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Oh HS, Cloninger CR. The role of temperament and character in the anxiety-depression spectrum among Korean adults. J Affect Disord 2024; 359:1-13. [PMID: 38759504 DOI: 10.1016/j.jad.2024.05.052] [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: 03/28/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND Temperament and character are useful in risk assessment and therapy of individuals in the anxiety-depression spectrum but understudied in South Korea. OBJECTIVE The study aimed to identify the temperament and character features associated with anxiety and/or depression in individuals with clinical disorders and in the general population. METHODS A representative sample of 1384 Korean adults over 18 years old (58 % female) were assessed with the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Temperament and Character Inventory (TCI). Multivariate analyses, including structural equation modeling and complex systems analysis, evaluated how personality influenced risk and resilience for anxiety and/or depression. RESULTS The three groups with anxiety and/or depression were strongly distinguished by temperament and character: (i) In AD (n = 58), Harm Avoidance and Reward Dependence were higher than in DD, and Self-directedness was higher than in AD+DD; (ii) In DD (n = 90), Persistence, Self-Directedness and Cooperativeness were higher than in AD+DD; and (iii) In AD+DD (n = 101), Harm Avoidance was highest and Persistence and Self-directedness were lowest (i.e., they were lowest in Resilience). Structural equation models confirmed these risk relations with strong character development reducing the adverse effects of emotional hyperreactivity from extreme temperaments. LIMITATIONS Self-reports were measured only at one point in time, requiring collateral experimental data to support causal interpretation. CONCLUSIONS Interactions of temperament and character are strongly predictive of risk and resilience to anxiety and/or depression by regulating both positive and negative affect. Character mediates the adverse effects of extreme temperaments on affect.
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Affiliation(s)
- Hyun Sook Oh
- Department of Psychology and Childcare, College of Human Services, Hanshin University, Seoul, South Korea
| | - C Robert Cloninger
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
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Weisholtz DS, Roy A, Sanayei A, Cha B, Reich D, Silbersweig DA, Dworetzky BA. Postictal psychiatric symptoms: A neurophysiological study. Epilepsy Behav 2024; 154:109728. [PMID: 38593493 DOI: 10.1016/j.yebeh.2024.109728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE Postictal psychiatric symptoms (PPS) are a relatively common but understudied phenomenon in epilepsy. The mechanisms by which seizures contribute to worsening in psychiatric symptoms are unclear. We aimed to identify PPS prospectively during and after admission to the epilepsy monitoring unit (EMU) in order to characterize the postictal physiologic changes leading to PPS. METHODS We prospectively enrolled patients admitted to the EMU and administered repeat psychometric questionnaires during and after their hospital stay in order to assess for postictal exacerbations in four symptom complexes: anger/hostility, anxiety, depression, and paranoia. Electroclinical and electrographic seizures were identified from the EEG recordings, and seizure durations were measured. The severity of postictal slowing was calculated as the proportion of postictal theta/delta activity in the postictal EEG relative to the preictal EEG using the Hilbert transform. RESULTS Among 33 participants, 8 demonstrated significant increases in at least one of the four symptoms (the PPS+ group) within three days following the first seizure. The most common PPS was anger/hostility, experienced by 7/8 participants with PPS. Among the 8 PPS+ participants, four experienced more than one PPS. As compared to those without PPS (the PPS- group), the PPS+ group demonstrated a greater degree of postictal EEG slowing at 10 min (p = 0.022) and 20 min (p = 0.05) following seizure termination. They also experienced significantly more seizures during the study period (p = 0.005). There was no difference in seizure duration between groups. SIGNIFICANCE Postictal psychiatric symptoms including anger/hostility, anxiety, depression, and paranoia may be more common than recognized. In particular, postictal increases in anger and irritability may be particularly common. We provide physiological evidence of a biological mechanism as well as a demonstration of the use of quantitative electroencephalography toward a better understanding of postictal neurophysiology.
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Affiliation(s)
- Daniel S Weisholtz
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Alexa Roy
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Rush University Medical College, Chicago, IL, USA
| | - Ava Sanayei
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Hospital, Harvard Medical School, Boston, MA, USA
| | - Brannon Cha
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; University of California San Diego School of Medicine, San Diego, CA, USA
| | - Dustine Reich
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Weill/Cornell Medical College, New York, NY, USA
| | - David A Silbersweig
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Barbara A Dworetzky
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Kim HM, Kang C, Chae B, Kang JC, Yoon HK. Exploring Brainstem Structural Abnormalities: Potential Biomarkers for Panic Disorder. Exp Neurobiol 2024; 33:18-24. [PMID: 38471801 PMCID: PMC10938071 DOI: 10.5607/en23034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 01/09/2024] [Accepted: 01/19/2024] [Indexed: 03/14/2024] Open
Abstract
Panic disorder (PD), characterized by recurrent and intense panic attacks, presents a complex interplay between psychological and neurobiological factors. Although the amygdala and hippocampus have been studied extensively in the context of PD, the brainstem's involvement remains relatively underexplored. This study aims to address this gap by examining structural abnormalities within specific brainstem regions, including the medulla, pons, and midbrain. The study sample population comprised twenty-one adult patients diagnosed with PD and an age-gender-education-matched control group. Utilizing rigorous inclusion and exclusion criteria, confounding factors related to comorbid psychiatric conditions and brain structure abnormalities were minimized. Our findings revealed a significant reduction in medulla volume among PD patients, a finding that persisted even after correcting for individual differences in total intracranial volume. The medulla's role in cardiovascular regulation and autonomic function, coupled with its involvement in fear responses, underscores its potential significance in the pathophysiology of PD. This study elucidates the medulla's structural abnormalities as a potential biomarker for PD. Understanding the role of the brainstem in PD could pave the way for more targeted and effective interventions for this condition.
