Hospital Anxiety And Depression Scale Depression Scale Research Articles

COVID-19 HASTALARINDA PSİKİYATRİK BELİRTİLER VE BU BELİRTİLERLE İLİŞKİLİ FAKTÖRLER: PERİFERİK İNFLAMASYON BELİRTEÇLERİ BUNLARDAN BİRİ OLABİLİR Mİ ?

OBJECTIVE: In addition to respiratory symptoms, there have been reports of increased psychiatric symptoms in COVID-19 patients. In this study, it is aimed to reveal the psychiatric symptoms seen in COVID-19 patients. We also investigated the relationship between these psychiatric symptoms and peripheral inflammatory markers. MATERIAL AND METHODS: The patients were evaluated with "Interview Forms" specially created by the researchers for the study. DSM-V Acute Stress Disorder Scale (ASDS); Perceived Stress Scale-10 (PSS-10); State-Trait Anxiety Inventory (STAI-T/S); and finally Hospital Anxiety and Depression Scale (HADS) were used to determine patients' acute and perceived stress levels, depression and anxiety symptoms, state and generalized anxiety levels, and how these psychiatric symptoms were affected by different social conditions. D-dimer, fibrinogen, lymphocytes, CRP (C-reactive protein) and ferritin levels were taken into account as inflammatory markers. RESULTS: Our study included 108 inpatients and 31 outpatients with COVID-19. The ASDS, STAI State Scale, and HADS depression scale scores of inpatients patients were found to be higher compared to outpatient patients. Increased fibrinogen levels in blood tests were found to predict higher acute stress disorder scores. HAD-Depression subscale and fibrinogen levels were also found to be positively correlated with each other. CONCLUSIONS: Stress, depression and anxiety symptoms accompany COVID-19. In addition, high fibrinogen levels may be associated with psychiatric symptoms. Psychiatric symptoms are indirectly affected by physical illnesses. We can say that a pandemic that causes fear and anxiety all over the world may suppress the immune system in individuals and the suppressed immune system may indirectly make the infection more complicated.

Neoadjuvant Chemotherapy Is Effective in Those Infected With SARS-CoV-2: The Real-World Experience of a Large Chinese Breast Cancer Center.

During the major shift in China's policies on coronavirus disease 2019 (COVID-19), many residents will be infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) over a short period, including a few patients with breast cancer undergoing neoadjuvant chemotherapy (NAC). Moreover, it is unknown whether this comorbidity affects the efficacy of NAC for breast cancer and the patient's psychological state and quality of life (QOL). This study aims to answer these questions. The clinical data of 2,793 patients with breast cancer who received NAC at The Affiliated Hospital of Qingdao University were retrospectively collected. The infected and non-infected groups were divided according to whether they were infected with COVID-19 during NAC. Propensity score matching was used to reduce patient selection bias. The effectiveness, psychological well-being, and QOL of the two groups were compared. No discernible differences were observed in the pathological complete response rates (p = 0.307) and major histological responses rate (p = 0.398) between the infected and non-infected groups. Following the full course of NAC, the Functional Assessment of Cancer Treatment General (p < 0.001) and Functional Assessment of Cancer Therapy for Breast Cancer (p < 0.001) were lower in the infected group than the non-infected group, the Hospital Anxiety and Depression Scale (HADS) anxiety scale (p < 0.001) and HADS depression scale (p < 0.001) were considerably higher in the infected group than the non-infected group. With timely treatment and effective medical management, SARS-CoV-2 does not appear to affect the efficacy of NAC; however, it can significantly affect the QOL of patients and increase their psychological distress. Therefore, in addition to a timely assessment of the efficacy of NAC, it is necessary to dynamically understand the patient's psychological state and QOL.

Gender specifics of affective disorders in patients with coronary heart diseas (according to screening and psychometric tests)

