Treatment Of Anxiety Disorders Research Articles

AVALIAÇÃO NEUROPSICOLÓGICA NO TRANSTORNO DE ANSIEDADE GENERALIZADA NA INFÂNCIA E ADOLESCÊNCIA

This study aimed to explore the role of neuropsychological assessment in enhancing the efficacy of Generalized Anxiety Disorder (GAD) treatment in children and adolescents. Given the significant influence of emotional development during this life stage on the manifestation of fears and worries, a comprehensive understanding of each individual's psychological profile is essential. The high prevalence of GAD in childhood and adolescence underscores the critical need for early intervention to prevent chronic conditions and long-term consequences. A literature review reveals that psychological assessment in this population presents unique characteristics and is vital for identifying specific GAD symptoms, assessing symptom severity, and pinpointing preserved abilities. Additionally, neuropsychological assessment offers insights into how anxiety impacts the daily functioning of children and adolescents, aiding in the selection of tailored interventions. However, it is crucial to recognize that neuropsychological assessment is a complex process, and results must be interpreted cautiously considering the multifaceted nature of anxiety disorders and the influence of various factors. In conclusion, further research is imperative to deepen our understanding of the psychological dimensions of GAD in childhood and adolescence, thereby improving clinical practices and ensuring more effective treatment for this population.

Sporun Fiziksel Aktivite Boyutunun Psiko-Eğitimle Desteklenmesinin Sonuçlarının İncelenmesi

Today, especially after the pandemic, the importance of physical activity, in which individuals remember its value once again, stands out even more. During this period, it has become indisputable to what extent physical activity provides benefits to the social, emotional, physical and psychological development of individuals. So much so that physical activity applications have also found a place among the contents added to the distance education activities. Dec. However, the problem of overweight and obesity, which is rapidly becoming one of the most important health problems in the world, is also effective in spreading physical activity practices Decently. Considering the benefits of regular physical activity in general, it contributes to healthy growth and development, helps to protect against unwanted habits, prevents socialization and the formation of certain long-term diseases that may be encountered during adulthood, as well as treating and supporting the treatment of disorders that may occur, ensuring that they last an active old age, in other words, it can make important contributions to improving the quality of life throughout life. In this context, psycho-education as a complementary element of physical activity is also defined as empowering education aimed at promoting individual's awareness and entrepreneurship. Psycho-education is not only to inform the individual and his family about the problematic situation or to offer them solutions, but also the process of providing education and training about the factors that cause this situation. In this way, the person understands the situation better and develops a sense of control, so that the problem can gradually decrease. The human body, which was created in order to be able to do physical activity, can encounter various problems every day due to inactivity. Besides the well-known health benefits of physical activity, it should not be overlooked that along with its cognitive effects, it may also contribute to increasing academic achievement in the sense of its positive role on mental processes at different age levels depending on these effects, and ultimately as a result of these processes. At the same time, it is known in past and recent studies that physical activity has a direct or indirect effect on many topics, from the use of individuals experiencing mental or mental problems in treatment processes, to coping with stress, anxiety, and post-traumatic stress disorder treatments, in addition to conditions such as self-confidence, self-esteem, and well-being. Key Words: Special Ability, Special Ability Students, Physical Activity

Effect of meditation or escitalopram on work performance in patients with anxiety disorders.

This study aimed to 1) examine how psychopharmacotherapy and mindfulness-based stress reduction (MBSR) influence absenteeism and job performance among individuals with anxiety disorders and 2) compare the effectiveness of these treatments in improving work performance. Adults (N=67) with a primary anxiety disorder were recruited to participate in the study. Participants were randomized to escitalopram, a common treatment for anxiety disorders, or MBSR. Absenteeism and job performance were measured with the Health and Work Performance (HPQ) questionnaire prior to treatment and at the week 24 follow up. At week 24, individuals in the escitalopram arm and the MBSR arm showed significant improvements in partial days of missed work due to mental/physical health problems from baseline (1.00 [0.00-2.50] to 0.00 [0.00=1.00], p=.034 and 0.00 [0.00-2.00] to 0.00 [0.00=1.00], p=.001, respectively). In the MBSR arm only, job performance increased from baseline to week 24 (65.00 [50.00-80.00] to 75.00 [67.50-82.50], p=.017). None of the outcome variables significantly varied by group at baseline or week 24. Our study finds evidence that MBSR improves work performance equivalently to SSRI medication among individuals with anxiety disorders. Given the limitations of SSRIs, MBSR should be considered as an alternative to individuals who desire improved anxiety symptoms and work outcomes. ClinicalTrials.gov Identifier: NCT03522844.

