Risk Factors For Emotional Distress Research Articles

Prevalence of and Risk Factors for Emotional Distress in Patients Undergoing Radiotherapy for Lung Cancer.

Quality of life of patients with lung cancer can be impaired by psychological distress. This study evaluated prevalence of and risk factors for emotional distress in patients undergoing radiotherapy or chemoradiotherapy. Fourteen potential risk factors were retrospectively investigated in 144 patients. Emotional distress was evaluated with the National Comprehensive Cancer Network Distress Thermometer. Values of p<0.0036 (Bonferroni correction) were considered significant. At least one emotional problem (worry, fear, sadness, depression, nervousness, loss of interest) was reported by the majority of patients (N=93, 65%). Prevalence of these problems was 37%, 38%, 31%, 15%, 32% and 23%, respectively. Physical problems were significantly associated with worry (p=0.0029), fear (p=0.0030), sadness (p<0.0001), depression (p=0.0008), nervousness (p<0.0001), and loss of interest (p<0.0001). Age ≤69 years was associated with worry (p=0.0003), and female sex with fear (p=0.0002) and sadness (p=0.0026). Trends were found for associations of age with sadness (p=0.045), female sex with nervousness (p=0.034), and chemoradiotherapy with worry (p=0.027). Many patients with lung cancer experience emotional distress. Early psycho-oncological assistance may be important, particularly for high-risk patients.

Dissociation mediates association between childhood trauma and distress from trauma research participation: analysis of pooled clinical data

ABSTRACT Background Childhood trauma and post-traumatic stress disorder (PTSD) are risk factors for emotional distress from trauma-related research participation. The role of dissociation, however, has not been investigated. This study examined the mediation effect of dissociation and PTSD on the relationship between childhood trauma and distress in trauma studies. Methods Pooled data of the Childhood Trauma Questionnaire, Impact of Events Scale-Revised, Dissociative Experiences Scale-Taxon, and Trauma Antecedents Questionnaire from 231 psychiatric patients (73% diagnosed with psychotic illnesses) at a psychiatric clinic in South Korea were analysed. We performed multiple mediation effect analysis to verify a structural model for distress in trauma-related questionnaires. Results Thirteen percent of participants reported distress after the survey. In the structural equation, the symptoms of PTSD did not show a significant relationship (p = .064). When the two parameters were included in the model, it was found that the direct effect of childhood trauma on distress was not significant (p = .43), but dissociation showed a direct effect on distress (p < .001). Discussion Childhood trauma affects distress through the sequential mediating effect of PTSD symptoms and dissociation. Dissociation should be considered as a significant contributor to distress from trauma research participation along with childhood trauma and PTSD.

Risk Factors for Emotional Distress among Youths Following the Experience of a Traumatic Event

Background to the Study Despite the fact that road traffic accidents are notorious for causing marked psychiatric morbidity among most affected persons, most studies focus on its psychological impact in adults. There is a dearth of data concerning the psychological consequences of road traffic accidents in adolescents. Objective: To determine the prevalence and correlates of emotional distress among secondary school pupils after the experience of a road traffic accident close to the school premises, which resulted in the death of some pupils, and severe injuries in others. Methods: This was a cross-sectional study of 107 adolescents who had heard about or witnessed the road traffic accident, and were selected using total sampling of those who met the inclusion criteria at a secondary school in Lagos, Nigeria. Questionnaires used were, The Rosenberg SelfEsteem Questionnaire, Strengths and Difficulties Questionnaire (Emotional Sub-Scale), and a Socio-Demographic Questionnaire. Results The prevalence of emotional distress among the secondary school pupils was 20%. Correlates of emotional distress were; age (OR=0.8, CI=0.63-0.84), junior secondary class (OR=0.1, CI=0.01- 0.49), female gender (OR=3.6, CI=1.2-7.9), and poor self-rated health perception (OR=0.1, CI=0.02-0.4). Conclusion For most people, emotional distress is quite common secondary to exposure to a road traffic accident, children and adolescents have a greater vulnerability to this. Early identification and psychosocial management of emotional problems in youths exposed to such accidents may help prevent the development of enduring mental health problems.

Interaction between APOE ɛ4 and Age Is Associated with Emotional Distress One Year after Moderate-Severe Traumatic Brain Injury.

