Psychiatric Diagnostic Screening Questionnaire Research Articles

Suicide ideation and male-female differences in major depressive disorder

Objective This study aimed to explore male-female differences in suicide ideation (SI) and suicide risk factors in major depressive disorder (MDD). Methods We analysed 482 adults (sample 1) and 438 elderly outpatients (sample 2) with MDD. Sample 1 was treated with different antidepressant combinations (escitalopram; bupropion plus escitalopram; venlafaxine plus mirtazapine) and assessed by means of the Concise Health Risk Tracking (SI), Quick Inventory of Depressive Symptomatology, Altman Mania Rating Scale and Psychiatric Diagnostic Screening Questionnaire. Sample 2 was treated with venlafaxine and assessed using the Hamilton scale for depression, Anxiety Sensitivity Index and Penn State Worry Questionnaire for anxiety, Beck Scale for Suicide Ideation and Repeatable Battery for the Assessment of Neuropsychological Status. Results In sample 1, females had greater depression severity (O.R 0.961 99%CI: 0.929 − 0.995), males reported more alcohol abuse (O.R 1.299 99%CI: 1.118 − 1.509) and active SI (O.R 1.109 99%CI: 1.005 − 1.255). In sample 2 men showed more severe SI (O.R 1.067; 99%CI: 1.014 − 1.122) and weight loss (OR = 5.89 99%CI: 1.01 − 34.19), women more gastrointestinal symptoms. Conclusions In these selected samples, although women had more severe depression, men had more suicide risk factors. Such differences might contribute to men’s increased suicide risk.

The Association between Cesarean Section Delivery and Child Behavior: Is It Mediated by Maternal Post-Traumatic Stress Disorder and Maternal Postpartum Depression?

Cesarean sections (C-sections) account for up to 21% of births worldwide. Studies have linked delivery via C-section with an increased risk of child behavior problems, such as internalizing and externalizing behaviors. Maternal postpartum depression (PPD) is also linked to child behavioral problems and may play a mediating role in the association between the mode of delivery and child behavior. Mixed findings between mode of delivery and PPD may be due to a failure to distinguish between C-section types, as unplanned/emergency C-sections are linked to post-traumatic stress disorder (PTSD), which has been linked to PPD. The objectives of this study were to determine whether, (1) compared with spontaneous vaginal delivery (SVD) and planned C-section, unplanned/emergency C-sections are associated with increased child behavior problems at two to three years of age and (2) maternal PTSD and PPD mediate the association between delivery type and child behavior problems. A secondary data analysis was conducted on 938 mother-child dyads enrolled in the Alberta Pregnancy Outcomes and Nutrition (APrON) study. Conditional process modeling was employed. Child behavior was assessed using the Child Behavior Checklist (CBCL) 1.5-5 years, and maternal PPD and PTSD were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the Psychiatric Diagnostic Screening Questionnaire (PDSQ), respectively. No associations were found between delivery type and child behaviors; however, the indirect effect of emergency C-section on child behaviors was significant via the mediating pathway of maternal PTSD on PPD symptoms.

Mental health outcomes of encephalitis: An international web-based study.

Acute encephalitis is associated with psychiatric symptoms. Despite this, the extent of mental health problems following encephalitis has not been systematically reported. We recruited adults who had been diagnosed with encephalitis of any aetiology to complete a web-based questionnaire. In total, 445 respondents from 31 countries (55.1% UK, 23.1% USA) responded. Infectious encephalitis constituted 65.4% of cases, autoimmune 29.7%. Mean age was 50.1 years, 65.8% were female, and median time since encephalitis diagnosis was 7 years. The most common self-reported psychiatric symptoms were anxiety (75.2%), sleep problems (64.4%), mood problems (62.2%), and unexpected crying (35.2%). Self-reported psychiatric diagnoses were common: anxiety (44.0%), depression (38.6%), panic disorder (15.7%), and posttraumatic stress disorder (PTSD; 21.3%). Severe mental illnesses such as psychosis (3.3%) and bipolar affective disorder (3.1%) were reported. Self-reported diagnosis rates were broadly consistent with results from the Psychiatric Diagnostic Screening Questionnaire. Many respondents also reported they had symptoms of anxiety (37.5%), depression (28.1%), PTSD (26.8%), or panic disorder (20.9%) that had not been diagnosed. Rates of psychiatric symptoms did not differ between autoimmune and infectious encephalitis. In total, 37.5% respondents had thought about suicide, and 4.4% had attempted suicide, since their encephalitis diagnosis. More than half of respondents (53.5%) reported they had no, or substandard, access to appropriate mental health care. High rates of sensory hypersensitivities (>75%) suggest a previously unreported association. This large international survey indicates that psychiatric symptoms following encephalitis are common and that mental health care provision may be inadequate. We highlight a need for proactive psychiatric input.