Pharmacodynamics of Drugs Adaptation to Activity in Extreme Conditions

A decrease in a person’s physical and mental performance, which occurs during activity in complicated conditions, under extreme influences, determines the advisability of using drugs aimed at pathogenetically significant mechanisms and targets for the development of distress as means of pharmacological support for adaptation processes. V.V. Zakusov Research Institute of pharmacology, over the course of many years, has accumulated significant experience in performing research and applied developments in order to improve the arsenal of medicines necessary for adaptation that are superior in effectiveness to existing ones. The review presents the developments of the original anxiolytic Afobazole, the nootropic drug Noopept, the antiasthenic drug Ladasten, and the drug Loxidan, an emergency means of increasing physical performance. Information is provided on the results of new exploratory pharmacological studies for the treatment of anxiety disorders, depression, post-traumatic stress disorders, aimed at regulating the central mechanisms that determine the development of distress and emerging pathologies.

CANNABIDIOL AS A FORM OF TREATMENT FOR PATIENTS WITH POST-TRAUMATIC STRESS DISORDER FROM VICTIMS OF VIOLENCE – INTEGRATIVE REVIEW

Introduction. Violence as a social and public health problem, with a particular focus on its consequences, such as Post-Traumatic Stress Disorder (PTSD). According to the World Health Organization, violence encompasses the intentional use of physical force or power, threatening or harming individuals, groups or communities. Objective: To describe the effects of Cannabidiol on patients with Post-Traumatic Stress due to physical and psychological violence. Methodology: This is an observational and retrospective integrative systematic review, with the exclusion criteria: non-empirical articles, non-indexed publications. A total of 545 articles related to post-traumatic stress and cannabidiol were found and only 13 articles were selected to present the results of this study. Results and discussion: The endogenous endocannabinoid system plays a significant role in the processing and extinction of fear memory. Cannabidiol (CBD), a non-psychoactive component of Cannabis sativa, has shown potential in the treatment of anxiety disorders, including PTSD. CBD interacts with the endocannabinoid system indirectly by increasing the availability of endocannabinoids such as anandamide, which act on CB1 receptors in the brain. This activation of the endocannabinoid system may help reduce the behavioral response to aversive memories and improve fear extinction. Final Thoughts: While early research on the effects of CBD on PTSD is promising, more studies are needed to determine its efficacy and safety, particularly in victims of violence. Sources also emphasize the need for greater awareness and accessibility of cannabinoid-based treatments for those who may benefit from them.

Acceptability of Digital Mental Health Interventions for Depression and Anxiety: Systematic Review.

