Hospital Anxiety And Depression Scale Scores Research Articles

Clinical outcomes of asynchronous telerehabilitation through a mobile app are equivalent to synchronous telerehabilitation in patients with fibromyalgia: a randomized control study

BackgroundThis study aimed to compare the effectiveness of exercise therapy delivered via a smartphone mobile app, using asynchronous video-based tools, with synchronous telerehabilitation models using videoconferencing for individuals with fibromyalgia syndrome (FMS).MethodsThe research, utilizing a randomized clinical study design, involves sixty-six FMS patients in an 8-week exercise program. Participants are divided into synchronous (n: 33) and asynchronous (n: 33) groups. Assessments, pain intensity (VAS), functional limitations (FIQr), health-related quality of life (SF 12), catastrophizing (PCS), anxiety and depression (HADS), functional capacity (6MWT), muscle strength (Arm curl test), and joint position sense (LI-RATT), are conducted at baseline, mid-treatment (week 4), end of treatment (week 8).ResultsNo significant group-time interaction was found for total VAS, FIQ, SF 12, PCS, HADS, 6MWT, Arm curl tests, LI-RATT extension, LI-RATT flexion, LI-RATT right rotation scores (p > 0.05). Significant effects of time and interactions between groups and time were observed in the neck (p = 0.010, ES = 0.19) and back region (p = 0.039, ES = 0.19) of the Visual Analog Scale, left rotation score of the LI-RATT (p = 0.008, ES = 0.36), and HADS Anxiety Score (p = 0.029, ES = 0.31). Group differences were significant at all-time points for the outcomes (p < 0.001), except for the right rotation of LI-RATT (p = 0.633).ConclusionThe study suggests that asynchronous telerehabilitation is comparable to synchronous methods in addressing pain, quality of life, and other factors in FMS patients. The asynchronous approach may offer advantages in reducing the burden on healthcare professionals and being cost-effective. Future research should explore diverse telerehabilitation protocols and their impact on overall care burdens.Trial registrationNCT06299527 (01/03/2024).

Evaluation of Inadequate Response to Ultrasound-Guided Subacromial Corticosteroid Injection in Shoulder Impingement Syndrome: Treatment Failure or Central Sensitization?: Central Sensitization in Injection Response.

To evaluate whether central sensitization (CS), pain catastrophizing, and psychological factors are associated with inadequate response to ultrasound-guided subacromial corticosteroid injection (SCI) in patients with chronic shoulder impingement syndrome (SIS). This study was designed as a prolective observational study, combining analytical cross-sectional and prospective elements to evaluate associations and treatment responses. Secondary care outpatient clinic. A total of 72 patients aged 18-75 years with SIS and at least 6 months of shoulder pain, planned to undergo ultrasound-guided SCI, were included in the study. Not applicable. Treatment response was defined as a ≥50% reduction in pain (VAS) at 4 weeks post-injection. The presence of central sensitization was assessed using the Central Sensitization Inventory (CSI) and Pressure Pain Threshold (PPT) via algometry (ipsilateral deltoid, contralateral deltoid, and contralateral vastus lateralis). Negative thoughts related to pain were evaluated with the Pain Catastrophizing Scale (PCS), and mood status was assessed using the Hospital Anxiety and Depression Scale (HADS). 48 patients (responders) experienced ≥50% VAS reduction, while 24 (non-responders) did not. Non-responders had significantly higher CSI (p=0.000), HADS-depression (p=0.001), and HADS-anxiety (p=0.000) scores. PPT values were significantly lower in non-responders at ipsilateral deltoid (p=0.030), contralateral deltoid (p=0.045), and contralateral vastus lateralis (p=0.036). CSI was significantly correlated with PPT at ipsilateral deltoid (r=-0.400, p=0.001), contralateral deltoid (r=-0.354, p=0.002), and contralateral vastus lateralis (r=-0.442, p=0.000); PCS total score (r=0.449, p=0.000); HADS-depression score (r=0.572, p=0.000); and HADS-anxiety score (r=0.618, p=0.000). CSI was the most predictive factor for non-response (AUC=0.755, 95% CI: 0.635-0.875). Multivariate analysis identified CSI as an independent predictor (p=0.022), with a predictive accuracy of 72.2%. Inadequate response to SCI in chronic SIS is strongly associated with CS, psychological distress, and altered pain perception. Integrating CS-targeted interventions into treatment strategies may improve outcomes.

