Somatization, Depression, and Anxiety Disorders in a Rhinology Practice

Background Patients present to rhinology clinics with various complaints. Symptoms may be attributable to objective findings, some remain unexplained. The objective is to investigate the incidence of psychological disorders in a rhinologic practice and evaluate a correlation of these psychiatric diseases with rhinologic symptoms. Methods Patients presenting to a rhinology clinic were administered the Generalized Anxiety Disorder 7 (GAD 7), Patient Health Questionnaire 9 (PHQ 9), and PHQ 15, psychometric instruments that can screen for generalized anxiety, major depression, and somatization disorder, respectively. Patients’ symptoms, endoscopic findings, medication, and psychiatric history were recorded. Multivariable analysis was performed for patients showed moderate-to-severe anxiety, depression, and somatic symptoms via 3 logistic regressions where the outcome was a GAD 7, PHQ 9, or PHQ 15 above 10. Results One hundred ninety-six patients were included for this study. There were 109 females and 87 males with a mean age of 49 years. Overall, 9%, 14%, and 21% exhibited moderate-to-severe anxiety, depressive, and somatization symptoms, respectively. Nasal obstruction was the only statistically significant variable that increased the odds of having moderate-to-severe anxiety symptoms. Similarly, headache, nasal obstruction, and anosmia/hyposmia were associated with increased odds of having depressive symptoms, and female gender, headache, and nasal discharge increased the odds of somatic symptom disorder. Edema was the only objective endoscopic finding, which was associated with depression only. Conclusions Patients should be counseled about the pathophysiology and psychiatric comorbidities affecting their primary rhinologic complaints. The provider needs to set realistic treatment expectations in order to achieve the desired clinical outcomes.

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A Longitudinal Study on Generalized Anxiety Among University Students During the First Wave of the COVID-19 Pandemic in Switzerland

Frontiers in Psychology ◽

10.3389/fpsyg.2021.643171 ◽

2021 ◽

Vol 12 ◽

Author(s):

Simone Amendola ◽

Agnes von Wyl ◽

Thomas Volken ◽

Annina Zysset ◽

Marion Huber ◽

...

Keyword(s):

Applied Sciences ◽

University Students ◽

Psychological Health ◽

Female Gender ◽

Anxiety Symptoms ◽

Psychological Interventions ◽

Generalized Anxiety ◽

Health Measures ◽

University Of Applied Sciences ◽

Severe Anxiety

ObjectiveThe COVID-19 pandemic and government measures implemented to counter the spread of the infection may be a major stressor affecting the psychological health of university students. This study aimed to explore how anxiety symptoms changed during the pandemic.Methods676 students (76% females) at Zurich University of Applied Sciences participated in the first (T0) and second (T1) survey waves. Anxiety symptoms were assessed using the Generalized Anxiety Disorder-Scale-7 (GAD-7). Risk and protective factors (e.g., COVID-19-related variables) were examined.ResultsGAD-7 scores decreased significantly from T0 to T1 (mean change: −0.446, SE = 0.132, 95% CI: −0.706, −0.186, t = −3.371, df = 659, p = 0.001). Participants with moderate-to-severe anxiety score were 20.2 and 15.6% at T0 and T1, respectively. The following positively predicted anxiety: older age, female gender, non-Swiss nationality, loneliness, participants’ concern about their own health, and interaction between time and participants’ concern about their own health. Resilience and social support negatively predicted anxiety.ConclusionsOur findings provide information for public health measures and psychological interventions supporting the mental health of university students during the COVID-19 emergency.

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Psychopathology and Somatic Complaints: A Cross-Sectional Study with Portuguese Adults

Healthcare ◽

10.3390/healthcare9040478 ◽

2021 ◽

Vol 9 (4) ◽

pp. 478

Author(s):

Joana Proença Becker ◽

Rui Paixão ◽

Manuel João Quartilho

Keyword(s):

