Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.433
Filtrar
1.
BMC Psychiatry ; 21(1): 208, 2021 04 23.
Artículo en Inglés | MEDLINE | ID: mdl-33892677

RESUMEN

BACKGROUND: Pregnancy is a challenging period for mothers and fathers. This study aimed to investigate the effect of counseling on stress and anxiety levels of fathers. METHODS: This randomized controlled trial was conducted on 102 spouses of pregnant women in Ardabil, Iran. The participants were randomly assigned to intervention and control groups. The intervention group attended four 60-min counseling sessions at weekly intervals. The perceived stress and anxiety questionnaires were completed before and 4 weeks after the intervention. RESULTS: The mean scores of state anxiety in the intervention group decreased significantly 4 weeks after the intervention compared with the control group (MD: -2.4; 95%CI: - 4.7 to - 0.2; p = 0.030). Four weeks after the intervention, no significant difference was found between the two groups in terms of trait anxiety (p = 0.472) and perceived stress (p = 0.635). CONCLUSIONS: The findings indicate that counseling reduced state anxiety in expectant fathers; therefore, this intervention is recommended to be used to reduce fathers' anxiety. TRIAL REGISTRATION: IRCT2017042910324N38 . Registered 25 June 2017.


Asunto(s)
Ansiedad , Padre , Ansiedad/terapia , Consejo , Femenino , Humanos , Irán , Masculino , Embarazo , Mujeres Embarazadas
2.
Artículo en Ruso | MEDLINE | ID: mdl-33899449

RESUMEN

Due to decrease in life quality of gynecological oncology patients after completed radical antitumor treatment because of chemotherapy and radiation therapy consequences, pre- and postoperative stress, the development of post-castration syndrome, the problem of this contingent rehabilitation remains important. The methods of non-drug therapy, in particular, physical factors that have a multifaceted effect on the body and increase its resistance to adverse conditions are of interest. These factors include normobaric hypoxia which improves oxygen transport and tissue respiration, enhances detoxification processes, increases mental and physical performance, and increases the body's nonspecific resistance. EHF-therapy promotes the implementation of anti-stress reactions, normalizes the activity of the sympathoadrenal link of the autonomic nervous system. It is assumed that the complex use of normobaric hypoxia and EHF-therapy would reduce the negative consequences of antitumor treatment and lead to positive dynamics of the post-castration syndrome clinical picture. OBJECTIVE: To study the dynamics of neurovegetative and psychoemotional disorders during rehabilitation in patients with post-castration syndrome after completed radical antitumor treatment for cervical cancer or uterine body cancer Ib-IIb stages. MATERIAL AND METHODS: 106 patients with post-castration syndrome developed after radical antitumor treatment for cervical cancer or uterine body cancer stage Ib-IIb were examined. The main group consisted of 66 patients who received the author's rehabilitation program which included normobaric hypoxia procedures, EHF-therapy and water aerobics 6-12 months after the completed radical antitumor treatment. The control group consisted of 40 patients were examined according to the protocol at the same time but they were not assigned a course of rehabilitation. RESULTS: After the completed radical antitumor treatment (6-12 months) the neurovegetative and psychoemotional disorders including anxiety and depression persisted. After patients' rehabilitation the severity of clinical symptoms of post-castration syndrome decreased; that was accompanied by positive dynamics of neurovegetative (p<0.01) and psychoemotional (p<0.01) symptoms (Kupperman scale), indicators of anxiety (p<0.01) and depression (p<0.05) (HADS scale), situational anxiety (p<0.01) (Spielberger-Khanin scale), the severity of mental and somatic signs of anxiety by 51.0% (Hamilton scale). CONCLUSION: The proposed rehabilitation complex helps to reduce the functional tension of the higher nervous system autonomic centers and to increase the nonspecific body reactivity. This allows to recommend the proposed course for the rehabilitation of this patients' category.


Asunto(s)
Trastornos de Ansiedad , Ansiedad , Ansiedad/terapia , Castración , Humanos , Calidad de Vida , Síndrome
3.
Artículo en Inglés | MEDLINE | ID: mdl-33804817

RESUMEN

BACKGROUND: Heart Rate Variability Biofeedback (HRVB) is a treatment in which patients learn self-regulation of a physiological dysregulated vagal nerve function. While the therapeutic approach of HRVB is promising for a variety of disorders, it has not yet been regularly offered in a mental health treatment setting. AIM: To provide a systematic review about the efficacy of HRV-Biofeedback in treatment of anxiety, depression, and stress related disorders. METHOD: Systematic review in PubMed and Web of Science in 2020 with terms HRV, biofeedback, Post-Traumatic Stress Disorder (PTSD), depression, panic disorder, and anxiety disorder. Selection, critical appraisal, and description of the Random Controlled Trials (RCT) studies. Combined with recent meta-analyses. RESULTS: The search resulted in a total of 881 studies. After critical appraisal, nine RCTs have been selected as well as two other relevant studies. The RCTs with control groups treatment as usual, muscle relaxation training and a "placebo"-biofeedback instrument revealed significant clinical efficacy and better results compared with control conditions, mostly significant. In the depression studies average reduction at the Beck Depression Inventory (BDI) scale was 64% (HRVB plus Treatment as Usual (TAU) versus 25% (control group with TAU) and 30% reduction (HRVB) at the PSQ scale versus 7% (control group with TAU). In the PTSD studies average reduction at the BDI-scale was 53% (HRV plus TAU) versus 24% (control group with TAU) and 22% (HRVB) versus 10% (TAU) with the PTSD Checklist (PCL). In other systematic reviews significant effects have been shown for HRV-Biofeedback in treatment of asthma, coronary artery disease, sleeping disorders, postpartum depression and stress and anxiety. CONCLUSION: This systematic review shows significant improvement of the non-invasive HRVB training in stress related disorders like PTSD, depression, and panic disorder, in particular when combined with cognitive behavioral therapy or different TAU. Effects were visible after four weeks of training, but clinical practice in a longer daily self-treatment of eight weeks is more promising. More research to integrate HRVB in treatment of stress related disorders in psychiatry is warranted, as well as research focused on the neurophysiological mechanisms.


