Effects of the Treatment of Carpal Tunnel Syndrome with Surgery and Injections on the Hospital Anxiety and Depression Scale (HADS)

Background: The prevalence of carpal tunnel syndrome (CTS) and of anxiety and depression in primary care practice are high. Different studies had shown an increased prevalence of anxiety and depression in CTS patients. Nevertheless, few papers had been published studying the anxiety and depression scales in the treatment of CTS, either with corticosteroid injections (I) or with surgical decompression (S). Objective: To assess whether clinical improvement observed after the treatment of CTS either with I or with S correlates with an improvement in the punctuations of the Hospital Anxiety and Depression scales (HADS), at 3, 6 and 12-month follow-up. Methods: Randomized and open-label clinical trial, comparing I and S. Patients with symptoms suggestive of CTS (nocturnal paraesthesias) of at least 3 months duration and neurophysiological confirmation were included. Patients with clinically apparent motor impairment were excluded. The subjective evaluation of symptoms was carried out using the visual-analogue scale of pain (VAS-p). Clinical reviews were performed 3, 6 and 12 months after treatment. Each patient completed the HADS questionnaire and a VAS-p at 0, 3, 6, and 12 months. Statistical significance was established using the Student’s t test and the Mann-Whitney U test when necessary. A linear regression analysis was used to know the effect of the treatment adjusted for the initial score of both scales. Results: 65 patients were included (30 in group I and 35 in group S). There was no statistical difference between both groups in terms of age, gender distribution, disease duration, VAS-p, neurophysiological testing severity of CTS or the 8 subscales of HADS. Both groups improved significantly in relation to the baseline VAS-p values, in the reviews at 3, 6 and 12 months, with no significant differences between I and S. At 6 months, the reduction in the anxiety scale was around 3 points for both treatments (S = 3.6 and I = 3.2), without reaching significant differences. At 12 months, it was somewhat higher for those treated with I, but always around 3 points and without significant differences. The Depression scale score was slightly reduced at 6 months, and in a similar way for both groups (I = 1 and S = 1.19;p = 0.8). After 12 months, group I doubled the previous reduction, with group S experiencing a very slight change (I = 1.96 and S = 1.03;p = 0.3). When analysing the effect of group S on group I, the result was a reduction of 0.25 points for Anxiety (p = 0.7) and of 0.02 points for Depression (p = 0.9). Conclusions: Treatment of CTS with I or S results in a similar and discrete improvement in Anxiety scores on the HADS scale at 6 and 12 months. For both types of treatment, the Depression scores barely changed at 6 months, being somewhat higher in group I after 12-month follow-up. The independent effect of the S on both scales is small and not significant.

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.

Cronbach's a reliability, concurrent validity, and factorial structure of the Death Depression Scale in an Iranian hospital staff sample

Objective: Death depression is an important component in the process of death and dying. Death depression is the second element of death. Depression is one of the important features in death distress. The aim of this study was to explore the performance of the Farsi version of the Death Depression Scale with an Iranian convenience sample of nurses (n =106).Methods: Nurses were selected using a convenience sampling method, and completed the Death Depression Scale (DDS), Death Concern Scale (DCS), Collett-Lester Fear of Death Scale (CLFDS), Reasons for Death Fear Scale (RDFS), Templer's Death Anxiety Scale (DAS), and Death Obsession Scale (DOS). Results: The results of exploratory factor analysis on DDS identified 4 factors (56.16%of variance). Factor 1 labeled"Death sadness", Factor 2 labeled"Death finality/end and Death dread/fear", Factor 3 labeled"Death despair and Death depression", and Factor 4 labeled"Death loneliness". Cronbach's a coefficient was 0.84, Spearman-Brown coefficient 0.85, and Guttman Split-Half coefficient 0.81 The DDS correlated 0.40 with the DCS, 0.39 with the CLFDS, 0.50 with the DAS, 0.35 with the RDFS, and 0.44 with the DOS, indicating good construct and criterion-related validity. Concurrent validity for the DDS with the other scales were significant. Conclusions: The DDS has good validity and reliability, and it can use in clinical and research settings.

