Screening For Anxiety Symptoms Research Articles

Anxiety-inducing factors among educators in the Capricorn district of Limpopo, South Africa

This study was aimed at screening for anxiety symptoms among educators in the Capricorn District of Limpopo Province, South Africa. Recent literature has identified the school environment as a risk factor for anxiety, putting teachers at a higher risk. We collected data from 381 teachers using a quantitative cross-sectional study design. The Generalized Anxiety Disorder (GAD-7) scale, along with a researcher-developed socio-demographic questionnaire, was used to determine the prevalence and associated risk factors for anxiety symptoms. Stata-14 was used to analyze the data through the use of bivariate and multivariate analysis. The sample consisted largely of black (n=318, 83.46%), female (n=270, 70.87%) teachers from 25 schools. The prevalence of anxiety was 36.85%, with a majority falling under the mild category (n=85, 22.31%). Personal factors such as gender, race, home language, whether the participant had sought professional mental health assistance in the past 6 months, and the impact of COVID-19 were significantly (p=0.05) associated with the symptoms of anxiety. Additionally, workplace factors such as school of employment and subjects taught were also significantly associated with anxiety symptoms. There is a high prevalence of anxiety symptoms among educators, which may negatively affect the students under their care.

The Emotional Journey: An Exploration of Women's Pre-Birth Anxieties

Pregnancy is an important period in a woman's life, but it is often accompanied by worries and fears that cause birth anxiety. Anxiety generally varies in intensity from mild to severe. Anxiety has a negative impact on the health of the mother and fetus, and it causes many women to refuse to give birth naturally. This study aims to explore the psychological and emotional dimensions of pregnant mothers' levels of anxiety toward childbirth, identifying the various concerns and factors that cause anxiety. The research design was non-experimental exploratory descriptive, conducted from May to June 2022. Respondents consist of multigravida women with a gestational age of 36–40 weeks (third trimester). The sample was chosen using purposive sampling. The data collection process uses a questionnaire in the form of semi-structured questions. The level of anxiety for multigravida women is moderate anxiety (36.0%), severe anxiety (32.0%), mild anxiety (24.0%), and 4.0% each with severe anxiety and not anxiety. The aspects found are generally feared to have a cesarean delivery (28.0%) and worry about the baby's condition (20.0%). Factors that cause anxiety are generally the condition of the baby (24.0%), illness suffered by the mother (12.0%), and negative experiences about childbirth (12.0%). Multigravida women generally experience various anxieties during labor, which are caused by various factors that influence them. There are aspects of anxiety that are different from previous studies. Screening for anxiety symptoms and education during the antenatal period are necessary.

P.114 The impact of screening for anxious and depressive symptoms on the outcome of patients with a mild traumatic brain injury

Background: An estimated 27-69 million individuals worldwide sustain a mild Traumatic Brain Injury (mTBI) each year, making it an important public health concern. Many victims experience post-injury neuropsychological issues such as anxiety and depression, which are associated with more post-concussive symptoms and worse functional outcomes. We sought to determine a systematic process to document the presence of anxiety and depression symptoms in mTBI patients to prevent negative impacts on their recovery. Methods: We administered the Generalized Anxiety Disorder-7 (GAD-7) and Center for Epidemiologic Studies Depression Scale Revised (CESDR-10) questionnaires, no more than three months after injury, to screen for these symptoms. A retrospective chart review was performed for 328 patients from the Montreal General Hospital mTBI Clinic who either received these questionnaires (N=143, Mage=40.36, SDage=15.557, Nfemale=90, Nmale=53) or did not (N=185, Mage=41.17, SDage=16.449, Nfemale=114, Nmale=71). The number of interventions received between groups were compared using ANOVA. Results: Patients who received the questionnaires (M=1.34, SD=0.978) were referred to significantly more interventions than those who did not (M=0.90, SD=0.876, p<0.001) and the rate of referral positively correlated with GAD-7 and CESDR-10 scores. Conclusions: Screening for symptoms of anxiety and depression post mTBI helps clinicians refer patients to the appropriate resources, which in turn should improve outcome.

