Mild Anxiety Research Articles

Safety and efficacy of fluoxetine in post-stroke anxiety-A pilot prospective randomized open blinded endpoint (PROBE) study.

The prevalence of post-stroke anxiety (PSA) is reported to be 20%-25%. There is insufficient evidence on the efficacy of antidepressants for treating anxiety in such patients. This Prospective Randomized Open Blinded Endpoint (PROBE) study was designed to assess the safety and efficacy of fluoxetine in PSA. In this single-center pilot study conducted in India, post-stroke patients (between 1 to 6months) were randomized to fluoxetine (intervention group: 20mg/day for 12weeks) or standard medical care (control group). The primary outcome was improvement in the Hamilton Anxiety Rating Scale (HAM-A) at 12weeks. The secondary outcomes were anxiety remission (>50% improvement in HAM-A), modified Rankin Scale (mRS), Barthel Index (BI), quality of life (SF-36), and Hamilton Depression Rating Scale (HAM-D). A linear regression analysis was done for determinants of HAM-A to account for baseline differences in the intervention and control groups. A total of 60 patients were randomized: (30: intervention, 30: control). The overall prevalence of post-stroke anxiety among participants in the study was 50.8%, and 31.5% experienced both anxiety and depression. The average HAM-A score at baseline was 11, and average follow-up score at study conclusion was 4. There was similar improvement in the HAM-A score at 12weeks post-randomization in the intervention and control groups [fluoxetine: -8.0 (95% CI = -11.0 to -4.0); control: -7.0 (95% CI = -9.5 to -4.0); P = 0.91]. Likewise, there was no significant difference between intervention and control groups at 12weeks post-randomization on the mRS, BI, SF-36, or HAM-D. There were no serious adverse events in either group during the study. Fluoxetine and standard medical care had comparable improvement in HAM-A in post-stroke patients with mild anxiety at 12weeks. Further study of the pharmacological treatment of post-stroke patients with more severe anxiety is needed. CTRI/2018/12/016568.

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

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

Restless sleep is associated with increased anxiety in physical therapy students: a cross sectional survey study

BackgroundSleep and mental health are intimately related and shown to impact graduate students enrolled in health sciences programs, including physical therapy education. Doctorate of Physical Therapy (DPT) students’ attitudes and behaviors surrounding sleep and whether these factors are associated with mental health are unknown. This study aimed to describe sleep behaviors and attitudes of entry-level DPT students and to explore the relationship between subjectively reported sleep quality and self-reported symptoms of anxiety in these students.MethodsA cross-sectional online survey consisting of the Sleep Practices and Attitudes Questionnaire (SPAQ), the Generalized Anxiety Disorder-7 (GAD-7) questionnaire, and demographic questions were used. Analyses investigated sleep behaviors and attitudes, along with the relationship (unadjusted odds ratio) between restless sleep and anxiety in DPT students in hybrid and traditional DPT programs across the United States (US).ResultsA total of 271 DPT students completed the survey. A majority of students reported feeling tired during most days (80.8%, n = 219), a quarter of participants (24.7%) reported having a history of trouble sleeping and four (1.5%) reported being diagnosed with a sleep disorder. Of those who reported their sleep duration, participants slept an average of 6.86 h. The mean GAD-7 score was 7.68 (SD = 4.90), suggestive of mild anxiety. Sixty-seven (24.7%) reported having a diagnosed anxiety disorder, with generalized anxiety being the most common diagnosis. Those who reported having restless sleep were 4.09 times more likely to have moderate to severe anxiety [unadjusted odds ratio = 4.09 (95% CI 2.27,7.35; p < 0.001)] compared to those who reported restful sleep.ConclusionsDPT students who rated sleep as restless exhibit signs of poor subjective sleep quality associated with an increased risk of experiencing moderate to severe anxiety compared to students who had restful sleep. Students reported behaviors surrounding sleep that may contribute to anxiety. These findings have implications for including sleep and mental health education and practices within DPT programs.

