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1.
Health Qual Life Outcomes ; 20(1): 7, 2022 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-35012545

RESUMO

BACKGROUND: Patients with noncardiac chest pain (NCCP) report more severe symptoms and lowered health-related quality of life when they present with comorbid panic disorder (PD). Although generalized anxiety disorder (GAD) is the second most common psychiatric disorder in these patients, its impact on NCCP and health-related quality of life remains understudied. This study describes and prospectively compares patients with NCCP with or without PD or GAD in terms of (1) NCCP severity; and (2) the physical and mental components of health-related quality of life. METHODS: A total of 915 patients with NCCP were consecutively recruited in two emergency departments. The presence of comorbid PD or GAD was assessed at baseline with the Anxiety Disorder Schedule for DSM-IV. NCCP severity at baseline and at the six-month follow-up was assessed with a structured telephone interview, and the patients completed the 12-item Short-Form Health Survey Version 2 (SF-12v2) to assess health-related quality of life at both time points. RESULTS: Average NCCP severity decreased between baseline and the six-month follow-up (p < .001) and was higher in the patients with comorbid PD or GAD (p < .001) at both time points compared to those with NCCP only. However, average NCCP severity did not differ between patients with PD and those with GAD (p = 0.901). The physical component of quality of life improved over time (p = 0.016) and was significantly lower in the subset of patients with PD with or without comorbid GAD compared to the other groups (p < .001). A significant time x group interaction was found for the mental component of quality of life (p = 0.0499). GAD with or without comorbid PD was associated with a lower mental quality of life, and this effect increased at the six-month follow-up. CONCLUSIONS: Comorbid PD or GAD are prospectively associated with increased chest pain severity and lowered health-related quality of life in patients with NCCP. PD appears to be mainly associated with the physical component of quality of life, while GAD has a greater association with the mental component. Knowledge of these differences could help in the management of patients with NCCP and these comorbidities.


Assuntos
Transtornos de Ansiedade , Qualidade de Vida , Transtornos de Ansiedade/epidemiologia , Dor no Peito , Comorbidade , Humanos , Medição da Dor
2.
PLoS One ; 17(1): e0262141, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34995288

RESUMO

The deadliest coronavirus disease 2019 (COVID-19) is taking thousands of lives worldwide and presents an extraordinary challenge to mental resilience. This study assesses mental health status during the COVID-19 pandemic and its associated factors among informal waste workers in Bangladesh. A cross-sectional survey was conducted in June 2020 among 176 informal waste workers selected from nine municipalities and one city corporation in Bangladesh. General Health Questionnaire (GHQ-12) was used to assess respondents' mental health. The study found that 80.6% of the individuals were suffering from psychological distress; 67.6% reported anxiety and depression, 92.6% reported social dysfunction, and 19.9% reported loss of confidence. The likelihood of psychological distress (Risk ratio [RR]: 1.23, 95% confidence interval [CI]: 1.02-1.48) was significantly higher for female than male. Multiple COVID-19 symptoms of the family members (RR: 1.20, 95% CI: 1.03-1.41), unawareness about COVID-19 infected neighbor (RR: 1.21, 95% CI: 1.04-1.41), income reduction (RR: 1.60, 95% CI: 1.06-2.41) and daily household meal reduction (RR: 1.34; 95% CI: 1.03-1.73) were also found to be associated with psychological distress. These identified factors should be considered in policy-making and support programs for the informal waste workers to manage the pandemic situation as well as combating COVID-19 related psychological challenges.


Assuntos
COVID-19/psicologia , Saúde Mental/tendências , Trabalhadores Pobres/psicologia , Adulto , Ansiedade , Transtornos de Ansiedade , Bangladesh/epidemiologia , COVID-19/epidemiologia , Estudos Transversais , Depressão , Transtorno Depressivo , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Angústia Psicológica , SARS-CoV-2/patogenicidade , Engenharia Sanitária/métodos , Engenharia Sanitária/tendências , Inquéritos e Questionários
3.
Handb Clin Neurol ; 184: 481-495, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35034756