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Affiliation(s)
- Hye-Min Kim
- Department of Psychiatry, Korea University Ansan Hospital, Ansan 15355, Korea
| | - Chanmi Kang
- Department of Brain and Cognitive Engineering, Korea University, Seoul 02841, Korea
| | - Boram Chae
- Department of Psychiatry, Korea University Ansan Hospital, Ansan 15355, Korea
| | - June Christoph Kang
- Department of Brain and Cognitive Engineering, Korea University, Seoul 02841, Korea
| | - Ho-Kyoung Yoon
- Department of Psychiatry, Korea University Ansan Hospital, Ansan 15355, Korea
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Pedramrazi S, Mohammadabadi A, Rooddehghan Z, Haghani S. Effectiveness of Peer-Based and Conventional Video Education in Reducing Perioperative Depression and Anxiety Among Coronary Artery Bypass Grafting Patients: A Randomized Controlled Trial. J Perianesth Nurs 2024:S1089-9472(23)01067-5. [PMID: 38416103 DOI: 10.1016/j.jopan.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/22/2023] [Accepted: 12/02/2023] [Indexed: 02/29/2024]
Abstract
PURPOSE Depression and anxiety are common comorbidities in patients undergoing coronary artery bypass grafting (CABG), with potential adverse effects on surgical outcomes. Effective interventions to reduce depression and anxiety in these patients are therefore warranted. This study investigated the effectiveness of peer-based video education compared to conventional video education in reducing perioperative depression and anxiety in CABG patients. DESIGN A three-arm, parallel, randomized, controlled trial design was employed. METHODS A total of 114 participants were randomly assigned to 1 of 3 groups (n = 38 per group): standard education (control), conventional video education, and peer-based video education. State anxiety levels were measured using the Spielberger State Anxiety Questionnaire at 1 day before surgery (baseline), 1 hour before surgery, and 4 weeks after surgery. Depression levels were measured using the Beck Depression Inventory Short-Form at baseline and 4 weeks after surgery. Statistical analyses, including χ2, Fisher's exact test, one-way analysis of variance, and repeated-measures analysis of variance, were applied to analyze the collected data. FINDINGS Both peer-based and conventional video education groups demonstrated lower preoperative anxiety levels compared to the control group. However, only the peer-based video education group exhibited a statistically significant difference (P < .05). Four weeks after surgery, anxiety and depression levels decreased in all participants compared to baseline, with no statistically significant differences among the three groups. CONCLUSIONS Our findings suggest that peer-based video education is more effective in controlling preoperative anxiety in patients undergoing CABG than conventional video education and standard education. Moreover, video-based education, whether conventional or peer-based, appears to be as effective as standard education in reducing anxiety and depression 4 weeks after CABG surgery. Further research is warranted to investigate the influence of content and presentation methods on patient outcomes and explore the potential long-term benefits of video-based education in promoting patient care.
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Affiliation(s)
- Shadan Pedramrazi
- Faculty of Nursing and Midwifery, Department of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Mohammadabadi
- Nursing Care Research Center, Department of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| | - Zahra Rooddehghan
- Nursing Care Research Center, Department of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Haghani
- Nursing Care Research Center, Department of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Ganslmeier M, Ehring T, Wolkenstein L. Effects of imagery rescripting and imaginal exposure on voluntary memory. Behav Res Ther 2023; 170:104409. [PMID: 37925798 DOI: 10.1016/j.brat.2023.104409] [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: 07/01/2023] [Revised: 09/19/2023] [Accepted: 10/01/2023] [Indexed: 11/07/2023]
Abstract
Trauma-focused imagery-based interventions, such as Imagery Rescripting (ImRs) and Imaginal Exposure (ImE), are effective in reducing involuntary re-experiencing in PTSD. However, it has been suggested that they may impair voluntary memory. This study investigates whether ImRs and ImE distort voluntary memory of an analogue trauma. We presented a trauma film to N = 120 healthy participants (Session 1) and randomly allocated them to one of two intervention conditions (receiving one session of ImRs or ImE) or to a no-intervention control condition (NIC) afterwards (Session 2). Voluntary memory was assessed using a free recall (Sessions 2 and 3), and a cued recall as well as a recognition task (both Sessions 3 and 4). The ImRs and ImE groups did not differ from NIC in the cued recall task and the recognition task. However, ImE (compared to ImRs and NIC) led to an increase in correct reported details in the free recall. In sum, the current findings do not suggest that ImRs or ImE impair voluntary memory.
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Affiliation(s)
| | - Thomas Ehring
- Department of Psychology, Ludwig-Maximilians-Universität, München, Germany
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Nakamura H, Sugihara G, Hara K, Inaji M, Noha M, Takumi I, Watanabe M, Takahashi H, Maehara T, Yamamoto H, Takagi S. Seizure-related stress and arousal responses mediate a relationship between anxiety trait and state in epilepsy. Epilepsy Behav 2023; 147:109442. [PMID: 37716325 DOI: 10.1016/j.yebeh.2023.109442] [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: 07/14/2023] [Revised: 08/25/2023] [Accepted: 09/05/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Epilepsy causes substantial psychological distress and anxiety, primarily due to seizures. However, the impact of stress responses and changes in arousal and their association with anxiety patterns in patients with epilepsy (PWE) remains unclear. This study aimed to investigate the relationships among seizures, stress and arousal characteristics, and trait and state anxiety characteristics in PWE. METHODS Our sample consisted of 159 outpatients with epilepsy recruited from five institutions in Japan in 2020. Participants completed the State-Trait Anxiety Inventory-Form JYZ (STAI) and the Japanese-Stress Arousal Check List (J-SACL). We analyzed the correlations between inventory scores and clinical information. Using principal component analysis (PCA), we derived epilepsy-specific stress/arousal characteristics, which accounted for high arousal and low-stress levels, termed epilepsy-specific stress or arousal response (ESAR), from the J-SACL scores. We conducted a mediation analysis to assess the mediating role of ESAR in the relationship between traits and state anxiety. RESULTS We found significant correlations between J-SACL stress and arousal factors (r = -0.845, p < 0.001), ESAR and seizure frequency (r = -0.29, p < 0.001), ESAR and trait anxiety scores on the STAI (r = -0.77, p < 0.0001), and ESAR and state anxiety scores on the STAI (r = -0.60, p < 0.0001). Mediation analysis supported by the Monte Carlo method revealed that ESAR significantly mediated the association between trait and state anxiety. CONCLUSIONS These findings elucidate the epilepsy-specific stress and arousal characteristics and their roles in mediating traits and state anxiety. These results may reflect the long-term clinical course and unique emotion recognition tendencies in epilepsy.
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Affiliation(s)
- Hironobu Nakamura
- Department of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, Tokyo, Japan; Hara Clinic, Kanagawa, Japan
| | - Genichi Sugihara
- Department of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Keiko Hara
- Hara Clinic, Kanagawa, Japan; Department of Respiratory and Nervous System Science, Biomedical Laboratory Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Motoki Inaji
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masahiro Noha
- Department of Neurosurgery, Okinawa Red Cross Hospital, Okinawa, Japan
| | - Ichiro Takumi
- Department of Neurosurgery, St. Marianna University School of Medicine, Kanagawa, Japan
| | | | - Hidehiko Takahashi
- Department of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, Tokyo, Japan; Center for Brain Integration Research, Tokyo Medical and Dental University, Tokyo, Japan
| | - Taketoshi Maehara
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hitoshi Yamamoto
- Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Shunsuke Takagi
- Department of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, Tokyo, Japan; Sleep Research Institute, Waseda University, 513 Waseda-Tsurumakicho, Shinjuku, Tokyo 162-0041 Japan.
