scholarly journals 43: PARENTAL SYMPTOMS OF ANXIETY AND DEPRESSION UPON PICU DISCHARGE AND AT 30-DAY FOLLOW-UP

2021 ◽  
Vol 50 (1) ◽  
pp. 22-22
Author(s):  
Lynne Rosenberg ◽  
Linda Gerber ◽  
Yuqing Qiu ◽  
Chani Traube
Keyword(s):  
Anxiety And Depression ◽  
Parental Symptoms

scholarly journals POS1234 IMPACT OF THE CHANGE IN ADMINISTRATION ROUTE OF TOCILIZUMAB AND ABATACEPT, DUE TO THE COVID-19 LOCKDOWN ON DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 900.1-900
Author(s):  
L. Diebold ◽  
T. Wirth ◽  
V. Pradel ◽  
N. Balandraud ◽  
E. Fockens ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Disease Activity ◽  
Univariate Analysis ◽  
Route Of Administration ◽  
Anxiety And Depression ◽  
Administration Route ◽  
Factors Associated ◽  
The Impact

Background:Among therapeutics used to treat rheumatoid arthritis (RA), Tocilizumab (TCZ) and Abatacept (ABA) are both biologic agents that can be delivered subcutaneously (SC) or intravenously (IV). During the first COVID-19 lockdown in France, all patients treated with IV TCZ or IV ABA were offered the option to switch to SC administration.Objectives:The primary aim was to assess the impact of changing the route of administration on the disease activity. The second aim was to assess whether the return to IV route at the patient’s request was associated with disease activity variation, flares, anxiety, depression and low physical activity during the lockdown.Methods:We conducted a prospective monocentric observational study. Eligibility criteria: Adult ≥ 18 years old, RA treated with IV TCZ or IV ABA with a stable dose ≥3 months, change in administration route (from IV to SC) between March 16, 2020, and April 17, 2020. The following data were collected at baseline and 6 months later (M6): demographics, RA characteristics, treatment, history of previous SC treatment, disease activity (DAS28), self-administered questionnaires on flares, RA life repercussions, physical activity, anxiety and depression (FLARE, RAID, Ricci &Gagnon, HAD).The primary outcome was the proportion of patients with a DAS28 variation>1.2 at M6. Analyses: Chi2-test for quantitative variables and Mann-Whitney test for qualitative variables. Factors associated with return to IV route identification was performed with univariate and multivariate analysis.Results:Among the 84 patients who were offered to switch their treatment route of administration, 13 refused to change their treatment. Among the 71 who switched (48 TCZ, 23 ABA), 58 had a M6 follow-up visit (13 lost of follow-up) and DAS28 was available for 49 patients at M6. Main baseline characteristics: female 81%, mean age 62.7, mean disease duration: 16.0, ACPA positive: 72.4%, mean DAS28: 2.01, previously treated with SC TCZ or ABA: 17%.At M6, the mean DAS28 variation was 0.18 ± 0.15. Ten (12.2%) patients had a DAS28 worsening>1.2 (ABA: 5/17 [29.4%] and TCZ: 5/32 [15.6%], p= 0.152) and 19 patients (32.8%) had a DAS28 worsening>0.6 (ABA: 11/17 [64.7%] and TCZ: 8/32 [25.0%], p= 0.007).At M6, 41 patients (77.4%) were back to IV route (26 TCZ, 15 ABA) at their request. The proportion of patients with a DAS28 worsening>1.2 and>0.6 in the groups return to IV versus SC maintenance were 22.5%, 42.5% versus 11.1% and 22.2% (p=0.4), respectively. The univariate analysis identified the following factors associated with the return to IV route: HAD depression score (12 vs 41, p=0.009), HAS anxiety score (12 vs 41, p=0.047) and corticosteroid use (70% vs 100%, p=0.021), in the SC maintenance vs return to IV, respectively.Conclusion:The change of administration route of TCZ and ABA during the first COVID-19 lockdown was infrequently associated with a worsening of RA disease. However, the great majority of the patients (77.4%) request to return to IV route, even without disease activity worsening. This nocebo effect was associated with higher anxiety and depression scores.Disclosure of Interests:None declared

scholarly journals COVID-19 Lockdown Effect on Not Institutionalized Patients with Dementia and Caregivers

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 893
Author(s):  
Rita Moretti ◽  
Paola Caruso ◽  
Mauro Giuffré ◽  
Claudio Tiribelli
Keyword(s):  
Medical Condition ◽  
Direct Consequence ◽  
Anxiety And Depression ◽  
Behavioral Reactions ◽  
Old Patients ◽  
Subcortical Vascular Dementia ◽  
Behavior Disturbances ◽  
Institutionalized Patients ◽  
Severity Degree

