Non-anxiety Group Research Articles

Prevalence of poststroke anxiety and its associations with global cognitive impairment: An individual participant data analysis

Background and purposeAnxiety is frequent after stroke; however, little is known about its determinants. This study aims to assess the prevalence and correlates of post stroke anxiety (PSA) within 3–6 months following ischemic stroke. MethodsThree cohort studies from the STROKOG consortium were involved. Demographic and clinical data were standardized. PSA and PSD were assessed using inventories. The criteria for post-stroke cognitive impairment (PSCI) were at least one cognitive domain impaired if applicable, or a Montreal Cognitive Assessment (MoCA) score. Descriptive analyses were conducted to ascertain the prevalence of anxiety. Comparisons between anxious and non-anxious patients in the total sample were made using χ2 and t-tests. A two-step individual participant data (IPD) meta-analysis was employed to identify factors associated with PSA. Results584 patients were included. The total prevalence of PSA was 35 % (95%CI = [31.23;38.97]) and ranged from 27 % to 45 % across cohorts. In the total sample, there was a higher proportion of females in the anxiety group than the non-anxiety group (χ2 = 19.62; p < 0.001). Anxious patients had lower education, (χ2 = 6.59; p = 0.03), higher stroke severity (t = 2.77; p = 0.002), and higher rates of PSD (χ2 = 118.09; p < 0.001), and PSCI (χ2 = 23.81, p < 0.001). The analysis demonstrates that the odds of presenting with PSA is larger in patients with PSCI (OR = 1.84, 95%CI = [1.14; 2.91]). ConclusionsAnxiety is frequent after stroke, especially in females, and is associated with depression and cognitive impairment.

Red Blood Cell Distribution Width (RDW) During Admission and Anxiety Following Acute Myocardial Infarction

Background: Myocardial infarction (MI), a life-threatening event, is often accompanied by an increased risk of anxiety. There is a growing association between anxiety and cardiovascular disease (CVD). Recent studies have shown that anxiety is associated with blood inflammatory markers, such as red blood cell distribution width (RDW). Objectives: We aimed to evaluate RDW levels during admission and anxiety levels after acute myocardial infarction (AMI). Methods: In this cross-sectional study, 250 patients with AMI participated during 2023-2024. Demographic information and RDW levels were obtained within 24 hours after admission. The intensity of anxiety was evaluated using the Hamilton Anxiety Rating Scale (HRSA) two weeks after the occurrence of AMI. All data analyses were performed using SPSS version 24. Results: Of the total participants, 51.6% experienced anxiety two weeks after AMI. The mean age of patients in the anxiety and non-anxiety groups was 59.77 ± 10.10 and 62.68 ± 12.20 years, respectively. Among the laboratory parameters, only blood urea nitrogen was statistically different between the two groups (P &lt; 0.027). The RDW level was 13.63 ± 1.20 in the anxiety group and 13.59 ± 1.51 in the non-anxiety group (P &gt; 0.174). There was no statistically significant difference between RDW levels and post-AMI anxiety (P &gt; 0.001). Conclusions: This study is the first to investigate the predictive value of RDW for post-AMI anxiety. Based on our findings, no significant relationship was observed between RDW and anxiety following AMI. Therefore, further studies in this field are needed to determine whether this cost-effective and readily available marker should be used for anxiety prediction after AMI.

A comparison of ondansetron in preventing postoperative nausea and vomiting for patients with or without preoperative anxiety with painless egg retrieval: a prospective, randomized, controlled trial.

