Correlation between anxiety, depression, and social stress in young patients with thoracolumbar spine fractures

BACKGROUND Traumatic injuries,such as falling,car accidents,and crushing mostly cause spinal fractures in young and middle-aged people,and>50%of them are thoracolumbar fractures.This kind of fracture is easily combined with serious injuries to peripheral nerves and soft tissues,which causes paralysis of the lower limbs if there is no timely rehabilitation treatment.Young patients with thoracolumbar fractures find it difficult to recover after the operation,and they are prone to depression,low self-esteem,and other negative emotions.AIM To investigate the association between anxiety,depression,and social stress in young patients with thoracolumbar spine fractures and the effect on rehabilitation outcomes.METHODS This study retrospectively analyzed 100 patients admitted to the orthopedic department of Honghui Hospital,Xi’an Jiaotong University who underwent thoracolumbar spine fracture surgery from January 2022 to June 2023.The general data of the patients were assessed with the Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),life events scale,and social support rating scale(SSRS)to identify the correlation between anxiety,depression scores,and social stress and social support.The Japanese Orthopedic Association(JOA)was utilized to evaluate the rehabilitation outcomes of the patients and to analyze the effects of anxiety and depression scores on rehabilitation.RESULTS According to the scores of HAMD and HAMA in all patients,the prevalence of depression in patients was 39%(39/100),and the prevalence of anxiety was 49%(49/100).Patients were categorized into non-depression(n=61)and depression(n=39),non-anxiety(n=51),and anxiety(n=49)groups.Statistically significant differences in gender,occupation,Pittsburgh Sleep Quality Index(PSQI)score,and monthly family income were observed between the non-depression and depression groups(P<0.05).A significant difference in occupation and PSQI score was found between the non-anxiety and anxiety groups.Both depression(r=0.207,P=0.038)and anxiety scores(r=0.473,P<0.001)were significantly and positively correlated with negative life events.The difference in negative life event scores as well as SSRS total and item scores was statist-ically significant between patients in the non-depression and depression groups(P<0.05).The difference between the non-anxiety and anxiety groups was statistically significant(P<0.05)in the negative life event scores as well as the total SSRS scores.Additionally,JOA scores were significantly lower in both anxious and depressed patients.CONCLUSION Young patients with thoracolumbar fractures are prone to anxiety and depression.Patients’anxiety and depression are closely associated with social pressure,which reduces the life pressure of young patients with thoracolumbar fractures,enhances social support,and improves the psychology of anxiety and depression.,which affects patients’recovery.

Increased excitatory amino acid transporter 2 levels in basolateral amygdala astrocytes mediate chronic stress–induced anxiety-like behavior

The conventional perception of astrocytes as mere supportive cells within the brain has recently been called into question by empirical evidence, which has revealed their active involvement in regulating brain function and encoding behaviors associated with emotions.Specifically, astrocytes in the basolateral amygdala have been found to play a role in the modulation of anxiety-like behaviors triggered by chronic stress. Nevertheless, the precise molecular mechanisms by which basolateral amygdala astrocytes regulate chronic stress–induced anxiety-like behaviors remain to be fully elucidated. In this study, we found that in a mouse model of anxiety triggered by unpredictable chronic mild stress, the expression of excitatory amino acid transporter 2 was upregulated in the basolateral amygdala. Interestingly, our findings indicate that the targeted knockdown of excitatory amino acid transporter 2 specifically within the basolateral amygdala astrocytes was able to rescue the anxiety-like behavior in mice subjected to stress. Furthermore, we found that the overexpression of excitatory amino acid transporter 2 in the basolateral amygdala, whether achieved through intracranial administration of excitatory amino acid transporter 2agonists or through injection of excitatory amino acid transporter 2-overexpressing viruses with GfaABC1D promoters, evoked anxiety-like behavior in mice. Our single-nucleus RNA sequencing analysis further confirmed that chronic stress induced an upregulation of excitatory amino acid transporter 2 specifically in astrocytes in the basolateral amygdala. Moreover, through in vivo calcium signal recordings, we found that the frequency of calcium activity in the basolateral amygdala of mice subjected to chronic stress was higher compared with normal mice.After knocking down the expression of excitatory amino acid transporter 2 in the basolateral amygdala, the frequency of calcium activity was not significantly increased, and anxiety-like behavior was obviously mitigated. Additionally, administration of an excitatory amino acid transporter 2 inhibitor in the basolateral amygdala yielded a notable reduction in anxiety level among mice subjected to stress. These results suggest that basolateral amygdala astrocytic excitatory amino acid transporter 2 plays a role in in the regulation of unpredictable chronic mild stress-induced anxiety-like behavior by impacting the activity of local glutamatergic neurons, and targeting excitatory amino acid transporter 2 in the basolateral amygdala holds therapeutic promise for addressing anxiety disorders.

