Caregiver and parent-child relationship during COVID-19: The mediator role of anxiety and life satisfaction.

AIM: This research was conducted to evaluate the mediation effect of anxiety and life satisfaction on the relationship between Care burden and Parent Child Relationship in Turkish parents during the COVID-19 epidemic. METHODS: The research was carried out with parents (221 women and 219 men) who have children between the ages of 6-18 living in Turkey. Data were collected in June-July 2021 using the demographic data form, "Care Burden Scale," "Pervasive Anxiety Disorder-7 Test," "Satisfaction with Life Scale," and "Parent Child Relationship Scale." Path analysis was used to analyse the relationships. In this study, structural equation modelling (SEM) was used to examine the path analysis. RESULTS: It was found that the burden of care and anxiety of the parents and the parent-child conflict relationship were positively correlated and negatively correlated with the life satisfaction and parent-child closeness relationship (p < 0.05). Path model analyses revealed that the burden of care had a direct effect on anxiety and life satisfaction, and an indirect effect on the parent-child relationship, respectively. CONCLUSIONS: It shows that parents' perceptions of how the COVID-19 pandemic is affecting their mental health have implications for parent and child well-being, with stronger relationships for low-income families. Anxiety and life satisfaction had a mediating effect between care burden and parent-child relationship. Given the demonstrable impact of COVID-19 on the parent-child relationship, this study may guide the planning of coping strategies and programmes focused on mental health.

Prevalence and factors for anxiety and depression among secondary school teachers from Sfax city of Tunisia in times of the coronavirus disease 2019 pandemic: a cross-sectional study.

Introduction: teachers have to adapt during the coronavirus disease 2019 (COVID-19) pandemic to many changes that could potentially make them more vulnerable to psychological distress. We aimed to assess anxiety and depression in Tunisian secondary school teachers during the COVID-19 pandemic and to explore their associated factors. Methods: we conducted a cross-sectional survey concerning Tunisian secondary school teachers between May 1st, 2021, and June 30th, 2021, using an online survey platform via Google Forms. Participants were asked to fill in a form including two psychometric tests: the General Anxiety Disorder 7 (GAD-7) and the Patient Health Questionnaire 9 (PHQ-9). We performed both univariable and multivariable logistic regression analyses. Results: a total of 170 secondary school teachers were included, of whom 22.4% (n=38) were males and 77.6% (n=132) were females. The median age was 45.5 years (Q1=39, Q3=49). The overall anxiety prevalence was 34.7% (n=59) while it was 41.7% (n=71) for depression. In multivariable analysis, anxiety was strongly associated with sleep disturbances (aOR: 5.1; 95% CI: 1.80-14.45; p=0.002) and depression (aOR: 33.91; 95% CI: 12.32-93.33; p<0.001) while depression was strongly associated with dissatisfaction with working conditions (aOR: 3.99; 95% CI: 1.49-10.65; p=0.006), the irregular wearing of protective masks (aOR: 3.94; 95% CI: 1.33-11.66; p=0.013) and anxiety (aOR=51.63; 95% CI: 17.74-150.25; p<0.001). Conclusion: secondary school teachers in Tunisia are characterized by a high rate of anxiety and depressive disorders which are related to personal and professional factors on which we can act by supplying of educational institutions by protective masks, the implementation of programs for adjusting working conditions and the practice of non-pharmacological interventions for insomnia management.

Social Determinants Among Pregnant Clients With Perinatal Depression, Anxiety, Or Serious Mental Illness.

To characterize co-occurring social determinants of health for clients experiencing perinatal anxiety and depression (perinatal mood and anxiety disorders) or serious mental illness (SMI) in a diverse population receiving prenatal care in a safety-net health system, we conducted a latent class analysis, using data from a social determinants screener in pregnancy for the health system's clients during 2017-20. The sample included clients with positive screens for depression or anxiety or SMI diagnoses. Prenatal clients with a positive screen for perinatal mood and anxiety disorders or SMI comprised 13-30 percent of classes, characterized by more than two co-occurring social determinants (for example, co-occurring socioeconomic and interpersonal factors). The study findings highlight the salience of social determinants among prenatal patients experiencing perinatal mood and anxiety disorder and SMI and suggest the necessity of consistent screening for both social determinants and perinatal mental health. Policies to address social determinants within and beyond health care settings are critical.

