Hospital Anxiety And Depression Scale Research Articles

Anxiety and Depression among patients with chronic pain

Background: Chronic pain is a pervasive and debilitating state experienced by many individuals across the globe. It produces a wide range of physiological impact which are well documented in literature but the psychological impact which is also equally profound has not received much attention. This study aims to investigate severity of anxiety and depression in patients with chronic pain that contributes to the development of holistic and effective treatment approaches. Materials and Methods: A non-experimental descriptive cross-sectional design was adopted. Non probability purposive sampling was used to recruit a sample of 50 patients with chronic pain attending OPD services in a secondary hospital, Chittoor, Andhra Pradesh. Patients who aged between 20 and 70 years with a chronic pain for at least 3 months were included. Patients with malignant pain were excluded. Hospital Anxiety and Depression Scale (HADS) was used to capture data on anxiety and depression. Results: The mean anxiety score on HADS was 9.2 (SD-3.72) and depression score was 8.48 (SD-3.23). Nearly one third of participants (32%) reported abnormal level of anxiety and 26% had reported abnormal depression. There is no significant association found between level of anxiety and Sociodemographic variables such as age, gender, marital status, type of family, education and occupation. Level of depression showed a significant association with age (p=0.042). Conclusion: Patients with chronic pain experience varying degrees of anxiety and depression. Routine assessment of these attributes would help the healthcare team to plan patient-tailored interventions to manage pain and to prevent anxiety and depression.

Evaluation of a probiotic blend on psychosocial health and biomarkers of inflammatory, immune and stress response in adults with subthreshold depression: a double-blind, randomised, placebo-controlled trial.

This study examined the efficacy of a probiotic in reducing depressive symptom severity in people with subthreshold depression. In a double-blind, randomised, placebo-controlled trial, a probiotic (1 × 10^9 live cells per strain: Limosilactobacillus fermentum LF16 (DSM26956), Lacticaseibacillus rhamnosus LR06 (DSM21981), Lactiplantibacillus plantarum LP01 (LMG P-21021) and Bifidobacterium longum 04 (DSM23233)) or placebo was taken daily for 12 weeks. Data were collected at baseline, 6 and 12 weeks including psychological symptom severity (Beck Depression Inventory, BDI; Patient Health Questionnaire, PHQ; Hospital Anxiety Depression Scale, HADS; and Depression Anxiety and Stress Scale, DASS). Biomarkers of glycaemia, inflammation (high-sensitivity C-reactive protein, hs-CRP), antioxidant status (total glutathione (GSH)) and stress (cortisol awakening response, CAR) were also measured. Thirty-nine participants (nineteen probiotic;twenty placebo) were enrolled. There were no significant between-group differences in the examined psychological symptom severity scores, despite certain significant within-group changes observed in both groups from baseline to 6 and/or 12 weeks of follow-up. Regarding biomarkers, the probiotic group showed reduced hs-CRP (-1520; 95 % CI -273·7, -2766·2 ng/dl) and CAR (-0·28; 95 % CI -0·05, -0·51 μg/dl) at 12 weeks, but increased total GSH (3·9; 95 % CI 0·1, 7·5 ng/dl) at 6 weeks, compared with the placebo. The current study reported favourable decreases in depressive symptoms in both groups. Although the within-group changes observed in the probiotic group were supported by favourable inflammatory, antioxidant status and stress biomarker changes compared with the placebo, further research is required to shed more light on the role of gut microbiota modulation on emotional regulation.

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

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

Differences in symptoms of anxiety and depression among out-of-hospital cardiac arrest survivors and their relatives, paired results from the DANCAS survey

Abstract Background It is well known that out-of-hospital cardiac arrest (OHCA) survivors, as well as their relatives, struggle with symptoms of anxiety and depression, but less is known about the potential differences in paired outcomes. Purpose To describe differences in symptoms of anxiety and depression among OHCA survivors and their relatives (paired) and to investigate characteristics associated with these symptoms among both groups. Methods A national cross-sectional survey (DANCAS) was conducted with OHCA survivors combined with a survey for their closest relatives. The Hospital Anxiety and Depression Scale (HADS) was included in both surveys. Paired t-tests were used to examine potential differences in HADS mean scores among survivors and relatives. Associations between characteristics (demographic and other self-reported outcomes) and symptoms of anxiety (HADS-A ≥8) and depression (HADS-D ≥8) were examined using multivariable logistic regression models, presented as odds ratios (OR) with 95% confidence intervals (CI), adjusted for potential confounders. Results In total, 526 pairs of OHCA survivors and their relatives both responded, with 447 (85%) of the survivors being men, a median age of 67 years (IQR 59-75) and 462 (88%) of the relatives being women with a median age of 64 years (IQR 55-70). Most relatives (85%) were spouses or unmarried partners. In the paired analyses, relatives had significantly higher scores of anxiety compared to survivors (mean 5.6 SD 4.0 vs 3.5 SD 3.8; p&amp;lt;0.001). On the contrary, survivors had significantly worse scores of depression (mean 3.1 SD 2.8 vs 2.4 SD 3.2; p&amp;gt;0.001). Several characteristics (demographic and self-reported) were associated with symptoms of anxiety and depression among both survivors and relatives, Table 1 &amp; 2. Conclusion Following OHCA, relatives report worse scores of anxiety while, in contrast, survivors report worse scores of depression, indicating psychological interventions should be tailored differently for the two groups. Further investigation of the reasons for these findings are needed, including whether fatigue might be a symptom of depression or a confounder.

