Mean Hospital Anxiety And Depression Scale Anxiety Research Articles

The Relationship Between Digital Game Addiction and Levels of Anxiety and Depression in Adolescents Receiving Cancer Treatment.

Adolescents diagnosed with cancer are vulnerable to symptoms of anxiety, depression, and posttraumatic stress. To examine the relationship between digital game addiction and levels of anxiety and depression in adolescents receiving cancer treatment. This analytical cross-sectional study was carried out with 120 adolescents aged 12-17 years who were receiving cancer treatment. Data were collected using the Digital Game Addiction Scale (DGAS-7) and the Hospital Anxiety and Depression Scale (HADS). Data were analyzed using independent-samples t test, 1-way analysis of variance, Pearson correlation analysis, and simple linear regression. The mean age of the adolescents participating in the study was 15.21 ± 1.64 years. The mean DGAS-7 score was 15.19 ± 5.58, whereas the mean HADS Anxiety subscale score was 8.54 ± 4.33, and the mean HADS Depression subscale score was 7.72 ± 3.96. A positive, statistically significant relationship was found between the DGAS-7 mean score and the HADS Anxiety and Depression subscale mean scores (P < .001). As the addiction levels increased in adolescents diagnosed with cancer, their anxiety and depression levels also increased. Health professionals should be mindful that in adolescents diagnosed and treated for cancer, digital game addiction and levels of anxiety and depression may mutually reinforce each other.

How Different Is The Status Of Depression And Anxiety In Patients With Rheumatoid Arthritis Receiving Methotrexate With Sulfasalazine Or Hydroxychloroquine?

Background — Depression and anxiety are among the most common clinical manifestations in patients with rheumatoid arthritis (RA). Sulfasalazine and hydroxychloroquine are important medications used to treat these patients. Objective — The goal of this study was to compare the occurrence of depression and anxiety in RA patients taking sulfasalazine or hydroxychloroquine for at least six months. Methods — This study included 300 patients with RA referred to inpatient or outpatient departments of a public hospital in northern Iran who were treated with two combination regimens of methotrexate and sulfasalazine or methotrexate and hydroxychloroquine. Participants were assessed on the standard Hospital Anxiety and Depression Scale (HADS) for symptoms of depression and anxiety. Results — The mean HADS depression subscale score was 6.77±3.98 in the hydroxychloroquine group and 3.50±3.53 in the sulfasalazine group (p&lt;0.001). The mean HADS anxiety subscale score was 7.66±4.43 in the hydroxychloroquine group and 5.34±4.35 in the sulfasalazine group (p&lt;0.001). Multiple linear regression analysis revealed a significant difference in the incidence of depression and anxiety between the two treatment groups. Conclusion — A higher prevalence of depression and anxiety was observed in RA patients treated with methotrexate and hydroxychloroquine versus those treated with methotrexate with sulfasalazine.

Does Anxiety Affect Survival in Patients with Coronary Heart Disease?

Behavioral and physiological risk factors worsen the prognosis of coronary heart disease (CHD). Anxiety is known to be a psychological predictor of CHD. In this study, we investigated whether this factor is associated with all-cause mortality in CHD patients in the long term. We studied 180 patients (mean age 60.6 SD 9.2 years, 26% women) with CHD from the Berlin Anxiety Trial (BAT) and the Stepwise Psychotherapy Intervention for Reducing Risk in Coronary Artery Disease (SPIRR-CAD) study. Their cardiac and psychological risk profile was represented by standardized procedures, including the Hospital Anxiety and Depression Scale (HADS) questionnaire. Mortality outcomes were assessed using a community-based registry. Of 180 patients, we obtained information on all-cause mortality in 175 (96.7%) after a mean follow-up of 12.2 years (range 10.4-16.6 years). Of all participants, 54.4% had prior myocardial infarction, 95.3% had percutaneous transluminal coronary angioplasty and 22.2% had prior coronary artery bypass graft. Most of the patients (98.4%) had New York Heart Association class I and II, 25.6% had diabetes and 38.2% were smokers. Patients had a mean HADS anxiety score of 9.7 SD 4.1 at study entrance. We found the highest HADS anxiety quartile all-cause mortality in 14%, 30.2% in the middle quartiles and 58.7% in the lowest quartile (chi2 20.8, p = 0.001). Related to psychological mechanisms, a low level of anxiety, seemed to be a significant predictor of all-cause mortality. We found no advantage for patients who had received psychosocial therapy in terms of survival. These first data confirmed our hypothesis about the association of psychological risk factors with the long-term outcome of CAD patients. Future studies will clarify whether the severity of disease, age or a particular type of coping or denial mechanism are associated with the presented outcome in low-anxious patients.

