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Du W, Wang J, Li Q, Lu S, Xiao J. Longitudinal mediation effect of hassles between neuroticism and dimensions of the tripartite model in college students. Stress Health 2024:e3407. [PMID: 38652730 DOI: 10.1002/smi.3407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 03/12/2024] [Accepted: 04/05/2024] [Indexed: 04/25/2024]
Abstract
This study addresses a gap in the literature by exploring the longitudinal effects of hassles in mediating the relationship between neuroticism and the tripartite model of depression and anxiety. The research investigates these associations in a large sample of university students, utilising baseline and 6-month follow-up data. Initial assessments involved participants completing measures for neuroticism, depression and anxiety symptoms, and the occurrence of stress, followed by monthly assessments of stress, anxiety symptom and mood symptoms over a 6-month period. Our results illuminate the mediating role of daily hassles in the relationship between neuroticism and various dimensions of anxiety and depression, including general distress, specific depression, and anxiety symptoms. These findings underscore the significant impact of neuroticism and hassles on a broad spectrum of mood symptoms, offering valuable insights for both research and clinical practice. Discussions around the implications of these findings are provided in the our paper, where we also outline potential directions for future research and clinical applications.
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Affiliation(s)
- Wenxin Du
- Beijing Key Laboratory of Learning and Cognition, Department of Psychology, Capital Normal University, Beijing, China
| | - Jieyi Wang
- Beijing Key Laboratory of Learning and Cognition, Department of Psychology, Capital Normal University, Beijing, China
| | - Qi Li
- Beijing Key Laboratory of Learning and Cognition, Department of Psychology, Capital Normal University, Beijing, China
| | - Shan Lu
- Beijing Key Laboratory of Learning and Cognition, Department of Psychology, Capital Normal University, Beijing, China
| | - Jing Xiao
- Beijing Key Laboratory of Learning and Cognition, Department of Psychology, Capital Normal University, Beijing, China
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Kong F, Yu L, Hou Y, Zhu L, Zhou J, Huang L, Lv Y, Wang L, Zhang L, Yang Y, Ying Y. Efficacy of Internet-Based Cognitive Behavioral Therapy for Subthreshold Depression Among Older Adults in Institutional Long-Term Care Settings: Pragmatic Randomized Controlled Trial. J Med Internet Res 2024; 26:e40187. [PMID: 38427424 PMCID: PMC10943436 DOI: 10.2196/40187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 01/03/2023] [Accepted: 01/31/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Subthreshold depression (sD) is prevalent in older populations in long-term care (LTC) settings, but psychological therapy in LTC settings in China is not readily available. Thus, internet-based cognitive behavioral therapy (ICBT) may be suitable for this population, but research on the efficacy of ICBT for older adults with sD, especially those living in LTC settings, is limited. OBJECTIVE This study aimed to evaluate the efficacy and acceptability of ICBT treatment for sD among LTC residents in China. We also examined whether ICBT is as effective as group-based cognitive behavioral therapy (CBT) for treating sD in this population. METHODS We conducted a pragmatic randomized controlled trial, which included 18 LTC institutions. A total of 354 participants were randomized to ICBT, group-based CBT, or a waiting list and were followed up for 12 months. The primary outcome was self-reported depressive symptoms on the Center for Epidemiological Studies Depression Scale (CES-D). Secondary outcomes were the scores of the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-Item (GAD-7), and Geriatric Depression Scale (GDS). A mixed-effects model was used to assess the efficacy of ICBT. RESULTS The ICBT group showed a significant improvement in self-reported depressive symptoms, which was maintained at the 12-month follow-up (all P<.001). The ICBT group exhibited a significantly larger reduction in the scores of the CES-D (Cohen d=0.07, 95% CI 0.04-0.09; P=.01), PHQ-9 (d=0.30, 95% CI 0.28-0.33; P<.001), GDS (d=0.10, 95% CI 0.08-0.13; P<.001), and GAD-7 (d=0.19, 95% CI 0.17-0.22; P<.001) compared with a waiting list at postintervention. ICBT had significantly stronger effects than CBT on the PHQ-9 and GAD-7 at postintervention (d=0.15, 95% CI 0.13-0.17; P<.001 and d=0.21, 95% CI 0.19-0.23; P<.001, respectively), 6-month follow-up (d=0.18, 95% CI 0.16-0.21; P<.001 and d=0.18, 95% CI 0.15-0.21; P<.001, respectively), and 12-month follow-up (d=0.15, 95% CI 0.11-0.19; P<.001 and d=0.18, 95% CI 0.14-0.21; P<.001, respectively). CONCLUSIONS ICBT is a relatively effective and acceptable intervention for reducing depressive symptoms among Chinese LTC residents with sD. These findings indicate the usefulness of ICBT application for sD in LTC settings. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2000030697; https://www.chictr.org.cn/showproj.aspx?proj=50781.
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Affiliation(s)
- Fanqian Kong
- Ningbo Medical Center Lihuili Hospital, Ningbo, China
| | - Libo Yu
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | | | - Lijie Zhu
- Pfizer Research and Development Co, Ltd, Shanghai, China
| | - Jing Zhou
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Lingjie Huang
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Yueer Lv
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Li Wang
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Li Zhang
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Yiling Yang
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Yuchen Ying
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
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Liu S, Cao L, Li H, Du Y, Wang M, Xiao H, Duan Y, Deng G, Huang X, Qiu C, Gong Q. Trait anxiety mediates the association between hippocampal-insula functional connectivity and anxiety symptom severity in adults with and without generalized anxiety disorder. J Affect Disord 2024; 344:1-7. [PMID: 37802321 DOI: 10.1016/j.jad.2023.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 08/30/2023] [Accepted: 10/03/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Trait anxiety is a vulnerability factor for the development of generalized anxiety disorder (GAD). The hippocampus has been implicated in trait anxiety in normal and GAD populations. However, the exact neural mechanism of hippocampal functional connectivity (FC) and its association with clinical symptoms and trait anxiety in GAD patients remains unknown. METHODS We recruited 68 participants (37 drug-naïve non-comorbidity GAD patients and 31 matched healthy controls (HC)), assessed their trait and state anxiety, scanned them with structural and resting-state functional magnetic resonance imaging (fMRI), and compared their hippocampal FC and volumes. We explored the relationships between hippocampal FC, clinical symptoms, and trait anxiety using partial correlation analyses; we also investigated the mediating effects of trait anxiety on the association between hippocampal FC and GAD symptom severity. RESULTS The GAD group showed increased right hippocampal FC with left insula, which was positively correlated with the Self-Rating Anxiety Scale (SAS), State Anxiety Inventory (SAI), and Trait Anxiety Inventory (TAI). Trait anxiety mediated the relationship between hippocampal FC and anxiety levels. We found no significant difference in hippocampal volumes between GAD and HC. LIMITATIONS The sample size was moderate. The exclusion of comorbidity may reduce the generalizability of our results in normal clinical settings. CONCLUSIONS The GAD patients showed no structural change but had functional alterations in the hippocampus. More importantly, future psychotherapy for this disorder should consider that trait anxiety might play a crucial role in the altered hippocampal FC in GAD.
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Affiliation(s)
- Shiyu Liu
- Mental Health Center, West China Hospital of Sichuan University, Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu 610041, China
| | - Lingxiao Cao
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Hailong Li
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Yang Du
- Mental Health Center, West China Hospital of Sichuan University, Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu 610041, China
| | - Mei Wang
- Mental Health Center, West China Hospital of Sichuan University, Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu 610041, China
| | - Hongqi Xiao
- Mental Health Center, West China Hospital of Sichuan University, Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu 610041, China
| | - Yingxu Duan
- Mental Health Center, West China Hospital of Sichuan University, Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu 610041, China
| | - Gaoju Deng
- Mental Health Center, West China Hospital of Sichuan University, Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu 610041, China
| | - Xiaoqi Huang
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.
| | - Changjian Qiu
- Mental Health Center, West China Hospital of Sichuan University, Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu 610041, China.
| | - Qiyong Gong
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China
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4
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Qi X, Xu W, Li G. Neuroimaging Study of Brain Functional Differences in Generalized Anxiety Disorder and Depressive Disorder. Brain Sci 2023; 13:1282. [PMID: 37759883 PMCID: PMC10526432 DOI: 10.3390/brainsci13091282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 08/23/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
Generalized anxiety disorder (GAD) and depressive disorder (DD) are distinct mental disorders, which are characterized by complex and unique neuroelectrophysiological mechanisms in psychiatric neurosciences. The understanding of the brain functional differences between GAD and DD is crucial for the accurate diagnosis and clinical efficacy evaluation. The aim of this study was to reveal the differences in functional brain imaging between GAD and DD based on multidimensional electroencephalogram (EEG) characteristics. To this end, 10 min resting-state EEG signals were recorded from 38 GAD and 34 DD individuals. Multidimensional EEG features were subsequently extracted, which include power spectrum density (PSD), fuzzy entropy (FE), and phase lag index (PLI). Then, a direct statistical analysis (i.e., ANOVA) and three ensemble learning models (i.e., Random Forest (RF), Light Gradient Boosting Machine (LightGBM), eXtreme Gradient Boosting (XGBoost)) were used on these EEG features for the differential recognitions. Our results showed that DD has significantly higher PSD values in the alpha1 and beta band, and a higher FE in the beta band, in comparison with GAD, along with the aberrant functional connections in all four bands between GAD and DD. Moreover, machine learning analysis further revealed that the distinct features predominantly occurred in the beta band and functional connections. Here, we show that DD has higher power and more complex brain activity patterns in the beta band and reorganized brain functional network structures in all bands compared to GAD. In sum, these findings move towards the practical identification of brain functional differences between GAD and DD.
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Affiliation(s)
- Xuchen Qi
- Department of Neurosurgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China;
- Department of Neurosurgery, Shaoxing People’s Hospital, Shaoxing 312000, China
| | - Wanxiu Xu
- College of Engineering, Zhejiang Normal University, Jinhua 321004, China;
| | - Gang Li
- College of Mathematical Medicine, Zhejiang Normal University, Jinhua 321004, China
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Ying Y, Ji Y, Kong F, Wang M, Chen Q, Wang L, Hou Y, Yu L, Zhu L, Miao P, Zhou J, Zhang L, Yang Y, Wang G, Chen R, Liu D, Huang W, Lv Y, Lou Z, Ruan L. Efficacy of an internet-based cognitive behavioral therapy for subthreshold depression among Chinese adults: a randomized controlled trial. Psychol Med 2023; 53:3932-3942. [PMID: 35388776 PMCID: PMC10317808 DOI: 10.1017/s0033291722000599] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 02/07/2022] [Accepted: 02/16/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Subthreshold depression (sD) negatively impacts well-being and psychosocial function and is more prevalent compared with major depressive disorder (MDD). However, as adults with sD are less likely to seek face-to-face intervention, internet-based cognitive-behavioral therapy (ICBT) may overcome barriers of accessibility to psychotherapy. Although several trials explored the efficacy of ICBT for sD, the results remain inconsistent. This study evaluated whether ICBT is effective in reducing depressive symptoms among Chinese adults with sD. METHODS A randomized controlled trial was performed. The participants were randomly assigned to 5 weeks of ICBT, group-based face-to-face cognitive-behavioral therapy (CBT), or a waiting list (WL). Assessments were conducted at baseline, post-intervention and at a 6-month follow-up. The primary outcome measured depressive symptoms using the Center for Epidemiological Studies Depression Scale (CES-D). Outcomes were analyzed using a mixed-effects model to assess the effects of ICBT. RESULTS ICBT participants reported greater reductions on all the outcomes compared to the WL group at post-intervention. The ICBT group showed larger improvement on the Patient Health Questionnaire-9 (PHQ-9) at post-intervention (d = 0.12) and at follow-up (d = 0.10), and with CES-D at post-intervention (d = 0.06), compared to the CBT group. CONCLUSIONS ICBT is effective in reducing depressive symptoms among Chinese adults with sD, and improvements in outcomes were sustained at a 6-month follow-up. Considering the low rates of face-to-face psychotherapy, our findings highlight the considerable potential and implications for the Chinese government to promote the use of ICBT for sD in China.
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Affiliation(s)
- Yuchen Ying
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang, People's Republic of China
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, People's Republic of China
| | - Yunxin Ji
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang, People's Republic of China
| | - Fanqian Kong
- Department of Medical Record and Statistics, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, People's Republic of China
| | - Minyao Wang
- School of Medicine, Ningbo University, Ningbo, Zhejiang, People's Republic of China
| | - Qiqi Chen
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, People's Republic of China
| | - Li Wang
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, People's Republic of China
| | - Yanbin Hou
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang, People's Republic of China
| | - Libo Yu
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, People's Republic of China
| | - Lijie Zhu
- Department of Statistics and Programming, Jiangsu Hengrui Pharmaceuticals Co. Ltd, Shanghai, People's Republic of China
| | - Pingping Miao
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang, People's Republic of China
| | - Jing Zhou
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, People's Republic of China
| | - Li Zhang
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, People's Republic of China
| | - Yiling Yang
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, People's Republic of China
| | - Guanjun Wang
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang, People's Republic of China
| | - Ruijia Chen
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, People's Republic of China
| | - Denong Liu
- School of Medicine, Ningbo University, Ningbo, Zhejiang, People's Republic of China
| | - Wenjun Huang
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, People's Republic of China
| | - Yueer Lv
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, People's Republic of China
| | - Zhongze Lou
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang, People's Republic of China
- Central Laboratory of the Medical Research Center, Ningbo First Hospital, Ningbo, Zhejiang, People's Republic of China
| | - Liemin Ruan
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang, People's Republic of China
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Lu B, Shi W, Zhou X, Fu D, Duan L, He X, You W, Gu J, Zhang X. Clinical Study on the Emotional Intervention of Patients with Asymptomatic and Mild Novel Coronavirus (COVID-19). MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050895. [PMID: 37241127 DOI: 10.3390/medicina59050895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/22/2023] [Accepted: 03/27/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: The aim was to explore the interventional effect of the traditional Chinese medicine (TCM) exercise of Tian Dan Shugan Tiaoxi on the emotions of patients with mild novel coronavirus (COVID-19). Materials and Methods: A total of 110 asymptomatic and mildly symptomatic COVID-19 patients from Hongkou Memorial Road Temporary Cabin Hospital and South Renji Hospital were selected between April 2022 and June 2022, and randomly divided into two groups: a control group and an intervention group. There were 55 participants in each group. The control group was treated with Lianhua Qingwen granules, and members of the intervention group were made to practice Tian Dan Shugan Tiaoxi (an exercise that soothes the liver and regulates emotions) every day for 5 days. The Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder questionnaire (GAD-7), and the Symptom Checklist 90 (SCL-90) were used to evaluate the data collected before and after the trial. Results: The incidence of anxiety and depression was high in the patients included in this study, at 73.64% and 69.09%, respectively. After intervention, the scores of the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder questionnaire (GAD-7) in the two groups had decreased in comparison with those recorded before intervention (p < 0.05). The PHQ-9 and GAD-7 scores in the intervention group were significantly better than those of the control group (p < 0.05). The factors of somatization, depression, anxiety, hostility, and fear in the SCL-90 in the intervention group were significantly improved after intervention, and generally, better than those in the control group (p < 0.05). Conclusions: Patients infected with novel coronavirus in shelter hospitals have different degrees of emotional abnormalities. Tian Dan Shugan Tiaoxi can reduce the anxiety and depression of people with mild novel coronavirus, and it can be practiced clinically to improve the recovery rate among infected people.