A survey on 564 cases of inpatients with anxiety and depression in general hospitals in 2015

Objective: To understand the prevalence of anxiety and depression in medical patients in general hospitals and find out main influencing factors. Methods: According to the inclusion criteria, a total of 564 inpatients from the Third Affiliated Hospital of Inner Mongolia Medical University were selected during January to June of 2015. Patients were assessed for anxiety and/or depression by use of Hospital Anxiety and Depression Scale (HADS), Hamilton Anxiety Scale (HAMAS) and Hamilton Depression Scale (HAMDS). Meanwhile, final diagnosis was made on the basis of diagnostic criteria listed in Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV). Results: In different departments, the positive rate (HADS ≥ 8) was the highest in Department of Oncology (45.42%), and the lowest in Department of Gastroenterology (16.05%). After assessment with the help of HAMD and HAMA, the prevalence of anxiety/depression was the highest in Department of Oncology (46.43%), and the lowest in Department of Gastroenterology (16.05%). There was no statistical significance in diagnostic results acquired from HAMD and HAMA (p = .071). Two types of diagnostic methods were highly consistent (κ = 0.852, p = .000). Inpatients aged from 40 to 59 years, with junior high school education or below, very tiring work, poor marital status (separated, divorced, widowed), unharmonious family, low personal income, completely self-paying and family history of anxiety and depression, currently unable to take care of themselves were more prone to anxiety and depression (p < .05). Conclusions: The prevalence of anxiety and depression in medical patients in general hospitals is high due to many influencing factors. It is necessary to establish an effective diagnosis and treatment system for anxiety and depression, in order to make patients easy to receive an early and comprehensive treatment and improve their life quality.

Role of irrational beliefs in depression and anxiety: a review

Irrational beliefs play a central role in cognitive theory and therapy;they have been shown to be related to a variety of disorders such as depression and anxiety. Irrational beliefs, which can be assessed via clinical interviewing techniques, are frequently assessed by self-report measures, both clinically and for research purposes. Much of the research demonstrating the effect of irrational beliefs has utilized such measures. The present article reviews the empirical work on irrational beliefs assessment and identifies 25 scales and techniques. The measures are organized according to their theoretical affiliation (i.e., either the Ellis or Beck model), with the goal of providing investigators a source to identify the available tests, their shortcomings, and potential applications. The authors conclude with recommendations which would strengthen empirical cohesion and precision in the measurement of irrational beliefs.

Peripartum depression and its predictors:A longitudinal observational hospital-based study

BACKGROUND Depression is a common problem in women in childbearing years due to burdens of motherhood and building a family.Few studies estimate the prevalence of antepartum depression compared to those in the postpartum period.AIM To estimate the prevalence and the severities of peripartum depression and major depressive disorder and their predictors.METHODS This is a longitudinal observation study.It included 200 women scoring≥13 with the Edinburgh Postpartum Depression Scale,indicating presence of symptoms of depression.They had a gestational age of≥6 wk and did follow-ups until the 10^(th) week to 12^(th) weeks postpartum.Information of women's reactions to life circumstances and stressors during the current pregnancy were gathered from answers to questions of the designed unstructured clinical questionnaire.Severities of depression,anxiety,and parenting stress were determined by the Beck Depression Inventory,State-Trait Anxiety Inventory for Adults,and Parenting Stress Index-Short Form,respectively.Psychiatric interviewing was done to confirm the diagnosis of major depression.Measuring the levels of triiodothronine(T3),thyroxine(T4),and thyroid stimulating hormone(TSH)was done in both antepartum and postpartum periods.RESULTS Out of 968(mean age=27.35±6.42 years),20.66%(n=200)of the patients had clinically significant symptoms of depression and 7.44%had major depression.Previous premenstrual dysphoria,post-abortive depression,and depression unrelated to pregnancy and were reported in 43%,8%,and 4.5%of the patients,respectively.Psychosocial stressors were reported in 15.5%of the patients.Antepartum anxiety and parenting stress were reported in 90.5%and 65%of the patients,respectively.Postpartum T3,T4,and TSH levels did not significantly differ from reference values.Regression analysis showed that anxiety trait was a predictor for antepartum(standardized regression coefficients=0.514,t=8.507,P=0.001)and postpartum(standardized regression coefficients=0.573,t=0.040,P=0.041)depression.Antepartum depression(standardized regression coefficients=-0.086,t=-2.750,P=0.007),and parenting stress(standardized regression coefficients=0.080,t=14.34,P=0.0001)were also predictors for postpartum depression.CONCLUSION Results showed that 20.66%of the patients had clinically significant symptoms of depression and 7.44%had major depression.Anxiety was a predictor for antepartum and postpartum depression.Antepartum depression and parenting stress were also predictors for postpartum depression.