Psychological burden in patients with sellar masses under conservative and surgical management

The aim of this study was to investigate the level of distress and the quality of life of operated and non-operated patients with pituitary tumors. Patients who presented to a neurosurgical center and two endocrinological services for outpatient follow-up after surgical treatment, as well as those under medical therapy or radiological follow-up without treatment, were invited to participate in the study. Sociodemographic, health-related quality of life and clinical data were assessed. Psychosocial factors were measured using the Distress Thermometer (DT), the Hospital Anxiety and Depression Scale (HADS), the Short Form (SF-36), and the Sino-nasal outcome test (SNOT). Thirty-two postoperative patients and thirty conservatively managed patients (n = 21 under medical treatment, n = 9 watch and wait), mean age 53, SD 19; 56% female participated in the study. Prolactinomas (35%) and non-functioning pituitary adenomas (21%) were the most common findings. There were no significant differences between conservative and operative groups in mean DT score (4.7 (SD 2.45) vs. 4.9 (SD 3.0), p = 0.61), HADS anxiety score (6.4 (SD 3.9) vs. 6.0 (SD 4.3), p = 0.76) or depression score (5.7 (SD 4.8) vs. 4.6 (SD 3.6), p = 0.50). For patients with ACTH-producing adenomas, the mean anxiety score was significantly higher (10.3 (SD 1.9) vs. 5.9 (SD 4.0), p = 0.03). The SNOT score correlated significantly with the DT, HADS-A, and HADS-D scores and therefore was associated with higher psychological distress. The level of self-reported distress in patients with sellar processes was not associated with a specific treatment strategy. ACTH-producing adenomas and manifest nasal symptoms were associated with higher psychological distress.

Influencing Factors for Residual Symptoms Following Canalith Repositioning Maneuver in Patients with Benign Paroxysmal Positional Vertigo.

Objectives: We aimed to analyze the influencing factors for residual symptoms following canalith repositioning maneuvers in patients with benign paroxysmal positional vertigo (BPPV). Methods: A total of 193 patients with BPPV who attended our hospital from July 2019 to December 2023 and were followed up in the outpatient clinic for 4 weeks after treatment were selected. The presence or absence of residual symptoms 4 weeks after repositioning was recorded, based on which the patients were assigned into a presence group (n = 72) and an absence group (n = 121). Their general data, incidence features, mental health, and sleep quality were compared. Results: After canalith repositioning maneuver and 4-week follow-up, the Dizziness Handicap Inventory (DHI) scores, Hospital Anxiety and Depression Scale (HADS) scores, and Pittsburgh Sleep Quality Index (PSQI) scores of the BPPV patients significantly decreased (P < .05). The presence of residual symptoms after repositioning in patients with BPPV had significant positive correlations with the time from onset to consultation, DHI score, HADS anxiety score, and PSQI score (P < .05). The area under the curve of the DHI score for predicting residual symptoms after repositioning in patients with BPPV was the largest (0.727), and the time from onset to consultation and the HADS anxiety score had the highest sensitivity (0.764) and specificity (0.801), respectively. Conclusions: Time from onset to consultation, DHI score, HADS anxiety score, and PSQI score are independent risk factors for and display significantly positive correlations with residual symptoms after canalith repositioning maneuver in patients with BPPV.

The relationship between anxiety, depression, and COVID-19 diagnosis in term pregnancy: a hospital-based Romanian study

Background and aim. There are few published data on the mental health problems of women with pregnancy complicated by SARS-CoV-2 infection. Our study aimed to evaluate anxiety and depression related to a COVID-19 diagnosis in women who gave birth in a Romanian tertiary maternity. Methods. A hospital-based cross-sectional study was conducted between September 2020 and October 2021 on 105 women admitted for term delivery; 51 women were diagnosed with SARS-CoV-2 infection just before delivery, and 54 without infection. Participants were assessed during the first 72 hours postpartum (T1) and the following two weeks postpartum (T2). Hospital Anxiety and Depression Scale (HADS) was used for anxiety and depression assessment at T1. The COVID-19 Pandemic Mental Health Questionnaire (CoPaQ) was applied at T2 only in the COVID-positive cases identified at T1. Results. Postnatal anxiety levels were higher in COVID-positive women compared to COVID-negative women (p = .004), but there were no differences in the postnatal depression level between the groups. Psychological manifestations related to the pandemic, such as contamination anxiety, posttraumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD) symptoms, were positively related to HADS anxiety scores, while maintaining social relationships were negatively associated with the scale. The COVID-19 diagnosis was found to be a significant predictor for adverse pregnancy outcomes (APOs), with COVID-positive women having a 4.72-fold higher risk of developing them than those who tested COVID-negative (OR=4.72, 95% CI [2.05; 10.86]). The multivariate analysis using anxiety and depression as dependent variables indicated a significant effect for COVID-19 diagnosis, Wilks’ Lambda = 0.940, p = 0.048. Conclusion. Increased levels of anxiety, PTSD, and obsessive-compulsive symptoms were associated with the postpartum period in pregnant women with COVID-19 infection during delivery. Maintaining social interaction proved to be a protective factor against the increased anxiety reported by COVID-19-infected women.