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Affiliation(s)
- Bo Lu
- Department of Cardiology, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Wenli Shi
- Department of Nursing, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Xunjie Zhou
- Department of Cardiology, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Deyu Fu
- Department of Cardiology, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Lei Duan
- Department of Orthopedics, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Xiaoli He
- Department of Endocrinology, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Wenjing You
- Department of Anesthesiology, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Junwei Gu
- Department of Traditional Chinese Medicine, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Xinyue Zhang
- Department of Surgery, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
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Mental condition and function of resilience among families of frontline medical workers during COVID-19: Potential influencing factors and mediating effect. J Affect Disord 2023; 324:600-606. [PMID: 36610594 PMCID: PMC9812468 DOI: 10.1016/j.jad.2022.12.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 12/25/2022] [Accepted: 12/31/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Studying the role of psychological resilience in self-perceived stress and mental disorders among family members of medical workers can help us understand its importance in mental health care and guide us to develop psychological intervention strategies for family members of medical workers. METHODS A total of 671 family members of medical workers were enrolled. Self-perceived stress, resilience, depression symptoms, anxiety symptoms, and post-traumatic stress disorder (PTSD) symptoms were measured in our research. RESULTS The prevalence of anxiety, depression, and PTSD symptoms among relatives of medical workers were 49.0 %, 12.2 %, and 20.3 % respectively during the COVID-19 epidemic. According to the Multivariate regression model, compared with family members of doctor, family members of nurse and medical technologists were more likely to report anxiety symptoms. Female members of medical staff were more likely to have PTSD symptoms than male counterparts; and family members of medical technologist appeared to less likely have PTSD symptoms than family members of either doctor or nurse. The mediation analysis confirmed that mental resilience mediated the relationship between self-perceived stress and anxiety symptoms. LIMITATIONS Single cross-sectional study design without the follow-up comparative analysis, only self-reported measurements were adopted, and inadequate pre-set demographic variables. CONCLUSIONS To the best of our knowledge, our study firstly demonstrated the risk of psychological distress present in the family members of medical providers during the COVID-19 epidemic. Meanwhile, our findings highlighted the importance of mental resilience in family members of frontline medical workers as it mediated the relationship between self-perceived stress and anxiety symptoms.
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Li Y, Hou T, Cheng M, Miao Y, Yeerjang Y, Sheng CS, Xue K, Wu C, Zhang S, Yan Q, Pei J, Yang Q, Tian J, Xu W, Shi Y. Anxiety prevalence and its association with physical activity in patients with non-communicable diseases during COVID-19 lockdown: a cross-sectional study in Shanghai, China. BMC Public Health 2023; 23:317. [PMID: 36782166 PMCID: PMC9924212 DOI: 10.1186/s12889-022-14369-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/17/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Quarantine due to the COVID-19 pandemic may have created great psychological stress among vulnerable populations. We aimed to investigate the prevalence of anxiety and explore the association between physical activities (PA) and anxiety risk in people with non-communicable diseases during the period of COVID-19 lockdown. METHODS We conducted a cross-sectional telephone survey from February 25 to April 20, 2020, the period of COVID-19 lockdown in Shanghai. Up to 8000 patients with type 2 diabetes and/or hypertension were selected using multi-stage cluster random sampling. PA level was measured based on the International Physical Activity Questionnaire using Metabolic Equivalent for Task scores, while symptoms of anxiety were assessed by the 7-item Generalized Anxiety Disorder scale. Multiple logistic regression analyses were performed to evaluate the associations of type and level of PA with the risk of anxiety. RESULTS Of a total 4877 eligible patients, 2602 (53.4%) reported with anxiety, and 2463 (50.5%), 123 (2.5%) and 16 (0.3%) reported with mild, moderate, and severe anxiety. The prevalence of anxiety was higher in the females, the elders, non-smokers, non-drinkers, and patients with diabetes, and the associations of anxiety with sex, age, smoking, drinking and diagnosis of diabetes were significant. A significant negative association was observed for housework activities (OR 0.53, 95%CI: [0.45, 0.63], p < 0.001) and trip activities (OR 0.55, 95%CI: [0.48, 0.63], p < 0.001) with anxiety, but no significant was found for exercise activities (OR 1.06, 95%CI: [0.94, 1.20], p = 0.321). Compared with patients with a low PA level, those with a moderate (OR 0.53, 95%CI: [0.44, 0.64], p < 0.001) or a high PA level (OR 0.51, 95%CI: [0.43, 0.51], p < 0.001) had a lower prevalence of anxiety. CONCLUSION This study demonstrates a higher prevalence of anxiety in patients with hypertension, diabetes, or both during the COVID-19 lockdown. The negative associations of housework and trip activities with anxiety highlight the potential benefit of PA among patients with non-communicable diseases.
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Affiliation(s)
- Yanyun Li
- grid.430328.eShanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Tianzhichao Hou
- grid.16821.3c0000 0004 0368 8293Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Minna Cheng
- grid.430328.eShanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ya Miao
- grid.16821.3c0000 0004 0368 8293Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yeerzati Yeerjang
- grid.8547.e0000 0001 0125 2443Key Lab of Health Technology Assessment (National Health Commission), School of Public Health, Fudan University, Shanghai, China ,grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, Shanghai, China
| | - Chang-sheng Sheng
- grid.16821.3c0000 0004 0368 8293Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kun Xue
- grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, Shanghai, China
| | - Cui Wu
- Center for Disease Control and Prevention of Baoshan District, Shanghai, China
| | - Sheng Zhang
- grid.430328.eShanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Qinghua Yan
- grid.430328.eShanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jianfeng Pei
- grid.8547.e0000 0001 0125 2443Key Lab of Health Technology Assessment (National Health Commission), School of Public Health, Fudan University, Shanghai, China ,grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, Shanghai, China
| | - Qinping Yang
- grid.430328.eShanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jingyan Tian
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical GenomicsRuijin HospitalShanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Wanghong Xu
- Key Lab of Health Technology Assessment (National Health Commission), School of Public Health, Fudan University, Shanghai, China. .,School of Public Health, Fudan University, Shanghai, China.
| | - Yan Shi
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China. .,National Clinical Research Center for Aging and Medicine, Shanghai, China.
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9
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Lai X, Jiang Y, Sun Y, Zhang Z, Wang S. Prevalence of depression and anxiety, and their relationship to social support among patients and family caregivers of rare bone diseases. Orphanet J Rare Dis 2023; 18:18. [PMID: 36703212 PMCID: PMC9878818 DOI: 10.1186/s13023-022-02611-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 12/29/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Rare bone diseases (RBDs) are a set of inherited rare diseases that can cause disability and have a devastating impact on families affected, which may lead to a particular high prevalence of psychological disorders in patients and caregivers. Social support plays a role in the well-being of families with rare disease patients, but its effect on psychology of RBD families remains unclear. The purpose of the current cross-sectional quantitative study was to investigate the frequency of depression and anxiety, and their relationship with social support among RBD patients and family caregivers. RESULTS A total of 196 participants responded to the questionnaire, including 72 patients and 124 caregivers. Depression was detected among 33.8% of patients and 57% of caregivers, and anxiety disorder was presented in 28.6% of patients and 50% of caregivers. Higher depression scores and anxiety scores were found in both patients and caregivers with an education level of ≤ middle school and monthly income of ≤ ¥2000 (all P < 0.05). The mean (SD) scores of Social Support Rating Scales in patients and caregivers were 37.06 (8.05) and 38.31 (5.76), respectively. After adjusting for gender, age, monthly income, education, employment and marital status, the reverse associations between depression scores, anxiety scores and social support were found merely in caregivers (depression & social support: β = - 0. 46, P < 0.001, anxiety & social support: β = - 0. 44, P < 0.001), specifically for subjective support (depression & subjective support: β = - 0.94, P < 0.001, anxiety & subjective support: β = - 0.87, P < 0.001). CONCLUSIONS The study identified a high prevalence of depression and anxiety among RBD patients and caregivers, and pointed out the significance of social support in alleviating psychological distress. In order to provide RBD families with comprehensive assistance, the government should actively develop programs aimed at psychological aid, policy advocacy and tangible support.
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Affiliation(s)
- Xuefeng Lai
- grid.11135.370000 0001 2256 9319Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191 China
| | - Yuling Jiang
- grid.11135.370000 0001 2256 9319School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191 China
| | - Yue Sun
- Lingyi Foundation for Rare Bone Diseases, 1A801, Gaofa West Bund Garden, 5th Avenue, Anbao District, Shenzhen, 518133 China
| | - Zhijun Zhang
- Lingyi Foundation for Rare Bone Diseases, 1A801, Gaofa West Bund Garden, 5th Avenue, Anbao District, Shenzhen, 518133 China
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
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10
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Mou Q, Gao M, Liu X, Wei C, Lan G, Zhao X, Shan Y, Wu C. Preoperative anxiety as an independent predictor of postoperative delirium in older patients undergoing elective surgery for lumbar disc herniation. Aging Clin Exp Res 2023; 35:85-90. [PMID: 36260215 DOI: 10.1007/s40520-022-02278-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/08/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Anxiety is common in older patients suffering from lumbar disc herniation. Postoperative delirium is related to poor prognosis. But the relationship between preoperative anxiety and postoperative delirium among older patients undergoing elective surgery for lumbar disc herniation is not clear. AIMS The study aimed to investigate if preoperative anxiety is an independent risk factor of postoperative delirium among older patients undergoing elective surgery for lumbar disc herniation. METHODS The medical records of 1290 patients undergoing elective surgery for lumbar disc herniation at a single institution from 2016 through 2021 were reviewed. Of 863 eligible patients, 225 (26.1%) patients had been diagnosed with anxiety by a board-certified psychiatrist and constituted the Anxiety group; the remaining 638 patients constituted the no-anxiety group. The demographics, baseline, operative variable and postoperative complications were collected and compared between the two groups. The primary outcome of this study was the incidence of delirium, according to the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition, during a hospital stay after surgery for lumbar disc herniation. The relationship between anxiety and postoperative delirium was determined through multivariate logistic regression analysis. RESULTS The demographics and comorbidity were similar between the two groups, except for age, sex, alcohol use and cerebrovascular disease. The operative variables were different between the two groups. The incidence of postoperative complications other than postoperative delirium was also similar between the two groups. In total, 86 patients (9.97%) had an episode of postoperative delirium, with anxiety group patients experiencing approximately a twofold higher rate (15.6% vs 7.99%). In a multivariate logistic regression analysis, anxiety was an independent predictor of postoperative delirium in older patients undergoing elective surgery for lumbar disc herniation (OR 2.228, 95% CI 1.494-3.416, p = 0.009). CONCLUSION This study suggests that anxiety is an independent risk factor of postoperative delirium among older patients undergoing elective surgery for lumbar disc herniation. Preoperative anxiety assessment can help to identify older patients at high risk of postoperative delirium and facilitate perioperative management of older patients undergoing elective surgery for lumbar disc herniation.
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Affiliation(s)
- Qing Mou
- Second Department of Spine, Sunshine Union Hospital, Weifang, China
| | - Mengling Gao
- Second Department of Spine, Sunshine Union Hospital, Weifang, China
| | - Xuepeng Liu
- Second Department of Spine, Sunshine Union Hospital, Weifang, China
| | - Chen Wei
- Orthopaedic Department, 970 Hospital of PLA, Yantai, China
| | - Gongquan Lan
- Orthopaedic Department, Haiyang People's Hospital, Yantai, China
| | - Xiaolong Zhao
- Orthopaedic Department, Pingdu People's Hospital, Qingdao, China
| | - Yaozhong Shan
- Neurology and Psychiatry Department, Sunshine Union Hospital, Weifang, China
| | - Congna Wu
- Nutriology Department, Sunshine Union Hospital, Weifang, China.
