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1.
Curr Oncol ; 30(1): 586-597, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36661695

RESUMO

BACKGROUND: Significant changes in the accessibility and viability of health services have been observed during the COVID-19 period, particularly in vulnerable groups such as cancer patients. In this study, we described the impact of radical practice and perceived changes on cancer patients' mental well-being and investigated potential outcome descriptors. METHODS: Generalized anxiety disorder assessment (GAD-7), patient health (PHQ-9), and World Health Organization-five well-being index (WHO-5) questionnaires were used to assess anxiety, depression, and mental well-being. Information on participants, disease baseline information, and COVID-19-related questions were collected, and related explanatory variables were included for statistical analysis. RESULTS: The mean score values for anxiety, depression, and mental well-being were 4.7 ± 5.53, 4.9 ± 6.42, and 72.2 ± 18.53, respectively. GAD-7 and PHQ-9 scores were statistically associated (p < 0.001), while high values of GAD-7 and PHQ-9 questionnaires were related to low values of WHO-5 (p < 0.001).Using the GAD-7 scale, 16.2% of participants were classified as having mild anxiety (GAD-7 score: 5-9).Mild to more severe anxiety was significantly associated with a history of mental health conditions (p = 0.01, OR = 3.74, 95% CI [1.372-10.21]), and stage category (stage III/IV vs. I/II, p = 0.01, OR = 3.83, 95% CI [1.38-10.64]. From the participants, 36.2% were considered to have depression (PHQ-9 score ≥ 5). Depression was related with older patients (p = 0.05, OR = 1.63, 95% CI [1.16-2.3]), those with previous mental health conditions (p = 0.03, OR = 14.24, 95% CI [2.47-81.84]), those concerned about the COVID-19 impact on their cancer treatment (p = 0.027, OR = 0.19, 95% CI [0.045-0.82]) or those who felt that COVID-19 pandemic has affected mental health (p = 0.013, OR = 3.56, 95% CI [1.30-9.72]). Additionally, most participants (86.7%) had a good well-being score (WHO-5 score ≥ 50). Mental well-being seemed more reduced among stage I-III patients than stage IV patients (p = 0.014, OR = 0.12, 95% CI [0.023-0.65]). CONCLUSION: There is a necessity for comprehensive cancer care improvement. These patients' main concern related to cancer therapy, yet the group of patients who were mentally affected by the pandemic should be identified and supported.


Assuntos
COVID-19 , Neoplasias , Humanos , COVID-19/epidemiologia , Depressão/etiologia , Depressão/psicologia , Pandemias , Ansiedade/epidemiologia , Ansiedade/etiologia , Ansiedade/psicologia , Inquéritos e Questionários , Neoplasias/radioterapia
2.
BMC Med ; 21(1): 7, 2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36600274

RESUMO

BACKGROUND: Perioperative neurocognitive disorders (PND) with a high incidence frequently occur in elderly surgical patients closely associated with prolonged anesthesia-induced neurotoxicity. The neuromorphopathological underpinnings of anesthesia-induced neurotoxicity have remained elusive. METHODS: Prolonged anesthesia with sevoflurane was used to establish the sevoflurane-induced neurotoxicity (SIN) animal model. Morris water maze, elevated plus maze, and open field test were employed to track SIN rats' cognitive behavior and anxiety-like behaviors. We investigated the neuropathological basis of SIN through techniques such as transcriptomic, electrophysiology, molecular biology, scanning electron microscope, Golgi staining, TUNEL assay, and morphological analysis. Our work further clarifies the pathological mechanism of SIN by depleting microglia, inhibiting neuroinflammation, and C1q neutralization. RESULTS: This study shows that prolonged anesthesia triggers activation of the NF-κB inflammatory pathway, neuroinflammation, inhibition of neuronal excitability, cognitive dysfunction, and anxiety-like behaviors. RNA sequencing found that genes of different types of synapses were downregulated after prolonged anesthesia. Microglial migration, activation, and phagocytosis were enhanced. Microglial morphological alterations were also observed. C1qa, the initiator of the complement cascade, and C3 were increased, and C1qa tagging synapses were also elevated. Then, we found that the "Eat Me" complement pathway mediated microglial synaptic engulfment in the hippocampus after prolonged anesthesia. Afterward, synapses were remarkably lost in the hippocampus. Furthermore, dendritic spines were reduced, and their genes were also downregulated. Depleting microglia ameliorated the activation of neuroinflammation and complement and rescued synaptic loss, cognitive dysfunction, and anxiety-like behaviors. When neuroinflammatory inhibition or C1q neutralization occurred, complement was also decreased, and synaptic elimination was interrupted. CONCLUSIONS: These findings illustrated that prolonged anesthesia triggered neuroinflammation and complement-mediated microglial synaptic engulfment that pathologically caused synaptic elimination in SIN. We have demonstrated the neuromorphopathological underpinnings of SIN, which have direct therapeutic relevance for PND patients.


