scholarly journals AB0926-PARE IMPACT OF COVID 19 PANDEMIC ON TUNISIAN SPA PATIENTS: PSYCHOLOGICAL STATE AND TREATMENT ADHERENCE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1484.2-1484
Author(s):  
M. Rachdi ◽  
A. Feki ◽  
Z. Gassara ◽  
S. Ben Jemaa ◽  
M. Ghali ◽  
...  

Background:The challenge posed by the COVID-19 pandemic may represent an overwhelmingly stressful event for ankylosing spondylitis (SpA) patients and impact their treatment adherence. In response to the COVID-19 pandemic, Tunisia,have adopted community containment to manage the spread of the virus. However, COVID-19 restrictions can alter psychological wellbeing and limit access to treatment for SpA patients.Objectives:This study aimed to evaluate the impact of COVID-19 pandemic on psychological health and treatment adherence on Tunisian SpA patients.Methods:This is a cross sectional study including patients with SpA (ASAS criteria). A survey comprising questions about adherence to stay home warnings; the obligation to go outside for work; satisfaction with the medical support or information received for COVID-19; showing up to medical check-ups, proper use of the medications; medications that the patient stopped taking.Anxious and depressive symptoms were assessed using the Arabic version of Hospital Anxiety and Depression Scale (HADS) questionnaire.Results:We included thirty patients. the average age was: 39,7 years-old and the sex ratio was: 13,3. 75 % of patients were married. The SpA was axial in 25%, peripheral in 20%, and both in 55 %. Most patients had a moderate activity and the mean activity scores were: BASDAI = 2.60, ASDAScrp:2.6538% of patients were on biologics, 36 % on sulfasalazine and NSAIDs and 26 % on NSAIDs only.It seemed that significant number of patients strictly adhered to stay home warnings (> 89%) only 11% were obliged to go out for work during general lockdown while only 24 % adhered to it after general lockdown.Most of the patient 78 % were not satisfied with the medical support or information about COVID 19. 88% of patients requested information from TV while 10 % requested it from social media and 2 % from relatives and friends working in health care field.After the outbreak, 23% of the patients who had a scheduled chek-up visit attended the appointment as it was before.The remaining either ‘did not want to come’ (43%), wanted to come but could not contact anyone in the hospital (11%), was advised to postpone their visits (10%), or couldn’t find means of transport (13%).A significant number of patients decreased or skipped their dose (69%), while only 13% continued their medications and 16%stopped taking NSAIDs.Biological DMARDs(anti-TNF agents) were the most frequent drugs which patients decreased their dose, skipped or stopped taking 33%. sulfasalazine and NSAIDs were least likely 17% to be skipped or stopped.43% of patients Had a HADS anxiety level more than or equal to 11: 87 % women and 13 % men. The highest anxiety scores were found among patients aged less than 45 years old (87%) married with children .32% of patients had a HADS depression level more than or equal to 11: 54 % women and 44 % men. the highest depression scores were found among patients aged less than 45 years old married with children.No significant relationship was found between anxiety and depression levels regarding biologic treatment.Conclusion:Our results suggest that patients with SpA were less likely to comply strictly to ‘stay home’ restrictions, most probably due to the male predominance and relatively younger age. Additionally, we noticed that SpA patients treated with anti-TNF agents were the patients that regular drug use had been considerably disrupted.COVID 19 pandemic has heightened the need to care for patients with SpA in an increasingly virtual environment.Additionally, we found that being female, having a lower level of education, having a child, living in a crowded family is correlated to higher levels of anxiety and depression.References:[1]Smarr KL, Keefer AL. Measures of depression and depressive symptoms: Beck Depression Inventory-II (BDI-II),Hospital Anxiety and Depression Scale (HADS), and Patient Health Questionnaire-9 (PHQ-9) Arthritis care.Acknowledgements:I would like to express my special thanks of gratitude to Rheumatology department of Hedi Chaker Hospital Sfax.Disclosure of Interests:None declared

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S250-S250
Author(s):  
Wael Foad ◽  
Rami Alhawi ◽  
Samer Altamimi ◽  
Zahid Hussain ◽  
Hamdy Moselhy ◽  
...  

