Hospital Anxiety And Depression Scale Research Articles

Prevalence of Anxiety, Depression, and Body Dysmorphic Disorders Among Dermatology Outpatients With Acne Vulgaris at a Public Hospital in Saudi Arabia.

Acne vulgaris is a chronic inflammatory skin condition that primarily affects the face, affecting a person's physical appearance. Anxiety, depression, and body dysmorphic disorder (BDD) are the three primary psychological conditions seen in dermatological patients. This study aimed to assess how prevalent anxiety, depression, and BDD in acne patients and the negative effect of acne on quality of life and self-esteem in dermatology patients. This cross-sectional study was done at the dermatology clinic in East Jeddah Hospital, Jeddah, Saudi Arabia. Data was collected using two pre-designed questionnaires. Part 1 contained demographic information and part 2 included four sets of questionnaires including the dermatology life quality index (DLQI), Rosenberg Self-Esteem Scale (RSES), Hospital Anxiety and Depression Scale (HADS), and Body Dysmorphic Disorder Questionnaire (BDDQ). Post-acne hyperpigmentation index (PAHPI), globalscale for acne scar severity (SCAR-S), and LEEDS were used by the dermatologist to assess the patients' acne severity, post-acne scars, and pigmentation conditions. Data were analyzed using the IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States). The majority of the participants were females (76%), Saudi Arabians (95%), students (58%), single (82%), and attended university (66%). The mean acne duration was 5.75 ± 4.58 years and 44% of the participants used social media for more than five hours per day. The participants scored high on the RSES (27.54 ± 3.05), indicating normal self-esteem. The HADS-A score was 11.14 ± 2.74, whereas the HADS-D score was 11.46 ± 1.78, indicating anxiety and depression symptoms. Their mean SCAR-S score is 4.38 ± 2.89. DLQI scores (6.04 ± 6.05) indicate that acne had a moderate effect on patients' quality of life. The percentage of positive BDD patients is significantly higher than those with negative BDD (p = 0.022). Furthermore, a significant association between PAHPI total score and SCAR-S (r = 0.48, p ≤ 0.001) and HADS-D (r = 0.39, p = 0.005) total scores. The study focuses on how acne vulgaris affects patients' quality of life. The findings suggest that acne-related quality of life is positively associated with anxiety and depressive symptoms. This study provides clinicians with practical advice for implementing a more thorough management strategy for acne vulgaris.

The relationship between psychological well-being with levels of anxiety, COVID-19 fear and depression in individuals hospitalized with COVID-19

Introduction and aim. The COVID-19 pandemic negatively affected both the physical and mental health of societies. The present study was conducted to determine the relationship between psychological well-being with levels of anxiety, COVID-19 fear, and depression in individuals hospitalized with COVID-19. Material and methods. This descriptive correlative study was conducted with 685 individuals diagnosed with COVID-19 treated in the clinics of a pandemic hospital. The data of the study were collected with the information form, psychological well-being scale (PWBS), COVID-19 fear scale (FCV-19S), and hospital anxiety and depression scale (HADS). Results. The mean PWBS score of the participants was 37.21±14.3, the FCV-19S score was 20.10±10.41, the HADS-anxiety score was 9.07±7.29, and the depression score was 10.74±7.35. The PWBS scores with FCV-19S scores of the participants, HADS-anxiety, and HADS-depression scores were found to be negatively correlated (p<0.001). Conclusion. In conclusion, as the anxiety, fear, and depression levels experienced by individuals receiving inpatient treatment in a pandemic hospital due to COVID-19 increase, their psychological well-being levels decrease at a statistically significant level. It may be recommended to intervene in the anxiety, fear, and depressive symptoms of individuals receiving inpatient treatment due to a diagnosis of COVID-19 to increase their psychological well-being.

Faktor-faktor yang Berhubungan dengan Kualitas Tidur Pasien dengan Lupus Eritematosus Sistemik