Asunto(s)
Autocontrol , Trastornos por Estrés Postraumático , Ansiedad/terapia , Trastornos de Ansiedad/terapia , Sistema Nervioso Autónomo , Biorretroalimentación Psicológica , Depresión/terapia , Femenino , Frecuencia Cardíaca , Humanos , Trastornos por Estrés Postraumático/terapia
4.
MMWR Morb Mortal Wkly Rep ; 70(13): 490-494, 2021 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-33793459

RESUMEN

The spread of disease and increase in deaths during large outbreaks of transmissible diseases is often associated with fear and grief (1). Social restrictions, limits on operating nonessential businesses, and other measures to reduce pandemic-related mortality and morbidity can lead to isolation and unemployment or underemployment, further increasing the risk for mental health problems (2). To rapidly monitor changes in mental health status and access to care during the COVID-19 pandemic, CDC partnered with the U.S. Census Bureau to conduct the Household Pulse Survey (HPS). This report describes trends in the percentage of adults with symptoms of an anxiety disorder or a depressive disorder and those who sought mental health services. During August 19, 2020-February 1, 2021, the percentage of adults with symptoms of an anxiety or a depressive disorder during the past 7 days increased significantly (from 36.4% to 41.5%), as did the percentage reporting that they needed but did not receive mental health counseling or therapy during the past 4 weeks (from 9.2% to 11.7%). Increases were largest among adults aged 18-29 years and among those with less than a high school education. HPS data can be used in near real time to evaluate the impact of strategies that address mental health status and care of adults during the COVID-19 pandemic and to guide interventions for groups that are disproportionately affected.


Asunto(s)
Ansiedad/epidemiología , Ansiedad/terapia , Trastorno Depresivo/epidemiología , Trastorno Depresivo/terapia , Servicios de Salud Mental/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Socioeconómicos , Estados Unidos/epidemiología , Adulto Joven
5.
Cochrane Database Syst Rev ; 3: CD013522, 2021 03 09.
Artículo en Inglés | MEDLINE | ID: mdl-33687070

RESUMEN

BACKGROUND: There is a common perception that smoking generally helps people to manage stress, and may be a form of 'self-medication' in people with mental health conditions. However, there are biologically plausible reasons why smoking may worsen mental health through neuroadaptations arising from chronic smoking, leading to frequent nicotine withdrawal symptoms (e.g. anxiety, depression, irritability), in which case smoking cessation may help to improve rather than worsen mental health. OBJECTIVES: To examine the association between tobacco smoking cessation and change in mental health. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group's Specialised Register, Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycINFO, and the trial registries clinicaltrials.gov and the International Clinical Trials Registry Platform, from 14 April 2012 to 07 January 2020. These were updated searches of a previously-conducted non-Cochrane review where searches were conducted from database inception to 13 April 2012.  SELECTION CRITERIA: We included controlled before-after studies, including randomised controlled trials (RCTs) analysed by smoking status at follow-up, and longitudinal cohort studies. In order to be eligible for inclusion studies had to recruit adults who smoked tobacco, and assess whether they quit or continued smoking during the study. They also had to measure a mental health outcome at baseline and at least six weeks later. DATA COLLECTION AND ANALYSIS: We followed standard Cochrane methods for screening and data extraction. Our primary outcomes were change in depression symptoms, anxiety symptoms or mixed anxiety and depression symptoms between baseline and follow-up. Secondary outcomes  included change in symptoms of stress, psychological quality of life, positive affect, and social impact or social quality of life, as well as new incidence of depression, anxiety, or mixed anxiety and depression disorders. We assessed the risk of bias for the primary outcomes using a modified ROBINS-I tool.  For change in mental health outcomes, we calculated the pooled standardised mean difference (SMD) and 95% confidence interval (95% CI) for the difference in change in mental health from baseline to follow-up between those who had quit smoking and those who had continued to smoke. For the incidence of psychological disorders, we calculated odds ratios (ORs) and 95% CIs. For all meta-analyses we used a generic inverse variance random-effects model and quantified statistical heterogeneity using I2. We conducted subgroup analyses to investigate any differences in associations between sub-populations, i.e. unselected people with mental illness, people with physical chronic diseases. We assessed the certainty of evidence for our primary outcomes (depression, anxiety, and mixed depression and anxiety) and our secondary social impact outcome using the eight GRADE considerations relevant to non-randomised studies (risk of bias, inconsistency, imprecision, indirectness, publication bias, magnitude of the effect, the influence of all plausible residual confounding, the presence of a dose-response gradient). MAIN RESULTS: We included 102 studies representing over 169,500 participants. Sixty-two of these were identified in the updated search for this review and 40 were included in the original version of the review.  Sixty-three studies provided data on change in mental health, 10 were included in meta-analyses of incidence of mental health disorders, and 31 were synthesised narratively.  For all primary outcomes, smoking cessation was associated with an improvement in mental health symptoms compared with continuing to smoke: anxiety symptoms (SMD -0.28, 95% CI -0.43 to -0.13; 15 studies, 3141 participants; I2 = 69%; low-certainty evidence); depression symptoms: (SMD -0.30, 95% CI -0.39 to -0.21; 34 studies, 7156 participants; I2 = 69%' very low-certainty evidence);  mixed anxiety and depression symptoms (SMD -0.31, 95% CI -0.40 to -0.22; 8 studies, 2829 participants; I2 = 0%; moderate certainty evidence).  These findings were robust to preplanned sensitivity analyses, and subgroup analysis generally did not produce evidence of differences in the effect size among subpopulations or based on methodological characteristics. All studies were deemed to be at serious risk of bias due to possible time-varying confounding, and three studies measuring depression symptoms were judged to be at critical risk of bias overall. There was also some evidence of funnel plot asymmetry. For these reasons, we rated our certainty in the estimates for anxiety as low, for depression as very low, and for mixed anxiety and depression as moderate. For the secondary outcomes, smoking cessation was associated with an improvement in symptoms of stress (SMD -0.19, 95% CI -0.34 to -0.04; 4 studies, 1792 participants; I2 = 50%), positive affect (SMD 0.22, 95% CI 0.11 to 0.33; 13 studies, 4880 participants; I2 = 75%), and psychological quality of life (SMD 0.11, 95% CI 0.06 to 0.16; 19 studies, 18,034 participants; I2 = 42%). There was also evidence that smoking cessation was not associated with a reduction in social quality of life, with the confidence interval incorporating the possibility of a small improvement (SMD 0.03, 95% CI 0.00 to 0.06; 9 studies, 14,673 participants; I2 = 0%). The incidence of new mixed anxiety and depression was lower in people who stopped smoking compared with those who continued (OR 0.76, 95% CI 0.66 to 0.86; 3 studies, 8685 participants; I2 = 57%), as was the incidence of anxiety disorder (OR 0.61, 95% CI 0.34 to 1.12; 2 studies, 2293 participants; I2 = 46%). We deemed it inappropriate to present a pooled estimate for the incidence of new cases of clinical depression, as there was high statistical heterogeneity (I2 = 87%). AUTHORS' CONCLUSIONS: Taken together, these data provide evidence that mental health does not worsen as a result of quitting smoking, and very low- to moderate-certainty evidence that smoking cessation is associated with small to moderate improvements in mental health.  These improvements are seen in both unselected samples and in subpopulations, including people diagnosed with mental health conditions. Additional studies that use more advanced methods to overcome time-varying confounding would strengthen the evidence in this area.


