Use Of Anxiolytics Research Articles

Use of Benzodiazepines in Hypertension Treatment

Hypertension is a worldwide prevalent disease and one of the main cardiovascular risk factors. Today we live in a society dominated by stress, depression and anxiety, disorders generating a high sympathetic discharge which is damaging for the cardiovascular health. It is usual that as physician we meet patients who in the office and/or emergency departments present some degree of anxiety associated with elevated blood pressure, and in these cases, the treatment chosen to decrease blood pressure is frequently anxiolytics, specially benzodiazepines. As currently no guidelines support the use of anxiolytics for blood pressure management, we decided to carry out a bibliographic review to assess the evidences of their indication to treat hypertension.

An evaluation of the accuracy and safety of prescribing antidepressants and anxiolytics in a paediatric population

Abstract Introduction An NHS Digital survey found that 1 in 8 children aged between 5-19 had at least one mental health disorder in England in 2017.1 Since this survey the prescribing of antidepressants and anxiolytics has increased every year for the past five years in England.2 A GP surgery within East Sussex requested an evaluation of whether prescribing of mental health disorder medication in paediatrics was following legal and clinical guidance. This evaluation reviewed whether the GP practice had followed Summary of Product Characteristics (SPC) prescribing requirements and the East Sussex Healthcare NHS Trust (ESHT) formulary requirements in the use of antidepressants and anxiolytics in the paediatric population. Aim To evaluate whether medicines were prescribed in accordance with their SPC, the ESHT Formulary requirements and monitoring requirements. The evaluation also assessed whether patients’ GP records were up to date as per clinic letters and whether patients were receiving cognitive behavioural therapy (CBT) and/or were under the care of appropriate mental health specialists. Methods A search was conducted via the EMIS system. Inclusion criteria were that the patient was under the age of eighteen, had an anxiolytic and/or antidepressant prescribed and were registered with the practice between the beginning of March 2022 to the end of April 2022. Data was analysed via excel spreadsheet with patients allocated a random number. Ethics approval was not required as this was a service evaluation. Results Eleven patients met the above criteria. Out of these patients 46% were on sertraline, 46% on fluoxetine, 18% on mirtazapine and 9% on citalopram. Audit results demonstrated that 90% of patients were under the supervision of a mental health specialist and/or receiving CBT, 66% of medications were prescribed as per their SPC with 69% prescribed in accordance with the ESHT formulary. Monitoring requirements conducted within the last 12 months was completed for 64% of patients. In addition, 45% of patients had an incorrect medication list when compared to neurology clinic letter with errors ranging from missing medication to incorrect dosing. It was also found that 82% of patients had incorrect coding on their problem lists with errors ranging from missed diagnoses to medication being incorrectly linked to problems. Discussion/Conclusion The results show that most prescribing followed formulary and SPC requirements, and that patients had CBT either in place or in the process of being organised. However, more care is needed with monitoring, coding and processing clinic letters within this practice. Clinic letters with new diagnoses and medication changes were not seen by a clinical professional, potentially leading to errors. A small cohort of patients and COVID restrictions with staff and patients were the primary limitations of this study. More research is needed to determine whether other GP surgeries have the same strengths and challenges found within this surgery, and whether lessons can be learnt to standardise practice.

Factors associated with poor academic performance among undergraduate dental students: A cross-sectional study.

To evaluate the factors associated with poor academic performance among undergraduate dental students enrolled at a public university in Brazil. A semi-structured questionnaire addressing the exploratory variables of interest (sociodemographic and economic characteristics, use of medications and drugs, dentistry as the first choice of undergraduate course, and the Pittsburgh Sleep Quality Index) was hosted on Google Forms and shared with all dental students at the Federal University of Pelotas. Academic performance was evaluated based on institutional records, access to which the participants had previously authorized; students with good (average≥7.0 points) or poor academic performance (average<7.0 points) were considered. Adjusted logistic regressions were performed to verify the association between academic performance and the exploratory variables (p<0.05). In total, 244 students were included, of whom 18.8% had poor academic performance. Increased age (OR: 1.34; 95%CI: 1.18-1.52), non-white skin color (OR: 1.34; 95%CI: 1.18-1.52), the use of medications for anxiety and depression (OR: 1.34; 95%CI: 1.18-1.52), and poor sleep quality (OR: 1.34; 95%CI: 1.18-1.52) were factors associated with poor academic performance. A low prevalence of poor academic performance was observed. Non-white skin color, increased age, use of anxiolytics or antidepressants, and poor or disturbed sleep may reduce dental students' academic performance.

