Subthreshold Anxiety Research Articles

Network Structure of Transdiagnostic Dimensions of Emotional Disorders in Adolescents With Subthreshold Anxiety and Depression: Links With Psychopathology and Socio-Emotional Adjustment.

The transdiagnostic and network model approaches to psychopathology have emerged as an alternative to taxonomic systems. The main goal was to examine the network structure of the transdiagnostic dimensions of emotional disorders in adolescents with subclinical emotional symptoms. In addition, cross-sectional network analyses were conducted to investigate the relationships between transdiagnostic dimensions, psychopathology, and socio-emotional adjustment. The sample consisted of a total of 476 adolescents from 85 schools from different provinces in Spain with subthreshold anxiety and depression. The mean age was 13.77 years (SD = 1.43, range: 10-18 years), 73.9% were female. Several questionnaires assessing transdiagnostic dimensions of emotional disorders, mental health difficulties, self-esteem, perceived social support, sense of belonging at school, and prosocial behaviour were used. A strong interrelation was found between the transdiagnostic variables, except with the positive temperament dimension. The dimensions with the greatest weight were those of traumatic re-experiencing, intrusive cognitions, avoidance, neuroticism, and depressed mood. Negative relationships were found between the transdiagnostic dimensions of emotional disorders and the protective factors included in the study. Stability analyses indicated that the networks were accurately estimated. The present paper points to the value of conceptualising emotional disorders from a transdiagnostic and network model perspective. In addition, the work provides new insights into the nature of the relationships between transdiagnostic dimensions of emotional disorders, and the role played by risk and protective factors.

Prevalence and risk of subthreshold anxiety developing into threshold anxiety disorder in the general population

BackgroundSubthreshold anxiety may act as a critical precursor and risk factor for the onset of threshold anxiety. However, accurate prevalence rates of subthreshold anxiety and its role in leading to threshold anxiety require further elucidation. MethodsWe conducted a search on PubMed and Web of Science using predefined criteria and identified 45 articles with a total of 278,971 individuals to estimate the prevalence rates using a random effects model. The incidence risk ratio (IRR) was estimated by comparing the proportion of individuals with subthreshold anxiety who developed threshold anxiety to those without subthreshold anxiety in seven articles involving 18,693 individuals. ResultsOur analysis revealed an overall prevalence of subthreshold anxiety of 6.19%. Specifically, among individuals with subthreshold generalized anxiety disorders, adolescents show the highest prevalence (9.47%), outpacing adults (4.69%) and the elderly (3.49%). Further analysis of seven studies showed an increased risk of developing threshold anxiety in individuals with subthreshold anxiety (IRR = 2.63), with a higher transition rate (9.59%) compared to those without subthreshold anxiety (3.65%). ConclusionsAnxiety disorders may be conceptualized as a spectrum, with subthreshold anxiety serving as a significant prodromal state and risk factor for the development of threshold anxiety. Proactive management of subthreshold anxiety represents an effective approach for the prevention of its progression to threshold anxiety. Future research should investigate the risk of progression from subthreshold to threshold anxiety across various types, and explore how factors, such as social support and personality traits facilitate this progression.

The assessment of transdiagnostic dimensions of emotional disorders: Validation of the Multidimensional Emotional Disorders Inventory (MEDI) in adolescents with subthreshold anxiety and depression

BackgroundThe transdiagnostic approach to psychopathology has emerged as an alternative to traditional taxonomic approaches. The Multidimensional Emotional Disorders Inventory (MEDI) is a specifically designed self-report to measure the transdiagnostic dimensions proposed by Brown and Barlow (2009). This study aims to analyse the psychometric properties of the MEDI scores in adolescents with subthreshold anxiety and depression. MethodThe sample consisted of a total of 476 students. The mean age was 13.77 years (SD = 1.43) (range 10 to 18 years), 73.9 % were females. Several questionnaires assessing positive affect, negative affect, mental health difficulties, and quality of life were used. ResultsThe original 9-factor structure of the MEDI was confirmed with good fit indices. Satisfactory levels of internal consistency were observed in most of the MEDI scores using McDonald's Omega, ranging from 0.58 to 0.87. The MEDI dimensions were associated with psychopathology, positive affect, negative affect, and quality of life. LimitationsReliance on self-reported data, a cross-sectional design limiting temporal assessment, and a 73.9 % female gender imbalance. ConclusionThe MEDI scores showed adequate psychometric properties among adolescents with subclinical emotional symptoms. The results found might have potential clinical implications for conceptualization, assessment, intervention, and prevention of emotional disorders at both clinical and research levels.