Asunto(s)
Ansiedad/terapia , Depresión/terapia , Salud Mental , Cese del Hábito de Fumar/métodos , Fumar/efectos adversos , Afecto , Intervalos de Confianza , Estudios Controlados Antes y Después , Humanos , Incidencia , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Persona de Mediana Edad , Calidad de Vida , Fumar/psicología , Cese del Hábito de Fumar/psicología , Estrés Psicológico/terapia , Cese del Uso de Tabaco/métodos , Cese del Uso de Tabaco/psicología
6.
Int J Mol Sci ; 22(5)2021 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-33652962

RESUMEN

Anxiety and eating disorders produce a physiological imbalance that triggers alterations in the abundance and composition of gut microbiota. Moreover, the gut-brain axis can be altered by several factors such as diet, lifestyle, infections, and antibiotic treatment. Diet alterations generate gut dysbiosis, which affects immune system responses, inflammation mechanisms, the intestinal permeability, as well as the production of short chain fatty acids and neurotransmitters by gut microbiota, which are essential to the correct function of neurological processes. Recent studies indicated that patients with generalized anxiety or eating disorders (anorexia nervosa, bulimia nervosa, and binge-eating disorders) show a specific profile of gut microbiota, and this imbalance can be partially restored after a single or multi-strain probiotic supplementation. Following the PRISMA methodology, the current review addresses the main microbial signatures observed in patients with generalized anxiety and/or eating disorders as well as the importance of probiotics as a preventive or a therapeutic tool in these pathologies.


Asunto(s)
Trastornos de Ansiedad/microbiología , Ansiedad/microbiología , Trastornos de Alimentación y de la Ingestión de Alimentos/microbiología , Probióticos/uso terapéutico , Animales , Ansiedad/terapia , Trastornos de Ansiedad/terapia , Trastornos de Alimentación y de la Ingestión de Alimentos/terapia , Microbioma Gastrointestinal , Humanos
7.
Artículo en Inglés | MEDLINE | ID: mdl-33671385

RESUMEN

Group psychological programs for intimate partner violence (IPV) survivors would seem particularly useful since they contribute to interrupting women's isolation and have cost-effectiveness advantage. This study aims to analyze whether the effectiveness of group interventions for female survivors of IPV is equivalent to that of the individual format. A cognitive-behavioral trauma-focused intervention program was applied in eight weekly sessions in Madrid (Spain) to IPV female survivors with significant posttraumatic symptoms that were randomly assigned to the individual (n = 25) or group (n = 28) intervention format. Measures of posttraumatic stress (Severity of Posttraumatic Stress Disorder Symptoms Scale), depression (Beck Depression Inventory), anxiety (Beck Anxiety Inventory), self-esteem (Rosenberg's Scale) and social support were analyzed at pre-treatment, post-treatment, and 1-, 3-, 6- and 12-months follow-ups. A total of 28.3% of women dropped out, without significant format differences. Intervention (both formats) had significant improvements with large effect sizes in posttraumatic stress (η2p = 0.56), depression (η2p = 0.45), anxiety (η2p = 0.41) and self-esteem (η2p = 0.26) that maintained in follow-ups (p < 0.001), without significant differences between formats. Both intervention formats had different evolutions for depression and anxiety (p < 0.05), with better effects in the individual format at the first post-test measurements, but the differences tended to disappear over time. Intervention was effective in improving social support, with no significant differences between formats. All in all, both formats showed similar effectiveness. The group format could be an alternative when applying psychological interventions for female IPV survivors, since it would maintain good cost-effectiveness balance, mainly in the long-term.