Patients undergoing painless egg retrieval are prone to preoperative anxiety, and whether preoperative anxiety induces postoperative nausea and vomiting (PONV) is debated. The primary objective of this prospective, randomized, controlled study was to compare the clinical effect of ondansetron in preventing PONV for patients with and without preoperative anxiety. The secondary objective was to investigate whether preoperative anxiety was associated with PONV. The self-rating anxiety scale (SAS) was used to assess the anxiety patients undergoing painless egg retrieval. Patients with a SAS standard score of 50-60 were selected to the anxiety group (n=105); and patients with a SAS standard score of 25-35 were assigned to the non-anxiety group (n=104). Venous blood samples of both groups of patients were obtained during admission and 1 hour after surgery, and all serotonin (5-HT) levels were tested using an enzyme-linked immunosorbent assay. The anxiety group was then randomly assigned into two subgroups: ondansetron (AO group, n=53) and placebo saline (AS group, n=52). Similarly, patients in the non-anxiety group were also randomly assigned to one of two subgroups: ondansetron (NO group, n=51) and placebo saline (NS group, n=53). The AO and NO groups received 8 mg (4 mL) of intravenous ondansetron 15 minutes before surgery, while the AS and NS groups received an equivalent volume (4 mL) of normal saline. We then analyzed the vital signs, risk factors for nausea and vomiting, intraoperative anesthetic doses, incidences of nausea and vomiting in 24 hours after surgery, serum 5-HT level before and after surgery, other adverse responses, pain scores, and satisfaction. A total of 200 patients eventually completed this study. The serum 5-HT values in the anxiety group were higher before and after surgery than in the non-anxiety group (P<0.05), but there was no significant difference in serum 5-HT before and after surgery in the same group (P>0.05). The incidence of PONV was more significant in the AS group than in the NS group (P<0.05). The incidence of PONV was also higher in the AS group than in the AO group (P<0.05). Still, there was no statistically significant difference between the NO and NS groups (P>0.05). There were no significant differences between the four groups in vital signs, risk factors for nausea and vomiting, intraoperative anesthetic doses, other adverse responses and pain scores (P>0.05). Patients in the AS group had lower satisfaction scores than those in the other three groups (P<0.05). Patients experiencing preoperative anxiety have a greater risk of PONV following painless egg retrieval compared to those without preoperative anxiety. Ondansetron can reduce the occurrence of PONV in patients with preoperative anxiety, but it has no discernible preventative effect in non-anxious patients. Chinese Clinical Trial Registry ChiCTR2400079504.

Association between preoperative anxiety states and postoperative complications in patients with esophageal cancer and COPD: a retrospective cohort study

BackgroundEsophageal cancer brings emotional changes, especially anxiety to patients. Co-existing anxiety makes the surgery difficult and may cause complications. This study aims to evaluate effects of anxiety in postoperative complications of esophageal cancer patients with chronic obstructive pulmonary disease (COPD).MethodsPatients with esophageal cancer and co-existing COPD underwent tumor excision. Anxiety was measured using Hospital Anxiety and Depression Scale (HAD) before surgery. Clavien-Dindo criteria were used to grade surgical complications. A multiple regression model was used to analyze the relationship between anxiety and postoperative complications. The chi-square test was used to compare the differences in various types of complications between the anxiety group and the non-anxiety group. A multinomial logistic regression model was used to analyze the influencing factors of mild and severe complications.ResultsThis study included a total of 270 eligible patients, of which 20.7% had anxiety symptoms and 56.6% experienced postoperative complications. After evaluation by univariate analysis and multivariate logistic regression models, the risk of developing complications in anxious patients was 4.1 times than non-anxious patients. Anxious patients were more likely to develop pneumonia, pyloric obstruction, and arrhythmia. The presence of anxiety, surgical method, higher body mass index (BMI), and lower preoperative oxygen pressure may increase the incidence of minor complications. The use of surgical methods, higher COPD assessment test (CAT) scores, and higher BMI may increase the incidence of major complications, while anxiety does not affect the occurrence of major complications (P = 0.054).ConclusionPreoperative anxiety is associated with postoperative complications in esophageal cancer patients with co-existing COPD. Anxiety may increase the incidence of postoperative complications, especially minor complications in patient with COPD and esophageal cancer.

Risk of Parkinson's disease in people aged ≥50 years with new-onset anxiety: a retrospective cohort study in UK primary care.

A history of anxiety is more common in people with Parkinson's disease (PD). The prospective risk of PD in those newly presenting with anxiety and factors that increase the risk of PD in patients with anxiety have not been investigated. To investigate the incidence of PD in people with anxiety aged ≥50 years and clinical features associated with later diagnosis of PD in people with anxiety. A retrospective cohort study using UK primary care data between 2008 and 2018, assessing patients with new-onset anxiety aged ≥50 years. Weibull survival regression models were fitted and hazard ratios (HRs) for modelling time-to-PD was estimated in those with and without anxiety, and when determining the risk of developing PD in those with anxiety. Results were adjusted for sociodemographic and lifestyle factors, and relevant physical and mental health conditions. The risk of PD increased two-fold compared with the non-anxiety group after adjustment for age, sex, social deprivation, lifestyle factors, severe mental illness, head trauma, and dementia (HR 2.1, 95% confidence interval = 1.9 to 2.4). In those with anxiety, the presence of depression, hypotension, tremor, rigidity, balance impairment, constipation, sleep disturbance, fatigue, and cognitive impairment were associated with an increased risk of developing PD. The risk of developing PD was at least doubled in people with anxiety compared with those without. The clinical features of those who developed PD can help identify patients presenting with anxiety who are in the prodromal phase of PD.

