Hospital Anxiety And Depression Scale Anxiety Subscale Research Articles

SCREENING OF ANXIETY AND DEPRESSIVE DISORDERS IN MEDICAL STUDENTS

The aim of the research was to study the frequency of occurrence of anxiety and depression in first-year medical university students in the post-holiday period.Materials and methods. The study involved 70 first-year medical university students (average age 17,9 ± 1,31 years). The study was conducted as part of a periodic medical examination of participants during the first semester (in the early post-holiday period). The Hospital Anxiety and Depression Scale (HADS) was used.Results. The analysis of the answers to the questions of the HADS anxiety subscale showed that more than a third of the survey participants (38,6%) had anxiety disorders, of which more than half of the participants (51,9%) needed the advice of a clinical psychologist or psychotherapist. 21,4% of participants had a feeling of tension, 27,2% - fear, 24,3% - restless thoughts, 17,1% - inability to relax, 22,8% - internal tension or trembling, 40% - restlessness, 31,4% - panic. Analysis of answers to questions on the HADS depression subscale indicated that 22,9% of students had depressive disorders, of which more than a third (37,5%) needed the advice of a clinical psychologist or psychotherapist. 27,1% of participants had a decrease/lack of pleasure from something that used to bring positive emotions, 10% - inability to laugh, 15,7% - lack of a sense of cheerfulness, 20% - slowness, 15,7% - unwillingness to monitor their appearance, 18,6% - decreased sense of satisfaction from hobbies, 20% - decreased feelings of pleasure from a good book, radio or TV program.Conclusion. The expansion of the standard scope of periodic medical examination made it possible to screen the psycho-emotional state of students in the post-holiday period of the autumn semester and identify a risk group for the development and increase of existing anxiety-depressive disorders during the educational process, which can have an adverse effect on both the quality of life of students and the effectiveness and success of training.

The Relationship Between Digital Game Addiction and Levels of Anxiety and Depression in Adolescents Receiving Cancer Treatment.

Adolescents diagnosed with cancer are vulnerable to symptoms of anxiety, depression, and posttraumatic stress. To examine the relationship between digital game addiction and levels of anxiety and depression in adolescents receiving cancer treatment. This analytical cross-sectional study was carried out with 120 adolescents aged 12-17 years who were receiving cancer treatment. Data were collected using the Digital Game Addiction Scale (DGAS-7) and the Hospital Anxiety and Depression Scale (HADS). Data were analyzed using independent-samples t test, 1-way analysis of variance, Pearson correlation analysis, and simple linear regression. The mean age of the adolescents participating in the study was 15.21 ± 1.64 years. The mean DGAS-7 score was 15.19 ± 5.58, whereas the mean HADS Anxiety subscale score was 8.54 ± 4.33, and the mean HADS Depression subscale score was 7.72 ± 3.96. A positive, statistically significant relationship was found between the DGAS-7 mean score and the HADS Anxiety and Depression subscale mean scores (P < .001). As the addiction levels increased in adolescents diagnosed with cancer, their anxiety and depression levels also increased. Health professionals should be mindful that in adolescents diagnosed and treated for cancer, digital game addiction and levels of anxiety and depression may mutually reinforce each other.

Investigating the effectiveness of music therapy combined with binaural beats on chronic tinnitus: A randomized controlled trial