Asunto(s)
Violencia de Pareja , Trastornos por Estrés Postraumático , Ansiedad/epidemiología , Ansiedad/terapia , Femenino , Humanos , España , Trastornos por Estrés Postraumático/terapia , Sobrevivientes
8.
Altern Ther Health Med ; 27(2): 22-26, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33711819

RESUMEN

Background: Auricular acupuncture (AA) is a complementary/integrative therapy, and can be used as adjuvant treatment in sleep disorders, anxiety and the painful symptomatology of temporomandibular disorders (TMDs). Objective: The aim of this investigation was to evaluate the effectiveness of AA in reducing the symptoms of sleep disorders, anxiety and TMDs by applying the Fletcher and Luckett, Beck-BAI and RDC/TMD questionnaires: Axis II, respectively. Design: This was a nonrandomized clinical trial in which AA was administered to patients between the ages of 20 and 45 years from the School of Dentistry at Ribeirão Preto, São Paolo, Brazil, who had at least one of the following: sleep disorder, anxiety or TMD. Intervention: Mustard seeds were applied to predetermined auricular acupoints including: Shen Men, neurovegetative system (sympathetic), kidney, anxiety, stomach, maxilla and mandible, liver and stress, once a week for 8 weeks. Outcome Measures: To analyze the reduction in sleep disorder symptoms, we used the Fletcher and Luckett questionnaire; for anxiety symptoms, the Beck-BAI questionnaire, and for the degree of chronic TMD pain, the RDC/TMD (Axis II) questionnaire. Results: Data on sleep, anxiety and TMD disorders were analyzed via Fisher's exact, Wilcoxon and Chi-Square non-parametric tests (α = 0.05), respectively. Reduction in sleep disorder symptoms after the proposed intervention was verified, showed a statistically significant difference (P = .014). There was a reduction in mean anxiety score and a decrease in painful TMD symptoms, but no significant difference (P = .50; P = .947, respectively) before and after AA. Conclusion: In our study, AA was effective in reducing sleep disorder symptoms and our data suggests some relief of symptoms of anxiety and TMD pain.


Asunto(s)
Acupuntura Auricular , Trastornos del Sueño-Vigilia , Trastornos de la Articulación Temporomandibular , Adulto , Ansiedad/terapia , Trastornos de Ansiedad , Brasil , Depresión , Humanos , Masculino , Persona de Mediana Edad , Sueño , Trastornos del Sueño-Vigilia/terapia , Trastornos de la Articulación Temporomandibular/terapia , Adulto Joven
9.
Trials ; 22(1): 186, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33673867

RESUMEN

BACKGROUND: Depression and anxiety impact up to 1 in 5 pregnant and postpartum women worldwide. Yet, as few as 20% of these women are treated with frontline interventions such as evidence-based psychological treatments. Major barriers to uptake are the limited number of specialized mental health treatment providers in most settings, and problems with accessing in-person care, such as childcare or transportation. Task sharing of treatment to non-specialist providers with delivery on telemedicine platforms could address such barriers. However, the equivalence of these strategies to specialist and in-person models remains unproven. METHODS: This study protocol outlines the Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) randomized trial. SUMMIT is a pragmatic, non-inferiority test of the comparable effectiveness of two types of providers (specialist vs. non-specialist) and delivery modes (telemedicine vs. in-person) of a brief, behavioral activation (BA) treatment for perinatal depressive and anxiety symptoms. Specialists (psychologists, psychiatrists, and social workers with ≥ 5 years of therapy experience) and non-specialists (nurses and midwives with no formal training in mental health care) were trained in the BA protocol, with the latter supervised by a BA expert during treatment delivery. Consenting pregnant and postpartum women with Edinburgh Postnatal Depression Scale (EPDS) score of ≥ 10 (N = 1368) will be randomized to one of four arms (telemedicine specialist, telemedicine non-specialist, in-person specialist, in-person non-specialist), stratified by pregnancy status (antenatal/postnatal) and study site. The primary outcome is participant-reported depressive symptoms (EPDS) at 3 months post-randomization. Secondary outcomes are maternal symptoms of anxiety and trauma symptoms, perceived social support, activation levels and quality of life at 3-, 6-, and 12-month post-randomization, and depressive symptoms at 6- and 12-month post-randomization. Primary analyses are per-protocol and intent-to-treat. The study has successfully continued despite the COVID-19 pandemic, with needed adaptations, including temporary suspension of the in-person arms and ongoing randomization to telemedicine arms. DISCUSSION: The SUMMIT trial is expected to generate evidence on the non-inferiority of BA delivered by a non-specialist provider compared to specialist and telemedicine compared to in-person. If confirmed, results could pave the way to a dramatic increase in access to treatment for perinatal depression and anxiety. TRIAL REGISTRATION: ClinicalTrials.gov NCT04153864 . Registered on November 6, 2019.


