Mild Anxiety Symptoms Research Articles

7527 Subacute Thyroiditis in First Trimester of Pregnancy: Rare Cause of Thyrotoxicosis

Abstract Disclosure: K. Wilcher: None. A. Gupta: None. Background: Subacute thyroiditis (SAT) is extremely rare in pregnancy with only 8 prior cases reported in the literature. SAT can result in maternal and fetal complications. In this case report, we describe a case of subacute thyroiditis presenting in the first trimester of pregnancy. Case Presentation: A 38-year-old female with past medical history of stillbirth presented with thyrotoxicosis in gestational week 10 of her pregnancy. The patient has a history of stillbirth in gestational week 38 of her first pregnancy requiring cesarean section one year prior to presentation. She was in the process of getting in vitro fertilization (IVF) and had an egg retrieval. During the process, she started on thyroxine 50 mcg daily for blood thyroid-stimulating hormone (TSH) 3.77 mcIU/mL. She became pregnant without the help of IVF and stopped thyroxine. One month later, labs showed low TSH 0.022 mcIU/mL (reference range: 0.4-4.5 mcIU/mL) and high blood free thyroxine (FT4) 1.87 ng/dL (reference range: 0.7-1.8 ng/dL). Repeat labs two weeks later showed low blood TSH 0.012 mcIU/mL, high FT4 2.08 ng/dL, and high blood free triiodothyronine (FT3) 5.2 pg/mL (reference range: 2.3-4.2 pg/mL). She was referred to endocrinology for evaluation. She reported mild intermittent right sided neck pain since diagnosis of pregnancy. She denied any history of viral infection, cough, or fever. She reported symptoms of severe nausea, mild constipation, and mild anxiety. She denied diarrhea, tremors, changes in voice, palpitations, or weight loss. Her family history is significant for hypothyroidism in her father. Physical exam demonstrated a non-tender, symmetric thyroid without enlargement or nodules. Ultrasound showed heterogenous thyroid with an ill-defined heterogenous area in the right lobe appearing pseudo-nodule, and increased vascularity. At this time, the patient was diagnosed with mild gestational hyperthyroidism with a plan to monitor thyroid hormone levels. Repeat labs two weeks later showed low blood TSH 0.005 mcIU/mL, high FT4 2.35 ng/dL, and high FT3 6.4 pg/mL. TSH-receptor antibodies, thyroid stimulating immunoglobulin, and thyroid peroxidase antibodies were normal on testing. In gestational week 16, labs showed normal TSH 2.76 mcIU/mL, low FT4 0.56 ng/dL, and low FT3 2.1 pg/mL. At that time, she started on levothyroxine 75 mcg daily and was diagnosed with subacute thyroiditis. Follow up labs in gestational weeks 18, 20, and 24 showed improvement in TSH and FT4 on thyroid hormone supplementation. Conclusion: This case report discusses the findings of SAT in first trimester pregnancy. Currently, she is in gestational week 28 and still requiring thyroid hormone supplementation. SAT in pregnancy is very rare. This case report significantly contributes to the literature and current knowledge of the prevalence, presentation, and disease process of subacute thyroiditis in first trimester pregnancy. Presentation: 6/2/2024

Social isolation, depression, and anxiety among young adult cancer survivors: The mediating role of social connectedness.

Social isolation and social connectedness are health determinants and aspects of social well-being with strong associations with psychological distress. This study evaluated relationships among social isolation, social connectedness, and psychological distress (i.e., depression, anxiety) over 1 year in young adult (YA) cancer survivors 18-39 years old. Participants were YAs in a large cohort study that completed questionnaires every 2 months for 1 year. Social isolation, aspects of social connectedness (i.e., companionship, emotional support, instrumental support, and informational support), depression, and anxiety were assessed with Patient-Reported Outcomes Measurement Information System short form measures. Mixed-effect models were used to evaluate changes over time. Confirmatory factor analysis and multilevel structural equation modeling were used to define social connectedness as a latent construct and determine whether relationships between social isolation and psychological distress were mediated by social connectedness. Participants (N = 304) were mean (M)= 33.5 years old (SD = 4.7) and M = 4.5 years (SD = 3.5) post-initial cancer diagnosis. Most participants were female (67.4%) and non-Hispanic White (68.4%). Average scores for social well-being and psychological distress were within normative ranges and did not change (p values >.05). However, large proportions of participants reported at least mild social isolation (27%-30%), depressive symptoms (36%-37%), and symptoms of anxiety (49%-51%) at each time point. Across participants, more social isolation was related to less social connectedness (p values <.001), more depressive symptoms (p < .001), and more symptoms of anxiety (p < .001). Social connectedness mediated the relationship between social isolation and depression (p = .004), but not anxiety (p > .05). Social isolation and connectedness could be intervention targets for reducing depression among YA cancer survivors.