Aim. To study gender characteristics of affective disorders (prevalence and severity of anxiety and depression) and quality of life in patients with coronary heart disease (CHD) according to screening and psychometric tests.Materials and methods. Five hundred seventy six patients with a verified diagnosis of CHD were tested using the Screening Questionnaire for Affective Spectrum Disorders (SQASD): 385 (67.8 %) men and 191 (33.2 %) women. From the total screening group using, 383 patients were examined with the Beck Depression Inventory (BDI), while examination with the hospital anxiety and depression scale (HADS) included 351 patients with CHD. The quality of life index was determined in 242 patients with CHD using the Modified Seattle Angina Questionnaire (SAQ).Results. In the general group of patients with CHD examined by SQASD, anxiety and depressive disorders (ADD) were diagnosed in 81 %, the absence of ADD – in 19 %, p &lt; 0.0001. In the group of patients examined using SQASD and the BDI scale, the presence of ADD was noted in 78.9 %, the absence – in 21.1 %, p &lt; 0.0001. Screening of patients examined with the BDI scale revealed higher incidence of ADD in women: 95 % vs. 71.5 %, p &lt; 0.0001. The overall score on the HADS anxiety scale in the men’s group was 7.9 ± 4.7, in the women’s group – 10.28 ± 3.9, p &lt; 0.0001, while according the HADS depression scale – 6.32 ± 3.92 and 7.7 ± 4.18, respectively, p &lt; 0.004. The level of depression by BDI scale in the men’s group was 14.07 ± 9.82, in the women’s group – 17.75 ± 8.42, p &lt; 0.0004. Absence of symptoms of depression according the BDI scale was observed more often in the group of men compared with the group of women: 36.9 % and 19.2 %, p &lt; 0.0005. The frequency of severe anxiety (45.8 % and 28.7 %, p &lt; 0.002) and depression (26.2 % and 11.5 %, p &lt; 0.0004) according the HADS was higher in the group of women compared to the group of men. The value of the IUCN quality of life index was higher in the group of men (25.4 ± 7.1 and 22.4 ± 4.8, p &lt; 0.001).Conclusion. In this study, screening of CHD patients using SQASD and psychometric tests (BDI and HADS) has revealed higher incidence of ADD and psychosocial risk factors (anxiety and depression) in the group of women compared with the group of men. The results of screening are generally consistent with the survey data of psychometric tests and QOL indicators.

The bidirectional association between depressive symptoms, assessed by the HADS, and albuminuria-A longitudinal population-based cohort study with repeated measures from the HUNT2 and HUNT3 Study.

Both albuminuria and depression are associated with cardiovascular disease, reflecting low-grade systemic inflammation and endothelial dysfunction. They share risk factors including weight, blood pressure, smoking and blood glucose levels. This longitudinal study aimed to examine bidirectional associations between depression symptoms, indexed by the Hospital Anxiety and Depression scale (HADS), and the inflammation marker albuminuria. 2909 persons provided urine samples in both the second (HUNT2, 1995-97) and third wave (HUNT3, 2006-2008) of the Trøndelag Health Survey, Norway. We used a generalized linear regression model (GLM) and ANOVA to assess the association between albuminuria levels (exposure HUNT2) with depression symptoms (outcome in HUNT3); and between depression symptoms (exposure HUNT2) with albuminuria (outcome HUNT3). Depression symptoms were measured with the HADS Depression Scale, analyzed utilising the full 7 items version and analyses restricted to the first 4 items (HADS-D and HADS-4). We accounted for confounders including baseline individual levels of the exposure variables. In this 10-years follow-up study, we found no statistical evidence for an association between baseline depression symptoms and subsequent albuminuria, nor between baseline albuminuria and subsequent depression symptoms. For albuminuria, only 0.04% was explained by prior depression, and for depression, only 0.007% was explained by previous albuminuria levels. The results were essentially the same for the shorter HADS-4 measure. There does not appear to be a longitudinal association between albuminuria and depression measured by the HADS.

Evaluation of pain, disease activity, anxiety, depression, and neuropathic pain levels after COVID-19 infection in fibromyalgia patients.

BackgroundPsychological stressors may cause mental disorders such as anxiety, depression, and post-traumatic stress disorders and fibromyalgia (FM) patients could be affected by these stressors.AimTo evaluate pain, disease activity, anxiety, depression, and neuropathic pain levels after COVID-19 infection in patients with FM.MethodsAccording to the 2016 American College of Rheumatology (ACR) criteria, fifty-seven patients with FM alone and 77 patients with FM and recovering from COVID-19 infection were recruited to the study (group 1: patients with FM alone and group 2: patients with FM and recovering from COVID-19). Demographic and clinical characteristics were recorded. The pain level was determined by the Numerical Rating Scale (NRS), the pain regions by the Widespread Pain Index (WPI) of the 2016 ACR criteria, the severity of the symptoms by the Symptom Severity Scale (SSS) of the 2016 ACR criteria, the disease activity by the Fibromyalgia Impact Questionnaire (FIQ), the anxiety and depression levels by the Hospital Anxiety and Depression Scale (HADS), and the neuropathic pain level by Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale (LANSS).ResultsAge, height, weight, Body Mass Index (BMI), and the duration of FM diagnosis were similar in both groups (p > 0.05). NRS, FIQ, HADS depression scale, and SSS and LANSS scores were similar between group 1 and group 2 (p > 0.05). HADS anxiety score and WPI were significantly increased in group 2 (p = 0.026 and p = 0.024 respectively).ConclusionsAnxiety and widespread pain levels were higher in patients with FM and recovering from COVID-19 infection.

