Efficacy of cognitive-behavioral therapy combined with habit reversal training on anxiety disorders in children with Tourette’s syndrome

BACKGROUND Cognitive-behavioral therapy(CBT)and habit reversal training(HRT)have shown application potential in addressing tic symptoms and comorbid psychiatric conditions.Despite their theoretical potential,empirical evidence on their combined efficacy remains limited.AIM To evaluate the efficacy of CBT combined with HRT on anxiety disorders in children with Tourette’s syndrome(TS).METHODS Clinical data of children with TS admitted to our hospital from January 2022 to June 2023 were collected,and the patients were grouped into the conventional therapy(control)group and the CBT combined with HRT group.Baseline charac-teristics,anxiety scores,tic severity scores,treatment adherence,and parental satisfaction were assessed.Statistical analysis was performed using t-tests,chi-square tests,and correlation analysis.RESULTS A total of 136 patients,including 65 patients in the control group and 71 patients in the CBT combined with HRT group,were included.The CBT combined with HRT group showed remarkable improvements compared with the control group.Post-intervention assessment revealed a decrease in anxiety scores from 63.52±1.81 to 40.53±1.64(t=2.022,P=0.045),and the Yale Global Tic Severity Scale total score decreased from 22.14±5.67 to 16.28±4.91(t=2.288,P=0.024).Treatment adherence was significantly higher in the CBT combined with HRT group(85.47±7.62%)compared with the control group(82.32±6.54%;t=2.596,P=0.010).Parental satisfaction scores were also higher in the CBT combined with HRT group(8.69±1.77)compared with the control group(7.87±1.92;t=2.592,P=0.011).CONCLUSION This study demonstrates that CBT combined with HRT significantly reduces anxiety symptoms and tic severity in children with TS,with higher treatment adherence and parental satisfaction.These findings support the potential application of this comprehensive therapeutic approach for TS treatment.

Study on the mechanism of SND in the treatment of anxiety disorders based on network pharmacology, molecular docking and experiment validation

Background:Sini decoction(SND)is a classic traditional Chinese medicine(TCM)formulation that can be used to treat anxiety-related disorders,but the active substance and underlying molecular mechanism of its anxiolytic effects are unknown.In this study,network pharmacology,molecular docking research and experimental verification methods were used to preliminarily explore the bioactive compounds and potential target mechanisms of SND anxiolytic.Methods:The active components and corresponding targets of SND were collected by TCMSP.GeneCards,OMIM,PharmGkb,TTD and Drugbank were used to search for the targets of anxiety disorders.The core target of SND in the treatment of anxiety was screened by PPI.R language was used to analyze the intersection targets of SND in the treatment of anxiety disorders by GO and KEGG enrichment analysis.AutoDock Vina was used for molecular docking,and Discovery Studio was used for visual conformation analysis after docking.The anti-anxiety effect and molecular mechanism of SND were studied by in vivo experiment.Results:Based on network pharmacological analysis,we obtained 112 active ingredients and 350 effective targets related to anxiety from SND.In PPI analysis,26 targets such as STAT3,MAPK3,MAPK1,MAPK14,SRC,HSP90AA1,TP53 and PIK3CA were identified as core targets.GO and KEGG analysis showed that the anxiolytic mechanism of SND may be related to the neuroactive ligand-receptor interaction pathway and inflammatory pathway.Molecular docking showed that quercetin,naringenin,licochalcone A had high affinity with JAK2,MAPK14 and MAPK3.Animal experiments have shown that SND reverses the upregulation of GluN2B(NMDAR)and GluA1(AMPAR)proteins,and SND improves anxiety disorders by regulating glutamate transmitter levels,which may be related to neuroactive ligand-receptor interaction pathways,particularly glutamate receptors.Conclusion:This study shows that SND can improve FS-induced behavioral changes in mice and can modulate hippocampal synapse-associated protein defects,partially reversing glutamate receptor expression through the neuroactive ligand-receptor interaction pathway,and further improved anxiety disorders.At the same time,combined with network pharmacology and molecular docking,the key components,core targets and related pathways of SND are discussed,which shows that the active components of SND play an effective role in anxiety through multi-targets and multi-pathways,which provides a reference for the material basis and mechanism of SND.