Emotional distress is common following moderate-severe traumatic brain injury (TBI) and is associated with poorer post-injury outcomes. Previously investigated sociodemographic, psychological, and injury-related factors account for only a small proportion of variance in post-TBI emotional distress, highlighting a need to consider other factors such as genetic factors. The apolipoprotein E gene (APOE) has been commonly studied in the TBI literature, with the ɛ4 allele linked to worse neuronal repair and recovery. Few studies have investigated the potential relationship between APOE ɛ4 and emotional distress after moderate-severe TBI, and results have been varied. We examined whether APOE ɛ4 was associated with emotional distress 1 year following moderate-severe TBI, and whether this relationship was moderated by age, sex, and TBI severity (as indexed by the duration of post-traumatic amnesia [PTA]). Moderate-severe TBI survivors provided saliva samples following inpatient admission to a TBI rehabilitation hospital. They completed a self-report measure of emotional distress, the Hospital Anxiety and Depression Scale (HADS), at a follow-up interview ∼1 year post-injury. Complete genetic and follow-up data were available for 441 moderate-severe TBI survivors (mean age = 39.42 years; 75% male). We constructed a linear regression model that included APOE ɛ4 carriage status (carrier vs. non-carrier) and interactions with age, sex, and TBI severity (APOE × age, APOE × sex, APOE × age × sex, and APOE × PTA duration) to predict total score on the HADS, while covarying for the main effects of age, sex, PTA duration, and previous head injury. There was a significant main effect of APOE ɛ4, whereby ɛ4 carriers reported less emotional distress than non-carriers (p = 0.04). However, we also found a significant interaction with age such that APOE ɛ4 carriers reported increasingly greater emotional distress with older age compared with non-carriers (p = 0.01). A sensitivity analysis (n = 306) suggested that the APOE × age interaction, and main effects of age and previous head injury, were not unique to individuals with pre-injury mental health problems (n = 136). However, the main effect of APOE ɛ4 was no longer significant when individuals with pre-injury mental health problems were removed. Our findings highlight the importance of considering moderation of genetic associations, suggesting that APOE ɛ4 may be a risk factor for emotional distress specifically among older survivors of moderate-severe TBI. If these findings can be independently replicated, APOE ɛ4 carriage status, interpreted in the context of age, could be incorporated into risk prediction models of emotional distress after moderate-severe TBI, enhancing targeted early detection and intervention efforts.

Risk factors associated with post-intensive care syndrome in family members (PICS-F): A prospective observational study.

The family members of intensive care unit (ICU) patients play a crucial role in modern ICUs. These individuals are predisposed to the development of post-intensive care syndrome in family members (PICS-F), a syndrome experienced by family members of ICU patients in response to critical illness and characterised by new or worsening psychological symptoms. This study sought to evaluate the levels of anxiety and depression exhibited by the family members of patients hospitalised in the ICU. It also aimed to identify the risk factors associated with the experience of PICS-F, which should assist with its prevention in the future. The study sample comprised 164 ICU patients and their family members. Sociodemographic data were gathered at the time of ICU admission and 3months after discharge, and the family members were screened for emotional distress using the Hospital Anxiety and Depression Scale (HADS). Comparison tests were used to test for an association between family/patient characteristics and a positive HADS score. In addition, a multivariable logistic regression model was constructed to identify the independent factors associated with a positive HADS score. Emotional distress was identified in 24% of the family members 3months after their relatives had been discharged from the ICU. A number of personal traits were found to be associated with emotional distress in the family members, namely unemployment (p = .008), smoking/drinking habits (p = .036) and personal history of psychopathology (p = .045). In the multiple logistic regression analyses, only unemployment was found to be an independent factor associated with both anxiety and depression in the family members (OR = 2.74, CI 95%: 1.09-6.93). No association was found between the patients' characteristics and emotional distress in the family members. The findings of this study indicate an association between emotional distress in the family members of ICU patients and their personal traits, thereby building on the prior literature by suggesting that patient characteristics are less pertinent to the experience of PICS-F. Unemployment may represent a meaningful risk factor for emotional distress in family members (a potential marker of PICS-F), given its relationship with family members' positive HADS scores post-ICU discharge. These findings should influence preventative strategies concerning PICS-F by illustrating the need to assess family characteristics and demographics early in a patient's ICU stay and, consequently, allowing for the early identification of at-risk individuals and the prompt implementation of adequate support services.