Health anxiety and work loss in patients diagnosed with serrated polyposis syndrome:A cross sectional study

BACKGROUND Serrated polyposis syndrome(SPS)is a polyposis condition with neoplastic potential,but its psychological impact is not well understood.AIM To assess health anxiety prevalence in a regional Australian cohort of SPS patients and explore factors influencing it,including workforce impacts of regular surveillance.METHODS This cross-sectional study screened patients aged 18-65 undergoing colonoscopy in a regional gastroenterology practice between January 2015 and June 2022.Eligible SPS patients were invited to participate.Data included the Short Health Anxiety Inventory,employment status,and previous demographic and medical findings.RESULTS Health anxiety was found in 21.57%of SPS patients,with anxious patients being significantly more concerned about surveillance(OR=7.70).Patients lost an average of 11.04 work hours per colonoscopy.CONCLUSION Health anxiety in SPS patients aligns with rates in other gastroenterology populations.Identifying it may improve management,though further research is needed to better understand prevalence and care improvements.

Identity and Anxiety:An Analysis of the Characters’ Anxieties Revolving Identity in The Woman in White

As a literary genre of fiction which enjoyed its great popularity in Britain in the 1860 s and 1870 s when the country had just gone through a series of social changes and a variety of anxieties prevailing the whole society,the sensation novel presents to readers a wide range of anxieties and gives responds to some of them.The Woman in White by Wilkie Collins(1859),which is generally regarded by critics as a typical representative of the sensation novel,displays diversified anxieties through the depiction of various impressive characters,and especially through their processes of establishing,losing,regaining,strengthening,hiding and faking their identities.This essay will analyze the representative work,exploring and examining the characters’ anxieties revolving their identities in relation to the social backgrounds of that era.

Identity and Anxiety: An Analysis of the Characters’ Anxieties Revolving Identity in The Woman in White

As a literary genre of fiction which enjoyed its great popularity in Britain in the 1860s and 1870s when the country had just gone through a series of social changes and a variety of anxieties prevailing the whole society,the sensation novel presents to readers a wide range of anxieties and gives responds to some of them.The Woman in White by Wilkie Collins(1859),which is generally regarded by critics as a typical representative of the sensation novel,displays diversified anxieties through the depiction of various impressive characters,and especially through their processes of establishing,losing,regaining,strengthening,hiding and faking their identities.This essay will analyze the representative work,exploring and examining the characters’anxieties revolving their identities in relation to the social backgrounds of that era.

Study on the impact of comprehensive geriatric assessment on anxiety and depression in chronic obstructive pulmonary disease patients

BACKGROUND Psychological factors such as anxiety and depression will not only aggravate the symptoms of chronic obstructive pulmonary disease(COPD)patients and reduce the quality of life of patients,but also affect the treatment effect and long-term prognosis.Therefore,it is of great significance to explore the clinical application of senile comprehensive assessment in the treatment of COPD and its influence on psychological factors such as anxiety and depression.AIM To explore the clinical application of comprehensive geriatric assessment in COPD care and its impact on anxiety and depression in elderly patents.METHODS In this retrospective study,60 patients with COPD who were hospitalized in our hospital from 2019 to 2020 were randomly divided into two groups with 30 patients in each group.The control group was given routine nursing,and the observation group was given comprehensive assessment.Clinical symptoms,quality of life[COPD assessment test(CAT)score],anxiety and depression Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)were compared between the two groups.RESULTS CAT scores in the observation group decreased from an average of 24.5 points at admission to an average of 18.3 points at discharge,and in the control group from an average of 24.7 points at admission to an average of 18.3 points at discharge.The average score was 22.1(P<0.05).In the observation group,HAMA scores decreased from 14.2 points at admission to 8.6 points at discharge,and HAMD scores decreased from 13.8 points at admission to 7.4 points at discharge.The mean HAMD scores in the control group decreased from an average of 14.5 at admission to an average of 12.3 at discharge,and from an average of 14.1 at admission to an average of 11.8 at discharge.CONCLUSION The application of comprehensive geriatric assessment in COPD care has a significant effect on improving patients'clinical symptoms and quality of life,and can effectively reduce patients'anxiety and depression.