Introduction. Sleep disturbances are often found among Systemic Lupus Erythematosus (SLE) patients. Poor sleep may cause low quality of life. Study about sleep quality among SLE patients and related factors in Indonesia is scarce. This study aimed to know factors related to poor sleep quality among SLE patients. Methods. This cross-sectional study was conducted among SLE patients at Cipto Mangunkusumo Hospital Jakarta Indonesia. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), with global PSQI score >5 indicates poor sleep quality. Factors evaluated were symptoms of depression and anxiety by Hospital Anxiety Depression Scale (HADS), pain by Visual Analogue Scale (VAS), Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), autonomic dysfunction by Low Frequency/High Frequency (LF/HF) ratio from Heart Rate Variability (HRV), and high sensitivity C-Reactive Protein (hs-CRP) level. Bivariate analysis was done by Chi Square or Fisher’s test. Multivariate analysis was done by logistic regression, p value <0.05 was considered statistically significant. Results. Total of 166 SLE patients were included. Mean age was 32.7 years old with the majority in age group of 21-30 years old and female. Poor sleep quality in SLE patients was found in 82.5% of subjects. Symptoms of depression were significantly associated with poor sleep quality in SLE patients, especially sleep efficiency. Anxiety was associated with subjective month- and week-long sleep quality, sleep disturbances, and sleep medication usage. Musculoskeletal component of the SLEDAI-2K was associated with month- and week-long sleep quality, sleep latency, and daytime dysfunction. Hematologic involvement was associated with daytime dysfunction, whereas mucocutaneous involvement was associated with sleep disturbances. Conclusions. Symptoms of depression were significantly associated with poor sleep quality in SLE patients, especially sleep efficiency. Anxiety was associated with subjective month- and week-long sleep quality, sleep disturbances, and sleep medication usage.

Association between Chronic Pain and Sarcopenia in Greek Community-Dwelling Older Adults: A Cross-Sectional Study.

(1) Background: Sarcopenia and chronic pain are prevalent syndromes among older adults that negatively affect their quality of life. The present study aimed to investigate the relationship between chronic pain and sarcopenia among Greek community-dwelling older adults. (2) Methods: Older adults >60 years of age were enrolled in this descriptive, cross-sectional study. Sarcopenia status was assessed according to the EWGSOP2 2019 algorithm. This assessment included the evaluation of muscle strength, body composition and gait speed. Pain location and pain characteristics were assessed using a self-reported questionnaire. Pain severity was assessed via the visual analog scale. The participants were also asked to fill out the SARC-F, the Hospital Anxiety and Depression Scale (HADS) and the Falls Efficacy Scale-International (FES-I) questionnaire. (3) Results: This study included 314 participants with a mean age of 71.3 ± 7.4 years. The prevalence of sarcopenia was 19.4 (n = 61), and 44.26% of the sarcopenic participants recorded chronic pain. Chronic pain was associated with sarcopenia, comorbidities, the number of drugs and HADS. (4) Conclusions: The results demonstrated a high percentage of chronic pain in the sarcopenic population. The results also highlight the importance of the detection of chronic pain in older patients with sarcopenia in order to develop effective preventive and therapeutic strategies.

Caregiver strain among relatives of out-of-hospital cardiac arrest survivors; the DANCAS relative survey

BackgroundKnowledge about caregiver strain among relatives of out-of-hospital cardiac arrest (OHCA) survivors is limited. Thus, the objectives were to i) describe differences in self-reported mental well-being, mental health, and caregiver strain at different time points (1–5 years) post-OHCA and ii) investigate characteristics associated with caregiver strain. MethodsA national cross-sectional survey (DANCAS) from October 2020 to March 2021 with OHCA survivors and their closest relatives. The relative survey included the WHO-5 Well-being Index (WHO-5), the Hospital Anxiety and Depression Scale (HADS) and the Modified Caregiver Strain Index (M−CSI). Differences in scores between time groups were explored using descriptive statistics. Associations between characteristics and caregiver strain were investigated with multivariable logistic regression models, presented as odds ratios (OR) with 95% confidence intervals (CI), adjusted for gender, age, education status, relative affiliation, and time after OHCA. ResultsOf 561 relatives, 24% (n = 137) experienced caregiver strain, with no significant differences in the relatives' mental well-being, mental health, or caregiver strain with time since OHCA. In the adjusted analyses, older age (OR 0.98 95% CI 0.96;0.99) and several self-reported outcomes, including reduced mental well-being (WHO-5 OR 7.27 95% CI 4.86;11.52), symptoms of anxiety (HADS-A OR 6.01 95% CI 3.89;9.29) and depression (HADS-D OR 15.03 95% CI 7.33;30.80) were significantly associated with worse caregiver strain. ConclusionNearly one-quarter of relatives of OHCA survivors experience caregiver strain, with this proportion remaining unchanged with time. Several outcomes were associated with caregiver strain, emphasising the need to identify relatives at greater risk of burden following OHCA.

