Anxious-depressive Disorders in Patients with Syndrome Chronic Venous Cerebral Dysfunction and Various Levels of Blood Pressu

Introduction. The syndrome of chronic venous cerebral dysfunction (SCVCD) - widely studied at present nosology. In the presence of anxiety-depressed disorders, this disease is complicated. Specific clinical manifestations of SCVCD, as pronounced practical experience, are found in people of different age and social groups, usually in conditions of comorbidity, in particular, with different arterial pressure (AP) and accompanying anxiety-depressive disorders, which is reflected in the general intellectual potential of society. In our opinion, it is an interesting and relevant issue that contributes to changes in the emotional-volitional sphere of a person carries out a SCVCD in combination with different indicators of arterial pressure (AP). The aim of the study. To conduct a comparative analysis of the interconnections of the indicators of the emotional-volitional sphere (anxiety and depression), estimated using the scales of the anxiety Ch. D. Spieberger - Yu. L. Hanin and depressions A. T. Beck, in patients with chronic cerebral venous dysfunction syndrome and without it and various indicators of arterial pressure. Materials and methods. 153 patients tested on a series of reactive and personal anxiety and depression. The main group amounted to 125 people who were elected by clinical signs of the existence of the SCVCD and various indicators of AP, and they were distributed to three clinical groups: 33 people - people with increased indicators of AP (157.20 ± 12.20 / 98.30 ± 4.20 mm Hg - hypertonics; 21 person with reduced blood pressure (100.32 ± 7.23 / 65.45 ± 6.40 mm Hg) - hypotonic; 24 people with labile AP with predominantly normal average digits of AP (125.23 ± 12.20 / 82.22 ± 4.14 mm Hg) - "conditional" normotonics. For comparison of indicators, 28 patients of the control group were involved - people without clinical signs of SCVCD and various indices of AP, distributed on the same principle: hypertension - eight people, hypotonics - five people, "conditional" normotonics - 15 people. The statistical elaboration of the results was carried out using the Medstat application package. Since the law of distribution of indicators differed from normal, for the presentation of data calculated median value and the inter-quatering interval (QI-QIII), for comparison used nonparametric criteria for U. Kruskala A. Wallis, criteria for J. Dannah and Chi-square. Results. The level of personal and reactive anxiety (among persons with chronic cerebral venous dysfunction) in hypertonics was statistically significantly higher than hypotonics. The level of depression (among persons with chronic cerebral venous dysfunction) in hypotonics was statistically significant than in hypertension and "conditional" normotonics. In patients in the control group, there is no statistically significant connection between the numbers of personal and reactive anxiety and the level of depression with the digits of arterial pressure. Anxiety is most often an essential part of depression. Transformation of hypotension in hypertension (and vice versa) in persons with chronic cerebral venous dysfunction syndrome may be accompanied by a transition of anxiety in depression or depression in anxiety. Conclusions. The assessment of personal and reactive anxiety on the scale of anxiety and depression revealed statistically significant bonds with arterial pressure in persons with chronic cerebral venous dysfunction syndrome. The figures of personal and reactive anxiety were statistically significant in hypertension compared to normotonics (p less than 0.001) an hypotonic (p less than 0.001). The figures of depression were statistically significant in hypotonics compared with hypertonics and normotonics (p less than 0.001). In persons from the control group, the level of reactive anxiety and blood pressure in hypertonics (p = 0.003) in comparison with hypotonic and normotonics is statistically significant. In hypеrtonics with chronic venous dysfunction syndrome, it was statistically significantly higher (p less than 0.001) level of personal anxiety compared with hypertonic control group, and among the hypotonics of the main group noted statistically significant (p less than 0.001) higher level of depression. Key words: Syndrome of chronic cerebral venous dysfunction, reactive anxiety, personal anxiety, arterial pressure, depression.

