Untreated Anxiety Research Articles

The anxiety care continuum and its association with viral suppression among persons with HIV.

It is unclear how often anxiety is diagnosed and treated and whether anxiety treatment is associated with improved viral suppression in persons with HIV. In this study, we characterized the anxiety care continuum and its association with viral suppression in a large urban HIV clinic in the United States. Observational cohort study. We described the anxiety care continuum by combining data on self-reported anxiety symptoms, engagement in mental health care, clinical diagnoses and prescriptions from 1,967 persons receiving HIV care and treatment in Baltimore, Maryland, from 2014-23. We examined cross-sectional associations with viral suppression. All analyses were stratified by sex and race/ethnicity; a secondary analysis adjusted for age, years in care, and depressive symptoms. Nearly 1 in 5 patients reported mild-severe symptoms of anxiety but were not currently receiving mental health care or pharmacologic treatment for anxiety; 6% of patients reported anxiety symptoms but were receiving treatment, and 7% had been treated for anxiety that was currently in remission. The prevalence of viral suppression ranged from 87-89% across the anxiety care continuum except among patients with untreated moderate-severe anxiety, only 81% of whom were virally suppressed (95% CI: 80, 83). In adjusted models, untreated moderate-severe anxiety remained associated with viral non-suppression across demographic groups. We observed a robust association between untreated anxiety and viral non-suppression in a large urban cohort of persons with HIV. Screening for anxiety may identify patients with unmet mental health care needs who face barriers to maintaining viral suppression.

Caregiver experienced racism, acculturative stress, and political hostility predict anxiety in Latinx families residing in the United States.

Cultural stress potently predicts mental health inequities, such as anxiety, among adult and adolescent immigrants in the United States. However, less work has focused on preadolescence, a period marked by neurodevelopmental and psychosocial changes that can exacerbate anxiety symptoms. Latina girls, who exhibit heightened levels of untreated anxiety, may be at elevated risk. The present study tests whether cultural stress predicts anxiety symptoms in Latina girls and their caregivers. The primary caregivers of 161 predominantly Mexican-identifying Latina girls (Mage = 10.70, SD = 1.68) reported their exposure to racism, acculturative stress, and political hostility. They also reported their own and their daughter's anxiety severity. To index cultural stress, a principal component was extracted from composite scores of the racism, acculturative stress, and political hostility questionnaires. Hierarchical regression analyses then tested whether the multidetermined cultural stress component predicted caregiver and child anxiety, with child age, annual household income, and subjective socioeconomic status entered at the first step. Cultural stress positively predicted caregiver (ΔR² = .13, p < .001) and child (ΔR² = .15, p < .001) anxiety symptoms over and above the observed inverse effects of subjective socioeconomic status, such that higher levels of cultural stress were associated with elevated levels of caregiver (ß = .37, p < .001) and child (ß = .39, p < .001) anxiety symptoms. The results of this study highlight the role of racism, acculturative stress, and political hostility in escalating anxiety symptoms in Latinx families and identify cultural stress as a factor that likely contributes to the high rates of anxiety in Latina girls during a key developmental period. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Ethnic–Racial Discrimination Exposure and Anxiety in Latina Girls: Amygdala Volume as an Indirect Neurobiological Pathway