Campus Connectedness and Its Relationship to Stress, Anxiety and Depression among Nepalese Undergraduate Nursing Students

Background: Campus connectedness is a kind of social connectedness that determines the students’ perception of their belonging to the other populace of the campus that includes students, teachers, administrators, and other staff. Campus connectedness plays a significant role in determining stress, anxiety, and depression among students. The purpose of the study was to examine the relationship of campus connectedness to stress, anxiety, and depression among nursing students. Methods: This cross-sectional analytical study was conducted among 680 undergraduate nursing students from nine nursing colleges affiliated with a university in Kathmandu Valley. Data were collected from June 1, 2018, through July 10, 2018. Depression, Anxiety, Stress Scale and Campus Connectedness Scale were used to collect data. The data were analyzed using Statistical Package for Social Sciences version 23. A one-way multivariate analysis of variance (MANOVA) test was used to examine the relationship of campus connectedness to stress, anxiety, and depression. Discriminant analysis was done as a follow-up procedure to MANOVA. Results: Students had moderate to extremely severe levels of depression (51.7%), anxiety (72.9%) and stress (47%). High campus connectedness score was observed (M = 62.42;SD = 9.79). Statistically significant differences were found among the levels of campus connectedness on the outcome variables, Wilks’ lambda (λ) = 0.90, F(3, 676) = 24.56, p < 0.001. Depression demonstrated the strongest relationship with the discriminant function. Conclusions: There was a significant relationship of campus connectedness to stress, anxiety, and depression. Despite the high level of campus connectedness, students had moderate to severe levels of stress, anxiety, and depression. The campus adminstration must take measures and efforts to provide conducive environment and counseling services for the wellbeing of their students.

Relationship between Female Sexual Function and Depression or Anxiety in Japan

Background: Sexual dysfunction is sexual complaints or disorders. There are various causes, but the onset leads to deterioration of relationships and quality of life with partners. There is still a deep-rooted awareness that sexuality is a secret in Japan. Aim: This study aims to clarify the relationship between female sexual function and depression or anxiety. Method: Four hundred and fifty-eight Japanese healthy women who worked in four randomly selected medical institutions in Okinawa Prefecture in Japan from March to May 2012 were asked to agree to a consent form of their own free will and participate in self-reported questionnaires. For their evaluation, the Female Sexual Function Index (FSFI;Rosen et al. 2000, which includes the six domains of desire, arousal, lubrication, orgasm, pain, and satisfaction) and the Kessler Psychological Distress Scale (K6;Kessler, 2002, which includes the following six items: felt nervous, hopeless, restless or fidgety, worthless, depressed, and felt that everything was an effort) was used. Moreover, participants’ characteristics showed age, marriage, menopause, annual income, and drinking. In addition, JMP16.2 and R 4.2.0 was used to perform Pearson’s chi-square test, Fisher’s exact test, Mann-Whitney U test, Kruskal-Wallis test, Steel-Dwass test, Spearman’s Rank-Order Correlation, and Cronbach’s alpha. This study was approved by the university and the medical institutional review board (IRB). Results: 178 women were included in the final analysis, and the median (IQR, interquartile range) was 39 (32 - 48) years old, and the mean ± SD (standard deviation) was 40.2 ± 10.4 years old. The median (IQR) and mean ± SD of FSFI Total Score were 22.0 (9.3 - 26.6) and 19.2 ± 9.6. The median (IQR) and the mean ± SD of K6 Total Score were 3 (0 - 7) and 4.2 ± 4.5. 16% of all women with a K6 Total Score of 10 and more, and 5% of all women with a K6 Total Score of 13 and more considered a serious mental illness. There was no clear association between female sexual function and depression or anxiety in all health worker participants between FSFI Total Score and K6 Total Score by Spearman’s Rank-Order Correlation Coefficient (ρ). However, there was a moderate correlation between the K6 Total Score and the FSFI Total Score in health worker participants with a K6 Total Score of 11 or more (n =19, ρ = ?0.62, P = 0.005). Moreover, there was a weak correlation between them in both married and drinking women or married and non-menopausal women. In the Mann-Whitney U test where few participants had morbid depression, significant relationships were found in the association between a sexual function with high depression or anxiety, whereas the low group had a K6 cut-off value of 11. Conclusion: Female sexual morbidity for high depression or anxiety should be managed with interventions. Especially, the intervention for decreasing female sexual function in the K6 Total Score of 11 or more will be needed, and a randomized study is required for more evidence.

