scholarly journals AB0123 ANXIETY AND DEPRESSION DURING RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1090.3-1091
Author(s):  
L. Ben Ammar ◽  
S. Rekik ◽  
S. Boussaid ◽  
S. Jemmali ◽  
E. Cheour ◽  
...  

Background:Although the management of rheumatoid arthritis (RA) has been booming since the advent of biological treatments, the consequences of this disease remain multiple, both physical and psychological.Objectives:The aim of our work was to investigate the factors influencing anxiety and depression in RA.Methods:This was a cross-sectional study of 49 RA patients. We used the Hospital Anxiety and Depression scale (HAD) to assess anxiety disorders.Results:We included 24 women and 5 men with an average age of 54.1 years. Sixty-nine percent of patients were unemployed and 81% had health insurance coverage. RA had been evolving for an average of 11.43 ± 7.32 years and the mean time to diagnosis was 2.35 years. It was erosive in 93.8% of cases. An atlanto-axial dislocation was found in 4.1% of cases and coxitis in 8.2% of cases. Eighty-three percent of patients were on cs-DMARDs and 14.2% were on biotherapy. Most patients had low active disease (53%) with a mean DAS28CRP score of 2.74 ± 0.81. Twelve percent of patients had a probable anxiety and 18% had a probable depression.A long delay in diagnosis was associated with a higher risk of anxiety disorders. Working patients had a lower risk of depression while patients from rural areas had a higher risk. The risk of anxiety and depression disorders was associated with increased VAS pain, EGP, and DAS28. In the multivariate study, EGP was the independent risk factor for the development of anxiety and depression disorders.Conclusion:Anxiety and depression disorders are a frequent yet underestimated consequence in RA. Appropriate care in psychiatry is required as soon as the diagnosis is announced.Disclosure of Interests:None declared

2014 ◽  
Vol 4 (1) ◽  
pp. 23-28
Author(s):  
Souhaibou Ndongo ◽  
Abdoulaye Pouye ◽  
Emeric Azankpan ◽  
Mourtalla M. Ka ◽  
Thérèse Moreira Diop

Background: Rheumatoid arthritis, formerly rare in sub-Saharan Africa, is becoming increasingly reported. The objective study determines the epidemiological, clinical and biological features of rheumatoid arthritis at diagnosis. Methods: A cross-sectional study conducted at the rheumatology outpatient department of Aristide Le Dantec Teaching Hospital of Dakar in Senegal. Results: Three hundred eight patients with rheumatoid arthritis according, to American College of Rheumatology 1987 criteria, were included: 273 women and 35 men (ratio of 7:8). Median age was 41 years (Q1: 31; Q3: 53 years); predominant age group was 30-40 years. Ninety-three percent resided in urban areas and 7% in rural areas. Family history of chronic inflammatory arthritis was reported by 35.1% of patients. Thirty-nine percent of patients initially consulted a traditional healer. On admission, the median Disease Activity Score 28 was 6.5 (Q1: 5.5; Q3: 7.3). Rheumatoid arthritis was very active in 81.1% and a positive factor in 84% of patients. Cyclic citrullinated peptide antibodies assessed in 116 patients; 95 reported positive (81.9%). Of 169 patients, at least one extra-articular manifestation was presented; the most common, anemia and sicca syndrome. Conclusion: Rheumatoid arthritis was characterized by an important delay in diagnosis, a polyarticular presentation, and a high positivity of immunological markers. Extra-articular manifestations included mainly anemia and sicca syndrome. Early management and a better understanding of rheumatoid arthritis in sub-Saharan Africa are required.