Study of Anxiety and Depression Factors in People with Mild Cognitive Impairment in COVID-19 Pandemic

Background. The COVID-19 pandemic is a major stressor with predictable negative impacts on mental health, especially for vulnerable populations, which include older people. Emotional disorders, a decrease in intellectual, physical, social activity are the risk factors for the development of cognitive decline in older people; in the situation of the COVID-19 pandemic, the influence of all these factors is exacerbated. In this regard, it seems relevant to study the level of emotional disorders and factors affecting the emotional state of patients with mild cognitive impairment (MCI) in the context of the COVID-19 pandemic in comparison with the period before the pandemic. Aims: emotional state assessment in patients over 55 years old with MCI during the COVID-19 pandemic and identification of factors influencing the emotional state of these patients. Materials and methods: A cross-sectional single-center observational study of patients with MCI who applied to the Memory Clinic in the autumn of 2018 (n = 121), 2019 (n = 114), in the autumn of 2020 (n = 70), and in the spring of 2020 (n = 110). Patients were examined using the Hospital Anxiety and Depression Scale (HADS), the Montreal Cognitive Assessment (MoCA), the MiniMental State Examination (MMSE), and the Khachinsky Modified Ischemia Assessment Scale. In 2020, in addition to these scales, a questionnaire Personal experience of COVID-19 pandemic was applied to assess the experience associated with the new coronavirus infection. Results: The severity of emotional disorders, assessed by HADS scale, did not differ between groups (F = 0.751; p = 0.522 and F = 0.310; p = 0.818 for the HADS anxiety and depression subscales, respectively). Adjustment for covariates (scores on the Khachinsky and/or MoCA and/or MMSE scales) did not affect the significance of differences between groups on the HADS subscales, regardless of the correction for multiple comparisons. Pathway modeling analysis demonstrated the low ability of the models to predict emotional state based on risk factors (age, gender, Khachinsky score) and cognitive symptoms (MoCA and MMSE scores) all coefficients r 0.7. A change in intellectual activity (decrease) and subjective impression of the difficulties obtaining medical care were associated with a higher score on the HADS anxiety scale. Decreased physical health and decreased personal communication were associated with higher scores on the HADS depression scale. Clinically pronounced changes in the emotional state were noted only in relation to anxiety, which depended on the changes in intellectual activity. Conclusions: severity of anxiety and depression was not increased in patients with MCI, regardless of the control of additional factors. No differences were found in the contribution of risk factors (age, gender, vascular and atrophic factors of cognitive decline) and cognitive dysfunction to the formation of emotional disorders in comparing with previous years.

Abstract 11426: Signs of Depression Predict Mortality Among Swedish Heart Failure Patients

Introduction: Anxiety and depression are common comorbid conditions in heart failure (HF), and there is growing evidence that they increase the risk of adverse outcomes, including rehospitalization and functional decline. Hypothesis: We aimed to determine if symptoms of anxiety and depression would predict mortality and rehospitalization in a Swedish prospective HF patient cohort. Methods: 387 patients hospitalized for HF (mean age 75 years; 32% women) were assessed using the Hospital Anxiety and Depression Scale (HADS) to measure symptoms of anxiety (HADS Anxiety) and depression (HADS Depression). The median follow-up time to death and rehospitalization was 665 (range,1737; interquartile range, 811) and 316 (range, 2069; interquartile range, 348) days, respectively. Relations between baseline HADS scores, mortality and rehospitalization risk were analyzed using multivariable Cox regression analysis adjusted for age, sex, body- mass index, smoking, prevalent atrial fibrillation, educational level, prevalent diabetes, NYHA-class at hospitalization and systolic blood pressure. Results: A total of 30 patients (8%) had signs of depression according to HADS Depression score &gt;11 points. In the fully adjusted Cox regression model using continuous standardized values per 1 SD change, higher score on HADS Depression scale (HR,1.42; CI, 1.16-1.75; p=0.001) yielded significant associations with increased mortality whereas no associations were found for HADS Anxiety scale (HR, 1.04; CI, 0.86-1.26; p=0.719). Rehospitalization risk (n = 246; 64%) was not significantly associated with higher scores on HADS Depression scale (HR, 1.08; CI, 0.94-1.25; p=0.274) or HADS Anxiety scale (HR, 0.95; CI, 0.82-1.09; p=0.449). Conclusions: Higher scores on HADS Depression scale indicated increased mortality risk in hospitalized HF patients, independently of traditional risk factors. However, higher scores on HADS Anxiety scale did not herald increased risk of mortality or rehospitalization.