Impact and determinants of depression in cardiac hospitalized patients

Abstract Depression increases cardiovascular risk and involves worse clinical outcomes. Little attention is paid to it in hospitalized patients. We studied prevalence and determinants of depression in this group, in order to select patients for further specific management. Methods Consecutive patients admitted to Cardiology wards were included. Cardiovascular risk factors, clinical and psychosocial data were collected. Self perceived mental and physical health quality were assesed by 12-item Short Form survey (SF-12), and Hospital Anxiety and Depression Scale (HADS) questionnaires were administered. Statistical analysis was performed using Spearman´s correlation, Mann-Whitney and Fisher tests, and Mantel-Cox, linear and logistic regression analyses. Results 170 consecutive patients, median age 74.5 (67.2-81.1), 59.4% male, were included. Most common pathologies were heart failure (44.7%) and coronary syndroms (28.8%). According to HADS results, depression was probable (score &amp;gt;10) in 10%, and at least possible (score &amp;gt; 8) in 27.1%. Both increased duration of hospitalization (Median 14 vs 7 days;p=0.016 and 11 vs 7 days;p=0.005 respectively). Anxiety was present in 16.5 % for probable case and 34.1% for possible case, with no significant change in median duration of hospitalization. 22.9% of patients were under antidepressant treatment, and 24% under anxiolytics, but they were added to treatment only in 1% and 7% respectively. No other not pharmacological measure was initiated. Self perceived mental health was diminished in probable depression (mean difference 14.9%;95%IC 9.7-20.2;p&amp;lt;0.001). Self perceived physical health was also lower (mean difference 6.4%;95%CI:1.1-11.8;p=0.016). Patients with depression were a mean of 5.6 years older (95%CI 1.4-9.8;p=0.032). Less than primary education (OR 5.69 (p 0.021), and Previous hospital admission OR 3.2 (1.0-10.3;p=0.034) increased the risk of depression in univariate analysis. By multivariate analysis, determinants of depression were anxiety (OR 22.5;95%CI 5.9-85.6;p&amp;lt;0.0001), need for surgery (OR 12.3;95%IC 2.1-73.2;p=0.009), need for intensive care unit surveillance (OR 4.2;95%CI 1.1-15.8;p=0.039), and age (OR 1.1;95%IC 1.0-1.2;p=0.001. AUC was 0.89;95%CI 0.81-0.96;p&amp;lt;0.0001. There was no difference in civil status, gender, income level, living accompanied, number of comorbidities, cardiovascular risk factor or reason for hospital admission. Conclusions Depression was prevalent in our hospitalized cardiac patients,in spite of previous pharmacological treatment. It prolongs duration of stay and impacts negatively in self perceived mental and physical health. Risk is increased in older people requiring intensive care surveillance or surgery, and specially by anxiety. These patients could benefit from a preventive multifactorial approach. Attention should also be paid to patients with a previous hospitalization and low educational level.ROC curve for multivariate model

Echocardiographic associates of impaired sleep quality in patients with anxiety and depression

