Psychopharmacologic Management of Anxiety and Depression

2017 ◽  
Author(s):  
Madeline Li ◽  
Joshua Rosenblat ◽  
Gary Rodin
Keyword(s):  
Depression And Anxiety ◽  
Pharmacological Management ◽  
Patients With Cancer ◽  
Symptoms Of Depression ◽  
Psychotherapeutic Interventions ◽  
Associated Symptoms ◽  
Normative Response ◽  
Severe Anxiety ◽  
Selection Of ◽  
The Continuum

Depression and anxiety are highly prevalent in patients with cancer. Defining the quality and severity of these symptoms, along with ruling out other causes for them, is required before treatment is initiated. The continuum of symptoms of depression or anxiety ranges from a normative response to more severe symptoms. Pharmacological management of depression and anxiety should be reserved for the latter, often in conjunction with psychotherapeutic interventions. Relative efficacy, adverse effects, and potential drug–drug interactions should be considered in the selection of medications. Antidepressants are first line in the treatment of both major depression and anxiety disorders. Antipsychotics may also be considered if antidepressant monotherapy yields only a partial response. Psychostimulants may be considered when time is short and when there are associated symptoms of fatigue or anergia. The short-term judicious use of benzodiazepines may also be considered for situational or severe anxiety, until an antidepressant takes effect.

scholarly journals QOLP-37. MOOD DISTURBANCE IN PATIENTS WITH CENTRAL NERVOUS SYSTEM (CNS) TUMORS DURING THE COVID-19 PANDEMIC

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi191-vi191
Author(s):  
Lily Polskin ◽  
Valentina Pillai ◽  
Elizabeth Vera ◽  
Alvina Acquaye ◽  
Nicole Briceno ◽  
...  
Keyword(s):  
Mood Disturbance ◽  
Cns Tumors ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Normative Sample ◽  
Disease Trajectory ◽  
Symptoms Of Depression ◽  
Patient Reported ◽  
Anxiety Depression ◽  
Severe Anxiety

Abstract BACKGROUND Primary CNS tumors are associated with uncertainty likely contributing to mood disturbance that is common throughout the disease trajectory. The intersection of the COVID-19 pandemic with a CNS tumor diagnosis may further impact the anxiety/depression experienced in this population. This study assessed key anxiety/depression symptoms in patients with CNS tumors prior to and during the COVID year. METHODS Patient reported outcomes (PROs), including the PROMIS Anxiety and Depression Short Forms and EQ-5D-3L, were collected at the time of clinical or telehealth evaluation from the COVID year (March 2020-February 2021) and were compared to assessments through February 2020 (a NOB-normative sample), reflecting what we would typically see in our regular clinic evaluations. RESULTS The COVID sample (N = 178) was primarily White (82%), male (55%), median age of 45 (range 18–79), and KPS ³ 90 (50%). The majority had high grade (70%) brain (83%) tumors with ³ 1 prior recurrence (60%) and 25% were on active treatment. Visits were primarily conducted via telehealth (64%) and 20% had progression at assessment. Compared to the NOB-normative sample, patients reported significantly higher depression scores (moderate-severe, 17% vs. 12%, p < 0.05), but not anxiety (18% vs. 16%). Eleven percent reported both moderate-severe anxiety and depressive symptoms (8% pre-COVID). Overall health assessed by the EQ-5D-3L was similar to the normative sample in all dimensions, apart from impact of moderate/extreme mood disturbance, which was more prevalent in the COVID year (53% vs. 43%, p < 0.05%). CONCLUSION Patients with CNS tumors are at risk for significant symptoms of depression and anxiety; this risk was heightened during the COVID year. Further evaluation of clinical factors associated with risk are underway. These findings highlight the need for assessments and interventions that can be administered via telehealth to address the mental health needs of this vulnerable population. Radiobiology

Symptoms of Depression and Anxiety in Adolescents and Young Adults With Allergies: A Comparison to Healthy Peers

2011 ◽  
Author(s):  
Elizabeth S. Molzon ◽  
Stephanie E. Hullmann ◽  
Angelica R. Eddington ◽  
Carmen A. Del Olmo Vazquez ◽  
Larry L. Mullins
Keyword(s):  
Young Adults ◽  
Adolescents And Young Adults ◽  
Depression And Anxiety ◽  
Symptoms Of Depression

A fully automated conversational agent with artificial intelligence capabilities (Youper) for treating depression and anxiety: A nonrandomized feasibility trial (Preprint)

2019 ◽  
Author(s):  
Jose Hamilton Vargas ◽  
Thiago Antonio Marafon ◽  
Diego Fernando Couto ◽  
Ricardo Giglio ◽  
Marvin Yan ◽  
...  
Keyword(s):  
Mental Health ◽  
Artificial Intelligence ◽  
Financial Incentives ◽  
Empirical Support ◽  
Digital Technologies ◽  
Feasibility Trial ◽  
Depression And Anxiety ◽  
Conversational Agents ◽  
Symptoms Of Depression ◽  
Viable Solution