The mental health of staff at violence against women organizations during the COVID-19 pandemic: Findings from a mixed-methods study of service providers in Canada's largest city.

Staff at violence against women (VAW) organizations provide essential services for survivors of violence. The increase in VAW during the COVID-19 pandemic placed additional pressures on VAW staff. We investigated the impacts of the pandemic on the mental health of VAW staff in the Greater Toronto Area to inform recommendations for policy and practice. We conducted a community-based, mixed-methods study on the processes, experiences, and outcomes of adapting VAW programming during the pandemic using a sequential explanatory approach. Throughout 2021, we conducted a survey of direct support and leadership staff who worked on VAW services ("VAW staff") followed by semi-structured interviews with VAW staff purposively sampled from the survey. We descriptively analyzed quantitative survey data on the mental health of 127 VAW staff. We then applied thematic analysis to qualitative data from 18 interviews with VAW staff. We used the qualitative data to support interpretation and enrich the quantitative findings regarding staff mental health. In the survey, 81% of leadership and 61% of direct support staff indicated that their work was more distressing during the pandemic. Participants reported moderate symptoms of vicarious trauma and mild symptoms of anxiety and depression. We generated three themes from the qualitative data to help explain these findings: (1) challenges related to changing work environments; (2) distress over not meeting client needs; and (3) difficulties in adapting self-care strategies in response to pandemic stressors. VAW organizations require increased resources and flexible funding to hire and retain more staff to respond to higher and more complex caseloads during public health emergencies. With more structural supports in place, VAW organizations could create more time and space to develop their trauma-informed organizational practices: for example, establishing a culture of connection and learning among staff virtually and in-person and facilitating a range of self-care opportunities.

Relationship between family function and anxiety among nurses during the COVID-19 pandemic: a mediating role of expressive suppression

BackgroundThe aims of the present study were to investigate the incidence of nurses who suffered anxiety during the COVID-19 pandemic and to explore how expressive suppression influences the relationship between family function and anxiety.MethodsThis study used cross-sectional research and simple random sampling. A total of 300 questionnaires were distributed and 254 questionnaires were qualified after invalid questionnaires were proposed, thus a total of 254 female nurses from a tertiary hospital were included in this study. The measurement included General demographic questionnaires, the Self-Scale Anxiety, Scale (SAS), Emotion Regulation Strategies Questionnaire (ERQ), and Family Function Assessment (FAD). T-test, nonparametric Wilcoxon or Kruskal-Wallis test, χ2 test, Pearson or Spearman correlation analysis, multiple stepwise regression and bootstrap methods was performed to analyze the data.ResultsIn this study, 22.4% of the nurses exhibited anxiety symptoms, with 17.7% eliciting mild anxiety symptoms, 4.3% showing moderate anxiety symptoms and 0.4% with severe anxiety symptoms. Family function and expressive suppression were positively associated with anxiety severity. And family function influenced anxiety among nurses via direct and indirect (Expressive suppression -mediated) pathways.ConclusionsExpressive suppression partially mediated the influence of family function on anxiety symptom. To this end, nurse administrators should establish a robust mental health support system encompassing psychological counseling and emotional support groups. Furthermore, nurse administrators should consistently inquire about nurses’ family situations, encourage nurses to articulate their emotions and needs candidly, both within the domestic sphere and the workplace, while refraining from excessive self-repression.

Mental health and cognition in relation to adherence to antiretroviral therapy among people living with HIV in Kazakhstan: a cross-sectional study.