Assuntos
Anestesia , Disfunção Cognitiva , Doenças Neuroinflamatórias , Animais , Ratos , Anestesia/efeitos adversos , Ansiedade/etiologia , Ansiedade/metabolismo , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/metabolismo , Complemento C1q/metabolismo , Hipocampo/metabolismo , Microglia/efeitos dos fármacos , Microglia/fisiologia , Doenças Neuroinflamatórias/induzido quimicamente , Doenças Neuroinflamatórias/complicações , Sevoflurano/efeitos adversos , Sevoflurano/metabolismo
3.
BMC Public Health ; 23(1): 161, 2023 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-36694166

RESUMO

BACKGROUND: Mental disorders are conditions that affect the usual function of the brain, causing a huge burden on societies. The causes are often unclear, but previous research has pointed out, as is the case with many other diseases, that nutrition could have a major role in it. Amino acids, the building blocks of proteins, are the main precursor of neurotransmitters (the chemical messengers in the brain) malfunction of which is heavily associated with a wide range of brain disorders. METHODS: We assumed different sources of dietary protein could have different impacts on mental well-being. Hence, we decided to collect the nutritional data (with a validated and reliable semi-quantitative food-frequency questionnaire) from a sample of 489 Iranian women and investigate the association between animal and plant protein sources and the risk of depression, anxiety, and stress. Symptoms of these mental disorders were assessed using a validated Depression, Anxiety, and Stress Scales (DASS) questionnaire with 21 items. RESULTS: After multivariable adjustment, it was shown that women in the highest tertile of animal protein intake were more likely to show symptoms of depression (OR: 2.63; 95% CI: 1.45, 4.71; P = 0.001), anxiety (OR: 1.83; 95% CI: 1.04, 3.22; P = 0.03), and stress (OR: 3.66; 95% CI: 2.06, 6.50; p < 0.001). While no significant association was seen between plant protein and any of the studied mental disorders. CONCLUSION: Overall, our findings suggest that a diet high in animal protein could predispose individuals to mental illnesses.


Assuntos
Ansiedade , Depressão , Feminino , Humanos , Animais , Depressão/epidemiologia , Depressão/etiologia , Irã (Geográfico)/epidemiologia , Ansiedade/epidemiologia , Ansiedade/etiologia , Transtornos de Ansiedade , Dieta , Proteínas de Plantas , Inquéritos e Questionários
4.
PLoS One ; 18(1): e0280054, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36603005

RESUMO

BACKGROUND: Infertility is a very distressing condition. It is often associated with long-term stress, which can emerge as anxiety and depression. AIM: To understand the effect of socio-demographic variables, reproductive trajectories, and lifestyle variables on stress, depression, and anxiety independently and to understand the relationship of psychological variables with each other among infertile and fertile women. METHODS: This cross-sectional study recruited 500 women which included 250 primary infertile cases and 250 age-matched fertile controls of the age group 22-35 years. A pretested modified interview schedule was administered which included demographic variables, lifestyle variables, and reproductive trajectories. In addition, psychological tools like PSS, GAD-7, and PHQ-9 were used to collect the data pertaining to Stress, anxiety, and depression, respectively. Data analysis was performed with the statistical software version SPSS, IBM version 24. RESULTS: Infertile women are more prone to various psychological disorder (stress, anxiety and depression). None of the demographic and lifestyle variables were associated with stress, anxiety, and depression among infertile women. Only reproductive trajectories were found to be causing stress, anxiety, and depression respectively among infertile women. In addition, stress is leading to both anxiety and depression among infertile women but only to depression in fertile women. CONCLUSION: Infertile women should be counselled by medical experts regarding reproductive trajectories. Infertile couples should be guided and counselled to incorporate mental health screening and treatment in their routine check-up.


Assuntos
Infertilidade Feminina , Infertilidade , Transtornos Mentais , Humanos , Feminino , Adulto Jovem , Adulto , Infertilidade Feminina/terapia , Estudos Transversais , Transtornos Mentais/complicações , Transtornos Mentais/epidemiologia , Infertilidade/epidemiologia , Infertilidade/psicologia , Ansiedade/epidemiologia , Ansiedade/etiologia , Transtornos de Ansiedade/psicologia , Depressão/epidemiologia , Depressão/etiologia
5.
Orv Hetil ; 164(3): 79-87, 2023 Jan 22.
Artigo em Húngaro | MEDLINE | ID: mdl-36681997