Network analysis of depression and anxiety symptoms and their associations with life satisfaction among Chinese hypertensive older adults: a cross-sectional study.

Background: Hypertension is one of the most prevalent chronic diseases among the older adult population in China and older adults with hypertension are more susceptible to mental health problems. This study aimed to explore the network structure of depression and anxiety, and their association with life satisfaction (LS) in older adults with hypertension. Methods: A total of 4,993 hypertensive individuals aged 60 and above were selected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS 2017-2018). The design of the CLHLS study was approved by the Campus Institutional Review Board of Duke University (Pro00062871) and the Biomedical Ethics Committee of Peking University (IRB00001052-13,074). The Center for Epidemiologic Studies Depression Scale-10 (CESD-10) and the Generalized Anxiety Disorder Scale-7 (GAD-7) were used to assess depressive and anxiety symptoms. Central and bridge symptoms were identified via "Expected Influence" and "Bridge Expected Influence", respectively. Network stability was assessed using the case-dropping bootstrap technique. Results: Network analysis identified CESD3 (Feeling blue/depressed), GAD4 (Trouble relaxing), and GAD2 (Uncontrollable worry) as the most influential central symptoms in the network of depression and anxiety. Concurrently, GAD1 (Nervousness or anxiety), CESD10 (Sleep disturbances), and CESD1 (Feeling bothered) stand as critical bridge symptoms between depression and anxiety disorders. Moreover, CESD7 (Lack of happiness) exhibited the strongest negative correlation with LS in Chinese hypertensive older adults. Conclusion: This exploratory study represents the first investigation to examine the mutual relationship between depressive and anxiety symptoms among Chinese hypertensive older adults. Interventions addressing targeting bridge symptoms have the potential to alleviate depressive and anxiety symptoms. Furthermore, improving happiness, hope, and sleep quality in this population may mitigate the adverse effects of depression and anxiety on LS.

The relationship between appearance anxiety and depression among students in a medical university in China: a serial multiple mediation model.

Background: Appearance anxiety and depression have become common and global public health problems worldwide, especially among adolescents. However, few studies have revealed the mechanisms between them. This study aimed to explore the multiple mediating roles of interpersonal sensitivity and social support between appearance anxiety and depression among medical college students. Methods: With 13 invalid samples excluded, 724 college students participated in our survey and completed questionnaires. The average age of 724 samples was 19.8 ± 2.02 including freshman to senior year and graduate school and above; 31.9% of the participants were male and 68.1% were female. SPSS 25.0 and Hayes' PROCESS macro were used for statistical description, correlation analysis and built multiple mediation models. Results: Appearance anxiety can not only directly affect depression, but also indirectly affect depression through three significant mediating pathways: (1) IS (B = 0.106, 95% CI [0.082-0.132]), which accounted for 49.77% of the total effect, (2) SS (B = 0.018, 95% CI [0.008-0.031]), which accounted for 8.45% of the total effect, and (3) IS and SS (B = 0.008, 95% CI [0.003-0.014]), which accounted for 3.76% of the total effect. And the total mediating effect was 61.97%. Limitations: It is a cross-sectional research method and the causal relationship is unclear. Conclusions: This study found that lower interpersonal sensitivity and higher social support can effectively reduce depression caused by appearance anxiety among college students. The schools and relevant departments should take measures to reduce the interpersonal sensitivity of college students and establish reliable social support, so as to reduce the occurrence of depression.

Prognostic value of depression and anxiety on colorectal cancer-related mortality: a systematic review and meta-analysis based on univariate and multivariate data.