There is a research gap in how mental health and cognition are associated with antiretroviral treatment (ART) adherence among people living with HIV (PLWH) in Kazakhstan. We randomly selected and enrolled 230 PLWH from the Almaty City AIDS Center registry (June-November 2019) into a cross-sectional study. We examined associations between self-reported ART adherence for the last 1 and 2 weeks; the Adherence Self-Efficacy Scale (ASES) and symptoms of depression (Patient Health Questionnaire-9 [PHQ-9]), anxiety (Generalized Anxiety Disorder tool [GAD-7]), post-traumatic stress disorder (PTSD Checklist [PTSD]); cognitive function (PROMIS v2.0 Adult Cognitive Function 8a short form) and forgetfulness (Forgetfulness Assessment Inventory). We used cut points of ≥5 for at least mild and ≥10 for at least moderate symptom severity for PHQ-9 and GAD-7 and of ≥44 for PTSD. Logistic and linear regression analyses were used. Participants' median age was 40.0 (IQR: 34-47) with 40.9% (n = 94) of females in the sample. Those who missed at least one pill for the last 2 weeks had higher odds of reporting at least mild depression (aOR = 3.34, 95% CI: 1.22-9.11, p <0.05); mild anxiety (aOR = 3.27, 95% CI: 1.20-8.92, p <0.05); and PTSD (aOR = 4.04, 95% CI: 1.15-14.21, p <0.05) symptoms. Participants who missed at least one pill for the last week had higher odds of at least mild depression (aOR = 7.74, 95% CI: 1.31-45.7, p <0.05), moderate anxiety (aOR = 21.33, 95% CI: 3.24-140.33, p <0.005) and PTSD (aOR = 13.81, 95% CI: 2.36-80.84, p <0.005) symptoms. Participants with better cognitive function had lower odds of non-adherence over the last week (aOR = 0.88, 95% CI: 0.81-0.96, p <0.005) and higher ASES scores (β = 0.26, 95% CI: 0.13-0.40, p < 0.005). Poor memory was associated with higher odds of non-adherence over the last week (aOR = 4.64, 95% CI: 1.76-12.24, p <0.005) and lower ASES score (β = -0.31, 95% CI: -0.45 to 0.16, p < 0.005). Those who had at least mild depression (β = -0.21, 95% CI: -0.35 to -0.07, p < 0.005); moderate anxiety (β = -0.21, 95% CI: -0.34 to -0.07, p < 0.005) and PTSD (β = -0.19, 95% CI: -0.33 to -0.05, p < 0.005) symptoms had lower ASES scores. Depression, anxiety and PTSD symptoms, poorer cognition, and forgetfulness were associated with poorer ART adherence and worse adherence self-efficacy. It is crucial to assess and treat mental illness and provide support for PLWH with worsened cognition to enhance ART adherence.

State of mental health, sleep status, and the interaction with health-related quality of life in HIV-infected Chinese patients during the COVID-19 pandemic

ObjectiveTo describe how mental health and sleep status influence the health-related quality of life (HRQOL) of people living with HIV/AIDS (PLWHA) during the novel coronavirus disease 2019 (COVID-19) pandemic, and to apply targeted interventions to improve the HRQOL.MethodsA web-based online questionnaire survey was administered. Descriptive analysis was used to depict the mental health and sleep status. Correlation analysis and the structural equation model (SEM) method were used to analyze the influence of mental health and sleep status on HRQOL in PLWHA.ResultsAfter excluding 24 unqualified questionnaires, a total of 490 participants in this survey were included in the statistical analysis. Of the participants, 66.1% and 55.1% reported mild or worse symptoms of depression and anxiety, respectively. Overall, 70.0% had varying degrees of sleep problems. Correlation analysis showed that anxiety had the strongest correlation with sleep disturbances and sleep quality (R = 0.588 and 0.551, respectively), while depression had the strongest correlation with the HRQOL psychological and physical domains (R = − 0.759 and − 0.682, respectively). SEM analysis showed that depression, sleep quality, and psychological domains had the greatest item load on mental health, sleep status, and HRQOL (093, 0.82, and 0.89, respectively). Mental health had a more significant influence than sleep status on HRQOL, as indicated by factor loading (− 0.75 and − 0.15, respectively).ConclusionsThere were more severe mental health and sleep problems among PLWHA during the COVID-19 pandemic, thus, mental health intervention, especially to relieve depression symptoms, may be the most important approach to improve the HRQOL among PLWHA.

Multidimensional Study of the Attitude towards Euthanasia of Older Adults with Mixed Anxiety-Depressive Disorder.

This study aims to verify if older adults with mixed anxiety-depressive disorder are more prone to euthanasia and identify factors that interfere with their satisfaction with health and capacity for well-informed decisions. The study applied a paper questionnaire composed of a sociodemographic section and a battery of scales (to assess depression, anxiety, cognitive performance, suicide risk, therapeutic adhesion, functionality, loneliness, attitude towards euthanasia, decision pattern, personality, empathy, and health status) in the Psychogeriatric Unity of Senhora da Oliveira Hospital in Portugal. The sample was collected by convenience to include patients and controls of the same age. Six months later, a reassessment was performed. Patients and controls were compared using descriptive statistics and a multiple-regression model. A total of 114 patients and 25 controls were included. Eighty-one point six percent of patients had four or fewer years of schooling. Contrary to controls, they presented mild depressive and anxiety symptoms, loneliness feelings, worse cognitive performance, a more fragile personality, higher personal distress, and a poorer health state. No statistically significant differences were found between controls and patients regarding their attitudes towards euthanasia. Patients more favourable to euthanasia had higher empathic concern, conscientiousness, and fantasy, and lower personal distress. When addressing euthanasia in these patients, it is crucial to ensure they are fully self-determinate and that all the necessary treatment and support are available. It may not be the case when the educational level is low and a mild disease persists, significantly affecting their well-being and cognitive performance.

