Zung Self-Rating Depression Scale Research Articles

Social support, anxiety symptoms, and depression symptoms among residents in standardized residency training programs: the mediating effects of emotional exhaustion

BackgroundAlthough studies indicate that social support is related to emotional exhaustion, depression symptoms, and anxiety symptoms, the underlying mechanism between those variables remains unknown.MethodsBased on a sample of 254 residents in standardized residency training programs, two mediation models were tested in which emotional exhaustion served as a mediator in the relationship between social support and anxiety symptoms/depression symptoms. We used the following self-reported questionnaires as instruments to collect data: zung self-rating depression scale, zung self-rating anxiety scale, social support rating scale, and emotional exhaustion scale.ResultsIn the final study sample, the mean age of the residents was 25.92 years old (SD =1.88), and a total of 41.3% were male, and 58.7% were female. This current study suggested that social support was proven to be a relevant factor affecting anxiety symptoms and depression symptoms. Particularly, the results also indicated that emotional exhaustion partially mediated the impact of social support on anxiety symptoms and depression symptoms among Chinese residents in the standardized residency training program.ConclusionsOur study signifies that enhancements in social support and reduction of emotional exhaustion can directly or indirectly affect anxiety symptoms and depression symptoms among Chinese residents in the standardized residency training program. These findings will offer insight for health-sector managers to develop programs aimed at social support and adopt individual-level interventions and organization-level interventions to reduce emotional exhaustion.

Stress and Metabolomics for Prediction of Spontaneous Preterm Birth: A Prospective Nested Case-Control Study in a Tertiary Hospital

Spontaneous preterm birth (sPTB) is the leading cause of infant morbidity and mortality worldwide. Deficiency of effective predict methods is an urgent problem that needs to be solved. Numbers of researchers spare no efforts to investigate differential indicators. To evaluate the value of the differential indicators, a prospective nested case-control study was carried out. Among an overall cohort of 1,050 pregnancies, 20 sPTB pregnancies, and 20 full-term pregnancies were enrolled in this study. Participants were followed-up until labor. The psychological profile was evaluated utilizing the Zung Self-Rating Depression Scale at 11–14 weeks. Stress-related biomarker-cortisol and metabolites were detected by Electrochemiluminescence Immunoassay (ECLIA) and Gas Chromatography-Mass Spectrometry (GC-MS) in serum samples during pregnancy, respectively. The expression level of cortisol was up-regulated in serum and the score of the Zung Self-Rating Depression Scale was significantly higher in the sPTB group when compared to the control group. Note that, 29 metabolomics were differentially expressed between the sPTB group and the control group. The scores of the Zung Self-Rating Depression Scale, the level of cortisol, Eicosane, methyltetradecanoate, and stearic acid in serum were selected to establish the model with lasso logistic regression. Validation of the model yielded an optimum corrected AUC value of 89.5%, 95% CI: 0.8006–0.9889 with a sensitivity of 100.0%, and specificity of 78.9%. In conclusion, this study establishes a prediction model of sPTB with five variables, which may predict sPTB more accurately and sensitively in the second trimester.

Эффективность использования Bifidobacterium infantis 35624 у больных неалкогольной жировой болезнью печени