Anxiety trajectories from pregnancy to one-year postpartum and their contributors during the COVID-19 pandemic

ABSTRACT Background Anxiety in the peripartum period (pregnancy through one-year postpartum) has negative impacts on mothers and infants. During the COVID-19 pandemic, high rates of anxiety were reported worldwide, but trajectories for how these symptoms change longitudinally in the peripartum period remain unknown. Methods A total of 1,411 women who were pregnant during the second U.S. COVID-19 surge completed four study questionnaires between December 2020 and March 2022, including assessments of anxiety symptoms (GAD-7) and individual and community-level contributors. Latent Class Growth Mixture Models (LCGMM) were used to identify anxiety trajectories, and multinomial logistic regression was used to identify contributors to class membership. Results Three classes of anxiety symptom trajectories were identified. Class 1 (n = 956, 67.8%) experienced minimal/mild anxiety throughout the peripartum period. Class 2 (n = 362, 25.7%) experienced initial moderate anxiety that remained stable. Class 3 (n = 93, 6.6%) experienced initial moderate anxiety that increased to severe in the postpartum period. Stress and history of mental health diagnosis contributed to higher initial levels of anxiety and ongoing social support contributed to lower levels of anxiety. In addition, financial insecurity increased the risk of belonging to Class 3. Conclusions Screening for anxiety symptoms and psychosocial vulnerabilities in the peripartum period is vital, as is early intervention. This is especially the case among women with limited financial and social resources who may experience chronic or worsening anxiety as they transition to parenthood.

Routine assessment of anxiety among adolescents in a primary care clinic.

Approximately 20% to 25% of all adolescents experience significant symptoms of anxiety, but only half of those adolescents are diagnosed and treated. Recent clinical guidelines recommend routine assessment of adolescent anxiety symptoms in the primary care setting to improve the rates of identification and treatment of anxiety in this population. The objective of this project was to increase early identification and referral for treatment of adolescent anxiety during primary care visits. This project used the Generalized Anxiety Disorder-7 screening tool to assess anxiety symptoms in adolescents in a school-based primary care clinic. Upon arrival to the clinic, adolescent patients completed the brief self-assessment. The provider then used the assessment score to determine the need for further assessment and referral for treatment. Of the 51 participants, 21.6% were referred to a mental health provider following assessment, compared with 1.2% of adolescent patients seen in the 6-month period immediately preceding the project. The results indicate that screening for symptoms of anxiety in adolescents using a brief self-assessment survey is an effective method for achieving the desired outcome of increased identification and referral for treatment of anxiety symptoms in this population.

Co-occurrence of depression, anxiety, and perinatal posttraumatic stress in postpartum persons

BackgroundThe study aim was to describe the incidence of depression, anxiety, perinatal-post-traumatic stress disorder (PTSD), and their co-occurrences in the early postpartum period in a low-resource OB/GYN clinic serving majority Medicaid-eligible persons. We hypothesized that postpartum persons screening positive for depression will have an increased risk of a positive screen for anxiety and perinatal PTSD.MethodsA retrospective study of postpartum persons receiving care in Baton Rouge, Louisiana was conducted using responses abstracted from the electronic medical record (EMR) of the Patient Health Questionnaire-9 (PHQ9), Generalized Anxiety Disorder-7 (GAD7), and Perinatal Post Traumatic Stress Disorder Questionnaire-II (PPQII). Categorical distributions were compared using Fisher exact tests, while t-tests were used to compare continuous covariates. Multivariable logistic regression was used to predict anxiety (GAD7) and perinatal PTSD (PPQII) scores while adjusting for potential confounders, as well as to predict continuous PPQII and GAD7 based on continuous PHQ9 scores.ResultsThere were 613 birthing persons 4–12 weeks postpartum that completed mental health screening (PHQ9, GAD7, and PPQII) between November 2020 and June 2022 as part of routine postpartum care in the clinic. The incidence of screening positive for symptoms of depression (PHQ9 > 4) was 25.4% (n = 156), while the incidence of positive screening for symptoms of anxiety (GAD7 > 4) and perinatal PTSD (PPQII ge 19) were 23.0% (n = 141) and 5.1% (n = 31) respectively. Postpartum patients with mild anxiety or more (i.e. GAD7 > 4) had 26 times higher odds of screening positive for symptoms of depression (PHQ9 > 4) (adjusted odds ratio [aOR] 26.3; 95% confidence interval [CI] 15.29–46.92; p < 0.001). Postpartum persons with a PPQII score indicating symptoms of perinatal PTSD (PPQII ge 19) had 44 times higher odds of screening positive for symptoms of depression (PHQ > 4) (aOR 44.14; 95%CI 5.07–5856.17; p < 0.001).ConclusionsDepression, anxiety, and perinatal PTSD are each independent risk factors for each other. To comply with the American College of Obstetricians and Gynecologists (ACOG) recommendations, providers should universally screen postpartum persons with validated screening tools for mood disturbances. However, if a complete full mood assessment is not feasible, this study provides evidence to support screening patients for depression, and if the patient screens positive, prompt additional screening for anxiety and perinatal PTSD.