Depression and anxiety disorders are common, and treatment often includes psychological interventions. Digital health interventions, delivered through technologies such as web-based programs and mobile apps, are increasingly used in mental health treatment. Acceptability, the extent to which an intervention is viewed positively, has been identified as contributing to patient adherence and engagement with digital health interventions. Acceptability, therefore, impacts the benefit derived from using digital health interventions in treatment. Understanding the acceptability of digital mental health interventions among patients with depression or anxiety disorders is essential to maximize the effectiveness of their treatment. This review investigated the acceptability of technology-based interventions among patients with depression or anxiety disorders. A systematic review was performed based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and PROSPERO (International Prospective Register of Systematic Reviews) guidelines. We searched PubMed, Web of Science, and Ovid in May 2022. Studies were included if they evaluated digital interventions for the treatment of depression or anxiety disorders and investigated their acceptability among adult patients. Studies were excluded if they targeted only specific populations (eg, those with specific physical health conditions), investigated acceptability in healthy individuals or patients under the age of 18 years, involved no direct interaction between patients and technologies, used technology only as a platform for traditional care (eg, videoconferencing), had patients using technologies only in clinical or laboratory settings, or involved virtual reality technologies. Acceptability outcome data were narratively synthesized by the direction of acceptability using vote counting. Included studies were evaluated using levels of evidence from the Oxford Centre for Evidence-Based Medicine. The risk of bias was assessed using a tool designed for this review and GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). A total of 143 articles met the inclusion criteria, comprising 67 (47%) articles on interventions for depression, 65 (45%) articles on interventions for anxiety disorders, and 11 (8%) articles on interventions for both. Overall, 90 (63%) were randomized controlled trials, 50 (35%) were other quantitative studies, and 3 (2%) were qualitative studies. Interventions used web-based programs, mobile apps, and computer programs. Cognitive behavioral therapy was the basis of 71% (102/143) of the interventions. Digital mental health interventions were generally acceptable among patients with depression or anxiety disorders, with 88% (126/143) indicating positive acceptability, 8% (11/143) mixed results, and 4% (6/143) insufficient information to categorize the direction of acceptability. The available research evidence was of moderate quality. Digital mental health interventions seem to be acceptable to patients with depression or anxiety disorders. Consistent use of validated measures for acceptability would enhance the quality of evidence. Careful design of acceptability as an evaluation outcome can further improve the quality of evidence and reduce the risk of bias. Open Science Framework Y7MJ4; https://doi.org/10.17605/OSF.IO/SPR8M.

Pilot study of a parent-based intervention for functional somatic symptoms in children.

Functional somatic symptoms are associated with significant distress and impairment for children and their families. Despite the central role that families play in their children's care, there is little clinical research to guide how parents can support their children with functional somatic symptoms and promote better functioning. To address this gap, we developed a parent-based intervention for functional somatic symptoms in children and obtained preliminary data on acceptability, feasibility, treatment satisfaction, and clinical outcomes. The intervention was adapted from SPACE (Supportive Parenting for Anxious Childhood Emotions), an evidence-based treatment for anxiety and related disorders in children. The intervention, SPACE-Somatic, was delivered to parents of 16 children (Mage = 14.50 years; 75% girls) with a range of functional somatic symptoms. Parents participated in seven weekly group sessions conducted via telehealth. We found that SPACE-Somatic was acceptable, feasible, and satisfactory to parents. There were significant improvements in several clinical outcomes from baseline to posttreatment, including children's level of functional impairment, with some gains maintained at 3-month follow-up. Parents also reported improvements in their own stress and their accommodation of children's symptoms. This pilot study provides preliminary evidence that a parent-based intervention is viable and beneficial to children with functional somatic symptoms and their parents.

Cost-effectiveness analysis of mindfulness-based cognitive therapy in patients with anxiety disorders in secondary mental health care settings alongside a randomized controlled trial.

Anxiety disorder is one of the most prevalent mental disorders. Mindfulness-based cognitive therapy (MBCT) is effective for treating anxiety disorders. However, no studies have investigated the cost-effectiveness of MBCT for anxiety disorders. We aimed to conduct a cost-effectiveness analysis alongside a randomized controlled trial (RCT) to clarify the cost-effectiveness of MBCT for anxiety disorders. A cost-effectiveness analysis alongside an RCT was conducted for 8 weeks in 40 patients with anxiety disorders at a university hospital. Patients (1) aged 20-75 years; (2) who were diagnosed with panic disorder/agoraphobia or social anxiety disorder based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria; and (3) who provided written consent were analyzed. The participants were allocated randomly (1:1 ratio) to the augmented MBCT group (i.e., MBCT plus treatment as usual [TAU]) or TAU (waitlist control) group. The cost-effectiveness was assessed using the incremental cost-effectiveness ratio (ICER), which is the ratio of the incremental costs divided by the incremental state-trait anxiety inventory- state (STAI-S), state-trait anxiety inventory- trait (STAI-T), and quality-adjusted life years (QALYs). The QALYs were estimated using The Japanese version of EuroQoL five-dimensional 3-level questionnaire. The unit cost data were derived from the government-regulated fees. This study was conducted from a public healthcare insurance perspective. No discount rates were considered. A total of 38 participants with complete data were included in the analysis. The MBCT was JPY 13,885 more than the cost of TAU and was associated with a STAI-S, STAI-T, and QALY increase of 10.13, 12.00, 0.009 respectively. The ICER were JPY 1,371 (USD13) per STAI-S, JPY 1,157 (USD 11) per STAI-T, and JPY 1,566,357 (USD 14,940) per QALY respectively. MBCT had an 77.5% probability of being cost-effective at a willingness to pay threshold in Japan (JPY 5,000,000 per QALY). The results of the four one-way sensitivity analyses supported the robustness of the base-case analysis findings. Augmented MBCT for anxiety disorders is cost-effective compared with TAU post-treatment from a public healthcare insurance perspective. Future studies should include long-term observations, and analysis from a societal perspective.

