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.

Generalized Anxiety and Major Depressive Symptoms of General Public in South Korea during the Early COVID-19 Pandemic

The extent of viral spread and strategies in dealing with the COVID-19 pandemic have been different in each country.There are overall increased mental health concerns in many countries but it is unclear what the general public individuals who do not have heighten vulnerability to stressors for existing mental diseases or significant physical illnesses were experiencing during the pandemic.We evaluated the stressors and mental health of general public in South Korea that has a relatively low confirmed cases and deaths.Responses on the on-line survey questions were used to assess the mental and physical symptoms in association with individuals’reported stressors.Individuals with the symptoms of the generalized anxiety disorder(GAD)were reported in 58.9%,and major depression(MD)in 23.2%,mostly in minimal to mild degrees,cut-off scores of 5 and 10,respectively by the validated screening tools,GAD-7 and PHQ-9.Both GAD and MD symptoms were in 21.5%of the respondents.The total number of stress had significant association with the scores of GAD-7,PHQ-9,physical symptoms,sleep difficulties and resilience(p<0.01).GAD scores were also associated with sleep difficulties(p<0.01)and raising young children(p<0.05).MD scores were associated with sleep difficulties,job-dissatisfaction,and educational level(p<0.05).The limitations of the study include small sample size,usage of smartphone or email,potential under-reporting by stigma in the socio-cultural context and evolving nature of pandemic.We conclude that keeping careful watch for mental symptoms,stressors,sleep difficulties and other physical symptoms are important even for the individuals without previous mental illnesses during the pandemic era.

Attribution retraining group therapy for outpatients with major depression disorder,generalized anxiety disorder,and obsessive-compulsive disorder:a pilot study

The aim of this present study is to examine the efficacy of attribution retraining group therapy （ARGT） and to compare the responses of outpatients with major depression disorder （MDD）, generalized anxiety disorder （GAD） and obsessive-compulsive disorder （OCD）. We carried out a prospective uncontrolled intervention study with a 8-weeks of ARGT on sixty three outpatients with MDD, GAD or OCD. Hamilton rating scale for depression, Hamilton rating scale for anxiety, Yale-Brown obsessive-compulsive scale, attribution style questionnaire, self-esteem scale, index of well-being, and social disability screening schedule were administered before and after treatment. Significant improvement in symptoms and psychological and social functions from pre- to posttreatment occurred for all participants. The changes favored MDD patients. Our study suggested that ARGT may improve the symptoms and psychological-social functions of MDD, GAD, and OCD patients. MDD patients showed the best response.

Characterization of event-related potentials in obsessive compulsive disorder patients: Comparison with depression and generalized anxiety disorder patients

BACKGROUND： Study results of event-refated potential in obsessive compulsive disorder （OCD） remain controversial, potentially as a result of different instruments utilized and their differing technical characteristics. OBJECTIVE： To investigate the differences in several common event-related potentials, Le. contingent negative variations, P300, and mismatch negativity （MMN）, in OCD patients, depression patients, generalized anxiety disorder （GAD） patients, and healthy controls. DESIGN, TIME AND SETTING： A case-control study was performed in the Department of Electrophysiology, Shanghai Mental Health Center from May 2002 to December 2005. PARTICIPANTS： A total of 38 OCD patients, 20 depression patients, and 18 GAD patients, who were diagnosed according to the criteria of Chinese Classification of Mental Disorders （Version 3）, formulated by the Chinese Psychiatry Association, were selected from the Outpatient Department of Shanghai Mental Health Center. Patients with two or more the above diseases were excluded. In addition, 28 healthy people, gender and age matched, were selected as controls. METHODS： Contingent negative variations, P300, and MMN were recorded by a Nicolet Spirit Instrument. All electrodes were attached at Cz according to the Intemationa11020 system, with the mastoid leads as reference and Fpz as ground. MAIN OUTCOME MEASURES： Amplitude and latency of contingent negative variations, P300, and MMN. RESULTS： The contingent negative variations, P300, and MMN were different （P 〈 0.01）. OCD patients showed an increased MI amplitude compared with controls, depression, and GAD patients （P 〈 0.01）. Target P300 amplitudes were significantly lower in OCD, depression, and GAD patients compared with controls （P 〈 0.01）. Moreover, N2 latency and latency of MMN were prolonged in OCD and depression groups compared with controls （P 〈 0.05）. CONCLUSION： Event-related potentials were different in depression, GAD, and OCD patients and healthy controls. In particular, OCD patients exhibited unique characteristics.

