Structure and invariance of the Hospital Anxiety Depression Scale (HADS) in adolescents

The main objective of this study was to test the factorial structure and gender invariance of the Hospital Anxiety Depression Scale (HADS) in a non-clinical sample of 657 adolescents (Mage = 16.3 years; SD = 1.19). The research design was an instrumental investigation, based on a cross-sectional survey with a sample of adolescents in Brazil. The results presented satisfactory evidence of the validity of the factorial structure and gender invariance for the sample. The composite reliability was also satisfactory, and no problems were detected related to common method bias. The mean of the items explained variance was .31 (31 %), with a Cronbach’s Alpha at .84 for the total scale, .81 and .69 for the anxiety and depression subscales, respectively. In the discussion, we analyzed questions related to the average variance extracted of the scale, which was lower than expected. Thus, we conclude that the current findings provide validity evidence to the application of the HADS with Brazilian adolescents for clinical or research purposes.

Psychological Impact of COVID-19 on People with Pre-Existing Chronic Disease

The COVID-19 pandemic has caused an increase in anxiety and depression levels across broad populations. While anyone can be infected by the virus, the presence of certain chronic diseases has been shown to exacerbate the severity of the infection. There is a likelihood that knowledge of this information may lead to negative psychological impacts among people with chronic illness. We hypothesized that the pandemic has resulted in increased levels of anxiety and depression symptoms among people with chronic illness. We recruited 540 participants from the ongoing Prospective Urban and Rural Epidemiology (PURE) study in British Columbia, Canada. Participants were asked to fill out an online survey that included the Hospital Anxiety Depression Scale (HADS) to assess anxiety and depression symptoms. We tested our hypothesis using bivariate and multivariable linear regression models. Out of 540 participants, 15% showed symptoms of anxiety and 17% reported symptoms of depression. We found no significant associations between having a pre-existing chronic illness and reporting higher levels of anxiety or depression symptoms during COVID-19. Our results do not support the hypothesis that having a chronic illness is associated with greater anxiety or depression symptoms during the COVID-19 pandemic. Our results were similar to one study but in contrast with other studies that found a positive association between the presence of chronic illness and developing anxiety or depression during this pandemic.

INVESTIGATION OF THE EMOTIONS OF HEALTH PERSONNEL DURING THE PANDEMIC PROCESS IN TERMS OF SOME VARIABLES

Objective: The aim of this study was to detect the prevalence of stress, insomnia and depression amongst medical personnel during the COVID-19 outbreak. Methods: This study, which uses a quantitative approach, is descriptive research based on the general screening model. The sample of the study consisted of 849 health workers who used social media and agreed to support research online. In the study, a questionnaire containing demographic information, The Hospital Anxiety-Depression Scale (HAD), and the Perceived Stress Scale (ASÖ) were used as a data collection tool. Analysis of the obtained data was performed by performing an independent sample t test and one-way analysis of variance (ANOVA) using the SPSS 20 program. Results: The study recruited 849 participants, of which 59.5.2% were nurse, 11.3 % were doctor and 29.2 % other medical personnel. When the distribution of anxiety (HAD-A), depression (HAD-D), Perceived Stress Scale score averages was examined, the distribution of anxiety (HAD-A), depression (HAD-D), perceived stress score averages of participants was found to have moderate levels of questionnaire and depression, while perceived stress was higher. There are statistically significant differences between depression (HAD-D) and anxiety (HAD-A) scores and participants ' “working or not working in a pandemic clinic” status. Result: As a result of the findings, it can be stated that health workers working in the pandemic clinic have higher stress, anxiety and depression scores It has been concluded that medical staff working as nurses and midwives are under more stress than specialists and general practitioners. During the covid-19 pandemic, measures that can be taken to identify the situations affecting the mental health of medical personnel working at the front line, the psychosocial problems they experience, the protection of the mental health of employees and the Prevention of mental trauma should be taken into account.

Depressive, anxiety, and post-traumatic stress symptoms affecting hospitalized and home-isolated COVID-19 patients: a comparative cross-sectional study