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11
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Cao X, Feng M, Ge R, Wen Y, Yang J, Li X. Relationship between self-management of patients with anxiety disorders and their anxiety level and quality of life: A cross-sectional study. PLoS One 2023; 18:e0284121. [PMID: 37172052 PMCID: PMC10180596 DOI: 10.1371/journal.pone.0284121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 03/23/2023] [Indexed: 05/14/2023] Open
Abstract
PURPOSE To explore the correlation between self-management and anxiety and quality of life in patients with anxiety disorders and to understand whether self-management can influence the relationship between anxiety and quality of life and provide a basis for improving their anxiety and quality of life. METHODS A cross-sectional survey of 245 patients with anxiety disorders in West China Hospital of Sichuan University was conducted using the Self-Management of Anxiety Disorders Scale, Self-rating anxiety scale (SAS), and World Health Organization Quality of Life-BBREF. The data were then analyzed using descriptive tests and Pearson correlation in SPSS 25. Bootstrap mediated effects tests were used to test the effect relationship between anxiety, quality of life and self-management scores in patients with anxiety disorders and Amos was used to establish the structural equation model. RESULTS The results of the correlation analysis showed that the total self-management score was positively correlated with the total quality of life score (r = 0.695, P <0.001), physical domain score (r = 0.552, P <0.001), psychological domain score (r = 0.661, P <0.001), social relations domain score (r = 0.542, P <0.001), and environmental domain score (r = 0.614, P <0.001). Additionally, it was negatively correlated with SAS score (r = -0.470, P <0.001). Self-management partially mediates the relationship between anxiety and quality of life, and the direct effect value of anxiety on quality of life was -0.44. The indirect effect value of self-management was -0.27, accounting for 38% of the total effect value. CONCLUSION Self-management of patients with anxiety disorders was negatively correlated with anxiety and positively correlated with quality of life. It played a partially mediating effect between anxiety and quality of life. We recommend that healthcare providers pay attention to self-management interventions for patients with anxiety disorders to further improve their quality of life.
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Affiliation(s)
- Xinyu Cao
- Department of Pulmonary and Critical Care Medicine, West China Hospital / West China School of Nursing, Sichuan University, Chengdu, China
| | - Mei Feng
- Department of Pulmonary and Critical Care Medicine, West China Hospital / West China School of Nursing, Sichuan University, Chengdu, China
| | - Ruyu Ge
- West China Hospital / West China School of Nursing, Sichuan University, Chengdu, China
| | - Yan Wen
- Department of Pulmonary and Critical Care Medicine, West China Hospital / West China School of Nursing, Sichuan University, Chengdu, China
| | - Jing Yang
- Department of Pulmonary and Critical Care Medicine, West China Hospital / West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaolin Li
- West China Hospital / West China School of Nursing, Sichuan University, Chengdu, China
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12
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Hou Z, Huang Y, Ma S, Feng H, Fu C, Li H, Yuan Y, Yuan Y. Mental health symptoms and sleep quality of asymptomatic/mild SARS-CoV-2 infected individuals during the Omicron wave of the COVID-19 pandemic in Shanghai China. Brain Behav 2022; 12:e2803. [PMID: 36326125 PMCID: PMC9759130 DOI: 10.1002/brb3.2803] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/07/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To investigate mental health symptoms (anxiety, depression, and sleep status) and their associated factors among people infected with the SARS-CoV-2 omicron variant during the quarantine period in Shanghai. METHODS To investigate the mental health symptoms among participants with SARS-CoV-2 omicron infection, an anonymous online survey questionnaire was used. The survey panel included the 9-item Patient Health Questionnaire-9 (PHQ-9), 7-item Generalized Anxiety Disorder Scale (GAD-7), Pittsburgh Sleep Quality Index (PSQI), and 22-item Ruminative Responses Scale (RRS). Group comparisons and correlation analyses were employed to explore the epidemiological characteristics of patients and factors related to depression and anxiety symptoms. RESULTS A total of 960 participants completed the survey. Of the total respondents, 583 participants (60.7%) were male, and the mean (SD) age was 34.33 (9.21) years (95% CI: 33.74-34.91). The prevalence of depressive and anxiety symptoms among the participants was 13.7% (n = 151, 95% CI: 11.6%-15.7%) and 8.6% (n = 90, 95% CI: 6.9%-10.3%), respectively. Age-stratified analysis showed that the prevalence of anxiety among the 36- to 45-year-old group (12.9%; n = 35, 8.9%-16.9%) was significantly higher than that of the 18- to 15-year-old group (7.4%; n = 42, 5.3%-9.6%, p = .011). Spearman's correlation analyses showed that rumination (assessed by the RRS) was significantly and positively correlated with depression (rho = .706, p < .001) and anxiety symptoms (rho = .758, p < .001). CONCLUSION The results suggest that female and middle-aged populations manifest higher susceptibility to mental health distress during the current Omicron wave of the COVID-19 pandemic. Population-specific psychological crisis intervention is warranted to improve the quality of epidemic prevention methods and to promote the mental well-being of the public.
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Affiliation(s)
- Zhenghua Hou
- Department of Psychosomatics & Psychiatry, Affiliated Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yingzi Huang
- Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Shaolei Ma
- Department of Emergency and Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Hui Feng
- Department of Traditional Chinese Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Cuiping Fu
- Department of Respiratory and Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Han Li
- Department of Pediatrics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yuexing Yuan
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Yonggui Yuan
- Department of Psychosomatics & Psychiatry, Affiliated Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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13
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Zhang X, Shen J, Li M, Shi Y, Wang Q, Chen F, Qin H, Zhao X. The Association between Socio-Demographics and Mental Distress Following COVID-19 Vaccination—Mediation of Vaccine Hesitancy. Vaccines (Basel) 2022; 10:vaccines10101697. [PMID: 36298562 PMCID: PMC9611688 DOI: 10.3390/vaccines10101697] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/25/2022] [Accepted: 09/27/2022] [Indexed: 12/03/2022] Open
Abstract
The COVID-19 vaccine has been administered to over 200 countries and regions. With the unprecedented vaccination scale and speed, vaccination correlated mental health issues should be paid precise attention to. This study aims to assess the association between socio-demographic factors and mental health following vaccination and to analyze the mediation effect of vaccine hesitancy. This study recruited 2112 individuals who took two doses of the COVID-19 vaccine in Shanghai. Structural equation modeling was performed to assess factors associated with anxiety and depression of the vaccinated individuals and the underlying mechanism. The results yielded that vaccine hesitancy partially mediated/suppressed the effect from gender and employment status to anxiety/depression and fully mediated the effects from education to anxiety/depression. This study advanced the understanding of mental health disparity among different socio-demographic groups after vaccination and the impact of vaccine hesitancy on the vaccinated population’s mental health. The finding offered insights into the possible mental vulnerability of people holding a hesitant attitude before vaccination and suggested that vaccine hesitancy played a crucial role in people’s mental health after vaccination. Health promotion programs can target vaccine hesitancy to prevent unfavorable mental health consequences among specific populations.
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Affiliation(s)
- Xiaoying Zhang
- College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
| | - Junwei Shen
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai 200124, China
| | - Ming Li
- Department of Health Sciences, Towson University, Towson, MD 21252, USA
| | - Yijian Shi
- School of Education, Shanghai Normal University, Shanghai 201418, China
| | - Qing Wang
- Department of Individual, Family, and Community Education, University of New Mexico, Albuquerque, NM 87131, USA
| | - Fazhan Chen
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai 200124, China
| | - Hongyun Qin
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai 200124, China
| | - Xudong Zhao
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai 200124, China
- Correspondence: ; Tel.: +86-21-6830-6915
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14
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Yang XY, Morton P, Yang F, Fang B. The Moderation Role of Neuroticism for Anxiety among Burdened Dementia Caregivers: A Study on Care Giver-Recipient Dyads. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2022; 65:692-710. [PMID: 34985409 DOI: 10.1080/01634372.2021.2019164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
Caregiving burden proves to be a risk factor of anxiety disorders and anxiety affection. The current study investigates how an endogenous personality dimension - neuroticism - moderates the association between caregiving burden and anxiety affection. Between 2015 and 2017, the study deployed a cross-sectional survey of 674 (response rate = 89%) older adults who were hospitalized for dementia at two hospitals. From all primary caregivers of these patients, 661 agreed to participate in the survey which yielded 661 matched dyads as the final sample. Caregiving burden, neuroticism, and anxiety affection were each measured by established assessment instruments. We employed multivariate OLS regression to test the moderator and regressor effects. We found that care burden is a significant risk factor of higher levels of anxiety affection (β = .17, p < .001), and accounts for 4.6% of the variance in anxiety. Neurotic personality is also significantly associated with a greater level of anxiety (β = .26, p < .001). Neurotic personality moderates the association between anxiety and care burden (β = .24, p < .001). Our findings suggest that social and healthcare workers should assess caregiver personality and burden as well as provide support, resources, and coping strategies to those with neurotic personality traits or high care burden in an effort to reduce anxiety among caregivers.
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Affiliation(s)
- Xiaozhao Yousef Yang
- Department of Sociology and Social Work, Sun Yat-sen University, Guangzhou, China
| | - Patricia Morton
- Department of Sociology/Department of Public Health, Wayne State University, Detroit, Michigan, USA
| | - Fangying Yang
- Department of Sociology and Social Work, Sun Yat-sen University, Guangzhou, China
| | - Boye Fang
- Department of Sociology and Social Work, Sun Yat-sen University, Guangzhou, China
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15
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Newman MG, Basterfield C, Erickson TM, Caulley E, Przeworski A, Llera SJ. Psychotherapeutic treatments for generalized anxiety disorder: cognitive and behavioral therapies, enhancement strategies, and emerging efforts. Expert Rev Neurother 2022; 22:751-770. [PMID: 36107159 PMCID: PMC9754763 DOI: 10.1080/14737175.2022.2125800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 09/14/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Generalized anxiety disorder (GAD) is common and disabling. Different versions of cognitive behavioral therapy (CBT) have been tested, but no treatment works for everyone. Therefore, researchers have attempted approaches to enhance CBT. AREAS COVERED The current narrative review examines meta-analyses and individual trials of CBT-based treatments for GAD. We focus on CBT and its cognitive and behavioral components as well as efforts to enhance CBT and its dissemination and generalizability. Enhancement efforts included interpersonal and emotional processing therapy, mindfulness-based CBT, emotion regulation therapy, intolerance of uncertainty therapy, the unified protocol, metacognitive therapy, motivational interviewing, and contrast avoidance targeted treatment. Emerging strategies to enhance dissemination have focused on technologically based treatments. Attempts at generalizability have included examination of efficacy within diverse racial and ethnic groups. EXPERT OPINION We conclude that CBT is efficacious, and a number of enhancement efforts have shown some promise in improving upon CBT in single trials. However, more research is needed, particularly efforts to determine which enhancements work best for which individuals and what are the mechanisms of change. Furthermore, few technological interventions have been compared to active treatments. Finally, much more attention needs to be paid to ethnic and racial diversity in randomized controlled trials.
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Affiliation(s)
- Michelle G Newman
- Department of Psychology, The Pennsylvania State University, Park, PA, USA
| | | | - Thane M Erickson
- Department of Psychology, Seattle Pacific University, Seattle, Washington, USA
| | - Evan Caulley
- Department of Psychology, Seattle Pacific University, Seattle, Washington, USA
| | - Amy Przeworski
- Department of Psychology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sandra J Llera
- Department of Psychology, Towson University, Baltimore, Maryland, USA
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16
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Shen Z, Li G, Fang J, Zhong H, Wang J, Sun Y, Shen X. Aberrated Multidimensional EEG Characteristics in Patients with Generalized Anxiety Disorder: A Machine-Learning Based Analysis Framework. SENSORS (BASEL, SWITZERLAND) 2022; 22:5420. [PMID: 35891100 PMCID: PMC9320264 DOI: 10.3390/s22145420] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/12/2022] [Accepted: 07/19/2022] [Indexed: 06/15/2023]
Abstract
Although increasing evidences support the notion that psychiatric disorders are associated with abnormal communication between brain regions, scattered studies have investigated brain electrophysiological disconnectivity of patients with generalized anxiety disorder (GAD). To this end, this study intends to develop an analysis framework for automatic GAD detection through incorporating multidimensional EEG feature extraction and machine learning techniques. Specifically, resting-state EEG signals with a duration of 10 min were obtained from 45 patients with GAD and 36 healthy controls (HC). Then, an analysis framework of multidimensional EEG characteristics (including univariate power spectral density (PSD) and fuzzy entropy (FE), and multivariate functional connectivity (FC), which can decode the EEG information from three different dimensions) were introduced for extracting aberrated multidimensional EEG features via statistical inter-group comparisons. These aberrated features were subsequently fused and fed into three previously validated machine learning methods to evaluate classification performance for automatic patient detection. We showed that patients exhibited a significant increase in beta rhythm and decrease in alpha1 rhythm of PSD, together with the reduced long-range FC between frontal and other brain areas in all frequency bands. Moreover, these aberrated features contributed to a very good classification performance with 97.83 ± 0.40% of accuracy, 97.55 ± 0.31% of sensitivity, 97.78 ± 0.36% of specificity, and 97.95 ± 0.17% of F1. These findings corroborate previous hypothesis of disconnectivity in psychiatric disorders and further shed light on distribution patterns of aberrant spatio-spectral EEG characteristics, which may lead to potential application of automatic diagnosis of GAD.
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Affiliation(s)
- Zhongxia Shen
- School of Medicine, Southeast University, Nanjing 210096, China;
- Sleep Medical Center, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou 313000, China
| | - Gang Li
- College of Mathematical Medicine, Zhejiang Normal University, Jinhua 321017, China; (J.F.); (H.Z.); (J.W.)