Depression and anxiety among cancer patients visiting a tertiary care cancer hospital

BACKGROUND Cancer patients frequently experience psychological problems related to reactions to cancer diagnosis,cancer type and stage,treatment effects,recurrence,fear of end-of-life,survivorship,and financial burden.Depression and anxiety are both psychological and physiological disturbances among cancer patients.AIM To assess the prevalence of depression and anxiety among cancer patients attending a tertiary care cancer hospital.METHODS A cross-sectional study was conducted at Bhaktapur Cancer Hospital in Kathmandu Valley among 220 cancer patients aged from 18 years to 70 years.Ethical approval was taken from the Institutional Review Committee of CiST College.Convenient sampling was used to interview patients with the standardized Patient-Health Questionnaire(PHQ-9)for Depression and Hospital Anxiety and Depression sub-scale(HADS-A)for anxiety.Epi-Data was used for data entry and transferred to SPSS Version 25 for analysis.RESULTS The study revealed that of 220 patients,most of the respondents belonged to the age group 51-60 years.More than half 131(59.6%)of the respondents were female,most of them had depression,and one-third had anxiety.Among the respondents,124(56.4%)had mild depression,70(31.8%)had moderate depression,and 3(1.3%)had severe depression;79(35.9%)had mild anxiety,64(29.1%)had moderate anxiety,and 4(1.8%)had severe anxiety.CONCLUSION Most respondents were depressed and one-third had anxiety.More than half and nearly one-third had mild and moderate depression,respectively,and nearly one-third had mild and moderate anxiety,which is higher than other studies.

Vibration-reduced anxiety-like behavior relies on ameliorating abnormalities of the somatosensory cortex and medial prefrontal cortex

Tibetan singing bowls emit low-frequency sounds and produce perceptible harmonic tones and vibrations through manual tapping.The sounds the singing bowls produce have been shown to enhance relaxation and reduce anxiety.However,the underlying mechanism remains unclear.In this study,we used chronic restraint stress or sleep deprivation to establish mouse models of anxiety that exhibit anxiety-like behaviors.We then supplied treatment with singing bowls in a bottomless cage placed on the top of a cushion.We found that unlike in humans,the combination of harmonic tones and vibrations did not improve anxietylike behaviors in mice,while individual vibration components did.Additionally,the vibration of singing bowls increased the level of N-methyl-D-aspartate receptor 1 in the somatosensory cortex and prefrontal cortex of the mice,decreased the level ofγ-aminobutyric acid A(GABA)receptorα1 subtype,reduced the level of CaMKII in the prefrontal cortex,and increased the number of GABAergic interneurons.At the same time,electrophysiological tests showed that the vibration of singing bowls significantly reduced the abnormal low-frequency gamma oscillation peak frequency in the medial prefrontal cortex caused by stress restraint pressure and sleep deprivation.Results from this study indicate that the vibration of singing bowls can alleviate anxiety-like behaviors by reducing abnormal molecular and electrophysiological events in somatosensory and medial prefrontal cortex.