Reducing the burden of care: Effect of art and dance therapy on Parkinson’s disease patients’ caregivers

While dance movement therapy (DMT) and art therapy (AT) have been found to improve Parkinson’s disease (PD) patients’ motor and non-motor symptoms, there is currently no research that addresses the effects of these therapies on PD caregivers. Therefore, this study aims to analyze the effect of art and dance therapy on PD caregivers. Twenty-seven PD patients and ten caregivers underwent either group AT, group DMT or co-group therapy (both group AT and group DMT combined in one session). In addition, all attended 10–12 sessions of group therapy. Nine patients also attended individual AT and DMT for at least 10 sessions. Patients completed the Hospital Anxiety and Depression Scale (HADS), Parkinson’s Disease Questionnaire-8 (PDQ8) and Parkinson’s Disease Sleep Scale-2 (PDSS-2) pre- and post-therapy sessions. HADS and Zarit Burden Interview scores were recorded for their caregivers. Patients’ anxiety, PDSS and PDQ8 were not significantly different post-intervention, but depression scores significantly improved in caregivers post-intervention. Additionally, depression in patients who attended the sessions with their caregivers improved significantly compared to those who attended alone. Thus, this study shows that art and dance therapy can improve depression scores amongst PD caregivers and PD patients who attend sessions with their caregivers.

Do the Gender and the Number of Comorbidities and the Use of Tertiary Prevention Play a Role in the Severity of Anxiety and Depression in Patients with Coronary Artery Disease? A POLASPIRE II Study.

Background/Objectives: The need to conduct research on anxiety and depression in patients with coronary artery disease in connection with factors such as gender or implemented tertiary prevention is very important for drawing practical conclusions and, consequently, implementing new recommendations and procedures. The aim of the study was to attempt to answer the question whether gender and the number of comorbidities, as well as the application of tertiary prevention principles, play a role in the severity of anxiety and depression in the studied group of patients with coronary artery disease. Material: The study involved 765 patients from 11 Polish cardiology centers. The presented material is part of the multicenter POLASPIRE II study. Methods: All patients completed The Hospital Anxiety and Depression Scale (HADS) questionnaire, and a medical interview was conducted with them. Conclusions: Although the intensity of anxiety and depression in the studied group of patients was low, gender differentiated them, which, however, did not influence undertaking tertiary prevention activities. In the study group of patients, the number of comorbidities and cardiac incidents/procedures after the event qualifying for the study, as well as preventive actions undertaken, were not associated with the severity of anxiety and depression. In the studied group of patients with coronary heart disease, there was still a large group of people who did not take preventive measures. Therefore, there is a need for systematic education regarding the benefits of implementing them to prevent the progression of the disease and premature death.

A novel temperature‐controlled device with standardized manipulation improves chronic back pain mediated by modulating deep muscle thickness: A multicenter randomized controlled trial

AbstractBackgroundChronic back pain affected 619 million people globally in 2020 which accounts for a heavy disease burden causing tremendous productivity losses. Current therapies including ibuprofen, duloxetine, and opioids might cause side effects and even severe drug use disorders. Therefore, a non‐pharmacologic therapy with better or equivalent efficacy and fewer side effects is needed.MethodsWe did a multi‐center, single‐blinded, randomized, positive drug controlled, clinical trial. Patients with chronic back pain in moderate severity were randomized into receiving hot stone massage or flurbiprofen plaster group. Both interventions were 2 weeks with a follow‐up of 4 weeks. The primary outcome was the change in the score of the Global Pain Scale (GPS) from baseline to week 2. Secondary outcomes included Numerical Rating Scale (NRS), Chronic Pain Acceptance Questionnaire (CPAQ), Pain Self‐Efficacy Questionnaire (PSEQ), Hospital Anxiety and Depression Scale (HADS), and Short Form‐36 (SF36) from baseline to week 2 and week 6. Exploratory outcome assessment included the muscle thickness measured by ultrasound. Any adverse event was monitored throughout the study period.ResultsA total of 120 patients were enrolled in this trial. At 2 weeks GPS decreased significantly in the hot stone massage group compared to the flurbiprofen group (difference between groups = ‐8.1 points, 95% confidence interval [CI] ‐15.8 to ‐0.3, p = 0.047). Moreover, hot stone massage also showed more improvement at 2 weeks compared to flurbiprofen, including NRS (‐0.5 points, 95% CI ‐1.0 to ‐0.1, p = 0.029), PSEQ (5.4 points, 95% CI 0.5 to 10.2, p = 0.030), and mental component of Short Form‐36 (SF‐36) (1.7 points, 95% CI 0.4 to 2.9, p = 0.010), but not in CPAQ (p = 0.131), HADS (p = 0.303 for depression, p = 0.399 for anxiety), or SF‐36 (p = 0.129 for physical component, p = 0.246 for social component, p = 0.076 for fatigue component). A total of two participants in the hot stone massage group reported mild pain on skin surface when receiving the procedure at the first intervention session.

