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1.
Behav Brain Res ; 456: 114711, 2024 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-37827252

RESUMO

Traumatic brain injury (TBI) is a leading cause of mortality and is associated with a high rate of functional comorbidities, including motor, cognitive, anxiety, depression, and emotional disorders. TBI pathophysiology and recovery are complicated and involve several mechanistic pathways that control neurobehavioral outcomes. In this study, male and female C57Bl/6 J mice were subjected to a controlled cortical impact model of TBI or sham injury and evaluated for different neurobehavioral and inflammatory outcomes over a month. We demonstrate that TBI mice have increased motor dysfunction at early and late time points following the injury as compared to the sham group. Anxiety-like symptoms were time- and task-dependent, with both sexes having increased anxiety-like behavior 2 weeks post-injury. Cognitive functions measured by T-maze presented greater deficits in TBI mice, while there was no sex or injury-related difference in depressive-like behaviors. Notably, a significant effect of sex was found in empathy-like behavior, with females showing more allogrooming and freezing behavior in the consoling and fear observational tests, respectively. Evaluating the impact of the injury-induced brain damage demonstrated a greater injury volume and neuronal degeneration in males compared to females one month after TBI. Moreover, male mice showed higher peripheral inflammatory responses, as represented by elevated serum levels of peripheral leukocytes and inflammatory markers. These results will have significant implications for understanding TBI's long-term consequences on neurobehavioral and inflammatory responses, which are sex-specific and can be considered for individualized therapeutic strategies in treating TBI.


Assuntos
Lesões Encefálicas Traumáticas , Lesões Encefálicas , Camundongos , Masculino , Feminino , Animais , Lesões Encefálicas/complicações , Ansiedade/etiologia , Cognição , Leucócitos/metabolismo , Camundongos Endogâmicos C57BL , Modelos Animais de Doenças
2.
Behav Brain Res ; 456: 114706, 2024 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-37806564

RESUMO

We examined the roles of oxytocin (OT) receptors in the prefrontal cortex (PFC) in short- and long-term social recognition and anxiety-related behaviors in mice. Mice injected with high or low doses of an OT receptor antagonist (OTA) or vehicle performed the social recognition test, the open-field test, and the light-dark transition test. In the social recognition test, with three daily trials over three consecutive days, control mice showed short-term recognition of a conspecific on all three days. In contrast, a high-dose injection of OTA impaired short-term social recognition on the second and third days, and it was impaired by a low-dose injection of OTA on the third day. These results suggested that OTA injection into the PFC dose-dependently inhibited short-term social recognition within each day. All three groups did not show any long-term social recognition across three days. OTA injection did not affect anxiety related behavior in the open-field and light-dark transition tests. Our findings demonstrated that OT receptors in the PFC played important roles in short-term social recognition.


Assuntos
Córtex Pré-Frontal , Receptores de Ocitocina , Comportamento Social , Animais , Camundongos , Ansiedade , Ocitocina/farmacologia , Córtex Pré-Frontal/metabolismo , Receptores de Ocitocina/metabolismo
3.
J Affect Disord ; 344: 33-40, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37793475

RESUMO

BACKGROUND: Depressive and anxiety symptoms (depression and anxiety hereafter) are common among psychiatric patients and their caregivers during the COVID-19 pandemic. Network analysis is a novel method to assess the associations between psychiatric syndromes/disorders at the symptom level. This study examined depression and anxiety among caregivers of psychiatric inpatients during the late stage of the COVID-19 pandemic from the perspective of network analysis. METHODS: A total of 1101 caregivers of psychiatric inpatients were included in this study. The severity of depression was assessed using the nine-item Patient Health Questionnaire (PHQ-9), while anxiety was assessed with the seven-item Generalized Anxiety Disorder Scale (GAD-7). The expected index (EI) and bridge EI index were used to identify the central and bridge symptoms, respectively. The stability of the network was evaluated via a case-dropping bootstrap procedure. RESULTS: The prevalence of depression and anxiety were 32.4 % (95%CI: 29.7 %-35.3 %) and 28.0 % (95%CI: 25.4 %-30.7 %), respectively while the prevalence of comorbid depression and anxiety was 24.9 % (95%CI: 22.4 %-27.6 %). The most central symptom was "Fatigue", followed by "Trouble Relaxing" and "Restlessness". The highest bridge symptom was "Restlessness", followed by "Uncontrollable worry" and "Suicide ideation". The bootstrap test indicated that the whole network model was stable, and no network difference was detected between genders and between different education levels. CONCLUSIONS: Depression, anxiety, and comorbid depression and anxiety were common among caregivers of psychiatric inpatients during the late stage of the COVID-19 pandemic. Central and bridge symptoms identified in this network analysis should be considered key target symptoms to address in caregivers of patients.


