Depression and Anxiety: Considerations for Interpretation of the SNOT-22 (22-Item Sinonasal Outcome Test)

2021 ◽  
pp. 019459982110597
Author(s):  
Katie M. Phillips ◽  
Ahmad R. Sedaghat
Keyword(s):  
Functional Impairment ◽  
Tertiary Care ◽  
Predictive Ability ◽  
Anxiety Symptoms ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Academic Center ◽  
Sinonasal Outcome Test ◽  
Snot 22

Objective The objective of this study was to determine whether depression and anxiety symptoms affect and confound scoring on the 22-item Sinonasal Outcome Test (SNOT-22), a commonly used outcome measure for chronic rhinosinusitis. Study Design Prospective cross-sectional. Setting Tertiary care academic center. Methods 240 participants completed the SNOT-22, from which nasal, sleep, ear/facial pain, and emotional subdomain scores were calculated. They also completed the 8-item Patient Health Questionnaire (PHQ-8) as a reflection of depression symptoms and 7-item Generalized Anxiety Disorder (GAD-7) questionnaire as a reflection of anxiety symptoms. Correlations were calculated between the 4 SNOT-22 subdomains and the PHQ-8 and GAD-7. Additionally, the predictive ability of subdomains and individual items of the SNOT-22 to predict depression and anxiety was calculated. Results The SNOT-22 sleep and emotional subdomains most strongly correlated with the PHQ-8 and the GAD-7. The emotional and sleep subdomain scores were predictive of having depression or anxiety. An emotional subdomain score ≥4 had 62.5% sensitivity and 90.1% specificity for detecting depression and 78.8% sensitivity and 88.9% specificity for detecting anxiety. A sleep subdomain score ≥21 had 81.2% sensitivity and 71.4% specificity for detecting depression and 87.9% sensitivity and 68.6% specificity for detecting anxiety. The emotional subdomain item related to sadness and the sleep subdomain items related to functional impairment were most predictive of depression and anxiety. Conclusion The SNOT-22 emotional and sleep subdomain scores may be used to predict active depression and anxiety symptoms, especially when items related to sadness or functional impairment are scored with moderate burden.

Clinical Traits Characterizing an Exacerbation-Prone Phenotype in Chronic Rhinosinusitis

2019 ◽  
Vol 161 (5) ◽  
pp. 890-896 ◽  
Author(s):  
Katie M. Phillips ◽  
Eric Barbarite ◽  
Lloyd P. Hoehle ◽  
David S. Caradonna ◽  
Stacey T. Gray ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Disease Burden ◽  
Tertiary Care ◽  
Symptom Burden ◽  
Cross Sectional ◽  
Patient Reported ◽  
Oral Corticosteroids ◽  
Sinonasal Outcome Test ◽  
Snot 22

Objective Acute exacerbation of chronic rhinosinusitis (AECRS) is associated with significant quality-of-life decreases. We sought to determine characteristics associated with an exacerbation-prone phenotype in chronic rhinosinusitis (CRS). Study Design Cross-sectional. Setting Tertiary care rhinology clinic. Subjects Patients with CRS (N = 209). Methods Patient-reported number of sinus infections, CRS-related antibiotics, and CRS-related oral corticosteroids taken in the last 12 months were used as metrics for AECRS frequency. Sinonasal symptom burden was assessed with the 22-item Sinonasal Outcome Test (SNOT-22). Ninety patients reporting 0 for all AECRS metrics were considered to have had no AECRS in the prior 12 months. A total of 119 patients reported >3 on at least 1 AECRS metric and were considered as having an exacerbation-prone phenotype. Characteristics associated with patients with an exacerbation-prone phenotype were identified with exploratory regression analysis. Results An exacerbation-prone phenotype was positively associated with comorbid asthma (adjusted odds ratio [ORadj] = 3.68, 95% CI: 1.42-9.50, P = .007) and SNOT-22 (ORadj = 1.06, 95% CI: 1.04-1.09, P < .001). Polyps were negatively associated (ORadj = 0.27, 95% CI: 0.11-0.68, P = .005) with an exacerbation-prone phenotype. SNOT-22 score ≥24 identified patients with an exacerbation-prone phenotype with a sensitivity of 93.3% and a specificity of 57.8%. Having either a SNOT-22 score ≥24 with a nasal subdomain score ≥12 or a SNOT-22 score ≥24 with an ear/facial discomfort subdomain score ≥3 provided >80% sensitivity and specificity for detecting patients prone to exacerbation. Conclusions In total, these results point to a CRS exacerbation-prone phenotype characterized by high sinonasal disease burden with comorbid asthma but interestingly without polyps.