Psychometric analysis of the Psychiatric Diagnostic Screening Questionnaire (PDSQ) and determinants of psychopathology in two outpatient clinics in Navarre (Spain).

The self-report Psychiatric Diagnostic Screening Questionnaire PDSQ is designed to screen Axis I psychiatric disorders. We aim to determine its psychometric properties in Spanish outpatients and assess its relationship with two interviews (for psychopathology and for personality disorders) and clinical/demographic variables. We administered the study questionnaire, the Mini International Neuropsychiatric Interview Plus (MINI-Plus), the Standardised Assessment of Personality Abbreviated Scale (SAPAS), and the List of Threatening Experiences Questionnaire (LTE-Q) to 375 patients at two public outpatient centres. Reliability of the study questionnaire was evaluated (Cronbach's alpha, ?) and known-group validity measured by comparing groups based on demographic and clinical variables (binary logistic regression analysis) and MINI-Plus diagnoses (Mann-Whitney U). The diagnostic accuracy of the study questionnaire score was analysed taking the MINI-Plus diagnoses as the gold standard (ROC analysis). Internal consistency was adequate across all PDSQ scales (? >0.7; mean ?=0.85). Known-group comparisons were satisfactory. Female and male patients showed higher prevalence of internalizing and externalizing diagnoses, respectively. Younger age, more life events and limitations, higher SAPAS scores, and lower economic levels were linked to a greater number of PDSQ diagnoses. Inter-group differences were found for all PDSQ scales based on the corresponding MINI-Plus diagnoses. Mean values of sensitivity, AUC, and negative predictive value were 88.7, 0.82, and 96.7, respectively. When applied to a sample of Spanish outpatients, the PDSQ exhibits satisfactory psychometric properties and adequate relationships with the psychopathology and personality interviews, and clinical and demographic variables. The study questionnaire is suitable for assessing comorbidity and psychopathology dimensions.

Common genetic and environmental bases of the mental disorders and personality traits: Special focus on the hierarchical model of psychopathology and NEO-PI-R facets.

This study examined whether phenotypic correlations between psychopathological dimensions and personality traits of different hierarchical levels originate from common genetic and environmental sources of variance. Participants were 386 monozygotic and 204 dizygotic twins. The Psychiatric Diagnostic Screening Questionnaire (PDSQ) was applied along with the Revised NEO Personality Inventory (NEO-PI-R). The results of the CFA confirmed the hypothesis of the internalizing and externalizing dimensions underlying PDSQ scales. The results indicated a significantly greater role of genetic compared to environmental factors in the relationship between internalizing psychopathology and personality traits. Facets of neuroticism showed positive genetic links with internalizing disorders, while negative genetic links were shown for all facets of extraversion except excitement-seeking, competence, self-discipline, achievement striving, actions, and trust. Lower-order personality traits were shown to be associated with internalizing disorders more intensively than the broader domains to which they belong, both at the phenotypic and genetic levels. High neuroticism, together with several facets from the domain of extraversion and conscientiousness seems to represent an increased genetic susceptibility to the disorders from the internalizing spectrum. Results also suggest that specific environmental factors which are not shared with personality traits contribute to the internalizing symptoms.

Multilevel Effects of Environmental and Neighborhood Factors on Sober Living House Resident 12-Month Outcomes.