Hypnotherapy Technique to Reduce Anxiety Levels in Elderly with Hypertension

Background: One of the non-pharmacological intervention that can be used is hypnotherapy. This intervention uses suggestions that will relax the client's condition so that the brain produces the hormones serotonin, endorpine, and activation of autonomic nerve responses. At the same time the neuroendocrine system will also lower levels of cortisol, glucocorticoids, gonadocorticoids, epinephrine, norepinephrine and will act directly on the alpha androgenic receptors of vascular smooth muscle, thus causing vasodilation of blood vessels, lowering total peripheral pressure and decreasing blood pressure, pulse, and breathing. Objectives: This study is to determine the effect of hypnotherapy techniques on reducing anxiety levels in elderly families with hypertension at RT 10/RW 05 Lenteng Agung, South Jakarta. Methods: This study employed a quantitative pre-experimental design with a one-group pre-test post-test approach to examine the effect of an intervention on anxiety levels in elderly individuals with hypertension. The study population consisted of 39 elderly individuals, with 15 participants meeting the inclusion criteria. Data were collected in 2023, and the sample was selected using total sampling, consisting of 9 women and 6 men. Participants were observed before and after the intervention to assess changes in anxiety levels. Results: This study showed that after being given hypnotherapy technique treatment, the majority experienced a decrease in anxiety levels, namely mild anxiety as many as 11 elderly (73.3%) and respondents who experienced moderate anxiety as many as 4 elderly (46.7%) Conclusion: The majority of elderly individuals with hypertension experienced severe anxiety before receiving hypnosis techniques. After the application of hypnosis, most experienced a reduction in anxiety to mild levels. This demonstrates that hypnosis techniques have a significant effect in reducing anxiety levels in elderly individuals with hypertension

Association of Anxiety with Uncinate Fasciculus Lesion Burden in Multiple Sclerosis.

Multiple sclerosis (MS) is an immune-mediated neurological disorder that affects 2.4 million people world-wide, and up to 60% experience anxiety. We investigated how anxiety in MS is associated with white matter lesion burden in the uncinate fasciculus (UF). Retrospective case-control study of participants who received research-quality 3-tesla (3T) neuroimaging as part of MS clinical care from 2010-2018. Analyses were performed from June 1 st to September 30 th , 2024. Single-center academic medical specialty MS clinic. Participants were identified from the electronic medical record. All participants were diagnosed by an MS specialist and completed research-quality MRI at 3T. After excluding participants with poor image quality, 372 were stratified into three groups which were balanced for age and sex: 1) MS without anxiety (MS+noA, n=99); 2) MS with mild anxiety (MS+mildA, n=249); and 3) MS with severe anxiety (MS+severeA, n=24). Anxiety diagnosis and anxiolytic medication. We first evaluated whether MS+severeA patients had greater lesion burden in the UF than MS+noA. Next, we examined whether increasing anxiety severity was associated with greater UF lesion burden. Generalized additive models were employed, with the burden of lesions (e.g. proportion of fascicle impacted) within the UF as the outcome measure and sex and spline of age as covariates. UF burden was higher in MS+severeA as compared to MS+noA (T=2.02, P=0.045, Cohen's f 2 =0.19). A dose-response effect was also found, where higher mean UF burden was associated with higher anxiety severity (T=2.08, P=0.038, Cohen's f 2 =0.10). We demonstrate that overall lesion burden in UF was associated with the presence and severity of anxiety in patients with MS. Future studies linking white matter lesion burden in UF with treatment prognosis are warranted. Question: Are white matter lesions that impact the uncinate fasciculus (UF) associated with anxiety in patients with multiple sclerosis (MS)?Findings: This retrospective, case-control study of 372 patients with MS included 3 anxiety severity groups: 1) MS without anxiety (MS+noA, n=99); 2) MS with mild anxiety (MS+mildA, n=249); and 3) MS with severe anxiety (MS+severeA, n=24). We identified associations between anxiety and UF lesion burden. Specifically, we showed that MS+severeA had higher UF lesion burden than MS+noA, and worsening anxiety severity increased with greater UF burden.Meaning: Lesion burden in the UF may contribute to anxiety comorbidity in MS.