RESUMO

To adapt to the sustained demands of chronic stress, discrete brain circuits undergo structural and functional changes often resulting in anxiety disorders. In some individuals, anxiety disorders precede the development of motor symptoms of Parkinson's disease (PD) caused by degeneration of neurons in the substantia nigra (SN). Here, we present a circuit framework for probing a causal link between chronic stress, anxiety, and PD, which postulates a central role of abnormal neuromodulation of the SN's axon initial segment by brainstem inputs. It is grounded in findings demonstrating that the earliest PD pathologies occur in the stress-responsive, emotion regulation network of the brainstem, which provides the SN with dense aminergic and cholinergic innervation. SN's axon initial segment (AIS) has unique features that support the sustained and bidirectional propagation of activity in response to synaptic inputs. It is therefore, especially sensitive to circuit-mediated stress-induced imbalance of neuromodulation, and thus a plausible initiating site of neurodegeneration. This could explain why, although secondary to pathophysiologies in other brainstem nuclei, SN degeneration is the most extensive. Consequently, the cardinal symptom of PD, severe motor deficits, arise from degeneration of the nigrostriatal pathway rather than other brainstem nuclei. Understanding when and how circuit dysfunctions underlying anxiety can progress to neurodegeneration, raises the prospect of timed interventions for reversing, or at least impeding, the early pathophysiologies that lead to PD and possibly other neurodegenerative disorders.


Assuntos
Segmento Inicial do Axônio , Doença de Parkinson , Ansiedade , Transtornos de Ansiedade , Humanos , Substância Negra
4.
Artigo em Inglês | MEDLINE | ID: mdl-34994472

RESUMO

OBJECTIVES: Research with younger adults has begun to explore associations between autism/autistic traits and vulnerability to Post Traumatic Stress Disorder (PTSD). Large scale studies and/or examination of age-effects have not been conducted. METHODS: Adults aged 50 years+ from the PROTECT study (n = 20,220) completed items about current and childhood socio-communicative difficulties characteristic of autism. Approximately 1% (n = 251) endorsed high autistic traits, henceforth the Autism Spectrum Traits (AST) group. Differences between the AST and an age-and sex-matched "Comparison Older Adults" (COA; n = 9179) group were explored for lifetime traumatic experiences and current symptoms of PTSD, depression, and anxiety. RESULTS: Almost 30% of the AST group, compared to less than 8% of the COA, reported severe trauma in childhood/adulthood, including emotional, physical or sexual abuse. Elevated current PTSD symptoms were reported by AST compared to COA. An interaction was observed between autistic traits and trauma severity; the effect of level of trauma on PTSD symptoms was significantly greater for AST versus COA participants. This interaction remained significant when controlling for current depression and anxiety symptoms. CONCLUSIONS: The findings suggest that high autistic traits may increase the likelihood of experiencing trauma across the lifespan, and the impact of severe trauma on PTSD symptoms. Older adults with high (vs. low) autistic traits may be at greater risk of experiencing PTSD symptoms in latter life. Future research should test whether the pattern of results is similar for diagnosed autistic adults.


Assuntos
Transtorno Autístico , Transtornos de Estresse Pós-Traumáticos , Adulto , Idoso , Ansiedade , Transtornos de Ansiedade , Humanos , Acontecimentos que Mudam a Vida , Pessoa de Meia-Idade
5.
PLoS One ; 17(1): e0261967, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35025910

RESUMO

PURPOSE: Mental health is a significant problem following exposure to a traumatic event. This study aimed to examine quarantine-related experiences, traumatic stress, and coping strategies among adults quarantined in Saudi Arabia due to coronavirus disease 2019 (COVID-19) exposure or travel history. METHODS: Individuals aged ≥ 18 years who were quarantined in Saudi Arabia due to COVID-19 exposure or travel history were included. We used a sequential mixed methods design, using an online survey followed by in-depth individual telephonic interviews. The Impact of Event Scale-Revised (IES-R) was used to measure post-traumatic stress disorder (PTSD) symptoms after the quarantine. To identify factors associated with significant symptoms (IES-R score ≥ 33), prevalence ratios (PR) with 95% confidence intervals were computed using Poisson regression with robust error variance. In the next phase, a subset of the participants (n = 26) were interviewed to elicit their quarantine-related experiences and coping responses. Major themes and subthemes were identified. RESULTS: Of the 111 adults who completed the survey, 32 (28.8% [95% CI, 21.1-38.0%]) had significant PTSD symptoms (IES-R score ≥ 33) and 27 (24.3% [95% CI, 17.2-33.3%]) had severe symptoms (IES-R score > 37). Marital status was the only variable that was significantly associated with significant PTSD symptoms (P = 0.028). Significant symptoms were twice as prevalent in married adults than among other marital groups (PR 2.00, 95% CI, 1.08-3.72). Participants reported negative emotions such as overwhelming fear, helplessness, anxiety, and disgust. Participants utilized both problem-centered coping (e.g., use of social support) and emotion-centered coping (e.g., use of positive diversionary activities) during the quarantine period. CONCLUSION: PTSD symptoms were present in one out of every four quarantined persons. The quarantine experience is viewed negatively. These findings highlight the need for increased awareness about stress-related disorders among quarantined individuals. Efforts are needed to detect and manage these symptoms early while making the quarantine experience more satisfying for the involved individuals and groups.