scholarly journals Depression and Anxiety among University Students: a Comparison Between COVID-19 Pandemic Panic Period and Post-Panic Period in Bangladesh

2021 ◽  
Author(s):  
Gowranga Kumar Paul ◽  
Meshbahur Rahman ◽  
Shayla Naznin ◽  
Mashfiqul Haq Chowdhury ◽  
Md Jamal Uddin
Keyword(s):  
University Students ◽  
Anxiety Symptoms ◽  
Health Concern ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Time Period ◽  
The Difference ◽  
The University

Abstract Background: The current COVID-19 pandemic is the biggest public health concern. It harmed everyone, both physically and mentally. Because of panic situations in COVID-19 pandemic, students all over the world, including those in Bangladesh, are suffering from depression and anxiety. Considering this, we aimed to assess psycho-emotional changes of the university students through investigating their level of depression and anxiety effects during panic and post-panic period of COVID-19 pandemic in Bangladesh.Methods: Cross-sectional online surveys were conducted among university students in Bangladesh from April to July 2020 (panic period, n=170) and then from August to November 2020 (post-panic period, n=170). The PHQ-9 and GAD-7 questionnaires were used to assess respondents' depression and anxiety levels, respectively. We used continuous scores to assess the severity of depression and anxiety symptoms. We also computed binary depression and anxiety scores. Multivariable logistic regression models were used to analyze the data. Results: The proportion of depression symptoms was 49.4% during the panic period and 52.4% after the panic period. Anxiety symptoms were experienced by 38.2% of students during the panic period, and this percentage was nearly identical in the post-panic interval. Depression levels increased in the post-panic period and urban students have significantly (P< 0.05) higher levels of depression and anxiety than their counterparts. Female students also exhibited significantly more anxious symptoms (p=0.002) than male. Depression symptoms significantly vary by family types, students place of residence whereas students age, gender, education, family head's occupation, time period and family economic condition found no significant association with the depression.Conclusions: Students during the post-panic period have a higher prevalence of depression and anxiety symptoms than during the panic period. Although the difference was small, it was still concerning for university students in Bangladesh because it interfered with their academic life.

scholarly journals Associations of depression and anxiety symptoms with sexual behaviour in women and heterosexual men attending sexual health clinics: a cross-sectional study

2019 ◽  
Vol 95 (4) ◽  
pp. 254-261 ◽  
Author(s):  
Rachel Margaret Coyle ◽  
Fiona C Lampe ◽  
Ada Rose Miltz ◽  
Janey Sewell ◽  
Jane Anderson ◽  
...  
Keyword(s):  
Sexual Health ◽  
Sexual Risk ◽  
Anxiety Symptoms ◽  
Heterosexual Men ◽  
Depression Symptoms ◽  
Sexual Risk Behaviour ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Study Region ◽  
Condomless Sex

