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Dudine L, Canaletti C, Giudici F, Lunardelli A, Abram G, Santini I, Baroni V, Paris M, Pesavento V, Manganotti P, Ronchese F, Gregoretti B, Negro C. Investigation on the Loss of Taste and Smell and Consequent Psychological Effects: A Cross-Sectional Study on Healthcare Workers Who Contracted the COVID-19 Infection. Front Public Health 2021; 9:666442. [PMID: 34123991 PMCID: PMC8193118 DOI: 10.3389/fpubh.2021.666442] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/12/2021] [Indexed: 12/24/2022] Open
Abstract
The aim of this study was to investigate the correlation between psychological distress and taste and sense of smell dysfunctions on healthcare workers (HCW) who contracted the COVID-19 infection in the midst of the disease outbreak. Reports of sudden loss of taste and smell which persist even after recovery from COVID-19 infection are increasingly recognized as critical symptoms for COVID-19 infections. Therefore, we conducted a cross-sectional study on COVID-19 HCW (N = 104) who adhered to respond to a phone semistructured interview addressing the virus symptoms and associated psychological distress. Data were collected from June to September 2020. Findings confirm the association between experienced taste/olfactory loss and emotional distress and suggest that dysfunctions of taste and smell correlate positively with anxiety and depression. Furthermore, their psychological impact tends to persist even after the recovery from the disease, suggesting the need for appropriate psychological interventions to prevent people from developing more serious or long-lasting psychological disorders and, as far as HCW, to reduce the risk of work-related distress.
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Affiliation(s)
- Luisa Dudine
- Clinic of Psychology, Department of Hospital Care, University Hospital and Health Services, Trieste, Italy
| | - Claudia Canaletti
- Clinic of Psychology, Department of Hospital Care, University Hospital and Health Services, Trieste, Italy
| | - Fabiola Giudici
- Unit of Biostatistics, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Epidemiology and Public Health, University of Padua, Padua, Italy
| | - Alberta Lunardelli
- Rehabilitation Division, Department of Integrated Neuroscience and Occupational Medicine, University Hospital and Health Services, Trieste, Italy
| | - Giulia Abram
- Clinic of Psychology, Department of Hospital Care, University Hospital and Health Services, Trieste, Italy
| | - Ingrid Santini
- Clinic of Psychology, Department of Hospital Care, University Hospital and Health Services, Trieste, Italy
| | - Vera Baroni
- Clinic of Psychology, Department of Hospital Care, University Hospital and Health Services, Trieste, Italy
| | - Marta Paris
- Clinic of Psychology, Department of Hospital Care, University Hospital and Health Services, Trieste, Italy
| | - Valentina Pesavento
- Rehabilitation Division, Department of Integrated Neuroscience and Occupational Medicine, University Hospital and Health Services, Trieste, Italy
| | - Paolo Manganotti
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy
| | - Federico Ronchese
- Clinical Unit of Occupational Medicine, Department of Integrated Neuroscience and Occupational Medicine, University Hospital and Health Services, Trieste, Italy
| | - Barbara Gregoretti
- Medical Directorate, University Hospital and Health Services, Trieste, Italy
| | - Corrado Negro
- Clinical Unit of Occupational Medicine, University of Trieste, Trieste, Italy
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Humphries SM, Wallert J, Norlund F, Wallin E, Burell G, von Essen L, Held C, Olsson EMG. Internet-Based Cognitive Behavioral Therapy for Patients Reporting Symptoms of Anxiety and Depression After Myocardial Infarction: U-CARE Heart Randomized Controlled Trial Twelve-Month Follow-up. J Med Internet Res 2021; 23:e25465. [PMID: 34028358 PMCID: PMC8185614 DOI: 10.2196/25465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/24/2020] [Accepted: 04/26/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The U-CARE Heart trial was one of the first randomized controlled trials to evaluate the effect of internet-based cognitive behavioral therapy on self-reported symptoms of anxiety or depression for patients with a recent myocardial infarction. While the effects of internet-based cognitive behavioral therapy on Hospital Anxiety and Depression Scale (HADS) scores at 14 weeks postbaseline were not significant, in this study, we investigated possible long-term effects of treatment. OBJECTIVE The aim of this study was to evaluate the long-term effectiveness of internet-based cognitive behavioral therapy on self-reported symptoms of anxiety and depression in patients 12 months after a myocardial infarction and to explore subsequent occurrences of cardiovascular disease events. METHODS Shortly after acute myocardial infarction, 239 patients (33% female, mean age 59.6 years) reporting mild-to-moderate symptoms of anxiety or depression were randomized to 14 weeks of therapist-guided internet-based cognitive behavioral therapy (n=117) or treatment as usual (n=122). Data from national registries were used to explore group differences in clinical outcomes such as cardiovascular disease and cardiovascular-related mortality for a follow-up period of up to 5 years: group differences in HADS total