AimsWe aim to investigate the effectiveness of repetitive Transcranial Magnetic Stimulation (rTMS) in reducing consumption and craving among patients with Substance Use Disorder (SUD) and comorbid depressive disorder.BackgroundDorsolateral prefrontal cortex (DLPFC) is greatly involved in SUD evolution (1). Research has turned to targeting this brain area with rTMS; a non-invasive brain stimulation technique that modulates cortical excitability by sending pulsatile electromagnetic fields through the skull and into the brain (2). rTMS is an FDA approved and safe treatment option for treatment-resistant depression (TRD) (3).MethodFifty-four patients were admitted over six-month period of time (June 2019- December 2019) to the inpatient unit of Erada center for treatment and rehabilitation of SUD in Dubai. All patients who fulfilled ICD-10 diagnoses of Depressive disorder and SUD were screened for further assessment.Positive drug screen was confirmed through urine analysis. Hospital Anxiety and Depression Scale (HADS) and Brief Substance Craving Scale (BSCS) were applied to all participants. Patients were contracted for 5-times weekly High frequency (10 Hz) rTMS for 4 weeks (total of 20 treatments). Those who managed to complete their contracted TMS sessions were matched for age and sex with similar number of patients who received standard treatment as usual (TAU). Stimulation was as per FDA clearance for rTMS application in TRD.ResultEight patients were excluded (previous head trauma). A total of 46 patients had TMS mapping; nine of whom completed 20 sessions.Opioids was the most commonly used drug in almost 52% of patients (n = 14), followed by amphetamines in almost 30% (n = 8) and Cannabis in 18.5% (n = 5).Among those who completed 20 rTMS sessions; HADS scores on anxiety and depression fell by 85% and 78% respectively. BSCS score fell by 98%. Relapse rate (defined by positive drug screen) at 3 months was 33%.For those who completed 10 sessions; there was only 50% reduction on BSCS scores and 66% relapse rate. There were no data available on their HADS scores (only collected at baseline and at completion of 20 sessions).Those who only had TAU; there were no reduction in their BSCS (average score of 7 at both baseline and after 2 weeks).ConclusionOur findings suggest that rTMS may be an effective and safe treatment for both depressive disorder and craving for SUD which is supported by other studies (3,4).Our study is probably the first of its kind within Middle East population with addiction problems.


2021 ◽  
Vol 36 (6) ◽  
pp. 1171-1171
Author(s):  
Winter Olmos ◽  
Daniel W Lopez-Hernandez ◽  
Isabel Munoz ◽  
Laura Schierholz ◽  
Rachel A Rugh-Fraser ◽  
...  

Abstract Introduction We examined the relationship between depression and anxiety, language, and functional outcomes in persons with traumatic brain injury (TBI). Methods The sample consisted of 48 acute TBI (ATBI: 23 Spanish-English Bilinguals; 25 English monolinguals), 30 chronic TBI (CTBI: 17 Spanish English Bilinguals; 12 English monolinguals), and 47 healthy comparison (HC: 29 Spanish-English Bilinguals; 18 English monolinguals) participants. The Hospital Anxiety and Depression Scale was used to measure depression (HADS-D) and anxiety (HADS-A). The Mayo Portland Adaptability Inventory-4 (MPAI-4) was used to measure functional outcomes (ability, adjustment, participation). Results An ANCOVA, controlling for age, revealed the ATBI group reported lower anxiety levels compared to the CTBI group, p = 0.034 np2 = 0.06. HC participants demonstrated significantly higher functional ability compared to both TBI groups, p < 0.05, np2 = 0.08–0.19. The ATBI group demonstrated worse participation scores compared to the CTBI and HC groups, p = 0.001, np2 = 0.11. Pearson correlations revealed mood was related to functional status in ATBI monolinguals (HADS-A: r = 0.29–0.64; HADS-D, r = 0.49–0.62). Monolingual participants with ATBI demonstrated correlations between depressive symptoms and functional adjustment (r = 0.57, p = 0.005) and ability (r = 0.44, p = 0.034). For monolinguals with CTBI, HADS-A correlated with functional outcomes, r = 0.60–0.66, p < 0.05. For bilinguals with CTBI, functional outcomes correlated with HADS-A, r = 0.53–0.66, p < 0.05, and HADS-D, r = 0.54–0.66, p < 0.05. For HC monolinguals, functional outcomes correlated with HADS-A, r = 0.53–0.70, p < 0.05, and HADS-D, r = 0.50–0.72, p < 0.05. Finally, for HC bilinguals, functional outcomes correlated with HADS-A, r = 0.59–0.68, p < 0.05. Conclusion Our results suggest that a relationship between anxiety and depressive symptoms is related more to functional outcomes in monolingual TBI survivors compared to bilingual TBI survivors.


Author(s):  
Francisco García-Torres ◽  
Marcin J. Jabłoński ◽  
Ángel Gómez Solís ◽  
María José Jaén-Moreno ◽  
Mario Gálvez-Lara ◽  
...  

