Hospital Anxiety And Depression Scale Scale Research Articles

Symptom status, body perception, and risk of anxiety and depression in breast cancer patients receiving paclitaxel: a prospective longitudinal study.

BackgroundPaclitaxel regimen which is widely used in clinical treatment causes many negative physical and psychological consequences on women with breast cancer (BC). This longitudinal study firstly aimed to investigate symptom status, body perception changes, and the risk of anxiety and depression in BC patients receiving during paclitaxel regimen.Materials and methodsThis descriptive and prospective study was conducted with 84 BC patients receiving paclitaxel regimen. “Chemotherapy Symptom Assessment Scale (C-SAS),” “Body Perception Scale (BPS),” and “Hospital Anxiety and Depression Scale (HADS)” were applied at five time points (T1, before the first Paclitaxel infusion; T2, at the end of first cycle; T3, at the end of fourth cycle; T4, at the end of eighth cycle; T5, at the end of twelfth cycle). Data was analyzed using descriptive statistics, Cochrane Q, and linear mix model regression analysis.ResultsThe frequency of needling and numbness in hands and feet, pain, and skin or nail changes significantly increased in the subsequent assessment points (T2, T3, T4, and T5) compared to the initial assessment (T1) (p < 0.05). The mean scores of BPS significantly decreased at T2, T4, and T5 compared to T1 (F = 8.152, p < 0.001). The mean scores of the anxiety subscale of the HADS scale decreased at the T3, T4, and T5 compared to T1 (F = 6.865, p < 0.001), and the mean scores of the depression subscale significantly increased at the T5 compared to T1 (F = 3.708, p = 0.006).ConclusionsThe oncology nurse should comprehensively evaluate the patients who scheduled to receive paclitaxel treatment, and provide counseling to the patients during these specific weeks. Better management of the symptoms that increase with the paclitaxel regimen with repeated interviews under the supervision of the nurse will also prevent the deterioration of body perception. In addition, since the risk of depression increases over time in patients receiving paclitaxel, nurses should periodically screen the risk of depression, and timely consult the patients for the appropriate support.

Worry and rumination predict insomnia in patients with coronary heart disease: a cross-sectional study with long-term follow-up.

Insomnia is highly prevalent and associated with anxiety and depression in patients with coronary heart disease patients. The development of effective psychological interventions is needed. Worry and rumination are potential risk factors for the maintenance of insomnia, anxiety, and depression that may be modified by psychological treatment grounded in the Self-Regulatory Executive Function model. However, the relationships between worry, rumination, anxiety and depression, and insomnia are not known. Therefore, we investigated these relationships both cross-sectionally and longitudinally among patients with coronary heart disease. A cross-sectional study consecutively included 1,082 patients in 2014-2015, and 686 were followed up after mean of 4.7 years. Data were gathered from hospital records and self-report questionnaires comprising assessment of worry (Penn State Worry Questionnaire), rumination (Ruminative Responses Scale), anxiety and depression (Hospital Anxiety and Depression Scale), and insomnia (Bergen Insomnia Scale). Insomnia correlated moderately with all other psychological variables (R 0.18-0.50, all P values < .001). After adjustments for anxiety and depression, odds ratios for insomnia at baseline were 1.27 (95% confidence interval 1.08-1.50) and 1.60 (95% confidence interval 1.31-1.94) per 10 points increase of worry and rumination, respectively. Corresponding odds ratios for insomnia at follow-up were 1.28 (95% confidence interval 1.05-1.55) and 1.38 (95% confidence interval 1.09-1.75). Depression was no longer significantly associated with insomnia after adjustments for worry and rumination, but anxiety remained significant. Worry and rumination predicted insomnia both cross-sectionally and prospectively, even after controlling for anxiety and depression, although anxiety remained significant. Future studies may test psychological interventions targeting these factors in patients with coronary heart disease and insomnia. Frøjd LA, Papageorgiou C, Munkhaugen J, etal. Worry and rumination predict insomnia in patients with coronary heart disease: a cross-sectional study with long-term follow-up. J Clin Sleep Med. 2022;18(3):779-787.

Assessment of vision-related quality of life and depression and anxiety rates in patients with neovascular age-related macular degeneration.