score 1 year post-myocardial infarction, the primary outcome, was analyzed using multiple linear regression. Secondary outcomes, such as HADS anxiety and depression subscales and the Cardiac Anxiety Questionnaire total score (CAQ), which measures heart-focused anxiety, were analyzed in the same way. Multiple imputation was used to account for missing data, and a pooled treatment effect was estimated. Adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) for data pertaining to registry outcomes. RESULTS Both groups reported lower HADS total scores 1 year after myocardial infarction than those at baseline. HADS total scores were not significantly different between the treatment and control groups 1 year after myocardial infarction (β=-1.14, 95% CI -2.73 to 0.45, P=.16). CAQ was the only measure improved significantly by internet-based cognitive behavioral therapy when compared with treatment as usual (β=-2.58, 95% CI -4.75 to -0.42, P=.02) before adjusting for multiple comparisons. The composite outcome of nonfatal cardiovascular events and cardiovascular-related mortality did not differ between groups but was numerically higher in the internet-based cognitive behavioral therapy group, who were at slightly greater risk (HR 1.8, 95% CI 0.96 to 3.4, P=.07). Adjusting for previous myocardial infarction and diabetes attenuated this estimate (HR 1.5, 95% CI 0.8 to 2.8, P=.25). CONCLUSIONS Internet-based cognitive behavioral therapy was not superior in reducing self-reported symptoms of depression or anxiety compared to treatment as usual at the 1-year follow-up after myocardial infarction. A reduction in cardiac-related anxiety was observed but was not significant after adjusting for multiple comparisons. There was no difference in risk of cardiovascular events between the treatment groups. Low treatment adherence, which might have affected treatment engagement and outcomes, should be considered when interpreting these results. TRIAL REGISTRATION ClinicalTrials.gov NCT01504191; https://clinicaltrials.gov/ct2/show/NCT01504191. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s13063-015-0689-y.
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Affiliation(s)
- Sophia Monica Humphries
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - John Wallert
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.,Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Fredrika Norlund
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Emma Wallin
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Gunilla Burell
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Family Medicine and Preventative Medicine, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Claes Held
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Medical Sciences, Cardiology, Uppsala Clinical Research Centre, Uppsala University, Uppsala, Sweden
| | - Erik Martin Gustaf Olsson
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Keddington KS, Jones AE, Feehan M, Witt DM. Development of a brief screening instrument for emotional distress associated with thromboembolism. THROMBOSIS UPDATE 2020. [DOI: 10.1016/j.tru.2020.100015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Faija CL, Reeves D, Heal C, Capobianco L, Anderson R, Wells A. Measuring the Cognitive Attentional Syndrome in Cardiac Patients With Anxiety and Depression Symptoms: Psychometric Properties of the CAS-1R. Front Psychol 2019; 10:2109. [PMID: 31620051 PMCID: PMC6760032 DOI: 10.3389/fpsyg.2019.02109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 08/30/2019] [Indexed: 11/13/2022] Open
Abstract
Metacognitive Therapy (MCT) is a recent treatment with established efficacy in mental health settings. MCT is grounded in the Self-Regulatory Executive Function (S-REF) model of emotional disorders and treats a negative perseverative style of thinking called the cognitive attentional syndrome (CAS), thought to maintain psychological disorders, such as anxiety and depression. The evaluation of effective psychological therapies for anxiety and depression in chronic physical illness is a priority and research in this area depends on the suitability and validity of measures assessing key psychological constructs. The present study examined the psychometric performance of a ten-item scale measuring the CAS, the CAS-1R, in a sample of cardiac rehabilitation patients experiencing mild to severe symptoms of anxiety and/or depression (N = 440). Participants completed the CAS scale, the Hospital Anxiety and Depression Scale and the Metacognitions Questionnaire 30 (MCQ-30). The latent structure of the CAS-1R was assessed using confirmatory factor analyses (CFA). In addition, the validity of the measure in explaining anxiety and depression was assessed using hierarchical regression. CFA supported a three-factor solution (i.e., coping strategies, negative metacognitive beliefs and positive metacognitive beliefs). CFA demonstrated a good fit, with a CFI = 0.988 and an RMSEA = 0.041 (90% CI = 0.017–0.063). Internal consistency was acceptable for the first two factors but low for the third, though all three demonstrated construct validity and the measure accounted for additional variance in anxiety and depression beyond age and gender. Results support the multi-factorial assessment of the CAS using this instrument, and demonstrate suitability for use in cardiac patients who are psychologically distressed.