When pregnancy and pandemic coincide: changes in stress and anxiety over the course of pregnancy

ABSTRACT Background Pregnant women experienced high levels of perceived stress and anxiety at the onset of the COVID-19 pandemic. However, the course of stress and anxiety in individual pregnant women during the pandemic is unknown. Methods Participants were 1,087 women ≤20 weeks pregnant in April–May 2020 (T1) at recruitment into the Stony Brook COVID-19 Pregnancy Experiences (SB-COPE) Study, with additional assessments in July–August 2020 (T2) and October 2020 (T3). Growth mixture models conditioned on covariates were used to identify patterns of change over time in pandemic-related stress (originating from feeling unprepared for birth and fearing perinatal infection), pregnancy-specific stress, and anxiety symptoms. Results A uniform pattern of change (i.e. one-class solution) in stress perceptions was observed over time. Participants showed the same functional form of decreases in all three types of stress perceptions over the course of their pregnancy and as the pandemic persisted. Initial level of stress did not predict change over time. Anxiety symptoms had a two-class solution in which 25% of participants had high and convex patterns of anxiety, and 75% had low levels with concave patterns. Discussion Stress perceptions and anxiety patterns of change over the course of pregnancy during the COVID-19 pandemic were different. Therefore, to evaluate the well-being of pregnant women during a global health crisis, it is important to assess both stress perceptions and emotional stress responses (i.e. anxiety). Screening for anxiety symptoms in early pregnancy would be valuable as symptoms may not spontaneously decrease even when stressful conditions improve.

Anxiety symptoms and associated functional impairment in children with CHD in a neurodevelopmental follow-up clinic.

To examine the prevalence of anxiety symptoms and associated functional impairment to adaptive skills among elementary-aged children with CHD and to determine the need for anxiety screening in this high-risk population. In a single-centreretrospective, cohort design, caregivers reported anxiety symptoms using Conner's scales and functional impairment to adaptive skills using the Adaptive Behavior Assessment System. A total of 194 children were stratified across two cohorts: early elementary (ages 3-6 years) and late elementary (ages 6-14 years). Descriptive statistics summarised the frequency of anxiety symptoms and functional impairment. Spearman's correlations compared anxiety symptoms to functional impairment of adaptive functioning. Univariable logistic regressions examined demographic and clinical characteristics associated with anxiety symptoms. The majority of patients presented with anxiety, early elementary (63%), and late elementary cohorts (78%). Functional impairment was moderately correlated with anxiety symptoms in the early elementary cohort (rs = -.42, 95% CI [-0.58, -0.21], p = <.001). Greater anxiety symptoms were associated with lower cardiac complexity at primary age of surgery in the late elementary cohort (OR = 12.15, p = 0.019). Lesser anxiety symptoms were associated with having private insurance (OR = 0.25, p = 0.014). This study demonstrates anxiety symptoms are common and associated with functional impairment to adaptive functioning in younger children with CHD. No clear clinical predictors exist for anxiety symptoms or functional impairment; therefore, screening for anxiety symptoms may need to be added to standard clinical assessment of all children with CHD participating in neurodevelopmental follow-up.

Parental Distress in Pediatric Inflammatory Bowel Diseases: Associations With Time From Diagnosis, Disease Activity, and Demographic Factors.

