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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.
Front Public Health ; 9: 590458, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34956994

RESUMO

Background: Low-income earners are particularly vulnerable to mental health, consequence of the coronavirus disease 2019 (COVID-19) lockdown restrictions, due to a temporary or permanent loss of income and livelihood, coupled with government-enforced measures of social distancing. This study evaluates the mental health status among low-income earners in southwestern Uganda during the first total COVID-19 lockdown in Uganda. Methods: A cross-sectional descriptive study was undertaken amongst earners whose income falls below the poverty threshold. Two hundred and fifty-three (n = 253) male and female low-income earners between the ages of 18 and 60 years of age were recruited to the study. Modified generalized anxiety disorder (GAD-7), Spielberger's State-Trait Anger Expression Inventory-2 (STAXI-2), and Beck Depression Inventory (BDI) tools as appropriate were used to assess anxiety, anger, and depression respectively among our respondents. Results: Severe anxiety (68.8%) followed by moderate depression (60.5%) and moderate anger (56.9%) were the most common mental health challenges experienced by low-income earners in Bushenyi district. Awareness of mental healthcare increased with the age of respondents in both males and females. A linear relationship was observed with age and depression (r = 0.154, P = 0.014) while positive correlations were observed between anxiety and anger (r = 0.254, P < 0.001); anxiety and depression (r = 0.153, P = 0.015) and anger and depression (r = 0.153, P = 0.015). Conclusion: The study shows the importance of mental health awareness in low resource settings during the current COVID-19 pandemic. Females were identified as persons at risk to mental depression, while anger was highest amongst young males.


Assuntos
COVID-19 , Pandemias , Adolescente , Adulto , Ira , Ansiedade/epidemiologia , Transtornos de Ansiedade/epidemiologia , Controle de Doenças Transmissíveis , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pobreza , SARS-CoV-2 , Uganda/epidemiologia , Adulto Jovem
3.
Rev. Nac. (Itauguá) ; 13(2): 18-28, DICIEMBRE, 2021.
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-1344187

RESUMO

RESUMEN Introducción: la pandemia de COVID-19 ha incrementado los casos de ansiedad y causado grandes modificaciones en la forma de prestar atención médica. Objetivo: describir las características epidemiológicas de los trastornos de ansiedad atendidos a través de telepsiquiatría en un Hospital Universitario. Metodología: estudio observacional, descriptivo, de corte transversal. Se realizó un muestreo no aleatorio intencional. Se utilizaron fichas electrónicas de pacientes tratados en el Servicio de Psiquiatría del Hospital de Clínicas, Paraguay, entre febrero y mayo de 2021. Se realizó estadística descriptiva de todas las variables. Se calcularon medidas de tendencia central y dispersión para las variables cuantitativas. Las cualitativas se resumieron en frecuencias y porcentajes. Resultados: el análisis incluyó 804 pacientes. El 71,5 % (575) de los pacientes procedían del ámbito rural. De todos los pacientes con diagnóstico de algún trastorno de ansiedad (20,49 % n = 165), el 69,1 % (114) correspondían a mujeres y el 49,7 % (82) presentaron trastorno de pánico (ansiedad paroxística episódica), 28,5 % (47) fueron diagnosticados con trastorno de ansiedad generalizada, y 21,8 % (36) tuvieron un trastorno de ansiedad no especificado. Conclusión: más del 20 % de los pacientes que consultaron a través de la modalidad de telepsiquiatría presentó algún cuadro del espectro ansioso. La presentación de casos se dio tanto en el ámbito rural como en el urbano y de preferencia en mujeres. El trastorno de pánico emergió como el trastorno de más alta frecuencia en la población accesible, representando casi la mitad de todos los casos de ansiedad diagnosticados.