Assuntos
COVID-19/psicologia , Quarentena/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/psicologia , Adulto , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Medo/psicologia , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Satisfação Pessoal , Prevalência , SARS-CoV-2/patogenicidade , Arábia Saudita , Apoio Social/psicologia , Inquéritos e Questionários
6.
Psicothema ; 34(1): 18-24, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35048891

RESUMO

BACKGROUND: Anxiety and depression are very prevalent in primary care, with high rates of chronic cases, comorbidity and lost quality of life, along with huge economic costs. The Improving Access to Psychological Therapies (IAPT) project, launched in the United Kingdom in 2007, has become an international benchmark for the treatment of common mental disorders. In Spain, Psicofundación developed the PsicAP clinical trial, following the precedent set by the IAPT. METHOD: This study reviews and compares and contrasts the methods, results, and contributions of the IAPT and PsicAP. RESULTS: The IAPT is a project for the pragmatic implementation of evidence-based psychological therapies in primary care. PsicAP is a randomized clinical trial whose results demonstrated that adding a psychological treatment (seven group sessions of transdiagnostic cognitive-behavioural therapy) to treatment-as-usual (TAU) for anxiety and depression in the primary care setting was more effective and cost-effective than TAU alone. The therapeutic gains and the cost-effectiveness were maintained at a 12 months follow-up. Moreover, the percentage of reliably recovered patients was comparable to the numbers from the IAPT. CONCLUSIONS: This brief psychological treatment should be implemented in the Spanish public health system, similar to the precedent set by the IAPT initiative.


Assuntos
Terapia Cognitivo-Comportamental , Qualidade de Vida , Transtornos de Ansiedade/terapia , Acesso aos Serviços de Saúde , Humanos , Espanha
7.
Psicothema ; 34(1): 25-34, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35048892

RESUMO

BACKGROUND: The Unified Protocol (UP) for the transdiagnostic treatment of emotional disorders (EDs) has demonstrated its efficacy in improving dimensions shared by EDs, but there is insufficient evidence regarding the specific symptoms of each ED. The main objective of the study was to evaluate the efficacy of the UP applied in a group format compared with individual Treatment as Usual (TAU), in improving specific ED symptoms. METHODS: The study sample (n=243) was a subset of participants of a randomized controlled trial conducted in the Spanish public health system. Specific symptoms assessed from pre-treatment to the six-month follow-up were: depressive, agoraphobic, generalized anxiety, panic, and obsessive-compulsive symptoms. Personality dimensions and quality of life were also measured. RESULTS: There were statistically significant changes after the UP in all the study variables (0.44 = d = 1.35). Changes in depressive symptoms, obsessive-compulsive disorder, and perceived quality of life were superior in the UP. CONCLUSIONS: The results support the efficacy of group UP for improving both transdiagnostic dimensions and specific ED symptoms, as well as quality of life, through the public health-care system.


Assuntos
Terapia Cognitivo-Comportamental , Qualidade de Vida , Transtornos de Ansiedade , Humanos , Saúde Pública , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
8.
Psicothema ; 34(1): 49-55, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35048895

RESUMO

BACKGROUND: This study explores the shared and specific associations of brooding rumination and anxiety sensitivity to depression and anxiety symptomatology in a sample of treatment-seeking smokers. METHODS: The sample was composed of 275 treatment-seeking adult smokers. Hierarchical linear regression analyses were conducted to examine the relations of both variables with depressive and anxiety symptoms. RESULTS: Greater brooding rumination and anxiety sensitivity predicted higher levels of depression and anxiety symptoms. A specific relationship emerged after controlling for comorbid symptoms (depressive or anxiety symptoms) where brooding rumination was associated with depressive symptoms and anxiety sensitivity with anxiety symptoms. CONCLUSIONS: The findings showed that the variables examined are transdiagnostically related to emotional symptoms, but this relationship was symptomatology-specific when controlling for comorbid symptoms (depressive or anxiety symptoms). Due to the impact of affective symptoms on abstinence outcomes, these findings have relevant clinical implications. In the context of smoking cessation treatment, identifying shared and specific vulnerabilities might contribute to tailoring and designing more precise and effective interventions for quitting smoking.


