Health Anxiety Research Articles

Analysis of the correlation between general postpartum well-being and depression in primiparas: A cross-sectional study.

To investigate the status quo and influencing factors of general postpartum well-being in primiparas, analyze its correlation with postpartum depression, and provide a theoretical foundation for enhancing the postpartum well-being of primiparas. From the start of November 2021 to the end of December 2021, the General Information Questionnaire, General Well-Being Scale, and the Edinburgh Postpartum Depression Scale were used to survey primiparas in a tertiary hospital, and the correlation between general well-being and postpartum depression was analyzed. We surveyed a total of 225 primiparas. The average score for general well-being in primiparas was 77.84 ± 6.83, and the total score for postpartum depression was 9.11 ± 2.51. Confinement location, planned pregnancy, pregnancy complications, neonatal sex, medical expenses, etc, had statistically significant effects on the general well-being scores (P < .05), whereas per capita monthly income, pregnancy complications, maternal and infant care skills, and medical expenses had statistically significant effects on postpartum depression scores (P < .05). Postpartum depression scores were negatively correlated with general well-being, health anxiety, energy, sad or happy mood, relaxation, and tension. There is a negative correlation between the general well-being of primiparas and postpartum depression, suggesting that in clinical care, the focus should be on primiparas with pregnancy complications, and psychological counseling should be provided in advance to prevent postpartum depression and the resulting decrease in well-being.

A Narrative Review of Psychobiotics: Probiotics That Influence the Gut-Brain Axis.

Mental health disorders and dementia have become a serious public health concern, with a heightened frequency of diagnoses observed in the wake of the global COVID-19 pandemic. Psychobiotics, a novel area of research at the intersection of microbiology and neuroscience, explore the potential of probiotics to influence the nervous system and mental health outcomes. This review explores the intricate mechanisms by which psychobiotics interact with the gut-brain axis, shedding light on their effects on mood, cognition, and the stress response. Through a comprehensive analysis of the current literature and recent advancements, we discuss the therapeutic potential of psychobiotics in various mental health disorders, including depression, anxiety, and neurodegenerative diseases like dementia. The findings from this research highlight the promising potential of psychobiotics as innovative interventions in mental health treatment. Further investigation into their mechanisms of action and clinical applications is warranted to fully realize their therapeutic benefits.

Social Isolation, Brain Food Cue Processing, Eating Behaviors, and Mental Health Symptoms

Perceived social isolation is associated with negative health outcomes, including increased risk for altered eating behaviors, obesity, and psychological symptoms. However, the underlying neural mechanisms of these pathways are unknown. To investigate the association of perceived social isolation with brain reactivity to food cues, altered eating behaviors, obesity, and mental health symptoms. This cross-sectional, single-center study recruited healthy, premenopausal female participants from the Los Angeles, California, community from September 7, 2021, through February 27, 2023. Participants underwent functional magnetic resonance imaging while performing a food cue viewing task. The main outcomes included brain reactivity to food cues, body composition, self-reported eating behaviors (food cravings, reward-based eating, food addiction, and maladaptive eating behaviors), and mental health symptoms (anxiety, depression, positive and negative affect, and psychological resilience). The study included 93 participants (mean [SD] age, 25.38 [7.07] years). Participants with higher perceived social isolation reported higher fat mass percentage, lower diet quality, increased maladaptive eating behaviors (cravings, reward-based eating, uncontrolled eating, and food addiction), and poor mental health (anxiety, depression, and psychological resilience). In whole-brain comparisons, the higher social isolation group showed altered brain reactivity to food cues in regions of the default mode, executive control, and visual attention networks. Isolation-related neural changes in response to sweet foods correlated with various altered eating behaviors and psychological symptoms. These altered brain responses mediated the connection between social isolation and maladaptive eating behaviors (β for indirect effect, 0.111; 95% CI, 0.013-0.210; P = .03), increased body fat composition (β, -0.141; 95% CI, -0.260 to -0.021; P = .02), and diminished positive affect (β, -0.089; 95% CI, -0.188 to 0.011; P = .09). These findings suggest that social isolation is associated with altered neural reactivity to food cues within specific brain regions responsible for processing internal appetite-related states and compromised executive control and attentional bias and motivation toward external food cues. These neural responses toward specific foods were associated with an increased risk for higher body fat composition, worsened maladaptive eating behaviors, and compromised mental health. These findings underscore the need for holistic mind-body-directed interventions that may mitigate the adverse health consequences of social isolation.