Anxiety and depression among patients with spondyloarthritis

IntroductionAnkylosing spondylitis (AS) is an inflammatory rheumatic disease characterized by spinal and/or peripheral involvement, enthesitis, dactylitis, and several extra-articular manifestations. Chronic inflammation often leads to reduced spinal mobility and functional disability. The frequency of psychological problems has increased in AS patients.ObjectivesThe objective of this study was to determine the prevalence of symptoms of anxiety and depression among AS patients and explore the underlying associated factors.MethodsThe Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and other clinical measures were collected during the clinical trial. We evaluated also the hospital anxiety and depression scale (HADs). P values &lt; 0.05 were considered statistically significant.ResultsSixty-two patients with AS were included in the study. The average age was 41 years [18-65]. The diagnostic delay varied from one year to 26 years with an average of 4 years. Twenty-nine years is the average age of onset of symptoms with a standard deviation of 10 years. The mean duration of the disease was 10 ± 8 years. At baseline, the mean BASFI score was 53.9 ± 2 and BASDAI was 4.5± 2.Clinically significant symptoms of anxiety and depression were present in 48.4% and 54.8% of patients, respectively. Depression was noted with a mean HADS depression of 10,5 ± 5,2. Anxiety was noted with a mean HADS anxiety of 11,3 ± 4,6.In univariate analysis, anxiety was associated with the low educational level of patients (p = 0.038) and with CRP level (p= 0.041). There was a significant association between depression and anxiety (p=0.000). There was no relationship between these psychiatric disorders and disease activity, treatment modalities or functional status (p&gt;0.05)ConclusionsIn patients with Ankylosing spondylitis, the prevalence of risk of mental disorders is high.Anxiety and depression are common in AS and even alter the quality of life.Patients should be regularly screened for these disorders.Disclosure of InterestNone Declared

P865 Anxiety and Depression is Associated with Poor Sleep Quality in patients with Inflammatory Bowel Disease (IBD)

Abstract Background Sleep disturbances affect 40-50% of patients with IBD and are associated with disease flares. Symptoms, treatment side effects and pro-inflammatory status have been shown to have an effect on sleep quality and duration. Anxiety and Depression disorders are also common with both conditions affecting approximately 20% of IBD patients. These disorders may also be associated with sleep disturbance Aim Our primary aim was to assess for a correlation between sleep quality and mood disorders in people with IBD. Our secondary aim was to assess the impact of these factors on quality of life. Methods 87 patients with IBD were invited to complete an online survey. This survey included general demographic information, inflammatory bowel disease information, Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), disease activity scores (Harvey Bradshaw Index and partial MAYO score), and the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). One-way ANOVA tests, Fisher’s test and unpaired t-tests were used to calculate the statistical significance. Results Mean age 43years. 46% male (n=40) and 54% female (n=47). Ulcerative Colitis 35.6% (n=31), Crohn’s Disease 62.1% (n=54), and indeterminate 2.3% (n=2). The mean global PSQI score was 7.66, with 62% (n=54) of participants having a global PSQI score &amp;gt;5, indicating poor sleep quality. Poor sleep quality was not associated with age or disease duration. However unsurprisingly, it was associated with increased disease activity; Remission 5.89, mild activity 7.53, and moderate activity 10.61 (p&amp;lt;0.001). See FIGURE 1 Participants with poor quality of sleep had significantly higher rates of anxiety (HADSA &amp;gt;8) with a mean HADS anxiety score of 10.78 with 79% (n=39/49) reporting anxiety, compared to those with good reported sleep with mean scores of 4.97 and 21% (n=7/33).reporting anxiety p&amp;lt;0.001. They also had higher rates of depression, 42%(n=21/49) versus 6%(n=2/33), p&amp;lt;0.001. Conclusion Poor sleep quality increases levels of anxiety and depression, which in turn impacts quality of life in patients with IBD. Physicians should enquire about sleep &amp; mood when treating patients with IBD to improve sleep quality.