Use of psychoactive substances and alcohol during the first three waves of the COVID-19 pandemic: Croatian experience

Background Increased prevalence and severity of both substance and behavioral addictions are among the most harmful consequences of the COVID-19 outbreak. Objective To determine the sociodemographic characteristics, COVID-19-related stressors, and stress, anxiety, and depression symptoms that may predict the use and changes in the use of psychoactive substances (PS) during the first three COVID-19 waves in Croatia. Methods The cross-sectional online survey included 1,118 adult participants (220 men and 898 women; mean age: 35.1 [SD = 12.3] years; age range: 18–78) from general adult population. Sociodemographic data were collected, and ad-hoc developed questionnaires on COVID-19-related stressors, PS use before and during the pandemic, CAGE Alcohol Questionnaire, Impact of Event Scale, and Hospital Anxiety Depression Scale were applied. Results The PS use increased in 31% of participants. The use of tobacco, caffeine, alcohol, cannabinoids, and anxiolytics showed the greatest increase in the last year (tobacco 7.1%; caffeine 5.8%; alcohol 6.4%; cannabinoids 2.5%; and anxiolytics 3.9%). Alcohol consumption during the pandemic increased in 16.8% of participants who consumed alcohol before the pandemic, with 4.5% of them reporting problematic alcohol use (PAU). The tested model demonstrated relatively good model-data fit and significantly predicted 11.8% increase in the use of PS and 9.8% of PAU. Conclusion Being married or in a relationship and severe anxiety and depression symptoms predicted increased use of PS and PAU, while higher education level and ever being diagnosed with COVID-19 predicted only increased use of PS.

Abstract 13748: The Relationship Between Anxiety, Cumulative Social Risk, and Adherence to Antihypertensive Medications

Introduction: Psychiatric disorders and social determinants of health impact the management of medical conditions. We examined the relationship between anxiety, cumulative social risk, and adherence to antihypertensive medications. Methods: We used data from the 2020 national health interview survey to evaluate antihypertensive medication use. Anxiety and use of anxiolytics were the independent variables. Cumulative social risk (CSR) was made up of a composite of economic stability, education, food insecurity, neighborhood, and health care system. Four quartiles were created, with the highest (4 th ) CSR quartile denoting the least social risk. Logistic regression was used for the analysis. Results: Of the 10,499 participants with hypertension, 8772 (80.2%) of were taking hypertensive medications. The mean (SE) age of the sample was 60.4 (0.23) years and 50% were females. Among those on antihypertensives, 16.2% reported anxiety and 68.0% reported using anxiolytic medications. Distribution of CSR is as shown in figure 1. Among those with anxiety, the odds of taking antihypertensive medications reduced as the CSR quartile increase from 2 nd [AOR 0.42; 95% CI 0.18, 0.96. p=0.039], 3 rd [AOR 0.38; 95% CI 0.18, 0.83. p=0.016] to 4 th quartile [AOR 0.34; 95% CI 0.13, 0.88. p=0.026] as compared to 1 st quartile. Among those on anxiolytic medications, belonging to CSR 4 quartile had a reduced [AOR 0.21; 95% CI 0.08, 0.58. p=0.003] as compared to the CSR 1 quartile. Conclusions: Individuals with anxiety with the least CSR are less likely to be taking antihypertensive medications. This may be related to an increased likelihood of a healthier lifestyle.

Nonmedical use of anxiolytics among Tunisian students: Connecting the dots from 2013 to 2021

