Risk Factor For Anxiety Disorders Research Articles

Gender disparities in incidence of psychological disorder among patients with breast cancer: A national cohort study.

e23285 Background: Male breast cancer (MBC) is rare. The features of MBC shares similar characteristics with female breast cancer, often resembling postmenopausal breast cancer. However, there are notable differences between male and female breast cancer, especially regarding gender and age, which can have distinct psychological impacts on male patients. In this study, we investigated whether the psychological distress experienced upon a diagnosis of breast cancer differs according to gender. Methods: Data were obtained from the National Health Insurance claims database of the Health Insurance Review and Assessment Service in South Korea. This study focused on the three most common psychological disorders: sleep disorders, anxiety disorders, and depression. Diagnosis confirmation relied on diagnostic codes based on the International Code of Disease, 10th revision, alongside breast cancer diagnoses. Propensity score matching was used in a 1:5 ratio, and adjustment variables included age, endocrine therapy, chemotherapy, HER2-targeted treatment, and Charlson Comorbidity Index score. Results: After excluding patients with previous psychological disorder, there were a total of 75,936 patients, and 281 (0.4%) male patients. Male patients were diagnosed at an older age, had a higher prevalence of hormone receptor-positive status, higher comorbidities, and lower rates of anxiety disorders, while sleep disorders and depressive disorders showed similar incidences. The Cox proportional hazard regression model exhibited that being female was a risk factor for anxiety disorder (after matching, multivariable, HR 1.498, 95% CI 1.057-2.123, p = 0.023). However, gender did not significantly influence the development of sleep or depressive disorders, despite these conditions typically having a higher incidence in females. During the acute phase shortly after diagnosis, women tend to have more distress, as seen on the cumulative incidence curves. Conclusions: MBC patients experienced similar levels of psychological distress related to sleep and depression disorders as female patients. These results suggested that both genders require an equal support system and psychological care to maintain mental well-being after a breast cancer diagnosis.

Mediating factors explain anxiety experienced by women with obesity during the Covid-19 pandemic.

The Covid-19 pandemic could be a source of great anxiety, especially for those at higher risk, such as women experiencing obesity. The aim of this study was to measure how some personal characteristics such as BMI (from underweight to class 3 obesity), bariatric surgery (yes or no), comorbidities, or age (as antecedent variables), and mediating factors impacted state anxiety during the Covid-19 Pandemic. Mediating factors were related to subjective knowledge or attitudes (e.g. interest or beliefs and practices around Covid-19, subjective health perception, and confidence in the government). French women (N = 532) were invited to take part in a voluntary online health survey during lockdown in Paris and its suburbs. Results showed that women with higher BMI had higher anxiety scores, primarily because they feel less healthy than other people. Secondly, the larger the body size of the participants was (BMI), the less they reported that information about Covid-19 held their attention. This lack of interest resulted in feelings of anxiety not being generated. Thirdly, the larger their body size was, the less confidence they had in the effectiveness of the proposed measures by the government and therefore, the more anxious they were. Finally, older age predicted higher interest in the pandemic, higher subjective health, and higher confidence in the government. Identifying obesity as a potential risk factor for anxiety disorders is crucial, but measuring the relationship between state anxiety and personal characteristics (e.g. BMI) requires considering mediating variables (e.g. subjective health perception). To reduce anxiety in women with obesity, it appears necessary to focus on psychological programs that can help them improve their perception of their health, as well as the confidence they may have in institutions, especially for younger women.

Neonatal neural responses to novelty related to behavioral inhibition at 1 year.

Behavioral inhibition (BI), an early-life temperament characterized by vigilant responses to novelty, is a risk factor for anxiety disorders. In this study, we investigated whether differences in neonatal brain responses to infrequent auditory stimuli relate to children's BI at 1 year of age. Using functional magnetic resonance imaging (fMRI), we collected blood-oxygen-level-dependent (BOLD) data from N = 45 full-term, sleeping neonates during an adapted auditory oddball paradigm and measured BI from n = 27 of these children 1 year later using an observational assessment. Whole-brain analyses corrected for multiple comparisons identified 46 neonatal brain regions producing novelty-evoked BOLD responses associated with children's BI scores at 1 year of age. More than half of these regions (n = 24, 52%) were in prefrontal cortex, falling primarily within regions of the default mode or frontoparietal networks or in ventromedial/orbitofrontal regions without network assignments. Hierarchical clustering of the regions based on their patterns of association with BI resulted in two groups with distinct anatomical, network, and response-timing profiles. The first group, located primarily in subcortical and temporal regions, tended to produce larger early oddball responses among infants with lower subsequent BI. The second group, located primarily in prefrontal cortex, produced larger early oddball responses among infants with higher subsequent BI. These results provide preliminary insights into brain regions engaged by novelty in infants that may relate to later BI. The findings may inform understanding of anxiety disorders and guide future research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Short-term training in watercolor painting on psychological anxiety of adult students from the perspective of art psychology