Effects of early palliative care integration on patients with newly diagnosed multiple myeloma.

While numerous studies underscore the benefits of early palliative care (EPC) for patients with solid tumors, its effects on patients with multiple myeloma (MM) are not as widely known. This study aims to determine the effects of EPC integration on patients with newly diagnosed symptomatic MM and the feasibility of this approach. This prospective cohort study enrolled patients within eight weeks of diagnosis. Participants met with a palliative care team monthly for 12months. Functional Assessment of Cancer Therapy-General (FACT-G) plus Multiple Myeloma Subscale (FACT-MM), and Hospital Anxiety and Depression Scale (HADS) were administered upon enrollment and every three months. Proportion of completed visits and assessments determined the feasibility of EPC. Of the twenty participants enrolled from January 2020 to November 2022, median age was 65 (range 40, 77), 15 (75%) were female, 15 (75%) were white, 65% completed assessments at six months, and 60% at 12months. The following measures significantly improved at 12months versus baseline: FACT-G scoresincreased by 15.1 points (adjusted 95% CI: 2.2-28.1, adjusted p = 0.02); Functional Well-Being scores increased by 6.0 points (adjusted 95% CI: 1.1-10.9, adjusted p = 0.01); and Pain Subscale scores increased by 3.4 points (adjusted 95% CI: 0.5-6.4, adjusted p = 0.02). Depression and anxiety scores did not significantly change over time. Functional well-being, pain experience and overall QOL improved in a cohort of patients with newly diagnosed MM after 12months of EPC involvement. Although monthly visits seemed feasible, the findings suggest thatfurther researchis needed to explore the optimal timing of palliative care interventionsin the MM trajectory. ClinicalTrials.gov ID NCT04248244 (Registration Date: January 30, 2020).

Trait emotional intelligence and its impact on quality of life, anxiety, and depression in patients with gastric cancer

Aims/Background Trait emotional intelligence is associated with anxiety and depression symptoms and quality of life in cancer patients. However, studies on the relationship of trait emotional intelligence with anxiety, depression, and quality of life in gastric cancer patients are limited. This study investigates the relationship of trait emotional intelligence with depression and quality of life in gastric cancer patients to provide a theoretical basis for clinical management. Methods A total of 270 patients with gastric cancer treated in our hospital from July 2020 to July 2023 were selected, of which 31 patients with missing questionnaire entries and missed visits were screened out, resulting in the enrolment of 239 gastric cancer patients in this study. In this survey, self-administered general information questionnaires, namely Trait Emotional Intelligence Short Form (TEIQue-SF), European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), and Hospital Anxiety and Depression Scale (HADS) were used. Results TEIQue-SF total scores were positively correlated with QLQ-C30 scores (p < ..001) and negatively correlated with HADS-A and HADS-D scores (p < ..001). TEIQue-SF total score was a superior positive predictor of the QLQ-C30 score (β = 0.412, p < ..001) and a superior negative predictor of the HADS score (β = –0.740, p < ..001). TEIQue-SF total score (β = 0.141, p = 0.006) and HADS score (β = –0.665, p < ..001) were good predictors of QLQ-C30 score. The direct effect of TEIQue-SF total score on QLQ-C30 score was 0.141, while HADS score between TEIQue-SF total score and QLQ-C30 score had a mediated effect value of 0.492. Conclusion Trait emotional intelligence not only directly affects the quality of life, but also indirectly affects the quality of life through anxiety and depression. Clinicians should pay attention to the anxiety, depression, and emotional intelligence of patients with gastric cancer to help them improve their quality of life.

Metacognitive beliefs, mood symptoms, and fatigue four years after stroke: An explorative study.