Low Energy Availability Risk Is Associated with Anxiety in Female Collegiate Athletes.

This study investigated the association between the risk of low energy availability, disordered eating, and anxiety in collegiate female athletes. Female athletes (n = 115) completed questionnaires that assessed disordered eating (Disordered Eating Screen for Athletes, DESA-6; and the Eating Disorder Examination Questionnaire Short, EDE-QS), anxiety (Generalized Anxiety Disorder-7) and the risk of low energy availability (Low Energy Availability in Females Questionnaire; LEAF-Q). The athletes were 19.9 ± 0.1 years old and presented with no anxiety (14.8%), mild (33.0%), moderate (24.3%), and severe (27.8%) anxiety. The EDE-QS scores revealed that 22.6% of the participants had a high risk of an eating disorder, while the DESA-6 scores revealed that 31.3% of the participants scored positive for a risk of disordered eating. The LEAF-Q total scores revealed that 68.7% of the participants were at risk of low energy availability. Increased GAD-7 scores were associated (p < 0.001) with measures of disordered eating (EDE-QS and DESA-6) and the risk of low energy availability (LEAF-Q total score). Non-parametric partial correlations demonstrated that anxiety (increased GAD-7 scores) correlated with the risk of low energy availability (increased LEAF-Q total scores) while controlling for eating disorder scores (EDE-QS) (r (112) = 0.353, p < 0.001), or while controlling for the risk of disordered eating (DESA-6 scores) (r (112) = 0.349, p < 0.001). In female collegiate athletes, both disordered eating and the risk of low energy availability were positively associated with increased anxiety.

7527 Subacute Thyroiditis in First Trimester of Pregnancy: Rare Cause of Thyrotoxicosis

Abstract Disclosure: K. Wilcher: None. A. Gupta: None. Background: Subacute thyroiditis (SAT) is extremely rare in pregnancy with only 8 prior cases reported in the literature. SAT can result in maternal and fetal complications. In this case report, we describe a case of subacute thyroiditis presenting in the first trimester of pregnancy. Case Presentation: A 38-year-old female with past medical history of stillbirth presented with thyrotoxicosis in gestational week 10 of her pregnancy. The patient has a history of stillbirth in gestational week 38 of her first pregnancy requiring cesarean section one year prior to presentation. She was in the process of getting in vitro fertilization (IVF) and had an egg retrieval. During the process, she started on thyroxine 50 mcg daily for blood thyroid-stimulating hormone (TSH) 3.77 mcIU/mL. She became pregnant without the help of IVF and stopped thyroxine. One month later, labs showed low TSH 0.022 mcIU/mL (reference range: 0.4-4.5 mcIU/mL) and high blood free thyroxine (FT4) 1.87 ng/dL (reference range: 0.7-1.8 ng/dL). Repeat labs two weeks later showed low blood TSH 0.012 mcIU/mL, high FT4 2.08 ng/dL, and high blood free triiodothyronine (FT3) 5.2 pg/mL (reference range: 2.3-4.2 pg/mL). She was referred to endocrinology for evaluation. She reported mild intermittent right sided neck pain since diagnosis of pregnancy. She denied any history of viral infection, cough, or fever. She reported symptoms of severe nausea, mild constipation, and mild anxiety. She denied diarrhea, tremors, changes in voice, palpitations, or weight loss. Her family history is significant for hypothyroidism in her father. Physical exam demonstrated a non-tender, symmetric thyroid without enlargement or nodules. Ultrasound showed heterogenous thyroid with an ill-defined heterogenous area in the right lobe appearing pseudo-nodule, and increased vascularity. At this time, the patient was diagnosed with mild gestational hyperthyroidism with a plan to monitor thyroid hormone levels. Repeat labs two weeks later showed low blood TSH 0.005 mcIU/mL, high FT4 2.35 ng/dL, and high FT3 6.4 pg/mL. TSH-receptor antibodies, thyroid stimulating immunoglobulin, and thyroid peroxidase antibodies were normal on testing. In gestational week 16, labs showed normal TSH 2.76 mcIU/mL, low FT4 0.56 ng/dL, and low FT3 2.1 pg/mL. At that time, she started on levothyroxine 75 mcg daily and was diagnosed with subacute thyroiditis. Follow up labs in gestational weeks 18, 20, and 24 showed improvement in TSH and FT4 on thyroid hormone supplementation. Conclusion: This case report discusses the findings of SAT in first trimester pregnancy. Currently, she is in gestational week 28 and still requiring thyroid hormone supplementation. SAT in pregnancy is very rare. This case report significantly contributes to the literature and current knowledge of the prevalence, presentation, and disease process of subacute thyroiditis in first trimester pregnancy. Presentation: 6/2/2024