Navigating the intersection of psychiatry and ophthalmology:A comprehensive review of depression and anxiety management in glaucoma patients

Glaucoma,a prevalent and debilitating eye disease,has long been associated with vision impairment and blindness.However,recent research has shed light on the often-underestimated psychological dimensions of this condition.Anxiety and depression,two pervasive psychiatric comorbidities,have been increasingly recognized among glaucoma patients.This comprehensive review aims to explore the intricate relationship between psychiatry and ophthalmology,in the context of managing depression and anxiety in glaucoma patients.By meticulously examining peer-reviewed literature,we synthesize current knowledge on the prevalence,risk factors,and underlying mechanisms of anxiety and depression in glaucoma.The evidence reveals that glaucoma patients face an elevated risk of experiencing these mood disorders.Factors such as progressive vision loss,complex medication regimens,and the fear of further visual deterioration contribute to their vulnerability.Moreover,we delve into the bidirectional relationship between glaucoma and mood disorders,shedding light on the complex interplay between ocular and emotional health.Our review investigates the implications of anxiety and depression on glaucoma management,including their potential impact on treatment adherence,disease progression,and overall quality of life.We also explore the neurobiological pathways linking glaucoma and mood disorders,providing a foundation for future research and potential therapeutic interventions.In conclusion,recognizing the psychological burden carried by glaucoma patients is essential for holistic and patient-centered care.This review underscores the pressing need for integrated approaches that bring together ophthalmological and psychiatric expertise to optimize the well-being of individuals facing the challenges of glaucoma.By addressing anxiety and depression in glaucoma care,healthcare providers can enhance the overall quality of life for these patients,ultimately leading to improved outcomes and a brighter future for those affected by this condition.This review offers valuable insight for healthcare practitioners and researchers,providing a concise overview of key topics and research in the field of managing depression and anxiety in glaucoma patients.

Assessing myocardial indices and inflammatory factors to determine anxiety and depression severity in patients with chronic heart failure

BACKGROUND Patients with chronic heart failure(CHF)have a progressive disease that is associated with poor quality of life and high mortality.Many patients experience anxiety and depression(A&D)symptoms,which can further accelerate disease progression.We hypothesized that indicators of myocardial function and inflammatory stress may reflect the severity of A&D symptoms in patients with CHF.Changes in these biomarkers could potentially predict whether A&D symptoms will deteriorate further in these individuals.AIM To measure changes in cardiac and inflammatory markers in patients with CHF to determine A&D severity and predict outcomes.METHODS We retrospectively analyzed 233 patients with CHF treated at the Jingzhou Hospital,Yangtze University between 2018-2022 and grouped them according to Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)scores.We compared clinical data in the no-A&D,mild-A&D,moderate-A&D,and severe-A&D groups,the SAS and SDS scores with the New York Heart Association(NYHA)functional classification,and cardiac markers and inflammatory factors between the no/mild-A&D and moderate/severe-A&D groups.Regression analysis was performed on the markers with P<0.05 to determine their ability to predict A&D severity in patients and the area under the receiver operating characteristic curve(AUROC)was used to evaluate their accuracy.RESULTS In the inter-group comparison,the following variables had an effect on A&D severity in patients with CHF:NYHA class,left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter,N-terminal pro-brain natriuretic peptide(NT-proBNP),interleukin-6(IL-6),and tumor necrosis factor-alpha(P<0.05).Other variables did not differ significantly between the A&D groups(P>0.05).In addition,we found that higher NYHA classes were associated with higher the SAS and SDS scores(P<0.05).Regression analysis showed that LVEF,NTproBNP,and IL-6 were independent risk factors for A&D severity(P<0.05).Among them,NT-proBNP had the best predictive ability as a single indicator(AUROC=0.781).Furthermore,the combination of these three indicators exhibited a good predictive effect toward discriminating the extent of A&D severity among patients(AUROC=0.875).CONCLUSION Cardiac and inflammatory biomarkers,such as LVEF,NT-proBNP,and IL-6,are correlated with A&D severity in patients with CHF and have predictive value.

Use of cognitive-behavioral career coaching to reduce work anxiety and depression in public employees

BACKGROUND Public employees worldwide are increasingly concerned about work anxiety and depression.Cognitive-behavioral career coaching has emerged as a promising strategy for addressing these mental health disorders,which can negatively impact on a person's overall well-being and performance.AIM To examine whether cognitive-behavioral career coaching reduces work anxiety and depression among Nigerian public employees.METHODS A total of 120 public employees(n=60)suffering from severe anxiety and depression were randomly assigned to the treatment or control groups in this study.Cognitive behavioral coaching was provided twice a week to those in the treatment group,whereas no treatment was given to those in the control group.As part of the study,the Hamilton Anxiety Rating Scales and Beck Depression Inventory were used to collect data.RESULTS Analysis of covariance of the data from participants indicates a significant effect of cognitive-behavioral career coaching on work anxiety and depression.CONCLUSION Insights into the underlying mechanisms by which cognitive behavior career coaching exerts its effects have been gained from this study.Also,the study has gathered valuable data that can inform future practice and guide the development of strategies for supporting mental health at work.