- Key Laboratory for Biomedical Engineering of Ministry of Education of China, Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027, China;
| | - Jiaqi Fang
- College of Mathematical Medicine, Zhejiang Normal University, Jinhua 321017, China; (J.F.); (H.Z.); (J.W.)
| | - Hongyang Zhong
- College of Mathematical Medicine, Zhejiang Normal University, Jinhua 321017, China; (J.F.); (H.Z.); (J.W.)
| | - Jie Wang
- College of Mathematical Medicine, Zhejiang Normal University, Jinhua 321017, China; (J.F.); (H.Z.); (J.W.)
| | - Yu Sun
- Key Laboratory for Biomedical Engineering of Ministry of Education of China, Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027, China;
| | - Xinhua Shen
- Sleep Medical Center, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou 313000, China
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Quality of Life and Mental Health Status in Recovered COVID-19 Subjects at Two Years after Infection in Taizhou, China: A Longitudinal Cohort Study. Brain Sci 2022; 12:brainsci12070939. [PMID: 35884745 PMCID: PMC9316455 DOI: 10.3390/brainsci12070939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 11/17/2022] Open
Abstract
According to previous studies, mental status in 1-year COVID-19 survivors might range from 6–43%. Longer-term psychological consequences in recovered COVID-19 subjects are unknown, so we analyzed longer-term quality of life and mental status in recovered COVID-19 subjects at 2 years after infection. Among 144 recovered COVID-19 subjects in the Taizhou region, 73 and 45 completed face-to-face follow-ups at the first year and second year after infection, respectively, with a 61.7% follow-up rate. The questionnaire, which was administered at both follow-ups, included questions about quality of life, psychological health, and post-traumatic stress disorder (PTSD). The Mann-Whitney U test was used to the differences of each scale between the first and second year. Among the 45 people who completed both follow-up visits, the incidence of psychological problems was 4.4% (2/45) in the first year, and no new psychological abnormalities were observed in the second year. Quality of life improved, while the General Health Questionnaire (GHQ-12) and Impact of Event Scale-Revised (IES-R) scores did not improve over time. The incidence of mental disorders was lower than those in previous studies. Multidisciplinary management for COVID-19 in this study hospital may have reduced the frequency to a certain extent. However, among those with mental health problems, such problems may exist for a long time, and long-term attention should be given to the psychological status of recovered COVID-19 subjects.
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18
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Qu M, Yang K, Cao Y, Xiu MH, Zhang XY. Mental health status of adolescents after family confinement during the COVID-19 outbreak in the general population: a longitudinal survey. Eur Arch Psychiatry Clin Neurosci 2022; 273:335-345. [PMID: 35833993 PMCID: PMC9281280 DOI: 10.1007/s00406-022-01459-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/27/2022] [Indexed: 11/29/2022]
Abstract
Few studies have examined the psychological impact on adolescents of family confinement and infection exposure during the COVID-19 pandemic. However, these surveys lacked follow-up data to determine how the family confinement affects participants' depression and anxiety. The purpose of this study was to evaluate the psychological status and related risk and protective factors of adolescents after two months of family confinement for preventing COVID-19 in China, and compare them with baseline data. We surveyed teenagers in January 2020 before the COVID-19 outbreak (T1) and after home confinement (T2). We used the Patient Health Questionnaire (PHQ), the Generalized Anxiety Disorder (GAD) Scale and the Childhood Trauma Questionnaire (CTQ). 13,637 valid questionnaires were collected at T1, of which 22.34% reported depressive symptoms (PHQ-9 ≥ 10) and 14.42% reported anxiety symptoms (GAD-7 ≥ 10). At T2, the rates decreased to 14.86 and 7.44%, respectively (all P < 0.0001). Of the adolescents, 223 reported potential risk of exposure to COVID-19. We then compared them to the 9639 non-risk adolescents using a propensity score matching analysis. The adolescents with potential exposure risk had higher rates of depression (26.91 vs 15.32%, P = 0.0035) and anxiety (14.80 vs 7.21%, P = 0.01) than risk-free adolescents. Among adolescents with an exposure risk, psychological resilience was protective in preventing depression and anxiety symptoms, while emotional abuse, a poor parent-child relationship were risk factors. Long-term home confinement had minimal psychological impact on adolescents, but COVID-19 infection rates accounted for 50% of the variance in depression and anxiety among adolescents even with low community rates.
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Affiliation(s)
- Miao Qu
- Neurology Department, Xuan Wu Hospital of Capital Medical University, Beijing, China
| | - Kun Yang
- Evidence-Based Department, Xuan Wu Hospital of Capital Medical University, Beijing, China
| | - Yujia Cao
- Neurology Department, Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Mei Hong Xiu
- Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Changping District, Beijing, 100096, China.
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.
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19
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Rodrigues IL, Nunes TP, Cortez CS, Lourenço AM. E-Learning Impact on Veterinary Medical Student's Mental Health during the COVID-19 Pandemic. JOURNAL OF VETERINARY MEDICAL EDUCATION 2022; 50:e20210052. [PMID: 35737894 DOI: 10.3138/jvme-2021-0052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Veterinary medical students are known to have significant levels of mental illness. The COVID-19 pandemic and the shift to online learning have brought increased psychological stress. We used a web-based survey to ask 415 veterinary medical students from Portugal about the impact of the pandemic and online learning on their anxiety levels. Results were analyzed using logistic regressions and Spearman's correlation. Results indicated that 15.4% had no symptoms of anxiety, 39.5% experienced mild anxiety, 21.4% had moderate anxiety, and 23.6% experienced severe anxiety. Having difficulty sleeping, the stress associated with confinement, and family conflicts were risk factors for anxiety, while being male was found to be protective. Most veterinary medical students (77%) were satisfied with online learning. The university's adaptation to online teaching and time spent participating in online classes were significantly associated with anxiety. Due to the known fragility of veterinary medical students' mental health, this group should be monitored and supported closely during life-disrupting events such as public health emergencies.
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Ren Z, Yang C, Yu D. Cognitive deficiency, parental relationship, and coping strategies are related with anxiety and depression among parents of children with epilepsy. Chronic Dis Transl Med 2022; 8:229-237. [PMID: 36161201 PMCID: PMC9481879 DOI: 10.1002/cdt3.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/19/2022] [Accepted: 03/22/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Zhengjia Ren
- Department of Clinical Psychology The Third Affiliated Hospital of Chongqing Medical University Chongqing 401120 China
| | - Chunsong Yang
- Department of Pharmacy, Evidence‐based Pharmacy Center, West China Second Hospital Sichuan University Chengdu Sichuan 610041 China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education Sichuan University Chengdu Sichuan 610041 China
| | - Dan Yu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education Sichuan University Chengdu Sichuan 610041 China
- Department of Medical Genetics, West China Second Hospital Sichuan University Chengdu Sichuan 610041 China
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Leite MDF, Faro A. Evidências de Validade da GAD-7 em Adolescentes Brasileiros. PSICO-USF 2022. [DOI: 10.1590/1413-82712022270211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo O objetivo deste estudo foi investigar evidências validade para a escala Generalized Anxiety Disorder (GAD-7) em adolescentes brasileiros, bem como validade concorrente para esta escala e apresentar a distribuição social do Transtorno de Ansiedade Generalizada (TAG). Participaram 302 adolescentes, com idades entre 15 e 19 anos, de ambos os sexos. Aplicou-se o questionário sociodemográfico, a GAD-7, a Hospital Anxiety and Depression Scale (HADS) e o Patient Health Questionnaire (PHQ-9). Os resultados da Análise Fatorial Exploratória (AFE) atestaram a unidimensionalidade da GAD-7 e indicaram consistência interna satisfatória. As evidências de validade concorrente apresentaram associações estatisticamente significativas e positivas entre a GAD-7 e as escalas PHQ-9 e HADS-A. Quanto à distribuição social, aproximadamente metade da amostra apresentou a ocorrência de sintomatologia positiva para TAG, sendo mais comum para o sexo feminino e em adolescentes mais jovens. Esses dados sugerem que a GAD-7 apresenta adequadas propriedades psicométricas para rastreamento de ansiedade em adolescentes.
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Shao H, Gan Q, Chen Z, Zhu S, Zhu Y. Analysis of the Underlying Mechanism of the Jiu Wei Zhen Xin Formula for Treating Generalized Anxiety Disorder Based on Network Pharmacology of Traditional Chinese Medicine. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:7761852. [PMID: 35677384 PMCID: PMC9168090 DOI: 10.1155/2022/7761852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/23/2022] [Indexed: 11/17/2022]
Abstract
Currently, there are many effective pharmacological treatments for generalized anxiety disorder (GAD), formulated herbal granule is also an alternative way. Our research intends to construct a pharmacological network on genetic targets and pathways between Jiu Wei Zhen Xin Formula (JWZXF) and GAD. Through the TCMSP database, we collected the active ingredients of JWZXF and potential targets of the active ingredients. The GAD-related proteins collected from GeneCards database and DisGeNET database were combined. Component-target protein networks were constructed and visualized using Cytoscape 3.8.2 software to comprehensively clarify the relationships between ingredients, components, and targets. The intersection targets were imported into the STRING database, and the protein-protein interaction (PPI) network was constructed. We constructed and analyzed the visualized "drug-target-disease" network. Gene Ontology (GO) enrichment together with Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis were conducted on the common target through R language. Forty-one effective components and 106 potential targets of JWZXF were found. There were top ten hub genes and multiple important signaling pathways involved in the treatment of GAD with the JWZXF. This study expounded the pharmacological actions and molecular mechanisms of the JWZXF in treating GAD from a holistic perspective. The potential pharmacological effects of the JWZXF are closely related to regulation because not only does it comprehensively analyze the possible mechanism of JWZXF treatment of GAD but it can also facilitate further in-depth research and provide a theoretical basis for the clinical expansion of its application.
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Affiliation(s)
- Heng Shao
- Department of Geriatrics, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Quan Gan
- Medical Faculty, Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Zhuangfei Chen
- Medical Faculty, Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Shasha Zhu
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
- Department of Clinical Psychology, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Yanqing Zhu
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
- Department of Clinical Psychology, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China
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Yu Q, Wang Z, Li Z, Liu X, Oteng Agyeman F, Wang X. Hierarchical Structure of Depression Knowledge Network and Co-word Analysis of Focus Areas. Front Psychol 2022; 13:920920. [PMID: 35664156 PMCID: PMC9160970 DOI: 10.3389/fpsyg.2022.920920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 04/29/2022] [Indexed: 12/02/2022] Open
Abstract
Contemporarily, depression has become a common psychiatric disorder that influences people's life quality and mental state. This study presents a systematic review analysis of depression based on a hierarchical structure approach. This research provides a rich theoretical foundation for understanding the hot spots, evolutionary trends, and future related research directions and offers further guidance for practice. This investigation contributes to knowledge by combining robust methodological software for analysis, including Citespace, Ucinet, and Pajek. This paper employed the bibliometric methodology to analyze 5,000 research articles concerning depression. This current research also employed the BibExcel software to bibliometrically measure the keywords of the selected articles and further conducted a co-word matrix analysis. Additionally, Pajek software was used to conduct a co-word network analysis to obtain a co-word network diagram of depression. Further, Ucinet software was utilized to calculate K-core values, degree centrality, and mediated centrality to better present the research hotspots, sort out the current status and reveal the research characteristics in the field of depression with valuable information and support for subsequent research. This research indicates that major depressive disorder, anxiety, and mental health had a high occurrence among adolescents and the aged. This present study provides policy recommendations for the government, non-governmental organizations and other philanthropic agencies to help furnish resources for treating and controlling depression orders.
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Affiliation(s)
- Qingyue Yu
- College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Zihao Wang
- College of Medicine, Jiangsu University, Zhenjiang, China
| | - Zeyu Li
- Jingjiang College of Jiangsu University, Zhenjiang, China
| | - Xuejun Liu
- College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | | | - Xinxing Wang
- School of Management, Jiangsu University, Zhenjiang, China
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24
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Aksoy SH, Yurdaışık I, Timurağaoğlu A. Ionizing Radiation Exposure due to Medical Imaging in Hematopoietic Stem Cell Transplant Recipients. ISTANBUL MEDICAL JOURNAL 2022. [DOI: 10.4274/imj.galenos.2022.40771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Effects of Jie Yu Wan on Generalized Anxiety Disorder: A Randomized Clinical Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:9951693. [PMID: 35432560 PMCID: PMC9012658 DOI: 10.1155/2022/9951693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 01/30/2022] [Accepted: 03/14/2022] [Indexed: 11/17/2022]
Abstract
Objective To systematically assess the clinical efficacy of the Jie Yu Wan (JYW) formula in treating generalized anxiety disorder (GAD). Methods A multicenter, prospective, double-blind, double-dummy, randomized controlled trial (RCT) was conducted at four hospitals in China. A total of one hundred thirty-three patients with GAD were enrolled from 2017 to 2019. This study aimed to evaluate the effects of a Traditional Chinese Medicine (TCM) JYW formula on GAD at eight weeks, with the use of Buspirone as the comparator. A stepwise dosing protocol was used (JYW: high dose 24 g/day, low dose 12 g/day; Buspirone: high dose 30 mg/day, low dose 15 mg/day) and the dose was adjusted depending on whether the treatment response of Hamilton Anxiety Scale (HAMA) score was less than or equal to 25% after one week. The primary outcome was a change in total score on the HAMA. The secondary outcomes included the Hamilton Depression Scale (HAMD), Clinical Global Impression (CGI) scale, and TCM Syndrome Scale. Adverse events were recorded using the Treatment Emergent Symptom Scale (TESS). Assessments were conducted at the baseline and 1, 2, 4, and 8 weeks. Results A total of one hundred thirty-three participants were randomly assigned to the JYW group (n = 66) and the Buspirone group (n = 67). One hundred twenty-one patients (91%) completed at least one follow-up session. There were no significant differences between the two groups in terms of gender, age, disease course, HAMA, HAMD, CGI, and TCM Syndrome Scale scores at baseline (all P > 0.05). Repeated-measures analysis of variance revealed statistically significant time effects for the HAMA (P=0.002), HAMD (P = 0.018), and CGI (P=0.001) in both groups. Sensitivity analyses supported the credibility of the main results (P > 0.05). The group effect was not significant for the HAMA (P=0.43), HAMD (P=0.27), CGI (P=0.37), and TCM Syndrome Scale (P=0.86). Furthermore, there were no significant interaction effects between time and group in terms of the HAMA (P=0.47), HAMD (P=0.79), CGI (P=0.67), and TCM Syndrome Scale (P=0.69). After one week, 53 patients (80%) of the JYW group and 52 patients (78%) of the Buspirone group were adjusted to high doses. The interaction effect between time, group, and the dose was determined by repeated measures ANOVA test, and the HAMA score served as the outcome measure. The interaction effect between time and dose was statistically significant (P=0.04), which shows that high-dose JYW (24 g/day) was more effective in decreasing patients' HAMA scores than low-dose JYW (12 g/day), and Buspirone had the same effect, which means that high-dose Buspirone (30 mg/day) was more effective than low dose. (15 mg/day). Conclusions The conclusion of this study supports that JYW and Buspirone can effectively alleviate the anxiety symptoms of GAD patients, which are both effective and safe for treatment of mild to moderate GAD. Besides, high-dose JYW or Buspirone are more effective than low-dose, which is of great importance in assisting clinical medication choice.