Early Detection ◽

Short Form ◽

Female Gender ◽

Cross Sectional Study ◽

Physical Symptoms ◽

Brief Symptom Inventory ◽

Cross Sectional ◽

Psychopathological Symptoms ◽

Patient Health ◽

The Impact

(1) Background: Functional somatic symptoms (FSS) are physical symptoms that cannot be fully explained by medical diagnosis, injuries, and medication intake. More than the presence of unexplained symptoms, this condition is associated with functional disabilities, psychological distress, increased use of health services, and it has been linked to depressive and anxiety disorders. Recognizing the difficulty of diagnosing individuals with FSS and the impact on public health systems, this study aimed to verify the concomitant incidence of psychopathological symptoms and FSS in Portugal. (2) Methods: For this purpose, 93 psychosomatic outpatients (91.4% women with a mean age of 53.9 years old) and 101 subjects from the general population (74.3% women with 37.8 years old) were evaluated. The survey questionnaire included the 15-item Patient Health Questionnaire, the 20-Item Short Form Survey, the Brief Symptom Inventory, the Depression, Anxiety and Stress Scale, and questions on sociodemographic and clinical characteristics. (3) Results: Increases in FSS severity were correlated with higher rates of depression, anxiety, and stress symptoms. The findings also suggest that increased rates of FSS are associated with lower educational level and female gender. (4) Conclusion: Being aware of the relationship between FSS and psychopathological symptoms and the need to explore psychosocial issues during clinical interviews may favor early detection of these cases. The early detection of mental disorders is essential for individuals’ adherence to treatments, reflecting on healthcare costs.

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Negative Emotions in Migraineurs Dreams: The Increased Prevalence of Oneiric Fear and Anguish, Unrelated to Mood Disorders

Behavioural Neurology ◽

10.1155/2014/919627 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

F. De Angeli ◽

C. Lovati ◽

L. Giani ◽

C. Mariotti D'Alessandro ◽

E. Raimondi ◽

...

Keyword(s):

Motor Skills ◽

De Novo ◽

Tension Type Headache ◽

Anxiety And Depression ◽

Generalized Anxiety ◽

Migraine Pain ◽

Patient Health ◽

Type Headache ◽

The Brain ◽

Negative Connotation

Background. Migraineurs brain has shown some functional peculiarities that reflect not only in phonophobia, and photophobia, but also in mood and sleep. Dreaming is a universal mental state characterized by hallucinatory features in which imagery, emotion, motor skills, and memory are created de novo. We evaluated dream contents and associated emotions in migraineurs.Materials and Methods. 412 subjects: 219 controls; and 148 migraineurs (66 with aura, MA; 82 without aura, MO), and 45 tension type headache patients (TTH). A semistructured retrospective self-reported questionnaire was used to evaluate dreams. The Generalized Anxiety Disorder Questionnaire (GAD-7), and the Patient Health Questionnaire (PHQ-9) were administered to evaluate anxiety and depression.Results. Migraineurs showed increased levels of anxiety (P=0.0002for MA versus controls,P=0.004for MO versus controls). Fear and anguish during dreaming were more frequently reported by migraine patients compared to controls, independently by anxiety and depression scores.Discussion. The brain of migraineurs seems to dream with some peculiar features, all with a negative connotation, as fear and anguish. It may be due to the recorded negative sensations induced by recurrent migraine pain, but it may just reflect a peculiar attitude of the mesolimbic structures of migraineurs brain, activated in both dreaming and migraine attacks.

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Role of mometasone furoate nasal spray in children with adenoid hypertrophy: impact on life style changes

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203578 ◽

2020 ◽

Vol 6 (9) ◽

pp. 1709

Author(s):

Venkatesha B. K. ◽

Ravi Shekhar

Keyword(s):