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Catalán-Aguilar J, González-Bono E, Lozano-García A, Tormos-Pons P, Hampel KG, Villanueva V, Cano-López I. Stress phenotypes in epilepsy: impact on cognitive functioning and quality of life. Front Psychol 2023; 14:1100101. [PMID: 37388654 PMCID: PMC10300421 DOI: 10.3389/fpsyg.2023.1100101] [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: 11/16/2022] [Accepted: 05/22/2023] [Indexed: 07/01/2023] Open
Abstract
Introduction Drug-resistant epilepsy has been proposed as a chronic stress model. Stress can be measured in terms of chronicity (epilepsy duration) and intensity (comorbidities), with depression and anxiety among the most important comorbidities in epilepsy due to its prevalence and its relationship with cognitive functioning and quality of life. This study aims to establish phenotypes according to how patients face a stressful condition (epilepsy) and examine differences in cognition and quality of life depending on these phenotypes. We hypothesize that there will be an interrelationship between epilepsy duration and negative affectivity, and these variables will influence cognition and quality of life. Methods 170 patients (82 men and 88 women) underwent a neuropsychological evaluation in which trait anxiety, depression, attention and executive function, verbal and visual memory, language, emotional recognition, and quality of life were assessed. Hierarchical clustering was performed using z-scores for three variables: trait anxiety; depression; and epilepsy duration. Results Three clusters were found: vulnerable (high negative affectivity and short duration); resilient (moderate negative affectivity and long duration); and low-impact group (low negative affectivity and short duration). Results show that the vulnerable group had poorer cognitive functioning and quality of life than the other groups. Specifically, the vulnerable group had poorer scores than the low-impact group on verbal memory, visual confrontation naming, and quality of life (except seizure worry). Furthermore, resilient patients had better scores than the low-impact group on cognitive flexibility variables, but lower scores on some quality-of-life subscales (i.e., overall quality of life, emotional well-being, and energy). Finally, the vulnerable group had poorer scores than the resilient group in executive functioning, naming, and quality of life. Discussion These results suggest that dealing with stress in patients with epilepsy is related to cognitive performance and quality of life. These findings underline the relevance of considering comorbidities in epilepsy and may be useful for detecting vulnerable or resilient profiles as risk or protective factors for cognitive and quality of life decline.
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Affiliation(s)
- Judit Catalán-Aguilar
- Institut d’Investigació en Psicologia dels Recursos Humans, del Desenvolupament Organitzacional i de la Qualitat de Vida Laboral (Idocal)/Department of Psychobiology, Psychology Center, Universitat de València, Valencia, Spain
| | - Esperanza González-Bono
- Institut d’Investigació en Psicologia dels Recursos Humans, del Desenvolupament Organitzacional i de la Qualitat de Vida Laboral (Idocal)/Department of Psychobiology, Psychology Center, Universitat de València, Valencia, Spain
| | - Alejandro Lozano-García
- Institut d’Investigació en Psicologia dels Recursos Humans, del Desenvolupament Organitzacional i de la Qualitat de Vida Laboral (Idocal)/Department of Psychobiology, Psychology Center, Universitat de València, Valencia, Spain
| | - Paula Tormos-Pons
- Institut d’Investigació en Psicologia dels Recursos Humans, del Desenvolupament Organitzacional i de la Qualitat de Vida Laboral (Idocal)/Department of Psychobiology, Psychology Center, Universitat de València, Valencia, Spain
| | - Kevin G. Hampel
- Refractory Epilepsy Unit, Neurology Service Member of ERN EPICARE, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Vicente Villanueva
- Refractory Epilepsy Unit, Neurology Service Member of ERN EPICARE, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Irene Cano-López
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
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Escolà-Gascón Á, Dagnall N, Denovan A, Drinkwater K, Diez-Bosch M. Who falls for fake news? Psychological and clinical profiling evidence of fake news consumers. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023; 200:111893. [PMID: 36089997 PMCID: PMC9450498 DOI: 10.1016/j.paid.2022.111893] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 08/18/2022] [Accepted: 08/29/2022] [Indexed: 11/29/2022]
Abstract
Awareness of the potential psychological significance of false news increased during the coronavirus pandemic, however, its impact on psychopathology and individual differences remains unclear. Acknowledging this, the authors investigated the psychological and psychopathological profiles that characterize fake news consumption. A total of 1452 volunteers from the general population with no previous psychiatric history participated. They responded to clinical psychopathology assessment tests. Respondents solved a fake news screening test, which allowed them to be allocated to a quasi-experimental condition: group 1 (non-fake news consumers) or group 2 (fake news consumers). Mean comparison, Bayesian inference, and multiple regression analyses were applied. Participants with a schizotypal, paranoid, and histrionic personality were ineffective at detecting fake news. They were also more vulnerable to suffer its negative effects. Specifically, they displayed higher levels of anxiety and committed more cognitive biases based on suggestibility and the Barnum Effect. No significant effects on psychotic symptomatology or affective mood states were observed. Corresponding to these outcomes, two clinical and therapeutic recommendations related to the reduction of the Barnum Effect and the reinterpretation of digital media sensationalism were made. The impact of fake news and possible ways of prevention are discussed.
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Affiliation(s)
- Álex Escolà-Gascón
- Blanquerna Faculty of Communication and International Relations, Ramon Llull University, Barcelona, Spain
| | - Neil Dagnall
- Psychology Department Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Andrew Denovan
- University of Huddersfield, Huddersfield, United Kingdom
| | - Kenneth Drinkwater
- Psychology Department Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Miriam Diez-Bosch
- Blanquerna Faculty of Communication and International Relations, Ramon Llull University, Barcelona, Spain
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Czorniej KP, Krajewska-Kułak E, Kułak W. Assessment of anxiety disorders in students starting work with coronavirus patients during a pandemic in Podlaskie Province, Poland. Front Psychiatry 2022; 13:980361. [PMID: 36032244 PMCID: PMC9403615 DOI: 10.3389/fpsyt.2022.980361] [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: 06/28/2022] [Accepted: 07/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background Anxiety disorders are considered the sixth most important factor resulting in non-fatal health loss in the world. Moreover, they are among the first ten causes of years lived with disability (YLD) across the globe. Important clinical disorders include e.g., panic disorder, social anxiety disorder, generalized anxiety disorder and specific phobia. Objectives The study aimed to analyse the occurrence of level anxiety in students who start work at the time of the COVID-19 pandemic, with relation to the socio-demographic factors and health status, vaccination, conovirus infection, assistance of a psychologist or psychiatrist in the past, and using tranquilizers. Methods The study involved 255 students from Poland starting work with coronavirus patients during the pandemic. It was conducted using our own questionnaire, the Liebowitz Social Anxiety Scale (LSAS) and the State-Trait Anxiety Inventory (STAI). Results Fifty-one percent of subjects demonstrated symptoms of mild to severe social phobia. Level of trait anxiety among students correlated significantly with age and gender (females). The level of social anxiety in the evaluated students was significantly correlated with marital status, the self-assessment of the experienced fear, self-perceived health status, having had a coronavirus infection, fear of deterioration of one's health after starting work with coronavirus patients, and fear of contracting the disease while working with coronavirus patients, and using tranquilizers. Level of state anxiety significantly correlated with state anxiety, the self-assessment of professional preparedness for work with coronavirus patients, self-perceived health status, vaccination against coronavirus, and the assistance of a psychiatrist in the past. Conclusions The proportion of students showing social anxiety is alarming. Anxiety among the evaluated students during the COVID-19 pandemic was correlated with many factors.