Characteristics of Subjective Cognitive Decline Associated with Alzheimer's Disease Amyloid Pathology: Findings from The CABLE Study.

Subjective cognitive decline (SCD) is considered as a preclinical hallmark of Alzheimer's disease (AD). However, the characteristics of SCD associated with amyloid pathology remain unclear. We aimed to explore the associations between SCD characteristics with amyloid pathology. Using logistic regression analyses, we analyzed the associations between cerebrospinal fluid (CSF) amyloid pathology with AD risk factors, SCD-specific characteristics (onset of SCD within the last five years, age at onset ≥60 years, feelings of worse performance, informant confirmation of complaints, worries, other domains of cognition complaints), as well as subthreshold depressive and anxiety symptoms among individuals with SCD. A total of 535 SCD individuals with available CSF Aβ42 information from the Chinese Alzheimer's Biomarker and LifestylE (CABLE) study (mean age of 63.5 years, range 40 to 88 years; 47.10% female) were enrolled. The characteristics of informant confirmation of complaints (OR, 95% CI = 2.00, 1.19-3.36), subthreshold depressive symptoms (OR, 95% CI = 2.31, 1.05-5.09), and subthreshold anxiety symptoms (OR, 95% CI = 2.22, 1.09-4.51) were found to be significantly associated with pathological amyloid in multivariate analyses when adjusting for age, sex, education, and APOE ɛ4. Besides, age and females were observed risks for amyloid pathology in subscale analyses. Nonetheless, we did not find any associations of other SCD-specific characteristics with amyloid pathology in this study. Our study suggested that informant confirmed complaints and subthreshold psychiatric symptoms might be critical for discriminating AD-related SCD from non-AD related SCD.

Efficacy of Silexan in patients with anxiety disorders: a meta-analysis of randomized, placebo-controlled trials

IntroductionWe report on a meta-analysis of Silexan, a proprietary active substance produced from Lavandula angustifolia, in subthreshold anxiety, mixed anxiety and depressive disorder (MADD), and generalized anxiety disorder (GAD).MethodsThe present analyses are based on all currently completed 5 double-blind, randomized, placebo-controlled trials investigating Silexan in adult out-patients who received Silexan 1 × 80 mg/day or placebo for ten weeks according to random assignment (n = 1213). Efficacy was assessed based on the Hamilton Anxiety Rating Scale (HAMA), several anxiety self-rating scales, the Clinical Global Impression (CGI) scale, and the Short Form-36 (SF-36) health status questionnaire.ResultsAfter ten weeks’ treatment, Silexan was significantly superior to placebo in reducing the HAMA total score (including the psychic and somatic anxiety sub-scores) and self-rated anxiety. Based on a ≥ 50% HAMA total score reduction, the responder rate ratio was 1.34 favoring Silexan, and the rate ratio of subjects much or very much improved according to the CGI was 1.51. Silexan was also significantly superior in improving the physical and mental health summary scores of the SF-36. There were no significant between-group differences concerning the occurrence of adverse events (AEs), serious AEs, and premature withdrawal due to AEs.ConclusionsThis meta-analysis demonstrates that Silexan exerts significant anxiolytic effects in subthreshold anxiety, GAD and MADD that were consistently reflected in investigator ratings and patient-reported outcomes, including improvement of health-related life-quality, while showing favorable tolerability and safety.

The anxiety and depression disorder in adults with atopic dermatitis: experience of a dermatology hospital.