The Effect of Operating Room Tour Video on Pre-Anesthetic Anxiety in Sectio Caesarea Patients

Background: Preoperative anxiety in patients undergoing cesarean sections (CS) can significantly impact both psychological well-being and physiological responses, potentially affecting the success of anesthesia. An educational intervention, such as an Operating Room (OR) Tour video, may alleviate anxiety by familiarizing patients with the surgical environment and process. Purpose: To determine the effect of an Operating Room Tour video on pre-anesthetic anxiety levels in CS patients. Methods: This study employed a pre-experimental design with a pretest-posttest approach to assess the impact of the video on pre-anesthetic anxiety in 30 CS patients at Cilacap General Hospital. Anxiety levels were measured using the Visual Analog Scale for Anxiety (VAS-A) before and after the intervention. Statistical analysis was conducted using the Wilcoxon signed-rank test to evaluate the significance of the change in anxiety levels. Results: The findings revealed a significant reduction in anxiety following the video intervention. Prior to the intervention, 43.3% of participants experienced moderate anxiety, while post-intervention, 66.7% reported only mild anxiety. The Wilcoxon test confirmed the significant impact of the OR Tour video on reducing pre-anesthetic anxiety (p = 0.011, p &lt; 0.05). Conclusion: The use of an Operating Room Tour video is an effective strategy to reduce preoperative anxiety in CS patients. This educational intervention could be a valuable addition to pre-anesthesia care, improving patient comfort and potentially contributing to better surgical outcomes.

The 2024-2025 Commonwealth Budget for Mental Health: Funding unproven initiatives and stings in the tail.

We discuss the ramifications of the Commonwealth of Australia Budget allocations for mental healthcare for 2024-2025. There is funding for population-based mental health initiatives for milder anxiety and depression but no direct funding of services for the most severe and disabling forms of mental illness, other than pre-existing state/territory disbursements from the Commonwealth for state-based health services. There are substantial concerns that the Commonwealth funding has potentially been misallocated to ineffective interventions that are unlikely to reduce the population prevalence of mild anxiety and depression in Australia. Funds may have been better allocated to provide effective care for those with the most severe and disabling illnesses including schizophrenia, bipolar disorder and severe depression.

The effect of anxiety on metabolic parameters in patients with primary hypertension

Aims: Although the role of anxiety in the pathogenesis of hypertension is known, the effect of anxiety on metabolic parameters in hypertension has not been demonstrated. This study aimed to evaluate the effect of anxiety on metabolic parameters and blood pressure regulation in patients with primary hypertension. Methods: The study was designed as a single-center, descriptive cross-sectional study. A total of 150 patients receiving antihypertensive therapy for primary hypertension were included in the study. Patients were divided into minimal, mild, moderate, and severe anxiety groups according to the Beck Anxiety Inventory. Anthropometric measurements, metabolic parameters, and blood pressure measurements were compared between groups. Results: Significant positive correlations were found between anxiety severity and total cholesterol, LDL cholesterol, body mass index, and waist circumference (p&lt;0.05). Subgroup analyses showed that total cholesterol, LDL cholesterol, body mass index, and waist circumference were higher in the severe anxiety group than in the minimal anxiety group (p&lt;0.05). Conclusion: Anxiety in patients with primary hypertension appears to have negative consequences on total cholesterol, LDL cholesterol, body mass index, and waist circumference. In hypertension, female gender and obesity are associated with increased anxiety levels.