Abstract Objective Sleep health, mental health and cardiovascular health are multidimensional constructs that are strongly associated with each other. Anxiety and depression are the most common psychiatric diseases in the community and frequently comorbid in routine clinical practice. This study sought to investigate whether there is an association between sleep quality and echocardiographic parameters in patients with anxiety and/or depression. Methods The clinical and instrumental find­ings of consecutive patients diagnosed with either of anxiety disorders and/or depressive disorders and underwent cardiac examination in our tertiary center on the same day were retrospectively reviewed. The diagnosis was made by a psychiatrist according to the criteria listed in the fifth edition of The Diagnostic and Statistical Manual of Mental Disorders. Afterwards, Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI) were applied to patients to assess symptom severity and sleep quality, respectively. Subsequent to psychiatric examination, the patients underwent echocardiographic examination that includes two-dimensional conventional echocardiography, tissue doppler imaging (TDI) echocardiography, atrial conduction times, and left atrium (LA) volumes and functions. Results The final study population consisted of 167 patients and divided into two groups according to their PSQI score: PSQI&amp;lt;5 (normal sleep quality) (n=32) and PSQI≥5 (impaired sleep quality) (n=135). Aortic diameter, left ventricular (LV) end-systolic diameter, LV end-diastolic and -systolic volume, LV stroke volume and LV stroke volume index, LV outflow tract velocity–time integral (LVOT-VTI), and LA conduit volume calculations were significantly lower in patients with impaired sleep quality compared to patients with normal sleep quality. The other echocardiographic parameters including LV systolic functions, doppler and TDI echocardiography indices, atrial conduction times, atrial mechanical functions including LA function index (LAFI) were similar among groups. Correlation analysis yielded a negative, weak but statistically significant correlation between LAFI and PSQI score (r=-0.17, p=.030) (Figure 1A). Left intra-AEMD positively and significantly correlated with PSQI score at a weak level (r=0.16, p=.043) (Figure 1B). Aortic diameter, LV stroke volume index, LVOT-VTI and conduit volume were determined as echocardiographic parameters significantly associated with impaired sleep quality in univariate analysis. Among these parameters, only conduit volume remained as significant and independent associate of impaired sleep quality in multivariate logistic regression analysis (Odds ratio:0.91, 95% Confidence interval:0.85-0.98, p=.018) (Table 1). Conclusion There is an independent association between LA conduit volume and impaired sleep quality in patients suffering from anxiety and/or depressive disorders.Figure 1Table 1

"I don't want hear about that": Treatment wishes/preferences of elderly patients regarding possible treatment goals in acute life-threatening illness or acute organ failure

Abstract Background In many people with acutely life-threatening illnesses, the will to undergo treatment is not known with sufficient precision. It is often unclear whether the person concerned would have consented to life-sustaining measures or would have preferred to die with palliative care. This applies in particular to the vulnerable group of elderly, chronically ill/fragile people. It is not uncommon for people to reject the risks/burdens of medical treatment, even if there is a chance of success. On the other hand, there are many people who fight to continue living, even if this can be associated with great burdens and the outcome is rather uncertain. Aim of the study is to determine the characteristics of cardiologic patients who refuse to discuss treatment wishes/preferences in case of acute emergencies, temporary (e.g. in the context of intensive care unit (ICU) treatment), or permanent (vegetative state) inability to consent. Methods Prospective, questionnaire-based cross-sectional study including Hospital Anxiety and Depression Scale (HADS) and assessment of quality of life using the 12-item Short Form Health Survey (SF-12) on normal cardiology wards. Results 455 cardiologic patients were interviewed (mean age 71.2 ± 12.9 years, 39.6% female), 76.1% had moderate-severe concomitant diseases according to the Carlsson Comorbidity Index (4.3 ± 2.4 points) (see Table I). 23.5 % of respondents did not wish to address the above-mentioned question, they were significantly older (74.6 ± 13.1 vs. 69.9 ± 12.8 years; p=0.0009), had more comorbidities, were less likely to have a high level of education (university degree: 13.0 % vs. 30.6 %; p=0.0021) and were less likely to be employed (11.7 % vs. 25.8 %; p=0.0026). Furthermore, these patients live alone more frequently (45.8% vs. 30.6%; p=0.0048) and are less likely to live in a partnership (52.0% vs. 68.0%; p=0.0043). Refusal of an advance directive was also more common (22.5% vs. 10.7%; p=0.05), quality of life was impaired (42.4 ± 9.8 vs. 45.9 ± 10.5 points; p=0.0022), and the HADS-score levels were higher (15.6 ± 7.3 vs. 12.7 ± 7.8 points; p=0.0007). Conclusions A relevant proportion of our patients refuse to discuss treatment wishes/preferences in case of acute emergencies, temporary or permanent inability to consent. Paradoxically, these were patients for whom it would make particular sense (older, sicker, and more socially isolated patients). Those patients are also prone to anxiety and depression, and have a reduced quality of life.

