Anxiety Index Research Articles

Abstract 13286: Symptoms in Heart Failure Improve With More Intense Physical Activity

Purpose. RCTs have demonstrated the benefits of exercise in heart failure (HF) including improved functional status and quality of life, with fewer hospitalizations. Little is known about how changes in physical activity (PA) over time may influence physical and psychological symptoms. This study examined the extent to which changes in PA over time were associated with changes in physical and psychological symptoms in HF. Methods. A secondary analysis was conducted using an RCT of exercise in HF patients (N=86) who received an initial ICD. Data were collected at baseline and 2 months. Physical activity was measured over 5 consecutive days using the StepWatch PA Monitor (Orthocare Innovations TM ) for total PA (mean steps/day) and intensity (mean steps/min for most intense 30 minutes/day). Other measures included: physical symptoms (Patient Concerns Assessment (PCA); fatigue and pain (SF-36 Vitality & Bodily Pain subscales, respectively), and symptoms of depression (Patient Health Questionnaire-9, PHQ9) and anxiety (State-Trait Anxiety Index, STAI). Multivariate regression was used to examine for associations between increased and decreased PA and changes in physical and psychological symptoms, adjusting for age, co-morbidities, body mass index, ejection fraction (EF), and study group. Results. Patients were male (82%), 55.3±12.1 years of age, white (79%), with multiple co-morbidities (Charlson Co-morbidity: 2.1±1.3), BMI of 30.0±5.1, with reduced EF (31.0±10.1%). An increase in PA intensity from baseline to 2 months was associated with significant improvement in psychological symptoms (PHQ9:β= -0.13, p=0.030; STAI:β= -0.26,p=0.026) and fatigue (β= 0.55,p=0.023). An increase in total PA (steps/day) was associated with improvement in anxiety only (β= -1.23, p=0.045). A decrease in PA (total and intensity) was not associated with changes in any symptoms. Conclusion. For patients with HF and an initial ICD, increased intensity of PA over 2 months was associated with improved psychological symptoms and reduced fatigue. Decreases in PA (total and intensity) were not associated with symptoms. These findings warrant further investigation as interventions focused on PA intensity rather than quantity may be more effective in reducing symptoms in HF.

Abstract 14606: Accurate Detection of Acute Psychological Stress Events Using Single Lead ECG Data

Introduction: Stress has been linked to numerous health conditions, including heart disease, diabetes, and mental health issues. By monitoring changes in physiological signals, such as heart rate (HR) and heart rate variability (HRV), wearable biosensing technology allows acute stress to be non-invasively tracked over long periods, providing valuable insights for preventative healthcare. Methods: This two-phase study comprised several protocols designed to induce varying levels of psychological stress in participants (N=39). HR and HRV metrics, derived from electrocardiogram (ECG) data collected throughout the protocol on the single lead HeartKey ® Chest Module, were used by the HeartKey Stress algorithm to generate a relative stress score (0-100), which was validated against two clinically recognized methodologies for assessing patient stress: i) state-trait anxiety index (STAI), a questionnaire that subjectively measured the individual’s perceptual stress after each stage of the protocol, and ii) electrodermal activity (EDA), which continuously monitored conductive changes at the skin’s surface with an Empatica ® E4 wrist wearable. Results: Over both phases, participant STAI scores increased significantly during stress protocols (49.9 ± 23.3) relative to the baseline (30.0 ± 10.0). Mean HR showed a similar significant increase ( p < 0.001), and HRV gradually decreased throughout the testing protocol. HeartKey Stress scores derived from HR and HRV data showed a strong correlation to STAI scores. Furthermore, the HeartKey Stress trend closely replicated that of the EDA data. Conclusions: HeartKey Stress algorithm consistently generated accurate and reliable stress scores in response to events of induced, acute psychological stress. The results suggest that the algorithm has potential utility for continuous clinical monitoring of patients with stress-related illnesses.

Acute stress increases behaviors that optimize safety and decreases the exploration of aversive areas

The avoidance-approach conflict has been proposed as the main drive of spontaneous exploration in rodents. Given this assumption, exploratory behavior has been interpreted as an anxiety index that can be measured in several paradigms. Although pharmacological manipulations predominate in anxiety and exploratory behavior studies, exposure to real stressful situations could be considered a more ecological approach. In the present study, we evaluated the immediate effect of 1-hour restraint stress on Wistars rats’ exploratory behavior in the following models of anxiety: the light/dark box (L/D box), the elevated plus-maze (EPM), and the elevated gradient of aversion (EGA). Results showed that animals avoid risky areas according to the complexity of each apparatus and that acute stress increases that tendency. We propose that subjects tend to search and remain in safer areas when exposed to novel environments and that a single exposure to stress by motor restriction increases these behaviors which could be associated with a response related to anxiety but also to the optimization of a more complex survival system.