2017 ◽  
Vol 24 (04) ◽  
pp. 589-595
Author(s):  
Muslim Ali Lakhiar ◽  
Shaheen Ahmed Mughal ◽  
Motti Ram Bhattia ◽  
Awais Bashir larik

Objectives: To determine the prevalence of Anxiety & Depression among thestudents of Peoples University of Medical and Health Sciences for Women Nawabshah and toascertain the relative impact of rural environment. Study Design: Cross-sectional, questionnairebasedsurvey. Setting: Peoples University of Medical & Health Sciences for Women (PUMHSW),Nawabshah. Methods: This is the only medical university for female students located in theinterior of Sindh. The students belong to various rural districts of the Sindh Province. Aftertaking verbal consent the questionnaire of the Aga Khan University Anxiety & Depression Scale(AKUADS) Urdu version was administered to the students from first year to the final year. A scoreof ≥20 on AKUADS was used as a cut-off for the presence of anxiety and depressive symptoms.The data collected was tabulated and analyzed using SPSS 19. Results: Out of a total of 1035students in a five year MBBS program at PUMHSW, 851 students responded &agreed toparticipate. The response rate was 82.2%. According to the AKUADS 66.7% of female studentswere found to have anxiety and depression. Majority of the students were originally from variousrural districts of Sindh. The Prevalence of anxiety and depression among students of 1st year,2nd year, 3rd year, 4th year and 5th year was 71.1%, 76.9%, 53.7%, 70.7% and 63.6% respectively.It was significantly higher in 1st year and 2nd year as compared to 3rd, 4th and 5thyear (p<0. 05)students. Those aged <21 years were most vulnerable (p<0.025).Marital status and eitherliving at home or in hostel was statistically not significant (p<0.922 and p<0.596 respectively).None of the students were using antidepressants nor they ever visited a psychiatrist before.All students were attending lectures and hospital postings regularly. Conclusion: Our studyindicates that a high proportion of female medical students particularly those belonging tothe rural areas of Sindh suffer from anxiety and depression during the course of their medicaleducation. Female gender, younger age and the rural environment appears to have a profoundnegative impact. The overall prevailing situation warrants a proper psychiatric evaluation ofthese students so that remedial measures can be undertaken whenever necessary.


2021 ◽  
Vol 11 ◽  
Author(s):  
Ouassil El kherchi ◽  
Amina Aquil ◽  
Noureddine El khoudri ◽  
Mustapha Mouallif ◽  
Mohamed Daghi ◽  
...  

Background: Breast cancer is the leading cause of cancer death in women worldwide with more than 1. 7 million new cases annually. Major advances have been made in the therapeutic management of this condition in many countries. However, neuropsychiatric disorders in patients with breast cancer constitute a significant concern due to their negative impact on patient's life and on the success of therapy itself.Methodology: In this study we aimed to evaluate psychological disorders in a population of 212 Moroccan women treated for breast cancer within the Mohammed VI Center for the Treatment of Cancers of Casablanca. A questionnaire was designed to this end on the basis of different validated scales, including the Hospital Anxiety Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI), and the Body Image Scale (BIS).Results: Data analysis has shown that 69.3% of participants had significant sleep disorders; 87% suffer from an anxiety-depressive syndrome (ADS), and 83.0% had significant body image dissatisfaction. A positive correlation was shown between ADS and both patients' national health insurance coverage and patients or husbands' education. Analysis further revealed that anxiety and depression were negatively correlated with different types of treatment. Similarly, both BIS and PSQI scores were positively associated with anxiety and depression disorders.Conclusion: The present investigation highlights the need to generalize and strengthen the psychological approach of patients treated for breast cancer in Morocco. We anticipate that such a strategy will alleviate suffering and promote therapy success in these patients and will diminish or prevent conjugal and familial impacts of the illness.