To assess the vision-related quality of life and the depression and anxiety rates in patients with neovascular Age-Related Macular Degeneration (nAMD). A cross-sectional study of patients with nAMD treated with intravitreal injections was performed. The patients completed two validated questionnaires: the Visual Functioning Questionnaire (VFQ-25, score from 0 to 100), and the Hospital Anxiety and Depression Scale (HADS) questionnaire. Age, gender and visual acuity (VA) in the Early Treatment Diabetic Retinopathy Study (ETDRS) scale was registered. Fifty-five patients with nAMD participated with a mean age of 80.9±6.6 years-old (range 67-93) and a mean VA in the best eye of 73.5±12.7 letters (range 44-95). The global VFQ-25 mean score was 57.4±21.9 being 38.9±13.2 for the general vision and 42.0±19.5 for the general health. VA in the best eye was associated with the global score of the VFQ-25 scale (R=0.608; P<.001), but no correlation was observed with general health (P=.936). In the HADS scale, 26.9% and 25.5% of patients had symptoms of depression and anxiety respectively. A negative correlation was found between the HADS and VFQ-25 scales for the general vision score (R=-0.438). This study elucidates the impact of vision impairment and the visual functioning in nAMD, describing an important rate of depression and anxiety symptoms.

Is the population level of anxiety and depression associated with mortality? Data from the ESSE-RF study

Aim. To study the associations of subclinical and clinical anxiety and depression, assesed by the Hospital Anxiety and Depression Scale (HADS), ≥8 points and ≥11 points, respectively, with all-cause mortality and cardiovascular mortality, as well as with the total number of nonfatal cardiovascular events (CVEs) in Russia.Material and methods. The study included male and female population aged 25-64 years from the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study who signed an informed consent. The study included 16941 people (men, 6811 (40,2%)). To assess the anxiety and depression, HADS scale was used. The statistical analysis included individuals with subclinical/clinical (HADS ≥8) and clinical (HADS ≥11) anxiety and depression (HADS-A and HADS-D). The median of prospective follow-up was 5,5 years (from 2012 to 2019). The composite endpoint (CE) (cardiovascular death and nonfatal CVE occurred in 268 (4,2%) men and 203 (2,1%) women, while all-cause — in 220 (3,2%) men and 152 (1,5%) women.Results. The results obtained showed that the survival rate of men and women with varying degrees of anxiety (HADS-A ≥8 and ≥11) was associated with all-cause mortality and CE in women. However, this relationship has not been confirmed in multivariate models. In the multivariate Cox proportional hazards model 1 (M1), a significant association of depression with all-cause mortality in women was revealed — HADS-D ≥8: relative risk (RR), 2,22; 95% confidence interval (CI): 1,56-3,15 and ≥11: RR, 2,43; 95% CI: 1,65-3,59 (p&lt;0,005), as well as in men — HADS-D ≥8: RR, 1,51; 95% CI: 1,10-2,08 (p=0,01). In model 2 (M2), when added to M1 as a predictor of prior cardiovascular disease (≥3), depression was significantly associated with all-cause mortality only in women — HADS-D ≥8: RR, 2,23; 95% CI: 1,53-3,24 (p&lt;0,005); HADS-D ≥11: RR, 2,61; 95% CI: 1,74-3,92 (p=0,01). In addition, only in women, subclinical/clinical depression (HADS-D ≥8) was significantly associated with fatal and non-fatal CVE — HADS-D ≥8: RR, 1,46; 95% CI: 1,08-1,98 (p=0,02).Conclusion. Depression (HADS-D ≥8 and ≥11) in Russian women was significantly associated with all-cause mortality and CE (HADS-D ≥8). In men, depression (HADS-D ≥8) was significantly associated with allcause mortality when only conventional risk factors were included in the model, without taking into account prior cardiovascular disease. Anxiety in multivariate models was not associated with all-cause mortality and CE in both sex groups.

Influence of anxiety on the heart rate variability of patients in preoperative orthopedic surgery

Anxiety is a negative emotional response to situations that threaten the subject. Objective: The present study aims to verify the influence of anxiety on heart rate variability, considering two specific times: hospitalization and before surgery. In this analytical and cross-sectional study, the Hospital Anxiety and Depression Scale (HADS) was used to classify anxiety levels. Methodology: The time series of RR intervals were collected by Polar® monitor. Nonlinear methods and decision tree algorithm were combined with HADS scale to analyze the influence of the preoperative period on heart rate variability. The nonlinear methods used detrended fluctuation analysis (DFA), recurrence quantification analysis (RQA), and central tendency measure (CTM). Results: Among the 42 study participants, 13 (31%) were classified as anxious at hospital admission. The applied time domain methods found an increase in the heart rate variability (HRV) values in all features analyzed (p &lt; 0.05). CTM method showed HRV reduction for the values considering radius between 6 and 20 milliseconds (p &lt; 0.05). Conclusion: The anxiety identified at admission is directly related to the reduction in heart rate variability demonstrated by nonlinear methods, such as the central tendency measure.