ABSTRACT Introduction: the COVID-19 pandemic has increased anxiety cases and caused big modifications in the way medical care is provided. Objective: to describe the epidemiological characteristics of anxiety disorders treated through telepsychiatry in a University Hospital. Methodology: observational, descriptive, cross-sectional study. A non-random purposive sampling was performed. Electronic records of patients treated in the Psychiatry Department of the "Hospital de Clínicas", Paraguay, between February and May 2021 were used. Descriptive statistics were performed for all variables. Measures of central tendency and dispersion were calculated for quantitative variables. Qualitative variables were summarized in frequencies and percentages. Results: the analysis included 804 patients. Out of the patients, 71,5 % (575) were from rural areas. Out of all patients diagnosed with an anxiety disorder (20,49 % n = 165), 69,1 % (114) were female and 49,7 % (82) had panic disorder (episodic paroxysmal anxiety), 28,5 % (47) were diagnosed with generalized anxiety disorder, and 21,8 % (36) had an unspecified anxiety disorder. Conclusion: more than 20 % of the patients who consulted through the telepsychiatry modality presented with an anxiety spectrum disorder. Cases were presented in both rural and urban areas and preferably in females. Panic disorder emerged as the most frequent disorder in the accessible population, representing almost half of all diagnosed anxiety cases.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Ansiedade/epidemiologia , Transtornos de Ansiedade/epidemiologia , Pandemias , Telepsiquiatria , Paraguai/epidemiologia , Saúde Mental/tendências , Transtorno de Pânico/epidemiologia , Consulta Remota/métodos , Distribuição por Idade e Sexo , COVID-19
4.
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
5.
Can J Surg ; 64(6): E663-E667, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34907014

RESUMO

BACKGROUND: The incidence of adverse perioperative cardiac complications after parathyroidectomy has not been well described. This study aimed to evaluate the incidence of perioperative chest pain and cardiac complications after parathyroidectomy and to evaluate risk factors that may identify patients who are more likely to benefit from a cardiac workup. METHODS: We performed a retrospective study of all patients undergoing parathyroidectomy for primary hyperparathyroidism by a single endocrine surgeon at a tertiary endocrine centre between 2011 and 2018. Patient demographics, clinicopathologic variables, operative and postoperative details (reported chest pain, performance of a cardiac workup and new postoperative cardiac diagnosis) were reviewed. Patients with chest pain were compared to those without chest pain using the Fisher exact test and Student t test. RESULTS: Fourteen of 295 patients (4.7%) reported chest pain in the immediate postoperative period. Most patients were investigated with a 12-lead electrocardiogram and troponin (n = 12/14), yet none were diagnosed with a cardiac event. When comparing patients with and without chest pain, there was no significant difference in age, gender, body mass index, presence of cardiovascular risk factors, American Society of Anesthesiologists score or length of surgery. CONCLUSION: Postoperative chest pain after parathyroidectomy is not an uncommon event and leads to a cardiac workup in most cases; however, the risk of significant postoperative cardiac events is minimal. In the "choosing wisely" era, one should evaluate each patient's pretest probability of such events and avoid extensive workup in low-risk patients to avoid unnecessary costs to the health care system.


Assuntos
Transtornos de Ansiedade , Dor no Peito , Hiperparatireoidismo Primário , Paratireoidectomia , Complicações Pós-Operatórias , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/epidemiologia , Dor no Peito/diagnóstico , Dor no Peito/epidemiologia , Dor no Peito/etiologia , Comorbidade , Feminino , Humanos , Hiperparatireoidismo Primário/epidemiologia , Hiperparatireoidismo Primário/cirurgia , Incidência , Masculino , Pessoa de Meia-Idade , Paratireoidectomia/efeitos adversos , Paratireoidectomia/estatística & dados numéricos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Fatores de Risco , Centros de Atenção Terciária/estatística & dados numéricos , Adulto Jovem
6.
CMAJ Open ; 9(4): E988-E997, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34785528

RESUMO

BACKGROUND: The extent to which heightened distress during the COVID-19 pandemic translated to increases in severe mental health outcomes is unknown. We examined trends in psychiatric presentations to acute care settings in the first 12 months after onset of the pandemic. METHODS: This was a trends analysis of administrative population data in Ontario, Canada. We examined rates of hospitalizations and emergency department visits for mental health diagnoses overall and stratified by sex, age and diagnostic grouping (e.g., mood disorders, anxiety disorders, psychotic disorders), as well as visits for intentional self-injury for people aged 10 to 105 years, from January 2019 to March 2021. We used Joinpoint regression to identify significant inflection points after the onset of the pandemic in March 2020. RESULTS: Among the 12 968 100 people included in our analysis, rates of mental health-related hospitalizations and emergency department visits declined immediately after the onset of the pandemic (peak overall decline of 30% [hospitalizations] and 37% [emergency department visits] compared to April 2019) and returned to near prepandemic levels by March 2021. Compared to April 2019, visits for intentional self-injury declined by 33% and remained below prepandemic levels until March 2021. We observed the largest declines in service use among adolescents aged 14 to 17 years (55% decline in hospitalizations, 58% decline in emergency department visits) and 10 to 13 years (56% decline in self-injury), and for those with substance-related disorders (33% decline in emergency department visits) and anxiety disorders (61% decline in hospitalizations). INTERPRETATION: Contrary to expectations, the abrupt decline in acute mental health service use immediately after the onset of the pandemic and the return to near prepandemic levels that we observed suggest that changes and stressors in the first 12 months of the pandemic did not translate to increased service use. Continued surveillance of acute mental health service use is warranted.