Актуальность. Неалкогольная жировая болезнь печени (НАЖБП) охватывает спектр заболеваний, тесно связанных с метаболическими факторами риска. Цель: изучить эффективность терапии с использованием препарата Bifidobacterium infantis (B.infantis) 35624 на динамику проявлений депрессии у больных НАЖБП и сахарным диабетом (СД) 2-го типа. Материалы и методы. Обследовано 56 больных НАЖБП. Больные разделены на 2 группы: больные I группы (n = 26) для коррекции дисбиоза толстой кишки (ДТК) получали комбинированный пробиотик; II группы (n = 30) — препарат B.іnfantis. Нарушение функций центральной нервной системы определяли с помощью таких нейропсихометрических тестов, как шкала самооценки Спилбергера — Ханина, шкала депрессии Бека (BDI), шкала Zung, Торонтская алекситимическая шкала. Результаты. Анализ микробиологического исследования фекалий у обследованных больных обеих групп до лечения указывает на выраженные изменениями в количественном и качественном составе микрофлоры толстой кишки. У больных НАЖБП и СД 2-го типа соматическая патология сопровождается выраженными проявлениями депрессии, тревожности, неуверенности в себе. Продемонстрировано значительное уменьшение выраженности депрессии, тревожности на фоне нормализации микробного состава толстой кишки при длительном приеме B.infantis 35624 у больных НАЖБП и СД 2-го типа. Выводы. У больных НАЖБП и СД 2-го типа установлено ДТК преимущественно II (у 53,3–53,8 % обследованных) и I степеней (у 30,0–30,8 % обследованных). У больных НАЖБП и СД 2-го типа определяются тревожные расстройства, умеренно выраженные проявления депрессии по шкале Спилбергера — Ханина, BDI, шкале Zung и Торонтской шкале, что требует соответствующей коррекции. Курсовой прием B.infantis 35624 у больных НАЖБП и СД 2-го типа является эффективным средством не только для коррекции дисбиоза толстой кишки, но и коррекции проявлений депрессии и тревожных состояний у данных пациентов.

Assessment of the emotional condition of women with cancer.

The incidence of malignant tumors in women is constantly rising. In 2018, 83 876 women were diagnosed with cancer, and 46 028 died from it. Since the 1980s, the incidence of malignant tumors in women aged 19-44 has been growing dynamically, and in middle-aged women (between 45 and 64 years old), nearly one in two deaths are due to cancer - exceeding mortality from cardiovascular disease. Upon diagnosis, the patient who may have been healthy so far faces emotions such as fear, anxiety, and sadness, caused by the awareness of having a progressive disease. Therefore, a somatic disease may trigger the development of a psychological disorder. The purpose of the present paper was to assess the emotional condition of women with cancer. Our survey included 100 patients hospitalized at the radiotherapy, gynecologic oncology, and breast units of the Lower Silesian Cancer Center in Wrocław, Poland, between August and November, 2017. We used the Mini-Mental State Examination (MMSE), the Zung Self-Rating Depression Scale (ZSDS), the Hospital Anxiety and Depression Scale (HADS-M), and the C-HOBIC readiness for discharge questionnaire. The mean patient age was 58.91 years (SD=13.74), the youngest patient was 23 years old and the oldest was 86 years old. More severe anxiety and depression symptoms were negatively associated with readiness for discharge. Among the women studied, widows and divorcees had higher levels of depression. Women who had completed primary education were more likely to suffer from anxiety than those with high school education. Duration of illness did not significantly affect the emotional condition of women undergoing cancer treatment. In the group of female cancer patients studied, more than half had no depressive symptoms. Emotional disorders negatively affect patients' readiness for discharge. Anxiety is significantly associated with education level, and depression - with the patients' marital status.

Emotional adaptation during a crisis: decline in anxiety and depression after the initial weeks of COVID-19 in the United States

Crises such as the COVID-19 pandemic are known to exacerbate depression and anxiety, though their temporal trajectories remain under-investigated. The present study aims to investigate fluctuations in depression and anxiety using the COVID-19 pandemic as a model crisis. A total of 1512 adults living in the United States enrolled in this online study beginning April 2, 2020 and were assessed weekly for 10 weeks (until June 4, 2020). We measured depression and anxiety using the Zung Self-Rating Depression scale and State-Trait Anxiety Inventory (state subscale), respectively, along with demographic and COVID-related surveys. Linear mixed-effects models were used to examine factors contributing to longitudinal changes in depression and anxiety. We found that depression and anxiety levels were high in early April, but declined over time. Being female, younger age, lower-income, and previous psychiatric diagnosis correlated with higher overall levels of anxiety and depression; being married additionally correlated with lower overall levels of depression, but not anxiety. Importantly, worsening of COVID-related economic impact and increase in projected pandemic duration exacerbated both depression and anxiety over time. Finally, increasing levels of informedness correlated with decreasing levels of depression, while increased COVID-19 severity (i.e., 7-day change in cases) and social media use were positively associated with anxiety over time. These findings not only provide evidence for overall emotional adaptation during the initial weeks of the pandemic, but also provide insight into overlapping, yet distinct, factors contributing to depression and anxiety throughout the first wave of the pandemic.

