Severity Of State Anxiety Research Articles

FREQUENCY OF ANXIETY DISORDERS IN PATIENTS WITH ARTERIAL HYPERTENSION AND COMORBID DISEASES

Background. Anxiety is more common in patients with hypertension. The comorbid presence anxiety disorders and arterial hypertension complicates medical treatment, may change the severity and/or progression of disease.
 Objective. To study the influence of comorbid diseases on the development of anxiety disorders in patients with hypertension in outpatient practice.
 Methods. This observational cohort study employed the State‐Trait Anxiety Inventory (STAI, Spielberger anxiety scale) to assess symptoms of anxiety in several groups with hypertension. The study cohort included 360 patients with isolated hypertension, 172 patients with hypertension in combination with obesity and 72 patients with comorbid hypertension and type 2 diabetes mellitus (DM)
 Results. A high incidence of anxiety disorders was found in patients with hypertension 98.06% regardless of the presence of obesity 97.09% and type 2 diabetes 98.18%. The incidence and severity of trait anxiety in the examined patients was the lowest in the group of patients with hypertension in combination with obesity 59.65%, compared with patients with isolated hypertension 68.61% p =0.042045 and the group of hypertension in combination with type 2 diabetes 78.18% p=0.012662. According to the severity of the combination of hypertension with obesity, patients with a low 40.35% and an average 41.52% indicator of trait anxiety prevailed, in patients with hypertension in combination with type 2 diabetes, an average 52.73% and a high 25.45% level of anxiety were more often observed (p<0.5).
 The presence of type 2 diabetes increases the frequency and severity of state anxiety in patients with hypertension. Thus, patients with hypertension in combination with type 2 diabetes were more likely to have a high (50.91%) level of state anxiety, while patients with isolated hypertension were more likely to have low (5.56%) and medium (70.35%) levels of anxiety disorders.

The effect of reflexology massage and passive music therapy intervention before burn dressing on pain, anxiety level and sleep quality

BackgroundThe pain, anxiety, and sleep disorders that burn patients experience due to burn dressing negatively affect their treatment process. The aim of this study was to determine the effect of reflexology massage and passive music therapy intervention before burn dressing on pain, anxiety level and sleep quality. MethodsThis study was a randomized controlled trial. The study sample consisted of 36 patients who were hospitalized in the Burn Center of a University Hospital. After obtaining written consent, patients were enrolled to study according to inclusion criteria and then, divided into Reflexology Massage (n = 12), Reflexology Massage with Passive Music Therapy (n = 12) and Control (n = 12) groups using simple random allocation. In the experimental groups, in addition to standard care, interventions were performed for consecutive three days. Interventions were done before dressing for 40 min in the patient’s room. The control group received only standard care during this time. Severity of pain in three groups was measured using “Visual Analog Scale” twice a day (before dressing change and 2 h after dressing change). Severity of state anxiety and sleep quality in three groups was measured using “State Anxiety Scale” and “Richards-Campbell Sleep Questionnaire” once a day (before dressing change). Severity of trait anxiety in three groups was measured using “Trait Anxiety Scale” for two times (before and after study). The drugs used by the patients for 3 days were recorded in the “Opioid and Analgesic Drug Form.” Data were analyzed using Pearson Chi-square, Independent Samples T-test, One-Way ANOVA, Bonferroni, Paired Sample T-Test, Repeated Measures ANOVA tests were used. ResultsThe results showed no significant difference in severity of pain, anxiety, and sleep quality (p > 0,05) between the three groups on the first day. However, the mean pain scores showed a significant difference between the experimental and control groups in the third (p < 0,05) and fourth (p < 0001) days after intervention. Anxiety scores also showed a significant difference between the experimental and control groups on the fourth (p < 0001) day. Sleep quality of the experimental groups was higher than the control group on the fourth day (p < 00001). No significant difference using of opioid and analgesic drugs between the three groups (p > 0,05). ConclusionsOur results showed reflexology massage and passive music therapy before burn dressing reduced pain and anxiety level, and increased sleep quality.

