2202Instant analysis of the ECG with a new digital technique during palpitations reduce symptoms, anxiety, depression, and increase HRQOL in women

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Carnlof ◽  
P Insulander ◽  
M Jensen-Urstad ◽  
K Schenck-Gustafsson
Keyword(s):  
Atrial Fibrillation ◽  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Sinus Tachycardia ◽  
Normal Sinus Rhythm ◽  
Depression Scale ◽  
Heart Rhythm ◽  
Generalized Anxiety ◽  
Digital Technique ◽  
Anxiety Depression

Abstract Background Palpitation is common, particularly in women, and usually benign caused by premature atrial/ventricular beats or stress-induced sinus tachycardia. Palpitations may cause disturbing symptoms, anxiety, depression, and decreased health related quality of life (HRQOL). Uncommonly, arrhythmias of clinical importance such as atrial fibrillation or paroxysmal supraventricular or ventricular tachycardia may be the cause. Purposes To evaluate if instant analysis of underlying heart rhythm during palpitations reduce symptoms, anxiety, depression, and increase HRQOL. Methods In all, 913 women (age 56±11 years) with palpitations causing anxiety were recruited from social web sites. Coala Heart Monitor® was used by participants and ECG recorded twice a day and at symptoms for 60 days. The system uses a well-validated algorithm to analyze heart rhythm, is connected to the user's smartphone and provides immediate response to the user. In cases of non-benign arrhythmias, the result was also analyzed manually. Questionnaires addressing symptom (Symptom severity and frequency checklist (SCL), anxiety, depression Hospital anxiety and depression scale (HADS), Generalized Anxiety Disorder (GAD-7) and HRQOL (RAND-36)) were analyzed before and after two months. Exclusion criterium was known atrial fibrillation. Results Between June 2018 and November 2018, 280 474 recordings (both chest and thumbs) ECG recordings were automatically analyzed. Frequency and severity of symptoms decreased (frequency from 23.7±8.4 to 19.7±8.5 (p<0.001), severity from 22.7±4.9 to 21±4.4 (p<0.001)). Total anxiety measured by HADS decreased from 6.4±4.2 to 5.7±4.2 (p<0.001) and depression from 5.1±3.9 to 4.6±4.1 (p<0.001). Generalized anxiety disorder decreased from 5.6±4.8 to 4.7±4.6 (p<0.001) and HRQOL increased in all domains (p<0.001). In 83% of recordings during symptomatic palpitation, benign premature atrial or ventricular beats, sinus tachycardia, or normal sinus rhythm were found. Conclusions Instant analysis of the ECG with direct response to the user during palpitations reduce symptoms, anxiety, depression, and increase HRQOL in women.

The French Version of the Revised Child Anxiety and Depression Scale (RCADS) in a Nonclinical Sample

2015 ◽  
Vol 74 (3) ◽  
pp. 119-127 ◽  
Author(s):  
Martine Bouvard ◽  
Anne Denis ◽  
Jean-Luc Roulin
Keyword(s):  
Factor Analysis ◽  
Anxiety Disorder ◽  
Confirmatory Factor Analysis ◽  
Generalized Anxiety Disorder ◽  
Child Anxiety ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Generalized Anxiety ◽  
French Version ◽  
Confirmatory Factor

This article investigates the psychometric properties of the Revised Child Anxiety and Depression Scale (RCADS). A group of 704 adolescents completed the questionnaires in their classrooms. This study examines potential confirmatory factor analysis factor models of the RCADS as well as the relationships between the RCADS and the Screen for Child Anxiety Related Emotional Disorders-Revised (SCARED-R). A subsample of 595 adolescents also completed an anxiety questionnaire (Fear Survey Schedule for Children-Revised, FSSC-R) and a depression questionnaire (Center for Epidemiological Studies Depression Scale, CES-D). Confirmatory factor analysis of the RCADS suggests that the 6-factor model reasonably fits the data. All subscales were positively intercorrelated, with rs varying between .48 (generalized anxiety disorder-major depression disorder) and .65 (generalized anxiety disorder-social phobia/obsessive-compulsive disorder). The RCADS total score and all the RCADS scales were found to have good internal consistency (> .70). The correlations between the RCADS subscales and their SCARED-R counterparts are generally substantial. Convergent validity was found with the FSSC-R and the CES-D. The study included normal adolescents aged 10 to 19. Therefore, the findings cannot be extended to children under 10, nor to a clinical population. Altogether, the French version of the RCADS showed reasonable psychometric properties.

scholarly journals Association between Generalized Anxiety Disorder and Premenstrual Dysphoric Disorder in a Diagnostic Interviewing Study

2020 ◽  
Vol 17 (3) ◽  
pp. 988 ◽  
Author(s):  
Ju-Yu Yen ◽  
Pai-Cheng Lin ◽  
Mei-Feng Huang ◽  
Wei-Po Chou ◽  
Cheng-Yu Long ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Luteal Phase ◽  
Premenstrual Dysphoric Disorder ◽  
Follicular Phase ◽  
Generalized Anxiety ◽  
Psychiatric Interview ◽  
Healthy Women ◽  
Behavior Inhibition ◽  
Anxiety Depression