Assuntos
COVID-19 , Depressão , Humanos , Feminino , Masculino , Depressão/psicologia , Cuidadores/psicologia , Pandemias , COVID-19/epidemiologia , Ansiedade/psicologia
4.
J Affect Disord ; 344: 104-114, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37802320

RESUMO

BACKGROUND: Prenatal maternal anxiety is a known influence on offspring development. General anxiety and pregnancy-related anxiety (a distinct type of anxiety encompassing fears associated with pregnancy) are associated with offspring socioemotional development, with potential consequences for later emotional and behavioral problems. This study examines whether maternal pregnancy-related and general anxiety relate to infant attention to affective faces, a process which plays an integral role in early socioemotional development. METHODS: Participants included 86 mothers and their 6-month-old infants (56.3 % female). Mothers completed measures of pregnancy-related and general anxiety three times through gestation. Infants' attention to affective faces was assessed with an eye-tracking task during which a series of face pairs were presented (happy, angry, or sad face paired with a neutral face). Overall attention measures included attention-holding (total looking time) and attention-orienting (latency to faces); affect-biased attention measures included proportion of total looking time to emotional faces and latency difference score. RESULTS: Higher maternal pregnancy-related anxiety across gestation predicted decreased infant attention-holding to affective faces [F(1,80) = 7.232, p = .009, partial η2 = 0.083]. No differences were found in infant attention-orienting or affect-biased attention. LIMITATIONS: Reliance on a correlational study design precludes the ability to make causal inferences. CONCLUSIONS: Maternal pregnancy-related anxiety is an important predictor of child outcomes. We provide novel evidence that pregnancy-related anxiety predicts infant attention to emotional faces, behaviors which have important implications for socioemotional development. Providers may consider pregnancy-related anxiety as a target for screening and treatment that may benefit both pregnant individual and offspring.


Assuntos
Ansiedade , Emoções , Feminino , Humanos , Lactente , Masculino , Gravidez , Ira , Ansiedade/psicologia , Expressão Facial , Felicidade , Mães/psicologia
5.
J Affect Disord ; 344: 1-7, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37802321

RESUMO

BACKGROUND: Trait anxiety is a vulnerability factor for the development of generalized anxiety disorder (GAD). The hippocampus has been implicated in trait anxiety in normal and GAD populations. However, the exact neural mechanism of hippocampal functional connectivity (FC) and its association with clinical symptoms and trait anxiety in GAD patients remains unknown. METHODS: We recruited 68 participants (37 drug-naïve non-comorbidity GAD patients and 31 matched healthy controls (HC)), assessed their trait and state anxiety, scanned them with structural and resting-state functional magnetic resonance imaging (fMRI), and compared their hippocampal FC and volumes. We explored the relationships between hippocampal FC, clinical symptoms, and trait anxiety using partial correlation analyses; we also investigated the mediating effects of trait anxiety on the association between hippocampal FC and GAD symptom severity. RESULTS: The GAD group showed increased right hippocampal FC with left insula, which was positively correlated with the Self-Rating Anxiety Scale (SAS), State Anxiety Inventory (SAI), and Trait Anxiety Inventory (TAI). Trait anxiety mediated the relationship between hippocampal FC and anxiety levels. We found no significant difference in hippocampal volumes between GAD and HC. LIMITATIONS: The sample size was moderate. The exclusion of comorbidity may reduce the generalizability of our results in normal clinical settings. CONCLUSIONS: The GAD patients showed no structural change but had functional alterations in the hippocampus. More importantly, future psychotherapy for this disorder should consider that trait anxiety might play a crucial role in the altered hippocampal FC in GAD.