Analysis of risk factors leading to anxiety and depression in patients with prostate cancer after castration and the construction of a risk prediction model

BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and depression.Prostate cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages that cannot be treated by radical surgery and which are accompanied by complications such as bodily pain and bone metastasis.Therefore,attention should be given to the mental health status of PC patients as well as physical adverse events in the course of clinical treatment.AIM To analyze the risk factors leading to anxiety and depression in PC patients after castration and build a risk prediction model.METHODS A retrospective analysis was performed on the data of 120 PC cases treated in Xi'an People's Hospital between January 2019 and January 2022.The patient cohort was divided into a training group(n=84)and a validation group(n=36)at a ratio of 7:3.The patients’anxiety symptoms and depression levels were assessed 2 wk after surgery with the Self-Rating Anxiety Scale(SAS)and the Selfrating Depression Scale(SDS),respectively.Logistic regression was used to analyze the risk factors affecting negative mood,and a risk prediction model was constructed.RESULTS In the training group,35 patients and 37 patients had an SAS score and an SDS score greater than or equal to 50,respectively.Based on the scores,we further subclassified patients into two groups:a bad mood group(n=35)and an emotional stability group(n=49).Multivariate logistic regression analysis showed that marital status,castration scheme,and postoperative Visual Analogue Scale(VAS)score were independent risk factors affecting a patient's bad mood(P<0.05).In the training and validation groups,patients with adverse emotions exhibited significantly higher risk scores than emotionally stable patients(P<0.0001).The area under the curve(AUC)of the risk prediction model for predicting bad mood in the training group was 0.743,the specificity was 70.96%,and the sensitivity was 66.03%,while in the validation group,the AUC,specificity,and sensitivity were 0.755,66.67%,and 76.19%,respectively.The Hosmer-Lemeshow test showed aχ^(2) of 4.2856,a P value of 0.830,and a C-index of 0.773(0.692-0.854).The calibration curve revealed that the predicted curve was basically consistent with the actual curve,and the calibration curve showed that the prediction model had good discrimination and accuracy.Decision curve analysis showed that the model had a high net profit.CONCLUSION In PC patients,marital status,castration scheme,and postoperative pain(VAS)score are important factors affecting postoperative anxiety and depression.The logistic regression model can be used to successfully predict the risk of adverse psychological emotions.

Influence of static cartoons combined with dynamic virtual environments on preoperative anxiety of preschool-aged children undergoing surgery

BACKGROUND Preschoolers become anxious when they are about to undergo anesthesia and surgery,warranting the development of more appropriate and effective interventions.AIM To explore the effect of static cartoons combined with dynamic virtual environments on preoperative anxiety and anesthesia induction compliance in preschool-aged children undergoing surgery.METHODS One hundred and sixteen preschool-aged children were selected and assigned to the drug(n=37),intervention(n=40),and control(n=39)groups.All the children received routine preoperative checkups and nursing before being transferred to the preoperative preparation room on the day of the operation.The drug group received 0.5 mg/kg midazolam and the intervention group treatment consisting of static cartoons combined with dynamic virtual environments.The control group received no intervention.The modified Yale Preoperative Anxiety Scale was used to evaluate the children’s anxiety level on the day before surgery(T0),before leaving the preoperative preparation room(T1),when entering the operating room(T2),and at anesthesia induction(T3).Compliance during anesthesia induction(T3)was evaluated using the Induction Compliance Checklist(ICC).Changes in mean arterial pressure(MAP),heart rate(HR),and respiratory rate(RR)were also recorded at each time point.RESULTS The anxiety scores of the three groups increased variously at T1 and T2.At T3,both the drug and intervention groups had similar anxiety scores,both of which were lower than those in the control group.At T1 and T2,MAP,HR,and RR of the three groups increased.The drug and control groups had significantly higher MAP and RR than the intervention group at T2.At T3,the MAP,HR,and RR of the drug group decreased and were significantly lower than those in the control group but were comparable to those in the intervention group.Both the drug and intervention groups had similar ICC scores and duration of anesthesia induction(T3),both of which were higher than those of the control group.CONCLUSION Combining static cartoons with dynamic virtual environments as effective as medication,specifically midazolam,in reducing preoperative anxiety and fear in preschool-aged children.This approach also improve their compliance during anesthesia induction and helped maintain their stable vital signs.