Background Coronavirus has affected more than 100 million people. Most of these patients are hospitalized in isolation wards or self-quarantined at home. A significant percentage of COVID-19 patients may experience psychiatric symptoms. This study attempts to assess depressive, anxiety, and post-traumatic stress symptoms in home-isolated and hospitalized COVID-19 patients, besides whether the isolation setting affected these symptoms’ presentation. Results The study involved 89 patients with confirmed COVID-19 virus, and the patients were divided into 2 groups: 43 patients in the home-isolated group (group A) and 46 patients in the hospital-isolated group (group B). The majority of subjects were male and married; also, they were highly educated. 30.2% from group A and 47.8% from group B had a medical occupation. There was a statistically significant difference (p= 0.03) between both groups in the presence of chronic disease. There was a statistically significant increase in suicidal thoughts in the home-isolated group (37.2%) (p = 0.008**). We found a statistically significant increase in the abnormal scores of Hospital Anxiety Depression Scale–Depression (HADS–Depression) in the home-isolated group (69.7%) compared to the hospital-isolated group (32.6%) (p <0.001**) which denotes considerable symptoms of depression. Moreover, we found that (32.6%) from the home-isolated group and (39.1%) from the hospital-isolated group had abnormal scores of Hospital Anxiety Depression Scale–Anxiety (HADS–Anxiety) which denotes considerable symptoms of anxiety. Also, we found 66.7% and 87.2% scored positive by the Davidson Trauma Scale (DTS) in the home-isolated group and hospital-isolated group, respectively. Which was statistically significant (p = 0.02**). On doing a binary logistic regression analysis of HADS and DTS with significantly related independent factors, we revealed that lower education levels and family history of psychiatric disorder were risk factors for abnormal HADS–Anxiety scores in COVID-19 patients. The medical occupation was a protective factor against having abnormal HADS–Depression scores in COVID-19 patients, while home isolation was a risk factor. On the contrary, the medical occupation was a risk factor for scoring positive in DTS in COVID-19 patients. Simultaneously, low levels of education and home isolation were protective factors. Conclusion A significant number of patients diagnosed with the COVID-19 virus develop depressive, anxiety, and post-traumatic stress symptoms, whether they were isolated in the hospital or at home; besides, the isolation setting may affect the presenting symptoms.

Common Psychological Disorder among Patients with Retroviral Disease

Major depressive disorder (MDD) and generalized anxiety disorder (GAD) increases further morbidity and mortality of patients with retroviral disease (RVD). This study aimed to determine the prevalence and the contributing factors of MDD and GAD. The symptoms were screened using the Hospital Anxiety Depression Scale (HADS), MDD and GAD was diagnosed with the Mini International Neuropsychiatric Interview (MINI). 27(12.9%) patients had MDD and 28(13.0%) had GAD. The contributing factors include illicit drug use in the past, social support system, and CD4 count. Interventions for RVD patients should include counselling for those abusing drugs, increasing support system and adherence to treatment. Keywords: Retroviral Disease, Anxiety, Depression, Support system eISSN 2514-7528 © 2021 The Authors. Published for AMER ABRA CE-Bs by E-International Publishing House, Ltd., UK. This is an open-access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer-review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians / Africans / Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/jabs.v6i18.380

Factors Associated With Depressive Symptoms and Perceived Stigma in Patients With Tuberculosis

Objective: The aim of this study is to determine the levels of perceived stigma and social support and presence of depressive and anxiety symptoms in patients with tuberculosis and to investigate the association of perceived stigma and depression with demographic and disease related factors.Methods: This study included patients older than 18 years of age with tuberculosis. The hospital anxiety depression scale (HADS), stigma of tuberculosis scale (STS), and multidimensional scale of perceived social support (MSPSS) were applied to the participants. Univariate and multivariate analyses were performed to define correlates of depression and perceived stigma.Results: A total of 204 patients were included. The risk of anxiety and depression were 25% and 36.8%, respectively. Multivariate binary logistic regression analyses suggested that higher HADS-anxiety scores and lower MSPSS scores were associated with a depressive HADS score and that a lower BMI, higher HADS-anxiety score, and higher HADS-depression score were associated with high levels of perceived stigma.Conclusions: The rates of depression, stigmatization, and anxiety were high in these patients. Anxiety symptoms were positively and social support was inversely associated with depressive symptoms. A lower BMI and higher depression and anxiety scores were independently associated with high levels of perceived stigma.

Frequency of emotional disturbances among hostelites and day scholars medical students

Objectives: This study was aimed to determine and compare the frequency of the emotional disturbances, anxiety and depression among the medical students on Hospital Anxiety Depression scale (HAD) score among the hostelites and day scholars. Methodology: This cross sectional study was conducted at private medical college in Faisalabad, Pakistan, from March 2019 to April 2019, comprising of 105 male and female students. Validated Hospital Anxiety depression scale (HAD-A and HAD-D) was used to collect data from 1st year and 2nd year MBBS students in order to evaluate anxiety and depression among them. Data was analyzed on SPSS 21. Pearson’s Chi-square was applied to compare the percentages of anxious and depressed subjects among the studied group. Independent sample t-test was applied for comparison of mean HAD scores between hostelites and day scholars. P value ? 0.05 was taken as significant. Results: There were 105 students in the study with a mean age of 19.4± 0.68 years. Overall, 82.7% students had anxiety, and 52.1% suffered from depression. Average HAD –A and HAD- D scores were 11.2 ± 3.41 and 7.2 ± 3.37 respectively. Greater number of hostelites was suffering from emotional disturbances as compared to day scholars. HAD –A scores was significantly higher in hostelites than day scholars with P value 0.003*(11.85 ± 3.42 Vs 10.92 ±2.56). HAD- D scores were also higher in hostilities but difference was insignificant. (7.57± 3.42 Vs 6.85 ±1.58) Continuous...