RESUMO

INTRODUCTION: The bidirectional relationship between diabetes and depression results in severe disease burden. Co-occurring depression is associated with a higher rate of diabetes complications. These complications impair quality of life, however, their impact on depressive symptoms is controversial. OBJECTIVE: In our cross-sectional study, we aimed to investigate whether the presence of diabetes complications is associated with depressive and anxiety symptoms among patients with type 2 diabetes in general practice. METHOD: We obtained patient history, anthropometric, socioeconomic, laboratory parameters. For symptom assessment, the Beck Depression Inventory (BDI) and the Hamilton Anxiety Scale (HAM-A) were used. We collected data between September 2018 and February 2020. RESULTS: We included 338 consecutive patients with type 2 diabetes. The mean age of the sample was 63.98 ± 11.51 (years ± SD), 61.2% of participants were female. We found significant univariate association between diabetes complications and older age, less physical activity, higher body mass index, insulin therapy, higher HbA1c, higher creatinine and carbamide concentrations, worse depressive and anxiety symptoms. In multivariate analysis, diabetes complications and certain socio-demographic factors (female gender, lower education, rural-dwelling) were the determinants of higher BDI and HAM-A scores. CONCLUSION: Among primary care patients with type 2 diabetes, the prevalence of depressive and anxiety symptoms was higher and more severe in patients with diabetes complications. The recommended screening for affective disorders among patients with diabetes is especially justified if complications are present. Orv Hetil. 2023; 164(3): 79-87.


Assuntos
Complicações do Diabetes , Diabetes Mellitus Tipo 2 , Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Masculino , Diabetes Mellitus Tipo 2/epidemiologia , Depressão/epidemiologia , Depressão/etiologia , Depressão/diagnóstico , Qualidade de Vida , Estudos Transversais , Ansiedade/epidemiologia , Ansiedade/etiologia , Ansiedade/psicologia , Complicações do Diabetes/epidemiologia
6.
Integr Cancer Ther ; 22: 15347354221147499, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36625232

RESUMO

BACKGROUND: At present, simple reminiscence has been widely used in the field of neurocognitive disorders, life review/life review therapy has been widely used in the field of cancer, and both simple reminiscence and life review/life review therapy are suitable for psychological disorders such as depression and anxiety. However, the efficacy of reminiscence in treating cancer-related symptom has not been fully assessed. OBJECTIVES: To evaluate the effect of reminiscence therapy (RT) on relieving cancer-related symptoms such as anxiety and depression in cancer survivals. METHODS: China National Knowledge Infrastructure (CNKI), VIP database, Wanfang Data Knowledge Service Platform, China Biomedical Database, PubMed, Cochrane Library, Embase, EBSCO, Scopus, and Ovid databases were searched. To collect clinical randomized controlled trials (RCT) on RT and cancer-related studies published from the establishment of the database to October 05, 2021. Two researchers independently evaluated the articles that met the inclusion criteria, meta-analysis was performed using RevMan5.4 software. RESULTS: A total of 20 RCTs published in 2010 to 2021 were included, with a total of 1853 cancer patients. Meta-analysis results showed that the anxiety scale (HADS-A and HAMA and SAS) and depression scale (HADS-D and HAMD and SDS) scores of the RT group were significantly lower than those of the control group (HADS-A: P = .0002; HAMA: P < .00001; SAS: P = .0010; HADS-D: P = .01; HAMD: P < .00001; SDS: P = .0001). Meta-analysis results showed that RT can improve overall quality of life of cancer patients of RT group to a certain extent hope (P < .00001). Meta-analysis results showed that the scores on the hope and dignity were significantly increased, and the difference were statistically significant (P < .001). CONCLUSION: This review indicates that RT has significant efficacy on cancer-related symptoms such as anxiety and depression. RT for cancer survivals can effectively improve quality of life, self-hope, and self-esteem. The findings of this meta-analysis can provide direction for future symptom management research.


Assuntos
Ansiedade , Neoplasias , Humanos , Ansiedade/etiologia , Ansiedade/terapia , Transtornos de Ansiedade , Neoplasias/terapia , Neoplasias/psicologia , China , Depressão/etiologia , Depressão/terapia
7.
Rev Neurol ; 76(2): 47-57, 2023 Jan 16.
Artigo em Espanhol | MEDLINE | ID: mdl-36631964

RESUMO

INTRODUCTION: The nationwide lockdown implemented in Spain in March 2020 in response to the 2019 coronavirus disease pandemic (COVID-19) could have had an effect on the clinical situation, disease management and access to care in patients with idiopathic intracranial hypertension. PATIENTS AND METHODS: A cross-sectional observational study was conducted by means of an online survey. The frequency and impact of headache, visual symptoms, dizziness, cognitive symptoms, diplopia, anxiety and depression on patients' quality of life were recorded. Disease treatment and delays experienced in accessing care were recorded. Participants were grouped according to the time elapsed since diagnosis. RESULTS: A total of 112 patients participated in the study (103 women). The average time since disease onset was 6.25 years. Headache, anxiety and depression were responsible for considerable impact in the period prior to lockdown. The impact of headache was not aggravated during lockdown, but anxiety and depression did become significantly worse. Recently diagnosed participants reported higher rates of anxiety, depression, dizziness and diplopia; chronically diagnosed participants reported a higher frequency of cognitive symptoms. CONCLUSIONS: The clinical situation of the participants deteriorated during lockdown, although the differences were smaller than previously thought. This was probably because the baseline situation was more severe than expected. Further studies are needed to clarify the medium and long-term impact of the COVID-19 pandemic on patients with idiopathic intracranial hypertension.


