial)

ObjectiveTo assess the impact of home telemonitoring on health service use and quality of life in patients with severe chronic lung disease.DesignRandomised crossover trial with 6 months of standard best...

Évaluation dimensionnelle des émotions en psychiatrie : validation du questionnaire Émotionnalité positive et négative à 31 items (EPN-31)

This paper reports the first validation study of the EPN-31 scale (Positive and Negative Emotionality scale, 31 items) in a French psychiatric sample. This questionnaire has been adapted by Rolland from an emotion inventory developed by Diener, and is also in accordance with Watson and Clark's tripartite model of affects. Respondents were asked to rate the frequency with which they had experienced each affect (31 basic emotional states) during the last month. The answer format was a 7-point scale, ranging from 1 "Not experienced at all" to 7 "Experienced this affect several times each day". Three main scores were calculated (positive affects, negative affects, and surprise affects), as well as six sub-scores (joy, tenderness, anger, fear, sadness, shame). Four hundred psychiatric patients were included in this study, and completed the EPN-31 scale and the Hospital Anxiety and Depression (HAD) scale. The Global Assessment of Functioning (GAF) scale was rated, as well as DSM IV diagnostic criteria. We performed a principal component analysis, with Varimax orthogonal transformation, and explored the factorial structure of the questionnaire, the internal consistency of each dimension, and the correlations between EPN-31 scores and HAD scores. The factorial structure of the EPN-31 was well-defined as expected, with a three-factor (positive, negative and surprise affects) solution accounting for 58.2% of the variance of the questionnaire. No correlation was obtained between positive and negative affects EPN-31 scores (r=0.006). All alpha Cronbach coefficients were between 0.80 and 0.95 for main scores, and between 0.72 and 0.90 for sub-scores. GAF scores were significantly correlated with EPN-31 positive affects scores (r=0.21; p=0.001) and with EPN-31 negative affects scores (r=- 0.45; p=0.001). We obtained significant correlations between positive affects score and HAD depression score (r=- 0.45; p<0.001), and between negative affects score and HAD anxiety (r=0.56; p<0.001) and depression (r=0.45; p<0.001) scores. This pattern of correlation was in accordance with the Watson tripartite model of emotionality. Significantly higher EPN-31 positive affect mean scores were observed in females when compared to males (p<0.001). The third factor of the EPN-31 is less robust than the others and, the validity of the surprise score could hence be discussed. In all, this study confirmed the validity and the interest of the EPN-31 use in psychiatric patients. Various clinical and research applications can be considered, such as infra-symptomatic studies of emotions in affective disorders and during treatment protocols or definition of phenotypic markers in genetic or neuro-imagery studies.

The Role of Coping Styles and Self-efficacy in the Development of Dysphoric Mood Among Nursing Students

Coping styles and self-efficacy have been recognized as important determinants of dysphoric mood. The objectives of this study were to determine the influence of these two factors on depression and anxiety in Japanese students. A set of questionnaires, including the Hospital Anxiety and Depression (HAD) Scale, the Coping Inventory for Stressful Situations (CISS), and the Self-efficacy Scale (SES) was distributed to 146 nursing students. Structural equation modelling was conducted to specify the relationships between measured variables. The HAD depression and anxiety scores were predicted by emotion-oriented coping. The HAD depression alone was predicted by avoidance-oriented coping. Self-efficacy scores predicted the emotion-oriented coping and HAD depression scores. Students’ dysphoric moods were influenced by emotional-oriented coping that mediated the effects of low self-efficacy, and self-efficacy also had a direct effect on depression.

Psychiatric screening for patients with faecal incontinence or chronic constipation referred for surgical treatment.

Fifty patients attending for surgical treatment of chronic constipation (n = 21) or faecal incontinence (n = 29) were studied using two psychiatric screening tests: the Hospital Anxiety and Depression (HAD) scale and the General Health Questionnaire (GHQ). Each patient was assessed preoperatively and 6-12 months postoperatively. Results were compared with age and sex-matched controls (n = 50). Constipated patients had significantly higher HAD depression scores compared with controls (median and range): 6 (2-12) versus 4 (0-8), P less than 0.05. Constipated patients who were improved by operation (n = 13) had significantly lower preoperative HAD anxiety scores compared with those who were not improved (n = 8): 8 (3-14) versus 15 (10-19), P less than 0.01; they also had significantly lower HAD depression scores: 4 (2-12) versus 7 (5-11), P less than 0.05. Using these parameters incontinent patients did not differ from controls, but patients who had a bad result after operation (n = 15) had significantly higher HAD anxiety scores than those who obtained clinical benefit (n = 14): 10 (2-15) versus 6 (2-12), P less than 0.05; HAD depression scores were also greater: 5 (2-15) versus 3 (0-9), P less than 0.05; and GHQ scores were greater: 12 (0-47) versus 4 (0-41), P less than 0.05.

Forewarned is forearmed — benefits of preparatory information on video cassette for patients receiving chemotherapy or radiotherapy — a randomised controlled trial

A series of UK and European audits have revealed that a high proportion of patients remain dissatisfied with the information they received following a diagnosis of cancer. Additional educational aids are often required to facilitate the consent process, and our previous work showed a high level of acceptability for video-directed information for this purpose. In this study a multidisciplinary team of health professionals worked with patients, a documentary film company and experienced television personalities to produce an information film. The aim of this study was to assess the benefits of receiving a cassette to take home following the first consultation and this was evaluated in a randomised multicentre controlled study among 220 patients receiving chemotherapy or radiotherapy over a 6-month period. There was a significant correlation between satisfaction and reduced treatment-related anxiety overall. In the video group, the mean Hospital Anxiety and Depression (HAD) anxiety score was significantly lower during treatment compared with the non-video group (4.6±3.7 (range: 0–18) versus 7.4±5.2 (range: 0–20), Chi square test P=0.001). Likewise, the mean HAD depression scores were also significantly lower in the patients prepared for the side-effects of treatment with the video (2.9±2.9 (range: 0–13) versus 5.3±4.7 (range: 0–21) Chi square test P=0.001). 81% felt the video was helpful, only 5% of patients felt this extra information was worrying. Well designed video cassettes should be regarded as a useful additional information strategy, within routine oncology practice.

The relationship between perceived risk, thought intrusiveness and emotional well‐being in women receiving counselling for breast cancer risk in a family history clinic

Objectives. This study was designed to assess changes in perceived risk, cognitive intrusions and distress in women undergoing counselling for familial risk of developing breast cancer. Design. A longitudinal design in which 90 consecutive women attending a family history clinic were asked to indicate their concerns before counselling and then again 3 and 6 months post‐counselling. Method. Questionnaires included measures of thought content and intrusiveness, cancer specific distress (Cockburn, De Luise, Hurley, &amp; Clover, 1992), a Visual Analogue scale (VAS) of perceived risk, and the Hospital Anxiety and Depression (HAD) scale (Zigmond &amp; Snaith, 1983). Results. Sixty‐nine women agreed to take part in the study, with 49 completing all three sets of questionnaires. Before counselling, thought intrusiveness and HAD depression scores accounted for 69% of the variance in the measure of cancer specific distress. Women who dropped out of the study before the post‐counselling assessments reported higher levels of intrusiveness at baseline than those who completed the study. Perceived risk was only moderately related to actual risk post‐counselling and increases/ decreases in thought intrusiveness correlated positively with increases/decreases in both perceived risk and distress. Conclusions. Psychological distress is related to levels of perceived risk, a relationship which may be mediated by thought intrusiveness. It could be more appropriate for genetic counselling services to provide strategies for managing intrusiveness of worries rather than attempting to modify risk perceptions.