Changes in anxiety and depression symptoms associated to the outcome of MOH: A post-hoc analysis of the Comoestas Project

Cephalalgia ◽  
2017 ◽  
Vol 38 (4) ◽  
pp. 646-654 ◽  
Author(s):  
Sara Bottiroli ◽  
Marta Allena ◽  
Grazia Sances ◽  
Roberto De Icco ◽  
Micol Avenali ◽  
...  

Aims To evaluate the impact of treatment success on depression and anxiety symptoms in medication-overuse headache (MOH) and whether depression and anxiety can be predictors of treatment outcome. Methods All consecutive patients entering the detoxification program were analysed in a prospective, non-randomised fashion over a six-month period. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale. Results A total of 663 MOH patients were evaluated, and 492 completed the entire protocol. Of these, 287 ceased overuse and reverted to an episodic pattern (responders) and 23 relapsed into overuse. At the final evaluation, the number of patients with depressive symptoms was reduced by 63.2% among responders ( p < 0.001) and did not change in relapsers ( p = 0.13). Anxious symptomatology was reduced by 43.1% in responders ( ps < 0.001) and did not change in relapsers ( p = 0.69). At the multivariate analysis, intake of a prophylactic drug and absence of symptoms of depression at six months emerged as prognostic factors for being a responder (OR 2.406; p = 0.002 and OR 1.989; p = 0.019 respectively), while lack of antidepressant drugs and presence of symptoms of depression at six months were prognostic factors for relapse into overuse (OR 3.745; p = 0.004 and OR 3.439; p = 0.031 respectively). Conclusions Symptomatology referred to affective state and anxiety can be significantly reduced by the treatment of MOH. Baseline levels of depression and anxiety do not generally predict the outcome at six months. Their persistence may represent a trait of patients with a negative outcome, rather than the consequence of a treatment failure.

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.


2015 ◽  
Vol 22 (2) ◽  
pp. 239-244 ◽  
Author(s):  
Marie Théaudin ◽  
Kristoffer Romero ◽  
Anthony Feinstein

Background: There is a high prevalence of depressive and anxiety disorders in multiple sclerosis (MS), a disease 2.5 times more frequent in females. Contrary to the general population, in whom studies have demonstrated higher rates of depression and anxiety in females, little is known about the impact of gender on psychiatric sequelae in MS patients. Objectives: We conducted a retrospective study to try to clarify this uncertainty. Methods: Demographic, illness-related and behavioral variables were obtained from a neuropsychiatric database of 896 patients with a confirmed diagnosis of MS. Symptoms of depression and anxiety were obtained with the Hospital Anxiety and Depression Scale (HADS). Gender comparisons were undertaken and predictors of depression and anxiety sought with a linear regression analysis. Results: HADS data were available for 711 of 896 (79.35%) patients. Notable gender differences included a higher frequency of primary progressive MS in males ( p = 0.002), higher HADS anxiety scores in females ( p < 0.001), but no differences in HADS depression scores. Conclusion: In MS, gender influences the frequency of anxiety only. This suggests that the etiological factors underpinning anxiety and depression in MS are not only different from one another, but also in the case of depression, different from those observed in general population samples.


2009 ◽  
Vol 67 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Martha M.C. Castro ◽  
Carla Daltro

BACKGROUND: Sleep disturbances and symptoms of anxiety and depression have been shown to be involved in the genesis and perpetuation of chronic pain. OBJECTIVE: To evaluate sleep patterns and the prevalence of symptoms of anxiety and depression in patients with chronic pain. METHOD: Four hundred consecutive patients referred to a chronic pain outpatient clinic were investigated using patient charts, the numerical Visual Analogue Scale for the evaluation of pain, the Hospital Anxiety and Depression scale and the Mini-Sleep Questionnaire. RESULTS: The mean age of patients was 45.6±11.4 years. The most frequent medical diagnosis was myofascial pain followed by neuropathic pain. The prevalence of symptoms of anxiety was 72.8%, depression 93% and altered sleep patterns 93%. CONCLUSION: This study revealed a high prevalence of symptoms of depression and anxiety and alterations in sleep patterns in patients with chronic pain, justifying investigation into these disturbances in this group of patients.