This cross-sectional study investigated the relationship between metacognition and mood symptoms four years post-stroke and examined fatigue as a potential moderator for this relationship. A number of 143 participants completed a survey that included the Hospital Anxiety and Depression Scale (HADS), the Metacognition Questionnaire-30 (MCQ-30), the Fatigue Severity Scale (FSS), and the modified Rankin Scale (mRS) (functional status) four years after stroke. Multiple regression analyses adjusting for demographic and stroke-specific covariates were performed with anxiety and depression as dependent variables and fatigue as a moderator. The proportions of participants satisfying the caseness criteria for anxiety and depression were 20% and 19%, respectively, and 35% reported severe fatigue. Analysed separately, all MCQ-30 subscales contributed significantly to anxiety, whereas only three MCQ-30 subscales contributed significantly to depression. In the adjusted analyses, the MCQ-30 subscales 'positive beliefs' (p < 0.05) and 'uncontrollability and danger' (p < 0.001), as well as fatigue (p < 0.001) and functional status at four years (p < 0.05) were significantly associated with anxiety symptoms. Similarly, the MCQ-30 subscales 'cognitive confidence' (p < 0.05) and 'self-consciousness' (p < 0.05), as well as fatigue (p < 0.001), stroke severity at baseline (p < 0.01), and functional status at four years (p < 0.01) were significantly associated with depression symptoms. Fatigue did not significantly moderate the relationship between any MCQ-30 subscale and HADS scores. Maladaptive metacognitions were associated with the mood symptoms of anxiety and depression, independent of fatigue, even after controlling for demographic and stroke-specific factors. Future studies should implement longitudinal designs to determine whether metacognitions precede anxiety or depression after a stroke, and more strongly indicate the potential of metacognitive therapy for improving the mental health of individuals after a stroke.

Study protocol for the MIND-PD study: a randomized controlled trial to investigate clinical and biological effects of mindfulness-based cognitive therapy in people with Parkinson’s disease

BackgroundPeople with Parkinson’s disease (PD) are very sensitive to the effects of stress. The prevalence of stress-related neuropsychiatric symptoms is high, and acute stress worsens motor symptoms. Animal studies suggest that chronic stress may accelerate disease progression, but evidence for this in humans is lacking. Mindfulness-based interventions (MBIs) train participants to focus on the present moment, on purpose and without judgement. Previous studies suggest that MBIs may alleviate stress and reduce depression and anxiety in PD. We aim to demonstrate the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) as a non-pharmacologic treatment strategy for neuropsychiatric (and motor) symptoms in PD, and to identify the mechanisms underlying stress and stress reduction in PD.MethodsIn a prospective randomized controlled trial (RCT), we investigate whether 8 weeks of MBCT, as compared to care as usual, can reduce symptoms of anxiety and depression in people with PD. We aim to include 124 PD patients, who experience mild-moderate symptoms of anxiety and depression, are eligible for magnetic resonance imaging (MRI) and naïve to mindfulness, and who have a disease duration ≤ 10 years. Every participant is followed for 12 months. Clinical and biochemical assessments take place at baseline (T0), after 2 months (T1), and after 12 months (T2); MRI assessments take place at T0 and T2. Our primary outcome is the total score on the Hospital Anxiety and Depression Scale (HADS) at T1, while correcting for the HADS score at T0, age, and gender. Beyond testing the effects of MBCT on symptoms of anxiety and depression in PD, we explore whether MBCT: (1) has an effect on motor symptom severity, (2) influences cerebral and biochemical markers of stress, and (3) leads to a change in biomarkers of PD progression.DiscussionMIND-PD is one of the first RCTs with a 1-year follow-up to investigate the effects of MBCT on symptoms of anxiety and depression in PD, and to explore possible mechanisms underlying stress and stress reduction in PD. Insight into these mechanisms can pave the way to new treatment methods in the future.Trial registrationClinicalTrials.gov, NCT05779137. Registered on 12 January 2023.

Sexual dysfunction and self-perceived sexual health in patients with rheumatoid arthritis and systemic lupus erythematosus: results from a cross-sectional survey.

Sexual dysfunction (SD) has been associated with worse quality of life and higher disease activity in patients with rheumatic diseases, yet it is still not regularly addressed during routine rheumatologic evaluations. This study aimed to determine the prevalence of sexual dysfunction in patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) and evaluate their perception of their sexual health. We performed a retrospective study in an outpatient rheumatology clinic to evaluate patients over 18 years old with a diagnosis of RA or SLE through the Spanish version of the Arizona Sexual Experiences Scale (ASEX) and the Sexual Health Perception Survey (SHEPS), a questionnaire of 6 items designed in our clinic. Additionally, we applied the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F version 4) and the Hospital Anxiety and Depression Scale (HADS). A total of 567 patients were evaluated with SHEPS, most of whom were women with a median age of 50 years (IQR: 34) and a median disease duration of 5 years (IQR: 9). Through the ASEX, we found that 67% of the patients with RA and 60% of the patients with SLE experienced SD. Patients reported the level of sex drive, arousal, and the ability to achieve orgasms as the areas with the most difficulties. Most patients did not know their disease could affect their sexuality and had never addressed these issues with their rheumatologists, but almost all of them were willing to. Our findings highlight the importance of addressing sexual health issues regularly during rheumatologic evaluations.