BACKGROUND: Depression and anxiety are common mental disorders in patients with colorectal cancer (CRC); however, it remains unclear whether they are related to cancer mortality. METHOD: Based on a systematic literature search, 12 eligible studies involving 26,907 patients with CRC were included in this study. RESULTS: Univariate analysis revealed that anxiety was associated with an all-cause mortality rate of 1.42 (1.02, 1.96), whereas multivariate analysis revealed that anxiety was not associated with an all-cause mortality rate of 0.73 (0.39, 1.36). In univariate and multivariate analyses, depression was associated with all-cause mortality rates of 1.89 (1.68, 2.13) and 1.62 (1.27, 2.06), respectively, but not with the cancer-associated mortality rate of 1.16 (0.91, 1.48) in multivariate analyses. Multivariate subgroup analysis of depression and all-cause mortality showed that younger age (≤65 years), being diagnosed with depression/anxiety after a confirmed cancer diagnosis, and shorter follow-up time (<5 years) were associated with poor prognosis. CONCLUSIONS: Our study emphasizes the key roles of depression and anxiety as independent factors for predicting the survival of patients with CRC. However, owing to the significant heterogeneity among the included studies, the results should be interpreted with caution. Early detection and effective treatment of depression and anxiety in patients with CRC have public health and clinical significance.

Metabolic Profile and Long-Term Risk of Depression, Anxiety, and Stress-Related Disorders.

Importance: Biomarkers of lipid, apolipoprotein, and carbohydrate metabolism have been previously suggested to be associated with the risk for depression, anxiety, and stress-related disorders, but results are inconsistent. Objective: To examine whether the biomarkers of carbohydrate, lipid, and apolipoprotein metabolism are associated with the risk of depression, anxiety, and stress-related disorders. Design, Setting, and Participants: This population-based cohort study with longitudinal data collection assessed 211 200 participants from the Apolipoprotein-Related Mortality Risk (AMORIS) cohort who underwent occupational health screening between January 1, 1985, and December 31, 1996, mainly in the Stockholm region in Sweden. Statistical analysis was performed during 2022 to 2023. Exposures: Lipid, apolipoprotein, and carbohydrate biomarkers measured in blood. Main Outcomes and Measures: The associations between biomarker levels and the risk of developing depression, anxiety, and stress-related disorders through the end of 2020 were examined using Cox proportional hazards regression models. In addition, nested case-control analyses were conducted within the cohort, including all incident cases of depression, anxiety, and stress-related disorders, and up to 10 control individuals per case who were individually matched to the case by year of birth, sex, and year of enrollment to the AMORIS cohort, using incidence density sampling. Population trajectories were used to illustrate the temporal trends in biomarker levels for cases and controls. Results: A total of 211 200 individuals (mean [SD] age at first biomarker measurement, 42.1 [12.6] years; 122 535 [58.0%] male; 188 895 [89.4%] born in Sweden) participated in the study. During a mean (SD) follow-up of 21.0 (6.7) years, a total of 16 256 individuals were diagnosed with depression, anxiety, or stress-related disorders. High levels of glucose (hazard ratio [HR], 1.30; 95% CI, 1.20-1.41) and triglycerides (HR, 1.15; 95% CI, 1.10-1.20) were associated with an increased subsequent risk of all tested psychiatric disorders, whereas high levels of high-density lipoprotein (HR, 0.88; 95% CI, 0.80-0.97) were associated with a reduced risk. These results were similar for male and female participants as well as for all tested disorders. The nested case-control analyses demonstrated that patients with depression, anxiety, or stress-related disorders had higher levels of glucose, triglycerides, and total cholesterol during the 20 years preceding diagnosis, as well as higher levels of apolipoprotein A-I and apolipoprotein B during the 10 years preceding diagnosis, compared with control participants. Conclusions and Relevance: In this cohort study of more than 200 000 participants, high levels of glucose and triglycerides and low levels of high-density lipoprotein were associated with future risk of depression, anxiety, and stress-related disorders. These findings may support closer follow-up of individuals with metabolic dysregulations for the prevention and diagnosis of psychiatric disorders.

Positive affect during adolescence and health and well-being in adulthood: An outcome-wide longitudinal approach.