Prevalence and correlates of sleep quality in the Chinese college students with migraine: a cross-sectional study.

Background: Migraineurs are often plagued by sleep disorders. The university student population is high in number and is more vulnerable to migraines. However, no study has analyzed the sleep quality of students with migraine and related contributing factors. Objective: We used the Pittsburgh Sleep Quality Index (PSQI) scale to assess the sleep of migraine patients among college students and to explore the influencing factors of sleep quality. Methods: We performed primary screening for migraine using the ID-migraine screening, and further assessed headache characteristics, sleep, anxiety, depression, and mobile phone addiction in college students with positive primary screening, then diagnosed migraine according to the third edition of the International Classification of Headache Disorders (ICHD-3). Finally, we analyzed the factors influencing sleep quality using Binary Logistic Regression Analysis. Those with scores greater than 5 points on the PSQI scale were believed to have poor sleep quality. Results: The prevalence of migraine was 6.6%. A total of 545 migraineurs were eventually included in the analysis, the incidence of poor sleep quality was 64.04%. The three factors of experiencing aura (OR = 2.966, 95%CI = 1.756-5.010, P < 0.05), anxiety (OR = 2.778, 95%CI = 1.434-5.382, P < 0.05), and high Mobile phone addiction index (MPAI) score (OR = 1.025, 95%CI = 1.002-1.049, P < 0.05) contributed enormously to poor sleep quality. Moreover, the factors of aura symptoms (OR = 3.796, 95%CI = 2.041-7.058, P < 0.05), anxiety (OR = 3.146, 95%CI = 1.473-6.719, P < 0.05), and MPAI score (OR = 1.028, 95%CI = 1.002-1.054, P < 0.05) influenced the sleep quality of female migraineurs rather than male migraineurs. Conclusions: The incidence of poor sleep quality is high among university students with migraine. Aura symptoms, anxiety, and high MPAI score influence the sleep quality of migraineurs, especially females. The proposal of prevention and intervention measures is of great importance to the physical and mental health of students with migraine. Clinical Trial Registration: identifier ChiCTR1800014343.

The correlation between anxiety, depression, and vertigo: a cross-sectional study

BackgroundDizziness, including vertigo, affects approximately 15% to over 20% of adults each year. A significant proportion of patients with vertigo develop secondary psychiatric disorders throughout their disease. On the other hand, patients with psychiatric disorders frequently report dizziness as a co-occurring symptom of their illness. The purpose of this study was to screen the prevalence of depression and anxiety indices in dizzy patients and their relation to the severity of their dizziness handicap by administering two different questionnaires: The dizziness handicap inventory (DHI) and the Hospital Anxiety and Depression Scale (HADS). ResultsPsychological assessments revealed that 49% of the study group was normal, 29% had anxiety, 7% had depression, and 15% had both anxiety and depression. Besides, vestibular neuritis was associated with a higher mean anxiety score, whereas Meniere's disease was associated with a higher mean depression score. ConclusionAs this study has shown, there was a statistically significant positive correlation between anxiety and depression scores and physical, emotional, functional, and total DHI scores. Screening and treatment of co-morbid mental health disorders are critical for appropriate management of vertigo disability that leads to a higher quality of life and fewer complications.

Anxiety, Post-COVID-19 Syndrome-Related Depression, and Suicidal Thoughts and Behaviors in COVID-19 Survivors: Cross-sectional Study.

