The Association between Social Integration, Coping Mechanisms and Anxiety in Patients with Non-Communicable Diseases

Recently, mental health issue and chronic physical condition are substantially linked and this comorbidity is likely to increase.Patient focusing in the self-care activities is an important component in the mechanism of coping with chronic disease with a significant impact on clinical and psychological outcomes. In this context, the current study is conducted to assess the impact of self-care and social integration mechanisms on anxiety levels among patients with chronic non-communicable diseases.This observational study of cross-sectional design was performed in the pathology service of Fier city hospital, in Albania during August-September 2020. To assess the level of anxiety, we used the scale of 7 items of General Anxiety Disorder (GAD-7) with a score of ≥10 indicating GAD. Subscales of the Health Education Impact Questionnaire (heiQ) were used in order to evaluate social integration and self-care mechanism. The data were entered into the statistical program SPSS, version 23. The regression analysis is performedto examine the relationship between variables. The findings revealed that 56% of participants had GAD, 47% of participants were unable to self-monitor the disease, while 89% of them didnot performe any type of physical activity. The scale of anxiety was significantly associated with variables of Self–monitoring (p=0.000<0.05; OR=0.10) and Social integration (p=0.000<0.05; OR=21.4). These findings address the need to support peoplewho struggle with chronic non-communicable diseases developing adaptive ways to deal with their chronic condition and improve their lifestyle for better overall health.

General anxiety and depression are associated with the physical activity and social interaction levels: Study in Argentinean university students during the COVID-19 outbreak

Background Due to the coronavirus disease 2019 (COVID-19), the planet is going through a historical time of exceptional concern and uncertainty, which impacts people mental health. Here, we explored the levels of depression and Generalized Anxiety Disorder (GAD) and their relation with the degree of physical activity and social interaction during the pandemic. Methods We performed a structured survey containing the PHQ-9 and GAD-7 tests to evaluate depressive symptoms and GAD levels. We also asked about weekly physical activity and the level of social interaction. We surveyed two groups of University students in the Buenos Aires Metropolitan Area: an internal group from the Instituto Tecnologico de Buenos Aires (ITBA), and an external group of students from multiple universities. The survey was conducted in late October/early-November 2020, after a peak of contagions. Some of the participants were surveyed again in January 2021, during academic holidays and after a valley of contagion, for longitudinal analysis Results Our data show that men and women of both groups exhibited a significant positive linear correlation between depression and GAD levels. Moreover, low levels of depression and anxiety were associated with performing physical activity for more than two days a week and to longer periods of social interaction. Finally, the second survey revealed a decrease of the symptoms. Conclusions Our results suggest that performing regular physical activity and avoiding long periods of social isolation gave benefits to mental health. We suggest that public policies could consider protecting these behaviors under health and safety standards.

Does fear mediate the neuroticism-psychopathology link for adults living through the COVID-19 pandemic?

Background COVID-19 has globally increased psychological distress. Although research has shown a clear link between neuroticism and psychopathology, pandemic fears—manifesting as fear of death and coronavirus anxiety, have not been examined as mediating factors for explaining this connection during the pandemic. Methods Therefore, to fill this void in the literature, this study examined 259 U.S. MTurk adult workers in May 2020 using an online questionnaire. The study used the Patient Health Questionnaire, the 8-item Big Five Inventory neuroticism subscale, a single-item fear of death measure, and the Coronavirus Anxiety Scale as well as collected demographic information to perform correlational and meditation analyses. Results The results showed that both coronavirus anxiety and fear of death partially mediated the relationship between neuroticism and symptoms of depression and generalized anxiety. The results also found that those high in trait neuroticism who were fearful of death or had coronavirus anxiety showed heightened levels of depression and general anxiety. Conclusion This study’s findings were consistent with previous research and current work on pandemic-related distress. In addition, the results of these findings can help bring to light the connectedness of these psychopathological constructs with fears surrounding the pandemic—which can be useful to both researchers and mental health professionals alike.

General Anxiety Disorder-7 Questionnaire as a marker of low socioeconomic status and inequity