BACKGROUND: Several intergovernmental organizations, including the World Health Organization and United Nations, are urging countries to use well-being indicators for policymaking. This trend, coupled with increasing recognition that positive affect is beneficial for health/well-being, opens new avenues for intervening on positive affect to improve outcomes. However, it remains unclear if positive affect in adolescence shapes health/well-being in adulthood. We examined if increases in positive affect during adolescence were associated with better health/well-being in adulthood across 41 outcomes. METHODS AND FINDINGS: We conducted a longitudinal cohort study using data from Add Health-a prospective and nationally representative cohort of community-dwelling U.S. adolescents. Using regression models, we evaluated if increases in positive affect over 1 year (between Wave I; 1994 to 1995 and Wave II; 1995 to 1996) were associated with better health/well-being 11.37 years later (in Wave IV; 2008; N = 11,040) or 20.64 years later (in Wave V; 2016 to 2018; N = 9,003). Participants were aged 15.28 years at study onset, and aged 28.17 or 37.20 years-during the final assessment. Participants with the highest (versus lowest) positive affect had better outcomes on 3 (of 13) physical health outcomes (e.g., higher cognition (ß = 0·12, 95% CI = 0·05, 0·19, p = 0.002)), 3 (of 9) health behavior outcomes (e.g., lower physical inactivity (RR = 0·80, CI = 0·66, 0·98, p = 0.029)), 6 (of 7) mental health outcomes (e.g., lower anxiety (RR = 0·81, CI = 0·71, 0·93, p = 0.003)), 2 (of 3) psychological well-being (e.g., higher optimism (ß = 0·20, 95% CI = 0·12, 0·28, p < 0.001)), 4 (of 7) social outcomes (e.g., lower loneliness (ß = -0·09, 95% CI = -0·16, -0·02, p = 0.015)), and 1 (of 2) civic/prosocial outcomes (e.g., more voting (RR = 1·25, 95% CI = 1·16, 1·36, p < 0.001)). Study limitations include potential unmeasured confounding and reverse causality. CONCLUSIONS: Enhanced positive affect during adolescence is linked with a range of improved health/well-being outcomes in adulthood. These findings suggest the promise of testing scalable positive affect interventions and policies to more definitively assess their impact on outcomes.

Network analysis of anxiety and depressive symptoms during the COVID-19 pandemic in older adults in the United Kingdom.

The health crisis caused by COVID-19 in the United Kingdom and the confinement measures that were subsequently implemented had unprecedented effects on the mental health of older adults, leading to the emergence and exacerbation of different comorbid symptoms including depression and anxiety. This study examined and compared depression and anxiety symptom networks in two specific quarantine periods (June-July and November-December) in the older adult population in the United Kingdom. We used the database of the English Longitudinal Study of Aging COVID-19 Substudy, consisting of 5797 participants in the first stage (54% women) and 6512 participants in the second stage (56% women), all over 50 years of age. The symptoms with the highest centrality in both times were: "Nervousness (A1)" and "Inability to relax (A4)" in expected influence and predictability, and "depressed mood (D1"; bridging expected influence). The latter measure along with "Irritability (A6)" overlapped in both depression and anxiety clusters in both networks. In addition, a the cross-lagged panel network model was examined in which a more significant influence on the direction of the symptom "Nervousness (A1)" by the depressive symptoms of "Anhedonia (D6)", "Hopelessness (D7)", and "Sleep problems (D3)" was observed; the latter measure has the highest predictive capability of the network. The results report which symptoms had a higher degree of centrality and transdiagnostic overlap in the cross-sectional networks (invariants) and the cross-lagged panel network model of anxious and depressive symptomatology.

Association of healthy eating index (2015) with depression and anxiety symptoms among Iranian adolescent girls.

Adolescence is a period of rapid growth, with changes in body composition and cognitive and psychosocial development. Teenagers who eat properly and participate in daily physical activities have a healthy lifestyle. Healthy living promotes optimal growth and performance at school and in the workplace and minimizes the risk of chronic nutrient-related diseases. Therefore, the present study was conducted to determine the relationship between the healthy eating index (2015) (HEI-2015) and depression and anxiety among Iranian adolescent girls. This cross-sectional study was designed based on the updated version of HEI-2015. The study population consisted of 412 high school girls aged 12-17 years old. Data were collected about the diet, sociodemographic, and anthropometric characteristics of the participants. HEI and anthropometric characteristics of the participants were measured. The depression, anxiety, and stress scale 42 (DASS-42) questionnaire was used to detect adolescents suffering from depression and anxiety. The relationships of the HEI and anthropometric measures with depression and anxiety were also assessed. The results showed that the HEI is inversely correlated with depression and anxiety in Iranian adolescent girls. HEI was greater in the healthy participants than in those suffering from depression and anxiety (P < 0.0001).

