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BACKGROUND: Childhood adversity is associated with abnormalities in brain structure, but this association has not been tested for childhood unpredictability, one form of adversity. We studied whether abnormalities in gray matter volume (GMV) could be a mechanism linking childhood unpredictability and psychopathology, over and above the effect of childhood trauma. METHODS: Participants were 158 right-handed healthy young adults (aged 17-28 years, M = 22.07, s.d. = 2.08; 66.46% female) who underwent structural magnetic resonance imaging measurements and provided retrospective reports of childhood unpredictability. The anxiety and depression subscales of the self-report Brief Symptom Inventory-53 were used to index psychopathology. RESULTS: Whole-brain voxel-based morphometric analyses showed that after controlling for the effect of childhood trauma, childhood unpredictability was correlated with greater GMV in bilateral frontal pole, bilateral precuneus, bilateral postcentral gyrus, right hemisphere of fusiform, and lingual gyrus, and left hemisphere of ventrolateral prefrontal cortex as well as occipital gyrus. Greater GMV in bilateral frontal pole, bilateral precuneus, and bilateral postcentral gyrus mediated associations between unpredictability and symptoms of depression and anxiety. CONCLUSIONS: The findings suggest that childhood unpredictability could exact unique effects on neural development, over and above the effect of childhood trauma. These findings are relevant for understanding the occurrence of psychopathology following childhood unpredictability and have implications for intervention.
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Encéfalo , Substância Cinzenta , Adulto Jovem , Humanos , Feminino , Masculino , Estudos Retrospectivos , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Substância Cinzenta/diagnóstico por imagem , Substância Cinzenta/patologia , Ansiedade/diagnóstico por imagem , Córtex Cerebral , Imageamento por Ressonância Magnética/métodosRESUMO
BACKGROUND: Traumatic brain injury (TBI) is defined as acquired cerebral damage caused by an external mechanical impact, which has the potential to lead to transient or enduring debilitation. TBI is associated with many forms of long-lasting psychiatric conditions, including anxiety disorders. As anxiety is highly debilitating by causing impaired social functioning and decreased quality of life for the afflicted, especially in the form of anxiety disorders such as generalized anxiety disorder, certain efforts have been made to explore the factors associated with it, and one such factor is TBI. METHODS: We searched PubMed, Scopus, and Web of Science on January 26th, 2024 for observational case-control or cohort or cross-sectional studies assessing the incidence of anxiety symptoms or disorders in patients with TBI compared to healthy individuals or the same individuals if pre-TBI information regarding anxiety was available. We calculated the pooled incidence and relative risk (RR) and 95% confidence interval (95CI) using the inverse variance method. Publication bias was assessed using Eggers's regression test. Quality assessment was performed using the Newcastle-Ottawa scale. Sub-group analyses were conducted for the type of anxiety (anxiety disorder vs anxiety symptoms), TBI severity, and type of anxiety disorders. RESULTS: The incidence rate of anxiety after traumatic brain injury was 17.45% (95CI: 12.59%, 22.31%) in a total of 705,024 individuals. Moreover, TBI patients were found to be 1.9 times as likely to have anxiety compared to their non-TBI counterparts [Random effects model RR = 1.90 [1.62; 2.23], p-value < 0.0001] using a population of 569,875 TBI cases and 1,640,312 non-TBI controls. Sub-group analysis revealed TBI severity was not associated with anxiety and generalized anxiety disorder was the most common type of anxiety disorder reported post-TBI. CONCLUSION: Patients who have experienced a TBI exhibit a significantly greater incidence of anxiety symptoms and anxiety disorders in the aftermath when compared to healthy individuals.
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Ansiedade , Lesões Encefálicas Traumáticas , Humanos , Lesões Encefálicas Traumáticas/epidemiologia , Lesões Encefálicas Traumáticas/psicologia , Lesões Encefálicas Traumáticas/complicações , Incidência , Ansiedade/epidemiologia , Ansiedade/etiologia , Ansiedade/psicologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/etiologia , Transtornos de Ansiedade/psicologiaRESUMO
BACKGROUND: Emotional problems can be evaluated using categorical approaches to guide treatment choices focused on targeting specific disorders, or dimensional approaches to reduce symptom severity. Moreover, recent evidence points out the need to intervene in patients' quality of life (QoL), which often remains low even after the remission of emotional problems. Thus, assessment instruments are needed to provide information on diagnosis, symptom severity, and QoL. The present study aimed to provide diagnostic and QoL cutoffs for the Inventory of Depression and Anxiety Symptoms-II (IDAS-II). METHODS: 273 patients recruited from mental health services in Huelva (Spain) completed the IDAS-II, Mini International Neuropsychiatric Interview, and Short Form-36 Health Survey. Receiver operating characteristic curve analyses were used to establish cutoff values. Diagnostic, balanced, and screening cutoffs were provided for each IDAS-II scale to detect corresponding diagnoses and poor QoL. RESULTS: The specific IDAS-II scales Suicidality, Panic, Social Anxiety, Claustrophobia, and Traumatic Intrusions showed adequate discrimination values for their corresponding diagnoses (suicidal behavior disorder, panic disorder, social anxiety disorder, agoraphobia, and post-traumatic stress disorder, respectively). Both the General Depression and Dysphoria scales showed adequate ability to detect major depressive disorder. The IDAS-II scales showed a higher discrimination ability for Mental Health-related QoL, than for General Health-related QoL. CONCLUSIONS: The diagnostic and QoL cutoffs expand the clinical utility of the IDAS-II in clinical practice and research, making it a comprehensive, detailed, and versatile self-report tool. The IDAS-II allows for the assessment of emotional problems consistent with the dimensional, categorical, transdiagnostic, and QoL approaches.
