A randomized controlled trial of cognitive behavior therapy for reducing anxiety and depressive symptoms in patients with locoregional advanced nasopharyngeal carcinoma.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12121-12121
Author(s):  
Feng Liu ◽  
Shengnan Fu ◽  
Yanzhu Chen ◽  
Ouying Yan ◽  
Xiangwei Wu ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Adverse Events ◽  
Randomized Trial ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Depression Scale ◽  
Response Rates ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Treatment As Usual

12121 Background: The purpose of this randomized trial was to compare the efficacy of cognitive behavioral therapy (CBT) versus treatment as usual (TAU) on anxiety and depression, response rates and acute adverse events in patients with locoregional advanced nasopharyngeal carcinoma (NPC) receiving chemoradiotherapy. To the best of our knowledge, this is the first randomized trial evaluating the effect of CBT for depression and anxiety in patients with locoregional advanced NPC treated with chemoradiotherapy. Methods: A total of 202 patients with diagnosis of stage III-IVa (8th AJCC) NPC were randomly assigned to receive CBT plus chemoradiotherapy (CBT group, n = 101) or treatment as usual (TAU) plus chemoradiotherapy (TAU group, n = 101). Patients in the CBT group received a series of six CBT sessions for 6 weeks during concurrent chemoradiotherapy. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS) score at baseline, the completion of chemoradiotherapy, 1 and 3 months after chemoradiotherapy. Response rates and adverse events were also evaluated. This trial is registered with chictr.org.cn, number ChiCTR2000034701. Results: Patients in the CBT group showed significantly less depression and anxiety than patients in the TAU group after the completion of CBT (P < 0.01). Complete response (CR) rate was significantly higher in CBT group than in TAU group (100% vs. 93.1%，P = 0.014). Compared with the TAU group, the CBT group showed a significantly lower incidence of acute adverse events including anemia, fatigue, mucositis, insomnia and weight losing (P < 0.05). Conclusions: The addition of CBT to chemoradiotherapy significantly reduced depressive and anxiety symptoms. CBT combined with chemoradiotherapy is associated with improved response rates, with reduced incidence of acute toxic effects in patients with locoregional advanced nasopharyngeal carcinoma. Clinical trial information: ChiCTR2000034701.

scholarly journals Effects of Cognitive Behavioral Therapy for Depression and Anxiety, Response Rates and Adverse Events in Patients with Locoregional Advanced Nasopharyngeal Carcinoma

2021 ◽  
Vol 20 ◽  
pp. 153473542110061
Author(s):  
Feng Liu ◽  
Sheng-nan Fu ◽  
Yan-zhu Chen ◽  
Ou-ying Yan ◽  
Fei Tong ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Adverse Events ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Response Rates ◽  
Cognitive Behavioral ◽  
Toxic Effects ◽  
Depression And Anxiety ◽  
Small Effect Size ◽  
Anxiety Response

Purpose: This retrospective study investigated the effects of cognitive behavioral therapy (CBT) on depression, anxiety, response rates, and adverse events in patients with locoregional advanced nasopharyngeal carcinoma (NPC). Methods: A total of 269 patients with diagnosis of stage III-IVA NPC received either CBT plus chemoradiotherapy (CBT group, n = 136) or treatment as usual (TAU) plus chemoradiotherapy (TAU group, n = 133). Patients in the CBT group received a series of 6 CBT sessions for 6 weeks during concurrent chemoradiotherapy. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS) score at baseline, the completion of radiotherapy, and 6, 12, and 24 months after radiotherapy. Response rates and adverse events were also evaluated. Results: Patients in the CBT group showed significantly less depression and anxiety than patients in the TAU group after the completion of radiotherapy ( P < .05). Complete response rates were 99.3% (135/136) and 92.5% (123/133) in the CBT group and TAU group with a small effect size (Phi coefficient = .171), respectively ( P = .005). Compared with the TAU group, the CBT group showed a significantly lower incidence of acute adverse events and late toxic effects. Conclusions: The addition of CBT to chemoradiotherapy significantly reduced depressive and anxiety symptoms. CBT combined with chemoradiotherapy is associated with improved response rates, with reduced incidence of toxic effects in patients with locoregional advanced NPC. Based on this study, we registered a randomized controlled clinical trials to better define the role of CBT in patients with locoregional advanced NPC (Registration number: ChiCTR2000034701).