BackgroundBinaural beat stimulation (BBS) involve presenting two sinusoidal waves with specific frequency differences to induce neural changes in the brain, often used for mental state induction and symptom reduction. However, there are limited studies on its effectiveness for tinnitus. This study aimed to assess the effectiveness of combining binaural beats with music containing nature sounds for chronic tinnitus. MethodsA total of 30 men, aged 45.87 on average (SD = 8.09), who had chronic tinnitus and symmetrical mild to moderate hearing loss, were included in this study. The participants were randomly assigned to two groups: MT group (Music therapy; n = 15), which received relaxing music containing the sound of sea waves, and MT + BBS group (Music therapy plus binaural beats; n = 15), which received the same music combined with alpha frequency (8 Hz) binaural beats. The therapy sessions were conducted twice a day for 15 min, over a period of 4 weeks. Outcome measures, including the Tinnitus Handicap Inventory (THI), Tinnitus Functional Index (TFI), Hospital Anxiety and Depression Scale (HADS), Visual Analog Scale (VAS) and the pitch and loudness of tinnitus were administered before, immediately after, and during the three-month follow-up period. ResultsThe findings revealed improvements in loudness and annoyance VAS, as well as THI total and all subscale scores in both groups (p < 0.001). Additionally, TFI total score showed improvement in both groups (MT: p = 0.001; MT + BBS: p < 0.001) except for the sense of control subscale in both groups and the cognitive subscale in the MT group after the treatment and during the three-month follow-up period. Furthermore, both groups exhibited a decrease in scores for both subscales of HADS. However, there were no significant differences between the two groups in any of the measurement outcomes (p > 0.05), except for the emotional subscale scores of TFI (p = 0.049) and the functional subscale scores of THI (p = 0.034). In other words, during the follow-up period, the MT + BBS group exhibited lower scores in these two subscales compared to the MT group. ConclusionAlthough our study failed to demonstrate the superiority of combining binaural beats with music, both groups experienced significant improvements. This suggest that there are potential benefits to be gained from these types of stimuli. Given the sustained effect of both methods and the even greater improvements in follow-up observed in the binaural beats group for some scales, it seems that the changes in neural response and brain waves caused by our stimulations are persistent. This necessitates further research involving brain mapping, especially with longer follow-up durations.

Burnout in Neurosurgery

Burnout is a pervasive psychosocial syndrome that manifests as a chronic response to interpersonal stressors encountered in the occupational setting. Neurosurgeons exhibit a high prevalence rate of burnout, ranging from 33% to 67%. The primary objective of this study is to examine the prevalence of Burnout syndrome within the neurosurgical community and identify the contributing factors. A prospective observational study was conducted utilizing an anonymous survey format, incorporating the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) questionnaire. Additional inquiries were made regarding demographic characteristics, occupational factors, lifestyle choices, and the Hospital Anxiety and Depression Scale (HADS) questionnaire. The survey was disseminated between March 23rd, 2023, and April 4th, 2023, utilizing the email registries of the Spanish Society of Neurosurgery (SENEC) and the Latin American Federation of Neurosurgical Societies (FLANC). Descriptive analysis was performed, comparing responses between participants with and without burnout syndrome using cross-tabulation and the Chi-square test to assess the presence of dependency. A total of 282 neurosurgeons completed the survey. The sample comprised 30.1% females and 69.9% males, with a median age within the 30-40 range. Among the surveyed neurosurgeons, 66.7% exhibited a prevalence of burnout, while 23.4% met the criteria for defined burnout. Significantly higher rates of burnout syndrome were observed among residents, specifically those in their fifth year of residency, as well as those whose departments perform a moderate range of surgeries (500-1000), participating in on-call duties, lacking regular physical exercise (at least twice a week), engaging infrequently in social activities with friends, lacking extracurricular hobbies, and obtaining scores exceeding 10 points in any of the HADS subscales. Burnout syndrome affects nearly a quarter of the neurosurgical specialists included in this study. Moreover, a distinct profile associated with defined burnout among neurosurgeons emerges, encompassing characteristics such as being a fifth-year resident, belongs to departments with a moderate number of surgeries, with few extra-occupational distractions and exhibiting symptoms of depression or anxiety.

P747 Assessment of a microlearning programme for patients with Inflammatory Bowel Disease (The ADEII project) on ansiety/depression status and illness perception

Abstract Background Information and communication technologies (ICTs) represent a novel approach to chronic disease management. However, their use in Inflammatory Bowel Disease (IBD) is lacking and their results as far unknown, because no specific tools are available, The prevalence of anxiety and/or depression in IBD ranges from 30-35% in clinically inactive phases. Furthermore, negative perceptions of the disease in the dimensions of consequences and emotions have been related to depression and anxiety. We aim to evaluate the outcomes of a novel microlearning programme for IBD patients in.anxiety/depression status and illness perception. Methods Prospective cohort study in adult patients with IBD (18 to 70 years old) who underwent a microlearning programme over a 2-month period, throught 4-minute videos organised in individualised video pathways that were sent via mobile phone using a Telegram bot. All patients received the 4-video main pack, consisting of 2 videos with information about their disease (ulcerative colitis or Crohn's disease), 1 video on adherence and another one on steroid treatment. To these were added as many videos as the number of drugs used by the patient to control IBD. Before starting the programme and at 6 months, patients completed the Hospital Anxiety and Depression Scale (HADS) and the Brief Illness Perception Questionnaire (BIPQ). Results Between June and October 2022, 1226 videos were sent to 200 IBD patients: 51.5% female (103), UC 52.5% (105), mean age 46.1 (13.2) years (Table 1). Median number of videos per patient was 6 (6-7). Attendance to ADEII programme ranged between 78% and 90%.The median score on the HAD anxiety subscale was 8.1 (4.3), while the median score on the HAD depression subscale was 6(4-8), Initially, anxiety was diagnosed in 60 patients (30%) and depressión in 16 (8%) as subescales scores&amp;gt;11. We found significant differences between the pre-intervention versus post-intervention medians and IQR in anxiety score 8(5-11) vs 7(4-11) (p=0.008) but no in depression. Regarding BIPQ test post -intervention there were significant decreases in P8 negative emotions 6(3-8) vs. 5(3-7) (p=0,003) and P5 identity 6(4-8) vs 5(3-7) (p=0,003) as well as a significant increase in P7 comprehensibility of disease 7(5-9) vs. 8(7-9) (p=0,003). Conclusion An ICT-based educational program was widely accepted by IBD patients and showed a decrease in anxiety and negative emotions and representations, along with improvement in the understanding of disease.