Assuntos
Depressão , Fumantes , Adulto , Ansiedade/epidemiologia , Transtornos de Ansiedade , Depressão/epidemiologia , Emoções , Humanos
9.
BMC Psychol ; 10(1): 7, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34986888

RESUMO

BACKGROUND: Beliefs about the unacceptability of experiencing or expressing negative emotions can contribute to diverse psychological symptoms and associated with poor treatment outcomes and low treatment attempts. The Beliefs about Emotions Scale (BES) was developed to assess such beliefs based on the cognitive-behavioral models; however, no study has reported on the psychometric properties of the BES in Korea. The present study aimed to cross-culturally adapt and validate the BES for the Korean population (BES-K). METHODS: The BES-K was administered to 592 Korean adults (323 men and 269 women) aged 20-59 years. Exploratory and confirmatory factor analysis were used to assess the factor model of the scale. Pearson correlation coefficients were used to evaluate the relationships between the BES-K and other psychological measures. RESULTS: The result showed a two-factor model of the BES-K, with Factor 1 relating to Interpersonal and Factor 2 representing Intrapersonal aspects. The scale had significant yet moderately low correlations with measures of depression, anxiety, and difficulties in emotion regulation. CONCLUSION: The BES-K is a useful instrument in evaluating the beliefs about emotions in the Korean population.


Assuntos
Transtornos de Ansiedade , Emoções , Adulto , Análise Fatorial , Feminino , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes , República da Coreia , Inquéritos e Questionários
10.
Rev Esp Salud Publica ; 962022 Jan 19.
Artigo em Espanhol | MEDLINE | ID: mdl-35042841

RESUMO

According to the World Health Organization (WHO), mental health is a fundamental component of a healthy lifestyle. Currently this notion has become universal and has permeated the public consciousness, society and the political agenda of public health programs. In Spain, as a result of the pandemic due to the Coronavirus Disease 2019 (COVID-19), this health issue has been revived and has also been the subject of parliamentary debates. This idea is not new because within the Greco-Roman medical tradition continued by the Arabs, all the great authors included in their texts chapters on general hygienic-dietary norms to lead a healthy life, their own medical genre called "health regimen". In Al-Andalus, the Jewish doctor Maimonides (1138-1204) was nine centuries ahead of the concept of mental health or hygiene of the soul and its disorders, topics now included in the field of psychology, psychiatry and psychosomatic medicine. Maimonides drew up a body of doctrine on mental disorders and systematized a complete management of them from a comprehensive view of the patient as a person, based on four preventive and therapeutic measures to achieve mental balance: a) a general health regime; b) mental and emotional re-education; c) measures to reduce anxiety; and d) specific antidepressant medication. These recommendations are the most original made up to then, even many of them are still valid today due to their modernity. In this historical context, Maimonides constitutes a scientific bridge between the Middle Ages and our era.


Según la Organización Mundial de Salud (OMS) la salud mental es un componente fundamental del estilo de vida saludable. Actualmente, esta noción se ha hecho universal y ha calado en la conciencia ciudadana, en la sociedad y en la agenda política de los programas de Salud Pública. En España, a consecuencia de la pandemia debida a la Enfermedad por Coronavirus 2019 (COVID-19), este asunto sanitario se ha reavivado y ha sido motivo también de debates parlamentarios. Esta idea no es nueva pues dentro de la tradición médica grecolatina, continuada por los árabes, todos los grandes autores incluyeron en sus textos capítulos acerca de normas higiénico-dietéticas generales para llevar una vida sana, género médico propio denominado "régimen de salud". En Al-Andalus, el médico judío Maimónides (1138-1204) se adelantó en nueve siglos al concepto de salud mental o higiene del alma y sus trastornos, temas incluidos ahora en el campo de la psicología, la psiquiatría y la medicina psicosomática. Maimónides confeccionó un cuerpo de doctrina sobre las afecciones psíquicas y sistematizó un manejo completo de las mismas desde una visión integral del paciente como persona, basado en cuatro medidas preventivas y terapéuticas para alcanzar el equilibrio psíquico: a) un régimen general de salud; b) reeducación mental y emocional; c) medidas para disminuir la ansiedad; y d) medicación específica antidepresiva. Estas recomendaciones son las más originales hechas hasta entonces. Incluso muchas de ellas siguen vigentes actualmente por su modernidad. En este contexto histórico Maimónides constituye un puente científico entre el Medievo y nuestra era.


