Subclinical Anxiety Symptoms Research Articles

Efficacy of an Internet- and Mobile-Based Intervention for Subclinical Anxiety and Depression (ICare Prevent) with Two Guidance Formats: Results from a Three-Armed Randomized Controlled Trial

Introduction: Limited research exists on intervention efficacy for comorbid subclinical anxiety and depressive disorders, despite their common co-occurrence. Internet- and mobile-based interventions (IMIs) are promising to reach individuals facing subclinical symptoms. Objective: This study aimed to evaluate the efficacy of a transdiagnostic and self-tailored IMI in reducing subclinical anxiety and depressive symptom severity with either individualized (IG-IMI) or automated (AG-IMI) guidance compared to a waitlist control group with care-as-usual access (WLC). Methods: Participants included 566 adults with subclinical anxiety (GAD-7 ≥ 5) and/or depressive (CES-D ≥16) symptoms, who did not meet criteria for a full-syndrome depressive or anxiety disorder. In a three-arm randomized clinical trial, participants were randomized to a cognitive behavioral 7-session IMI plus booster session with IG-IMI (n = 186) or AG-IMI (n = 189) or WLC (n = 191). Primary outcomes included observer-rated anxiety (HAM-A) and depressive (QIDS) symptom severity 8 weeks after randomization assessed by blinded raters via telephone. Follow-up outcomes at 6 and 12 months are reported. Results: Symptom severity was significantly lower with small to medium effects in IG-IMI (anxiety: d = 0.45, depression: d = 0.43) and AG-IMI (anxiety: d = 0.31, depression: d = 0.32) compared to WLC. No significant differences emerged between guidance formats in primary outcomes. There was a significant effect in HAM-A after 6 months favoring AG-IMI. On average, participants completed 85.38% of IG-IMI and 77.38% of AG-IMI. Conclusions: A transdiagnostic, self-tailored IMI can reduce subclinical anxiety and depressive symptom severity, but 12-month long-term effects were absent. Automated guidance holds promise for enhancing the scalability of IMIs in broad prevention initiatives.

Cognitive-Behavioral Intervention for Pediatric Rumination Disorder: A Single Case Experimental Design

This report presents the single case of Liam, a 10-year-old boy with rumination disorder (RD) and subclinical symptoms of anxiety. The primary aim was to explore the effectiveness of habit reversal therapy (HRT) in reducing regurgitation frequency in a young child. The secondary aim was to explore whether modular cognitive-behavioral techniques, based on idiosyncratic cognitive-behavioral formulations tailored to the child, may further augment the effect of habit reversal therapy on regurgitation frequency. An A-B-C design was utilized to compare regurgitation frequency and emotional distress across baseline, intervention (primary and secondary), and follow-up phases. Results demonstrated that HRT adapted for children was an effective approach to reducing regurgitation frequency. Self-monitoring alone and additional anxiety management skills provided further benefits to regurgitation frequency though to a lesser extent. Research on pediatric RD remains scarce, particularly regarding treatment for children of a younger age with additional psychological difficulties within clinical settings. Results from the current case study suggest that HRT adapted for children with RD and additional internalizing symptoms in a real-life clinical setting was feasible, acceptable, and effective. More research needs to be conducted on standardizing age-appropriate treatment adaptations for young children with RD and on exploring whether and which cognitive-behavioral techniques provide further meaningful reductions in regurgitation frequency.

Between Subclinical Symptoms of Depression and Anxiety and Nutritional Psychology, Including Mental Illness

Between Subclinical Symptoms of Depression and Anxiety and Nutritional Psychology, Including Mental Illness

Trajectories of change in subclinical anxiety and alcohol use during alcohol treatment: A parallel process growth model