The objectives of this study are to identify the proportion of atopic dermatitis adult patients having anxiety and depression disorder and to measure the relationship between anxiety and depression disorder and characteristics of atopic dermatitis. A cross-sectional study with convenience sampling was conducted. Diagnostic criteria for atopic dermatitis were based on modified Hanifin and Raijka criteria and the severity of anxiety-depression disorder was evaluated using the hospital anxiety and depression scale. In this study, 208 patients were enrolled. The percentage of patients with anxiety and subthreshold anxiety were 11.1% and 34.1%, respectively. 5.3% of patients had depression and 39.4% of patients suffered from subthreshold depression. The proportion of patients with mixed anxiety-depressive disorder was 1.44%. Patients with severe atopic dermatitis were more likely to endure anxiety but not depression. Allergies or autoimmune diseases and scoring atopic dermatitis C were two independent risk factors of depression whereas edema and excoriation were two independent risk factors related to anxiety in atopic dermatitis patients. These findings suggest that atopic dermatitis is associated with anxiety and depression. Allergies, autoimmune diseases, pruritus, and insomnia had a correlation with anxiety and depression disorder.

Prevalence and Risk Factors of Psychiatric Symptoms Among Older People in England During the COVID-19 Pandemic: a Latent Class Analysis

The COVID-19 pandemic has affected mental health and social connections. Older people may be disproportionately affected, placing them at increased risk for complex mental ill-health outcomes and quality of life undermined by anxiety and depression. Understanding gender differences in the determinants of anxiety and depression symptoms is crucial to policy and practice. This study aims to examine gender-specific symptom subtypes (and subthreshold symptoms) in an older English population sampled during the COVID period, in relation to their socio-demographic, social, and health circumstances. The sample comprises all individuals aged 50 years or older and included in the English Longitudinal Study of Ageing COVID-19 sub-study conducted during June–July 2020. Latent class analysis (LCA) defined indicative sample subgroups of clinically relevant anxiety and depression. Multinomial logistic regression assessed associations between socio-demographic characteristics, health and social care indicators, loneliness, and pre-pandemic mental ill-health. LCA derived three classes of self-reported depression and anxiety: for females (1) comorbid depression and anxiety (19.9% of the sample), (2) depression and subthreshold anxiety (31.6%), and (3) no or low symptoms of depression and anxiety (48.5%), and for males (1) comorbid depression and anxiety (12.8%), (2) subthreshold anxiety and depression (29.6%), and (3) no or low depression and anxiety (57.6%). Multinomial logistic regression analyses indicate that compared to those with low/no mental health symptoms, severity of pandemic-era mental ill-health was positively associated with pre-pandemic mental health levels, worry over finances, having access to essentials, loneliness, and access to health and social care services. Findings support the persistence of comorbidity of both depression and anxiety in the pandemic period. Results may inform government health strategy on interventions to prevent social isolation and mitigate the effects of the pandemic on deteriorating mental health in older people who may be more susceptible.

The prevalence of subthreshold psychiatric symptoms and associations with alcohol and substance use disorders: from a nationally representative survey of 36,309 adults

BackgroundOur aim was to describe a broad number of subthreshold psychiatric symptoms (SPS) in a nationally representative population and evaluate associations with substance use. SPS describe groups of symptoms with significant pathology, but that do not quite meet full psychiatric diagnostic criteria. They have been associated with significant impairment and cost.MethodsThe National Epidemiologic Survey on Alcohol and Related Conditions-III was a multistage, weighted, cross-sectional survey completed in the United States in 2013 comprising 36,309 noninstitutionalized adults. We report lifetime prevalence rates of 14 SPS related to mood, anxiety, trauma, eating, and personality disorders. We then evaluate associations with lifetime alcohol use disorders (AUD) and all substance use disorders (SUD) using logistic regression and adjusted odds ratios. SPS and psychiatric diagnoses were mutually exclusive (could not co-occur).ResultsLifetime prevalence of having at least one of 14 SPS was 57% compared with 37% for the related psychiatric disorders. This was similar for males and females, in contrast to psychiatric disorders in which prevalence was 42% in females and 31% in males. Otherwise, overall SPS and disorders had similar prevalence patterns across sociodemographic characteristics. Subthreshold personality symptoms had the highest prevalence rates (schizotypal 21.3%, antisocial 18.3%, and borderline 17.6%), followed by posttraumatic stress (13.1%). Subthreshold bipolar and depression had lifetime prevalence rates of 2.7 and 8.5%, respectively. Prevalence rates of subthreshold anxiety symptoms ranged from 2.2% (agoraphobia) to 9.8% (specific phobia). Subthreshold eating disorder related symptoms had the lowest prevalence rates (anorexia 1.5% and bulimia 1.7%). Half (seven) of the SPS had significantly increased odds of lifetime AUD. This number increased to 12 for all SUD. Subthreshold antisocial personality symptoms had the highest odds of AUD (2.2; 95% CI 2.00–2.37) and SUD (3.5; 95% CI 3.22–3.81).ConclusionsWe found high lifetime SPS prevalence rates and significant associations with AUD and SUD. To our knowledge, this is the first published study evaluating a broad number of SPS. This indicates possible opportunities for early intervention and prevention but requires additional research and development of infrastructure and guidelines to better understand and manage patients who experience SPS.