Sober living houses (SLHs) are abstinence-based environments designed for individuals in recovery to live with others in recovery. Research shows that SLHs help some individuals maintain recovery and that certain SLH-related factors may be particularly protective. Here we assess how SLH housing and neighborhood characteristics are related to abstinence and psychiatric symptoms over time. Baseline, 6-month, and 12-month data were collected from 557 SLH residents. Multilevel mixed models tested associations between house and neighborhood characteristics and individual-level percent days abstinent (PDA) and the number of psychiatric symptoms (measured with the Psychiatric Diagnostic Screening Questionnaire [PDSQ]) as outcomes. Final models adjusted for sex, age, and race/ethnicity; ratings of house characteristics; and objective measurements of neighborhood-level exposures. Both PDA and PDSQ improved significantly (ps ≤ .05) over time in both unadjusted and adjusted models. More self-help groups and fewer alcohol outlets within one mile were significantly protective for PDA, whereas walkability was significantly related to worse PDA and PDSQ (ps ≤ .05). For house-level factors, better ratings of house maintenance were related to significantly fewer psychiatric symptoms, whereas higher scores on SLH's safety measures and personal or residence identity were related to more psychiatric symptoms (ps ≤ .05). No house-level factor was significantly related to PDA. Neighborhood-level factors such as increased availability of self-help groups and fewer nearby alcohol outlets may increase abstinence among individuals living in SLHs. House-level factors related to better maintenance may also facilitate improved mental health.

Effects of resistance exercise training on depressive symptoms among young adults: A randomized controlled trial

Evidence supports the antidepressant effects of resistance exercise training (RET); however, findings among young adults at-risk for elevated depressive symptoms are limited. This randomized controlled trial examined the effects of eight weeks of ecologically-valid, guidelines-based RET, compared to a wait-list control, on depressive symptoms among 55 young adults (26±5y; 36 female) with and without subclinical, or analogue, Generalized Anxiety Disorder (AGAD; Psychiatric Diagnostic Screening Questionnaire GAD subscale ≥6 and Penn State Worry Questionnaire ≥45) and Major Depressive Disorder (AMDD). Following a three-week familiarization period, participants completed one-on-one, twice-weekly RET sessions. The 16-item, self-reported Quick Inventory of Depressive Symptomatology (QIDS) assessed depressive symptoms. RM-ANCOVAs examined between-group differences, and significant interactions were decomposed with simple effects analysis. Hedges’ d effect sizes (95%CI) quantified the magnitude of differences in change between groups across time. Stratified analyses were conducted among subsamples with AMDD and AGAD. There were no baseline depressive symptom differences between groups. Attendance was 83%, and compliance was 80%. RET induced statistically significant, clinically-meaningful, large-magnitude reductions in depressive symptoms from baseline to week eight in the total (d = 1.01; [95%CI: 0.44–1.57]), AMDD (d = 1.71; [95%CI: 0.96–2.46]), and AGAD (d = 1.39; [95%CI: 0.55–2.24]) samples. These findings support guidelines-based RET as a promising treatment for mild depression.

Students stress patterns in a Kenyan socio-cultural and economic context: toward a public health intervention

This study aimed at determining the prevalence of stress, different types of stress, their severity and their determinants in Kenyan university, college and high school students. The following tools were administered to 9741 students: (1) Researcher-designed socio-demographic tool, (2) Psychiatric Diagnostic Screening Questionnaire (PDSQ) for psychiatric disorders, (3) WERC Stress Screen for stress, (4) Washington Early Recognition Center Affectivity and Psychosis (WERCAP) screen for psychosis and affectivity, (5) Wealth Index Questionnaire for economic indicators. Descriptive analysis for the prevalence of different types of stress and inferential analysis for stress and independent variables were done. Significant variables (p < 0.05) were fitted into generalized linear model to determine independent predictors. The mean age of the respondents was 21.4 years (range 16–43). Money issues were the commonest stressors while alcohol and drug use were the least. The independent predictors of stress were females, college students and use of gas stove. In conclusion, up to 30% of the students suffer from mild to severe stress. The students experience a wide range of stressors. The most important stressors include money and finances, family related problems and concerns about their future. Our findings suggest a public health approach to create stress awareness in students.