Psychological Impact of the Northern Ethiopia War on Tigray Athletes

The war in northern Ethiopia (November 4, 2020-November 2, 2022) caused unimaginable suffering to the people of Tigray. Psychological suffering is among the many. It is well known that war affects all people living in the war zone and alters life dramatically, as its effects can be both physical injury of varying degrees of severity and the dangerous invisible wounds caused by psychological trauma and stress. As far as this issue is concerned, numerous research results have shown the psychological impact of war on the general population. However, no research has been carried out on the psychological impact of war on athletes. So, the main objective of this study was to assess the psychological impact of the Northern Ethiopia civil war on Tigray Athletes. To achieve the purpose of this study, a total of 144 athletes from various clubs in the Tigray area were selected using the convenience sampling method. The anxiety symptom was assessed using the Generalized Anxiety Disorder Scale (GAD-7) and the depression symptom was assessed using the Centre for Epidemiologic Studies (CES-D) depression scale. The data gathered was analyzed using the SPSS statistical package (version 25 for Windows). Of 144 participants, 1 (0.7%) showed minimal anxiety; 4 (2.8%) showed mild anxiety; 29 (20.1%) showed moderate anxiety; and 110 (76.4%) showed severe anxiety. And regarding depression, all of the participants were shown symptoms of depression as their score was higher than 16 points. As the result shows, almost all participants have a risk of anxiety and depression. It can thus be concluded that the two-year war in northern Ethiopia had a negative psychological impact on Tigray athletes.

Study of Anxiety Among Older People in Kazakhstan and Factors Affecting This Indicator

&lt;b&gt;Aim:&lt;/b&gt; The purpose of this research was to study of anxiety among older people in Kazakhstan and factors affecting this indicator.&lt;br /&gt; &lt;b&gt;Methods:&lt;/b&gt; A cross-sectional survey was conducted with 221 randomly selected elderly people from different regions of Kazakhstan. The survey covered questions of socio-demographic type and also used the GAD-7 (Generalized Anxiety Disorder-7).&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; The majority of participants showed low levels of anxiety on the test. Nevertheless, a significant proportion of older adults experienced mild and moderate anxiety, accounting for 33% and 23.1%, respectively. The analysis showed that age (OR = 0,852, 95% CI: 0,779-0,931, p &amp;lt; 0,001), gender (OR = 8,167, 95% CI: 3,232-20,642, p &amp;lt; 0,001), level of education (OR=9,928, CI 95%: 3,760 - 26,212, p &amp;lt; 0,001) and living conditions (OR=0,167, 95% CI: 0,060-0,467, p = 0,001) have a statistically significant impact on the anxiety level of this population group.&lt;br /&gt; &lt;b&gt;Conclusion:&lt;/b&gt;&lt;b&gt; &lt;/b&gt;The results of the analysis confirm the importance of developing and implementing a set of measures aimed at improving the quality of life of older people, taking into account the individual characteristics and needs of each person. The following measures can be suggested to improve the quality of life of older persons: organize social activity and community involvement programs through clubs and activities; establish accessible health and social service centers where older persons can receive qualified care; use technology, such as mobile applications and smart devices, to facilitate daily life, including telemedicine and home-based services.

A comparison of challenging and positive caregiving experiences for caregivers of individuals with schizophrenia spectrum and bipolar disorders

BackgroundCaregivers of people with serious mental illness experience challenges that may affect their mental health. Few researchers have explored whether positive or negative caregiver experiences differ due to disorder characteristics of the person receiving care. We aimed to determine whether caregiver appraisals and psychological functioning differed between caregivers of those diagnosed with schizophrenia spectrum (SSD) and bipolar disorder (BD). MethodsCaregivers of people with SSD and BD participated in an online self-report survey assessing appraisals, distress, anxiety, depression, and psychological wellbeing. Independent samples t-tests and multivariate generalised linear models determined group differences, and Pearson correlation coefficients and Fisher z-score transformations determined differences in the strength of correlations between groups. Results108 caregivers participated in the study. Caregivers of people with SSD reported significantly greater negative appraisals of the care recipient's negative symptoms and dependency. Caregivers did not differ on positive appraisals. Both groups reported moderate distress, mild anxiety and depression, and moderate psychological wellbeing, but did not differ. Higher negative caregiver appraisals were more strongly associated with higher distress, anxiety and depression, and lower psychological wellbeing, for caregivers of those with SSD than BD. LimitationsSmall between group sample sizes, and analyses may have been moderated by significant demographic differences between groups. ConclusionsCaregivers can experience difficulties associated with their role, and some differences may be attributed to the care recipient's disorder. Future research and interventions should consider specific disorder characteristics, such as symptom profiles, to better support caregivers in having their specific needs addressed whilst themselves providing care.