Assuntos
COVID-19 , Saúde Mental , Transtornos de Ansiedade , Humanos , SARS-CoV-2 , Espanha
11.
Support Care Cancer ; 30(1): 511-519, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34333717

RESUMO

PURPOSE: Scan-associated anxiety ('scanxiety') is a problem for people with advanced cancer. We aimed to determine the prevalence, severity and associations of scanxiety in this population. METHODS: People with advanced cancer and a computed tomography scan within the last 4 months completed a multicentre survey including self-rated presence (yes/no) and severity (distress thermometer, 0-10) of scanxiety, state anxiety (STAI-6), clinical anxiety and depression (HADS), and fear of progression (FOP-Q-SF). Associations with scanxiety were evaluated. RESULTS: There were 222 participants: mean age 64 years (range 26 to 91), female (61%), most common cancer types (breast 37%, lung 19%, colorectal 16%) and > 1 year since cancer diagnosis (82%). Sixty-two percent had a scan within the last month, and 70% reported waiting > 2 days for the result. Over half (55%) of participants experienced scanxiety. On multivariable analysis, scanxiety was more prevalent in participants who were younger (mean age 62 years with v 66 years without scanxiety, p = 0.02) and more remote (v major city, OR 2.6, p = 0.04). Among participants with scanxiety, the mean severity score was 6 (range 1-10) with peak severity occurring when waiting for scan results. On multivariable analysis, scanxiety was 1.2 points higher in participants who had been diagnosed within the past year (v > 1 year, p = 0.04) and was higher in participants who had higher STAI-6 scores (ß = 0.06, p = 0.004). CONCLUSION: Scanxiety is common and can be severe. Strategies to reduce scanxiety are needed.


Assuntos
Ansiedade , Neoplasias , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Ansiedade/etiologia , Transtornos de Ansiedade , Depressão , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Prevalência , Inquéritos e Questionários
12.
Support Care Cancer ; 30(1): 635-645, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34363110

RESUMO

BACKGROUND: OBJECTIVE: Having a child diagnosed with cancer is stressful for the whole family and may cause significant psychological impact on parents and siblings. Chronic, life-altering diseases may also have similar effects in siblings due to the daily life changes in the family to accommodate the child with chronic disease. We investigated the impact of having a sibling with cancer or type 1 diabetes mellitus (T1DM) on the psychological features of adolescents, with particular focus on self-conscious emotions such as guilt and shame-which are associated with the development of psychopathologies. METHOD: Sixty-four children who were siblings of patients diagnosed with cancer (CS group), 54 children who were siblings of patients diagnosed with T1DM (DMS group), and 200 adolescents with siblings who did not have any chronic disease (control group) were included in the study. The CS group was also divided into two subgroups with respect to cancer type (leukemia and non-leukemia). Feelings of guilt and shame were evaluated via the Test of Self-Consciousness Affect for Adolescents (TOSCA-A). The Children's Depression Inventory (CDI) and the State-Trait Anxiety Inventory (STAI) were used to determine the levels of depression and anxiety symptoms. Comparisons between groups were performed and within-group directional relationships between scores were analyzed. RESULTS: Guilt scores were significantly higher in CSs than controls (p = 0.009), and the guilt scores of CSs and DMSs were similar (p = 0.508). Other subdimension scores obtained from the TOSCA-A and the CDI and STAI scores were similar in all three groups. In the CS group, externalization scores of siblings with leukemia were significantly higher than that of siblings with non-leukemia cancer. Although shame scores were similar in the CS, DMS, and control groups, shame scores were found to be positively correlated with CDI and STAI total scores in each group (p < 0.05 for all), whereas guilt scores did not demonstrate any significant correlations. CONCLUSION: Our results support prior studies in showing that CSs feel a greater level of guilt compared to adolescents without disease-stricken siblings, whereas, interestingly, CSs and DMSs were found to experience similar levels of guilt. Despite lack of significant increase in the CS and DMS groups, shame levels were positively correlated with depression and anxiety scores in all groups, but the lower correlation coefficients for the CS group indicate the presence of other factors influencing this relationship. We believe our results warrant the need for future studies evaluating the needs of the siblings of children with other chronic diseases, preferably with longitudinal follow-up to determine situations associated with need for psychosocial support.


Assuntos
Diabetes Mellitus Tipo 1 , Neoplasias , Adolescente , Transtornos de Ansiedade , Criança , Emoções , Humanos , Irmãos
13.
Auton Neurosci ; 237: 102927, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34923228

RESUMO

We here described the frequency and nature of voiding and storage bladder symptoms in depression/anxiety, for which we propose the name "bladder somatic symptom disorder (SSD)" because such symptoms most probably have brain mechanisms. SSD was formerly called as various terms including "somatoform disorder", "medically unexplained physical symptoms", "functional somatic syndrome" and "hysterical neurosis/hysteria". Bladder SSD has the following specific features that are distinguishable from "true" neurologic/organic bladder dysfunction: 1) situation-dependence (close association with life event in some), 2) urodynamically increased bladder sensation/hypersensitivity and 3) absence of neurologic/organic diseases, in addition to 4) other stress symptoms (insomnia, etc.), are key clues to the possibility of bladder SSD. Urodynamics in these patients showed, to a lesser extent, underactive bladder without post-void residual. These findings might reflect the biological changes of the depressive brain; e.g., decreases in serotonin and GABA, and possible increases in CRH. Treatment of bladder SSD can follow that of general depression/anxiety, with the potential addition of anticholinergic or selective beta3 bladder drugs.