Investigation and analysis of the job-hunting intentions and employment orientations of students majored in nursing

In recent years, China＇s employment problem of the college graduates has become a hot topic in the communities. Each year there are a large number of the graduating students, but few can find the job suitable for their own professional direction in colleges and universities. The employment problems have plagued the university graduates, and also have brought the unnecessary trouble to some students in the colleges. The college students have just entered the society, and they do not understand a lot of the social status very well, and have very little experience in the employment. In order to reduce the pressure of the employment of the university students, and help the graduate students bettor get employed, also to make the college students have a better planning for their future, in this paper, the author carried out the investigation and analysis of the job-hunting intentions and the employment orientations of the students majored in nursing, hoping to hclp the employment of the college students in some aspects, and do a good job in the planning of their career.

Risk and Protective Factors Associated with Depression and Anxiety among Pregnant Women during the COVID-19 Pandemic

Background: The coronavirus disease (COVID-19) pandemic has impacted perinatal women’s mental health. However, protective factors associated with depression among pregnant Japanese women during the pandemic have not been reported. Purpose: The present study investigated the risk and protective factors associated with depression and anxiety among pregnant women during the COVID-19 pandemic. Methods: An online questionnaire was administered to 157 pregnant women between October 2022 and May 2023 at two general hospitals in Japan. The Japanese versions of the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to assess symptoms of depression and anxiety. The χ2 test or Fisher’s exact test and multivariate logistic regression model were used to examine factors associated with depression and anxiety among pregnant women. Results: Overall, 47.1% and 35.7% of the pregnant women reported depressive and anxiety symptoms, respectively. A “history of mental illness” was a risk factor for depression and anxiety among pregnant women during the COVID-19 pandemic. Additionally, unmarried status was a risk factor for anxiety among pregnant women, whereas outdoor and indoor exercises were protective factors against depression and anxiety, respectively. Conclusions: Exercise may have protected pregnant women from depression and anxiety during the COVID-19 pandemic. Encouraging exercise may help maintain the mental health of pregnant women who do not have exercise restrictions.

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.

Effects of a 4-week internet-delivered mindfulness-based cancer recovery program on anxiety,depression,and mindfulness among patients with breast cancer

Objective:The efficacy of monotherapy in alleviating psychological disorders like anxiety and depression among breast cancer patients is suboptimal,necessitating effective psychosocial interventions.Mindfulness-based interventions have been shown to mitigate anxiety-depression symptoms and encourage beneficial behaviors.The online mindfulness based cancer recovery(MBCR)offers flexibility and guides practice across various settings,facilitating full patient engagement.This study amis to analyze the impact of a 4-week internet-delivered mindfulness-based cancer recovery program on anxiety,depression,and mindfulness among Chinese patients with breast cancer,and to evaluate the degree of satisfaction breast cancer patients experienced after participating in this program.Methods:This study utilized a two-armed,parallel,randomized controlled trial design.A total of 103 patients with breast cancer from June 2020 to January 2021 in the ward of Breast and Thyroid Surgery of a tertiary hospital in Changsha,Hunan Province were selected and randomly assigned to an intervention group(n=51)and a control group(n=52).The intervention group participated in an internet-delivered mindfulness-based cancer recovery program,which was delivered once a week for 4 weeks.Meanwhile,the control group received weekly group health education for 4 weeks.The outcomes of hospital anxiety and depression scale and mindfulness Attention Awareness Scale were evaluated at 3 distinct time points:Baseline(T1),postintervention(T2),and 1-month follow-up(T3).The satisfaction questionnaire of 4-week mindful cancer rehabilitation training program was used at T2 to evaluate patients’satisfaction with the intervention program.Generalized estimation equations were used to assess differences in anxiety,depression and mindfulness levels between groups before and after the intervention.Results:There were no statistically significant differences in demographic data and outcome index scores between the 2 groups at T1(all P>0.05),indicating that the 2 groups were comparable.The generalized estimating equation analyses showed that the intervention group had significantly better improvement in outcomes compared to the control group,particularly for anxiety(T2β=−1.30,95%CI−1.87 to−0.72;T3β=−2.78,95%CI−3.51 to−2.05)and depression(T2β=−1.92,95%CI−2.78 to−1.06;T3β=−2.96,95%CI−4.05 to−1.87;all P<0.001).Moreover,the mindfulness score in the intervention group was significantly higher than that in the control group at T2(β=3.23,95%CI 0.73 to 5.72)and T3(β=8.06,95%CI 4.37 to 11.75;both P<0.05).In addition,patients in the intervention group were satisfied with the 4-week mindfulness-based cancer recovery intervention and teaching/learning activities used to implement the program.Conclusion:In patients with breast cancer,the 4-week internet-delivered mindfulness based cancer recovery program,as a low-threshold,short-term mental health intervention,has a positive effect on reducing anxiety and depression and improving mindfulness levels.This program holds great promise as a tool for clinical nursing practice,given the high satisfaction and applicability.