Family caregivers of rare disease: A survey on health-related quality of life in family caregivers for Gaucher disease patients in China.

BackgroundRare diseases affect the health‐related quality of life (HRQoL) of patients and their family caregivers (FCs). However, limited evidence is available on the HRQoL of FCs of patients with Gaucher disease (GD). This study aimed to assess HRQoL and related factors among FCs of patients with GD in China.MethodsA cross‐sectional online survey was conducted with 49 FCs recruited by convenience sampling. Participants completed the Medical Outcome Study Short Form‐36 (SF‐36), Zung's Self‐Rating Anxiety Scale, Zung's Self‐Rating Depression Scale, the Multi‐dimensional Scale of Perceived Social Support, the Herth Hope Index, and a questionnaire about FCs’ and patients’ sociodemographic characteristics. Single‐sample t tests, one‐way analysis of variance, and multivariate linear regression analysis were used to analyze the data analysis.ResultsParticipating FCs had significantly lower scores in all eight SF‐36 domains compared with the general population in China (p < 0.01). FCs’ gender, education, daily care time, anxiety, and the perceived disease severity of patients were significant predictors of SF‐36 physical component summary scores. Caregiving help from others, anxiety, perceived disease severity, and medical insurance type were significant predictors of SF‐36 mental component summary scores.ConclusionThe findings showed FCs of patients with GD had lower HRQoL. There is an urgent need to address the health concerns of FCs of people with rare diseases including their HRQoL.

Depression, Social Support, and Coping Strategies in Individuals with Spinal Injury Depression with Spinal Injury Patients

Objective: To investigate the prevalence of and factors associated with depression, the social support received by, and the coping strategies used by individuals with spinal injury. Materials and Methods: Individuals with spinal injury who received follow-up evaluation at the Siriraj Hospital during 2016 to 2018. The instruments used included a general information, the Zung Self-Rating Depression Scale (Thai version), the Social Provisions Scale, and the Spinal Cord Lesion-Related Coping Strategies Questionnaire (Thai version). Results: Eighty-six individuals with spinal injury (age: 43.1±15.7 years, 66.3% male) were included, and 59.3% had some level of permanent impairment. The prevalence of depression was 55.8%. Depression was found to be negatively associated with all social support domains. Regarding coping, depression was shown to be negatively associated with the fighting spirit, but positively associated with the social reliance strategy. Multivariate analysis by multiple logistic regression showed level of impairment (p=0.005), guidance provision (p=0.040), fighting spirit strategy (p=0.031), and the social reliance strategy (p=0.032) to be independently associated with depression. Conclusion: The prevalence of depression among SCI was 55.8%. The results revealed the types of social support received, and the coping strategies used by individuals with spinal injury after hospital discharge. These findings can be implemented in an intervention to reduce depression among the individuals with spinal injury such as the promotion of the guidance provision which is provided by the professionals and the arrangement of a counseling psychology workshop focusing on effective coping strategy, especially for individuals with paraplegia and tetraplegia.

B-PO02-002 ANXIETY AND DEPRESSION AMONG ARRHYTHMIA INPATIENTS IN CHINA: A CROSS-SECTIONAL STUDY OF A SINGLE TERTIARY CENTER