Anxiety and depression prior to total knee arthroplasty are associated with worse pain and subjective function: A prospective comparative study.

The aim of this study was to investigate the influence of preoperative anxiety and depression on subjective function, pain and revision rates following total knee arthroplasty (TKA). A prospective comparative study was conducted, including 349 patients undergoing TKA surgery between January 2019 and April 2021. Patients completed the Hospital Anxiety and Depression Scale (HADS) questionnaire preoperatively, and a set of Patient-Reported Outcome Measures (PROMs) preoperatively and at 6, 12 and 24 months postoperatively. Patients were categorized into anxiety and depression groups based on HADS scores. PROMs included the Knee injury and Osteoarthritis Outcome Score-Physical Function Shortform (KOOS-PS), Oxford Knee Score (OKS) and NRS-Pain. Differences in PROM scores between the anxiety/depression group and, respectively, nonanxiety/nondepression group were assessed, as well as differences in minimal clinical important difference (MCID) and attainment of Patient Acceptable Symptom State (PASS). Lastly, revision rates were compared. Anxiety and depression groups exhibited inferior subjective function preoperatively and postoperatively compared to nonanxiety and nondepression groups (all p < 0.05), experienced more pain preoperatively (p < 0.001) and also postoperatively for depression patients (all p < 0.05). Significantly fewer patients with anxiety and depression reached the PASS for KOOS-PS, OKS and NRS-Pain (all p < 0.05). There were no differences in the proportion of patients reaching the MCID for all PROMs (all p > 0.060), and revision rates did not differ between groups (both p > 0.96). Preoperative anxiety and depression negatively influence subjective function and pain preoperatively and up to 2-year follow-up in patients undergoing TKA. Revision rates did not differ between groups, and there were no relevant differences in clinical improvement of subjective function and pain. Level II, prospective comparative study.

Analysis of Depression Rates among Working and Non-Working Women in Karachi

Background: Women frequently navigate the dual responsibilities of home and work. Although their participation in the workforce is on the rise, their domestic obligations have not diminished. This balancing act can create unavoidable work-family conflicts, often leading to job dissatisfaction and heightened stress. Nevertheless, employment can serve as a beneficial outlet, offering women a way to relieve some of the burdens associated with their household duties. Objective: We aim to compare the quality of life and depression/anxiety of a working woman vs a stay-at-home woman in Karachi. Methods: Place and duration of study: A cross-sectional study was conducted among 200 women aged 20-50 years irrespective of their occupation, marital status, and number of children in Karachi to determine the prevalence of depression in working vs non-working individuals using PHQ-9 and HAD scales and quality of life was assessed. An Independent t-test was computed to see the association of depression among working vs non-working women. Results: The mean age of the participants was 33.2+7.7 years. The mean HAD depression score in working women was 14.8+7.9 and in non-working women was 15.3+8.7 showing depression was more common in stay-at-home women. Conclusion: Depression tends to be more prevalent among women who are not a part of the workforce. The findings hint that the blues tend to visit non-working women more often, painting a clearer picture of the challenges they might face in day to day lives of Pakistani women.

Brain tumor and mood disorders: a retrospective analysis of anxiety and depression in patients with primary and metastatic brain tumors.