Do depressive and anxiety symptoms influence the construct validity of Multiple Sclerosis Walking Scale-12 scores?

Walking dysfunction, depression, and anxiety are prevalent, burdensome, and interrelated outcomes in persons with multiple sclerosis (MS). The 12-item Multiple Sclerosis Walking Scale (MSWS-12) is a common patient-reported outcome (PRO) of walking dysfunction in research and practice involving MS, but the construct validity of its scores might be influenced by symptoms of depression and anxiety. This study examined if symptoms of depression and anxiety influenced the construct validity of MSWS-12 scores. The sample included 189 participants with MS who completed the MSWS-12, Hospital Anxiety and Depression Scale (HADS-Depression subscale [HADS-D] and HADS-Anxiety subscale [HADS-A]), 6-minute walk (6MW), and timed 25-foot walk (T25FW). We conducted bivariate correlation analysis to examine the associations between MSWS-12 scores and both the 6MW and T25FW, while controlling for HADS-D and HADS-A scores. MSWS-12 scores were significantly correlated with the 6MW (r = -.752), T25FW (r = .694), HADS-D (r = .405), and HADS-A (r = .235). The correlations between MSWS-12 and 6MW (pr = -.725) and T25FW (pr = .685) did not change when controlling for HADS-D and HADS-A scores. The correlations between MSWS-12 and 6MW (r = -.708 and r = -.726) and T25FW (r = .687 and r = .748) were strong in subsamples with elevated HADS-D and HADS-A scores. Our results strengthen the validity evidence for MSWS-12 scores as a PRO of walking dysfunction in MS, including among those with symptoms of depression and anxiety. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The association of disease activity with depression and sleep quality in patients with rheumatoid arthritis in Hong Kong.

Patients with rheumatoid arthritis (RA) often experience depression and poor sleep. Depression and poor sleep may, in turn, worsen RA disease activity. This cross-sectional study aimed to investigate the relationship between RA disease activity as measured using the Disease Activity Score-28 (DAS28-ESR), depression measured using the Beck's Depression Inventory-II (BDI-II), and sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI). Anxiety was measured using the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A). A total of 164 consecutive patients with RA were recruited from the Rheumatology Specialist Clinic of a regional hospital in Hong Kong. They were asked to complete questionnaires that included demographic information, the Health Assessment Questionnaire (HAQ), BDI-II, HADS-A, and PSQI. The DAS28-ESR was assessed by the attending rheumatologists. Clinical information was retrieved from the electronic medical records. The mean DAS28-ESR score was 3.35 ± 1.24 (SD). The mean BDI-II was 10.97 ± 9.15 (SD). The mean HADS-A score was 5.57 ± 3.77 (SD). The mean PSQI score was 7.55 ± 4.16 (SD). The BDI-II score was statistically correlated with the DAS28-ESR and PSQI scores. Multiple regression analysis revealed that the association of BDI-II with DAS28-ESR and PSQI was confounded by the HAQ. The association of DAS28-ESR with BDI-II but not with PSQI is in accordance with the results of previous studies. The association between the HAQ and BDI-II has also been demonstrated in previous studies. Clinicians should be aware of mood and sleep problems in patients with RA and adopt a multidisciplinary approach to their management. Future studies should provide information on causality in a more representative sample of patients with RA.