BackgroundAlthough the mental health impacts of COVID-19 on the general population have been well studied, studies of the long-term impacts of COVID-19 on infected individuals are relatively new. To date, depression, anxiety, and neurological symptoms associated with post–COVID-19 syndrome (PCS) have been observed in the months following COVID-19 recovery. Suicidal thoughts and behavior (STB) have also been preliminarily proposed as sequelae of COVID-19.ObjectiveWe asked 3 questions. First, do participants reporting a history of COVID-19 diagnosis or a close relative having severe COVID-19 symptoms score higher on depression (Patient Health Questionnaire-9 [PHQ-9]) or state anxiety (State Trait Anxiety Index) screens than those who do not? Second, do participants reporting a COVID-19 diagnosis score higher on PCS-related PHQ-9 items? Third, do participants reporting a COVID-19 diagnosis or a close relative having severe COVID-19 symptoms score higher in STB before, during, or after the first year of the pandemic?MethodsThis preliminary study analyzed responses to a COVID-19 and mental health questionnaire obtained from a US population sample, whose data were collected between February 2021 and March 2021. We used the Mann-Whitney U test to detect differences in the medians of the total PHQ-9 scores, PHQ-9 component scores, and several STB scores between participants claiming a past clinician diagnosis of COVID-19 and those denying one, as well as between participants claiming severe COVID-19 symptoms in a close relative and those denying them. Where significant differences existed, we created linear regression models to predict the scores based on COVID-19 response as well as demographics to identify potential confounding factors in the Mann-Whitney relationships. Moreover, for STB scores, which corresponded to 5 questions asking about 3 different time intervals (i.e., past 1 year or more, past 1 month to 1 year, and past 1 month), we developed repeated-measures ANOVAs to determine whether scores tended to vary over time.ResultsWe found greater total depression (PHQ-9) and state anxiety (State Trait Anxiety Index) scores in those with COVID-19 history than those without (Bonferroni P=.001 and Bonferroni P=.004) despite a similar history of diagnosed depression and anxiety. Greater scores were noted for a subset of depression symptoms (PHQ-9 items) that overlapped with the symptoms of PCS (all Bonferroni Ps<.05). Moreover, we found greater overall STB scores in those with COVID-19 history, equally in time windows preceding, during, and proceeding infection (all Bonferroni Ps<.05).ConclusionsWe confirm previous studies linking depression and anxiety diagnoses to COVID-19 recovery. Moreover, our findings suggest that depression diagnoses associated with COVID-19 history relate to PCS symptoms, and that STB associated with COVID-19 in some cases precede infection.

Biophilic virtual reality on children’s anxiety and pain during circumcision: A randomized controlled study

The aim of this study was to evaluate the effects of the biophilic virtual reality (BVR) method on children's pain and anxiety undergoing circumcision. This randomized controlled study used a parallel trial design guided by the CONSORT checklist. A total of 106 children were included in the analysis. Intraoperative anxiety was assessed by using the simplified Chinese version of the modified Yale Preoperative Anxiety Scale (CmYPAS), Visual Analogue Scale (VAS), heart rate (HR), and Anxiety index (Ai). Intraoperative pain was assessed by using the Faces Pain Scale-Revised (FPS-R), and Pain index (Pi). The Pearson correlation analysis was used to analyze the relationship between Ai and the CmYPAS. The primary outcomes were CmYPAS, VAS, and FPS-R, which were analyzed using the Kruskal-Wallis test. Baseline variables were not significantly different between the BVR group (34 patients), the indoor virtual reality (IVR) group (36 patients), and the blank control group (36 patients). The CmYPAS scores during surgery were significantly lower in the BVR group and the IVR group versus the blank control group (25.0[22.9-29.2], 22.9[22.9-29.2], 33.3[33.3-38.5] respectively; P<0.001). The VAS scores during surgery were significantly lower in the BVR group and the IVR group versus the blank control group (5.0[3.0-7.0], 3.0[2.0-5.0], 6.0[5.0-8.8] respectively; P<0.001). The FPS-R scores during surgery were significantly lower in the BVR group and IVR group versus the blank control group (2.0[1.8-4.2], 3.0[2.0-4.8], 5.5[5.0-8.0], respectively; P<0.001). At removal of the foreskin, Pi were significantly lower in the BVR group and IVR group versus the blank control group (6.9[4.1], 7.7[3.3], 9.8[6.2] respectively; P=0.033). The Ai scores at each time point were significantly lower in the BVR group and IVR group versus the control (P=0.015, P=0.006 respectively). The correlation analysis of Ai (at removal of the foreskin) and CmYPAS scores in children showed that the Pearson correlation coefficient was 0.194 (P=0.046). This is the first RCT to investigate the effects of BVR in children undergoing circumcision. This study demonstrates a reduction in pediatric intraoperative pain and anxiety with the use of virtual reality (VR). Intraoperative VR may be an effective noninvasive modality for reducing pain and anxiety during circumcision. Pi and Ai might be used to assess subjective pain and anxiety in patients.