Beneficial effects of Silexan on co-occurring depressive symptoms in patients with subthreshold anxiety and anxiety disorders: randomized, placebo-controlled trials revisited

Silexan is a proprietary active substance produced from Lavandula angustifolia, with proven anxiolytic efficacy in subthreshold and generalized anxiety disorder as well as in mixed anxiety and depressive disorder with beneficial impact on anxiety-related sleep disturbances. The pharmacological profile and clinical observations suggest that Silexan may also have an antidepressant effect. To investigate the effect of Silexan on co-occurring depressive symptoms, we present a meta-analysis of the five placebo-controlled clinical trials hitherto performed with Silexan in subthreshold anxiety (n = 3) and anxiety disorders (n = 2). Patients of all trials received Silexan 1 × 80 mg/day or placebo for 10 weeks according to random assignment. Assessment of the antidepressant effect was based on item ‘depressed mood’ from the Hamilton Anxiety Rating Scale (HAMA) administered in all trials and on the total scores of the Montgomery Åsberg Depression Rating Scale (MADRS) or the Hamilton Depression Rating Scale (HAMD) used in three trials. After 10-week treatment, patients receiving Silexan showed significantly more pronounced score reduction for HAMA item ‘depressed mood’ than those in the placebo group (p = 0.01). Significant superiority of Silexan over placebo could also be shown for mean MADRS or HAMD total score reduction (three studies; p < 0.01). Silexan-treated patients with more severe depressive symptoms at baseline showed more pronounced improvements than those with milder symptoms. Our meta-analysis clearly shows that Silexan has a beneficial effect on co-occurring depressive symptoms in patients with subthreshold anxiety and anxiety disorders and may, hence, lead to important therapeutic implications for depressive disorders.

The Effectiveness of Virtual Reality Exposure-Based Cognitive Behavioral Therapy for Severe Anxiety Disorders, Obsessive-Compulsive Disorder, and Posttraumatic Stress Disorder: Meta-analysis.

BackgroundIn recent years, virtual reality exposure–based cognitive behavioral therapy (VRE-CBT) has shown good treatment results in (subclinical) anxiety disorders and seems to be a good alternative to exposure in vivo in regular cognitive behavioral therapy (CBT). However, previous meta-analyses on the efficacy of VRE-CBT on anxiety disorders have included studies on specific phobias and subthreshold anxiety; therefore, these results may not be generalizable to patients with more severe and disabling anxiety disorders.ObjectiveThe objective of our study is to determine the efficacy of VRE-CBT on more severe anxiety disorders, excluding specific phobias and subthreshold anxiety disorders. Meta-analyses will be conducted to examine the efficacy of VRE-CBT versus waitlist and regular CBT. Our secondary objectives are to examine whether the efficacy differs according to the type of anxiety disorder, type of recruitment, and type of VRE-CBT (virtual reality exposure either with or without regular CBT). Furthermore, attrition in VRE-CBT and CBT will be compared.MethodsStudies published until August 20, 2020, were retrieved through systematic literature searches in PubMed, PsycINFO, and Embase. We calculated the effect sizes (Hedges g) for the difference between the conditions and their 95% CIs for posttest and follow-up measurements in a random effects model. A separate meta-analysis was performed to compare attrition between the VRE-CBT and CBT conditions.ResultsA total of 16 trials with 817 participants were included. We identified 10 comparisons between VRE-CBT and a waitlist condition and 13 comparisons between VRE-CBT and a CBT condition. With regard to risk of bias, information on random sequence generation, allocation concealment, and risk of bias for selective outcome reporting was often absent or unclear. The mean effect size of VRE-CBT compared with waitlist (nco=10) was medium and significant, favoring VRE-CBT (Hedges g=−0.490, 95% CI −0.82 to −0.16; P=.003). The mean effect size of VRE-CBT compared with CBT (nco=13) was small and nonsignificant, favoring CBT (Hedges g=0.083, 95% CI −0.13 to 0.30; P=.45). The dropout rates between VRE-CBT and CBT (nco=10) showed no significant difference (odds ratio 0.79, 95% CI 0.49-1.27; P=.32). There were no indications of small study effects or publication bias.ConclusionsThe results of our study show that VRE-CBT is more effective than waitlist and as effective as CBT in the treatment of more severe anxiety disorders. Therefore, VRE-CBT may be considered a promising alternative to CBT for patients with more severe anxiety disorders. Higher-quality randomized controlled trials are needed to verify the robustness of these findings.