Atrial fibrillation, prevention and rehabilitation in a primary healthcare setting. A feasibility study

Abstract Background Atrial fibrillation (AF) often influences daily life with symptoms like palpitations, dyspnoea, fatigue, fear and anxiety. Research show that patients with AF benefit from prevention and rehabilitation interventions. However, evidence is scarce and mainly hospital-based, and it is unknown whether the transition to the primary healthcare sector gives the same positive results. In 2019, a Danish primary care Health Center and the cardiology department at the local hospital completed a multidimensional prevention and rehabilitation intervention for patients with AF. Purpose To investigate the feasibility of delivering a multidimensional prevention and rehabilitation intervention for patients with AF in a primary care Health Center. Methods This study was a mixed-methods, non-randomized, intervention, feasibility study. A convergent mixed-methods design was used, and results were illustrated in side-by-side joint displays. Patients were included at a Hospital AF clinic referring to the Health Center. The prevention and rehabilitation intervention consisted of risk factor management, patient education, physical activity and yoga. Two patient-reported outcomes measures (PROMs) were used, the HeartQoL measuring health-related quality of life (HRQoL) and the Hospital Anxiety and Depression Scale (HADS) measuring symptoms of anxiety and depression. Data were collected at baseline (T0), at end of intervention (T1), and at two-months follow-up (T2) and analysed descriptively. Focus group interviews were analysed thematically and covered experiences of participating, needs and preferences, outcomes and feasibility of collecting PROMs. The reporting was guided by the Consolidated Standards of Reporting Trials (CONSORT) extension to pilot and feasibility trials. Results 43 patients (53% women; median age 66 (range 52-81) years) completed the intervention. Table 1 shows that HRQoL increased, and symptoms of anxiety and depression decreased. These results maintained at follow-up. Figure 1 shows the qualitative themes. Patients experienced being understood and supported by health professionals and peers. They thought it difficult to know what their needs were. However, some patients had specific preferences for interventions. For changes in outcomes, the patients identified that gaining tools and knowledge about the disease from the interventions helped. It was feasible to collect PROMs during the intervention and finally, the patients had an attention to what comes next, when finishing the intervention in the primary care setting. Conclusion It was feasible to deliver a multidimensional prevention and rehabilitation intervention for patients with AF at a primary care Health Center. HRQoL increased and symptoms of anxiety and depression decreased. The patients experienced being supported and gaining tools and knowledge to handle AF. Future large randomized controlled trials must confirm these results.

Credentialed pharmacist-led home medicines reviews targeting treatable traits and their impact on health outcomes in people with chronic obstructive pulmonary disease: a pre- and post-intervention study.

Patients with chronic obstructive pulmonary disease (COPD) should engage in self-management strategies targeting behavioural traits and lifestyle risk-factors for optimal outcomes. To evaluate the impact of credentialed pharmacist-led home medicines review (HMR) targeting treatable traits (TTs) on health outcomes in COPD in primary care. A pre- and post-intervention study was nested within a cluster-randomised controlled trial. A total of 81 participants with COPD from 21 Australian general practices received an HMR with a credentialed pharmacist targeting TTs. Changes in health outcomes at 6 and 12months from baseline were assessed. Ten TTs were assessed and targeted during the HMR. At baseline, no-one had a written action plan for managing exacerbations, and medication adherence was sub-optimal in 85% of patients. Additionally, 53% of participants demonstrated inadequate inhaler device technique, while 52% were current smokers. At 6-months follow-up, significant improvements were observed in health-related quality of life (St. George's Respiratory Questionnaire score = 34.6 versus 39.1 at baseline, p = 0.006), health status (COPD Assessment Test score = 12 versus 16, p = 0.002), anxiety (Hospital Anxiety and Depression Scale (HADS)-Anxiety score = 2.0 versus 5.0, p < 0.001), depression (HADS-Depression score = 1.0 versus 5.0, p < 0.001), self-reported smoking (47% versus 51.9%, p = 0.031) and treatment adherence (Tool for Adherence Behaviour Screening score = 12.5 versus 10.0, p = 0.002). At 12-months: health status, anxiety, depression, smoking abstinence and adherence to treatment, continued to show statistically significant improvements compared to baseline measurements. HMRs targeting TTs improved health outcomes in people with COPD. Credentialed pharmacists in primary care can work alongside general practitioners to optimise COPD management.

Analysis of preoperative and postoperative depression and anxiety in patients with lumbar disc herniation with radiculopathy treated with percutaneous transforaminal endoscopic discectomy

ObjectiveThis study aims to examine the mental health of patients with lumbar disc herniation with radiculopathy (LDHR) and to evaluate the effects of percutaneous transforaminal endoscopic discectomy (PTED) on their mental well-being.MethodThis study included 114 LDHR patients who received PTED in the Spinal Orthopedics Department of Zhongshan Hospital of Traditional Chinese Medicine between May 2022 and May 2023. The study population was stratified into two groups according to the presence of preoperative anxiety and depression: Group A comprised patients with such symptoms, and Group B included the remainder. Patients were assessed using the Hospital Anxiety and Depression Scale (HADS), the Visual Analog Scale for Pain (VAS), and the Oswestry Disability Index (ODI) at preoperative and final follow-up visits. Evaluations were performed using the Hospital Anxiety and Depression Scale (HADS), the Visual Analog Scale, and the Oswestry Disability Index (ODI) at the time of preoperation and during the last follow-up.ResultsAmong the 114 LDHR patients who obtained complete follow-up, fifty-four had anxiety/depression symptoms before surgery, which accounted for a incidence of 47%. Both Group A and Group B patients showed significant improvement in all evaluation indicators after PTED, but the overall prognosis of Group A was worse than that of Group B.ConclusionPTED can effectively improve patients’ pain, functional activities and mental health, which has a positive impact on patients’ quality of life, and there is a significant correlation between patients’ preoperative mental health and prognosis.

