Neuropsychiatric Properties of the ACE2/Ang-(1-7)/Mas Pathway: A Brief Review

2020 ◽  
Vol 27 (6) ◽  
pp. 476-483 ◽  
Author(s):  
Leonardo Augusto de Melo ◽  
Ana Flávia Almeida-Santos
Keyword(s):  
Anxiety Disorders ◽  
Therapeutic Target ◽  
Clinical Success ◽  
Renin Angiotensin System ◽  
Anxiety And Depression ◽  
Time Range ◽  
Proven Efficacy ◽  
Pubmed Search ◽  
Depression Disorders ◽  
New Research

The current pharmacological strategies for the management of anxiety disorders and depression, serious conditions which are gaining greater prevalence worldwide, depend on only two therapeutic classes of mood-stabilizing drugs: Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs). Although first line agents with proven efficacy, their clinical success in the management of anxiety disorders and depression is still considered highly complex due to the multifaceted nature of such conditions. Several studies have shown a possible therapeutic target could be found in the form of the Angiotensin-Converting Enzyme [ACE] type 2 (ACE2), Angiotensin [Ang]-(1-7) and Mas receptor pathway of the Renin- Angiotensin System (RAS), which as will be discussed, has been described to exhibit promising therapeutic properties for the management of anxiety disorders and depression. In this article, the literature to describe recent findings related to the role of the RAS in anxiety and depression disorders was briefly revised. The literature used covers a time range from 1988 to 2019 and were acquired from the National Center for Biotechnology Information’s (NCBI) PubMed search engine. The results demonstrated in this review are promising and encourage the development of new research for the treatment of anxiety and depression disorders focusing on the RAS. In conclusion, the ACE2/Ang-(1-7)/Mas pathway may exhibit anxiolytic and anti-depressive effects through many possible biochemical mechanisms both centrally and peripherally, and result in highly promising mental health benefits which justifies further investigation into this system as a possible new therapeutic target in the management of neuropsychiatric disorders, including any as of yet undescribed risk-benefit analysis compared to currently-implemented pharmacological strategies.

scholarly journals Prevalence of anxiety and depression among domestic and foreign medical students in Poland

2020 ◽  
Author(s):  
Aneta Anna Jaroszewska ◽  
Szymon Tyras ◽  
Martyna Dziewit ◽  
Joanna Jaroszewska ◽  
Katarzyna Podhorodecka
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Anxiety Disorders ◽  
Study Groups ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Student Group ◽  
Significant Difference ◽  
Prevalence Of Depression ◽  
Depression Disorders

Introduction: Depression and anxiety disorders are much more common among medical students than in the general population. Due to additional risk factors, foreign students may be particularly vulnerable. Despite this, there is still an insufficient number of studies analyzing the prevalence of mental disorders among foreign medical students, especially in Poland. Aim: The aim of the study was to assess and compare the prevalence of anxiety and depression disorders between domestic and foreign medical students in Poland. Material and methods: An anonymous internet survey containing questions about socio-demography and the Hospital Anxiety and Depression Scale questionnaire was distributed among students. Based on the field of study and country of origin, participants were divided into 3 groups – Polish medical student group (PMG, n = 214); foreign medical student group (FMG, n = 59) and control group, which were Polish students of other faculties (CG, n = 476). The study groups were compared using the χ2 test. Results and discussion: The prevalence of depression disorders was 30%, 31% and 28% (PMG, FMG and CG, respectively). No statistically significant difference was observed between the study groups (P = 0.77). The prevalence of anxiety disorders was 57%, 90% and 59% (PMG, FMG and CG, respectively). Anxiety disorders were more common among FMG as compared to PMG and CG (P < 0.01 in both cases). Conclusions: The prevalence of depression and anxiety among medical students in Poland is high. Foreign medical students appear to be particularly vulnerable to anxiety disorders.