BackgroundThere are limited studies examining caregiver distress when raising a child with inflammatory bowel disease (IBD). The aim of this study was to investigate the occurrence of symptoms of distress (anxiety, depression, and post-traumatic stress disorder [PTSD]) among parents with children with IBD and associations with disease severity, time from diagnosis, and demographic factors.MethodsWe conducted a cross-sectional study with parents of children (2–17 years) diagnosed with IBD. There were 2 cohorts: (1) recently diagnosed cohort (<6 months from diagnosis); (2) established diagnosis cohort (>1 year from diagnosis). Parents completed measures of anxiety, depression, and PTSD, while children completed surveys on the symptoms of their IBD.ResultsFifty-two parents in the recently diagnosed cohort and 103 parents in the established diagnosis cohort completed surveys. For the entire cohort of parents, we found the mean scores on all measures of distress were within the normal ranges with 20%, 13%, and 8% of parents reporting moderate-to-severe symptoms of anxiety, depression, and PTSD, respectively. Symptoms of anxiety and depression were not significantly associated with time from diagnosis; symptoms of anxiety and PTSD were significantly associated with patients’ IBD clinical activity.ConclusionsParents with children with IBD are remarkably resilient to distress even soon after their child’s diagnosis. Despite considerable resilience, routine brief caregiver screening for symptoms of anxiety during annual visits seems reasonable and feasible.

Screening for symptoms of anxiety and depression in patients treated with renal replacement therapy: utility of the Edmonton Symptom Assessment System-Revised.

The Edmonton Symptom Assessment System-revised (ESASr) is widely used in clinical oncology to screen for physical and emotional symptoms. The performance of the anxiety and depression items (ESASr-A and ESASr-D, respectively) as screening tools have not been evaluated in patients treated with renal replacement therapy. Kidney transplant recipients and patients on dialysis were recruited in Toronto. Patients were classified as having moderate/severe depression and anxiety symptoms using the established cut-off score of ≥ 10 on the Patient Health Questionnaire-9 (PHQ-9) and the General Anxiety Disorder-7 (GAD-7) questionnaires. This study included 931 participants; 62% male, mean age (SD) 55(16), and 52% White. All participants completed ESASr, however only 748 participants completed PHQ-9 and 769 participants completed GAD-7. Correlation between ESASr item scores and legacy scores were moderately strong (ESASr-D/PHQ-9: 0.61; ESASr-A/GAD-7: 0.64). We found good discrimination for moderate/severe depression and anxiety [area under the receiver operating characteristics curve (95% CI) ESASr-D 0.82(0.78-0.86); ESASr-A 0.87 (0.82, 0.92)]. The cut-off ≥ 2 for ESASr-D [Sensitivity = 0.76; Specificity = 0.77; Likelihood Ratio (LR) + = 3.29; LR - = 0.31] and ≥ 4 for ESASr-A (Sensitivity = 0.75; Specificity = 0.87; LR + = 5.76; LR - = 0.29) had the best combination of measurement characteristics. The identified ESASr-D and ESASr-A cut-off scores may be used to rule out patients without emotional distress with few false negatives. However, the low sensitivity identified in our analysis suggests that neither ESASr-D or ESASr-A are acceptable as standalone screening tools.

The prevalence of anxiety and depression in transgender people living in russia

IntroductionThe prevalence rates of mental health issues, particularly anxiety and depression, is high among transgender people. However, the incidence of anxiety and depression in transgender people living in Russia is unclear until now.ObjectivesTo examine the frequency of anxiety and depression in transgender people living in Russia.MethodsThe Hospital Anxiety and Depression Scale (HADS) was used for online screening for symptoms of anxiety and depression in transgender people living in Russia throughout November 2019. 588 transgender adults living in all Federal Districts of Russia (mean age 24.0±6.7) were included in the final analysis. 69.6% (n=409) of the survey participants indicated the direction of transition as transmasculine (TM), 23.1% (n=136) – as transfeminine (TW), and 7.3% (n=43) – as other (TO).ResultsIt was found that 45.1% (n=265) and 24.0% (n=141) of transgender people had clinically significant levels of anxiety and depression, respectively (HADS score of 11 or higher). The rates of anxiety (TM=10.21±4.68; TW=8.72±3.91; TO=10.72±4.43) and depression (TM=7.53±4.09; TW=7.40±4.19; TO=7.74±4.33) did not have statistically significant differences within the direction of transition. The anxiety and depression mean scores in all subgroups were statistically significantly higher than in the general Russian population (p&lt;0.001; one sample t-test).ConclusionsOur findings suggest a high prevalence of depression and anxiety disorders in the transgender population as compared to the cisgender population in Russia. The identified frequency of anxiety and depression in transgender people in Russia is worrying and requires immediate action to improve the availability and quality of medical and psychological care for this group of people.DisclosureNo significant relationships.