Features of the use of art therapy in working with members of military families

The article is devoted to the analysis of the peculiarities of the use of art therapy in working with members of military families. The concepts of art therapy, social adaptation, and coping resources are characterized. The concept of grief and its course during war, in particular when a loved one is lost in war, is defined. The results of an empirical study on the severity of anxiety, depression and post-traumatic growth of women who lost relatives in the war are presented. The art therapy technique "Painting grief" is characterized. The purpose of this article is to determine the possibilities of using art therapy in working with military family members. The tasks of the article are to define the concept of grief and its course during war, in particular when a loved one is lost in war; analysis of the results of an empirical study on the severity of anxiety, depression and post-traumatic growth of women who lost relatives in the war, an outline of the possibilities of implementing the art therapy technique "Painting grief". To achieve the goals of the study, we used the following methods: Hospital anxiety and depression scale (HADS) Post-traumatic growth questionnaire (PGI). The hospital scale of anxiety and depression is designed to assess the severity of depression and anxiety in the conditions of general medical practice, contains 14 items, each of which corresponds to 4 options of answers that reflect the degree of increase in the corresponding symptomatology: normal, borderline state, moderately expressed anxiety/depression, severe form of anxiety /depression. Questionnaire of post-traumatic growth (R. Tadeshi and L. Calhoun) contains 21 statements with six possible answer options that form five scales: attitude to others, new opportunities, personal strength, spiritual changes, increased value life, as well as the general index of post-traumatic growth. According to the HADS method, subclinically expressed depression, the so-called borderline state, was detected, however, in the case of the death of a loved one in the war, relatives feel moderately expressed anxiety, while after death from diseases or simply death in civilian life, relatives note the absence of reliably expressed symptoms. Personal growth means the feeling that after a loss a person has become more merciful, tolerant towards himself and others, learned to forgive himself and the people around him, and look optimistically at the future. Although the loss of a loved one is a natural life event experienced by all people, it is also one of the most difficult experiences in a person's life. For many people, the loss of a loved one is accompanied by an intense emotional and devastating period. Experiencing the death of a loved one causes great stress both because of the loss and because of the encounter with mortality. Numerous stressors also occur when a bereaved person attends various events and services that are not normally included in the routine of daily life, including memorial services in a church. Many bereaved people find a path that leads to the restoration of a relatively normal life. However, some people do not cope effectively with loss. They experience grief very emotionally, often denying the fact of loss, trying to avoid reminders of death and helplessly focusing on the nagging waves of painful emotions. One of the effective methods of dealing with grief is art therapy.

The impact of cutaneous neurofibromas on quality of life and mental health in neurofibromatosis type 1.

The skin manifestations of neurofibromatosis 1 significantly reduce health-related quality-of-life. However, data on the utility of existing surveys in capturing neurofibromatosis 1 skin treatment outcomes are lacking. This quantitative study examined the relationship between clinician-rated severity and visibility and patient-rated itch and quality-of-life (QoL) to (1) establish baseline levels of skin- and condition-specific-related QoL, itch, depression and anxiety; (2) identify patient concerns to inform the development and evaluation of skin interventions; and (3) compare the sensitivity of different QoL measures. Validated scales included Skindex-29, Dermatology Life Quality Index (DLQI), Neurofibromatosis 1-adult quality-of-life (NF1-AdQOL) questionnaire, and the Hospital Anxiety and Depression Scale (HADS). We recruited 100 participants (response rate: 95%). Of these, 42% reported itch and 23% had probable clinical anxiety. Our cohort had higher levels of anxiety and total HADS scores compared to a control population. Using multivariate regression analysis, increasing visibility significantly predicted poorer QoL using the Skindex-29, NF1-AdQOL, and DLQI (p < 0.05); and itch significantly predicted worse QoL in Skindex-29 and NF1-AdQOL (p < 0.05). The highest mean scoring questions in Skindex-29 and NF1-AdQOL concerned worry about worsening skin disease and embarrassment. The highest mean scoring questions in DLQI were regarding itch, pain, and embarrassment. Items asking specifically about cutaneous neurofibromas (cNF) scored higher than comparable skin-specific questions (t-test p value <0.05). In summary, this study provides insights into the factors contributing to impaired QoL, anxiety, and mood in NF1 patients with cutaneous neurofibromas. Key factors identified for use in cNF measures include visibility, itch, anxiety, embarrassment, fears of worsening skin disease, and cNF-specific questions.

Analysis of physical activity in psoriatic arthritis: relationship with clinical and analytical parameters and comorbidity-description of the sedentary patient.