Long-term health-related quality of life in patients treated with subcutaneous C1-inhibitor replacement therapy for the prevention of hereditary angioedema attacks: findings from the COMPACT open-label extension study

BackgroundLong-term prophylaxis with subcutaneous C1-inhibitor (C1-INH[SC]; HAEGARDA, CSL Behring) in patients with hereditary angioedema (HAE) due to C1-INH deficiency (C1-INH-HAE) was evaluated in an open-label extension follow-up study to the international, double-blind, placebo-controlled COMPACT study. The current analysis evaluated patient-reported health-related quality of life (HRQoL) data from 126 patients in the open-label extension study randomized to treatment with C1-INH(SC) 40 IU/kg (n = 63) or 60 IU/kg (n = 63) twice weekly for 52 weeks. HRQoL was evaluated at the beginning of the open-label study and at various time points using the European Quality of Life-5 Dimensions Questionnaire (EQ-5D), the Hospital Anxiety and Depression Scale (HADS), the Work Productivity and Activity Impairment Questionnaire (WPAI), and the Treatment Satisfaction Questionnaire for Medication. The disease-specific Angioedema Quality of Life Questionnaire (AE-QoL) and HAE quality of life questionnaire (HAE-QoL) instruments were administered in a subset of patients. Statistical significance was determined by change-from-baseline 95% confidence intervals (CIs) excluding zero. No adjustment for multiplicity was done.ResultsMean baseline EQ-5D scores (Health State Value, 0.90; Visual Analog Scale, 81.32) were slightly higher (better) than United States population norms (0.825, 80.0, respectively) and mean HADS anxiety (5.48) and depression (2.88) scores were within “normal” range (0–7). Yet, patients using C1-INH(SC) 60 IU/kg demonstrated significant improvement from baseline to end-of-study on the EQ-5D Health State Value (mean change [95% CI], 0.07 [0.01, 0.12] and Visual Analog Scale (7.45 [3.29, 11.62]). In the C1-INH(SC) 60 IU/kg group, there were significant improvements in the HADS anxiety scale (mean change [95% CI], − 1.23 [− 2.08, − 0.38]), HADS depression scale (− 0.95 [− 1.57, − 0.34]), and WPAI-assessed presenteeism (mean change [95% CI], − 23.33% [− 34.86, − 11.81]), work productivity loss (− 26.68% [− 39.92, − 13.44]), and activity impairment (− 16.14% [− 26.36, − 5.91]). Clinically important improvements were achieved in ≥ 25% of patients for all domains except WPAI-assessed absenteeism (which was very low at baseline). Mean AE-QoL total score by visit ranged from 13.39 to 17.89 (scale 0–100; lower scores = less impairment). Mean HAE-QoL global scores at each visit (115.7–122.3) were close to the maximum (best) possible score of 135.ConclusionsLong-term C1-INH(SC) replacement therapy in patients with C1-INH-HAE leads to significant and sustained improvements in multiple measures of HRQoL.Trial registration A Study to Evaluate the Long-term Clinical Safety and Efficacy of Subcutaneously Administered C1-esterase Inhibitor in the Prevention of Hereditary Angioedema, NCT02316353. Registered December 12, 2014, https://clinicaltrials.gov/ct2/show/NCT02316353.

Moderate-to-high intensity exercise with person-centered guidance influences fatigue in older adults with rheumatoid arthritis