Resistance Training Modulates Hippocampal Neuroinflammation and Protects Anxiety-Depression-like Dyad Induced by an Emotional Single Prolonged Stress Model.

Stress is a triggering factor for anxious and depressive phenotypes. Exercise is known for its action on the central nervous system. This study aimed to evaluate the role of resistance exercise in an anxiety-depression-like dyad in a model of stress. Male Swiss mice (35-day-old) were exercised, three times a week for 4 weeks on nonconsecutive days. The resistance exercise consisted of climbing a 1-m-high ladder 15 times. After mice were subjected to an emotional single prolonged stress (Esps) protocol. Seven days later, they were subjected to anxiety and depression predictive behavioral tests. The results showed that exercised mice gain less weight than sedentary from weeks 3 to 5. Resistance exercise was effective against an increase in immobility time in the forced swim test and tail suspension test and a decrease in grooming time of mice subjected to Esps. Resistance exercise protected against the decrease in the percentage of open arms time and open arm entries, and the increase in the anxiety index in Esps mice. Four-week resistance exercise did not elicit an antidepressant/anxiolytic phenotype in non-stressed mice. Esps did not alter plasma corticosterone levels but increased the hippocampal glucocorticoid receptor content in mice. Resistance exercise protected against the decrease in hippocampal levels of tropomyosin kinase B (TRκB), the p-Akt/Akt, and the p-mTOR/mTOR ratios of Esps mice. Resistance exercise proved to be effective in decreasing hippocampal neuroinflammation in Esps mice. Resistance exercise protected against the increase in the hippocampal Akt/mTOR pathway and neuroinflammation, and anxiety/depression-like dyad in Esps exposed mice.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12035-022-03069-x.

Aile hekimliği polikliniğine başvuran hastalarda vücut kitle indeksi ve anksiyete durumunun kan basıncı üzerine etkisi

Introduction: Hypertension is a global public health problem that is the leading cause of preventable death in the world and a disease which can cause many morbidities and mortality if not controlled or treated effectively. In many studies, it has been determined that anxiety and body mass index(BMI) are among the factors affecting hypertension. However, different results have been obtained in many studies in terms of the relationship between anxiety and hypertension. This study was carried out with the aim to evaluate the effect of body mass index and anxiety on blood pressure and the factors affecting blood pressure in patients who applied to outpatient clinic of family medicine at Dicle University Faculty of Medicine.Methods: 403 patients aged between 18- 65 years, who applied to outpatient clinic of family medicine at Dicle University Faculty of Medicine between 01.04.2018 and 01.07.2018, were included in this cross-sectional study. The population of the study was the province where the study was carried out, and the sample size was calculated with a power of 80%. The patients' body mass index and anxiety scores from Beck anxiety scale were calculated and measurements of arterial blood pressure were performed. The relationship between BMI, Beck anxiety scores and blood pressure of patients were investigated.Results: Of the participants, 50.1% were male, 49.9% were female and the average age was 34.11 in years. Of the patients, the mean BMI as 25.52 kg/m², the mean anxiety score as 7.40 and the arterial blood pressures as 117.80/75.54 mmHg were measured. It was found that arterial blood pressure raised significantly as the BMI group increased. While the relationship between the severity of anxiety and systolic blood pressure was significant, its relationship with diastolic blood pressure was not significant. There was a positive correlation between BMI, anxiety score and systolic and diastolic blood pressure.Conclusions: According to the results of this study, it was found that the increase in BMI and Beck anxiety scores may be related with increase in arterial blood pressure. This result showed that common health problems in primary care such as anxiety, obesity and hypertension may be associated with each other, and it can be effectively fought against hypertension and its complications with the perspective of family medicine and biopsychosocial approach.Keywords: Anxiety, Hypertension, Blood Pressure, Obesity, Body Mass Index

Zinc supplement reverses short-term memory deficit in sodium benzoate-induced neurotoxicity in male Wistar rats by enhancing anti-oxidative capacity via Nrf 2 up-regulation