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26
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Zhang W, Yan Y, Wu Y, Yang H, Zhu P, Yan F, Zhao R, Tian P, Wang T, Fan Q, Su Z. Medicinal herbs for the treatment of anxiety: a systematic review and network meta-analysis. Pharmacol Res 2022; 179:106204. [DOI: 10.1016/j.phrs.2022.106204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/25/2022] [Accepted: 03/30/2022] [Indexed: 12/22/2022]
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Xie H, Huang X, Zhang Q, Wei Y, Zeng X, Chang F, Wu S. The Prevalence of and Factors Associated With Anxiety and Depression Among Working-Age Adults in Mainland China at the Early Remission Stage of the Coronavirus 2019 Pandemic. Front Psychol 2022; 13:839852. [PMID: 35432080 PMCID: PMC9009372 DOI: 10.3389/fpsyg.2022.839852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 03/16/2022] [Indexed: 12/20/2022] Open
Abstract
BackgroundThe Coronavirus 2019 (COVID-19) outbreak has led to a considerable proportion of adverse psychological symptoms in different subpopulations. This study aimed to investigate the status of anxiety and depression and their associated factors in the adult, working-age population in Mainland China at the early remission stage of the COVID-19 pandemic.MethodsAn online study was conducted among 1,863 participants in 29 provinces in Mainland China from March 23 to 31, 2020. Their mental health was evaluated by the generalized anxiety disorder scale (GAD-7) and the patient health questionnaire (PHQ-9). Descriptive analysis, Chi-square, and multiple logistic regressions were applied.ResultsAbout 44.5% of the participants had anxiety, 49.2% had depression, and 37.9% showed a combination of depression and anxiety. Around 83.7% of the participants claimed that the pandemic had a negative impact on their medical needs, which was the primary predictor of mental health, the degree of impact being positively related to the prevalence of anxiety and depression. More chronic diseases, moderate to bad self-rated health, severe perceived infection risk, and younger age group were the common risk factors for anxiety and depression. Having no children, unemployment, and a college-level educational background were associated with higher anxiety prevalence, whereas unmarried participants were correlated with higher depression prevalence.ConclusionThe working-age population showed a relatively high risk of anxiety and depression in Mainland China at the early remission stage of the pandemic. To improve medical services capacity for routine and delayed medical service needs should be a part of policy-makers’ priority agenda during this period of crisis.
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Affiliation(s)
- Haixia Xie
- Department of Social Work, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Xiaowei Huang
- Department of Gastroenterology and Hepatology, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Qi Zhang
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA, United States
| | - Yan Wei
- China Research Center on Disability, School of Public Health, Fudan University, Shanghai, China
| | - Xuheng Zeng
- China Research Center on Disability, School of Public Health, Fudan University, Shanghai, China
| | - Fengshui Chang
- China Research Center on Disability, School of Public Health, Fudan University, Shanghai, China
- *Correspondence: Fengshui Chang,
| | - Shuyin Wu
- School of Health Management, Bengbu Medical College, Bengbu, China
- Shuyin Wu,
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28
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Wang L, Qiu H, Luo L, Zhou L. Age- and Sex-Specific Differences in Multimorbidity Patterns and Temporal Trends on Assessing Hospital Discharge Records in Southwest China: Network-Based Study. J Med Internet Res 2022; 24:e27146. [PMID: 35212632 PMCID: PMC8917436 DOI: 10.2196/27146] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/06/2021] [Accepted: 01/12/2022] [Indexed: 02/06/2023] Open
Abstract
Background Multimorbidity represents a global health challenge, which requires a more global understanding of multimorbidity patterns and trends. However, the majority of studies completed to date have often relied on self-reported conditions, and a simultaneous assessment of the entire spectrum of chronic disease co-occurrence, especially in developing regions, has not yet been performed. Objective We attempted to provide a multidimensional approach to understand the full spectrum of chronic disease co-occurrence among general inpatients in southwest China, in order to investigate multimorbidity patterns and temporal trends, and assess their age and sex differences. Methods We conducted a retrospective cohort analysis based on 8.8 million hospital discharge records of about 5.0 million individuals of all ages from 2015 to 2019 in a megacity in southwest China. We examined all chronic diagnoses using the ICD-10 (International Classification of Diseases, 10th revision) codes at 3 digits and focused on chronic diseases with ≥1% prevalence for each of the age and sex strata, which resulted in a total of 149 and 145 chronic diseases in males and females, respectively. We constructed multimorbidity networks in the general population based on sex and age, and used the cosine index to measure the co-occurrence of chronic diseases. Then, we divided the networks into communities and assessed their temporal trends. Results The results showed complex interactions among chronic diseases, with more intensive connections among males and inpatients ≥40 years old. A total of 9 chronic diseases were simultaneously classified as central diseases, hubs, and bursts in the multimorbidity networks. Among them, 5 diseases were common to both males and females, including hypertension, chronic ischemic heart disease, cerebral infarction, other cerebrovascular diseases, and atherosclerosis. The earliest leaps (degree leaps ≥6) appeared at a disorder of glycoprotein metabolism that happened at 25-29 years in males, about 15 years earlier than in females. The number of chronic diseases in the community increased over time, but the new entrants did not replace the root of the community. Conclusions Our multimorbidity network analysis identified specific differences in the co-occurrence of chronic diagnoses by sex and age, which could help in the design of clinical interventions for inpatient multimorbidity.
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Affiliation(s)
- Liya Wang
- Big Data Research Center, University of Electronic Science and Technology of China, Chengdu, China
| | - Hang Qiu
- Big Data Research Center, University of Electronic Science and Technology of China, Chengdu, China.,School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Li Luo
- Business School, Sichuan University, Chengdu, China
| | - Li Zhou
- Health Information Center of Sichuan Province, Chengdu, China
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Zhou D, Wang L, Ding S, Shen M, Qiu H. Phenotypic Disease Network Analysis to Identify Comorbidity Patterns in Hospitalized Patients with Ischemic Heart Disease Using Large-Scale Administrative Data. Healthcare (Basel) 2022; 10:healthcare10010080. [PMID: 35052244 PMCID: PMC8775672 DOI: 10.3390/healthcare10010080] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 12/24/2021] [Accepted: 12/29/2021] [Indexed: 02/04/2023] Open
Abstract
Ischemic heart disease (IHD) exhibits elevated comorbidity. However, few studies have systematically analyzed the comorbid status of IHD patients with respect to the entire spectrum of chronic diseases. This study applied network analysis to provide a complete picture of physical and mental comorbidities in hospitalized patients with IHD using large-scale administrative data. Hospital discharge records from a provincial healthcare database of IHD inpatients (n = 1,035,338) and one-to-one matched controls were included in this retrospective analysis. We constructed the phenotypic disease networks in IHD and control patients and further assessed differences in comorbidity patterns. The community detection method was applied to cluster diagnoses within the comorbidity network. Age- and sex-specific patterns of IHD comorbidities were also analyzed. IHD inpatients showed 50% larger comorbid burden when compared to controls. The IHD comorbidity network consisted of 1941 significant associations between 71 chronic conditions. Notably, the more densely connected comorbidities in IHD patients were not within the highly prevalent ones but the rarely prevalent ones. Two highly interlinked communities were detected in the IHD comorbidity network, where one included hypertension with heart and multi-organ failures, and another included cerebrovascular diseases, cerebrovascular risk factors and anxiety. Males exhibited higher comorbid burden than females, and thus more complex comorbidity relationships were found in males. Sex-specific disease pairs were detected, e.g., 106 and 30 disease pairs separately dominated in males and females. Aging accounts for the majority of comorbid burden, and the complexity of the comorbidity network increased with age. The network-based approach improves our understanding of IHD-related comorbidities and enhances the integrated management of patients with IHD.
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Affiliation(s)
- Dejia Zhou
- Big Data Research Center, University of Electronic Science and Technology of China, Chengdu 611731, China; (D.Z.); (L.W.)
- School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Liya Wang
- Big Data Research Center, University of Electronic Science and Technology of China, Chengdu 611731, China; (D.Z.); (L.W.)
| | - Shuhan Ding
- School of Electrical and Computer Engineering, Cornell University, Ithaca, NY 14853, USA;
| | - Minghui Shen
- Health Information Center of Sichuan Province, Chengdu 610041, China;
| | - Hang Qiu
- Big Data Research Center, University of Electronic Science and Technology of China, Chengdu 611731, China; (D.Z.); (L.W.)
- School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu 611731, China
- Correspondence: ; Tel.: +86-28-618-302-78
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Yang X, Gao L, Zhang S, Zhang L, Zhang L, Zhou S, Qi M, Chen J. The Professional Identity and Career Attitude of Chinese Medical Students During the COVID-19 Pandemic: A Cross-Sectional Survey in China. Front Psychiatry 2022; 13:774467. [PMID: 35242061 PMCID: PMC8886109 DOI: 10.3389/fpsyt.2022.774467] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 01/10/2022] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Although professional identity is a strong predictor of career choice, only a few studies have reported on medical students' career attitude during a public health emergency. This study investigates the changes in medical students' professional identity and career attitude during the COVID-19 pandemic, evaluates their mental health and social support system under stress, and explores the relationship between their career attitude and other factors. METHODS An online survey of 6,226 Chinese medical students was conducted to collect information on demographics, professional identity, and career attitude. The collected data were assessed using the Patient Health Questionnaire, the Generalized Anxiety Disorder Scale, and the Social Support Rating Scale. RESULTS The results revealed that most (80.8%) of the participants did not change their career attitude and the professional identity of most participants strengthened, and they preferred to participate on the frontline during the COVID-19 pandemic. The prevalence of depression and anxiety among medical students was 22.86% and 35.43%. Low social support, depressive symptoms, male gender, and higher grades were factors that negatively affected career attitude. CONCLUSIONS After the outbreak of the pandemic, it was necessary to conduct diversified professional identity research to support medical students, especially those with low social support and depressive symptoms.
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Affiliation(s)
- Xingjie Yang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Lan Gao
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Suoyuan Zhang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Libin Zhang
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
| | - Ligang Zhang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Shuangjiang Zhou
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Meng Qi
- Department of Applied Psychology, Chengde Medical College, Chengde, China
| | - Jingxu Chen
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
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Wathelet M, Vincent C, Fovet T, Notredame CE, Habran E, Martignène N, Baubet T, Vaiva G, D'Hondt F. Evolution in French University Students' Mental Health One Month After the First COVID-19 Related Quarantine: Results From the COSAMe Survey. Front Psychiatry 2022; 13:868369. [PMID: 35592379 PMCID: PMC9110762 DOI: 10.3389/fpsyt.2022.868369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/12/2022] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION The COVID-19 related quarantine had negative psychological effects among University students. Evidence from previous epidemics suggests that negative psychological effects of quarantine measures can last or even worsen after the quarantine lift. The objective of this study was to assess the evolution of students' mental health and to identify factors associated with mental health outcomes 1 month after the lift of the lockdown. MATERIALS AND METHODS This repeated cross-sectional study collected data during the first quarantine in France (T1, N = 68,891) and 1 month after its lift (T2, N = 22,540), through an online questionnaire sent to all French University students. Using cross-sectional data, we estimated prevalence rates of suicidal thoughts, severe anxiety (State-Trait Anxiety Inventory, State subscale), depression (Beck Depression Inventory), and stress (Perceived Stress Scale) at T1 and T2. Using longitudinal data (N = 6,346), we identified risk factors of poor mental health outcomes among sociodemographic characteristics, precariousness indicators, health-related data, information on the social environment, and media consumption, adjusting for baseline mental health status. RESULTS We found lower prevalence rates of severe stress (21.7%), anxiety (22.1%), and depression (13·9%) one month after the quarantine compared to the quarantine period (24.8%, 27.5%, and 16.1%, respectively). The prevalence rate of suicidal thoughts increased from 11.4 to 13.2%. Regardless of the existence of symptoms during quarantine, four factors were systematically associated with poor mental health outcomes 1 month after the quarantine was lifted: female gender, a low feeling of integration before the quarantine period, a low quality of social ties during the quarantine, and a history of psychiatric follow-up. CONCLUSIONS The prevalence rates of severe stress, anxiety, and depression, although being lower than during the first lockdown, remained high after its lift. The prevalence rate of suicidal ideation increased. This stresses the need to consider the enduring psychological impact of the pandemic on students as a critical public health issue.