Prevalence and risk factors for depression, anxiety and suicidal ideation in youth with persistent post-concussive symptoms (PPCS)

ABSTRACT Objectives: To assess the prevalence and risk factors for emotional distress in youth with persistent post-concussive symptoms (PPCS) greater than one month. Methods: We used baseline data from an intervention study for youth with PPCS, utilizing Poisson regression to examine factors associated with exceeding clinical cut-points on measures of depression, anxiety, self-harm and suicidal ideation. Predictors included: age, sex, socioeconomic status, mental health history, duration of concussion symptoms, history of prior concussion, trauma history and sleep quality. Results: The sample included 200 youth with PPCS, (mean 14.7 SD 1.7 years, 82% white, 62% female). Forty percent reported clinically significant depressive symptoms, 25% anxiety, 14% thoughts of self-harm and 8% thoughts of suicide. History of depression was associated with 3-fold higher risk for thoughts of self-harm (95% CI:1.82–6.99) and 6-fold higher risk for suicidal ideation (95% CI:1.74–24.46). Better sleep quality was associated with lower risk for all outcomes. History of prior concussion and duration of PPCS were not significantly associated with any outcomes. Conclusions: Suicidal thoughts are common post-concussion, and history of depression is a strong risk factor. Tailored interventions may be needed to address mental health in this population.

Prenatal maternal sleep and trajectories of postpartum depression and anxiety symptoms.

Postpartum emotional distress is very common, with 10%-20% of postpartum women reporting depressive or anxiety disorders. Sleep is a modifiable risk factor for emotional distress that has a pivotal role in postpartum adjustment. The present study aimed to examine whether sleep duration and quality during pregnancy predict trajectories of emotional distress in the postpartum period. Participants were 215 women that were assessed from the third trimester of pregnancy to 18-months postpartum. At all five time points (third trimester, 3-, 6-, 12-, and 18-months postpartum), measures of sleep duration and quality (measured by wake time after sleep onset; WASO) were derived from both actiography and diary-based measures. Repeated measures of depression and anxiety symptoms were collected using self-report measures. Results indicated four bivariate postpartum depression and anxiety growth trajectories, including (a) high comorbidity (5.4%); (b) moderate comorbidity (19.4%); (c) low anxiety and decreasing depression symptomology (18.6%); and (d) low symptomology (56.6%). Multinomial logistic regression analyses showed that mothers with shorter sleep durations during pregnancy were more likely to belong to the high comorbidity or moderate symptoms classes compared to the low symptomology class. In addition, mothers with higher WASO (i.e. lower sleep quality) at 3-months postpartum were more likely to belong to the moderate class compared to the low symptomology class. Given the potential negative implications of disrupted sleep in the perinatal period, the present study may inform future intervention studies that target sleep problems during pregnancy.

Emotional Changes and Protective Factors of Emotional Workers in the Public and Private Sector.

ObjectiveEmotional labor is known to be a risk factor for emotional distress. This study aimed to evaluate specific stressors according to the type of occupation and identify protective and adverse factors. MethodsWe recruited 349 workers engaged in emotional labor in a suburban city. They were assessed using scales regarding emotional status, job stress, resilience, and job satisfaction. Correlation and regression analyses were performed to evaluate their emotional state according to their stress level. A mediation model using structural equation modeling was utilized to identify the mediating effects of resilience and workplace satisfaction. ResultsThe correlation analysis indicated that the level of workplace stress was statistically correlated with depressed mood and anxiety and showed a significant inverse correlation with individuals’ resilience and job satisfaction. According to the regression analysis, in private institution workers, “emotional disharmony and hurt” had a statistically significant negative effect on their emotional state, and in public institution workers, “emotional demands and regulation” were prominent. Resilience partially mediated the relationship between emotional stress and anxiety/depressive symptoms. ConclusionOur findings indicate that the causes of stress differed according to the working environment. Preventive strategies such as resilience training and relieving stress on individual factors are needed to promote mental health.