Recent Progress in Synthetic and Natural Catechol-O-methyltransferase Inhibitors for Neurological Disorders.

Catechol-O-methyltransferase (COMT) inhibitors have played a crucial role in the development of potent and selective drugs for the treatment of Parkinson's disease, depression, and anxiety disorders. This review provides a comprehensive analysis of the structure-activity relationship (SAR) of COMT inhibitors, highlighting key structural features and pharmacophoric elements that govern their potency, selectivity, and pharmacokinetic properties. This review also discusses the application of SAR principles in the design and optimization of COMT inhibitors. Our analysis reveals the emergence of novel chemical scaffolds and the potential for COMT inhibitors to address unmet medical needs in neurology and psychiatry. This Perspective serves as a valuable resource for clinicians and researchers, providing insights into the rational design of COMT inhibitors and the development of next-generation therapeutics.

THE KEY CHARACTERISTICS OF THE COGNITIVE-BEHAVIORAL THERAPY AS A PERFORMANCE FACTOR IN THE PSYCHOLOGICAL PRACTICE

Cognitive Behavioral Therapy (CBT) is a modern, pragmatic, evidence-based psychotherapeutic approach. Numerous studies have proven the effectiveness of CBT in the treatment of depression, anxiety disorders, eating disorders and personality disorders. CBT is used along with the pharmacological treatment of schizophrenia, bipolar disorder, and other mental disorders. The research focuses on the main characteristics of cognitive-behavioral therapy, such as therapeutic relationship, conceptualization, psychoeducation, and relapse prevention, which are essential for therapeutic performance. The ways of reflection development are outlined, the difficulties encountered by a CBT therapist are identified. An evaluation form of the implementation of key components of CBT in practice is proposed, which includes a list of questions for sessions planning and the therapeutic plan development. Keywords: fundamentals of cognitive-behavior therapy (CBT), principles, conceptualization, therapeutic relationships, psychoeducation, reflection, relapse prevention

A review on the efficacy of artificial intelligence for managing anxiety disorders.

Anxiety disorders are psychiatric conditions characterized by prolonged and generalized anxiety experienced by individuals in response to various events or situations. At present, anxiety disorders are regarded as the most widespread psychiatric disorders globally. Medication and different types of psychotherapies are employed as the primary therapeutic modalities in clinical practice for the treatment of anxiety disorders. However, combining these two approaches is known to yield more significant benefits than medication alone. Nevertheless, there is a lack of resources and a limited availability of psychotherapy options in underdeveloped areas. Psychotherapy methods encompass relaxation techniques, controlled breathing exercises, visualization exercises, controlled exposure exercises, and cognitive interventions such as challenging negative thoughts. These methods are vital in the treatment of anxiety disorders, but executing them proficiently can be demanding. Moreover, individuals with distinct anxiety disorders are prescribed medications that may cause withdrawal symptoms in some instances. Additionally, there is inadequate availability of face-to-face psychotherapy and a restricted capacity to predict and monitor the health, behavioral, and environmental aspects of individuals with anxiety disorders during the initial phases. In recent years, there has been notable progress in developing and utilizing artificial intelligence (AI) based applications and environments to improve the precision and sensitivity of diagnosing and treating various categories of anxiety disorders. As a result, this study aims to establish the efficacy of AI-enabled environments in addressing the existing challenges in managing anxiety disorders, reducing reliance on medication, and investigating the potential advantages, issues, and opportunities of integrating AI-assisted healthcare for anxiety disorders and enabling personalized therapy.