Assuntos
Transtornos de Ansiedade , Imageamento por Ressonância Magnética , Humanos , Adulto , Imageamento por Ressonância Magnética/métodos , Ansiedade/diagnóstico por imagem , Hipocampo/patologia
6.
J Affect Disord ; 344: 301-310, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37805157

RESUMO

BACKGROUND: Mental health problems in mothers and fathers are common. This longitudinal study analyzed the prevalence, course, and persistence of symptoms of depression, anxiety, and stress over 18 years in parents based on a sample from the Future Family project (N = 316). METHODS: At pre-assessment the children were on average 4.2, the mothers 35.3, and the fathers 38.1 years old. Over time, the parents repeatedly filled out the "Depression, Anxiety, Stress Scales" (DASS). Analyses included descriptive methods, Chi2-tests, binary logistic regression models, and different analytical approaches (number chains, transition probability). RESULTS: Approximately 6.2 % of mothers and 8.2 % of fathers suffered from borderline clinical or clinically relevant depression (anxiety: 5.4 %/6.3 %, stress: 12.6 %/14.2 %). The largest proportion of the sample was stable healthy over the 18-year period (depression: 89.1 %/86.8 %; anxiety: 90.2 %/86.2 %; stress: 75.3 %/75.7 %), whereas 2.2 % of mothers and 3.9 % of fathers showed chronic symptoms of depression (anxiety: 1.8 %/3.9 %; stress: 5.1 %/9.2 %). The remaining mothers and fathers were distributed among positive, negative, and transient courses. Child's mental health problems and mother's traumatic experiences in childhood were found to be important predictors of maternal chronic symptoms of depression, anxiety, and stress. Based on the selected models, no significant prediction was found for fathers. The average short-term persistence (from one assessment to the next) was 42 % in mothers and 44 % in fathers, the average long-term persistence rates (over 18 years) were somewhat lower (35 %/38 %). CONCLUSION: Prevention programs and psychotherapy should be considered as an effective and economic approach to reduce mothers' and fathers' psychopathology in Germany.


Assuntos
Depressão , Mães , Feminino , Criança , Humanos , Adulto , Masculino , Mães/psicologia , Depressão/psicologia , Estudos Longitudinais , Prevalência , Ansiedade/psicologia , Pai/psicologia
7.
J Affect Disord ; 344: 69-78, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37820955

RESUMO

BACKGROUND: The growth of social media platforms has created a plethora of user-generated content, and social media has become an important channel of users to express their emotions. Although many studies have explored the influencing factors on user-generated content, there is an insufficient understanding the impact temporal cues on mental health content generation. OBJECTIVE: This study aimed to explore how the on-the-hour time points affect users' anxiety content generation on social media platforms. Further, this study investigates the difference between weekdays and weekends, and the moderating effects of regional economic levels. METHODS: We collected information on 2,543,902 user-generated anxiety-related posts from a leading social media platform in China. Then, we used fixed effect models to analyze the relationship between on-the-hour time points and user anxiety content generation. RESULTS: The results show that on-the-hour time points affect user anxiety-related content generation, especially at the beginning of each hour (ß = 894.564, p < 0.01). And the impact is greater on weekdays (ß = 774.695, p < 0.01) than on weekends (ß = 119.869, p < 0.01). Furthermore, regional economic moderates the impact, the better the economic condition, the greater the impact. LIMITATIONS: Limitations include incomplete coverage of patient types and a single anxiety dictionary. CONCLUSIONS: This study uncovers the relationship between temporal cues and user-generated anxiety content, providing new insights into the mental illness observation, and provides insights for mental health services providers and designers of online social platforms.


Assuntos
Mídias Sociais , Humanos , Ansiedade , Emoções , Transtornos de Ansiedade , Saúde Mental
8.
J Affect Disord ; 344: 115-121, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37827258

RESUMO

BACKGROUND: People with severe COVID anxiety have had experiences of the COVID-19 pandemic which are overwhelming, and have led to patterns of behaviours that add little protective benefit but are at the expense of other priorities in life. It appears to be a complex social and psychological phenomenon, influenced by demographic and social factors. Identifying subgroups of people with severe COVID anxiety would better place clinicians to assess and support this distress where indicated. METHODS: Measurement tools assessing depression, generalised and health anxiety, obsessive-compulsive symptoms, personality difficulty and alcohol use from 284 people living in United Kingdom with severe COVID anxiety were explored with latent profile analysis. Further analyses examined the associations of identified clusters with demographic and social factors and daily functioning, quality of life and protective behaviours. RESULTS: A model with 4 classes provided the best fit. Distinct patterns of psychopathology emerged which were variably associated with demographic factors and COVID behaviours. LIMITATIONS: Given the complex aetiology of COVID anxiety a number of factors which might better cluster subgroups are likely to have gone uncollected. Moreover, using data collected at a single time-point limits these results' ability to conclude whether observed relationships were the product of the pandemic or longstanding. CONCLUSIONS: People living with severe COVID anxiety are a heterogenous group. This analysis adds to evidence that certain health behaviours and demographic factors are inextricably linked to poor mental health in people with COVID anxiety, and that targeting health behaviours with specific intervention might be beneficial.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Pandemias , Qualidade de Vida , Ansiedade/psicologia , Transtornos de Ansiedade/epidemiologia , Depressão/psicologia
9.
J Affect Disord ; 344: 335-338, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37827263