Factors associated with anxiety and depression in rheumatoid arthritis patients: A cross-sectional study

Background Management of anxiety and depressive symptoms in rheumatoid arthritis (RA) patients is vital. Previous studies investigating this topic are conflicting, and this topic still has not been thoroughly investigated. This study aimed to clarify the association of disease activity with anxiety and depressive symptoms after controlling for physical disability, pain, and treatment.Methods We conducted a cross-sectional study of RA patients from the Kyoto University Rheumatoid Arthritis Management Alliance cohort. For assessments, we used the Disease Activity Score (DAS28), Health Assessment Questionnaire Disability Index (HAQ-DI), and Hospital Anxiety Depression Scale. Depression and anxiety were defined by a Hospital Anxiety Depression Scale score ≥8. We then performed multivariable logistic regression analyses.Results Of 517 participants, 17.9% had anxiety and 28.2% had depression. The multivariable logistic regression analyses showed that DAS28-based non-remission was not statistically associated with anxiety symptoms (odds ratio [OR] [95% confidence interval {CI}], 0.93 [0.48–1.78]: p = 0.82) and depressive symptoms (OR [95% CI], 1.45 [0.81–2.61]: p = 0.22). However, severity of the patient’s global assessment (PtGA) on DAS28 was associated with anxiety symptoms (OR [95% CI], 1.15 [1.02–1.29]; p = 0.03) and depressive symptoms (OR [95% CI], 1.21 [1.09–1.35]; p < 0.01). Additionally, HAQ-DI-based non-remission was associated with anxiety symptoms (OR [95% CI], 3.51 [1.85–6.64]; p < 0.01) and depressive symptoms (OR [95% CI], 2.65 [1.56–4.50]; p < 0.01). Patients using steroids had a closer association with depressive symptoms than those not using them (OR [95% CI], 1.66 [1.03–2.67]; p = 0.04).Conclusions As per the multivariable logistic regression analysis, there was no association between DAS28-based-non-remission and anxiety and depressive symptoms; however, the univariate analysis revealed such association. In the multivariate analysis, PtGA and non-remission on HAQ were associated with anxiety and depressive symptoms. Rather than focusing solely on controlling disease, activity and treatment should focus on improving or preserving physical function and patient's overall sense of well-being.

Factors Contributing to Depressive Disorder among Patients with Retroviral Disease

Major depressive disorder (MDD) increases further morbidity and mortality of patients with retroviral disease (RVD) or human immunodeficiency virus (HIV) infection. This study aimed to determine the prevalence of MDD and its contributing factors among them. Depressive symptoms were screened using the Hospital Anxiety Depression Scale (HADS), and MDD was diagnosed with the Mini International Neuropsychiatric Interview (MINI). Of the total 210 RVD patients, 27(12.9%) had MDD. The contributing factors for MDD include amphetamine-type stimulants use, social support system, and CD4 count. Interventions for RVD patients should include counselling for those abusing drugs, increasing support system and adherence to treatment. Keywords: Retroviral Disease, Human Immunodeficiency Virus, Depression, Support system. eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer-review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI:

Ψυχολογικά και σωματικά συμπτώματα, συμβολική λειτουργία και ρύθμιση του συναισθήματος σε ασθενείς με σκλήρυνση κατά πλάκας