BackgroundAnxiety is implicated in the course and prognosis of alcohol use disorder (AUD); however, it is unclear how current AUD treatments affect the joint trajectories of anxiety and alcohol use. We used data from the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence (COMBINE) study to examine the longitudinal relationship between subclinical anxiety symptoms and alcohol use during and following AUD treatment in adults with AUD and no comorbid anxiety disorders. MethodsUnivariate and parallel process growth models using five waves of COMBINE study data were analyzed from 865 adults randomized to medication (n = 429) or medication plus psychotherapy (n = 436). Weekly drinking quantity and average weekly anxiety symptoms were measured at baseline, mid-treatment, end-of-treatment, and three follow-up periods. ResultsSignificant positive associations of anxiety symptoms and drinking were found at mid-treatment and over time. Temporal associations revealed that higher mid-treatment anxiety predicted decreases in drinking over time. Baseline anxiety and drinking predicted mid-treatment anxiety and drinking. Only baseline anxiety predicted increases in drinking over time. Group differences revealed mid-treatment drinking predicted decreases in anxiety over time in the medication group. ConclusionsFindings demonstrate the influence of subclinical anxiety on alcohol use during and up to one year after AUD treatment. Baseline anxiety symptoms may influence drinking behavior over the course of treatment. Findings suggest that greater attention to negative affect in AUD treatment is warranted even for those individuals who do have a comorbid anxiety disorder.

FEATURES OF INFERTILITY-RELATED STRESS EXPERIENCED BY WOMEN

Studies emphasize the role of infertility-related stress in the development of infertility and the infl uence of psychological factors on success of treatment. The purpose of the study was to investigate characteristics of individual components of infertility-related stress such as anxiety, depression, emotional schemas, and stress coping strategies. The data were collected and processed with Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI); Fertility Quality of Life (FertiQoL) Questionnaire (by J. Boivin); Emotional Schemas Questionnaire II (LESS II) (by R.L. Leahy); and COPE Stress Coping Questionnaire adapted by T.O. Gordeeva, E.N. Osin, et.al., Mann-Whitney U nonparametric test for statistical analysis. A sample of  infertile women (the main group) and  women without infertility who were not planning pregnancy in the near future (control group) participated in the study. The study showed that the infertile women experience insuffi - cient satisfaction with their quality of life, subjective emotional distress, lack of social support, and some extent of marital dissatisfaction. Moreover, subclinical levels of anxiety and depression are accompanied by general intensity of emotional schemas and prevalence of such schemas as “Guilt about Emotions”, “Incomprehensibility”, “Invalidation by Others”, “Predicted Duration of Emotions”, “A Tendency to Ruminate”, “Simplistic View of Emotions”. In stressful situations, the women experiencing infertility-related stress tend to use behavioral strategies characterized by infl exibility, avoidance, denial, and rare use of positive reframing or humor. The study revealed various factors contributing to the infertility-related stress experienced by the infertile women: insuffi cient satisfaction with their quality of life, subjective emotional distress, lack of social support, and marital dissatisfaction. Moreover, subclinical symptoms of anxiety and depression are accompanied by general intensity of emotional schemas and a limited range of stress coping strategies.

Somatic symptoms mediate the association between subclinical anxiety and depressive symptoms and its neuroimaging mechanisms

BackgroundSubclinical anxiety, depressive and somatic symptoms appear closely related. However, it remains unclear whether somatic symptoms mediate the association between subclinical anxiety and depressive symptoms and what the underlying neuroimaging mechanisms are for the mediating effect.MethodsData of healthy participants (n = 466) and participants in remission of major depressive disorder (n = 53) were obtained from the Human Connectome Project. The Achenbach Adult Self-Report was adopted to assess anxiety, depressive and somatic symptoms. All participants completed four runs of resting-state functional magnetic resonance imaging. Mediation analyses were utilized to explore the interactions among these symptoms and their neuroimaging mechanisms.ResultsSomatic symptoms partially mediated the association between subclinical anxiety and depressive symptoms in healthy participants (anxiety→somatic→depression: effect: 0.2785, Boot 95% CI: 0.0958–0.3729; depression→somatic→anxiety: effect: 0.0753, Boot 95% CI: 0.0232–0.1314) and participants in remission of MDD (anxiety→somatic→depression: effect: 0.2948, Boot 95% CI: 0.0357–0.7382; depression→somatic→anxiety: effect: 0.0984, Boot 95% CI: 0.0007–0.2438). Resting-state functional connectivity (FC) between the right medial superior frontal gyrus and the left thalamus and somatic symptoms as chain mediators partially mediated the effect of subclinical depressive symptoms on subclinical anxiety symptoms in healthy participants (effect: 0.0020, Boot 95% CI: 0.0003–0.0043). The mean strength of common FCs of subclinical depressive and somatic symptoms, somatic symptoms, and the mean strength of common FCs of subclinical anxiety and somatic symptoms as chain mediators partially mediated the effect of subclinical depressive symptoms on subclinical anxiety symptoms in remission of MDD (effect: 0.0437, Boot 95% CI: 0.0024–0.1190). These common FCs mainly involved the insula, precentral gyri, postcentral gyri and cingulate gyri. Furthermore, FC between the triangular part of the left inferior frontal gyrus and the left postcentral gyrus was positively associated with subclinical anxiety, depressive and somatic symptoms in remission of MDD (FDR-corrected p < 0.01).ConclusionsSomatic symptoms partially mediate the interaction between subclinical anxiety and depressive symptoms. FCs involving the right medial superior frontal gyrus, left thalamus, triangular part of left inferior frontal gyrus, bilateral insula, precentral gyri, postcentral gyri and cingulate gyri maybe underlie the mediating effect of somatic symptoms.