Few studies have demonstrated psychological status in forms of anxiety and depression among overall arrhythmia patients. To assess whether arrhythmia inpatients have a higher prevalence of mental disorders than the general population in China and identify potential factors. This cross-sectional survey was conducted in the arrhythmia department of a single Chinese tertiary center. The psychological status of all enrolled inpatients was assessed using the Zung Self-Rating Anxiety Scale (SAS) and the Zung Self-Rating Depression Scale (SDS). Four hundred and ninety-five arrhythmia inpatients were enrolled in this study. The mean age of the participants was 52.80±14.38 years, and 58.0% were male. Moreover, 90.1% of the participants were married, 41.2% were unemployed. Of these patients, 18.8% were in an anxious state and 34.1% were in a depressive state. The overall anxiety (41.24±9.42) and depression (44.11±12.05) scores were much higher than the Chinese norm (29.78±10.46 and 33.50±8.60, respectively), and the differences were statistically significant (t=27.075, P<0.001 and t=34.381, P<0.001, respectively). Multivariable logistic regression results showed that being unemployed (B=0.787, P=0.016) was significantly associated with anxiety; arrhythmia type (B=-0.830, P=0.003) was significantly associated with depression; marital status (B=-0.981, P=0.045) and arrhythmia type (B=-0.772, P=0.006) were significantly associated with mental disorders (anxiety or depression). Patients with cardiac implanted electronic devices were at higher mental disorders than patients under radiofrequency catheter ablation, (48.5% vs 34.3%, Chi-square values =6.782, P =0.009). Anxiety and depression are widespread in arrhythmia patients. Being unemployed has a positive association with anxiety. Cardiac implanted electronic devices have a positive association with depression. Being married has a negative association with mental disorders.

Validating the bifactor structure of the Ruminative Thought Style Questionnaire-A psychometric study.

The Ruminative Thought Style Questionnaire (RTSQ) is a self-report measure that aims to capture rumination globally, unbiased by depressive symptoms. We explored its psychometric properties among university students (N = 1123), as the existing models about the factor structure of the RTSQ have been inconclusive. In a second study (N = 320) we tested its convergent validity compared to the Ruminative Response Scale (RRS) and its construct validity compared to the Zung Self-rating Depression Scale (ZSDS). The results of Study 1 suggest that the factor structure of the RTSQ is best described with a 19-item bifactor Exploratory Structural Equation Modelling (ESEM), where most of the variance is explained by the general factor. The model was found to be invariant across genders. The correlations in Study 2 demonstrated that the RTSQ is congruent with the RRS, and that rumination captured by the RTSQ is rather maladaptive, as it was more strongly associated with the brooding subscale of the RRS than with reflective pondering. Significant positive associations were found with depressive symptoms, reaffirming the validity of the RTSQ due to the well-known association between rumination and depressive symptoms. Our results support that RTSQ assesses rumination globally, and it is a valid measure of ruminative thinking style that is rather negatively valenced but does not solely focus on depressive mood and symptoms.

Study of emotional disorders in dermatological and cardiological patients

Objective. To study the character and features of emotional disorders in patients of dermatological and cardiological profile. Emotional changes, accompanying many somatic diseases, have a negative effect and aggravate their course, worsening the quality of life and functioning. Materials and methods. 68 persons, divided into two groups, participated in a single-stage study: group I included 38 patients with dermatoses without any concomitant diseases of the internal organs; group II 30 cardiological patients without dermatological pathology in anamnesis. Complex research included general clinical and laboratory methods as well as psychological study using the Hospital Anxiety and Depression Scale HADS, Zung Self-Rating Depression Scale, Montgomery Asberg Depression Scale, Spielberger Hanin Anxiety Scales. To assess the results, the methods of parametric and nonparametric statistics were used. Results. When assessing the parameters by the Hospital Anxiety and Depression Scale HADS, in dermatological patients clinically and subclinically expressed anxiety was manifested more evidently, and in cardiological patients, it was depression. According to the data obtained by the Zung and Hamilton scales, depression also predominated in cardiological patients but anxiety symptoms and disorders reliably more often were observed in patients of dermatological profile. As for studying depression using the Montgomery-Asberg scale, in dermatological patients it was revealed less often, in the structure of symptoms there prevailed a small depressive episode. According to Spielberger Hanin Scale, anxiety was more expressed in dermatological patients. Conclusions. Emotional disorders in dermatological and cardiological patients are reliably different. In dermatological patients, they are characterized by increased anxiety in case of an insignificant depressive disorder. In cardiological patients, there prevail depressive changes, especially mild depression; anxiety symptomatology is not expressed.

The relationship between sunlight exposure duration and depressive symptoms: A cross-sectional study on elderly Chinese women.