scholarly journals State-of-the-art diagnostic and treatment modalities for anxiety and depression

2021 ◽  
Vol 5 (10) ◽  
pp. 648-653
Author(s):  
O.V. Kotova ◽  
◽  
A.A. Belyaev ◽  
E.S. Akarachkova ◽  
◽  
...  
Keyword(s):  
Depressive Disorder ◽  
Rating Scale ◽  
State Of The Art ◽  
Behavioral Therapy ◽  
Depression Scale ◽  
Treatment Modalities ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Keywords Anxiety ◽  
Anxiety Depression

Depressive disorder, or depression, is one of the most common psychiatric diseases affecting millions worldwide. Anxiety disorders are also common. Most patients with anxiety refer to general practitioners with the signs of vegetative dysfunction. Anxiety per se occurs in 40% and is associated with depression (mixed anxiety-depressive disorder) IN 26%. Comorbidity of anxiety and depression is relatively high, and the extent of this comorbidity changes with aging. This paper reviews diagnostic and treatment modalities for anxiety and depression. Their diagnosis includes clinical examination and questionnaire. This paper describes Neuro Scanner, an application that includes four scales to diagnose anxiety and depression, i.e., the Veyn Scale, Spielberg Trait Anxiety scale, Hospital Anxiety and Depression Scale (HADS), and Montgomery–Asberg Depression Rating Scale (MADRS). To date, a large amount of data illustrating a significant genetic, neurobiological, and symptomatic similarity of depression and anxiety has been accumulated. This phenomenon accounts for the efficacy of the same drugs (e.g., antidepressants, anxiolytics, neuroleptics, etc.). KEYWORDS: anxiety, depression, comorbidity, anhedonia, diagnosis, Neuro Scanner, anti-depressants, anxiolytics, cognitive behavioral therapy. FOR CITATION: Kotova O.V., Belyaev A.A., Akarachkova E.S. State-of-the-art diagnostic and treatment modalities for anxiety and depression. Russian Medical Inquiry. 2021;5(10):648–653 (in Russ.). DOI: 10.32364/2587-6821-2021-5-10-648-653.

The Effect of Lavender Oil on Perioperative Pain, Anxiety, Depression, and Sleep after Microvascular Breast Reconstruction: A Prospective, Single-Blinded, Randomized, Controlled Trial

2021 ◽  
Author(s):  
Ronnie L. Shammas ◽  
Caitlin E. Marks ◽  
Gloria Broadwater ◽  
Elliot Le ◽  
Adam D. Glener ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Adverse Events ◽  
Breast Reconstruction ◽  
Controlled Trial ◽  
Depression Scale ◽  
Control Group ◽  
Lavender Oil ◽  
Entire Cohort ◽  
Randomized Controlled ◽  
Anxiety Depression

Abstract Background Psychosocial distress, depression, or anxiety can occur in up to 50% of women after a breast cancer diagnosis and mastectomy. The purpose of this study was to assess the potential benefit of lavender oil as a perioperative adjunct to improve anxiety, depression, pain, and sleep in women undergoing microvascular breast reconstruction. Methods This was a prospective, single-blinded, randomized, controlled trial of 49 patients undergoing microvascular breast reconstruction. Patients were randomized to receive lavender oil or placebo (coconut oil) throughout their hospitalization. The effect of lavender oil on perioperative stress, anxiety, depression, sleep, and pain was measured using the hospital anxiety and depression scale, Richards–Campbell Sleep Questionnaire, and the visual analogue scale. Results Twenty-seven patients were assigned to the lavender group and 22 patients were assigned to the control group. No significant differences were seen in the perioperative setting between the groups with regard to anxiety (p = 0.82), depression (p = 0.21), sleep (p = 0.86), or pain (p = 0.30) scores. No adverse events (i.e., allergic reaction) were captured, and no significant differences in surgery-related complications were observed. When evaluating the entire cohort, postoperative anxiety scores were significantly lower than preoperative scores (p < 0.001), while depression scores were significantly higher postoperatively as compared with preoperatively (p = 0.005). Conclusion In the setting of microvascular breast reconstruction, lavender oil and aromatherapy had no significant adverse events or complications; however, there were no measurable advantages pertaining to metrics of depression, anxiety, sleep, or pain as compared with the control group.