Predictors of long-term anxiety and depression in discharged COVID-19 patients: A follow-up study.

BACKGROUNDPatients who were hospitalized for coronavirus disease 2019 (COVID-19) faced an extremely stressful experience that challenged their mental health and the long-term effects are not definitely known yet.AIMTo identify both the course of mental symptoms (anxiety and depressive symptoms) and the related risk factors of recovered patients at the 20-22 mo follow-up.METHODSOne hundred and seventy-two patients were enrolled. The patients were evaluated with a telepsychiatry interview and the Hospital Anxiety and Depression Scale (HADS). Sociodemographic and clinical features were analyzed by regression analysis.RESULTSThe mean HADS-Anxiety (HADS-A) score was 9.08 ± 4.90, and the mean HADS-Depression (HADS-D) score was 8.55 ± 4.39. The mean HADS-A (P = 0.484) and HADS-D (P = 0.011) scores were increased compared to scores during hospitalization. Being over 50 years old, having lower financial status, and being vaccinated were associated with symptoms of depression (adjusted R2 = 0.168) while being over 50 years old, female sex, being vaccinated, and dyspnea were associated with higher anxiety (adjusted R2 = 0.245).CONCLUSIONTo prevent the deterioration of mental health, psychiatrists should play an active role in identifying emerging mental problems as soon as possible, more vulnerable groups should be characterized, and psychological support should be sustained after discharge.

Coronaphobia: A barrier to ongoing cancer treatment?

IntroductionIncreased stress levels caused by the pandemic might cause delays in cancer treatment. We conducted a survey among cancer patients undergoing treatment to evaluate their psychological wellbeing and treatment adherence during Coronavirus disease 19 (COVID‐19) pandemic.Material and MethodsPatients receiving active chemotherapy at a private oncology center between January and May 2021 were included. Healthy volunteers were employees of a district health directorate with no history of cancer or chronic disease. Treatment adherence was described as compliant if the prescribed treatment was received within a week and the information was gained from patient charts. Hospital anxiety and depression scale (HADS) and COVID‐19 phobia scale (CP19‐S) were administered to participants.Results402 participants were included; 193 (48%) were cancer patients. The mean age of the participants was 44 years old and 68% of the participants were female. All participants' CP19‐S mean score was 47.9. Patient group had significantly lower CP19‐S (p = 0.006). Chronic disease and history of a shocking event were the factors associated with CP19‐S. All participants reporting hospital anxiety were found to have significantly higher COVID‐19 phobia levels (p < 0.05). Patients' mean HADS‐anxiety score was significantly higher (7.3 vs. 6.5, p = 0.027). COVID‐19 phobia was an independent factor increasing the level of anxiety and depression in both groups. Adherence to treatment was 100%.ConclusionThe pandemic increased levels of anxiety, however, cancer treatment continued to be a priority in patients' lives. Strategies should be developed to support oncology patients cope with the pandemic and increase their courage to avoid treatment delays.

How Healthcare Utilization Due to Dizziness and Vertigo Differs Between Older and Younger Adults

BackgroundVertigo and dizziness are common in older adults. We describe self-reported healthcare utilization because of dizziness and vertigo in older adults attending a tertiary care specialized vertigo center.MethodsData from 765 patients (45% were ≥60 years old) with chronic dizziness and vertigo who attended a daycare multimodal treatment program were recorded. Data included sociodemographic parameters, dizziness-related characteristics, the Body Sensations Questionnaire (BSQ), the Agoraphobic Cognitions Questionnaire (ACQ), and the Hospital Anxiety and Depression Scale (HADS). Also, healthcare utilization, including (1) physician and clinical services, (2) hospitalizations in the year before consulting the vertigo center, (3) prescription of drugs and other professional services were included. Descriptive statistics, exploratory data analysis, and regression models were used.ResultsIntensity of dizziness was similar in both age groups, however, distress due to dizziness was more severe in younger persons. Dizziness symptoms lasted longer in older adults than in younger persons. Older adults had a somatic diagnosis (74.6 vs. 35.0%) more frequently and reported more falls (37.2 vs. 28.5%) than younger individuals. Anxiety about bodily sensations was higher in younger patients (mean BSQ1 = 9.33 ± 5.6) than in older patients (mean BSQ1 = 6.72 ± 5.4). Older persons had fewer depressive symptoms (mean HADS depression = 5.8 ± 3.6 vs. 6.5 ± 4.1) and less anxiety (mean HADS anxiety = 5.7 ± 3.7 vs. 7.8 ± 4.1) than younger individuals. Younger people were more frequently hospitalized (24.4%) than older adults (16.3%) in the year before consulting the vertigo center. Also, younger patients and patients with non-somatic etiologies had considerably more consultations with healthcare providers than older patients. Older adults received less medication (50.3%), less physiotherapy (41%), and less psychological therapy (11.6%) for vertigo than younger people (59.7, 52.2, 20.4%, respectively).ConclusionAge-associated differences in healthcare utilization were defined in selected patients attending a specialized vertigo center. Since dizziness is frequently a heterogeneous disorder requiring interdisciplinary care, its diagnostic and therapeutic work-up must be improved for older patients with dizziness.