Assessment of correction effectivenes of psychoemitional state in pregnant women after application of assisted reproductive technologies

To determine the role and effectiveness of the proposed the­rapeutic and preventive complex in the correction of psychoemotional state in the dynamics of pregnancy in pregnant women after assisted reproductive technologies (ART) application in order to improve the tactics of antenatal obser­vation and prevention of obstetric and perinatal complications. 299 pregnant women were comprehensively examined and a set of therapeutic and preventive measures was carried out: the main group included 249 women whose pregnancy occurred as a result of ART application. The control group consisted of 50 pregnant women with spon­taneous pregnancy. The complex of measures for pregnant women after ART application included: micronized pro­gesterone, magnesium oxide, folic acid, L-arginine aspartate, Omega-3 polyunsaturated fatty acids and long-term psychological correction – before ART program, at 8-10 weeks of pregnancy, at 16-18 weeks of pregnancy and at 28-30 weeks of pregnancy. Introduction of the proposed complex of psychoemotional correction contributed to the formation of reactive anxiety and personal anxiety levels at a moderate level in women of subgroups IA-44 (89.8%) and 43 (87.6%), IIA – 43 (89.6%) and 44 (91.7%) and IIIA – 30 (83.3%) and 26 (72.2%), which is considered to be an adaptive, physiological type during pregnancy. The positive effect of the proposed complex of psychoemotional correction demonstrates the improvement of processes of formation of type of component gestational dominant, its return to the optimal type in women of subgroup IA – 41 (83.6%), IIA – 39 (81.3%) and IIIA – 26 (72.2%) that is close to the physiological course of pregnancy and contributes to the reduction of perinatal and obstetric complications among pregnant women of these subgroups.

Depressive disorders in patients with diabetes mellitus. The effect of sedariston phytopreparation on carbohydrate metabolism and psycho-emotional state of patients with anxiety-depressive syndrome

Background. Depressive disorders are quite common in patients with diabetes mellitus (DM). Depression is associated with worsening glycemic control. Attempts to improve it through the use of synthetic antidepressants in complex therapy have had mixed results. The study was aimed to evaluate the prevalence of depressive disorders in patients with diabetes mellitus treated in the endocrinology department and to evaluate the effect of combined herbal medicine Sedariston containing standardized extracts of Hypericum perforatum (100 mg) and Valeriana (50 mg) (Esparma GmbH, Germany) on carbohydrate metabolism and psycho-emotional state of diabetic patients with the anxiety-depressive syndrome. Materials and methods. The study included 122 patients with type 1 and 2 DM, 103 women and 19 men, aged 18 to 75 years. Thirty-three of them with anxiety-depressive syndrome participated in a 3-month study, 16 of which additionally received Sedariston 2 capsules twice a day for 2 months. Prior to, as well as 2 weeks, 1, 2, 3 months from the beginning of the observation, the psycho-emotional state was assessed with a determination of the severity of the depressive syndrome on the PHQ-9, Beck scales, as well as the state of personal and reactive anxiety on the Spielberger-Hanin’s scales. Glycated hemoglobin was determined before and 3 months after the start of monitoring. All patients received insulin therapy and/or hypoglycemic oral medications at constant doses during the observation. Results. Depressive disorders were identified in 80.3 and 67.2 %, respectively, according to the PHQ-9 and Beck scales. Most patients experienced mild and moderate depression. High personal anxiety was found in 66.4 %, high reactive anxiety in 50.8 % of patients. Patients in the Sedariston basic group reported significant improvement in depressive symptomatology with a decrease in PHQ-9 scores from 13.7 ± 1.6 to 9.3 ± 1.4 (p < 0.05) after 1 month of treatment, and on the Beck’s scale from 23.9 ± 1.8 to 18.2 ± 1.9 points (p < 0.05) after 2 months of treatment, in contrast to patients in the control group without Sedariston: 11.9 ± 1.2 and 10.8 ± 1.1 points (p > 0.1) on the PHQ-9 scale and 19.7 ± 1.7 and 18.9 ± 2.3 points (p > 0.1) on the Beck’s scale, respectively. The achieved improvement of the psycho-emotional state of patients after the end of treatment with Sedariston was maintained after 3 months from the beginning of monitoring: 7.1 ± 1.3 points on the PHQ-9 scale and 16.1 ± 2.1 points on the Beck’s scale (p < 0.01). After 2 months of Sedariston therapy in the group of patients with the anxiety-depressive syndrome, unlike the patients of the control group, personal anxiety decreased from 59.5 ± 2.2 to 53.5 ± 1.9 points on the Spielberger-Hanin’s scale (p < 0.05), in patients with high reactive anxiety, after 2 months of treatment significantly decreased its level from 57.4 ± 2.5 to 49.3 ± 2.7 points and remained so until the end of observation. Against the background of the positive dynamics of depressive symptoms in patients receiving Sedariston, a significant decrease in glycated hemoglobin occurred 3 months after the start of therapy: from 9.4 ± 0.5 to 8.1 ± 0.2 % (p < 0.05), unlike the patients of the control group. Conclusions. An anxiety-depressive syndrome is defined in 63.1 % of patients of the diabetology department, with depressive disorders mainly of mild and moderate severity, high personality and reactive anxiety, and 19.7 % of patients experienced a depressive syndrome without disturbance of anxiety, which indicates their diagnosis and conducting appropriate treatment. The combined phytopreparation Sedariston in the complex therapy of patients with diabetes mellitus, against the backdrop of the positive and long-lasting effect on anxiety-depressive symptoms, contributes to the improvement of carbohydrate metabolism, with a decrease of 1.3 % of glycated hemoglobin in 3 months. This indicates that Sedariston may be used not only for the treatment of anxiety-depressive syndrome but also to improve carbohydrate metabolism in patients with DM.