A study on the correlations of PRL levels with anxiety, depression, sleep, and self-efficacy in patients with prolactinoma.

The purpose of this study was to explore the factors influencing PRL levels in patients with prolactinoma and to investigate the correlations between anxiety, depression, sleep, self-efficacy, and PRL levels. This retrospective study included 176 patients with prolactinoma who received outpatient treatment at the Affiliated Hospital of Zunyi Medical University from May 2017 to August 2022. The general information questionnaire, Hospital Anxiety and Depression Scale (HADS), Athens Insomnia Scale (AIS), and General Self-Efficacy Scale (GSES) were used for data collection. A generalized estimating equation (GEE) model was used to analyze the factors influencing PRL levels in patients with prolactinoma. GEE single-effect analysis was used to compare PRL levels at different time points between anxiety group and nonanxiety group, between insomnia group and normal group, and between low, medium, and high self-efficacy groups. The median baseline PRL level and the PRL levels at 1, 3, 6, and 12 months of follow-up were 268.50 ng/ml, 122.25 ng/ml, 21.20 ng/ml, 19.65 ng/ml, and 16.10 ng/ml, respectively. Among patients with prolactinoma, 59.10% had anxiety (HADS-A score = 7.35 ± 3.34) and 28.98% had depression (HADS-D score = 5.23 ± 3.87), 9.10% had sleep disorders (AIS score = 6.10 ± 4.31) and 54.55% had low self-efficacy (GSES score = 2.13 ± 0.83). Educational level, tumor size, number of visits, sleep quality, anxiety level, and self-efficacy level were found to be factors influencing PRL levels in patients with prolactinoma (P<0.05). Higher PRL levels were observed in the anxiety group compared to the non-anxiety group (P<0.001), in the insomnia group compared to the normal group (P<0.05), and in the low self-efficacy group compared to the medium and high self-efficacy groups (P<0.05). PRL levels in patients with prolactinoma are related to education level, tumor size, number of visits, anxiety, self-efficacy, and sleep but not depression. PRL levels were higher in patients with anxiety, low self-efficacy, and sleep disorders.

Prevalence and clinical profile of comorbid anxiety in young adult patients with first-episode and drug-naive major depressive disorder.

Patients with major depressive disorder (MDD) frequently have coexisting anxiety disorders. However, few studies have focused on the prevalence and risk factors of comorbid anxiety symptoms in young adult first-episode and drug-naive (FEDN) MDD patients. We recruited 520 FEDN MDD patients and collected their demographic and clinical data. The Hamilton Depression Rating Scale (HAMD), the Hamilton Anxiety Rating Scale (HAMA) and the positive scale of the Positive and Negative Syndrome Scale (PANSS) were used to measure depressive symptoms, anxiety symptoms and psychotic symptoms, respectively. Anxiety symptoms were found in 79.6% of young adult patients. Besides, anxiety group patients had a higher prevalence of psychotic symptoms than the non-anxiety group. Anxiety symptoms were substantially related to suicide attempts in young adult patients. Logistic analysis shows that suicide attempts and total HAMD scores were significantly associated with anxiety symptoms. The findings show that anxiety symptoms are common in Chinese young adult MDD patients. The anxiety group was more likely to have psychotic symptoms, suicide attempts, and more severe depressive symptoms than the non-anxiety group. Suicide attempts were associated with anxiety symptoms in young adult MDD patients, suggesting the importance of reducing anxiety symptoms in this population to prevent suicides.

Text mining analysis of factors related to employment anxiety disorders among science and engineering students

BackgroundIn recent years, the issue of employment anxiety disorder among science and engineering college students has become increasingly prominent. The study analyzed the relevant factors of employment anxiety disorder among science and engineering students through text mining methods.Subjects and MethodsThe study selected students from a certain university of science and engineering as the research subjects and divided them into anxiety group and non-anxiety group. Social media data was used for text mining to identify factors related to employment anxiety disorder among science and engineering students. The statistical software SPSS23.0 is used to analyze data and evaluate the correlation of factors using methods such as t-tests or correlation coefficients.ResultsBy analyzing social media texts of science and engineering students, research has identified several factors related to employment anxiety. In the anxiety group, the score of employment pressure was significantly higher than that of the non-anxiety group (M=4.58 in the anxiety group, M=3.26 in the non-anxiety group, P&lt;0.001), Score of career uncertainty (anxiety group M=3.92, non-anxiety group M=2.95, P&lt;0.001), competitive pressure (anxiety group M=4.27, non-anxiety group M=3.18, P&lt;0.001), and career development opportunities (anxiety group M=2.68, non-anxiety group M=3.52, P&lt;0.001). The results showed significant high scores in the anxiety group.ConclusionsThe research provides valuable information for universities and related institutions to develop targeted coping measures and psychological support, thereby reducing the employment anxiety disorder of science and engineering students and promoting their career development.