The Impact of COVID-19 Pandemic on Acne Patients and Their Management: An Observational Multicenter Study from Italy

Acne vulgaris was one of several diseases whose progression was significantly influenced psychologically by the rapid and protracted alteration of daily routines that occurred during the COVID-19 pandemic, especially for specific populations like adolescents. In order to assess their psychological impact and the relationship with the progression of acne vulgaris, this study aims to examine the quality of life, stress, anxiety, and depression of acne patients during the COVID-19 pandemic and their care. This observational, multicenter investigation was carried out in five dermatology clinics in Italy. Data were obtained via a remote telephone interview using questionnaires that were approved by a group of dermatologists and psychiatrists. Evaluations included demographic information, treatment status, disease progression, dietary habits, and employment activities. Some 178 acne vulgaris patients in various stages of systemic or topical medication were included in the study: 47 of 178 (26.4%) patients showed high scores on the HADS anxiety subscale, and 41 of 178 (23%) patients showed high scores on the HADS depression subscale. The Brief Resilience Scale (BRS) was used to measure resilience; 70 patients out of 178 (or 39.3%) showed low resilience (range: 1.00–2.99). In 32 out of 178 patients with PSS, high levels of stress were discovered (18%). Some 50 out of 178 patients experienced alterations in their way of life, including increased acne-related symptoms of relationship humiliation and constraints on everyday activities. Some 52 out of 178 patients (29.2%) said that they felt their condition had gotten worse over the study period. Our findings revealed a potential link between the exacerbation of acne and high levels of anxiety and depressive symptoms, as well as an elevated sense of stress and low or moderate levels of adaptability and resilience.

Effects of inpatient energy management education and high-intensity interval training on health-related quality of life in persons with multiple sclerosis: A randomized controlled superiority trial with six-month follow-up.

Fatigue is one of the most frequent symptoms in persons with multiple sclerosis (pwMS) and impacts health-related quality of life (HRQoL). A multidisciplinary rehabilitation approach is recommended for the treatment of fatigue in pwMS. However, high-quality evidence exists only for unimodal interventions, such as physical therapies/exercise or energy/fatigue management programmes. The primary objective of the current study was to test the hypothesis that a combination of inpatient energy management education (IEME) and high-intensity interval training (HIIT) is superior to a combination of progressive muscle relaxation (PMR) and moderate continuous training (MCT) for improving HRQoL at 6-month follow-up in fatigued pwMS. A randomized (1:1) controlled superiority trial with fatigued pwMS >18 years of age, with Expanded Disability Status Scale (EDSS) score ≤6.5, recruited at the Valens clinic, Switzerland. Participants in the experimental group performed IEME twice and HIIT 3 times per week and those in the usual care group performed PMR twice and MCT 3 times per week, during a 3-week inpatient rehabilitation stay. Primary outcome was HRQoL (Physical and Mental Component Scales of the Medical Outcome Study 36-item Short Form Health Survey (SF-36)), assessed at entry to the clinic (T0), after 3 weeks' rehabilitation (T1) and 4 (T2) and 6 (T3) months after T0. Secondary outcomes included SF-36 subscales, fatigue (Fatigue Scale for Motor and Cognitive Functions (FSMC)), mood (Hospital Anxiety and Depression Scale (HADS)), self-efficacy for performing energy conservation strategies (Self-Efficacy for Performing Energy Conservation Strategies Assessment (SEPECSA)), self-perceived competence in activities of daily living (Occupational Self Assessment (OSA)) and cardiorespiratory fitness (peak oxygen consumption (VȮ2peak)). Data were analysed using a mixed model for repeated measures approach. A total of 106 pwMS (age (years): 49.75 (9.87), 66% female, EDSS: 4.64 (1.32)) were recruited. There were no significant group×time interaction effects in the primary and secondary outcomes. There were significant between-group differences in the pairwise comparisons of the group×time interaction in favour of the IEME+HIIT group at: (i) T1 in cardiorespiratory fitness (p=0.011) and SEPECSA (p=0.032); (ii) T2 in SF-36 mental health subscale (p=0.022), HADS anxiety subscale (p=0.014) and SEPECSA (p=0.040); (iii) T3 in SF-36 physical functioning subscale (p=0.012) and SEPECSA (p=0.003). IEME+HIIT was not superior to PMR+MCT regarding the effects on HRQoL (SF-36 Physical and Mental Component Scales) at 6-month follow-up in pwMS. However, there were significant between-group differences in favour of IEME+HIIT in physical functioning and mental health (SF-36 subscales), anxiety (HADS), cardiorespiratory fitness (VȮ2peak) and self-efficacy (SEPECSA) at different measurement time-points that need to be considered in clinical practice.