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.

Neurological Insights into Attentional Deficits in High Trait Anxiety: a Commentary on Hu et al.’s Paper in Cerebral Cortex (2023)

In a recent publication,Hu et al.(2023)have reported that individuals with high trait anxiety exhibit attentional deficits characterized by reduced inhibition of distractors and delayed attentional selection of targets,indicating impaired top-down attentional control.This commentary underscores their significant contributions to the cognitive theory of anxiety.Based on their findings,we propose a novel training approach called attentional inhibition training(AIT),aimed at improving top-down attentional control to alleviate symptoms of anxiety.Furthermore,we explore the potential application of non-invasive transcranial magnetic stimulation(TMS)for rapidly enhancing attentional control function.

Associated Factors of Anxiety Symptoms in Patients with Keratinocyte Carcinoma:A Cross-Sectional Study

Background:Keratinocyte carcinoma(KC)is a common malignancy characterized by a high recurrence rate and considerable psychological distress.The incidence of KC is increasing in China,raising concerns about its psychological consequences and adverse effects on quality of life.Demographic and clinical factors are thought to influence mental health outcomes in these patients.Nonetheless,data on the prevalence of anxiety in Chinese patients with KC and the factors associated with this anxiety are notably lacking.Therefore,a comprehensive investigation into the anxiety of patients with KC is imperative.Objective:This study aimed to investigate the prevalence of anxiety in patients with KC,a disease that can significantly affect a patient’s appearance and overall quality of life.Understanding the level of anxiety in this population is critical to developing targeted interventions,improving treatment outcomes,supporting mental health,and improving patient care practices.Methods:This cross-sectional study was conducted at China’s largest dermatology hospital from November 2017 to September 2022.A consecutive sampling method was used to recruit participants.Anxiety status was surveyed by the Self-rating Anxiety Scale(SAS).Explanatory variables were surveyed by demographic data questionnaires.Non-parametric test and Chi-square test analyses were used to compare the differences between groups.Multiple linear regression analysis was performed to identify factors associated with anxiety.Results:A total of 192 patients with KC were included.The median score of SAS was 35(IQR 16.25).The prevalence of anxiety in patients with KC was 20.8%.Females(p=0.008),under 60 years old(p=0.011),living in rural(p=0.010)or urban areas(p=0.029),having fewer than three children(p=0.016),with a history of skin diseases(p<0.001),with a history of long-term oral medication(p=0.001),and experiencing pain or itching(p=0.001)had SAS scores that were significantly higher than their counterparts.Conclusion:This study showed that the prevalence of anxiety was very high among Chinese patients with KC,especially among women,young patients,rural residents,patients with fewer than three children,and individuals with a history of skin disease,long-term oral medications,or symptoms of pain or itching.Targeted psychological interventions for these specific populations should be implemented to effectively alleviate anxiety and improve quality of life in these at-risk groups.