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Affiliation(s)
- Klaudia Paula Czorniej
- Students' Scientific Society, Department of Integrated Medical Care and Department of Pediatric Rehabilitation and Center of Early Support for Handicapped Children “Give a Chance,” Medical University of Białystok, Białystok, Poland
| | | | - Wojciech Kułak
- Department of Pediatric Rehabilitation and Center of Early Support for Handicapped Children “Give a Chance,” Medical University of Białystok, Bialystok, Poland
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Chieffo D, Avallone C, Serio A, Kotzalidis GD, Balocchi M, De Luca I, Hirsch D, Gonsalez del Castillo A, Lanzotti P, Marano G, Rinaldi L, Lanzone A, Mercuri E, Mazza M, Sani G. Pregnancy-related psychopathology: A comparison between pre-COVID-19 and COVID-19–related social restriction periods. World J Clin Cases 2022; 10:6370-6384. [PMID: 35979303 PMCID: PMC9294903 DOI: 10.12998/wjcc.v10.i19.6370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/13/2021] [Accepted: 05/08/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic impacted in a still undefined way pregnant women’s mental health. There are reports of mood and affect changes in the general population and the suggestion that similar changes occur also in the pregnant population. The greater vulnerability of women during the COVID-19 restriction period may translate into a greater risk for mental disorders in the gestational period. We hypothesised that pregnant women in the pre-pandemic period would have less psychopathology and more psychological support than pregnant women during the pandemic restriction period.
AIM To compare pregnant women for anxiety, prenatal depression, psychopathology, and social support before and after the awareness of the pandemic.
METHODS We administered to women willing to participate in their 2nd-3rd trimesters of pregnancy the Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory Form Y (STAI-Y), and the Symptom CheckList-90-Revised (SCL-90R); we further collected sociodemographic variables and explored women’s social support. The comparison was cross-sectional. The first sample was termed nonCOVID-19 because data were gathered before the COVID-19 outbreak (January 2020-February 2020) was declared, and the second sample termed COVID-19 because participants were already subjected to the COVID-19–related restrictive measures (January 2021-February 2021). Since normal distribution was not met (Shapiro-Wilk test applied), we applied nonparametric Mann-Whitney’s U-test to compare psychometric tests. Ethical standards were met.
RESULTS The nonCOVID-19 group reported higher support from partners only, while the COVID-19 group reported multiple support (χ2 = 9.7181; P = 0.021); the nonCOVID-19 group scored higher than the COVID-19 group only on state anxiety among psychometric scales [STAI-Y1, nonCOVID-19 median = 39 (95%CI: 39.19-51.10) vs COVID-19 median= 32 (95%CI: 30.83-38.90); Mann-Whitney’s U=117.5, P = 0.00596]. Other measures did not differ meaningfully between the two groups. Scores on the EPDS, the state and trait subscales of the STAI-Y, and most SCL-90R subscales inter-correlated with one another. The anxiety component of the EPDS, EPDS-3A, correlated poorly with other measures, while it was the Global Symptom Index of the SCL-90-R that correlated most strongly with most measures. Our results are at odds with most literature and do not confirm increased depression and anxiety rates in pregnant women during the pandemic.
CONCLUSION The ability of pregnant women to deal with novel generalised threats involves mobilization of inner resources. Increasing sources of social support may have produced anxiolysis in the COVID-19 sample.
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Affiliation(s)
- Daniela Chieffo
- Service of Clinical Psychology, Catholic University of Sacred Heart, Rome 00168, Italy
| | - Carla Avallone
- Department of Neurosciences, Catholic University of Sacred Heart , Rome 00168, Italy
| | - Annamaria Serio
- Service of Clinical Psychology, Catholic University of Sacred Heart, Rome 00168, Italy
| | | | - Marta Balocchi
- Service of Clinical Psychology, Catholic University of Sacred Heart, Rome 00168, Italy
| | - Ilaria De Luca
- Department of Neurosciences, Catholic University of Sacred Heart , Rome 00168, Italy
| | - Daniele Hirsch
- Department of Neurosciences, Catholic University of Sacred Heart , Rome 00168, Italy
| | | | - Pierluigi Lanzotti
- Department of Neurosciences, Catholic University of Sacred Heart , Rome 00168, Italy
| | - Giuseppe Marano
- Department of Neurosciences, Catholic University of Sacred Heart , Rome 00168, Italy
| | - Lucio Rinaldi
- Department of Neurosciences, Catholic University of Sacred Heart , Rome 00168, Italy
| | - Antonio Lanzone
- Department of Obstetrics and Gynaecology, Catholic University of Sacred Heart, Rome 00168, Italy
| | - Eugenio Mercuri
- Paediatric Neurology Unit, Catholic University of Sacred Heart, Rome 00168, Italy
| | - Marianna Mazza
- Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Gabriele Sani
- Department of Neurosciences, Catholic University of Sacred Heart , Rome 00168, Italy
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Rauh R, Schulze-Bonhage A, Metternich B. Assessment of Anxiety in Patients With Epilepsy: A Literature Review. Front Neurol 2022; 13:836321. [PMID: 35547374 PMCID: PMC9081800 DOI: 10.3389/fneur.2022.836321] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/16/2022] [Indexed: 01/07/2023] Open
Abstract
Objective Approximately 20% of people with epilepsy (PWE) suffer from anxiety. These fears are quite diverse and may manifest periictally or interictally, be part of the seizure's semiology, or an expression of reactive psychological distress from seizures themselves. Our review addresses the question of what screening tools are used in clinical care and epileptological research to capture the complexity of epilepsy-specific anxieties. Method On 2021/11/11, we entered a search string in PubMed that covered our research interest as completely as possible. We also screened the bibliographies of our findings and followed PubMed's recommendations. From the assessments we found in the included studies, we extracted domains that represent the range of manifestations of anxiety, in order to compare the tools and to discuss to what extent they are suitable for assessing epilepsy-specific anxieties. Results We screened 1,621 abstracts. In total, we identified 24 different anxiety assessments. In addition to the psychiatric assessments in use, we found 7 tools that were designed to assess epilepsy-specific anxieties. The latter focus on different aspects of epilepsy-specific anxieties. In some cases, the conceptual frameworks are not sufficiently transparent or divergent. Conclusion Because a diagnosis of epilepsy can result in, or seizures may appear as, anxiety, it is important to better understand this psychological burden and address it therapeutically, if necessary. There is a need for screening tools that integrate specific points of a variety of assessments, so as to cover the broad range of epilepsy-specific fears. None of the assessments we found meets this integrative perspective. At the same time, the appropriate design of such a required tool presupposes a conceptual framework of what should be considered as epilepsy-specific anxiety.