Assessment of Stress Cognitive Control and Executive Function with Stress Control Rating Scale (ECOSTRESS) and Low Resolution Brain Electromagnetic Tomography (LORETA) (In Portuguese People in Situations of Unemployment and Economic Insufficiency)

This article reviews the constructs of stress, appraisal, coping, according to a transactional perspective, and executive function, and presents a stress control rating scale (ECOSTRESS), which design is founded in these constructs. This psychometric tool is useful in the assessment of cognitive control of stress, correlated with the function of dorsolateral prefrontal cortex. It has been validated for its use in the assessment of Portuguese people in situations of stress related to unemployment and economic insufficiency. Also, within the context of the cognitive control of stress, it is highlighted the usefulness of low resolution brain electromagnetic tomography (LORETA).

Increased P wave duration in patients with depression or anxiety disorder

BACKGROUND： Activation of the sympathetic nervous system plays an important role in regulating cardiovascular actions. P wave parameters can provide general information on central cardiovascular autonomic regulatory responses, which are altered in patients with anxiety disorders and depression. In particular, there are no reports addressing changes in P wave duration and dispersion. OBJECTIVE： To compare the differences in P wave duration and P wave dispersion between patients with anxiety disorders and depression, because patients with anxiety disorders and depression develop abnormal electrocardiograms. DESIGN, TIME AND SETTING： A non-randomized concurrent controlled study was performed. Patients with depression and general anxiety disorders were admitted at the psychiatry outpatient clinics of the Medical Faculty of Duezce University of Turkey between May 2005 and October 2006. PARTICIPANTS： A total of 71 consecutive patients with depression and anxiety disorders, as well as 50 physically and mentally healthy age- and gender-matched controls were selected. METHODS： Electrocardiogram records were obtained at the time of admission to the outpatient clinics. MAIN OUTCOME MEASURES： P wave duration and P wave dispersion were measured. RESULTS： Both the maximum （Prnax） and minimum （Pmin） P wave duration were greater in patients with psychiatric disorders than in healthy controls. Pmax was significantly greater in patients with depression or anxiety disorders （Bonferroni test, P 〈 0.017）. The P wave dispersion was similar between patients and controls （P 〉 0.017）. P waves were similar between panic patients and other anxiety patients. Beck depression results were positively correlated with Prawn and Prnax （r= 0.374, 0.302, P = 0.013, 0.049, respectively）, and not associated with P wave dispersion （P 〉 0.05）. CONCLUSION： Psychiatric disorders are associated with increases in Prnax, but not with P wave dispersion. The P wave changes were associated with the degree of depression.

Narrative nursing for negative emotions in patients with acute pancreatitis:Based on model construction and application