BackgroundAnxiety disorders often involve excessive and persistent feelings of worry and fear, which develop to a peak in a short period of time. The etiology of anxiety disorder is complex, and its pathogenesis is not clear. Genetic factors are one of the important risk factors of anxiety disorder, and neurobiochemical factors, psychological factors and biosocial factors may lead to this disease. In order to explore more ways to intervene in psychological anxiety, the study introduced psychology into the short-term training course of watercolor painting, and analyzed its influence mechanism and effect on psychological anxiety of adult students.Subjects and Methods Forty-six adult students with psychological anxiety in a painting training course were randomly divided into the experimental group and the control group. The experimental group participated in the watercolor painting training course from the perspective of psychology. Symptom self-rating Scale SCL-90, social anxiety scale LSAS and Hamilton anxiety Scale HAMA were used for assessment before treatment, the second, fourth and eighth weeks after treatment, respectively.Results The scores of HAMA, LSAS and SCL-90 in the experimental group after receiving painting training from the perspective of psychology were lower than those before participation (P<0.05), and the differences were statistically significant.ConclusionsThe short-term painting training course from the perspective of psychology has a positive effect on the psychological anxiety of adult students, which can maintain attention for a long time, improve the quality of sleep, and avoid the anxiety of nervousness or excessive thinking.

Prevalence and risk factors of prenatal anxiety disorders: A cross-sectional study.

Studies regarding the risk factors of prenatal anxiety disorders are inconclusive and sometimes contradictory. The current study aimed to define the prevalence and risk factors for anxiety disorders in women during pregnancy. This is a cross-sectional and hospital-based survey of two public hospitals (Ayatollah Rohani and Yahyanejad) of inpatients/outpatients, obstetric wards/clinics, and four private outpatient obstetric clinics in the city of Babol. Convenience sampling was utilized to recruit 432 pregnant women. A trained clinical psychologist conducted the Structured Clinical Interview for DSM-5 (SCID-5) to diagnose anxiety disorders. In addition, the Brief Symptom Inventory 18 (BSI-18) was completed by the participants to assess the severity of psychological distress. Of 432 pregnant women, 132 (30.5%) were diagnosed with anxiety disorders. Anxiety disorders included 61 cases of pregnancy adjustment disorder (47.7%), 52 cases of generalized anxiety disorder (40.6%), and 15 cases of specific phobia (to delivery) (11.7%). The logistic regression results showed that the age, pregnancy, education, parity, and high-risk pregnancy variables predicted 28% of the variance of anxiety disorders. Furthermore, as the age (β = 0.94, p = 0.003) and gestational age (β = 0.9, p < 0.001) increased, the probability of anxiety disorders in pregnancy decreased. Moreover, university education (β = 1.65, p = 0.049) and high-risk pregnancy (β = 1.72, p = 0.02) were recognized as risk factors for developing anxiety disorders during pregnancy. The high incidence of anxiety disorders in pregnant women suggests that obstetricians should pay more attention to identifying and treating anxiety disorders in all pregnant women, especially in high-risk pregnancies.

Arsenic exposure induced anxiety-like behaviors in male mice via influencing the GABAergic Signaling in the prefrontal cortex.