scholarly journals Prevalence of Depression and Anxiety amongst Cancer Patients in a Hospital Setting: A Cross-Sectional Study

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Anish Khalil ◽  
Muhammad Faheem ◽  
Ammad Fahim ◽  
Haran Innocent ◽  
Zainab Mansoor ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Mental Wellbeing ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Sectional Study ◽  
Cross Sectional

Background. The biomedical care for cancer has not been complemented by psychosocial progressions in cancer care.Objectives. To find the prevalence of anxiety and depression amongst cancer patients in a hospital setting.Design and Setting. This cross-sectional study was conducted at the tertiary care hospitals Shifa International Hospital Islamabad and Nuclear Medicine, Oncology, and Radiotherapy Institute [NORI].Patients and Methods. 300 patients were interviewed from both the outpatient and inpatient department using The Aga Khan University Anxiety and Depression Scale (AKUADS).Main Outcome Measures. Using a score of 20 and above on the AKUADS, 146 (48.7%) patients were suffering from anxiety and depression.Results. When cross tabulation was done between different factors and the cancer patients with anxiety and depression, the following factors were found out to be significant with associatedpvalue < 0.05: education of the patient, presence of cancer in the family, the severity of pain, and the patient’s awareness of his anxiety and depression. Out of 143 (47.7%) uneducated patients, 85 (59.4%) were depressed, hence making it the highest educational category suffering from depression and anxiety.Conclusion. The prevalence of anxiety and depression amongst cancer patients was high showing that importance should be given to screening and counseling cancer patients for anxiety and depression, to help them cope with cancer as a disease and its impact on their mental wellbeing.Limitations. The frequency of female patients in our research was higher than those of male patients.

scholarly journals Sleep patterns and symptoms of anxiety and depression in patients with chronic pain

2009 ◽  
Vol 67 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Martha M.C. Castro ◽  
Carla Daltro
Keyword(s):  
Chronic Pain ◽  
Sleep Disturbances ◽  
Myofascial Pain ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Sleep Patterns ◽  
Symptoms Of Depression ◽  
High Prevalence ◽  
The Mean

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.

scholarly journals Screening of Anxiety and Depression Related CD4 Count of People Living with HIV/AIDS with Anti-Retroviral in Medan, Indonesia

2019 ◽  
Vol 7 (16) ◽  
pp. 2590-2594
Author(s):  
Dona Farila Agus ◽  
Elmeida Effendy ◽  
Vita Camellia
Keyword(s):  
Negative Correlation ◽  
Depression Scale ◽  
Severe Depression ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
People Living With Hiv ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Correlation Strength ◽  
Hiv Aids

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.

scholarly journals Bot to the Rescue? Effects of a Fully Automated Conversational Agent on Anxiety and Depression: A Randomized Controlled Trial

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Gutu SM ◽  
◽  
Cosmoiu A ◽  
Cojocaru D ◽  
Turturescu D ◽  
...  
Keyword(s):  
Behavioral Therapy ◽  
Controlled Trial ◽  
Anxiety And Depression ◽  
Conversational Agents ◽  
Web Based ◽  
Time Interaction ◽  
Transdiagnostic Factors ◽  
Secondary Outcomes ◽  
Intent To Treat ◽  
Main Effects

Web-based conversational agents powered by Artificial Intelligence (AI) and rooted in cognitive-behavioral therapy have been proven efficacious in alleviating the symptoms of anxiety and depression, when compared to passive controls. However, the benefits of a fully automated agent vs. active controls have not yet been examined. Furthermore, the potential impact of such interventions on the transdiagnostic factors underlying anxiety and depression is not known. To elucidate this, 95 adults were randomized to receive (1) a 2-week intervention with an AI-powered chatbot (Woebot) (n=39) or (2) regular psychoeducational materials (n=54). In completers’ analyses, significant main effects of time were obtained for one of the primary outcomes, anxiety, and for the secondary outcomes, transdiagnostic factors, with both groups showing decreased anxiety and intolerance of uncertainty and increased rumination, selfcompassion, guilt and shame. No group by time interaction effects were found for either of the primary outcomes, depression and anxiety, or for the secondary outcomes. Intent-to-Treat analyses also revealed no significant effects of group on the primary or secondary outcomes. Our findings point to the necessity of further research to better understand the areas where chatbots might bring benefits superior to those obtained through simple and inexpensive strategies.