This study aimed to relate physical activity and a sedentary lifestyle to clinical, biological, functional, and comorbid parameters in a cohort of patients with psoriatic arthritis (PsA). A cross-sectional study was conducted with 232 PsA patients. Physical activity and sedentary lifestyle were obtained using the International Physical Activity Questionnaire (IPAQ) questionnaire. The demographic, clinical, and biological variables measured were age, time since PsA diagnosis, smoking, type of treatment used, clinical form, presence of enthesitis, dactylitis (present or past), fatigue, tumor necrosis factor (TNF)-alpha, and interleukin 6 (IL-6). Activity and functionality were measured using the Disease Activity Index for Psoriatic Arthritis (DAPSA) and Health Assessment Questionnaire (HAQ) in peripheral forms, while the Ankylosing Spondylitis Disease Activity Score (ASDAS-PCR) and Bath Ankylosing Spondylitis Functional Index (BASFI) were measured in axial forms. Disease impact was assessed using the Psoriatic Arthritis Impact of Disease (PsAID) questionnaire. Alongside comorbidities, obesity, anxiety, depression [Hospital Anxiety and Depression Scale (HADS)], and sleep quality [Insomnia Severity Index (ISI)] were assessed. The mean age was 54.6 (SD: 11.4) years, with 54.3% being male. A total of 25.6% of patients were sedentary. Physical activity and sedentary lifestyle were inversely correlated with fatigue, activity, functionality, and disease impact. Within comorbidities, they correlated with anxiety, depression, and insomnia. In addition, physical activity was inversely correlated with obesity. In linear regression analysis, physical activity was found to be related to body mass index (BMI) with a ß coefficient of -0.1 (p < 0.04; 95%CI: -194.1--4.5), and an R2 value of 0.11. In logistic regression analysis, a sedentary lifestyle was found to be related to pain, with an odds ratio (OR) of 1.5 (p < 0.001; 95%CI:1.1-1.8) and an R2 Nagelkerke value of 0.36. A quarter of the patients were sedentary. Lack of physical activity correlated with worse parameters of clinical activity, functionality, disease impact, and the presence of comorbidities.

Intriguing connection between diminished ovarian reserve and childhood traumatic experiences, a prospective case-control study

IntroductionDiminished ovarian reserve (DOR) presents a complex challenge in the field of infertility, with factors like age and genetics traditionally under scrutiny. However, the potential influence of adverse childhood experiences on ovarian reserve remains a relatively unexplored area. This research aims to contribute novel insights to the understanding of diminished ovarian reserve etiology, shedding light on previously unexplored risk factors and their potential implications. DesignThis case-control study was conducted at an Assisted Reproductive Technology (ART) Center of a university hospital. Infertile patients admitted to the ART center were enrolled in the study. The case group consisted of 102 infertile women diagnosed with diminished ovarian reserve, and the control group consisted of 103 healthy women with male factor infertility. An interview lasting approximately 30 min was held in a separate room with those who volunteered to participate in the study. Due to the sensitivity of the research subject, the data was collected anonymously. The Childhood Trauma Questionnaire was used to measure adverse childhood experiences, and the Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression in the study. The results were compared between the case and the control groups. ResultsOverall, the total score of the Childhood Trauma Questionnaire and all subscale scores were higher in the case group (38.28 ± 9.86) than in the control group (35.10 ± 9.52). According to HADS, the total score was 15.92 ± 7.98 in the case group and 14.22 ± 6.87 in the control group. ConclusionsOur pioneering study is designed to investigate a previously unexplored risk factor in low ovarian reserve. Considering our data and other studies in the literature examining childhood traumas as a risk, it makes us think that the issue is worth examining.

Patient perceptions underlying ctDNA molecular surveillance for HPV(+) oropharyngeal squamous cell carcinoma