TITLE: Impacto del confinamiento por COVID-19 en pacientes con hipertensión intracraneal idiopática en España.Introducción. El confinamiento nacional instaurado en España en marzo de 2020 como respuesta a la pandemia por la enfermedad por coronavirus 2019 (COVID-19) pudo tener un efecto en la situación clínica, el manejo de la enfermedad y el acceso a la atención médica en pacientes con hipertensión intracraneal idiopática. Pacientes y métodos. Se realizó un estudio observacional transversal por medio de una encuesta en línea. Se registraron la frecuencia y el impacto en la calidad de vida de la cefalea, los síntomas visuales, el mareo, los síntomas cognitivos, la diplopía, la ansiedad y la depresión. Se registró el tratamiento de la enfermedad y los retrasos experimentados en el acceso a la atención médica. Se agrupó a los participantes según el tiempo de evolución desde el diagnóstico. Resultados. Participaron 112 pacientes (103 mujeres). El tiempo medio de evolución de la enfermedad fue 6,25 años. La cefalea, la ansiedad y la depresión fueron responsables de un impacto considerable en el período previo al confinamiento. El impacto de la cefalea no empeoró durante el confinamiento, pero la ansiedad y la depresión empeoraron significativamente. Los participantes diagnosticados recientemente comunicaron mayores tasas de ansiedad, depresión, mareo y diplopía; los de evolución crónica, mayor frecuencia de síntomas cognitivos. Conclusiones. La situación clínica de los participantes se deterioró durante el confinamiento, aunque las diferencias fueron menores de lo que se pensaba. Esto se debió, probablemente, a que la situación basal era más grave de lo esperado. Son necesarios más estudios para aclarar el impacto a medio y largo plazo de la pandemia por COVID-19 en pacientes con hipertensión intracraneal idiopática.


Assuntos
COVID-19 , Pseudotumor Cerebral , Humanos , Feminino , COVID-19/epidemiologia , COVID-19/psicologia , Qualidade de Vida , Espanha/epidemiologia , Pandemias , Estudos Transversais , Tontura , Diplopia , Pseudotumor Cerebral/epidemiologia , Controle de Doenças Transmissíveis , Ansiedade/epidemiologia , Ansiedade/etiologia , Cefaleia/epidemiologia , Cefaleia/etiologia , Depressão/epidemiologia , Depressão/psicologia
9.
Commun Biol ; 6(1): 50, 2023 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-36641530

RESUMO

Psychiatric disorders, such as anxiety, are associated with inflammatory bowel disease (IBD), however, the neural mechanisms regulating this comorbidity are unknown. Here, we show that hypothalamic agouti-related protein (AgRP) neuronal activity is suppressed under chronic restraint stress (CRS), a condition known to increase anxiety and colitis susceptibility. Consistently, chemogenic activation or inhibition of AgRP neurons reverses or mimics CRS-induced increase of anxiety-like behaviors and colitis susceptibility, respectively. Furthermore, CRS inhibits AgRP neuronal activity by suppressing the expression of c-Jun. Moreover, overexpression of c-Jun in these neurons protects against the CRS-induced effects, and knockdown of c-Jun in AgRP neurons (c-Jun∆AgRP) promotes anxiety and colitis susceptibility. Finally, the levels of secreted protein thrombospondin 1 (THBS1) are negatively associated with increased anxiety and colitis, and supplementing recombinant THBS1 rescues colitis susceptibility in c-Jun∆AgRP mice. Taken together, these results reveal critical roles of hypothalamic AgRP neuron-derived c-Jun in orchestrating stress-induced anxiety and colitis susceptibility.


Assuntos
Colite , Hipotálamo , Camundongos , Animais , Proteína Relacionada com Agouti/genética , Proteína Relacionada com Agouti/metabolismo , Hipotálamo/metabolismo , Ansiedade/etiologia , Neurônios/fisiologia , Colite/genética , Colite/metabolismo
10.
Support Care Cancer ; 31(2): 117, 2023 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-36645499