Sodium benzoate (SB) is a commonly-used food preservative, with a controversial report to its neurological benefit and toxicity. Zinc (Zn) is a trace element that plays a crucial role in memory, inflammation and oxidative stress. This study was to investigate the effect of SB on rat cognition and memory and the possible modulatory effect of Zn supplement. Twenty four male Wistar rats were divided into four groups of six animals each. Animals in groups 1–4 were treated with normal saline 1 ml/kg, SB 200 mg/kg, zinc sulphate 10 ml/kg and SB 200 mg/kg + zinc sulphate 10 ml/kg/day daily respectively for three weeks. After treatment, the animals were subjected to different behavioural tests, and then sacrificed. Their blood samples were collected for catalase(CAT), superoxide dismutase(SOD) and interleukin-1B(IL-1B) assay. Brain samples were also collected for nuclear factor-erythroid-related factor 2(Nrf2), and acetylcholinesterase (AchE) mRNA gene expression. The serum levels of CAT and SOD were (p < 0.0001; p < 0.0001) reduced in the SB only-treated group compared to the other groups. Nrf2 gene expression was totally shut down in the SB only-treated group but, up-regulated in the Zn-treated groups (p < 0.0001). The serum level of IL-1B was higher in the SB only-treated group compared to the other groups. SB-treated group spent longer time in the close arm (p = <0.0001), shorter time in the open arm (p = <0.0001) and had higher anxiety index (p = 0.0045) than the Zn-treated groups. Conclusively, Zinc improves memory deficit, has anxiolytic, anti-oxidant and anti-inflammatory properties.

The anti-anxiety/depression effect of a combined complex of casein hydrolysate and γ-aminobutyric acid on C57BL/6 mice.

In view of a series of adverse side effects of drugs for anxiety/depression on the market at present, it is imminent to extract and develop novel anti-anxiety and depression drugs from plants and proteins (like casein hydrolysate) as adjuncts or substitutes for existing anti-anxiety and depression drugs. Consequently, this study investigated the improvement of the anxiety/depression function by the compound of casein hydrolysate and γ-aminobutyric acid (GABA) (casein hydrolysate: GABA = 4:1; CCHAA) on mice induced by chronic restraint stress-corticosterone injection. Animal experiments revealed that oral gavage administration of CCHAA significantly reversed the anxiety/depression-like behaviors. Compared to the model control group, body weights were increased after treatment with CCHAA groups [1.5, 0.75 mg/(g⋅d)]. As a diagnostic index of anxiety and depression, we assessed GABA and 5-HT levels in response to CCHAA ingestion. The GABA and 5-HT levels were increasingly enhanced by the CCHAA diet. In addition, histopathological changes in the hippocampus CA3 region of the anxious/depressed mice were also alleviated after the treatment with the CCHAA. Thus, the casein hydrolysate and GABA formula diets may induce beneficial effects on the mice with anxiety/depression.

Autism and anorexia nervosa: Longitudinal prediction of eating disorder outcomes.

BackgroundRecently, elevated levels of autistic features and autism diagnoses have been reported among people with anorexia nervosa (AN). In clinical settings high levels of autistic features have been linked to more complex, highly comorbid illness presentation and poorer treatment outcome. This study aimed to examine whether autistic features predict AN symptom profile in long term.MethodsAltogether 118 women with lived experience of AN completed two autism assessments at time 1, the Autism Diagnostic Observation Schedule (ADOS) and the short version of the Autism Quotient (AQ10). Measures assessing AN symptom profile, including eating disorders symptoms, anxiety, depression, OCD symptoms, and Body Mass Index (BMI), were also recorded. The symptom profile measures were administered again 6 months and 2 years later. We conducted two analyses to examine the extent to which the ADOS and AQ10 scores predicted broad AN symptom profile at each three time points.ResultsOverall, high levels of autistic features were consistently associated with worse psychological symptoms, but not BMI, across all time points. Both the analysis using baseline ADOS scores and self-reported AQ10 scores showed similar pattern.ConclusionThe present findings consolidate previously reported associations between autistic features and worse psychological outcome among people with AN. The findings also suggest that self-report measures may be sufficient for assessing the impact of autistic features on illness outcome among people with AN. Importantly, the study highlights the need for development and further investigation of neurodiversity accommodations in the treatment of AN.