Fatigue is described as a dominant and disturbing symptom of rheumatoid arthritis (RA) regardless of the advances in pharmacological treatment. Fatigue is also found to correlate with depression. The objective was to evaluate the impact of moderate-to-high intensity, aerobic and resistance exercise with person-centered guidance on fatigue, anxiety and depression, in older adults with RA. Comparisons were made between older adults (> 65 years) with RA taking part in a 20-week moderate-to-high intensity exercise at a gym (n = 36) or in home-based exercise of light intensity (n = 38). Assessments were performed at baseline, at 20 weeks, and at 52 weeks. Outcomes were differences in Multidimensional Fatigue Inventory (MFI-20), Visual Analog Scale Fatigue (VAS fatigue), and Hospital Anxiety and Depression Scale (HADS). Analysis of metabolomics was also performed. The subscales “physical fatigue” and “mental fatigue” in MFI-20 and symptoms of depression using HADS depression scale improved significantly at week 20 in the exercise group compared with the control group. Exercise did not influence global fatigue rated by VAS or subscales “reduced motivation”, “reduced activity” and “general fatigue” in MFI-20. No significant change was found on the anxiety index of HADS. The improvements in physical fatigue were associated with changes in the metabolism of lipids, bile acids, the urea cycle and several sugars. Moderate-to-high intensity exercise with person-centered guidance decreased fatigue and improved symptoms of depression and were accompanied by metabolic changes in older adults with RA.

Distress Screening in Adolescents and Young Adults with Cancer: Development of Cut-Points for the Cancer Distress Scales-Adolescent and Young Adults.

Purpose: Distress is an important issue facing adolescent and young adults (AYA) with cancer due to their stage of development. Metrics are necessary to help improve psychosocial outcomes in this population. This study determined cut-points for the newly developed Cancer Distress Scales (CDS)-AYA. Methods: The CDS-AYA is a new patient-reported outcomes measure that comprises five independently functioning scales, including the following: Impact of Cancer (12 items), Physical (12 items), Emotional (11 items), Cognitive (8 items), and Cancer Worry (5 items). Canadian AYA with cancer 15-39 years of age completed the CDS-AYA and the Hospital Anxiety and Depression Scale (HADS), as part of the CDS-AYA field test. Only patients who had completed responses to the CDS-AYA and HADS were included in these analyses. Receiver operating characteristic (ROC) curve analysis was used to generate cut-points for five CDS-AYA scales based on distress defined by the HADS anxiety and HADS depression scale. Results: In total 453 of 515 respondents had complete data for the CDS-AYA and HADS were included in analyses. Area under the curve (AUC) in the ROC analyses ranged from 0.75 to 0.85. The CDS-AYA Emotional scale had the greatest AUC. The cutoff value for the Emotional scale was 27 based on the HADS anxiety scores (78.3% and 78.9%). Conclusions: The five CDS-AYA scales had fair to good accuracy when classifying the none/low and moderate/severe distress categories based on HADS anxiety and depression scales. For screening purposes, it is recommended that the Emotional scale or Impact of Cancer scale be utilized.

Psychological well-being in patients with aneurysms-osteoarthritis syndrome.

Aneurysms‐osteoarthritis syndrome (AOS) is characterized by arterial aneurysms and dissection in combination with early‐onset osteoarthritis, which can impact quality of life. We describe the subjective quality of life and investigate anxiety and depression in 28 AOS patients aged 15–73 years. Three questionnaires were used: 36‐Item Short Form Survey (SF‐36), hospital anxiety and depression scale (HADS) and Rotterdam disease specific questionnaire. Results of the SF‐36 and HADS were compared to a reference Dutch cohort and the SF‐36 questionnaire also to patients with Marfan syndrome. Compared to the general population, AOS patients scored significantly lower on the following SF‐36 domains: physical functioning, vitality, social functioning, bodily pain, and general health. Physical functioning was also lower than in Marfan patients. Patients with AOS scored higher on the HADS depression scale, while anxiety did not show a significant difference compared to the general population. No difference in SF‐36 and HADS domain scores were found between patient with and without orthopaedic symptoms and patients with or without previous aortic surgery. Additionally, we found that patients' worries for their future and heredity of their disease are important factors for anxiety, which should be addressed in clinical practice.

Effects of a randomized, culturally adapted, lifestyle intervention on mental health among Middle-Eastern immigrants.