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Affiliation(s)
- Raphael Rauh
- Epilepsy Center, University Medical Center, University of Freiburg, Freiburg, Germany
| | | | - Birgitta Metternich
- Epilepsy Center, University Medical Center, University of Freiburg, Freiburg, Germany
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12
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Macalli M, Orri M, Tzourio C, Côté SM. Contributions of childhood peer victimization and/or maltreatment to young adult anxiety, depression, and suicidality: a cross-sectional study. BMC Psychiatry 2021; 21:354. [PMID: 34261482 PMCID: PMC8278608 DOI: 10.1186/s12888-021-03354-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/28/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Childhood maltreatment and peer victimization are major risk factors for depression and suicidal behavior. Furthermore, childhood maltreatment increases the risk of peer victimization. Our objective was to distinguish between the contributions of parental maltreatment and peer victimization to the development of mental health problems in young adulthood. Specifically, we tested whether peer victimization alone or in combination with parental maltreatment before 18 years old was associated with anxiety, depression, and suicidal thoughts and behaviors at age 21 years. METHODS We analyzed data collected from questionnaires administered in the i-Share (Internet-based Students' Health ResearchEnterprise) study in France from February 2013 to September 2019 (N = 2271 participants). We performed multinomial and binary logistic regression analyses to assess the single and combined contributions of childhood peer victimization and parental maltreatment to anxiety, depression, and suicidality in adulthood. RESULTS Nearly one third of students (28.8%) reported at least one mental health problem; 29.8% reported peer victimization alone; 7.5% reported parental maltreatment alone; and 10.3% reported both parental maltreatment and victimization. In multivariate models, compared to participants that did not experience maltreatment or peer victimization, those that experienced peer victimization alone were more likely to report anxiety (adjusted odds ratio [aOR]: 1.90; 95% CI: 1.50-2.40), depression (aOR: 1.95; 95% CI: 1.46-2.60), or suicidal ideation, without (aOR: 1.62; 95% CI: 1.26-2.09) or with a suicide attempt (aOR: 2.70; 95% CI: 1.51-4.85). Similar associations were observed for participants that experienced maltreatment alone. Participants that experienced both maltreatment and peer victimization were at increased risk of depression (aOR: 2.63; 95% CI: 1.79-3.86) and suicidal ideation, with (aOR: 9.19; 95% CI: 4.98-16.92) and without a suicide attempt (aOR: 2.64; 95% CI: 1.86-3.76). CONCLUSIONS Separate and combined exposures to parental maltreatment and peer victimization in childhood or adolescence were associated with increased risks of anxiety, depression, and suicidal behaviors. Peer victimization appeared to play a specific role in mental health disorders that were not otherwise explained by polyvictimization. Currently, peer victimization is a frequent, but avoidable type of child abuse; therefore, these findings have implications for policies for preventing and dealing with peer victimization.
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Affiliation(s)
- Melissa Macalli
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000, Bordeaux, France.
| | - Massimiliano Orri
- grid.508062.9University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France ,grid.14709.3b0000 0004 1936 8649McGill Group for Suicide Studies, Douglas Mental Health University Institute and Department of Psychiatry, McGill University, Montreal, QC Canada
| | - Christophe Tzourio
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000, Bordeaux, France. .,CHU de Bordeaux, F-33000, Bordeaux, France.
| | - Sylvana M. Côté
- grid.508062.9University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France ,grid.14848.310000 0001 2292 3357School of Public Health, University of Montreal, Montreal, QC H3T 1J4 Canada
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Gravel V, Boucher O, Citherlet D, Hébert-Seropian B, Bouthillier A, Nguyen DK. Psychological status after insulo-opercular resection in patients with epilepsy: Depression, anxiety, and quality of life. Epilepsy Behav 2021; 118:107919. [PMID: 33770610 DOI: 10.1016/j.yebeh.2021.107919] [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: 01/07/2021] [Revised: 02/28/2021] [Accepted: 03/01/2021] [Indexed: 10/21/2022]
Abstract
Insular epilepsy is increasingly recognized in epilepsy surgery centers. Recent studies suggest that resection of an epileptogenic zone that involves the insula as a treatment for drug-resistant seizures is associated with good outcomes in terms of seizure control. However, despite the existing evidence of a role of the insula in emotions and affective information processing, the long-term psychological outcome of patients undergoing these surgeries remain poorly documented. A group of 27 adults (18 women) who underwent an insulo-opercular resection (in combination with a part of the temporal lobe in 10, and of the frontal lobe in 5) as part of epilepsy surgery at our center between 2004 and 2019 completed psychometric questionnaires to assess depression (Beck Depression Inventory - 2nd edition; BDI-II), anxiety (State-Trait Anxiety Inventory, Trait Version; STAI-T), and quality of life (Patient Weighted Quality of Life In Epilepsy; QOLIE-10-P). Scores were compared to those of patients who had standard temporal lobe epilepsy (TLE) surgery with similar socio-demographic and disease characteristics. Seizure control after insular epilepsy surgery was comparable to that observed after TLE surgery, with a majority of patients reporting being seizure free (insular: 63.0%; temporal: 63.2%) or having rare disabling seizures (insular: 7.4%; temporal: 18.4%) at the time of questionnaire completion. Statistical comparisons revealed no significant group difference on scores of depression, anxiety, or quality of life. Hemisphere or extent of insular resection had no significant effect on the studied variables. In the total sample, employment status and seizure control, but not location of surgery, significantly predicted quality of life. Self-reported long-term psychological status after insulo-opercular resection as part of epilepsy surgery thus appears to be similar to that observed after TLE surgery, which is commonly performed in epilepsy surgery centers.