Cancer caregiving is associated with burden and a poor psychological state. However, there is no previous information about the predictive utility of specific burden domains on anxiety and depression in the first six months after a partner’s cancer diagnosis. In a longitudinal study, 67 caregivers completed the Zarit Burden Interview (ZBI) and Hospital Anxiety and Depression Scale (HADS) at T1 (45–60 days after diagnosis) and T2 (180–200 days after diagnosis). Most of the caregivers were female (65.7%, mean age = 51.63, SD = 13.25), while patients were mostly male (56.7%). The TRIPOD checklist was applied. ZBI scores were moderate and HADS anxiety reached significant values. There were no differences in ZBI and HADS between T1 and T2. The relationship between burden, anxiety, and depression were more consistent at T2, while emotional burden at T1 were related and predicted anxiety and depression at T2. Some burden domains were related and predicted anxiety in caregivers in the first six months after partner cancer diagnosis. This information could be useful to prevent the onset of these symptoms in the first six months after diagnosis.


2001 ◽  
Vol 178 (1) ◽  
pp. 12-17 ◽  
Author(s):  
K. Ostler ◽  
C. Thompson ◽  
A.-L. K. Kinmonth ◽  
R. C. Peveler ◽  
L. Stevens ◽  
...  

BackgroundHealth inequalities exist for many disorders, but the contribution of deprivation to the prevalence and outcome of depressive symptoms in primary care populations has been infrequently studied.AimsTo examine the influence of Jarman under-privileged area (UPA) scores on the prevalence and outcome of depressive symptoms in general practice patients.Method18 414 patients attending 55 representative practices completed the Hospital Anxiety and Depression Scale and a questionnaire for employment status. Outcome of those screening positive was assessed at 6 weeks and 6 months.ResultsThe UPA score accounted for 48.3% of the variance between practices in prevalence of depressive symptoms. Attending a high UPA score practice predicted persistence of depressive symptoms to 6 months.ConclusionsThe socio-economic deprivation of a practice locality is a powerful predictor of the prevalence and persistence of depressive symptoms.


2013 ◽  
Vol 20 (1) ◽  
pp. 108-111 ◽  
Author(s):  
Johannis A van Rossum ◽  
Anke Vennegoor ◽  
Lisanne Balk ◽  
Bernard M Uitdehaag ◽  
Chris H Polman ◽  
...  

The use of natalizumab in multiple sclerosis has been restricted by the risk of progressive multifocal leukoencephalopathy (PML). JC virus carriership, duration of natalizumab treatment and past immunosuppression are known risk factors. This has allowed for calculated risk assessment for individual patients to be implemented. Not much data are available about the effect of JCV carriership on patient willingness to continue natalizumab. Here, we evaluated the impact of JCV seropositivity on safety feelings, anxiety and treatment continuation for patients treated with natalizumab, using a visual analog scale, the Hospital Anxiety and Depression Scale and a decisional conflict scale. Seropositivity led to an elevated anxiety level for PML ( p = 0.004). However, so far only 3% of patients have discontinued natalizumab because of JCV positivity in our cohort.


2021 ◽  
Author(s):  
Özlem Sönmez ◽  
Evrim Tezcanli Tjon A Meeuw ◽  
Elif Şenocak Taşçı ◽  
Hande Büşra Kazancı ◽  
Ayşe Altınok ◽  
...  

Abstract Introduction : We conducted a survey among cancer patients undergoing active oncology treatment to evaluate their psychological wellbeing during COVID-19 pandemic in comparison to healthy individuals and whether the COVID-19 anxiety affected treatment adherence. Material and Methods 402 participants were included in the study; 193 were cancer patients receiving active treatment while 209 were healthy volunteers. Hospital anxiety and depression scale (HADS) and COVID-19 phobia scale (C19P-S) questionnaires were used. Results Patient group had significantly lower CP19-S compared to healthy individuals. Patients’ mean HADS-anxiety score was significantly higher. Mean depression scores were similar between patients and healthy volunteers. There were no treatment deferrals. Conclusion Although the pandemic increased levels of anxiety, oncology treatment continued to be a priority for cancer patients.


2015 ◽  
Vol 27 (9) ◽  
pp. 1577-1578 ◽  
Author(s):  
Guy Campbell ◽  
Christina Bryant ◽  
Kathryn A. Ellis ◽  
Rachel Buckley ◽  
David Ames ◽  
...  

Screening measures such as the 15-item Geriatric Depression Scale (GDS-15) (Sheikh and Yesavage, 1986) and the Hospital Anxiety and Depression Scale (HADS) (Zigmond and Snaith, 1983) are important tools in the recognition of depressive symptoms in older people. While these measures are widely used, there is evidence of specific weaknesses in some cohorts and contexts, with the GDS-15 showing limitations in the context of cognitive impairment (Gilley and Wilson, 1997), and the depression subscale of the HADS (HADS-D) losing sensitivity in the context of older participants in hospital inpatient settings (Davies et al., 1993).


Sign in / Sign up

Export Citation Format

Share Document