Effects of Compression of the 4th Ventricle (CV4) Treatment on Medical Student Anxiety

Introduction: This study explores the effects of one Compression of the 4th Ventricle (CV4) treatment performed by experienced osteopathic physicians on reactive anxiety in healthy medical students. Anxiety was assessed with heart rate, blood pressure, and the Hamilton Anxiety Scale (HAM-A). Methods: Western University of Health Sciences IRB #15/IRB/113 was obtained for this single blind study. Volunteer first and second year medical students naïve to Osteopathic Cranial Manipulative Medicine, both in curriculum and as a patient, were recruited for this two-day study. Students were de-identified and demographic information was collected. On the first day, all 64 students received a sham treatment. Eight practitioners agreed on CV4 and sham techniques (mastoid cranial hold). In the CV4 technique, the operator’s thenar eminences contact the lateral angles of the occiput, and the operator encouraged the extension phase and discouraged the flexion phase of the CRI. Compression continued until a still point was reached in each student as identified by the practitioner. Students were evaluated before and after treatment using heart rate, blood pressure, and the Hamilton Anxiety Rating Scale (HAM-A). Results: No significant difference was found in demographics of the two groups. A significant difference between sham and CV4 treatments was found for heart rate (p=0.036), but not for systolic or diastolic blood pressure (p=0.446 and p=0.799, respectively). Average heart rate reduction of CV4 group was 3.11 and of sham group was 1.12, with p=0.036 (Mann Whitney U = 1271). Heart rate increased in a few students after both CV4 and sham treatments. Average HAM-A score for students before and after CV4 treatment were 21.9 and 18.3, with an average net reduction of 3.58 compared to the sham’s 2.77, but results were not found to be statistically significant (p=0.09, U=1172). Conclusion: A statistically significant average reduction in heart rate, but not in blood pressure or HAM-A scores, was found after CV4 treatment compared to sham treatment. More studies with larger samples are needed to further investigate the effects of CV4.

Detecting Subclinical Social Anxiety Using Physiological Data From a Wrist-Worn Wearable: Small-Scale Feasibility Study

Background Subclinical (ie, threshold) social anxiety can greatly affect young people’s lives, but existing solutions appear inadequate considering its rising prevalence. Wearable sensors may provide a novel way to detect social anxiety and result in new opportunities for monitoring and treatment, which would be greatly beneficial for persons with social anxiety, society, and health care services. Nevertheless, indicators such as skin temperature measured by wrist-worn sensors have not been used in prior work on physiological social anxiety detection. Objective This study aimed to investigate whether subclinical social anxiety in young adults can be detected using physiological data obtained from wearable sensors, including heart rate, skin temperature, and electrodermal activity (EDA). Methods Young adults (N=12) with self-reported subclinical social anxiety (measured using the widely used self-reported version of the Liebowitz Social Anxiety Scale) participated in an impromptu speech task. Physiological data were collected using an E4 Empatica wearable device. Using the preprocessed data and following a supervised machine learning approach, various classification algorithms such as Support Vector Machine, Decision Tree, Random Forest, and K-Nearest Neighbours (KNN) were used to develop models for 3 different contexts. Models were trained to differentiate (1) between baseline and socially anxious states, (2) among baseline, anticipation anxiety, and reactive anxiety states, and (3) social anxiety among individuals with social anxiety of differing severity. The predictive capability of the singular modalities was also explored in each of the 3 supervised learning experiments. The generalizability of the developed models was evaluated using 10-fold cross-validation as a performance index. Results With modalities combined, the developed models yielded accuracies between 97.54% and 99.48% when differentiating between baseline and socially anxious states. Models trained to differentiate among baseline, anticipation anxiety, and reactive anxiety states yielded accuracies between 95.18% and 98.10%. Furthermore, the models developed to differentiate between social anxiety experienced by individuals with anxiety of differing severity scores successfully classified with accuracies between 98.86% and 99.52%. Surprisingly, EDA was identified as the most effective singular modality when differentiating between baseline and social anxiety states, whereas ST was the most effective modality when differentiating anxiety among individuals with social anxiety of differing severity. Conclusions The results indicate that it is possible to accurately detect social anxiety as well as distinguish between levels of severity in young adults by leveraging physiological data collected from wearable sensors.