Arsenic contamination in drinking water causes a global public health problem. Emerging evidence suggests that arsenic may act as an environmental risk factor for anxiety disorders. However, the exact mechanism underlying the adverse effects has not been fully elucidated. This study aimed to evaluate the anxiety-like behaviors of mice exposed to arsenic trioxide (As2O3), to observe the neuropathological changes, and to explore the link between the GABAergic system and behavioral manifestations. For this purpose, male C57BL/6 mice were exposed to various doses of As2O3 (0, 0.15, 1.5, and 15mg/L) through drinking water for 12weeks. Anxiety-like behaviors were assessed using the open field test (OFT), light/dark choice test, and elevated zero maze (EZM). Neuronal injuries in the cerebral cortex and hippocampus were assessed by light microscopy with H&E and Nissl staining. Ultrastructural alteration in the cerebral cortex was assessed by transmission electron microscope (TEM). The expression levels of GABAergic system-related molecules (i.e., glutamate decarboxylase, GABA transporter, and GABAB receptor subunits) in the prefrontal cortex (PFC) were determined by qRT-PCR and western blotting. Arsenic exposure showed a striking anxiogenic effect on mice, especially in the group exposed to 15mg/L As2O3. Light microscopy showed neuron necrosis and reduced cell counts. TEM revealed marked ultrastructural changes, including the vacuolated mitochondria, disrupted Nissl bodies, an indentation in the nucleus membrane, and delamination of myelin sheath in the cortex. In addition, As2O3 influenced the GABAergic system in the PFC by decreasing the expression of the glutamate decarboxylase 1 (GAD1) and the GABAB2 receptor subunit, but not the GABAB1 receptor subunit. To sum up, sub-chronic exposure to As2O3 is associated with increased anxiety-like behaviors, which may be mediated by altered GABAergic signaling in the PFC. These findings shed light on the mechanisms responsible for the neurotoxic effects of arsenic and therefore more cautions should be taken.

Node of Ranvier remodeling in chronic psychosocial stress and anxiety

Differential expression of myelin-related genes and changes in myelin thickness have been demonstrated in mice after chronic psychosocial stress, a risk factor for anxiety disorders. To determine whether and how stress affects structural remodeling of nodes of Ranvier, another form of myelin plasticity, we developed a 3D reconstruction analysis of node morphology in C57BL/6NCrl and DBA/2NCrl mice. We identified strain-dependent effects of chronic social defeat stress on node morphology in the medial prefrontal cortex (mPFC) gray matter, including shortening of paranodes in C57BL/6NCrl stress-resilient and shortening of node gaps in DBA/2NCrl stress-susceptible mice compared to controls. Neuronal activity has been associated with changes in myelin thickness. To investigate whether neuronal activation is a mechanism influencing also node of Ranvier morphology, we used DREADDs to repeatedly activate the ventral hippocampus-to-mPFC pathway. We found reduced anxiety-like behavior and shortened paranodes specifically in stimulated, but not in the nearby non-stimulated axons. Altogether, our data demonstrate (1) nodal remodeling of the mPFC gray matter axons after chronic stress and (2) axon-specific regulation of paranodes in response to repeated neuronal activity in an anxiety-associated pathway. Nodal remodeling may thus contribute to aberrant circuit function associated with anxiety disorders.

Burden and risk factors of anxiety disorders among Arabic pediatric population: A systematic review

&lt;b&gt;Aim:&lt;/b&gt; In the general population, where 6 to 20% of individuals experience anxiety disorders, children also experience a higher burden of anxiety. We undertook a systematic review In order to examine and summarize the results from studies that estimated the prevalence of anxiety and/or its associated risk factors in the pediatric populations of Arab nations, primarily the gulf countries.&lt;br /&gt; &lt;b&gt;Methods:&lt;/b&gt; Any study that focused on the pediatric population and completed in Arab nations to determine the incidence of anxiety and/or its risk factors among children under the age of 18. The review had 13 articles were included.&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; The results of the systematic review found that there was a wide variation in the prevalence of anxiety among children. At least 30.2% of the children were found to suffer from anxiety and the prevalence could go up to 60% in some countries with a higher prevalence among girls than boys. Associated factors of anxiety were diverse including exposure to environmental tobacco smoke, parenting style, living with parents suffering from mental disorders, school type, and being female.&lt;br /&gt; &lt;b&gt;Conclusion:&lt;/b&gt; The findings of the review demonstrate the higher prevalence of anxiety among children as almost at least one-third of children suffer from anxiety in the Gulf countries. The program managers and the respective government of these Arab countries need to devise some strategies and interventions that not only focus on the children but also their environment.

Prenatal exposure to air pollution and childhood internalizing problems: roles of shyness and anterior cingulate cortex activity.