Relationship between Psychosocial Factors and Physical Activity among Undergraduate Students from a South African University.

Psychosocial factors such as mental health, motivation, and social support are key determinants of behavior that play a significant role in physical activity participation. Limited studies have investigated the relationship between psychosocial factors and physical activity among university students in Africa. The aim of this study was to determine the relationship between psychosocial factors and physical activity participation among undergraduate university students at a historically disadvantaged university (HDU) in South Africa. This was a cross-sectional study that used convenience sampling (n = 534, majority female, 53.6% with a mean age of 20.69). The study was conducted through an online, self-administered, and hard-copy, valid questionnaire in September 2022. Data on sociodemographic information were collected. Psychosocial factors were assessed using the Depression, Anxiety, and Stress-21 Scale for mental health, the Physical Activity and Leisure Motivation Scale for motivation, and the Perceived Social Support Scale for social support. Physical activity (calculated as MET-min/week) was assessed using the international physical activity questionnaire in short form. Results revealed that almost a third (29%) of undergraduate students were physically inactive, 31.1% were minimally active, and 39.9% were in the health-enhancing category. Physical activity was positively related to stress (r = 0.11, p < 0.05) and anxiety (r = 0.10, p < 0.05). Motivational factors were positively related to psychological condition and others' expectations (r = 0.10, p < 0.05), and depression and others' expectations (r = 0.11, p < 0.05). Results from this study highlighted that psychosocial factors were related to physical activity participation among undergraduate university students. Psychosocial factors should be considered a coping mechanism when implementing health-promoting strategies.

Integrated Hepatitis C–Opioid Use Disorder Care Through Facilitated Telemedicine

Facilitated telemedicine may promote hepatitis C virus elimination by mitigating geographic and temporal barriers. To compare sustained virologic responses for hepatitis C virus among persons with opioid use disorder treated through facilitated telemedicine integrated into opioid treatment programs compared with off-site hepatitis specialist referral. Prospective, cluster randomized clinical trial using a stepped wedge design. Twelve programs throughout New York State included hepatitis C-infected participants (n = 602) enrolled between March 1, 2017, and February 29, 2020. Data were analyzed from December 1, 2022, through September 1, 2023. Hepatitis C treatment with direct-acting antivirals through comanagement with a hepatitis specialist either through facilitated telemedicine integrated into opioid treatment programs (n = 290) or standard-of-care off-site referral (n = 312). The primary outcome was hepatitis C virus cure. Twelve programs began with off-site referral, and every 9 months, 4 randomly selected sites transitioned to facilitated telemedicine during 3 steps without participant crossover. Participants completed 2-year follow-up for reinfection assessment. Inclusion criteria required 6-month enrollment in opioid treatment and insurance coverage of hepatitis C medications. Generalized linear mixed-effects models were used to test for the intervention effect, adjusted for time, clustering, and effect modification in individual-based intention-to-treat analysis. Among 602 participants, 369 were male (61.3%); 296 (49.2%) were American Indian or Alaska Native, Asian, Black or African American, multiracial, or other (ie, no race category was selected, with race data collected according to the 5 standard National Institutes of Health categories); and 306 (50.8%) were White. The mean (SD) age of the enrolled participants in the telemedicine group was 47.1 (13.1) years; that of the referral group was 48.9 (12.8) years. In telemedicine, 268 of 290 participants (92.4%) initiated treatment compared with 126 of 312 participants (40.4%) in referral. Intention-to-treat cure percentages were 90.3% (262 of 290) in telemedicine and 39.4% (123 of 312) in referral, with an estimated logarithmic odds ratio of the study group effect of 2.9 (95% CI, 2.0-3.5; P < .001) with no effect modification. Observed cure percentages were 246 of 290 participants (84.8%) in telemedicine vs 106 of 312 participants (34.0%) in referral. Subgroup effects were not significant, including fibrosis stage, urban or rural participant residence location, or mental health (anxiety or depression) comorbid conditions. Illicit drug use decreased significantly (referral: 95% CI, 1.2-4.8; P = .001; telemedicine: 95% CI, 0.3-1.0; P < .001) among cured participants. Minimal reinfections (n = 13) occurred, with hepatitis C virus reinfection incidence of 2.5 per 100 person-years. Participants in both groups rated health care delivery satisfaction as high or very high. Opioid treatment program-integrated facilitated telemedicine resulted in significantly higher hepatitis C virus cure rates compared with off-site referral, with high participant satisfaction. Illicit drug use declined significantly among cured participants with minimal reinfections. ClinicalTrials.gov Identifier: NCT02933970.