Brain tumors are associated with a dismal prognosis, and the diagnosis often evokes significant psychological distress. However, the progression of emotional well-being throughout the clinical course of brain tumors remains poorly understood. This study aims to assess the prevalence of anxiety and depression in brain tumor patients and to identify the risk factors associated with postoperative emotional derangement in glioma and metastatic groups seperately. Psychological conditions were evaluated using the Hospital Anxiety and Depression Scale (HADS) at various preoperative and postoperative time points. A total of 159 patients who underwent surgery and HADS assessment between May 2018 and November 2020 were included in the analysis, comprising 112 glioma patients and 47 metastatic brain tumor patients. After surgery, the incidence of anxiety and depression increased in both the glioma and the metastatic brain tumor group. In both groups, tumors involving the frontal lobe were associated with a significant increase in postoperative HADS depression scores, whereas involvement of other lobes did not significantly affect postoperative HADS scores. Additionally, postoperative HADS scores did not differ significantly among gliomas of different grades. Among glioma patients, univariate analysis indicated that left-sided tumors were associated with an increased risk of postoperative depression worsening. In the metastatic group, a BMI > 24 was identified as a risk factor for postoperative anxiety exacerbation. The findings from this study highlight clinical characteristics associated with a higher risk of postoperative psychological disturbance, aiding in early prevention and tailored care to improve the quality of life for patients with intracranial tumors.

Comparing Quality of Life and Psychological Changes in Benign and Malignant Lung Resections.

Background and Objectives: Pulmonary resections are critical interventions for treating various lung pathologies, both benign and malignant. Understanding the impact of these surgeries on patients' Quality of Life (QoL) is essential for optimizing care. This study aims to compare the Health-Related Quality of Life (HRQoL) and psychological well-being in patients who underwent pulmonary resections for benign versus malignant etiologies. Methods: A cross-sectional study was conducted involving 117 patients who underwent pulmonary resection between January 2022 and June 2023. Participants were divided into two groups: 51 patients with benign lung conditions and 66 with malignant lung tumors. HRQoL was assessed using the SF-36 and WHOQOL-BREF questionnaires. Anxiety and depression levels were evaluated using the Hospital Anxiety and Depression Scale (HADS) and the Perceived Stress Scale (PSS-10). Patients were assessed pre- and post-intervention. Results: Patients with malignant etiologies were older (58.7 vs. 54.2 years) and had lower FEV1% predicted (79.1% vs. 82.5%) compared to the benign group. Malignant patients reported significantly lower scores in physical functioning (68.1 vs. 75.4), role-physical (65.0 vs. 72.3), and general health domains of the SF-36 (62.4 vs. 70.2). WHOQOL-BREF scores indicated a lower overall QoL in the malignant group, particularly in the physical health (65.3 vs. 72.1) and psychological domains (68.0 vs. 74.5). HADS scores revealed higher anxiety (9.1 vs. 7.2) and depression levels (8.5 vs. 6.8) among malignant patients. Correlation analyses showed strong associations between lower QoL scores and higher anxiety and depression levels. Conclusions: Pulmonary resections for malignant conditions are associated with a significant decline in HRQoL compared to benign conditions. Patients with malignant etiologies experience higher levels of anxiety and depression, emphasizing that clinicians should integrate specialized mental health services and tailored physical rehabilitation programs for patients undergoing pulmonary resections for malignant lung conditions to address their significantly reduced quality of life and increased psychological distress.

Health-related quality of life in 62 patients with diffuse low-grade glioma during a non-therapeutic and progression-free phase: a cross-sectional study.

Few studies have evaluated the health-related quality of life (HRQoL) of patients with diffuse low-grade glioma (LGG) during a clinical and radiological monitoring period. We report a cross sectional cohort study of HRQoL in patients with LGG and compare the results with normative population data. We then explore factors associated with HRQoL. We used the European Organisation for Research and Treatment of Cancer QLQ-C30, BN-20 and the Hospital Anxiety and Depression Scale (HADS) to evaluate HRQoL. Averaged QLQC30 and HADS scores were compared with scores of a normative population. A general linear model multivariate analysis of variance was used to investigate the association between HRQoL and independent factors. A total of 62 patients with LGG completed HRQoL questionnaires. Compared with a normative population, LGG patients reported statistical and clinically significant lower cognitive, emotional, role and social functioning. Fatigue, anxiety, depression and sleep disturbances were frequently reported. Awake surgery and preserved high Karnofsky Performance Status were found to be independent prognostic factors for better global HRQoL, while radiotherapy was associated with worsened HRQoL. Despite a non-therapeutic and progression free phase, LGG patients report noticeable limitations in several HRQoL subscales. Our study highlights the importance of HRQoL assessment not only at diagnosis or during active therapeutic stage. Further studies are needed to develop better adapted tools of HRQoL assessment.

Anxiety and Depression in Japanese Patients with Genitourinary Syndrome of Menopause.