RESUMO

BACKGROUND: Psoriasis patients are more likely to have mental disorders. The relationship between the reduction of involvement area and severity of lesions and the associated improvement in anxiety and depression in psoriasis patients, remains inadequately researched. METHODS: 200 psoriasis patients were enrolled in this prospective study, and received 12-week narrowband ultraviolet B (NB-UVB) therapy. The Psoriasis Area and Severity Index (PASI), Body Surface Area (BSA), and Physician Global Assessment (PGA) scores were obtained as the objective assessments of disease, each reflecting distinct aspects of the disease. The Hospital Anxiety and Depression Scale (HADS) was used to evaluate the anxiety and depression symptoms. RESULTS: Successful treatment brought an improvement in anxiety and depression levels and rates (all p < 0.05). Statistical analysis revealed no significant improvements in the scores of HADS or rates of symptomatic anxiety and depression in patients who did not achieve a PASI 75 response (all p > 0.05). Reductions in PASI, BSA and PGA were all statistically associated with reductions in HADS (all p < 0.05). BSA 75 response was found to play a more crucial role in the transition of symptomatic psoriatic patients to asymptomatic status (all p < 0.01). LIMITATIONS: The study focused on the short-term effects, and further research is needed to investigate the long-term effects. CONCLUSION: Successful treatment of psoriasis resulted in improvements in anxiety and depression levels and rates. In comparison with the lesion severity, reduction in the lesion involvement area had a greater impact on the anxiety and depression symptoms.


Assuntos
Depressão , Psoríase , Humanos , Estudos Prospectivos , Depressão/terapia , Ansiedade/terapia , Transtornos de Ansiedade/complicações , Psoríase/complicações , Psoríase/terapia , Índice de Gravidade de Doença , Resultado do Tratamento
10.
J Affect Disord ; 344: 122-131, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37832729

RESUMO

OBJECTIVE: To assess the presence of anxiety, depression and somatization in women with vulvodynia. METHODS: The search for articles was performed in the electronic databases MEDLINE, via PubMed, EMBASE, LILACS and the American Psychological Association (PsycINFO). A search strategy was developed using the following terms: "Vulvodynia" and "psychological symptom" and their respective synonyms. The search was limited to human studies and no language restriction. RESULTS: After the screening process, 10 studies met the eligibility criteria and were included in this review. The studies were published between 1993 and 2017, with 2886 participants, of which 912 are cases and 1974 are controls. Meta-analysis of included studies revealed a significant difference between groups in depression outcomes (DMP: 0.75; 95 % CI: 0.41 to 1.10; p < 0.0001; I2: 28 %), anxiety (DMP: 1.22; 95 % CI: 0.84 to 1.59; p < 0.00001; I2:0%) and somatization (DMP: 1.31; 95%CI: 0.80 to 1.82; p < 0.00001; I2: 46 %). CONCLUSION: Through the meta-analyses, significant associations were observed between vulvodynia and depression, anxiety and somatization.


Assuntos
Depressão , Vulvodinia , Humanos , Feminino , Depressão/diagnóstico , Depressão/epidemiologia , Vulvodinia/epidemiologia , Ansiedade/epidemiologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia
11.
J Affect Disord ; 344: 365-372, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37832734

RESUMO

BACKGROUND: Despite emerging evidence for the effect of childhood psychological maltreatment on adolescent depressive symptoms, the underlying processes for this effect are largely under-investigated. This study examined a conceptual framework for the effect of childhood psychological maltreatment on adolescent depressive symptoms through social anxiety disorder (SAD) and maladaptive emotion regulation strategies. METHODS: The participants were 1649 Chinese middle school students (751 girls and 898 boys) with a mean age of 16.29 ± 1.04 years old. A moderation-mediation model hypothesized that childhood psychological maltreatment predicts adolescent depressive symptoms, with SAD as a mediator and maladaptive emotion regulation strategies as a moderator. RESULTS: Childhood psychological maltreatment significantly positively predicted adolescent depressive symptoms, while SAD mediated the relation. Maladaptive emotion regulation strategies moderated the pathways from psychological maltreatment to depressive symptoms (but not from psychological maltreatment to SAD) and from SAD to adolescent depressive symptoms. LIMITATIONS: Subjective measures, and the cross-sectional design are the main limitations. CONCLUSIONS: SAD plays a mediating role in the relation between childhood psychological maltreatment and depressive symptoms. Maladaptive emotion regulation strategies exacerbate the relation between childhood psychological maltreatment and depressive symptoms, as well as the relation between SAD and depressive symptoms. These results highlight the importance of addressing social anxiety in reducing adolescent depressive symptoms by improving their cognitive emotion regulation strategies.