Early signs of autism in infants whose mothers suffered from a threatened preterm labour: a 30-month prospective follow-up study.

Infants born after a threatened preterm labour (TPL infants) are at high risk of autism spectrum disorder (ASD). Studying this population may provide insight on the pathophysiological underpinnings of this condition. This study aimed to (i) ascertain the presence and autistic symptom load in TPL infants aged age 30months relative to non-TPL infants, regardless of preterm birth; (ii) explore the association between early (at 6months) psychomotor development and temperament features with the autistic symptom load of TPL infants at age 30months and (iii) examine the association among perinatal risk factors for ASD development with the autistic symptom load of TPL infants at age 30months. A group of 111 mother-infant pairs recruited at TPL diagnosis and a group of 47 healthy mother-infant controls completed the follow-up. Irrespective of preterm birth, TPL infants showed higher autistic symptom load at age 30months than non-TPL infants. TPL infants presented poorer communication and problem-solving skills, reduced smiling and laughter, and greater vocal reactivity at age 6months, predicting higher autistic symptom load at age 30months. Higher levels of anxiety symptoms in TPL mothers after a TPL diagnosis also predicted higher autistic symptom load for the infants at age 30months. These results suggest that TPL infants may be an undescribed cluster, with features that differentiate them from other "at-risk" populations. These findings support the need for routine assessment of TPL infants and screening of anxiety symptoms in mothers.

Joint Hypermobility Classes in 9-Year-Old Children from the General Population and Anxiety Symptoms.

To obtain joint hypermobility classes in children from the general population and to study their characteristics in relation to anxiety measures. A total of 336 nine-year-old children from the general population were clinically assessed through 9 items of hypermobility, and their parents reported about the severity of anxiety symptoms. Latent class analysis was estimated to group the children according to the presence of hypermobility symptoms, and the obtained classes were related to anxiety. A 2-class solution, labeled as high hypermobility and low hypermobility, best fitted the data. Children in the high hypermobility group scored higher in separation anxiety, social phobia, physical injury fears, and total anxiety than did those in the low group. When applying the threshold reference scores to the total anxiety score, 7.4% of children in the high hypermobility group versus 6% in the low group were reported to experience clinical elevations on total anxiety. High symptoms of hypermobility are associated with higher scores in anxiety symptoms in children from the general population. Children with frequent symptoms of hypermobility may benefit from screening for anxiety symptoms because a subset of them are experiencing clinical elevations and may need comprehensive physical and psychological treatment.

Family Health-related Quality of Life in Pediatric Cyclic Vomiting Syndrome.

The aim of the study was to evaluate the relationship of disease characteristics and child anxiety symptoms to family health-related quality of life (FHRQoL) in youth with cyclic vomiting syndrome (CVS). Forty-two parents of youth ages 8 to 18 years diagnosed with CVS completed the Family Impact Module of the PedsQL, a measure of the impact of the child's illness on the family. We evaluated the relationship of disease characteristics and child and parent proxy reports of anxiety symptoms on the Screen for Childhood Anxiety and Related Emotional Disorders to FHRQoL. Parent report of child anxiety symptoms and missed school days (mean = 11.93, standard deviation = 14.62) were the strongest predictors of FHRQoL (r = 0.33, df = 1.39, F = 8.51, P = 0.006). Other disease characteristics, including frequency, duration, chronicity of CVS episodes, and delay in initial CVS diagnosis were not significantly associated with the FHRQoL total score. Child anxiety symptoms by either parent and/or child report were associated with subscales of the FHRQoL, including family physical functioning, family communication, and family daily activities. HRQoL for the families assessed in this study was associated with anxiety symptoms to a greater extent than disease characteristics, indexing the importance of a biopsychosocial approach to CVS management. Screening for anxiety symptoms and support for school absences due to illness are indicated to help lessen the impact of CVS on the family as a whole.

Screening for symptoms of anxiety and depression in patients admitted to a university hospital with acute coronary syndrome.