Ethnic–racial discrimination, the differential treatment of individuals based on ethnic or racial group membership, predicts poor mental health outcomes such as anxiety. This is supported by long-standing theories on the social determinants of health and minority stress. However, these theories are rarely expanded to neurobiological sciences, limiting our understanding of mechanisms underlying observed associations. One potential neurobiological pathway between ethnic–racial discrimination exposure and anxiety is that ongoing exposure to racially charged encounters presents imminent threats that may modify stress-sensitive neurocircuitry, like the amygdala.The current study evaluated whether amygdala volume mediated associations between ethnic–racial discrimination exposure and anxiety symptoms in Latina girls, a group exhibiting heightened levels of untreated anxiety and disproportionately subjected to ethnic–racial discrimination.Thirty predominantly Mexican-identifying Latina girls residing in Southern California (MAge = 9.76, SD = 1.11 years) completed a T1-weighted structural MRI scan. Using the Perceptions of Racism in Children and Youth, participants self-reported the prevalence and severity of various discriminatory experiences. Participants also self-reported their anxiety symptoms via the Screen for Child Anxiety and Related Emotional Disorders. Controlling for total intracranial volume and annual household income, an indirect effect of ethnic–racial discrimination on anxiety symptoms via left amygdala volume was observed, β = −0.28, SE = 0.17, BC 95% CI [−0.690, −0.017]. The current findings suggest that the left amygdala is sensitive to racialized threats in childhood and that stress-related alterations may, in part, contribute to elevated anxiety in Latina girls. Our data elucidate a potential mechanism by which this form of sociocultural stress can adversely impact mental health, particularly in the transition from middle childhood to early adolescence, a period marked by a host of interlinked neurophysiological and social changes.

Separation anxiety

Anxiety disorders are the most common mental disorders in children and are often under-recognized. Untreated anxiety disorders in children can significantly affect the quality of life. They can lead to comorbid psychiatric conditions and interfere with social, emotional and academic development, including in adulthood. Separation anxiety disorder is one of the most common childhood anxiety disorders. It involves an exaggeration of the anxiety typical for the developmental process and is manifested by excessive distress at separation from the attachment figure or family environment. The etiology of separation anxiety disorder points to the interaction of biological and environmental factors, particularly the family environment in early childhood. Diagnostic criteria for SAD are provided by DSM-V and are used in the comprehensive assessment of the disorder, in combination with other internationally validated assessment tools. The diagnosis provides essential information for the elaboration of the therapeutic approach by the clinical specialists. In this sense, there are conclusive data on the effectiveness of combining psychotherapy with pharmacotherapy to achieve lasting results. Furthermore, the importance of coordinating inter-professional efforts is essential for the effectiveness of the comprehensive approach to TAS.

Employees Job Anxiety - Challenges and Strategies to Deal at a Private Hospital in Kolar - A Case Study

Purpose: Job Anxiety among employees in a private hospital setting can have a number of negative effects on both individuals and the organization as a whole. It can lead to decreased Job satisfaction, increased burnout, decreased productivity, and reduced patient safety and treatment quality. Furthermore, untreated anxiety can lead to absenteeism, high employee turnover, and higher healthcare expenditures for the firm. The goal of this analysis is to explore employee Job Anxiety in the context of a private hospital and propose appropriate techniques. Design/Methodology/Approach: Descriptive statistics and stratified random sampling were employed. The methodology includes the study Plan, study setting up, sources of data, participants, gathering data process, size of the sample, sample plan of action, questionnaire framework, and data analysis. Finding/Result: As a result, there is an important desire to investigate and propose targeted techniques aimed specifically at addressing and mitigating staff Job Anxiety in private hospitals. Such initiatives should take into account the unique features of the private hospital setting, including healthcare personnel's different roles and responsibilities, organizational culture, and available resources. By filling this knowledge gap, private hospitals can help their staff's mental health, increase Job satisfaction, and improve patient care outcomes. The data analysis of this study verified that there is no significant difference in Job Anxiety levels among Male and Female employees at a private Hospital. Originality/Value: The worth of staff Job Anxiety and methods for dealing with it in a private hospital are important because of their contribution to knowledge and potential consequences for improving the general wellness of healthcare personnel and the facility itself. Paper Type: Case study-original research findings

The effectiveness of the clinical skills model for continuity of care in postpartum mothers