Subthreshold lifetime depression and anxiety are associated with increased lifetime suicide attempts: A Korean nationwide study

BackgroundSubthreshold depression and anxiety are highly prevalent and known to be associated with functional limitations and future onset of major depression or anxiety disorders. However, studies regarding suicidality at subthreshold levels of depression and anxiety are limited. MethodsA total of 17,639 Koreans aged from 18 to 64 responded to the Korean version of the WHO-composite international diagnostic interview (K-CIDI) version 2.1 between 2006 and 2016. Prevalence of subthreshold depression and anxiety, and information on lifetime suicide attempt (SA) were assessed. Multivariable logistic regression was performed to calculate the risk of SA by the level of depression or anxiety. ResultsThe risk of lifetime SA increased incrementally according to the level of depression and anxiety. In the subthreshold depression group, individuals with subthreshold anxiety increased the odds about threefold (OR = 3.15, 95% CI 3.12–3.18) and the threshold anxiety disorder group increased the odds about fivefold (OR = 5.33, 95% CI 5.27–5.38) for SA, compared to the group without any level of anxiety. In threshold depressive disorder, the subthreshold anxiety group showed about 1.8-fold higher odds (OR = 1.76, 95% CI 1.75–1.77) and the threshold anxiety disorder group showed threefold higher odds (OR = 2.93, 95% CI 2.92–2.95) for SA compared to the group without any level of anxiety. ConclusionsSubthreshold levels of depression and anxiety were prevalent among Koreans and were associated with an increased prevalence of lifetime SA. A detailed assessment of depression and anxiety symptoms according to their level should be performed on a diagnostic continuum to prevent suicide.

Exercise interventions to reduce anxiety in mid-life and late-life anxiety disorders and subthreshold anxiety disorder: a systematic review.

Background:Anxiety disorders are highly prevalent and cause significant distress, disability, and cost. Medication adverse effects and interactions increase in mid-life and late-life, highlighting the need for effective non-pharmacological interventions.Objectives:We aimed to evaluate the extent of evidence supporting exercise interventions for anxiety and subthreshold anxiety disorders in mid-life and late-life.Design:Systematic review.Data Sources and Methods:We searched MEDLINE, PsycINFO, Embase, Emcare, Ovid Nursing, CINAHL Plus, Cochrane Library, Health Collection, Humanities & Social Sciences Collection, and https://clinicaltrials.gov databases for trials published January 1994–May 2019. Randomised controlled trials of exercise interventions involving aerobic exercise or resistance training for adults aged 40 years and above with anxiety or subthreshold anxiety disorders in residential or health settings were identified. The primary outcome was change in anxiety. We excluded trials including participants aged below 40 years, participants with diagnosis of separation anxiety, selective mutism, obsessive-compulsive disorder, acute stress disorder and post-traumatic stress disorder, and head-to-head comparisons of interventions. Trial quality was assessed using the Cochrane Risk of Bias Tool and evidence synthesised in narrative form.Results:Four trials totalling 132 participants met inclusion criteria, although some had methodological limitations. Interventions included a home-based resistance training intervention, supervised group-based aerobic intervention, Tai Chi intervention, and supervised group-based aerobic and strength intervention. Three trials included late-life participants and the fourth mid-life. Three trials demonstrated greater reductions in anxiety in the intervention group compared with control. The fourth trial showed pre–post reductions in anxiety in both groups, with between-group difference not reaching statistical significance.Conclusion:There is limited supportive evidence suggesting that exercise interventions have potential to be effective, feasible and safe non-pharmacological interventions for anxiety and subthreshold anxiety disorders in mid-life and late-life. The heterogeneity, limited number and high risk of bias of some trials meant that we were not able to conduct a meta-analysis. Tailoring of interventions may improve uptake and reduce dropout. The paucity of research in this area with only four included trials demonstrates the urgent need for future and larger trials to provide proof of concept, data about effective types and doses of exercise interventions, and guidance to community, clinical, and public health services.