The Relationship Between Cyberchondria and Health Anxiety in Pregnant Women

Pregnant women frequently use the internet to obtain health information about pregnancy. The increased anxiety about health during pregnancy can trigger the cyberchondria form of this behavior. This study aimed to investigate cyberchondria and health anxiety in pregnant women. The descriptive and cross-sectional study was conducted with 314 pregnant women who visited the obstetrics clinics of two hospitals in western Turkey between October and December 2019. The Cyberchondria Severity Scale (CSS-15) and the Short Health Anxiety Inventory (SHAI) were used for data collection. Data were evaluated with parametric tests and correlation analysis. The mean age of pregnant women participating in the study was 28.10 ± 5.19, and 72.6% were unemployed. The CSS-15 mean score was 39.87 ± 8.82, and SHAI was 15.81 ± 6.84. The nulliparous pregnant women, employed university graduates, used the internet almost every day and searched some topics related to pregnancy, birth, and breastfeeding and were found to have higher scores on CSS-15 (p < 0.05). A significant positive correlation was found between cyberchondria and health anxiety (r: 0.253, p < 0.001). This study showed that cyberchondria severity increases anxiety in pregnant women. Health professionals should also consider cyberchondria when assessing the anxiety of pregnant women.

Evaluating alexithymia as a mediator of the relationship between sensory processing sensitivity and health anxiety

Highly sensitive individuals demonstrate heightened responses to environmental stimuli than their peers, often presenting with anxious and depressive symptomatology akin to those in alexithymic individuals. Alexithymia, referred to as difficulty in describing or identifying emotions, is of particular interest to use as a mediating variable between sensitivity to sensory processing and health anxiety. The present study aims to explore the relationship between sensory processing sensitivity (SPS) and alexithymia, and their collective impact on health anxiety, a correlation which, to the best of our knowledge, has not been previously examined, despite the common preoccupation with health among those affected. Health anxiety, defined by the fear of suffering from a serious and/or chronic illness, or of misinterpreting somatic symptoms as signs of illness, is the focal point of this investigation. The study recruited 814 adults (79.7% women and 20.3% men), with a mean age of 30 years old (standard deviation = 12.5 years), ranging from 18 to 76 years. Participants anonymously answered a questionnaire consisting of the French versions of the Highly Sensitive Person Scale (HSPS-FR), the Toronto Alexithymia Scale-20, and the Health Anxiety Questionnaire (HAQ). Statistical analyses, including correlations, ANOVA, linear regressions, and mediation analysis, were performed using SPSS and the SPSS macro PROCESS. Results revealed significant positive correlations among the three constructs (P &lt; 0.001). Furthermore, both SPS and alexithymia were found to be predictive of health anxiety (P &lt; 0.001). In addition, an indirect partial mediation effect between SPS and health anxiety through alexithymia was observed. This study highlights the intertwined relationship between sensitivity and alexithymia, shedding light on their collective impact on anxiety, particularly health anxiety. Moreover, it facilitates the examination of this relationship within a large population and amidst the specific context of COVID-19. Practical perspectives concerning support for highly sensitive people are discussed, taking into account their potential specific needs.