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Psicometria , Qualidade de Vida , Humanos , Qualidade de Vida/psicologia , Feminino , Masculino , Adulto , Espanha , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica/normas , Depressão/diagnóstico , Depressão/psicologia , Ansiedade/diagnóstico , Ansiedade/psicologia , Inquéritos e Questionários , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Reprodutibilidade dos TestesRESUMO
Social media is viewed to be a key contributor to worsening mental health in adolescents, as most recently reflected in a public health advisory by the US Surgeon General. We provide new evidence on the causal effects of social media on mental health of college students during the Covid-19 pandemic, exploiting unique, longitudinal data collected before the Covid-19 pandemic began and at two points during the pandemic. We find small insignificant effects of social media 4 months into the pandemic during a period of social distancing, but large statistically significant negative effects 18 months into the pandemic when colleges were mostly back to normal operations. Using rich data on substance use, exercise, sleep, stress, and social support, we find some evidence of substitution away from activities that better support mental health at later stages of the pandemic but not at early stages. We find that the negative effects of social media are mostly concentrated among socially-isolated students. Both social support and resilience protect students from the negative effects of social media use. Policy implications include regulating social media while also bolstering social support and resilience as important protective factors.
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COVID-19 , Saúde Mental , Mídias Sociais , Apoio Social , Estudantes , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , Estudantes/psicologia , Feminino , Masculino , Universidades , Adulto Jovem , Adolescente , Pandemias , Estudos Longitudinais , Estados Unidos , SARS-CoV-2 , Resiliência Psicológica , Estresse PsicológicoRESUMO
BACKGROUND: Parent-child separation poses a significant challenge for left-behind children (LBC). However, limited empirical evidence exists regarding the correlation between left-behind characteristics and the psychological symptoms of LBC. This study investigated psychological symptoms among LBC and explored associations between left-behind characteristics and those symptoms. METHODS: Using stratified cluster sampling, 1,832 LBC aged 13-18 years from three cities in East China were selected for analysis. Participants' depression and anxiety symptoms were assessed with the Patient Health Questionnaire 9 and the General Anxiety Disorder 7, respectively. Chi-square tests were used to compare differences in detection rates of psychological symptoms among LBC in different groups. Binary logistic regression analysis was used to infer associations between left-behind characteristics and psychological symptoms. RESULTS: Depression and anxiety symptoms were detected in 32.86% and 33.24%, respectively, of participating LBC. Univariate analysis showed statistically significant differences in detection rates of depression symptoms by sex, grade, and timing of parent-child separation. Statistically significant differences were observed in anxiety symptom rates by sex, grade, type of caregiver, and timing of mother-child separation. Multivariate analysis indicated a positive association between LBC's anxiety symptoms and mother-child separation that occurred during post-primary school, and type of caregiver (father only or mother only). Our findings confirm a positive association between left-behind characteristics and anxiety symptoms among LBC. CONCLUSION: The timing of mother-child separation and type of caregiver are potential risk factors for the development of anxiety symptoms in this population.