2014 ◽  
Vol 4 (1) ◽  
pp. 23-28
Author(s):  
Souhaibou Ndongo ◽  
Abdoulaye Pouye ◽  
Emeric Azankpan ◽  
Mourtalla M. Ka ◽  
Thérèse Moreira Diop

Background: Rheumatoid arthritis, formerly rare in sub-Saharan Africa, is becoming increasingly reported. The objective study determines the epidemiological, clinical and biological features of rheumatoid arthritis at diagnosis. Methods: A cross-sectional study conducted at the rheumatology outpatient department of Aristide Le Dantec Teaching Hospital of Dakar in Senegal. Results: Three hundred eight patients with rheumatoid arthritis according, to American College of Rheumatology 1987 criteria, were included: 273 women and 35 men (ratio of 7:8). Median age was 41 years (Q1: 31; Q3: 53 years); predominant age group was 30-40 years. Ninety-three percent resided in urban areas and 7% in rural areas. Family history of chronic inflammatory arthritis was reported by 35.1% of patients. Thirty-nine percent of patients initially consulted a traditional healer. On admission, the median Disease Activity Score 28 was 6.5 (Q1: 5.5; Q3: 7.3). Rheumatoid arthritis was very active in 81.1% and a positive factor in 84% of patients. Cyclic citrullinated peptide antibodies assessed in 116 patients; 95 reported positive (81.9%). Of 169 patients, at least one extra-articular manifestation was presented; the most common, anemia and sicca syndrome. Conclusion: Rheumatoid arthritis was characterized by an important delay in diagnosis, a polyarticular presentation, and a high positivity of immunological markers. Extra-articular manifestations included mainly anemia and sicca syndrome. Early management and a better understanding of rheumatoid arthritis in sub-Saharan Africa are required.


2020 ◽  
Author(s):  
Miyabi Uda ◽  
Motomu Hashimoto ◽  
Ryuji Uozumi ◽  
Mie Torii ◽  
Takao Fujii ◽  
...  

Abstract Introduction / objectives Management of anxiety and depression in rheumatoid arthritis (RA) patients is vital. Previous studies investigating this topic are conflicting, and this topic still has not been thoroughly investigated. This study aimed to clarify the association of disease activity with anxiety and depression after controlling for physical disability, pain, and treatment. Method We conducted a cross-sectional study of RA patients from the Kyoto University Rheumatoid Arthritis Management Alliance cohort. For assessments, we used the Disease Activity Score (DAS28), Health Assessment Questionnaire Disability Index (HAQ-DI), and Hospital Anxiety Depression Scale. Depression and anxiety were defined by a Hospital Anxiety Depression Scale score ≥8. We then performed multivariable logistic regression analyses. Results Of 517 participants, 17.9% had anxiety, and 28.2% had depression. The multivariable logistic regression analyses showed patients with DAS28-based non-remission had low association with anxiety (odds ratio [OR] [95% confidence interval {CI}], 0.93 [0.48–1.78]: p = 0.82) but slight association with depression (OR [95% CI], 1.45 [0.81–2.61]: p = 0.22). However, severity of the patient’s global assessment (PtGA) on DAS28 was associated with anxiety (OR [95% CI], 1.15 [1.02–1.29]; p = 0.03) and depression (OR [95% CI], 1.21 [1.09–1.35]; p < 0.01). Additionally, HAQ-DI-based non-remission was associated with anxiety (OR [95% CI], 3.51 [1.85–6.64]; p < 0.01) and depression (OR [95% CI], 2.65 [1.56–4.50]; p < 0.01). Younger patients (OR [95% CI], 0.83 [0.68–1.01]; p = 0.07) and patients not treated with methotrexate (OR [95% CI], 0.67 [0.40–1.13]; p = 0.13) tended to suffer from anxiety. Patients using steroids had a closer association with depression than those not using them (OR [95% CI], 1.66 [1.03–2.67]; p = 0.04). Conclusions Assessment of disease activity, PtGA, and HAQ-DI are important for assessing anxiety and depression in RA patients. Attention should be paid to improving PtGA and physical function.


2011 ◽  
Vol 26 (S2) ◽  
pp. 1988-1988
Author(s):  
L. Zhang ◽  
Y.-L. He ◽  
H. Ma ◽  
Z.-N. Liu ◽  
F.-J. Jia ◽  
...  