Background: The postpartum period is a period of recovery for mothers. At this time, many physical and psychological changes make mothers uncomfortable. Those feelings of discomfort can cause anxiety in some persons. Long-term untreated anxiety will affect the mother's mental health and even how she cares for her child. Midwives, who are the front-line providers of maternal health services, must be able to decrease anxiety by using the continuity of care model beginning with pregnancy, labor, and postpartum babies in order to avoid having an impact on excessive stress, even postpartum depression. This study aimed to determine the effect of applying the continuity of care model on maternal anxiety postpartum. Methods: This research was a quasi-experimental study with an equivalent non-control group design at the Paciran District Health Center from May to July 2022. Analyzing quantitative data allowed researchers to compare the postpartum anxiety levels of primiparous mothers in the intervention and control groups. The intervention group and the control group were each given a group of research participants. During the postpartum period, the intervention group received continuity of care (COC) support, whereas the control group received standard postpartum care. Results: The size of the effect of mentoring pregnant women with COC on anxiety was 7.80, and there was a significant difference between anxiety in postpartum women with COC and traditional help (p&lt;0.001). Conclusion: Anxiety in primiparous postpartum moms treated with COC as opposed to traditional assistance differs significantly.

Testing anxiety and reward processing in anorexia nervosa as predictors of longitudinal clinical outcomes

Anorexia nervosa (AN) is a psychiatric disorder with a tenuous longitudinal course marked by a high risk of relapse. Previous studies suggest that aberrant threat perception and reward processing operate in many with AN, and may produce obstacles to treatment engagement; therefore, these could potentially represent predictors for longitudinal clinical outcomes. In this study, anxiety and reward symptoms, behaviors, and neural circuit connectivity were measured in intensively treated AN-restrictive subtype patients (n = 33) and healthy controls (n = 31). Participants underwent an fMRI experiment using a monetary reward task in combination with either overlapping individually tailored anxiety-provoking words or neutral words. Behavioral/psychometric measures consisted of reaction times on the monetary reward task and self-ratings on anxiety symptoms at study entry. We tested multimodal, multivariate models based on neural, behavioral, and psychometric measures of reward and anxiety to predict physiological (Body Mass Index; BMI) and psychological (eating disorder symptom severity) longitudinal outcomes in AN over six months. Our results indicated that higher anxiety symptom psychometric scores significantly predicted BMI reductions at follow-up. Untreated anxiety after intensive treatment could put individuals with AN at heightened risk for weight loss. This represents a potentially modifiable risk factor that could be targeted more aggressively to help reduce the chance of future clinical worsening.

ENGLISH LANGUAGE ANXIETY AMONG MALAYSIAN SIAMESE STUDENTS: EXPLORING THE CONTRIBUTING FACTORS

This study examined the English language anxiety of Siamese students as one of the minority ethnicities in Malaysia. The consequences of untreated anxiety and depression among students cannot be underestimated, as they are vulnerable to various social and behavioral problems, compromised learning performance, and diminished self-esteem. To delve into this issue, a total of 113 Malaysian Siamese students attending national and national type-secondary schools with a minimum of seven years of experience learning English filled up the Foreign Language Anxiety Scale (FLCAS), a popularly used instrument to measure foreign language anxiety among learners. The findings revealed items categorised under the fear of negative evaluation as the most likely to provoke anxiety among the students, whereas components covering anxieties in English tests reported the lowest. The results generally indicate that minority Siamese students view evaluation by others as more anxious than being academically tested. Hence, teachers are recommended to be more particular in planning and designing English lessons in multiracial classrooms so the anxiety-provoking vibes can be handled appropriately.

PERSONAL ANXIETY AS A CAUSE OF CVD AMONG YOUNG POPULATION

Introduction: The past decade has seen an increased research interest in anxiety disorders, in large part due to greater recognition of their burden and consequences associated with an untreated disease. Untreated anxiety is associated with significant personal and societal costs associated with frequent visits to primary and emergency care, reduced work productivity, unemployment, and deteriorating social relationships. Purpose: to study the relationship between personal anxiety (PT) and self-determination of health among young people Materials and methods: a study was conducted in 2013-2016. sampling of the population of Novosibirsk. A total of 975 persons were examined, of which 43.7% were men. A test was used to determine LT in the modification of Yu.L. Khanin. Results: 57% of men with a high level of anxiety (HUT) considered themselves not quite healthy, while with a low level of anxiety (LAT) 27%. Among females experiencing excessive anxiety, in 65% of cases they assumed poor health, while women who feel safe are 2 times less. Over-anxious young people were 2 times more likely to express complaints related to health. Moreover, excessive anxiety prevented them from taking full care of maintaining their health, both young men and women believed. Expressed anxiety also manifested itself in obsessive thoughts in the near future to get a serious illness, which was more pronounced in women. Young men were more distrustful in communicating with medical specialists and believed that they could trust only after rigorous checks. Only 14% of men who were excessively anxious felt confidence in self-checking their health, assuming that they could completely rely only on their feelings of health or ill health. However, VUT did not prevent positive emotions from interacting with medical staff, according to the men's responses. Conclusion: personal anxiety contributes to low self-esteem of the state of one's own health. On the other hand, anxiety may be associated with a delay, irregular or inconsistent seeking of medical care.