Assuntos
Maus-Tratos Infantis , Regulação Emocional , Masculino , Criança , Feminino , Humanos , Adolescente , Depressão/psicologia , Estudos Transversais , Maus-Tratos Infantis/psicologia , Inquéritos e Questionários , Ansiedade/psicologia
12.
J Affect Disord ; 344: 325-328, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37838267

RESUMO

BACKGROUND: Psychotic experiences are associated with depression and anxiety, but emerging research suggests that psychotic experiences are also associated with impairment within psychopathology. METHODS: We analyzed a subsample from the Healthy Minds Study (2020-2021; N = 91,435) and used multivariable logistic regression to examine the associations between psychotic experiences and impairment resulting from depression and anxiety, adjusting for age, gender, and race/ethnicity. RESULTS: Around one-in-five students with depression or anxiety impairment reported 12-month psychotic experiences. Psychotic experiences were associated with greater odds of depression impairment and anxiety impairment, adjusting for age, gender, race/ethnicity. Odds ratios varied depending on the type of psychotic experience and the outcomes. CONCLUSION: Psychotic experiences are associated with greater odds of impairment resulting from depression and anxiety. In clinical practice, psychotic experiences may serve as a useful marker of assessing impairment resulting from psychopathology.


Assuntos
Transtornos Mentais , Transtornos Psicóticos , Humanos , Estados Unidos/epidemiologia , Transtornos Psicóticos/epidemiologia , Depressão/epidemiologia , Ansiedade/epidemiologia , Estudantes
13.
J Affect Disord ; 344: 380-388, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37838273

RESUMO

BACKGROUND: Social anxiety (SA) has been linked to the coronavirus disease 2019 (COVID-19) pandemic, but the neurobiopsychological mechanisms underlying this relationship remain unclear. This study aimed to elucidate the neurofunctional markers for COVID-induced SA development and the potential role of COVID-related posttraumatic stress symptoms (PTSS) in the brain-SA alterations link. METHODS: Before the COVID-19 pandemic (T1), 100 general college students underwent resting-state magnetic resonance imaging and behavioral tests. During the period of community-level outbreaks (T2), these students were re-contacted to undergo follow-up behavioral assessments. RESULTS: Whole-brain correlation and prediction analyses found that pre-pandemic spontaneous neural activity (measured by fractional amplitude of low-frequency fluctuations) in the right fusiform gyrus (FG) was positively correlated to SA alterations (T2 - T1). Mediation analyses revealed that COVID-specific PTSS mediated the effects of right FG on SA alterations. LIMITATIONS: The results should be interpreted carefully because only one-session neuroimaging data in a sample of normal adults were included. CONCLUSIONS: The results provide evidence for neurofunctional markers of COVID-induced SA and may help develop targeted brain-based interventions that reduce SA.


Assuntos
COVID-19 , Pandemias , Adulto , Humanos , Encéfalo , Lobo Temporal/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Ansiedade/diagnóstico por imagem , Ansiedade/epidemiologia
14.
J Affect Disord ; 344: 219-232, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37839469