Effect of different doses of esketamine on the median effective concentration of propofol for inhibiting body movement during hysteroscopy

The objective of this study is to investigate the effects of various doses of esketamine on the median effective concentration (EC50) of propofol required for inhibiting body movement during hysteroscopy. Additionally, this research aims to explore the pharmacodynamic interactions between esketamine and propofol. Prospective, double-blind, up-down sequential allocation study. Operating room, post-anesthesia care unit (PACU), and general ward. A total of 90 patients were allocated into three groups in a randomized, double-blinded manner as follows: 0.1 mg/kg esketamine combined with propofol intravenous injection (EP0.1) group, 0.2 mg/kg esketamine combined with propofol intravenous injection (EP0.2) group, 0.3 mg/kg esketamine combined with propofol of intravenous injection (EP0.3) group. For the initial patient in each group, the starting effector target concentration of propofol was set at 4 µg/ml. Each patient received an initial intravenous injection of 0.04 mg/kg midazolam, followed by the administration of the appropriate dose of esketamine. Ten seconds after the esketamine injection, propofol was administered intravenously to achieve the target concentration. In accordance with the sequential method principle, the concentration of propofol for the subsequent patient was adjusted based on the response of the previous patient. Effective inhibition of body movement was defined as the absence of any involuntary body movements throughout the entire surgical process. If the previous patient exhibited body movements, the propofol concentration for the next patient was increased by 0.5 µg/ml; conversely, if no movements were observed, it was decreased by 0.5 µg/ml. The up-down sequential allocation method and probit regression were used to calculate the EC50 of propofol. Hospital Anxiety and Depression Scale-Anxiety (HADS-A) and Depression (HADS-D) score, adverse events, hemodynamic changes, demographic data and clinical characteristics. The EC50 of propofol was 3.849 μg/ml (95% CI: 3.419–4.281) in the EP0.1 group, 3.641 μg/ml (95% CI: 2.807−4.200) in the EP0.2 group, and 3.417 μg/ml (95% CI: 2.845–3.852) in the EP0.3 group. These findings suggest that esketamine can dose-dependently reduce the EC50 of propofol. Esketamine can dose-dependently reduce the EC50 of propofol in hysteroscopy, while concurrently lowering patients’ HADS-A and HADS-D scores 24 h post-operation. It is concluded that the optimal dose of esketamine, when combined with propofol for hysteroscopy, is 0.3 mg/kg.

Development and validation of a nomogram for sleep disorders among stroke patients

BackgroundPrecisely identifying high-risk sleep disorder patients and implementing suitable measures are important for decreasing the incidence of sleep disorders. In this study, a nomogram method was adopted to construct a tool to predict sleep disorders in stroke based on four factors: individual characteristics, treatment-related factors, psychological factors, and family-related factors. MethodsA total of 450 stroke patients were continuously diagnosed at the Affiliated Hospital of Nantong University, and the data on participants were randomly distributed into a training set (n = 315) and a validation set (n = 135). Within the training set, using LASSO regression and random forest methods, five optimal predictors of sleep disorders were identified. Five optimal predictors were used to develop a model. The calibration, discrimination, generalization, and clinical applicability of the model were evaluated using calibration curves, receiver operating characteristic (ROC) curves, internal validation, and decision curve analysis (DCA). ResultsWe found that the place of residence, average daily infusion time, the Hospital Anxiety and Depression Scale (HADS), the Type D Personality Scale-14 (DS14), and the Fatigue Severity Scale (FSS) were crucial factors associated with sleep disorders. The validation data showed an area under the curve (AUC) of 0.903 compared to 0.899 in the training set. There was an approach to the diagonal in the calibration curve of this model, and the results of DCA noted that it is clinically beneficial across a range of thresholds from 5 % to 99 %. ConclusionA model was developed to predict sleep disorders among stroke patients to help hospital staff evaluate the risk among patients and screen high-risk patients.