Maternal Benzodiazepines and Z-Drugs Use during Pregnancy and Adverse Birth and Neurodevelopmental Outcomes in Offspring: A Population-Based Cohort Study

Introduction: The use of benzodiazepines and/or z-drugs in women of childbearing age has increased. Objective: The aim of the study was to evaluate whether gestational benzodiazepine and/or z-drug exposure is associated with adverse birth and neurodevelopmental outcomes. Methods: A population-based cohort including mother-child pairs from 2001 to 2018 in Hong Kong was analysed to compare gestationally exposed and nonexposed children on the risk of preterm birth, small for gestational age, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) through logistic/Cox proportional hazards regression with a 95% confidence interval (CI). Sibling-matched analyses and negative control analyses were applied. Results: When comparing gestationally exposed with gestationally nonexposed children, the weighted odds ratio (wOR) was 1.10 (95% CI = 0.97–1.25) for preterm birth and 1.03 (95% CI = 0.76–1.39) for small for gestational age, while the weighted hazard ratio (wHR) was 1.40 (95% CI = 1.13–1.73) for ASD and 1.15 (95% CI = 0.94–1.40) for ADHD. Sibling-matched analyses showed no association between gestationally exposed children and their gestationally nonexposed siblings for all outcomes (preterm birth: wOR = 0.84, 95% CI = 0.66–1.06; small for gestational age: wOR = 1.02, 95% CI = 0.50–2.09; ASD: wHR = 1.10, 95% CI = 0.70–1.72; ADHD: wHR = 1.04, 95% CI = 0.57–1.90). Similarly, no significant differences were observed when comparing children whose mothers took benzodiazepines and/or z-drugs during pregnancy to children whose mothers took benzodiazepines and/or z-drugs before but not during pregnancy for all outcomes. Conclusions: The findings do not support a causal relationship between gestational benzodiazepines and/or z-drugs exposure and preterm birth, small for gestational age, ASD, or ADHD. Clinicians and pregnant women should carefully balance the known risks of benzodiazepines and/or z-drugs use against those of untreated anxiety and sleep problems.

Towards precision medicine for anxiety disorders: objective assessment, risk prediction, pharmacogenomics, and repurposed drugs

Anxiety disorders are increasingly prevalent, affect people’s ability to do things, and decrease quality of life. Due to lack of objective tests, they are underdiagnosed and sub-optimally treated, resulting in adverse life events and/or addictions. We endeavored to discover blood biomarkers for anxiety, using a four-step approach. First, we used a longitudinal within-subject design in individuals with psychiatric disorders to discover blood gene expression changes between self-reported low anxiety and high anxiety states. Second, we prioritized the list of candidate biomarkers with a Convergent Functional Genomics approach using other evidence in the field. Third, we validated our top biomarkers from discovery and prioritization in an independent cohort of psychiatric subjects with clinically severe anxiety. Fourth, we tested these candidate biomarkers for clinical utility, i.e. ability to predict anxiety severity state, and future clinical worsening (hospitalizations with anxiety as a contributory cause), in another independent cohort of psychiatric subjects. We showed increased accuracy of individual biomarkers with a personalized approach, by gender and diagnosis, particularly in women. The biomarkers with the best overall evidence were GAD1, NTRK3, ADRA2A, FZD10, GRK4, and SLC6A4. Finally, we identified which of our biomarkers are targets of existing drugs (such as a valproate, omega-3 fatty acids, fluoxetine, lithium, sertraline, benzodiazepines, and ketamine), and thus can be used to match patients to medications and measure response to treatment. We also used our biomarker gene expression signature to identify drugs that could be repurposed for treating anxiety, such as estradiol, pirenperone, loperamide, and disopyramide. Given the detrimental impact of untreated anxiety, the current lack of objective measures to guide treatment, and the addiction potential of existing benzodiazepines-based anxiety medications, there is a urgent need for more precise and personalized approaches like the one we developed.