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Affiliation(s)
- Marielle Wathelet
- Univ. Lille, INSERM, Lille University Hospital (CHU de Lille), U1172-LilNCog - Lille Neuroscience & Cognition, Lille, France.,Fédération de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France (F2RSM), Lille, France.,Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France.,Department of Psychiatry, Lille University Hospital (CHU de Lille), Lille, France
| | - Camille Vincent
- Department of Public Health, Lille University Hospital (CHU de Lille), Lille, France
| | - Thomas Fovet
- Univ. Lille, INSERM, Lille University Hospital (CHU de Lille), U1172-LilNCog - Lille Neuroscience & Cognition, Lille, France.,Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France.,Department of Psychiatry, Lille University Hospital (CHU de Lille), Lille, France
| | - Charles-Edouard Notredame
- Univ. Lille, INSERM, Lille University Hospital (CHU de Lille), U1172-LilNCog - Lille Neuroscience & Cognition, Lille, France.,Department of Psychiatry, Lille University Hospital (CHU de Lille), Lille, France
| | | | - Niels Martignène
- Fédération de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France (F2RSM), Lille, France.,Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France
| | - Thierry Baubet
- Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France.,Department of Infant, AP-HP, Avicenne Hospital, Child and Adolescent Psychiatry, Sorbonne Paris Nord, Paris, France
| | - Guillaume Vaiva
- Univ. Lille, INSERM, Lille University Hospital (CHU de Lille), U1172-LilNCog - Lille Neuroscience & Cognition, Lille, France.,Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France.,Department of Psychiatry, Lille University Hospital (CHU de Lille), Lille, France
| | - Fabien D'Hondt
- Univ. Lille, INSERM, Lille University Hospital (CHU de Lille), U1172-LilNCog - Lille Neuroscience & Cognition, Lille, France.,Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France.,Department of Psychiatry, Lille University Hospital (CHU de Lille), Lille, France
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Shen Z, Cui L, Mou S, Ren L, Yuan Y, Shen X, Li G. Combining S100B and Cytokines as Neuro-Inflammatory Biomarkers for Diagnosing Generalized Anxiety Disorder: A Proof-of-Concept Study Based on Machine Learning. Front Psychiatry 2022; 13:881241. [PMID: 35815053 PMCID: PMC9256955 DOI: 10.3389/fpsyt.2022.881241] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/29/2022] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION S100 calcium-binding protein B (S100B) is a neurotrophic factor that regulates neuronal growth and plasticity by activating astrocytes and microglia through the production of cytokines involved in Generalized Anxiety Disorder (GAD). However, few studies have combined S100B and cytokines to explore their role as neuro-inflammatory biomarkers in GAD. METHODS Serum S100B and cytokines (IL-1β, IL-2, IL-4, and IL-10) of 108 untreated GAD cases and 123 healthy controls (HC) were determined by enzyme-linked immunosorbent assay (ELISA), while Hamilton Anxiety Rating Scale (HAMA) scores and Hamilton Depression Rating Scale (HAMD) scores were measured to evaluate anxiety and depression severity. This was used to help physicians identify persons having GAD. Machine learning techniques were applied for feature ordering of cytokines and S100B and the classification of persons with GAD and HC. RESULTS The serum S100B, IL-1β, and IL-2 levels of GAD cases were significantly lower than HC (P < 0.001), and the IL-4 level in persons with GAD was significantly higher than HC (P < 0.001). At the same time, IL-10 had no significant difference between the two groups (P = 0.215). The feature ranking distinguishing GAD from HC using machine learning ranked the features in the following order: IL-2, IL-1β, IL-4, S100B, and IL-10. The accuracy of S100B combined with IL-1β, IL-2, IL-4, and IL-10 in distinguishing persons with GAD from HC was 94.47 ± 2.06% using an integrated back propagation neural network based on a bagging algorithm (BPNN-Bagging). CONCLUSION The serum S-100B, IL-1β, and IL-2 levels in persons with GAD were down-regulated while IL-4 was up-regulated. The combination of S100B and cytokines had a good diagnosis value in determining GAD with an accuracy of 94.47%. Machine learning was a very effective method to study neuro-inflammatory biomarkers interacting with each other and mediated by plenty of factors.
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Affiliation(s)
- Zhongxia Shen
- School of Medicine, Southeast University, Nanjing, China.,Department of Neurosis and Psychosomatic Diseases, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, China
| | - Lijun Cui
- School of Medicine, Southeast University, Nanjing, China
| | - Shaoqi Mou
- Department of Psychiatry, Wenzhou Medical University, Wenzhou, China
| | - Lie Ren
- School of Medicine, Southeast University, Nanjing, China
| | - Yonggui Yuan
- Department of Psychiatry, Affiliated ZhongDa Hospital of Southeast University, Nanjing, China
| | - Xinhua Shen
- Department of Neurosis and Psychosomatic Diseases, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, China
| | - Gang Li
- College of Engineering, Zhejiang Normal University, Zhejiang, China.,Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, Zhejiang University, Zhejiang, China
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The mental health of transgender and gender non-conforming people in China: a systematic review. Lancet Public Health 2021; 6:e954-e969. [DOI: 10.1016/s2468-2667(21)00236-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/12/2021] [Accepted: 10/12/2021] [Indexed: 11/19/2022]
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Hou WK, Li TW, Liang L, Liu H, Ettman CK, Hobfoll SE, Lee TMC, Galea S. Trends of depression and anxiety during massive civil unrest and COVID-19 in Hong Kong, 2019-2020. J Psychiatr Res 2021; 145:77-84. [PMID: 34875462 PMCID: PMC8636149 DOI: 10.1016/j.jpsychires.2021.11.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/16/2021] [Accepted: 11/21/2021] [Indexed: 12/16/2022]
Abstract
Both COVID-19 and unrest are posing a significant threat to population mental health across the globe. This study examined trends of probable depression and anxiety during a time of civil unrest and concurrent COVID-19 in Hong Kong. Four random digit dialing telephone surveys were conducted in July 2019 (n = 1112), February-March 2020 (n = 2003), April-May 2020 (n = 2008), and July-August 2020 (n = 2034). The prevalence of probable depression increased from 25.7% (95% CI: 23.2-28.3) in July 2019 to 28.2% (95% CI: 26.2-30.1) in February-March 2020, and then decreased to 15.3% (95% CI: 14.0-17.0) in April-May 2020 and 13.7% (95% CI: 12.2-15.2) in July-August 2020. The prevalence of probable anxiety was 19.2% (95% CI: 17.5-20.9) in February-March 2020 and then stabilized in April-May 2020 and July-August 2020 (14.1%, 95% CI: 12.0-15.8). Probable depression and anxiety were more prevalent among persons with high relative to low daily routine disruptions. Combined high unrest-COVID-19 stress was associated with probable depression and anxiety across all persons; high unrest stress alone was associated with probable mental disorders at high daily routine disruptions. Civil unrest and COVID-19 are jointly associated with depression and anxiety among Hong Kong citizens. While population mental health improved, daily routine disruptions is a risk factor of mental disorders at every time-point.
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Affiliation(s)
- Wai Kai Hou
- Department of Psychology, The Education University of Hong Kong, Hong Kong SAR, China; Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China.
| | - Tsz Wai Li
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
| | - Li Liang
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
| | - Huinan Liu
- Department of Psychology, The Education University of Hong Kong, Hong Kong SAR, China; Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
| | - Catherine K Ettman
- Boston University School of Public Health, Boston, MA, USA; Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, USA
| | - Stevan E Hobfoll
- STAR Consultants-STress, Anxiety and Resilience, Salt Lake City, UT, USA
| | - Tatia Mei-Chun Lee
- State Key Laboratory of Brain and Cognitive Sciences and Laboratory of Neuropsychology & Human Neuroscience, The University of Hong Kong, Hong Kong SAR, China
| | - Sandro Galea
- Boston University School of Public Health, Boston, MA, USA
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Ji K, Bai Z, Tang L, Yan H, Zhu Y, Chen G, Chen R. Institutional Satisfaction and Anxiety Mediate the Relationship Between Social Support and Depression in Hypertension Patients in Elderly Caring Social Organizations: A Cross-Sectional Study. Front Psychol 2021; 12:772092. [PMID: 34759876 PMCID: PMC8573192 DOI: 10.3389/fpsyg.2021.772092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/27/2021] [Indexed: 01/19/2023] Open
Abstract
Background: Depression is a prevalent health condition among hypertension patients in elderly caring social organizations (SOs). Patients with hypertension and depression symptoms have worse health outcomes than those without depression. As the population ages, chronic and mental health issues such as depression of hypertension patients in elderly caring SOs have become prominent. However, the combined effects of social support, institutional satisfaction, and anxiety on depression among hypertension individuals in elderly caring SOs remain unclear. This study aimed to explore the mediating effects of institutional satisfaction and anxiety on the relationship between social support and depression among hypertension patients in elderly caring SOs in Anhui Province, China. Methods: A cross-sectional study was conducted using a multi-stage stratified random sampling method. A questionnaire was used to collect data on demographic characteristics, the satisfaction of elderly caring SOs, social support, anxiety, and depression. A multiple linear regression model was utilized to investigate depression-related factors, and structural equation modeling (SEM) was employed to examine the relationships between social support, institutional satisfaction, anxiety, and depression among patients with hypertension in elderly caring SOs. Results: Our results indicated that the mean scores of social support were 20.19 ± 6.98 and 1.92 ± 3.18 for anxiety, and 6.24 ± 5.03 for depression; besides, 33.3% of participants were very satisfied with elderly caring SOs, 48.5% were satisfied, and only 6.0% were dissatisfied or very dissatisfied. Comorbid chronic diseases were significantly associated with depression. Institutional satisfaction was directly negatively related to depression, whereas anxiety was directly positively correlated with depression. Social support had an indirect negative association with depression by the mediating effects of institutional satisfaction and anxiety. Conclusions: The study highlights the importance of social support in maintaining mental health among hypertension patients residing in elderly caring SOs. To alleviate depression among hypertension patients in elderly caring SOs, strategies that target enhancing social support, institutional satisfaction, and anxiety reduction should be prioritized. More importantly, more attention should be paid to patients with comorbid chronic diseases.
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Affiliation(s)
- Kai Ji
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Zhongliang Bai
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Ling Tang
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Huosheng Yan
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Ying Zhu
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Guimei Chen
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Ren Chen
- School of Health Services Management, Anhui Medical University, Hefei, China.,Office of Science and Education, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou, China
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Hasanpour M, Maroufizadeh S, Mousavi H, Noughani F, Afshari M. Prevalence of generalized anxiety disorder among nursing students in Iran during the COVID-19 pandemic: A web-based cross-sectional study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2021; 15:100360. [PMID: 34660199 PMCID: PMC8506196 DOI: 10.1016/j.ijans.2021.100360] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/26/2021] [Accepted: 08/29/2021] [Indexed: 01/08/2023] Open
Abstract
Background The Coronavirus disease 2019 (COVID-19) is a public health emergency that poses anxiety symptoms to nursing students (P. Li et al., 2020). Therefore, this study aimed to examine the prevalence of anxiety and its associated factors in nursing students in Iran during the COVID-19 pandemic. Methods We performed this web-based cross-sectional study on 174 nursing students in Iran, between 4 and 24 April 2020. Data were collected through an online questionnaire using social media like Telegram and WhatsApp. Anxiety was measured via the Generalized Anxiety Disorder-7 (GAD-7). Simple and multiple logistic regression analyses were undertaken to examine independent predictors of anxiety. Statistical analysis was performed using SPSS for Windows, version 16.0. Results The mean GAD-7 total score was 6.05 ± 4.77, and the prevalence of GAD using a cut-off value of 10 for the GAD-7 was 20.7%. According to the adjusted analysis, GAD was significantly associated with having chronic diseases (OR = 5.74, 95% CI: 1.39-23.72), long time thinking about COVID-19 (OR = 14.09, 95% CI: 4.36-45.54), and death of family members, relatives or friends due to COVID-19 (OR = 4.53, 95% CI: 1.08-18.93). Conclusion The prevalence of GAD is considerably high in nursing students during the COVID-19 pandemic in Iran. Thus, a holistic approach, including management policies, psychosocial interventions, and training, is critical to reducing anxiety symptoms during the COVID-19 pandemic as well as during any outbreaks of other infectious diseases in the future.
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Affiliation(s)
- Maryam Hasanpour
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Saman Maroufizadeh
- Department of Biostatistics, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Hossein Mousavi
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Noughani
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojgan Afshari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Yang C, Liu W, Chen Y, Zhang J, Zhong X, Du Q, Zhang J, Mo J, Chen Z, Ning Y, Du B. Prevalence and risk factors for mental health symptoms in community epidemic prevention workers during the postpandemic era of COVID-19 in China. Psychiatry Res 2021; 304:114132. [PMID: 34348211 PMCID: PMC9754730 DOI: 10.1016/j.psychres.2021.114132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 07/13/2021] [Accepted: 07/17/2021] [Indexed: 11/25/2022]
Abstract
Few people have paid attention to community epidemic prevention workers in the postpandemic era of COVID-19. This study aimed to explore the prevalence and risk factors for mental health symptoms in community epidemic prevention workers during the postpandemic era. Mental health status was evaluated by the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Chinese Perceived Stress Scale, Insomnia Severity Index, and Maslach Burnout Inventory-General Survey. The results showed that a considerable proportion of community epidemic prevention workers reported symptoms of depression (39.7%), anxiety (29.5%), high stress (51.1%), insomnia (30.8%), and burnout (53.3%). The prevalence of depression and anxiety in community epidemic prevention workers was higher than in community residents. Among community epidemic prevention workers, short sleep duration was a risk factor for depression, anxiety, high stress and insomnia. Concurrent engagement in work unrelated to epidemic prevention and current use of hypnotics were risk factors for depression, anxiety and insomnia. Our study suggests that during the postpandemic era, the mental health problems of community epidemic prevention workers are more serious than those of community residents. Several variables, such as short sleep duration and concurrent engagement in work unrelated to epidemic prevention, are associated with mental health among community epidemic prevention workers.
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Affiliation(s)
- Chunyu Yang
- The Third People's Hospital of Zhongshan, Zhongshan, Guangdong, China,The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China,The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Weijian Liu
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, China,The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yihua Chen
- The Third People's Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Jie Zhang
- The Third People's Hospital of Zhongshan, Zhongshan, Guangdong, China,Joint Laboratory of Psychiatric Genetic Research, The Third People's Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Xiaomei Zhong
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Qifeng Du
- The Third People's Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Jianlong Zhang
- The Third People's Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Jingrong Mo
- The Third People's Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Zhenjie Chen
- The Third People's Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.
| | - Baoguo Du
- The Third People's Hospital of Zhongshan, Zhongshan, Guangdong, China.