RESUMO

BACKGROUND AND PURPOSE: Anxiety and depression have been associated with imbalances in the gut microbiota and bile acid metabolism. Takeda G protein-coupled receptor 5 (TGR5), a bile acid receptor involved in metabolism, is influenced by the gut microbiota. This study aimed to investigate the relationship between anxiety, depression, and microbiota using TGR5 knockout mice. METHODS: We employed the following methods: (1) Assessment of behavioral changes, (2) Measurement of 5-HT levels and protein expression, (3) Analysis of stool samples, (4) Utilization of gene sequencing and statistical analysis to identify microbial signatures, (5) Examination of correlations between microbial signatures and 5-HT levels, and (6) Fecal microbiota transplantation experiments of TGR5-/- mice. RESULTS: The deletion of TGR5 was found to result in increased anxiety- and depression-like behaviors in mice. TGR5 knockout mice exhibited significant reductions in 5-hydroxytryptamine (5-HT) levels in both serum and hippocampus, accompanied by a decrease in the expression of 5-HT1A receptor in the hippocampus. Moreover, TGR5 deficiency was associated with a decrease in the species richness of the gut microbiota. Specifically, the gut microbiota compositions of TGR5 knockout mice displayed distinct differences compared to their littermates, characterized by higher abundances of Anaeroplasma, Prevotella, Staphylococcus, Jeotgalicoccus, and Helicobacter, and a lower abundance of Bifidobacterium. Notably, a strong association between Jeotgalicoccus as well as Staphylococcus and serum 5-HT levels was observed in co-occurrence network. Furthermore, mice that received fecal microbiota transplants from TGR5-/- mice displayed anxiety and depression -like behaviors, accompanied by alterations in 5-HT levels in the hippocampus and serum. LIMITATIONS: Study limitations for gut bacteria were analyzed at the genus level only. CONCLUSION: TGR5 deletion in mice induces anxiety and depression-like behaviors, linked to reduced 5-HT levels in serum and the hippocampus. Gut microbiota changes play a direct role in these behaviors and serotonin alterations. This implicates TGR5 and gut bacteria in mood regulation, with potential therapeutic implications.


Assuntos
Microbioma Gastrointestinal , Camundongos , Animais , Microbioma Gastrointestinal/genética , Depressão , Disbiose , Serotonina , Ansiedade , Camundongos Knockout , Ácidos e Sais Biliares
15.
J Affect Disord ; 344: 414-422, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37848088

RESUMO

BACKGROUND: Exposure-based cognitive-behaviour therapies (CBT) are effective but their acceptability in pregnancy is untested. Time-intensive delivery of CBT (INT-CBT) may accelerate treatment response. This feasibility trial aimed to explore this. METHODS: This multi-centre parallel-group trial recruited pregnant women with anxiety-related disorders via maternity and mental health settings and randomised (1:1) to INT-CBT (8-10 treatment hours over two weeks) or standard weekly one-hour CBT sessions (WCBT). Both groups also received late pregnancy and postpartum follow-ups. Participants received 10-12 total hours of individual therapy using remote delivery (95 %). Outcomes were assessed: at baseline; after two weeks of treatment, late pregnancy, at 1 and 3 months postpartum (by blinded assessors), alongside a qualitative interview. Pre-specified primary feasibility outcomes regarding acceptability, recruitment and retention were evaluated. The secondary outcome of adjusted mean difference was estimated for the proposed primary outcome. RESULTS: All feasibility outcomes were met. Of 135 screened, 59 women were randomised into the trial (29 INT-CBT:30 WCBT). 93 % completed treatment and 81 % provided data at 3 m postpartum. No adverse effects were attributable to treatment. Women receiving INT-CBT showed a reduction in anxiety (GAD-7) after two weeks of treatment compared to WCBT (aMD = -4.17, 95%CI -6.03 to -2.31) with narrower difference at 3-month postpartum aMD = -0.11 (95%CI -3.23, 3.00). Women described the momentum of INT-CBT as helpful to drive change. CONCLUSIONS: Exposure-based therapies are acceptable to pregnant women. INT-CBT may reduce anxiety quickly and should be tested in a confirmatory trial examining longer term outcomes. There may be limitations to generalisability from sampling and COVID. TRIAL REGISTRATION: doi:https://doi.org/10.1186/ISRCTN81203286 prospectively registered 27/6/2019.


Assuntos
Terapia Cognitivo-Comportamental , Humanos , Feminino , Gravidez , Estudos de Viabilidade , Terapia Cognitivo-Comportamental/métodos , Psicoterapia , Ansiedade/terapia , Cognição , Resultado do Tratamento
16.
J Affect Disord ; 344: 592-599, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37858732

RESUMO

BACKGROUND: This systematic review and meta-analysis examined the efficacy of low intensity psychological interventions for older adults (60+ years) with clinical anxiety and/or depressive disorders. METHOD: Systematic review and meta-analysis of randomised control trials of low-intensity psychological interventions for anxiety and/or depression with an active or passive control condition (e.g., waitlist, treatment-as-usual or active control) in any setting. Low intensity psychological interventions (e.g., cognitive behaviour therapy [CBT]) targeted anxiety and/or depression as primary outcomes, were primarily self-help, and included support from trained practitioners/facilitators with <6 h total contact time (typically <30 min p/contact). RESULTS: Seven studies consisting of 304 older adults (65-78 years, Mage = 70, SD = 4) were identified and six included in the meta-analysis of depression outcomes and three for anxiety. A random effects meta-analysis of group differences in symptom change from pre-post treatment found evidence favouring low intensity psychological interventions over passive control groups for the treatment of depressive and anxiety symptoms, with moderate effect sizes for depression (Cohen's d = -0.62) and large effect sizes for anxiety (Cohen's d = -0.84) at post-treatment. LIMITATIONS: Results are limited by study design of included studies such that the efficacy of interventions compared to treatment-as-usual, non-CBT approaches, in adults >80 years and long-term effects are unknown. CONCLUSIONS: There is some evidence supporting the clinical benefits of low intensity psychological interventions for depressive and anxiety symptoms in older adults compared to passive controls. More research is needed to examine efficacy compared to active control conditions, and among those over 80 years.


