Vasomotor symptoms in perimenopausal women have a significant effect on the quality of life of perimenopausal women. In addition to these symptoms, perimenopausal women also experience mental health issues and cognitive decline. The physical symptoms of generalized anxiety disorder (GAD) include restlessness, muscle aches, insomnia, fatigue, and others.

In the current study, the authors investigated the combined effects of vasomotor symptoms and anxiety in perimenopausal women. The findings are published in the Rawal Medical Journal.

Baseline Characteristics

The study included 346 females with vasomotor symptoms aged 30–70 years. Based on the Composite Symptom Severity Score (CSSI), the patients were divided into three groups. These groups were further divided into four categories based on anxiety level. The CSSI < 50 group included 11 patients aged 30–40 years, 43 patients aged 41–50 years, 47 patients aged 51–60 years, and 26 patients aged 61–70 years. The CSSI 50–100 group included 3 patients aged 30–40 years, 59 patients aged 41–50 years, 84 patients aged 51–60 years, and 16 patients aged 61–70 years. The CSSI > 100 group included 23 patients aged 41–50 years, 31 patients aged 51–60 years, and 3 patients aged 61–70 years.

Generalized Anxiety Disorder and Low Composite Symptom Severity Score Group

Younger females (aged 30–40 years) in the CSSI < 50 group were found to have a greater incidence of severe anxiety compared to other participants in the group. Women in the 5^th and 6^th decades also had severe anxiety based on the GAD scale.

Generalized Anxiety Disorder and Moderate Composite Symptom Severity Score Group

In the CSSI 51–100 group, younger females (aged 30–40 years) had moderate anxiety scores. Females in the 5^th and 6^th decades mostly had moderate and severe anxiety scores on the GAD scale.

Generalized Anxiety Disorder and High Composite Symptom Severity Scores

None of the younger females (aged 30–40 years) with CSSI scores > 100 had high anxiety scores on the GAD scale. The elderly females (age 61–70 years) in this group had intermediate anxiety scores on the GAD scale. The majority of the women in the 5^th and 6^th decades had high anxiety scores on the GAD scale.

Source:

Rana, M. M., Gani, D., Alia, A., Afzal, M. W., Aimen, U. A., & Zulfiqar, N. (2024, February 14). Coexisting Generalized Anxiety Disorder add fuel to the fire of severity of Perimenopausal Vasomotor Symptoms affecting quality of life. Rawal Medical Journal. https://www.rmj.org.pk/index.php?mno=167955 

Anxiety and depression are associated with an increased incidence of gastroesophageal reflux disease (GERD), according to a study published online March 19 in Scientific Reports.

Qian Li, from The Third People’s Hospital of Chengdu in China, and colleagues gathered 24-hour pH monitoring data and baseline patient information for a cohort of 518 individuals with GERD. In addition, their psychological well-being was assessed using the Hospital Anxiety and Depression Scale.

The researchers identified statistically significant variation in anxiety levels based on gender and significant disparity in depression based on age and literacy levels. In the patient cohort, there was a significant positive correlation observed between severity of anxiety and depression and the 24-hour pH monitoring results. A higher anxiety level was associated with a higher level of GERD in a logistic regression modeling analysis; the incidence of GERD was increased in the presence of mild anxiety (odds ratio, 2.64). A causal relationship was seen for the moderately severe anxiety group with increased GERD incidence (odds ratio, 6.84). A higher incidence of GERD was seen in association with moderate-to-severe depression (odds ratio, 2.32). GERD prevalence was increased among men versus women (odds ratio, 2.29). In addition, increased body mass index was positively associated with GERD susceptibility (odds ratio, 1.07).

“There is a certain correlation between GERD and anxiety and depression, which provides theoretical references for individuals and clinical workers to focus on patients’ psychological emotions when treating GERD,” the authors write.

Abstract/Full Text

Impaired quality of life and diminished family functioning are among the many results possible in families that parent a child with food allergies. Anxiety is a central component of food allergy-related distress, and as such, serves as a potential target for therapeutic intervention of the overall psychosocial dynamic involved in families where food allergies are present. This systematic review, published in Pediatric Allergy and Immunology, aimed to clarify the concept of food allergy-specific anxiety, and to describe its consequences and possible methods of intervention.

For this study, the authors relied on data gathered from MEDLINE, EMBASE, PsycINFO, and CENTRAL. Both qualitative and quantitative studies that examined distress or anxiety in parents of children with food allergies were analyzed, and 98 studies were included, in total. Most of the participating parents were mothers, and they primarily identified anxiety as the most difficult form of food allergy-specific emotional distress. Interventions that reduced parental anxiety were both allergy-related as well as medical and psychosocial in nature. Affective, cognitive, and behavioral aspects of food allergy-related anxiety were not fully addressed by existing measures for anxiety management, even though anxiety and distress were reduced.