The variation characteristics of fecal microbiota in remission UC patients with anxiety and depression.

Ulcerative colitis (UC) patients with relapsed disease are most likely to suffer from anxiety and depression. Increasing data indicates that psychological issues can change the composition of intestinal flora. Thus, we aim to seek the variation of intestinal microbiota composition in remission UC patients with anxiety and depression in Northwest China. In this study, 45 UC patients in remission were enrolled. The incidence of anxiety was 33.3%, and the prevalence of depression was 22.2%. There was no statistical difference in the alpha diversity of fecal microbiota, while beta diversity had a significant difference between the anxiety group and the non-anxiety group and the depression group and the non-depression group. Species composition analysis results showed that the ratio of Bifidobacterium and Lactobacilales significantly decreased. At the same time, the proportion of Escherichia-Shigella and Proteus_mirabilis increased in the anxiety group, and the ratio of Faecalibacterium and Bifidobacterium significantly decreased. In contrast, Escherichia-Shigella increased in the depression group at the gene levels. Anxiety and depression still exist in UC patients even in the remission period. We first identify that the proportion of probiotics decreases while the proportion of pathogens increases in UC patients with anxiety and depression. These findings may provide a new pathophysiological mechanism for the recurrence of disease caused by impaired psychological function and a new method for the treatment strategy of UC patients with psychological issues.

Vitamin D levels and anxiety symptomatology in pregnancy and the postpartum.

Anxiety and vitamin D deficiency are both common in pregnancy, but research into the relationship between vitamin D levels and perinatal anxiety is sparse. We sought to examine whether an association exists and compare the distribution of vitamin D levels in women with and without anxiety symptoms. We analyzed 25-hydroxyvitamin D using ab213966 25(OH) vitamin D enzyme-linked immunosorbent assay in 54 women with and 47 women without anxiety symptoms at the first, second, and third trimesters and at 6 weeks postpartum. We conducted univariate and chi-square analyses to compare the frequencies of non-optimal and optimal vitamin D levels between the anxiety and non-anxiety groups at each timepoint. Overall, vitamin D levels were lower in the first and second trimesters than in the third trimester. In the first trimester only, the non-anxiety group had a marginally higher proportion of women with optimal vitamin D levels when compared to the anxiety group. Many pregnant women have insufficient or deficient levels of vitamin D, and our exploratory findings point to the need for further research into whether this differs between women with anxiety compared to healthy women.

Metabolites of progesterone in pregnancy: Associations with perinatal anxiety

BackgroundAnxiety disorders are the most common psychiatric disorder during the perinatal period and one of the major risk factors for postpartum depression, yet we know little about biological factors in the etiology of perinatal anxiety. A growing literature points to neuroactive steroid (NAS) dysregulation in perinatal mental illness, but directionality has not been clearly demonstrated, results are not consistent, and no studies have investigated NAS in a population with pure anxiety without comorbid depression. We aimed to add to the limited literature by examining the association between anxiety without comorbid depression and metabolic pathways of NAS longitudinally across the peripartum. MethodsWe measured anxiety symptoms by psychological scales and NAS levels using Gas Chromatography-Mass Spectrometry (GC-MS) at the second and third trimester (T2 and T3) and week 6 postpartum (W6) in n = 36 women with anxiety and n = 38 healthy controls. The anxiety group was determined by a data-driven approach, and cross-sectional and longitudinal statistical methods were used to examine the relationship between the study population and NAS. ResultsWe found that anxiety had a significant moderating effect on the relationship between progesterone and allopregnanolone, with no such effect for the relationships between progesterone and the intermediate (5α-DHP) or isomeric (isoallopregnanolone) compounds in this pathway, and no effects on the corresponding pathway converting progesterone to pregnanolone and epipregnanolone. We also found a less precipitous decline in the ratio of allopregnanolone to progesterone between T3 and W6 in the anxiety group compared to the non-anxiety group. A genotype analysis of a single-nucleotide polymorphism in the AKR1C2 gene demonstrated that the relationship of allopregnanolone to the intermediate metabolite, 5α-DHP, differed by genotype. ConclusionOur exploratory findings indicate that, for pregnant people with anxiety, metabolism is shunted more aggressively toward the endpoint of the progesterone to allopregnanolone metabolic pathway than it is for those without anxiety.