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Ansiedade , Depressão , Humanos , Feminino , Masculino , Adolescente , China/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Depressão/diagnóstico , Ansiedade/psicologia , Ansiedade/epidemiologia , Separação da FamíliaRESUMO
BACKGROUND: The majority of persons with dementia (PWD) are mainly cared for by their family members in the home. Evidence is however scarce on family caregivers' psychosocial burden and quality of life in Asian countries including Malaysia. This study describes the baseline data of a telephone-delivered psychoeducational intervention study and examines the determinants of outcome measures (caregiver burden, depressive and anxiety symptoms, quality of life and caregiving self-efficacy) among Malaysian family caregivers to PWD. METHODS: This was a cross-sectional study originated from the baseline survey of a randomized control trial of 121 family caregivers recruited from lists of PWD who were registered at memory and psychiatry clinics in three tertiary care hospitals in Malaysia. The participants were assessed for caregiver burden by the Zarit Burden Interview, depressive and anxiety symptoms by the Hospital Anxiety and Depression Scale, quality of life by the Control, Autonomy, Self-Realization, and Pleasure Scale, and caregiving self-efficacy by the Revised Scale for Caregiving Self-Efficacy. RESULTS: Prevalence of caregiver burden was 69.4%, depressive symptoms 32.2% and anxiety symptoms 32.2%. Family caregivers to PWD having perceived peer support e.g., social/family/friend/significant other supports were less likely to report caregiver burden, depressive and anxiety symptoms, and more likely to report higher levels of quality of life and caregiving self-efficacy. Being married and PWD's ability to self-care were associated with lesser likelihood of experiencing caregiver burden, depressive and anxiety symptoms. The other determinants of greater probability of reporting better quality of life were caregivers' employment and having Islamic faith. Marital status (married), PWD's ability to self-care, spousal relationship with PWD and shared caregiving process were associated with higher likelihood of reporting caregiving self-efficacy. CONCLUSION: Caregiver burden, depressive and anxiety symptoms are prevalent in family caregivers to PWD in Malaysia. Social support and caregiving related factors influence family caregivers' quality of life and caregiving self-efficacy. Implementing psychoeducational intervention and support in the psychiatry and memory clinics may help improve the psychosocial burden, quality of life and caregiving self-efficacy in family caregivers of PWD. TRIAL REGISTRATION: ISRCTN14565552 (retrospectively registered).
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Cuidadores , Demência , Saúde Mental , Qualidade de Vida , Autoeficácia , Humanos , Qualidade de Vida/psicologia , Masculino , Cuidadores/psicologia , Feminino , Malásia/epidemiologia , Estudos Transversais , Demência/psicologia , Pessoa de Meia-Idade , Idoso , Sobrecarga do Cuidador/psicologia , Idoso de 80 Anos ou mais , Adulto , Efeitos Psicossociais da DoençaRESUMO
PURPOSE: To investigate the association between lifestyle and atypical antipsychotic drug use in patients with schizophrenia and the risk of constipation and to assess the impact of anxiety and depressive symptoms on constipation risk. METHODS: Cross-sectional convenience sampling was employed, and 271 participants aged 20-65 were enrolled. Data were collected via a structured questionnaire comprising participants' demographic data, medication information, dietary behavior assessment, and the Baecke Physical Activity Questionnaire, Beck Depression Inventory-II, and Beck Anxiety Inventory. IBM SPSS 24.0 with multivariate logistic regression was used for data analysis. We performed a subgroup analysis of anticholinergic drugs via multivariate logistic regression. RESULTS: In total, 180 participants had functional constipation; risk factors included female sex, anxiety symptoms, depressive symptoms, and quetiapine and aripiprazole use. Patients who drank more than 3,000 cc of water daily or used risperidone were less likely to have functional constipation. Depressive and anxiety symptoms were risk factors even after adjusting for sex, use of anticholinergics and laxatives, consuming two servings of fruit, consuming three servings of vegetables, consuming more than 3,000 cc of water daily, physical activity, medical comorbidity, chlorpromazine equivalent dose, and atypical antipsychotic use. Similar associations were found for two affective symptoms and functional constipation in the subgroup analysis of anticholinergic drugs. CONCLUSION: The prevalence of functional constipation in patients with schizophrenia was 66.4%. The risk factors included female sex, anticholinergics, aripiprazole, quetiapine, and depressive and anxiety symptoms. Risperidone users and those who drank 3000 cc of water daily were less likely to have constipation.
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BACKGROUND: Mold exposure is a common environmental issue that can adversely affect health, particularly among older adults. The impact of mold exposure on anxiety symptoms in this population has not been extensively studied. OBJECTIVE: This study aims to examine the relationship between mold exposure and anxiety symptoms in older adults, considering the mediating role of cognitive function and the moderating effects of open window ventilation and multivitamin supplementation. METHODS: Data from the eighth wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) was utilized, including 11,021 participants aged 65 and older. Logistic regression models and moderated mediation analysis were employed to explore these relationships. RESULTS: Mold exposure was significantly associated with increased anxiety symptoms (OR=1.831, 95â¯% CI=1.588-2.110). Cognitive impairment partially mediated this relationship. Open window ventilation (B=-0.040, P<0.001) and multivitamin supplementation (B=-0.197, P<0.001) served as protective factors. Subgroup analysis indicated higher vulnerability among females (OR=1.72, P<0.001), those aged 65-79 (OR=1.86, P<0.001), urban residents (OR=2.50, P<0.001), individuals not living with family members (OR=1.89, P<0.001), those with higher education (OR=2.01, P<0.001), married individuals (OR=1.80, P<0.001), and those in very good health (OR=2.11, P=0.026). CONCLUSION: Mold exposure contributes to anxiety symptoms in older adults, with cognitive decline playing a mediating role. Effective interventions, including improved ventilation and multivitamin supplementation, can mitigate these effects. These findings highlight the need for targeted public health strategies to enhance the well-being of older adults.