Risk factors and digital interventions for anxiety disorders in college students:Stakeholder perspectives

The worldwide prevalence of anxiety disorders among college students is high,which negatively affects countries,schools,families,and individual students to varying degrees.This paper reviews the relevant literature regarding risk factors and digital interventions for anxiety disorders among college students from the perspectives of different stakeholders.Risk factors at the national and societal levels include class differences and the coronavirus disease 2019 pandemic.College-level risk factors include the indoor environment design of the college environment,peer relationships,student satisfaction with college culture,and school functional levels.Family-level risk factors include parenting style,family relationship,and parental level of education.Individual-level risk factors include biological factors,lifestyle,and personality.Among the intervention options for college students'anxiety disorders,in addition to traditional cognitive behavioral therapy,mindfulness-based interventions,psychological counseling,and group counseling,digital mental health interventions are increasingly popular due to their low cost,positive effect,and convenient diagnostics and treatment.To better apply digital intervention to the prevention and treatment of college students'anxiety,this paper suggests that the different stakeholders form a synergy among themselves.The nation and society should provide necessary policy guarantees,financial support,and moral and ethical supervision for the prevention and treatment of college students'anxiety disorders.Colleges should actively participate in the screening and intervention of college students'anxiety disorders.Families should increase their awareness of college students'anxiety disorders and take the initiative to study and understand various digital intervention methods.College students with anxiety disorders should actively seek psychological assistance and actively accept and participate in digital intervention projects and services.We believe that in the future,the application of methods such as big data and artificial intelligence to improve digital interventions and provide individualized treatment plans will become the primary means of preventing and treating anxiety disorders among college students.

Recent advances in anxiety disorders:Focus on animal models and pathological mechanisms

Anxiety disorders have become one of the most severe psychiatric disorders,and the incidence is increasing every year.They impose an extraordinary personal and socioeconomic burden.Anxiety disorders are influenced by multiple complex and interacting genetic,psychological,social,and environmental factors,which contribute to disruption or imbalance in homeostasis and eventually cause pathologic anxiety.The selection of a suitable animal model is important for the exploration of disease etiology and pathophysiology,and the development of new drugs.Therefore,a more comprehensive understanding of the advantages and limitations of existing animal models of anxiety disorders is helpful to further study the underlying pathological mechanisms of the disease.This review summarizes animal models and the pathogenesis of anxiety disorders,and discusses the current research status to provide insights for further study of anxiety disorders.

Significance of music therapy in treating depression and anxiety disorders among people with cancer

Globally,cancer cases and mortality have recently escalated and have attracted global concern.The clinical diagnosis and manifestation of cancer can result in significant mental health issues like depression and anxiety disorders.The tendency of people with cancer to suffer from psychological disorders such as anxiety and depression is usually high.A significant number of deaths related to cancer may likely not be from the killer disease but from psychological disorders associated with the illness.The utilization of music as a remedial approach to healing mental disorders cannot be overstated.Thus,identifying the impacts of music therapy in dealing with depression and anxiety disorders among people with cancer is relevant,as the majority of methods used in treating cancer have some side effects which may trigger psychological disorders in cancer patients.Ultimately,this study explored the significance of music therapy in treating depression and anxiety disorders among people with cancer.To achieve the aim of this study,the authors employed a narrative literature review to investigate the significance of music therapy in addressing depression and anxiety disorders among people with cancer.The type of literature review employed in this study is to provide an understanding of the selected research papers.The review found that music therapy significantly reduces depression and anxiety disorders among breast cancer,lung cancer,prostate cancer,and colorectal cancer patients.It is needful for healthcare providers to incorporate music therapy interventions while treating people with cancer.This will help reduce cancer deaths resulting from psychological disorders rather than the killer disease,cancer.However,the standardized procedures and evaluation criteria for applying music-based intervention strategies in oncology medicine still need to be further established and improved.