BACKGROUND Acute pancreatitis(AP),as a common acute abdomen disease,has a high incidence rate worldwide and is often accompanied by severe complications.Negative emotions lead to increased secretion of stress hormones,elevated blood sugar levels,and enhanced insulin resistance,which in turn increases the risk of AP and significantly affects the patient's quality of life.Therefore,exploring the intervention effects of narrative nursing programs on the negative emotions of patients with AP is not only helpful in alleviating psychological stress and improving quality of life but also has significant implications for improving disease outcomes and prognosis.AIM To construct a narrative nursing model for negative emotions in patients with AP and verify its efficacy in application.METHODS Through Delphi expert consultation,a narrative nursing model for negative emotions in patients with AP was constructed.A non-randomized quasi-experimental study design was used in this study.A total of 92 patients with AP with negative emotions admitted to a tertiary hospital in Nantong City of Jiangsu Province,China from September 2022 to August 2023 were recruited by convenience sampling,among whom 46 patients admitted from September 2022 to February 2023 were included in the observation group,and 46 patients from March to August 2023 were selected as control group.The observation group received narrative nursing plan,while the control group was given with routine nursing.Self-rating anxiety scale(SAS),self-rating depression scale(SDS),positive and negative affect scale(PANAS),caring behavior scale,patient satisfaction scale and 36-item short form health survey questionnaire(SF-36)were used to evaluate their emotions,satisfaction and caring behaviors in the two groups on the day of discharge,1-and 3-month following discharge.RESULTS According to the inclusion and exclusion criteria,a total of 45 cases in the intervention group and 44 cases in the control group eventually recruited and completed in the study.On the day of discharge,the intervention group showed significantly lower scores of SAS,SDS and negative emotion(28.57±4.52 vs 17.4±4.44,P<0.001),whereas evidently higher outcomes in the positive emotion score,Caring behavior scale score and satisfaction score compared to the control group(P<0.05).Repeated measurement analysis of variance showed that significant between-group differences were found in time effect,inter-group effect and interaction effect of SAS and PANAS scores as well as in time effect and inter-group effect of SF-36 scores(P<0.05);the SF-36 scores of two groups at 3 months after discharge were higher than those at 1 month after discharge(P<0.05).CONCLUSION The application of narrative nursing protocols has demonstrated significant effectiveness in alleviating anxiety,ameliorating negative emotions,and enhancing satisfaction among patients with AP.

共情护理对肝硬化住院焦虑抑郁症状影响的研究

目的 探究共情护理对肝硬化住院患者焦虑抑郁症状的影响。方法 选取2023年1月至2024年1月本院收治的肝硬化住院患者60例,采用随机数字表均分为两组,对照组行常规健康教育和心理护理,观察组同步实施共情护理。比较两组的焦虑抑郁严重程度、自我管理行为水平、治疗依从性以及生活质量。结果 干预前,两组各项指标之间的评分均无显著性差异(P>0.05)。干预后,相较于对照组,观察组SAS、SDS评分均明显下降(P<0.05);自我管理行为评分、FCS评分、生活质量各维度评分均明显升高(P<0.05)。结论 在肝硬化住院患者中应用共情护理,可显著改善患者的焦虑抑郁严重程度和自我管理行为,有效提高患者的治疗依从性,明显提升患者的生活质量,值得临床推广。

人文关怀理念精细化护理干预在甲状腺肿瘤腔镜微创手术患者中的应用

目的探讨基于人文关怀理念的精细化护理应用于甲状腺肿瘤腔镜微创手术患者的效果。方法将该院2022年3月至2024年3月的300例接受腔镜微创治疗的甲状腺肿瘤患者分为对照组150例与试验组150例,对照组采用常规护理干预,试验组采用基于人文关怀理念的精细化护理。比较2组患者心理状态、疼痛、并发症发生情况、心理弹性与护理满意度。结果术前、术后试验组焦虑自评量表、抑郁自评量表评分均低于对照组(P<0.05);试验组术后6、12、24、48 h的疼痛数字评分法评分均低于对照组(P<0.05);试验组术后并发症发生率低于对照组[2.67%(4/150)vs.9.33%(14/150)],差异有统计学意义(P<0.05);试验组心理弹性[(84.72±5.92)分vs.(77.43±6.08)分]与护理满意度评分[(91.77±5.70)分vs.(83.64±6.28)分]均高于对照组(P<0.05)。结论基于人文关怀理念的精细化护理应用于甲状腺肿瘤腔镜微创手术患者能有效改善其心理状态,减轻术后疼痛与并发症发生率。

SAS和HADS-A对心血管疾病患者焦虑症状评定结果比较

目的探讨焦虑自评量表(SAS)和医院焦虑抑郁量表焦虑亚量表(HADS-A)对心血管疾病患者焦虑症状评定结果的一致性。方法选取2014年11月-2016年5月在临沂市4所医院住院的心血管疾病患者615例,应用SAS、HADS-A对患者进行测评,随机抽取30例患者间隔两周接受重测。结果 SAS、HADS-A的Cronbach'sα系数分别为0.834、0.806;二者重测信度组内相关系数(ICC)分别为0.934、0.921。SAS与HADS-A总评分呈正相关(r=0.552,P<0.01);二者评定的一致性Kappa值=0.38(U=9.96,P<0.01)。结论 SAS和HADS-A均具有良好的信度,但SAS与HADS-A焦虑评定结果的一致性仅为尚好。