THE RELATIONSHIP BETWEEN ANXIETY AND RESILIENCE IN YOUNG ADULTS OF COVID-19 SURVIVOR IN JAKARTA

The Covid-19 pandemic has had a major impact and changed many aspects of human life. More than 50% of the number of people infected with COVID-19 in Jakarta are young adults. Therefore, young adult Covid-19 survivors are one of the groups who feel the impact of the Covid-19 pandemic. The high stigma of society towards Covid-19 has further worsened public acceptance of Covid-19 survivors. In addition, their self-productivity and career development are hampered due to social restrictions. This also results in the difficulty of finding work and even layoffs in various places. The condition and presence of Covid-19 survivors can cause anxiety and this anxiety greatly disrupts the lives of Covid-19 survivors. Prolonged and untreated anxiety can lead to self-defeating actions such as the emergence of suicidal intentions, so anxiety needs to be addressed as early as possible. Keye and Pidgeon (2013) called resilience as the mental capacity that can help and maintain a person's psychological stability in dealing with anxiety. The purpose of this study was to determine the relationship between resilience and anxiety in young adult Covid-19 survivors. This study involved 310 Covid-19 survivors aged 18 to 40. The measuring instruments used in this study were the Beck Anxiety Inventory (BAI) and The Connor Davidson Resilience Scale (DC-RISC). The data were analyzed using quantitative analysis methods, namely the spearman correlation technique. Based on the results of data processing, the correlation coefficient or r = -0.313 with significance or p = 0.000 ˂ 0.05. This means that there is a significant negative relationship between anxiety and resilience in young adult Covid-19 survivors in Jakarta.

Effect of Distraction Interventions on Anxiety in Children Undergoing Surgery: A Meta-Analysis

AbstractDue to the unfamiliarity of the surroundings, children having surgery endure worry and tension. Untreated anxiety in children impairs postoperative healing and causes changes in postoperative behavior. The purpose of this review was to determine the efficacy of distraction therapies on anxiety in children undergoing surgery. The systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. PubMed via MEDLINE, CINAHL, ProQuest, Web of Science, and the Cochrane Central Register of Controlled Trials were used to find relevant trials. Full-text papers published in English from January 1, 2000 to December 31, 2021 were included. Children undergoing surgery aged 1 to 18 years were included. A data extraction form was created to extract data from the selected studies. According to the Cochrane risk of bias assessment tool, studies were classified as “low risk,” “high risk,” or “unclear risk.” Review Manager software was used to do a quantitative meta-analysis. Thirteen studies looked at the effect of distraction intervention on children. Nine of them were selected for meta-analysis. The distraction interventions included in this review were: handheld video game, play dough and play with blocks and puzzles, tablet-based interactive distraction, animated video, painting and storytelling, age-appropriate video, distraction with video glasses, watching a movie, and bringing favorite toy during hospital stay. Meta-analysis showed that distraction interventions are effective on preoperative anxiety in children (standardized mean difference = –17.07, 95% confidence interval: 27.11–7.02, p = 0.0009).