Nasal Obstruction ◽

Nasal Spray ◽

Statistical Tests ◽

Nasal Congestion ◽

Sleep Apnea Syndrome ◽

Mometasone Furoate ◽

Nasal Discharge ◽

Adenoid Hypertrophy ◽

Obstructive Sleep ◽

Life Style Changes

Background: Adenoid hypertrophy (AH) is a common cause of upper airway obstruction and obstructive sleep apnea syndrome (OSAS) in children having major impact on child’s growth and development. Symptoms like nasal congestion, mouth breathing, nasal discharge, snoring, day time sleepiness, hyponasal voice, ear popping, and craniofacial abnormalities are observed. Adenoidectomy is considered the treatment of choice for symptomatic children. Co-existing medical illnesses and choice of surgical treatment is governed by the paediatricians and apprehensive parents. Need for conservative treatments in alleviating symptoms have been tried. Topical, intranasal administered, steroid preparations have been proven effective in the literature.Methods: In this prospective study, 35 symptomatic children (3-12 years) with adenoid hypertrophy were included. Each of the symptoms was scored from 0 (absent) to 4 (severe) over Visual Analogue Scale (VAS). Nasal obstruction index was calculated. Results of mometasone furoate nasal spray 100 microgram/day used once daily at the interval of 8 weeks and 12 weeks were analysed using statistical tests. Results: A statistically significant reduction in nasal obstruction index and other symptoms were noted at the end of third month follow up.Conclusions: Mometasone furoate nasal spray caused improvements in outcomes of nasal obstruction, snoring, total nasal symptoms, ear symptoms and overall quality of life.

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Allergic fungal rhinosinusitis: an overview on pathogenesis, early diagnosis and management

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20181853 ◽

2018 ◽

Vol 4 (3) ◽

pp. 694 ◽

Cited By ~ 1

Author(s):

Neeraj Suri ◽

Bhavya B. M.

Keyword(s):

Nasal Obstruction ◽

Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Histological Evaluation ◽

Nasal Discharge ◽

Fungal Sinusitis ◽

Surgical Specimen ◽

Specimen Handling ◽

Fungal Rhinosinusitis ◽

Allergic Fungal Rhinosinusitis

Background: The objective of the study was to evaluate the criteria for diagnosing allergic fungal rhinosinusitis and to maintain permanent drainage and ventilation, while preserving the integrity of the mucosa.Methods: This is a prospective study of 50 patients with allergic fungal sinusitis with or without polyposis all of whom were treated with endoscopic debridement. Mucous sample collection, nasal secretion culture, surgical specimen handling, and histological evaluation of surgical specimens are described. All patients treated with endoscopic sinus surgery, debridement, post-operative use of steroids and antifungal therapy. Results: Fungal mucin was found in all 50 cases, histology and fungal cultures confirmed the diagnosis. Out of 50 patients, 29 were females and 21 were males, with a mean age of 32 years. The most common symptom was nasal discharge 41 (82%) cases, nasal obstruction in 38 (76%) cases, headache and facial pain in 32 (72%) cases, 7 (14%) patients had bronchial asthma. Symptoms of nasal obstruction and nasal discharge were improved in 46 (92%) cases. All preoperative versus postoperative changes in AFRS associated complaints reached statistical significance of p value <0.001 except in patients with asthma.Conclusions: Comprehensive management with endoscopic sinus surgery, oral steroids and antifungals reduces the recurrence or need for revision surgery. Long term follow up is very important.

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Psychometric Analysis Of The Generalized Anxiety Disorder Scale And The Patient Health Questionnaire Using Mokken Scaling And Confirmatory Factor Analysis

Health and Primary Care ◽

10.15761/hpc.1000145 ◽

2018 ◽

Vol 2 (4) ◽

Cited By ~ 1

Author(s):

Luke Boothroyd ◽

David Dagnan ◽

Steven Muncer

Keyword(s):

Factor Analysis ◽

Anxiety Disorder ◽

Confirmatory Factor Analysis ◽

Generalized Anxiety Disorder ◽

Psychometric Analysis ◽

Generalized Anxiety ◽

Health Questionnaire ◽

Mokken Scaling ◽

Confirmatory Factor ◽

Patient Health

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Influence of Psychological Variables on the Diagnosis of Facet Joint Involvement in Chronic Spinal Pain

January 2018 - Pain Physician ◽

10.36076/ppj.2008/11/145 ◽

2008 ◽

Vol 2;11 (3;2) ◽

pp. 145-160

Author(s):

Laxmaiah Manchikanti

Keyword(s):