RESUMO

PURPOSE: In clinical cancer care, distress screening is recommended to identify highly burdened patients in objective need for psychosocial support to improve psychological distress and quality of life and to enhance patient empowerment. It is however unclear whether distress screeners are suitable for psychosocial care planning and thus whether they can predict the willingness that is need, intention, and utilization, to seek psychosocial support. METHODS: In a secondary analysis of a cluster intervention study, we assessed cancer patients with three distress screeners (DT, PHQ-9, GAD-7) at baseline. The willingness to seek psychosocial support services was assessed binary for psychosocial services at 3 and 6 months. Logistic regression models were applied to examine the predictive effect of the screeners on need, intention, and utilization. We corrected all models for multiple testing. RESULTS: The 660 patients included in the study were on average 60 years, 54% were male. At the 3- and 6-month follow-up, 353 and 259 patients participated, respectively. The screeners were best in predicting the need for support (OR reaching up to 1.15, 1.20, and 1.22 for the PHQ-9, GAD-7, and DT respectively). The intention was predicted by the PHQ-9 and GAD-7, whereas utilization of psychosocial support services was not predicted by the screeners. CONCLUSION: The three distress screeners might be useful in psychosocial care planning, as they are able to predict the need and to some degree the intention to seek psychosocial support. Future research needs to examine potential barriers and supporting factors that may explain utilization of psychosocial support. TRIAL REGISTRATION: The study was retrospectively registered (2/2021) at ClinicalTrials.gov (number: NCT04749056).


Assuntos
Neoplasias , Reabilitação Psiquiátrica , Feminino , Humanos , Masculino , Ansiedade/etiologia , Ansiedade/psicologia , Depressão/etiologia , Depressão/psicologia , Intenção , Neoplasias/psicologia , Sistemas de Apoio Psicossocial , Qualidade de Vida , Estresse Psicológico/diagnóstico , Estresse Psicológico/etiologia , Estresse Psicológico/terapia
11.
BMC Cardiovasc Disord ; 23(1): 32, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36650441

RESUMO

OBJECTIVE: This study aimed to assess how listening to music after cardiac valve replacements affected patients' pain, anxiety, and vital signs. METHOD: In Fuzhou, China's Fujian Medical University Union Hospital, the cardiac surgery division conducted a randomized controlled clinical experiment. 86 patients were enrolled, and 43 were assigned randomly to each group (control and experimental group). The standard treatment was given to the control group, while the experimental group was given standard treatment + a 15-min music intervention 3 times. Indicators include pain, anxiety and vital signs (respiratory rate, heart rate, and blood pressure). RESULTS: In comparison to the control group, the experimental group, over time, demonstrated a statistically substantial decrease in pain, anxiety, systolic blood pressure, heart rate and respiratory rate (all P < 0.001), yet, there were no discernible variations (P > 0.05) in diastolic blood pressure. CONCLUSIONS: In conclusion, these results provide additional proof for using music therapy to minimize cardiac postoperative pain and anxiety, as well as systolic blood pressure, heart rate and respiratory rate. Moreover, it should be regarded as a supplementary treatment for pain and anxiety after cardiac valve replacement and other medical procedures with comparable postoperative pain.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Musicoterapia , Humanos , Musicoterapia/métodos , Ansiedade/diagnóstico , Ansiedade/etiologia , Ansiedade/prevenção & controle , Frequência Cardíaca/fisiologia , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Valvas Cardíacas
12.
Behav Brain Res ; 438: 114202, 2023 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-36343695

RESUMO

Depression and anxiety disorders overlap in clinical populations, suggesting common mechanisms that may be further investigated in reliable animal models. We used filial 8 female Long-Evans rats bred for high (HAn; n = 19) and low anxiety (LAn)-like behavior (n = 21) to assess forced swim test mobility strategies and chronic mild stress (CMS)-induced depression-like symptoms. We measured (1) weight, (2) fur piloerection, (3) sweet food consumption, (4) grooming behavior, and (5) circulating estradiol (E2). One month after CMS terminated and following a terminal forced swim test, brains were processed for immunohistochemistry targeting c-Fos and serotonin 1 A receptor (5-HT1AR) protein in the paraventricular nucleus (PVN) of the hypothalamus. HAn female rats showed increased anxiety-like behavior (i.e., lower open to closed arm ratios, increased closed arm entries), more swimming (i.e., mobility), and less floating (i.e., immobility) behavior in the forced swim test. Overall, HAn females weighed less than their LAn counterparts. After chronic mild stress, HAn lines displayed even greater mobility and consumed fewer Froot Loops™. Fur and grooming analyses indicated no significant differences in mean counts across experimental groups. One month after CMS, cycling E2 concentrations (pg/ml) did not differ between HAn and LAn animals. Elevated c-Fos and 5-HT1AR expression were observed in the PVN, where HAn CMS rats expressed the most c-Fos and 5-HT1AR immunoreactivity. In summary, outbred HAn rats show robust anxiety-like behavior, exhibit more mobility in the forced swim test, and are more sensitive to chronic mild stress-induced grooming and decline in palatable food ingestion.