Abstract Background Nonmedical use of prescription drugs such as sedatives and anxiolytics is a fast growing public health threat in several countries. In Tunisia, although several studies have investigated the prevalence of nonmedical use of anxiolytics among school-age students, there is a gap in knowledge regarding trends in anxiolytics misuse. We aimed to determine the prevalence of nonmedical use of anxiolytics and examine trends between 2013 and 2021. Methods Pooled data from three Mediterranean school surveys on alcohol and other drugs (MedSPAD I-2013, MedSPAD II-2017, MedSPAD III-2021) were used. Based on three-stage stratification sampling method, teenagers in first and second grades of secondary education, were enrolled. Were not included students enrolled in vocational training centers and out-of-school adolescents. Data collection was performed using a self-administered standardized questionnaire. We studied weighted lifetime nonmedical use of prescription anxiolytics and performed global and by gender trend analysis. Epi data software was used for data entry and all statistical analysis, were performed with STATA software. Results A total of 14.723 students were enrolled with sex ratio (Male/Female) equal to 0.61 and mean age of 16.2±0.8 years. The prevalence of nonmedical anxiolytics’ use increased from 2.1% to 3% then to 8.4% for 2013, 2017 and 2021, respectively. Global and by gender trends analysis concluded to significant increase from 2017 to 2021 (p &amp;lt; 10-3). However, a non-significant increase was revealed from 2013 to 2017. Conclusions Our study is the first to confirm a significant increasing trend in non-medical use of anxiolytics among Tunisian adolescents. These findings emphasize the urgent need for early detection of psychological vulnerability among adolescents in order to prevent their engagement in such risky behaviors. Key messages • Decision makers should be sensitized regarding the alarming increasing trend in non-medical use of anxiolytics, among Tunisian adolescents. • The state control of these substances accessibility and early detection of psychological vulnerability, are highly required.

Over-the-counter Medication Use during Pandemic: Lessons Learned from Covid-19 in Lithuania

Abstract Background Despite the growing awareness about nonprescription misuse of anxiolytics, there is not much evidence about people’s behavior during the covid-19 lockdown when access to healthcare specialists was limited. Over the counter drug use has risen sharply in the past decades among college students and junior health care workers, yet, there are few studies reporting on the use of nonprescription medicine groups during the COVID-19 pandemic. Methods A cross-sectional study among 163 second-year medical students of the Lithuanian University of Health Sciences was conducted in Kaunas, Lithuania with self-reported measures of anxiety and insomnia and comparing nonprescription medicine use for anxiety and insomnia before and during the covid-19 pandemic. Results A near two-fold increase in the prevalence of anxiety and insomnia among Lithuanian medical students was reported during the covid-19 pandemic compared to before the onset of the pandemic (p &amp;lt; 0,001). The use of nonprescription medication increased during the pandemic (p &amp;lt; 0,001), in particular anxiolytics (p &amp;lt; 0,05). Once-weekly anxiolytic medication use increased from 8,0% before the pandemic to 14,7% during the pandemic. Regular nonprescription medicine use (2-3 times weekly) had more than tripled, from 2,4% to 9,2%. During the pandemic, almost a fifth of the respondents were increasingly searching for information on anxiolytic nonprescription medication online during the pandemic compared to before the pandemic. Conclusions During the covid-19 pandemic, the prevalence of anxiety and insomnia increased among Lithuanian medical students, along with the practice of anxiolytic nonprescription medications. Lithuanian medical students increasingly practiced self-medication during the pandemic and found the information on nonprescription medication increasingly online, which offers opportunities for telemedicine. Key messages • During the covid-19 pandemic, the prevalence of anxiety and insomnia increased among Lithuanian medical students, along with the practice of anxiolytic nonprescription medications. • During covid-19, Lithuanian medical students increasingly retrieved information on nonprescription medication online instead of consulting a pharmacist, offering opportunities for telemedicine.

The role of pharmacogenic factor in the modulation of compliance to treatment

In the article the problem of compliance to treatment is discussed considering pharmacodynamics of different classes of psychotropic drugs. Use of antipsychotics is associated with a high risk of non-compliance. Antipsychotics can inhibit the endogenous reward system and decreasing its tone reduce adherence to treatment. Both antidepressants and anxiolytics increase the tone of the reward system. But if for antidepressants an increase in adherence is associated with the activation of the reward system limited by related clinical effects, for anxiolytics high adherence to treatment is associated to the rapid development of specific effect and an indirect increase in the tone of the reward system with an increase general subjective satisfaction with treatment. The tolerance associated with the chronic use of benzodiazepine anxiolytics secondarily worsens the situation leading to the development of pathological addiction.