P075 Evaluation of the impact of the COVID-19 pandemic on patients with rheumatic diseases in the UK: results from the REUMAVID study

Background/Aims This study presents the impact of the COVID-19 pandemic on health care, access to treatment, daily activities, well-being and mental health and the role of patient organisations from the perspective of the patient with rheumatic disease in the UK. Methods REUMAVID is an international collaboration led by HTR of the University of Seville, together with a multidisciplinary team of rheumatologists and patient organisations from 7 European countries (in the UK: NASS, NRAS and Arthritis Action). The study consists of an online survey, including the following instruments: Self-Perceived Health, WHO-5 Well-Being Index and Hospital Anxiety and Depression Scale (HADS). Data are collected in two phases: the first wave of the pandemic (from May 14th to July 18th 2020) and the second wave (to be conducted in winter 2020). Results 558 patients with rheumatic diseases participated in REUMAVID UK. The most frequently reported diagnoses were axial spondyloarthritis (44.6%), rheumatoid arthritis (44.1%) and osteoarthritis (25.6%). The mean age was 58.5±13.4 years, 78.7% women, 70.8% married or in a relationship and 54.1% having university studies. 45.8% perceived their health status being "fair to very poor" with 38.4% reporting a worsening during lockdown. 48.8% had their rheumatology appointment cancelled. Of these, 46.9% were offered either online or telephone follow-up, while the remaining 50.6% were not given any alternative. 15.6% changed their medication, of which 66.3% were indicated to do so by the medical team and 21.7% did so out of concern with COVID-19 with the major fear being that their treatment would lead to serious illness if they contracted SARS-CoV-2, while the greater hope was to be able to continue with their treatment as usual. 10.3% smoked more than before, 59.4% quit smoking and 36.3% drank more alcohol than before. 20.7% were unable to physically exercise at home and 39.2% reported weight gain. According to the WHO-5 scale, 52.5% declared poor well-being (≤50). A total of 43.6% were at risk of anxiety and 33.6% at risk of depression according to the HADS scale. During the lockdown, 54.3% were able to continue their psychological therapy. The main source of COVID-19 information was the patient organisations (reaching 63.6% of members), compared to 45.3% of non-members who did not receive any information. Conclusion The REUMAVID study has allowed us to measure and quantify the experience of British patients with rheumatic disease during an unprecedented public health crisis. A reduction in healthcare access, concern about treatment, changes in daily life habits and worsening of well-being and mental health were reported during the first wave. Patient organisations were the main source of COVID-19-related information. Further data will be gathered during the second wave. Disclosure M. Garrido-Cumbrera: None. V. Navarro-Compán: Honoraria; Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche, UCB. D. Webb: Grants/research support; AbbVie, Biogen, Janssen, Lilly, Novartis, UCB. C. Jacklin: Grants/research support; Abbvie, Amgen, Biogen, Eli, Lilly, Gilead, Janssen, Pfizer, Roche, Sanofi, UCB. S. Irwin: Other; Coronavirus Community Support Fund. L. Christen: Other; Novartis employee. J. Correa-Fernández: None. S. Sanz-Gómez: None. H. Marzo-Ortega: Honoraria; Abbvie, Celgene, Eli-Lilly, Janssen, Novartis, Pfizer, Takeda, UCB. Grants/research support; Janssen, Novartis.

Depression and Anxiety in Patients With Cancer: A Cross-Sectional Study.

ObjectivesDepression and anxiety persist in cancer patients, creating an additional burden during treatment and making it more challenging in terms of management and control. Studies on the prevalence of depression and anxiety among cancer patients in the Middle East are limited and include many limitations such as their small sample sizes and restriction to a specific type of cancer in specific clinical settings. This study aimed to describe the prevalence and risk factors of depression and anxiety among cancer patients in the inpatient and outpatient settings.Materials and MethodsA total of 1,011 patients (399 inpatients and 612 outpatients) formed the study sample. Patients’ psychological status was assessed using the Hospital Anxiety and Depression Scale (HADS), the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder 7-item (GAD-7) scale. The prevalence rate of depressive and anxious symptomatology was estimated by dividing the number of patients who exceeded the borderline score: 10 or more for each subscale of the HADS scale, 15 or more for the GAD-7 scale, and 15 or more in the PHQ-9 by the total number of the patients. Risk factors were identified using logistic regression.ResultsThe prevalence of depressive and anxious symptomatology among all patients was 23.4% and 19.1–19.9%, respectively. Depressive symptomatology was more prevalent across patients who were hospitalized (37.1%) compared with patients in the outpatient setting (14.5%) (p < 0.001). Similarly, anxious symptomatology was more prevalent in the inpatient setting (p < 0.001). In the inpatient setting, depressive symptomatology was more prevalent among patients with bladder cancer, while severe anxious symptomatology was more prevalent across patients with lung cancer. In the outpatient setting, depressive and anxious symptomatology was more prevalent among breast and prostate cancer patients, respectively. Despite that, around 42.7% and 24.8% of the patients, respectively, reported that they feel anxious and depressed, and only 15.5% of them were using medications to manage their conditions.ConclusionOur study findings demonstrated a higher prevalence of depressive and anxious symptomatology in the inpatient setting and advanced disease stages. In addition, the underutilization of antidepressant therapy was observed. There is a need to consider mental disorders as part of the treatment protocol for cancer patients. Enhanced clinical monitoring and treatment of depression and anxiety of cancer patients are required.