Prenatal exposure to air pollution increases the risk for psychiatric disorders characterized by internalizing problems. In this study, we examined the roles of shyness and anterior cingulate cortex (ACC) activity in the association between prenatal exposure to polycyclic aromatic hydrocarbons (PAH) and children's internalizing problems at 7-9 years old. Participants include 53 children (31 girls, 22 boys). Personal air monitoring was conducted over 48 continuous hours during the third trimester of pregnancy to measure 8 PAHs. Mothers reported children's shyness (Emotionality Activity Sociability Temperament Survey) at age 5 and internalizing problems (Child Behavior Checklist) at ages 7-9. ACC activity was measured by fMRI during the Simon Spatial Incompatibility task at ages 7-9. Shyness mediated the association between prenatal PAH exposure and internalizing problems. Higher prenatal PAH exposure predicted increased shyness, which in turn predicted greater internalizing problems. Moreover, left ACC activity during the Simon task moderated the association between prenatal PAH exposure and internalizing problems. Prenatal PAH exposure predicted increased risk for internalizing problems only when children showed heightened left ACC activity during the resolution of cognitive conflict. Our study innovatively synthesizes the fields of developmental psychology and environmental health science to offer new insights into the risk factors for anxiety disorders. Facilitating the development of healthy reactive and regulatory processes may improve the developmental outcomes for children highly exposed to air pollution.

Anxiety Disorders in Pregnancy During The COVID-19 Pandemic: What are The Risk Factors?

Introduction: The COVID-19 pandemic, since the beginning of 2020, has become a concern for the world community in the health sector. Literature found anxiety symptoms to increase during the COVID-19 pandemic, particularly in the pregnant women population. Objective: This literature review study aims to provide an overview and risk factors for anxiety in pregnancy related to the COVID-19 pandemic. Methods: PubMed and Google Scholar were searched using the following keyword (anxiety disorders) AND (pregnancy) AND (COVID-19) using the journal publication filter for the 2009-2021 issues. Results: Therefore, the psychological condition of pregnant women during COVID-19 pandemic is influenced by various restrictive measures taken by the government and the community, the uncertainty of the pandemic in the future, and most importantly, the fear of being infected so that it can harm the baby they are carrying. Risk factors for anxiety disorders that may be closely related to pregnancy are women who became pregnant for the first time reported having significantly more pregnancy-related anxiety than women who had given birth, high levels of anxiety and depression were found in women with unplanned pregnancies, increased anxiety was associated with worry pregnant women do not receive adequate antenatal care as a result of COVID-19, and a significant correlation was found between higher education and anxiety levels. Conclusion: Risk factors for anxiety disorders in pregnancy are the first pregnancy, unplanned pregnancy, inadequate ANC visits, and higher education. The risk factors that affect pregnant women do not stand alone but simultaneously with each other.

Incidence and risk factors for anxiety disorders in young adults: A population-based prospective cohort study

Anxiety disorders are among the most common psychiatric disorders in the general population. Our objective was to describe the cumulative incidence and risk factors of anxiety disorders, including obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD), in a follow-up of young adults over a five-year period. This is a prospective cohort conducted in two waves. The first took place from 2007 to 2009, in which 1,560 young adults aged between 18 and 24 years were evaluated using the Mini-International Neuropsychiatric Interview (MINI). Subjects were invited to participate in the second wave, which wave took place from 2012 to 2014, where 1,244 young adults were evaluated using the MINI-Plus. Our findings showed a cumulative incidence of 10.9% for any anxiety disorder, 6.5% for generalized anxiety disorder, 6.0% for agoraphobia, 2.0% for OCD, 1.6% for panic disorder, 1.1% for social anxiety and 0.7% for PTSD. Being female and having had a depressive episode were risk factors to develop any anxiety disorder. We observed a high cumulative incidence of anxiety disorders in a population-based sample of young adults. Our data highlights the importance of the early identification of these disorders as this could lead to early illness detection, early illness management and a reduced burden of disease.

Are adolescents more likely to have antenatal anxiety disorders than adult women? A comparison between two samples