Utilization of Mental Health Services Within 1 Year of Delivery among Different Language Groups.

OBJECTIVES: Cultural differences can affect postpartum mental health disorders and the utilization of mental health services. We compared women speaking English, Spanish, Russian, and Urdu/Bengali/Punjabi from postpartum through 1 year after delivery. METHODS: This was a retrospective study of 3478 pregnant women from a public hospital in New York City. The primary outcome was a composite outcome of the presence of any of the following: diagnosis of depressive disorder, diagnosis of anxiety disorder, visit to a behavioral health service provider, and/or psychiatric admission. The secondary outcome was healthcare provider referral to a behavioral health service provider. RESULTS: Languages spoken were English (n = 1881), Spanish (n = 694), Russian (n = 600), and Urdu/Bengali/Punjabi (n = 303). The language groups differed significantly (P = 0.02) for the composite outcome, with English having the greatest percentage (3.5%) and Russian the lowest percentage (1.2%). The language groups significantly differed for referral to behavioral health (P = 0.04), with Spanish having the greatest percentage (1.6%) and Russian the lowest percentage (0.2%). Anxiety disorder history (odds ratio [OR] 10.43, 95% confidence interval [CI] 4.75-22.91, P < 0.001) and psychiatric disorder history (OR 5.26, 95% CI 2.13-8.49, P < 0.001) were each significantly associated with increased odds for the composite outcome. Anxiety disorder history (OR 6.42, 95% CI 1.92-21.45, P = 0.003) and elevated depressive symptoms (OR 4.92, 95% CI 2.04-11.83, P < 0.001) each were significantly associated with increased odds for referral to behavioral health. CONCLUSIONS: Russian language was associated with lower utilization of mental health services postpartum. These findings can help clinicians determine among postpartum women who will be affected with mental health concerns and who will seek treatment for mental health concerns.

Virtual reality to reduce periprocedural anxiety during invasive coronary angiography: rationale and design of the VR InCard trial.

INTRODUCTION: Patients undergoing invasive coronary angiography (ICA) experience anxiety due to various reasons. Procedural anxiety can lead to physiological and psychological complications, compromising patient comfort and overall procedural outcomes. Benzodiazepines are commonly used to reduce periprocedural anxiety, although the effect is modest. Virtual reality (VR) is a promising non-pharmacological intervention to reduce anxiety in patients undergoing ICA. METHODS AND ANALYSIS: A single-centre open-label randomised controlled trial is conducted assessing the effectiveness of add-on VR therapy on anxiety in 100 patients undergoing ICA and experiencing anxiety in a periprocedural setting. The primary outcome is the Numeric Rating Scale (NRS) anxiety score measured just before obtaining arterial access. Secondary outcomes include postarterial puncture and postprocedural anxiety, patient-reported outcome measures (PROMs) of anxiety and physiological measurements associated with anxiety. The NRS anxiety level and physiological measurements are assessed five times during the procedure. The PROM State-Trait Anxiety Inventory and Perceived Stress Scale are completed preprocedure, and the PROM STAI and the Igroup Presence Questionnaire are performed postprocedure. ETHICS AND DISSEMINATION: The protocol of this study has been approved by the Research Ethics Committee of the Radboud University Medical Centre, the Netherlands (CMO Arnhem-Nijmegen, 2023-16586). Informed consent is obtained from all patients. The trial is conducted according to the principles of the Helsinki Declaration and in accordance with Dutch guidelines, regulations, and acts (Medical Research involving Human Subjects Act, WMO). REGISTRATION DETAILS: Trial registration number: NCT06215456.