Assuntos
COVID-19/epidemiologia , Serviços de Saúde Mental/estatística & dados numéricos , Serviços de Saúde Mental/tendências , Pandemias/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos de Ansiedade/epidemiologia , Criança , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Ontário/epidemiologia , Transtornos Psicóticos/epidemiologia , SARS-CoV-2 , Comportamento Autodestrutivo/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
7.
Rev Environ Health ; 36(4): 501-521, 2021 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-34821119

RESUMO

OBJECTIVES: Ambient air pollution (AAP) is an important risk factor for increased mental health morbidity. Studies have highlighted the effect of AAP on psychological stress and anxiety disorder. However, existing evidence regarding this is largely equivocal. This systematic review with meta-analysis aims to synthesize published evidence to calculate the pooled estimate of the effect of AAP on psychological stress and anxiety disorder. CONTENT: A systematic bibliographic search was undertaken using PubMed, JGateplus, Google Scholar, and Cochrane Library for observational human studies published in English till 31st March 2020 reporting the effect of AAP on psychological stress and anxiety disorder. Study quality was assessed using the Joanna Briggs Institute critical appraisal tools. Meta-analysis was performed adopting a random-effects model using Meta-XL. Of 412 articles retrieved, a total of 30 articles [AAP and anxiety disorders, (n=17, 57%); AAP and psychological stress, (n=9, 30%) and AAP and both psychological stress and anxiety disorders, (n=4, 13%)] fulfilled the inclusion criteria covering a total population of 973,725 individuals. The pooled estimate (OR) of the effects of PM10 on psychological stress was 1.03 [(95% CI: 1.00, 1.05) (p=0.17, I 2=41%)]. The pooled estimate of the effects of NO2 and PM10 on anxiety disorder was 0.93 [(95% CI: 0.89, 0.97) (p=0.91, I 2=0%)] and 0.88 [(95% CI: 0.78, 0.98) (p=0.01, I 2=59%)] respectively. The pooled estimate of the effects of PM2.5 on anxiety Disorder was 0.88 [(95% CI: 0.72, 1.06) (p=0.00, I 2=80%)]. SUMMARY AND OUTLOOK: The present study provides the most updated pooled estimate of the effect of AAP on psychological stress and anxiety disorder. Future studies should focus on longitudinal studies conducted in LIC and LMIC countries using uniform and standardized criteria for exposure and outcome assessment as well as robust adjustment for confounders to minimize methodological heterogeneity resulting in reliable and comparable estimation of environmental mental health burden.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/etiologia , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Humanos , Saúde Mental , Estresse Psicológico/epidemiologia
8.
Vertex ; XXXII(151): 6-14, 2021 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-34783772

RESUMO

The confinement due to the pandemic caused by COVID-19 in Argentina produced many changes. OBJECTIVE: To assess sleep, anxiety disorders, and depression in adults. SUBJECTS AND METHODS: Through an anonymous survey distributed in the country through the web that was completed by 2,594 people (69% women, 32% men). 30% reported working in the health field. Demographic information, quality and other sleep variables, depressive symptoms and anxiety were analyzed. RESULTS: The general prevalence of bad sleepers, depressive symptoms, and anxiety were 53%, 21.1%, and 43.8%, respectively. Those over 65 years of age showed a significantly higher prevalence of going to bed earlier and having a lower sleep onset latency. Multivariate logistic regression showed that age <55 years and being a woman were associated with anxiety and with being a poor sleeper. Sleeping more than 10 hours, going to bed later, being a poor sleeper and anxiety, were associated with depressive symptoms. Being a healthcare worker was associated with more anxiety. CONCLUSIONS: We identified poor sleep quality and alteration mental health in times of confinement. We found that more than half of the evaluated population turned out to be poor sleepers and presented high scores of symptoms related to anxiety and depression. Additionally, health workers presented more anxiety than the rest.