Women with genitourinary syndrome of menopause (GSM) may have anxiety and depression; however, this is unclear. A total of 646 postmenopausal women undergoing treatment for menopausal symptomswereenrolled in this retrospective cross-sectional study. Questionnaire responses were recorded at the first visit, and participants were divided into GSM (≥1 moderate or severe GSM symptom) or no-GSM (without any moderate/severe symptoms) groups. Mental health was assessed using the Hospital Anxiety and Depression Scale (HADS). The HADS scores of the two groups were compared, and GSM symptoms affecting mental health were analyzed using a logistic regression model. 350 (54.2%) women were assigned to the GSM group. Among GSM symptoms, urinary frequency was the most common (moderate/severe: 37.5%). The proportion of participants with anxiety was significantly higher in the GSM group than in the no-GSM group, and odds ratio (OR) was 1.429 (95% confidence interval [CI]: 1.046-1.951). Additionally, the proportion of participants with both anxiety and depression was significantly higher in the GSM group than in the no-GSM group. Furthermore, logistic regression analysis showed that urinary frequency was significantly associated with anxiety (OR 1.429; 95% CI 1.046-1.951) and depression (OR 1.639, 95% CI 1.189-2.261). Japanese women with GSM reported higher HADS scores for anxiety than those without GSM. Among GSM symptoms, urinary frequency was common, which affected the mental health of menopausal women the most. Therefore, clinicians should be aware of the possibility that women seeking care for menopausal symptoms may have comorbid frequent urination and anxiety.

The Impact of Alpha-s1 Casein Hydrolysate On Chronic Insomnia: A Randomized, Double-Blind Controlled Trial

BackgroundAlpha-s1 casein hydrolysate (ACH; Lactium®) is recognized as a supplementary treatment to enhance sleep quality. However, limited studies utilizing objective sleep assessment tools have resulted in a lack of substantial validation. This study aimed to assess the effects of ACH on both subjective sleep assessments and objective polysomnography (PSG) recordings in a hospital-based cohort of Taiwanese individuals with chronic insomnia. MethodsIn this 4-week randomized, double-blind, placebo-controlled trial, 36 participants diagnosed with chronic insomnia were enrolled and randomly assigned to either the ACH or placebo groups. Initially, participants in the ACH group received 600 mg of ACH daily, which was reduced to 300 mg for the latter two weeks; the placebo group received maltodextrin capsules throughout the study. The study utilized polysomnography (PSG), along with detailed sleep questionnaires including the Insomnia Severity Index (ISI), Global Sleep Disorders Score (GSDS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Hospital Anxiety and Depression Scale (HADS), to assess improvements in sleep quality and related health markers. The efficacy of the intervention was assessed through measures of sleep efficiency, stage distribution, and psychological well-being, comparing results from before to after the treatment phase. ResultsThe study demonstrated that ACH treatment notably enhanced sleep quality, evidenced by significant improvements in ISI, GSDS, PSQI, ESS, and HADS scores at both week 2 and 4 (all p-values < 0.05) compared with baseline scores. When compared to the placebo group, the ACH group experienced a marked reduction in GSDS scores over time (p = 0.045). Furthermore, PSG data revealed a significant decrease in sleep onset latency from baseline in the ACH group compared to the placebo group (p = 0.012; -7.7 ± 16.0 minutes vs. 6.1 ± 17.7 minutes for ACH and placebo groups, respectively). These results indicate that ACH treatment effectively improved sleep initiation and overall sleep quality. ConclusionACH Supplementation significantly improved sleep quality, particularly by reducing GSDS scores and sleep onset latency, demonstrating its potential as an effective intervention for chronic insomnia. Future studies with larger samples and exploration of long-term effects are needed to confirm these results.

Efficacy of Virtual Visitation in ICU During COVID-19 Pandemic: The ICU Visits Randomized Controlled Trial.