Assuntos
Depressão , Estresse Psicológico , Animais , Feminino , Ratos , Ansiedade/etiologia , Transtornos de Ansiedade , Depressão/etiologia , Modelos Animais de Doenças , Proteínas Proto-Oncogênicas c-fos/metabolismo , Ratos Long-Evans , Estresse Psicológico/metabolismo , Natação , Receptor 5-HT1A de Serotonina
13.
Eur J Pharmacol ; 939: 175437, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36502961

RESUMO

Pimavanserin is a highly selective 5-HT2A inverse agonist in current medical use. Prior studies suggest that 5-HT2A serotonin receptors may play a role in anxiety and emotional memory. Therefore, pimavanserin was tested in a rat model of PTSD to determine whether it might ameliorate PTSD-like symptoms. The lifetime prevalence of PTSD is estimated to be 125% higher in women than men. Consequently, in an effort to create a robust model of PTSD that was more representative of human PTSD prevalence, 20-week old female rats of the emotionally hyperreactive Lewis strain were used for these studies. The rats were single-housed and exposed twice to restraint stress coupled with predator odor or to a sham-stressed condition. Twenty days after the second stress or sham-stress exposure, rats were injected with saline alone or with 0.3 or 1.0 mg/kg pimavanserin, doses that were confirmed to substantially block 5-HT2A receptor activity in this study without causing any non-specific behavioral or adverse effects. One hour later, rats were tested for anxiety through acoustic startle response, the elevated plus-maze and three parameters of open field behavior. Five days later, blood was sampled for plasma corticosterone. The stressed/saline-injected rats had higher anxiety scores and corticosterone levels than sham-stressed/saline-injected rats. Pimavanserin significantly and generally dose-dependently reversed these persistent stress effects, but had no significant effect on the behavioral measures in normal, non-stressed rats. These results, consistent with a role for the 5-HT2A receptor, suggest that pimavanserin might have potential to reduce some consequences of traumatic stress.


Assuntos
Transtornos de Estresse Pós-Traumáticos , Animais , Feminino , Humanos , Masculino , Ratos , Ansiedade/tratamento farmacológico , Ansiedade/etiologia , Corticosterona/farmacologia , Modelos Animais de Doenças , Agonismo Inverso de Drogas , Ratos Endogâmicos Lew , Receptor 5-HT2A de Serotonina , Reflexo de Sobressalto , Serotonina/farmacologia , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Transtornos de Estresse Pós-Traumáticos/etiologia , Estresse Psicológico/complicações , Estresse Psicológico/tratamento farmacológico
14.
Neurosurgery ; 92(2): 225-240, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36580643

RESUMO

BACKGROUND: Awake craniotomy (AC) enables real-time monitoring of cortical and subcortical functions when lesions are in eloquent brain areas. AC patients are exposed to various preoperative, intraoperative, and postoperative stressors, which might affect their mental health. OBJECTIVE: To conduct a systematic review to better understand stress, anxiety, and depression in AC patients. METHODS: PubMed, Scopus, and Web of Science databases were searched from January 1, 2000, to April 20, 2022, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. RESULTS: Four hundred forty-seven records were identified that fit our inclusion and exclusion criteria for screening. Overall, 24 articles consisting of 1450 patients from 13 countries were included. Sixteen studies (66.7%) were prospective, whereas 8 articles (33.3%) were retrospective. Studies evaluated stress, anxiety, and depression during different phases of AC. Twenty-two studies (91.7%) were conducted on adults, and 2 studies were on pediatrics (8.3 %). Glioma was the most common AC treatment with 615 patients (42.4%). Awake-awake-awake and asleep-awake-asleep were the most common protocols, each used in 4 studies, respectively (16.7%). Anxiety was the most common psychological outcome evaluated in 19 studies (79.2%). The visual analog scale and self-developed questionnaire by the authors (each n = 5, 20.8%) were the most frequently tools used. Twenty-three studies (95.8%) concluded that AC does not increase stress, anxiety, and/or depression in AC patients. One study (4.2%) identified younger age associated with panic attack. CONCLUSION: In experienced hands, AC does not cause an increase in stress, anxiety, and depression; however, the psychiatric impact of AC should not be underestimated.


Assuntos
Neoplasias Encefálicas , Adulto , Humanos , Criança , Neoplasias Encefálicas/cirurgia , Depressão , Vigília , Estudos Retrospectivos , Estudos Prospectivos , Craniotomia/métodos , Ansiedade/etiologia
15.
J Infus Nurs ; 46(1): 36-42, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36571826

RESUMO

This study was conducted as a quasiexperimental, single-blind study to examine the effect of cold therapy on pain and anxiety during port needle removal. Patients in the experimental group received cold therapy 10 minutes before port needle removal. Patients in the control group received no intervention before port needle removal. Data were collected using the visual analog scale (VAS) and State-Trait Anxiety Inventory (STAI). After cold therapy was applied to the patients in the experimental group, the second and third VAS scores were found to be statistically significant and lower than those in the control group ( P < .05). There was no statistically significant difference between the anxiety levels of the experimental group and the control group before cold therapy ( P > .005). However, the STAI scores of the experimental group were found to be statistically and significantly lower than those of the control group after cold therapy ( P < .05). This study determined that cold therapy before port needle removal reduces pain and anxiety. Cold therapy may be recommended as an effective nonpharmacological pain control method with ease of application to prevent pain induced by port needle removal.