The effects of coloring therapy on patients with generalized anxiety disorder

Generalized anxiety disorder(GAD)has harmful effects on physical and mental health and quality of life.Coloring therapy has been reported to have a positive effect on improving patient anxiety and depression.But there are no reported clinical trials examining their effectiveness as a treatment for GAD.This study was planned to evaluate the effectiveness of coloring therapy combined with conventional therapy in improving anxiety,depression,and positive and negative emotions with GAD.This randomized controlled study comprising 88 GAD patients was selected for intervention in different wards.The control group(n=45)was given conventional antianxiety medication and physical therapy,and the experimental group(n=43)received coloring therapy combined with conventional therapy.The Self-Rating Depression Scale,Self-Rating Anxiety Scale(SAS),Hamilton Depression Scale,Hamilton Anxiety Scale(HAMA),and Positive and Negative Affect Scale were assessed in both groups before and 3 weeks after the intervention.After the intervention,there were statistical differences in intra-and inter-group comparisons of anxiety,depression,and positive and negative mood scales in the experimental and control groups(p<.05).The minus in anxiety/positive emotions pre-and postintervention in the experimental group was statistically significant compared to that in anxiety/positive emotions pre-and postintervention in the control group(HAMA:d=1.45,95%confidence interval[CI](0.34,2.57),p=.011;SAS:d=3.87,95%CI(1.73,6.00),p=.001;positive:d=1.76,95%CI(0.17,3.34),p=.030).The minus in depressive/negative emotions pre-and postintervention in the experimental group was not statistically significant compared with that in depressive/negative emotions pre-and postintervention in the control group(p>.05).For GAD patients,adding coloring therapy based on conventional drug therapy and physical therapy can not only reduce depression and negative emotions but also have better effects on reducing anxiety and improving positive emotions than conventional therapy.

Clinical Effect Observation of Jieyu Decoction in the Treatment of Generalized Anxiety Disorder

Objective:To observe the clinical effect of Jieyu decoction in treating generalized anxiety disorder with stagnation-heat in liver meridian type.Methods:There were 72 cases of generalized anxiety disorders outpatient and inpatient patients,and 36 in the control and treatment group.The control group was given oral Deanxit;the treatment group was given Jieyu decoction granules,and necessary psychological counseling was given to patients in both groups.Changes in traditional Chinese medicine syndrome scoring scale,Hamilton scale(HAMA),dynamic electrocardiogram heart rate variability and other indicators were recorded and compared between the two groups.Results:The total effective rate of the control group was 76.5%,and the total effective rate of the treatment group was 80.0%.The curative effect of the treatment group and the control group was significantly higher than that before treatment(P<0.05),and there was no significant difference in the overall curative effect between the two groups(P>0.05).The HAMA scale score of the two groups was significantly lower than that before treatment(P<0.05),and there was no significant difference in the reduction rate of HAMA score between the two groups(P>0.05).The traditional Chinese medicine syndrome scores of the two groups were significantly decreased compared with that before treatment(P<0.05).The traditional Chinese medicine syndrome scores of the treatment group were significantly different from that of the control group after 8 weeks of treatment(P<0.05).Two groups of heart rate variability in 24 h period of standard deviation between the average normal R-R(SDNN),24 h per 5 min normal R-R period between the standard deviation(SDANN),root mean square of phase difference between adjacent R-R(RMSSD)and the number of cardiac 50 ms accounted for the percentage of the total number of cardiac(PNN50)than before treatment significantly increased(P<0.05),8 weeks after treatment the SDNN,SDANN than the control group no significant difference(P>0.05),RMSSD,PNN50 significantly difference compared with control group(P<0.05).Conclusion:Jieyu decoction has good efficacy and high safety in the treatment of generalized anxiety disorder of the type of liver meridian and heat stagnation,which is suitable for clinical promotion and application.