Prevalence and Association of Stress with Gestational Diabetes Mellitus among Pregnant Women in a Rural Area of Maharashtra: A Community-based Cross-sectional Study

Abstract Aim: Gestational diabetes mellitus (GDM) is a major public health problem. There is a scarcity of knowledge regarding the association of stress with GDM. Our objective was to determine the prevalence and association of stress with GDM among pregnant women in a rural area of Maharashtra. Methods: A community-based cross-sectional study was conducted among 965 pregnant women from the rural field practice area of the Department of Community Medicine, MGIMS, Sevagram. After taking written informed consent, a pretested semistructured questionnaire was administered. Diabetes in Pregnancy Study Group India recommendation was used (2-h plasma glucose &gt; 140 mg/dL with 75 g oral glucose load to diagnose GDM irrespective of the duration of the last meal). Kessler Psychological Distress Scale (K10) was administered to assess the stress (anxiety and depression). Results: The K10 scale showed that 3.11% of participants were moderately affected, and 3.01% had mild symptoms of anxiety and depression. Only 1.14% of pregnant women had severe mental disorders. The participants with normal to mild depression (K10 score &lt; 25) had 90% less chance (odds ratio: 0.10; 95% confidence interval: 0.05–0.23) of becoming GDM than participants with moderate to severe depression (K10 score &gt; 25), which was statistically significant (P &lt; 0.001). Conclusion: Our study highlighted that normal to mild stress had a lesser chance of getting GDM than moderate to severe stress during pregnancy, indicating that stress is a positive risk factor of GDM. Hence, it is advisable to screen for stress during pregnancy.

Substance use, anxiety and depression among Tunisian college students

IntroductionSubstance use and mental health symptoms are frequent among college students worldwide.ObjectivesThis study examined the prevalence of substance use, anxiety and depression among college students and their associated factors.MethodsA total of 115 college students aged between 19 and 30 years from different universities completed a self-reported online survey during March 2023. The questionnaire included items on demographic information, substance use and the Hospital Anxiety and Depression scale.ResultsWomen represented 70% of our population. The average age was 25,1±3,5 years.Twenty-nine (25,2%) were smokers, thirty-three students (28,7%) consumed alcohol and nine students (7,8%) used cannabis. Five students used ecstasy. Four students used LSD. Three students used cocaine.Average HADS anxiety score was 7,96±4,26. Twenty-one students (18,3%) had mild anxiety symptoms. Thirty-three students (28,7%) had moderate to severe anxiety symptoms.Average HADS depression score was 8,59±4. Thirty-one students (27%) had mild depressive symptoms. Forty-one (35,7%) had moderate to severe symptoms of depression.Smoking was unrelated to gender, age, field of studies, economic or social status, family or personal history. It was related to drinking and doing other activities or hanging out with friends (p&lt;0,001). Drinking alcohol was related to the field and year of study, age, hanging out with friends and other substance use (p&lt;0,001). Using cannabis was related to psychiatric family history (p&lt;0,05). Using one substance was related to using other substances (p&lt;0,05). Anxiety was related to gender (p&lt;0,001). Depression levels were related to socio-economic statuts (p=0,041). Poly-use was more frequent among older students (p=0,003) and medical students (p=0,031). Substance use was unrelated to anxiety and depression levels.ConclusionsTunisian universisties should consider detecting students with substance and mental health problems and offer them support and treatment if needed.Disclosure of InterestNone Declared

Association between weight, weight perception, weight teasing and mental health among adolescents

BackgroundAdolescent mental health problems are becoming increasingly prevalent, and there are correlations between weight-related concerns and adolescent mental health. The aim of this study is to explore the association between three weight-related factors (actual weight, weight perception, and weight teasing) and mental health problems (depressive symptoms, anxiety symptoms, and loneliness) in Chinese adolescents.Methods10,070 adolescents between the ages of 11–18 from schools in Shanghai, China were selected using a stratified random cluster sampling method. Self-reported questionnaires were collected to investigate weight-related factors and mental health problems. Logistic regression analysis was used to examine the relationship.ResultsThe prevalence of depressive symptoms, loneliness, mild anxiety symptoms, and moderate to severe anxiety symptoms among adolescents were 18.0%, 53.8%, 26.5%, and 12.3%, respectively, with a higher prevalence found in females. After adjusting for weight perception and weight teasing, actual weight had no harmful impact on adolescents’ mental health. Adolescents' perception of being overweight increased the risk of depressive symptoms, loneliness, mild anxiety symptoms, and moderate to severe anxiety symptoms, while the perception of being underweight had a similar but more profound impact (depressive symptoms OR = 1.590, 95% CI: 1.342–1.883; loneliness OR = 1.537, 95% CI: 1.353–1.746; mild anxiety symptoms OR = 1.368, 95% CI: 1.178–1.589; moderate to severe anxiety symptoms OR = 1.780, 95% CI: 1.449–2.186). Experiencing weight teasing more than once a year had a greater effect on adolescents' mental health, especially among adolescents with overweight/obesity (depressive symptoms OR = 2.970, 95% CI: 2.325–3.793; loneliness OR = 3.839, 95% CI: 3.119–4.727; mild anxiety symptoms OR = 2.822, 95% CI: 2.236–3.562; moderate to severe anxiety symptoms OR = 5.212, 95% CI: 3.846–7.065).ConclusionsThe prevalence of mental health problems among adolescents was high, especially loneliness. Weight perception and weight teasing, but not the actual weight, independently influenced adolescent mental health.