Assuntos
Ansiedade , Dor , Humanos , Método Simples-Cego , Dor/etiologia , Dor/prevenção & controle , Ansiedade/etiologia , Ansiedade/prevenção & controle , Crioterapia , Medição da Dor
16.
Holist Nurs Pract ; 37(1): E14-E23, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36378093

RESUMO

Dyspnea is a common symptom and anxiety is a common comorbidity of chronic obstructive pulmonary disease (COPD). They affect individuals with COPD in a multifaceted way, causing many disabilities. Progressive relaxation exercises (PREs) are an important intervention in reducing symptoms and comorbidity. The aim of this study was to determine the effects of PREs on dyspnea and anxiety levels in individuals with COPD. A pretest-posttest randomized controlled trial was conducted at the chest diseases clinic of a university hospital in Turkey. Forty-four patients with COPD who met the inclusion criteria for participation in the study were assigned either to an intervention or a control group, with 22 patients in each group. In the intervention group, the patients performed PREs once a day for 4 weeks in addition to the standard treatment. The patients in the control group received the standard treatment. In the data collection stage of the study, questionnaire forms, namely, the Modified Borg Scale (MBS), Modified British Medical Research Council Dyspnea Scale, COPD Assessment Test (CAT), and Beck Anxiety Inventory (BAI), were used. Data were collected before (the first follow-up) and after the intervention (the second follow-up). In the second follow-up, the MBS, BAI, and CAT scores decreased significantly in the intervention group (P < .05) but showed no significant changes in the control group (P > .05). This study demonstrates that PREs can reduce dyspnea and anxiety levels in individuals with COPD.


Assuntos
Treinamento Autógeno , Doença Pulmonar Obstrutiva Crônica , Humanos , Dispneia/etiologia , Dispneia/terapia , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/terapia , Comorbidade , Ansiedade/etiologia , Ansiedade/terapia , Qualidade de Vida
17.
Curr Probl Cancer ; 47(1): 100933, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36563484

RESUMO

BACKGROUND AND PURPOSE: Anxiety and fatigue is a common symptom that is seen in cancer survivors, who have recently been diagnosed as well as those who are undergoing chemotherapy and radiation therapy as they are emotionally distressed. Progressive relaxation technique and Benson's relaxation is seen to be efficacious in lowering anxiety and fatigue in cancer survivors as individual treatment. To compare the depiction of progressive relaxation technique and Benson's technique on anxiety using Hamilton anxiety scale (HAM-A), blood pressure (BP) and heart rate (HR), and fatigue using cancer fatigue scale (CFS). MATERIALS AND METHODS: A randomized clinical trial (chit method) was carried out on 42 subjects with cancer related anxiety and fatigue. Subjects were randomly allotted to Group A and Group B. Group A was administered Progressive relaxation technique. Group B was administered Benson's technique. Primary outcome measures used were Hamilton Anxiety Scale and Cancer fatigue scale, secondary outcome measures were HR and BP. Outcomes were evaluated at baseline, immediate and after 5 days of the treatment. RESULTS: The results were analyzed using independent t test for comparing the 2 groups. On comparing group, A and B for baseline to immediate and baseline to after 5 days, using HAM-A, BP, HR, CFS, no statistical significance was found. Whereas within group analysis (within group A and B) showed significant reduction in anxiety and fatigue in cancer survivors, with a P value significant at <0.05 as seen from baseline to immediate and baseline to 5 days, with 0.7 effect size. CONCLUSION: The study concludes that both Progressive relaxation technique and Benson's technique are equally effective in reducing anxiety and PRT lowers fatigue more effectively than Benson's technique in cancer survivors.


Assuntos
Sobreviventes de Câncer , Síndrome de Fadiga Crônica , Neoplasias , Humanos , Treinamento Autógeno , Ansiedade/etiologia , Ansiedade/prevenção & controle , Neoplasias/complicações , Neoplasias/terapia , Fadiga/etiologia , Fadiga/prevenção & controle
18.
Heart Lung ; 57: 130-139, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36194947

RESUMO

BACKGROUND: Little is known about the mental health burden or the factors that contribute to mental health variables in parents of children with congenital heart defects (CHD) during the COVID-19 pandemic. OBJECTIVE: The purpose of this study was to examine risk and protective factors associated with anxiety symptoms, depression symptoms, and perceived stress in parents of young children with CHD during the COVID-19 pandemic. METHODS: A nonexperimental design was used in this study of 127 parents of children aged newborn to five years with CHD during the COVID-19 pandemic. Regression analyses were conducted to examine associations between COVID-19 stressors, CHD care-related factors, parental resilience, external support, and mental health variables. RESULTS: Parental resilience, emotional support, and informational support were key protective factors for anxiety, depression, and stress. However, resilience was remarkably low in CHD parents. Increased levels of anxiety symptoms, depression symptoms, and perceived stress were associated with 1) Exposure to a greater number of COVID-19-related stressors, 2) Distress from family visitation restrictions during healthcare encounters, 3) Worry related to the perceived risk of their CHD child's exposure to COVID-19 during healthcare encounters, and 4) Worry about their CHD child's risk of death or serious illness from COVID-19. CONCLUSIONS: The additive impact of the COVID-19 pandemic plus CHD care-related worries on this parent population's mental health is significant. Interventions that promote resilience, address the effect of healthcare system changes, and support the needs of parents of young children with CHD during this and future pandemics are needed.