Anxiety Disorder ◽

Major Depression ◽

Generalized Anxiety Disorder ◽

Local Anesthetic ◽

False Positive ◽

Joint Pain ◽

Facet Joint ◽

Somatization Disorder ◽

Generalized Anxiety ◽

Facet Joint Pain

Background: Facet or zygapophysial joint pain is one of the common conditions responsible for chronic spinal pain. Controlled diagnostic blocks are considered the only means of reliable diagnosis of facet joint pain, due to the inability of physical examination, clinical symptoms, radiologic evaluation, and nerve conduction studies to provide a reliable diagnosis. The prevalence of facet joint pain has been established to be 15% to 45% of patients with low back pain, 39% to 67% of patients with neck pain, and 34% to 48% of patients with thoracic pain. However, using only a single block, false-positive rates of 27% to 63% in the cervical spine, 42% to 58% in the thoracic spine, and 17% to 50% in the lumbar spine have been reported. While there are multiple reasons for false-positive results, psychological variables may also contribute to false-positive results. A lack of influence of psychological factors on the validity of controlled diagnostic local anesthetic blocks of lumbar facet joints has been demonstrated. However, no such studies have been performed in the thoracic or cervical spine. Objective: To study the influence of psychopathology (depression, generalized anxiety disorder, and somatization individually or in combinations of multiple psychopathologic conditions) on the ability of controlled, comparative local anesthetic blocks to accurately identify facet joint pain and false-positive rates with a single block. Methods: Four hundred thirty-eight patients undergoing controlled, comparative local anesthetic blocks were included in the study. Patients were allocated based on their psychological profiles — each diagnostic group or combination was divided into distinct categories. Primary groups consisted of patients with major depression, generalized anxiety disorder, and somatization disorder. Combination groups consisted of 4 categories based on multiple combinations. All the patients were treated with controlled, comparative local anesthetic blocks either with 1% lidocaine or 1% lidocaine and 0.25% bupivacaine. A positive response was defined as at least an 80% reduction in pain and the ability to perform previously painful movements with appropriate relief with 2 separate local anesthetics. Results: The prevalence of facet joint pain in chronic spinal pain ranged from 25% to 40% in patients without psychopathology, whereas it ranged from 28% to 43% in patients with a positive diagnosis of major depression, generalized anxiety disorder, and somatization disorder, respectively, compared to 23% to 39% in patients with a negative diagnosis. Regional facet joint pain prevalence and false-positive rates were higher in the cervical region in patients with major depression. In the lumbar and thoracic regions, no significant differences were noted. Conclusion: This study demonstrated that, based on patient psychopathology, there were no significant differences among the patients either in terms of prevalence or false-positive rates in the lumbar and thoracic regions. A higher prevalence and lower false-positive rates in the cervical region were established in patients with major depression. Key words: Zygapophysial joint pain, facet joint pain, prevalence, false-positive rate, controlled comparative local anesthetic blocks, major depression, generalized anxiety disorder, somatization disorder

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Rhinolith causing unilateral chronic rhinosinusitis: a case report

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200163 ◽

2020 ◽

Vol 6 (2) ◽

pp. 414

Author(s):

Sumit Prinja ◽

Garima Bansal ◽

Jailal Davessar ◽

Simmi Jindal ◽

Suchina Parmar

Keyword(s):

Nasal Cavity ◽

Nasal Obstruction ◽

Maxillary Sinusitis ◽

Nasal Discharge ◽

Endonasal Approach ◽

Review Of Literature ◽

Medical College ◽

Uncommon Disease ◽

Chronic Maxillary Sinusitis ◽

The Right

Rhinolith or nasal stone is formed by mineralization within nasal cavity. They are calcareous concretions that are formed by the deposition of salts on an intranasal foreign body. It is an uncommon disease that may present asymptomatically or cause symptoms like nasal obstruction, consecutive sinusitis with or without purulent rhinitis, post nasal discharge, epistaxis, anosmia, nasal malodour and headache. They are usually diagnosed incidentally on radiographic examinations or depending on the symptoms. In this paper we report a 28-year-old woman admitted in the ENT department of GGS Medical College and Hospital, Faridkot with a calcified mass in the right nasal cavity causing long standing unilateral nasal obstruction for 3 years, rhinorrhoea (usually malodourous foetid), post nasal discharge and headache for 1 year. The calcified mass was thought to contain the air cell and removed by endonasal approach. The aim of this study is to report a case of rhinolith with chronic maxillary sinusitis along with a review of literature.

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