Assuntos
COVID-19 , Depressão , Adulto , Ansiedade/epidemiologia , Ansiedade/etiologia , Transtornos de Ansiedade/epidemiologia , Depressão/epidemiologia , Depressão/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Sono
9.
Psychiatry Res ; 305: 114251, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34739953

RESUMO

This study was conducted on elementary school students in Henan Province, China, from February 4th to 11th, 2020, during the coronavirus disease 2019 (COVID-19) epidemic. The purpose of the study was to examine the prevalence of anxiety among students and identify the related risk factors contributing to anxiety. Demographic information and psychological status were assessed by using self-reported measures. The generalized anxiety disorder tool (GAD-7) and a multiple logistic regression model were used to assess anxiety and identify potential influencing factors. Cross-sectional data indicated that the overall anxiety prevalence was 13.4%. The prevalence of anxiety symptoms was highest among rural primary school students and lowest among city students. Three groups of students in different regions were surveyed, and the prevalence of anxiety symptoms was significantly higher among students with poor knowledge of COVID-19 than among students with good knowledge of COVID-19. After adjusting for potential confounding factors, it was found that location, knowledge, and practice were related to anxiety. This study showed that the prevalence of anxiety symptoms was higher among Chinese primary school students. The influencing factors found in this study may help relevant staff improve the mental health of children during the epidemic.


Assuntos
COVID-19 , Ansiedade/epidemiologia , Transtornos de Ansiedade/epidemiologia , Criança , China/epidemiologia , Estudos Transversais , Depressão , Surtos de Doenças , Humanos , Internet , Prevalência , SARS-CoV-2 , Estudantes , Inquéritos e Questionários
10.
BMC Psychiatry ; 21(1): 498, 2021 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-34641795

RESUMO

OBJECTIVE: The novel coronavirus disease 2019 (COVID-19) is a global public health emergency that has caused worldwide concern. The mental health of medical students under the COVID-19 epidemic has attracted much attention. This study aims to identify subgroups of medical students based on depression and anxiety and explore the influencing factors during the COVID-19 epidemic in China. METHODS: A total of 29,663 medical students were recruited during the epidemic of COVID-19 in China. Depression and anxiety symptoms were assessed using Patient Health Questionnaire 9 (PHQ9) and Generalized Anxiety Disorder 7 (GAD7) respectively. Latent class analysis was performed based on depression and anxiety symptoms in medical students. The latent class subtypes were compared using the chi-square test. Multinomial logistic regression was used to examine associations between identified classes and related factors. RESULTS: In this study, three distinct subgroups were identified, namely, the poor mental health group, the mild mental health group and the low symptoms group. The number of medical students in each class is 4325, 9321 and 16,017 respectively. The multinomial logistic regression results showed that compared with the low symptoms group, the factors influencing depression and anxiety in the poor mental health group and mild mental health group were sex, educational level, drinking, individual psychiatric disorders, family psychiatric disorders, knowledge of COVID-19, fear of being infected, and participate in mental health education on COVID-19. CONCLUSIONS: Our findings suggested that latent class analysis can be used to categorize different medical students according to their depression and anxiety symptoms during the outbreak of COVID-19. The main factors influencing the poor mental health group and the mild mental health group are basic demographic characteristics, disease history, COVID-19 related factors and behavioural lifestyle. School administrative departments can carry out targeted psychological counseling according to different subgroups to promote the physical and mental health of medical students.


Assuntos
COVID-19 , Epidemias , Estudantes de Medicina , Ansiedade/epidemiologia , Transtornos de Ansiedade/epidemiologia , China/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Humanos , Análise de Classes Latentes , SARS-CoV-2 , Inquéritos e Questionários
11.
Health Aff (Millwood) ; 40(10): 1585-1591, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34606349

RESUMO

Reducing the rate of cesarean sections among women considered at low risk for delivery by that method is a goal of Healthy People 2030. Prior research suggests that perinatal mood and anxiety disorders increase the risk for cesarean section, but data are limited. This cross-sectional study of commercially insured women examined the relationship between perinatal depression and anxiety disorders and primary (first-time) cesarean section rates, using administrative claims data for US in-hospital deliveries from the period 2008-17. Of the 360,225 delivery hospitalizations among 317,802 unique women, 24.0 percent included a delivery by primary cesarean section, and 3.1 percent carried a diagnosis of depression, anxiety, or both made during the index pregnancy. Using an adjusted generalized estimating equation, we found that the predicted probability of primary cesarean section was 3.5 percentage points higher, on average, among women with these disorders compared with those without them. Our findings confirm the importance of pursuing research to identify mechanisms by which perinatal depression and anxiety disorders increase the risk for primary caesarean section among women otherwise considered at low risk for delivery by that method, as well as effective interventions.