Middle-Eastern immigrants in Sweden are at increased risk for type 2 diabetes (T2D) and poor mental health. Physical activity not only prevents/delays onset of T2D but also shows favorable effects on mental health. However, the effects of a culturally adapted lifestyle intervention on mental health among Middle-Eastern immigrants have not been explored before. We aimed to study the effects of a randomized controlled, culturally adapted lifestyle intervention on anxiety and depression levels in diabetes-prone Iraqi immigrants. Participants (n = 96) were randomized to intervention group, IG (n = 50) or control group, CG (n = 46). The IG received seven group sessions addressing lifestyle change and the CG received treatment as usual. Montgomery-Åsberg Depression Rating Scale (MADRS-S) and Hospital Anxiety and Depression Scale (HADS) assessed mental health at start, mid (2 months) and end of the study (4 months). Proportional odds ratio (OR) model was used to study the effect of the intervention. The odds of scoring lower on MADRS-S and HADS depression scale at visit 3 vs. baseline were higher in the IG compared to the CG (MADRS-S OR 5.9, 95% CI: 1.6-22.5; HADS OR 4.4, 95% CI: 0.9-20.3). The findings persisted after adjustment for age, sex, body mass index, time since migration, sedentary lifestyle and language spoken at home. Group differences were non-significant at visit 2 vs. baseline. A culturally adapted lifestyle intervention addressing T2D prevention in Middle-Eastern immigrants has favorable effects on mental health. The effect was more pronounced at the 4 months than at 2 months follow-up, indicating beneficial effect of longer study duration. www.clinicaltrials.gov NCT01420198.

1766P - Sexual functioning and depression among Egyptian breast cancer patients following surgery and neoadjuvant/adjuvant chemotherapy

Background: Breast cancer and its treatment may have a negative impact of the sexual wellbeing of patients and psychological morbidity may further add to this impact. Little is known about the sexuality of Egyptian patients with breast cancer. This may be due to barriers related to health care professionals, patients and their families and the culture. Aim: To evaluate sexual functioning among Egyptian breast cancer patients following treatment and to determine the relation between their sexual wellbeing and anxiety and depression and other possible factors. Methods: This prospective cross-sectional observational study included married breast cancer patient from 20 to 50 years of age who underwent surgery and received neoadjuvant/adjuvant chemotherapy. The Female Sexual Function Index (FSFI) was used to assess their sexual wellbeing. FSFI total score cutoff value of 26.55 was used to determine sexual dysfunction. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression. In addition, demographic and clinical data were collected. Results: Thirty-six out of 38 patients (94.7%) invited to participate in the study signed an informed consent and completed the FSFI questionnaire. The mean FSFI total score was 23.1±7.4 and 61% of patients had sexual dysfunction. The HADS depression scale was >7 (borderline-abnormal/abnormal) in 12 (33%) patients and the HADS anxiety scale was >7 in 25 (69%). Patients with borderline-abnormal/abnormal HADS depression score had a significantly lower FSFI total score compared to those with normal HADS depression score (20 vs. 25, respectively; p = 0.029). The HADS anxiety score did not correlate significantly with the FSFI scores. Conclusions: Unlike the common belief, the majority of Egyptian female breast cancer patients included in this study was willing to discuss their sexual wellbeing. The results suggest that a significant proportion of Egyptian patients who completed treatment for breast cancer experience sexual dysfunction and psychological morbidity and that sexual dysfunction correlate significantly with depression among them. Legal entity responsible for the study: Clinical Oncology Department, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

The Hospital Anxiety and Depression scale: Factor structure and psychometric properties in older adolescents and young adults with autism spectrum disorder.

Research on the validity of measurement of anxiety and depression in ASD is currently lacking. The aim of this study was to explore the properties of the Hospital Anxiety and Depression Scale (HADS) in a sample of 151 young people with ASD. Participants completed HADS and a range of mental health and well-being measures. Encouragingly, our findings suggest that HADS provides a reliable and valid assessment of anxiety and depression in ASD.

Personality traits, gender differences and symptoms of anhedonia: What does the Hospital Anxiety and Depression Scale (HADS) measure in nonclinical settings?

In healthy populations men report more depressive symptoms than women when depression is measured by the Hospital Anxiety and Depression Scale (HADS). This study aims to investigate the role of neuroticism and extroversion in symptom reporting by men and women and whether anhedonia can explain these reversed gender differences in depression observed when using HADS. HADS, Positive and Negative Affect Schedule (PANAS) and NEO Five Factor Inventory (NEO FFI) were administered twice to a sample of university students. Number of subjects at T1 was 372 and 160 at T2, measured two months apart. Men had a higher average score on depressive symptoms measured by HADS-D compared to women (p = 0.029). Women scored higher than men on HADS-A (p = 0.012), neuroticism (p < 0.001) and PANAS-negative affect (p < 0.029). No significant gender differences were observed in extroversion and positive affect. Test-retest stabilities on HADS-A and HADS-D were high. Neuroticism predicted HADS-A at Time 2. Gender, extroversion, and neuroticism predicted HADS-D at Time 2. The anhedonic content in HADS may be a plausible explanation of reversed gender differences in the HADS depression scale. HADS-D represents a specific anhedonic subtype of depression where symptom reporting reflects dispositional tendencies related specifically to extroversion.