This study aimed to demonstrate the impact of virtual visits on the satisfaction of family members and the anxiety and depression of patients in the ICU during the COVID-19 pandemic. A single-center, randomized controlled trial. This study was conducted from July 2021 to May 2022, in the Seoul National University Hospital. A total of 40 patients eligible for virtual visitation whose Richmond Agitation-Sedation Scale score was -2 or above were recruited and randomized into virtual visitation and usual care groups. Virtual visitation began on the first day after ICU admission and continued until ICU discharge, lasting for a maximum of 7 days. The primary outcome was the satisfaction level of the family members with care and decision-making in the ICU, assessed using the Family Satisfaction-ICU (FS-ICU) 24-survey questionnaire. Secondary outcomes included patient anxiety and depression levels assessed using the Hospital Anxiety and Depression Scale (HADS), at the study enrollment after ICU admission and at the end of the study. After two patients were excluded due to clinical deterioration, 38 patients were ultimately analyzed, including 18 patients in the virtual visitation group and 20 patients in the usual care group. The FS-ICU 24 survey score was significantly higher in the virtual visitation group (89.1 ± 13.0 vs. 75.1 ± 17.7; p = 0.030). The reduction in HADS-Anxiety (59.4% vs. 15.39; p < 0.001) and HADS-Depression (64.5% vs. 24.2%; p < 0.001) scores between the two time points, from study enrollment after ICU admission to the end of the study was significantly larger in the virtual visitation group. In the COVID-19 pandemic era, virtual visits to ICU patients helped reduce depression and anxiety levels of patients and increase the satisfaction of their family members. Enhancing access to virtual visits for family members and developing a consistent approach may improve the quality of care during another pandemic.

Relationships between emotional state, sleep disturbance and health-related quality of life in patients with axial spondyloarthritis.

Axial spondyloarthritis (ax-SpA) is an autoinflammatory disease affecting multiple organs. While emphasizing the treatment of chronic diseases, it has been found that the prevalence of mental disorders and insomnia in patients is also increasing. We investigated mood status, sleep quality and the health-related quality of life (HRQoL) in these patients. A total of 94 pairs ax-SpA patients and age- and sex-matched healthy controls were included in this cross-sectional study. Demographic and clinical data were collected. We assessed the disease activity by the Ankylosing Spondylitis Disease Activity Score, including C-reactive protein (ASDAS-CRP), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI). The Hospital Anxiety and Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI) and the Medical Outcomes Survey Sheet Form-36 (SF-36) were used to evaluate mood status and quality of sleep and life, respectively. We evaluated the factors related to anxiety and depression scores, sleep disturbance scores and quality of life scores, and the predictors of anxiety, depression and sleep disturbance were analyzed. Forty-five active patients and forty-nine relieved patients were enrolled. We found that the median HADS anxiety (HADS-A), depression (HADS-D) subscale scores and PSQI score were significantly higher in active ax-SpA than in inactive patients, and were significantly higher than those in controls (HADS-A 9 vs. 5 vs. 3, p < 0.001; HADS-D 8 vs. 5 vs. 3, p < 0.001; PSQI 10 vs. 6 vs. 3, p < 0.001). Moreover, the HADS-A scores were positively correlated to positive HLA-B27 (p = 0.042), pain (p = 0.002) and the BASFI score (p = 0.012), HADS-D scores were positively correlate to disease course (p < 0.001) and PSQI scores were significantly positively correlated to the BASFI score (p = 0.009). Logistic regression analysis showed that BASFI was a risk factor for anxiety, age was a protective factor for depression and disease course was a risk factor for depression. The optimal cut-off value of BASFI in predicting anxiety was 1.55 with an area under the curve value of 0.8488 (p < 0.001), and the optimal cut-off value of age and the course of the disease in predicting depression was 50.5years old with an area under the curve value of 0.62 (p = 0.0482) and 54months with an area under the curve value of 0.7988 (p < 0.001). In addition, disease activity was negatively correlated with SF-36 dimensions, and anxiety, depression and sleep disturbance in ax-SpA patients also had significant negative effects on HRQoL (p < 0.05). Patients with active ax-SpA tend to be more anxious, depressed and sleep disturbed, and have worse HRQoL than patients in remission. Patients with ax-SpA are more likely to be anxious with worse spinal function, more likely to be depressed with younger age and longer course of disease. Therefore, the assessment of mental health, sleep and HRQoL should also be included in the long-term management of patients with ax-SpA. Key Points • Active ax-SpA patients tend to have more anxiety, depression, sleep disturbances and worse HRQoL compared with patients in remission • The optimal cut-off value of BASFI in predicting anxiety was 1.55, the age and the course of the disease in predicting depression was 50.5years old and 54months.