Assuntos
Cesárea , Complicações na Gravidez , Transtornos de Ansiedade/epidemiologia , Estudos Transversais , Feminino , Humanos , Parto , Gravidez , Complicações na Gravidez/epidemiologia
12.
Curr Psychiatry Rep ; 23(11): 77, 2021 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-34613508

RESUMO

PURPOSE OF REVIEW: Anxiety disorders are highly prevalent conditions that have a detrimental impact on quality of life (QOL), particularly when left untreated. In the present review, we summarize recent literature, published within the last 3 years, on QOL in anxiety disorders, with a focus on factors that may play a role in the relationship between anxiety and QOL. RECENT FINDINGS: We organize our findings into four categories: (1) subjective distress, (2) behavioral responses, (3) functional impairment, and (4) clinical factors. Results indicate that greater anxiety symptom severity is linked with poorer QOL, and cognitive behavioral therapies for anxiety yield positive effects on QOL. Additional transdiagnostic mechanisms are highlighted, including anxiety sensitivity, distress tolerance, emotion regulation, and avoidant coping. We examine the role of functional impairment, and we discuss factors related to treatment, including comorbidity and longitudinal effects. We also consider early research from the COVID-19 pandemic. Understanding the underlying factors that contribute to QOL detriments provides important insight into the impact of anxiety disorders and identifies targets for enhancing QOL through treatment.


Assuntos
COVID-19 , Qualidade de Vida , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/terapia , Humanos , Pandemias , SARS-CoV-2
13.
Am J Public Health ; 111(10): 1855-1864, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34623878

RESUMO

Objectives. To examine associations of current mental and substance use disorders with self-reported gun ownership and carrying among recently separated US Army soldiers. Veterans have high rates of both gun ownership and mental disorders, the conjunction of which might contribute to the high suicide rate in this group. Methods. Cross-sectional survey data were collected in 2018-2019 from 5682 recently separated personnel who took part in the Army Study to Assess Risk and Resilience in Servicemembers. Validated measures assessed recent mood, anxiety, substance use, and externalizing disorders. Logistic regression models examined associations of sociodemographic characteristics, service characteristics, and mental disorders with gun ownership and carrying. Results. Of the participants, 50% reported gun ownership. About half of owners reported carrying some or most of the time. Mental disorders were not associated significantly with gun ownership. However, among gun owners, major depressive disorder, panic disorder, posttraumatic stress disorder, and intermittent explosive disorder were associated with significantly elevated odds of carrying at least some of the time. Conclusions. Mental disorders are not associated with gun ownership among recently separated Army personnel, but some mental disorders are associated with carrying among gun owners. (Am J Public Health. 2021;111(10):1855-1864. https://doi.org/10.2105/AJPH.2021.306420).


Assuntos
Armas de Fogo/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Militares/estatística & dados numéricos , Propriedade/estatística & dados numéricos , Adulto , Transtornos de Ansiedade/epidemiologia , Estudos Transversais , Transtorno Depressivo Maior/epidemiologia , Humanos , Masculino , Transtornos Mentais/psicologia , Militares/psicologia , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Inquéritos e Questionários , Estados Unidos
14.
PLoS One ; 16(10): e0258105, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34624044