Investigation of the Effect of Time to Ambulation on Patient Outcomes, Anxiety and Depression

Purpose: The aim of the study was to investigation of the effects of time to ambulation on patient outcomes, anxiety and depression.&#x0D; Method: This is a descriptive cross-sectional study. The study was conducted on 157 patients in the general surgery clinic of a training and research hospital in western Turkey. The data were collected using a Descriptive Form, Patient Outcomes Follow-up Form, Brief Pain Inventory, Hospital Anxiety and Depression Scale (HADS) and analysed by number, percentage, Mann–Whitney U test, Spearman correlation method using the Statistical Package for Social Science software version 24.&#x0D; Results: The mean age of the patients who participated in the study was 49.5±18.1 years. The mean time to ambulation of the patients was 12.45±9.07 hours. The mean pain level of the participants in the last 24 hours, mean HADS-anxiety score and mean HADS-depression score were 3.7±1.7, 4.0±2.6 and 4.4±3.0, respectively. &#x0D; Conclusions: In our study, we found that the time to ambulation was increased as the patients' age, duration of anaesthesia and depression scores increased. Additionally, the ambulation of patients with drains and catheters delayed. Furthermore, it was found that the duration of hospitalisation increased with the increase in the time to ambulation of patients.

Prevalence of anxiety and depressive disorders in facial trauma patients: A cross-sectional study

Abstract Background To evaluate the prevalence of anxiety and depressive disorders in facial trauma patients admitted to the Ibn ROCHD University Hospital of Casablanca, we initiated this study. Indeed, facial trauma is damage that can have serious repercussions on the mental health of patients. However, there is little data in Morocco. Methods This was a cross-sectional study conducted at the Ibn Rochd University Hospital in Casablanca from January to April 2019 among facial trauma patients without a history of anxiety and depressive disorders, admitted to the Maxillofacial Surgery Department within 72 hours of the trauma. The patients' socio-demographic and clinical data were collected through a questionnaire, and then the Hospital Anxiety and Depression Scale (HADS) was applied to assess depression and anxiety. In addition to a descriptive analysis of the results, a multinomial regression analysis was performed to assess factors that might be associated with depression and anxiety. Results Among 50 facial trauma patients admitted to the Ibn Rochd University Hospital in Casablanca and included in our study, 11 had symptoms of anxiety (22%) and 12 had symptoms of depression (24%) according to the HADS classification. The mean HADS anxiety and depression subscale scores of the patients were 7.32±4.17 and 6.32±5.10, respectively. Although gender (OR = 2.28 [0.35; 5.70] females), marital status (OR = 3.30 [0.70; 12.70] singles), occupation (OR = 2.66 [0.58; 12.18] not employed), and circumstances of occurrence (OR = 3.66 [0.35; 15.70] public roads) increased the risk of anxiety in patients without anxiety (HADS score≤7); none of these factors was statistically associated with either anxiety or depression. Conclusions This cross-sectional study showed that the prevalence of anxiety and depression in victims of facial trauma is very high in Casablanca. Key messages The prevalence of anxiety and depression among facial trauma victims is very high. Gender, marital status, occupation, and circumstances of occurrence non-significantly increase the risk of anxiety and depression.