BackgroundThe literature reports that teenage pregnancy is considered a risk factor for anxiety disorders (ADs). However, research on this topic is limited. This study aimed to investigate if pregnant adolescents presented a greater likelihood of having ADs by comparing two samples of pregnant women in a southern city of Brazil. We also observed the prevalence rates of antenatal ADs among adolescents and adult women. MethodsIn this cross-sectional study, we evaluated 1852 women from two different studies: 995 pregnant adolescents attending prenatal care in the public health system (convenience sample) and 857 pregnant women from a population-based study. We used the Mini International Neuropsychiatric Interview (MINI Plus) to assess antenatal ADs, using the Social Anxiety Disorder (SAD) and Generalized Anxiety Disorder (GAD) modules. The primary aim of this study was tested through multivariate analysis using Poisson regression. ResultsThe prevalence of ADs was 11.0 % among pregnant adolescents and 13.8 % among adult pregnant women. Both samples presented similar rates of ADs (p = 0.065). In the adjusted analysis, maternal age did not predict antenatal ADs (PR = 0.97; p = 0.853). LimitationsConsidering the particularities of each study where the samples came from, it was not possible to include other ADs such as panic disorder or phobias. ConclusionsOur findings suggest that pregnancy in adolescence does not increase the likelihood of antenatal ADs. However, we emphasize the importance of an adequate psychological screening and care in pregnancy in order to prevent possible psychiatric disorders.

Potential Sociodemographic Predictors of Childhood Anxiety Disorders: A Cross-Sectional Study

Background: Previous studies have shown that the prevalence of anxiety among primary school students in rural areas is relatively high. Also, this stage is a critical developmental stage of academic life. Childhood anxiety disorders lead to significant disruption and interference with other aspects of life, including behavioral, emotional, cognitive, and academic achievement. Aims: This study aimed to find the frequency of 6 subtypes of anxiety disorders and to determine the potential sociodemographic factors of anxiety disorders among primary school students in a rural area of Malaysia. Methods: This was a cross-sectional study in which 411 students answered the Spence Children’s Anxiety Scale-Child version (SCAS-C). Descriptive analyses elucidated at-risk students, and multivariate analysis of variance and multiple linear regression presented potential predictors of anxiety disorders. Results: The most common abnormal level was for social phobia (SP) (n = 109/18.6%), and the least common were panic/agoraphobia (n = 85/14.1%) and physical injury fears (PIF) (n = 82/13.6%). Multivariate analysis of variance revealed that age ( P &lt; .05), gender ( P &lt; .05), father’s employment ( P &lt; .05), and mother’s educational level (EL) P &lt; .05) were predictors of overall anxiety. A Tukey post-hoc test revealed that older children are more likely to suffer from overall anxiety, separation anxiety (SA), SP, and obsessive-compulsive problems. Children of low-income families were less likely to suffer from SA than those of middle-income families. Children of stay-at-home mothers were less likely to suffer from overall anxiety, SA, and SP than mothers who worked more than 8 h per day. Multiple linear regression could predict 6 models of anxiety based on sociodemographic factors. Conclusion: According to our findings in this study, promoting mental health by providing preventive strategies and screening programs is more recommended for students with sociodemographic risk factors for anxiety disorders.

Early risk factors for anxiety disorders in children with autism spectrum disorders: results from the ELENA Cohort

Anxiety in children with autism spectrum disorder (ASD) negatively affects their social interactions, and quality of life. It is necessary to identify early risk factors for anxiety to tailor prevention and interventions. We aimed to examine the clinical level of anxiety in children with ASD from 5 to 10 years of age and identify potential early risk factors 3 years earlier. Participants were ASD children included in ELENA, a French prospective cohort. In this study, we used the collection of data at Time 1-T1 (at baseline) and Time 2-T2 (3 years after T1). Two groups were identified at T2 according to the threshold for anxiety on the CBCL: ASD-only group and ASD + anxiety group. Our results showed that half of the children in our sample had a clinical level of anxiety at T2. Regression analysis showed that greater ASD severity and lower sensory processing difficulties predicted lower anxiety, whereas higher levels of restricted and repetitive behaviours tended to predict higher levels of anxiety. The high prevalence of clinical-level anxiety in our sample suggests the need for specific assessment and targeted treatment of anxiety on a routine basis.

The Moderator Role Of Gender In The Relationship Between Behavioral Inhibition And Parental Behaviour In Preschool Children