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OBJECTIVES: This randomized controlled trial aimed to assess the efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a home-delivered cognitive-emotional intervention, among the homebound older population presenting with mild cognitive impairment and depressive or anxiety symptoms. METHODS: Participants were randomly assigned either to the intervention group or the treatment-as-usual group and completed baseline, post-intervention, and three-month follow-up assessments. Changes in episodic memory and symptoms of depression and anxiety were the primary outcomes. Secondary outcomes included changes in global cognition, attentional control, subjective memory complaints, functional status, and quality of life. Data were analyzed on an intention-to-treat basis employing a linear mixed models approach. ClinicalTrials.gov identifier: NCT05499767. RESULTS: Compared with the treatment-as-usual group, the HEPPI group reported significant immediate improvement in cognition, mood, and daily functional performance. Positive effects of HEPPI were maintained over the follow-up phase only in depressive symptomatology, perceived incapacity to perform advanced instrumental activities of daily living, and self-reported emotional ability. A significant impact of the intervention on the subjective memory complaints level was observed only three months after the intervention. CONCLUSIONS: This study suggests that HEPPI may be a promising home-delivered cognitive-emotional intervention to help homebound older adults improve their mental health.
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Disfunção Cognitiva , Qualidade de Vida , Humanos , Idoso , Atividades Cotidianas , Emoções , Disfunção Cognitiva/terapia , CogniçãoRESUMO
BACKGROUND: Depression is a highly heterogeneous disorder, often resulting in suboptimal response and remission rates. This underscores the need for more nuanced clinical characterization of patients to tailor individualized treatment plans. Emerging evidence highlights the critical role of cognitive and emotional dysfunction in major depression, prompting the exploration of novel therapeutic interventions that target these specific symptom domains. MAIN TEXT: Vortioxetine, a multimodal antidepressant, enhances serotonergic activity while also modulating several other neurotransmitter systems involved in depressive symptoms such as emotional blunting, anhedonia, and cognitive dysfunction. Numerous randomized, placebo-controlled trials have demonstrated vortioxetine's efficacy and safety in treating depression, particularly in specific subgroups of depressed patients, including those with cognitive deficits and comorbid anxiety symptoms or disorders. Although not randomized or placebo-controlled, studies have also shown vortioxetine's efficacy in depressed patients with emotional blunting or anhedonia. Vortioxetine's ability to effectively treat a range of depressive symptoms, including anhedonia, emotional blunting, anxiety, and cognitive dysfunction, provides an individualized treatment solution for depressed individuals suffering from these symptoms. The purpose of this paper is to identify clinical profiles of patients who may benefit from vortioxetine, with the goal of optimizing therapeutic outcomes. CONCLUSION: Vortioxetine has been shown to be effective for patients with depression and symptoms such as anhedonia, emotional blunting, anxiety, and cognitive dysfunction. Tailoring treatment plans to individual needs and personalizing treatment choices based on the specific symptoms presented by depressed patients improve treatment outcomes.
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OBJECTIVES: The psychological effects of the COVID-19 pandemic may include anxiety. However, the association between demographic and physiological factors in COVID-19 associated anxiety symptoms is poorly understood. Therefore, the present cross-sectional study was conducted to examine anxiety symptoms and associated factors among patients with the SARS-CoV-2 omicron variant during quarantine in Shanghai. METHODS: The study was conducted between April 16, 2022, and May 21, 2022, at Fangcang Shelter Hospital in Shanghai, China. Data were collected using an anonymous online questionnaire. Demographic characteristics, respiratory symptoms, vaccine dose, comorbidities (such as hypertension and diabetes), type of work, and mental health symptoms were evaluated. Logistic regression was used to investigate the relationship between anxiety symptoms and risk factors. Stratification analysis was performed to investigate potential interactions. RESULTS: A total of 2132 patients with confirmed omicron variant SARS-CoV-2 infection were enrolled. The results showed that sex, age, type of work, respiratory symptoms, and comorbidities were positively associated with anxiety symptoms. Female gender (OR = 1.47, 95% CI = 1.11-1.94), nonmanual labor (OR = 1.62, 95% CI = 1.25-2.09), respiratory symptoms (OR = 3.19, 95% CI = 2.30-4.43), and other comorbidities (OR = 1.65, 95% = 1.09-2.50)were positively associated with anxiety symptoms. A significant interaction was observed between gender and nonmanual labor (OR = 1.54, 95% = 1.29-1.85), respiratory symptoms (OR = 2.06, 95% = 1.72-2.48), and comorbidities (OR = 1.57, 95% = 1.16-2.12), such that effects were stronger in women compared to men. There were also significant interactions between age group and nonmanual labor and respiratory symptoms in their association with anxiety symptoms. CONCLUSIONS: Alleviation of respiratory symptoms, addressing comorbidities, and both psychological and psychopharmacological treatments may help reduce anxiety symptoms following infection with the SARS-CoV-2 omicron variant in mainland China.