Type and Severity of Mental Illness and Participation in Colorectal Cancer Screening

The effectiveness of colorectal cancer screening programs depends on the participation rate. This study examined the association between type and severity of mental illness and colorectal cancer screening participation. Between 2012 and 2017, a total of 46,919 individuals were invited to sigmoidoscopy screening in Norway, and 70,019 were invited to fecal immunochemical testing. In 2022, logistic regression was used to evaluate the association between the use of antipsychotics, anxiolytics, hypnotics, and antidepressants in the year preceding the screening invitation and screening participation, adjusted for demographic and socioeconomic factors. Defined daily doses of individual drugs were used to assess dose‒response relationships. Overall, 19.2% (24.8% of women, 13.4% of men) of all invitees used at least 1 psychotropic medication. Nonparticipation in the 2 arms combined was associated with the use of anxiolytics (60.7% in users vs 43.2% in nonusers; OR=1.53; 95% CI=1.45, 1.62) and antipsychotics (64.3% vs 43.8%; OR=1.41; 95% CI=1.30, 1.53) and increased with higher doses for both drugs. Hypnotics and antidepressants were only weakly associated with nonparticipation in higher doses. Participation rates were 57.3%, 52.3%, 42.9%, and 35.4% in those prescribed 0, 1, 2, and 3-4 classes of psychotropic medications, respectively. The associations between the use of psychotropic medications and nonparticipation were similar for the 2 screening tests. These findings show significant disparities in colorectal cancer screening participation for individuals with mental illness, independent of the screening method. Moreover, screening participation varied depending on the type and severity of mental illness. Targeted interventions are warranted to ensure that people with mental illness are supported to access the benefits of colorectal cancer screening.

AML-078 Pain and Anxiety Associated With Bone Marrow Aspiration in Hematologic Patients

Bone marrow aspiration is an essential procedure used to diagnose hematologic malignancies, monitor treatment, and evaluate the response. It is painful and feared by patients but has to be done frequently during the course of the disease. The objective of this study was to assess the degree of pain and anxiety in patients undergoing bone marrow aspiration in order to make it easier and more tolerable. We observed 54 patients admitted for bone marrow aspiration in the outpatient hospital unit of the Department of Hematology in Gustave Roussy Institute in Paris during the month of February 2022. The patients were adults already diagnosed with hematologic malignancies who were undergoing treatment or under surveillance. Each patient filled out a questionnaire before and after the procedure, and another was filled out by the doctor performing the procedure. The Hospital Anxiety and Depression Scale (HADS) was used to evaluate anxiety in patients during this period of their lives. Pain was assessed using the Wong-Baker FACES® pain scale with numbers ranging from zero to 10 and was compared to the patient's expectations. On the other hand, the doctor noted the analgesics used and graded the anxiety and the pain he observed in the patient on a scale of one to 10. The average HADS score was 7.85/21, suggesting a basal anxious state in patients, and anxiety assessed by doctors was 4.7/10. Pain during the procedure averaged 3.25/10 and exceeded expectations in only 2 patients. We can see that anxiety is the main problem in patients undergoing bone marrow aspiration, whereas objective pain is well controlled by analgesics. These results encourage the use of anxiolytics before the procedure to make it more comfortable for patients and doctors.

Management of Phenibut Use Disorder and Withdrawal in a Geriatric Patient

Phenibut is a misused substance which has shown an increase in use over the past decade. Marketed as a "dietary supplement," it is not approved in the United States for use and is not regulated by the Food and Drug Administration. The substance, however, is readily available for purchase through online markets. It has a similar drug profile as alcohol, gabapentin and benzodiazepines. Clinical effects of this drug include physiologic dependence, euphoria, anxiolysis, antispasticity, sedation, and possible nootropic properties. While there are emerging new cases of managing phenibut withdrawal, no cases currently feature phenibut addiction and withdrawal management in the geriatric population. Here we discuss such a case of phenibut addiction and withdrawal in a 68-year-old male who initially began misusing phenibut to alleviate anxiety and insomnia precipitated by worsening affective disorder, sedative, hypnotic, or anxiolytic use disorder, and alcohol use disorder.

Anxiolytic Herbs and Naturopathic Treatment of Anxiety-Induced Female Sexual Dysfunction: A Case Report

We report on successful treatment of female sexual dysfunction in a young (23-year-old) woman (she/her) with a combination of anxiolytic and stress-relieving natural health products (NHPs) together with patient education and lifestyle counselling. Presenting symptoms included decreased sexual desire and arousal, anorgasmia, dyspareunia, and vaginismus that had improved with pelvic physiotherapy prior to the onset of naturopathic treatment. Contributing factors in this case included a personal history of abuse and sexual trauma. Alongside counseling and patient education, NHPs initially included L-theanine, Rhodiola rosea, Panax ginseng, and vitamin D. Over approximately 4 months of treatment, the patient reported significant improvements in sexual desire, both physical and psychological arousal, and was able to achieve orgasm. This case report identifies the important role of mental health and stress in female sexual dysfunction and supports the use of natural anxiolytics to support sexual function, in particular in patients with a history of trauma.