The Prevalence and Determinants of Mental Health Problems in Lebanon: A Meta-Analytic Study of 3957 Healthcare Workers.

Healthcare workers are continuously exposed to challenging environments, making them liable for poor mental health. The COVID-19 pandemic exacerbated this problem, however available data in Lebanon is scarce. We conducted this investigation to provide comprehensive evidence on the mental health of Lebanese healthcare workers. In this systematic review, we analyzed 3957 workers reported in 15 cross-sectional studies (10 during and five before the pandemic), identified after searching four databases. Examined mental health problems included depression, anxiety, stress, posttraumatic stress disorder (PTSD), and poor sleep quality. STATA software was used to pool the prevalence across studies. Subgroup analyses were performed based on the pandemic status, severity of mental health problems, and healthcare worker type. Gender and marital status were analyzed as potential risk factors. The methodological quality of all included studies was good as per the National Institute of Health risk of bias tool. Anxiety, depression, stress, PTSD, insomnia, and poor sleep quality were reported in 50%, 52%, 50%, 35%, 45%, and 41% of the population, respectively. Most cases had mild anxiety (40%), mild depression (45%), but severe stress (27%). Depression and anxiety were highest among pharmacists (69% and 56%) and nurses (49% and 45%), respectively. Compared to the pre-pandemic period, depression (36% vs. 62%) and anxiety (30% vs. 56%) rates were higher during the pandemic, while stress levels were lower (62% vs. 45%). Both gender and marital status were insignificant predictors of depression, anxiety, stress, or PTSD. Depression, anxiety, posttraumatic stress, insomnia, and poor sleep quality are experienced by approximately one in every two Lebanese healthcare workers. The rate of depression and anxiety almost doubled during the pandemic with higher rates among pharmacists and nurses than physicians and residents. Both gender and marital status were deemed insignificant predictors of reported mental health problems.

Neuropsychiatric comorbidities in adult patients with new-onset epilepsy

BackgroundNeuropsychiatric comorbidities in adult patients with new-onset epilepsy in our university hospitals has not been assessed, so the purpose of this study was to identify the neuropsychiatric comorbidities in adult patients with new onset epilepsy in our university hospitals. We recruited one hundred patients, assessed them clinically, radiologically, electrophysiologically, and we performed Wechsler Adult Intelligence Scale Fourth Edition (WAIS-IV), Liverpool Seizure Severity Scale (LSSS), Generalized Anxiety Disorder 7-item (GAD-7) scale, Beck’s Depression Inventory II (BDI II) and Quality of Life In Epilepsy-10 Questionnaire (QOLIE-10) to assess cognitive function, seizure severity, anxiety, depression, and quality of life of the patients, respectively.ResultsOlder adult age group had higher LSSS than other groups. Middle-aged adults’ group had higher WAIS-IV full scale Intelligence Quotient (IQ) score and lower GAD-7 scale scores than other age groups. Patients regularly on more than one anti-seizure medication had lower IQ results, more seizure severity, depression, anxiety and worse quality of life than those on monotherapy. Males had slightly higher IQ scores. Patients with moderate and severe BDI-II score had significantly higher rate of uncontrolled seizures, higher seizures’ frequency, more abnormal EEG and were regularly on valproate at significantly higher rates as compared to those with minimal BDI-II score. Patients with moderate anxiety were significantly older than those with normal and severe anxiety. Patients with severe anxiety had higher rate of family history of epilepsy, higher rates of uncontrolled seizures and higher seizures’ frequency as compared to those with mild and moderate anxiety. Patients with mild, moderate, and severe score on GAD-7 had more abnormal EEG as compared to those with normal GAD-7 score. Patients with severe and very severe seizures had significantly higher levels of anxiety, depression and impaired quality of life than those with mild and moderate seizure severity.ConclusionsMost patients with epilepsy had psychiatric comorbidities such as depression and anxiety which strongly reduce their quality of life and interfere with their compliance to anti-seizure medication. Males had slightly higher Intelligence Quotient (IQ) scores on WAIS-IV. Moreover, patients regularly taking more than one anti-seizure medication had a statistically significantly lower IQ score, more seizure severity, higher Beckʼs depression inventory II score, higher generalized anxiety disorder 7-item scale score, and worse quality of life than those on monotherapy.