Assuntos
Terapia Cognitivo-Comportamental , Psicoterapia , Humanos , Idoso , Psicoterapia/métodos , Depressão/terapia , Transtornos de Ansiedade/terapia , Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos
17.
J Affect Disord ; 344: 577-584, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37863363

RESUMO

BACKGROUND: Childhood trauma is a risk factor for developing multiple forms of psychopathology, including depression, posttraumatic stress disorder (PTSD), and social anxiety. Yet, the mechanisms linking childhood trauma and these psychopathologies remain less clear. OBJECTIVE: Here we examined whether anhedonia, a reduced ability to experience pleasure, may mediate the relationship between childhood trauma and symptom severity of depression, PTSD, and social anxiety. METHODS: A total of 230 trauma-exposed participants aged 18-75 were assessed for lifetime trauma exposure, including general and childhood traumatic events, anhedonia, and symptoms of depression, PTSD, and social anxiety. RESULTS: Controlling for age, gender, and general lifetime trauma exposure, mediation analyses revealed a significant mediation effect of anhedonia for the relationship between childhood trauma and symptom severity of depression and PTSD, but not social anxiety. To better understand these significant mediation effects, we repeated the analyses separately for childhood abuse and neglect, and then for the various subtypes of each type of childhood trauma. Results showed a significant mediation effect of anhedonia on symptoms of both depression and PTSD in individuals who reported high emotional and sexual abuse levels. F Anhedonia was also found to mediate the relationship between both emotional and physical neglect and symptoms of depression and PTSD. CONCLUSION: These findings refine our understanding of the ways in which childhood traumatic experiences may be associated with different mental health problems by increasing anhedonia. Anhedonia may be an important treatment target in survivors of childhood abuse and neglect.


Assuntos
Experiências Adversas da Infância , Transtornos de Estresse Pós-Traumáticos , Humanos , Criança , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Anedonia , Depressão/psicologia , Ansiedade/epidemiologia
18.
J Affect Disord ; 345: 51-58, 2024 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-37875226

RESUMO

BACKGROUND: Although Intolerance of uncertainty (IU), separation anxiety, and negative affectivity seem theoretically interrelated, no empirical study has considered them jointly so far. However, deepening this topic is clinically relevant, especially during the delicate phase of emerging adulthood. This study aimed to pinpoint psychological profiles based on IU, separation anxiety symptoms, and negative affectivity in a group of Italian non-clinical emerging adults. Such profiles were then compared in terms of key psychological and psychosocial characteristics. METHODS: 868 young adults (73 % women) aged 18-26 years entered the study. They completed a socio-demographic survey and self-report tools assessing IU, separation anxiety symptomatology, and personality traits. Subgroups exhibiting distinctive patterns of IU, separation anxiety symptoms, and negative affectivity were identified using latent profile analysis. To deepen disparities in psychological and psychosocial features by profile, analyses of variance and chi-square tests were performed. RESULTS: Three profiles were detected, respectively with high, low, and moderate levels of the variables considered. In each profile, IU, separation anxiety symptoms, and negative affectivity had a consistent trend. The "High-level" profile had the greatest proportion of women and people who had not spent infancy with both parents. LIMITATIONS: The sample included mainly women and university students, and data were collected using self-report questionnaires only. CONCLUSIONS: IU, separation anxiety symptoms, and negative affectivity can co-occur, highlighting the importance of transdiagnostic interventions. Preventive efforts should be directed to emerging adult women and those who did not spend infancy with both parents, as they may be particularly vulnerable to internalizing distress.