Challenges in Recruiting University Students for Web-Based Indicated Prevention of Depression and Anxiety: Results From a Randomized Controlled Trial (ICare Prevent).

Depression and anxiety are common mental health conditions in college and university student populations. Offering transdiagnostic, web-based prevention programs such as ICare Prevent to those with subclinical complaints has the potential to reduce some barriers to receiving help (eg, availability of services, privacy considerations, and students' desire for autonomy). However, uptake of these interventions is often low, and accounts of recruitment challenges are needed to complement available effectiveness research in student populations. The aims of this study were to describe recruitment challenges together with effective recruitment strategies for ICare Prevent and provide basic information on the intervention's effectiveness. A 3-arm randomized controlled trial was conducted in a student sample with subclinical symptoms of depression and anxiety on the effectiveness of an individually guided (human support and feedback on exercises provided after each session, tailored to each participant) and automatically guided (computer-generated messages provided after each session, geared toward motivation) version of ICare Prevent, a web-based intervention with transdiagnostic components for the indicated prevention of depression and anxiety. The intervention was compared with care as usual. Descriptive statistics were used to outline recruitment challenges and effective web-based and offline strategies as well as students' use of the intervention. A basic analysis of intervention effects was conducted using a Bayesian linear mixed model, with Bayes factors reported as the effect size. Direct recruitment through students' email addresses via the central student administration was the most effective strategy. Data from 35 participants were analyzed (individually guided: n=14, 40%; automatically guided: n=8, 23%; care as usual: n=13, 37%). Use of the intervention was low, with an average of 3 out of 7 sessions (SD 2.9) completed. The analyses did not suggest any intervention effects other than anecdotal evidence (all Bayes factors10≤2.7). This report adds to the existing literature on recruitment challenges specific to the student population. Testing the feasibility of recruitment measures and the greater involvement of the target population in their design, as well as shifting from direct to indirect prevention, can potentially help future studies in the field. In addition, this report demonstrates an alternative basic analytical strategy for underpowered randomized controlled trials. International Clinical Trials Registry Platform NTR6562; https://tinyurl.com/4rbexzrk. RR2-10.1186/s13063-018-2477-y.

Proactive psychological and psychiatric support of patients with chronic non-communicable diseases in a randomised trial: a Ukrainian experience

BackgroundPresently, approaches for the early treatment of pathological anxiety in patients with chronic non-communicable diseases are lacking, thus delaying the initiation of symptom management at the early onset of the...

Decreases in State and Trait Anxiety Post-psilocybin: A Naturalistic, Observational Study Among Retreat Attendees.