The network structure of self-reported psychopathological dimensions in common mental disorders (CMDs)

Background and objectivesCommon mental disorders (CMDs) in mental health settings show high rates of comorbidities. While semi-structured interviews are the gold standard to establish a diagnosis, there are self-report instruments such as the Psychiatric Diagnostic Screening Questionnaire (PDSQ) that aids clinicians in improving the diagnostic process in a time-efficient manner. MethodsNetwork analysis of the 13 domains of the PDSQ was applied to a sample of 374 first-contact outpatients to identify domains of psychopathology acting as hubs and bridges of interconnections within the CMDs. ResultsA global network densely connected with positive connections among PDSQ domains was found. The global network has four main clusters: depression-anxiety, somatoform, psychosis and substance-related domains. This network allowed for the identification of main ‘nodes’ acting as hubs favoring interconnections between dimensions and main ‘bridges’ easing the connections between clusters. ConclusionThe network structure of the PDSQ domains might provide a complementary explanation to the high rates of comorbidity among CMDs. Moreover, our results support the relevance of the self-administered PDSQ inventory to account for a deeper understanding of comorbidities among CMDs.

A-186 Injury Mechanism, Premorbid Intelligence, and Psychological Outcomes Post Mild Traumatic Brain Injury

Abstract Objective: This study aimed to explore psychological outcomes of individuals who sustained a mild traumatic brain injury (mTBI) as impacted by injury mechanism and premorbid intelligence. Cognitive outcomes post mTBI are well-researched, and the impact of premorbid intelligence has routinely been shown in the literature to impact cognitive outcomes, but type of injury and psychiatric outcomes have received much less attention. Method: All 108 participants were referred for outpatient neuropsychological evaluation following presentation to the emergency room with head injury. A multivariate analysis of covariance (MANCOVA) was used to explore the relationship of injury mechanism (motor vehicle accident (MVA) or fall) to psychological outcomes as measured by the major depressive disorder, generalized anxiety disorder, alcohol abuse/dependence, drug abuse/dependence, and posttraumatic stress disorder (PTSD) scales on the Psychiatric Diagnostic Screening Questionnaire (PDSQ). Premorbid intelligence as assessed using WRAT—4 Reading was the covariate. A binary logistic regression was also used to determine which PDSQ scales were predictors of injury mechanism. Results: In the MANCOVA analysis, alcohol abuse/dependence was the sole variable approaching significance (p = .068). The logical regression equation model accurately classified 98.9% of MVA cases, wherein alcohol abuse/dependence emerged as the lone significant predictor (p = .028). Conclusions: Contrary to literature on cognitive outcomes, premorbid intelligence was not associated with psychological outcomes post mTBI. Independent of injury mechanism, no significant differences among PDSQ outcome scales were discovered. Finally, those with mTBI due to MVA had a higher probability of alcohol abuse/dependence compared to those with those suffering a mTBI from a fall.

The Interplay Between Expected Psychological Responses to Exercise and Physical Activity in Analogue Generalized Anxiety Disorder: a Cross-sectional Study.

Expectations for psychological responses to exercise are not well characterized, particularly in people at risk for anxiety-related illnesses. Given the substantial evidence for salutary effects of exercise on anxiety symptoms and emerging recognition for expectations as a critical mechanism of placebo/nocebo effects, this study explored the interplay between expectations and physical activity in young adults with and without analogue generalized anxiety disorder. Participants (N=470, 23.2±4.8 years, 63% female) completed a physical activity and mood survey, including a 7-day physical activity recall questionnaire, and a 20-item questionnaire designed to measure positive and negative expectations for psychological and perceptual responses to exercise, particularly expectations for symptoms in the generalized anxiety disorder symptom profile. Analogue generalized anxiety disorder status was determined using the Generalized Anxiety Disorder subscale of the Psychiatric Diagnostic Screening Questionnaire. For select outcomes, expected exercise-induced changes significantly differed according to analogue generalized anxiety disorder (whole-body pain, sleep quality, psychological well-being, stress, relaxation) and active versus inactive (anxious mood, depressed mood, concentration, physical function, psychological well-being, relaxation) status. However, these findings did not survive corrections for multiple comparisons and the magnitude of these differences was small, approximating 0.25 standard deviations. Expectations for anxious (Spearman's ρ=-0.14, p≤0.002) and depressed mood (ρ=-0.15, p≤0.002), and psychological well-being (ρ=0.15, p≤0.001) were significantly associated with higher physical activity levels. Exercise expectations for anxious mood explained a significant, but small (+1.5%, p≤0.03), amount of variance in physical activity. Expectations for exercise-induced improvements did not significantly differ between young adults based on analogue generalized anxiety disorder or physical activity status.

Associations among Caesarean Section Birth, Post-Traumatic Stress, and Postpartum Depression Symptoms.

