Anxiety and depression on the liver transplant waiting list: a case for psychological prehabilitation?

Introduction: Anxiety and depression in patients awaiting liver transplantation are associated with worse clinical outcomes. However, optimising patient mental health is not routinely addressed in pre-transplant care. Aims: To understand the prevalence of anxiety and depression in patients awaiting transplantation and their access to pharmacological and psychological therapies. Methods: Patients awaiting transplantation were offered screening for anxiety and depression using the Hospital Anxiety and Depression Screening (HADS) tool. Data pertaining to patient demographics and previous treatment for anxiety and depression were recorded and analysed. Findings: Over 50% of patients recorded abnormal scores for anxiety and depression. Of the 19 patients screened, 42% had received treatment for either disorder, and most found the intervention unhelpful due to lack of follow-up appointments and limited understanding of their underlying chronic liver disease. There was a significant association between female sex and screening positive for depression. Conclusion: Anxiety and depression are prevalent in patients awaiting liver transplantation. The integration of a psychologist into the transplantation multidisciplinary team may improve patient outcomes.

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Changes in insomnia as a risk factor for the incidence and persistence of anxiety and depression: a longitudinal community study

Sleep Science and Practice ◽

10.1186/s41606-020-00053-z ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Magnus Johansson ◽

Markus Jansson-Fröjmark ◽

Annika Norell-Clarke ◽

Steven J. Linton

Keyword(s):

Risk Factor ◽

Depression Scale ◽

Binary Logistic Regression ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Dynamic Risk ◽

Increased Risk ◽

Longitudinal Association ◽

Development Of Anxiety

Abstract Background The aim of this investigation was to examine the longitudinal association between change in insomnia status and the development of anxiety and depression in the general population. Methods A survey was mailed to 5000 randomly selected individuals (aged 18–70 years) in two Swedish counties. After 6 months, a follow-up survey was sent to those (n = 2333) who answered the first questionnaire. The follow-up survey was completed by 1887 individuals (80.9%). The survey consisted of questions indexing insomnia symptomatology, socio-demographic parameters, and the Hospital Anxiety and Depression Scale. Change in insomnia status was assessed by determining insomnia at the two time-points and then calculating a change index reflecting incidence (from non-insomnia to insomnia), remission (from insomnia to non-insomnia), or status quo (no change). Multivariate binary logistic regression analyses were used to examine the aim. Results Incident insomnia was significantly associated with an increased risk for the development of new cases of both anxiety (OR = 0.32, p < .05) and depression (OR = 0.43, p < .05) 6 months later. Incident insomnia emerged also as significantly associated with an elevated risk for the persistence of depression (OR = 0.30, p < .05), but not for anxiety. Conclusions This study extends previous research in that incidence in insomnia was shown to independently increase the risk for the development of anxiety and depression as well as for the maintenance of depression. The findings imply that insomnia may be viewed as a dynamic risk factor for anxiety and depression, which might have implications for preventative work.

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Higher Self-Esteem Associated With Less Symptoms of Anxiety and Depression Among Young Adults After the Loss of a Parent to Cancer—A Longitudinal Study

Journal of Palliative Care ◽

10.1177/08258597211044585 ◽

2021 ◽

pp. 082585972110445

Author(s):

Tina Lundberg ◽

Kristofer Årestedt ◽

Ulla Forinder ◽

Mariann Olsson ◽

Carl Johan Fürst ◽

...

Keyword(s):

Young Adults ◽

Support Group ◽

Depression Scale ◽

Self Esteem ◽

Anxiety And Depression ◽

Linear Regression Models ◽

Hospital Anxiety ◽

Parentally Bereaved ◽

Loss Of A Parent

Objective: The purpose of the study was to examine associations between self-esteem and symptoms of anxiety and depression among young adults who lost a parent to cancer. Methods: Older adolescents and young adults, aged 16 to 28 years, who had lost their parent to cancer and had accepted an invitation to join a support group, completed a questionnaire 5 to 8 months after the loss and a similar questionnaire about 10 months later (follow-up). Of a total of 77 young adults who participated in the study, 56 completed both questionnaires. Self-esteem was measured with the Rosenberg Self-Esteem Scale. Symptoms of anxiety and depression were measured with the Hospital Anxiety and Depression Scale. Univariate and multiple linear regression models were used to analyze the associations. Result: Self-esteem was significantly associated with symptoms of anxiety and depression at baseline and at follow-up. Conclusion: This study reveals that self-esteem is a valuable explanatory variable, and that it is associated with both symptoms of anxiety and depression in bereavement. This new knowledge could be used to guide future support to parentally bereaved young adults.