IntroductionDepression and anxiety disorders are prevalent mental disorders in China. But some those patients do not seek help from psychiatrists firstly but see internists first.Objectives and aimsThis study aimed to investigate the prevalence of depressive - anxiety disorders in gastroenterology outpatients and assess the detection rate provided by physicians in China.MethodsA multicenter, hospital-based cross-sectional study was carried on in the 15 large general hospitals of five cities cross China. A total of 1995 gastroenterological outpatients were screened by Hospital Anxiety and Depression Scale (HADS). Subjects whose HADS scores ≥ 8 were interviewed by psychiatrists, using Mini International Neuropsychiatric Interview (M.I.N.I) to make further diagnoses. Physicians’ diagnoses and treatment were recorded.ResultsThe adjusted prevalence of depressive disorder and anxiety disorders was 14.39% and 9.42% respectively.ConclusionsThe prevalence of depressive-anxiety disorder is high in gastroenterology outpatients in China, which suggests the related training of detecting these mental disorders is needed to gastroenterologists.


2015 ◽  
pp. 89-95
Author(s):  
Thi Hoai Thuong Nguyen ◽  
Hoang Lan Nguyen ◽  
Mau Duyen Nguyen

Background:To provide information helps building policy that meets the practical situation and needs of the people with the aim at achieving the goal of universal health insurance coverage, we conducted this study with two objectives (1) To determine the rate of participating health insurance among persons whose enrolment is voluntary in some districts of ThuaThien Hue province; (2) To investigate factor affecting their participation in health insurance. Materials and Methodology:A cross-sectional descriptive study was conducted in three districts / towns / city of ThuaThien Hue in 2014. 480 subjects in the voluntary participation group who were randomly selected from the study settings were directly interviewed to collect information on the social, economic, health insurance participation and knowledge of health insurance. Test χ2 was used to identify factors related to the participation in health insurance of the study subjects. Results:42.5% of respondents were covered by health insurance scheme. Factors related to their participation were the resident location (p = 0.042); gender (p = 0.004), age (p <0.001), chronic disease (p <0.001), economic conditions (p<0.001) and knowledge about health insurance (p <0.001). Conclusion: The rate of participating health insurance among study subjects was low at 42,5%. There was "adverse selection" in health insurance scheme among voluntary participating persons. Providing knowledge about health insurance should be one of solutions to improve effectively these problems. Key words: Health insurance, voluntary, Thua Thien Hue


2020 ◽  
Vol 27 (6) ◽  
pp. 476-483 ◽  
Author(s):  
Leonardo Augusto de Melo ◽  
Ana Flávia Almeida-Santos

The current pharmacological strategies for the management of anxiety disorders and depression, serious conditions which are gaining greater prevalence worldwide, depend on only two therapeutic classes of mood-stabilizing drugs: Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs). Although first line agents with proven efficacy, their clinical success in the management of anxiety disorders and depression is still considered highly complex due to the multifaceted nature of such conditions. Several studies have shown a possible therapeutic target could be found in the form of the Angiotensin-Converting Enzyme [ACE] type 2 (ACE2), Angiotensin [Ang]-(1-7) and Mas receptor pathway of the Renin- Angiotensin System (RAS), which as will be discussed, has been described to exhibit promising therapeutic properties for the management of anxiety disorders and depression. In this article, the literature to describe recent findings related to the role of the RAS in anxiety and depression disorders was briefly revised. The literature used covers a time range from 1988 to 2019 and were acquired from the National Center for Biotechnology Information’s (NCBI) PubMed search engine. The results demonstrated in this review are promising and encourage the development of new research for the treatment of anxiety and depression disorders focusing on the RAS. In conclusion, the ACE2/Ang-(1-7)/Mas pathway may exhibit anxiolytic and anti-depressive effects through many possible biochemical mechanisms both centrally and peripherally, and result in highly promising mental health benefits which justifies further investigation into this system as a possible new therapeutic target in the management of neuropsychiatric disorders, including any as of yet undescribed risk-benefit analysis compared to currently-implemented pharmacological strategies.