ObjectiveTo assess the association of symptoms of depression and anxiety with sexual risk behaviour and history, among women and heterosexual men attending genitourinary medicine (GUM) clinics.MethodsAttitudes to and Understanding of Risk of Acquisition of HIV (AURAH) was a cross-sectional, self-administered questionnaire study recruited from 20 GUM clinics in England, 2013–2014. This analysis included women and heterosexual men. The prevalence of depression and anxiety symptoms was assessed. Modified Poisson regression was used to produce adjusted prevalence ratios (aPR) for the association of t demographic, socioeconomic and lifestyle factors with depression and anxiety, adjusted for gender, age, ethnicity, education level and study region. Among individuals reporting sex in the past 3 months, associations of depression and anxiety with sexual risk behaviour and history were assessed separately by gender, adjusted for age, ethnicity, study region, education and relationship status.ResultsQuestionnaires were completed by 676 women and 470 heterosexual men. Depression symptoms were reported by 100 (14.8%) women and 33 men (7.0%). Anxiety symptoms were reported by 79 women (11.7%) and 21 men (4.5%). Among women reporting recent sex, those with depression symptoms were more likely to report condomless sex with a non-regular partner, aPR 1.38 (1.07–1.77) and recent condomless sex with two or more partners, 1.80 (1.25–2.59). Women with anxiety symptoms more likely to report recent condomless sex with two or more partners, 1.68 (1.13–2.50), low self-efficacy for condom use, 1.54 (1.02–2.31) and STI diagnosis in the last year 1.51 (1.04–2.20). Among heterosexual men reporting recent sex, depression and anxiety symptoms were associated with low self-efficacy with condom use, 2.32 (1.29–4.19) for depression and 2.23 (1.26–3.94) for anxiety, but not with measures of condomless sex.DiscussionThe associations between psychological symptoms and sexual risk behaviours highlight the importance of holistic assessment of need by both general and sexual health clinicians. We highlight the challenge in delivering holistic care associated with fragmentation of sexual health services.

scholarly journals Self-reported symptoms of depression and anxiety among informal caregivers of persons with dementia: a cross-sectional comparative study between Sweden and Italy

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Joseba Wulff ◽  
Agneta Malmgren Fänge ◽  
Connie Lethin ◽  
Carlos Chiatti
Keyword(s):  
Informal Caregivers ◽  
Depression Scale ◽  
Well Being ◽  
Anxiety Symptoms ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Symptoms Of Depression ◽  
People With Dementia

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.

scholarly journals Determinants of increased frequency of depressive and anxiety symptoms in exercise professionals during the COVID-19 pandemic

Work ◽  
2021 ◽  
pp. 1-11
Author(s):  
Natan Feter ◽  
Eduardo L. Caputo ◽  
Igor R. Doring ◽  
Marcelo C. da Silva ◽  
Felipe F. Reichert ◽  
...  
Keyword(s):  
Physical Activity ◽  
Depressive Symptoms ◽  
Depression Scale ◽  
Exercise Program ◽  
Anxiety Symptoms ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Social Distancing

BACKGROUND: The coronavirus disease (COVID-19) pandemic has affected workers in different health services including exercise professionals (EP). The urgent need to adapt in-person to online activities might have led to increased frequency of anxiety and depressive symptoms. OBJECTIVE: We aimed to identify the determinants of aggravated depressive and anxiety symptoms in EP in southern Brazil during social distancing from the COVID-19. METHODS: A cross-sectional study was conducted with EP who worked at fitness centers, sports clubs, private schools, or at a public exercise program offered by the municipal council. We used an online-based, self-administered, adapted version of the Hospital Anxiety and Depression scale to compare symptoms of depression and anxiety pre- and during social distancing. RESULTS: Participants (n = 201) had a mean age of 32.7±8.0 years, with more than half being male, white, and having an university degree. We observed that 81%and 71%of respondents reported higher frequency in anxiety and depression symptoms, respectively, during social distancing than in the period before it. Physical education teachers, women, non-white professionals, and those with chronic disease were more likely to worsen anxiety symptoms. Women had higher odds to increased frequency in depressive symptoms. Physical activity and previous experience with internet-based tools for working activities reduced the risk of increased depressive symptoms. CONCLUSIONS: Sex, ethnicity, chronic diseases, educational level, physical activity, and experience with online tools were determinants for increased frequency of depression and anxiety symptoms in EP.