Caesarean section (C-section) deliveries account for nearly 30% of births annually with emergency C-sections accounting for 7–9% of all births. Studies have linked C-sections to postpartum depression (PPD). PPD is linked to reduced quality of parent-child interaction, and adverse effects on maternal and child health. New mothers’ perceptions of more negative childbirth experiences, such as unplanned/emergency C-sections, are linked to post-traumatic stress disorder (PTSD), which in turn is related to PPD. Our objectives were to determine: (1) the association between C-section type (unplanned/emergency vs. planned) and PPD symptoms, and (2) if postnatal PTSD symptoms mediate this association. Employing secondary analysis of prospectively collected data from 354 mother-child dyads between 2009 and 2013 from the Alberta Pregnancy Outcomes and Nutrition (APrON) study, conditional process modeling was employed. The Edinburgh Postnatal Depression Scale (EPDS) and the Psychiatric Diagnostic Screening Questionnaire (PDSQ) were administered at three months postpartum, to assess for postpartum depressive and post-traumatic stress symptoms. The direct effect of emergency C-section on PPD symptoms was non-significant in adjusted and non-adjusted models; however, the indirect effect of emergency C-section on PPD symptoms with PTSD symptoms as a mediator was significant after controlling for prenatal depression symptoms, social support, and SES (β = 0.17 (SE = 0.11), 95% CI [0.03, 0.42]). This suggests that mothers who experienced an emergency or unplanned C-section had increased PTSD scores of nearly half a point (0.47) compared to mothers who underwent a planned C-section, even after adjustment. Overall, emergency C-section was indirectly associated with PPD symptoms, through PTSD symptoms. Findings suggest that PTSD symptoms may be a mechanism through which emergency C-sections are associated with the development of PPD symptoms.

Psychiatric Outcomes after Mild Traumatic Brain Injury in Adults

<h3>Research Objectives</h3> To enhance the knowledge regarding psychiatric outcomes after mild traumatic brain injury (mTBI) in adults, specifically considering premorbid psychiatric history. <h3>Design</h3> A retrospective observational study using a clinical dataset from the initial evaluation in clinic. Self-reported premorbid psychiatric history was determined by clinician interviews. <h3>Setting</h3> An ambulatory mTBI clinic. <h3>Participants</h3> Participants were 85 adults with mTBI confirmed by clinicians. Participants were 14 to 365 days post injury with valid psychiatric history and outcomes data. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> The Psychiatric Diagnostic Screening Questionnaire (PDSQ) was part of the clinical assessment process. The PDSQ is a brief screening measure for common psychiatric diagnoses based upon the diagnostic and statistical manual of mental disorders, 4th edition. Major depressive disorder (MDD), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD) scales represented psychiatric outcomes. Raw scores were used as well as binary categories with scores above and below cut-off scores indicating caseness. <h3>Results</h3> There were no significant differences (p > .05) in demographic and injury characteristics (age, gender, race, loss of consciousness, and days since injury) by psychiatric history status (yes/no) with exception of year of education (p= .025). On average, participants were 36.6 years old with 13.8 years of education. Men (47.6%) and women (52.4%) were fairly even in representation. Most participants were Caucasian (89.4%). Individuals with premorbid psychiatric histories had greater symptoms of GAD (F(1, 76)= 11.90, p=.001, partial eta squared=0.14), MDD (F(1, 76)= 4.62, p=.035, partial eta squared=0.06), and PTSD (F(1, 76)= 6.54, p=.013, partial eta squared=0.08). When considering scores above respective cut-offs for each outcome, similar findings were revealed. Of note, the Odds Ratio for positive screens on depression was 7.08 (p < .001), and it was 5.45 (p= .002) for anxiety, among those with a premorbid psychiatric history. There was no association with PTSD screening and premorbid psychiatric history (p= .083). <h3>Conclusions</h3> Premorbid psychiatric history is demonstrably associated with worse psychiatric outcomes after mTBI in adults, particularly for anxiety and depression outcomes. <h3>Author(s) Disclosures</h3> None.