Asunto(s)
Ansiedad/terapia , Depresión Posparto/terapia , Depresión/terapia , Accesibilidad a los Servicios de Salud , Complicaciones del Embarazo/terapia , Psicoterapia/métodos , Telemedicina/métodos , Prestación de Atención de Salud/métodos , Estudios de Equivalencia como Asunto , Femenino , Humanos , Servicios de Salud Materna , Servicios de Salud Mental/organización & administración , Partería , Enfermeras y Enfermeros , Ensayos Clínicos Pragmáticos como Asunto , Embarazo , Escalas de Valoración Psiquiátrica , Psiquiatría , Psicología , Trabajadores Sociales , Especialización
10.
J Altern Complement Med ; 27(S1): S14-S27, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33788604

RESUMEN

Objective: Suicide is a major public health problem, specifically among U.S. veterans, who do not consistently engage in mental health services, often citing stigma as a barrier. Complementary and Integrative Health (CIH) interventions are promising alternatives in promoting patient engagement and further, they may play a critical role in transitioning people into mental health care. Toward this goal, the Resilience and Wellness Center (RWC) was developed to break through the stigma barrier by addressing risk factors of suicide through multimodal CIH interventions via cohort design, promoting social connectedness and accountability among participants. Design: This is a program evaluation study at a large urban VA medical center, where assessments were evaluated from pre- to post-program completion to determine the effectiveness of an intensive multimodal CIH 4-week group outpatient intervention for suicide prevention. Outcome measures: Primary outcomes measured included group connectedness, severity of depression and hopelessness symptoms, suicidal ideation, sleep quality, and diet. Secondary outcomes included measures of post-traumatic stress disorder (PTSD), generalized anxiety severity stress/coping skills, pain, and fatigue. Results: The RWC showed high participant engagement, with an 84%-95% attendance engagement rate depending on suicide risk history. Data from 15 cohorts (N = 126) demonstrate favorable outcomes associated with participation in this comprehensive program, as evidenced by a reduction in suicidal ideation, depression, and hopelessness, but not sleep quality and diet. In addition, in a subset of veterans with a history of suicidal ideation or attempt, significant improvements were noted in pain, PTSD/anxiety symptoms, and stress coping measures. Conclusions: The RWC shows that an intensive complement of CIH interventions is associated with a significant improvement with high veteran engagement. Findings from this program evaluation study can be used to aid health care systems and their providers in determining whether or not to utilize such multimodal CIH integrated interventions as an effective treatment for at-risk populations as a part of suicide prevention efforts.


Asunto(s)
Terapias Complementarias , Suicidio/prevención & control , Salud de los Veteranos , Adaptación Psicológica , Adulto , Anciano , Ansiedad/terapia , Depresión/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos por Estrés Postraumático/terapia , Estados Unidos , Veteranos
11.
J Affect Disord ; 286: 282-295, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33756306

RESUMEN

Parent- and family-level correlates of youth anxiety are well-documented, and they highlight potential targets for family-focused intervention. Although family-based approaches for treating youth anxiety generally are considered efficacious for achieving symptom reduction, they vary in format and approach and it remains unclear whether they offer an advantage over individual child treatment. To better understand the current state of the evidence, we used meta-analytic methods to examine the therapeutic approaches described in existing family interventions for child and adolescent anxiety, whether they mapped to the major mechanisms proposed in the literature, and the timeline along which relevant parent/family variables were measured. We examined how these mechanism-focused family interventions performed in RCTs relative to individual child CBT and whether they shifted symptoms and relevant parenting behaviors. A total of 11 randomized controlled trials (RCTs) compared individual cognitive behavior therapy (CBT) to CBT+ a family component (CBT + FAM) and included a youth anxiety measure at pre- and post-treatment; only half of these (n=6) also included a parent/family functioning measure at both pre- and post-treatment (across both primary and secondary outcome papers). Only a single study included anxiety measures at a mid-treatment time point, and none included parent measures at a mid-treatment time point. Findings are discussed in terms of design considerations and advancing the field of family intervention for youth anxiety.


Asunto(s)
Trastornos de Ansiedad , Terapia Cognitivo-Conductual , Adolescente , Ansiedad/terapia , Trastornos de Ansiedad/terapia , Niño , Humanos , Responsabilidad Parental , Padres
12.
Medicine (Baltimore) ; 100(12): e25040, 2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33761662

RESUMEN

BACKGROUND: Lung cancer patients often accompanied with severe depression and anxiety emotions, and those negative emotions could affects the treatment and recovery of the illness, decrease the patients' quality of life. In recent years, traditional Chinese medicine five-element music therapy (TCM-FEMT) is widely used for psychological problems of lung cancer patients for its unique advantages, TCM-FEMT applied to negative emotions management of lung cancer patients has been reported in many publications, but there is lacks evidence-based medicine, in this study, effectiveness of TCM-FEMT on anxiety and depression emotions of lung cancer patients will be systematically evaluated. METHODS: PubMed, the Cochrane Library, Web of Science, Embase, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Database, WanFang Database were electronically searched to collect RCTs on the efficacy of TCM-FEMT on anxiety and depression emotions of lung cancer patients from inception to February 2021. In addition, retrospect the references of the included literature to supplement the relevant literature. Research selection, data extraction and quality evaluation of literature will be carried out by 2 researchers, respectively. RevMan 5.3 software will be used for statistical analysis. RESULTS: This study will comprehensively summarize the current trials to determine the effectiveness of TCM-FEMT on anxiety and depression emotions of lung cancer patients. CONCLUSION: This study will provide comprehensive evidence for the efficacy of TCM-FEMT on anxiety and depression emotions of lung cancer patients.