RESUMO

INTRODUCTION: Over the past two decades, there have been several global interventions including the Sustainable Development Goals (SDGs), aimed at improving health outcomes. Despite efforts by countries to achieve the SDG targets, mental health challenges remain major public health concerns globally. We examined the prevalence and predictors of depression, anxiety, and stress as well as the comorbidities of these mental health issues among adults. MATERIALS AND METHODS: This was a community-based cross-sectional study conducted among 2456 adults in four districts of the Volta Region of Ghana using data from the UHAS-Yonsei University Partnership Project. We analysed the data using frequency, percentage, mean, standard deviation, correlation, and binary logistic regression. RESULTS: Overall, 51.8% of the participants had at least one of the mental health issues examined. The prevalence of a mental health issue was 25.2%, 53.3%, and 9.7% for depression, anxiety, and stress respectively. Participants constituting 8.3% experienced all three mental health issues as comorbidities. Participants' level of formal education and income significantly predicted depression, anxiety, and stress respectively at the multivariable level. Adults with a tertiary level of education were, for instance, 68% (AOR = 0.32, 95%CI = 0.15-0.66), 65% (AOR = 0.35, 95%CI = 0.17-0.73), and 50% (AOR = 0.50, 95%CI = 0.33-0.76) less likely to experience depression, anxiety, and stress, respectively compared with those who had no formal education. CONCLUSION: The majority of our study participants either experienced depression, anxiety, or stress. There were quite high comorbidities of the mental health issues among the adult population. To accelerate progress towards the achievement of SDG 3.4 target of promoting mental health and wellbeing for all by the year 2030, there is a need for effective implementation of the country's 2012 Mental Health Act which makes provisions for the establishment of a Mental Health Fund. This could improve the financial circumstances of indigenes as income has been realised in the present study as an important factor influencing depression, anxiety, and stress among the adult population.


Assuntos
Transtornos de Ansiedade/epidemiologia , Ansiedade/epidemiologia , Depressão/epidemiologia , Saúde Mental , Adolescente , Adulto , Idoso , Ansiedade/patologia , Transtornos de Ansiedade/patologia , Estudos Transversais , Depressão/patologia , Feminino , Gana/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários , Desenvolvimento Sustentável/tendências , Adulto Jovem
15.
Seizure ; 92: 211-215, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34600300

RESUMO

PURPOSE: Anxiety symptoms and depressive symptoms are frequent in PWE and associated with poorer outcomes. Investigation of specific characteristics of anxiety and depressive symptoms in PWE is of interest. METHODS: We used psychometric analyses in symptom networks using screening tools validated in PWE: Generalized Anxiety Disorder 7 (GAD-7) and Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). We conducted an estimation to build the NDDIE and GAD-7 network, analyzed network inferences (especially centrality measures) and performed network robustness analyses as well as modularity-based community detection. RESULTS: 145 PWE were included. The criteria with highest centrality was "Trouble relaxing" (G4) from the GAD-7, which represents a possible substantial symptom at the interface of anxiety and depressive comorbidities in epilepsy. Robustness was very moderate, despite results consistent with the literature. The two communities of nodes corresponded to criteria of the two scales. CONCLUSION: Epilepsy is a unique model for studying psychiatric symptoms since correlation with cerebral mechanisms can be assessed. "Trouble relaxing" as a key symptom is of interest, since this relates to the "Arousal" construct of the RDoC. Limitations of this study are the number of patients, single population, limits of psychometric analysis and network analysis, and a moderate robustness. Nevertheless, arousal is linked to seizure control, and thus these observations are of relevance to future investigation of pathophysiological mechanisms of psychopathology in epilepsy.


Assuntos
Depressão , Epilepsia , Ansiedade/epidemiologia , Ansiedade/etiologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/etiologia , Depressão/epidemiologia , Depressão/etiologia , Epilepsia/complicações , Epilepsia/epidemiologia , Humanos , Escalas de Graduação Psiquiátrica , Psicometria
17.
Lancet ; 398(10312): 1700-1712, 2021 11 06.
Artigo em Inglês | MEDLINE | ID: mdl-34634250