Assuntos
Transtornos de Ansiedade , Ansiedade de Separação , Adulto Jovem , Humanos , Feminino , Adulto , Masculino , Ansiedade de Separação/epidemiologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Incerteza , Inquéritos e Questionários , Autorrelato , Ansiedade/epidemiologia , Ansiedade/psicologia
19.
J Affect Disord ; 345: 455-466, 2024 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-37879410

RESUMO

BACKGROUND: Progress in addressing depression after traumatic brain injury (TBI) has been limited. Traditional approaches to measuring depression classify individuals with diverse symptoms as having the same problem. We adopted a novel, symptom-oriented approach to characterize post-TBI depression, emphasizing specific symptoms rather than the number of symptoms. METHODS: We assessed depressive symptoms cross-sectionally in 393 participants with moderate-severe TBI (range 0.4-35.4 years post-injury; M = 12.6) using the Inventory of Depression and Anxiety Symptoms - Expanded Version (IDAS-II). We analyzed symptoms of DSM-5 major depressive disorder (MDD), separating compound symptoms into sub-symptoms. We quantified depression heterogeneity across 16 specific symptoms and explored associations between each symptom and personal, injury-related, treatment, and functional/psychosocial outcome factors. RESULTS: 28 % of participants self-reported a current depression diagnosis, and 35 % met DSM-5 symptom criteria for MDD. Depressed participants (according to either self-reported diagnosis or MDD symptom criteria) were more likely to endorse each specific depressive symptom, including those that overlap with TBI. Post-TBI depression was highly heterogeneous, with 84-91 % of depressed participants (depending on classification method) showing a unique symptom profile not shared with any other individual. The most common symptom profile was shared by only three individuals. This heterogeneity was meaningful, as specific depressive symptoms had distinct associations with personal, injury-related, treatment, and outcome factors. LIMITATIONS: Cross-sectional design. We only analyzed DSM-5 MDD symptoms, and some symptoms were assessed using only one item. CONCLUSIONS: A symptom-oriented approach to post-TBI depression captures the individual's unique profile of depressive symptoms, which relate differently to outcomes and other factors. We recommend future studies investigating post-TBI depression analyze specific symptoms alongside overall depression scores.


Assuntos
Lesões Encefálicas Traumáticas , Transtorno Depressivo Maior , Humanos , Depressão/diagnóstico , Depressão/etiologia , Transtorno Depressivo Maior/etiologia , Transtorno Depressivo Maior/complicações , Estudos Transversais , Lesões Encefálicas Traumáticas/complicações , Lesões Encefálicas Traumáticas/diagnóstico , Lesões Encefálicas Traumáticas/psicologia , Ansiedade
20.
J Affect Disord ; 345: 335-341, 2024 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-37898475

RESUMO

BACKGROUND: People with multiple health risk behaviors (HRBs) are at higher risk for psychological problems, and vice versa. However, the mechanisms underlying this association remain unknown. METHOD: We collected questionnaire and blood sample data from 2 universities in Anhui and Jiangxi Provinces. Demographic information, HRBs and blood samples were collected at baseline. Depression/anxiety symptoms were collected using questionnaires at follow-up. Latent class analysis was used to explore clustered HRBs pattern, and logistic regression analysis was used to examine the association between clustered HRBs quantity, pattern and anxiety-depression symptoms comorbidity. The Mplus software was used to analyze the moderating effects of inflammatory cytokines. RESULTS: Compared to the HRB low-risk group, the substance dependence group (OR: 1.89, 95%CI: 1.11-3.21) and sedentary group (OR: 2.98, 95%CI: 1.48-6.02) had a higher risk of anxiety-depression comorbid symptoms. Compared to participants with no clustered HRBs, participants with 2 HRBs (OR: 2.16 95%CI: 1.17-4.00) and >3 HRBs (OR: 3.55, 95%CI: 1.68-7.48) were more likely to suffer from comorbid symptoms of anxiety and depression. Moreover, IL-6, IL-1ß, IL-10 had negative moderating effects between clustered HRBs pattern and comorbid symptoms of anxiety and depression. LIMITATIONS: Recall bias may exist for anxiety / depression symptoms, and cannot exclude unmeasured confounders or the effect of residual confounding. CONCLUSIONS: This study finds clustered HRBs have a significant impact on mental health among young adults, and inflammatory cytokine evidence supports a negative moderating effect on the relationship. Interventions that decrease clustered HRBs may support mental health development in adolescence.


Assuntos
Depressão , Comportamentos de Risco à Saúde , Adolescente , Humanos , Adulto Jovem , Depressão/epidemiologia , Depressão/psicologia , Citocinas , Ansiedade/epidemiologia , Ansiedade/psicologia , Comorbidade
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