Sunlight has been reported to have various beneficial effects on human health. Although research indicates an association between sunlight exposure and depressive symptoms, no study has examined it among the older adult population, especially among elderly Chinese women. This cross-sectional study addresses the aforesaid gap by investigating this association in 1,429 Chinese women aged 60 years and older. Information on their sunlight exposure was collected through a self-reported questionnaire. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS). The logistic regression models revealed that greater exposure to sunlight is associated with a lower prevalence of depressive symptoms. In the final adjusted model, when the short sunlight exposure category (reference) was compared with the medium and long ones, the odds ratios and 95% confidence intervals for the prevalence of depressive symptoms (SDS cutoff ≥ 45) were 0.84 (0.60, 1.19) and 0.62 (0.43, 0.91), respectively (p-value for trend = 0.01). This significant association did not change when the SDS cutoff points were altered to ≥ 40 and ≥ 50. Findings indicate that an increased sunlight exposure duration is associated with a lower prevalence of depressive symptoms in elderly women.

Impact of COVID Pandemic on Psychological Health and Academics of Undergraduate Students

Introduction: Novel coronavirus disease (COVID-19) first caused an outbreak in Wuhan, China in December 2019. After its spread in India, lockdown was initiated which forced students to continue their education through online learning platforms. Aim: The aim of the study was to assess the impact of the pandemic on psychological health and academics of undergraduate students in India. Settings and Design: Online survey conducted among undergraduate students. Materials and Methods: Cross-sectional study was conducted using three validated scales to assess fear, anxiety and depression (Numeric Rating Scale, Hamilton Anxiety Scale A, and Zung Self-Rating depression Scale). Statistical Analysis: Data were analyzed using the SPSS software version 25.0. The Chi-square test was used for the comparison of variables with demographic characteristics and regression analysis was done to calculate anxiety and depression scores. Results: Online survey was filled by 721 undergraduate students from across India. Moderate scores of fear, anxiety, and depression were reported to be 43.3%, 23.4%, and 76.4%, respectively. A total of 82.5% of respondents reported that the pandemic had affected their studies with disturbed routine, loss of concentration, and eye strain being the major causes. Conclusions: Mental health of students should be assessed and psychological guidance should be provided during the pandemic. Online teaching curriculum should consider all the stressors faced by students and planned accordingly.

Prevalence and factors associated with depression among the mothers of school-going children in Dhaka city, Bangladesh: A multi stage sampling-based study

BackgroundMotherhood is associated with extra stress, and mothers of young children are particularly prone to developing depression and mental health problems. MethodologyThis analytical cross-sectional study was conducted in Dhaka city, Bangladesh, from June to December 2019. Mothers of school-going children were recruited through a multistage sampling technique. Dhaka city was divided into two divisions and then further subdivided into public and private sectors. Six schools were selected from each sector by using a simple random sampling technique. A list of class five to eight students were collected from each school by systematic random sampling. Data were collected through face-to-face interviews using semi-structured questionnaires. The rate of depressive symptoms was measured by the validated Zung Self-Rating Depression Scale (SDS). ResultA total of 324 women participated in this study; the majority of the women (85.5%) were Muslim, 67.0% were housewives, and 53.1% had a girl child. Among the women, 15.4% had mild, 22.2% had moderate, and 20.1% had severe depression. Most of the child's behavioral and lifestyle factors were associated with the mother's depression. Adjusted analyses indicate that if a child is often unhappy, depressed, or tearful [(OR (95%CI = 22.27 (8.39–59.11)], gets nervous in new situations or easily loses confidence [(OR (95%CI) = 5.45 (2.96–10.00)], often lies or cheats [(OR (95%CI) = 8.93 (3.76–21.22)], gets afraid easily [(OR (95%CI) = 7.09 (3.79–13.24)], watches television for 3 h or more [(OR (95%CI) = 23.77 (6.46–87.48)] browses the internet for 3 h or more [(OR (95%CI = 7.37 (2.76–19.67)] were associated with mother's depression. ConclusionThe study concludes that depression among the mothers of school-going children in Dhaka city of Bangladesh is high. Several lifestyles and behavioral factors of school-going children are significantly associated with the mothers' depression.

Depression and its correlation with social support and health-promoting lifestyles among Chinese university students: a cross-sectional study

ObjectivesTo investigate the prevalence of depression in college students and determine how social support and healthy lifestyle factors are associated with depression in this population.DesignA cross-sectional design.SettingA comprehensive university in...