Clinical characteristic of prodromal symptoms between bipolar I and II disorder among Chinese patients: a retrospective study

BackgroundThis study aimed to identify the clinical characteristic of prodromal symptoms in Chinese patients with bipolar disorder (BD), prior to the first affective episode. It further aimed to characterize the prodromal traits between bipolar disorder type I (BD-I) and type II (BD-II).Methods120 individuals with BD-I (n = 92) and BD- II (n = 28) were recruited to the study. Semi-structured interviews were then administered to evaluate prodromal symptoms in patients, within 3 years of BD onset, by using the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R).ResultsIn the prodromal phase of the first depressive episode, patients with BD-II experienced more prodromal symptoms (p = 0.0028) compared to BD-I. Additionally, more frequent predictors were reported in patients with BD-II than BD-I including educational and occupational dysfunction (p = 0.0023), social isolation (p < 0.001), difficulty making decisions (p = 0.0012), oppositionality (p = 0.012), and suspiciousness/persecutory ideas (p = 0.017). There were also differences in the duration of the precursors. The duration of “weight loss or decrease in appetite” (p = 0.016) lasted longer in patients with BD-I, while “obsessions and compulsions” (p = 0.023) started earlier in patients with BD-II and occurred during the pre-depressive period. The prevalence and duration of each reported prodrome, preceding a first (hypo) manic episode, showed no difference between patients with BD-I and BD-II.ConclusionsSpecific affective, general, or psychotic symptoms occurred prior to both affective episodes. The characteristic of prodromal symptoms were key predictors for later episodes of BD including attenuated mania-like symptoms, subthreshold depressed mood, mood swings/lability, and anxiety. In the pre-depressive state, when compared to BD-II, BD-I presented with more prodromal symptoms in nonspecific dimensions, which indicated the substantial burden of BD-II. In conclusion, this study extends the understanding of the characteristics of prodromes of BD-I and BD-II.

Catalyst Twenty-Twenty: Post-Traumatic Growth at Scales of Person, Place and Planet

Planetary health is a broad multidisciplinary effort that attempts to address what has been described as “Anthropocene Syndrome”—the wicked, interrelated challenges of our time. These include, but are not limited to, grotesque biodiversity losses, climate change, environmental degradation, resource depletion, the global burden of non-communicable diseases (NCDs), health inequalities, social injustices, erosion of wisdom and civility, together with the many structural underpinnings of these grand challenges. The ultimate aim of planetary health is flourishing along every link in the person, place and planet continuum. The events of “2020” have illuminated the consequences of “mass trauma” and how sub-threshold anxiety and/or depressive symptoms erase the rigid lines between mental “health” and mental “disorders”, and unmasked the systemic forms of injustice, discrimination, and oppression that have too often escaped discourse. Here, we query the ways in which post-traumatic growth research might inform the larger planetary health community, especially in the context of a global pandemic, broadening socioeconomic inequalities, a worsening climate crisis, and the rise of political authoritarianism. The available research would suggest that “2020” fulfills the trauma criteria of having a “seismic impact on the assumptive world”, and as such, provides fertile ground for post-traumatic growth. Among the many potential positive changes that might occur in response to trauma, we focus on the value of new awareness, perspective and greater wisdom.

Prevalence of anxiety disorders and subthreshold anxiety throughout later life: Systematic review and meta-analysis.