Background: The General Anxiety Disorder-7 (GAD-7) questionnaire is a standard tool used for screening and follow-up of patients with Generalized Anxiety Disorder (GAD). Although it is generally accepted that anxiety correlates with clinical and psychosocial stressors, precise quantitative data is limited on the relations among GAD-7, traditional biomarkers, and other measures of health. Even less is known about how GAD-7 relates to race, ethnicity, and socioeconomic status (SES).We determined how multiple demographic and socioeconomic data correlate with the participant's GAD-7 results when compared with laboratory, physical function, clinical, and other biological markers. Methods: The Project Baseline Health Study (BHS) is a prospective cohort of adults representing several populations in the USA. We analyzed a deeply phenotyped group of 2502 participants from that study. Measures of interest included: clinical markers or history of medical diagnoses; physical function markers including gait, grip strength, balance time, daily steps, and echocardiographic parameters; psychometric measurements; activities of daily living; socioeconomic characteristics; and laboratory results. Results: Higher GAD-7 scores were associated with female sex, younger age, and Hispanic ethnicity. Measures of low SES were also associated with higher scores, including unemployment, income ≤$25,000, and ≤12 years of education. After adjustment for 166 demographic, clinical, laboratory, and symptom characteristics, unemployment and overall higher SES risk scores were highly correlated with anxiety scores. Protective factors included Black race and older age. Limitations: Correlations identified in this cross-sectional study cannot be used to infer causal relationships; further, we were not able to account for possible use of anxiety treatments by study participants. Conclusions: These findings highlight the importance of understanding anxiety as a biopsychosocial entity. Clinicians and provider organizations need to consider both the physical manifestations of the disorder and their patients' social determinants of health when considering treatment pathways and designing interventions.

UTILIZAÇÃO DE PSICOFÁRMACOS E SINTOMAS DE ANSIEDADE E DEPRESSÃO EM ESTUDANTES UNIVERSITÁRIOS DE LAGARTO/SE DURANTE A PANDEMIA DA COVID-19

Introdução: A pandemia causada pela COVID-19 pode provocar impactos na saúde mental dos universitários, devido a fatores como suspensão das aulas presenciais e a sobrecargas do ensino online, assim objetivou-se quantificar o número de estudantes universitários com ansiedade e depressão provável relacionando com o uso de psicofármacos durante a pandemia. Métodos: Estudo transversal, descritivo e quantitativo aprovado pelo CEP (CAAE: 37453920.0.0000.5546). Foi aplicado um questionário online para verificação dos sintomas de depressão (Questionário Sobre Saúde do Paciente; PHQ-2) e ansiedade (Escala de Transtorno geral de Ansiedade; GAD-2), e sobre o uso de psicofármacos e perfil sociodemográfico de estudantes de graduação da Universidade Federal de Sergipe (UFS) de Lagarto-SE. Resultados: Dos 99 participantes, 48,5% foram classificados com ansiedade provável (GAD-2 ≥ 3) e 37,4% com depressão provável (PHQ-2 ≥ 3), enquanto que 33,3% (n=33) apresentaram depressão e ansiedade provável, simultaneamente. Destes 10,1% (n=10) faziam uso de psicofármacos. Uma quantidade significativa de pessoas que não fazem uso de psicofármacos apresentou sintomas de ansiedade (47,2%, n=42) e de depressão (33,7%, n=30). Conclusão: A grande maioria dos estudantes foi avaliada com depressão ou ansiedade provável, entretanto, uma pequena porcentagem faz uso de psicofármacos, podendo sugerir outras formas de tratamentos ou a falta de tratamento. Assim é sugerido que os mesmos procurem por apoio psicológico para avaliações adicionais. ABSTRACT Introduction: The pandemic caused by COVID-19 can cause impacts on the mental health of university students, due to factors such as suspension of in-person classes and overload of online teaching, so the objective was to quantify the number of university students with anxiety and depression likely related to the use of psychotropic drugs during the pandemic. Methods: Cross-sectional, descriptive, and quantitative study approved by CEP (CAAE: 37453920.0.0000.5546). An online questionnaire was applied to check the symptoms of depression (Questionnaire on Health of the Patient; PHQ-2) and anxiety (General Anxiety Disorder Scale; GAD-2), and on the use of psychotropic drugs and the sociodemographic profile of undergraduate students of the Federal University of Sergipe (UFS) in Lagarto-SE. Results: Of the 99 participants, 48.5% were classified with probable anxiety (GAD-2 ≥ 3) and 37.4% with probable depression (PHQ-2 ≥ 3), while 33.3% (n=33) presented depression and likely anxiety. Of these 10.1% (n=10) were using psychotropic drugs. A significant number of people who do not use psychotropic drugs had symptoms of anxiety (47.2%, n=42) and 33.7% (n=30) of depression. Conclusion: The vast majority of students were assessed with probable depression and anxiety, however, a small percentage uses psychotropic drugs, which may suggest other forms of treatment or lack of treatment. Thus, it is suggested that they look for psychological support for further evaluations.