Effectiveness of wide local excision and secondary intention healing in Hidradenitis Suppurativa: a single-center study on quality of life and mental health outcomes.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that significantly impacts patients' quality of life and mental health. Effective management often involves both medical and surgical interventions. The aim of the study was to assess the effectiveness of wide local excision and secondary intention healing in improving quality of life and mental health in patients with moderate to severe HS. A single-center prospective study was conducted with 40 patients suffering from moderate to severe HS, refractory to prior treatments. Pre-surgical ultrasound mapping of lesions was performed using Ultra High-Frequency Ultrasound (UHFUS). Patients underwent wide surgical excision followed by secondary intention healing based on HS-TIME principles. Quality of life was measured using Skindex-16, and mental health was assessed using the Hospital Anxiety and Depression Scale (HADS), with subscales for anxiety (HADS-A) and depression (HADS-D). Assessments were conducted at baseline, 4 weeks post-surgery, and after complete wound healing. Statistical analyses included paired t-tests and multiple linear regression to determine factors influencing outcomes. The study included 14 males and 26 females with a mean age of 39 years. Significant improvements were observed in Skindex-16 scores (pre: 57.92, post: 16.03) and HADS scores (HADS-A: pre: 6.13, post: 2.63; HADS-D: pre: 5.50, post: 3.21), indicating reduced pain, discomfort, and psychological distress. Multivariate analysis revealed that improvements were associated with male sex, HS stage II, longer disease duration, and lower BMI. Wide local excision combined with secondary intention healing significantly improves quality of life and mental health in HS patients. The findings suggest that a comprehensive approach addressing both surgical and psychological aspects can enhance patient outcomes. Future research should focus on long-term benefits and the development of standardized postoperative care protocols.

The assessment of psychosocial distress in hospitalized cancer patients during radio-oncological treatment: a monocentric experience study.

This study investigated the prevalence and determinants of psychosocial distress among hospitalized patients undergoing radiotherapy to identify opportunities for interventions to enhance patient well-being. Between January 2021 and May 2023, 137 hospitalized patients received radiotherapy treatment at the Department of Radiation Oncology of the Fondazione A. Gemelli IRCCS were recruited. Participants completed a questionnaire comprising the Distress Thermometer (DT) and the Hospital Anxiety and Depression Scale (HADS). The study revealed a significant correlation among anxiety, depression, total HADS scores, and Distress Thermometer scores (p < 0.001). Female patients exhibited higher total HADS scores and anxiety levels compared to males (p < 0.004, p < 0.010, respectively). Sleep disturbances were associated with increased anxiety, depression, and overall distress (p < 0.05). Younger patients (< 65years old) demonstrated elevated anxiety and depression levels, while no significant depressive tendency was observed among older participants (> 65years old). These findings underscore the intricate interplay between demographic variables, psychological distress, and treatment-related symptoms among patients during radiotherapy treatments. The study highlights the critical necessity of promptly identifying and addressing psychosocial distress in this population. It suggests that implementing a psychological therapeutic approach, particularly one focused on support, could effectively deter the onset of depression, especially among younger patients. Future research should focus on longitudinal studies to explore distress trajectories and interventions' effectiveness in mitigating distress, with collaborative efforts to translate research findings into evidence-based clinical practice for improved patient care.

Depression, anxiety, and suicidal ideation in college students in the aftermath of COVID-19 pandemic

ABSTRACT Background: The COVID-19 pandemic was not merely limited to physical health concerns, and after the pandemic, the mental health consequences of the pandemic are still reverberating within our societies, especially in India. The college students in India were left to grapple with unforeseen circumstances, facing abrupt uncertainties with respect to their education and careers. Although their physical health was relatively more robust, their mental health status was left unexplored. Aim: To assess depression, anxiety, and suicidal ideation in college students in the aftermath of COVID-19 pandemic. Materials and Methods: An observational cross-sectional survey was conducted on 323 undergraduate students from June 2021 to August 2021, who were required to fill a survey form which comprised basic sociodemographic details, student’s concerns about COVID-19 and the following scales: Hospital Anxiety and Depression Scale (HADS) and Positive and Negative Suicide Ideation Scale (PANSI) after obtaining written and informed consent from them. The data collected was analyzed using descriptive and inferential statistics. Results: The study revealed that 23.52% of the participants suffered from depressive disorders, and 34.98% from anxiety disorders. Although a statistically higher number of males were depressed as compared to females (33.87% versus 17.08%), it was the opposite for anxiety disorders (47.73% females versus 14.51% males). HADS anxiety score was positively correlated with worrying about family members, COVID-19 infection in family members, fear of contracting the infection, presence of psychiatric illness in family, and history of attempted suicide. HADS depression score was positively correlated with worrying about family, COVID-19 infection in family members, a prior consultation with a mental health professional, and history of attempted suicide. Suicidal ideations as predicted by PANSI Positive score was predicted by rural place of residence, number of family members, and presence of psychiatry patient in the family. Conclusion: In the following era of the COVID-19 pandemic, anxiety and depression were high amongst college students. Various COVID-19-related and personal correlates for anxiety and depression as well as predictors for suicidal ideations could also be delineated. Institutions need to find out at-risk students and plan active measures for them.