Anxiety profiles are associated with stress, resilience and symptom severity in outpatients receiving chemotherapy.

The purposes of this study, in a sample of oncology patients (n = 1326) receiving chemotherapy, were to identify subgroups of patients with distinct anxiety profiles and evaluate for differences in demographic and clinical characteristics, stress and resilience measures, and severity of co-occurring symptoms (i.e., depression, sleep disturbance, attentional function, fatigue, pain). Patients completed self-report questionnaires a total of six times over two cycles of chemotherapy. Severity of state anxiety was evaluated using the Spielberger State Anxiety Inventory and resilience was assessed using the Connor-Davidson Resilience Scale. Symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, General Sleep Disturbance Scale, Lee Fatigue Scale, Attentional Function Index and Brief Pain Inventory. Based on the findings from the latent profile analysis that utilized the six assessments of state anxiety, 47.7% of the patients were classified as "Low," 28.3% as "Moderate," 19.5% as "High," and 4.5.% as "Very High." Anxiety levels remained relatively stable across the six timepoints. Compared to the Low class, membership in the Moderate, High, and Very High classes was associated with a number of characteristics (e.g., younger age, female gender, lower functional status, more comorbidities). Those patients with higher levels of anxiety reported higher levels of stress, lower levels of resilience, and increased severity of co-occurring symptoms. Our findings suggest that a substantial number of oncology patients may warrant referral to psychological services. Clinicians need to perform systematic assessments of anxiety, stress, and common symptoms and initiate appropriate interventions to enhance resilience and coping.

Single nucleotide polymorphisms in tinnitus patients exhibiting severe distress

The association between distress caused by tinnitus and psychological factors such as depression and anxiety has been examined and reported. However, prognostic factors remain poorly understood because there are only a few reports on genetic associations. We theorized there might be an association between the grade of tinnitus distress and the genetic background related to psychological factors which might lead us to identify prognostic markers. We enrolled 138 patients who had suffered from tinnitus for over 3 months. Using Tinnitus Handicap Inventory (THI) scores, we examined the association between tinnitus distress and a genetic background related to depression or anxiety. A significant association between single nucleotide polymorphism rs131702 of the Breakpoint Cluster Region (BCR) gene and the severe THI score was identified. In addition, there was an association with the severity of the State-Trait Anxiety Inventory, an index of state anxiety severity. No association was found with the Self-Rating Depression Scale, an index of depression severity. It is reported that rs131702 of BCR in Japanese patients are related to bipolar II depression characterized by fluctuation between abnormal mood states of mania and depression. Our results indicate that rs131702 of BCR is independent of depression in this study and is, therefore, a prognostic factor unique to tinnitus. We conclude that the severity of tinnitus is associated with genes related to depression.

Yatarak tedavi gören alkol kullanım bozukluğu hastaları örnekleminde TSSB semptomlarının şiddeti ve alkolle ilişkili sorunlarla ilişkisi

Objective: The aim of the present study was to evaluate the effect of post-traumatic stress disorder (PTSD) symptoms measured with the PTSD Checklist Civilian (PCL-C) version on the severity of alcohol-related problems while controlling for the effects of anxiety and depression in a sample of inpatients with alcohol use disorder (AUD). Method: Participants (n=190) were evaluated with the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory State Subscale (STAI-S), the PTSD Checklist Civilian (PCL-C) Version and the Michigan Alcohol Screening Test (MAST). Results: Although severity of the state of anxiety predicted the severity of alcohol-related problems in the first and depression in the second step of a linear regression model, when severity of PTSD symptoms was included in the analysis, it was the only independent variable that predicted the severity of alcohol-related problems while the state of anxiety and depression were no longer predictors. Conclusion: These findings suggest that the severity of PTSD symptoms is related to the severity of alcohol-related problems, independent from severity of state anxiety and depression among inpatients with AUD.