Assessing dance movement therapy in Chinese undergraduates with depression and anxiety: An initial randomized controlled trial

Mental health problems, especially depression and anxiety, are becoming increasingly prominent among college students, which negatively affects academic achievement and physical and mental health. To address this issue, this study introduced dance movement therapy (DMT) to a group of Chinese university students - a group never addressed in DMT research. Addressing the gap, this randomized controlled trial evaluates DMT's effectiveness in reducing depressive and anxious symptoms in thirty-six students. Over a concise three-day program, participants engaged in 18 h of structured DMT, exploring twelve themes, while counterparts in the control group awaited treatment. Outcomes were promising:students undergoing DMT showed marked improvements in mental health measures immediately following therapy, and these benefits for intervention group were maintained after three months. Significantly, the treatment's positive effects were consistent across genders, showcasing DMT's broad potential. This initial investigation suggests DMT is a promising avenue for mental health management in Chinese undergraduates, calling for further trials with larger cohorts and longer observation to confirm and extend these findings.

COVID-19 Salgını Döneminde Anksiyete: Yaygınlığı, Etkileri ve Yatkınlık Faktörleri

Although infectious diseases have emerged in various periods of history, the outbreaks seen worldwide due to globalization have started to increase in recent years. Epidemics had significant effects on the psychological health of individuals. The most important effect of COVID-19 pandemic on individuals was anxiety. In the days when other pandemic diseases are at the door, the understanding of anxiety during the COVID-19 pandemic in individuals is a very important issue. In the COVID-19 outbreak, the general sample, university students, those diagnosed with COVID-19, and healthcare workers were the groups most affected by anxiety. In different countries, moderate anxiety symptoms in different waves of the epidemic ranged from 6.3% to 66.8% in the general sample, between 18.6% and 87.7% in university students, between 13.0-60.3% in people diagnosed with COVID-19, and between 13.0-51.6% in healthcare workers. In the follow-up studies, it was noted that the anxiety symptoms did not regress to the pre-pandemic level for a long time in these samples. According to the findings, anxiety associated with COVID-19 is associated with psychological health. As COVID-19-related anxiety increased, negative emotions, dysfunctional behaviors, sleep problems and depressive symptoms increased.The fact that anxiety is common, persistent and associated with other psychological symptoms during the epidemic made it necessary to understand the underlying factors of anxiety. Findings indicate that anxiety sensitivity, disgust susceptibility/sensitivity, intolerance to uncertainty, and health anxiety play a role in explaining anxiety symptoms associated with COVID-19. These susceptibility factors may contribute to the development of cognitive-behavioral oriented therapeutic and preventive intervention programs both during/after epidemic and future epidemics especially in the general sample, university students, those diagnosed with COVID-19, and healthcare workers.

Impact of Classic Music Intervention on Anxiety Levels of Medical Students during Online Learning on COVID-19 Pandemic