Anxiety in pregnancy and stress responsiveness: An exploratory study of heart rate variability, cortisol, and alpha-amylase in the third trimester.

The present study aimed to explore the association between anxiety symptoms, including sleep, and physiological stress responsiveness in pregnant women with and without anxiety, as identified by psychiatric diagnosis. Fifty-four pregnant women with (n=25) and without (n=29) anxiety completed a laboratory cognitive stressor (the Stroop Color-Word Task) during the third trimester. Heart rate variability (HRV) (as the root mean square of successive differences, RMSSD) was recorded during baseline, stressor, and recovery periods. Salivary cortisol (sCORT) and alpha amylase (sAA) were measured at four timepoints surrounding the stressor task. Psychometric scales (Penn State Worry Questionnaire [PSWQ], Perceived Stress Scale [PSS], Spielberg Trait Anxiety Inventory Scale [STAI], and Pittsburgh Sleep Quality Index [PSQI]) were collected. Women in the anxiety group exhibited significantly less rebound in HRV (RMSSD, change of 4-ms difference, p=.025) from baseline to recovery following the Stroop than did those in the non-anxiety group. Neither neuroendocrine measure (sCORT, sAA) differed between groups at any measurement period. Across the recording period, lower reported sleep quality (PSQI, p=.0092) and higher subjective stress (PSS, p=.039) were associated with lower RMSSD. The findings suggest that women with and without anxiety in late pregnancy display differences in the degree of autonomic rebound as indicated by HRV following a stressor. In addition, levels of HRV over time were associated with subjective perceptions of increased stress and poor sleep. PREGNANCY AND ANXIOUS: The Role of the Immune and Endocrine Systems (NCT03664128).

Worse psychological traits associated with higher probability of emotional problems during the Omicron pandemic in Tianjin, China

Background and ObjectivesIndividuals with specific psychological weaknesses are prone to mental problems during the coronavirus pandemic. This self-rating study assessed the combined effects of infection-related stress, resilience, worry, and loneliness on the likelihood of depression and anxiety among infected and non-infected individuals during the Tianjin Pandemic in 2022. MethodsIndividuals infected with Omicron (n = 249) and health residents (n = 415) were recruited from two hospitals and communities in Tianjin. Each respondent completed the following on-site assessment: Self-developed Scale of Demographics, Zung Self-Rating Depression Scale (SDS), Zung Self-Rating Anxiety Scale (SAS), the Connor-Davidson Resilience Scale (CD-RISC), De Jong Gierveld Scale (DJGLS), and the Penn State Worry Questionnaire (PSWQ). The respondents were categorized into depression or non-depression group by SDS scores, and anxiety or non-anxiety group by SAS scores. ResultsThe overall scores of CD-RISC, DJGJLS, and PSWQ were significantly different both between the depression group and non-depression groups and between the anxiety group and non-anxiety groups. The greater likelihood of depression was associated with lower overall scores of CD-RISC and higher scores of PSWQ; the greater likelihood of anxiety was associated with higher scores of PSWQ. The likelihood of depression was also positively associated with having infection-related stress and three demographics. ConclusionsThis on-site study demonstrates the importance of specific traits in a small-scale pandemic: the worse resilience and the greater worry propensity related to the higher probability of depression, and the greater propensity of worry related to the higher probability of anxiety. Moreover, those experiencing infection-related stress, being male, living alone, and being unemployed are more likely to have depressive problems.

Association between skin disease and anxiety: a logistic analysis and prediction.

Dermatosis has symptoms of flushing, itching, pain, and burning, which causes psychological distress in patients. We collected the data of 214 patients from the Wuhan Institute of Dermatology and Venereology from January 2020 to January 2022, including age, gender, diagnosis, Hamilton Anxiety Rating Scale (HAMA), and anxiety. First, descriptive analysis and difference analysis of the included data were carried out. Second, a correlation matrix was used to exclude the confounding factors with strong collinearity. Finally, logistic regression was used to analyze and predict the risk factors of anxiety. In the anxiety group and nonanxiety group, eczema and generalized eczema accounted for the largest proportion, and there was no difference in the composition of the diagnosis between the 2 groups. Several related analyses proved the accuracy of the logistic model. The results showed that age had a protective effect on the anxiety of patients with skin diseases [odds ratio (OR) =0.8606 with 95% confidence interval (CI): 0.7812, 0.8987]. Neurodermatitis (OR =1.0853 with 95% CI: 1.0115, 1.2512), eczema (OR =1.1358 with 95% CI: 1.0215, 1.2129), generalized eczema (OR =1.3346 with 95% CI: 1.1212, 1.5521), and psoriasis (OR =1.3685 with 95% CI: 1.1728, 1.6215) were associated with the anxiety of patients. Prediction analysis showed that with increase of patients' age, the likelihood of anxiety decreased. This study demonstrated a strong correlation between skin diseases and anxiety and that the likelihood of anxiety decreases as age increases. Therefore, psychological intervention for patients with skin diseases, especially young patients, is essential.