scholarly journals AB0123 ANXIETY AND DEPRESSION DURING RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1090.3-1091
Author(s):  
L. Ben Ammar ◽  
S. Rekik ◽  
S. Boussaid ◽  
S. Jemmali ◽  
E. Cheour ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Anxiety Disorders ◽  
Rural Areas ◽  
Insurance Coverage ◽  
Depression Scale ◽  
Health Insurance Coverage ◽  
Anxiety And Depression ◽  
Cross Sectional ◽  
Delay In Diagnosis ◽  
Depression Disorders

Background:Although the management of rheumatoid arthritis (RA) has been booming since the advent of biological treatments, the consequences of this disease remain multiple, both physical and psychological.Objectives:The aim of our work was to investigate the factors influencing anxiety and depression in RA.Methods:This was a cross-sectional study of 49 RA patients. We used the Hospital Anxiety and Depression scale (HAD) to assess anxiety disorders.Results:We included 24 women and 5 men with an average age of 54.1 years. Sixty-nine percent of patients were unemployed and 81% had health insurance coverage. RA had been evolving for an average of 11.43 ± 7.32 years and the mean time to diagnosis was 2.35 years. It was erosive in 93.8% of cases. An atlanto-axial dislocation was found in 4.1% of cases and coxitis in 8.2% of cases. Eighty-three percent of patients were on cs-DMARDs and 14.2% were on biotherapy. Most patients had low active disease (53%) with a mean DAS28CRP score of 2.74 ± 0.81. Twelve percent of patients had a probable anxiety and 18% had a probable depression.A long delay in diagnosis was associated with a higher risk of anxiety disorders. Working patients had a lower risk of depression while patients from rural areas had a higher risk. The risk of anxiety and depression disorders was associated with increased VAS pain, EGP, and DAS28. In the multivariate study, EGP was the independent risk factor for the development of anxiety and depression disorders.Conclusion:Anxiety and depression disorders are a frequent yet underestimated consequence in RA. Appropriate care in psychiatry is required as soon as the diagnosis is announced.Disclosure of Interests:None declared

scholarly journals Psychodinamic Aspect in Mixed Anxiety and Depression Disorder: a Case Report

2020 ◽  
Vol 1 (4) ◽  
pp. 24-28
Author(s):  
Lisda Yanti ◽  
Mahar Agusno
Keyword(s):  
Case Report ◽  
Anxiety Disorders ◽  
Depressed Mood ◽  
Anxiety And Depression ◽  
Thin Body ◽  
Psychiatric Clinic ◽  
Case Presentation ◽  
Icd 10 ◽  
Depression Disorders ◽  
Depression Disorder

Abstract Introduction. According to the ICD-10 criteria, mixed anxiety disorders and depression (MADD) are characterized by symptoms of anxiety and subsyndromal depression that occur together, but nothing dominates. A mixture of anxiety and depression disorders have various risk factors that underlie the occurrences. This case report aims to discuss the mixture of anxiety and depression disorders and their background. Case Presentation. A man, 23 years old, college student, single, middle down the socio-economic background, lived in a rural area in Yogyakarta, came to consult a psychiatrist at the psychiatric clinic Dr. Sardjito general hospital with complaints felt excessive anxiety and depressed because they were unable to do the thesis. From the psychiatric examination, it was found that men according to age, good self-care, thin body posture, many bowed, often moving his hands, looking nervous, cooperative, intonation and small voice volume, clear articulation, depressed mood, depressed mood, inappropriate affect, realistic thought, worried, worried about moving house, worried about the future, worried about people's assumptions about patients for fear of being blamed, sinful ideas, low self-esteem ideas, ideas of reference, ambivalence, a progression of coherent thought, relevance, good orientation, good memory, mental relations can, there are disturbances in concentration and attention, good impulse control. The patient realizes that what he is thinking is not real and only exists in his mind. Conclusion. Psychodynamic aspects have a role in anxiety disorders and depression.