Assuntos
COVID-19 , Cardiopatias Congênitas , Criança , Recém-Nascido , Humanos , Pré-Escolar , COVID-19/epidemiologia , Pandemias , Saúde Mental , Fatores de Proteção , Pais/psicologia , Ansiedade/epidemiologia , Ansiedade/etiologia , Cardiopatias Congênitas/epidemiologia , Cardiopatias Congênitas/psicologia , Fatores de Risco , Depressão/epidemiologia , Depressão/etiologia
19.
BJOG ; 130(2): 192-200, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36161454

RESUMO

OBJECTIVE: To measure anxiety levels in women aged ≥45 years undergoing diagnostic large loop excision of the transformation zone (LLETZ) at the first colposcopy visit. DESIGN: Longitudinal study. SETTING: Three colposcopy clinics in the Central Denmark Region. POPULATION: Women aged ≥45 years undergoing diagnostic LLETZ. METHODS: Women completed the State-Trait Anxiety Inventory (STAI) and Short Form 12 (mental and physical health) questionnaires before, immediately after, and at 1 and 6 months after LLETZ. MAIN OUTCOME MEASURES: STAI state anxiety median scores were calculated and stratified by health status, by letter with information about screening result and by LLETZ results. RESULTS: Of 109 eligible women, 11 were excluded, leaving 98 women for the final analyses. Response rates ranged from 84.7% to 100%. Overall, state anxiety levels were low; however, a decrease was observed from before to immediately after the LLETZ (33.4 vs 29.3, p < 0.001). The anxiety levels remained stable up to 6 months after LLETZ. Women with poor mental health were more likely to have higher anxiety levels compared with women with good mental health (before LLETZ, RR 3.77, 95% CI 2.12-6.70; 1 month after LLETZ, RR 3.37, 95% CI 1.59-7.15; 6 months after LLETZ, RR 1.93, 95%CI 1.06-3.51). CONCLUSIONS: Overall, colposcopy and diagnostic LLETZ in women aged ≥45 years were not associated with high levels of anxiety. Anxiety levels were highest before colposcopy, and the women seemed to experience immediate relief afterwards. Women with poor mental health had the highest anxiety levels throughout the study, which might call for special attention.


Assuntos
Displasia do Colo do Útero , Neoplasias do Colo do Útero , Feminino , Humanos , Gravidez , Neoplasias do Colo do Útero/diagnóstico , Estudos Longitudinais , Colposcopia/métodos , Ansiedade/etiologia , Displasia do Colo do Útero/diagnóstico
20.
Top Spinal Cord Inj Rehabil ; 28(4): 68-75, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36457353

RESUMO

Background: The incidence of anxiety in adults with spinal cord injury/disorder (SCI/D) exceeds that of the general population. Heart rate variability (HRV) biofeedback training is a potential treatment associated with a reduction in stress and anxiety, however HRV training has not been explored in the SCI/D population. Objectives: To describe a modified protocol piloting HRV training to reduce anxiety associated with SCI/D and detail the COVID-19-related modifications. Methods: To test the feasibility of the biofeedback treatment, 30 adults with SCI/D will complete this pilot randomized controlled trial. Enrollment started in January 2020, halted in March 2020 due to the COVID-19 pandemic, and resumed in March 2021 with a modified protocol. Protocol modifications are documented using the Framework for Reporting Adaptations and Modifications (FRAME). Participants are allocated to the treatment or control arm and undergo eight sessions of physiological monitoring at home using a commercially available HRV sensor and mobile application, which also delivers biofeedback training for those in the treatment arm. Surveys are administered following each session to capture self-reported stress, anxiety, and mood. The study is approved by the HCA-HealthONE institutional review board and is registered with clinicaltrials.gov (NCT# 03975075). Conclusion: COVID-19 has changed the research landscape, forcing scientists to rethink their study designs to address patient and staff safety in this new context. Our modified protocol accomplished this by moving the treatment setting and delivery out of the clinic and into the home. In doing so, we address patient and staff safety, increase external validity, and reduce participant burden.


Assuntos
COVID-19 , Doenças da Medula Espinal , Traumatismos da Medula Espinal , Adulto , Humanos , Pandemias , Projetos Piloto , Traumatismos da Medula Espinal/complicações , Ansiedade/etiologia , Ansiedade/terapia , Biorretroalimentação Psicológica , Ensaios Clínicos Controlados Aleatórios como Assunto
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