The sociodemographic characteristics and clinical features of the late-life depression patients: results from the Beijing Anding Hospital mental health big data platform

BackgroundThe sociodemographic characteristics and clinical features of the Late-life depression (LLD) patients in psychiatric hospitals have not been thoroughly studied in China. This study aimed to explore the psychiatric outpatient attendance of LLD patients at a psychiatric hospital in China, with a subgroup analysis, such as with or without anxiety, gender differences.MethodsThis retrospective study examined outpatients with LLD from January 2013 to August 2019 using data in the Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM) in Beijing Anding Hospital. Age, sex, number of visits, use of drugs and comorbid conditions were extracted from medical records.ResultsIn a sample of 47,334 unipolar depression patients, 31,854 (67.30%) were women, and 15,480 (32.70%) were men. The main comorbidities of LDD are generalized anxiety disorder (GAD) (83.62%) and insomnia (74.52%).Among patients with unipolar depression, of which benzodiazepines accounted for the largest proportion (77.77%), Selective serotonin reuptake inhibitors (SSRIs) accounted for 59.00%, a noradrenergic and specific serotonergic antidepressant (NaSSAs) accounted for 36.20%. The average cost of each visit was approximately 646.27 yuan, and the cost of each visit was primarily attributed to Western medicine (22.97%) and Chinese herbal medicine (19.38%). For the cost of outpatient visits, depression comorbid anxiety group had a higher average cost than the non-anxiety group (p < 0.05). There are gender differences in outpatient costs, men spend more than women, for western medicine, men spend more than women, for Chinese herbal medicine, women spend more than men (all p < 0.05). The utilization rate of SSRIs and benzodiazepines in female patients is significantly higher than that in male patients (p < 0.05).ConclusionLLD patients are more commonly women than men and more commonly used SSRIs and NaSSAs. Elderly patients with depression often have comorbid generalized anxiety. LLD patients spend most of their visits on medicines, and while the examination costs are lower.

The immune phenotype of perinatal anxiety

BackgroundImmune dysregulation has been linked to both psychiatric illness and pregnancy morbidity, including perinatal depression, but little is known about the immune phenotype of perinatal anxiety. Here, we sought to identify the unique immune profile of antenatal anxiety. Materials and MethodsPregnant women (n = 107) were followed prospectively at 2nd and 3rd trimesters (T2, T3) and 6 weeks postpartum (PP6). Each visit included a blood draw and psychological evaluation, with clinical anxiety assessed using the Spielberg State-Trait Anxiety Scale. We enrolled both healthy controls and participants with anxiety alone; those with comorbid depression were excluded. Multiplex cytokine assays and flow cytometry were used to examine the association of anxiety symptoms with secreted immune markers and PBMC-derived immune cells. ResultsK cluster means revealed three clusters of anxiety symptomatology; due to low numbers in the highest severity anxiety group, these were collapsed into two groups: Non-Anxiety and Anxiety. Principal components analysis revealed two distinct clusters of cytokine secretion including one cluster that consisted of many innate immune cytokines and differed between groups. Compared to women in the Non-Anxiety group, women in the Anxiety group had lower levels of cytokine expression during pregnancy and an increase in levels into the postpartum, whereas Non-Anxiety women experienced a time-dependent decline. Immune cell populations also differed between our two groups, with the Anxiety group showing a decrease in the ratio of B cells to T cells from pregnancy to postpartum, whereas the Non-Anxiety women showed an increase in this ratio over time. Women in the Anxiety group also demonstrated an increased ratio of cytotoxic to helper T cells throughout pregnancy, a modest increase in the Th1:Th2 ratio across pregnancy, and a lower ratio of Th17:TREG cells in the postpartum as compared with Non-Anxiety women. ConclusionThese data suggest that the immune response throughout the antenatal period differs for women with anxiety symptoms compared to those without, suggestive of a unique immune phenotype of perinatal anxiety.

Cerebral Perfusion Patterns of Anxiety State in Patients With Pulmonary Nodules: A Study of Cerebral Blood Flow Based on Arterial Spin Labeling.