Investigating the Feasibility of Using a Wearable Device to Measure Physiologic Health Data in Emergency Nurses and Residents: Observational Cohort Study.

Emergency departments play a pivotal role in the US health care system, with high use rates and inherent stress placed on patients, patient care, and clinicians. The impact of the emergency department environment on the health and well-being of emergency residents and nurses can be seen in worsening rates of burnout and cardiovascular health. Research on clinician health has historically been completed outside of clinical areas and not personalized to the individual. The expansion of digital technology, specifically wearable devices, may enhance the ability to understand how health care environments impact clinicians. The primary objective of this pilot study was to assess the feasibility and acceptability of using wearable devices to measure and record physiologic data from emergency nurses and resident physicians. Understanding strategies that are accepted and used by clinicians is critical prior to launching larger investigations aimed at improving outcomes. This was a longitudinal pilot study conducted at an academic, urban, level 1 trauma center. A total of 20 participants, including emergency medicine resident physicians and nurses, were equipped with a wearable device (WHOOP band) and access to a mobile health platform for 6 weeks. Baseline surveys assessed burnout, mental health, and expectations of the device and experience. Participants provided open-ended feedback on the device and platform, contributing to the assessment of acceptance, adoption, and use of the wearable device. Secondary measures explored early signs and variations in heart rate variability, sleep, recovery, burnout, and mental health assessments. Of the 20 participants, 10 consistently used the wearable device. Feedback highlighted varying experiences with the device, with a preference for more common wearables like the Apple Watch or Fitbit. Resident physicians demonstrated higher engagement with the device and platform as compared with nurses. Baseline mental health assessments indicated mild anxiety and depressive symptoms among participants. The Professional Fulfillment Index revealed low professional fulfillment, moderate workplace exhaustion, and interpersonal disengagement. This pilot study underscores the potential of wearable devices in monitoring emergency clinicians' physiologic data but reveals challenges related to device preferences and engagement. The key takeaway is the necessity to optimize device and platform design for clinician use. Larger, randomized trials are recommended to further explore and refine strategies for leveraging wearable technology to support the well-being of the emergency workforce.

Anxiety symptoms and coping strategies among high school students in Vietnam after COVID-19 pandemic: a mixed-method evaluation.

The objective of the current study was to examine the rate of high school students at risk of anxiety disorder during the COVID-19 pandemic in Vietnam, as well as the coping strategies utilized within this demographic. An evaluation was conducted through the utilization of mixed methods, consisting of a combination of a cross-sectional study and in-depth interviews. In this study, a sample of 3,910 students from 13 high schools in Hanoi, Vietnam were selected for participation. The measurement of symptoms of anxiety disorder was conducted through the application of the seven-item General Anxiety Disorder (GAD-7) scale. To comprehend the underlying causes of anxiety and the various coping mechanisms employed, in-depth interviews were conducted. The findings indicate a prevalence rate of anxiety disorder symptoms among students at 40.6% The prevalence rates of mild, moderate, and severe anxiety symptoms were found to be 23.9%, 10.9%, and 5.8%, respectively. In-depth interviews uncovered multiple sources of anxiety experienced by high school students, namely their academic performance, social interactions, prejudicial attitudes from their social circle, and familial expectations. Numerous coping strategies were then documented. The current investigation ascertained that there exists a moderate level of anxiety amongst high school students in Hanoi, Vietnam during the COVID-19 outbreak. Furthermore, this study configured potential indicators to identify vulnerable individuals and further suggests the development of targeted interventions.

Generalized anxiety and mild anxiety symptoms in U.S. military veterans: Prevalence, characteristics, and functioning