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Patients with hypertension (HTN) are at increased risk of developing cardiovascular disease, which can be reduced with blood pressure (BP) control. Anxiety can contribute to high BP and low heart rate variability (HRV). Although relationships between social support, self-rated health-status (SRHS), anxiety and measures of HRV and BP have been suggested, they have not been clearly established. This cross-sectional correlational study aimed to 1) examine relationships between social support, SRHS, and anxiety; and 2) examine if HRV mediated relationships between anxiety symptoms and BP. Patients with primary HTN were recruited from a cardiovascular outpatient clinic using convenience sampling (N = 300). Data included scale scores for SRHS, social support, and anxiety (Hospital Anxiety and Depression Scale). A handheld limb-lead electrocardiogram monitor measured HRV, using the ratio of low-frequency bands to high-frequency bands; an automatic sphygmomanometer measured systolic and diastolic blood pressure (SBP and DBP, respectively). Path analysis of structural equation models examined relationships between variables; the bootstrap method examined the mediating effects of HRV. Analysis showed scores for SRHS and social support had a direct effect on anxiety scores. Scores for anxiety directly affected HRV and BP. HRV also had a direct effect on BP. Bootstrapping indicated HRV mediated the relationship between anxiety symptoms and BP. The final model indicated SRHS, social support, and anxiety symptoms together explained 80% of SBP and 33% of DBP. These findings suggest HRV could be used to measure the effectiveness of strategies aimed at reducing anxiety and improving control of BP.
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Ansiedade , Pressão Sanguínea , Frequência Cardíaca , Hipertensão , Humanos , Masculino , Frequência Cardíaca/fisiologia , Feminino , Pessoa de Meia-Idade , Pressão Sanguínea/fisiologia , Estudos Transversais , Ansiedade/fisiopatologia , Hipertensão/fisiopatologia , Hipertensão/psicologia , Apoio Social , Adulto , Idoso , Nível de SaúdeRESUMO
OBJECTIVE: This longitudinal cohort study aimed to identify trajectories of parent well-being over the first 2 years after their child's evaluation for candidacy for epilepsy surgery, and to identify the baseline clinical and demographic characteristics associated with these trajectories. Parent well-being was based on parent depressive and anxiety symptoms and family resources (i.e., family mastery and social support). METHODS: Parents of 259 children with drug-resistant epilepsy (105 of whom eventually had surgery) were recruited from eight epilepsy centers across Canada at the time of their evaluation for epilepsy surgery candidacy. Participants were assessed at baseline and 6-month, 1-year, and 2-year follow-up. The trajectories of parents' depressive symptoms, anxiety symptoms, and family resources were jointly estimated using multigroup latent class growth models. RESULTS: The analyses identified three trajectories: an optimal-stable group with no/minimal depressive or anxiety symptoms, and high family resources that remained stable over time; a mild-decreasing-plateau group with mild depressive and anxiety symptoms that decreased over time then plateaued, and intermediate family resources that remained stable; and a moderate-decreasing group with moderate depressive and anxiety symptoms that decreased slightly, and low family resources that remained stable over time. Parents of children with higher health-related quality of life, fathers, and parents who had higher household income were more likely to have better trajectories of well-being. Treatment type was not associated with the trajectory groups, but parents whose children were seizure-free at the time of the last follow-up were more likely to have better trajectories (optimal-stable or mild-decreasing-plateau trajectories). SIGNIFICANCE: This study documented distinct trajectories of parent well-being, from the time of the child's evaluation for epilepsy surgery. Parents who present with anxiety and depressive symptoms and low family resources do not do well over time. They should be identified and offered supportive services early in their child's epilepsy treatment history.
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Epilepsia Resistente a Medicamentos , Epilepsia , Criança , Humanos , Estudos Longitudinais , Qualidade de Vida , Pais , Epilepsia Resistente a Medicamentos/cirurgia , Epilepsia/diagnóstico , DepressãoRESUMO
Several studies have shown that eveningness is positively related to both depressive and anxiety symptoms. However, little is known about factors that may play a protective role against the undesirable emotional consequences of evening preference. Thus, in the present study, we explored the moderating effects of dispositional mindfulness on the relationship between morningness-eveningness and the presence of depressive symptoms, as well as between morningness-eveningness and the presence of anxiety symptoms. The study was conducted on a group of 1107 individuals (559 women and 548 men) aged 18-55 years (M = 36.26, SD = 9.89). Consistent with previous findings, eveningness was positively related to the presence of both depressive and anxiety symptoms. The magnitude of these effects decreased with higher dispositional mindfulness. The latter result remained significant when the analogical moderating effects of personality, established in earlier studies, were controlled for in the regression models. This leads to the conclusion that dispositional mindfulness may act as a protective factor against the elevated depressive and anxiety symptoms reported by evening-oriented individuals.