Background and PurposeThe proportion of patients with somatic diseases associated with anxiety is increasing each year, and pulmonary nodules have become a non-negligible cause of anxiety, the mechanism of which is unclear. The study focus on the cerebral blood flow (CBF) of anxiety in patients with pulmonary nodules to explore the cerebral perfusion pattern of anxiety associated with pulmonary nodules, blood perfusion status and mode of pulmonary nodule induced anxiety state.Materials and MethodsPatients with unconfirmed pulmonary nodules were evaluated by Hamilton Anxiety Scale (HAMA). The total score > 14 was defined as anxiety group, and the total score ≤ 14 points was defined as non-anxiety group. A total of 38 patients were enrolled, of which 19 patients were the anxiety group and 19 were the non-anxiety group. All subjects underwent arterial spin labeling imaging using a 3.0 T MRI. A two-sample t-test was performed to compare the CBF between the two groups. The CBF was extracted in brain regions with difference, and Spearman correlation was used to analyze the correlation between CBF and HAMA scores; ROC was used to analyze the performance of CBF to distinguish between the anxiety group and the non-anxiety group.ResultsThe CBF in the right insula/Heschl’s cortex of the anxiety group decreased (cluster = 109, peak t = 4.124, and P < 0.001), and the CBF in the right postcentral gyrus increased (cluster = 53, peak t = −3.912, and P < 0.001) in the anxiety group. But there was no correlation between CBF and HAMA score. The ROC analysis of the CBF of the right insula/Heschl’s cortex showed that the AUC was 0.856 (95%CI, 0.729, 0.983; P < 0.001), the optimal cutoff value of the CBF was 50.899, with the sensitivity of 0.895, and specificity of 0.789. The ROC analysis of CBF in the right postcentral gyrus showed that the AUC was 0.845 (95%CI, 0.718, 0.972; P < 0.001), the optimal cutoff value of CBF was 43.595, with the sensitivity of 0.737, and specificity of 0.842.ConclusionThe CBF of the right insula/Heschl’s cortex decreased and the CBF of the right postcentral gyrus increased in patients with pulmonary nodules under anxiety state, and the CBF of the aforementioned brain regions can accurately distinguish the anxiety group from the non-anxiety group.

The Correlation Between Probiotics and Anxiety and Depression Levels in Cancer Patients: A Retrospective Cohort Study.

ObjectiveStudies have shown a correlation between gut microbiota and anxiety and depression levels. However, these studies are mainly animal studies or clinical studies of non-cancer patients, there is still a lack of relevant studies in cancer patients. The main objective of this trial was to analyze the correlation between probiotics and anxiety and depression levels in cancer patients.MethodsWe screened all cancer patients consecutively admitted to the inpatient department of the First Affiliated Hospital, Zhejiang University School of Medicine in May 2020. A total of 292 cancer patients met our inclusion criteria. Then, we followed up all patients for 24 weeks. Patients who had incomplete data or loss of follow-up were excluded. In addition, in patients who took probiotics, those did not take probiotics consistently or did not take specific probiotics were excluded. Ultimately, the number of patients enrolled was 82 in probiotics cohort and 100 in non-probiotics cohort. The 17-item Hamilton Depression Scale (HAMD-17) questionnaire was used to measure the depression levels of the patients, and we also used Hamilton Anxiety Scale (HAMA) questionnaire to assess the patients’ anxiety levels. A logistic regression model was used to analyze whether the difference in baseline data of two cohorts would affect the final result.ResultsDemographic and clinical characteristics of all cancer patients enrolled in probiotics cohort and non-probiotics cohort were similar except the cancer therapy (P = 0.004). According to the HAMA score, we divided cancer patients into non-anxiety group (HAMA score < 14) and anxiety group (HAMA score ≥ 14). Similarly, cancer patients were also divided into non-depression group (HAMD-17 score ≤ 7) and depression group (HAMD-17 score > 7). The results demonstrated that there was no statistical difference in the proportion of patients with anxiety (6.1 and 13.0%, respectively, P = 0.121) and depression (30.5 and 23.0%, respectively, P = 0.254) between probiotics and non-probiotics cohorts. The results of logistic regression model analysis further proved that the baseline difference in cancer therapy did not affect the conclusions.ConclusionOur results still suggest that there is no significant correlation between probiotics and anxiety and depression levels in cancer patients. Therefore, we do not recommend supplementing probiotics for cancer patients to prevent anxiety and depression. Moreover, high-quality RCTs are also needed to further confirm the conclusions of this study.