Task-Based Attentional Control: The Role of Anxiety and Age.

Attentional Control Theory (ACT) posits that anxiety impacts cognitive functioning through interference in working memory and processing efficiency, resulting in performance deficits in set-shifting and inhibition. Few studies have examined the effects of anxiety on set-shifting and inhibition in clinical samples or how these relationships might be affected by age. The current study tested whether increased age, elevated anxiety, and their interaction were associated with reduced performance on measures of set-shifting and inhibition. Symptom and neuropsychological testing data were obtained from outpatient participants presenting at an academic medical center (N = 521; mean age = 50.39years, SD = 22.35, range = 18-90; 47.4% female; 78.3% White). The Trail Making Test Difference score was used to assess set-shifting and the Stroop Color-Word Test Interference score was used to assess inhibition. After controlling for demographic variables, ADHD diagnosis, depression symptoms, and Mild Cognitive Impairment (MCI), both age and anxiety were significant predictors of set-shifting (β = 0.45 and β = 0.18, respectively, ps < 0.001) and inhibition (β = -0.37, p < 0.001 and β = -0.19, p = 0.001, respectively). No interaction was found between age and anxiety in the prediction of set-shifting or inhibition. Congruent with ACT, anxiety was associated with worse performance on measures of set-shifting and inhibition. Older age was an independent predictor of worse set-shifting and inhibition but did not moderate the relationship between anxiety and attentional control, suggesting that anxiety adversely affected working memory and processing efficiency equivalently across the adult lifespan. The results highlight the importance of anxiety assessment in neuropsychological evaluation in patients of all ages.

Examining the influence of anxiety and depression on medication adherence among patients diagnosed with acute myocardial infarction

BackgroundEffective medication adherence is vital for managing acute myocardial infarction (AMI) and enhancing patient well-being. This study aimed to evaluate medication adherence levels and associated factors among AMI patients using standardized assessment tools.MethodsEmploying a cross-sectional descriptive design, the study involved 210 patients diagnosed with acute myocardial infarction. Participants completed the General Medication Adherence Scale (GMAS), Hospital Anxiety and Depression Scale (HADS), and provided socio-demographic details.ResultsThe study revealed partial adherence to medications among AMI patients, with mean scores of 24.89 (± 3.64) out of 33. Notably, good adherence was observed in non-adherence due to patient behavior (mean ± SD = 11.8 ± 2.3 out of 15) and additional disease burden (mean ± SD = 8.65 ± 2.21 out of 12), while partial adherence was noted in non-adherence due to financial constraints (mean ± SD = 4.44 ± 1.34 out of 6). Patients reported mild anxiety (mean ± SD = 8.38 ± 2.81) and no depressive symptoms (mean ± SD = 7.43 ± 2.42). Multiple linear regression analysis indicated that employed status, younger age, shorter duration of MI, lower anxiety, and depression levels were associated with higher medication adherence. However, factors such as monthly income, gender, educational level, and marital status did not predict medication adherence.ConclusionThe study highlights the significance of addressing anxiety and depression levels and considering socio-demographic factors when designing interventions to enhance medication adherence among AMI patients. Further research is needed to explore additional determinants of medication adherence and develop tailored interventions to improve patient outcomes post-AMI.