scholarly journals Mental Health Burden of the COVID-19 Outbreak in Germany: Predictors of Mental Health Impairment

2020 ◽  
Vol 11 ◽  
pp. 215013272095368 ◽  
Author(s):  
Alexander Bäuerle ◽  
Jasmin Steinbach ◽  
Adam Schweda ◽  
Jil Beckord ◽  
Madeleine Hetkamp ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Status ◽  
Cross Sectional Study ◽  
Anxiety Symptoms ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Psychological Burden ◽  
Individual Level ◽  
Subjective Level

Introduction: COVID-19 is causing an enormous psychological burden for most people. This study aims to assess individual changes in mental health and health status before and after the COVID-19 outbreak, and to explore potential predictors of change. Methods: A cross-sectional study in Germany (n = 15 037) were conducted. Demographics, depression and anxiety symptoms (PHQ-2, GAD-2), distress (DT), and health status (EQ-5D-3L) were assessed. Additionally, all instruments used were adapted to measure the participants’ mental health and health status before the COVID-19 outbreak. COVID-19-related fear, trust in governmental actions to face COVID-19, and the subjective level of information about COVID-19 were examined. Results: Overall, the participants showed a significant increase in depression and anxiety symptoms, and distress, while health status deteriorated since the COVID-19 outbreak. Impairment in mental health was predicted by COVID-19-related fear. Pre-existing mental illness predicted an increase in depression symptoms and a deterioration in health status. Trust in governmental actions and the subjective level of information predicted less increase in psychological burden. Conclusions: Our data revealed that there have been changes in mental health and health status at an individual level since the outbreak of COVID-19. In order to maintain mental health, the observed predictors should be addressed.

scholarly journals Psychopathology in Elderly COVID-19 Survivors and Controls

2021 ◽  
pp. 089198872110026
Author(s):  
Arash Mowla ◽  
Mehrnoosh Ghaedsharaf ◽  
Azadeh Pani
Keyword(s):  
Rating Scales ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Anxiety Symptoms ◽  
Control Group ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Post Discharge ◽  
Cross Sectional ◽  
Global Pandemic

Background: The highly infectious and pathogenic coronavirus-19 (COVID-19) has emerged to cause a global pandemic. In this cross-sectional comparative study, our objective is to compare the depression and anxiety symptoms in elderly COVID-19 survivors with a control group. Method: 69 elderly COVID-19 survivors (age 65 or older) within 2 weeks post-discharge were assessed for anxiety and depression symptoms by a package of self-rating scales (Geriatric Anxiety Scale-10 (GAS-10), Geriatric Depression Scale-15 (GDS-15) and General Health Questionar-28 (GHQ-28)). Their scores were compared with a group of aged-matched residents without COVID-19 in their community. Results: The mean scores on GAS-10, GDS-15 and GHQ-28 in the COVID-19 survivors group and control group were 12.06 vs. 6.53 (p < .001), 12.48 vs. 5.73 (p < .001), 52.7 vs. 29.8 (p < .001), respectively. All of the COVID-19 survivors and 60% of the controls had scores in the pathological range of GHQ-28 scale. A total of 93.2% of COVID-19 survivors revealed anxiety symptoms in GAS-10 scale. This rate was 60% in the control group. A total of 86.6% of COVID-19 survivors compared to 46.6% of the controls reported symptoms of depression in GDS-15 scale. Conclusion: The rate of depression and anxiety symptoms in elderly COVID-19 survivors and controls found to be high during the pandemic. However, COVID-19 survivors significantly suffered more.

scholarly journals Prevalence of anxiety and depressive symptoms among emergency physicians in Libya after civil war: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039382
Author(s):  
Muhammed Elhadi ◽  
Ala Khaled ◽  
Ans Bassam Malek ◽  
Ahmed El-Alem El-Azhari ◽  
Ahmed Zakaria Gwea ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Measurement Tool ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Emergency Physicians ◽  
Sectional Study ◽  
Cross Sectional