Asunto(s)
Ansiedad/terapia , Depresión/terapia , Neoplasias Pulmonares/psicología , Medicina China Tradicional/métodos , Metaanálisis como Asunto , Musicoterapia/métodos , Revisiones Sistemáticas como Asunto , Humanos , Proyectos de Investigación
13.
Trials ; 22(1): 171, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33648555

RESUMEN

BACKGROUND: The coronavirus-19 (COVID-19) has reached pandemic status and is affecting countries all over the world. The COVID-19 pandemic is accompanied by various stressors that require adjustment in everyday life and possibly changes in personal future prospects. While some individuals cope well with these challenges, some develop psychological distress including depressive symptoms, anxiety, or stress. Internet-based self-help interventions have proven to be effective in the treatment of various mental disorders such as depression and anxiety. Based on that, we developed an internet-based self-help program for individuals with psychological distress due to the situation surrounding the COVID-19 pandemic. The 3-week self-help program consists of 6 modules comprising texts, videos, figures, and exercises. Participants can request guidance within the self-help program (guidance on demand). The primary aim of this study is to evaluate the efficacy and feasibility of the self-help program compared to a waiting control condition. METHODS: The design is a parallel group randomized controlled trial. Participants are allocated to a 3-week self-help intervention plus care as usual or a 3-week waiting period with only care as usual. There are follow-ups after 6 weeks and 18 weeks. At least 80 participants with COVID-19 pandemic related psychological distress will be recruited. Primary outcome are depressive symptoms. Secondary outcomes include anxiety and chronic stress, suicidal experiences and behavior, health-related quality of life, generalized optimism and pessimism, embitterment, optimistic self-beliefs, emotion regulation skills, loneliness, resilience, and the satisfaction with and usability of the self-help program. DISCUSSION: To the best of our knowledge, this is one of the first studies investigating the efficacy of an internet-based self-help program for psychological distress due to the situation surrounding the COVID-19 pandemic. Thus, the results of this study may give further insight into the use of internet-based self-help programs in pandemic-related psychological distress. TRIAL REGISTRATION: ClinicalTrials.gov NCT04380909 . Retrospectively registered on 8 May 2020.


Asunto(s)
Ansiedad/terapia , Depresión/terapia , Intervención basada en la Internet , Autocuidado , Estrés Psicológico/terapia , Ansiedad/psicología , Depresión/psicología , Regulación Emocional , Humanos , Soledad , Optimismo , Cuestionario de Salud del Paciente , Satisfacción del Paciente , Pesimismo , Distrés Psicológico , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Resiliencia Psicológica , Autoeficacia , Automanejo , Estrés Psicológico/psicología , Ideación Suicida
14.
Medicine (Baltimore) ; 100(8): e24958, 2021 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-33663136

RESUMEN

BACKGROUND: Irritable bowel syndrome (IBS) is the most commonly gastrointestinal diseases. The Rome Foundation's global study on 33 countries shows the total prevalence of IBS under the Rome IV Diagnostic Criteria was 3.8%. It is well established that people with IBS have higher levels of anxiety and depression. The impact of the acupuncture associated with anxiety and depression has been widely studied in Western countries. Acupuncture may be a promising choice for the treatment of anxiety and depression in IBS. METHODS: RCTs of acupuncture for depression and anxiety in IBS will be searched in the relevant database, including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), and Chinese Scientific Journal Database (VIP database). The studies of electronic searches will be exported to EndNote V.9.1 software. We will run meta-analyses using the Review Manager (RevMan) V.5.3 software. Any disagreement will be solved in consultation with a third reviewer. RESULTS: Our study aims to explore the efficacy of acupuncture for depression and anxiety in IBS and to provide up-to-date evidence for clinical of IBS. CONCLUSION: This study will perform a comprehensive systematic review and meta-analysis on the efficacy of acupuncture for depression and anxiety in IBS, making up for the lack of relevant evidence of the clinical use of acupuncture. INPLASY REGISTRATION NUMBER: INPLASY 202120014.


Asunto(s)
Terapia por Acupuntura/métodos , Ansiedad/terapia , Depresión/terapia , Síndrome del Colon Irritable/psicología , Ansiedad/complicaciones , Depresión/complicaciones , Humanos , Síndrome del Colon Irritable/complicaciones , Revisiones Sistemáticas como Asunto
15.
Public Health ; 192: 49-55, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33631514

RESUMEN

OBJECTIVES: Arts on prescription (AoP) interventions are part of mainstream social prescribing provision in primary health care. Whilst the body of evidence for AoP interventions has been developing, this has primarily focused on well-being. STUDY DESIGN: The present work is an observational longitudinal study on a community-based AoP social prescribing intervention in the South West UK. METHOD: The present study assessed changes in anxiety, depression, and well-being in a cohort of patients participating in up to two eight-week cycles of AoP. The sample consisted of 245 individuals referred into the programme from 2017 to 2019, with a sub-sample of participants (N = 110) with identifiable multimorbidity. Outcomes were measured pre- and post-intervention at both initial and re-referral. RESULTS: Anxiety, depression, and well-being were all significantly improved after initial referral, re-referral, and overall from initial to post re-referral for this intervention in the whole sample and multimorbid sub-sample. Multivariate analyses revealed that no participant variables appeared to account for the variance in outcome change scores. CONCLUSION: The research provides further support for AoP interventions, finding associations with reduced anxiety and depression and increased well-being. Additionally, these outcomes are evidenced in those with multimorbidity, as well as across initial- and re-referral cycles.