Anxiety disorders are the most common type of psychiatric disorders among Western countries. Evidence-based treatment modalities including pharmacological and cognitive-behavioral therapy result in deficient treatment responses. Historical and recent research suggests psychedelic drugs may be efficacious in alleviating anxiety-related symptoms among healthy and clinical populations. The main aim of the present study was investigation of the effects of psilocybin-containing truffles, when taken in a supportive group setting, on ratings of state and trait anxiety across self-reported healthy volunteers. Attendees of psilocybin ceremonies were asked to complete a test battery at three separate occasions: before the ceremony (baseline), the morning after, and 1 week after the ceremony. The test battery included questionnaires assessing state and trait anxiety (State-Trait Anxiety Inventory), mindfulness capacities (Five Facet Mindfulness Questionnaire), and personality (Big Five Inventory). Additionally, the psychedelic experience was quantified with the Persisting Effects Questionnaire and the Ego Dissolution Inventory. The total amount of psilocybin-containing truffles consumed by each participant was recorded, and a sample of the truffles was analyzed to determine psilocin concentrations. Fifty-two attendees (males = 25; females = 25; others = 2) completed parts of the baseline assessment, 46 (males = 21; females = 24; others = 1) completed assessments the morning after the ceremony, and 23 (males = 10; females = 13) completed assessments at the 1-week follow-up. Average psilocin consumption across individuals was 27.1 mg. The morning after the ceremony, we observed medium reductions in anxiety measures (both state and trait) compared to baseline ( = 6.4; p < 0.001 and = 6; p = 0.014, respectively), which persisted over a 1-week period post-ceremony ( = 6.7; p = 0.001 and = 8.6; p = 0.004, respectively). At 1 week post-ceremony, the non-judging facet of the mindfulness scale was increased ( = 1.5; p = 0.03), while the personality trait neuroticism decreased ( = 5.2; p = 0.005), when compared to baseline. Additionally, we found ratings of ego dissolution (mean: 59.7, SD: 28.3) and changes in neuroticism to be the strongest predictors of reductions in state and trait anxiety, respectively. In sum, results suggest rapid and persisting (up to 1 week) anxiolytic effects in individuals with sub-clinical anxiety symptoms, which are related to the acute experience of ego dissolution, as well as lasting changes in trait neuroticism. Results also add support to the feasibility and potential efficacy of group sessions with psychedelics. To understand whether these effects extend to wider populations suffering from heightened anxiety, and the mechanisms involved, further experimental research is needed.

P428. Altered Trajectory of dMPFC Connectivity in Youth With Subclinical Anxiety and PTSD Symptoms

The default mode network (DMN) plays a crucial role in internal self-processing, rumination, and social functions. Alterations to DMN connectivity have been found in children with diagnosed mental health disorders, but the impact of subclinical psychopathology on DMN connectivity is less understood. Herein, we examine whether subclinical symptoms modulate DMN functional connectivity during the pubertal transition.

Prevention of Depression and Anxiety in Subclinical Adolescents: Effects of a Transdiagnostic Internet-Delivered CBT Program.

Anxiety and depressive symptoms are common problems in adolescence that could be addressed by means of preventive interventions. Even though transdiagnostic cognitive behavior therapy (T-CBT) is potentially an ideal strategy to deal with anxiety and depression, it has rarely been used for preventive purposes. In addition, so far, no study has used internet-delivered T-CBT to prevent anxiety and depression in adolescents. This study aimed to examine the utility of AMTE, an internet-delivered T-CBT program, for the indicated prevention of anxiety and depression in adolescents. AMTE was applied to 30 adolescents (56.7% females, age range = 12–18 years, Mage = 14.00, SDage = 1.89) who showed subclinical symptoms of anxiety and/or depression. Participants were assessed at pre- and post-treatment and follow-up (3 months). We found that after the program, the symptoms of self-reported anxiety and depression, clinician-rated symptom severity, and self-reported and parent-reported severity of the main problems had significantly improved. In addition, there were significant improvements in anxiety sensitivity and emotional avoidance. Finally, we found high feasibility and acceptability of the program. AMTE is feasible and potentially effective for the indicated prevention of anxiety and depression as well as of clinical transdiagnostic factors, in adolescents.

Neurological and neuropsychological characteristics of postconcussion syndrome following blast mild traumatic brain injury