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Predictors of Emotional Distress and Wellbeing 2–5 Years After Stroke

ISRN Stroke ◽

10.1155/2013/467398 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

H. Bergersen ◽

A.-K. Schanke ◽

K. S. Sunnerhagen

Keyword(s):

Emotional Distress ◽

General Health Questionnaire ◽

Depression Scale ◽

Well Being ◽

Anxiety And Depression ◽

Independent Mobility ◽

Hospital Anxiety ◽

Gender Education ◽

Comprehensive Rehabilitation

Objectives. To identify predictors of emotional distress and psychological wellbeing in stroke survivors 2–5 years after discharge from comprehensive rehabilitation. Material and Methods. The Hospital Anxiety and Depression Scale (HADS), the General Health Questionnaire (GHQ-30), and questions regarding life situations were mailed to former patients. Multiple regression analyses were performed. Results. The responses from 68 participants (37% women), of an average age of 58 years old, were used. Emotional distress (HADS > 10) was identified in 41%. Well-being (GHQ-30 < 6) was identified in 46%. Not surprisingly, there was a strongly negative association between well-being (GHQ-30 < 6) and emotional distress (HADS > 10) at follow up. Dependency in toileting during rehabilitation predicted emotional distress 2–5 years later. Finally, well-being at followup was predicted by age > 65 years, independent mobility, perceiving proxies as supportive, and being in employment. Conclusions. Dependence in the activities of daily living 3–6 months after-injury predicted emotional distress 2–5 years after-stroke. Being over 65 years, having an occupation, proxy support and being less dependent all predicted well-being. Emotional distress and well-being were clearly negatively associated. Gender, education, marital status, and type of stroke were not associated with the outcome measures.

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Long-Term Follow-Up of Disability, Cognitive, and Emotional Impairments after Severe Traumatic Brain Injury

Behavioural Neurology ◽

10.1155/2019/9216931 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Britt-Marie Stålnacke ◽

Britt-Inger Saveman ◽

Maud Stenberg

Keyword(s):

Cognitive Function ◽

Clinical Course ◽

Depression Scale ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Emotional Impairments ◽

Long Term Follow Up ◽

Severe Tbi

Aim. To assess the clinical course of disability, cognitive, and emotional impairments in patients with severe TBI (s-TBI) from 3 months to up to 7 years post trauma.Methods. A prospective cohort study of s-TBI in northern Sweden was conducted. Patients aged 18-65 years with acute Glasgow Coma Scale 3-8 were assessed with the Glasgow Outcome Scale Extended (GOSE), the Hospital Anxiety and Depression Scale (HADS), and the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) at 3 months, 1 year, and 7 years after the injury.Results. The scores on both GOSE and BNIS improved significantly from 3 months (GOSE mean:4.4±2.3, BNIS mean:31.5±7.0) to 1 year (GOSE mean:5.5±2.7,p=0.003, BNIS mean:33.2±6.3,p=0.04), but no significant improvement was found from 1 year to 7 years (GOSE mean:4.7±2.8,p=0.13, BNIS mean:33.5±3.9,p=0.424) after the injury. The BNIS subscale “speech/language” at 1 year was significantly associated with favourable outcomes on the GOSE at 7 years (OR=2.115, CI: 1.004-4.456,p=0.049).Conclusions. These findings indicate that disability and cognition seem to improve over time after s-TBI and appear to be relatively stable from 1 year to 7 years. Since cognitive function on some of the BNIS subscales was associated with outcome on the GOSE, these results indicate that both screening and follow-up of cognitive function could be of importance for the rehabilitation of persons with s-TBI.