Psychometric properties of the Spanish version of the Fear of COVID-19 scale in Paraguayan population

The aim of this study is to test the psychometric properties of the Spanish validation of the Fear of COVID-19 Scale (FCV-19S) in a Paraguayan population. Participants were recruited through an Internet-based survey. All participants whose scores in the Hospital Anxiety and Depression Scale (HADS) and The Fear Questionnaire (FQ) were greater than zero were included. 1245 subjects responded voluntarily: 1077 subjects, scoring >0, were considered. To establish construct validity of the FCV-19S, an exploratory factor analysis was performed using the KMO test, which was adequate, and the Bartlett sphericity test, which was significant (p <.0001). The CFI, NFI, GFI, TLI and RMSEA indices were used to evaluate the model and showed good adjustment. Cronbach's α showed valid internal consistency (α = 0.86). This validation was supported by significant correlation (p <.001) with the HADS scale for anxiety and depression and with the FQ scale for specific phobia. The Spanish version of the FCV-19S is a 7-item scale with two dimensions, psychological symptoms and physiological symptoms, which demonstrated robust psychometric properties in a Paraguayan population.

Psychometric Properties of the Persian Version of Penn Parkinson Daily Activities Questionnaire-15.

Appropriate information about the ability of patients with Parkinson disease (PD) to perform cognitive instrumental activities of daily living (IADL) is necessary. The present study aimed to assess the psychometric properties of the Persian version of the Penn Parkinson daily activities questionnaire-15 (PDAQ-15). A total of 165 knowledgeable informants of PD patients completed the PDAQ-15. The clinical dementia rating scale, Hoehn and Yahr staging, hospital anxiety and depression scale (HADS), and Lawton IADL scale were used in the study. Internal consistency and test-retest reliability were evaluated by the Cronbach α coefficient and intraclass correlation coefficient (ICC), respectively. To examine the dimensionality of the questionnaire, exploratory factor analysis was used. The construct validity was assessed using the Spearman rank correlation test. To assess the discriminative validity, PDAQ-15 scores were compared across cognitive stages. The PDAQ-15 showed strong internal consistency (the Cronbach α=0.99) and test-retest reliability (ICC= 0.99). Only one dimension was identified for the PDAQ-15 in the factor analysis. There was a strong correlation between PDAQ-15 with the depression domain of the HADS scale and the Lawton IADL scale (rs=|0.71-0.95|). The correlation of PDAQ-15 with the anxiety domain of the HADS scale was moderate (rs=0.66). Discriminative validity analysis showed that the PDAQ-15 has significant power to discriminate between PD patients across cognitive stages. These results suggest that the PDAQ-15 is a valid and reliable PD-specific instrument and can be useful in clinical and research settings.

The effectiveness of local and general magnetotherapy in early rehabilitation of women after surgical treatment of breast cancer

Effectiveness comparison of local and general magneto-therapy for determining differentiated indications in order to prescribe the techniques for early rehabilitation of patients after surgical treatment of breast cancer (BC). It was examined 114 women after radical mastectomy for breast cancer. The patients were divided into 3 groups by the method of simple randomization: the control group (37 women) received therapeutic exercises without additional prescription of physiotherapeutic procedures; 1st main group (38 women) - in addition to exercises a course of local magneto-therapy; 2nd main group (39 women) - general magneto-therapy. The results were assessed using a visual analogue pain scale, goniometry results, remote infrared thermography, hospital anxiety and depression scale (HADS). The inclusion of magneto-therapy in the rehabilitation complex reduced local hyperemia and edema in the area of the postoperative suture on the 7th-8th day in 73.7 and 76.9% of patients of the 1st and 2nd groups, respectively, while in the control group a similar result was observed by 10-14 days. Both methods of magneto-therapy eliminated temperature asymmetry and restored the normal thermographic pattern of the skin surface in the area of the surgical field, reduced the severity of pain, and increased the range of motion in the shoulder joint on the side of the operation. When studying the possibility of eliminating the manifestations of asthenic syndrome a comparison of the two studied methods showed the undoubted advantage of the general exposure to a magnetic field. In addition, it has also caused a statistically significant decrease in indicators of anxiety and depression on the HADS scale, while local exposure to a magnetic field did not have a similar effect. The choice of exposure to a magnetic field at the stage of early rehabilitation of women after surgery for breast cancer is determined by the intensity of the pain syndrome, the degree of activity of aseptic inflammation in the area of the postoperative suture, the level of anxiety and depression, and the severity of asthenic syndrome.