IntroductionPreschool Behavioural Inhibition (BI) was found to be a temperamental risk factor of anxiety disorders in later life; especially in women. Similarly, previous research revealed that parental behaviour plays a major role in the development and maintenance of anxiety disorders. Gender differences in parental responses to child’s temperament may contribute to the stronger association between BI and anxiety disorders in females.ObjectivesWe aimed to examine the moderating effect of child’s gender in the association between child’s BI and parenting behaviour in a non-clinical sample of parents of preschool children.MethodsA cross-sectional sample of parents (N=94) of preschool children (girls 47.4%) filled out the Behavioural Inhibition Questionnaire (BIQ) and the Multidimensional Assessment of Parenting Scale (MAPS).ResultsChild’s gender was found to moderate the relationships between BIQ scores and MAPS Supportive Parenting (F(3,90)=4.350, p=.007, R2=.127), as well as Hostile Parenting (F(3,89)=3.478, p=.019, R2=.105). In boys, higher BIQ scores were associated with higher levels of Supporting Parenting (b=.005, p=.027), while in girls this association was reversed (b=-.004, p=.037). Furthermore, in boys, no association was found between BIQ scores and Hostile Parenting (b=.005, p=.835); however, higher BIQ scores were related to higher levels of Hostile Parenting in girls (b=.067, p&lt;.001).ConclusionsOur results suggest that parental responses to their preschool child’s Behavioural Inhibition may vary as a function of child’s gender. This may lead to gender differences in developmental pathways to anxiety disorders.DisclosureNo significant relationships.

Estradiol Promotes Social Stress Susceptibility in Female Rats in a Region‐ and CRF‐Specific Manner

Repeated exposure to social stress is a common risk factor for anxiety disorders. Women are twice as likely as men to suffer from anxiety. However, the mechanisms behind this increased risk remain unclear, which limits targeted therapeutic options. Interestingly, this increased susceptibility in females is confined between the onset of puberty and the end of menopause, suggesting that ovarian hormones may contribute to this disproportionate risk of stress‐related disorders. We have previously shown that witness stress (WS), a model of social stress in which a female rat is subjected to witnessing an aggressive social defeat encounter between a male intruder and a novel male resident, produces lasting anxiety‐like behaviors selectively in intact, cycling female rats. Ovariectomized (OVX) females are largely resistant to WS‐evoked behaviors, but estradiol replacement reinstates these anxiety‐like behaviors. Moreover, intact females, but not OVX, exposed to WS exhibit a distinct and long‐lasting increase in corticotropin releasing factor (CRF) expression in the central amygdala (CeA), a stress sensitive brain region. The current study seeks to understand specific 17‐β estradiol (17‐βE)‐induced neural regulation that may contribute to the heightened susceptibility to social stress among females to identify a druggable target to promote stress resilience. Following recovery from OVX or sham surgery, adult female rats were treated with either 17‐βE (10μg/rat, s.c.) or vehicle (0μg/rat, s.c.) and one hour later, were exposed to WS or control handling. WS/control episodes were video recorded to measure burying, freezing, and rearing behaviors, and blood samples were collected one hour after WS/control to assess corticosterone (CORT) levels. Brains were collected two hours after WS/control. To quantify activity of CRF neurons, immunohistochemistry was used to double label for CRF and cFos in various stress sensitive regions. Behavioral responses were shown to be regulated by 17‐βE; WS‐evoked burying evident in intact females was decreased by OVX and reinstated by 17‐βE. However, there was no effect of WS or 17‐βE on freezing or rearing behaviors. Additionally, 17‐βE increased WS‐induced plasma CORT levels. cFos positive CRF expression in the CeA was robustly enhanced by 17‐βE during WS, but not control. This effect was not globally observed as there was no effect of WS or 17‐βE on cFos expression in CRF positive neurons within the paraventricular nucleus of the hypothalamus and the hippocampus. Analysis of stress‐ and CRF‐sensitive brain regions including the locus coeruleus are ongoing. Taken together, these findings suggest that an interaction between 17‐βE and CRF is paramount in facilitating the anxiety‐like responses to WS. Given the controversial impact of CRF1 receptor antagonists to date, this study provides evidence of conditions under which anxiety‐like behaviors are associated with enhanced CRF responses and may serve as a personalized viable target to treat increased sensitivity to stress‐related disorders in females.