Pharmaceutical Management of General Anxiety Disorder

Generalized anxiety disorder (GAD) is a mental disorder defined as excessive worrying over little things. It is a one of the most common types of anxiety disorders. A study stated that 1-5% of the general population suffers from GAD. The condition affects the quality of life of a patient negatively and activities in their everyday life. In this review article, we highlighted several studies that compared combined therapy of psychotherapy and pharmacotherapy to either therapy alone, results were conflicting and differ from one study to another. Provide a thorough and comprehensive review of the different approaches of GAD management, several database websites were searched for articles discussing the pharmacological management of general anxiety disorder. Clinical trials, clinical guidelines, systematic reviews, meta-analyses and review articles were all reviewed and considered for inclusion. The review emphasizes the importance of taking the decision of therapy after counseling the patient, taking into account, the cost effectiveness of the treatment, patient’s symptomatology, comorbidity, medical conditions, concomitant using medications, previous trials and preference. Accordingly, thorough assessment should be done before moving to management plan, and a trial of other group or other therapies should be taken if there is no response seen. However, generalized anxiety disorder is one of the most common types of anxiety disorders. It has a lifetime prevalence around 5%, it can include intolerable cognitive, emotional and physical symptoms. Thus, GAD can adversely affect the patient’s life aspects, including personal, functional, social or educational. There are options to be taken among psychotherapy, pharmacotherapy or combined therapy.

An Assessment of the Level of COVID-19 Anxiety among Pregnant Women in Poland: A Cross-Sectional Study

Introduction: The COVID-19 pandemic has caused general anxiety worldwide. Pregnant women are at a much higher risk of developing the infection due to multiple changes that occur in the body during this period. The consequences of the disease can be dramatic not only for the expectant mothers, but also for their unborn children. SARS-CoV-2 infection is generally known to cause serious concerns about future health and life. The data on the severity of COVID-19 pandemic-related anxiety in pregnant women are insufficient. The aim of the study was to assess the level of COVID-19-related anxiety among pregnant women in Poland. Materials and Methods: The study included 173 pregnant women who volunteered for the research. The research was conducted by means of an online diagnostic survey containing an original questionnaire and the following standardized tools: State-Trait Anxiety Inventory (STAI), Short Health Anxiety Inventory (SHAI), and General Anxiety Disorder-7 (GAD-7). Results: Women hospitalised during pregnancy differed statistically significantly in terms of STAI-X1 scores. Primiparas obtained statistically significantly higher SHAI scores than multiparas. Women with higher education had higher SHAI scores. In the GAD-7 scale, 13.3% of respondents obtained a score suggesting a suspected generalised anxiety disorder. Conclusions: Pregnant women are concerned about both developing COVID-19 and the consequences of infection for themselves and their unborn children. The study demonstrated anxiety of varying severity (depending on the tool used). Hospital stay during pregnancy is an additional stressor in expectant women. Further studies are needed to assess the level of COVID-19-related anxiety to assess this phenomenon in Poland in more detail.

Anxiety disorders in clinical practice - a modern view on the problem of therapy

Clinically significant anxiety occurs in 5-7% of the general population and in 25% or more of patients seen by general practitioners. The lifetime incidence of anxiety disorders can be over 30%. Anxiety in adolescence and young adulthood often later develops into depression. The line between a “normal” response to a threat and a pathological anxiety disorder is often very blurred and there may be a continuum from personal distress to mental disorder. The real clinical situation is that most people with anxiety do not have their diagnosis. Only about a quarter (27.6%) of people who meet DSM-V, criteria for anxiety disorder receive treatment. The aim of the study was to optimize the treatment of anxiety disorders using the drug Mexidol®, taking into account modern data of epidemiology and neurobiology. Material and methods. This review is based on relevant publications obtained through selective searches in PubMed from 2010 to 2020 (58 references). The search was conducted for the following words: anxiety disorders, terminology, Mexidol®. The presence of at least one of these keywords served as a criterion for inclusion in this review. Results and discussion. Recently, there have been changes in the classification of anxiety disorders terminology. In ICD-10, disorders that were previously defined as neuroses are now located systemically in the headings F40 - F42: panic disorder, agoraphobia, social phobia; specific isolated phobias; general anxiety disorder, obsessive thoughts, compulsive actions and others. Estimates are widely spread across countries, with the highest prevalence in low-income countries (5.0%), lower in middle-income countries (2.8%), and lowest in high-income countries (1.6%). Mixed anxiety-depressive disorders are also one of the manifestations of chronic cerebral ischemia (CCI). In order to optimize treatment and to consider development of psychosomatic pathology in patients with anxiety disorders, Mexidol® is widely used. It has a vegetotropic, anti-stress, anxiolytic and other effects. Mexidol® creates a mechanism for biological desensitization of recurring neurotic, anxious experiences, stabilizes the parameters of the neuropsychiatric status. Conclusions. Our clinical and research experience shows that the management of patients with anxiety disorders can be optimized with the use of Mexidol®. Against the background of sequential drug therapy in most studies, a regression of affective disorders was noted (a decrease in the severity of anxiety, depressive manifestations, and asthenic syndrome). Keywords: anxiety disorders, terminology features, Mexidol®.