Psychological Nursing Combined with Biofeedback to Promote the Rehabilitation of Patients with Anxiety Disorders

Objective:To explore the effect of psychological nursing combined with biofeedback on the rehabilitation of patients with anxiety disorders.Methods:100 patients with anxiety disorders in our hospital from January to December 2021 were randomly divided into two groups:control group(n=50)and study group(n=50).The control group was given routine nursing,while the study group was given psychological nursing combined with biofeedback.The changes of self-rating anxiety scale(SAS)score,self-rating depression scale(SDS)score,symptom score,and quality of life of the two groups were compared before and after nursing.Results:Before nursing,there was no significant difference in the scores of SAS and SDS between the two groups,but after nursing,the scores of SAS and SDS in the study group were lower than those in the control group,and the degree of improvement in the study group was higher than that of the control group.Before nursing,there was no significant difference in the scores of symptoms between the two groups(P>0.05),but after nursing,the scores of stress,crying spells,tremor,and general discomfort in the study group were lower than those of the control group(P<0.05).Besides,before nursing,there was no significant difference in the quality of life between the two groups(P>0.05),but after nursing,the scores of physical function,psychological activity,social ability,and material life in the study group were higher than those in the control group(P<0.05).Moreover,the degree of improvement after nursing in the study group was better than that of the control group.Conclusion:Psychological nursing combined with biofeedback to promote the rehabilitation of patients with anxiety disorders effectively improves the negative emotion of patients,reduces stress,depression,tremor,and general discomfort,and improve the overall quality of life.Therefore,it is worth further popularization.

Meta analysis on the effectiveness of auricular therapy combined with modern medicine in the treatment of depression/anxiety disorders in maintenance hemodialysis patients

Objective:We used meta-analysis to explore the clinical efficacy of auricular point therapy combined with modern medicine in improving depression/anxiety in maintenance hemodialysis patients.Methods:We searched CNKI,Wanfang,Weipu,CBM,The Cochrane Library,PubMed,Web of Science,Embase through computer to build a randomized controlled trials of auricular therapy combined with modern medicine in the treatment of depression/anxiety disorders in China and abroad since 2022.Two evaluators independently screened the studies,extracted and cross-checked the key data in the studies independently after determining the included studies,and then evaluated the quality of the studies respectively.Finally,we used RevMan 5.3 platform for statistical processing of data.Results:This meta-analysis included a total of 12 clinical randomized controlled trials,including a total of 899 patients.The results showed that the observation group was more effective in reducing the scores of Hamilton Anxiety Scale,self rating Anxiety Scale,self rating Depression Scale,Pittsburgh sleep quality index score of maintenance hemodialysis patients.In addition,there was no statistical difference between the observation group and the control group in improving the total clinical effective rate.Conclusion:The observation group has a more obvious effect on the improvement of anxiety or depression in maintenance hemodialysis patients.However,due to the limitation of the quantity and quality of the included studies,the real efficacy of auricular therapy combined with modern medicine in improving anxiety or depression disorder after maintenance hemodialysis still needs to be supported by more carefully designed and standardized multi-center,large-sample clinical studies.

Central choroidal thickness in children and adolescents with anxiety disorders:enhanced depth imaging optical coherence tomography findings

AIM:To measure the central choroidal thickness(ChT)in children and adolescents with anxiety disorders.METHODS:Totally 41 anxiety patients(8-16 y)and 35 healthy controls(age-matched)were evaluated.Complete ophthalmic examination was performed.Inclusion criteria were best corrected visual acuity≥20/20,normal intraocular pressure(IOP;10-21 mm Hg),and no systemic or ocular diseases according to history.The diagnosis of psychiatric disorders was determined using Schedule for Affective Disorders and Schizophrenia for School Aged Children Present-Lifetime Version(K-SADS-PL).Enhanced depth imaging optical coherence tomography(EDI-OCT)was used to measure the central ChT.RESULTS:The mean age was 12.18±3.24 y in the patient group and 12.86±3.15 y in the control group.Age and gender distribution of the two groups was similar.Central ChT mean value was 353.26±31.9μm in anxiety patients while 318.75±60.9μm in the control group.Mean central ChT was statistically significantly higher in the children and adolescents with anxiety disorders than healthy controls(P=0.002).CONCLUSION:The children and adolescents with anxiety disorders have significantly thicker central ChT than controls.In the larger sample,longitudinal studies will contribute to the use of choroidal differences as a clinical marker for monitoring anxiety disorders.