Psychological Status of Clinical Laboratory Staff During the COVID-19 Outbreak.

In early December 2019, during the outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was first detected in Wuhan, COVID-19 was suspected, detected, and confirmed in an increasing number of patients every day. The clinical laboratory staff have always played an important role in the laboratory diagnosis of patients. Currently, there are many research studies on the mental health of the first-line doctors or nurses managing the COVID-19 outbreak, both domestically and overseas, but data of the mental health and associated factors among the clinical laboratory staff who handle the blood or biological samples of confirmed cases and are consequently exposed to COVID-19 are limited. This cross-sectional survey-based study was performed via an online survey in a single designated hospital from April 20 to April 23, 2020 in Yiwu,China. The online survey included questions on sociodemographic and clinical variables. Totally, 45 clinical laboratory staff and 20 nonmedical health workers participated. Mental health variables were assessed via 4 Chinese versions of validated measurement tools : Zung's Self-rating Depression Scale (SDS), Zung's Self-rating Anxiety Scale (SAS), the Pittsburgh Sleep Quality Index (PSQI), and the Eysenck Personality Questionnaire (EPQ). Significant differences were observed in the SDS and SAS scores, between the clinical laboratory staff and the nonmedical health workers (P < .001, P < .003, respectively). The scores for exposure risk and neuroticism of participants were the main factors influencing both the SDS scores of the clinical laboratory staff (P = .002, P = .005, respectively), and also their SAS scores (P = .003 P = .006, respectively). The results showed that a significant proportion of clinical laboratory staff experienced anxiety and depression symptoms. Their scores for mental health problems, exposure risk, and neuroticism were associated with severe symptoms of depression and anxiety. Therefore, the high-risk group of the clinical laboratory staff and those individuals with higher neuroticism scores may need special attention.

Association of Excessive Daytime Sleepiness with the Zung Self-Rated Depression Subscales in Adults with Coronary Artery Disease and Obstructive Sleep Apnea.

Excessive daytime sleepiness (EDS) is a factor associated with both obstructive sleep apnea (OSA) and depressive symptoms. Continuous positive airway pressure (CPAP) treatment may decrease EDS in adults with OSA; however, the modulatory role of depressive symptoms on the improvement of EDS is not known. We aimed to explore the association between subscales of the Zung Self-rated Depression Scale (SDS) and Epworth Sleepiness Scale (ESS) over a 2-year period in coronary artery disease (CAD) patients with OSA. This was a post-hoc analysis of the RICCADSA cohort, in which 399 adults with CAD (155 sleepy OSA [apnea–hypopnea index ≥ 15/h] and ESS score ≥ 10, who were offered CPAP; and 244 nonsleepy OSA [ESS < 10]), randomized to CPAP [n = 122] or no-CPAP [n = 122]) were included. Three factors were extracted from the Zung SDS, based on the principal component analysis: F1, cognitive symptoms and anhedonia; F2, negative mood; and F3, appetite. In a mixed model, the ESS score decreased by 3.4 points (p < 0.001) among the sleepy OSA phenotype, which was predicted by the decline in the F2, but not in the F1 and F3 scores. The fixed effects of time were not significant in the nonsleepy OSA groups, and thus, further analyses were not applicable. Additional within-group analyses showed a significant decrease in all subscales over time both in the sleepy and nonsleepy OSA patients on CPAP whereas there was a significant increase in the nonsleepy OSA group randomized to no-CPAP. We conclude that the improvement in negative mood symptoms of depression, but not changes in cognitive symptoms and anhedonia as well as appetite, was a significant predictor of decline in the ESS scores over a 2-year period in this CAD cohort with sleepy OSA on CPAP treatment.