Background: Situation of COVID-19 pandemic has become a global health problem and has caused public health anxiety, especially for medical students. Anxiety disorder experienced by a person can be treated by pharmacological or non-pharmacological therapy. One of many procedures of non-pharmacological treatments that can be done is by intervening in western classical instrumental music. According to existing studies, music interventions are known to have the effect of providing calm, elevating mood, and making a person feel more relaxed. This study aimed to determine the effectiveness of receptive western classical instrumental music intervention in overcoming anxiety disorders in preclinical medical students of FKIK Atma Jaya University during online classroom learning during the COVID-19 pandemic.Methods: This study was an experimental study composed of a single group with a research design of pre-test and post-test done by 78 medical students from FKIK UnikaAtma Jaya Batch 2021. The measuring instrument used was the GAD-7 questionnaire. The data analysis performed was univariate, bivariate, and multivariate analysis.Results: There were 78 respondents, with the majority aged 17-18 years old. The majority gender was female (61.54%). Most of the respondents were in the upper socioeconomic class (84.62%). The 78.21% of students live with their parents. Bivariate analysis showed a decrease in student anxiety before and after the music intervention. Multivariate analysis showed a significant relationship between anxiety level and place of residence.Conclusion: Western instrumental classical music can reduce anxiety in medical students of FKIK UnikaAtma Jaya Batch of 2021 during online learning.

Patients with Hypochondriasis (Illness Anxiety Disorder): Key Elements of Effective Communication in the Dental Practice

The world data show a large number of people with illness anxiety disorder (hypochondriasis) among the population all over the world. Russia is no exception: hypochondriacal patients often seek dental care. A dentist should be able to identify this category of patients. As a rule, these patients "know everything": their diagnosis and the most modern and effective methods of treatment. They are truly literate people. Their medical literacy is the result of watching popular shows, reading articles in trendy magazines and medical websites. Frequently, these patients are not emotionally stable; they have been stressed for a long time, or are undergoing long-term hormone therapy. Identifying these patients is the key to the successful practice. This article describes an interesting clinical case of the patient, who was treated for 2 months by 5 different specialists and took strong medications. During treatment her condition only worsened: allergic reaction developed to medications, with lesion of mucous membrane of oral cavity. Her reluctance to stop taking medications, insistence on consulting a dentist-oncologist alerted the attending doctor. Analysis of medical history revealed that the patient had experienced severe stress in the recent past and was currently undergoing a course of hormonal corrective therapy. A clinical psychologist confirmed the dentist's suggestion that the patient had hypochondriacal disorder. Patients with hypochondria - who are they? How to recognize them? If you meet such patients at a dental appointment, how you should communicate with them? How to treat them? A good result is achieved by establishing contact with the patients and their family and friends. Sometimes it is impossible to do without the help of a clinical psychologist. Only this specialist can definitively decide: does the patient have hypochondriacal disorder or not? If necessary, the clinical psychologist provides special treatment. The probability of a favorable outcome with this approach is high.

Debunking the Dilemma: Is Cyberchondria Truly a Form of Hypochondria?

Abstract In today’s digital age, the Internet has become an integral part of our lives, providing a wealth of information at our fingertips. However, the ease of accessing medical information online has given rise to a new phenomenon known as cyberchondria (CCD). CCD is characterized by the excessive anxiety and worry caused by the information discovered on the internet, leading individuals to believe that they have a serious medical condition. Although it shares similarities with hypochondria or illness anxiety disorder, there is an ongoing debate about whether CCD should be regarded as a separate condition or simply a manifestation of preexisting hypochondria. Those who engage in self-diagnosis and self-management of their health concerns without confirming the accuracy of the published material are presumed to be affected by CCD. No research has yet been undertaken on CCD therapeutic approaches. Psychoeducation is the cornerstone of CCD therapy. There is no specific pharmaceutical therapy. CCD is a developing public mental health concern in India that needs prompt response or might seriously harm the general public.

Impact of Benzodiazepines and Illness Duration on Obsessive-Compulsive Disorder during COVID-19 in Italy: Exploring Symptoms' Evolutionary Benefits.