scholarly journals Evaluation of Depression and Anxiety Disorders and Correlation with the Treatment of Patients with Psoriasis Vulgaris

2020 ◽  
Vol 78 (4) ◽  
pp. 321-327
Author(s):  
Adriana Kamilly Leitão Pitman Machado ◽  
Caio Vinicius Botelho Brito ◽  
João Augusto Gomes de Souza Monteiro de Brito ◽  
Carla Andrea Avelar Pires ◽  
Francisca Regina Oliveira Carneiro
Keyword(s):  
Anxiety Disorders ◽  
Female Gender ◽  
Anxiety And Depression ◽  
Published Data ◽  
Treatment Of Depression ◽  
Prevalence Of Depression ◽  
Multisystemic Disease ◽  
Pasi Score ◽  
Depression Disorders ◽  
Psychiatric Conditions

Introduction: Psoriasis is a chronic inflammatory multisystemic disease with several comorbidities, namely anxiety and depression disorders. Methods: In this study, the prevalence of these psychiatric entities was investigated by the PHQ-9 and GAD-7 questionnaries and related to the socio-demographic variables and to the forms of clinical treatment. Results: A total of 90 patients (56 females) were analyzed. Of these, 41 patients (45.56%) used topical treatment only, 28 patients (31.11%) used oral methotrexate and 21 patients (23.33%) used immunobiological agents (anti-TNF-alfa agents). It was observed that 47 patients (52.23%) presented some degree of depression (mild, moderate or severe) and 53 patients (58.89%) presented some degree of anxiety disorder (mild, moderate or severe). There was no statistical relationship between the anxiety and depression scores and the PASI score, as well as age, employability or schooling. There was a statistical association between psychiatric comorbidities and the female gender (p <0.0001). It was also observed a lower prevalence of depression (p = 0.0336) on patients using immunobiological treatments. Conclusion: The findings confirm published data, showing association of psychiatric conditions with psoriasis, especially in relation to TNF-alpha, so that anti-TNF therapies may become an alternative for the treatment of depression or anxiety disorders associated with psoriasis.

Effects of an Anxiety-Specific Psychometric Factor on Fear Conditioning and Fear Generalization

2017 ◽  
Vol 225 (3) ◽  
pp. 200-213 ◽  
Author(s):  
Christian Baumann ◽  
Miriam A. Schiele ◽  
Martin J. Herrmann ◽  
Tina B. Lonsdorf ◽  
Peter Zwanzger ◽  
...  
Keyword(s):  
Risk Factor ◽  
Anxiety Disorders ◽  
Fear Conditioning ◽  
Longitudinal Design ◽  
Principal Component ◽  
Anxiety And Depression ◽  
Specific Factor ◽  
High Anxious ◽  
Two Factors ◽  
Fear Generalization

Abstract. Conditioning and generalization of fear are assumed to play central roles in the pathogenesis of anxiety disorders. Here we investigate the influence of a psychometric anxiety-specific factor on these two processes, thus try to identify a potential risk factor for the development of anxiety disorders. To this end, 126 healthy participants were examined with questionnaires assessing symptoms of anxiety and depression and with a fear conditioning and generalization paradigm. A principal component analysis of the questionnaire data identified two factors representing the constructs anxiety and depression. Variations in fear conditioning and fear generalization were solely associated with the anxiety factor characterized by anxiety sensitivity and agoraphobic cognitions; high-anxious individuals exhibited stronger fear responses (arousal) during conditioning and stronger generalization effects for valence and UCS-expectancy ratings. Thus, the revealed psychometric factor “anxiety” was associated with enhanced fear generalization, an assumed risk factor for anxiety disorders. These results ask for replication with a longitudinal design allowing to examine their predictive validity.