The authors conclude by noting that more interventions that take into account the unique situation of parents with food allergies may be needed to fully capture all dimensions of food allergy anxiety. They also note that more detailed methods for assessing and monitoring food allergy anxiety and its impact on parents are needed for future studies, and that their research and characterization is useful as a first step in developing these standardized methods.

Reference
Westwell-Roper, C., To, S., Andjelic, G., Lu, C., Lin, B., Soller, L., . . . Stewart, S. E. (2022). Food-allergy-specific anxiety and distress in parents of children with food allergy: A systematic review. Pediatric Allergy and Immunology, 33(1), e13695. doi:10.1111/pai.13695

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune inflammatory disease primarily affecting the visual pathway, brain, and spinal cord. Global NMOSD incidence rates are 0.039–0.73/100,000 person-years in adults and 0.01–0.06/100,000 person-years in children. Psychiatric issues like depression, anxiety, and poor sleep decrease the health-related quality of life in these patients. 

A study in Multiple Sclerosis and Related Disorders estimated the pooled prevalence of depression, anxiety, and sleep disturbances in NMOSD patients.

Studies Included in the Review

A total of 31 studies comprising 4213 participants were included in this review. Among the 31 studies, 26 reported the prevalence of depression, 8 reported anxiety, and 6 reported poor sleep. Sample sizes in the studies ranged between 14 and 1349. All included studies were of moderate quality at least (quality assessment score of 3 or above).

A High Prevalence of Depression Observed in NMOSD

The pooled prevalence of depression from 26 studies (n=3780) was calculated at 40% (95% confidence interval (CI): 32–49%). A decreasing trend in depression prevalence was observed with increasing severity of depression. Depression prevalence was 21% with mild severity, 15% with moderate severity, and 9% with severe depression.

According to Cochran’s Q test and Higgins’ I-squared statistic (I2=98%, P<0.01), there was significant heterogeneity among studies, and a random-effects model was applied. In the sensitivity analysis, no study affected the pooled prevalence by over 2% or the I2 value by over 1% when excluded. Visual inspection of the funnel plot and Egger’s regression test revealed no evidence of publication bias (P=0.006). Screening tools and study design were identified as the relevant heterogeneity moderators.

A High Prevalence of Anxiety Observed in NMOSD

The pooled prevalence of anxiety from eight studies (n=2344) was 45% (95% CI: 24–66%). According to Cochran’s Q test and Higgins’ I-squared statistic (I2=100%, P<0.01), significant heterogeneity existed among studies, and a random-effects model was applied. The pooled prevalence ranged from 37% to 51% by removing a single study one time in the sensitivity analysis. Possible publication bias was suggested by the asymmetric funnel plot and Egger’s regression test (P=0.344). Region, study design, and screening tools were identified as the relevant heterogeneity moderators.

Sleep Disturbances Are Highly Prevalent in NMOSD Patients

The pooled prevalence of sleep disturbances from six studies (n=762) was 55% (95% CI:46–64%). According to Cochran’s Q test and Higgins’ I-squared statistic (I2=79%, P<0.01), significant heterogeneity existed among studies, and a random-effects model was applied. The pooled prevalence ranged from 51% to 58% by removing a single study one time in the sensitivity analysis. Possible publication bias was suggested by the asymmetric funnel plot and Egger’s regression test (P=0.160). Region and sample size were identified as the relevant heterogeneity moderators.

Source:

Liu, J., Zhang, X., Zhong, Y., & Liu, X. (2023). The prevalence of depression, anxiety, and sleep disturbances in patients with neuromyelitis optica spectrum disorders (NMOSD): A systematic review and meta-analysis. Multiple Sclerosis and Related Disorders, 79, 105007. https://doi.org/10.1016/j.msard.2023.105007 

Use of augmented reality (AR) reduces preoperative anxiety but does not affect postoperative anxiety, pain levels, or narcotic use when compared with a standard education packet, according to a study published online Aug. 17 in JAMA Network Open.

Michael G. Rizzo Jr., M.D., from the University of Miami, and colleagues examined whether use of an AR walkthrough affects patient perioperative anxiety in a randomized clinical trial. Ninety-five patients undergoing elective orthopedic surgery were randomly assigned to the treatment or control group (46 and 49, respectively). The AR experience explained what to expect on the day of surgery and walked patients through the surgery space; the control group received a standard education packet.