Obsessive-compulsive disorder (OCD) is believed to follow a waxing and waning course, often according to environmental stressors. During the COVID-19 pandemic, pre-existing OCD symptoms were reported to increase and to change from checking to washing behaviors, while new-onset symptoms were predominantly of the hoarding type. In the present study, we followed the evolution of OCD symptoms, anxiety, depression, and insights of illness in forty-six OCD patients throughout the pandemic. Clinical measures were collected at four different time points before and during the COVID-19 pandemic in Italy. Within-subject comparisons were used to compare clinical scale scores across time, and correlations were examined between patients' baseline characteristics and changes in clinical scores. We found that all clinical measures increased during the first Italian lockdown with respect to the pre-pandemic values. Anxiety decreased during the temporary elimination of restriction provisions, whereas the severity of OCD symptoms and insight returned to pre-pandemic values during the second mandatory lockdown. These results were observed only in two sub-groups of patients: those taking benzodiazepines and those with shorter illness duration. Our findings suggest the need for additional clinical attention to these specific sub-groups of OCD patients in case of particularly distressing circumstances while pointing to a possible adaptive role of their OCD symptoms when the environment requires a higher care of hygiene and an extraordinary supply of essential resources.

Brucella canis: a clinical review and rationalising risk

Background: After a letter published by the chief veterinary officer in February 2021 highlighted an increase in the number of positive Brucella canis dogs, the frequency of B canis testing in the UK has increased substantially. To date, roughly 160 positive cases have been reported by the APHA. Amid growing unease, veterinary teams have implemented practice protocols to mitigate risk associated with this non‐endemic, zoonotic infection. Although well‐meaning, blanket policy and inappropriate application of serological tests can negatively impact client and patient welfare while fuelling health anxiety among staff. The combination of increased pet travel, increased popularity of importing dogs and a lack of centralised border requirements for dogs, means B canis is likely to be increasingly encountered and warrants regular, evidence‐based discussion to empower the profession and preserve canine welfare.Aim of the article: This article summarises the clinically relevant issues surrounding Brucella canis, focussing on epidemiology, transmission, human health and safety, clinical signs, diagnosis and treatment. Governmental recommendations and recent risk assessments by the Human Animal Infection and Risk Surveillance group are drawn on where appropriate. Moreover, the article aims to instil confidence in veterinary personnel when rationalising B canis infection risk, and help to ensure that canine and staff health are protected.

Untangling influences of information relevance and media richness on health anxiety and COVID-19-related stress: perspective of stimulus-organism-response

PurposeIn light of the stimulus-organism-response (SOR) theoretical paradigm, this paper explores how information relevance and media richness affect social network exhaustion and, moreover, how social network exhaustion ultimately leads to health anxiety and COVID-19-related stress.Design/methodology/approachThe conceptual model is explicitly analyzed and estimated by using data from 309 individuals of different ages in mainland China. Confirmatory factor analysis (CFA) and structural equation modeling (SEM) were utilized to validate the proposed hypotheses through the use of online data.FindingsThe findings suggest that information relevance is negatively associated with social network exhaustion. In addition, social network exhaustion is a significant predictor of health anxiety and stress. Furthermore, information relevance and media richness can indirectly influence health anxiety and stress through the mediating effect of social network exhaustion.Research limitations/implicationsTheoretically, this paper verifies the causes and consequences of social network exhaustion during COVID-19, thus making a significant contribution to the theoretical construction and refinement of this emerging research area. Practically, the conceptual research model in this paper may provide inspiration for more investigators and scholars who are inclined to further explore the different dimensions of social network exhaustion by utilizing other variables.Originality/valueAlthough social network exhaustion and its adverse consequences have become prevalent, relatively few empirical studies have addressed the deleterious effects of social network exhaustion on mobile social media users’ psychosocial well-being and mental health during the prolonged COVID-19. These findings have important theoretical and practical implications for the rational development and construction of mobile social technologies to cultivate proper health awareness and mindset during the ongoing worldwide COVID-19 epidemic.