The impact of sleep disturbances on treatment efficacy and prognosis in patients with depressive and anxiety disorders.

Little was known about the relationship between sleep disturbances and depressive and anxiety disorders, as well as the efficacy of treatment regimens. During 2021 to 2023, a total of 417 participants were screened by Hamilton Depression Rating Scale (HAMD-17) and Hamilton Anxiety Rating Scale (HAMA-14) for psychological status, and Pittsburgh sleep quality index (PSQI) assessment. 409 participants were finally enrolled, of which 188 (45.97%) were suffered from sleep disorders. All participants were received polysomnography (PSG) followed by six-week pharmacological treatment of escitalopram and zopiclone, and finally assessed by HAMD-17 and HAMA-14 for treatment efficacy. PSG monitoring indicated that participants with depression experienced prolonged rapid eye movement sleep latency (REMSL) and increased wakefulness after sleep onset (WASO) (P=0.030 and P=0.002, respectively). Those with anxiety disorders demonstrated a significantly higher percentage of non-rapid eye movement sleep (NREM%) and reduced WASO (P=0.013 and P=0.001, respectively). After six-weeks pharmacological treatment, participants with or without sleep disorders exhibited with similar efficacy outcomes of depression and anxiety disorders (P>0.05). However, every point of PSQI increment at baseline would decrease 0.78 and 0.85 times of probability of effective pharmacological treatment of depression and anxiety disorders. Moreover, participants with both effective outcomes of depression and anxiety disorders were found significant shorter sleep onset latency (SOL) (P<0.001). The insights gained underscore the necessity of considering sleep disturbances in enhancing the overall effectiveness of pharmacological treatments for depression and anxiety disorders.

Use of Subsidized Health Services by Artists in Canada: An Exploratory Study.

Creative and performing artists are often confronted with precarious employment and insufficient healthcare coverage. A clinic in Canada that provides specialized healthcare to artists offers eligible artists subsidized health services. We aim to compare the use of health services, demographics and health conditions between subsidy artist recipients (SAs) and non-subsidy artists (NSAs). We accessed existing data from 265 SAs and 711 NSAs and applied descriptive and inferential statistics to address our research questions. Musculoskeletal issues, stress, anxiety disorders, and depressive disorders are the most common health problems faced by SAs. Compared to NSAs, SAs were more likely to seek treatment for stress, but less likely to seek treatment for anxiety disorders, depressive disorders, chronic problems, and upper extremity problems. Future research may investigate the enduring effects of subsidized health services on SAs' health outcomes. Sustained positive outcomes are crucial for maintaining an artist's career and well-being.

The Role of Psychological Flexibility in the Treatment of Anxiety Disorders: A Systematic Review

The Role of Psychological Flexibility in the Treatment of Anxiety Disorders: A Systematic Review

Mindfulness Meditation vs Escitalopram for Treatment of Anxiety Disorders

This secondary analysis of a randomized clinical trial assesses patient-reported anxiety, depression, and quality of life among patients receiving mindfulness-based stress reduction vs escitalopram for the treatment of anxiety disorders.

Pleasant Odor Decreases Mouse Anxiety-like Behaviors by Regulating Hippocampal Endocannabinoid Signaling.

Anxiety disorder is one of the most common neuropsychiatric disorders, and affects many people's daily activities. Although the pathogenesis and treatments of anxiety disorder have been studied for several decades, the underlying mechanisms remain elusive. Here, we provide evidence that olfactory stimuli with inhaled linalool or 2-phenylethanol decreased mouse anxiety-like behaviors and increased the activities of hippocampal dentate granule cells (DGCs). RNA-sequencing analysis identified retrograde endocannabinoid signaling, which is a critical pathway for mood regulation and neuron activation, is altered in the hippocampus of both linalool- and 2-phenylethanol-exposed mice. Further studies found that selective inhibition of endocannabinoid signaling by injecting rimonabant abolished the activation of DGCs and the anxiolytic effect induced by linalool or 2-phenylethanol. Together, these results uncovered a novel mechanism by which linalool or 2-phenylethanol decreases mouse anxiety-like behaviors and increases DG activity likely through activating hippocampal retrograde endocannabinoid signaling.