Relationship of the Prime Diet Quality Score (PDQS) and Healthy Eating Index (HEI-2015) with depression and anxiety: a cross-sectional study

BackgroundPrevious studies have suggested a significant association between diet quality and mental health. However, a limited number of studies have utilized the Prime Diet Quality Score (PDQS) to examine this association. Additionally, no study has yet compared the PDQS and Healthy Eating Index-2015 (HEI-2015) in terms of their association with depression and anxiety.AimThis cross-sectional study aimed to investigate the association between diet quality, measured by the PDQS and HEI-2015, and the odds of depression and anxiety in adults.MethodsThis study utilized data from the LIPOKAP study, which was conducted between February 2018 and July 2019 in five cities in Iran. We included 1994 adults aged 18 and above who were selected through a multistage cluster sampling method. Participants completed a validated semiquantitative food frequency questionnaire (FFQ) to evaluate their dietary intake. The FFQ was used to calculate the PDQS and HEI-2015. Depression and anxiety levels were determined using the Hospital Anxiety and Depression Scale (HADS).ResultsThe participants had a mean age of 39.79 ± 13.87 years, with females accounting for 1,041 (52.2%) of the total population. PDQS showed a significant inverse association with the odds of depression (OR = 0.45, 95% CI: 0.28–0.71) and anxiety (OR = 0.40, 95% CI: 0.25–0.62) in the fully adjusted model. Similarly, the highest quartile of HEI-2015 showed a significantly lower odds of depression (OR = 0.60, 95% CI: 0.40–0.90) and anxiety (OR = 0.62, 95% CI: 0.42–0.92) compared to the lowest quartile.ConclusionBoth PDQS and HEI-2015 were associated with a reduced risk of depression and anxiety. However, the PDQS demonstrated a stronger inverse association with these risks compared to the HEI-2015. This suggests that the PDQS could be a more beneficial dietary pattern for preventing depression and anxiety compared to HEI-2015. Further large-scale studies are required to confirm these findings.

Application of WeChat-based cognitive behavioural stress management for early-stage cervical cancer patients: a randomised controlled study

Background This randomised controlled study was aimed at investigating the effects of WeChat-based cognitive behavioural stress management (WB-CBSM) on the mental health of patients with early-stage cervical cancer treated with surgical resection. Methods A total of 184 patients with early-stage cervical cancer were randomised to receive either WB-CBSM (n = 92) or normal care (NC) (n = 92) for 8 weeks. Results Compared with the NC group, the WB-CBSM group exhibited reduced Hospital Anxiety and Depression Scale (HADS)–anxiety scores at months (M)1 (t = 2.022, P = 0.045), M3 (t = 2.575, P = 0.011), and M6 (t = 2.709, P = 0.007); anxiety rates at M3 (χ2 = 4.834, P = 0.028) and M6 (χ2 = 5.182, P = 0.023); HADS–depression scores at M3 (t = 2.069, P = 0.040) and M6 (t = 2.449, P = 0.015); and depression rates at M6 (χ2 = 4.268, P = 0.039). Moreover, the WB-CBSM group showed increased Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being scale scores at M1 (t = −2.001, P = 0.047), M3 (t = −2.281, P = 0.024), and M6 (t = −3.501, P = 0.001); the Quality of Life Questionnaire-Core 30 (QLQ-C30) global health score at M3 (t = −2.034, P = 0.043) and M6 (t = −2.426, P = 0.016); and QLQ-C30 function score at M3 (t = −2.009, P = 0.046). However, the groups exhibited decreased EuroQol-5 dimension scores at M3 (t = 2.056, P = 0.041) and M6 ((t = 2.242, P = 0.026) and QLQ-C30 symptom scores at M1 (t = 2.026, P = 0.044) and M3 (t = 2.210, P = 0.028). Conclusion WB-CBSM reduced anxiety and depression and improved the spiritual well-being and quality of life of patients with early-stage cervical cancer treated with surgical resection.

A real-world study on the clinicopathological profile, treatment outcomes and health-related quality of life, anxiety and depression among patients with desmoid tumor at two tertiary care centers in India