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Longitudinal comparison of anxiety and depression between idiopathic pulmonary fibrosis and other interstitial lung diseases: a prospective cohort study

10.21203/rs.3.rs-36517/v1 ◽

2020 ◽

Author(s):

Won Bae ◽

Jaeyoung Cho ◽

Jinwoo Lee ◽

Young Sik Park ◽

Chang-Hoon Lee ◽

...

Keyword(s):

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Odds Ratio ◽

Lung Diseases ◽

Depression Scale ◽

Interstitial Lung Diseases ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

St George's Respiratory Questionnaire

Abstract Background and objective: Few studies have investigated the differences in the incidence of anxiety and depression among the interstitial lung diseases (ILDs). We evaluated the differences in the incidence of anxiety and depression between idiopathic pulmonary fibrosis (IPF) and non-IPF ILD, and the changes after a 1-year follow-up period. Methods The study participants were patients included in a prospective ILD cohort of Seoul National University Hospital between March 2013 and August 2018. Clinical variables were recorded at baseline and at 1 year. The Hospital Anxiety and Depression Scale was used to assess patient anxiety and depression at baseline and at 1-year follow-up. Results A total of 224 patients in the cohort participated in the study (154 [68.8%] with IPF and 70 [31.2%] with non-IPF ILD). Among them, 111 patients completed a follow-up Hospital Anxiety and Depression Scale questionnaire 1 year later (77 in the IPF group, 34 in the non-IPF group). In the IPF group, 20.8% and 27.3% of patients suffered from anxiety and 29.9% and 31.2% suffered from depression at baseline and 1-year follow-up, respectively. In the non-IPF group, 14.3% and 23.5% of patients suffered from anxiety and 24.3% and 17.6% suffered from depression at baseline and 1-year follow-up, respectively. Total score on the St. George’s Respiratory Questionnaire at baseline was associated with depression both at baseline (odds ratio 1.05; 95% confidence interval 1.02–1.08) and at 1-year follow-up (odds ratio 1.03; 95% confidence interval 1.00-1.05), even after adjusting other factors. The interaction of prevalence change of anxiety and depression at baseline and 1-year follow-up between the IPF group and the non-IPF ILD group were not statistically significant (p-value 0.878 for anxiety and 0.376 for depression, respectively). Conclusion The prevalence of anxiety and depression at baseline and at 1-year follow-up were not significantly different between patients with IPF and non-IPF ILD. St. George’s Respiratory Questionnaire total score at baseline was associated with depression at baseline and at 1-year follow-up.

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A Novel Group Cognitive Behavioral Therapy Approach to Adult Non-rapid Eye Movement Parasomnias

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.679272 ◽

2021 ◽

Vol 12 ◽

Author(s):

David O'Regan ◽

Alexander Nesbitt ◽

Nazanin Biabani ◽

Panagis Drakatos ◽

Hugh Selsick ◽

...

Keyword(s):