Erectile Dysfunction after Allogeneic Hematopoietic Stem Cell Transplant: Results from a Single Center Experience

▪Erectile dysfunction (ED) is a multidimensional disturbance of the erectile response involving organic, relational and psychological components, which has been reported to affect a significant proportion of patients after allogeneic hematopoietic stem cell transplant (HSCT). Although predictors for ED have been established in the general population, few studies have addressed which variables are associated with ED in HSCT patients.Aims of the study were to establish prevalence and extent of ED in 55 consecutive patients transplanted in our Institution between 2003 and 2015, and to identify within socio-demographic, medical and psychological domains eventual ED predictors.Patients were enrolled in the study upon informed consent. Inclusion criteria were age ≥ 18 years, continuous disease remission, and ≥ 6 months from HSCT. Exclusion criteria were concurrent malignancy, major psychiatric disorder or mental retardation, and hormonal replacement.ED was assessed and measured by the International Index of Erectile Dysfunction (IIEF15).Patient socio-demographics were collected by an ad hoc schedule.Medical data were obtained from hospital records. The andrological visit included testicular measure, penis and genital skin inspection, and penile ultrasound and elastosonography. Free testosterone (FT), inhibin B, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, thyroid stimulating hormone (TSH), free triiodothyronine 3 (FT3), FT4, cortisol, and adrenocorticotropic hormone (ACTH) levels were measured.Anxiety was quantified by the State-Trait Anxiety Inventory (STAI), depression by the Zung Self-rating Depression Scale (SDS).Differences between groups were analyzed by the non-parametric Mann-Whitney test and the Fisher's exact test when testing quantitative and categorical variables, respectively. Logistic regression analysis was used to estimate the association of the variables predictive for ED, when including into the association model the relevant covariates. Chronic graft versus host disease (cGVHD) was diagnosed according to NIH criteria.Fifty-two (94.5%) of the 55 patients eligible for the study returned the self-administered questionnaires and underwent the andrological visit: 32 had acute leukemia, 7 non-Hodgkin lymphoma, 4 myelodysplastic syndrome, 4 chronic myeloproliferative disease, 3 multiple myeloma, 2 B cell chronic lymphocytic leukemia.Median time from HSCT to study assessment was 19 (6-108) months. Thirty-nine patients (75%) had hypogonadism, while 10 (19.2%) presented genital cGVHD, with post-HSCT phimosis in 7 cases, meatal scarring in 2, lichen sclerosis-like lesions in 1. At penile ultrasound and elastosonography, 12 (23%) and 7 (13.5%) patients had a medium-hard and hard penile elasticity.FT and inhibin B were below the range limit in 34 (65.4%) and 33 (63.5%) patients, while FSH was above in 47 (90.4%), thus indicating a large prevalence of gonadal failure. Three patients (5.7%) had a mild hypotyrodism. No prolactin, cortisol or ACTH alterations were observed.Forty-seven (90.4%) of the 52 participants declared a stable sexual partner: the 5 patients [median age 42 (19-50) years, 1 with cGVHD] who reported not having any sexual activity due to partner absence were excluded from the analysis of ED predictors according to IIEF15 requirements.ED was reported by 31/47 (66%) patients: it was severe in 42% cases, moderate in 22.6%, moderate to mild in 6.4% and mild in 29%. There was no difference between patients with and without ED in terms of time from HSCT [25 (6-108) vs 15 (6-79) months, p=0.32].In univariate analysis higher age, low education level, and cGVHD (excluding the isolated genital one) were significantly associated to ED, while the same variables in addition to hypertension maintained their significance in the subgroup of patients with moderate-severe ED only (Table 1). In a logistic regression model, age and cGVHD were the only variables independently associated with ED (any grade, p=0.02 and moderate-severe, p=0.0001, respectively).Our study confirms that ED is a frequent long-term complication of HSCT, with cGVHD being a major predictor. We suggest that an early screening of sexual dysfunction and a close partnership between HSCT clinicians and andrologists could help to implement reliable prevention strategies and/or prompt interventions for patients suffering from ED. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Reduced Quality of Life and Sexual Satisfaction in Isolated Hypogonadotropic Hypogonadism.