The researchers found that from the screening to preoperative survey, the AR group experienced a significant decrease in anxiety while the standard care group experienced an increase. Postoperatively, all patients experienced a mean decrease in anxiety score compared with the screening survey and preoperative survey. Overall, 71.4 percent of the 42 patients in the AR group who completed the postoperative follow-up survey agreed or strongly agreed that they enjoyed the experience, and 69.0 and 66.7 percent agreed or strongly agreed that they would recommend the experience and that they would repeat the experience, respectively. There were no differences in postoperative pain levels or narcotic use.

“The administration of a preoperative AR experience decreased preoperative patient anxiety, and with most patients enjoying the experience, but there was no significant effect on postoperative anxiety, pain levels, or narcotic use,” the authors write.

Abstract/Full Text

Shift work is associated with an increased risk for depression and anxiety, according to a study published online Aug. 14 in JAMA Network Open.

Minzhi Xu, Ph.D., from the Huazhong University of Science and Technology in Wuhan, China, and colleagues explored the correlations of shift work with anxiety and depression in a cohort study including 175,543 employed or self-employed workers who participated in the U.K. Biobank baseline survey from 2006 to 2010. Of the participants, 16.2 percent reported shift work.

The researchers found that 2.3 percent of workers developed depression and 1.7 percent developed anxiety during a median follow-up of 9.06 years. Individuals who reported engaging in shift work, or shift workers, had an elevated risk for depression and anxiety in the fully adjusted model (hazard ratios, 1.22 and 1.16, respectively); there was a positive association seen for the risk with shift frequency. No significant difference was observed among shift workers for night shifts and nonnight shifts. A negative association was seen for years of shift work with the risk for depression and anxiety in the dose-association analyses. The main potentially modifiable mediators were smoking, sedentary time, body mass index, and sleep duration; these mediators explained 31.3 and 21.2 percent of the association between shift work and depression and between shift work and anxiety, respectively.

“Our study not only supports that shift work should be considered an occupational hazard, but also provides evidence for the urgent need for the development of public health interventions that promote healthy lifestyles aimed at improving the mental health of shift workers,” the authors write.

Abstract/Full Text

There is a comparatively increased prevalence of anxiety and depression among adults with different cardiovascular diseases (CVD) relative to the general population. However, to date, there have been no studies analyzing the prevalence of anxiety and depression in individuals with transthyretin cardiac amyloidosis (ATTR-CA), which is a CVD characterized by the deposition of TTR-derived amyloid in the extracellular space. A study published in the journal Frontiers in Psychology found a high prevalence of depression and anxiety in ATTR-CA patients. Offering psychological support to these patients can help counter the disease burden and enhance their quality of life. 

Psychological Burden of Transthyretin Cardiac Amyloidosis

ATTR-CA is associated with pain, discomfort, depression, anxiety, and tiredness. This study evaluated the psychological burden in ATTR-CA patients, since the pathology is linked to impairment in quality of life and physical health and reduced productivity.

Overall Prevalence of Anxiety and Depression in ATTR-CA Patients

Anxiety and depression were found to be prevalent in patients with ATTR-CA compared to the control group, with 48.6% (n=53) of the patients reporting anxious or depressive symptoms in the clinical range. The prevalence of these symptoms was not greater in the hereditary ATTR  (ATTR-v) subgroup patients compared to ATTR-wild type (ATTR-wt) patients.

Age- and Sex-Based Prevalence of Depression and Anxiety

Older ATTR-CA patients, particularly female patients with an advanced disease course, exhibited a greater prevalence of depression and anxiety symptoms. Older and especially female patients are at a greater risk for developing an anxiety disorder.

Female Transthyretin Cardiac Amyloidosis Patients in the Study Population

The low number of female ATTR-CA patients in the study population may influence the generalizability of the study results. Gender constituted a significant predictor for anxiety symptoms, whereas New York Heart Association class and gender were the predictors for depression symptoms.

Association of Clinical and Sociodemographic Risk Factors

There was no significant association between the clinical and sociodemographic risk factors with depression and anxiety symptoms in the clinical range.

This study concluded that there is a dire need for increased awareness and coherent evaluation of anxiety and depression symptoms in ATTR-CA patients.

Source

Smorti, M., Ponti, L., Soffio, F., Argirò, A., Perfetto, F., Zampieri, M., Mazzoni, C., Tomberli, A., Allinovi, M., Di Mario, C., Olivotto, I., & Cappelli, F. (2022). Prevalence of anxiety and depression symptoms in a sample of outpatients with ATTR cardiac amyloidosis. Front Psychol, 13, 1066224. https://doi.org/10.3389/fpsyg.2022.1066224

 Mental health disorders and substance use were often intertwined.