Perioperative mental health intervention for depression and anxiety symptoms in older adults study protocol: design and methods for three linked randomised controlled trials.

INTRODUCTION: Preoperative anxiety and depression symptoms among older surgical patients are associated with poor postoperative outcomes, yet evidence-based interventions for anxiety and depression have not been applied within this setting. We present a protocol for randomised controlled trials (RCTs) in three surgical cohorts: cardiac, oncological and orthopaedic, investigating whether a perioperative mental health intervention, with psychological and pharmacological components, reduces perioperative symptoms of depression and anxiety in older surgical patients. METHODS AND ANALYSIS: Adults ≥60 years undergoing cardiac, orthopaedic or oncological surgery will be enrolled in one of three-linked type 1 hybrid effectiveness/implementation RCTs that will be conducted in tandem with similar methods. In each trial, 100 participants will be randomised to a remotely delivered perioperative behavioural treatment incorporating principles of behavioural activation, compassion and care coordination, and medication optimisation, or enhanced usual care with mental health-related resources for this population. The primary outcome is change in depression and anxiety symptoms assessed with the Patient Health Questionnaire-Anxiety Depression Scale from baseline to 3 months post surgery. Other outcomes include quality of life, delirium, length of stay, falls, rehospitalisation, pain and implementation outcomes, including study and intervention reach, acceptability, feasibility and appropriateness, and patient experience with the intervention. ETHICS AND DISSEMINATION: The trials have received ethics approval from the Washington University School of Medicine Institutional Review Board. Informed consent is required for participation in the trials. The results will be submitted for publication in peer-reviewed journals, presented at clinical research conferences and disseminated via the Center for Perioperative Mental Health website. TRIAL REGISTRATION NUMBERS: NCT05575128, NCT05685511, NCT05697835, pre-results.

Effects of Music Therapy on Negative Emotions and Physiological Parameters in Patients Undergoing Colonoscopic Polypectomy: A Retrospective Study.

OBJECTIVE: This study aimed to determine the postoperative effects of music therapy on negative emotions, pain, and inflammatory and physiological parameters in patients undergoing colonoscopic polypectomy. METHODS: Patients who underwent colonoscopic polypectomy in Funan County People's Hospital between March 2020 and June 2023 were selected as the research subjects. Patients were divided into exposure (underwent music therapy) and control (did not undergo music therapy) groups. Baseline characteristics, Self-rating Anxiety Scale (SAS) and Visual Analog Scale (VAS) scores, physiological parameters [systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR)], and inflammatory marker levels [neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and erythrocyte sedimentation rate (ESR)] of patients before and after exposure to music were determined. The propensity score matching (PSM) method (1:1) was used to balance the baseline characteristics of the two groups. RESULTS: After PSM, the exposure group comprised 50 cases and the control group comprised 50 cases. The baseline characteristics were not significantly different between the two groups (P > 0.05). The postoperative SAS score of the exposure group was significantly lower than that of the control group (P < 0.05). Meanwhile, the postoperative VAS score of the exposure group was nonsignificantly lower than that of the control group (P > 0.05). Furthermore, the postoperative SBP, DBP, and HR levels of the exposure group were significantly lower than that of the control group (P < 0.05). The postoperative levels of NLR, PLR, and ESR were not significantly different between the exposure and control groups (P > 0.05). CONCLUSION: Music therapy exerts beneficial effects on the postoperative psychological and physiological parameters of patients undergoing colonoscopic polypectomy.

Music Nursing as Complementary Therapy Improves Anxiety, Fatigue, and Quality of Life in Children with Acute Leukaemia: A Retrospective Study.