POSSIBILITIES OF THERAPY OF PAIN SYNDROME IN ENDOMETRIOSIS

Therapeutic tactics of endometriosis are aimed primarily at overcoming the pain syndrome, the absence of recurrence of the underlying disease, maintaining fertility and improving the psycho-emotional state of women. The objective to develop, pathogenetically substantiate treatment and rehabilitation measures taking into account pathogenetic preconditions in women with endometriosis in combination with pain. Materials and methods 85 patients with genital endometriosis with severe pelvic pain (VAS 7-10 points) (n = 44) - group I and moderate (VAS 4-6 points) (n = 41) - group II. The mean age of women in clinical trials I and II of the study was 37.71 ± 0.93 and 41.05 ± 1.08 (M ± m) years, respectively. The choice of treatment tactics was determined on the basis of immunohistochemical markers: estrogen receptors (ER), progesterone (PGR), proliferation index (Ki-67), vasculoendothelial growth factor (VEGF), cyclooxygenase-2 (COX-2) in eutopic acid., psychoemotional characteristics and intensity of pelvic pain. Rеsultes of treatment in the examined patients a significant (p <0.05) reduction of pelvic pain was determined, both in the short and long term. After 6 months, the level of personal anxiety decreased - by - 38.62%, after 12 months. – at - 48.15% (p <0.05). The rate of decrease in the level of depressive disorders on the Hamilton scale of all studied women was: - 32.2% after 6 months and -42.15% after 12 months (p <0.05). Conclusion our approach to treating endometriosis helped to overcome pain in 83.53% of women, improve psycho-emotional and general condition, normalize sleep - was determined in 88.3% of women, reduce reactive anxiety and depressive disorders in 84.7% of patients, indicates the effectiveness proposed therapy.

Psychological condition of the children who were in quarantine for COVID-19 pandemic

Objective: We determined the features of psychoemotional condition of the children who wereunder quarantine restrictions for COVID-19pandemic for a long time. Methods and scope of research:We carried out the assessment of the psychoemotional condition of 52 adolescents who were in quarantine forCOVID-19 pandemic. The number of girls and boys among the surveyed was the same - 26 children of each gender. A "non-existent animal" projective test was used to assess the psychoemotional sphere of the children. We appliedthe psychometric method by Ch.D. Spielberg, Yu.L. Haninto determine the reactive anxiety (RА) and personal anxiety (PA). The questionnaire by A. Bass, A. Darki was used to single out the various aspects of the symptom complex of aggression and to calculate the index of aggression (IA) and the index of hostility (IH). Sleep quality was assessed with the help of the Pittsburgh Questionnaire. Results and discussion: Assessment of the psychoemotional condition of the children, who were in quarantine for COVID-19, showed the significant violationsin the majority of them (95.15%), which were characterized by the manifestations of anxiety (78.85%), aggression (59.62%) and exhaustion (15.38%). A high level of anxiety was found to be more often in the girls (25.00%), while in the boys, it was registered almost 2 times less (11.54%), and on the contrary, a high level of aggression in the combination with anxiety orwithout itwas determined more often in the boys (26.92%) than in the girls (13.46%). The frequency of exhaustionsymptom complex did not depend on gender. A more detailed description of the level of anxiety,performed with the help of psychometric methods Ch.D. Spielberg, Yu.L. Hanin, confirmed that the high levels of both personal and reactive anxiety were more inhering in the girls. Assessment ofthe forms of aggressive behavior showed that the manifestations of physical aggression and negativism were the most typical features for the boys, while the indirect aggression, resentment and guilt were observed in the girls more often. Thehighlevels of IA werefoundtooccur almost 3 times more oftenin theboys than in thegirls, whilethehighlevel of IH wasdetected equally often both inthegirls and intheboys. In the children who were in quarantine for COVID-19, psychoemotional conditions were often accompanied by sleep disorders, at the same time,they were observed more often in the girls than in the boys.