Assuntos
Depressão , Sintomas Inexplicáveis , Ansiedade , Transtornos de Ansiedade , Humanos , Transtornos Somatoformes
14.
Midwifery ; 104: 103169, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34749125

RESUMO

OBJECTIVE: Anxiety is a significant public health concern, that if untreated may lead to adverse outcomes for mother, baby and the family unit. The aim of this review was to determine the efficacy of psychological interventions for pregnant women with anxiety in the antenatal period. Although guidelines recommend psychological interventions for managing anxiety in the perinatal period, there is a lack of strong evidence on the most effective psychological intervention for use in the antenatal period. Effective non-pharmacological interventions are an important area that requires significant clinical attention. DESIGN: A systematic review of quantitative and qualitative studies was conducted using Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Applied Social Sciences Index and Abstracts (ASSIA), Web of Science and PsychInfo. Quality appraisal was performed using The Joanna Briggs Institute (JBI) critical appraisal tool to assess methodological quality on all six included papers. All four RCT's were assessed separately using the Cochrane Risk of Bias Tool. FINDINGS: Of the 7278 articles, six quantitative studies were included. The overall results of this review found that mindfulness based interventions are by far the most effective intervention for the treatment of anxiety in the antenatal period. These findings are not in line with current guidance on treatment of women with anxiety in the antenatal period and warrants immediate attention. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Healthcare professionals need to be aware of the potential benefits of mindfulness based interventions in practice. There is some evidence to support their use in the antenatal period, however, there remains insufficient evidence to confidently advocate for their use in practice. Follow-up research needs to be conducted on the efficacy of mindfulness based interventions on women with anxiety in the antenatal period using rigorous RCT's. Education and training of Midwives to help promote and use this intervention is recommended.


Assuntos
Gestantes , Intervenção Psicossocial , Ansiedade/terapia , Transtornos de Ansiedade , Feminino , Pessoal de Saúde , Humanos , Gravidez
15.
Addict Behav ; 124: 107109, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34547644

RESUMO

Social media use is on the rise among young adults (YA) and evidence suggests a positive association between social media addiction (SMA) and the psychological symptoms of depression and anxiety globally. However, the contribution of attachment and its transgenerational influence on YAs' SMA and psychological symptoms have not been widely explored. Thus, we examined how parental reports of attachment (anxiety and avoidance) can directly and through YAs' attachment predict YAs' SMA, depression and anxiety symptoms. A sample of 375 YAs (MAge = 21.22) and their parents completed the Emotions in Close Relationships-Revised Questionnaire (Fraley et al., 2000), and the Brief Symptom Inventory (Deragotis, 1992). The SMA Scale (Sahin, 2018) was responded to by only YAs. We tested the pattern of associations in a path model. Parental attachment anxiety predicted YAs' attachment anxiety and only paternal attachment avoidance predicted YAs' attachment avoidance. YAs' attachment anxiety and avoidance predicted their depression and anxiety. However, YAs' attachment anxiety uniquely predicted their SMA. Both parents' attachment anxiety indirectly predicted the link between YAs' attachment anxiety and depression, but only paternal attachment avoidance indirectly predicted the association between YAs' attachment avoidance and depression. Furthermore, paternal attachment avoidance indirectly predicted the association between YAs' attachment avoidance and anxiety symptoms. Maternal attachment anxiety indirectly predicted SMA via YAs' attachment anxiety. While parental anxiety and paternal avoidance may impact YAs' symptoms, YAs' and maternal attachment anxiety can shape SMA. The findings about the differential role of attachment in YAs' psychological symptoms and SMA can facilitate further research and interventions.


Assuntos
Depressão , Transtorno de Adição à Internet , Adulto , Ansiedade , Transtornos de Ansiedade , Depressão/epidemiologia , Emoções , Humanos , Apego ao Objeto , Adulto Jovem
16.
Cien Saude Colet ; 26(12): 5997-6004, 2021 Dec.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34909992

RESUMO

Community Health Agents (CHAs) play a crucial role in assisting the population. Due to the complexity of functions and situations to which they are exposed, they can present with emotional problems. The aim of this article was to verify the prevalence of anxiety symptoms and the association with sociodemographic and occupational factors in community health agents. It is a cross-sectional and populational study that used a questionnaire to collect data on the sociodemographic, economic and occupational conditions and the State Trait Anxiety Inventory (STAI). Descriptive analyses and multiple Poisson regression were performed with robust variation, considering a 5% significance level (p <0.05) for the final model. A total of 673 community health agents were evaluated. The prevalence of anxiety symptoms in the STAI-State was 47.4% and in the STAI-trait, 42.4%. The time working as a CHA longer than five years was associated with the STAI-state (p<0.001) and the STAI-trait (p=0.018), where as the female gender was associated with the STAI-trait (p=0.011). A high prevalence of anxiety symptoms in community health agents was verified. Health promotion strategies aimed at improving and monitoring the mental health of these workers by reducing anxiety disorders is required.


