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 ◽  
...  

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

Author(s):  
Madeline Li ◽  
Joshua Rosenblat ◽  
Gary Rodin

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.


2016 ◽  
Vol 29 (3) ◽  
pp. 697-710 ◽  
Author(s):  
Evin Aktar ◽  
Cristina Colonnesi ◽  
Wieke de Vente ◽  
Mirjana Majdandžić ◽  
Susan M. Bögels

AbstractThe present study investigated the associations of mothers' and fathers' lifetime depression and anxiety symptoms, and of infants' negative temperament with parents' and infants' gaze, facial expressions of emotion, and synchrony. We observed infants' (age between 3.5 and 5.5 months, N = 101) and parents' gaze and facial expressions during 4-min naturalistic face-to-face interactions. Parents' lifetime symptoms of depression and anxiety were assessed with clinical interviews, and infants' negative temperament was measured with standardized observations. Parents with more depressive symptoms and their infants expressed less positive and more neutral affect. Parents' lifetime anxiety symptoms were not significantly related to parents' expressions of affect, while they were linked to longer durations of gaze to parent, and to more positive and negative affect in infants. Parents' lifetime depression or anxiety was not related to synchrony. Infants' temperament did not predict infants' or parents' interactive behavior. The study reveals that more depression symptoms in parents are linked to more neutral affect from parents and from infants during face-to-face interactions, while parents' anxiety symptoms are related to more attention to parent and less neutral affect from infants (but not from parents).


2021 ◽  
Vol 12 ◽  
Author(s):  
Christina Andersson ◽  
Cecilia U. D. Stenfors ◽  
Peter Lilliengren ◽  
Stefan Einhorn ◽  
Walter Osika

ObjectiveBenevolence is an emerging concept in motivation theory and research as well as in on pro-social behavior, which has stimulated increasing interest in studying factors that impair or facilitate benevolence and effects thereof. This exploratory study examines the associations between benevolence, stress, mental health, self-compassion, and satisfaction with life in two workplace samples.MethodsIn the first study n = 522 (38% = female, median age = 42) participants answered questionnaires regarding self-reported stress symptoms (i.e., emotional exhaustion), depressive symptoms and benevolence. In the second study n = 49 (female = 96%) participants answered questionnaires regarding perceived stress, self-compassion, anxiety, depression symptoms, and benevolence.ResultsIn study 1, measures of emotional exhaustion (r = −0.295) and depression (r = −0.190) were significantly negatively correlated with benevolence. In study 2, benevolence was significantly negatively correlated with stress (r = −0.392) and depression (r = −0.310), whereas self-compassion (0.401) was significantly positively correlated with benevolence. While correlations were in expected directions, benevolence was not significantly associated with Satisfaction with Life (r = 0.148) or anxiety (r = −0.199) in study 2.ConclusionSelf-assessed benevolence is associated with levels of perceived stress, exhaustion, depression, and self-compassion. Future studies are warranted on how benevolence is related to stress and mental ill health such as depression and anxiety, and if benevolence can be trained in order to decrease stress and mental ill health such as depression and anxiety in workplace settings.


2014 ◽  
Vol 38 (6) ◽  
pp. 270-275 ◽  
Author(s):  
Clarissa M. Giebel ◽  
Paul Clarkson ◽  
David Challis

Aims and methodTo investigate the demographic and clinical characteristics of subgroups of UK veterans attending a dedicated psychological therapies service following the Improving Access to Psychological Therapies (IAPT) treatment model. Veterans accessing a newly established service in the north-west were categorised into three groups: early service leavers, those with a physical disability, and substance and/or alcohol misusers. Anxiety, depression and social functioning were measured pre- and post-treatment.ResultsVeterans vary in their demographic and clinical characteristics as well as in treatment efficacy, as measured by the post-treatment scores on probable depression and anxiety. Therapy appears to be most effective in early service leavers, whereas veterans with a physical disability or a substance or alcohol misuse problem tend not to do as well in terms of symptoms of depression or anxiety.Clinical implicationsThis study highlights the importance of targeting different veteran subgroups for dedicated psychological therapy.


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Abdullah Alhurani ◽  
Rebecca Dekker ◽  
Mona Abed ◽  
Amani Khalil ◽  
Kyoung Suk Lee ◽  
...  