Socio-demographic, economic and mental health problems were risk factors for suicidal ideation among Kenyan students aged 15 plus

BackgroundAbout a third of youth with suicidal ideation develop suicidal plans and about 60% of youth with suicidal plans make suicidal attempts. This study aimed to study different types of suicidal ideation and the risk factors in Kenyan youth. MethodsWe studied a total of 9742 high school, college and university students using following self-administered instruments: - a researcher design socio-demographic questionnaire, Psychiatric Diagnostic Screening Questionnaire (PDSQ) to document psychiatric disorders and various types of suicidal ideas in previous two weeks, Washington Early Recognition Center Affectivity and Psychosis tool to assess stress, affectivity and psychosis, Wealth index questionnaire to document economic indicators based on household items for the families of the students. We used descriptive statistics, univariate analysis, bivariate logistic regression analysis and variables with a p-value of less than <.05 were entered into generalized linear models using logit links to identify independent predictors. ResultsThe overall prevalence of different types of suicidal ideation was (22.6%), major depression was found in 20.0%, affectivity, psychosis and stress was found in 10.4%, 8.7% and 26.0% respectively. Female gender, major depression, stress, affectivity and psychosis and being in high school were significant (p < 0.05) predictors of suicidal ideation. LimitationsThis was a cross sectional study that focused only on suicidal ideas and associated economic factors and mental health disorders. It did not study suicidal behavior. ConclusionFuture studies are needed to study the progression from suicidal ideas to suicidal attempts and the factors associated with that progression.

Assessment of chemotherapy-induced cognitive impairment: a prospective study of the cognitive effects of platinum/taxane-based chemotherapy in gynecologic cancer patients

<h3>Background:</h3> Chemotherapy-induced cognitive impairment (CICI), ‘chemo-brain,' involves concentration and executive functioning difficulty and slowed processing speed and memory. Although cognitive changes in CICI can be subtle and difficult to quantify, CICI affects up to 75% of cancer survivors and impacts quality of life. <h3>Objectives:</h3> The objective of our study was to add to the definition of CICI by quantifying changes in specific cognitive domains before and after administration of platinum/taxane-based chemotherapy in gynecologic cancer patients using a tailored battery of neurocognitive tests. <h3>Methods:</h3> Following institutional review board approval, chemotherapy-naïve gynecologic cancer patients scheduled to receive six cycles of intravenous platinum/taxane-based chemotherapy were identified. Baseline demographic, social, and clinical characteristics were obtained. Eleven neurocognitive assessments measured cognitive domains of interest (Table 1), including a brief cognitive screen, evaluation of fine motor skills, verbal fluency, working memory, information processing speed, visuospatial learning and memory, attention, mental flexibility, and abstract problem-solving skills. The European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core-30 and Psychiatric Diagnostic Screening Questionnaire assessed emotional functioning. The Functional Assessment of Cancer Therapy - Cognitive Function assessed self-perceived cognitive functioning. Testing was performed prior to the first and three to four weeks after the last cycle of chemotherapy. Descriptive statistics identified trends in individual indices of cognitive dysfunction and quality of life. <h3>Results:</h3> Fourteen patients enrolled and nine were eligible for complete analyses. The mean age was 60.6 years. The mean full scale intelligence quotient prior to therapy was 103.5. Most patients were White (8/9, 89%), had obtained at least a Bachelor's degree (5/9, 55.6%), and were diagnosed with high grade (6/9, 66.7%) stage III or IV disease (5/9, 55.6%). The majority of patients declined on cognitive screening performance (5/9, 55.6%) as well as worse scores on indices of attention (7/9, 77.8%), mental flexibility (5/8, 62.5%) verbal learning (5/9, 55.6%), and fine motor skills (5/9, 55.6%) after completion of chemotherapy. Most patients improved on indices of verbal memory (7/9, 77.8%), visuospatial learning (6/8, 75%), and verbal fluency (5/9, 55.6%). Despite changes in indices of cognitive function, most patients' perceived quality of life improved (5/9, 55.6%) after chemotherapy. <h3>Conclusions:</h3> Although gynecologic cancer patients complain of CICI, there is discrepancy regarding its incidence and affected cognitive domains. This pilot study highlights attention and mental flexibility as indices of cognitive dysfunction that may be at risk following receipt of chemotherapy in gynecologic cancer patients. Future research may focus on targeted assessment strategies.