Generalized anxiety disorder (GAD) is a mental disorder characterized by excessive anxiety and worries that impair daily functioning. While prior work has documented the prevalence and correlates of GAD and subthreshold GAD (SGAD) in clinical samples, contemporary data on the epidemiology of anxiety symptoms are lacking, particularly in higher-risk populations such as military veterans. To address this gap, we analyzed data from a large, nationally representative sample of U.S. veterans to examine the: prevalence of probable GAD and mild anxiety symptoms measured using a brief screener; sociodemographic and military characteristics associated with anxiety symptoms; and psychiatric and functional correlates of anxiety symptoms. Results revealed that a total of 7.9% (95% confidence interval [CI] = 6.7–9.3%) and 22.1% (95%CI = 20.5–23.9%) of veterans screened positive for probable GAD and mild anxiety symptoms, respectively. Relative to veterans without anxiety symptoms, those with probable GAD and mild anxiety symptoms were younger, more likely to be female and racial/ethnic minorities, and more likely to have served 2+ deployments. Further, a “dose-response” association was observed between anxiety symptom severity and clinical correlates, with robust associations observed between probable GAD and poorer mental health, suicidal thoughts and behaviors, and functional impairment. Mild anxiety symptoms showed intermediate magnitude associations with these outcomes. Results of this study suggest that 3-of-10 U.S. veterans report anxiety symptoms. While the use of a brief screener to assess mild anxiety symptoms and probable GAD is limited, findings underscore the importance of a dimensional approach to assessing anxiety symptoms and associated clinical and functional characteristics in veterans.

The psychological impact of the COVID-19 pandemic on physicians in Puerto Rico: a cross-sectional study after the second wave in 2021.

Health care providers faced a challenge with the emergence of COVID-19 and its rapid spread. Early studies measuring the psychological impact of COVID-19 on the general population found high levels of anxiety and sleep disorders. The primary goal of this project was to assess the psychological impact of COVID-19 on physicians in Puerto Rico. A cross-sectional study of physicians in Puerto Rico was conducted anonymously and electronically from February 2021 through April 2021. The electronic survey included socio-demographic data and 4 self-administered assessment tools (Generalized Anxiety Disorder-7, Perceived Stress Scale-10, Pittsburgh Sleep Quality Index and COVID-19 Organizational Support) for anxiety, perceived stress, sleep disturbances, and organizational support during the COVID-19 pandemic. A total of 145 physicians completed the survey, with a female predominance of 53.5% and a majority practicing in the San Juan metropolitan area (50.3%). Mild anxiety symptoms were reported in 26.9% of physicians, and 33.8% had moderate to severe anxiety symptoms. Moderate to high perceived stress was found in 69.9% of participants, and women reported statistically significantly higher levels of anxiety symptoms (8.84 ± 5.99; p = 0.037) and stress (19.0 ± 6.94, p = 0.001). The Pittsburgh Sleep Quality Index reported 67.9% of physicians with global scores associated with poor sleep quality. Assessment of perceived organizational support found a high perception of work support (65.7%) but low perception of personal support (43.4%) and risk support (30.3%). A correlation analysis found a negative correlation for work and personal support, but a positive correlation for risk support, all statistically significant. COVID-19 had a lasting psychological impact in health care providers in Puerto Rico a year after the beginning of the pandemic. Our data supports the importance of organizational support and its correlation with the development of anxiety. It is thus essential to develop strategies to identify individuals at risk of experiencing psychological disturbances and to provide effective support for medical professionals during medical emergencies for their well-being and optimal delivery of patient care.

Remote Delivery of the Cuidándome Telehealth Intervention for Self-Management of Depression and Anxiety Among Latina Immigrant Women: Randomized Controlled Trial.

Growing evidence suggests that Latina immigrant survivors of adverse childhood experiences (ACEs) are at increased risk for developing and remaining with either depression or anxiety or both symptoms. This study examined the feasibility and acceptability of a telehealth intervention-Cuidándome (quee-DAN-doh-meh, "taking care of myself"). Cuidándome is a 10-week, patient-centered, trauma-informed intervention delivered by a trained facilitator that promotes self-management of depression and anxiety symptoms through improved problem-solving skills and strategies. The aim of this study was to examine the feasibility and acceptability of Cuidándome delivered remotely (via Zoom) with Latina immigrant ACE survivors with either depression or anxiety or both symptoms. We also estimated the effect sizes associated with the intervention on decreasing depression and anxiety symptoms and improving social problem-solving styles. We evaluated Cuidándome using a randomized controlled trial design. Latina immigrants (N=47) who had experienced at least 1 ACE and had at least mild depression or anxiety symptoms were randomized to Cuidándome or a comparison group delivered by trained facilitators. We assessed for changes in depression and anxiety symptoms as well as social problem-solving styles at baseline, post intervention, and 3- and 6-month follow-up. Analyses indicated significant decreases over time within both Cuidándome and comparison groups for depression and anxiety symptoms and maladaptive problem-solving. The intervention effect was largest for anxiety; at 6-month follow-up, Cuidándome participants had significantly lower anxiety scores than the comparison group. In addition, we observed a greater average point reduction in depression symptoms at 6 months among Cuidándome participants (5.7 points) than in the comparison group (3.7 points). A mental health program delivered via Zoom by a trained facilitator was feasible and acceptable to Latina immigrant women and can be beneficial for reducing anxiety and depression symptoms. More research is needed to assess the effectiveness of Cuidándome among a powered sample size of Latina immigrants. ISRCTN Registry ISRCTN16668518; https://www.isrctn.com/ISRCTN16668518.