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Ying Y, Ji Y, Kong F, Chen Q, Lv Y, Hou Y, Zhu L, Miao P, Yu L, Li L, Kuang W, Jiang L, Zhu X, Liu X, Xu L, Mi Y, Lou Z, Ruan L. Internet-based cognitive behavioral therapy for psychological distress in older adults without cognitive impairment living in nursing homes during the COVID-19 pandemic: A feasibility study. Internet Interv 2021; 26:100461. [PMID: 34631432 PMCID: PMC8487764 DOI: 10.1016/j.invent.2021.100461] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 09/17/2021] [Accepted: 09/26/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has had a detrimental effect on the mental health of older adults living in nursing homes. Very few studies have examined the effects of Internet-based Cognitive Behavioral Therapy (ICBT) on older adults living in nursing homes during the pandemic. We conducted a feasibility study using a single-group design, to explore the effectiveness of ICBT on psychological distress in 137 older adults (without cognitive impairment) from 8 nursing homes in 4 southeast cities in China, between January and March 2020. METHODS Symptoms of depression, anxiety, general psychological distress, and functional disability were measured at baseline, post-treatment (5 weeks) and at a 1-month follow-up. Mixed-effects model was used to assess the effects of ICBT. RESULTS Statistically significant changes with large effect sizes were observed from pre- to post-treatment on the PHQ-9 (p < .001, Cohen's d = 1.74), GAD-7 (p < .001, d = 1.71), GDS (p < .001, d = 1.30), K-10 (p < .001, d = 1.93), and SDS (p < .001, d = 2.03). Furthermore, improvements in treatment outcomes were sustained at 1-month follow-up, and high levels of adherence and satisfaction were indicated. CONCLUSION ICBT was effective in reducing psychological distress in older adults without cognitive impairments living in nursing homes during the COVID-19 pandemic. Thus, it could be applied in improving the mental health of this vulnerable group during the pandemic.
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Key Words
- CBT, cognitive behavioral therapy
- CIs, confidence intervals
- COVID-19
- DSM-IV, The Diagnostic and Statistical Manual of Mental Disorders-4th edition
- Feasibility study
- GAD-7, Generalized Anxiety Disorder 7-item
- GDS, Geriatric Depression Scale
- ICBT, Internet-based cognitive behavioral therapy
- ITT, intention-to-treat
- Internet-based cognitive behavioral therapy
- K-10, 10-item Kessler Psychological Distress Scale
- LOCF, last observation carried forward
- MMRM, mixed-effects model for repeated measure
- Mental health
- Older adults
- PHQ-9, Patient Health Questionnaire 9-item
- Psychological distress
- RCT, randomized controlled trials
- REML, restricted maximum likelihood
- SD, standard deviation
- SDS, Sheehan Disability Scales
- UN, unstructured
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Affiliation(s)
- Yuchen Ying
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang, PR China
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, PR China
- School of Medicine, Ningbo University, Ningbo, Zhejiang, PR China
| | - Yunxin Ji
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang, PR China
| | - Fanqian Kong
- Department of Medical Record and Statistics, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, PR China
| | - Qiqi Chen
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, PR China
| | - Yueer Lv
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, PR China
| | - Yanbin Hou
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang, PR China
| | - Lijie Zhu
- Department of Statistics and Programming, Jiangsu Hengrui Pharmaceuticals Co. Ltd, Shanghai, PR China
| | - Pingping Miao
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang, PR China
| | - Libo Yu
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, PR China
| | - Laiyou Li
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, PR China
| | - Wei Kuang
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, PR China
| | - Lingli Jiang
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, PR China
| | - Xiaozhuo Zhu
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, PR China
| | - Xiaozhuang Liu
- Department of Elderly Health Care and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, Zhejiang, PR China
| | - Le Xu
- School of Medicine, Ningbo University, Ningbo, Zhejiang, PR China
| | - Yuwei Mi
- School of Medicine, Ningbo University, Ningbo, Zhejiang, PR China
| | - Zhongze Lou
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang, PR China
- Central Laboratory of the Medical Research Center, Ningbo First Hospital, Ningbo, Zhejiang, PR China
- Corresponding authors at: Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, 59 Liuting Street, Haishu District, Ningbo, Zhejiang 315211, PR China.
| | - Liemin Ruan
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang, PR China
- Corresponding authors at: Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, 59 Liuting Street, Haishu District, Ningbo, Zhejiang 315211, PR China.
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ÖZCAN TOZOĞLU E, ALKAN E, ÖZPOLAT G. Covid-19 pandemisinde toplum ruh sağlığı merkezlerinin hizmet şekli değişikliği ile şizofreni hastalarındaki anksiyete düzeyleri arasındaki ilişki. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.903054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Long-Term Impact of COVID-19 on Mental Health among the General Public: A Nationwide Longitudinal Study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168790. [PMID: 34444539 PMCID: PMC8393580 DOI: 10.3390/ijerph18168790] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/07/2021] [Accepted: 08/11/2021] [Indexed: 12/30/2022]
Abstract
COVID-19 might have long-term mental health impacts. We aim to investigate the longitudinal changes in mental problems from initial COVID-19 peak to its aftermath among general public in China. Depression, anxiety and insomnia were assessed among a large-sample nationwide cohort of 10,492 adults during the initial COVID-19 peak (28 February 2020 to 11 March 2020) and its aftermath (8 July 2020 to 8 August 2020) using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Insomnia Severity Index. We used generalized estimating equations and linear mixed models to explore factors associated with long-term mental health symptoms during COVID-19. During the five months, mental health symptoms remained consistently elevated (baseline 46.4%; follow-up 45.1%). Long-term depression, anxiety and insomnia were associated with several personal and work-related factors including quarantine (adjusted OR for any mental health symptoms 1.31, 95%CI 1.22–1.41, p < 0.001), increases in work burden after resuming work (1.77, 1.65–1.90, p < 0.001), occupational exposure risk to COVID-19 (1.26, 1.14–1.40, p < 0.001) and living in places severely affected by initial COVID-19 peak (1.21, 1.04–1.41, p = 0.01) or by a COVID-19 resurgence (1.38, 1.26–1.50, p < 0.001). Compliance with self-protection measures, such as wearing face masks (0.74, 0.61–0.90, p = 0.003), was associated with lower long-term risk of mental problems. The findings reveal a pronounced and prolonged mental health burden from the initial COVID-19 peak through to its aftermath in China. We should regularly monitor the mental health status of vulnerable populations throughout COVID-19.
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Chakeri A, Rostami Qadi M, Haghani S. Comparison of Anxiety Levels in Patients with Coronavirus Disease (COVID-19) and their Families. BIONATURA 2021. [DOI: 10.21931/rb/2021.06.03.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Very little research has been done on the anxiety of the families of patients with covid-19. Considering the vital role of the family in the continuation of supportive-psychological therapies and the direct impact on the patient's anxiety level, in this study, we examined the anxiety level of the family of patients with Covid-19 and compared their with their patient's anxiety level. In this comparative study, the samples were 60 people who were given a definitive diagnosis of covid-19 in selected hospitals (Masih Daneshvari Hospital and Besat Hospital). From the family members, the person who, according to the patient, is most affected and has an emotional relationship with him (spouse-father-mother-child) was selected. The standard Spielberger Anxiety Questionnaire has been used to measure apparent (state) and hidden (trait) anxiety. The questionnaire was completed by both groups (patient-family) and compared with each other. The mean of evident anxiety in patients and caregivers was 70.82 and 74.2, respectively, which this difference was statistically significant (P = 0.023). It is also observed that the mean of hidden anxiety in patients and caregivers was 68.83 and 74.71, respectively, which the mean of hidden anxiety in patients was significantly less than caregivers (P = 0.006). After identifying anxiety, nurses can better and more effectively deal with these unwanted conditions in the patient and her family by providing appropriate and correct education.
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Affiliation(s)
- Azin Chakeri
- Correspond author, Department of Nursing, Garmsar branch, Islamic Azad University, Garmsar, Iran
| | - Maryam Rostami Qadi
- Department of nursing sari bu-Ali sina Therapeutic and Education center Mazandaran University of medical science, Sari, Iran
| | - Shima Haghani
- Master of Biostatistics, Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
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Guo X, Yang F, Fan L, Gu Y, Ma J, Zhang J, Liao M, Zhai T, Zhang Y, Li L, Su L, Dai Z. Disruption of functional and structural networks in first-episode, drug-naïve adolescents with generalized anxiety disorder. J Affect Disord 2021; 284:229-237. [PMID: 33618206 DOI: 10.1016/j.jad.2021.01.088] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/11/2021] [Accepted: 01/31/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Individuals with generalized anxiety disorder (GAD) tend to worry exaggeratedly and uncontrollably about various daily routines. Previous studies have demonstrated that the GAD patients exhibited widespread alternations in both functional networks (FN) and structural networks (SN). However, the simultaneous alternations of the topological organization of FN, SN, as well as their couplings in GAD still remain unknown. METHODS Using multimodal approach, we constructed FN from resting-state functional magnetic imaging (R-fMRI) data and SN from diffusion magnetic resonance imaging (dMRI) data of 32 adolescent GAD patients and 25 healthy controls (HC). Graph theory analysis was employed to investigate the topological properties of FN, SN, and FN-SN coupling. RESULTS Compared to HC, the GAD patients showed disruptions in global (i.e., decreased clustering coefficient, global, and local efficiency) and subnetwork (i.e., reduced intermodular connections, rich club, and feeder connections) levels in FN. Abnormal global level properties (i.e., increased characteristic path length and reduced global efficiency) were also observed in SN. Altered FN-SN couplings in normalized characteristic path length and feeder connections were identified in the GAD patients. The identified network measures were correlated with anxiety severity in the GAD patients. LIMITATIONS The sample size of the current study is small and the cross-sectional nature can not infer causal relationship. CONCLUSIONS Our findings identified GAD-related topological alternations in both FN and SN, together with the couplings between FN and SN, providing us with a novel perspective for understanding the pathophysiological mechanisms of GAD.
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Affiliation(s)
- Xiaotong Guo
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Fan Yang
- Guangdong mental health center, Guangdong general hospital & Guangdong academy of medical sciences, Guangzhou, China
| | - Linlin Fan
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Yue Gu
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Junji Ma
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Jinbo Zhang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Mei Liao
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China..
| | - Tianyi Zhai
- Department of Psychiatry, Guangzhou Huiai Hospital, Guangzhou, China
| | - Yan Zhang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lingjiang Li
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Linyan Su
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhengjia Dai
- Department of Psychology, Sun Yat-sen University, Guangzhou, China.
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Ni Z, Lebowitz ER, Zou Z, Wang H, Liu H, Shrestha R, Zhang Q, Hu J, Yang S, Xu L, Wu J, Altice FL. Response to the COVID-19 Outbreak in Urban Settings in China. J Urban Health 2021; 98:41-52. [PMID: 33258088 PMCID: PMC7703725 DOI: 10.1007/s11524-020-00498-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/10/2020] [Indexed: 02/05/2023]
Abstract
The COVID-19 outbreak in China was devastating and spread throughout the country before being contained. Stringent physical distancing recommendations and shelter-in-place were first introduced in the hardest-hit provinces, and by March, these recommendations were uniform throughout the country. In the presence of an evolving and deadly pandemic, we sought to investigate the impact of this pandemic on individual well-being and prevention practices among Chinese urban residents. From March 2-11, 2020, 4607 individuals were recruited from 11 provinces with varying numbers of COVID-19 cases using the social networking app WeChat to complete a brief, anonymous, online survey. The analytical sample was restricted to 2551 urban residents. Standardized scales measured generalized anxiety disorder (GAD), the primary outcome. Multiple logistic regression was conducted to identify correlates of GAD alongside assessment of community practices in response to the COVID-19 pandemic. We found that during the COVID-19 pandemic, the recommended public health practices significantly (p < 0.001) increased, including wearing facial mask, practicing physical distancing, handwashing, decreased public spitting, and going outside in urban communities. Overall, 40.3% of participants met screening criteria for GAD and 49.3%, 62.6%, and 55.4% reported that their work, social life, and family life were interrupted by anxious feelings, respectively. Independent correlates of having anxiety symptoms included being a healthcare provider (aOR = 1.58, p < 0.01), living in regions with a higher density of COVID-19 cases (aOR = 2.13, p < 0.01), having completed college (aOR = 1.38, p = 0.03), meeting screening criteria for depression (aOR = 6.03, p < 0.01), and poorer perceived health status (aOR = 1.54, p < 0.01). COVID-19 had a profound impact on the health of urban dwellers throughout China. Not only did they markedly increase their self- and community-protective behaviors, but they also experienced high levels of anxiety associated with a heightened vulnerability like depression, having poor perceived health, and the potential of increased exposure to COVID-19 such as living closer to the epicenter of the pandemic.
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Affiliation(s)
- Zhao Ni
- School of Medicine, Yale University, New Haven, Connecticut, USA.
| | - Eli R Lebowitz
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Zhijie Zou
- School of Health Sciences, Wuhan University, Wuhan, Hubei, China.
| | - Honghong Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Huaping Liu
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Roman Shrestha
- School of Medicine, Yale University, New Haven, Connecticut, USA.,Institute for Collaboration on Health, Intervention, & Policy, University of Connecticut, Storrs, Connecticut, USA
| | - Qing Zhang
- School of Health Sciences, Wuhan University, Wuhan, Hubei, China
| | - Jianwei Hu
- College of Nursing, Xi'an Medical University, Xi'an, Shaanxi, China
| | - Shuying Yang
- Hohhot Vocational College, Hohhot, Inner Mongolia, China
| | - Lei Xu
- School of Nursing, Fudan University, Shanghai, China
| | - Jianjun Wu
- Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Frederick L Altice
- School of Medicine, Yale University, New Haven, Connecticut, USA.,West China Hospital/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.,School of Public Health, Yale University, New Haven, Connecticut, USA
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44
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Wilmer MT, Anderson K, Reynolds M. Correlates of Quality of Life in Anxiety Disorders: Review of Recent Research. Curr Psychiatry Rep 2021; 23:77. [PMID: 34613508 PMCID: PMC8493947 DOI: 10.1007/s11920-021-01290-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/24/2021] [Indexed: 01/04/2023]
Abstract
PURPOSE OF REVIEW Anxiety disorders are highly prevalent conditions that have a detrimental impact on quality of life (QOL), particularly when left untreated. In the present review, we summarize recent literature, published within the last 3 years, on QOL in anxiety disorders, with a focus on factors that may play a role in the relationship between anxiety and QOL. RECENT FINDINGS We organize our findings into four categories: (1) subjective distress, (2) behavioral responses, (3) functional impairment, and (4) clinical factors. Results indicate that greater anxiety symptom severity is linked with poorer QOL, and cognitive behavioral therapies for anxiety yield positive effects on QOL. Additional transdiagnostic mechanisms are highlighted, including anxiety sensitivity, distress tolerance, emotion regulation, and avoidant coping. We examine the role of functional impairment, and we discuss factors related to treatment, including comorbidity and longitudinal effects. We also consider early research from the COVID-19 pandemic. Understanding the underlying factors that contribute to QOL detriments provides important insight into the impact of anxiety disorders and identifies targets for enhancing QOL through treatment.