Evaluación de la calidad de vida y la presencia de síntomas de depresión y ansiedad en pacientes con degeneración macular asociada a la edad neovascular

PurposeTo assess the vision-related quality of life and the depression and anxiety rates in patients with neovascular Age-Related Macular Degeneration (nAMD). MethodsA cross-sectional study of patients with nAMD treated with intravitreal injections was performed. The patients completed two validated questionnaires: the Visual Functioning Questionnaire (VFQ-25, score from 0 to 100), and the Hospital Anxiety and Depression Scale (HADS) questionnaire. Age, gender and visual acuity (VA) in the Early Treatment Diabetic Retinopathy Study (ETDRS) scale was registered. ResultsFifty-five patients with nAMD participated with a mean age of 80.9±6.6 years-old (range 67 to 93) and a mean VA in the best eye of 73.5±12.7 letters (range 44 to 95). The global VFQ-25 mean score was 57.4±21.9 being 38.9±13.2 for the general vision and 42.0±19.5 for the general health. VA in the best eye was associated with the global score of the VFQ-25 scale (R=.608; P<.001), but no correlation was observed with general health (P=.936). In the HADS scale, 26.9% and 25.5% of patients had symptoms of depression and anxiety respectively. A negative correlation was found between the HADS and VFQ-25 scales for the general vision score (R=–0.438). ConclusionsThis study elucidates the impact of vision impairment and the visual functioning in nAMD, describing an important rate of depression and anxiety symptoms.

Family caregiver emotional distress in advanced cancer: the DME-C scale psychometric properties

BackgroundFamily caregivers of patients with advanced illness at end of life often report high levels of emotional distress. To address this emotional distress is necessary to have adequate and reliable...

Influence of long-term swimming exercises on cardiac index, life duality and level of depression in patients with heart failure with pEF and diabetes mellitus type 2

Abstract Introduction In the number of studies it was proved that specific physical activity can significantly improve the control of Heart Failure (HF). Physical exercises improve mobility, strength and cardiovascular fitness, can easily be performed in patients with HF. Purpose To investigate the effect of regular swimmings on cardiac output, life duality, anxiety and depressive symptoms in patients with HF and DM type 2. Material and methods 62 patients (20 women and 42 men, mean age 55.3±7.9 years) with HFpEF and DM type 2 were included in prospective observation during 6 months. The intensity of physical activity was 6 points due to Borg scale (60–70.0%). Hospital Anxiety and Depression Scale (HADS), MLHFO and SF-36 surveys were used. The water temperature was 32°C throughout the study. Results It was set that lowest scores QL in patients with HF and DM type 2 were obtained on the scales of physical (PF, GH and RP) and psychological (RE, VE and SF) health components (p&amp;lt;0.05). The life duality in patients with HF and DM type 2 depended on the degree of physical activity. The reliable improvement of both physical (p&amp;lt;0.05) and psychological components (p&amp;lt;0.05) of health after regular swimming is proved (table). According to MLHFQ was set reducing the restriction of physical and social activity after regular swimming. Water exercises increased efficacy of pharmacological therapy on 61.8% (p&amp;lt;0.001) according to MLHFQ. According to the HADS scale anxiety and depression disorders were reduced from higher to lower level in 88.0% patients. After 6 months of swimming exercises it was set increasing of cardiac index by 12.0% (p&amp;lt;0.05). Conclusions It has been established that regular swimming exercises in patient with Heart Failure and Diabetes Mellitus type 2 has favourable effect for cardiac index by 12.0% (p&amp;lt;0.05), life duality (p&amp;lt;0.05) and decrease the level of anxiety and depression disorders (p&amp;lt;0.05). Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Health Service of Ukraine

Clinical effectiveness of «thresholdless» low-frequency transcranial magnetic stimulation in patients with ischemic stroke