Accuracy of the Personal Economic Distress Index Among Arabic Unemployed.

Objectives: Studies about The Index of Personal Economic Distress (IPED) in Arab countries since the onset of the COVID-19 pandemic have been alarming. This study aimed to explore the reliability, factor structure, and criterion validity of the Arabic IPED in a sample of unemployed Tunisians during the past 6months. Methods: The Arabic version of the IPED and the validated Hospital Anxiety and Depression Scale (HADS) were administered to a total of 2011 unemployed people originating from all Tunisian regions. Principal component analysis (PCA) with confirmatory factor analysis (CFA) was used to establish the spontaneous distribution of the 8 items and possible factors of the IPED. Receiver operating characteristic (ROC) analysis was conducted to assess the ability of the IPED to distinguish between unemployed individuals with no economic distress and those in distress. The correlation between the IPED and the HADS were explored. Results: The reliability of the Arabic version of the IPED was adequate. The PCA suggested two main components of the Arabic version of the IPED: the first component including five items focused on financial responsibilities towards state structures and the second dimension containing three items focused on well-being. A statistically significant association (p = 0.01; r = 0.05) was found between the well-being dimension of the IPED and the Anxiety subscale of HADS. Conclusion: This validated version of the IPED is an important tool to study the impact of economic crises on the mental health of unemployed people, as demonstrated in the link found in this study between economic distress and anxiety.

Development and validation of the dizziness fear-avoidance behaviours and beliefs inventory for patients with vestibular disorders.

The purpose of this study is to present the development and analysis of the factorial structure and psychometric properties of a new self-administered questionnaire (Dizziness Fear-Avoidance Behaviours and Beliefs Inventory (D-FABBI)) designed to measure fear-avoidance behaviors and cognitions related to dizziness disability. A mixed-method design combining a qualitative study with an observational and cross-sectional study was employed to develop (content validity) and psychometrically validate (construct validity, reliability, and convergent/discriminant validity) a new instrument. A total of 198 patients with vestibular disorders (acute vestibular syndrome (AVS), 23.2%; chronic vestibular syndrome (CVS), 35.4%; and episodic vestibular syndrome (EVS) 41.4%) were recruited. Sociodemographic characteristics, the Dizziness Handicap Inventory (DHI) and the Hospital Anxiety and Depression Scale (HADS) and D-FABBI were evaluated. The final version of the D-FABBI consists of 17 items distributed across two subscales: activities of daily living fear-avoidance and movement fear-avoidance. The D-FABBI showed high internal consistency (Cronbach α = 0.932; 95% CI [0.91-0.94]) and so did the subscales (Cronbach α > 0.8). The exploratory structural equation model and confirmatory factor analysis provided better fit results, with a comparative fit index and root mean square error of approximation values of 0.907 to 0.081. No floor or ceiling effects were identified. There was a positive, significant, and moderate-strong magnitude correlation with the total DHI (r = 0.62) and low-moderate with respect to the HADS depression (r = 0.35) and HADS anxiety subscales (r = 0.26). The patients with CVS had a higher D-FABBI score than those with AVS or EVS. The D-FABBI appears to be a valid and reliable instrument for measuring the fear-avoidance behaviors and cognition related to dizziness disability of patients with vestibular disorders.

Effects of ozone therapy on anxiety and depression in patients with refractory symptoms of severe diseases: a pilot study.

Patients with refractory symptoms of severe diseases frequently experience anxiety, depression, and an altered health-related quality of life (HRQOL). Some publications have described the beneficial effect of ozone therapy on several symptoms of this kind of patient. The aim of this study was to preliminarily evaluate, in patients treated because of refractory symptoms of cancer treatment and advanced nononcologic diseases, if ozone therapy has an additional impact on self-reported anxiety and depression. Before and after ozone treatment, we assessed (i) anxiety and depression according to the Hospital Anxiety and Depression Scale (HADS); (ii) the HRQOL (according to the EQ-5D-5L questionnaire), which includes a dimension on anxiety and depression and a visual analog scale (VAS) measuring self-perceived general health. Before ozone therapy, 56% of patients were on anxiolytic and/or antidepressant treatment. Before and after ozone therapy, the anxiety and depression HADS subscales (i) significantly correlated with the anxiety/depression dimension of the EQ-5D-5L questionnaire and (ii) inversely correlated with the health status as measured by the VAS. After ozone therapy, we found a significant improvement in anxiety and depression measured by both the (i) HADS subscales and (ii) EQ-5D-5L questionnaire. The addition of ozone therapy for patients with refractory symptoms of cancer treatment and advanced chronic nononcologic diseases can decrease anxiety and depression severity levels. Additional, more focused studies are ongoing to provide the needed explanatory information for this finding.