Assessment of mental health in medical students of GMERS Medical College, Patan, Gujarat

Background: Medical students are more likely to developmental disorders such as anxiety disorders, major depressive disorder, and psychiatric comorbidity as compared to other students. Mental distress can lead to poor classroom performance, poor communication, and frequent medical errors, burnout, social isolation, suicidal thoughts, substance abuse, cynicism, and harm to self and others. An active coping approach such as positive framing, talking to friends, family member, leisure activities, and sport activities can reduce stress level. Objectives: The objectives of the study were (a) to find out the prevalence of depression, anxiety, and stress among medical students and (b) to assess risk factors for emotional distress. Materials and Methods: This study was conducted among 530 MBBS student of Gujarat Medical Education and Research Society Medical College, Patan during October 2018–March 2019 after the Institutional Ethical Committee permission. A Depression Anxiety Stress Scale-21 was used to collect data on depression, anxiety, and stress. Other information such as sociodemographic, academic profile, and personal characteristics of students were collected. Results: The prevalence of depression, anxiety, and stress was 10.5%, 33.6%, and 38.3%, respectively, in medical students. The risk factors for emotional distress were female gender, residing at home, nuclear family, addiction, poor academic performance, less extracurricular activities, and positive family history. Joint family and strong relationship with friends were found protective against emotional distress. The prevalence of any emotional state was not affected by the number of supplementary exams, personal choice to join MBBS, and personal satisfaction with body image and life. Conclusion: Anxiety and depression are significant hidden problems in medical students. Substance abuse, less extracurricular activities, poor relationship with friends, and positive family history are risk factors for depression. Therefore, these risk factors should be identified and interventions to reduce stress should be carried out.

An exploration of moderator effect of Negative Mood Regulation Expectancies (NMRE) in the association of Looming Cognitive Style (LCS) with trait anxiety

Negative Mood Regulation Expectancies (NMRE) refer to the beliefs that one has concerning his/her ability to control and regulate a negative mood state. NMRE play an important role in development of psychological disorders since it is known to buffer the negative impact of various risk factors for emotional distress. The present study aims to test the interaction of NMRE with Looming Cognitive Style (LCS), a cognitive vulnerability factor specific for anxiety disorders and the role this interaction plays in subjectively felt anxiety. Data were collected from 326 university students (251 female) through self-report questionnaires assessing LCS, NMRE, anxiety and depression. The results showed that both LCS and NMRE are significantly associated with anxiety scores while controlling for the overlap between anxiety and depression. Moreover, NMRE was found to be significantly able to moderate the association between LCS and anxiety. That is; tendency to generate looming cognitions appeared to be linked to higher anxiety when the individuals have low levels of confidence in their capacities for mood regulation and coping.

Can Psychopathic Traits be Adaptive?

One of the most prominent models of psychopathy operationalizes this construct as consisting of four factors: interpersonal, affective, lifestyle and antisocial traits. These traits show different relationship patterns with other constructs, and these relations may differ in men and women. The aim of this study was to investigate whether the relations between psychopathic traits and indicators of emotional distress (depression, anxiety and stress), differ between men and women. Data was collected on 650 students (60% women) at the University of Zagreb. The results of Canonical Correlation Analysis indicated that affective psychopathic traits have adaptive potential and represent a protective factor for experiencing emotional distress, while Lifestyle and Antisocial behavior represent risk factors for emotional distress. Moreover, sex had a moderating role in the relationship between Interpersonal and Lifestyle traits and distress, indicating that psychopathic traits seem to be more adaptive in males, compared to females.