BACKGROUND Mental health conditions, including depression and anxiety disorders, are significant global concerns. Many people with these conditions don't get the help they need because of the high costs of medical treatment and the stigma attached to seeking help. Digital technologies represent a viable solution to these challenges. However, these technologies are often characterized by relatively low adherence and their effectiveness largely remains empirical unverified. While digital technologies may represent a viable solution for this persisting problem, they often lack empirical support for their effectiveness and are characterized by relatively low adherence. Conversational agents using artificial intelligence capabilities have the potential to offer a cost-effective, low-stigma and engaging way of getting mental health care. OBJECTIVE The objective of this study was to evaluate the feasibility, acceptability, and effectiveness of Youper, a mobile application that utilizes a conversational interface and artificial intelligence capabilities to deliver cognitive behavioral therapy-based interventions to reduce symptoms of depression and anxiety in adults. METHODS 1,012 adults with symptoms of depression and anxiety participated in a real-world setting study, entirely remotely, unguided and with no financial incentives, over an 8-week period. Participants completed digital versions of the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder scale (GAD-7) at baseline, 2, 4, and 8 weeks. RESULTS After the eight-week study period, depression (PHQ-9) scores of participants decreased by 48% while anxiety (GAD-7) scores decreased by 43%. The RCI was outside 2 standard deviations for 93.0% of the individuals in the PHQ-9 assessment and 90.7% in the GAD-7 assessment. Participants were on average 24.79 years old (SD 7.61) and 77% female. On average, participants interacted with Youper 0.9 (SD 1.56) times per week. CONCLUSIONS Results suggest that Youper is a feasible, acceptable, and effective intervention for adults with depression and anxiety. CLINICALTRIAL Since this study involved a nonclinical population, it wasn't registered in a public trials registry.

scholarly journals Systematic review: Symptoms of parental depression and anxiety and offspring overweight

2020 ◽  
Vol 54 ◽  
pp. 49
Author(s):  
Paula Lobo Marco ◽  
Inaê Dutra Valério ◽  
Christian Loret de Mola Zanatti ◽  
Helen Gonçalves
Keyword(s):  
Depressive Symptoms ◽  
Childhood Obesity ◽  
Mental Disorder ◽  
Common Mental Disorder ◽  
Positive Association ◽  
Depression And Anxiety ◽  
Recurrent Depression ◽  
Child Feeding ◽  
Middle Income ◽  
Symptoms Of Depression

OBJECTIVE: To evaluate the existing literature on the association between parents’ depression and anxiety and their influence on their children’s weight during childhood, identifying possible mechanisms involved in this association. METHODS: A systematic search of the literature was conducted in the PubMed, PsycINFO and SciELO databases, using the following descriptors: (maternal OR mother* OR parent* OR paternal OR father) AND (“common mental disorder” OR “mental health” OR “mental disorder” OR “depressive disorder” OR depress* OR anxiety OR “anxiety disorder”) AND (child* OR pediatric OR offspring) AND (overweight OR obes* OR “body mass index” OR BMI). A total of 1,187 articles were found after peer selection. RESULTS: In total, 16 articles that met the inclusion criteria were selected for the review. Most of them investigated depressive symptoms and only three, symptoms of maternal anxiety. The evaluated studies suggested a positive association between symptoms of maternal depression and higher risk of childhood obesity. The results diverged according to the chronicity of depressive symptoms (episodic or recurrent depression) and income of the investigated country (high or middle income). Mechanisms were identified passing by quality of parenthood, affecting behaviors related to physical activity and child-feeding, as mediators of the association. CONCLUSIONS: We conclude there is evidence of a positive relationship between the occurrence of maternal symptoms of depression and anxiety and childhood obesity. It is emphasized the need for a better understanding on the effect of depressive symptoms and the contextual factors involved in this relationship so that effective intervention strategies can be implemented.

Episodic versus Chronic Dizziness: An Analysis of Predictive Factors

2021 ◽  
pp. 000348942110254
Author(s):  
Eric J. Formeister ◽  
Ricky Chae ◽  
Emily Wong ◽  
Whitney Chiao ◽  
Lauren Pasquesi ◽  
...  
Keyword(s):  
Multivariate Regression ◽  
Treatment Options ◽  
Depression And Anxiety ◽  
Imaging Studies ◽  
Comorbid Depression ◽  
Cross Sectional ◽  
Tertiary Center ◽  
Chronic Dizziness ◽  
Associated Symptoms ◽  
History Of

Objectives: To elucidate differences in demographic and clinical characteristics between patients with episodic and chronic dizziness. Methods: A cross-sectional, observational study of 217 adults referred for dizziness at 1 tertiary center was undertaken. Subjects were split into a chronic dizziness group (>15 dizzy days per month) and an episodic dizziness group (<15 dizzy days per month). Results: 217 adults (average age, 53.7 years; 56.7% female) participated. One-third (n = 74) met criteria for chronic dizziness. Dizziness handicap inventory (DHI) scores were significantly higher in those with chronic dizziness compared to those with episodic dizziness (53.9 vs 40.7; P < .001). Comorbid depression and anxiety were more prevalent in those with chronic dizziness (44.6% and 47.3% vs 37.8% and 35.7%, respectively; P > .05). Abnormal vestibular testing and abnormal imaging studies did not differ significantly between the 2 groups. Ménière’s disease and BPPV were significantly more common among those with episodic dizziness, while the prevalence of vestibular migraine did not differ according to chronicity of symptoms. A multivariate regression that included age, sex, DHI, history of anxiety and/or depression, associated symptoms, and dizziness triggers was able to account for 15% of the variance in the chronicity of dizziness (pseudo- R2 = 0.15; P < .001). Conclusions: Those who suffer from chronic dizziness have significantly higher DHI and high comorbid rates of depression and anxiety than those with episodic dizziness. Our findings show that factors other than diagnosis alone are important in the chronification of dizziness, an observation that could help improve on multimodal treatment options for this group of patients.

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