As you know, complete successful recovery in stroke patients occurs only in 8% of cases, 20% need constant care. The use of innovative rehabilitation technologies, namely «thresholdless» low-frequency transcranial magnetic stimulation, will speed up the process of restoring impaired functions, increase independence in everyday life and, accordingly, the quality of life. To evaluate the effectiveness of use of low-frequency «thresholdless» transcranial magnetic stimulation in the treatment of patients in acute period of ischemic stroke. The study included 93 patients aged from 49 to 68 years on second-third days of ischemic stroke. The 1st (main) group (n=48) received low-frequency «thresholdless» transcranial magnetic stimulation from the «Diamag» apparatus (AlMag-03) daily for 20 minutes, course - 8-10 procedures, with the background of drug treatment, and in addition to classes with an exercise therapy instructor and an occupational therapist. In the 2nd (control) group (n=45), standard therapy was carried out in accordance with the Procedure for rendering medical care to patients with stroke, only with the exception of physiotherapy. Assessment methods: clinical and neurological examination, indicators of duplex scanning of brachiocephalic vessels, Rivermead mobility index, modified Rankin scale, FIM scale (Functional Independence Measure), Hospital anxiety and depression scale (HADS). In patients of the 1st (main) group, an increase in the linear velocity of blood flow in the internal carotid artery on the side of lesion was revealed by 18.1% when compared with the 2nd (control) group (p=0.042); mobility increased by 42.1%, functional independence in everyday life - by 38.1%, muscle strength - by 50%, compared with the 2nd (control) group (p=0.0005). According to the HADS scale, in 29 (60.8%) patients of the main group, psychoemotional disorders were not detected, neither a single case of significantly expressed symptoms of depression (p<0.0001). The inclusion of low-frequency transcranial electromagnetic stimulation in complex rehabilitation leads to the regression of movement disorders, reduces the level of anxiety and depression, improves daily activity and, as a consequence, the quality of life.

Influence of differentiated metabolic therapy on dynamics of quality of life in patients with rheumatoid arthritis in combination with arterial hypertension

The combination of arterial hypertension (AH) with rheumatoid arthritis (RA) significantly aggravates the course of each person. The constant use of drugs, chronic pain, disability and social connections leads to a decrease in the quality of life (QOL).Materials and methods. We examined 96 patients with stage II hypertension in combination with RA, 45 patients with stage II hypertension, and 31 healthy patients. To assess QOL, we used the MOS SF-36 questionnaire (Medical Outcomes Study-Short Form). An assessment of anxiety and depression was performed using the Hospital Anxiety and Depression Scale (HADS). RA activity was determined according to the DAS28 scale, pain assessment according to the visual analogue scale (VAS). Patients with hypertension in combination with RA received basic therapy: 83 patients ─ methotrexate, 10 patients leflunomide, 79 of them were glucocorticoids 6 (6, 8) mg methylprednisolone, all patients received ramipril 10 mg per day, amlodipine 5 (5, 10) mg per day, atorvastatin 20 mg, and differentiated metabolic therapy using meldonium 500 mg per day and L-arginine aspartate 6 g per day for twelve weeks.Aim of the research. In order to improve approaches to the treatment of patients with hypertension in combination with RA, to study the dynamics of the quality of life, the severity of anxiety and depressive disorders during complex treatment, with the inclusion of differentiated metabolic therapy, for twelve weeks.Conclusions. In the subgroups of patients receiving metabolic therapy, there was a significantly pronounced improvement in QOL for all indicators of the MOS SF-36 scale and a decrease in anxiety manifestations in terms of the HADS scale (p<0.05). The largest decrease in activity by 7 % on a DAS 28 scale of 2.65 (2.52; 2.75) points was noted in the subgroup of patients receiving meldonium, compared with the performance of the subgroup without metabolic therapy (p=0.01)

Evaluation of the effectiveness of psychopharmacotherapy and psychotherapy in the complex treatment of systemic lupus erythematosus