Depression and anxiety disorders in a sample of facial trauma: A study from Iran.

BackgroundVarious studies have shown that such patients are susceptible to psychological problems and poor quality of life. The aim of the present study was to evaluate and compare the prevalence of depression and anxiety disorders and quality of life in a group of facial trauma.Material and MethodsIn the present cross-sectional study Hospital Anxiety and Depression Scale (HADS) and Oral Health Impact (OHIP-14) questionnaires were used. In this study, fifty subjects were selected from the patients with maxillofacial traumas based on the judgment of the physicians, referring to hospitals in Kerman and Rafsanjan during 2012-2013. In addition, 50 patients referring to the Dental School for tooth extraction, with no maxillofacial traumas, were included. SPSS 13.5 was used for statistical analysis with two-sample t-test, Mantel-Haenszel technique, Pearson’s correlation coefficient and chi-squared test.ResultsSeven patients with maxillofacial traumas were depressed based on HADS depression scale, with 5 other borderline cases. However, patients referring for surgery or tooth extraction only 2 were depressed and 1 patient was a borderline case. The results showed that patients with maxillofacial traumas had higher rates of depression and anxiety, with significant differences between this group and the other group (P=0.01). The results of the present study showed a significant prelateship between depression severity and confounding factors. The mean of OHIP-14 parameters were 35.51 ±5.2 and 22.3±2.4 in facial trauma and dental surgery groups, respectively, with statistically significant differences (P=0.01).ConclusionsThe results of the present study showed depression and anxiety disorders in patients with maxillofacial trauma. The results showed a higher rate of anxiety and anxiety in patients with maxillofacial traumas compared to the control group. Key words:Depression, facial trauma, HADS, OHIP-14, questionnaire.

Abstract NS18: Prevalence and Predictors of Depression among Elderly Stroke Patients in Korea

Background: Depression after stroke not only affects rehabilitation and recovery, but increases caregiver burden. With rapidly increasing aged population, stroke burden substantially increases in Korea, which makes depression after stroke an important concept to assess. Purpose: The purposes of this study were to (1) assess the prevalence of depression and (2) identify predictors of depression among elderly stroke patients in Korea. Methods: A cross-sectional, descriptive study was conducted in a convenience sample of 233 hospitalized elderly patients with acute ischemic stroke using a self-administered survey. We assessed depression using the Hospital Anxiety and Depression Scale (HADS) and collected demographic data and stroke severity (e.g., hemiparesis, dysphagia, cognitive impairment). Descriptive statistics, chi-square test, and logistic regression analyses were used for data analysis. Results: Of the total participants, 60.5% were men, 76.8% were aged ≥ 61 years, 70% were married, 80.3% lived with family, and 71.7% were depressed (HADS depression scale ≥ 8). Individuals who were women (χ 2 =10.32), lived alone (χ 2 =3.38), had symptoms of dysphagia (χ 2 =6.14), dysphasia (χ 2 =8.14), hemiparesis (χ 2 =5.61), cognitive impairment (χ 2 =4.86), or anxiety (χ 2 =54.53) were more likely to be depressed than those who were men, lived with family, had no symptoms of dysphagia, dysphasia, hemiparesis, cognitive impairment ( p &lt; .05), or anxiety. The likelihood of being depressed was higher in individuals who had anxiety (OR=18.93, 95% CI=[6.88, 52.08]) or lived alone (OR=0.28, 95% CI=[0.06, 0.77]) than individuals who did not have anxiety or lived with family. Conclusions: In conclusion, the study findings suggest that clinicians who handle elderly stroke patients should pay attention to the individuals who have anxiety or live alone as the risk of depression after stroke seems to be higher in these groups. Further research focus should be given to (1) identifying underlying factors of anxiety, (2) developing preventive interventions for depression after stroke, including strategies to decrease anxiety and ensure social support, and (3) exploring the association of depression with other health outcomes, such as quality of life and mortality.