Comparison of professional competency and anxiety of nursing students trained based on two internship models: a comparative study

BackgroundImproving the professional competency of nursing students during the internship is critical. This study aimed to compare the professional competency and anxiety of nursing students trained based on two internship models.MethodsThis is a two-group posttest-only quasi-experimental design study. One hundred nursing students who passed internship models A (a previous internship model) and B (an intervention with more educator support and a more planned and programmed process) were randomly enrolled in this study. Internship model groups A and B were conducted for the students in semesters 7 and 8. The outcomes assessed in both groups were “The Competency Inventory for Registered Nurses” and Spielberger “State-Trait Anxiety Inventory”. T-test and MANOVA were used to analyze the data.ResultsThe mean scores of competency were 134.56 (SD = 43.23) and 160.19 (SD = 35.81) for the nursing students in the internship model groups A and B, respectively. The mean scores of nursing students’ anxiety were 92.14 (SD = 15.36) and 80.44 (SD = 18.16) in the internship model groups A and B, respectively. MANOVA test showed a significant difference between the groups regarding professional competency (F = 10.34, p = 0.002) and anxiety (F = 11.31, p = 0.001).ConclusionsThe internship model group B could improve the professional competency of nursing students to a great extent and they experienced mild anxiety; it is suggested that this intervention should be done for nursing students. Conducting more studies to evaluate the effect of this model on the nursing students’ competency and anxiety after graduation and as a novice nurse is suggested.

Beyond medications: a multifaceted approach to alleviating comorbid anxiety and depression in clinical settings.

Comorbid anxiety and depression are common and can make the problems more complex and sometimes resistant to pharmacological treatment. In existing research, the diagnoses are often studied separately, and physical activity, healthy nutrition, psychoeducation, and social support have shown good effects. The aim of the present study was to explore the longitudinal effects of a comprehensive treatment on patients with comorbid anxiety and depression in a clinical context. Eighty inpatients (15 men and 65 women) in age range 23-65 years receiving psychiatric treatment in Norwegian clinic participated in the longitudinal study. Treatment was person-centered and was most frequently given for anxiety and depression, e.g., pharmacological treatment and psychotherapy, individually and in groups. In combination with this, physical activity, healthy nutrition, psychoeducation and social support in contacts with authorities and relatives were also a part of treatment. Depression and anxiety were assessed using the Beck Anxiety Inventory and Beck Depression Inventory at three points in time: baseline, at the end of treatment, and 3 months after treatment. The answers were categorized and combined into four groups according to severity of anxiety and depression to measure effects on comorbidity. Mann Whitney U test, Chi-square, Friedmans test, and McNemar test were used to analyze the data. The results showed a significant increase of frequencies in the group with mild anxiety and depression 3 months past treatment compared to baseline. Through the comprehensive, person-centered treatment more patients had low levels of both anxiety and depression 3 months after treatment. We suggest that clinics working with comorbid depression and anxiety patients should add physical activity, nutrition advice, social support, and psychoeducation to the traditional treatment regimes. More research concerning comorbid anxiety and depression are urgent to further expand the treatment possibilities.

Mental Health Study and Psychological Factors Impacting the Behaviour Among College Students in India

Health risk behaviour, sometimes referred to as health impairing behaviour, is dangerous when it comes to children since it might have unfavourable consequences that last into adulthood. Although not entirely inherited, anxiety disorders can also result from the use of drugs, such as alcohol and caffeine, as well as the withdrawal from particular medications. They frequently occur in conjunction with other mental health issues, including actual depression, bipolar disorder, identity issues, and food issues. The phrase "nervousness" refers to four types of contacts that a person may experience: dissociative unease, physical tension, mental fear, and bodily symptoms. Feelings associated with unease range from mild anxiety to depressive bouts. While there are other psychological and therapeutic conditions that can mimic the signs of a tension disorder, this study outlines the elements that contribute to anxiety and how they impact students' mental health. The results and conclusions of the data collection process using a questionnaire were presented by the researcher. The researcher also talked about some inferences drawn from the participants' comments in addition to this.