RESUMO

BACKGROUND: Before 2020, mental disorders were leading causes of the global health-related burden, with depressive and anxiety disorders being leading contributors to this burden. The emergence of the COVID-19 pandemic has created an environment where many determinants of poor mental health are exacerbated. The need for up-to-date information on the mental health impacts of COVID-19 in a way that informs health system responses is imperative. In this study, we aimed to quantify the impact of the COVID-19 pandemic on the prevalence and burden of major depressive disorder and anxiety disorders globally in 2020. METHODS: We conducted a systematic review of data reporting the prevalence of major depressive disorder and anxiety disorders during the COVID-19 pandemic and published between Jan 1, 2020, and Jan 29, 2021. We searched PubMed, Google Scholar, preprint servers, grey literature sources, and consulted experts. Eligible studies reported prevalence of depressive or anxiety disorders that were representative of the general population during the COVID-19 pandemic and had a pre-pandemic baseline. We used the assembled data in a meta-regression to estimate change in the prevalence of major depressive disorder and anxiety disorders between pre-pandemic and mid-pandemic (using periods as defined by each study) via COVID-19 impact indicators (human mobility, daily SARS-CoV-2 infection rate, and daily excess mortality rate). We then used this model to estimate the change from pre-pandemic prevalence (estimated using Disease Modelling Meta-Regression version 2.1 [known as DisMod-MR 2.1]) by age, sex, and location. We used final prevalence estimates and disability weights to estimate years lived with disability and disability-adjusted life-years (DALYs) for major depressive disorder and anxiety disorders. FINDINGS: We identified 5683 unique data sources, of which 48 met inclusion criteria (46 studies met criteria for major depressive disorder and 27 for anxiety disorders). Two COVID-19 impact indicators, specifically daily SARS-CoV-2 infection rates and reductions in human mobility, were associated with increased prevalence of major depressive disorder (regression coefficient [B] 0·9 [95% uncertainty interval 0·1 to 1·8; p=0·029] for human mobility, 18·1 [7·9 to 28·3; p=0·0005] for daily SARS-CoV-2 infection) and anxiety disorders (0·9 [0·1 to 1·7; p=0·022] and 13·8 [10·7 to 17·0; p<0·0001]. Females were affected more by the pandemic than males (B 0·1 [0·1 to 0·2; p=0·0001] for major depressive disorder, 0·1 [0·1 to 0·2; p=0·0001] for anxiety disorders) and younger age groups were more affected than older age groups (-0·007 [-0·009 to -0·006; p=0·0001] for major depressive disorder, -0·003 [-0·005 to -0·002; p=0·0001] for anxiety disorders). We estimated that the locations hit hardest by the pandemic in 2020, as measured with decreased human mobility and daily SARS-CoV-2 infection rate, had the greatest increases in prevalence of major depressive disorder and anxiety disorders. We estimated an additional 53·2 million (44·8 to 62·9) cases of major depressive disorder globally (an increase of 27·6% [25·1 to 30·3]) due to the COVID-19 pandemic, such that the total prevalence was 3152·9 cases (2722·5 to 3654·5) per 100 000 population. We also estimated an additional 76·2 million (64·3 to 90·6) cases of anxiety disorders globally (an increase of 25·6% [23·2 to 28·0]), such that the total prevalence was 4802·4 cases (4108·2 to 5588·6) per 100 000 population. Altogether, major depressive disorder caused 49·4 million (33·6 to 68·7) DALYs and anxiety disorders caused 44·5 million (30·2 to 62·5) DALYs globally in 2020. INTERPRETATION: This pandemic has created an increased urgency to strengthen mental health systems in most countries. Mitigation strategies could incorporate ways to promote mental wellbeing and target determinants of poor mental health and interventions to treat those with a mental disorder. Taking no action to address the burden of major depressive disorder and anxiety disorders should not be an option. FUNDING: Queensland Health, National Health and Medical Research Council, and the Bill and Melinda Gates Foundation.


Assuntos
Transtornos de Ansiedade/epidemiologia , COVID-19/epidemiologia , Depressão/epidemiologia , Carga Global da Doença , Saúde Global , Humanos , Pandemias , Prevalência , SARS-CoV-2 , Inquéritos e Questionários
18.
BMC Public Health ; 21(1): 1830, 2021 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-34627208

RESUMO

BACKGROUND: Generalized Anxiety Disorder (GAD) is a common but urgent mental health problem during disease outbreaks. Resilience buffers against the negative impacts of life stressors on common internalizing psychopathology such as GAD. This study assesses the prevalence of GAD and examines the protective or compensatory effect of resilience against worry factors during the COVID-19 outbreak. METHODS: A cross-sectional online survey was conducted among Chinese citizens aged ≥18 years from January 31 to February 2, 2020. A total of 4827 participants across 31 provinces and autonomous regions of the mainland of China participated in this study. The Generalized Anxiety Disorder scale (GAD-7), the Connor-Davidson Resilience Scale (CD-RISC), and a self-designed worry questionnaire were used to asses anxiety disorder prevalence, resilience level, and anxiety risk factors. Multivariable logistic regression was used to identify the associations of resilience and worry factors with GAD prevalence after controlling for other covariates. RESULTS: The prevalence of anxiety disorder was 22.6% across the 31 areas, and the highest prevalence was 35.4% in Hubei province. After controlling for covariates, the results suggested a higher GAD prevalence among participants who were worried about themselves or family members being infected with COVID-19 (adjusted odds ratio, AOR 3.40, 95%CI 2.43-4.75), worried about difficulty obtaining masks (AOR 1.92, 95%CI 1.47-2.50), worried about difficulty of distinguishing true information (AOR 1.65, 95%CI 1.36-2.02), worried about the prognosis of COVID-19 (AOR 2.41, 95%CI 1.75-3.33), worried about delays in working (AOR 1.71, 95%CI 1.27-.31), or worried about decreased income (AOR 1.45, 95%CI 1.14-1.85) compared with those without such worries. Additionally, those with a higher resilience level had a lower prevalence of GAD (AOR 0.59, 95%CI 0.51-0.70). Resilience also showed a mediating effect, with a negative influence on worry factors and thereby a negative association with GAD prevalence. CONCLUSION: It may be beneficial to promote public mental health during the COVID-19 outbreak through enhancing resilience, which may buffer against adverse psychological effects from worry factors.