ASSESS THE SEPARATION ANXIETY AMONG DEAF AND MUTE STUDENTS LIVING AND STUDYING IN SPECIAL SCHOOLS

Background: Research is aimed at studying the separation anxiety among deaf and mute students living and studying in special schools due to the internalized nature of their symptoms, anxiety disorders frequently go undiagnosed in school students. Academic performance and daily activities can be severely harmed by anxiety. Additionally, untreated anxiety over time can lead to behaviors like skipping school and eventually, early school exit. Objectives of the Study:1) Assess the separation anxiety among deaf and mute students with selected demographic variables.2) To associate separation anxiety with specific demographic variables. Materials and Methods: The purpose of this descriptive study and the goal of the research was to assess the anxiety among deaf and mute students living and studying in special schools. Based on inclusion criteria and purposeful convenient sample approaches, 52 students were chosen. The information was gathered in an organized way. Results: The goal of the research was to assess the separation anxiety among deaf and mute students living and studying in special schools. The deaf and mute students represent their separation anxiety in the form of mild separation anxiety, moderate separation anxiety, and severe separation anxiety, and the result was 92.33%, 5.75%, and 1.92% respectively. Conclusion: The researchers did a descriptive research investigation on the topic as part of their undergrad curriculum to assess the separation anxiety among deaf and mute students living and studying in a special school.

Developing an Anxiety Screening Tool for Children in South Africa: Protocol for a Mixed Methods Study.

BackgroundEarly childhood experiences such as trauma, exposure to violence, and poverty can significantly contribute to childhood anxiety, which is viewed as the most common mental health issue among children. In South Africa, there is no uniform tool to screen for anxiety during early childhood. This study aims to develop a tool to screen for anxiety in children aged 4 to 8 years, which could be utilized by preschool and foundation phase teachers to aid in the early identification of childhood anxiety.ObjectiveThe overall objective of this study is to explore understanding and perceptions of childhood anxiety among teachers, parents, and experts and to develop a tool to screen for anxiety in children aged 4 to 8 years.MethodsThis project will use a mixed method design that will consist of 4 stages. Stage 1 will consist of a scoping review. In Stage 2, data will be collected via semistructured interviews with 60 participants, including parents, teachers, and experts, and will be thematically analyzed. Stage 3 will consist of 20 experts and the researcher collaboratively formulating the proposed screening tool in the form of an e-Delphi component. Once the tool is refined, it will be piloted in Stage 4 with 20 teachers, and data will be analyzed with the Shapiro-Wilk test to test for normality. Additionally, factor analysis will be done to refine and restructure the tool as necessary.ResultsThis project was funded from April 2020 to December 2021. Data collection began in September 2022 and is projected to conclude in December 2022 for the qualitative component. The e-Delphi component is expected to be carried out from March to November 2023. Ethical approval was obtained from the Biomedical Research Ethics Committee in November 2021.ConclusionsAnxiety in early childhood has been linked to various repercussions in adolescence and adulthood, such as school dropout, substance abuse, anxiety disorders, depression, and suicide ideation. Therefore, identifying the presence of anxiety earlier on and providing the necessary referral services could aid in reducing the negative consequences of unidentified and untreated anxiety in early childhood.International Registered Report Identifier (IRRID)PRR1-10.2196/37364

Prevalence of Mental Health and Social Connection among Patients Seeking Tobacco Dependence Management: A Pilot Study.

Introduction: with regards to tobacco dependence management, there are certain barriers to successful smoking cessation for patients, such as untreated anxiety and depression. Complicating the impact of mental health morbidities on tobacco dependence may be the significant portion of patients whose mental health issues and limited social connections are undiagnosed and unaddressed. We hypothesize that patients with no prior mental health diagnoses who are treated for tobacco dependence have high rates of undiagnosed mental health morbidities. Methods: patients were recruited from a tobacco treatment clinic in 2021. Every patient who came for an inaugural visit without a prior diagnosis of mental health disease was screened for depression, anxiety, social isolation and loneliness. Sociodemographic variables were collected. Results: over a 12-month period, 114 patients were seen at the tobacco treatment clinic. Of these 114 patients, 77 (67.5%) did not have a prior diagnosis of a mental health disease. The mean age was 54.3 ± 11.2 years, 52 (67.5%) were females, and 64 (83.1%) were Black/African American. The mean age of starting smoking was 19.3 ± 5.2 years, and 43 (55.8%) had never attempted to quit smoking in the past. With regards to mental health screening, 32 (41.6%) patients had a score of 9 or greater on the Patient Health Questionnaire (PHQ) 9, 59 (76.6%) had a score of 7 or greater on the Generalized Anxiety Disorder (GAD) 7, 67 (87.0%) were identified with social isolation and 70 (90.1%) for loneliness on screening. Conclusion: there was a high prevalence of undiagnosed mental health morbidities and social disconnection in patients who were actively smoking and were struggling to achieve smoking cessation. While a larger scale study is necessary to reaffirm these results, screening for mental health morbidities and social disconnection may be warranted in order to provide effective tobacco dependence management.