BackgroundThe medical management of DT comprises tyrosine kinase inhibitors (TKIs), hormonal agents, anti-inflammatory drugs with the recently approved gamma secretase inhibitor nirogacestat being the current standard of care. Real-world data on evolving treatment landscapes of DT remains scarce.MethodsThis is a retrospective study of patients with DT registered between 1995 and 2020 at All India Institute of Medical Sciences, New Delhi and Tata Medical Center, Kolkata. Baseline characteristics were analyzed in form of median values and interquartile range. Categorical and continuous variables were compared by chi square and independent samples T- tests respectively. Anxiety, depression and QoL were prospectively measured among 30 patients using Hospital Anxiety and Depression (HADS) and Functional Assessment of Cancer Therapy-General (FACT-G) scales respectively between 2022 to 2023.Results200 patients were included with a male-predominant (n=111, 55.5%) population and median age 26.5 (2.5-75) years. Extremity (n=100, 50%) and abdomen (n=65, 32.5%) were commonest primary sites and median of 2 (1–4) lines of treatment were received. First-line included surgery (n=116, 58%), systemic therapy (n=67, 33.5%), radiotherapy (10, n=5%) and active surveillance (n=7, 3.5%). First-line systemic agents included tamoxifen (n=55, 27.5%), imatinib (n=7, 3.5%), sorafenib (n=1, 0.5%) and chemotherapy (n=4, 2%). 2019 onward, 3% and 63% underwent active surveillance and surgery respectively. Best radiological response obtained with tamoxifen was stable disease (SD) (n=76, 59%) and partial response (PR) (n=31, 24.2%). Best radiological response obtained with sorafenib was PR (n=17, 60.7%) and SD (n=9, 32.1%). Thirty patients underwent HADS and FACT-G scale assessment. Mean HADS-Anxiety subscale score was 3.6 (+/-3.9 SD) and HADS-Depression sub-scale score was 2.6 (+/-3.5 SD) with clinically significant anxiety and depression in 2 (6.7%) patients each. The overall mean FACT-G score was 87.5 (+/-12.6 SD) and lower mean physical well-being (p=0.006) and emotional well-being (0.017) scores were significantly associated with higher HADS-anxiety (&amp;gt;/=8) scores.ConclusionsAssessment of anxiety, depression and QoL are paramount to gauge the psychological impact of DT. This study gives an overview of clinical and management profile of patients with DT in India, with limitations of selection bias, heterogeneous population and small sample size for QoL assessment.

The Relationship of Cyber Bullying and Victimization with Anxiety and Depression Risk in High School Students

In this research, it was intended to find out the frequency of cyber bullying and cyber victimization experienced by students who are attending different schools in a city center and to investigate the relationship between these situations and anxiety and risk of depression. The research population consisted of 460 students studying at Anatolian High School, Private High School, and Imam Hatip High School. This cross-sectional, analytical study included 9th, 10th, 11th and 12th grade voluntary students. Data collected via questionnaire consisted of three parts: socio-demographic information form, the cyber bullying scale (CBS) and the hospital anxiety and depression scale (HADS). The daily internet usage time of the participants were found to be 4.07±3.77 hours. Fifty-eight point seven percent (n=270) of the students were victims while 24.5% (n=112) of them were both bully and victims. The cyber victimization score of male students was found to be 24.1±9.6. The mean anxiety and depression scores of the students were 9.6 ± 4.3 and 7.2 ±3.9 respectively, and difference was significant between cyber victims and those who are neither bully nor victims (p&amp;lt;0.001). Anxiety and depression risk were positively correlated to cyber victimization score. The results of this study reveal that cyber bullying and victimization in young people are quite high. The relationship between cyber bullying, cyber victimization and anxiety and depression poses a significant threat for adolescents.

Anxiety and depression among various blood groups of undergraduate medical and physical therapy students

Objective: To access the frequency of depression and anxiety among the various blood groups of medical and physiotherapy students. Method: A cross-sectional study on 215 MBBS and DPT students was conducted at Aziz Fatimah Medical and Dental College (AFMDC) from November 2022-May 2023. Google Form containing sections for relevant information concerning participants and fourteen items- Hospital anxiety and depression Scale (HADS) questionnaire for evaluation of anxiety and depression, was administered among the MBBS and DPT students through social media. The data was analyzed using SPSS version 26. Mean ±SD was calculated for continuous variables like HADS score and age. Frequency and percentage were calculated for categorical variables such as blood groups, anxiety and depression. ANOVA was used to compare HADS score among various blood groups. P-value ≤0.05 was taken statistically significant. Result: Mild anxiety was found in A&gt;O&gt;B&gt;AB, while severe anxiety was found in B&gt;A&gt;AB&gt;O. Mild depression was found in A&gt;B&gt;O&gt;AB, while severe depression was found in A&gt;O&gt;B&gt;AB. However, on ANOVA, when comparing anxiety and depression scores with blood groups, they were found to be higher in blood Group-A. Rhesus factor positive blood groups have severe anxiety and mild depression while Rhesus factor negative blood groups have mild anxiety and severe depression. Conclusion: Severe anxiety was common in blood Group-B while severe depression was common in people with blood Group-A. While mild anxiety and mild depression was found in blood Group-A, however, sever anxiety was common in positive Rhesus factor blood types while severe depression was found in negative Rhesus factor blood types. doi: https://doi.org/10.12669/pjms.40.10.8984 How to cite this: Rubab-e-Hira, Ali M, Jawed S, Altaf B. Anxiety and depression among various blood groups of undergraduate medical and physical therapy students. Pak J Med Sci. 2024;40(10):2422-2427. doi: https://doi.org/10.12669/pjms.40.10.8984 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Evaluating psychological distress in Chinese patients with head and neck squamous cell carcinoma planned for radiotherapy: a cross-sectional study using the distress thermometer.