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Affiliation(s)
- Cintia L Faija
- Division of Nursing, Midwifery & Social Work, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - David Reeves
- Manchester Academic Health Science Centre, NIHR School for Primary Care Research, The University of Manchester, Manchester, United Kingdom
| | - Calvin Heal
- Faculty of Biology, Medicine and Health, Centre for Biostatistics, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Lora Capobianco
- Faculty of Biology, Medicine and Health, School of Psychological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United Kingdom
| | - Rebecca Anderson
- Faculty of Biology, Medicine and Health, School of Psychological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Adrian Wells
- Faculty of Biology, Medicine and Health, School of Psychological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United Kingdom
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Prevalence of anxiety in patients with an implantable cardioverter defibrillator: measurement equivalence of the HADS-A and the STAI-S. Qual Life Res 2019; 28:3107-3116. [PMID: 31230167 PMCID: PMC6803579 DOI: 10.1007/s11136-019-02237-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2019] [Indexed: 11/17/2022]
Abstract
Purpose The Hospital Anxiety and Depression Scale (HADS-A) and State-Trait Anxiety Inventory (STAI-S) are popular instruments for assessing anxiety and are considered interchangeable, although little is known about their equivalence. Hence, we examined whether the two instruments are (i) equivalent with respect to determining the prevalence of probable clinical anxiety levels and (ii) reflect variation on a common anxiety attribute. Methods Score and construct concordance were evaluated using equipercentile equating and bifactor modeling, respectively. Secondary data from the WEBCARE trial and the MIDAS study were used for the current study, where patients implanted with a first-time implantable cardioverter defibrillator completed both the HADS-A and the STAI-S within 10 days post implant. Results Data from 710 patients were included in the analyses. Results showed that the STAI-S produced a higher prevalence rate than the HADS-A (39% vs. 23%). A crosswalk table was generated with equivalent scores and cutoffs for the HADS-A and STAI-S, respectively. Bifactoring suggested that HADS-A and STAI-S largely tapped into the same generic anxiety attributes. Conclusions STAI-S and HADS-A reflect a common anxiety attribute, but using the recommended cutoff scores on the respective measures show very different prevalence rates and would classify patients as anxious with the STAI-S who would not be identified as such with the HADS-A. Clinicians and researchers should be aware of the inequivalence when using these measures for screening and determining the prevalence of probable clinical anxiety levels.
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Stauber S, Rohrbach T, Saner H, Schmid JP, Grolimund J, von Känel R. Heart Rate Recovery After Exercise in Outpatients with Coronary Heart Disease: Role of Depressive Symptoms and Positive Affect. J Clin Psychol Med Settings 2017; 24:376-384. [PMID: 28975490 DOI: 10.1007/s10880-017-9511-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Heart rate recovery after 1 min of exercise cessation (HRR-1) is an important prognostic factor in patients with cardiovascular disease (CVD). We aimed to further elucidate the association between HRR-1 and known psychosocial risk factors in patients referred for comprehensive cardiac rehabilitation. We examined 521 patients with coronary heart disease in the first week of an outpatient cardiac rehabilitation program. Depressive and anxiety symptoms were measured with the Hospital Anxiety and Depression Scale, and positive (PA) and negative affect were rated with the Global Mood Scale. Depressive symptoms showed a significant inverse relationship with HRR-1 (p < .05), controlling for sociodemographic and medical covariates, whereas anxiety symptoms did not show a significant association. PA made a significant contribution to HRR-1 as well (p < .05). Our findings suggest an independent association between HRR-1 and psychosocial risk factors of CVD.