(1) Background: Isolated hypogonadotropic hypogonadism (IHH) is a genetic condition characterized by impaired puberty and fertility. IHH can significantly impact patient health-related quality of life (HRQoL), sexual satisfaction (SS) and mood. (2) Methods: Participants included 132 IHH subjects (89 men and 43 women) and 132 sex- and age-matched controls. HRQoL, depressive symptoms, erectile dysfunction (ED), and SS were assessed in an online survey using the Zung Self-Rating Depression Scale (SDS), 15D instrument of HRQoL (15D), Sexual Satisfaction Questionnaire (SSQ), and 5-item International Index of Erectile Function (IIEF-5). (3) Results: QoL and SS were significantly lower in the IHH group vs. controls. There was a high rate of ED (53.2% vs. 33%, p = 0.008) and depressive symptoms (45.00 ± 17.00 vs. 32.00 ± 12.00, p < 0.001) in patients vs. controls. The age of patients at IHH diagnosis inversely correlated with their overall 15D scores. An alarming non-compliance rate was seen (51.6%). No differences were found between scores of patients receiving hormone replacement therapy (HRT) and untreated subjects in any of the scales. (4) Conclusions: The HRQoL, SS, ED, and depression levels observed in IHH patients, despite HRT, are alarming. Late IHH diagnosis may have a particularly negative impact on HRQoL. More attention should be devoted to HRT adherence and various HRQoL aspects of IHH patients.

Retrospective analysis of exercise capacity in patients with coronary artery disease after percutaneous coronary intervention or coronary artery bypass graft

ObjectivesTo describe the current state of exercise capacity as well as to identify its predictors in patients with coronary artery disease (CAD) following percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) in the mainland of China. MethodsA retrospective study design was employed. We evaluated 230 CAD patients following PCI or CABG in a cardiac rehabilitation center from January 2019 to October 2019. The patients were referred to undergo incremental cardiopulmonary exercise testing with a cycle ergometer. The Zung Self-Rating Anxiety Scale and the Zung Self-Rating Depression Scale were used to evaluate patients’ mental health. Statistical analysis was performed using the chi-square test, Fisher’s exact test, t-test, Mann-Whitney U test, and binary logistic regression. ResultsAmong the 230 patients, 223 patients demonstrated reduced exercise capacity. Resutlts of the logistic regression analysis showed that anxiety (OR = 1.13, 95% CI 1.01–1.32, P = 0.029) was an independent risk factor for reduced exercise capacity in patients following the PCI or CABG. ConclusionsExercise capacity of Chinese CAD patients after PCI or CABG was relatively poor. Alleviating symptoms of anxiety and making exercise prescriptions according to the results of the cardiopulmonary exercise test should be considered during the intervention to improve CAD patients’ exercise capacity.

Relationship between free fatty acids, body mass index and depressive symptoms in patients with chronic heart failure.

AimTo explore the prevalence of depressive symptoms among patients with chronic heart failure (CHF) and analyse the relationship between free fatty acids (FFAs), body mass index (BMI) and depressive symptoms among patients with CHF.DesignA cross‐sectional study.MethodsQuestionnaires were distributed to 200 patients with CHF in the department of Cardiology at a tertiary first‐class hospital in Shandong province. A total of 195 hospitalized patients completed the survey. Data collected from February 2017–November 2017 were analysed by using Pearson's correlation and multiple linear regression. The depressive status of the patients was assessed by the Zung Self‐rating Depression Scale (SDS), and the relationships between FFA, BMI and depressive symptoms were analysed using SPSS 20.0.ResultsThe results showed that 71.28% CHF patients have depressive symptoms. The serum FFA level was significantly higher in CHF patients with depressive symptoms than those without depressive symptoms (p = .003), and FFA level was significantly positively correlated with the SDS score (r = .242, p = .001). The differences in SDS scores were statistically significant between two different BMI groups (p < .01), and BMI was negatively correlated with the SDS score (r = −.139, p = .040). Regression analysis showed that high FFAs (β = 0.184, p = .009) and low BMI (β = −0.116, p = .049) were risk factors for depressive symptoms in CHF patients. Gender, age, FFA and BMI were associated with depressive symptoms, accounting for 7.1% of the variance in depressive symptoms.ConclusionsThe prevalence of depressive symptoms in CHF patients is very high, and high FFAs and low BMI are risk factors for depressive symptoms. Targeted interventions to strengthen nutritional support in CHF patients may be benefit to improve depression‐related outcomes.