To evaluate the effectiveness of psychotherapy(PT) and psychopharmacotherapy(PPhT) in the complex treatment of systemic lupus erythematosus The study was performed in 48 patients. Of these, 44 (91.7%) women and 4 males (8.3%). The average age of the subjects was 32 ± 8.2 years. Patients were divided into 2 groups: 1) Main group - 25 (52%) patients which treated with PPhT and PT; 2) Control group which separated into two group: A - 12 (25%) patients which cured with PPhT and basis therapy; B – 11 (23%) were treatment limited by basic therapy. For evaluation psycho-emotional status, anxiety, and depression disorders we used Hospital Anxiety and Depression Scale (HADS). According to the HADS scale, clinical manifestations of anxiety-depressive syndrome (16 ± 5 points) in main group were at 21 patients (84%), at 8 (66.7%) in group 2A and at 7 (63.6%) in group 2B. Clinically expressed anxiety (16 ± 4.7 points) and subclinical depression (9 ± 1.1 points) in main group at 3 (12%), at 3 (25%) in 2A and 2B 27.3% were observed. [r <0,03]. After treatment, data were analyzing in 2 months by HADS, showed that psychoemotional disorders in the main group have changed dramatically 7.5 times. In patients with psychopharmacotherapy in the 2A group psychoemotional condition was improved 3.5 times. Compare with 2B group - only 1.5 times. According the study anxiety-depressive syndrome are widespread among patients with the systemic lupus erythematosus, which need complex treatment with Psychotherapy and psychopharmacotherapy.

Proposal for Improvement of the Hospital Anxiety and Depression Scale for the Assessment of Emotional Distress in Patients With Chronic Musculoskeletal Pain: A Bifactor and Item Response Theory Analysis

The Hospital Anxiety and Depression Scale (HADS) is a scale originally developed for the assessment of anxiety and depression in hospitalized patients. Despite its wide diffusion, research on its factorial structure has displayed inconsistent results, leaving doubts about its use in chronic musculoskeletal pain. The purpose of this study was to thoroughly assess the factorial structure of the HADS in patients with chronic pain and to give guidance for a potential refinement. Data from 2,522 patients with chronic pain from the Amsterdam Pain (AMS-PAIN) cohort were analyzed through: 1) exploratory bifactor analysis based on a Schmid-Leiman orthogonalization, 2) confirmatory factor analysis comparing a unidimensional model, the original correlated factors model and a bifactor model, 3) item response theory (IRT) analysis based on the graded response model. The results of the confirmatory factor analysis and of the IRT analysis were then cross-validated in an independent sample of patients with chronic pain (n = 8,604). Both exploratory and confirmatory analyses revealed the presence of a strong general emotional distress factor, suggesting that the HADS can be used as a unidimensional scale. The IRT analysis led to the exclusion of three items and to the recoding of one item. The refined 11-item HADS scale was successfully cross-validated and confirmed as a unidimensional, locally independent, monotonic, and reliable scale. PerspectiveAn 11-item shorter version of the HADS could be used to measure emotional distress in patients with chronic musculoskeletal pain. Given its unidimensionality, the use of its total score seems appropriate.

A Radiation Therapist-Led Educational Intervention for Patients Receiving Radiotherapy For Gastro-Intestinal and Lung Cancer

Patients about to undergo radiotherapy experience significant anxiety and often have a limited knowledge of radiotherapy at the time of consent for treatment. This lack of knowledge and anxiety can make it difficult to make informed decisions. There is limited, but promising, evidence that a Radiation Therapist (RT)-led educational intervention may be beneficial for patients. However, this has only been evaluated in breast cancer patients. This study investigated whether a single RT-led educational intervention was associated with a decrease in patient anxiety and increased knowledge about radiotherapy. A prospective randomized-controlled trial was used to compare patient anxiety and knowledge of radiotherapy for those that received standard-of-care education versus those that received education via a RT-led education session. This educational session was conducted by a RT prior to CT simulation and included information about: radiotherapy procedures, treatment planning and delivery process, sensory experiences during treatment, radiation side effects, and basic radiation principles. Patients were considered eligible if they were receiving radical radiation therapy for lung or gastrointestinal cancers. Patients were randomized to receive either standard of care or the educational intervention. For both groups, radiotherapy knowledge and anxiety was captured using validated questionnaires at baseline, prior to CT simulation and prior to the first fraction. The validated questionnaires included the Hospital Anxiety and Depression Scale (HADS), Cancer Treatment Scale (CaTS) and the Knowledge of Radiation Therapy Scale (K-RT). 70 patients provided written informed consent. Thirty-two were randomized to the standard of care arm and 38 were randomized to the intervention arm. Six patients withdrew from the study. The majority of patients were 60-79yrs, had a partner and a university-level education. Accrual was evenly distributed across the genders, and eligible disease sites. The majority of patients (73%) had little or no prior knowledge of radiotherapy. At baseline, there were no statistically significant differences between the cohorts regarding demographics, CaTS responses or K-RT responses. According to the HADS scale, patients reported substantial rates of baseline anxiety (18%). At CT simulation, significantly more patients in the intervention group reported feeling “well prepared for the planning procedure” (58% vs. 21%; p 0.048), and felt that they “knew what was going to happen at the planning appointment” (61% vs. 16%; p 0.003). Just before the first treatment fraction, significantly more patients in the standard group agreed that they would find it helpful to receive more information about “possible side-effects of treatment” (50% vs. 29%; p 0.05) and “things they should do before treatment” (44% vs. 30%; p 0.0005). The intervention had no effect on patients’ anxiety levels. A single RT-led educational intervention was associated with a substantial increase in patient knowledge about radiotherapy. Performing that specialist intervention before the CT simulation, ameliorated patients’ concerns much earlier in the process compared to standard education timelines. This has the potential to improve patients’ experiences and overall satisfaction with the care provided while undergoing radiotherapy.