Asunto(s)
Trastornos de Ansiedad/terapia , Ansiedad/terapia , Enfermedad Crónica/terapia , Depresión/psicología , Depresión/terapia , Promoción de la Salud/métodos , Prescripciones , Derivación y Consulta/organización & administración , Adulto , Ansiedad/diagnóstico , Ansiedad/psicología , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/psicología , Depresión/diagnóstico , Femenino , Personal de Salud , Humanos , Estudios Longitudinales , Masculino , Salud Mental , Persona de Mediana Edad , Multimorbilidad , Atención Primaria de Salud , Resultado del Tratamiento
16.
Epilepsy Behav ; 116: 107800, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33571838

RESUMEN

OBJECTIVE: To evaluate the impact of the coronavirus disease 2019 (COVID-19) measures on the lives and psychosocial well-being of persons with epilepsy (PWE) during the third trimester of the COVID-19 pandemic. METHODS: A structured questionnaire investigating different aspects of the lives and psychosocial well-being of PWE during the COVID-19 pandemic was developed. Persons with epilepsy were invited via social media to anonymously respond to a secure web-based online questionnaire (www.icpcovid.com). Responses were collected between July 26th and December 3rd, 2020. Hospital anxiety and depression scales (HADS) were used to screen respondents for depression (HADS-D) and anxiety (HADS-A). RESULTS: Responses of 407 PWE were included in the analysis; 304 (74.7%) respondents were female and 245 (60.2%) living in Europe, 157 (38.6%) in South America, and 5 (1.2%) in Canada. Seventy-six (18.7%) reported a decrease of income during the COVID-19 lockdown, and 122 (30.0%) experienced difficulties in obtaining anti-seizure medication (ASM), mostly (72/122, 59.0%) due to unavailability. Seizure frequency increased in 122 (30.0%); 295 (72.5%) screened positive for anxiety, and 159 (39.1%) for depression. Hundred eighty-eight (46.2%) reported reluctance to seek medical care; 27.3% believed that epilepsy was associated with an increased risk of COVID-19 disease. Forty-six (74.2%) of 62 PWE who were followed up by telephone or video consult were satisfied with this consult. Fifty-five respondents, most (89.1%) of whom were from Europe, had also participated in a previous survey during the early months of the pandemic. In this subgroup, although there was no difference in prevalence of a positive screening for depression or anxiety, mean scores on HADS-A and HADS-D increased from 6.65 ±â€¯3.99 to 7.27 ±â€¯4.01 (p = 0.418), and from 5.84 ±â€¯4.43 to 6.60 ±â€¯4.45 (p = 0.371), respectively. CONCLUSIONS: The COVID-19 pandemic continues to impact the psychosocial and somatic well-being of PWE. To minimize this impact, ensuring uninterrupted access to ASM is essential. Teleconsultations are valid alternatives for continued follow-up, but should include attention to psychosocial well-being. Persons with epilepsy should be more actively informed that epilepsy is not a risk factor for developing (more severe) COVID-19 disease.


Asunto(s)
/epidemiología , Epilepsia/epidemiología , Epilepsia/psicología , Internacionalidad , Encuestas y Cuestionarios , Adulto , Ansiedad/epidemiología , Ansiedad/psicología , Ansiedad/terapia , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/tendencias , Prestación de Atención de Salud/métodos , Prestación de Atención de Salud/tendencias , Epilepsia/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias/prevención & control , Consulta Remota/métodos , Consulta Remota/tendencias , Factores de Riesgo , Convulsiones/epidemiología , Convulsiones/psicología , Convulsiones/terapia
17.
Medicine (Baltimore) ; 100(4): e23684, 2021 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-33530169

RESUMEN

BACKGROUND: The present evidence is insufficient for evaluating the impact of exclusive music therapy on anxiety and pain control in extracorporeal shock wave lithotripsy (ESWL). METHODS: A systematic review and meta-analysis was conducted to explore the efficacy of music therapy in reducing pain and anxiety in patients undergoing ESWL. PubMed, Web of Science, Embase, EBSCO, and Cochrane library databases (updated March 2020) were searched for randomized controlled trials assessing music therapy in reducing pain and anxiety in patients undergoing ESWL. The search strategy and study selection process were managed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. RESULTS: Five randomized controlled trials were included in the meta-analysis. Overall, music intervention groups experienced significant reductions in pain (risk ratios = -1.20, 95% confidence intervals = -1.95 to -0.45, P = .002) and anxiety (risk ratios = -3.31, 95% confidence intervals = -4.97 to -1.84, P < .0001) compared with control groups during ESWL. Music therapy gave patient more satisfaction with the treatment and a willingness to repeat the therapy was reported. However, there was no significant difference in the stone clearance rate. CONCLUSIONS: Listening to music can reduce patient's pain and anxiety significantly with increased therapy satisfaction and willingness to repeat.