OBJECTIVE: To explore the effects of music nursing as a complementary therapy on anxiety, fatigue, and quality of life in children with acute leukemia (AL). METHODS: This study included 150 children with AL admitted to our hospital from August 2021 to August 2023 and divided them into two groups based on treatment: the control (n = 76, received routine nursing) and observation (n = 74, received music nursing on the basis of routine nursing) groups. Comparison of groups was performed in terms of general information, anxiety, fatigue, and quality of life at admission (T0) and 1 month after admission (T1). RESULTS: No significant differences were observed in the general data between the two groups (P > 0.05). Anxiety, fatigue, and quality of life of the two groups also showed no significant differences at T0 (P > 0.05). The observation group showed significantly lower anxiety than the control group at T1 (P < 0.05). At T1, the observation group exhibited a lower fatigue degree compared with the control group (P < 0.05). At T1, the observation group attained higher scores on physiological and emotional dimensions of the quality of life compared with the control group, and the differences were statistically significant (P < 0.05). CONCLUSION: Music nursing for AL children, which has a certain clinical application value, can effectively reduce their anxiety and fatigue and improve their quality of life.

A study on the correlations of PRL levels with anxiety, depression, sleep, and self-efficacy in patients with prolactinoma.

Purpose: The purpose of this study was to explore the factors influencing PRL levels in patients with prolactinoma and to investigate the correlations between anxiety, depression, sleep, self-efficacy, and PRL levels. Methods: This retrospective study included 176 patients with prolactinoma who received outpatient treatment at the Affiliated Hospital of Zunyi Medical University from May 2017 to August 2022. The general information questionnaire, Hospital Anxiety and Depression Scale (HADS), Athens Insomnia Scale (AIS), and General Self-Efficacy Scale (GSES) were used for data collection. A generalized estimating equation (GEE) model was used to analyze the factors influencing PRL levels in patients with prolactinoma. GEE single-effect analysis was used to compare PRL levels at different time points between anxiety group and nonanxiety group, between insomnia group and normal group, and between low, medium, and high self-efficacy groups. Results: The median baseline PRL level and the PRL levels at 1, 3, 6, and 12 months of follow-up were 268.50 ng/ml, 122.25 ng/ml, 21.20 ng/ml, 19.65 ng/ml, and 16.10 ng/ml, respectively. Among patients with prolactinoma, 59.10% had anxiety (HADS-A score = 7.35 ± 3.34) and 28.98% had depression (HADS-D score = 5.23 ± 3.87), 9.10% had sleep disorders (AIS score = 6.10 ± 4.31) and 54.55% had low self-efficacy (GSES score = 2.13 ± 0.83). Educational level, tumor size, number of visits, sleep quality, anxiety level, and self-efficacy level were found to be factors influencing PRL levels in patients with prolactinoma (P<0.05). Higher PRL levels were observed in the anxiety group compared to the non-anxiety group (P<0.001), in the insomnia group compared to the normal group (P<0.05), and in the low self-efficacy group compared to the medium and high self-efficacy groups (P<0.05). Conclusion: PRL levels in patients with prolactinoma are related to education level, tumor size, number of visits, anxiety, self-efficacy, and sleep but not depression. PRL levels were higher in patients with anxiety, low self-efficacy, and sleep disorders.

Two- and 3-year outcomes in convalescent individuals with COVID-19: A prospective cohort study.

As the long-term consequences of coronavirus disease 2019 (COVID-19) have not been defined, it is necessary to explore persistent symptoms, long-term respiratory impairment, and impact on quality of life over time in COVID-19 survivors. In this prospective cohort study, convalescent individuals diagnosed with COVID-19 were followed-up 2 and 3 years after discharge from hospital. Participants completed an in-person interview to assess persistent symptoms and underwent blood tests, pulmonary function tests, chest high-resolution computed tomography, and the 6-min walking test. There were 762 patients at the 2-year follow-up and 613 patients at the 3-year follow-up. The mean age was 60 years and 415 (54.5%) were men. At 3 years, 39.80% of the participants had at least one symptom; most frequently, fatigue, difficulty sleeping, joint pain, shortness of breath, muscle aches, and cough. The participants experienced different degrees of pulmonary function impairment, with decreased carbon monoxide diffusion capacity being the main feature; results remained relatively stable over the 2-3 years. Multiple logistic regression analysis demonstrated that female sex and smoking were independently associated with impaired diffusion capacity. A subgroup analysis based on disease severity was performed, indicating that there was no difference in other parameters of lung function except forced vital capacity at 3-year follow-up. Persistent radiographic abnormalities, most commonly fibrotic-like changes, were observed at both timepoints. At 3 years, patients had a significantly improved Mental Component Score compared with that at 2 years, with a lower percentage with anxiety. Our study indicated that symptoms and pulmonary abnormalities persisted in COVID-19 survivors at 3 years. Further studies are warranted to explore the long-term effects of COVID-19 and develop appropriate rehabilitation strategies.