ObjectivesWe aimed to identify the prevalence of depression and anxiety among physicians working in the emergency departments of nine tertiary care centres in Libya.DesignThis was a cross-sectional study.SettingNine main tertiary centres in LibyaParticipantsEmergency department doctors were surveyed between December 2018 and February 2019.InterventionThe standardised Hospital Anxiety and Depression Scale (HADS) was selected as a measurement tool for analysing anxiety and depression symptoms; a HADS score of 8 indicated anxiety as well as depression symptoms. The primary outcomes were anxiety and depression, which were tabulated with independent sociodemographic variables. χ2 tests were conducted to compare the prevalence of anxiety and depression between the groups. Statistical analysis was performed using SPSS V.25.ResultsA total of 108 out of 150 (72%) emergency physicians from all levels participated in the study and took the survey. The emergency physicians had a mean±SD age of 31.2±4.5 years, and were predominantly males (74 out of 108, 68.5%). Overall, 49 (45.4%) physicians reached the cut-off score to define both depression and anxiety (ie, a score ≥8). In terms of violence, 71 (65.7%) reported incidents of verbal violence, while 26 (24.1%) reported physical violence or abuse by militias. In addition, 28 reported being threatened by militias.ConclusionThe high prevalence rate of anxiety and depression is of concern, and the high rate of physical and verbal abuse highlights the range of abuse endured by doctors in Libya. Therefore, screening for anxiety and depression at regular intervals is needed to avoid the deterioration of mental health, which can increase the risk of suicide and dropping out, and decrease the level of healthcare for patients.

scholarly journals Graduating from Medical School amid a Pandemic: A Study of Graduates’ Mental Health and Concerns

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Hend M. Alkwai
Keyword(s):  
Medical Students ◽  
Online Survey ◽  
Virus Disease ◽  
Demographic Data ◽  
Anxiety Symptoms ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
The Impact

The corona virus disease of 2019 (COVID-19) pandemic has vastly impacted individuals worldwide. Millions have contracted the disease thus far; however, the ramifications of containment measures such as quarantine and lockdown have affected many more. This study aimed to explore the prevalence of self-reported anxiety and depression among a cohort of Saudi medical students, as well as graduating medical students’ concerns, during this pandemic. This cross-sectional study utilized an online survey that collected demographic data, scores on validated anxiety, and depression scales, as well as the graduates’ concerns. The Generalized Anxiety Disorder 7-item (GAD-7) and the Public Health Questionnaire 9-item (PHQ-9) scales were used. Cutoff scores for anxiety symptoms were (GAD-7 ≥ 8) and for depression (PHQ-9 ≥ 10). Out of 83 graduates, 55 completed the online survey. Anxiety symptoms were present in 34%, depression was present in 26%, and 19% had both depression and anxiety symptoms. Female graduates experienced higher anxiety symptoms (54 vs. 15%, p = 0.004 ). The highest-ranked concerns were the possible effect of the pandemic on the forthcoming internship year and on the impact on the current academic course. We found high levels of anxiety and depression symptoms during the pandemic among our cohort of medical students in their final year of study. Our findings suggest that medical students in their final years may be negatively affected by the pandemic, where high levels of depression and anxiety coincide with concerns about the effect of the pandemic on the next phase of their vocation.

scholarly journals Ayahuasca use and reported effects on depression and anxiety symptoms: An international cross-sectional study of 11,912 consumers

2021 ◽  
Vol 4 ◽  
pp. 100098
Author(s):  
Jerome Sarris ◽  
Daniel Perkins ◽  
Lachlan Cribb ◽  
Violeta Schubert ◽  
Emerita Opaleye ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Anxiety Symptoms ◽  
Depression And Anxiety ◽  
Sectional Study ◽  
Cross Sectional
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