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Affiliation(s)
- M. Taylor Wilmer
- Center for Anxiety and Behavioral Change, 1487 Chain Bridge Road, Suite #203, McLean, VA 22101 USA
| | - Kelley Anderson
- Center for Anxiety and Behavioral Change, 1487 Chain Bridge Road, Suite #203, McLean, VA 22101 USA
| | - Monique Reynolds
- Center for Anxiety and Behavioral Change, 1487 Chain Bridge Road, Suite #203, McLean, VA 22101 USA
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45
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Wang S, Zhang Y, Guan Y, Ding W, Meng Y, Hu H, Liu Z, Zeng X, Wang M. A nationwide evaluation of the prevalence of and risk factors associated with anxiety, depression and insomnia symptoms during the return-to-work period of coronavirus disease 2019 in China. Soc Psychiatry Psychiatr Epidemiol 2021; 56:2275-2286. [PMID: 33616693 PMCID: PMC7898251 DOI: 10.1007/s00127-021-02046-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 02/12/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE To evaluate the prevalence of and risk factors associated with anxiety, depression, and insomnia symptoms during the return-to-work period of coronavirus disease 2019 in China. METHODS The authors conducted a large-scale, nationwide, multicenter, cross-sectional study in China. A population-based quota and snowball sampling were designed to recruit a representative sample. Online questionnaires and telephone reviews were used to collect characteristics and assess psychological and sleep problems. Anxiety, depression, and insomnia symptoms were measured by the generalized anxiety disorder-7, patient health questionnaire-9, and insomnia severity index tools. RESULTS A total of 42,000 participants were recruited from 15 centers, and 36,795 valid questionnaires were received. Generally, 18.3, 14.9, and 17.9% of the participants had anxiety, depression, and insomnia symptoms, respectively, and 2.2-2.7% had severe symptoms. Engaging in outside activity once in ≥ 30 days (OR = 2.719, OR = 2.074, OR = 2.225) and age 50-64 years (OR = 2.431, OR = 1.936, OR = 2.036) were common risk factors for anxiety, depression and insomnia symptoms. Living in Hubei Province (OR = 1.304, OR = 1.242) was a common risk factor for anxiety and insomnia symptoms. Working as frontline medical staff (OR = 2.150) was another risk factor for anxiety symptoms. The health education rate of the samples reached 98.9%. However, the psychological intervention rate was only 16.2%, and 2.5% received targeted interventions. CONCLUSIONS An increasing number of people might have psychological and sleep problems. However, the current psychological interventions are not sufficient. Efforts should be made to strengthen interventions for high-risk populations.
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Affiliation(s)
- Shu Wang
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing, 100093 China
| | - Yuan Zhang
- Dalian Medical University, Dalian, 116044 Liaoning China
- Department of Pediatric Hematology-Oncology, Dalian Municipal Women and Children’s Medical Center, Dalian, 116037 Liaoning China
| | - Yuguang Guan
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing, 100093 China
- Beijing Key Laboratory of Epilepsy, Beijing, 100093 China
- Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing, 100093 China
| | - Wei Ding
- Department of Neurology, Liaocheng People’s Hospital, Liaocheng, 252000 Shandong China
| | - Yao Meng
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University, Jinan, 250014 Shandong China
| | - Huiting Hu
- Department of Neurology, Heze Mudan People’s Hospital, Heze, 274000 Shandong China
| | - Zhenhua Liu
- Sleep Medicine Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021 Shandong China
| | - Xianwei Zeng
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, 250012 Shandong China
| | - Minzhong Wang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021 Shandong China
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Zhu W, Xu D, Li H, Xu G, Tian J, Lyu L, Wan N, Wei L, Rong W, Liu C, Wu B, Bian X, Lyu A. Impact of Long-Term Home Quarantine on Mental Health and Physical Activity of People in Shanghai During the COVID-19 Pandemic. Front Psychiatry 2021; 12:782753. [PMID: 35153854 PMCID: PMC8829462 DOI: 10.3389/fpsyt.2021.782753] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/23/2021] [Indexed: 01/01/2023] Open
Abstract
This study aimed to investigate the effects of long-term home quarantine on the mental health of people during the COVID-19 epidemic in Shanghai. We conducted an online questionnaire survey on March 26 2020 and collected data on demographics, level of physical activity (PA), and mental health status of the participants. We assessed the mental health status using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7), whereas PA was assessed using International Physical Activity Questionnaire Short Form (IPAQ-SF). Of all 2,409 valid samples, participants reported performing a total of 2015.20 metabolic equivalent of task (MET)-minutes/week of total PA before the outbreak period and 1720.29 MET-minutes/week of total PA during the outbreak period (p < 0.001). Participants who spent a longer time at home reported to have a better performance on the PHQ-9 (p = 0.087) and GAD-7 (p < 0.001). A high level of PA was considered an protective factor against depression (OR = 0.755, 95% CI 0.603-0.944, p < 0.001). Additionally, a high level of PA had a preventative effect on anxiety (OR = 0.741, 95% CI 0.568-0.967, p < 0.001), and a longer working period during the outbreak was shown to be a risk factor for anxiety (11-29 days, OR 1.455, 95% CI 1.110-1.909; 30-60 days OR 1.619, 95% CI 1.227-2.316). Home confinement during the pandemic might not have a negative effect on mental health provided that people engage in more PA indoors. This study encourages interventions for mental health problems through physical exercise.
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Affiliation(s)
- Wentong Zhu
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Doudou Xu
- Department of Nursing, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hui Li
- Department of Pharmacy, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Gang Xu
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jingyan Tian
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Luheng Lyu
- Department of Biochemistry and Molecular Biology, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Naifu Wan
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lijiang Wei
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wuwei Rong
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenchen Liu
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Beiwen Wu
- Department of Nursing, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaolan Bian
- Department of Pharmacy, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Ankang Lyu
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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47
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Cheng P, Jasinski N, Zheng W, Yadava A, Wang L, Li L, Xu L, Zhou Y, Zhang L, Li W. Psychometric Properties of the Primary Care PTSD Screen for DSM-5: Findings From Family Members of Chinese Healthcare Workers During the Outbreak of COVID-19. Front Psychiatry 2021; 12:695678. [PMID: 34594246 PMCID: PMC8477025 DOI: 10.3389/fpsyt.2021.695678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Minimal research has examined utility of PC-PTSD-5 in family members of frontline medical workers. The aims of our study were to develop and elucidate the psychometric properties of the Chinese version of the PC-PTSD-5 and to determine its usefulness in screening for possible PTSD in relatives of Chinese healthcare workers during the COVID-19. Methods: We conducted a cross-sectional research in the relatives of medical staffs working in a general hospital during the COVID-19. Descriptive analysis was used to characterize demographic information of family members to find factors associated with PTSD symptoms. For reliability test, the internal consistency of PC-PTSD-5 was accessed using Cronbach's alpha coefficient. A validity test was assessed by Pearson's correlation between scales. A receiver operating characteristic (ROC) curve was used to evaluate the optimal cutoff score with the maximum Youden Index in this study. Results: The result of demographic information indicated that gender and the type of work undertaken by medical staff in the family have a potential impact on the PTSD symptoms of medical staff's family members. Cronbach's alpha coefficient of PC-PTSD-5 was 0.83, indicating the high reliability. Good validity was also demonstrated by Pearson coefficient. By calculating the Youden index, a cutoff score of 2 was found to be optimal in our study, with sensitivity of 80.74% and specificity of 88.43%. Conclusions: Our study has demonstrated the robust psychometric strengths of the PC-PTSD-5, introducing a reliable tool for screening PTSD among vulnerable and neglected families of these medical workers.
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Affiliation(s)
- Peng Cheng
- National Clinical Research Center for Mental Disorders, Department of Psychaitry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Nicholas Jasinski
- Department of Behavioral Medicine and Psychiatry, School of Medicine, West Virginia University, Morgantown, WV, United States
| | - Wanhong Zheng
- Department of Behavioral Medicine and Psychiatry, School of Medicine, West Virginia University, Morgantown, WV, United States
| | - Aradhita Yadava
- Department of Biology and Psychology, Eberly College of Arts and Sciences, West Virginia University, Morgantown, WV, United States
| | - Lirong Wang
- XiangYa School of Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Lingjiang Li
- National Clinical Research Center for Mental Disorders, Department of Psychaitry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lizhi Xu
- National Clinical Research Center for Mental Disorders, Department of Psychaitry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ying Zhou
- National Clinical Research Center for Mental Disorders, Department of Psychaitry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Li Zhang
- National Clinical Research Center for Mental Disorders, Department of Psychaitry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - WeiHui Li
- National Clinical Research Center for Mental Disorders, Department of Psychaitry, The Second Xiangya Hospital of Central South University, Changsha, China
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48
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Monteiro RP, Nascimento BS, Monteiro TMC, da Silva PDG, Ferreira AJC. Psychometric Evidence of the 7-Item Generalized Anxiety Disorder Questionnaire in Brazil. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00423-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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49
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Kong W, Deng H, Wan J, Zhou Y, Zhou Y, Song B, Wang X. Comparative Remission Rates and Tolerability of Drugs for Generalised Anxiety Disorder: A Systematic Review and Network Meta-analysis of Double-Blind Randomized Controlled Trials. Front Pharmacol 2020; 11:580858. [PMID: 33343351 PMCID: PMC7741609 DOI: 10.3389/fphar.2020.580858] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/23/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Generalized anxiety disorder (GAD) is one of the most common psychiatric disorders associated with substantial dysfunction and socioeconomic burden. Pharmacotherapy is the first choice for GAD. Remission [Hamilton Anxiety Scale (HAM-A) score ≤7] is regarded as a crucial treatment goal for patients with GAD. There is no up-to-date evidence to compare remission rate and tolerability of all available drugs by using network meta-analysis. Therefore, the goal of our study is to update evidence and determine the best advantageous drugs for GAD in remission rate and tolerability profiles. Method: We performed a systematic review and network meta-analysis of double-blind randomized controlled trials (RCTs). We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, wanfang data, China Biology Medicine and ClinicalTrials.gov from their inception to March 2020 to identify eligible double-blind, RCTs reporting the outcome of remission in adult patients who received any pharmacological treatment for GAD. Two reviewers independently assessed quality of included studies utilizing the Cochrane Collaboration’s risk of bias tool as described in Cochrane Collaboration Handbook and extracted data from all manuscripts. Our outcomes were remission rate (proportion of participants with a final score of seven or less on HAM-A) and tolerability (treatments discontinuations due to adverse events). We calculated summary odds ratios (ORs) and 95% confidence intervals (CIs) of each outcome via pairwise and network meta-analysis with random effects. Results: Overall, 30 studies were included, comprising 32 double-blind RCTs, involving 13,338 participants diagnosed as GAD by DSM-IV criteria. Twenty-eight trials were rated as moderate risk of bias, four trials as low. For remission rate, agomelatine (OR 2.70, 95% CI 1.74–4.19), duloxetine (OR 1.88, 95% CI 1.47–2.40), escitalopram (OR 2.03, 95% CI 1.48–2.78), paroxetine (OR 1.74, 95% CI 1.25–2.42), quetiapine (OR 1.88, 95% CI 1.39–2.55), and venlafaxine (OR 2.28, 95% CI 1.69–3.07) were superior to placebo. For tolerability, sertraline, agomelatine, vortioxetine, and pregabalin were found to be comparable to placebo. However, the others were worse than placebo in terms of tolerability, with ORs ranging between 1.86 (95% CI 1.25–2.75) for tiagabine and 5.98 (95% CI 2.41–14.87) for lorazepam. In head-to-head comparisons, agomelatine, duloxetine, escitalopram, quetiapine, and venlafaxine were more efficacious than tiagabine in terms of remission rate, ORs from 1.66 (95% CI 1.04–2.65) for duloxetine to 2.38 (95% CI 1.32–4.31) for agomelatine. We also found that agomelatine (OR 2.08, 95% CI 1.15–3.75) and venlafaxine (OR 1.76, 95% CI 1.08–2.86) were superior to vortioxetine. Lorazepam and quetiapine were poorly tolerated when compared with other drugs. Conclusions: Of these interventions, only agomelatine manifested better remission with relatively good tolerability but these results were limited by small sample sizes. Duloxetine, escitalopram, venlafaxine, paroxetine, and quetiapine showed better remission but were poorly tolerated.
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Affiliation(s)
- Wenqiang Kong
- Department of Pharmacy, Zi Gong First People's Hospital, Zi Gong, China
| | - Huiyuan Deng
- Department of Pharmacy, Zi Gong First People's Hospital, Zi Gong, China
| | - Jie Wan
- Department of Pharmacy, Zi Gong First People's Hospital, Zi Gong, China
| | - Yilu Zhou
- Department of Pharmacy, Zi Gong First People's Hospital, Zi Gong, China
| | - Yan Zhou
- Department of Pharmacy, Zi Gong First People's Hospital, Zi Gong, China
| | - Bihui Song
- Department of Pharmacy, Zi Gong First People's Hospital, Zi Gong, China
| | - Xiuling Wang
- Department of Pharmacy, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
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50
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Horenstein A, Heimberg RG. Anxiety disorders and healthcare utilization: A systematic review. Clin Psychol Rev 2020; 81:101894. [DOI: 10.1016/j.cpr.2020.101894] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 07/21/2020] [Accepted: 07/29/2020] [Indexed: 12/18/2022]
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