Cyberchondria severity and utilization of health services in Polish society: a cross-sectional study

BackgroundIt has been suggested that cyberchondria leads to increased utilization of healthcare services. Unfortunately, not many studies have analyzed this effect comprehensively. The aim of this study was to analyze the relationship between cyberchondria severity and the utilization of healthcare services among adult Internet users after adjusting for sociodemographic characteristics and the health status of respondents.MethodsThe analysis detailed in this paper examined data from a computer-based, web-based interviewing survey performed among a representative sample of 1613 Polish Internet users. Cyberchondria severity was assessed with the Cyberchondria Severity Scale (CSS). The variables reflecting the use of healthcare services were based on the frequency of visits to family physicians and specialists, diagnostic procedures, hospital admissions, and emergency services, and finally being vaccinated against COVID-19. The effect of cyberchondria severity on the utilization of healthcare services and alternative medicine was adjusted for key sociodemographic variables, the presence of chronic diseases, disability, and unspecific symptoms. For variables reflecting the use of services, ordinal logistic regression and multivariable logistic regression models were developed.ResultsCyberchondria severity was a significant predictor of the utilization of all but one of the analyzed healthcare services and alternative medicine. The odds of being in a higher category of the utilization of visits to family physicians and specialists, hospital admissions, emergency services and alternative medicine services increased by a factor of 1.01–1.02 for every unit increase of the cyberchondria score. The cyberchondria score was a negative predictor of COVID-19 vaccine uptake. The effect of cyberchondria on outcome variables was independent of the level of health anxiety, sociodemographic variables, and variables reflecting the health status of respondents.ConclusionsCyberchondria leads to more intensive use of nearly all healthcare services, but in the case of vaccination against COVID-19, cyberchondria severity was a negative predictor. Cyberchondria’s effect extends beyond health anxiety.

The COVID-19 lockdown experience suggests that restricting the supply of gambling can reduce gambling problems: An Australian prospective study.

COVID-19 lockdowns limited access to gambling but simultaneously elevated psychosocial stressors. This study assessed the relative effects of these changes on gambling risk status during and after the Australian COVID-19 lockdown from late-March to late-May 2020. The study administered three surveys to people who had gambled within the past year at T1. Wave 1 asked about before (T1, N = 2,125) and during lockdown (T2, N = 2,125). Subsequent surveys focused on one year (T3; N = 649) and two years after lockdown (T4, N = 458). The dependent variable was changes in reporting any problem gambling symptoms (PGSI 0 vs 1+). Bivariate analyses and multinomial logistic regression tested for significant associations with: demographics, psychosocial stressors (perceived stress, psychological distress, loneliness, health anxiety about COVID, financial hardship, stressful life events), gambling participation and gambling frequency. Gambling participation and at-risk gambling decreased between T1 and T2, increased at T3, with little further change at T4. When gambling availability was curtailed, decreased gambling frequency on EGMs, casino games, sports betting or race betting, and lower psychosocial stress, were associated with transitions from at-risk to non-problem gambling. When gambling availability resumed, increased EGM gambling frequency, decreased online gambling frequency, and higher psychosocial stress were associated with transitions from non-problem to at-risk gambling. Gambling availability appears a stronger influence on gambling problems, at the population level, than psychosocial risk factors. Reducing the supply of high-risk gambling products, particularly EGMs, is likely to reduce gambling harm.

Intrarelationships between suboptimal health status and anxiety symptoms: A network analysis