Psychological status of women with miscarriage

Introduction. During pregnancy, a woman becomes vulnerable to develop symptoms of depression and anxiety, which in turn are associated with increased risk of perinatal complications, postpartum depression as well as behavioral problems in children.Aim: to assess the prevalence of symptoms related to depression and anxiety in pregnant women with threatened abortion (ТА), non-developing pregnancy (NP) as well as those with physiological course of pregnancy (РР) in the first trimester of pregnancy; to reveal major predictors of psycho-emotional disorders in pregnant women.Materials and Methods. Three groups of pregnant women were stratified: 62 patients with TA, 60 patients with NP and 57 women with PP. Clinical history and physical examination were performed in all subjects. All pregnant women were assessed by Hamilton Anxiety Rating Scale and the Beck Depression Inventory.Results. It was found that the mean Beck’s score was significantly higher in NP vs. TA and PP groups (p &lt; 0.05). Moreover, significant differences were also observed while comparing TA and PP groups (p = 0.037). Clinically important depression was found in 3.3 % NP women and in 1.6 % TA women. Preclinical depression was found in 13 % and 6.5 % women with NP and TA, respectively. The mean Hamilton scale score was significantly higher in NP vs. PP group (p &lt; 0.05), but was comparable with that in TA group (p &gt; 0.05). The mean score on the anxiety scale was significantly higher in TA vs. PP group (p = 0.001). Clinically significant mild to moderate anxiety was found in 4.9 % and 1.6 % TA and NP women, respectively. Mild anxiety symptoms were noted in 35.5 % of women with TA, 38.3 % of women with NP, and 15.7 % of women with PP. Multiple linear regression analysis revealed that a burdened obstetric history and the duration of the patient hospital stay had the strongest association with symptoms of depression and anxiety.Conclusion. Symptoms of prenatal anxiety and depression are widespread and should be identified in a timely manner. Psychological counseling and testing of pregnant women should be included into recommendations for pregnancy management.

The relationship of climate change awareness and psychopathology in persons with pre-existing mental health diagnoses

IntroductionPersons with pre-existing mental health diagnoses are known to be more vulnerable to the consequences of climate change, such as extreme weather events and rising temperatures. However, it remains unclear if this holds true for adverse effects of climate change awareness, too.MethodsN = 89 patients of a psychosomatic outpatient clinic were assessed with well-established mental health questionnaires (PHQ-9 for depressive, GAD-7 for anxious, and PTSS-10 for post-traumatic symptoms) in their original form and in a modified version (PHQ-9-C, GAD-7-C, PTSS-10-C) specifically asking for patients’ symptom load regarding climate change awareness, and instruments evaluating personality factors (OPD-SF, SOC, RQ).Results21% of the sample reported at least mild symptoms of anxiety regarding climate change awareness, and 11% mild symptoms of depression due to climate change awareness. General anxiety (GAD-7) scores significantly predicted if people reported any psychological symptoms due to climate change awareness. In multiple regression analyses, higher scores of clinical symptoms of depression, anxiety or post-traumatic stress predicted higher scores of depressive, anxious or post-traumatic symptoms regarding climate change awareness, and higher scores of psychological symptoms regarding climate change awareness predicted each other. Younger participants reported significantly more traumatic symptoms regarding climate change awareness.DiscussionThe reported mental health impairments regarding climate change awareness in persons with pre-existing mental health diagnoses indicate an increased vulnerability. Hereby, depressive mental health burden seems to induce a predominantly depressive processing of climate change resulting in climate chance related depression. This holds also true for anxious and traumatic symptoms, and points toward biased attentional and memory processes and mood congruent processing.

67 COVID-19 Mobile Brain Health

Objective:Over 80% of hospitalized COVID-19 patients have neurological symptoms, including memory loss, attention difficulties, and trouble thinking clearly that can last for months. The long-term neurological impact of the SARS-CoV-2 virus is unknown and it remains to be seen whether it would create a surge in cases of dementia and cognitive decline years later, which is already a global public health challenge. Examining the cognitive effects of the virus will help with understanding its impact on the brain and inform treatment options. The goal of the present study was to examine cognitive performance among those who have had COVID-19 via mobile-based assessments using smartphone-based cognitive tests. Participants with a previous COVID-19 diagnosis (COVID+) were expected to have worse cognitive performance at baseline than those without COVID-19 (COVID-).Participants and Methods:Participants (n=23) with self-reported positive or negative COVID-19 statuses based on polymerase chain reaction or antigen testing were recruited from the Boston area. Inclusion criteria included access to a smartphone with an Android or iOS operationsystem and to internet connectivity, along with proficiency in English. Cognitive performance was measured using Defense Automated Neurobehavioral Assessment (DANA) from AnthroTronix. Welch’s 2-sample t-test was used to compare cognitive performance among those with and without COVID-19.Results:The sample was comprised primarily of COVID+ (59%), female (59%), and Caucasian (50%) participants that were generally well educated (77% with a bachelor’s degree), and had &gt;1 COVID vaccination (95%). About 50% of the sample reported symptoms of depression and mild anxiety. Results were not indicative of significant differences between COVID+ and COVID- groups at baseline: Simple Reaction Time (Immediate; M = 5.62; p = 0.81), Code Substitution (M = 1.25; p = 0.77), Procedural Reaction Time (M = -7.26; p = 0.49), Spatial Processing (M = -3.14; p = 0.50), Go No Go (M = -1.37; p = 0.89), Match to Sample (M = 2.00; p = 0.57), Memory Search (M = -2.62; p = 0.75), and Simple Reaction Time (Delayed; M = 2.99; p = 0.81).Conclusions:Results indicate that cognitive performance at baseline does not differ based on COVID status, emphasizing the need for examination of longitudinal cognitive performance. Future directions include examining the impact of COVID disease severity and reinfection on cognition.