Dynamics of correlation between the level of anxiety and abilities to adapt to university in students

Elaborated is the content of the concepts of “anxiety” and “adaptation”. The dynamics of neuropsychiatric stability, situational anxiety and adaptation in students during the initial period of study at the university were revealed. During the adaptation period, reactive anxiety changes in the direction of its increase. The presence of the relationship of adaptive abilities and anxiety in students in 1–3 semester of study is shown. There is an increased interaction of these mental phenomena among themselves in 1st semester. During the adaptation period, the level of statistical connection between reactive anxiety and communicative abilities increases. Moral normality is a situational characteristic during adaptation and its relationship with personal and reactive anxiety is weak, but tends to increase. Most students successfully overcome the initial period of study, but the values of personal adaptation potential in students lie in the zone of “reduced adaptation”, that is, the adaptation process is in a positive direction, but it is difficult. In order for a student to effectively pass the adaptation period, he needs to increase the level of communicative abilities and neuropsychiatric resistance. This will reduce anxiety to the optimal level.

Neurological manifestations of post-COVID syndrome and possibilities of rehabilitation

Changes related to COVID-19 have been made to the International Classifi cation of Diseases of the Tenth Revision (ICD-10) – a separate code has appeared to describe the postcoid syndrome.he neurosomatic status of patients who had COVID-19 is characterized not only with clinical manifestations of the disease but also with complaints of cerebral, cardiac and general somatic nature. Moreover, they are combined with severe personal and reactive anxiety as well as moderate cognitive impairments and low level of satisfaction of patients with their condition.

Detecting Subclinical Social Anxiety Using Physiological Data from a Wrist-worn Wearable: A Small-Scale Feasibility Study (Preprint)

BACKGROUND Subclinical (i.e., threshold) social anxiety can greatly affect young people’s lives, but existing solutions appear inadequate considering its rising prevalence. Wearable sensors may provide a novel way to detect social anxiety and result in new opportunities for monitoring and treatment that would be greatly beneficial for sufferers, society and healthcare services. Nevertheless, indicators such as skin temperature from wrist-worn sensors have not been used in prior work on physiological social anxiety detection. OBJECTIVE This study aimed to investigate whether subclinical social anxiety in young adults can be detected using physiological data obtained from wearable sensors, including Heart Rate (HR), Skin Temperature (ST) and Electrodermal Activity (EDA). METHODS Young adults (N = 12) with self-reported subclinical social anxiety (measured by the widely used self-reported version of the Liebowitz Social Anxiety Scale, LSAS-SR) participated in an impromptu speech task. Physiological data was collected using an E4 Empatica wearable device. Using the pre-processed data and following a supervised machine learning approach, various classification algorithms such as Support Vector Machine (SVM), Decision Tree, Random Forest and K-Nearest Neighbours (KNN) were used to develop models for three different contexts. Models were trained to (1) classify between baseline and socially anxious states, (2) differentiate between baseline, anticipation anxiety and reactive anxiety states, and (3) classify between social anxiety experienced by individuals with differing social anxiety severity. The predictive capability of the singular modalities was also explored in each of the three supervised learning experiments. The generalisability of the developed models was evaluated using 10-fold cross validation as a performance index. RESULTS With modalities combined, the developed models yielded accuracies between 97.54% and 99.48% when detecting between baseline and socially anxious states. Models trained to differentiate between baseline, anticipation anxiety and reactive anxiety states yielded accuracies between 95.18% and 98.10%. Alongside this, the models developed to detect between social anxiety experienced by individuals with differing anxiety severity scores successfully classified with accuracies between 98.86% and 99.52%. Surprisingly, EDA was identified as the most effective singular modality when differentiating between baseline and social anxiety states, whereas ST was the most effective modality when differentiating between anxiety experienced by individuals with differing social anxiety severity. CONCLUSIONS The results indicate that it is possible to accurately detect social anxiety as well as distinguish between levels of severity in young adults by leveraging physiological data collected from wearable sensors.