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Affiliation(s)
- Victoria Gravel
- Département de psychologie, Université de Montréal, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal, Canada
| | - Olivier Boucher
- Département de psychologie, Université de Montréal, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal, Canada; Service de psychologie, Centre hospitalier de l'Université de Montréal, Canada
| | - Daphné Citherlet
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Canada; Département de neurosciences, Université de Montréal, Canada
| | - Benjamin Hébert-Seropian
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Canada; Département de psychologie, Université du Québec à Montréal, Canada
| | - Alain Bouthillier
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Canada; Service de neurochirurgie, Centre hospitalier de l'Université de Montréal, Canada
| | - Dang Khoa Nguyen
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Canada; Département de neurosciences, Université de Montréal, Canada; Service de neurologie, Centre hospitalier de l'Université de Montréal, Canada.
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14
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Lima EM, Gois J, Paiva ML, Vincentiis S, Moschetta S, Valente KDR. Anxiety symptoms are the strongest predictor of quality of life in temporal lobe epilepsy. Seizure 2021; 88:78-82. [PMID: 33838568 DOI: 10.1016/j.seizure.2021.03.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/10/2021] [Accepted: 03/22/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE It is established that the severity of depressive and anxiety symptoms is associated with poorer quality of life (QOL) in persons with drug-resistant epilepsy. We aimed to verify the presence of subsyndromic depressive episodes (SDEs) and subsyndromic anxiety episodes (SAEs) in persons with temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) compared to healthy controls and to determine the impact of depressive and anxiety symptoms on patients' QOL. METHODS We prospectively evaluated 35 persons with TLE-HS and 90 healthy controls. QOL was assessed by the Epilepsy Surgery Inventory (ESI) and QOL in Epilepsy Inventory-31 (QOLIE-31). The Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI-X) were used to assess symptoms, and SDEs and SAEs diagnosis were made considering the total scores of BDI (<9) and STAI-Trait (<49), respectively. RESULTS Persons with TLE-HS had higher symptoms on BDI, STAI-S, and STAI-T. They have 3.011 greater odds of presenting SDEs and 7.056 times odds, SAEs. The depressive and anxiety symptoms, added in the model with epilepsy-related factors, accounted for a significant increase in the variance in several aspects of QOL. Anxiety-trait symptoms are the most critical individual determinant of the QOL. CONCLUSION Our results demonstrated that persons with TLE-HS had greater odds of presenting SDE and SAE than healthy controls. Besides, there was a relationship between anxiety and depressive symptoms and worse QOL in TLE-HS. It is essential to be aware of psychiatric symptoms, even though these symptoms do not meet the criteria to be considered a "disorder."
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Affiliation(s)
- Ellen Marise Lima
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil.
| | - Juliana Gois
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
| | - Maria Luisa Paiva
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
| | - Silvia Vincentiis
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
| | - Sylvie Moschetta
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
| | - Kette Dualibi Ramos Valente
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
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Agabio R, Baldwin DS, Amaro H, Leggio L, Sinclair JMA. The influence of anxiety symptoms on clinical outcomes during baclofen treatment of alcohol use disorder: A systematic review and meta-analysis. Neurosci Biobehav Rev 2021; 125:296-313. [PMID: 33454289 DOI: 10.1016/j.neubiorev.2020.12.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/17/2020] [Accepted: 12/27/2020] [Indexed: 12/22/2022]
Abstract
Given the high coexistence of anxiety symptoms in people with alcohol use disorder (AUD), we aimed to determine the influence of anxiety symptoms on outcomes in patients with AUD treated with the GABAB receptor agonist baclofen. A meta-analysis of 13 comparisons (published 2010-2020) including baseline and outcome data on alcohol consumption and anxiety after 12 weeks was undertaken. There were significantly higher rates of abstinent days in patients treated with baclofen compared to placebo (p = 0.004; high certainty evidence); specifically in those with higher baseline anxiety levels (p < 0.00001; high certainty evidence) compared to those with lower baseline anxiety levels (p = 0.20; moderate certainty evidence). The change in anxiety ratings over 12 weeks did not differ between those treated with baclofen or placebo (p = 0.84; moderate certainty evidence). This may be due to different anxiety constructs being measured by scales not validated in this patient group, or that anxiety is not a biobehavioral mechanism by which baclofen may reduce alcohol drinking. Given the prevalence of anxiety symptoms in AUD all these factors warrant further research.
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Affiliation(s)
- Roberta Agabio
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Italy.
| | - David S Baldwin
- Faculty of Medicine, University of Southampton, Southampton, UK; University Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
| | - Hugo Amaro
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD, United States; Medication Development Program, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, United States; Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, United States; Division of Addiction Medicine, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States; Department of Neuroscience, Georgetown University Medical Center, Washington DC, United States.
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16
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Gugała-Iwaniuk M, Sławińska K, Bochyńska A, Konopko M, Rola R, Ryglewicz D, Sienkiewicz-Jarosz H. The prevalence of depressive and anxiety symptoms in Polish epilepsy patients - The context of pharmaco-resistance. Epilepsy Behav 2021; 114:107522. [PMID: 33272895 DOI: 10.1016/j.yebeh.2020.107522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/11/2020] [Accepted: 09/21/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Patients with epilepsy (PWE) are at a higher risk of experiencing depressive and anxiety symptoms than the general population; these symptoms are more prevalent in patients with drug-resistant epilepsy (DRE) compared to those with non-drug-resistant epilepsy (NDRE). The aim of the present study was to compare the level of reported depressive and anxiety symptoms in patients with DRE and patients with NDRE and to examine the relationships between demographic and epilepsy-related variables and severity of depression and anxiety symptoms. MATERIAL AND METHODS A total of 193 adult PWE, divided into a DRE group (n = 87), and an NDRE group (n = 106), completed the Beck Depression Inventory (BDI) and the Stat-Trait Anxiety Inventory (STAI-Sand STAI-T). Data analysis included sociodemographic and disease-related variables such as the type of epilepsy syndrome, age at onset of disease, and duration of the disease. RESULTS The DRE group presented a higher score of BDI than the NDRE group (p = 0.04). Age correlated with the score of STAI-S in the NDRE group (r = 0.22). Sex was the only significant predictor of the score of STAI-T in the NDRE group. Men from the DRE group presented higher scores in BDI, STAI-S, and STA-T compared with the NDRE group. CONCLUSIONS Patients with DRE reported more severe depressive symptoms than patients with NDRE. In NDRE patients, the level of anxiety, considered as a state, was correlated with age. Sex was a significant predictor of the level of anxiety in DRE patients. Pharmaco-resistance was significantly associated with severity of depression and anxiety in male patients.