Efficacy of mindfulness-based cognitive therapy on symptoms of depression and anxiety in patients with coronary artery disease: insights from a prospective registry

Abstract Introduction Patients with coronary artery disease (CAD) report psychological distress and poor physical functioning after cardiovascular events. In cardiac rehabilitation, an exercise program is often used as A primary strategy; however, this is often not sufficient to address stress and psychosocial well-being. Purpose To investigate the effectiveness of a mindfulness-based cognitive therapy (MBCT) program on feelings of anxiety and depression in patients with CAD. Methods In this single-center prospective observational study, eligible cardiac rehabilitation patients with symptoms of anxiety or depression were recruited after referral for psychological consultation. During eight consecutive weeks, patients participated in group meetings. The program included psycho- education, cognitive behavioral therapy, meditation and slow abdominal breathing. Standard measures of depression, anxiety and blood pressure were obtained at baseline and after completion of the program. The Hospital Anxiety and Depression Scale (HADS) questionnaire was used as an instrument for detecting states of anxiety and depression. Results A total of 135 patients (mean age 56±9 years; 24% female) were enrolled. The mean HADS-Anxiety score improved from 11.0±3.7 at baseline to 6.6±3.4 after MBCT (p&amp;lt;0.001). The mean HADS-Depression score improved from 8.8±3.6 to 4.7±3.2 (p&amp;lt;0.001). In addition, during the MBCT program a significant decrease in blood pressure was noted: systolic from 140±18 to 130±17 mmHg and diastolic from 84±12 to 77±10 mmHg (p&amp;lt;0.001 for both). Conclusion This study provides evidence that a MBCT program has the potential to improve feelings of anxiety and depression in patients with CAD. Therefore, adding MBCT to cardiac rehabilitation in selected patients may be of great value. Funding Acknowledgement Type of funding sources: None.

Anxiety and related factors among parents of patients with breast cancer after surgery in Japan: A multi-informant and multilevel study.

Anxiety and its correlates in parents of patients with breast cancer have rarely been studied. We explored anxiety among parents of postoperative patients with breast cancer and its relationship with parents' social support and care needs and patients' anxiety. A cross-sectional survey using self-report questionnaires and medical records was conducted among patients with breast cancer after surgery and their parents at four designated cancer care hospitals between September 2015 and June 2016. Anxiety was measured using the Hospital Anxiety and Depression Scale (HADS). Parents provided information about social support and care needs. Multilevel analysis was performed on patient-parent paired data controlling for patient-level variation. Participants included 107 patients, 83 mothers, and 51 fathers. The mean HADS anxiety scores reported by mothers and fathers were 7.2 and 6.5, respectively, which were higher than patients' HADS anxiety scores. Fulfillment of important care needs was related to lower anxiety among mothers and fathers (estimate=-1.38, p=.01). Lower family support and higher patient anxiety were associated with higher anxiety in mothers, but not fathers. Parents of patients with breast cancer had high anxiety. Communication, providing cancer-related information, and fulfilling care needs can alleviate anxiety in parents of patients with breast cancer after surgery. Furthermore, increasing family support and decreasing patients' anxiety are essential to alleviating mothers' anxiety.

Prevalence of Anxiety and Depression in Patients With Primary Glaucoma in Western India.

Glaucoma can cause disturbance in psychological and emotional functioning of patients, leading to anxiety and depression, even early in the disease. Identification and management of these problems should be included as a part of the holistic approach for patient care. The purpose of this study was to assess the prevalence of anxiety and depression in patients with primary glaucoma using a standard validated questionnaire. A cross-sectional prevalence study was carried out on 200 patients attending the glaucoma outpatient clinic at a tertiary care eye hospital in Pune, India. After obtaining written consent, all patients underwent a thorough ophthalmic examination. Those with primary glaucoma were included in the study and classified on the basis of the Hodapp-Parrish-Anderson criteria. Participants were asked to respond to the Hospital Anxiety and Depression Scale (HADS) questionnaire, and responses were analyzed statistically. The mean HADS-Anxiety score was 4.5 (SD=3.4), while HADS-Depression was 4.1 (SD=3.8). The severity of the disease was associated with significantly higher HADS scores. Mean HADS-Anxiety scores were 3.1 (SD=2.9) for mild glaucoma, 4.4 (SD=2.6) for moderate, and 7.7 (SD=3.0) for advanced disease (P<0.001). Similarly, mean HADS-Depression scores were 2.0 (SD=2.6), 4.2 (SD=3.0), and 8.3 (SD=3.3), respectively for mild, moderate, and severe glaucoma (P<0.001). Based on HADS scores, a third of patients (34.5%) were symptomatic for anxiety or depression, out of which 25 (12.5%) could be classified as definite cases. Duration of treatment had no association with HADS scores. An association exists between the amount of visual loss among patients with glaucoma and symptoms of anxiety and depression, irrespective of disease duration. This information may help to choose treatment approaches most likely to be beneficial to the patients.