We aim to estimate the prevalence of baseline clinically significant distress in Chinese patients with head and neck squamous cell carcinoma (HNSCC) before receiving the first radiotherapy and assess factors predictive of distress. One hundred and sixty-eight patients were enrolled to complete a set of questionnaires including Distress Thermometer (DT) and Hospital Anxiety and Depression Scale (HADS). Of these, 131 questionnaires were available for the final analysis. The accuracy of DT was validated using HADS as the gold standard, and receiver operating characteristic (ROC) curves were employed to identify the optimal cutoff score of DT. Distress was reported in sixty-two patients (47%). Patients who were visited in the last week (p = 0.022) and those with medical-related occupations (p = 0.017) were less likely to suffer from psychological distress. Additionally, religious belief was negatively associated with both the DT and HADS-T scores, indicating that patients with religious beliefs were less likely to report high levels of distress (odds ratio (OR) for DT ≥ 4 = 0.291, p = 0.039; OR for HADS-T ≥ 15 = 0.316, p = 0.047). Factors such as age, gender, marital status, education and residency did not contribute to distress levels. DT was significantly correlated with HADS-T (Correlation coefficient (r) = 0.624, p < 0.001) and the best cutoff score of DT was 4 in screening distress. DT was a brief and effective tool to screen distress among HNSCC patients.

Psychological resilience in patients with primary Sjögren's syndrome: effect of involvement of major salivary and lacrimal glands.

The aim of this study was to assess whether the involvement of major salivary and lacrimal glands in primary Sjögren's syndrome (pSS) affected the psychological resilience of patients. This cross-sectional study included 116 patients with pSS. Data were collected through clinical examinations, measurement of salivary flow rates (SFRs), and from Schirmer's test, as well as from patient-reported outcome measures (PROMs), such as the European League Against Rheumatism (EULAR) Sjögren's Syndrome Patient Reported Index (ESSPRI), Brief Resilience Scale (BRS), Work Productivity and Activity Impairment (WPAI), Oral Health Impact Profile-14 (OHIP-14), and the Hospital Anxiety and Depression Scale (HADS). Hyposalivation was defined as an unstimulated SFR of≤0.1mL/min. The BRS score (mean±SD=2.60±0.69) was lower in patients with recurrent parotitis (2.11±0.37) than in those without recurrent parotitis (2.67±0.86), in the whole group. In patients with an unacceptable symptom state (ESSPRI score≥5 points), a lower BRS score was observed in patients with both hyposalivation and ocular dryness (2.59±0.69) than in patients with isolated hyposalivation (2.84±0.84). The BRS score was also negatively associated with the WPAI-Daily Impairment and OHIP-14 scores in patients with hyposalivation as well as with HADS-A (the seven items of HADS relating to the anxiety dimension) and HADS-D (the seven items of HADS relating to the depression dimension) in the whole group. The results suggest that psychological resilience in pSS may be affected by recurrent parotitis, the levels of anxiety and depression, as well as hyposalivation with ocular dryness.

Psychological Well-Being and Quality of Life in Laryngeal Cancer Patients across Tumor.

Background/Objectives: Laryngeal cancer significantly impacts patients' psychological well-being and quality of life (QoL). This study aims to evaluate the psychological impact and QoL in patients with laryngeal cancer, focusing on differences based on tumor stage and treatment. Methods: This longitudinal study included 75 patients diagnosed with laryngeal cancer. Participants were assessed at diagnosis and 3 months post-treatment using validated tools such as the Hospital Anxiety and Depression Scale (HADS) and the EORTC QLQ-H&N35 questionnaire. This study analyzed the impact of tumor stage, treatment type, and demographic factors on psychological well-being and QoL. Results: Patients with early-stage tumors (Stage I) reported significantly better psychological well-being and QoL compared to those with more advanced tumors (Stages III and IV) both before and after treatment. The non-significant p-values in advanced stages suggest a uniformity of severe distress and poor QoL among these patients. Treatment led to significant reductions in anxiety and depression in early-stage patients, while those with advanced-stage disease showed less improvement. Conclusions: The findings highlight the critical need for early psychological intervention, particularly in advanced-stage laryngeal cancer patients who continue to experience substantial psychological distress and poor QoL despite treatment. Integrating comprehensive psychological support into standard care is essential to improve overall outcomes for these patients.