Glial cell line-derived neurotrophic factor (GDNF) in blood serum and lacrimal fluid of patients with a current depressive episode

BackgroundMany studies indicate a significant role of GDNF in the pathogenesis of the mood disorders, including bipolar disorder (BD) and major depressive disorder (MDD). Potentially, neurotrophic factors in lacrimal fluid (LF) could become biomarkers of various specific disorders. The aim of this study was to assess GDNF levels in LF and blood serum (BS) of patients with a current depressive episode (cDE). MethodsWe studied the glial cell line-derived neurotrophic factor (GDNF) concentration in the LF and BS of 39 healthy controls and 137 patients with a current depressive episode (cDE) (both subgroups members were 20–49 years): BD – 46 patients, MDD – 91 patients. ResultsGDNF concentration in BS of women with MDD was significantly lower than in men. In BD patients, univariate linear regression analysis revealed significant correlations between GDNF concentration in the LF and the use of anxiolytics or antidepressants. These correlations were confirmed by the multivariate linear regression analysis. A significant correlation between GDNF concentrations in the LF and BS was found in controls. LimitationsThe unequal proportion of men in the BD group did not permit adjusting GDNF concentrations for sex. The collected LF was stimulated, which could influence GDNF levels. It should also be noted that the patients included in the study were not treatment- naïve. ConclusionsOur findings suggest that GDNF concentration in LF could be a biomarker of the cDE (both unipolar and bipolar), though the sensitivity of this potential biomarker may be lower in depressive patients with anxiety symptoms.

Guided imagery for treatment (GIFT): protocol of a pilot trial of guided imagery versus treatment as usual to address radiotherapy-related distress in head and neck cancer

BackgroundCancers of the head and neck region are associated with high symptom burden and elevated levels of psychological distress. Radiotherapy (RT) is a common treatment for patients with head and neck cancer (HNC) that is associated with psychological distress related to the immobilizing nature of the treatment, frequency of treatment delivery, and side effects. Guided imagery is a relaxation technique that is beneficial in reducing psychological distress in patients with other cancer diagnoses but has not been studied in this patient population. The purpose of this study is to evaluate the feasibility and acceptability of a brief guided imagery intervention (guided imagery for treatment, GIFT) to reduce RT-related anxiety and depression in patients with HNC relative to treatment as usual (TAU).MethodsPatients with HNC planning to receive RT will be recruited to participate in a randomized controlled trial evaluating a brief, two-session guided imagery intervention (GIFT) relative to TAU alone. Primary aims include acceptability and feasibility evaluated through quantitative and qualitative methods. Measures of anxiety and depression, symptom burden, health-related quality of life, and anxiolytic medication use will be collected at baseline, during treatment, and at 1-month follow-up.DiscussionThere are no published interventions of guided imagery for anxiety and depression in patients with HNC despite its efficacy in other populations of patients with cancer. This proposed project evaluates the feasibility and acceptability of an intervention that has the potential to reduce psychological distress in a vulnerable population. Additionally, we will preliminarily examine the impact of behavioral intervention on psychological distress and the use of anxiolytic medication, a novel area of study.Trial registrationClinicaltrials.gov NCT03662698; registered on 9/6/2018.

Management of Functional Seizures and Functional Movement Disorder: A Cross-Sectional Comparative Study.

IntroductionFunctional neurological disorders (FND) are conditions that cause to alterations in nervous system functions. They are disabling and impair the quality of life of patients but that are potentially reversible provided they have specific management. Functional seizures (FS) and functional movement disorder (FMD) are among the most common subtypes. Studies suggest a strong overlap between FS and FMD; however, there are still no cross-sectional studies that compare the management between these two conditions. Thus, our focus was to carry out a research that compares how these two subtypes of FND are being managed, in addition to assessing rates of understanding and acceptance of a diagnosis of FND.MethodsIt is a cross-sectional study with data collected from medical records and interviews with two patients’ groups (FS and FMD) treated from a FND clinic of the public health system of Brazil.ResultsFrom 105 medical records of patients with FND analyzed, 60 participants were eligible and agreed to participate in this research, being FS (n = 31) and FMD (n = 29). Statistically significant differences (p < 0.05) were found in the use of antiseizure (FS > FMD), opioids (FMD > FS), multi-professional follow-up (FMD > FS) and rates of understanding and acceptance of an FND diagnosis (FMD > FS). Similarities were found in sociodemographic profiles, medical follow-up, psychiatric comorbidities and use of antidepressants, anxiolytics, antipsychotics and mood stabilizers between two conditions.ConclusionMore similarities than differences in management were found between FS and FMD. Similarities may be related to overlaps in sociodemographic and clinical characteristics between the two groups. Differences may be related to specific issues of each patient and condition. Regardless of the group, patients who perform psychotherapeutic follow-up have higher rates of understanding and acceptance of an FND diagnosis.