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Affiliation(s)
- Magdalena Gugała-Iwaniuk
- Ist Department of Neurology, The Institute of Psychiatry and Neurology, Warsaw (I Klinika Neurologiczna, Instytut Psychiatrii I Neurologii, ul.Sobieskiego 9, 02-957 Warszawa, Poland.
| | - Ksenia Sławińska
- Ist Department of Neurology, The Institute of Psychiatry and Neurology, Warsaw (I Klinika Neurologiczna, Instytut Psychiatrii I Neurologii, ul.Sobieskiego 9, 02-957 Warszawa, Poland
| | - Anna Bochyńska
- Ist Department of Neurology, The Institute of Psychiatry and Neurology, Warsaw (I Klinika Neurologiczna, Instytut Psychiatrii I Neurologii, ul.Sobieskiego 9, 02-957 Warszawa, Poland
| | - Magdalena Konopko
- Ist Department of Neurology, The Institute of Psychiatry and Neurology, Warsaw (I Klinika Neurologiczna, Instytut Psychiatrii I Neurologii, ul.Sobieskiego 9, 02-957 Warszawa, Poland
| | - Rafał Rola
- Ist Department of Neurology, The Institute of Psychiatry and Neurology, Warsaw (I Klinika Neurologiczna, Instytut Psychiatrii I Neurologii, ul.Sobieskiego 9, 02-957 Warszawa, Poland; Neurological Department, Military Institute of Aviation Medicine, Warsaw (Klinika Neurologiczna, Wojskowy Instytut Medycyny Lotniczej, ul.Krasińskiego 54/56, 01-755 Warszawa, Poland
| | - Danuta Ryglewicz
- Ist Department of Neurology, The Institute of Psychiatry and Neurology, Warsaw (I Klinika Neurologiczna, Instytut Psychiatrii I Neurologii, ul.Sobieskiego 9, 02-957 Warszawa, Poland
| | - Halina Sienkiewicz-Jarosz
- Ist Department of Neurology, The Institute of Psychiatry and Neurology, Warsaw (I Klinika Neurologiczna, Instytut Psychiatrii I Neurologii, ul.Sobieskiego 9, 02-957 Warszawa, Poland
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17
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Racial disparities in sleep disturbances among patients with and without coronary artery disease: The role of clinical and socioeconomic factors. Sleep Health 2020; 6:570-577. [PMID: 32819889 PMCID: PMC7704917 DOI: 10.1016/j.sleh.2020.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 01/22/2020] [Accepted: 02/04/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate differences in sleep quality by race in participants with and without a prior myocardial infarction (MI). DESIGN Case-control study. SETTING Emory-affiliated hospitals in Atlanta, Georgia. PARTICIPANTS Two hundred seventy-three individuals (190 Black) ≤60 years of age with a verified MI in the previous 8 months, and 100 community controls (44 Black) without a history of MI. MEASUREMENTS Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Psychological factors were assessed using standardized questionnaires and clinical risk factors through medical history and chart review. RESULTS A significant interaction existed between race and MI status on sleep quality (P= .01), such that Black individuals with a history of MI, but not controls, reported worse sleep quality than their non-Black counterparts. Among MI cases, being Black was independently associated with higher PSQI scores after adjusting for baseline demographics (B = 2.17, 95% confidence interval 1.17, 3.17, P = .006). Clinical risk factors, psychological factors and socioeconomic status (household income and years of education) all contributed equally to explain race-related disparities in sleep among MI cases. After further adjustment for these factors, the association was attenuated and no longer significant (B = 0.70, 95% confidence interval = -0.10, 1.21, P = .26). CONCLUSION Black post-MI patients, but not healthy controls, have significantly poorer sleep quality than non-Blacks. This difference is driven by a combination of factors, including clinical risk factors, psychological factors as well as adverse socioeconomic conditions among Black individuals with MI.
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Paiva ML, Lima EM, Siqueira IB, Rzezak P, Koike C, Moschetta SP, Vincentiis S, Alessi R, Khafif TC, Mendoza M, Valente KD. Seizure control and anxiety: Which factor plays a major role in social adjustment in patients with Juvenile Myoclonic Epilepsy? Seizure 2020; 80:234-239. [PMID: 32663782 DOI: 10.1016/j.seizure.2020.06.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/28/2020] [Accepted: 06/30/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study aimed to determine the presence of anxiety disorder and severity of anxiety symptoms in an extensive series of consecutive patients with JME and its association with epilepsy-related factors. In addition, we evaluated the impact of anxiety and clinical variables on social adjustment. METHODS We prospectively evaluated 112 (56.2 % females, mean age 27.2 years) patients with an electroclinical diagnosis of JME and 61 (52.4 % females, mean age 29.3 years) healthy controls. Anxiety symptoms were assessed by the State and Trait Anxiety Inventory (STAI). Social functioning was addressed with Self-Report Social Adjustment Scale (SAS). The patient group was also evaluated with a psychiatric interview. RESULTS Patients with JME presented more severe anxiety symptoms and worse social adjustment compared with controls. The presence of anxiety disorder and the severity of anxiety symptoms was associated with frequent seizures - generalized tonic-clonic seizures (p = 0.008) and drug-resistant epilepsy (p = 0.021). Regarding social adjustment, the severity of anxiety symptoms was associated with lower economic adjustment (p = 0.039), while the presence of anxiety disorder impacted family relationships (p 0.025). The presence of hard-to-control myoclonic seizure was associated with lower scores on work (p = 0.019), leisure activities (p = 0.008), family relationship (p = 0.022) and overall social adjustment (p = 0.038). CONCLUSION Patients with JME have severe anxiety symptoms and worse social adjustment. Anxiety disorder and symptoms were associated with frequent seizures and drug-resistant epilepsy. Epilepsy-related factors and anxiety impaired distinct aspects of social functioning.
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Affiliation(s)
- Maria Luisa Paiva
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Ellen Marise Lima
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Isabelle Bimbatti Siqueira
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Patricia Rzezak
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Camila Koike
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Sylvie P Moschetta
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Silvia Vincentiis
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Rudá Alessi
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Tatiana Cohab Khafif
- Bipolar Disorder Program, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Melanie Mendoza
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Kette D Valente
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil.
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Yang TW, Kim DH, Kim YS, Kim J, Kwon OY. Anxiety disorders in outpatient clinics of epilepsy in tertiary care hospitals: A meta-analysis. Seizure 2020; 75:34-42. [PMID: 31874357 DOI: 10.1016/j.seizure.2019.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/11/2019] [Accepted: 12/15/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND AND PURPOSE Although anxiety disorders (ADs) occur frequently in people with epilepsy (PWE) and impair quality of life and treatment outcomes, current efforts to categorize and investigate AD subtypes in PWE remain insufficient. Thus, the present meta-analysis aimed to determine the current prevalence rates of any AD type and various AD subtypes in PWE managed by outpatient clinics. METHODS MEDLINE, EMBASE, Cochrane Library, Web of Science, and SCOPUS were searched to identify and select studies that assessed the prevalence of ADs or individual AD subtypes in adult PWE under the routine care of outpatient epilepsy clinics in tertiary hospitals. Only studies that used gold-standard diagnostic tools for assessing ADs were included in this meta-analysis. RESULTS The database search ultimately identified 15 studies, of which 9 provided current prevalence rates of any type of AD. The pooled estimated prevalence of any AD was 26.1 %. Of the 15 total studies, 13 provided current prevalence rates of generalized anxiety disorder (GAD), revealing an overall estimated prevalence of 18.2 %. In terms of current prevalence rates, GAD was highest, followed by agoraphobia, social phobia, panic disorder, and obsessive-compulsive disorder. CONCLUSIONS Among PWE managed in the outpatient epilepsy clinics of tertiary care hospitals, the current prevalence of any AD was 26.1 %, and GAD was the most prevalent subtype of AD.