A common complication of blast mild traumatic brain injury (mTBI) is postconcussion syndrome (PCS), the diagnostic criteria of which are based on the patient's subjective complaints. Creation of reliable tools for clinical signs of blast mild TBI objectification is of great priority. Objective: using a comprehensive neurological and neuropsychological examination to determine the characteristics of clinical signs of blast mild TBI in the long-term period to assess the correlation with the data of neurophysiological and radiological studies. Materials and methods. The study involved 115 male participants of hostilities in the East of Ukraine (main group) with a diagnosis of " PCS after previous blast mTBI " and 30 healthy individuals (control group). Patients were in the long-term period of injury (from 6 months to 3 years). After collecting complaints and medical history data, the neurological status and the state of cognitive functions were examined. The latter were studied using the questionnaire "Cicerone". Neuropsychological testing according to the Montreal Cognitive Assessment score (MoCA) was carried out. The Hospital Anxiety and Depression Scale (HADS) was also used, and to objectify asthenic disorders - the Asthenic State Scale (ASS). Results. Assessment of the severity of cognitive impairment using the questionnaire "Cicerone" allowed identifying three clinical variants of PCS: 1) with cognitive impairment in combination with affective disorders (44,3 ± 9,1) % of patients), 2) with a predominance of affective disorders (23,5 ± 7,7) % of patients), 3) moderate and mild disorders of the cognitive and affective spectrum in combination with moderate autonomic disorders ((32,2 ± 8,5) % of patients). In 43,5% of cases, according to the MoCA scale, a decrease in cognitive impairment was found for memorization (memory), attention, delayed recall, total score. According to the HADS scale, the distribution of patients was as follows: clinically significant anxiety was noted in (9,6%) patients, depression - in (11,3%) patients, combination of clinically significant anxiety with depression - in (5,2%) patients, subclinical symptoms of anxiety of various severity - in (55,7%) patients. The phenomena of asthenia due to fatigue with mood swings, loss of the ability to concentrate for a long time on mental and physical tasks occurred in all patients with PCS. Factors with a probably higher risk of cognitive impairment were identified: 1) complaints of extreme fatigue and headache, 2) neurological signs in the form of pyramidal insufficiency, brisk tendon reflexes, 3) anxiety level according to the HADS scale. They can be considered as predictors of detection of cognitive deficit in patients with PCS as a result of blast mild TBI. Conclusions. Comprehensive neurological and neuropsychological examination is an effective tool for diagnosing cognitive changes in PCS as a result of blast mild TBI.

The SOLAR group program to promote recovery after disaster and trauma—A randomized controlled feasibility trial among German trauma survivors.

Many disaster and trauma survivors experience persistent subclinical distress that places them at risk of developing a mental health disorder. This study describes the first European feasibility study of a brief and scalable skills-based intervention targeting persistent subclinical distress following disasters and trauma. Randomized controlled feasibility study of the Skills fOr Life Adjustment and Resilience (SOLAR) group program. German trauma survivors (N = 30) with subclinical symptoms of depression, anxiety, or posttraumatic stress disorder or functional impairment, but no current mental disorder other than adjustment disorder, were randomized to the SOLAR group program (n = 15) or to a wait-list control group (n = 15). The primary outcome was feasibility, operationalized through eligibility rate, recruitment speed, treatment adherence, dropout rate, and participant satisfaction with the program. Secondary outcomes were psychological distress, symptoms of insomnia, posttraumatic stress disorder, patient-centered outcomes, quality of life, and perceived social support. Eligibility rate was 33.6%; recruitment speed was two days per participant; 92.9% completed at least four of five sessions; dropout rate was 10.0%; 92.3% were "very satisfied" with the program. Between-group change scores showed a large effect size for patient-centered outcomes. Medium effect sizes were found for symptoms of insomnia, perceived social support, and quality of life. Small effects were identified for reductions in distress and functional impairment. The application of the SOLAR group program within a randomized controlled trial was feasible. Its efficacy should be further tested in a larger trial. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Effects of Probiotic NVP-1704 on Mental Health and Sleep in Healthy Adults: An 8-Week Randomized, Double-Blind, Placebo-Controlled Trial.

The human gut microbiome is closely linked to mental health and sleep. We aimed to verify the efficacy and safety of probiotic NVP-1704, a mixture of Lactobacillus reuteri NK33 and Bifidobacterium adolescentis NK98, in improving stress, depression, anxiety, and sleep disturbances, along with the measurement of some blood biomarkers. A total of 156 healthy adults with subclinical symptoms of depression, anxiety, and insomnia were retrospectively registered and randomly assigned to receive either NVP-1704 (n = 78) or a placebo (n = 78) for eight weeks. Participants completed the Stress Response Inventory, Beck’s Depression and Anxiety Inventory, Pittsburg Sleep Quality Index, and Insomnia Severity Index at baseline, at four and eight weeks of treatment. Pre- and post-treatment blood tests for biomarkers were conducted. After intervention, gut microbiota composition was quantified by pyrosequencing the bacterial 16S rRNA gene. The NVP-1704 group had a more significant reduction in depressive symptoms at four and eight weeks of treatment, and anxiety symptoms at four weeks compared to the placebo group. Those receiving NVP-1704 also experienced an improvement in sleep quality. NVP-1704 treatment led to a decrease in serum interleukin-6 levels. Furthermore, NVP-1704 increased Bifidobacteriaceae and Lactobacillacea, whereas it decreased Enterobacteriaceae in the gut microbiota composition. Our findings suggest that probiotic NVP-1704 could be beneficial for mental health and sleep.