Osteopathic correction effect on anxiety and depression level according to HADS scale in children with various forms of epilepsy

Introduction.Epilepsy is a chronic brain disease, which treatment consists of relieving the seizures with the help of constant long-term use of anti-epileptic drugs. This, in turn, can cause various negative effects on the body. Epilepsy is not a single disease with various attacks, it is a whole spectrum associated with comorbid conditions, including anxiety and depression. Additional medication is suggested to correct this. Therefore, developing the effective drug-free methods with the help of osteopathic treatment to correct anxiety and depression in epilepsy complex therapy received priority.Goal of research— to study the osteopathic treatment potential to reduce anxiety and depression levels in children with various forms of epilepsy.Materials and methods.The study included 72 children with various forms of epilepsy, aged from 7 to 17 years, 35 girls, 37 boys. The selection criteria were as follows: at least 1 year of epilepsy course duration, no status or serial course of epileptic seizures, no motor and cognitive deteriorations, all children studied in public schools. All children received osteopathic treatment for 2 months, along with medical treatment. Before and after treatment, each patient′s anxiety and depression levels were assessed according to the Hospital Anxiety and Depression Scale (HADS), along with an osteopathic examination.Results.All children taken in the study revealed a range of somatic dysfunctions of craniosacral system, skull and reciprocal tension membranes, with biomechanical abnormality. By initial testing, anxiety and depression average values according to HADS scale were above normal in all children. After osteopathic treatment, a statistically signifi cant decrease in anxiety and depression levels was found.Conclusion. Osteopathic treatment is effi cient for epilepsy complex therapy in children. It helps to reduce drug load in correction of anxiety and depression that accompany the underlying disease.

Clinical-psychopathologic and pathophychological features of adaptation disorders in computer addicted individuals

The aim. Comprehensive study of clinical, psychopathological and pathopsychological features of adaptation disorders in persons with computer addiction.Materials and methods. 147 patients with adaptation disorders (F43.21, F43.22). The main group consisted of 85 patients with signs of computer addiction according to the results of AUDIT-like tests, the control group - 62 patients with no signs of addictive behavior. The average age of the patients was 27.0 ± 3.0 years.Methods of the research: clinical and anamnestic; clinical-psychopathological, using AUDIT-like tests for a comprehensive assessment of addictive status (Linsky I.V., Minko A.I., Artemchuk A.P., et al., 2009); psycho-diagnostic using the hospital anxiety and depression scale (HADS) (Zigmond A.S., Snaith R.P., 1983); Clinical scales of anxiety and depression by Hamilton (M. Hamilton, 1967), adapted to ICD-10 (G. P. Panteleeva, 1988) (HDRS) scales of situational and personal anxiety by C. D. Spielberger (in adaptation by Yu. L. Khanin, 1981); enquirer of neuro-psychological stress by Nemchin T.A. (1984); statistical.Results of the research. The structure of computer addiction in the main group of surveyed was as follows: intrusive surfing (46.2 %), computer games (22.3 %); virtual dating (6.4 %); passion for online gambling (13.7 %); cybersex (1.4 %).Depression of mood dominates in the clinical picture of eradication adaptation in persons with computer addiction; internal stress with inability to relax; increased susceptibility to previously neutral stimuli; irritability; asthenic symptoms; loss of interest in work or school, family and friends; sleep-wake cycle disorders.According to the psychodiagnostic examination data, the main group of examined showed clinical signs of anxiety and depression on a hospital scale; severe depressive and disturbing episodes on the Hamilton scale; high drop situational and personal anxiety according to the method of C. D. Spielberger, a high level of severity of neuropsychic stress on a scale T.A. Nemchin.Conclusions. For the clinical picture of adaptation disorders in individuals with computer addiction, a characteristic is decreased mood background; irritability, tendency to affects; disturbing manifestations; hyperesthesia; sleep-wake cycle disorders; clinical manifestations of anxiety and depression on the HADS scale; severe depressive and disturbing episodes on the HDRS scale; high drop situational and personal anxiety; excessive mental stress