Measuring True Change in Individual Patients: Reliable Change Indices of Cardiac Rehabilitation Outcomes, and Implications for Quality Indicators

BackgroundMediated by outcomes such as improved exercise capacity, cardiac rehabilitation (CR) reduces morbidity and mortality. For accuracy, an individual CR patient's change must be measured reliably, an issue not typically considered in practice. Drawing from psychometric theory, we calculated reliable change indices (RCIs), to measure individual CR patients’ true clinical change, apart from that from error and test practice/exposure, in exercise capacity, anxiety, and depression. MethodsIndirectly calculated exercise capacity (peak metabolic equivalents [METs]) and psychological symptoms were each measured twice, 1 week apart, by administering treadmill tests or the Hospital Anxiety and Depression Scale (HADS) to separate samples of 35 (mean age: 59.0 years; 6 women) and 96 (mean age: 64.4 years; 32 women) CR patients, respectively. Using test-retest reliability and mean difference scores from these samples to estimate error and practice/exposure effects, we calculated RCIs for a separate cohort (n = 2066; mean age: 62.0 years; 533 women) who completed 6-month CR, and compared change distributions (worsened/unchanged/improved) based on critical RCIs, mean and percent changes, cut-off scores, and standard deviations. ResultsPractice/exposure effects were nonsignificant, except the mean HADS anxiety score decreased significantly (P ≤ 0.013; d = 0.17, small effect). Test-retest reliabilities were high (METs r = 0.934; HADS anxiety score r = 0.912; HADS depression score r = 0.90; P < 0.001). Among 2066 CR patients, RCI distributions differed (P < 0.001) from those of most other change criteria. ConclusionsChange ascertainment depends on criterion choice. A Canadian Cardiovascular Society CR quality indicator of increase by 0.5 MET may be too small to assess individuals’ functional capacity change. RCIs offer a pragmatic approach to benchmarking reliable change frequency, and pending further validation, could be used for feedback to individual patients.

Pediatric and Maternal Anxiety at First Visit to a Turkish Gastroenterology Clinic Compared to Anxiety Prior to Pediatric Endoscopy Procedure.

The aim of this study was the prospective comparison of pediatric and maternal anxiety at the first visit to a gastroenterology clinic with anxiety prior to a pediatric endoscopy procedure. A total of 101 children aged 4-18 years plus their mothers who were referred to an outpatient pediatric gastroenterology clinic were included in the first group. The second group consisted of 101 different children aged 4-18 years undergoing pediatric endoscopy. The Hospital Anxiety and Depression Scale (HADS) was administered to mothers. Visual analog scale scores were obtained from the children to measure anxiety. The demographic characteristics of the groups were similar. The mean HADS anxiety score was 3.83 in mothers of the first group. The same score was significantly higher as (6.96) in the mothers whose children underwent an endoscopy (p < .001). The comparison of the depression scores revealed significantly higher scores in the endoscopy group. Visual analog scale values of the children revealed remarkably higher anxiety scores in the endoscopy group. About 5% of mothers in the first group and almost half of the mothers in the endoscopy group developed remarkable anxiety (>8 HADS anxiety). The rate of significant depression (>8 HADS depression) was 2% and 17.82% in the first and second groups, respectively. The current prospective trial concluded that particularly anxiety is a major concern for mothers and children when endoscopy is required.

Psychosocial response of infertile patients to COVID-19-related delays in care at the epicenter of the global pandemic.