Исследование психометрических свойств «Госпитальной шкалы тревоги и депрессии» (HADS), рекомендованной для врачей общесоматической практики, на выборке пациентов с нарушением двигательных функций

&lt;p style="text-align: justify;"&gt;The aim of the study is to investigate the psychometric characteristics of the Hospital Anxiety and Depression Scale (HADS) on a sample of patients with impaired motor functions. HADS was used to examine the current psychoemotional state of 73 women and 27 men aged 62.1&amp;plusmn;13.7 years who were in the hospital for inpatient rehabilitation for motor function disorders arising from a stroke (n=50) or developing against the background of chronic musculoskeletal disorders (n=50). Independent of the psychologist, a psychiatrist examined the same patients, filling out Hamilton Anxiety and Depression scales. A comparison of the findings led to the conclusion of overdiagnosis with the HADS subscales. At the same time, it is shown that the questionnaire items have satisfactory indices of discriminativeness and internal reliability. The combination of low content and convergent validity of some items of the questionnaire allowed modifying subscales, reducing the number of items without prejudice to psychometric characteristics. By comparing the data obtained with an objective external criterion for the Anxiety (HADS-A) and Depression (HADS-D) subscales, new cutoffs (9 points) were determined for diagnosing the presence or absence of anxiety and depression, which allows to use this version of the test more effectively for screening the current psychoemotional state in patients with impaired motor functions who enter the second stage of medical rehabilitation.&lt;/p&gt;

Screening for Anxiety in Patients With Inflammatory Arthritis Using the Multidimensional Health Assessment Questionnaire.

To analyze the Multidimensional Health Assessment Questionnaire (MDHAQ) in screening for anxiety in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA), compared to the Hospital Anxiety and Depression Scale (HADS) as the reference standard. Patients with a physician diagnosis of RA or PsA were invited to complete the MDHAQ and HADS at their routine rheumatology clinic visit. Sensitivity, specificity, percent agreement, and [Formula: see text] statistics were used to evaluate agreement between 2 MDHAQ items for anxiety and HADS subscale for Anxiety (HADS-A) score of ≥ 8. The first item is a question asked on a 4-point scale (0-3.3), and the second is a yes or no (blank) question asked within a 60-item review of symptoms (ROS) checklist. The study included 183 participants, of whom 126 (68.9%) had RA and 57 (31.1%) had PsA. The mean age was 57.3 years and 66.7% were female. Positive screening for anxiety according to a HADS-A score of ≥ 8 was seen in 39.3% of patients. Compared to those with a HADS-A score of ≥ 8, patients with an MDHAQ score of ≥ 2.2 or a positive on ROS had a sensitivity of 69.9%, specificity of 73.6% and substantial agreement (agreement 80.9%, [Formula: see text] 0.59). The MDHAQ provides information similar to the HADS in screening for anxiety in patients with RA and PsA. The use of this single questionnaire, which can also be used to monitor clinical status and to screen for fibromyalgia and depression without requiring multiple questionnaires, may prove a valuable tool in routine clinical practice.

Relationships among autistic traits, depression, anxiety, and maternal–infant bonding in postpartum women

BackgroundAlthough several studies have found significant relationships between autistic traits and depression/anxiety, the relationships between autistic traits and postpartum depression/anxiety remain unclear. Moreover, few studies have examined the relationships between autistic traits and mother–infant bonding while considering depression or anxiety.MethodsThis study used a cross-sectional data analysis design. Participants were 2692 women who completed the Autism-Spectrum Quotient (AQ), Hospital Anxiety and Depression Scale (HADS), and Mother-to-Infant Bonding Scale (MIBS) at 1 month postpartum. We performed path analysis that included parity, the five AQ subscales (social skills, attention switching, attention to detail, communication, and imagination), both HADS subscales (anxiety and depression), and the two MIBS subscales (lack of affection and anger and rejection).ResultsOur path analysis revealed that higher scores for social skills, attention switching, communication, and imagination were associated with higher scores for depression. Higher scores for social skills, attention switching, attention to detail, and communication were associated with higher scores for anxiety. Moreover, difficulties in social skills and imagination were associated with failure of maternal–infant bonding. However, more attention to detail was associated with better maternal–infant bonding.ConclusionsThis study suggests that maternal autistic traits are related to anxiety and depression to a certain degree, but only slightly related to maternal–infant bonding at 1 month postpartum. To improve autistic women’s quality of life and that of their newborns, perinatal mental health issues such as anxiety, depression, and maternal–fetal bonding difficulties should be appropriately addressed.