Association Between Anxiety and Reflux Symptoms in Patients With Gastroesophageal Reflux Disease: A Prospective Cohort Study.

The purpose of this paper is to examine the prevalence and symptom severity of anxiety and depression in patients with gastroesophageal reflux disease (GERD). The correlation between anxiety and depression with the DeMeester score is determined. GERD is a common gastrointestinal disorder that manifests as heartburn, regurgitation, retrosternal pain, cough, and dysphagia. Patients are severely affected by reflux symptoms. We conducted a prospective cohort study of 458 consecutively enrolled patients who presented tothe Department of Functional Upper GI Surgery atthe University Hospital of Cologne,Germany. Patients underwent upper gastrointestinal endoscopy, 24-hour pH impedance testing, and high-resolution manometry. We determined the DeMeester score. Psychometric data werecollected using the Hospital Anxiety and Depression Scale (HADS). 44.1% (n = 202) of patients had abnormally high HADS anxiety scores and 23.8% (n = 109) had abnormally high HADS depression scores (both >7). Patients without an indication for surgery (51.1%, n = 234) were the most distressed subgroup: 47.9% (n= 112) of these patients had an anxiety score of 8 or higher, and as many as 23.9% (n = 56) of these patients had an anxiety score of 11 or higher. We found a significant effect of elevated anxiety and elevated depression scores on the severity of symptoms such as heartburn and fullness, as well as an effect of elevated anxiety scores on the severity of dysphagia. Patients with reflux symptoms have a high prevalence of anxiety. Anxiety and partly depression are significantly associated with the severity of reflux symptoms. An adequate multidisciplinary treatment strategyis required.

Sleep Quality in Head and Neck Cancer.

Patients with head and neck cancer often experience impaired sleep. Moreover, the treatment may negatively affect sleep quality. The aim of this observational study was to evaluate the sleep quality after treatment for head and neck cancer, and its relationship with quality of life and psychological distress. A total of 151 patients who underwent treatment for head and neck cancer at our department were included in the study. Quality of life, sleep quality, risk of sleep apnea, sleepiness, pain, and psychological distress were assessed by means of specific questionnaires. The median follow-up was 30 months. Poor sleep quality was observed in 55.6% of the cases. An association between PSQI global sleep quality and EORTC global health status was found. The DT, HADS anxiety, and HADS depression scores were associated to PSQI global score, sleep quality, sleep latency, sleep disturbances, and daytime dysfunction. Sleep disturbances, particularly OSA and insomnia, are frequent in HNC patients, and significantly impact their quality of life and psychological well-being. Given the effect of sleep on overall well-being, addressing sleep disorders should be a priority in the care of HNC patients.

REM sleep behavior disorder: Relation between aggressiveness and emotions expressed in dream enactment and cognitive and anxiety/depression status

Aggressiveness and negative emotions in dreams reports of patients with alfa-synucleinopathies have been associated with cognitive dysfunction. Observation of dream enactment episodes could be a more precise method to capture dream content in patients with REM sleep behavior disorder (RBD). Our objective was to assess the relation between aggressive and emotional dream enactment episodes in patients with RBD and cognition and depression/anxiety.Motor events (ME) during REM sleep were classified by visual inspection of video-PSG files. Cognition and anxiety/depression were assessed with MoCA and the Hospital Anxiety and Depression Scale (HADS), respectively. Multivariate regression analysis was performed, with MoCA or HADS scores as predictors, age and DED as co-variates and aggressive, negative and positive ME frequency (raw values, per total and per complex indexes) as the dependent variable.We included 15 patients with isolated RBD and 12 and 4 with RBD associated with Parkinson's disease and Dementia with Lewy Bodies, respectively. They presented a total of 873 ME. There was a significant positive association between HADS score and violent/complex and negative emotion/complex indexes. There was a significant positive association between MoCA score and violent/complex index.A significant correlation between depression/anxiety severity and negative emotion and aggression ME frequency agrees with the dream continuity hypothesis and suggests that REM sleep acts as a regulator of emotional experience. Patients with a higher prevalence of aggressive ME had higher scores in cognitive testing, suggesting that the elaboration of these complex movements could depend on the integrity of cognitive functions.