2019 ◽  
Vol 7 (16) ◽  
pp. 2590-2594
Author(s):  
Dona Farila Agus ◽  
Elmeida Effendy ◽  
Vita Camellia

BACKGROUND: HIV, which causes AIDS, infects the immune system cells, by destroying or damaging the function of the CD4. PLWHA will have twice the risk of experiencing mental health disorders such as depression and anxiety compared with the general population, thereby suppressing immune function, decreasing their quality of life, decreasing the level of adherence to treatment, and contributing significantly to the occurrence of premature death. AIM: To determine the correlation Anxiety and Depression symptoms and CD4 levels in PLWHA who are undergoing Anti-Retroviral treatment at the HIV/AIDS METHODS: The study was a cross-sectional study, which assesses the correlation between Hospital Anxiety and Depression Scale scores (HADS) and CD4 levels in PLWHA who are receiving ARV in the HIV/AIDS Special Services Polyclinic Medan Haji general hospital. RESULTS: It was found that the average HADS-A score, PLWHA was 15.286 and the SD ± 2.244. This shows that PLWHA is in moderate to severe anxiety and moderate to severe depression. The mean CD4 level of people with HIV/AIDS/PLWHA was 288.171 and SD ± 88.955. According to WHO criteria, regarding the classification of HIV immunodeficiency in adults, are classified as moderate immunodeficiency. There was a significant correlation between the HADS-A score and CD4 level with a correlation value of r = -0.592 indicating a negative correlation with a moderate correlation strength, and the correlation between HADS-D score and CD4 level. The strength of the relationship between HADS-D score and CD4 level is r = -0.650, shows a negative correlation with strong correlation strength. CONCLUSION: from this study, it was found that there is a relationship between depression and anxiety symptom and CD4 level.


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.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S45-S45
Author(s):  
Courtney J Bolstad ◽  
Anisha L Thomas ◽  
Michael R Nadorff

Abstract Symptoms of insomnia are associated with symptoms of depression and anxiety in older adults, yet less is known about the impact of specific forms of insomnia (i.e. onset, maintenance, and terminal insomnia). We explored how insomnia type predicted symptoms of anxiety and depression in older adults (n = 133; mean age 69, range 65-89). We hypothesized that onset and maintenance insomnia would have stronger relations to depression and anxiety than terminal insomnia. Regression analyses indicated that onset insomnia was the only significant predictor of anxiety symptoms, and maintenance was the only significant predictor of depressive symptoms. Thus, our findings suggest that despite overlap between depression and anxiety, insomnia may have different mechanisms of affecting each disorder. Implications for the treatment of anxiety and depressive symptoms by addressing insomnia problems will be discussed.


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.


2017 ◽  
Vol 41 (S1) ◽  
pp. s500-s500
Author(s):  
I. Papava ◽  
A.C. Bredicean ◽  
L. Dehelean ◽  
R. Romosan ◽  
A.M. Romosan ◽  
...  

IntroductionCOPD (chronic obstructive pulmonary disease) is a chronic illness associated with psychological distress. Self-esteem and the associated comorbidities, like depression and anxiety, can influence its evolution.ObjectivesTo analyze how predominant coping styles associated with different levels of self-esteem and mental status in patients with COPD.AimsTo demonstrate that different types of coping-styles have an impact on self-esteem, depression and anxiety.MethodsTo a lot consisting of 28 subjects with COPD, was applied the COPE scale to assess the style of coping, to rate anxiety and depression The Hospital Anxiety and Depression Scale (HADS) and for self-esteem the Rosenberg Self-Esteem Scale. According to their higher coping sub-scale score, they were classified to one dominant coping type as follows: patients with problem-focused coping type (n = 9), emotion-focused coping (n = 10), social support-focused coping (n = 6), respectively avoiding coping type (n = 3).ResultsPatients with dominant problem-focused coping had the most elevated self-esteem compared to patients with social-focused coping (22.0 vs. 16.2; P = 0.039), the depression score was the highest in patients with dominant avoidance-type coping and the lowest in patients with dominant problem-focused coping (11.0 vs. 5.6; P = 0.042) respectively anxiety, was the highest in patients with dominant social-focused coping and the lowest in patients with dominant emotion-focused coping (11.6 vs. 5.0; P = 0.006).ConclusionsIn patients with COPD, problem-focused and emotion-focused copings are adaptive, while avoidance and emotion-focused copings are maladaptive on self-esteem and mental status. Such as, the coping represents a psychological dimension with an impact on the evolution of the disease, and the patients with COPD should be assessed and addressed multidisciplinary.Disclosure of interestThe authors have not supplied their declaration of competing interest.


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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