COMPARISON OF ORAL MIDAZOLAM,ORAL DEXMEDETOMIDINE AND ORAL MIDAZOLAM KETAMINE COMBINATION FOR PREMEDICATION IN PAEDIATRIC SURGERY

Background: Children especially age group &lt;10years undergoing operation may experience preoperative anxiety &amp; may be uncooperative.This uncooperative behavior of children may be observed at the time of separation from parents, venipuncture or mask application. Untreated anxiety may lead to difficult induction, greater rescue analgesic needs, emergence delirium (ED), behavioural &amp; postoperative psychological effects. An atraumatic premedication, calm separation from parents can minimize these problems and a smooth induction of anaesthesia can be achieved.Method : Prospective randomized double blind active controlled study was conducted in Government medical college &amp; hospital, Aurangabad from 2018 to 2020 after Institution Ethics Committee approval. 75 ASA I &amp; II subjects aged between 2 to 5 year weighing less than 15 Kg posted for elective paediatric surgery under general anaesthesia at tertiary care centre were selected. They were randomly allocated into 3 groups Group M ,Group M K &amp; Group D with 25 subjects in each group using computer generated randomization list. Oral premedication was given in each group 30 minutes before surgery.Baseline heart rate,SBP and RR measured before administering premedication and at 10 minutes intervals up to 30 to 45 minutes after premedication. Results: Sedation &amp; anxiolysis score at induction[S1] was significant higher in Group M K&amp; Group D [p Value &lt;0.05] compared to Group M. Sedation at the time of separation from parents [S2] was better in Group M K &amp; Group D compared to Group M[p Value &lt;0.05].Sedation during Mask Acceptance[S3] was better in Group M K &amp; Group D compared to Group M[p Value &lt;0.05].Wake up Behaviour [when the patient recovers from anaesthesia at end of surgery [S4] ] was assessed &amp; Subjects were more Sedated[post anaesthesia] in Group D when compared to Group m &amp; Group M K[p Value &lt;0.05]. Time taken for maximum change in vital parameters was more in Group D followed by Group M K and Group M respectively p Value 0.001].There was significant changes in Vital parameters in Group D compared to Group M &amp; Group M K .Bradycardia p Value 0.00044] &amp; Hypotension [p Value 0.01]was more significant in Group D when compared to Group MK &amp;Group M Conclusion: Oral Midazolam (0.2mg/kg) &amp; Ketamine (2mg/kg) combination &amp; oral Dexmedetomidine (0.5 g/kg) both provide satisfactory sedation levels &amp; offers significant ease of separation from parents with satisfactory mask acceptance in children&lt;10 years compared to oral Midazolam alone.

The Rapid Evolution of Crisis Mental Health Services in Utah: Opportunities and Challenges as a Result of the Global Pandemic.

Our country is facing a resurgence of behavioral health crises from over the past 30 years, further illuminated and exacerbated by the global COVID-19 pandemic. Increasing suicide crises among youths over recent decades, untreated anxiety and depression, and serious mental illness are signs of the need for improvements in accessible, affordable, timely, and comprehensive behavioral health services. Against the backdrop of high suicide rates and low behavioral health services in Utah, statewide collaborators aligned with a common goal: deliver crisis services to anyone, anytime, and anywhere. After its initiation in 2011, the integrated behavioral health crisis response system continued to expand and excel, ultimately improving access and referral to services, flattening suicide rates, and reducing stigma. The global pandemic further motivated the expansion of Utah's crisis response system. This review focuses on the unique experiences of the Huntsman Mental Health Institute as a catalyst and partner in these changes. Our goals are to: inform about unique Utah partnerships and actions in the crisis mental health space, describe initial steps and outcomes, highlight continuing challenges, discuss pandemic-specific barriers and opportunities, and explore the long-term vision to improve quality and access to mental health resources.