Eye Movement ◽

Behavioral Therapy ◽

Depression Scale ◽

Severity Index ◽

Anxiety And Depression ◽

Severity Scale ◽

Hospital Anxiety ◽

Clinical Measures ◽

Insomnia Severity

Background: Following the success of Cognitive Behavioral Therapy (CBT) for insomnia, there has been a growing recognition that similar treatment approaches might be equally beneficial for other major sleep disorders, including non-rapid eye movement (NREM) parasomnias. We have developed a novel, group-based, CBT-program for NREM parasomnias (CBT-NREMP), with the primary aim of reducing NREM parasomnia severity with relatively few treatment sessions.Methods: We investigated the effectiveness of CBT-NREMP in 46 retrospectively-identified patients, who completed five outpatient therapy sessions. The outcomes pre- and post- CBT-NREMP treatment on clinical measures of insomnia (Insomnia Severity Index), NREM parasomnias (Paris Arousal Disorders Severity Scale) and anxiety and depression (Hospital Anxiety and Depression Scale), were retrospectively collected and analyzed. In order to investigate the temporal stability of CBT-NREMP, we also assessed a subgroup of 8 patients during the 3 to 6 months follow-up period.Results: CBT-NREMP led to a reduction in clinical measures of NREM parasomnia, insomnia, and anxiety and depression severities [pre- vs. post-CBT-NREMP scores: P (Insomnia Severity Index) = 0.000054; P (Paris Arousal Disorders Severity Scale) = 0.00032; P (Hospital Anxiety and Depression Scale) = 0.037]. Improvements in clinical measures of NREM parasomnia and insomnia severities were similarly recorded for a subgroup of eight patients at follow-up, demonstrating that patients continued to improve post CBT-NREMP.Conclusion: Our findings suggest that group CBT-NREMP intervention is a safe, effective and promising treatment for NREM parasomnia, especially when precipitating and perpetuating factors are behaviorally and psychologically driven. Future randomized controlled trials are now required to robustly confirm these findings.

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Trajectories of Anxiety and Depression After Liver Transplantation as Related to Outcomes During 2-Year Follow-Up

Psychosomatic Medicine ◽

10.1097/psy.0000000000000539 ◽

2018 ◽

Vol 80 (2) ◽

pp. 174-183 ◽

Cited By ~ 7

Author(s):

Coby Annema ◽

Gerda Drent ◽

Petrie F. Roodbol ◽

Roy E. Stewart ◽

Herold J. Metselaar ◽

...

Keyword(s):

Liver Transplantation ◽

Anxiety And Depression

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Implementation of a Follow-Up Program for Intensive Care Unit Survivors

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph181910122 ◽

2021 ◽

Vol 18 (19) ◽

pp. 10122

Author(s):

Marta Villa ◽

Silvia Villa ◽

Simona Vimercati ◽

Mara Andreossi ◽

Fabrizia Mauri ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Depression Scale ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Symptom Scale ◽

Icu Stay ◽

Icu Discharge ◽

Length Of Icu Stay

In Intensive Care Unit (ICU) survivors, critical illness has an impact on an individual’s long-term health status and quality of life. Adults who have recovered from intensive care management could develop muscle weakness, neurocognitive impairment, difficulties in managing activities of daily living and to returning to work, and psychological problems such as depression and anxiety. A prospective, observational study was designed. Data were collected from January to December 2018 from a structured follow-up program, at 3 time points after ICU discharge: at seven days, a visit in the general ward, a phone interview at three months and an ambulatory visit at six months. A total of 95 patients were enrolled, 36% female, with a median age of 65 (55–73) years and a median ICU length of stay of 13 (8–20) days. At the seven days follow-up, patients who had a positive Hospital Anxiety and Depression Scale showed a significantly longer time of intubation (p = 0.048) and length of ICU stay (p = 0.023). At three months, we observed a significant relationship between a positive Hospital Anxiety and Depression Scale and a median value of EuroQol-5D (p = 0.048). At six months, we observed that patients who had a positive Post-Traumatic Symptom Scale were significantly younger than the other group. Findings from the present study suggest that a longer time of intubation and length of ICU stay are associated with a higher level of anxiety and depression immediately after ICU discharge. Follow-up programs are recommended to assess and rehabilitate cognitive function at ICU discharge.

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Ovarian Cancer Follow-up: A Preliminary Comparison of 2 Approaches

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000877 ◽

2016 ◽

Vol 27 (1) ◽

pp. 59-68 ◽

Cited By ~ 11

Author(s):

Anne Lanceley ◽

Carlo Berzuini ◽

Matthew Burnell ◽

Sue Gessler ◽

Stephen Morris ◽

...