Positive effects of fetal echocardiography on maternal anxiety: a prospective study in a tertiary center in Turkey

Aim: The aim of this study was to determine the anxiety levels of pregnant women who were referred to a tertiary center for fetal echocardiography (FE) and the effect of FE results on maternal anxiety. Methods: This prospective study was conducted between January 2020 and February 2021 and included 118 pregnant women. The anxiety levels of the participants were evaluated with the Spielberger State-Trait Anxiety Inventory, which evaluates state (STAI-I) and trait (STAI-II) anxiety. STAI-I and STAI-II were administered to participants at first admission using a standard interview technique prior to FE. After the FE was completed, a structured interview was performed and the state anxiety index (STAI-I-R) was re-administered to the participants. Results: Severe congenital heart disease (CHD) was detected in 63 (53.4%) fetuses. The participants’ mean STAI-I scores were significantly higher than their mean STAI-II scores (44.19 ± 8.56 and 41.98 ± 5.98, respectively, t = 2.59 and p = 0.011). In pregnant women with fetuses with severe CHD, STAI-I-R scores were significantly lower compared to STAI-I scores (43.48 ± 7.97 and 46.28 ± 7.18, respectively, t = 2.13 and p = 0.037). Conclusion: Referral for FE is associated with increased maternal anxiety, and a structured interview may result in reduced anxiety levels even in those with abnormal FE.

PSYCHOEMOTIONAL INDICATORS OF PATIENTS WITH PURULONECROTIC COMPLICATIONS OF THE DIABETIC FOOT SYNDROME WHO USED DEVICE FOR OFFLOADING OF FOOT DURING MARTIAL LAW

Abstract. Aim. To study the psychoemotional state of patients with purulent-necrotic complications of diabetic foot syndrome (DFS), who used the device for offloading of foot developed by us during the martial law in Ukraine and to compare it with the results of health-related quality of life indicators in peacetime.&#x0D; Materials and methods. All operated patients had stage 3 or 4 of the pathological process on the foot according to the Meggitt-Wagner classification, a neuroischemic form of DFS. The first group includes 28 patients who received prescribed treatment before the introduction of martial law in the country; the second group – 24 patients who were treated during martial law. The psychoemotional state of patients with purulent-necrotic complications of DFS was studied on the 1st and 20th days using the «Emotions» subscale from the «Illness Impact Profile» questionnaire; index of general (good) well-being/ WHO, version 1999; hospital anxiety and depression scale.&#x0D; Results and discussion. The indicators of patients of the first group according to the subscale «Emotions» on the 1st day — (85.7±14.3) points, and of the second group — (104.6±16.1) points. In the group of patients who were interviewed before martial law, the result of the general well-being index was (48.4±1.2). Patients of the second group have (43.5±1.1). Anxiety level: (7.5±0.3) points and (8.7±0.4) points; level of depression: (6.4±0.5) points and (7.6±0.4), respectively. Although the indicators remain unsatisfactory on the 20th day, the tendency towards the improvement of the psychoemotional state is already becoming obvious. The difference in indicators between the two groups remains, which is explained by the influence of military events.&#x0D; Conclusions. In the second group, worse indicators were found for the psychoemotional component of health-related quality of life, both on the 1st and 20th days. The worse dynamics of the improvement of the specified indicators on the 20th day were recorded. In the first group, according to the «Emotions» subscale, there was an improvement of 63.1 %, in the second group — by 36.2 %; the general well-being index increased by 40.1 % and 25.1 %, respectively. If in the first group, the anxiety index decreased by 16 %, and depression by 20.3 %, then in the second group, the anxiety index decreased by 12.6 %, and depression — by 10.6 %.

Chronic non-communicable diseases and health awareness of patients: An observational study analysing the health adaptive behaviours through self-care skills

The incidence of chronic non-communicable diseases (CNCDs) increases with age, thus placing a burden on individuals and healthcare systems; furthermore, CNCDs are associated with lower quality of life (QoL) in the elderly. This study aimed to evaluate the behavioural management of CNCDs by comparing different diseases under its ambit exhibiting various side effects, as well as vascular, gastrointestinal, and other chronic diseases, simultaneously analysing self-care efficacy and emotional dimensions (i.e. anxiety, stress, and depression). A total of 122 outpatients aged >18 years (mean age, 50.0 years; standard deviation, ±13.8) participated in the study, and 59% of the participants were women. The psychological battery was composed of three standardised self-assessments measuring the relevant emotional dimensions, QoL, and self-care indices. Analysis of the emotional dimensions of depression, anxiety, and stress indices resulted in significant differences. Furthermore, post-hoc analyses (Tukey test) showed that patients with gastrointestinal disease (GD) experienced depression more than patients with vascular disease (VD) (p = 0.002). In addition, there were no differences between the VD and Oth and between the GD and Oth groups; however, the Oth group appeared to experience more anxiety than the VD group (p = 0.04); there were no differences between the GD and VD groups, as well the Oth group. The ANCOVA test compared the chronic disease groups, the disease stage (early and long-term), self-care indices, and sex. They were covariated by age, showing a significant effect on the management index only in chronic disease groups (p = 0.007). Our study suggests that the following specific factors need to be considered in health decision-making processes to enhance the compliance of patients to the clinically expected results: (1) tailored clinical therapies; (2) side effects of disease; (3) comorbidity; (4) mental health. The harmonisation of these internal and external factors could offer a powered perspective for personalized medicine.