To investigate the prevalence of anxiety and depression in patients admitted for acute coronary syndrome to a university hospital and to examine associations with use of psychotropic drugs. Ninety-one patients who had had an acute coronary event were enrolled on this cross-sectional prevalence study. Characteristics of the study population and the prevalence rates of depression and anxiety in the sample were assessed using the Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) psychiatric consultation protocol, which includes clinical and sociodemographic data, and the Hospital Anxiety and Depression Scale (HADS). The prevalence of symptoms of anxiety was 48.4% (44 patients) and the prevalence of depressive symptoms was 26.4% (24 patients). Of these, 19 patients (20.9% of the whole sample) had scores indicative of both types of symptoms concomitantly. Considering the whole sample, just 17 patients (18.7%) were receiving treatment for anxiety or depression with benzodiazepines and/or antidepressants. Anxiety and depression are disorders that are more prevalent among patients with acute coronary syndrome than in the general population, but they are generally under-diagnosed and under-treated. Patients with anxiety and depression simultaneously had higher scores on the HADS for anxiety and depression and therefore require more intensive care.

318 Prevalence and impact of anxiety and depression symptoms in adolescents and adults with cystic fibrosis in Spain

Objectives: It has been shown that a chronic disease involves a significant risk for developing depression and anxiety symptoms. The impact of anxiety and depression on quality of life is well known in adults but not among adolescents. The aim of the study is to estimate the prevalence of depression and anxiety in adolescents with CF and to describe their health-related quality of life. Methods: 26 patients, age 12 to 17 were recruited. Mean age 15. Participants completed the Hospital Anxiety and Depression Scale (HADS) including 14 items on a Likkert scale (cut off mild = 7, severe = 10) and the Cystic Fibrosis Quality of Life Questionnaire (CFQ-R) (8 sub-domains in proportions of 100%). Results: HADS shows a depression mean of 2 (range 0−15) and an anxiety mean of 4 (range 0−11). The CFQ-R sub-domains means: physical 88% (range 42–100), emotional state 79% (range 46–100), social 78% (range 44–100), body image 82% (range 44–100), eating 86% (range 22–100), treatment burden 63% (range 0−89), respiratory 76% (range 50–100), digestion 74% (range 33–100). Conclusions: Anxiety and depressive symptoms are not very common among CF adolescents at Stockholm CF-center but there are some patients that suffer from both depression and anxiety. The symptoms of anxiety appears to occur to a greater extent than depression. Among the domains of CF quality of life the treatment burden was the most troubling. A routine screening for symptoms of anxiety, depression and health-related quality of life is important in the prevention of mental illness. Those identified with elevated clinical symptoms need appropriate treatment.

319 Anxiety and depression symptoms in caregivers of children and adolescents with cystic fibrosis in Spain

Objectives: It has been shown that a chronic disease involves a significant risk for developing depression and anxiety symptoms. The impact of anxiety and depression on quality of life is well known in adults but not among adolescents. The aim of the study is to estimate the prevalence of depression and anxiety in adolescents with CF and to describe their health-related quality of life. Methods: 26 patients, age 12 to 17 were recruited. Mean age 15. Participants completed the Hospital Anxiety and Depression Scale (HADS) including 14 items on a Likkert scale (cut off mild = 7, severe = 10) and the Cystic Fibrosis Quality of Life Questionnaire (CFQ-R) (8 sub-domains in proportions of 100%). Results: HADS shows a depression mean of 2 (range 0−15) and an anxiety mean of 4 (range 0−11). The CFQ-R sub-domains means: physical 88% (range 42–100), emotional state 79% (range 46–100), social 78% (range 44–100), body image 82% (range 44–100), eating 86% (range 22–100), treatment burden 63% (range 0−89), respiratory 76% (range 50–100), digestion 74% (range 33–100). Conclusions: Anxiety and depressive symptoms are not very common among CF adolescents at Stockholm CF-center but there are some patients that suffer from both depression and anxiety. The symptoms of anxiety appears to occur to a greater extent than depression. Among the domains of CF quality of life the treatment burden was the most troubling. A routine screening for symptoms of anxiety, depression and health-related quality of life is important in the prevention of mental illness. Those identified with elevated clinical symptoms need appropriate treatment.