This systematic review and meta-analysis compared prevalence rates for subthreshold anxiety and anxiety disorders in adults aged 55+ and examined if these rates were associated with age. A systematic search and screening procedure resulted in 46 included articles. First, prevalence rates for subthreshold anxiety and anxiety disorders were statistically compared. Subthreshold panic, generalized anxiety and specific phobia were significantly more prevalent than the corresponding clinical disorders. In general, subthreshold anxiety appeared to be at least similarly prevalent to anxiety disorders, although firm conclusions are precluded due to the small number of samples that could be included in the analyses and the large heterogeneity between the reported prevalence rates. Second, using subgroup analyses, pooled prevalence rates for four age groups of older adults (55-64, 65-74, 75-84, 85+) were compared. For specific phobia, the 75-84 and 85+ groups had significantly lower prevalence rates than the 55-64 and 65-74 groups. Posttraumatic stress disorder was significantly more prevalent in the 55-64 group than in the other age groups, and lowest in the 85+ group. No other significant differences between age groups were found. The association between later life subthreshold anxiety and age could not be examined due to a lack of reported information. The main limitation of this study is the small number of samples in the analyses, which limits their power and generalizability. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Therapeutic effects of Silexan on somatic symptoms and physical health in patients with anxiety disorders: A meta-analysis.

A meta‐analysis was performed to examine therapeutic effects of Silexan on somatic symptoms, including insomnia/fatigue, and physical health in patients with anxiety disorders. Five randomized, placebo‐controlled trials were included in this analysis: The efficacy of Silexan (80 mg/day) was investigated in patients with subthreshold anxiety disorders (three trials) and in patients with generalized anxiety disorder (two trials). Silexan was superior to placebo in terms of the mean change from baseline in the Hamilton Anxiety Rating Scale (HAMA) subscore somatic anxiety at week 10 with a standardized mean difference of −0.31 [95% Cl: −0.52 to −0.10, p = .004]. Treatment effects of silexan on somatic anxiety were independent of gender and age. Statistically significant differences were also shown for single HAMA items somatic muscular, cardiovascular, respiratory, and genitourinary symptoms, indicating clinical relevance with small to medium effects of Silexan. Similar clinically meaningful effects of Silexan on SF‐36 physical health, including reduced bodily pain and improved general health, and on insomnia complaints and fatigue, were demonstrated. In this meta‐analysis including all placebo‐controlled clinical trials in patients with anxiety disorders to date, statistically significant and clinically meaningful advantages of Silexan over placebo treatment were found in improving somatic symptoms and physical health.

Psychiatric evaluation of individuals treated with the diagnosis of COVID-19 following recovery period (tur)

Objective: A limited number of studies are available on the impact of COVID-19 pandemic on mental health. Studies have mostly focused on general population and healthcare providers at risk. There are no studies in the literature investigating the mental status of COVID-19 patients during the post-treatment period. The aim of the present study was to evaluate the mental status of the adults recovering from COVID-19. Method: Fifty adults with a clinically confirmed diagnosis of COVID-19 and a post-discharge period of at least one month were included in the study. Results: Among the study sample, other specified anxiety disorder (diagnostic criteria for generalized anxiety disorder were met except for the duration) was diagnosed in 5 (10%) individuals, panic disorder in 3 (6%), other specified somatic symptom and related disorder (brief somatic symptom disorder) in 2 (4%) individuals, and major depressive disorder, post-traumatic stress disorder, obsessive-compulsive disorder and other specified insomnia disorder (brief insomnia disorder) in one individual each (%2). There were 6 (12%) participants with subthreshold anxiety and 2 (4%) participants with subthreshold depression. No mental disorder was identified in the remaining 28 (56%) participants. Discussion: Despite important limitations, the current study revealed that anxiety symptoms are quite common in individuals recovering from COVID-19.

The Assessment of Knowledge, Behaviors, and Anxiety Levels of the Orthodontists about COVID-19 Pandemic.