The parental psychological distress caused by separation from their critically ill child during the COVID-19 pandemic: A tale of two cities.

IntroductionA child’s critical illness is a stressful event for the entire family, causing significant emotional distress among parents and changes to family functioning. The Severe Acute Respiratory Syndrome-Related Coronavirus 2 (SARS-CoV-2) pandemic has abruptly caused modifications in visitation policies of Pediatric Intensive Care Units (PICUs) in many countries. We hypothesized that caregivers with no or severely restricted access to PICUs would demonstrate increased psychological distress as compared to those who had limitless access (LA) to PICUs.MethodsSociodemographic variables, levels of psychological distress, ratings of family functioning, and ability to cope with stressful events were collected with an online survey in a group of caregivers after their child’s hospitalization. Ratings of psychological distress were compared between caregivers with no/severely restricted (NA) and with LA to PICUs.ResultsMeasures of depression, anxiety, and global severity index (GSI) of psychological distress were significantly higher in NA caregivers as compared to LA. Among demographic characteristics of the sample, only gender influenced the severity of psychological symptoms: women showed an increased score on levels of somatization, depression, anxiety, and GSI. Avoidant coping style positively correlated with measures of depression. Univariate General Linear Model (GLM) analyses of the effects of sex, age, visitation policies of PICUs, and score of avoidant coping strategies on measures of psychological distress confirmed a significant univariate effect of no access to PICUs on parents’ psychopathological scores.ConclusionRestrictions imposed on visitation policies in PICU during the pandemic negatively impacted families’ psychological wellbeing. A balance between the safety of patients, families, and health care professionals and meeting the needs of families is of utmost importance.

A Study on the Effects of a Cartoon Text Version of Health Education Manual with Sandplay on the Psychological Status and Cognitive Function of Children with Attention Deficit Hyperactivity Disorder.

Purpose The study aimed to examine the effects of a cartoon text version of a health education manual with sandplay on the psychological status and cognitive function of children with attention deficit hyperactivity disorder (ADHD). Methods Eighty cases of children with ADHD admitted from February 2019 to September 2021 were selected for the study. They were numbered according to the order of consultation, and after obtaining family consent, they were divided into the control group (n = 40) and the observation group (n = 40) using the random number table method. The control group received only medication and verbal health education, while the observation group received a cartoon text version of the health education manual together with sandplay on top of the above, and both groups were treated for 30 weeks. The attention test results and the Swanson, Nolan, and Pelham-IV rating scales (SNAP-IV) were used to assess the effectiveness of the treatment for both groups of children. The awareness rate of health education knowledge of children and their families in both groups was counted. The Conners Parent Symptom Questionnaire (PSQ) and the Combined Raven's test (CRT) were used to assess the psychological status and cognitive functioning of the children in both groups. Results After treatment, the response time, the number of errors, and the number of missed alarms in the attention test results were lower in the observation group than in the control group (P < 0.05). After treatment, the inattention, antagonism and defiance, and impulsiveness and hyperactivity scores on SNAP-IV were lower in the observation group than in the control group (P < 0.05). After treatment, the knowledge of disease and treatment, medical and nursing cooperation, safety and protection, and dietary precautions were higher in the observation group than in the control group (P < 0.05). After treatment, the learning problems, conduct problems, psychosomatic problems, anxiety, impulsivity-hyperactivity, and hyperactivity index scores on the PSQ were lower in the observation group than in the control group (P < 0.05). After treatment, the A, B, C, D, and E theme scores in the CRT were higher in the observation group than in the control group, and the IQ score was also higher in the observation group than in the control group (P < 0.05). Conclusion The cartoon text version of the health education manual with sandplay can significantly improve the attention deficit, hyperactive behaviour, psychological status, and cognitive function of children with ADHD on the basis of pharmacological treatment, which has a good clinical application.