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Atenção Plena , Masculino , Humanos , Feminino , Ritmo Circadiano , Emoções , Ansiedade , PersonalidadeRESUMO
BACKGROUND: Unhealthy lifestyle behaviours are becoming increasingly common and might contribute to the growing burden of mental disorders in adolescence. We examined the associations between a comprehensive set of lifestyle behaviours and depression and anxiety in middle adolescents. METHODS: School-based survey responses were collected from 24,274 Canadian high school students at baseline and 1-year follow-up (average age 14.8 and 15.8 years, respectively). Using linear mixed-effects models, we examined prospective associations of adherence to recommendations for vegetables and fruit, grains, milk and alternatives, meat and alternatives, sugar-sweetened beverages [SSB], physical activity, screen time, sleep, and no use of tobacco, e-cigarettes, cannabis, and binge drinking at baseline with the depressive and anxiety symptoms (measured by CESD-R-10 and GAD-7 scales, respectively) at follow-up. RESULTS: Adherence to recommendations was low overall, particularly for vegetables and fruit (3.9%), grains (4.5%), and screen time (4.9%). Students adhering to individual recommendations, particularly for meat and alternatives, SSB, screen time, sleep, and no cannabis use, at baseline had lower CESD-R-10 and GAD-7 scores at follow-up. Adhering to every additional recommendation was associated with lower CESD-R-10 (ß=-0.15, 95% CI -0.18, -0.11) and GAD-7 scores (ß=-0.10, 95% CI -0.14, -0.07) at follow-up. Assuming cumulative impact, this might translate into 7.2- and 4.8-point lower CESD-R-10 and GAD-7 scores, respectively, among students adhering to 12 vs. 0 recommendations over four years of high school. CONCLUSIONS: The results highlight the preventive potential of population-based approaches promoting healthy lifestyle behaviours, particularly those with the lowest prevalence, as a strategy to improve mental health in adolescence.
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Ansiedade , Depressão , Estilo de Vida , Canadá/epidemiologia , Depressão/epidemiologia , Ansiedade/epidemiologia , Humanos , Masculino , Feminino , Adolescente , Estudantes , Tempo de Tela , Dieta , Uso de Tabaco , Consumo de Álcool por Menores , Sono , Exercício Físico , Questionário de Saúde do Paciente , Comportamentos Relacionados com a Saúde , Cooperação do Paciente/estatística & dados numéricosRESUMO
OBJECTIVE: To explore relevant factors for the severity of obsessive-compulsive symptoms (OCSs) in adult epileptic patients and investigate whether the severity of OCSs is a mediator in the relationship between depressive/anxiety symptoms and suicide risk in epileptic patients. METHODS: This was a cross-sectional study from a hospital in Northeast China. Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Neurological Disorders Depression Inventory for Epilepsy (NDDIE), Generalized Anxiety Disorder (GAD-7), and Nurses' Global Assessment of Suicide Risk (NGASR) were used to assess the severity of OCSs, depressive symptoms, anxiety symptoms, and suicide risk in epileptic patients, respectively. The independent factors of the severity of OCSs and their mediating effects in the relationship between depressive/anxiety symptoms and suicide risk were evaluated by regression analyses and mediator models, respectively. RESULTS: NDDIE scores (ß = 0.404, p < 0.001), GAD-7 scores (ß = 0.247, p = 0.009), and polytherapy (ß = 0.119, p = 0.032) were the independent factors of Y-BOCS scores. The Y-BOCS scores partially mediated the relationship between GAD-7 scores and NGASR scores (standardized coefficients of indirect effect = 0.109, Bootstrap 95% CI = 0.024 to 0.214). Still, they did not mediate the relationship between NDDIE scores and NGASR scores (standardized coefficients of indirect effect = 0.062, Bootstrap 95% CI = -0.024 to 0.169). CONCLUSIONS: Depressive symptoms, anxiety symptoms, and polytherapy are independently associated with the severity of OCSs in epileptic patients. Depressive and anxiety symptoms mediate the effect of the severity of OCSs on suicide risk in epileptic patients completely.