Introduction: Depression or anxiety are associated with survival in heart failure (HF); however, whether co-morbid symptoms of anxiety and depression are associated with survival in patients with HF is unknown. Hypothesis: Co-morbid symptoms of depression and anxiety are more strongly associated with all-cause mortality in patients with HF compared to those with anxiety or depression alone. Methods: A total of 1,260 HF patients participated and were followed for mortality outcomes for 12 months. The Patient Health Questionnaire (PHQ-9) and Brief Symptom Inventory-anxiety subscale (BSI) were used to measure symptoms of depression and anxiety. Cox regression analysis was used to determine whether co-morbid symptoms of depression and anxiety independently predicted all-cause mortality controlling for age,gender, ethnicity, and NYHA class. Depression and anxiety were treated first as continuous level variables, then as categorical variables using standard published cut points. Patients were divided into four groups based on the presence of anxiety and depression symptoms: 1) neither anxiety nor depression, 2) depression alone, 3) anxiety alone, and 4) co-morbid depression and anxiety Results: When entered as continuous variables, the interaction between anxiety and depression (HR 1.02; 95% CI: 1.01-1.03; p = 0.002) was a significant predictor of all-cause mortality. When entered as a categorical variable, co-morbid symptoms of depression and anxiety (versus the other three groups) independently predicted all-cause mortality (HR 2.59; 95% CI: 1.49-4.49; p = 0.001). Conclusions: To improve mortality outcomes in patient with HF, attention must be paid by healthcare providers to the assessment and management of co-morbid symptoms of depression and anxiety.


Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 555-555
Author(s):  
Lauren Mednick ◽  
Shuli Yu ◽  
Felicia Trachtenberg ◽  
Dorothy A. Kleinert ◽  
Patricia J Giardina ◽  
...  

Abstract Abstract 555 Background and Significance: Individuals with chronic medical conditions are vulnerable to symptoms of anxiety and depression. Promoting healthy emotional functioning is important not only to psychological well-being, but also to physical health as it has been shown to impact adherence to medical regimens. Thalassemia is an inherited blood disorder which requires lifelong intervention and may be associated with treatment and disease-related complications that impact both the length and quality of life for most who are affected. While several studies have examined the prevalence of anxiety and depressive symptoms in patients with thalassemia, most have been conducted with small, homogeneous samples of children. In addition, the one study which examined psychological adjustment in adults included patients from only one medical center (Messina et al.; Intern Emerg Med, 3:339, 2008). Further, few studies have examined demographic, medical, and psychosocial variables possibly correlated with the occurrence of these symptoms. Understanding the factors that are related to the experience of depressive and anxiety symptoms may help us to identity individuals at risk and help in developing targeted interventions. The current study aimed to (1) determine the prevalence of depressive and anxiety symptoms in adolescent and adult patients with thalassemia; and (2) explore possible demographic, medical, and psychosocial correlates of these symptoms. Specifically, we hypothesized that (1) anxiety and depressive symptoms in this sample would be similar to the rates of these symptoms in individuals diagnosed with other chronic medical conditions and higher than in individuals without chronic medical conditions; (2) symptoms of depression and anxiety would be inversely correlated with measures of adherence (i.e., subjective report, ferritin); and (3) symptoms of depression and anxiety would be inversely correlated with functional health and well-being. Method: Data on quality of life and mental health self assessments were collected as part of the Thalassemia Longitudinal Cohort (TLC), a multi-center multinational study conducted by the NHLBI-sponsored Thalassemia Clinical Research Network. The current analysis included 281 participants (14-58 years old, M age=27.83; 52% female) who completed the Hospital Anxiety and Depression Scale (HADS), a 14-item questionnaire examining presence of anxiety and depression symptoms. Participants also completed a measure of functional health and well-being (SF-36), as well as questions related to adherence to their medical regimen. In addition, as part of the larger TLC study, medical data such as ferritin and method of chelation was collected. Results: 32% of participants indicated experiencing at least mild symptoms of anxiety and 11% at least mild symptoms of depression. While these rates are higher than rates of symptoms of depression and anxiety found in the general population, they are similar to rates found in other groups with chronic illness (e.g., diabetes). Older age, female gender, and chelation with deferoxamine (as compared to deferasirox) were factors that were significantly associated with anxiety and/or depression and were statistically controlled for in subsequent analyses. Symptoms of depression, but not anxiety, were inversely correlated with subjective reports of adherence (p<.05), although not with ferritin levels. However, a significant correlation in the expected direction between subjective report of adherence and ferritin was found (p<.01). Finally, as hypothesized, both symptoms of depression and anxiety were significantly and negatively correlated with functional health and well-being (p<.0001). Conclusion: While the majority of patients with thalassemia do not report significant symptoms of anxiety and depression, the rates are higher than in the general population. Given that symptoms of anxiety and depression were associated with poor adherence and lower functional health and well-being, regular screening for anxiety and depression symptoms could help to identify at risk individuals in order to provide them with appropriate psychological support with the goal of improving both emotional and physical health. Disclosures: Porter: Novartis: Research Funding. Thompson:Novartis: Research Funding. Neufeld:Novartis: Research Funding.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Joseba Wulff ◽  
Agneta Malmgren Fänge ◽  
Connie Lethin ◽  
Carlos Chiatti