Assuntos
COVID-19 , Pandemias , Adolescente , Adulto , Ansiedade , Transtornos de Ansiedade/epidemiologia , China/epidemiologia , Estudos Transversais , Depressão , Surtos de Doenças , Humanos , Prevalência , SARS-CoV-2 , Inquéritos e Questionários
19.
Lancet Psychiatry ; 8(11): 991-1000, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34627532

RESUMO

Urbanisation and common mental disorders (CMDs; ie, depressive, anxiety, and substance use disorders) are increasing worldwide. In this Review, we discuss how urbanicity and risk of CMDs relate to each other and call for a complexity science approach to advance understanding of this interrelationship. We did an ecological analysis using data on urbanicity and CMD burden in 191 countries. We found a positive, non-linear relationship with a higher CMD prevalence in more urbanised countries, particularly for anxiety disorders. We also did a review of meta-analytic studies on the association between urban factors and CMD risk. We identified factors relating to the ambient, physical, and social urban environment and showed differences per diagnosis of CMDs. We argue that factors in the urban environment are likely to operate as a complex system and interact with each other and with individual city inhabitants (including their psychological and neurobiological characteristics) to shape mental health in an urban context. These interactions operate on various timescales and show feedback loop mechanisms, rendering system behaviour characterised by non-linearity that is hard to predict over time. We present a conceptual framework for future urban mental health research that uses a complexity science approach. We conclude by discussing how complexity science methodology (eg, network analyses, system-dynamic modelling, and agent-based modelling) could enable identification of actionable targets for treatment and policy, aimed at decreasing CMD burdens in an urban context.


Assuntos
COVID-19/psicologia , Transtornos Mentais/epidemiologia , Saúde Mental/normas , Saúde da População Urbana/normas , Adulto , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/virologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Ecossistema , Feminino , Indicadores Básicos de Saúde , Humanos , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Saúde Mental/tendências , Metanálise como Assunto , Prevalência , SARS-CoV-2/genética , Análise de Rede Social , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Análise de Sistemas , Saúde da População Urbana/tendências
20.
Res Dev Disabil ; 119: 104108, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34653831

RESUMO

BACKGROUND: Children with learning difficulties are vulnerable to internalizing symptoms, particularly anxiety and depression. However, only few studies have examined this relationship in low-and-middle-income countries using a nationally representative data. AIMS: This study aimed to examine the relationship between learning difficulty and internalizing symptoms of children aged 5-17 years in Ghana while controlling for covariates. METHODS AND PROCEDURES: We analyzed children's data using mothers'/caregivers' reports from the 2017/2018 Ghana Multiple Indicator Cluster Survey Six (MICS 6). Data of 8,958 children aged 5-17 years were used for the analysis. OUTCOMES AND RESULTS: About 20% of the children had some learning difficulties whereas 5% could not learn at all. Learning difficulty was associated with symptoms of anxiety and depression of children. Specifically, children who had some learning difficulties had higher odds of feeling anxious [APOR = 1.28, 95% CI:1.11, 1.49, p = 0.001] while those with some difficulties [APOR=1.24, 95% CI:1.07, 1.44, p = 0.004] and a lot of difficulties or could not learn at all [APOR=1.74, 95% CI:1.28, 2.37, p < 0.01] had higher odds of feeling depressed. CONCLUSION AND IMPLICATIONS: The findings call on stakeholders in education and health to prioritize the mental health of all school-going children, particularly those with learning difficulties in Ghana.


Assuntos
Cuidadores , Mães , Ansiedade/epidemiologia , Transtornos de Ansiedade/epidemiologia , Criança , Feminino , Gana/epidemiologia , Humanos
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