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Epilepsia , Transtorno Obsessivo-Compulsivo , Suicídio , Adulto , Humanos , Transtorno Obsessivo-Compulsivo/complicações , Estudos Transversais , Epilepsia/complicações , AnsiedadeRESUMO
Although previous studies have established the association between parental marital status and mental health problems in adolescents, however, the adverse effects of incomplete family settings and childhood maltreatment on adolescent anxiety symptoms have not been fully investigated. Moreover, whether childhood maltreatment can mediate the relationship between parental marital status and anxiety symptoms remains unclear. A population-based cross-sectional study was performed among 35,573 adolescents in elementary schools across 17 provinces in China. And childhood maltreatment, resilience, and anxiety symptoms were assessed among adolescents, respectively. The parental marital status was self-reported as having two married biological parents, divorced parents, stepparents, and single-parent. We found that the rates of anxiety symptoms among adolescents were 35.1% in intact families, 48.8% in divorced families, 49% in stepparent families, and 48% in single-parent families. Divorced parents (aOR = 1.191, 95% CI [1.060-1.337]) was an independent risk factor for adolescents' anxiety symptom while having stepparents and single-parent were not. In addition, emotional abuse (aOR = 1.300, 95% CI [1.285-1.316]), sexual abuse (aOR = 1.088, 95% CI [1.063-1.114]), and physical neglect (aOR = 1.019, 95% CI [1.007-1.031]) were all independent risk factors for anxiety symptoms in adolescents, while physical abuse and emotional neglect were not. The negative impacts of divorced and remarried parents on adolescent anxiety symptoms were mediated by childhood maltreatment partially (64.9% and 72.2%), while childhood maltreatment completely mediated the adverse impacts of single-parent on adolescent anxiety symptoms. Childhood maltreatment intervention strategies could be necessary for anxiety symptoms of adolescents in divorced/stepparent/single-parent families.
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BACKGROUND: Academic pressure is a prevalent stressor among Chinese adolescents and is often linked to anxiety symptoms, although the underlying mechanism remains unclear. This study aimed to investigate the association between NR3C1 gene methylation, academic pressure, and anxiety symptoms among Chinese adolescents. METHODS: This nested-case control study included 150 adolescents (boys: 38.7%; baseline age: 12-17 years) from a school-based longitudinal study of Chinese adolescents. Cases (n = 50) were defined as those with anxiety symptoms at both baseline and follow-up, while controls (n = 100) were randomly selected from those without anxiety symptoms at both timepoints. The cases and controls were 1:2 matched by age. Academic pressure, anxiety symptoms, and potential covariates were measured using a self-report questionnaire. Peripheral whole blood samples were collected from each participant for the detection of cortisol level (i.e., morning serum cortisol level) and DNA methylation. The methylation analysis included a total of 27 CpG units at the NR3C1 promoter region. RESULTS: The final adjusted models showed that students with heavy academic pressure at baseline were at a higher risk of anxiety symptoms at follow-up compared to those with mild academic pressure (ß estimate: 6.24 [95% CI: 3.48 ~ 9.01]). After adjusting for covariates, the methylation level of one CpG unit (NR3C1-16 CpG10) in NR3C1 differed significantly between cases and controls (F = 6.188, P = 0.014), and the difference remained significant after correction for multiple testing (P < 0.025). The adjusted regression models showed that moderate (ß estimate = 0.010 [95% CI: 0.000 ~ 0.020], P = 0.046) and heavy (ß estimate = 0.011 [95% CI: 0.001 ~ 0.020], P = 0.030) academic pressure were significantly associated with the methylation level of NR3C1-16 CpG 10. Further mediation analysis demonstrated that the association of academic pressure and anxiety symptoms was significantly mediated by the methylation of NR3C1-16 CpG 10 (ß estimate for indirect effect = 0.11 [95% CI: 0.005 ~ 0.32]; indirect/total effect = 8.3%). CONCLUSION: The present study suggests that NR3C1-16 CpG 10 DNA methylation might be a potential mechanism that partially explains the lasting effects of academic pressure on subsequent anxiety symptoms among adolescents. Further studies with larger sample sizes are recommended to replicate this finding.