Killing pain?: a population-based registry study of the use of prescription analgesics, anxiolytics, and hypnotics among all children, adolescents and young adults in Norway from 2004 to 2019.

The ongoing opioid epidemic has been a global concern for years, increasingly due to its heavy toll on young people’s lives and prospects. Few studies have investigated trends in use of the wider range of drugs prescribed to alleviate pain, psychological distress and insomnia in children, adolescents and young adults. Our aim was to study dispensation as a proxy for use of prescription analgesics, anxiolytics and hypnotics across age groups (0–29 years) and sex over the last 15 years in a large, representative general population. The study used data from a nationwide prescription database, which included information on all drugs dispensed from any pharmacy in Norway from 2004 through 2019. Age-specific trends revealed that the prevalence of use among children and adolescents up to age 14 was consistently low, with the exception of a substantial increase in use of melatonin from age 5. From age 15–29, adolescents and young adults used more prescription drugs with increasing age at all time points, especially analgesics and drugs with higher potential for misuse. Time trends also revealed that children from age 5 were increasingly dispensed melatonin over time, while adolescents from age 15 were increasingly dispensed analgesics, including opioids, gabapentinoids and paracetamol. In contrast, use of benzodiazepines and z-hypnotics slightly declined in young adults over time. Although trends were similar for both sexes, females used more prescription drugs than their male peers overall. The upsurge in use of prescription analgesics, anxiolytics and hypnotics among young people is alarming.Trial registration The study is part of the overarching Killing Pain project. The rationale behind the Killing Pain research was pre-registered through ClinicalTrials.gov on April 7, 2020. Registration number NCT04336605; https://clinicaltrials.gov/ct2/show/record/NCT04336605.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00787-022-02066-8.

Association and Familial Coaggregation of Childhood-Onset Type 1 Diabetes With Depression, Anxiety, and Stress-Related Disorders: A Population-Based Cohort Study.

OBJECTIVETo estimate the association and familial coaggregation of childhood-onset type 1 diabetes with depression, anxiety, and stress-related disorders.RESEARCH DESIGN AND METHODSThis was a population-based cohort study with use of data from Swedish nationwide registers. A total of ∼3.5 million individuals born in Sweden 1973–2007 were linked to their biological parents, full siblings and half-siblings, and cousins. Cox models were used to estimate the association and familial coaggregation of type 1 diabetes with depression, anxiety, and stress-related disorders.RESULTSIndividuals diagnosed with childhood-onset type 1 diabetes (n = 20,005) were found to be at greater risks of all outcomes: any psychiatric diagnosis (adjusted hazard ratio [aHR] 1.66 [95% CI 1.59–1.72]) or specific diagnoses of depression (1.85 [1.76–1.94]), anxiety (1.41[1.33–1.50]), and stress-related disorders (1.75 [1.62–1.89]), as well as use of antidepressants or anxiolytics (1.30 [1.26–1.34]), compared with individuals without type 1 diabetes. Overall, relatives of individuals with type 1 diabetes were at elevated risks of developing these outcomes, with the highest risks seen in parents (aHRs 1.18–1.25), followed by full siblings (aHRs 1.05–1.20), and the magnitudes of risk estimates appear proportional to familial relatedness.CONCLUSIONSThese results support existing evidence that children and adolescents with type 1 diabetes are at greater risks of developing depression, anxiety, and stress-related disorders and indicate that shared familial factors might contribute to these elevated risks. Our findings highlight the need for psychological consulting for children and their families in diabetes care. Quantitative and molecular genetic studies are warranted to further understand the etiology of these psychiatric disorders in type 1 diabetes.

Psychotropic medication use and Parkinson's disease risk amongst older women.