SARS-COV-2 is a severe medical condition. Old patients are very vulnerable, but they have been studied only as institutionalized patients. During the lock-down, little attention is dedicated to old, demented patients who lived at home. This study wants to examine their behavioral reactions by video-phone follow-up. We conducted a longitudinal study in subcortical vascular dementia (sVAD) patients. We enrolled 221 sVAD, not institutionalized patients. We divided sVAD patients into low-medium grade sVAD (A) and severe sVAD (B), based on neuroimaging severity degree and executive alterations. At baseline, at the end of lock-down, and two months later, global behavioral symptoms were recorded for each patient. We found significantly higher scores of general behavioral deterioration, anxiety, delusions, hallucinations and apathy after controlling for sVAD severity. The direct consequence was a drastic increment of psychotropic drugs prescribed and employed during the lock-down. Moreover, caregivers’ stress has been evaluated, together with their anxiety and depression levels. During the lock-down, their scores increased and reflected a severe worsening of their behavior. Our data demonstrate that social isolation induces a severe perception of loneliness and abandonment; these fears can exacerbate behavior disturbances in old-aged frail persons. Thus, these can be considered as indirect victims of SARS-COV-2.

scholarly journals Changes in insomnia as a risk factor for the incidence and persistence of anxiety and depression: a longitudinal community study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Magnus Johansson ◽  
Markus Jansson-Fröjmark ◽  
Annika Norell-Clarke ◽  
Steven J. Linton
Keyword(s):  
Risk Factor ◽  
Depression Scale ◽  
Binary Logistic Regression ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Dynamic Risk ◽  
Increased Risk ◽  
Longitudinal Association ◽  
Development Of Anxiety

Abstract Background The aim of this investigation was to examine the longitudinal association between change in insomnia status and the development of anxiety and depression in the general population. Methods A survey was mailed to 5000 randomly selected individuals (aged 18–70 years) in two Swedish counties. After 6 months, a follow-up survey was sent to those (n = 2333) who answered the first questionnaire. The follow-up survey was completed by 1887 individuals (80.9%). The survey consisted of questions indexing insomnia symptomatology, socio-demographic parameters, and the Hospital Anxiety and Depression Scale. Change in insomnia status was assessed by determining insomnia at the two time-points and then calculating a change index reflecting incidence (from non-insomnia to insomnia), remission (from insomnia to non-insomnia), or status quo (no change). Multivariate binary logistic regression analyses were used to examine the aim. Results Incident insomnia was significantly associated with an increased risk for the development of new cases of both anxiety (OR = 0.32, p < .05) and depression (OR = 0.43, p < .05) 6 months later. Incident insomnia emerged also as significantly associated with an elevated risk for the persistence of depression (OR = 0.30, p < .05), but not for anxiety. Conclusions This study extends previous research in that incidence in insomnia was shown to independently increase the risk for the development of anxiety and depression as well as for the maintenance of depression. The findings imply that insomnia may be viewed as a dynamic risk factor for anxiety and depression, which might have implications for preventative work.

scholarly journals Supervised exercise rehabilitation in survivors of critical illness: A randomised controlled trial

2018 ◽  
Vol 20 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Ceri Battle ◽  
Karen James ◽  
Paul Temblett ◽  
Hayley Hutchings
Keyword(s):  
Hospital Discharge ◽  
Controlled Trial ◽  
Unit Length ◽  
Exercise Programme ◽  
Anxiety And Depression ◽  
Six Minute Walk Test ◽  
Supervised Exercise ◽  
Randomised Controlled ◽  
Minute Walk

Objectives To investigate the impact of a six-week supervised exercise programme on cardiopulmonary fitness, balance, muscle strength and anxiety and depression in patients who have been discharged home from hospital following an intensive care unit length of stay of greater than 48 h. To investigate patients' perceptions of a six-week supervised exercise programme delivered at three months post hospital discharge. Design A single centre parallel, randomised controlled trial. Setting Outpatient department of a university teaching hospital in the UK. Participants Sixty adult survivors of critical illness, at three months post-hospital discharge. Intervention A six-week individually prescribed and supervised exercise program, with associated advice to home exercise modification. Twice weekly exercise sessions were individualised to participant's functional status and included cardiopulmonary, balance and strengthening exercises. Follow up at seven weeks, six months and 12 months. Outcome measures Six-Minute Walk Test, BERG balance test, grip strength and Hospital Anxiety and Depression Scale. A pre-designed survey was used to explore patient perceptions of the programme. Results Sixty participants ( n = 30 received allocated programme in both control and treatment groups) were randomised. Loss to follow up resulted in n = 34 participants for intention to treat analysis at 12 months follow up (leaving n = 19 in control group, n = 15 in treatment group). Median participant age at enrolment was 62 years (interquartile range: 49–72), with a median intensive care unit length of stay of nine days (interquartile range: 4–17). No significant differences were found for the Six-Minute Walk Test at any time point ( p > 0.05). Anxiety levels and balance were significantly improved in the treatment group at 12 months ( p = 0.006 and p = 0.040, respectively). Conclusions Further research is needed into appropriate interventions and outcome measures, target patient populations and timing of such intervention post-hospital discharge.