BackgroundSuboptimal health status is a global public health concern of worldwide academic interest, which is an intermediate health status between health and illness. The purpose of the survey is to investigate the relationship between anxiety statuses and suboptimal health status and to identify the central symptoms and bridge symptoms. MethodsThis study recruited 26,010 participants aged <60 from a cross-sectional study in China in 2022. General Anxiety Disorder-7 (GAD-7) and suboptimal health status short form (SHSQ-9) were used to quantify the levels of anxiety and suboptimal health symptoms, respectively. The network analysis method by the R program was used to judge the central and bridge symptoms. The Network Comparison Test (NCT) was used to investigate the network differences by gender, place of residence, and age in the population. ResultsIn this survey, the prevalence of anxiety symptoms, SHS, and comorbidities was 50.7 %, 54.8 %, and 38.5 %, respectively. “Decreased responsiveness”, “Shortness of breath”, “Uncontrollable worry” were the nodes with the highest expected influence. “Irritable”, “Exhausted” were the two symptom nodes with the highest expected bridge influence in the network. There were significant differences in network structure among different subgroup networks. LimitationsUnable to study the causal relationship and dynamic changes among variables. Anxiety and sub-health were self-rated and may be limited by memory bias. ConclusionsInterventions targeting central symptoms and bridge nodes may be expected to improve suboptimal health status and anxiety in Chinese residents. Researchers can build symptom networks for different populations to capture symptom relationships.

The influence of health literacy, anxiety and education on shared decision making and decisional conflict in older adults, and the mediating role of patient participation: A video observational study

ObjectiveTo explore the relationship between personal characteristics of older adults with multiple chronic conditions (MCCs) and perceived shared decision making (SDM) resp. decisional conflict. MethodsIn a video-observational study (N = 213) data were collected on personal characteristics. The main outcomes were perceived level of SDM and decisional conflict. The mediating variable was participation in the SDM process. A twostep mixed effect multilinear regression and a mediation analysis were performed to analyze the data. ResultsThe mean age of the patients was 77.3 years and 56.3% were female. Health literacy (β.01, p < .001) was significantly associated with participation in the SDM process. Education (β = −2.43, p = .05) and anxiety (β = −.26, p = .058) had a marginally significant direct effect on the patients’ perceived level of SDM. Education (β = 12.12, p = .002), health literacy (β = −.70, p = .005) and anxiety (β = 1.19, p = .004) had a significant direct effect on decisional conflict. The effect of health literacy on decisional conflict was mediated by participation in SDM. ConclusionHealth literacy, anxiety and education are associated with decisional conflict. Participation in SDM during consultations plays a mediating role in the relationship between health literacy and decisional conflict. Practice ImplicationsTailoring SDM communication to health literacy levels is important for high quality SDM.

Gender-Specific Effects on the Cardiorespiratory System and Neurotoxicity of Intermittent and Permanent Low-Level Lead Exposures.

Lead exposure is a significant health concern, ranking among the top 10 most harmful substances for humans. There are no safe levels of lead exposure, and it affects multiple body systems, especially the cardiovascular and neurological systems, leading to problems such as hypertension, heart disease, cognitive deficits, and developmental delays, particularly in children. Gender differences are a crucial factor, with women's reproductive systems being especially vulnerable, resulting in fertility issues, pregnancy complications, miscarriages, and premature births. The globalization of lead exposure presents new challenges in managing this issue. Therefore, understanding the gender-specific implications is essential for developing effective treatments and public health strategies to mitigate the impact of lead-related health problems. This study examined the effects of intermittent and permanent lead exposure on both male and female animals, assessing behaviours like anxiety, locomotor activity, and long-term memory, as well as molecular changes related to astrogliosis. Additionally, physiological and autonomic evaluations were performed, focusing on baro- and chemoreceptor reflexes. The study's findings revealed that permanent lead exposure has more severe health consequences, including hypertension, anxiety, and reactive astrogliosis, affecting both genders. However, males exhibit greater cognitive, behavioural, and respiratory changes, while females are more susceptible to chemoreflex hypersensitivity. In contrast, intermittent lead exposure leads to hypertension and reactive astrogliosis in both genders. Still, females are more vulnerable to cognitive impairment, increased respiratory frequency, and chemoreflex hypersensitivity, while males show more reactive astrocytes in the hippocampus. Overall, this research emphasizes the importance of not only investigating different types of lead exposure but also considering gender differences in toxicity when addressing this public health concern.