Keyword(s):

Quality Of Life ◽

Ovarian Cancer ◽

Patient Satisfaction ◽

Confidence Interval ◽

Depression Scale ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Preliminary Comparison

ObjectiveThe aim of the study was to perform a preliminary comparison of quality of life (QoL) and patient satisfaction in individualized nurse-led follow-up versus conventional medical follow-up in ovarian cancer.MethodsOne hundred twelve women who received a diagnosis of ovarian, fallopian tube, or peritoneal cancer, completed primary treatment by surgery alone or with chemotherapy, irrespective of outcome with regard to remission, and expected survival of more than 3 months. Fifty-seven participants were randomized to individualized follow-up and 55 patients to conventional follow-up. Well-being was measured at baseline and at 3, 6, 12, and 24 months after randomization for QoL (QLQ-C30 [European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire], QLQ-Ov28), the Hospital Anxiety and Depression Scale (HADS), and a Patient Satisfaction Questionnaire (PSQ-III). The primary endpoints were the effects of follow-up on each of the scores (via hierarchical mixed-effects model) and on relapse-free time (via Cox model). The total cost of follow-up was compared between each group.ResultsThere was evidence for a QoL and patient satisfaction benefit for individualized versus standard follow-up (QLQ-C30, P = 0.013; 95% confidence interval, −0.03 to −0.001; PSQ-III P = 0.002; 95% confidence interval, −0.003 to −0.015; QLQ-Ov28, P = 0.14). Hospital Anxiety and Depression Scale data provided no evidence in favor of either treatment (P = 0.42). Delivered to protocol individualized follow-up resulted in a delay in the presentation of symptomatic relapse (P = 0.04), although the effect on survival in this study is unknown. Cost was £700 lower on average for the individualized follow-up group, but the difference was not statistically significant at the 5% level (P = 0.07).ConclusionsIndividualized follow-up was superior to conventional follow-up in 3 of the 4 QoL and patient satisfaction surveys in this preliminary study. Further prospective studies are needed in a larger population.Trial registration number is ISRCTN59149551.

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Number needed to treat with ursodeoxycholic acid therapy to prevent liver transplantation or death in primary biliary cholangitis

Gut ◽

10.1136/gutjnl-2019-319057 ◽

2019 ◽

Vol 69 (8) ◽

pp. 1502-1509 ◽

Cited By ~ 2

Author(s):

Maren H Harms ◽

Rozanne C de Veer ◽

Willem J Lammers ◽

Christophe Corpechot ◽

Douglas Thorburn ◽

...

Keyword(s):

Liver Transplantation ◽

Ursodeoxycholic Acid ◽

Primary Biliary Cholangitis ◽

Number Needed To Treat ◽

Proportional Hazard ◽

Acid Therapy ◽

Free Survival ◽

Cox Proportional Hazard ◽

Improve Patient

ObjectiveThe clinical benefit of ursodeoxycholic acid (UDCA) in primary biliary cholangitis (PBC) has never been reported in absolute measures. The aim of this study was to assess the number needed to treat (NNT) with UDCA to prevent liver transplantation (LT) or death among patients with PBC.MethodsThe NNT was calculated based on the untreated LT-free survival and HR of UDCA with respect to LT or death as derived from inverse probability of treatment weighting-adjusted Cox proportional hazard analyses within the Global PBC Study Group database.ResultsWe included 3902 patients with a median follow-up of 7.8 (4.1–12.1) years. The overall HR of UDCA was 0.46 (95% CI 0.40 to 0.52) and the 5-year LT-free survival without UDCA was 81% (95% CI 79 to 82). The NNT to prevent one LT or death within 5 years (NNT5y) was 11 (95% CI 9 to 13). Although the HR of UDCA was similar for patients with and without cirrhosis (0.33 vs 0.31), the NNT5y was 4 (95% CI 3 to 5) and 20 (95% CI 14 to 34), respectively. Among patients with low alkaline phosphatase (ALP) (≤2× the upper limit of normal (ULN)), intermediate ALP (2–4× ULN) and high ALP (>4× ULN), the NNT5y to prevent one LT or death was 26 (95% CI 15 to 70), 11 (95% CI 8 to 17) and 5 (95% CI 4 to 8), respectively.ConclusionThe absolute clinical efficacy of UDCA with respect to LT or death varied with baseline prognostic characteristics, but was high throughout. These findings strongly emphasise the incentive to promptly initiate UDCA treatment in all patients with PBC and may improve patient compliance.

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