Memory processes and the course of anxiety and depression in cancer patients

1998 ◽  
Vol 28 (1) ◽  
pp. 219-224 ◽  
Author(s):  
C. R. BREWIN ◽  
M. WATSON ◽  
S. McCARTHY ◽  
P. HYMAN ◽  
D. DAYSON
Keyword(s):  
Cancer Patients ◽  
Stressful Life Events ◽  
Psychiatric Symptoms ◽  
Stressful Events ◽  
Anxiety And Depression ◽  
Intrusive Memories ◽  
Memory Functioning ◽  
Depressed Group ◽  
Initial Severity

Background. Intrusive memories of stressful events, many involving illness and death, are found in a minority of depressed cancer patients, and may predict the course of anxiety and depression.Method. Matched samples of mild to moderately depressed and non-depressed cancer patients were followed up after 6 months. Anxiety and depression at follow-up were related to measures of intrusive memories of stressful life events and autobiographical memory functioning that had been assessed at baseline.Results. Levels of anxiety and depression remained fairly constant over time in the two groups, and the depressed group continued to experience high levels of intrusive memories. The presence of intrusive memories at baseline, and the extent to which these memories were consciously avoided, predicted greater anxiety at follow-up, even after controlling for initial severity of physical and psychiatric symptoms. None of the measures of memory functioning predicted levels of depression at follow-up.Conclusions. Intrusive memories appear to be a marker of more prolonged psychopathology in cancer patients and may respond to direct therapeutic intervention.

scholarly journals Transdiagnostic CBT Treatment of Co-morbid Anxiety and Depression in an Older Adult: Single Case Experimental Design

2014 ◽  
Vol 43 (1) ◽  
pp. 119-124 ◽  
Author(s):  
Ben Hague ◽  
Shonagh Scott ◽  
Stephen Kellett
Keyword(s):  
Older Adults ◽  
Experimental Design ◽  
Treatment Approach ◽  
Single Case ◽  
Anxiety And Depression ◽  
Unified Protocol ◽  
End Of Treatment ◽  
Routine Clinical Setting ◽  
Clinical Models

Background: Despite the prevalence of co-morbid anxiety and depression in older adults, evaluation of suitable clinical models is rare. Aims: This study tested the acceptability and effectiveness of a transdiagnostic approach to treating co-morbid anxiety and depression in an older adults in a routine clinical setting. Method: In an A/B single case experimental design, a patient completed five daily ideographic measures of anxiety and depression across baseline and treatment and the HADS at five time points over time, including 3-month follow-up. The 8-session treatment was transdiagnostic CBT informed by the Unified Protocol. Results: All sessions were attended. Significant baseline-treatment improvements were found for daily structure, mood, confidence and worry, with large associated effect sizes. The HADS showed that the patient met recovery criteria by the end of treatment, with some evidence of anxious relapse at follow-up. Conclusion: Transdiagnostic CBT offers promise as a treatment approach to mixed anxiety and depression in older adults. The model needs to be further tested using more rigorous and suitably powered methodologies.

scholarly journals Risk of Anxiety and Depression in Patients with Inflammatory Bowel Disease: A Nationwide, Population-Based Study

2019 ◽  
Vol 8 (5) ◽  
pp. 654 ◽  
Author(s):  
Kookhwan Choi ◽  
Jaeyoung Chun ◽  
Kyungdo Han ◽  
Seona Park ◽  
Hosim Soh ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
General Population ◽  
Bowel Disease ◽  
Population Based ◽  
Anxiety And Depression ◽  
Healthcare Insurance ◽  
Inflammatory Bowel ◽  
One Year ◽  
Constant Slope

Background and Aims: Inflammatory bowel disease (IBD) may be associated with anxiety and depression. The aim of this study was to evaluate the incidence of anxiety and depression in patients with IBD compared to the general population. Methods: A nationwide population-based cohort study was conducted using claims data from the National Healthcare Insurance service in Korea. We compared the incidence of anxiety and depression between 15,569 IBD patients and 46,707 non-IBD controls, age and sex matched at a ratio of 1:3. Results: During a mean follow-up of six years, IBD patients experienced significantly more anxiety (12.2% vs. 8.7%; p < 0.001) and depression (8.0% vs. 4.7%; p < 0.001) compared to controls. The curves showing cumulative incidences of anxiety and depression showed a steep rise within one year following a diagnosis of IBD, leading to lines with a constant slope. The hazard ratio (HR) for new onset anxiety following a diagnosis of Crohn’s disease (CD) and ulcerative colitis (UC) was 1.63 and 1.60, respectively, compared to controls (p < 0.001). Compared to controls, the HR for developing depression after a diagnosis of CD and UC was 2.09 and 2.00, respectively (p < 0.001). The risks of anxiety and depression in patients with IBD were higher compared to controls, except in those with diabetes mellitus, hypertension, and dyslipidemia, or who required immunomodulators and biologics within one year of the IBD diagnosis. Conclusions: The risk of anxiety and depression increased after a diagnosis of IBD compared to the general population.

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