Sex differences in behavior and glutamic acid decarboxylase in Long Evans rats after prolonged social isolation beginning in adolescence.

Social isolation can have long-term effects on brain development and behavior and increases the risk of developing clinical conditions, including anxiety disorders. One modulator of the stress response is gamma-aminobutyric acid, an inhibitory neurotransmitter synthesized by glutamic acid decarboxylase (GAD). This study examined sex differences in behavior and GAD expression following prolonged social isolation beginning in adolescence in Long Evans rats. Males and females were equally divided into group-housed (GH) and socially isolated conditions on Postnatal Day 28 (n = 8 per group). Beginning 5 weeks later, tests were conducted for anxietylike behaviors (open-field test and elevated plus maze), social interactions (sociability test), and spatial memory (novel object location). Sex differences in behavior were observed, with GH females showing fewer anxietylike behaviors in the open-field test and elevated plus maze and spending more time with objects (sociability task) compared to GH males. Isolation had no effect on males but increased anxiety and reduced neophilic measures in females, removing sex differences. On the sociability task, all groups spent more time with novel rats compared to objects, suggesting social interest was retained after isolation. In the hippocampus, isolation reduced GAD in both sexes, and sex differences were seen (F > M). However, no group differences in behavior were observed in the hippocampal-dependent novel object location task. Our findings suggest that prolonged social isolation beginning in adolescence is anxiogenic for female Long Evans rats. Furthermore, sex and housing impact hippocampal GABA-ergic activity, which may have important implications in the treatment of anxiety disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Acute Augmented Effect of Virtual Reality (VR)-Integrated Relaxation and Mindfulness Exercising on Anxiety and Insomnia Symptoms: A Retrospective Analysis of 103 Anxiety Disorder Patients With Prominent Insomnia.

Anxiety disorder is one of the most common mental disorders and often accompanied with sleep disturbance which can in turn exacerbate anxiety symptoms, creating a vicious cycle. In addition to psychopharmacological therapy, the effectiveness of psychotherapy as cognitive behavioral therapy (CBT) for treating anxiety disorders and insomnia has been well documented and widely accepted, but it is labor-intensive and costly. However, virtual reality (VR)-integrated CBT may improve this condition but needs more evidences to support its extensive application in routine clinical practice. This explorative study was aimed to conduct a retrospective analysis to evaluate the acute (2 weeks) augmented effect of VR-integrated relaxation and mindfulness exercising in improving anxiety and insomnia symptoms for patients who were diagnosed with anxiety disorders and concurrently with prominent insomnia symptoms and admitted to the Department of Psychiatry, The Affiliated Guangdong Second Provincial General Hospital of Jinan University during January 2021 to June 2021. All patients who were admitted to the department of psychiatry during January 1, 2021 to June 30, 2021 were screened with inclusion criteria and exclusion criteria, and the sociodemographic and clinical data of those included patients were collected from the electronic medical record system of the hospital using a self-designed case report form (CRF). Subjects who were administrated with medication alone were designated as conventional group, and those receiving treatment of medication combined with VR-integrated CBT (VR relaxation and mindfulness exercising) as VR group. The baseline and 2-week posttreatment data were compared between the two groups. In total, there were 103 patients (70 female, 68%) included in the study. Among all, 68 (66.02%) were designated as the "VR group," and 35 (33.98%) as the "conventional group." The majority of patients (67%) were diagnosed with generalized anxiety disorder (GAD). Twenty-three (22.3%) patients had a comorbid diagnosis with primary insomnia, and insomnia was just one of the accompanying symptoms with anxiety for the rest 80 subjects. No statistically significant differences were found between VR and conventional groups in all baseline sociodemographic and clinical characteristics except for occupation. There were statistically significant differences for the remission rates of anxiety symptoms or insomnia symptoms and reduction of Hamilton Anxiety Rating Scale or Insomnia Severity Index total scores between conventional and VR groups. Greater remission rates or score reductions were found in VR group than in conventional group either for anxiety or for insomnia. Robust differences still existed when controlled for the variable "occupation." Two-week augmented VR-integrated relaxation and mindfulness exercising is acutely beneficial for relieving both anxiety and insomnia symptoms and worth being recommended for routine clinical practice. Further prospective and randomized study compared to traditional CBT to explore its acute and long-term effect on anxiety and insomnia is needed.