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Affiliation(s)
- Stefanie Stauber
- Division of Psychosomatic Medicine, Department of Neurology, Inselspital, Bern University Hospital, 3010, Bern, Switzerland.
| | - Tina Rohrbach
- Department of Gynecology and Obstetrics, Thun Hospital, Thun, Switzerland
| | - Hugo Saner
- Preventive Cardiology and Sports Medicine, Swiss Cardiovascular Centre, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Jean Paul Schmid
- Department of Cardiology, Clinic Barmelweid, Barmelweid, Switzerland
| | - Johannes Grolimund
- Division of Psychosomatic Medicine, Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Roland von Känel
- Department of Psychosomatic Medicine, Clinic Barmelweid, 5017, Barmelweid, Switzerland
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Tesio V, Marra S, Molinaro S, Torta R, Gaita F, Castelli L. Screening of depression in cardiology: A study on 617 cardiovascular patients. Int J Cardiol 2017; 245:49-51. [PMID: 28747268 DOI: 10.1016/j.ijcard.2017.07.065] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 06/27/2017] [Accepted: 07/18/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Depression screening in the cardiovascular disease (CVD) care setting is under-performed, also because the issue of the optimal screening tools cut-off is still open. We analysed which HADS (Hospital Anxiety and Depression Scale) total score cut-off value shows the best properties in two groups of 357 Acute Coronary Syndrome (ACS) and 260 Chronic Coronary Artery Disease (CAD) hospitalized patients. METHODS A Receiver Operating Characteristics (ROC) curve was plotted for both groups using the Montgomery-Asberg Depression Rating Scale (MADRS) as the criterion. Accuracy, positive (PPV) and negative (NPV) predictive values were computed for different cut-off scores. RESULTS The ROC curves confirmed the excellent/very good accuracy of the HADS in both groups, with an area under the curve of 0.911 for the ACS and 0.893 for the CAD patients. The cut-off of 14 showed the best compromise between high sensitivity and good specificity in both groups, with high negative predicted values (95.5% and 92.4%, respectively). CONCLUSION Using a cut-off value of 14, the HADS could be considered a good screening tool to identify hospitalized CAD and ACS patients requiring a more accurate depression assessment, in order to promptly plan the most appropriate treatment strategies and prevent the negative effects of depression in CVD patients.
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Affiliation(s)
- Valentina Tesio
- Department of Psychology, University of Turin, Via Po 14, 10123 Turin, Italy.
| | - Sebastiano Marra
- Division of Cardiology, University of Turin, "Città della Salute e della Scienza" Hospital, Corso Bramante 88, 10126 Turin, Italy
| | - Stefania Molinaro
- Clinical Psychology and Psycho-Oncology Unit, University of Turin, "Città della Salute e della Scienza" Hospital, Corso Bramante 88, 10126 Turin, Italy
| | - Riccardo Torta
- Clinical Psychology and Psycho-Oncology Unit, University of Turin, "Città della Salute e della Scienza" Hospital, Corso Bramante 88, 10126 Turin, Italy
| | - Fiorenzo Gaita
- Division of Cardiology, University of Turin, "Città della Salute e della Scienza" Hospital, Corso Bramante 88, 10126 Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Via Po 14, 10123 Turin, Italy
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Ski CF, Worrall-Carter L, Cameron J, Castle DJ, Rahman MA, Thompson DR. Depression screening and referral in cardiac wards: A 12-month patient trajectory. Eur J Cardiovasc Nurs 2016; 16:157-166. [DOI: 10.1177/1474515115583617] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Chantal F Ski
- Centre for the Heart and Mind, Australian Catholic University, Melbourne, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Linda Worrall-Carter
- St Vincent’s Centre for Nursing Research, Australian Catholic University, Melbourne, Australia
| | - Jan Cameron
- Centre for the Heart and Mind, Australian Catholic University, Melbourne, Australia
| | - David J Castle
- Centre for the Heart and Mind, Australian Catholic University, Melbourne, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Muhammad A Rahman
- St Vincent’s Centre for Nursing Research, Australian Catholic University, Melbourne, Australia
| | - David R Thompson
- Centre for the Heart and Mind, Australian Catholic University, Melbourne, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
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