Exercise addicts with injuries are in risk of depression

IntroductionExercise addiction is characterized by increasing exercise amounts, withdrawal symptoms and lack of control. Exercisers with addiction continue to exercise in spite of pain and injury because they use exercise to regulate emotions, identity and self-esteem. How do they react to injuries?ObjectivesIt is hypothesized that exercise addiction is a risk factor for emotional distress when an injury occur due to withdrawal symptoms and lack of identity.AimsTo estimate the prevalence of exercise addiction in exercisers with injuries at the musculoskeletal system and to test the relationship between addiction and emotional distress (depression and stress).MethodsThe Exercise Addiction Inventory was used to identify exercise addiction. To measure depression and stress we used the Major Depression Inventory (MDI) and the Perceived Stress Scale (PSS). Participants (n = 694) were regular exercisers with injuries at foot, knee or shoulder at an orthopedic hospital department.ResultsThe prevalence of exercise addiction was 7.6%. We found that exercisers with addiction reported more emotional distress in terms of higher MDI-scores 18.0 (SD = 11.0) versus 11.7 (SD = 9.1); P = 0.00 and in total PSS-score 17.6 (SD = 7.2) versus 13.9 (SD = 6.8); P = 0.00. Chi2 analyses showed that 25% of the addicted exercisers met the criteria for clinical depression, while only 11% of the non-addicted exercisers were depressed; P = 0.00.ConclusionsExercisers with addiction appear at somatic departments treating musculoskeletal injuries. It is a vulnerable group characterized by elevated levels of depressive symptoms and clinical stress. We recommend to offer psychological interventions focusing on emotional distress and prevention of re-injury by reducing excessive and obsessive exercise patterns.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Maternal attitudes, depression, and anxiety in pregnant and postpartum multiparous women.

The Attitudes Toward Motherhood (AToM) Scale was developed to assess women's beliefs about motherhood, a specific risk factor for emotional distress in perinatal populations. As the measure was initially developed and validated for use among first-time mothers, this study assessed the reliability and validity of the AToM Scale in a sample of multiparous women. Maternal attitudes were significantly associated with symptoms of depression, even after controlling for demographic, cognitive, and interpersonal risk factors. Maternal attitudes were also associated with symptoms of anxiety after controlling for demographic risk factors, but this association was not significant after accounting for cognitive and interpersonal risk factors. Compared to primiparous women from the initial validation study of the AToM Scale, multiparous women reported lower levels of social support and marital satisfaction. The relationships between cognitive and interpersonal risk factors and symptoms of depression and anxiety were comparable between multiparous and primiparous women.

Psychological, demographic, illness and treatment risk factors for emotional distress amongst paediatric oncology patients prior to reaching 5-year survivorship status.

Studies assessing emotional distress severity of paediatric oncology patients prior to reaching 5-year survivorship status have produced inconsistent findings. This cross-sectional multi-centre study aimed to determine psychological, demographic, illness and treatment risk factors for emotional distress in this population. Paediatric oncology patients (n = 74), aged 12-18 years, completed the Paediatric Index of Emotional Distress, Self-Description Questionnaire and Paediatric Quality of Life Inventory. Seventy-two parents provided background information regarding demographics, diagnoses and treatment protocols in addition to appropriate proxy ratings. Hierarchical multiple regression analyses demonstrated that demographic, illness and treatment factors explained little variance in emotional distress. Global self-concept, global-generic and cancer-specific health-related quality of life (HRQOL) were significant predictors. Provisional multiple regression analyses indicated that pain/hurt, illness-related worries, communication difficulties and negative self-views in relation to math abilities, parent relations and opposite-sex peer relations were risk factors for emotional distress in this sample. Paired-sample t-tests and Pearson's moment-correlation coefficients showed patient and parent reports of patients' self-concepts and HRQOL were highly consistent. This study empirically identified modifiable psychological risk factors for emotional distress prior to 5-year survivorship status and provided guidance for future interventions. Furthermore, findings suggest that parent reports can provide reliable estimates of patients' self-concepts and HRQOL. Generalizability of the findings was enhanced by the diversity of the sample studied, in terms of diagnosis and treatment exposure, and the multi-centre recruitment strategy employed. Nevertheless, the findings should be corroborated by larger, longitudinal studies.