Estrogen‐Mediated Mechanisms of Social Stress Susceptibility within the Central Amygdala

Social stress is the most common form of stress humans experience and is a risk factor for anxiety disorders. Women are 2‐3 times more likely to suffer from stress‐related anxiety disorders than men, but this heightened susceptibility is limited to the timeframe between the onset of puberty and menopause, suggesting a role for ovarian hormones. While the underlying neural mechanisms of stress susceptibility are unclear, many anxiety‐like behaviors in rodents including burying, startle responses and avoidance of elevated open spaces are regulated in part by corticotropin releasing factor (CRF) in the stress‐sensitive central nucleus of the amygdala (CeA). Recent evidence also highlights a critical role for estrogen (E) in regulating social stress susceptibility in female rats, and the CeA expresses estrogen receptor‐β (ER‐β). Although a large body of literature suggests that E may signal through ER‐β to reduce anxiety‐like behaviors during non‐stressful conditions, we hypothesize that in the context of social stress, E exacerbates anxiety‐like behaviors through increased expression of CRF in the CeA of female rats. This study examines the role for ER‐β in CeA in regulating stress susceptibility in female rats via region‐specific pharmacological blockade of ER‐β using PHTPP, an ER‐β antagonist. Following recovery from surgical implantation of indwelling bilateral CeA cannulae, adult female Sprague‐Dawley rats were injected with vehicle or PHTPP (0 or 10 µM; 0.5 µL over 1 min). One hour later, rats were subjected to control handling or witnessing an aggressive social defeat encounter between two male rats (WS, 15min/day x 5 days). WS and control rats were video‐recorded on days 1 and 5, and burying, freezing and rearing behaviors were quantified. Following 2 days of undisturbed rest in the absence of drug, all rats underwent a battery of tests to assess anxiety‐like behaviors including elevated plus maze (EPM), acoustic startle (ASR), and marble burying (MB). Each test was separated by 24 hours, and brain and blood were collected 2 days after MB. This study demonstrated that WS‐induced burying behavior was reduced by intra‐CeA PHTPP on days 1 and 5 of WS. There was no effect of WS nor PHTPP on freezing or rearing behavior during WS/control. The anxiogenic effects of WS are persistent as indicated by an enhanced ASR, increased MB and reduced open arm exploration during EPM among vehicle‐treated witnesses. PHTPP administration during WS attenuated these persistent anxiety‐like behaviors after WS exposure. Interestingly, PHTPP had opposing effects in WS and control rats such that PHTPP‐treated controls exhibited increased anxiety‐like behaviors indicated by increased marble burying and EPM closed arm time compared to vehicle‐treated controls. Brain tissue is currently being analyzed to determine the mechanism by which ER‐β regulates stress susceptibility, including measurement of CRF in the CeA and its projection regions. The findings from this study highlight a paradoxical role for E in regulating anxiety‐like behaviors, and further, identify that under conditions of social stress, E, acting through ER‐β, promotes stress susceptibility in female rats. Understanding the specific role for E in heightened stress susceptibility in females will help us to determine the physiological mechanisms underlying exaggerated social stress susceptibility among women.

Pharmacological Manipulation of Microglia Regulates Social Stress Susceptibility Among Females in a Region‐Specific Manner

Social stress is a major risk factor for anxiety disorders and co‐morbid cardiovascular (CV) dysfunction. Women are particularly susceptible to these stress‐related pathologies, yet the etiology of this is unclear. Recently, neuroinflammation has been linked with anxiety disorders, yet the therapeutic value of region‐specific microglial manipulation, and thus precise neuroinflammatory modulation, is not known. Our previous findings indicate that female rats repeatedly exposed to witnessing an aggressive social defeat episode between two male rats (WS) develop an anxiety‐like phenotype and robust, long‐lasting increases in inflammatory cytokines in stress‐sensitive brain regions. One region that facilitates behavioral and CV responses to social stress is the locus coeruleus (LC), but the role for LC microglia in regulating stress susceptibility is unknown. Here, we use targeted intra‐LC infusions of lipopolysaccharide (LPS; study 1), a potent microglial activator, and mannosylated lipid‐based nanoparticles containing clodronate (m‐CLD; study 2), a compound toxic to microglia, to manipulate LC microglial activation or expression, respectively, in the presence and absence of WS. In study 1, female rats were treated with intra‐LC vehicle or LPS (0, 1, or 3 μg/side). One hour later, rats underwent 15 min of WS or non‐stress control handling. Blood and brains were collected immediately following WS/control. In study 2, female rats were treated with intra‐LC or intra‐central amygdala (CeA) vehicle or m‐CLD (0 or 25μg/side) 3 days prior to undergoing 5 daily 15‐min WS exposures. In both studies, WS and control sessions were video‐recorded. Freezing, rearing, and burying were quantified, and anhedonia was assessed using a two‐bottle choice sucrose preference test. CV telemetry was used to assess sympathovagal balance via measures of heart rate variability (HRV). Brain and plasma cytokines were quantified to assess the effects of stress and m‐CLD on central and peripheral inflammation. Intra‐LC LPS dose dependently augmented the anxiety‐like burying response induced by WS. The higher (3μg) dose of intra‐LC LPS also increased plasma corticosterone (CORT) and IL‐1β. Conversely, intra‐LC m‐CLD attenuated the anxiety‐like burying response to WS. Intra‐LC m‐CLD did not impact stress‐evoked vagal withdrawal indicated by HRV. Even though m‐CLD reduced neuroinflammation (IL‐1β) in both the LC and CeA, the effects of m‐CLD on stress‐evoked burying were region specific as intra‐CeA m‐CLD had no effect on stress‐evoked behavior nor CV function. Repeated WS increased plasma CORT, but this response was not impacted by intra‐LC nor intra‐CeA m‐CLD. Importantly, this study identified for the first time that m‐CLD can be used to pharmacologically reduce microglial expression in a discrete, region‐specific functional manner. Taken together, these studies highlight a novel role for microglia within the LC in regulating the hypervigilant responses to WS and indicate that microglia may serve as an effective pharmacological target for regulating social stress susceptibility in females.