[Did entry into nursing home during the health crisis favor the emergence of traumatic symptoms in the elderly?: Entry into nursing home and Covid]. / L'entrée en Ehpad, durant la crise sanitaire, a-t-elle favorisé l'émergence de symptômes traumatiques chez le sujet âgé ?

Our aim is to explore the possible emergence of traumatic symptoms and the identity-related repercussions of the restrictions on elderly, who entered into nursing homes during the Covid-19 health crisis in France. Twenty-five subjects institutionalised before the health crisis and twenty-six subjects institutionalised during the periods of lockdown into nursing homes completed scales assessing anxiety-depressive symptomatology, traumatic symptoms and identity. Anxiety and depression symptoms were similar between the groups. The institutionalised group showed a significantly higher prevalence of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria D and E on the Post traumatic Stress Disorder Checklist version DSM-5 (PCL-5) during lockdown. Entry into an institution during the health crisis would have favored the emergence of traumatic symptoms in the participants. Consideration of the ethical issues raised by this study could make it possible to offer more individualised support to elderly during their transition to a new home.

Grief-focused cognitive behavioral therapies for prolonged grief symptoms: A systematic review and meta-analysis.

BACKGROUND: Studies suggest that cognitive behavioral therapies (CBTs) may be efficacious in reducing symptoms of prolonged grief disorder (PGD), but no comprehensive overview and pooled estimate of CBTs' effect on PGD in adulthood exist. We conducted a systematic review and meta-analysis of randomized controlled trials. METHOD: Studies were selected independently by two researchers based on a systematic literature search in Pubmed, APA PsycInfo, Web of Science, and Embase. Meta-analyses provided pooled effect sizes for the effects of CBTs on PGD symptoms and secondary outcomes. We explored potential moderators of effect, risk of bias of included studies, and evaluated the quality of the meta-analytical evidence through the Grading of Recommendations, Assessment, Development, and Evaluation system. RESULTS: The meta-analysis included 22 studies of 2,602 bereaved adults (averaged study Mage = 49 years). CBTs had a statistically significant medium effect on PGD symptoms at postintervention (K = 22, g = 0.65, 95% CI [0.49, 0.81]), and a large effect at follow-up (K = 7, g = 0.90, 95% CI [0.37, 1.43]). Statistically significant small-to-medium effects were found at postintervention on posttraumatic stress symptoms (K = 10, g = 0.74, 95% CI [0.49, 0.98]), depression (K = 19, g = 0.53, 95% CI [0.36, 0.71]), and anxiety (K = 9, g = 0.35, 95% CI [0.22, 0.49]). The effects on PGD remained unchanged when adjusted for possible outliers. None of the moderator analyses reached statistical significance. CONCLUSION: This review suggests that CBTs are efficacious in reducing PGD symptoms in adulthood. Generalization of findings should be done with caution due to considerable inconsistency and indirectness of meta-analytic evidence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Internet use by pregnant women during prenatal care.

OBJECTIVE: The search for medical information on the internet is a part of people's daily lives. Exponential volumes of data are available through various media and platforms. There are several problems related to the ease of creating and accessing medical information on the internet, as evidenced by the quantity of false content and increasing anxiety due to the consumption of these data. In light of this accessibility, it is necessary to understand how people use internet-based medical information and its impact on specific populations. This prospective study aimed to analyze pregnant women's behavior when searching for health-related information on the internet, and how they were influenced by the information. METHODS: Questionnaires were administered to the participants during their immediate puerperium, and their answers were tabulated. RESULTS: Three hundred and two patients answered the questionnaires. We observed that internet use was frequent, and most patients discussed the findings with their physicians. However, this did not affect the delivery routes. CONCLUSION: The search for health information by pregnant women is very prevalent but does not interfere with the delivery route.