The aim of this study was to describe the psychosocial response of the infertile population whose care was curtailed due to the COVID-19 pandemic. A web-based cross-sectional survey was administered to 117 infertile patients at our Center who had their infertility treatment delayed due to suspension of care at our hospital during the COVID-19 pandemic. The survey consisted of 52-question multiple-choice questions including the Life Orientation Test-Revised (LOT-R) and the Hospital Anxiety and Depression Scale (HADS) instruments. Characteristics of respondents who "agreed" (strongly agree and agree) that "delaying treatment has permanently impacted my chances at future conception" were compared with participants who "disagreed" (neutral, disagree, and strongly disagree) using Fischer's Exact Test. In total, 79.5% agreed that delaying treatment has permanently impacted their chances at future conception. There were no discernible demographic differences between patients who "agreed" versus "disagreed" with the above statement. The mean LOT-R score was 14.1 (5.1) with an optimism score of 6.8 (2.6) and a pessimism score of 7.3 (2.9). The mean HADS depression score was 5.4 (3.4) with 28.2% reporting scores in the borderline-abnormal to abnormal range. The mean HADS anxiety score was 9.0 (3.9) with 64.6% reporting scores in the borderline-abnormal to abnormal range. Nearly one third of respondents (36.8%) reported wanting to "expedite/be more aggressive with treatment," whereas only 5.1% wanted to postpone treatment. Women undergoing ART during the COVID-19 pandemic express significant concern and signs of distress about how delays in care affect their future reproductive potential.

Anxiety on the lockdown resolution

IntroductionLockdown due to the management of infectious diseases such as corona virus disease affect mental health. We would think that with the end of the lockdown due to the corona virus pandemic, the feeling of regaining freedom and movement would be good for our morale.Objectives Through this servery, we examine the prevalence of anxiety symptoms in the Tunisian population face to the end of lockdown.Methods The survey was conducted using the online anonymous questionnaires and distributed through social networks from 24 April to 23 May 2020(which was considered the end of the lockdown in Tunisia). It included socio-demographic questions and participants’ experience of SARS-CoV-2related stressful events (A member of your family was suspected of having Corona virus /someone you know had Corona virus‘s symptoms /You were quarantined). Anxiety symptoms were evaluated with the Hospital anxiety and depression scale-anxiety (HADS-A)Results Our study included 80 participants: 71.3% female and 42.5% married. The mean age of the participants was 29.30 years (SD = 8.72). The mean HADS-A score was 8.03 (SD=2.938) (maximum=16 minimum=1). Two-thirds of the participants exhibited anxiety symptoms (66.3%) with 1.3 % reported moderate severe anxiety symptoms. Anxiety was correlated with age and gender (p=0.013, p=0.027).ConclusionsOur results suggest that in this early phase of the COVID-19 lockdown resolution we can already observe its fundamental impact on anxiety.

Long-term health-related quality of life in patients treated with subcutaneous C1-inhibitor replacement therapy for the prevention of hereditary angioedema attacks: findings from the COMPACT open-label extension study

BackgroundLong-term prophylaxis with subcutaneous C1-inhibitor (C1-INH[SC]; HAEGARDA, CSL Behring) in patients with hereditary angioedema (HAE) due to C1-INH deficiency (C1-INH-HAE) was evaluated in an open-label extension follow-up study to the international, double-blind, placebo-controlled COMPACT study. The current analysis evaluated patient-reported health-related quality of life (HRQoL) data from 126 patients in the open-label extension study randomized to treatment with C1-INH(SC) 40 IU/kg (n = 63) or 60 IU/kg (n = 63) twice weekly for 52 weeks. HRQoL was evaluated at the beginning of the open-label study and at various time points using the European Quality of Life-5 Dimensions Questionnaire (EQ-5D), the Hospital Anxiety and Depression Scale (HADS), the Work Productivity and Activity Impairment Questionnaire (WPAI), and the Treatment Satisfaction Questionnaire for Medication. The disease-specific Angioedema Quality of Life Questionnaire (AE-QoL) and HAE quality of life questionnaire (HAE-QoL) instruments were administered in a subset of patients. Statistical significance was determined by change-from-baseline 95% confidence intervals (CIs) excluding zero. No adjustment for multiplicity was done.ResultsMean baseline EQ-5D scores (Health State Value, 0.90; Visual Analog Scale, 81.32) were slightly higher (better) than United States population norms (0.825, 80.0, respectively) and mean HADS anxiety (5.48) and depression (2.88) scores were within “normal” range (0–7). Yet, patients using C1-INH(SC) 60 IU/kg demonstrated significant improvement from baseline to end-of-study on the EQ-5D Health State Value (mean change [95% CI], 0.07 [0.01, 0.12] and Visual Analog Scale (7.45 [3.29, 11.62]). In the C1-INH(SC) 60 IU/kg group, there were significant improvements in the HADS anxiety scale (mean change [95% CI], − 1.23 [− 2.08, − 0.38]), HADS depression scale (− 0.95 [− 1.57, − 0.34]), and WPAI-assessed presenteeism (mean change [95% CI], − 23.33% [− 34.86, − 11.81]), work productivity loss (− 26.68% [− 39.92, − 13.44]), and activity impairment (− 16.14% [− 26.36, − 5.91]). Clinically important improvements were achieved in ≥ 25% of patients for all domains except WPAI-assessed absenteeism (which was very low at baseline). Mean AE-QoL total score by visit ranged from 13.39 to 17.89 (scale 0–100; lower scores = less impairment). Mean HAE-QoL global scores at each visit (115.7–122.3) were close to the maximum (best) possible score of 135.ConclusionsLong-term C1-INH(SC) replacement therapy in patients with C1-INH-HAE leads to significant and sustained improvements in multiple measures of HRQoL.Trial registration A Study to Evaluate the Long-term Clinical Safety and Efficacy of Subcutaneously Administered C1-esterase Inhibitor in the Prevention of Hereditary Angioedema, NCT02316353. Registered December 12, 2014, https://clinicaltrials.gov/ct2/show/NCT02316353.