A Review of Stressors as Inducer for Personality Disorders and Anxiety Disorders

Personality Disorders(PDs)and Anxiety Disorders(ADs)are common mental disorders.PDs are often more or less related to anxiety and ADs are affected by Personality Functioning(PF).To clarify the pathology of both ADs and PDs,along with their similarities and differences,the literature review by paired keywords search on NCBI PubMed and subsequent analysis are used.The findings support that abnormal stressors can damage the Hypothalamus-Pituitary-Adrenal(HPA)axis time by time throughout life through the epigenetic pathway,lowering down the ability of the stress system to deal with stressors.Biological basis,like the genetic issue,for PDs,is important but after-born experience also matters a lot.Adjoint stressful long-term memory may largely affect normal personality formation,contributing to some kinds of PDs.It seems that early exposure to these stressors influences PDs more,compared to ADs.More researches are needed to explore the effect on ADs from later life stress.This study partially explained the process of ADs and PDs,linked them by abnormal stressors,and emphasized the importance of focusing on the effect of stressful long-term memory formation,which is psychological,and the HPA axis disability,which is biological,on patients having these diseases,reminds psychiatrist to treat disease at the source,to lower down the potential risk of getting PDs in patients who are diagnosed with ADs,to prevent arouse of ADs in patients who are diagnosed with PDs and to combine biological treatment with psychological therapies.

Predictive effect of lipopolysaccharide-stimulated inflammatory cytokines on symptoms of generalized anxiety disorder

BACKGROUND Generalized anxiety disorder(GAD)is a relatively common mental disorder.Recently,inflammation,an important factor for the development of depression,has attracted increasing attention.Several studies have shown that inflammatory cytokines can affect the pathophysiological processes of several nervous system diseases.We hypothesized that there is a correlation between the levels of lipopolysaccharide(LPS)-stimulated inflammatory cytokines and the clinical symptoms of GAD.AIM To investigate the predictive effect of LPS-stimulated inflammatory cytokines on symptoms of GAD.METHODS This was a cross-sectional study in which 89 patients with GAD diagnosed at The First Hospital of Hebei Medical University from January 2022 to December 2022 and 70 individuals without anxiety and depression(controls)during the same period were included.Fasting venous blood was collected from all the subjects in heparin tubes,and another 3 ml of blood was supplemented with LPS(10 ng/ml).The plasma levels of 12 cytokines[Interleukin(IL)-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-10,tumor necrosis factor(TNF)-α,interferon(IFN)-γ,IL-17A,IL-12p70,and IFN-α]were detected.RESULTS Post-LPS stimulation,the levels of IL-1β,IL-6,IL-8,IL-10,and TNF-αin both the control and GAD groups were significantly elevated above those in the nonstimulated groups,with IL-6 and IL-8 showing marked increases.Increases in IL-8 and TNF-αwere statistically significant in the GAD group(P<0.05).IL-1β,IL-6,IL-8,IL-10,and TNF-αwere found to be significantly correlated with Hamilton Anxiety Rating Scale(HAMA)scores(P<0.05).A negative correlation was observed between IL-10 levels and HAMA scores.Further analysis revealed that TNF-αwas associated with mental anxiety,whereas IL-1β,IL-8,and IL-10 were associated with physical anxiety symptoms,with IL-10 showing a negative correlation with physical anxiety.IL-6 was associated with both mental and physical aspects of anxiety.CONCLUSION The physical symptoms of GAD are related to inflammatory factors.IL-1β,IL-8,IL-10,and TNF-a can be used as predictors of physical or mental anxiety in patients with GAD.