Increasing Prevalence of Anxiety and Depression Disorders After Diagnosis of Chronic Pancreatitis

Pancreas ◽  
2021 ◽  
Vol 50 (2) ◽  
pp. 153-159
Author(s):  
Motasem Alkhayyat ◽  
Mohannad Abou Saleh ◽  
Wendy Coronado ◽  
Mohammad Abureesh ◽  
Omaymah Al-otoom ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Anxiety And Depression ◽  
Depression Disorders

P–504 A randomised controlled trial comparing expectant management or intrauterine-insemination in couples with unexplained subfertility and a poor prognosis for natural conception: the impact on health-related-quality-of-life

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
F Mol ◽  
J Wessel ◽  
H A Verhoeve ◽  
J Maas ◽  
J P D Bruin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Poor Prognosis ◽  
Intrauterine Insemination ◽  
Controlled Trial ◽  
Expectant Management ◽  
Mean Difference ◽  
Anxiety And Depression ◽  
Depression Disorders ◽  
The Impact

Abstract Study question Is health-related quality of life (HRQoL) in women with unexplained subfertility and a poor prognosis influenced by expectant management or intrauterine insemination with ovarian stimulation? Summary answer HRQoL did not differ, except for the relational domain which was lower after expectant management. Anxiety and depression disorders occurred frequently in both groups. What is known already In couples with unexplained subfertility and a poor prognosis, IUI with ovarian stimulation (IUI-OS) is a first line treatment. Not much is known about quality of live or depression and anxiety in these couples. The Fertility Quality of Life (FertiQoL) is reliable for assessment within relational and social domains, the Hospital Anxiety and Depression Scale (HADS) is a reliable tool to detect anxiety and depression disorders. Study design, size, duration We performed a multicentre RCT in couples with unexplained subfertility with a poor prognosis of conceiving naturally within one year. Women were allocated 1:1 to six months expectant management or to six months IUI-OS. HRQoL was assessed with standard self-administered psychometric measures with established reliability and validity: FertiQol and HADS. We intended to include 1091 couples but after almost 4 years, the study had to stop due to slow inclusion and therefore lack of funding. Participants/materials, setting, methods Between June 2017 and September 2020, we recruited 178 women of wich 92 were assigned expectant management and 86 IUI-OS. All women who participated and could read Dutch were eligible for the HRQoL measurements because HRQoL questionnaires in foreign languages were not yet available online. Women completed the questionnaires before randomisation, 3 and 6 months after randomisation. We used mixed model analyses to assess differences between treatment groups and the effect of time. Main results and the role of chance One hundred sixty-two women could read Dutch and were invited (162/178 (91%)). Analyzable data of the FertiQol questionnaire were available for 80% (130/162). Compared to women allocated to IUI-OS, women allocated to expectant management had a lower FertiQol score in the relational domain (mean difference –4.3 (95% CI –7.3 to –1.3) but not in the social domain (mean diff van –0.8 (95% CI –4.5 to 2.9). Data of the HADS questionnaire were available of 156 women (96% (156/162)). Both groups had comparable scores in the Anxiety (mean difference –0.20; 95% CI 0.63; –0.99 to 0.6) and Depressions score (mean difference 0.002; 95% CI –0.67 to 0.67) at all three moments. At baseline, the incidence of an anxiety disorder (definition score 8 or higher) was 19% (30/156) and increased to 30% and 29% at 3 months and 6 months respectively. The incidence of a depression disorder (definition score 8 or higher) was 5% (7/156) and increased to 16% and 18% at 3 months and 6 months respectively. The incidences of anxiety or depression disorders did not differ significantly between expectant management and IUI. Limitations, reasons for caution Our randomized controlled trial did not reach the planned sample size. The results are only applicable to women with unexplained subfertility and a poor prognosis and not to all women with unexplained subfertility. Wider implications of the findings: Although often assumed, IUI-OS does not improve HRQoL compared to expectant management in all domains. IUI might prevent loss of quality of the relationship, but the impact seems small. Future studies should look into the high incidence of anxiety and depression disorders in these women and how to support them. Trial registration number Trial register NL5455 (NTR5599)

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