ID 328 – Anxiety-related increase of functional connectivity in the ventromedial prefrontal network in Parkinson’s disease

Objective Anxiety is a common symptom of Parkinson’s disease (PD) negatively influencing quality of life. To identify brain regions associated with this symptom we compared resting brain connectivity to subjective assessment of anxiety. Participants and methods Using the resting state-fMRI (3T, TR = 2s, 300 scans) we analysed spontaneous signal fluctuations in 25 PD patients (66.7 ± (SD) 7.4 years) in their OFF and ON medication states. The State-Trait Anxiety Inventory was used to assess the severity of anxiety immediately before each fMRI session. To evaluate brain connectivity we used method of Eigenvector centrality (EC) detecting voxels with high-ranking connections to voxels, which are also important hubs within the network. Results While the trait anxiety score did not change between the sessions, the state anxiety increased during OFF compared to ON condition (p 0.01). Severity of state anxiety was positively correlated with EC values in the right ventromedial prefrontal cortex and both caudates (P 0.05 FWE cluster corrected). Conclusions The state anxiety worsening in the OFF medication state was accompanied by increase of the functional connectivity in the regions belonging to the limbic network. Key message As expected, actual limbic network shows abnormal synchronization related only to the actual state of anxiety. Supported by LH13256-VES13-KontaktII; PRVOUK-P26/LF1/4.

Levels in neurotransmitter precursor amino acids correlate with mental health in patients with breast cancer

Breast cancer is the most common cancer among females. Approximately 30% of cancer patients develop depression or depressive adaptation disorder within 5 years post diagnosis. Low grade inflammation and subsequent changes in neurotransmitter levels could be the pathophysiological link. In the current study we investigated the association of neurotransmitter precursor amino acids with a diagnosis of depression or state anxiety in 154 subjects suffering from breast cancer (BCA(+)), depression (DPR(+)), both or neither. Sociodemographic parameters, severity of depressive symptoms, and state anxiety (ANX) were recorded. Neopterin, kynurenine/tryptophan and phenylalanine/tyrosine were analysed by HPLC or ELISA. Significantly higher serum neopterin values were found in DPR(+) patients (p = 0.034) and in ANX(+) subjects (p = 0.008), as a marker of Th1-related inflammation. The phenylalanine/tyrosine ratio (index of the catecholamine pathway) was associated with the factors "breast cancer" and "depression" and their interaction (all p < 0.001); it was highest in the DPR(+)BCA(+) group. The kynurenine/tryptophan ratio (index of the serotonin pathway) was significantly associated with the factors "breast cancer" and "state anxiety" and their interaction (p < 0.001, p = 0.026, p = 0.02, respectively); it was highest in the ANX(+)BCA(+) group. In BCA(+) patients kynurenine/tryptophan ratios correlated with severity of state anxiety (r = 0.226, p = 0.048, uncorrected) and phenylalanine/tyrosine ratios with severity of depressive symptoms (r = 0.376, p < 0.05, corrected). In conclusion, levels of neurotransmitter precursor amino acids correlate with mental health, an effect which was much more pronounced in BCA(+) patients than in BCA(-) subjects. Aside from identifying underlying pathophysiological mechanisms, these results could be the basis for future treatment studies: in BCA(+) patients with depression the use of serotonin-noradrenaline reuptake inhibitors might be recommended while in those with predominant anxiety selective serotonin reuptake inhibitors might be the treatment of choice.