The Effects of Peat-Pack Poultice and Salt Groundwater Foot Bath in Taean-gun on Depression and Pain in Single Parent Family

Purpose: Studies have reported on treating various diseases with marine healing, but not the effects of marine healing on depression, anxiety, and pain in single-parent families. This study aimed to evaluate the scientific efficacy of treatment using peat-pack poultice and salt groundwater and evaluate its effects on depression, anxiety, and pain in single-parent families.Methods: For 26 women of single-parent families, peat-pack thermal therapy and salt-water foot baths were performed daily for 4 days. Of the 26 subjects, three dropped out and 23 were enrolled in the study. The depression and pain results were compared before versus after the peat-pack poultice and salt groundwater treatments. The Edinburgh Postnatal Depression Scale, Hospital Anxiety and Depression Scale (HADS), and visual analog scale (VAS) pain score were evaluated.Results: In Taean-gun, a peat-pack poultice and salt groundwater foot bath program were administered along with a questionnaire for depression, anxiety, and pain. Mean Edinburgh score was significantly improved after the program (11.78±7.6 vs. 9.7±7.6, p=0.005), mean HADS anxiety score (7±9.7 vs. 5.3± 2.7, p=0.002) and mean VAS pain score also improved (5.39±2.8 vs. 3.96±2.7, p=0.003).Conclusion: Peat-pack thermal therapy and salt groundwater foot bath improved chronic pain, depression, and anxiety in single-parent families.

Service evaluation of a pilot psychology clinic including psychological intervention within a Tier 2 community adult weight management service

Background:Obesity levels in Scotland are amongst the highest in the developing world and psychological co-morbidities are common amongst the obese population. and evidence suggests that psychological approaches, can result in sustained weight loss, improved wellbeing and reduced binge eating. However, there is limited evidence of effective intervention supporting weight outcomes in a general setting.Aim:The aim of this pilot intervention was to determine if the addition of a psychology clinic within a Tier 2 community adult weight management service (CAWMS) supported positive weight management outcomes.Methods:Service evaluation data was gathered at an urban and rural GP practice within Grampian. Patients were referred to the pilot psychology clinic if mild to moderate mental health concerns were highlighted. Eight patients (average age 46 years; mean BMI 46.2) attended between four and eight appointments within the psychology clinic. Progress, goal setting, barriers and relapse prevention were discussed using a motivational interviewing approach. Psycho-education, self-management advice and brief psychological interventions, were offered where appropriate.Results:Mean weight loss for patients who attended the psychology clinic was 7.4kg. Mean HADS anxiety scores did not change, whereas HADS depression scores reduced by 3.5, although not statistically significant (p &gt; 0.001). Qualitative feedback suggests that the majority of patients found the addition of psychological support helpful.Conclusion:The pilot has highlighted the value and importance of a psychology clinic within Tier 2 CAWMS. Feedback from dietitians suggests that the addition of psychological support better informed their understanding of patients concerns. It highlights the need for ‘joined-up’ working within the community weight management service.