Effectiveness of an Internet-Based Transdiagnostic Unified Protocol Intervention for the Treatment of Depressive and Anxiety Disorders in Women with Threatened Abortion: A Feasibility Study

Background: Despite the high prevalence of depressive and anxiety disorders among women with threatened abortion (TA), there is scant evidence regarding the efficacy of psychotherapies for this group Objectives: This research aimed to assess the effectiveness, acceptability, and feasibility of specific internet-based cognitive behavioral therapy (iCBT-Specific) and unified protocol (iUP) for women with a TA. Methods: In this semi-experimental study (from April to October 2023), after the treatment content was prepared, a total of 80 pregnant women with TA, over 18 years of age, having a gestational age of 5 - 12 weeks, from a hospital and two private clinics, who were diagnosed with depressive and anxiety disorders based on the short structured diagnostic interview (Mini-International Neuropsychiatric Interview), were selected. The participants were divided into two groups, undergoing iUP or iCBT-specific psychotherapies. All participants completed the Brief Symptom Inventory (BSI-18) to measure the levels of depressive and anxiety symptoms. Following eight weeks of internet-based therapy, consisting of eight 50-minute sessions, they completed the BSI-18 again, along with the Client Satisfaction Questionnaire (CSQ-8) and the System Usability Scale (SUS). Statistical analysis was performed using SPSS version 22 software, and t-test, paired t-test, and ANCOVA tests were used. Results: Both the iUP and iCBT-Specific models demonstrated high acceptability, and the average feasibility of treatment was above average for both models. In terms of acceptability and feasibility of treatment for women with TA, neither model proved to be superior (all P &gt; 0.05). Both iUP and iCBT-Specific models were effective in reducing depression and anxiety in these women (effect size for within groups were respectively Eta = 0.370, Eta = 0.536). Also, in terms of improving depression and anxiety, there was no significant difference in the effectiveness of iUP and iCBT-Specific treatments (respectively P = 0.146, Eta = 0.027 and P = 0.221, Eta = 0.019) Conclusions: The iUP treatment can be recognized as a reliable alternative to the iCBT-Specific method for alleviating depressive and anxiety symptoms in women with TA. Also, our results help gynecologists to use iUP as an alternative treatment when there is no definitive diagnosis of the type of disorder.

Triagem in silico de compostos com atividade ansiolítica encontrados na espécie Magnolia obovata

Magnolia obovata, known as “Japanese cucumber”, is a deciduous tree of Asian origin, constituting a medicinal plant due to its anti-inflammatory, anxiolytic, antidepressant effects, among other central effects, already demonstrated in the literature. The objective of this study was to suggest the mechanisms of action for the effects on the central nervous system of the compounds identified in the species M. obovata, especially regarding the anxiolytic effect currently sought with the use of the plant. Nineteen compounds present in M. obovata were identified, with only 2 molecules (alpha-eudesmol and gamma-eudesmol) showing in silico pharmacokinetic and toxicological properties favorable to anxiolytic bioactivity. Such molecules inhibit acylcarnitine hydrolase and increase free acylcarnitine, possibly generating an anxiolytic effect. Pharmacophoric modeling of those molecules showed 6 interaction points with the 5 most potent known ligands of acylcarnitine hydrolase and such structural similarity is promising for acting on this target. There are advantages of the alternative mechanism of action of this compound in relation to current anxiolytics, which could be used to formulate new therapies in the treatment of anxiety disorders. The results obtained here open perspectives for tests in in vitro and in vivo models, aiming to confirm the results of the computational analyses.