Analysis of the severity of anxiety in a group of pregnant women hospitalized for threatened premature delivery

Abstract Introduction An important element that contributes to the increase of the level of anxiety in pregnant women is threatened preterm labor and the need for hospitalization in pregnancy pathology department. Fear of low intensity, by induction of autonomic and endocrine response, can stimulate defense mechanisms of the body, thus, to a certain extent, having beneficial effects on pregnancy. In contrast, excessive and imprinted fear has negative effects by predisposing to pregnancy and fetal development disorders. Aim The aim of the study is to assess the level of anxiety, as a trait and as a state, in a group of pregnant women hospitalized for preterm labor in relation to socio-demographic factors and obstetric situation. Material and methods The study included 313 pregnant women hospitalized for threatened preterm labor. Research tools included a questionnaire of own authorship developed to determine characteristics of pregnant subjects and a standardized State-Trait Anxiety Inventory (STAI). Results and discussion The mean score of state anxiety (STAI X-1) in the group of pregnant women was 44.27 ± 9.84, with the score range 20–73 points, which indicates a high level of state anxiety. On the other hand, the mean score of trait anxiety (STAI X-2) in the study group was 44.52 ± 8.93, with the score range 20–90 points, which indicates the average level of trait anxiety. There was no statistically significant relationship between the intensity of state anxiety and marital status, place of residence and obstetric situation in the study ( P > 0.05), while significant differences were found between the severity of state anxiety and the age and education of the respondents. Statistical analysis showed no significant differences between intensity of anxiety and age, marital status and obstetric situation ( P > 0.05). Conclusions Pregnant women hospitalized due to preterm labor, who were included in the study, were characterized by high levels of state anxiety and average levels of trait anxiety.

Reduced resting-state functional connectivity between amygdala and orbitofrontal cortex in social anxiety disorder

Social anxiety disorder patients suffer from excessive anxious responses in social interaction leading to avoidance behavior and social impairment. Although the amygdala has a central role in perception and processing of threatening cues, little is known about the involved networks and corresponding dysfunctions in social anxiety. Therefore, this study aims to investigate the functional connectivity network of the amygdala in patients with social anxiety disorder and to identify regions that might influence amygdalar reactivity via modulatory pathways.Ten patients with anxiety disorders (social and/or panic) and 27 healthy controls underwent a facial emotion processing task as well as 6-min functional MRI at resting state. Individual voxel-wise functional connectivity maps were calculated using the amygdala as seed region. Group comparisons were done by random-effects analysis in SPM.Patients exhibited an amygdala hyperactivation during the emotional task and decreased functional coupling of the left amygdala with the medial orbitofrontal cortex and the posterior cingulate cortex/precuneus. The strength of this functional connectivity showed a negative association with the severity of state anxiety. In addition, an exploratory analysis revealed further reduced functional connectivity and a marked functional separation between the medial orbitofrontal and anterior cingulate cortices in the patient group.Our results suggest alterations within the amygdalar functional connectivity network in social anxiety disorder. Combined with the amygdalar hyperactivation our findings corroborate the proposed dysfunction of the fronto-amygdalar inhibition in anxiety disorders and indicate a modulatory influence of the anterior and posterior cingulate cortices on threat perception and processing.

Differences in Temperament, Character and Psychopathology among Subjects with Different Patterns of Cannabis Use

Background: Patients who use illicit drugs and suffer from comorbid psychiatric illnesses have worse outcomes than drug users without a dual diagnosis. For this reason we aimed at identifying predictors of cannabis use severity using a multivariate model in which different clinical and socio-demographic variables were included. Sampling and Methods: We administered the Temperament and Character Inventory, SCID-P, SCID-II, the Beck Depression Inventory and the State-Trait Anxiety Inventory. Of the 84 subjects included, 25 were occasional users, 37 were abusers, and 22 were dependent on cannabis. Results: A stepwise multiple regression analysis identified increased self-transcendence scores and state anxiety severity as the only predictors of a increased cannabis use severity (F = 6.635; d.f. = 2, 81; p = 0.0021). In particular, in a further multivariate analysis of variance, the transpersonal identification issue of self-transcendence was associated significantly (F = 4.267; d.f. = 2, 81; p = 0.017) with greater severity of cannabis use. Conclusions: Character dimension of self-transcendence and symptoms of state anxiety should be taken into consideration during the assessment procedure of patients with cannabis use as they may be helpful in the discrimination of cannabis use severity.