A new viral disease called Coronavirus disease-19 (COVID-19) affected the whole world because of its characteristics of spreading rapidly via respiratory droplets and aerosol. As one of the most aerosol-generating occupations, dentists are at high risk and are recommended to treat emergency cases only. We aimed to assess the general knowledge, emergencies, personal precautions, and avoided behaviors among the orthodontists and also their anxiety levels, during COVID-19. A survey research, including demographic information, general knowledge about COVID-19, treatment strategies, protective measures, and Generalized Anxiety Disorder (GAD) 7 test, was conducted via a web-based questionnaire (1 open-ended and 26 closed-ended questions). A total of 215 orthodontists older than 20 years of age and practicing in different regions of Turkey were included in this study. The answers received within the first 10 days were included. Most of the orthodontists were aware of COVID-19 symptoms and transmission routes (n=159 and n=183, respectively). Almost all of them treated only emergency cases (n=209). Orthodontic emergencies were reported mostly as injury due to band/bracket failure, soft/hard tissue trauma, and problems in retention appliances (n=197, n=186, and n=81, respectively). The participants also avoided aerosol-generating procedures and used transmission-based protective equipment. The prevalence of GAD was 16.7% during COVID-19, and there was no statistically significant difference when it was stratified by gender, age, city, and COVID-19 related questions (p>0.05). The orthodontists followed the guidelines and took protective measures during COVID-19, and the majority had subthreshold anxiety levels.

The relationship between resilience, anxiety and depression among patients with mild symptoms of COVID-19 in China: A cross-sectional study.

Aims and objectivesTo explore the role of resilience in anxiety and depression and to clarify their relationships among patients with mild symptoms of coronavirus disease 2019 (COVID‐19) in Wuhan, China.BackgroundThe outbreak of COVID‐19 has negatively affected some individuals, but resilience plays a decisive role in the response of individuals under pressure and can help them deal with pressure more effectively.DesignThe cross‐sectional descriptive correlational survey was reported in line with the STROBE guidelines.Subject and settingIn total, 296 patients from FangCang Hospital in Wuhan, Hubei, China, with mild symptoms of COVID‐19 were recruited.MethodsParticipants were recruited through convenience sampling. The data collected included their demographic information, the Connor‐Davidson Resilience Scale and Hospital Anxiety and Depression Scale.ResultsA small number of patients in this study had above threshold anxiety (subthreshold anxiety and major anxiety) and depression (subthreshold depression and major depression). The mean total resilience score of the participants was slightly below the normal level of ordinary Chinese adults. Resilience was inversely associated with and was a protective factor for both anxiety and depression in our samples. Risk factors for anxiety include being female and having colleagues with COVID‐19, while a risk factor for depression was having family members with COVID‐19.ConclusionsThis study shows that after taking the general demographics into consideration, higher levels of resilience were associated with lower anxiety and depression among mild COVID‐19 patients in Wuhan, China.Relevance to clinical practiceHealth professionals, especially clinical nurses, need to be aware of the psychological status of COVID‐19 patients and promote resilience to improve their mental health.

The association between, depression, anxiety, and mortality in older people across eight low- and middle-income countries: Results from the 10/66 cohort study.

ObjectivesDepression and anxiety are common mental disorders in later life. Few population‐based studies have investigated their potential impacts on mortality in low‐ and middle‐income countries (LMICs). The aim of this study is to examine the associations between depression, anxiety, their comorbidity, and mortality in later life using a population‐based cohort study across eight LMICs.MethodsThis analysis was based on the 10/66 cohort study including 15 991 people aged 65 years or above in Cuba, Dominican Republic, Venezuela, Mexico, Peru, Puerto Rico, China, and India, with an average follow‐up time of 3.9 years. Subthreshold and clinical levels of depression were determined using EURO‐D and ICD‐10 criteria, and anxiety was based on Geriatric Mental State (GMS)–Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT). Cox proportional hazard modelling was used to estimate how having depression, anxiety, or both was associated with mortality adjusting for sociodemographic and health factors.ResultsParticipants with clinical depression (hazard ratio [HR]: 1.45; 95% CI, 1.24‐1.70) and subthreshold anxiety (HR: 1.26; 95% CI, 1.15‐1.38) had higher risk of mortality than those without the conditions after adjusting for sociodemographic factors and health conditions. Comorbidity of depression and anxiety was associated with a 30% increased risk of mortality but the effect sizes varied across countries (Higgins I2 = 58.8%), with the strongest association in India (HR: 1.99; 95% CI, 1.21‐3.27).ConclusionsDepression and anxiety appear to be associated with mortality in older people living in LMICs. Variation in effect sizes may indicate different barriers to health service access across countries. Future studies may investigate underlying mechanisms and identify potential interventions to reduce the impact of common mental disorders.