ANALISIS KECEMASAN PADA IBU HAMIL DALAM MENGHADAPI PERSALINAN DI MASA PANDEMI COVID-19 DI RUMAH SAKIT IMELDA MEDAN

Pregnant women are one of the groups that are vulnerable to the risk of transmitting Covid-19, this happens because pregnant women tend to experience physical changes that can lower their immune system, if the immune system decreases, the Covid-19 virus will easily enter and cause pregnant women was infected with the Covid-19 virus. Pregnancy during a pandemic like this may be a risk factor for anxiety disorders in pregnant women. Pregnant women easily experience feelings of worry about something that will happen to them and their children so that it can interfere with mental health in this case anxiety disorders. These negative feelings are increasing during the current Covid-19 pandemic. This feeling of anxiety is characterized by worrying about being ignored or isolated. There is a relationship between education and anxiety for pregnant women at Imleda Hospital Medan with p-value 0.002 &lt; =0.05 and there is a relationship between parity and anxiety for pregnant women at Imelda Hospital Medan with p-value 0.001 &lt; =0.05 Closeness between parity and Anxiety at Imelda Hospital Medan is in the strong category

Time trends in treated incidence, sociodemographic risk factors and comorbidities: a Finnish nationwide study on anxiety disorders

BackgroundThere has been a lack of research about the time trends and socio-demographic risk factors for children and adolescents who receive treatment for anxiety disorders. This study aimed to fill these gaps in our knowledge by examining a nationwide sample of Finnish children and adolescents diagnosed in specialized healthcare settings.MethodsThis study comprised national register data of all singleton children born in Finland from 1992–2006 who were diagnosed with anxiety disorders from 1998–2012. The changes in time trends in incidence were studied by dividing the study sample into three cohorts by birth years: 1992–1996, 1997–2001 and 2002–2006, who were followed up until the age of 20, 15 and 10 years, respectively. The 22,388 individuals with anxiety disorders were age and gender matched with 76,139 controls from the general population. Logistic regression was used to examine the socio-demographic risk factors and anxiety disorders in the entire sample. Comorbid disorders were examined in the oldest birth cohort (1992–1996 born).ResultsComparing the 1992–1996 and 2002–2006 cohorts showed that the cumulative incidence of treated anxiety disorders at the age of 10 increased from 0.3 to 1.2% among females and 0.46 to 1.9% among males. Subjects had higher likelihood for being diagnosed with an anxiety disorder if their mothers had low maternal socio-economic status class at birth (OR 1.53, 95% CI 1.45–1.61) compared to higher SES class, and marital status was single at the time of birth (OR 2.02, 95% CI 1.87–2.17) compared to married or in a relationship. They had lower risk of anxiety disorders diagnosis if born in rural (OR 0.82, 95% CI 0.79–0.86) or semi-urban areas (OR 0.79, 95% CI 0.76–0.82) when compared to urban residence. There was a wide range of psychiatric comorbidities, and unipolar depression was the most common (31.2%).ConclusionAnxiety disorders diagnosed by specialized Finnish services increased from 1998–2012 in both genders. This could indicate a real increase in overall anxiety disorders or an increase in treatment seeking. The findings on maternal socioeconomic status and single parenting improve the recognition of the environmental risk factors for anxiety disorders among children and adolescents.