• Only 38% of university students with anxiety or depression accessed mental health treatment.
• Students who used marijuana and other illicit substances were more likely to access treatment.
• University services should become more accessible to improve treatment utilization in vulnerable students.

Alcohol, cannabis, tobacco, and other drug use is common among university students. Substance use, associated with higher engagement in health-risk behavior, can exacerbate anxiety and depression in university students. Likewise, symptoms of anxiety and depression often lead individuals to seek relief in illicit substances.

Underutilization of Campus Mental Health Services

Despite the rise in mental health disorders and substance use among university students, campus mental health services remain underutilized. Fewer than half of students with an identified need for mental health treatment accessed it at their school.

Effects of Different Types of Drug Use on Treatment Access

In a national sample of university students with generalized anxiety or major depression, the relationship between substance use and mental health service utilization was assessed. This large-scale study, published in Drug and Alcohol Dependence, sought to address these issues in university students and determine how using different types of drugs may affect treatment utilization.

Only 37.8% of students with anxiety or depression had accessed an on- or off-campus mental health service in the past year. Students who used stimulants, cocaine, opioids, ecstasy, or marijuana were more likely to have accessed services. Alcohol and tobacco users used mental health services similarly to non-drug users. The study showed that non-marijuana drug users reported a utilization rate of 3.2% within the past year, which is almost double that of marijuana users, at 1.7%. Additionally, non-marijuana drug users sought ED services for mental health needs almost three times more frequently than alcohol or tobacco users, at 1.1%, and non-users at 1.2%.

Barriers to Mental Health Treatment for University Students

The most significant barriers to treatment were not having enough time and preference for talking to friends. Students also noted financial reasons, not knowing where to go, and difficulty scheduling appointments as barriers.

On-campus healthcare is an underutilized entryway into mental health treatment. There is an unmet need amongst university students with anxiety and depression, and universities can close these barriers to meet the growing demands of their students.

Source:

Auty, S. G., Lipson, S. K., Stein, M. D., & Reif, S. (2022). Mental health service use in a national sample of college students with co-occurring depression or anxiety and substance use. Drug Alcohol Depend Rep, 2, 100025. https://doi.org/10.1016/j.dadr.2022.100025

• Self-help websites and apps using acceptance and commitment therapy improve anxiety, depression, and quality of life
• ACT apps are more accessible than in-person therapy and can help reduce the gap in mental healthcare

The prevalence of mental illness, especially anxiety and depression, has been increasing each year. Despite the greater need for mental health services, 30.5% of people with a diagnosable mental health disorder report they are not receiving treatment. Gaps in mental health care arise from logistical barriers preventing therapy access, unperceived need, and social stigma associated with seeking care.

Online Self-Help Programs for Anxiety and Depression

In-person therapy is the traditional approach to mental health treatment, but online self-help programs are gaining popularity, according to a study published in Cognitive Behaviour Therapy. At least 100,000 web- and mobile-based applications are currently available for download. Over the past 10 years, over 50 studies have investigated whether online self-help treatment can effectively improve anxiety and depression.

 Most apps use the acceptance and commitment therapy (ACT) method, rooted in cognitive behavioral therapy. The focus of ACT is to improve psychological flexibility by strengthening mindful awareness and accepting internal experiences. Flexibility is achieved by acting within three pillars: being open, being centered, and being engaged.

Effectiveness of Act-Based Websites and Apps

 ACT-based websites and apps improved anxiety, depression, quality of life, and psychological flexibility compared to control groups that did not receive treatment. The structure of ACT makes it particularly suited for online dissemination, breaking down topics into self-guided modules. 

Advantages of Web-Based Platforms for Mental Health Care

Web-based platforms allow patients to take moment-by-moment assessments and track progress more often than is possible with in-person therapy. More research is required to determine whether ACT is superior to other types of online interventions, but these treatments can make therapy more affordable and accessible. With its potential to reach a broader range of individuals in need of mental healthcare, online ACT may provide a promising and effective alternative to traditional therapy methods.

Source: 

Klimczak, K. S., San Miguel, G. G., Mukasa, M. N., Twohig, M. P., & Levin, M. E. (2023). A systematic review and meta-analysis of self-guided online acceptance and commitment therapy as a transdiagnostic self-help intervention. Cognitive Behaviour Therapy, 1-26. https://doi.org/10.1080/16506073.2023.2178498