Clinical-DNA Correlates of Anxiety in Patients with Ehlers-Danlos Syndrome

Introduction: Anxiety disorders have a lifetime prevalence of 34% with a similar level of heritability (31%) yet lack objective markers that could differentiate patients with underlying conditions. Up to 60%-70% of patients with Ehlers-Danlos syndrome have anxiety that meets criteria of generalized anxiety disorder, their clinical-DNA findings worth examining as biomarkers for patients with generalized anxiety. Method: Of the 1899 patients diagnosed with Ehlers-Danlos syndrome, 1261 were systematically evaluated for 80 history and 40 physical findings and separated into 826 who reported anxiety and 435 who did not. The most consistently reported or management-directing 60 of these clinical findings were, along with variations in genes relevant to these disorders, examined for association with anxiety. Results: Among the 30 anxiety- associated findings judged most predictive of Ehlers-Danlos syndrome in patients with anxiety were expected ones of adrenergic stimulation (difficulty concentrating-87% frequency and 1.26 anxiety/no anxiety ratio;chronic fatigue-84%, 1.17;sleep issues 69%, 1.52 that are criteria for generalized anxiety disorder) or of cholinergic suppression (e.g., frequent nausea 64%, 1.26). Less associated but more discriminating for underlying disease were those reflective of neuromuscular impact (e.g., chronic daily headaches 76%, 1.12);hypermobility (e.g., awareness of flexibility 72%, 1.03), or skin changes (e.g., elasticity around jaw 71%, 1.06). Anxiety-associated DNA variants included 54 of 88 in collagen type I/V/VII/IX genes, 14 of 16 in sodium channel SCN9A/10A/ 11A genes, 59 of 85 in POLG/MT-DNA genes, and 21 of 28 in profilaggrin- FLG genes that respectively impacted tissue laxity, sensory neural, autonomic-mitochondrial, and autonomic-inflammatory functions. Conclusion: Analysis of pathogenetic mechanisms in Ehlers-Danlos syndrome selected some 50 clinical-DNA findings useful for its diagnosis in those with generalized anxiety disorders.

The Evolutionary Psychological Perspective on Social Anxiety Disorder and Its Underlying Mechanism

An evolutionary view of social anxiety disorder in its original occurrence of function and adaptive design helps us understand why SAD(social anxiety disorder)exists in the first place.In this paper,we found social anxiety can be a useful strategy to acquire better resources and maintain harmony in interpersonal relationships in ancestral environments.This finding helps us reveal how the mismatch between the ancestral and modern world may cause the overreaction we see in SAD in contemporary contexts.In addition,alcohol seems to be a short-term solution to ease the negative impact of SAD,but its long-term effectiveness requires further research.The paper also introduces compassion therapy to encourage patients to rekindle their passion for themselves by connecting with a friendly social environment.To better understand SAD,we encouraged future research to focus on rebuilding inner values and group relationships.

2023:A year of accomplishments for the 13 Science Citation Index Expanded-and Emerging Sources Citation Index-indexed Baishideng journals

In 2023,Baishideng Publishing Group(Baishideng)routinely published 47 openaccess journals,including 46 English-language journals and 1 Chinese-language journal.Our successes were accomplished through the collective dedicated efforts of Baishideng staffs,Editorial Board Members,and Peer Reviewers.Among these 47 Baishideng journals,7 are included in the Science Citation Index Expanded(SCIE)and 6 in the Emerging Sources Citation Index(ESCI).With the support of Baishideng authors,company staffs,Editorial Board Members,and Peer Reviewers,the publication work of 2023 is about to be successfully completed.This editorial summarizes the 2023 activities and accomplishments of the 13 SCIEand ESCI-indexed Baishideng journals,outlines the Baishideng publishing policy changes and additions made this year,and highlights the unique advantages of Baishideng journals.

Mechanism of Zuojin Pill in the treatment of anxiety disorder and Major depressive disorder based on network pharmacology and molecular docking validation

Background:Zuojin Pill(ZJP)is a classic Chinese herbal prescription with good efficacy in the treatment of Anxiety disorder(AD)and Major depressive disorder(MDD).Nevertheless,the potential mechanisms of ZJP remain unclear.Based on network pharmacology and molecular docking methods,this study aims to elucidate the possible mechanism of ZJP in the treatment of AD and MDD.Methods:The components and targets of Rhizoma Coptidis and Fructus Evodiae were collected from TCMSP,ETCM,HERB,SWISSADME and STITCH databases.The disease targets related to MDD and AD were collected from DISGENET,GENECARDS and OMIM databases.Protein-protein interaction network was constructed by STRING database,GO and KEGG enrichment analysis was performed by METASCAPE database,and“drugs-components-targets network”was constructed by Cytoscape software.Molecular docking verification was performed by Sailvina2.0 software.Results:ZJP may act on AKT1,IL6,TNF and other targets through caffeine,isorhamnetin,berberine and other components,regulating the Inflammatory mediator regulation of TRP channels,Serotonergic synapse,Dopaminergic synapse,PI3K/AKT signaling pathway,and other pathways.The results of molecular docking showed that berberine had the best binding activity with the core target.Conclusion:ZJP can exert anti-anxiety and anti-depression effects through multiple components,multiple targets and multiple pathways.