Associations of symptoms of anxiety and depression with diabetes and cardiovascular risk factors in older people with intellectual disability

Depression, anxiety, diabetes and cardiovascular risk factors are frequent health problems among older people with intellectual disability (ID). These conditions may be bidirectionally related. Depression and anxiety may have biological effects causing glucose intolerance, fat accumulation and also lifestyle changes causing metabolic syndrome. But also the effects of diabetes, metabolic syndrome and subsequent cardiovascular disease may affect mood and anxiety. This study investigated the association between depression, anxiety and diabetes and cardiovascular risk factors in older people with ID. The healthy ageing in intellectual disability-study (HA-ID study) is a cross-sectional study among people aged 50 years and over with ID, receiving formal ID care. Screening instruments for symptoms of anxiety and depression were completed and physical examination and vena-puncture were performed to establish components of the metabolic syndrome, peripheral arterial disease and c-reactive protein. Of the 990 people who participated, 17% had symptoms of depression and 16% had symptoms of anxiety. Type I diabetes was present in 1%, type II diabetes in 13% of the study population. Metabolic syndrome, central obesity, hypercholesterolemia and hypertension were present in 45%, 48%, 23% and 53% respectively. In a multivariate logistic regression analysis a significant association was found between increased anxiety symptoms and diabetes only (OR 2.4, 95%CI 1.2-4.9). Increased anxiety symptoms and diabetes are related in older people with ID. This association may be bidirectional. No other associations of depression and anxiety symptoms with cardiovascular risk factors could be proven to be significant. Therefore, more research is needed to unravel the mechanisms of stress, mood disorders and cardiovascular disease in older people with ID. To provide comprehensive care for older people with ID, screening for diabetes and components of the metabolic syndrome in people with anxiety or mood disorders, and screening for symptoms of anxiety or depression in people with diabetes is warranted.

Screening for Anxiety Symptoms in Parkinson Disease

A limited number of studies examined anxiety in Parkinson disease (PD). Questionable validity of the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) defined anxiety disorders in PD population as well as a lack of validated rating scales hampered the investigation in this field. To screen for prevalence of anxiety symptoms and their associated demographic and clinical features in an outpatient-based cohort with PD. A consecutive series of 360 patients with PD underwent investigation with the Hamilton Anxiety Rating Scale (HARS), the 17-item Hamilton Depression Rating Scale, Neuropsychiatric Inventory, section E (anxiety), motor scoring with Hoehn and Yahr staging, the Unified Parkinson's Disease Rating Scale, and cognitive screening with the Mini-Mental State Examination. In all, 136 (37.8%) patients with PD of our cohort had anxiety symptoms, whereas both depression and anxiety were recorded in 5.6% of the patients, while in 56.7% neither anxiety nor depression was present. Female gender, motor disability, and core depression symptoms were the main markers of anxiety in patients with PD. The severity of anxiety symptoms was not associated with asymmetry of motor symptoms. Education, disease duration, and levodopa dose were poor predictors in the model. The HARS had a satisfactory inter-item correlation, convergent validity, and factorial structure. Anxiety may be present as an isolated symptom, with specific demographic and clinical markers, and not only as a feature of depression in PD population. This highlighted the importance of identifying anxiety symptoms when treating patients with PD.

Screening for anxiety symptoms and social desirability in children and adolescents living with chronic illnesses in Jordan

This research aims to investigate the rate and nature of anxiety symptoms in a group of children and adolescents living with chronic illnesses in Jordan, and their relation to social desirability in a cultural sample not previously researched. Using the Revised Children's Manifest Anxiety Scale (R-CMAS), anxiety and social desirability data were obtained from 114 children diagnosed with chronic illnesses and 162 healthy control participants. Based on children's self-report, participants were categorized according to their adaptive style paradigm as either high anxious, low anxious, or repressor. It was proposed that children who score high on social desirability and low on anxiety are repressors. The prevalence of these categories was compared across the two groups. Anxiety was reported in 9.64 percent of the chronic illnesses and 12.34 percent of the healthy peers. Using the data obtained in the present study, the rate and nature of anxiety in children with chronic illnesses were lower for children in Jordan when compared to previous studies. However, social desirability values were similar to those established in Western societies suggesting a significantly higher percentage of children identified as repressors in children with long-term illnesses. These results supported the hypothesis regarding the relationship between social desirability and expressed anxiety symptoms.