HAD问卷在住院期间孕妇心理评估中的作用分析及干预

目的 探讨医院焦虑抑郁量表（HAD）在住院期间孕妇心理评估及干预中的应用.方法 选取2012年1月～2013年1月在本院住院的孕妇1000例,将其随机分为研究组与对照组各500例,对两组孕妇在孕24周及38周时进行HAD问卷调查,分析影响孕妇产生焦虑抑郁情绪的因素,对照组采用常规的干预措施,研究组采用针对影响焦虑抑郁的因素的干预措施,并在两组产后1、2、4周再次进行HAD问卷调查,对两组干预后的焦虑抑郁情绪进行比较.结果 两组在孕24、38周及产后1、2周的焦虑情绪差异无统计学意义（P＞0.05）,产后4周研究组的焦虑情绪干预效果优于对照组（P＜0.05）.两组在孕24、38周及产后1周的抑郁情绪差异无统计学意义（P＞0.05）,产后2、4周研究组的抑郁情绪干预效果优于对照组（P＜0.05）.结论 HAD问卷在住院期间孕妇心理评估中的作用及干预效果显著,有效降低了孕产妇焦虑抑郁的产生,提高了护理服务质量,值得临床推广应用.

Brain activity in different brain areas of patients with diabetic vitreous hemorrhage according to voxel-based morphometry

AIM:To elucidate the neuropathological mechanisms underlying diabetic vitreous hemorrhage(DVH)and its correlation with clinical characteristics.METHODS:Twenty-one individuals with DVH(male/female 12/9;mean age 52.29±11.66y)were selected,alongside 21 appropriately matched controls with diabetes mellitus(DM).Voxel-based morphometry(VBM)techniques were employed to identify aberrant functional regions in the brain.Receiver operating characteristic(ROC)curves were utilized for classification based on the average VBM values of the two groups,and Pearson correlation analysis was conducted to assess the relationship between average VBM values in distinct brain regions and clinical manifestations.RESULTS:Relative to the DM controls,DVH patients exhibited reduced VBM values in the right superior temporal pole,the right superior temporal gyrus,the right medial orbital frontal gyrus,and the left superior frontal gyrus.Furthermore,ROC curve analysis of these four brain regions in DVH patients demonstrated a high degree of accuracy,as indicated by the area under the curve.The average VBM value in each of these regions exhibited a negative correlation with both the duration of DVH and the score on the Hospital Anxiety and Depression Scale(HADS).CONCLUSION:Pathological alterations in four distinct brain regions are observed in patients with DVH,potentially reflecting neuropathological changes associated with this condition.

基于HADS评价疏肝和胃方对非糜烂性反流病患者的心理干预作用

目的:探讨疏肝和胃方对非糜烂性反流病(non-erosive reflux disease,NERD)患者焦虑抑郁状态的影响。方法:将90例NERD患者随机分为中药组(予疏肝和胃方颗粒剂)和西药组(予雷贝拉唑钠肠溶片)各45例,疗程8周,治疗前后应用医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)评价两组患者焦虑抑郁状态。结果:HADS-A、HADS-D积分中药组治疗前后组内及两组治疗后组间比较差异均有统计学意义(P<0.05)。结论:疏肝和胃方可改善NERD患者焦虑抑郁状态。

Quality of life and emotional change for middle -aged and elderly patients with diabetic retinopathy

AIM:To evaluate the SF-36, Diabetes Specificity Quality of Life Scale (DSQL) and anxiety and depression symptoms and investigate its changes in proliferative diabetic retinopathy (PDR) by vitrectomy interventions. METHODS:The present study included 108 diabetic retinopathy (DR) patients:54 with PDR and 54 with non-proliferative diabetic retinopathy (NPDR). Each healthy control group (n =54) sociodemographically matched to DR groups was established respectively. The quality of life, anxiety and depression symptoms were evaluated and analyzed on preoperative and postoperative month 1 using SF-36, DSQL and Hospital Anxiety and Depression Scale (HADS). · RESULTS:DR patients described impaired HRQL (Health Related Quality of life, SF -36) in 6 out of 8 subscales, including ‘Body Health’, ‘Body RoleFunction’,‘General Health’,‘Society Function’,‘Emotion Role Function’and‘Mental Health’. Compared with controls, DR patients (NPDR and PDR) suffered from statistically significantly impaired HRQL (SF-36 Summary score) (P【 0.05). By surgical intervention, the anxiety and depression score were significantly reduced, while the health and quality of life (SF-36 Summary scores and DSQL scores) was improved in patients with PDR (P 【0.05). CONCLUSION:DR patients were affected in mentation and quality of life. Surgery interventions can improve SF-36, DSQL, anxiety and depression in PDR patients.