Experimental Composite Indicators of Cyclical Response in Surveys of Consumer Expectations of the Population

The article proposes a theoretical rationale and procedure for constructing new composite indicators that combine the results of quarterly consumer expectations surveys conducted by the Federal State Statistics Service (Rosstat). The information capabilities of surveys for the period 2005–2021 were studied to find the best alternative to the traditional consumer confidence index in the context of early estimates of the growth in household final consumption. The experimental Consumer Behavior Index reflects the «common profile» in the changes in the key parameters of consumer activity. The index is based on time series of primary survey indicators with high cross-correlation coefficients and a confirmed statistically significant causal relationship with a statistical referent – the growth rate of the final consumption expenditure of households. The new Consumer Anxiety Index with a counter-directional profile assesses the scale and tendencies of household response to market shocks based on short-term gaps between the indicator components and their long-term average.In accordance with the proposed procedure for statistical testing of the time series, a cross-correlation analysis was carried out. Granger causality was studied, principal component analyses applied, unobservable cyclical components were identified in the dynamics of the Consumer Behavior Index and the referent using Hodrick – Prescott, Christian – Fitzgerald and Kalman statistical filters, and phase-by-phase movement of these components is demonstrated. A statistically significant cyclical correspondence and a close relationship of leading and coinciding nature between the composite survey-based index and the growth rate of the final consumption expenditure of households were confirmed.

Ortodontik Tedavi Görmek İsteyen Bireylerde Kaygı Düzeyleri, Temporomandibular Eklem Disfonksiyonu Skorları ve Ortodontik Maloklüzyon Arasındaki İlişkinin Değerlendirilmesi

Amaç: Ortodontik tedavi görme isteğiyle başvuran genç yetişkin bireylerde Beck Anksiyete İndeksi (BAI)&#x0D; ile belirlenen kaygı düzeyleri ve Fonseca Anamnestik İndeksi (FAI) ile belirlenen Temporomandibular&#x0D; Eklem Disfonksiyonu (TMD) prevalansı ile Sınıf I, Sınıf II ve Sınıf III ortodontik maloklüzyonlar arasındaki&#x0D; ilişkinin değerlendirilmesidir.&#x0D; Gereç ve Yöntemler: Maloklüzyonlarının düzeltilmesi için ardışık olarak başvuran, 14-24 yaş arası&#x0D; genç yetişkinlerden oluşan 120 katılımcı çalışmamızın gerecini oluşturmuştur. Yapılan klinik muayene&#x0D; sonucunda dental maloklüzyonlarına göre bireyler Angle Sınıf I, II ve III olarak 3 gruba ayrılmıştır. Her&#x0D; grup kendi içinde kadın ve erkek bireyler olarak iki alt gruba ayrılmış ve sonuçta her bir grupta 20 birey&#x0D; olacak şekilde 6 grup oluşturulmuştur. Hastalara rutin ortodontik muayenenin yanı sıra TMD prevalansı&#x0D; ve şiddetini değerlendirmek amacıyla FAI ve kaygı düzeylerini belirlemek amacıyla da Beck Anksiyete&#x0D; BAI uygulanmıştır. Verilerin istatistiksel değerlendirmesi için Fischer’s Exact, Mann-Whitney U ve&#x0D; Kruskal Wallis testleri kullanılmıştır. BAI ve FAI arasındaki ilişkiyi değerlendirmek için Kendall Tau-b&#x0D; korelasyon testi kullanılmıştır. Anlamlılık düzeyi p

The Impact of Foehn Wind on Mental Distress among Patients in a Swiss Psychiatric Hospital.

Psychiatric patients are particularly vulnerable to strong weather stimuli, such as foehn, a hot wind that occurs in the alps. However, there is a dearth of research regarding its impact on mental health. This study investigated the impact of foehn wind among patients of a psychiatric hospital located in a foehn area in the Swiss Alps. Analysis was based on anonymized datasets obtained from routine records on admission and discharge, including the Brief Symptom Checklist (BSCL) questionnaire, as well as sociodemographic parameters (age, sex, and diagnosis). Between 2013 and 2020, a total of 10,456 admission days and 10,575 discharge days were recorded. All meteorological data were extracted from the database of the Federal Office of Meteorology and Climatology of Switzerland. We estimated the effect of foehn on the BSCL items using a distributed lag model. Significant differences were found between foehn and non-foehn admissions in obsession–compulsion, interpersonal sensitivity, depression, anxiety, phobic anxiety, paranoid ideation, and general severity index (GSI) (p < 0.05). Our findings suggest that foehn wind events may negatively affect specific mental health parameters in patients. More research is needed to fully understand the impact of foehn’s events on mental health.