Comprehensive interventions for adult cyclic vomiting syndrome complicated by superior mesenteric artery syndrome:A case report

BACKGROUND Cyclic vomiting syndrome(CVS)is a chronic functional gastrointestinal disorder involving the gut–brain interaction that is characterized by recurring episodes of nausea,vomiting,abdominal pain,and interspersed complete normal periods.Superior mesenteric artery(SMA)syndrome(SMAS)is a vascular condition in which the horizontal portion of the duodenum is compressed due to a reduced angle between the aorta and the SMA.This condition presents with symptoms similar to CVS,posing challenges in distinguishing between the two and often resulting in misdiagnosis or inappropriate treatment.CASE SUMMARY A 20-year-old female patient presented with recurrent episodes of vomiting and experienced a persistent fear of vomiting for the past 2 years.She adopted conscious dietary restrictions,which led to severe malnutrition.Initially,she was diagnosed with SMAS,as revealed by computed tomography angiography.Despite efforts to increase the angle between the aorta and the SMA through weight gain,her vomiting did not improve.Finally,she was diagnosed with comorbidities including CVS,SMAS and anxiety disorder.She underwent comprehensive interventions,including enteral and parenteral nutritional supplementation,administration of antiemetic and anti-anxiety agents,and participation in mindfulness-based cognitive therapy.The patient eventually experienced a notable improvement in both body weight and clinical symptoms.CONCLUSION We present a rare case of CVS in an adult complicated with SMAS and propose additional treatment with nutritional support,pharmacological intervention,and psychotherapy.

Predictive value of intracranial high-density areas in neurological function

BACKGROUND Intracranial high-density areas(HDAs)have attracted considerable attention for predicting clinical outcomes;however,whether HDAs predict worse neurological function and mental health remains controversial and unclear,which requires further investigation.In this prospective study,96 patients with acute ischemic stroke(AIS)who accepted endovascular mechanical thrombectomy(EMT)were included.The enrolled patients underwent cranial computed tomography(CT)examination within 24 hours after EMT.Clinical data in terms of National Institutes of Health Stroke Scale(NIHSS),the 3-month modified Rankin Scale(mRS),self-rating depression scale(SDS),and self-rating anxiety scale(SAS)scores were collected and compared between patients with HDAs and non-HDAs and between patients with good and poor clinical prognosis.Compared to patients without HDAs,patients with HDAs presented severe neurological deficits(admission NIHSS score:18±3 vs 19±4),were more likely to have post-stroke disabilities(mRS<3:35%vs 62%),and suffered more severe depression(SDS score:58±16 vs 64±13)and anxiety disorder(SAS score:52±8 vs 59±10).Compared to patients with a good prognosis,patients with a poor prognosis presented severe neurological deficits(admission NIHSS score:17±4 vs 20±3),were more likely to have HDAs on CT images(64%vs 33%),and suffered more severe depression(SDS score:55±19 vs 65±11)and anxiety(SAS score:50±8 vs 58±12).Multivariate analysis revealed that HDAs were independent nega-tive prognostic factors.CONCLUSION In conclusion,HDAs on CT images predicted poor prognosis and severe depressive and anxiety symptoms in patients with AIS who underwent EMT.

Psychological Consequences of a Mass Attack Following Multiple Gunshots and Explosions among Victims in a State in Southwest Nigeria