Effects of a Mindfulness-Based Intervention versus Health Self-Management on Subclinical Anxiety in Older Adults with Subjective Cognitive Decline: The SCD-Well Randomized Superiority Trial

Introduction: Older adults experiencing subjective cognitive decline (SCD) have a heightened risk of developing dementia and frequently experience subclinical anxiety, which is itself associated with dementia risk. Objective: To understand whether subclinical anxiety symptoms in SCD can be reduced through behavioral interventions. Methods: SCD-Well is a randomized controlled trial designed to determine whether an 8-week mindfulness-based intervention (caring mindfulness-based approach for seniors; CMBAS) is superior to a structurally matched health self-management program (HSMP) in reducing subclinical anxiety. Participants were recruited from memory clinics at 4 European sites. The primary outcome was change in anxiety symptoms (trait subscale of the State-Trait Anxiety Inventory; trait-STAI) from pre- to postintervention. Secondary outcomes included a change in state anxiety and depression symptoms postintervention and 6 months postrandomization (follow-up). Results: One hundred forty-seven participants (mean [SD] age: 72.7 [6.9] years; 64.6% women; CMBAS, n = 73; HSMP, n = 74) were included in the intention-to-treat analysis. There was no difference in trait-STAI between groups postintervention (adjusted change difference: –1.25 points; 95% CI –4.76 to 2.25) or at follow-up (adjusted change difference: –0.43 points; 95% CI –2.92 to 2.07). Trait-STAI decreased postintervention in both groups (CMBAS: –3.43 points; 95% CI –5.27 to –1.59; HSMP: –2.29 points; 95% CI –4.14 to –0.44) and reductions were maintained at follow-up. No between-group differences were observed for change in state anxiety or depression symptoms. Conclusions: A time-limited mindfulness intervention is not superior to health self-management in reducing subclinical anxiety symptoms in SCD. The sustained reduction observed across both groups suggests that subclinical anxiety symptoms in SCD are modifiable. ClinicalTrials.gov identifier: NCT03005652.

Prefrontal cortex and amygdala anatomy in youth with persistent levels of harsh parenting practices and subclinical anxiety symptoms over time during childhood

Childhood adversity and anxiety have been associated with increased risk for internalizing disorders later in life and with a range of brain structural abnormalities. However, few studies have examined the link between harsh parenting practices and brain anatomy, outside of severe maltreatment or psychopathology. Moreover, to our knowledge, there has been no research on parenting and subclinical anxiety symptoms which remain persistent over time during childhood (i.e., between 2.5 and 9 years old). Here, we examined data in 94 youth, divided into four cells based on their levels of coercive parenting (high / low) and of anxiety (high / low) between 2.5 and 9 years old. Anatomical images were analyzed using voxel-based morphometry (VBM) and FreeSurfer. Smaller gray matter volumes in the prefrontal cortex regions and in the amygdala were observed in youth with high versus low levels of harsh parenting over time. In addition, we observed significant interaction effects between parenting practices and subclinical anxiety symptoms in rostral anterior cingulate cortical thickness and in amygdala volume. These youth should be followed further in time to identify which youth will or will not go on to develop an anxiety disorder, and to understand factors associated with the development of sustained anxiety psychopathology.

Prevention of anxiety disorders

Preventive interventions, such as universal and targeted, i.e. selective and indicated, interventions can effectively reduce the incidence of anxiety disorders and thus lower the high individual and socioeconomic burden of anxiety disorders. This review article provides an overview of internationally established prevention programs for children, adolescents and adults. The efficacy and cost effectiveness of preventive interventions are discussed. Due to the large target group, universally implemented strategies are costly and organizationally complex but can prevent alarge number of manifest anxiety disorders or reduce the clinical expression, despite only small effect sizes. Selective preventive measures are aimed at persons with a high risk for anxiety disorders (e.g. with high anxiety sensitivity, behavioral inhibition, harm avoidance, family history of anxiety disorders). The indicated preventive interventions in high-risk individuals with first subclinical anxiety symptoms are successful in preventing the manifestation of anxiety disorders and constitute the most cost-effective type of preventive measures. Biological, i.e. genetic, imaging or neurophysiological markers, or their combination, are discussed as promising future targets for selective or indicated prevention of anxiety disorders.