Sadness, Anxiety, and Experiences with Emotional Support among Veteran and Nonveteran Patients and their Families at the End of Life

Although many veterans are progressing into older adulthood and a substantive subset of people who die each year in the United States served in the military, there is limited evidence on the role of military service at the end of life. The objective of the study was to examine differences in caregivers' perceptions of sadness and anxiety at the end of life between veteran and nonveteran patients and levels of contentment with the emotional support provided to the patient and family by hospice staff. This cross-sectional study used clinical information from the Family Evaluation of Hospice Care (FEHC) survey administered to caregivers of a patient who received hospice services. The sample in this study included 560 individuals who completed the FEHC survey (from December 2007 to April 2013) after receiving services at a large hospice in an urban southwestern U.S. city. Caregivers responded to questions on the FEHC survey about demographic information, perceptions of the patient's level of sadness/anxiety, and the emotional support the patient and family received from hospice staff. In addition, information regarding veteran status was obtained from patients' medical records. Caregivers of veterans were significantly more likely to report that the patient experienced sadness/anxiety at the end of life, as well as a desire for more emotional support for the family from hospice staff after the death. Results provide preliminary evidence for veteran status being a risk factor for emotional distress at the end of life, highlighting the possible need for augmented support services for veterans and their families in hospice and palliative care.

The buffering effect of relationship satisfaction on emotional distress in couples

BackgroundMarital distress and depression frequently co-occur, and partnership quality is associated with depressive symptoms and mental disorders in both men and women. One aim of this study was to investigate the contribution of a set of risk factors for emotional distress among men and women in couples, with a special focus on satisfaction with partner relationship. The most important aim was to investigate the extent to which high relationship satisfaction in couples acts as a buffer against stressful events.MethodsPregnant women and their husbands (n = 62,956 couples) enrolled in the Norwegian Mother and Child Cohort Study completed a questionnaire with questions about emotional distress, relationship satisfaction, and other risk factors. Twelve potential risk factors were included in the analyses, including relationship satisfaction, demographic characteristics, and somatic diseases in men and women. Associations between the predictor variables and emotional distress were estimated by multiple linear regression analysis. Cross-spousal effects, in which data reported by one of the spouses predicted emotional distress in the other, were also investigated. Possible interaction effects between certain risk factors and self-reported and partner's relationship satisfaction were tested and further explored with regression analyses in subsamples stratified by relationship satisfaction scores.ResultsThe unique effects of relationship satisfaction were of similar sizes for both men and women: substantial for self-reported (β = -0.23 and β = -0.28, respectively) and weak for partner-reported satisfaction (β = -0.04 and β = -0.02, respectively). Other relatively strong risk factors were somatic disease, first-time motherhood, and unemployment. Self-reported as well as partner-reported relationship satisfaction appeared to strongly buffer the effects of a number of stressors.ConclusionsPartner relationship dissatisfaction is strongly associated with emotional distress in men and women. Good partner relationship, both as perceived by the individual him(her)self and by the spouse, quite strongly moderates adverse effects of various types of emotional strain.

Construction and Preliminary Validation of a Dictionary for Cognitive Rigidity: Linguistic Markers of Overconfidence and Overgeneralization and their Concomitant Psychological Distress

Fanaticism and extremism are increasingly recognized as seminal to psychopathology and distress, especially considering the increase in political unrest and violence over the last decade. In the psychopathological literature, however, the cognitive style associated with extremism and overgeneralization has long been recognized as a risk factor for emotional distress, leading to both externalizing behavior (e.g. aggression) and internalizing pathology (e.g. depression). Despite its recognized importance, however, virtually no standardized measures of this cognitive style exist. Since direct inquiry about a respondent's Cognitive Rigidity, is likely to be biased, a text-analytical measure of extremism in spontaneous autobiographical narratives is proposed. In contrast to self-reports, naturally occurring speech often suggests cognitive proclivities towards overgeneralization, overconfidence or extremization. In this study, spoken autobiographical narratives were elicited from 483 participants, and contrasted with extensive mental health information using a hierarchical concordanced-keyword technique. The resulting corpus-based dictionary is context-sensitive, and exhibits significant correlations with measures of negative emotionality, with minimal association with response bias measures.