Physical activity and analogue anxiety disorder symptoms and status: Mediating influence of social physique anxiety

BackgroundAssociations between physical activity (PA) and subclinical anxiety disorder symptoms and status, and potential mediating effect of social physique anxiety (SPA), remain understudied. We examined associations between PA and analogue Generalized Anxiety Disorder (AGAD), analogue Social Anxiety Disorder (ASAD), and analogue Panic Disorder (APD) symptoms and status, the mediating effect of SPA, and sex-related differences. MethodsParticipants (n = 470, 23.2 ± 4.8 years, 298 female) completed the Psychiatric Diagnostic Screening Questionnaire, seven-day PA recall, and Social Physique Anxiety Scale. ANCOVA examined differences in SPA and anxiety disorder symptoms between PA levels. Logistic regression examined associations between PA and analogue anxiety disorder status. Mediation analyses estimated the effect of change in PA on analogue anxiety disorder odds when SPA was at its mean. ResultsAGAD, ASAD, and APD prevalence was 38.1%, 60.0%, and 15.1%, respectively. AGAD and ASAD symptoms, but not APD symptoms, were significantly lower among higher PA levels. PA was associated with lower odds of AGAD, ASAD, and APD; findings were not significant after adjustment. The pure indirect effect of SPA significantly accounted for 58.2% and 47.9% of the total effect of PA on AGAD and ASAD, respectively; findings were not significant after adjusting for depression. Females showed greater odds of AGAD, ASAD, and APD; mediation findings did not differ based on gender. LimitationsCross-sectional design, self-reported exposure and outcomes, and sample size are potential limitations. ConclusionSymptoms and odds of AGAD and ASAD status were lower among young adults with greater PA; SPA partially mediated associations and warrants experimental investigation.

Associations Between Physical Activity, Generalized Anxiety Disorder, And Social Physique Anxiety Among Young Adults

Social Physique Anxiety (SPA) has been associated with physical activity (PA) behaviors and anxiety disorder symptoms. However, little is known about the potential influence of SPA on associations between PA and Generalized Anxiety Disorder (GAD). PURPOSE: This study quantified associations between PA, GAD and SPA among young adults (N=470, 23.2±4.8y; 63.4% female) and explored SPA as a mediator of the association between PA and GAD. METHODS: Seven-day PA Recall determined estimated expenditure (kcal/wk) and classified inactive, moderately active, and highly active PA dose categories. The Psychiatric Diagnostic Screening Questionnaire GAD subscale assessed GAD symptom severity; a score of ≥6 indicated analogue GAD (AGAD) status. The Social Physique Anxiety Scale assessed SPA. Independent t-tests examined baseline differences based on gender and AGAD status. Cohen’s d quantified the magnitude of difference. Logistic regression quantified odds of AGAD based on PA dose, adjusting for age, gender, and smoking status. Simple mediation analyses examined mediation of the continuous PA-GAD symptom association by SPA. RESULTS: Females reported less PA (p≤0.002, d=0.31) and greater SPA (p≤0.001, d=-0.63) and GAD symptom severity (p≤0.001, d=-0.51). AGAD reported greater SPA (p≤0.001, d=0.92). Compared to inactive, odds of AGAD were 28.3% (OR=0.72, 95%CI: [0.43, 1.20], p≥0.21) and 42.5% (OR=0.58, [0.35, 0.94], p≤0.03) lower among moderately active and highly active, respectively. In adjusted models, compared to inactive, odds were 29.3% (OR= 0.71, [0.42, 1.20], p≥0.21) and 36.9% (OR=0.63, [0.38, 1.06], p≥0.08) lower among moderately active and highly active, respectively. Regression models of PA on GAD symptoms (β=-0.01, p≤0.04), SPA on PA (β=-0.02, p≤0.03), and SPA on GAD symptoms (β=0.14, p≤0.001) were significant. When regressed together, SPA was (β=0.14, p≤0.001), but PA was not (β=-0.003, p≤0.27), statistically significant, supporting mediation. CONCLUSION: PA may lower odds of GAD, but findings were not significant after adjusting for covariates. SPA, a modifiable factor that was higher among females and those with AGAD, mediated the association between PA and GAD. Future research should examine these relationships longitudinally and explore SPA experimentally.

The Influence of Socio-Demographic Factors, Lifestyle and Psychiatric Indicators on Adherence to Treatment of Patients with Rheumatoid Arthritis: A Cross-Sectional Study.