ObjectiveCirculating tumor DNA assays have robust potential as molecular surveillance tools. They may also exacerbate patient distress without improving outcomes. We investigate patient acceptability of a validated ctHPVDNA assay (NavDx) during cancer surveillance for HPV(+) oropharyngeal cancer (OPC). MethodsConsented HPV(+) OPC participants completed the NCCN Distress Thermometer, the Hospital Anxiety Depression Scale (HADS), and the Functional Assessment of Cancer Therapy-General (FACT-G) scale both (1) before NavDx blood draw, and (2) after results were provided. Patients then completed a series of focused questions related to their perceptions of the assay. ResultsOverall, 55 patients completed the study, with 98.2 % showing no recurrence. For the NCCN Distress Thermometer, median patient distress decreased (2.0 (IQR 1–5) vs. 1.0 (IQR 0–3)) (p < 0.001) in association with NavDx. Using scores ≥ 4 as a cutoff point to define clinically elevated distress, scores also improved (36.4 % vs. 18.2 %, p = 0.031). For HADS, anxiety significantly improved (5.0 (IQR 2.0–7.0) vs. 3.0 (IQR 1.0–6.5)) (p = 0.037), but not depression (3.0 (IQR 1.0–7.0) vs. 3.0 (IQR 1.0–6.5)) (p = 0.870). FACT-G scores showed no substantial differences. On survey questionnaires, 95.5 % of patients believed the test to be helpful, and 100 % felt “somewhat” or “extremely” confident in the assay as a monitoring tool. While 59.1 % felt that it reduced anxiety, 88.4 % concordantly felt that it did not introduce anxiety. ConclusionctHPVDNA as a molecular surveillance tool reduced distress levels in HPV(+) OPC patients, with notably high patient confidence in the approach. Further investigation is warranted to judiciously incorporate this emerging modality in surveillance guidelines.

Mood, Cognitive Function, and Plasma Kynurenine Metabolites Responses Following Severe Changes in Physical Activity.

To monitor changes in mood, cognitive function, brain electrical activity, and circulating kynurenine pathway metabolites in response to a 3-wk severe physical activity (PA) restriction, followed by 3 wk of resumed activity adding resistance and high-intensity interval exercise training. Twenty healthy participants (14 males, 6 females; 25.4 ± 5.2 yr) underwent 3 wk of limited PA using forearm crutches with one leg suspended (INACT) and then 3 wk of resumed activity plus supervised resistance and high-intensity interval training sessions (ACT, three to six sessions per week). At baseline, after INACT, and then after ACT, venous blood was sampled for analysis of major kynurenine pathway metabolites, a short version of the International Physical Activity Questionnaire, Hospital Anxiety and Depression Scale (HADS) and Profile of Mood States (POMS) questionnaires were completed, and cognitive tests with electroencephalography were performed. During INACT, the depression score on the HADS scale tended to increase (3.5 to 6.8; P = 0.065), whereas it was reduced with ACT compared with after INACT (2.8; P = 0.022). On the POMS scale, depression, fatigue, and confusion increased within INACT ( P < 0.05). Notably, subjects exhibited considerable variability, and those experiencing depression symptoms recorded by the HADS scale ( n = 4) displayed distinct mood disturbances on POMS. All HADS and POMS scores were fully restored to baseline with ACT. Neither INACT nor ACT induced significant changes in cognition, brain electrical activity, or kynurenine pathway metabolites ( P > 0.05). Although young healthy individuals with 3 wk of severely restricted PA do not undergo changes in circulating kynurenine pathway metabolites, cognitive performance, and brain electrical activity, their mood response is quite variable, and depression develops in some. Three weeks of resuming mobility plus exercise training reversed the mood profile.

First Trimester Abortion and Psychiatric Morbidity.

Early pregnancy loss is a traumatic event following which clients may experience psychological morbidities. Mental illness is associated with multiple obstetric and social factors surrounding the period of pregnancy loss. The aim of this study was to find the prevalence of depression and anxiety before and after undergoing spontaneous or induced first trimester abortion and to analyze demographic and obstetric factors associated with it. This is an observational study conducted as Kathmandu Medical College (KMC) for a duration of one year from September 2022 to August 2023. All clients with abortion were screened for psychiatric morbidity using the The Hospital Anxiety and Depression Scale (HADS). Each client was assessed at first hospital visit and then at two weeks and two months following abortion. Level of anxiety and depression was analyzed in relation to socio-demographic factors and the type of abortion. 171 clients with pregnancy loss were enrolled. Pre-abortion, severe anxiety was present in 6(13%) clients with spontaneous abortion. Pre-abortion, mild to severe anxiety was present in 31 (67.3%) clients and at two weeks and two months in 11 (23.9%) and 11 (23.9%) clients respectively. In clients undergoing induced abortion, varying levels of anxiety was present in 54(43.2%) pre-abortion, and 48(38.4%) and 54(43.2%) clients at two weeks and two months. Mild to moderate depression was seen in 21 (45.6%) among spontaneous abortion and 51 (40.8%) clients among induced abortion. Mean score on HADS decreased with time. Anxiety and depression were common following early pregnancy loss. Rate of anxiety seems to decrease with time in spontaneous abortion but in induced abortion it remains persistent. Rate of depression tends to decrease with time for both types of abortion.