Longitudinal screening for depression and anxiety in prostate cancer (PC) and association with disease and treatment factors.

5023 Background: Untreated depression and anxiety are associated with worse outcomes in patients with cancer. Despite recommendations for longitudinal screening, many patients are only assessed at the start of care. Men with PC often experience many phases of disease or treatment over a span of years, and androgen deprivation therapy (ADT) is associated with mood changes and depression. How depressive or anxiety symptoms fluctuate in men with PC, influenced by disease and treatment factors, is not well-described. Methods: Men with ≥1 Urology or Medical Oncology clinic visit for PC in the prior 6 months were emailed the PHQ-9 and GAD-7 depression and anxiety screening tools every 60 days; a score of ≥10 (moderate to severe symptoms) on either was considered a positive screen. Baseline characteristics and disease/treatment changes (PSA, radiographic, or biopsy progression, treatment change or start, or discontinuation of treatment due to lack of efficacy or toxicity) were collected by survey and chart review. We report early findings of factors associated with a positive screen or change in screening status with χ2 and forward stepwise binary logistic regression (model inputs: receipt of ADT or disease/treatment change during study, and variables previously associated with depression or anxiety: age, race, marital status, education, income, history of psychiatric disorder, use of psychoactive medication, time since diagnosis, and localized, biochemically recurrent, or metastatic disease). Results: From 6/2021-12/2021, 201 men enrolled. At baseline, 50.7% had localized, 18.9% biochemically recurrent, and 30.3% metastatic disease; 40.8% were on ADT; 30.8% had a history of psychiatric disorder (22.9% depression, 19.9% anxiety, 9.0% other); and 24.9% were on psychoactive medication (19.9% antidepressant, 8.5% anxiolytic, 2.0% antipsychotic). 184 men completed at least 2 screens with mean follow-up 6.5 months (SD 1.3). 32 men (15.9%) screened positive at least once (15.4% PHQ-9, 4.5% GAD-7), of which half (N = 16) initially screened negative and later positive. Changing from a negative to positive screen was more likely when a disease/treatment change occurred during the study (18.3% vs 4.5%, p = 0.003). A higher proportion of men on ADT screened positive, especially if newly started during the study or in the 60 days preceding (35.7% new ADT vs 24.7% continuing ADT vs 8.0% no ADT, p = 0.002). In fully adjusted multivariable analyses, factors associated with a positive screen were history of psychiatric disorder (OR 6.3, 95% CI 2.6-15.4, p &lt; 0.001), receipt of ADT (OR 3.8, 95% CI 1.5-9.5, p = 0.005), and lower income bracket (OR 1.7, 95% CI 1.3-2.5, p = 0.002). Conclusions: Longitudinal screening for depression and anxiety in PC identifies men who initially screen negative. Symptoms are associated with ADT and disease or treatment changes, which may inform optimal screening practices.

Motherhood and Me (Mom-Me): The Development of an Acceptance-Based Group for Women with Postpartum Mood and Anxiety Symptoms.

Untreated postpartum mood and anxiety disorders (PMADs) place women and their families at risk for negative biopsychosocial sequelae. Innovative and tailored treatments are needed to address potential disruptions in maternal functioning. Third-wave cognitive–behavioral approaches, including acceptance and commitment therapy (ACT) and dialectical behavioral therapy (DBT), hold promise for optimizing functioning given the focus on values-based living, rather than symptom reduction. Purpose: The purpose of this paper is to describe the development of an innovative psychotherapy group for women with symptoms of PMADs. Methods: This seven-session group, Motherhood and Me (Mom-Me), includes selected skills training from ACT, DBT, and Emotion-Centered Problem-Solving Therapy. Results: Mom-Me group sessions are described, and an outline of key information (session goals, content, and homework assignments) is provided to facilitate practical implementation. Conclusion: In line with third-wave approaches, this group was developed to enhance maternal functioning, which, in turn, may help women cope with psychological distress during the transition to motherhood.