Author(s):  
Yuri Sasaki ◽  
Yugo Shobugawa ◽  
Ikuma Nozaki ◽  
Daisuke Takagi ◽  
Yuiko Nagamine ◽  
...  

The aim of the study was to investigate rural–urban differences in depressive symptoms in terms of the risk factors among older adults of two regions in Myanmar to provide appropriate intervention for depression depending on local characteristics. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from the two regions, for face-to-face interviews. Depressive symptoms were assessed using the 15-item version of the Geriatric Depression Scale (GDS). Depressive symptoms were positively associated with living in rural areas (B = 0.42; 95% confidence interval (CI): 0.12,0.72), female (B = 0.55; 95% CI: 0.31,0.79), illness during the preceding year (B = 0.68; 95% CI: 0.45,0.91) and non-Buddhist religion (B = 0.57; 95% CI: 0.001,1.15) and protectively associated with education to middle school level or higher (B = −0.61; 95% CI: −0.94, −0.28) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.30, −0.10). In women in urban areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.78; 95% CI: 0.36, 1.20) and protectively associated with education to middle school level or higher (B = −0.67; 95% CI: −1.23, −0.11), middle or high wealth index (B = −0.92; 95% CI: −1.59, −0.25) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.38, −0.03). In men in rural areas, illness during the preceding year was positively associated with depressive symptoms (B = 0.87; 95% CI: 0.33, 1.42). In women in rural areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.83; 95% CI: 0.36, 1.30) and protectively associated with primary education (B = −0.62; 95% CI: −1.12, −0.12) and the frequency of visits to religious facilities (B = −0.44; 95% CI: −0.68, −0.21). Religion and wealth could have different levels of association with depression between older adults in the urban and rural areas and men and women. Interventions for depression in older adults should consider regional and gender differences in the roles of religion and wealth in Myanmar.


2021 ◽  
pp. 205141582110140
Author(s):  
Nuala Murray ◽  
Charles O’Connor ◽  
Rhona Dempsey ◽  
Sean Liew ◽  
Helen Richards ◽  
...  

Purpose: The purpose of this study was to evaluate the psychological distress of urological and uro-oncological patients undergoing surgery. Methods: Patients who presented to Mercy University Hospital from October 2019–May 2020 were consecutively recruited. Demographic and clinical characteristics including age, gender, marital status, type of surgery (uro-oncology or general urology), endoscopy or open surgery were gathered. Mood was evaluated using the Hospital Anxiety and Depression Scale prior to admission, prior to discharge and 6 weeks post-surgery. Results: A total of 118 participants (79.7% male) completed the Hospital Anxiety and Depression Scale prior to admission, prior to discharge and at 6 weeks post-surgery. Forty patients (33.9%) underwent uro-oncology-related surgery. At pre-admission 39 patients (33%) fell into a possible-probable clinical category for anxiety and 15 (12.7%) for depression. Older patients had significantly lower anxiety levels than younger patients ( p⩽0.01). There were no differences between patients undergoing uro-oncology or more general urology surgery and levels of anxiety or depression. Repeated measures analysis of variance with age as a covariate indicated no significant differences in Hospital Anxiety and Depression Scale anxiety scores over time. There was a statistically significant reduction in Hospital Anxiety and Depression Scale depression scores over the three assessment time points ( p=0.004). Conclusion: Over one-third of patients were experiencing moderate to severe levels of psychological distress pre-surgery – higher than levels previously reported in uro-oncological patients. Surprisingly, there was no difference in anxiety and depression scores in uro-oncology and urology patients. Psychological distress in both uro-oncology and more general urology patients should be considered in the surgical setting. Level of evidence Moderate


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