scholarly journals Prevalence and course of anxiety and depression among patients selected for bariatric surgery

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S25-S25
Author(s):  
Jonathan Gibb ◽  
Chris Rogers ◽  
Eleanor Gidman ◽  
Graziella Mazza ◽  
Jane Blazeby ◽  
...  
Keyword(s):  
Mental Health ◽  
Bariatric Surgery ◽  
Controlled Trial ◽  
Depression Scale ◽  
High Rate ◽  
Anxiety And Depression ◽  
Rank Test ◽  
Signed Rank Test ◽  
Randomised Controlled ◽  
Post Randomisation

AimsTo determine the prevalence of anxiety and depression amongst participants with severe or complex obesity randomised and selected for bariatric surgery in a large multi-centre trial.To describe the change in prevalence of anxiety and depression amongst participants who had undergone bariatric surgery, within 6 months of randomisation and at 12 months post-randomisation.MethodThe By-Band-Sleeve (BBS) study is a multi-site randomised controlled trial evaluating the surgical management of severe or complex obesity and is the largest trial of its kind. Participants completed the Hospital Anxiety and Depression Scale (HADS) on study enrolment (pre-randomisation) and at 12 months post-randomisation. In this sub-study, we describe provisional data concerning the baseline prevalence of anxiety and depression along with change in median HADS symptom score amongst those who actually underwent bariatric surgery.Result758 participants met the criteria for study inclusion with 716 (94.46%) and 712 (93.93%) individuals fully completing questionnaires for HADS-A and HADS-D. At pre-randomisation, the prevalence of possible (HADS A/D = 8-10) and probable (HADS A/D >11) anxiety or depression was 46.19% (n 330/716) and 48.17% (n 48.17%) respectively. Paired and complete HADS-A and HADS-D questionnaires were available for 70.25% (n 503/716) and 69.94% (n 498/712) participants. There was a highly statistically significant decrease in median HADS-A and HADS-D scores at 12 months post-randomisation (Wilcoxon signed-rank test p < 0.001). This was coupled with a statistically significant reduction in the proportion of cases with possible and probable anxiety (–9.54%, p < 0.001) and also depression (–22.21%, p < 0.001) at 12 months post-randomisation.ConclusionOur results characterise the high rate of psychological comorbidity amongst patients with severe or complex obesity selected for bariatric surgery. Whilst bariatric surgery remains the most clinically effective treatment for severe obesity, its effects on long-term post-operative mental health outcomes are less clear. These findings contribute to the growing body of evidence calling for increased pre/post-operative mental health surveillance and integrated care for this cohort of patients.

A-121 Functional Outcomes in Bilingual Persons with Traumatic Brain: The Role of Mood

2021 ◽  
Vol 36 (6) ◽  
pp. 1171-1171
Author(s):  
Winter Olmos ◽  
Daniel W Lopez-Hernandez ◽  
Isabel Munoz ◽  
Laura Schierholz ◽  
Rachel A Rugh-Fraser ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Functional Outcomes ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Hospital Anxiety ◽  
Anxiety Levels ◽  
The Relationship ◽  
Pearson Correlations

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 &lt; 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 &lt; 0.05. For bilinguals with CTBI, functional outcomes correlated with HADS-A, r = 0.53–0.66, p &lt; 0.05, and HADS-D, r = 0.54–0.66, p &lt; 0.05. For HC monolinguals, functional outcomes correlated with HADS-A, r = 0.53–0.70, p &lt; 0.05, and HADS-D, r = 0.50–0.72, p &lt; 0.05. Finally, for HC bilinguals, functional outcomes correlated with HADS-A, r = 0.59–0.68, p &lt; 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.

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