Background and Objectives: Rheumatoid arthritis (RA) is a severe autoimmune disease characterized by chronic inflammation of the joints accompanied by the progressive deformation and destruction of cartilage and joint bones. This study aims to gain insight into the outcomes related to adherence in patients with rheumatoid arthritis. Predicting the medication adherence in RA patients is a key point to improve the treatment outcome. Materials and Methods: A number of 119 Romanian patients with RA were included and divided into two groups: first group included 79 patients treated with conventional therapy and second group included 40 patients treated with biologic therapy. A CQR-9 (compliance questionnaire rheumatology with nine items) and PDSQ (psychiatric diagnostic screening questionnaire) were performed to assess correlations between medication adherence, patient sociodemographic variables, 11 psychiatric scales (major depressive disorder, posttraumatic stress disorder, obsessive-compulsive disorder, panic disorder, psychosis, agoraphobia, social phobia, drug abuse/dependence, generalized anxiety disorder, somatization disorder, hypochondriasis) and lifestyle (bulimia, alcohol intake). Results: Whilst modelling factors associated with adherence, it was found that women and patients with higher education are more adherent. From the psychiatric indicators, only major depressive disorder and post-traumatic stress disorder were found to be positively correlated with therapeutic adherence. None of the assessed lifestyle factors influenced the adherence of RA patients. Conclusion: The knowledge of factors that impact on treatment adherence can be useful for clinicians to guide patient-centred care.

Acute and chronic effects of resistance exercise training among young adults with and without analogue Generalized Anxiety Disorder: A protocol for pilot randomized controlled trials

ObjectivesRecent meta-analyses support the chronic anxiolytic effects of resistance exercise training (RET) among women with diagnosed Generalized Anxiety Disorder (GAD). However, the effects of RET among those with subclinical, or analogue, GAD (AGAD) is unknown. The purpose of the pilot randomized controlled trial (RCT) detailed in this protocol was to quantify the acute and chronic effects of RET on signs and symptoms of GAD among young adults with and without AGAD. MethodsThis protocol details the full methods of two parallel, RCTs of an eight-week RET intervention compared to a wait-list control condition among young adults with and without AGAD. AGAD status was determined using validated cut-scores for both the Psychiatric Diagnostic Screening Questionnaire GAD subscale (≥6) and the Penn State Worry Questionnaire (≥45). The ecologically-valid RET was designed according to World Health Organization and American College of Sports Medicine guidelines. The primary outcome was AGAD status, assessed pre- and post-intervention. Secondary outcomes were assessed weekly. Two acute RET trials were nested within the design at pre- and post-intervention to determine response and change in response to a single bout of RET. ConclusionsThis pilot RCT examines the effect of an ecologically-valid RET intervention among young adults with subclinical levels of GAD. Given that GAD most often emerges during young adulthood, and young adults who display elevated subclinical symptoms are more likely to develop clinically significant psychopathology, investigating the effects of RET among individuals with emerging signs and symptoms of an anxiety disorder is particularly important. Trial registrationClinicalTrials.gov Identifier: NCT04116944.

Physical activity is indirectly associated with pain in college women through associations with somatization and panic disorder symptoms: a cross-sectional study

PurposeThis study tested whether the severity of somatization, panic, generalized anxiety, and depression symptoms mediated relationships between physical activity and pain using structural equation modeling. MethodsCollege women (n = 1036; mean = SD age of 19.7 ± 3.0 years) reported past week physical activity and the presence of persistent pain (≥1 month). The Psychiatric Diagnostic Screening Questionnaire assessed hypothesized mediators of physical activity effects on pain via symptoms of generalized anxiety, panic, major depressive disorder, and somatization disorder. ResultsThe percentage of the sample screening positive was 15.7% for generalized anxiety, 5.8% for panic, 11.0% for major depressive, and 16.0% for somatization. The hypothesized model had good fit and accounted for a significant amount of variance in pain (9.1%). Direct paths from physical activity to somatization, generalized anxiety, major depressive disorder, and panic disorder were significant. Paths to pain were significant from somatization and panic disorder. The path from physical activity to pain was not direct but indirect and through significant paths to pain from somatization and panic disorder. Each standard deviation increase in physical activity decreased the probability of pain by 11.0% through panic disorder and 10.7% through somatization disorder. ConclusionsPhysical activity is associated with pain indirectly through associations with panic disorder and somatization disorder symptoms in college women.