Association between gastrointestinal symptoms and affectivity in patients with bipolar disorder

AIM To study if anxiety, depression and experience of stress are associated with gastrointestinal(GI) symptoms in patients with bipolar disorder.METHODS A total of 136 patients with bipolar disorder(mean age 49.9 years; 61% women) and 136 controls from the general population(mean age 51.0 years; 60% women) were included in the study. GI symptoms were assessed with The Gastrointestinal Symptom Rating Scale-irritable bowel syndrome(GSRS-IBS), level of anxiety and depression with The Hospital Anxiety and Depression Scale(HADS) and stress-proneness with Perceived Stress Questionnaire. Over a ten year period, all visits in primary care were retrospectively recorded in order to identify functional GI disorders.RESULTS In subjects with low total HADS-score, there were no significant differences in GI-symptoms between patients and controls(GSRS-IBS 7.0 vs 6.5, P = 0.513). In the patients with bipolar disorder there were significant correlations between all GSRS and HADS subscores for all symptom clusters except for "constipation" and "reflux". Factors associated to GI symptoms in the patient group were female sex(adjusted OR = 2.37, 95%CI: 1.07-5.24) and high HADS-Depression score(adjusted OR = 3.64, 95%CI: 1.07-12.4). These patients had also significantly more visits for IBS than patients with low HADS-Depression scores(29% vs 8%, P = 0.008). However, there was no significant differences in consulting behaviour for functional GI disorders between patients and controls(25% vs 17%, P = 0.108).CONCLUSION Female patients and patients with high HADS depression score reported significantly more GI symptoms, whereas patients with low HADS scores did not differ from control subjects.

Effects of nursing care in fast-track surgery on postoperative pain, psychological state, and patient satisfaction with nursing for glioma

BACKGROUND The brain is the most complex organ in the human body.Treatment for a glioma always involves a multi-disciplinary team.Nursing care in fast-track surgery or enhanced recovery after surgery is such kind of work implemented by an interdisciplinary team to provide services to patients to improve their outcomes.AIM To explore the effects of nursing care in fast-track surgery on postoperative pain,psychological state,and patient satisfaction with nursing for glioma.METHODS From June 2018 to June 2020,138 patients who underwent operation for glioma at Cancer Hospital Affiliated to Chongqing University were selected.They were categorized into groups according to different nursing care that they received.Of them,69 patients receiving nursing care in fast-track surgery were included in an experimental group,and 69 patients receiving conventional postoperative nursing were included in a control group.Visual analogue scale was used to evaluate postoperative pain in the two groups immediately after the operation and at 3 d after the operation.Self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used to evaluate the psychological status of patients immediately after operation and on the 3rd postoperative day.A self-made satisfaction scale for patient satisfaction with nursing was used to evaluate and compare patient satisfaction with nursing between the two groups.RESULTS Time to excretion,time to out-of-bed activities,and length of hospital stay were significantly shorter in the observation group than in the control group(P<0.05).There was no significant difference in duration of operative time or intraoperative bleeding between the two groups(P>0.05).There was no significant difference in postoperative pain score between the two groups(P>0.05).The pain score was significantly lower in the observation group than in the control group at 3 d after the operation(P<0.05).There was no significant difference in postoperative SAS or SDS score between the two groups(P>0.05).SAS and SDS scores were significantly lower in the observation group than in the control group at 3 d after operation(P<0.05).The rate of patient satisfaction with nursing was 94.2%in the observation group,which was significantly higher than that(81.2%)of the control group(P<0.05).CONCLUSION Nursing care in fast-track surgery can relieve postoperative pain,anxiety,and depression,and improve patient satisfaction with nursing in patients with glioma,which is worthy of clinical application.