The Impact of Physical, Psychological, and Sexual Intimate Male Partner Violence on Women's Mental Health: Depressive Symptoms, Posttraumatic Stress Disorder, State Anxiety, and Suicide

This study aimed to determine the impact of lifetime physical, psychological, and sexual intimate male partner violence (IPV) on the mental health of women, after controlling for the contribution of lifetime victimization. The comorbidity of depressive symptoms and posttraumatic stress disorder (PTSD) and their relation to state anxiety and suicide were also assessed. Physically/psychologically (n = 75) and psychologically abused women (n = 55) were compared with nonabused control women (n = 52). Information about sociodemographic characteristics, lifetime victimization, and mental health status (depressive and state anxiety symptoms, PTSD, and suicide) was obtained through face-to-face structured interviews. Women exposed to physical/psychological and psychological IPV had a higher incidence and severity of depressive and anxiety symptoms, PTSD, and thoughts of suicide than control women, with no differences between the two abused groups. The concomitance of sexual violence was associated with a higher severity of depressive symptoms in both abused groups and a higher incidence of suicide attempts in the physically/psychologically abused group. The incidence of PTSD alone was very rare, and depressive symptoms were either alone or comorbid with PTSD. The severity of state anxiety was higher in abused women with depressive symptoms or comorbidity, as was the incidence of suicidal thoughts in the physically/psychologically abused group. Lifetime victimization was not a predictor of the deterioration of mental health in this study. These findings indicate that psychological IPV is as detrimental as physical IPV, with the exception of effects on suicidality, which emphasizes that psychological IPV should be considered a major type of violence by all professionals involved.

Assessment of Anxiety in Intensive Care Patients By Using the Faces Anxiety Scale

Anxiety is difficult to detect in patients receiving mechanical ventilation because clinical signs are confounded and patients often cannot respond to validated anxiety measures. Most patients can respond to the single-item Faces Anxiety Scale. To assess the validity of the Faces Anxiety Scale, the frequency and severity of state anxiety, and correlates of anxiety in intensive care patients. A research assistant made a single clinical judgment of anxiety in the range of 1 to 10 on the basis of patients' nonverbal responses (ie, nods) to 9 questions about mood and their physical and behavioral signs. Patients then responded to the Faces Anxiety Scale. Demographic, clinical, and pharmacological data were obtained from the patients' charts. Mean age of the 106 patients was 61 years; 62% were men. Admission diagnoses were cardiovascular in 26% of patients, respiratory in 26%, trauma in 18%, neurological in 12%, gastrointestinal in 12%, and other in 6%. At the time of anxiety assessment, 89% were receiving mechanical ventilation. The correlation between patients' self-reports of anxiety on the Anxiety Faces Scale and the research assistant's assessments was 0.64 (P <.001). Some anxiety was reported by 85% of patients (mean level 2.9; SD 1.2). Anxiety levels were lower in patients who had recently received sedatives or opioids but were not related to heart rate or blood pressure. The Faces Anxiety Scale is a valid means of measuring anxiety in intensive care patients. Anxiety is common in these patients and is often moderate to severe.

Cytokine production in panic disorder patients.

Based on findings that stress and anxiety may modulate immune function, we compared the production of interleukin-2 (IL-2) and interleukin-3 (IL-3) by peripheral blood mononuclear cells between 24 patients with nonmajor depressed panic disorders, 9 with agoraphobia and 15 without, and 19 healthy volunteers. No differences in the production of these cytokines was noted between the patients with panic disorders and the volunteers or between the patients with and without agoraphobia. However, in the patients, a negative correlation was found for interleukin-3 production with severity of state anxiety, but not with trait anxiety or depression. This finding indicates that interleukin-3 levels may be sensitive to the presence of anxiety and stress.