Validation of Hospital Anxiety and Depression Scale in an Indonesian population: a scale adaptation study

ObjectiveThis study aims to adapt the English-language Hospital Anxiety and Depression Scale (HADS) to the Indonesian language and evaluate the validity and reliability of the adapted version (ie, HADS-Indonesia).DesignA cross-sectional...

AB1803-HPR EVALUATION OF THE FACTORS ASSOCIATED WITH THE BIOPSYCHOSOCIAL STATUS OF PATIENTS WITH AS WHO WERE DECIDED TO BE TREATED WITH ANTI-TNF THERAPY FOR THE FIRST TIME

BackgroundAnkylosing spondylitis (AS) is a rheumatic disease that affects patients in a biopsychosocial framework due to its chronic inflammatory nature. It is known that anti-TNF therapy is given to patients with persistently high disease activity despite conventional treatments according to the ASAS recommendations [1].ObjectivesThe aim of this study was to examine the factors associated with the biopsychosocial status of patients with AS who were decided to be treated with anti-TNF therapy for the first time.Methods76 AS patients who were decided to treated with anti-TNF therapy included in the study. Socio-demographic informations of patients were collected. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) values were recorded for disease activity levels. Biopsychosocial status of the patients was evaluated by the BETY-Biopsychosocial Questionnaire (BETY-BQ). The Bath Ankylosing Spondylitis Functional Index (BASFI) and Health Assessment Questionnaire (HAQ) were used to assess functional and and daily living activities. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression levels.ResultsThe mean age of the patients was 39.99 ± 10.0 years. The mean BASDAI scores indicated active disease and were 5.98 ± 1.78. There was a statistically significant moderate correlation between the BETY and the anxiety and depression subscales of HADS and BASDAI, in the positive direction (r= 0.692, p &lt;0.001 and r= 0.685, p &lt;0.001 and r= 0.552, p &lt;0.001). A statistically significant, strong correlation was found between the BETY, HAQ and BASFI scores in the positive direction (r= 0.834, p &lt;0.001 and r= 0.747, p &lt;0.001) (Table 1). It was observed that patients showed anxiety and depression characteristics according to HADS cut-off values (&gt;10 and &gt;7).ConclusionIt was concluded that the biopsychosocial status of anti-TNF naive patients with AS was affected by anxiety-depression levels, functionality, and disease activity score. In addition to anti-TNF therapy, it was interpreted that the treatment of biopsychosocial characteristics of patients should also be taken into consideration in disease management.Reference[1] Braun Jv, Van Den Berg R, Baraliakos X, Boehm H, Burgos-Vargas R, Collantes-Estevez E, et al. 2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis. Annals of the rheumatic diseases. 2011;70(6):896-904.Table 1.Patients characteristics and correlation of outcome measuresPatients Characteristics (n=76)Age (year)39.99 ± 10.0BMI (kg/m2)27.81 ± 5.51Duration of disease (year)4.21 ± 5.65BETY-BQ (0-120)60.0 ±23.7BASDAI (0-10)5.98 ± 1.78BASFI (0-10)5.16 ± 2.31HADS anxiety10.43 ± 4.92 depression8.53 ± 4.34HAQ15.70 ± 9.48CorrelationsBASDAIBASFIHAQHADS-aHADS-dBETY-BQr0.552*0.747*0.834*0.692*0.685*p*0.0000.0000.0000.0000.000*Pearson testAcknowledgements:NIL.Disclosure of InterestsNone Declared.