Assuntos
Ansiedade , População do Leste Asiático , Receptores de Glucocorticoides , Adolescente , Criança , Humanos , Masculino , Ansiedade/genética , Estudos de Casos e Controles , Metilação de DNA , Hidrocortisona , Estudos Longitudinais , Receptores de Glucocorticoides/genética , FemininoRESUMO
BACKGROUND: Although life satisfaction is a predictor of depressive and anxiety symptoms, the mechanisms underlying this association are poorly understood. This study examined how psychological capital (PsyCap), a positive psychological state, mediated the association between life satisfaction and depressive and anxiety symptoms among Chinese medical students during the COVID-19 pandemic. METHODS: A cross-sectional survey was conducted at three medical universities in China. A self-administered questionnaire was distributed to 583 students. Depressive symptoms, anxiety symptoms, life satisfaction, and PsyCap were measured anonymously. A hierarchical linear regression analysis was performed to explore the effects of life satisfaction on depressive and anxiety symptoms. Asymptotic and resampling strategies were used to examine how PsyCap mediates the association between life satisfaction and depressive and anxiety symptoms. RESULTS: Life satisfaction was positively associated with PsyCap and its four components. There were significant negative associations between life satisfaction, psychological capital, resilience, optimism, and depressive and anxiety symptoms among medical students. Self-efficacy was negatively associated with depressive and anxiety symptoms. Psychological capital (a×b = -0.3201, BCa 95% CI: -0.3899, -0.2446; a×b = -0.2749, BCa 95% CI: -0.3817, -0.1996), resilience (a×b = -0.2103, BCa 95% CI: -0.2727, -0.1580; a×b = -0.1871, BCa 95% CI: -0.2520, -0.1414), optimism (a×b = -0.2100, BCa 95% CI: -0.3388, -0.1150; a×b = -0.1998, BCa 95% CI: -0.3307, -0.0980), and self-efficacy (a×b = -0.0916, BCa 95% CI: 0.0048, 0.11629; a×b = 0.1352, BCa 95% CI: 0.0336, 0.2117) significantly mediated the association between life satisfaction and depressive and anxiety symptoms. LIMITATIONS: This was a cross-sectional study, and causal relationships between the variables could not be ascertained. Self-reported questionnaire instruments were used for data collection, which may have recall bias. CONCLUSIONS: Life satisfaction and PsyCap can be used as positive resources to reduce depressive and anxiety symptoms among third-year Chinese medical students during the COVID-19 pandemic. Psychological capital and its components (self-efficacy, resilience, and optimism) partially mediated the relationship between life satisfaction and depressive symptoms, and completely mediated the relationship between life satisfaction and anxiety symptoms. Therefore, improving life satisfaction and investing in psychological capital (especially self-efficacy, resilience, and optimism) should be included in the prevention and treatment of depressive and anxiety symptoms among third-year Chinese medical students. Additional attention is needed to pay for self-efficacy in such disadvantageous contexts.
Assuntos
COVID-19 , Satisfação Pessoal , Estudantes de Medicina , Humanos , Ansiedade/epidemiologia , China/epidemiologia , COVID-19/epidemiologia , COVID-19/psicologia , Estudos Transversais , Depressão/psicologia , População do Leste Asiático , Esperança , Otimismo , Pandemias , Resiliência Psicológica , Estudantes de Medicina/psicologia , AutoeficáciaRESUMO
BACKGROUND: With the rise of reported mental disorders and behavioral issues after the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, psychiatrists and mental health care are urgently needed more than ever before. The psychiatric career carries a high emotional burden and stressful demands, which bring issues on psychiatrists' mental health and well-being into question. To investigate the prevalence and risk factors of depression, anxiety, and work burnout among psychiatrists in Beijing during the COVID-19 pandemic. METHODS: This cross-sectional survey was conducted from January 6 to January 30, 2022, two years after COVID-19 was declared a global pandemic. Recruitment was performed using a convenience sample approach by sending online questionnaires to psychiatrists in Beijing. The symptoms of depression, anxiety, and burnout were evaluated using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Maslach Burnout Inventory-General Survey (MBI-GS). The perceived stress and social support were measured by the Chinese Perceived Stress Scale (CPSS) and Social Support Rating Scale (SSRS), respectively. RESULTS: The data of 564 psychiatrists (median [interquartile range] age, 37 [30-43] years old) of all 1532 in Beijing were included in the statistical analysis. The prevalence of symptoms of depression, anxiety and burnout were 33.2% (95% CI, 29.3-37.1%, PHQ-9 ≥ 5), 25.4% (95% CI, 21.8-29.0%, GAD-7 ≥ 5) and 40.6% (95% CI, 36.5-44.7%, MBI-GS ≥ 3 in each of the three subdimensions), respectively. The psychiatrist with a higher score on perceived stress was more likely to suffer from depressive symptoms (adjusted odds ratios [ORs]: 4.431 [95%CI, 2.907-6.752]); the anxiety symptoms (adjusted ORs: 8.280 [95%CI, 5.255-13.049]), and the burnout conditions (adjusted ORs: 9.102 [95%CI, 5.795-14.298]). Receiving high social support was an independent protective factor against symptoms of depression (adjusted ORs: 0.176 [95%CI, [0.080-0.386]), anxiety (adjusted ORs: 0.265 [95%CI, 0.111-0.630]) and burnout (adjusted ORs: 0.319 [95%CI, 0.148-0.686]). CONCLUSIONS: Our data suggest a considerable proportion of psychiatrists also suffer from depression, anxiety, and burnout. Perceived stress and social support influence depression, anxiety, and burnout. For public health, we must work together to reduce the pressure and increase social support to mitigate mental health risks in psychiatrists.