The Relationship Between Blood Parameters, Sleep, Anxiety and Depression Symptoms: A Retrospective Polysomnography Study

Objective: It is known that anxiety and depression are associated with sleep disorders and many systemic diseases. This study aims to analyse the relationship between anxiety, depression symptoms and sleep parameters among the patients subjected to polysomnographic recording. Material and Methods: A total of 808 patients who were subjected to a polysomnographic recording were included in the retrospective cross-sectional and hospital-based study. Body mass index (BMI) was calculated. Anxiety and depression symptoms were evaluated using the Beck anxiety and Beck depression inventory. Patients were divided into groups according to anxiety and depression scores. The apnoea hypopnea index (AHI), oxygen desaturation index (ODI), and peripheral oxygen saturation (SaO2) were obtained from the polysomnographic recordings. Results: In the study, there were 528 (65.3%) male and 280 (34.7%) female patients with the mean age 47.64 ± 12.25 (18-82). Depression was detected in 307 (38.0%) patients according to Beck depression score. Mild anxiety symptoms were detected in 516 (63.9%), moderate anxiety symptoms in 215 (26.6%) patients and severe anxiety symptoms in 77 (9.5%) patients according to Beck anxiety score. There was a statistical difference for all polysomnographic parameters in depression and anxiety severity groups (p=0.001). In patients with depression had lower free-T3 and higher C-reactive protein (CRP) levels (p=0.001, p=0.014). The difference between thyroid stimulating hormone (TSH) and FT4 levels was determined according to the severity of the depression (p=0.037, p=0.047). CRP was higher in patients with severe anxiety (p=0.008); and free-T3 was lower in patients with moderate and severe anxiety (p=0.003, p=0.001). In the logistic regression analysis, free-T3, minimum SaO2 and BMI had an impact on anxiety (p=0.002, p=0.033, p=0.031) and depression (p=0.001, p=0.017, p=0.035). Conclusion: Anxiety and depression symptoms are affected by numerous factors, especially sleep characteristics. Minimum SaO2, CRP and free-T3 are main predisposing factors on anxiety and depression

Trajectories of parent well-being in children with drug-resistant epilepsy.

This longitudinal cohort study aimed to identify trajectories of parent well-being over the first 2 years after their child's evaluation for candidacy for epilepsy surgery, and to identify the baseline clinical and demographic characteristics associated with these trajectories. Parent well-being was based on parent depressive and anxiety symptoms and family resources (i.e., family mastery and social support). Parents of 259 children with drug-resistant epilepsy (105 of whom eventually had surgery) were recruited from eight epilepsy centers across Canada at the time of their evaluation for epilepsy surgery candidacy. Participants were assessed at baseline and 6-month, 1-year, and 2-year follow-up. The trajectories of parents' depressive symptoms, anxiety symptoms, and family resources were jointly estimated using multigroup latent class growth models. The analyses identified three trajectories: an optimal-stable group with no/minimal depressive or anxiety symptoms, and high family resources that remained stable over time; a mild-decreasing-plateau group with mild depressive and anxiety symptoms that decreased over time then plateaued, and intermediate family resources that remained stable; and a moderate-decreasing group with moderate depressive and anxiety symptoms that decreased slightly, and low family resources that remained stable over time. Parents of children with higher health-related quality of life, fathers, and parents who had higher household income were more likely to have better trajectories of well-being. Treatment type was not associated with the trajectory groups, but parents whose children were seizure-free at the time of the last follow-up were more likely to have better trajectories (optimal-stable or mild-decreasing-plateau trajectories). This study documented distinct trajectories of parent well-being, from the time of the child's evaluation for epilepsy surgery. Parents who present with anxiety and depressive symptoms and low family resources do not do well over time. They should be identified and offered supportive services early in their child's epilepsy treatment history.