Η σκλήρυνση κατά πλάκας (ΣΚΠ) είναι η συχνότερη αιτία μη τραυματικής νευρολογικής αναπηρίας με επιπτώσεις στο σύνολο της ζωής των πασχόντων. Ο ψυχολογικός παράγων, με προεξάρχοντα το συναίσθημα, το στρες και την ψυχοπαθολογία, θεωρείται ιδιαίτερα σημαντικός στην πρόγνωση και την ποιότητα ζωής των πασχόντων. Η ΣΚΠ και άλλες χρόνιες σωματικές παθήσεις έχουν αποτελέσει αντικείμενο ενδιαφέροντοςτης ψυχανάλυσης καίτοι με μικρή εμπειρική τεκμηρίωση. Σκοπός της έρευνας ήταν να διερευνήσει από ψυχαναλυτική σκοπιά την επίδραση της συμβολικής λειτουργίας και της αλεξιθυμίας στην κλινική εικόνα και την πορεία των ασθενών με ΣΚΠ. Δεκαέξι πάσχουσες/ντες απο ΣΚΠ εξετάστηκαν με τα Rorschach Inkblot Test, Toronto Alexithymia Scale, Hospital Anxiety-Depression Scale και Expanded Disability Status Scale. Στη συνέχεια κράτησαν ημερολόγιο απαντώντας το δις εβδομαδιαίως για 3 μήνες. Το ημερολόγιο αποτελείτο από τις Multiple Sclerosis Impact Diary, Perceived Stress Scale και Positive Affect-Negative Affect Scale. Είναι η πρώτη φορά που η μεθοδολογία παρούσας έρευνας χρησιμοποιήθηκε για τη μελέτη της ΣΚΠ και συγκεκριμένα για τις υπό μελέτη μεταβλητές. Οι αναλύσεις έγιναν με Πολυεπίπεδη Ιεραρχική Γραμμική Μοντελοποίηση. (1) Η αλεξιθυμία και η ψυχοπαθολογία προέβλεψαν τα συμπώματα κινητικότητας και κόπωσης της ΣΚΠ, της επίπτωσής τους στη ζωή των ασθενών και την ποιότητας ζωής τους. Υψηλότερα επίπεδα αλεξιθυμίας και πιο σοβαρή ψυχοπαθολογία συνδέθηκαν με περισσότερα συμπτώματα κινητικότητας και κόπωσης, μεγαλύτερη επίπτωση των συμπτωμάτων αυτών στη ζωή των ασθενών και χειρότερη ποιότητα ζωής. (2) Η φαντασιακή δραστηριότητα προέβλεψε τα συμπτώματα των ασθενών όπου ελλιπης ή υπερβολική φαντασιακή δραστηριότητα προέβλεψε περισσότερα συμπτώματα κινητικότητας και κόπωσης. (3) Το αρνητικό συναίσθημα και το αντιλαμβανόμενο στρες συσχετίστηκαν με τα συμπτώματα κόπωσης και κινητικότητας της ΣΚΠ, την επίπτωση της κόπωσης στη ζωή των ασθενών και την ποιότητα ζωής με κυκλικής φύσης συσχέτιση. Η επίπτωση των συμπτωμάτων κινητικότητας προέκυψε να ακολουθεί χρονικά αλλαγές του θετικού συναισθήματος, το οποίο προβλέφθηκε από τα ίδια τα συμπτώματα κινητικότητας. (4) Τα προβλήματα στη συμβολική λειτουργία και η αλεξιθυμία προέκυψαν να επαυξάνουν την επίδραση του αρνητικού συναισθήματος και του στρες στη δραστηριότητα της πάθησης αλλά πλευρές της χρηστικής ή και νορμοπαθούς σκέψης και καταστολής της φαντασίωσης να μειώνουν την επίπτωσή της στη ζωή των ασθενών. Συνοψίζοντας τα ιδιαίτερα πρωτότυπα ευρήματα, επιβεβαιώνεται ότι η δυσλειτουργική συμβολική λειτουργία, το αντιλαμβανόμενο στρες και το αρνητικό συναίσθημα επιβαρύνουν τους ασθενείς ψυχολογικά αλλά και σωματικά, ενώ το θετικό συναίσθημα δρα προστατευτικά ως προς την ψυχολογική και σωματική ευρρωστία των ασθενών. Μολαταύτα, οι πλευρές της συμβολικής λειτουργίας που αφορούν στην καταστολή ή την αποφυγή της συναισθηματικής και φαντασιακής ζωής προέκυψαν να προστατεύουν την καθημερινότητα των ασθενών μειώνοντας τη συνειδητή επίπτωση του αρνητικού συνασθήματος και του στρες. Ταυτόχρονα μειώνουν όμως και την ευεγερτική επίδραση του θετικού συναισθήματος. Η αποτυχία της συμβολοποίησης φαίνεται ότι επιβαρύνει άμεσα τους ασθενείς ως προς τη δραστηριότητα της πάθησης. Εντούτοις, πιθανώς λειτουργεί ως άμυνα έναντι του στρες και του συναισθήματος, τα οποία καίτοι έχουν ιδιαίτερα σημαντική επίδραση στην ΣΚΠ θα πρέπει να διερευνώνται λαμβάνοντας υπόψιν την αλληλλεπίδρασή τους με άλλους παράγοντες.