Abstract Background Around 50 million people worldwide are diagnosed with dementia and this number is due to triple by 2050. The majority of persons with dementia receive care and support from their family, friends or neighbours, who are generally known as informal caregivers. These might experience symptoms of depression and anxiety as a consequence of caregiving activities. Due to the different welfare system across European countries, this study aimed to investigate factors associated with self-reported depression and anxiety among informal dementia caregivers both in Sweden and Italy, to ultimately improve their health and well-being. Methods This comparative cross-sectional study used baseline data from the Italian UP-TECH (n = 317) and the Swedish TECH@HOME (n = 89) studies. Main outcome variables were the severity of self-reported anxiety and depression symptoms, as measured by the Hospital Anxiety and Depression Scale (HADS). HADS scores were investigated using descriptive and bivariate statistics to compare means and standard deviations. Linear regressions were used to test for associations between potential factors and self-reported symptoms of depression and anxiety. Results Italian informal caregivers reported more severe symptoms of depression and anxiety than Swedish caregivers. In Italy, a higher number of hours of caregiving was associated with anxiety symptoms (β = − 1.205; p = 0.029), being 40–54 years-old with depression symptoms (β = − 1.739; p = 0.003), and being female with symptoms of both depression (β = − 1.793; p < 0.001) and anxiety (β = 1.474; p = 0.005). In Sweden, a higher number of hours of caregiving and being < 39 years-old were associated with depression symptoms (β = 0.286; p < 0.000; β = 3.945; p = 0.014) and a higher number of hours of caregiving, the lack of additional informal caregivers and dementia severity were associated with anxiety symptoms (β = 0.164; p = 0.010; β = − 1.133; p = 0.033; β = − 1.181; p = 0.031). Conclusion Multiple factors are associated with self-reported symptoms of depression and anxiety among informal caregivers in Sweden and Italy. Factors found in this study partly differ between the two countries, suggesting the important role of cultural and social factors affecting the experience of caregiving. A deeper knowledge of these factors may increase the knowledge on potential protective and risk factors, provide information to policymakers and ultimately improve the psychological well-being of informal caregivers to people with dementia across Europe.


2013 ◽  
Vol 43 (11) ◽  
pp. 2403-2415 ◽  
Author(s):  
B. F. Jeronimus ◽  
J. Ormel ◽  
A. Aleman ◽  
B. W. J. H. Penninx ◽  
H. Riese

BackgroundHigh neuroticism is prospectively associated with psychopathology and physical health. However, within-subject changes in neuroticism due to life experiences (LEs) or state effects of current psychopathology are largely unexplored. In this 2-year follow-up study, four hypotheses were tested: (1) positive LEs (PLEs) decrease and negative LEs (NLEs) increase neuroticism; (2) LE-driven change in neuroticism is partly long-lasting; and (3) partly independent of LE-driven changes in anxiety/depression; and (4) childhood adversity (before age 16 years) moderates the influence of NLEs/PLEs on neuroticism scores in adult life.MethodData came from the Netherlands Study of Depression and Anxiety [NESDA, n = 2981, mean age 41.99 years (s.d. = 13.08), 66.6% women]. At follow-up (T2) we assessed PLEs/NLEs with the List of Threatening Experiences (LTE) over the prior 24 months and categorized them over recent and distant PLE/NLE measures (1–3 and 4–24 months prior to T2 respectively) to distinguish distant NLE/PLE-driven change in trait neuroticism (using the Dutch version of the Neuroticism–Extroversion–Openness Five Factor Inventory, NEO-FFI) from state deviations due to changes in symptoms of depression (self-rated version of the 30-item Inventory of Depressive Symptomatology, IDS-SR30) and anxiety (Beck Anxiety Inventory, BAI).ResultsDistant NLEs were associated with higher and distant PLEs with lower neuroticism scores. The effects of distant LEs were weak but long-lasting, especially for distant PLEs. Distant NLE-driven change in neuroticism was associated with change in symptoms of anxiety/depression whereas the effect of distant PLEs on neuroticism was independent of any such changes. Childhood adversity weakened the impact of distant NLEs but enhanced the impact of distant PLEs on neuroticism.ConclusionsDistant PLEs are associated with small but long-lasting decreases in neuroticism regardless of changes in symptom levels of anxiety/depression. Long-lasting increases in neuroticism associated with distant NLEs are mediated by anxiety/depression.


2017 ◽  
Vol 16 (4) ◽  
pp. 1 ◽  
Author(s):  
Natália Mendes Ferrer da Rosa ◽  
Vinícius Ferreira Borges ◽  
Leonardo Cheffer ◽  
Nelson Torro Alves ◽  
Célio Estanislau

Previous studies have shown that depression and anxiety are associated to changes in the recognition of facial expression. In the present research, a non-clinical sample was evaluated with respect to trait and state anxiety and depression symptoms. In the experimental task, participants evaluated facial expressions of happiness, anger, sadness, and fear, presented at four intensities (25, 50, 75, and 100%), as well as the neutral face. Results showed that the trait anxiety was associated with a better recognition of anger, fear, and happiness. For depression, we only found differences between groups for emotional attribution to neutral faces, in which participants scoring high in depression were more likely to attribute fear to neutral faces. Findings indicate an improvement of the recognition of happiness, anger, and fear in trait anxiety, whereas symptoms of depression and state anxiety were associated to changes in the evaluation of neutral faces in non-clinical individuals.


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