Background: Premenstrual dysphoric disorder (PMDD) demonstrates predictable, cyclic, affective and somatic symptoms that are aggravated in the late luteal phase and are resolved by menstruation. Generalized anxiety disorder (GAD) is characterized by excessive and persistant worry. The present study aims to evaluate the association between PMDD and GAD. The fluctuations of behavior inhibition, anxiety, depression, and irritability were also evaluated during the menstrual cycle among women with PMDD and healthy women. Methods: There were 100 women diagnosed with PMDD based on a psychiatric interview and on a prospective evaluation in three menstrual cycles. A total of 96 healthy women were recruited as controls. Each individual’s GAD diagnosis, behavior inhibition, behavior activation, depression, anxiety, and irritability were assessed in both luteal and follicular phases. Results: The odds ratio of women with GAD having PMDD was 7.65 (95% CI: 1.69–34.63) in relation to those without it. This association was partially mediated by behavior inhibition and irritability and was completely mediated by depression. Women with PMDD and GAD had higher anxiety during the luteal phase and higher PMDD severity, depression, and irritability than those without GAD in the follicular phase. There is no difference in anxiety, depression, or irritability between the luteal and follicular phases among women with PMDD and GAD. Conclusions: Women with GAD were more likely to have PMDD. Anxiety, depression, and irritability symptoms in women with PMDD and GAD were not relieved in the follicular phase. Thus, GAD should be assessed for women with PMDD. Their anxiety, depression, and irritability should be intervened not only in the luteal phase, but also in the follicular phase. Depression, irritability and behavior inhibition mediated the association between PMDD and GAD. Intervening with these mediators to attenuate GAD and PMDD comorbidity should be researched in the future.

scholarly journals Psychiatric symptoms and moral injury among US healthcare workers in the COVID-19 era

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Doron Amsalem ◽  
Amit Lazarov ◽  
John C. Markowitz ◽  
Aliza Naiman ◽  
Thomas E. Smith ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Healthcare Workers ◽  
Clinical Symptoms ◽  
Psychiatric Symptoms ◽  
Moral Injury ◽  
Generalized Anxiety ◽  
Anxiety Depression

Abstract Background Emerging cross-sectional data indicate that healthcare workers (HCWs) in the COVID-19 era face particular mental health risks. Moral injury – a betrayal of one’s values and beliefs, is a potential concern for HCWs who witness the devastating impact of acute COVID-19 illness while too often feeling helpless to respond. This study longitudinally examined rates of depression, generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD), and moral injury among United States HCWs in the COVID-19 era. We anticipated finding high levels of clinical symptoms and moral injury that would remain stable over time. We also expected to find positive correlations between clinical symptoms and moral injury. Methods This three-wave study assessed clinical symptoms and moral injury among 350 HCWs at baseline, 30, and 90 days between September and December 2020. Anxiety, depression, PTSD, and moral injury were measured using the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Primary Care PTSD Screen (PC-PTSD), and Moral Injury Events Scale (MIES). Results Of the 350 HCWs, 72% reported probable anxiety, depression, and/or PTSD disorders at baseline, 62% at day 30, and 64% at day 90. High level of moral injury was associated with a range of psychopathology including suicidal ideation, especially among healthcare workers self-reporting COVID-19 exposure. Conclusions Findings demonstrate broad, persisting, and diverse mental health consequences of the COVID-19 pandemic among United States HCWs. This study is the first to longitudinally examine the relationships between moral injury and psychopathology among HCWs, emphasizing the need to increase HCWs’ access to mental healthcare.

Generalized anxiety disorder in the anxiety/depression spectrum

2008 ◽  
Vol 23 ◽  
pp. S216-S217
Author(s):  
H. Oskarsso ◽  
T.E. Thorgeirsson ◽  
F. Geller ◽  
H. Kolbeinsson ◽  
J.G. Stefansson ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Generalized Anxiety ◽  
Anxiety Depression

P6574Symptomatic palpitations causing anxiety in women, what are the underlying arrhythmias

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Insulander ◽  
C Carnlof ◽  
M Jensen-Urstad ◽  
K Schenck-Gustafsson
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Tachycardia ◽  
Supraventricular Tachycardia ◽  
Sinus Tachycardia ◽  
Normal Sinus Rhythm ◽  
Sinus Bradycardia ◽  
Clinical Importance ◽  
Great Majority ◽  
Block Type ◽  
Digital Technique

Abstract Background Highly symptomatic palpitations are common, particularly in women, and may cause disturbing symptoms including anxiety, depression, and decreased health related quality of life. Palpitation in this context has been considered generally benign and caused by premature atrial or ventricular beats or stress-induced sinus tachycardia. However, how often arrhythmias of clinical importance such as atrial fibrillation and supraventricular or ventricular tachycardia is the cause is unknown. Purpose To evaluate to what extent symptomatic palpitation in women is caused by clinically important arrhythmias. Methods A new Swedish digital technique was used. The system uses a well-validated algorithm to analyze heart rhythm (both thumbs and chest recordings), is connected to the user's smartphone and provides immediate response to the user. The result is simultaneously available for the supervising physician. In cases of non-benign arrhythmias, the result was also analyzed manually. In all, 909 women (age 56±11 years) with palpitations causing anxiety were included. ECG was recorded twice a day and at symptoms for 60 days. Participants with known atrial fibrillation were excluded. Results In all, 6 861 ECG recordings were done due to symptomatic palpitation. Underlying heart rhythms were as follows: normal sinus rhythm (73%), sinus tachycardia (12%), premature atrial beats or ventricular beats (7%), atrial fibrillation (4%), benign sinus bradycardia and second-degree AV block type 1 (4%), and supraventricular tachycardia (1%). In 1% of recordings, quality was too poor for analysis. No ventricular tachycardia was recorded. In all, 19 women with previously undiagnosed atrial fibrillation and 12 women with undiagnosed supraventricular tachycardia were found. Conclusions In the great majority of episodes causing symptomatic palpitation in women, the underlying arrhythmia is benign. However, in 5% previously undiagnosed atrial fibrillation or supraventricular tachycardia were found.

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