Introduction: On the 5th of June 2022, an incident of a mass attack following multiple gunshots and explosions occurred in a community in Ondo State Nigeria. This study aims to assess the mental health status of victims of the mass attack to guide further interventions among them. Methods: A cross-sectional study was conducted among victims of a mass attack in Owo community, Ondo State. A total of 209 affected victims were interviewed on socio-demographic characteristics, symptoms of anxiety (AD) and post-traumatic stress disorder (PTSD), threat experienced, and mental health support received. A 7-item Generalized Anxiety Disorder (GAD-7) and 9-item Post Traumatic Stress Disorder (PTSD) scale were used to assess the mental health status of the victims. A point was assigned to respondents who reported the symptoms of GAD, with a maximum score of 7 attained. For GAD, scores were categorized as follows: 1 - 2 as mild, 2 - 3 as minimal, 4 - 5 as moderate and 6 - 7 as severe. The PTSD symptoms were rated using a 5-point Likert scale response, and assigned the following points;4 = extremely, 3 = quite a bit, 2 = moderate, 1 = a little bit and 0 = not at all. From a maximum score of 36, participants with scores 18 and above were categorized as those with provisional PTSD. The independent samples t-test and correlational analysis were used to determine the association between PTSD score and other independent variables, with an alpha level of significance set at 0.05. Results: Generally, 38 (18.2%) of the respondents had severe AD. About half (89;42.6%) were categorized as those with provisional PTSD. The mean level of both AD (3.40 ± 2.26) and PTSD (16.51 ± 7.63) score is higher among those who were married compared to those not married (anxiety disorder;2.52 ± 2.20, P = 0.005 and PTSD;13.20 ± 8.86, P = 0.004). Respondents who have been counseled by a healthcare worker had a higher mean level (15.89 ± 7.58) of provisional PTSD compared to those not counseled by a healthcare worker (13.56 ± 9.22, P = 0.046). The level of PTSD score increased with a higher age group (r = 0.21, P = 0.003). Conclusions: The results show that the mass attack had psychological consequences among a high proportion of the victims, particularly, those married and in the older age groups. This suggests the need for continuous supportive counseling targeting these affected groups, and considering other factors moderating the effectiveness of counseling among them in future interventions.

Acupuncture Treatment for 157 Cases of Anxiety Neurosis

Anxiety neurosis, a mental disorder characterized mainly by extensive anxiety or paroxysmal panic, is often seen in females in their 40s.

Predictors of long-term anxiety and depression in discharged COVID-19 patients:A follow-up study

BACKGROUND Patients who were hospitalized for coronavirus disease 2019(COVID-19)faced an extremely stressful experience that challenged their mental health and the longterm effects are not definitely known yet.AIM To identify both the course of mental symptoms(anxiety and depressive symptoms)and the related risk factors of recovered patients at the 20-22 mo follow-up.METHODS One hundred and seventy-two patients were enrolled.The patients were evaluated with a telepsychiatry interview and the Hospital Anxiety and Depression Scale(HADS).Sociodemographic and clinical features were analyzed by regression analysis.RESULTS The mean HADS-Anxiety(HADS-A)score was 9.08±4.90,and the mean HADSDepression(HADS-D)score was 8.55±4.39.The mean HADS-A(P=0.484)and HADS-D(P=0.011)scores were increased compared to scores during hospitalization.Being over 50 years old,having lower financial status,and being vaccinated were associated with symptoms of depression(adjusted R2=0.168)while being over 50 years old,female sex,being vaccinated,and dyspnea were associated with higher anxiety(adjusted R2=0.245).CONCLUSION To prevent the deterioration of mental health,psychiatrists should play an active role in identifying emerging mental problems as soon as possible,more vulnerable groups should be characterized,and psychological support should be sustained after discharge.

SARS-CoV-2 consequences for mental health:Neuroinflammatory pathways linking COVID-19 to anxiety and depression

The coronavirus disease 2019(COVID-19)pandemic has been linked to an increased prevalence of mental health disorders,particularly anxiety and depression.Moreover,the COVID-19 pandemic has caused stress in people worldwide due to several factors,including fear of infection;social isolation;difficulty in adapting to new routines;lack of coping methods;high exposure to social media,misinformation,and fake reports;economic impact of the measures implemented to slow the contagion and concerns regarding the disease pathogenesis.COVID-19 patients have elevated levels of pro-inflammatory cytokines,such as interleukin(IL)-1β,IL-6,and tumor necrosis factor-α,and other inflammation-related factors.Furthermore,invasion of the central nervous system by the novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)may potentially contribute to neuroinflammatory alterations in infected individuals.Neuroinflammation,a consequence of psychological stress due to the COVID-19 pandemic,may also play a role in the development of anxiety and depressive symptoms in the general population.Considering that neuroinflammation plays a significant role in the pathophysiology of depression and anxiety,this study investigated the effects of SARS-CoV-2 on mental health and focused on the impact of the COVID-19 pandemic on the neuroinflammatory pathways.