Psychological Distress Related to COVID-19 Among Nepalese Professionals: An Online Cross-sectional Study

Background: COVID-19 is a highly infectious disease caused by SARS-CoV2 virus. It's psychological distress would be a major obstacle towards social normalcy to pre-COVID era. There were lacks of studies to assess these distresses. The aim of this study was to study psychological distress related to COVID-19 among Nepalese professionals.&#x0D; Methods: This online cross-sectional survey was conducted from 12th-20th, June-2020. Questionnaires were based on Corona-virus Anxiety Scale (CAS) and Obsession with COVID-19 scale (OCS).&#x0D; Results: Among 244 participants, majority were in the age group of 20-45 years with male female ratio of 2.1:1. About one third were health workers, 46% were teachers and service holders and remaining were from other professions. Majority of participants had subclinical obsessive (83.2%) and sub-clinical anxiety symptoms (69.3%). Law enforcement professionals (30.0%) and journalists 18.2% had highest prevalence of problematic obsessive symptoms. Law enforcement professionals (40%) had highest prevalence of problematic anxiety symptoms followed by health care workers (28.4%). About 35% of participants opted for multiple positive methods to cope with their obsessive and anxiety symptoms. Participants with higher obsession score had higher anxiety symptoms (r=0.592, p=&lt;0.001).&#x0D; Conclusion: Majority of participants only had sub-clinical obsession and anxiety related to COVID. But, health workers, law enforcement and journalism professionals were having problematic symptoms. Thus, efforts need to be concentrated towards formulation of policies for safe and productive environment for these professionals.

STRESS AND DEPRESSION IN THE EXCLUSION OF THE COVID-19 PANDEMIC IN GREEK UNIVERSITY STUDENTS

With the advent of the new corona virus, all aspects of our daily lives have changed radically, adding great weight to the physical and psychological well-being of all of us, but even more so of students, having to deal with the stress of separation and separation. The aim of the current study was to measure the psychological impact of the new viral disease (COVID-19) on the symptoms of stress and depression in the Greek student population and to determine the possible clinical correlations. 1140 students of the University of Patras participated and 68.0% of the participants reported moderate subclinical anxiety symptoms, which means that the Covid-19 virus initially seemed to affect the stress levels of the students, while 32.3% of the students reported moderate depression symptoms. Student stress seems to be due to the gradually increasing distances between people resulting from quarantine.&#x0D; &#x0D; &lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0820/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Elucidating vulnerability to inflammation-induced hyperalgesia: Predictors of increased musculoskeletal pain sensitivity during experimental endotoxemia

Despite broad clinical implications, the mechanisms linking inflammation and pain remain incompletely understood. Using human experimental endotoxemia as a translational model of systemic inflammation, we aimed to elucidate putative vulnerability factors of inflammation-induced musculoskeletal hyperalgesia.We pooled data from three published randomized controlled trials, resulting in a sample of N = 98 healthy volunteers who received either low-dose endotoxin (lipopolysaccharide) or vehicle (saline) intravenously. As measure of musculoskeletal pain sensitivity, pressure pain thresholds (PPTs) were assessed at baseline and 3 h post injection with a handheld algometer for the low back (erector spinae muscle), calf (gastrocnemius muscle), and shoulder region (deltoid muscle). Implementing multiple regression models, we tested the contribution of putative vulnerability factors on musculoskeletal hyperalgesia during systemic inflammation, including acute changes in pro-inflammatory cytokines, state anxiety and mood, as well as pre-existing symptoms of anxiety and depression.Endotoxin application led to significant increases in plasma cytokines, state anxiety, and negative mood, and significantly decreased PPTs for all muscle groups. Regression models revealed that greater M. erector spinae PPT changes were predicted by higher HADS-anxiety scores. Higher TNF-α concentration emerged as predictor for M. gastrocnemius PPT changes, and more pronounced TNF-α increase and higher HADS-anxiety were predictive for M. deltoideus PPTs. HADS scores emerged as predictor for a mean PPT score (computed across all body sites).Together, our results indicate that musculoskeletal hyperalgesia during systemic inflammation is related to pro-inflammatory cytokines, specifically TNF-α. Importantly, subclinical anxiety symptoms (even though in a low and normal range in this cohort of healthy volunteers) may contribute to inflammation-induced hyperalgesia, making individuals more vulnerable to the detrimental effects of systemic inflammation.