Asunto(s)
Ansiedad/terapia , Litotricia/efectos adversos , Musicoterapia/métodos , Manejo del Dolor/métodos , Dolor Asociado a Procedimientos Médicos/terapia , Adulto , Ansiedad/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor Asociado a Procedimientos Médicos/etiología , Satisfacción del Paciente , Ensayos Clínicos Controlados Aleatorios como Asunto , Proyectos de Investigación , Resultado del Tratamiento
18.
Medicine (Baltimore) ; 100(4): e24154, 2021 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-33530205

RESUMEN

ABSTRACT: This study intended to discover the effect of education and muscle relaxation (EMR) program on anxiety, depression and care burden among caregivers of acute stroke survivors.This randomized, controlled study enrolled a total of 110 caregivers of first-ever acute stroke patients, and randomly assigned to EMR (N = 55) and control (N = 55) groups. The caregivers in the EMR group received 12-month health education and progressive muscle relaxation, and those in control group were provided common rehabilitation advices. Hospital Anxiety and Depression Scale (HADS) and Zarit Caregiver Burden Scale in caregivers were evaluated at the time of patients' discharge from hospital (M0), then at month(M) 3, M6 and M12 after the discharge.HADS-anxiety score, anxiety rate and severity were similar at M0, M3, while were reduced at M6 and M12 in EMR group compared to control group. Furthermore, HADS-depression score was similar at M0 and M3 but was decreased at M6 and M12 in EMR group compared with control group, however, there was no difference of depression rate and severity between the 2 groups at each time point. Moreover, Zarit Caregiver Burden Scale score was similar at M0 and M3, but was decreased at M6 and M12; meanwhile, degree of care burden was similar at M0, M3 and M6, but was reduced at M12 in EMR group compared to control group.EMR program decreases anxiety, depression and care burden in caregivers of acute stroke survivors, suggesting its potential in improving mental health and further promoting quality of lives in these caregivers.


Asunto(s)
Ansiedad/terapia , Entrenamiento Autogénico/métodos , Cuidadores/psicología , Depresión/terapia , Educación en Salud/métodos , Accidente Cerebrovascular/epidemiología , Anciano , Anciano de 80 o más Años , Ansiedad/epidemiología , Entrenamiento Autogénico/educación , Cuidadores/educación , Depresión/epidemiología , Escolaridad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad
19.
J Affect Disord ; 282: 766-775, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33601717

RESUMEN

INTRODUCTION: Anxiety expression varies by age in youth, and evaluation of putative mechanisms in treatment must consider both conjointly. Accordingly, age would moderate the mediation effect of anxiety in a youth obsessive-compulsive disorder (OCD) treatment trial. METHODS: Fifty-six children ages 7 - 17 participated in an RCT comparing three treatments: CBT with standard dosing of sertraline, CBT with slow dosing of sertraline, and CBT with placebo. To examine the moderated-mediation effects for OCD symptom improvement, we discretized the continuous anxiety and OCD measures into three symptom outcome categories, "improved", "unchanged", and "deteriorated". To evaluate the moderating effect of age, we further examined the association of age and anxiety with the "improved" OCD category. For analysis, the age groups used as rows were cross tabulated with discretized anxiety and OCD measures. To estimate category associations with correlations, we adopted correspondence analysis. RESULTS: The correlational results indicate that for all treatment conditions, age was a moderator of the mediation effect of physical anxiety symptoms for the improved OCD measures (outcomes). Specifically, age suppressed correlations with OCD outcomes, with Physical Symptoms as a mediator for the outcome measures. This moderated mediation effect was most evident for ages 8-10 in the CBT with placebo group. LIMITATIONS: The moderated mediation effect manifest in this single RCT-based study should be validated in other studies. DISCUSSION: Future research investigating a wider range of ages as a potential moderator of other symptom and emotion mediators of outcome is warranted, particularly in relation to individual symptom profiles of OCD.


Asunto(s)
Terapia Cognitivo-Conductual , Trastorno Obsesivo Compulsivo , Adolescente , Ansiedad/terapia , Trastornos de Ansiedad/terapia , Niño , Terapia Combinada , Humanos , Trastorno Obsesivo Compulsivo/terapia , Resultado del Tratamiento
20.
J Affect Disord ; 282: 996-1004, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33601745

RESUMEN

OBJECTIVE: . Exercise has established efficacy in people with anxiety and stress-related disorders. Dropouts from randomized controlled trials (RCT's) pose a threat to the validity of the evidence, with dropout rates varying across studies. We conducted a meta-analysis to investigate the prevalence and predictors of dropout rates among adults with anxiety and stress-related disorders participating in exercise RCT's. METHODS: . Two authors searched major electronic databases up to 07/2020. We included RCT's of exercise interventions in people with anxiety and stress-related disorders that reported dropout rates. A random effects meta-analysis and meta-regression were conducted. RESULTS: . Fourteen RCT's involving 16 exercise interventions (n=369, mean age 20.7 to 67.7years; 38.4% male) were included. The trim-and-fill-adjusted prevalence of dropout across all studies was 22.4% (95%CI = 15.0% to 32.0%). Applying controlled motivation strategies (P<0.001) predicted higher dropout. Supervision during all sessions and by an expert in exercise prescription and applying autonomous motivation strategies predicted lower dropout (all P<0.001). Dropout was similar in exercise versus control conditions (OR = 0.84, 95%CI = 0.54 to 1.29, p = 0.42, I2 = 0%; N=16). LIMITATIONS: . Potentially important moderators of dropout, such as the severity of mental health symptoms and illness duration were insufficiently available. CONCLUSIONS: . Exercise is well tolerated by people with anxiety and stress-related disorders and drop out in RCT's is comparable to control conditions. Thus, exercise is a feasible treatment, in particular when autonomous motivation strategies are included and when the intervention is delivered by healthcare professionals with expertise in exercise prescription.


Asunto(s)
Trastornos de Ansiedad , Pacientes Desistentes del Tratamiento , Adulto , Anciano , Ansiedad/terapia , Trastornos de Ansiedad/terapia , Ejercicio Físico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Adulto Joven
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...