ObjectiveTo examine associations of antidepressant, anxiolytic and hypnotic use amongst older women (≥65 years) with incident Parkinson's Disease (PD), using data from Women's Health Initiative linked to Medicare claims.MethodsPD was defined using self‐report, first diagnosis, medications and/or death certificates and psychotropic medications were ascertained at baseline and 3‐year follow‐up. Cox regression models were constructed to calculate adjusted hazard ratios (aHR) with 95% confidence intervals (CI), controlling for socio‐demographic, lifestyle and health characteristics, overall and amongst women diagnosed with depression, anxiety and/or sleep disorders (DASD).ResultsA total of 53,996 WHI participants (1,756 PD cases)—including 27,631 women diagnosed with DASD (1,137 PD cases)—were followed up for ~14 years. Use of hypnotics was not significantly associated with PD risk (aHR = 0.98, 95% CI: 0.82, 1.16), whereas PD risk was increased amongst users of antidepressants (aHR = 1.75, 95% CI: 1.56, 1.96) and anxiolytics (aHR = 1.48, 95% CI: 1.25, 1.73). Compared to non‐users of psychotropic medications, those who used 1 type had ~50% higher PD risk, whereas those who used ≥2 types had ~150% higher PD risk. Women who experienced transitions in psychotropic medication use (‘use to non‐use’ or ‘non‐use to use’) between baseline and 3‐year follow‐up had higher PD risk than those who did not. We obtained similar results with propensity scoring and amongst DASD‐diagnosed women.InterpretationThe use of antidepressants, anxiolytics or multiple psychotropic medication types and transitions in psychotropic medication use was associated with increased PD risk, whereas the use of hypnotics was not associated with PD risk amongst older women.

Use of hypnotics among women diagnosed with cervical cancer – A population-based cohort study

ObjectivePrevious studies suggest that sleeping problems are frequent after cervical cancer. However, the evidence on the use of hypnotics is sparse. We investigated if women diagnosed with cervical cancer have an increased risk of using hypnotics and identified risk factors for prolonged use. MethodsIn this nationwide register-based cohort study, 4264 women diagnosed with cervical cancer from 1997 to 2013 and 36,632 cancer-free women were followed in registers until 2016. Prolonged use of hypnotics was defined as more than three prescriptions with no more than three months in between. Data were analysed using Cox proportional hazards regression models and multistate Markov models separately for women with localized and advanced cervical cancer. ResultsThe rate of first use of hypnotics was substantially increased during the first year after cervical cancer diagnosis compared to cancer-free women (HRlocalized 4.4, 95% CI 3.9–5.1; HRadvanced 8.9, 95% CI 7.5–10.6) and remained markedly increased for up to five years after diagnosis. Dependent on stage of disease and age, 1.4 to 4.7 excess women per 100 with cervical cancer were prolonged users of hypnotics compared to cancer-free women one year after diagnosis. Risk factors for prolonged use of hypnotics were higher age, short education, previous use of antidepressants or anxiolytics, and advanced disease. ConclusionsWomen diagnosed with cervical cancer are at increased risk of prolonged use of hypnotics. For the majority, treatment with hypnotics is initiated within the first year after cancer diagnosis, but the rate of first use is increased for up to five years.

Anxiety among frontline healthcare professionals during the coronavirus pandemic

IntroductionAnxiety has become a topical issue since the arrival of the coronavirus pandemic, especially for frontline healthcare professionals as they deal with patients affected by the Covid-19.ObjectivesObjectify anxiety in frontline medical and paramedical staff and study its associated factors.MethodsWe conducted a national descriptive and analytical cross-sectional study via a survey over a 2-month period from September to October 2020. We used “Beck Anxiety Inventory” to screen anxiety as well as “Brief Cope Scale” to detect probable correlations between anxiety and coping mechanisms.ResultsWe collected 78 persons. The mean age was 29.86 years. 35.9% moved out of home. 39.7% worked in Covid units. 7.7% had personal psychiatric history. 76.9% provided direct care to patients with Coronavirus. The frontline staff reported that only 29.5% of patients were stables. Only 48.4% received adequate training of protection against Covid-19. 64.1% of professionals did PCR test and only 16.7% of them tested positive. We objectified an increase of 6.4% in the anxiolytics use. Stigma affected 57.7% of professionals. We highlighted a link between anxiety and social support strategy (p=0.048). 92.3 % of the staff suffered from anxiety according to Beck Anxiety Inventory.ConclusionsScreening anxiety among frontline medical and paramedical staff might enhance their productivty and thus provide patients with the best care.DisclosureNo significant relationships.