Bifactor analysis of the Hospital Anxiety and Depression Scale (HADS) in individuals with traumatic brain injury

Anxiety and depression symptoms are commonly experienced after traumatic brain injury (TBI). However, studies validating measures of anxiety and depression for this population are scarce. Using novel indices derived from symmetrical bifactor modeling, we evaluated whether the Hospital Anxiety and Depression Scale (HADS) reliably differentiated anxiety and depression in 874 adults with moderate-severe TBI. The results showed that there was a dominant general distress factor accounting for 84% of the systematic variance in HADS total scores. The specific anxiety and depression factors accounted for little residual variance in the respective subscale scores (12% and 20%, respectively), and overall, minimal bias was found in using the HADS as a unidimensional measure. Further, in a subsample of 184 participants, the HADS subscales did not clearly discriminate between formal anxiety and depressive disorders diagnosed via clinical interview. Results were consistent when accounting for degree of disability, non-English speaking background, and time post-injury. In conclusion, variance in HADS scores after TBI predominately reflects a single underlying latent variable. Clinicians and researchers should exercise caution in interpreting the individual HADS subscales and instead consider using the total score as a more valid, transdiagnostic measure of general distress in individuals with TBI.

Anxiety and Depressive Symptoms Correlated to Patient-Reported Outcome Measures after Rotator Cuff Repair: A Prospective Study in the Perioperative Period.

Anxiety and depressive symptoms adversely affect surgical outcomes in patients with rotator cuff tear (RCT) undergoing surgical repair. Patients without a diagnosis of mood disorders, such as anxiety and depression, before rotator cuff repair (RCR) can be considered an optimal candidate for surgery. The objective of this prospective observational study was to evaluate the relationship between anxiety and depressive symptoms, using the Hospital Anxiety and Depression Scale (HADS) as an assessment tool, and patient-reported outcome measures in RCT after repair surgery. This study included patients with RCT undergoing arthroscopic rotator cuff repair (RCR). Forty-three patients were included who had completed the HADS, Constant Murley Score (CMS), and Short Form Health Survey 36 (SF-36) questionnaires before surgery and in the postoperative follow-up, at 1 month, 3 months, and 6 months. The Friedman test showed that there were statistically significant changes in the different times point for HADS (p < 0.001), anxiety subscale of HADS, i.e., HADS-A (p < 0.001), depression subscale of HADS, i.e., HADS-D (p < 0.001), CMS (p < 0.001), and SF-36 (p < 0.001). The average scores of HADS, HADS-A, and HADS-D improved at each follow-up, showing improvement in discomfort. From the third month after surgery, there was an improvement in anxiety and depression disorders related to improved quality of life, functionality, and pain perception. The trend remained stable until the sixth month of follow up. This study shows that anxiety and depressive symptoms in RCT patients are significantly reduced after RCR with subsequent important improvements in terms of functionality, ability to carry out activities of daily living, perceived pain, and quality of life.

Incidence Rate of Nicotine Addiction in University Students of Tomsk

Background: tobacco use is one of the leading risk factors for early death and disability worldwide. Comorbidity of anxiety disorders and nicotine dependence reduces the efficiency of the specialist complex therapy of tobacco dependence. Of significance is a problem of timely detection of such concurrent disorders.Objective: to study nicotine addiction and severity of anxiety in students of the Tomsk State University (TSU) and Siberian State Medical University (SSMU) of Tomsk City.Surveyed students and methods: the Fagerström Test for Nicotine Dependence (FTND) and the Hospital Anxiety and Depression Scale (HADS) were usedto recognize nicotine addiction in 323 students (78 males; 24.1% and 245 women; 75.9%).Results: the findings on nicotine addiction in students were as follows: 59.0% never smoked, 12.4% smoked previously, 21.9% are currently cigarette smokers, 6.7% use tobacco heating systems (THS). The median total score according to the HADS anxiety subscale in current smokers made 7 (6; 9) points, in current THS smokers — 7 (5; 10), in previously smokers — 7 (5; 9), in never smoking —7 (4; 9). The median total score according to the HADS depression subscale in currently cigarette smokers made 6 (4; 8) points, currently THS smokers — 4.5 (2; 5), previously smokers — 4 (3; 7), in never smoking — 5 (3; 7). The study revealed formation of nicotine addiction in 26% of surveyed individuals; age of the regular smoking onset was 16.1 (14.2; 17.5) years, nicotine dependence formed at the age of 17.0 (16; 18) years (p = 0.001).Conclusions: the availability of direct dependency between indicators of total score of anxiety according to the HADS and the FTND (rs = 0.51; p &lt; 0.05) is an evidence of predictive value of anxiety for nicotine addiction and need of timely preventive intervention.