Emotional disorders in testicular cancer survivors in relation to hypogonadism, androgen receptor polymorphism and treatment modality

Purpose It has been documented that testicular germ cell cancer (TGCC) patients may be at increased risk of developing emotional distress (EMD). Hence, the aim of the present study was to investigate whether EMD is related to the presence of hypogonadism, androgen receptor (AR) polymorphism and/or treatment intensity. Patients and methods Three to five years after treatment, testosterone and luteinizing hormone (LH) levels were measured in 165 TGCC patients. These patients also completed a questionnaire concerning mental health. EMD was measured by the Hospital Anxiety and Depression Scale (HADS). The androgen receptor ( AR) gene has two polymorphic regions in exon I; glutamine encoding CAG and glycine encoding GGN repeats. Association between emotional disorders and AR polymorphisms as well as type of treatment was assessed. Results Neither anxiety (OR 1.0; 95% CI 0.40–2.4) nor depression (OR 1.1; 95% CI 0.20–6.4) were overrepresented in biochemically hypogonadal TGCC patients and no association between AR polymorphisms and EMD was found. Patients treated with ≥ 5 cycles of cisplatinum based chemotherapy due to refractory or relapsed disease were more prone to experiencing symptoms of anxiety ( p = 0.006), but not depression ( p = 0.38). Conclusions Biochemical hypogonadism and AR polymorphism do not seem to be risk factors for EMD in TGCC patients. Patients with refractory or relapsed disease receiving ≥ 5 cycles of cisplatinum based chemotherapy may, to a higher degree than patients receiving less intense therapy, suffer from anxiety.

Depressive coping is a predictor for emotional distress and poor quality of life in a German–Austrian sample of cardioverter-defibrillator implant recipients at 3 months and 1 year after implantation

Objective The implantable cardioverter defibrillator (ICD) has been proven to prolong the lives of patients with life-threatening ventricular arrhythmia. However, implant recipients must cope with numerous challenges. We studied the effects of specific coping strategies and the adaptability of coping in ICD implant recipients. Method This prospective study investigated the subjective well-being and objective disease course in 180 patients with life-threatening cardiac arrhythmias, who were recruited while awaiting implantation of a cardioverter defibrillator. Patients completed well-validated self-assessment questionnaires before implantation (T0), as well as 3 months (T1) and 1 year (T2) after implantation. In addition, cardiological findings were documented. Results Depressive coping (range Beta, −0.36 to −0.58) was found to be a stable highly-significant predictor for low emotional well-being and quality of life. Active problem-oriented coping showed small positive influence (range Beta, 0.10 to 0.19). Employing a broad range of coping strategies was predictive of less emotional distress and better quality of life. Conclusions Depressive coping is a risk factor for emotional distress and poor quality of life after ICD implantation. Patients with this tendency should be identified early and offered supportive psychotherapy.

Emotional distress in patients with retinal disease

PURPOSE: To investigate the prevalence of, and potential risk factors for, emotional distress among patients with retinal disease. DESIGN: Cross-sectional study. METHODS: Cases consisted of 86 consecutive patients at Wilmer Eye Institute Retinal Vascular Center. Fifty-one controls with normal visual acuity and no known ocular disease were frequency-matched to the cases by age, sex, and race. Subjects were interviewed using the Community Disability Scale, a functional status questionnaire, and the General Health Questionnaire, a questionnaire assessing emotional distress. RESULTS: The prevalence of probable (General Health Questionnaire score 4 or greater and less than 10) or definite (General Health Questionnaire score 10 or greater) emotional distress was 59.3% among ophthalmic patients and 2.0% among controls. There were significant relationships between emotional distress, as assessed by General Health Questionnaire score, and degree of 1) visual impairment, as assessed by weighted bilateral average logarithm of minimal angle of resolution (logMAR), and 2) functional impairment, as assessed by Community Disability Scale score ( P = .001). Univariate analyses identified significant predictors of emotional distress: shorter duration of ocular disease ( P = .019), worse visual acuity ( P = .001), increased systemic comorbidities ( P = .001), and increased functional impairment ( P < .001). Multiple regression analysis demonstrates that worse visual acuity, increased systemic comorbidities, and shorter duration of ocular disease each explain over 10% of the variability in General Health Questionnaire score (r 2 = 0.15, 0.12, and 0.11, respectively). Addition of Community Disability Scale score to the regression model eliminates the significance of visual acuity and systemic comorbidities; Community Disability Scale score explains nearly 30% of the variability in emotional distress, as assessed by General Health Questionnaire score (r 2 = 0.29). CONCLUSIONS: Emotional distress is prevalent among patients with retinal disease; potential risk factors for emotional distress among such patients include shorter duration of ocular disease, worse visual acuity, increased systemic comorbidities, and increased functional impairment.