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Affiliation(s)
- Tae-Won Yang
- Department of Neurology and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea; Department of Neurology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Do-Hyung Kim
- Department of Neurology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Young-Soo Kim
- Department of Neurology and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea; Department of Neurology, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Juhyeon Kim
- Department of Neurology and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea; Department of Neurology, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Oh-Young Kwon
- Department of Neurology and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea; Department of Neurology, Gyeongsang National University Hospital, Jinju, Republic of Korea.
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20
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Cybulski M, Cybulski Ł, Cwalina U, Kowalczuk K, Krajewska-Kułak E. Mental Health of the Participants of the Third Age University Program: A Cross-Sectional Study. Front Psychiatry 2020; 11:656. [PMID: 32754065 PMCID: PMC7365889 DOI: 10.3389/fpsyt.2020.00656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 06/24/2020] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Population aging is a progressive demographic phenomenon observed in all countries worldwide. The progressive global process of population aging poses many threats, especially in the context of the mental health of the elderly. Third Age Universities are an essential preventive measure shown to improve the quality of life and psychological wellbeing of the elderly. OBJECTIVES The aim of this study was to analyze the mental status of older persons attending Third Age Universities in Poland, with particular emphasis on sociodemographic sources of variance in psychological indices. METHODS The study included a group of the Third Age University program participants from Poland. A total of 247 persons were enrolled, among them 215 women and 32 men. The study was carried out as a diagnostic survey, using the following validated psychometric scales: The Mood Disorder Questionnaire (MDQ), Geriatric Depression Scale (GDS), General Health Questionnaire-28 (GHQ-28), The Athens Insomnia Scale (AIS), Courtauld Emotional Control Scale (CECS), State-Trait Anxiety Inventory (STAI) and SMAST-G-Short Michigan Alcoholism Screening Test-Geriatric Version. RESULTS The vast majority of the respondents did not screen positively for possible bipolar disorder. However, more than 90% of the participants presented with the symptoms of mild depression, and more than one-third had manifestations of non-psychotic mental morbidity. Nearly half of the respondents had complaints associated with insomnia, and in more than one-fourth, SMAST-G score raised suspicion of problem alcohol drinking. Retired participants were shown to present with significantly higher levels of anger control than the occupationally active respondents. Respondents with poor economic status had significantly higher levels of symptoms for non-psychotic mental disorders. Men significantly more often than women showed symptoms raising suspicion of alcohol-related problems. DISCUSSION In conclusion, the study group was characterized primarily by the mild depressive and anxiety symptoms. The mental health of the Polish participants of the Third Age University program was significantly modulated by their socio-occupational and marital status, and financial condition. The study showed that persons with likely problem alcohol drinking differed from other respondents in terms of the occurrence of possible bipolar disorder, depression, and non-psychotic symptoms of mental disorders, state and trait anxiety levels and anger control. There is a need for further research in the field of mental health status in the Third Age Universities seniors to determine the prevalence of these phenomena on a national scale.
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Affiliation(s)
- Mateusz Cybulski
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland
| | - Łukasz Cybulski
- Faculty of Social Sciences, University of Warmia and Mazury, Olsztyn, Poland
| | - Urszula Cwalina
- Department of Statistics and Medical Informatics, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland
| | - Krystyna Kowalczuk
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland
| | - Elżbieta Krajewska-Kułak
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland
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Wang Z, Luo Z, Li S, Luo Z, Wang Z. Anxiety screening tools in people with epilepsy: A systematic review of validated tools. Epilepsy Behav 2019; 99:106392. [PMID: 31521915 DOI: 10.1016/j.yebeh.2019.06.035] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/18/2019] [Accepted: 06/27/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Anxiety is a common neurological condition often comorbid with epilepsy, with approximately 20% of patients with epilepsy exhibiting symptoms of anxiety. Despite this prevalence, accurate and efficacious tools designed to screen for anxiety specifically in patients with epilepsy have not yet been developed. The purpose of this study is to systematically review the literature and better understand this relationship. METHODS Ovid MEDLINE, EMBASE, and PsyclNFO were searched until April 22nd, 2019 without language restrictions. We extracted abstracts, data abstraction, and full-text reviews in duplicate and chose the studies that included measures for anxiety screening in patients with epilepsy. The Quality Assessment of Diagnostic Accuracy Studies Version was used to assess study quality. We used the medians and ranges to calculate the accuracy of the tools. RESULTS We screened 4758 abstracts and selected 11 articles dealing with anxiety. The most common validated anxiety screening tools were the Generalized Anxiety Disorder (GAD-7) and Hospital Anxiety and Depression Scale-A (HADS-A). The Mini International Neuropsychiatric Interview (MINI) was the most common reference standard used. SIGNIFICANCE Many studies have validated depression screening tools rather than anxiety. This lack of data has left much uncertainty about the relationship of epilepsy to anxiety, as well as diagnostic inconsistencies. The effectiveness of these assessments in practice may be overestimating the prevalence, as the cutpoints are usually chosen after the fact, based on the study sample.
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Affiliation(s)
- Zilin Wang
- Queen Marry School of Nanchang University, Nanchang, Jiangxi 330006, People's Republic of China
| | - Zhiwen Luo
- Queen Marry School of Nanchang University, Nanchang, Jiangxi 330006, People's Republic of China; Affiliated Eye Hospital of Nanchang University, Jiangxi, Research Institute of Ophthalmology and Visual Science, Nanchang, People's Republic of China
| | - Shunhua Li
- Queen Marry School of Nanchang University, Nanchang, Jiangxi 330006, People's Republic of China
| | - Zhiwen Luo
- Queen Marry School of Nanchang University, Nanchang, Jiangxi 330006, People's Republic of China; Affiliated Eye Hospital of Nanchang University, Jiangxi, Research Institute of Ophthalmology and Visual Science, Nanchang, People's Republic of China.
| | - Zilin Wang
- Queen Marry School of Nanchang University, Nanchang, Jiangxi 330006, People's Republic of China.
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