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.

Duloxetine versus placebo in the treatment of patients with generalized anxiety disorder in China

Background Duloxetine is approved for the treatment of generalized anxiety disorder （GAD） in the United States and elsewhere. This study aimed to assess the efficacy, tolerability, and safety of duloxetine in Chinese patients with GAD. Methods This 9-site study consisted of double-blind treatment for 15 weeks either with duloxetine 60-120 mg or with placebo. Patients with at least moderately severe GAD and a Sheehan Disability Scale （SDS） global functioning impairment total score 〉12 were included in this study. Patients who were randomly assigned to duloxetine received 60 mg for 7 weeks; at that point, for nonresponders the dose was increased to 120 mg for the remaining 8 weeks. The primary efficacy measure was mean change from baseline to endpoint on the Hospital Anxiety and Depression Scale-Anxiety subscale score （HADS-A）. Secondary efficacy measures included the Hamilton Anxiety Rating Scale （HAMA）, the SDS, and pain measures. Safety and tolerability were assessed. Results Baseline characteristics did not differ significantly between treatment groups. Mean age of the subjects （n=210） was 37.6 years, 50.5% were female, and 74.3% completed the 15 weeks treatment. Patients treated with duloxetine had significantly greater improvement compared to placebo on the HADS-A （mean change -6.6 vs. -4.9, respectively, P=0.022）. Improvement in anxiety was greater with duloxetine treatment at 7 weeks and continued through 15 weeks for both the HADS-A and the HAMA total score （0.01 〈 P 〈0.05）. Compared with placebo, duloxetine was also associated with greater improvement on most seconda~ measures, but not on the SDS global functioning score. Nausea, dizziness, and somnolence occurred significantly more frequently as treatment-emergent adverse events with duloxetine treatment compared with placebo treatment. Conclusions Duloxetine 60-120 mg once daily is effective and well-tolerated for the treatment of patients with GAD in China.

Frequency of Depression and Anxiety among Tuberculosis Patients

Objective: The aim of present study was to determine the frequency of depression and anxiety among tuberculosis patients. Methods: It was a descriptive study that had investigated the co-morbidity of depression and anxiety among tuberculosis patients with reference to gender. This study was conducted in Jinnah Post Graduate Medical Centre—Chest ward (TB clinic) from July 2014 to September 2014. Hundred diagnosed patients of tuberculosis (50 males and 50 females) were randomly selected. Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Questionnaire (GAD-7) were used to assess the level of anxiety and depression. Results: Findings indicated that 56% tuberculosis (TB) patients had moderate to severe level of depression, whereas 65% TB patients had moderate to severe level of anxiety. Female patients had significantly high prevalence of depression as compared to males (t = –2.173, P –3.468, P Conclusion: Likelihood of depression and anxiety was frequent in tuberculosis patients. However, better management of these psychiatric morbidities may improve treatment adherence, illness perception and patient coping skills.

Impact of COVID-19 pandemic on health-promoting lifestyle behaviors:A cross-sectional study

Objective:To explore health-improving behaviors during COVID-19 pandemic and to reveal the impact of the risk perception of COVID-19 on these behaviors.Methods:We recruited a total of 510 participants for this cross-sectional study.The data were collected online using a questionnaire booklet covering a form inquiring about the participants’demographic,physical,and mental characteristics,the Generalized Anxiety Disorder-7 Scale,and the COVID-19 Perceived Risk Scale.Results:The mean age of the participants was(28.7±10.1)years,and 76.1%were females.Of the participants,31.8%were overweight and obese.While 35.1%experienced negative alterations in their dietary patterns,23.9%reported positive changes to their diet during the pandemic.Besides,47.8%reported their sleep to be negatively affected during the pandemic.While the rate of those with extended screen time was 72.5%,it was 44.3%for the participants engaging in regular exercise.More than one-third of the participants(35.9%)had high and severe anxiety.We also found increased risk perception of COVID-19 among females,obese,those with disturbed eating and sleep quality,healthcare workers,and those with severe anxiety.Conclusions:Overall,the pandemic has appeared to have brought both positive and negative impacts on maintaining and improving eating,sleep,physical activity,and mental health.