Os Agentes Comunitários de Saúde possuem papel fundamental para o atendimento à população. Devido à complexidade de funções e situações que são expostos podem apresentar problemas emocionais. O objetivo deste artigo foi verificar a prevalência dos sintomas de ansiedade e a associação com os fatores sociodemográficos e ocupacionais entre agentes comunitários de saúde. Estudo transversal, populacional, no qual utilizou-se o Inventário de Ansiedade Traço Estado (IDATE- Traço e IDATE-Estado) e um questionário sobre as condições sociodemográficas e ocupacionais. Realizou-se análises descritivas e de regressão múltipla de Poisson com variância robusta, considerando um nível de significância de 5% (p<0,05) para o modelo final. Foram avaliados 673 agentes comunitários de saúde, a prevalência dos sintomas de ansiedade no IDATE-estado foi de 47,4% e no IDATE-traço, 42,4%. O tempo de trabalho acima de cinco anos esteve associado ao IDATE-estado (p<0,001) e ao IDATE-traço (p=0,018), o sexo feminino ficou associado ao IDATE-traço (p=0,011). Verificou-se alta prevalência de sintomas de ansiedade entre os agentes comunitários da saúde. Há necessidade de estratégias que visem a promoção, proteção, monitoramento da saúde mental desses trabalhadores, reduzindo os transtornos de ansiedade.


Assuntos
Ansiedade , Saúde Pública , Ansiedade/epidemiologia , Transtornos de Ansiedade/epidemiologia , Estudos Transversais , Feminino , Humanos , Prevalência
17.
BMC Psychiatry ; 21(1): 625, 2021 12 11.
Artigo em Inglês | MEDLINE | ID: mdl-34895184

RESUMO

BACKGROUND: The Coronavirus Disease 2019 (COVID-19) is an emerging disease with many unknown clinical and therapeutic dimensions. Patients with COVID-19 experience a variety of psychological problems during the disease. Understanding patients' mental condition and their distress during the disease is the first step to help these patients. So, the aim of this study was to explain COVID-19 patients' experiences of psychological distress during the disease course. METHODS: The present qualitative research was conducted in Iran from April 2020 to April 2021 using the conventional content analysis method. The participants included patients with COVID-19, selected by the purposeful sampling method. Data was collected through 34 telephone and in-person interviews and analyzed based on the method proposed by Lundman and Graneheim. RESULTS: Qualitative data analysis led to the emergence of sources of psychological distress as the main theme as well as seven categories and seven sub-categories. The categories were the disease's nature (the subcategories of disease's unknown dimensions, and disease severity), the anxiety caused by preventive behaviors (the subcategories of quarantine, worry about transmitting the infection to others and obsessive thoughts related to disinfection measures), the inefficient management by the health system (the subcategories of poor health care condition and lack of spiritual care), death anxiety, stigma, anxiety after recovery, and sleep pattern disturbance. CONCLUSION: Patients with COVID-19 experience great psychological distress during the acute phase of the disease or even long after recovery. It is suggested that psychological and spiritual counseling, as a key element of treatment and support for these patients, is provided to patients in the acute phase of the disease, as well as after recovery. National and local media should boost awareness about the disease as a dangerous yet preventable and curable infectious disease. People should follow health instructions and leave their seeing the disease as a taboo. TRIAL REGISTRATION NUMBER: Not applicable.