Anxiety is associated with higher blood pressure rise induced by cuff inflation.

To assess whether anxiety is associated with a higher rise of blood pressure induced by cuff inflation. At first, intro-aortic blood pressure was continuously record before cuff inflation as baseline value in 234 patients underwent coronary angiography, then the cuff was inflated to 200 mmHg and the intro-aortic blood pressure was record again as cuff inflation blood pressure. According to anxiety score, the patients were divided into anxiety group, subanxiety group, and nonanxiety group. The difference between the baseline blood pressure and the cuff inflation blood pressure was calculated as cuff inflation-induced blood pressure elevation. When the difference ≥10 mmHg, cuff inflation-induced blood pressure elevation was diagnosed. The cuff inflation systolic blood pressure (134.9 ± 22.4 versus 131.6 ± 22.3 mmHg, P < 0.01) and diastolic blood pressure (80.5 ± 11.9 versus 78.4 ± 11.6 mmHg, P < 0.01) were significantly higher than the baseline values, thus the mean cuff inflation-induced blood pressure elevation on systolic blood pressure was 3.3 ± 4.7 mmHg and that on diastolic blood pressure was 2.1 ± 4.9 mmHg. The anxiety subgroup had significantly higher percentage increase-systolic blood pressure and percentage increase-diastolic blood pressure levels (4.5 ± 3.1% and 5.6 ± 6.3%) than the nonanxiety subgroup (1.9 ± 3.3% and 2.0 ± 6.5%), meanwhile these values in the subanxiety subgroup were higher (3.2 ± 4.1% and 3.4 ± 5.7%) than the nonanxiety subgroup. Cuff inflation can induce a transient rise of intro-aortic blood pressure. Anxiety is associated with higher cuff inflation-induced blood pressure elevation.

The association between methylation in specific cpg sites of slc6a4 gene promoter region and prognosis of acs patients with different level of burnout

Abstract Background Given that psychosocial disorders like depression and burnout are top causes of disease burden, meanwhile have negative effect on the prognosis of acute coronary syndrome (ACS), many studies mounted on their pathogenesis. Recently, epigenetic modifications of stress-related genes like serotonin transporter gene (SLC6A4) have been found to be involved in these disease courses, but the study to investigate the influence of methylation of SLC6A4 gene on the association of these disorders and prognosis of ACS is not found. Objectives To investigate the association of methylation of SLC6A4 gene and prognosis of patients with ACS who were in different level of burnout. Methods Patients with first onset of ACS were enrolled, and their blood sample, demographic and clinical data were collected. Then they were evaluated baseline level of burnout, anxiety, depression, quality of life and heart rate variability (HRV) before discharge, by Copenhagen Burnout Inventory (CBI), Hospital Anxiety and Depression Scale (HADS), 8-item Short Form Generic Health-Related Quality-of-life Questionnaire (SF-8), Seattle Angina Questionnaire (SAQ) and ambulatory electrocardiogram (24h-AECG) respectively. At one-month and six-month's follow-up, their physical performance was evaluated by Short Physical Performance Battery (SPPB) and same indices above were assessed repeatedly. Genomic DNA was extracted from whole blood, and methylation level in 11 CpG sites of SLC6A4 gene promotor region were tested by bisulfite sequencing PCR (BSP) technique. Last, the associations among burnout, anxiety, depression, and their interactions with methylation were analyzed by IBM SPSS Statistics 24.0, so as the association of methylation and the prognosis of ACS. Results 74 patients were enrolled. Chi-square test implied that methylation of CpG7 was more obvious in non-anxiety group compared to anxiety group. And log linear model was used to explore the association among burnout, anxiety, depression, and their interactions with methylation, only the interaction of non-methylation of CpG7 and anxiety was positively correlated to the distribution of frequency. Next, five CpG sites (CpG6–10) were included in generalized estimating equations (GEEs) to analyze the association of methylation and prognosis indices of ACS patients. Results showed that methylation of CpG7 was positively correlated to standard diviation of NN intervals (SDNN), square root of the mean squared differences of successive NN intervals (RMSSD), high frequency (HF), low frequency (LF), very low frequency (VLF), total power (TP), and no significant relations were found among the score of SPPB, SF-8, SAQ and methylation. Conclusions Methylation in CpG7 of SLC6A4 gene promotor region may foretell a good prognosis of ACS patients by being correlated to less anxiety. Epigenetic modifications could be promising biomarkers to help identifying people that need special rehabilitation strategy. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Nature Science Foundation of Yunnan Province; Yunnan Health Training Project of High Level Talents