What predicts negative effects of rheumatoid arthritis? A follow-up two years after diagnosis

We aimed at analyzing important predictive factors for experienced negative emotional and social effects of rheumatoid arthritis (RA) two years after diagnosis in patients aged 18–65 years. The first group included 41 participants, who had psychosocial problems (PSP) already at diagnosis, and who received an intervention by a medical social worker to improve coping capacity and social situation. The second group included 54 patients (NPSP) without such problems at diagnosis. All completed a questionnaire mapping their social situation, the Hospital Anxiety and Depression Scale (HADS), the Sense of Coherence Scale (SOC) and the General Coping Questionnaire (GCQ) at diagnosis and after 24 months. The most pronounced predictive factor for a strong impact of the disease was high scores on HADS depression scale. After 24 months, PSP participants had a more strained life situation, with higher scores on anxiety and depression and lower on SOC, in comparison with NPSP. NPSP participants improved their coping strategies regarding self-trust, cognitive revaluation, protest and intrusion, but deteriorated regarding problem focusing and social trust. PSP patients kept their initial coping strategies, except for intrusion decreasing over time, and seemed to have a more rigid coping pattern. However, the experienced negative impact of the disease increased over time in both groups despite improvement in sickness related data. Mostly influenced areas were economy, leisure time activities and social life. We conclude that psychosocial consequences of RA are more connected to emotional and social vulnerability than are RA-related clinical factors.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-3-118) contains supplementary material, which is available to authorized users.

Sexual Function in Italian Women with Systemic Sclerosis Is Affected by Disease-related and Psychological Concerns

In patients with systemic sclerosis (SSc), sexual function is somewhat impaired. Our aim was to evaluate sexual function in women with SSc in comparison to controls, and to investigate the association with sociodemographic and disease characteristics, and physical and psychological variables. Forty-six women with SSc and 46 healthy women were assessed for sociodemographic characteristics and gynecological development and administered the Female Sexual Function Index (FSFI), Medical Outcomes Study Short Form-36 (SF-36), Health Assessment Questionnaire (HAQ), Hospital Anxiety and Depression Scale (HADS), Rosenberg Self-Esteem Scale, Coping Orientation to Problems Experienced-New Italian Version, and Functional Assessment of Chronic Illness Therapy-Fatigue Scale. Patients were also assessed for disease duration and subset, Female Sexual Function in SSc, Hand Mobility in Scleroderma test (HAMIS), Cochin Hand Functional Disability Scale, Mouth Handicap in Systemic Sclerosis Scale (MHISS), Disability Sexual and Body Esteem Scale (PDSBE); and fist closure, hand opening, and mouth opening. In patients with SSc, only FSFI desire subscale score was significantly lower (p = 0.035) versus controls. Total FSFI score, similar to controls, was related with Medical Outcomes Study Short Form-36 mental component, HAQ (p = 0.022), MHISS (p = 0.038), and HAMIS (p = 0.037). In SSc, the main factors independently associated with sexual functioning were vaginal dryness [regression coefficient (B) = -0.72; p < 0.001], PDSBE (B = 0.42; p = 0.001), and HADS depression scale (B = -0.23; p = 0.035). Together, these variables explained 70% of the variance in the FSFI total score. In SSc, sexual function, although not different from controls, is influenced by specific disease-related and psychological concerns. Thus it should be included in patient evaluations and assessed in daily clinical practice.

Is brief psychodynamic psychotherapy in primary fibromyalgia syndrome with concurrent depression an effective treatment? A randomized controlled trial

ObjectiveThere are no studies investigating the efficacy of short-term psychodynamic psychotherapy in primary fibromyalgia syndrome (FMS). We conducted a randomized controlled trial evaluating an adapted form of individual short-term psychodynamic psychotherapy (ASTPP) versus primary care management (TAU). The study focused on FMS patients with psychiatric comorbidity. MethodsForty-six female patients with FMS and an International Classification of Diseases, 10th Revision diagnosis of a comorbid depression or anxiety disorder were recruited in a hospital setting. Participants were randomized to receive either ASTPP (25 sessions, 1 session/week) or TAU (4 consultations/6 months). Outcome measures included the Fibromyalgia Impact Questionnaire (FIQ), the Hospital Anxiety and Depression Scale (HADS), the Pain Disability Index, the Symptom Checklist 27 and the health-related quality of life. Primary endpoints of the outcome assessment were the FIQ total score and the HADS depression scale at 12-month follow-up. ResultsBoth treatments were effective in reducing the FIQ total score (ES=0.56 and ES=0.75, respectively). Intent-to-treat analyses failed to provide evidence suggesting a marked superiority of individual psychodynamic psychotherapy as compared to TAU. ConclusionsA high-standard routine treatment focusing on the improvement of health behavior and including antidepressant and analgesic medication is equally effective as a short-term individual psychodynamic psychotherapy in improving fibromyalgia-related symptoms.