Assuntos
COVID-19 , Angústia Psicológica , Transtornos de Ansiedade , Humanos , Pesquisa Qualitativa , SARS-CoV-2
18.
Front Public Health ; 9: 767517, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34900913

RESUMO

Background: The spread of coronavirus disease 2019 (COVID-19) throughout the world leads to a series of modifications of several National Health Service organizations, with a potential series of psychological consequences among nurses. Methods: This study was undertaken to assess the psychological stress, anxiety factors, and coping mechanisms of critical care unit nurses during the COVID-19 outbreak. A cross-sectional research design was employed, and the convenience sample consisted of 469 nurses working at several hospitals in Saudi Arabia during the period from July to September 2020. This study used the Generalized Anxiety Disorder, Coping Mechanism, and Nursing Stress scale. Results: Interestingly, more than one-third and one-quarter of the studied nurses had severe and moderate anxiety levels, respectively. In addition, the most anxiety-causing factors included providing care for their infected colleagues and worrying about infecting their families. More than one-quarter and slightly less than half of the studied nurses had high and moderate stress levels, respectively. Furthermore, more than half of the participants had low coping mechanisms and one-quarter had moderate coping mechanisms. In addition, there was a strong positive correlation between anxiety and stress levels, and there was a strong negative correlation between coping mechanisms and stress and anxiety levels. Conclusions: Collectively, this study explored the psychological stress, anxiety factors, and coping mechanisms among critical care unit nurses during the COVID-19 outbreak in Saudi Arabia. Continuous educational programs for nurses on using coping mechanisms should be developed in combination with teaching preventive measures for defining a psychological intervention plan within a mandatory occupational health surveillance program. This study recommends that constructive planning and necessary provision of supportive measures by the legal authorities and policymakers protect nurses and minimize their psychological stress to fulfill high-quality nursing care.


Assuntos
COVID-19 , Adaptação Psicológica , Ansiedade/epidemiologia , Transtornos de Ansiedade , Cuidados Críticos , Estudos Transversais , Surtos de Doenças , Humanos , SARS-CoV-2 , Arábia Saudita/epidemiologia , Medicina Estatal , Estresse Psicológico/epidemiologia
19.
BMC Pregnancy Childbirth ; 21(1): 829, 2021 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-34903196

RESUMO

BACKGROUND: To date, there is a significant lack of research validating clinical tools for early and accurate detection of anxiety disorders in perinatal populations. Intolerance of uncertainty was recently identified as a significant risk factor for postpartum anxiety symptoms and is a key trait of non-perinatal anxiety disorders. The present study aimed to validate the Intolerance of Uncertainty Scale (IUS) in a perinatal population and evaluate its use as a screening tool for anxiety disorders. METHODS: Psychiatric diagnoses were assessed in a sample of perinatal women (n = 198), in addition to completing a self-report battery of questionnaires. Psychometric properties including internal consistency and convergent and discriminant validity were assessed. Determination of an optimal clinical cut-off score was measured through a ROC analysis in which the area under the curve, sensitivity, specificity, as well as positive and negative predictive values were calculated. RESULTS: The IUS demonstrated excellent internal consistency (α = 0.95) and an optimal clinical cut-off score of 64 or greater was established, yielding a sensitivity of 89%. The IUS also demonstrated very good positive (79%) and negative (80%) predictive values. CONCLUSIONS: These findings suggest that the IUS represents a clinically useful screening tool to be used as an aid for the early and accurate detection of perinatal anxiety.


Assuntos
Transtornos de Ansiedade/diagnóstico , Período Periparto/psicologia , Complicações na Gravidez/diagnóstico , Feminino , Humanos , Valor Preditivo dos Testes , Gravidez , Escalas de Graduação Psiquiátrica , Psicometria/instrumentação , Curva ROC , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Incerteza
20.
PLoS One ; 16(12): e0260640, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34910753

RESUMO

COVID-19 infection and the resultant restrictions has impacted all aspects of life across the world. This study explores factors that promote or support wellbeing for young people during the pandemic, how they differ by age, using a self-reported online survey with those aged 8-25 in Wales between September 2020 and February 2021. Open-ended responses were analysed via thematic analysis to provide further context. A total of 6,291 responses were obtained from 81 education settings across Wales (including primary and secondary schools as well as sixth form, colleges and universities). Wellbeing was highest in primary school children and boys and lowest in those who were at secondary school children, who were girls and, those who preferred not to give a gender. Among primary school children, higher wellbeing was seen for those who played with lots of others (rather than alone), were of Asian ethnicity (OR 2.17, 95% CI: 1.26 to 4.3), had a safe play area (OR: 2.4, 95% CI: 1.67 to 2.56) and had more sleep. To support their wellbeing young people reported they would like to be able to play with their friends more. Among secondary school children those who were of mixed ethnicity reported lower wellbeing (OR: 5.14, 95% CI: 1.68 to 15.79). To support their wellbeing they reported they would like more support with mental health (due to anxiety and pressure to achieve when learning online). This study found self-reported wellbeing differed by gender, ethnicity and deprivation and found younger children report the need for play and to see friends to support wellbeing but older children/young people wanted more support with anxiety and educational pressures.


Assuntos
COVID-19 , Adolescente , Transtornos de Ansiedade , Criança , Humanos
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