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.

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.

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.

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.

Preclinical and clinical evidence of the association of colibactinproducing Escherichia coli with anxiety and depression in colon cancer

BACKGROUND The association between the intestinal microbiota and psychiatric disorders is becoming increasingly apparent.The gut microbiota contributes to colorectal carcinogenesis(CRC),as demonstrated with colibactin-producing Escherichia coli(CoPEC).AIM To evaluate the association between CoPEC prevalence and anxiety-and depressive-like behaviors with both preclinical and clinical approaches.METHODS Patients followed after a CRC surgery and for whom the prevalence of CoPEC has been investigated underwent a psychiatric interview.Results were compared according to the CoPEC colonization.In parallel C57BL6/J wild type mice and mice with a CRC susceptibility were chronically infected with a CoPEC strain.Their behavior was assessed using the Elevated Plus Maze test,the Forced Swimming Test and the Behavior recognition system PhenoTyper®.RESULTS In a limited cohort,all patients with CoPEC colonization presented with psychiatric disorders several years before cancer diagnosis,whereas only one patient(17%)without CoPEC did.This result was confirmed in C57BL6/J wildtype mice and in a CRC susceptibility mouse model(adenomatous polyposis colimultiple intestinal neoplasia/+).Mice exhibited a significant increase in anxiety-and depressive-like behaviors after chronic infection with a CoPEC strain.CONCLUSION This finding provides the first evidence that CoPEC infection can induce microbiota-gut-brain axis disturbances in addition to its procarcinogenic properties.

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.

Acupuncture for cervical dystonia associated with anxiety and depression: A case report

BACKGROUND Cervical dystonia(CD)is a type of muscle tone disorder that usually occurs in the neck muscles.Due to the intermittent or continuous involuntary contraction of the neck muscles,the head and neck are twisted and skewed and some postural abnormalities occur.Long-term abnormal posture or pain can cause negative emotions in patients,which can affect their quality of life.CASE SUMMARY This case report included a 37-year-old woman who was diagnosed with CD associated with anxiety and depression;the accompanying symptoms were head and neck tilt of approximately 90°to the right and mental abnormality.After two courses of acupuncture treatment,the patient’s head and neck can be maintained in a normal position,and the negative emotions can be relieved.CONCLUSION This case indicates that acupuncture can effectively improve CD and the emotional state and quality of life of patients,making it an effective alternative treatment for the condition.

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.

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.

Sleep Quality and Emotional Adaptation among Freshmen in Elite Chinese Universities during Prolonged COVID-19 Lockdown:The Mediating Role of Anxiety Symptoms

Under the effects of COVID-19 and a number of ongoing lockdown tactics,anxiety symptoms and poor sleep quality have become common mental health issues among college freshmen and are intimately related to their emotional adaptation.To explore this connection,this study gathered data from a sample of 256 freshmen enrolled in an elite university in China in September 2022.The association between sleep quality,anxiety symptoms,and emotional adaptation was clarified using correlation analysis.Additionally,the mediating function of anxiety symptoms between sleep quality and emotional adaptation was investigated using a structural equation model.The results reveal that:(1)Chinese elite university freshmen who were subjected to prolonged lockdown had poor sleep quality and mild anxiety symptoms;(2)a significant positive correlation between poor sleep quality and anxiety symptoms was identified;(3)anxiety symptoms were found to have a significant negative impact on emotional adaptation;(4)poor sleep quality had a negative impact on emotional adaptation through anxiety symptoms.This research makes a valuable contribution by offering insights into the intricate relationship between sleep quality and emotional adaptation among freshmen in elite Chinese universities during prolonged lockdown conditions,and it is beneficial for schools and educators to further improve school schedules and psychological health initiatives.

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.

Comparing pharmacotherapy and transcranial magnetic stimulation for the treatment of anxiety and depression after aortic dissection surgery

BACKGROUND Aortic coarctation is a potentially fatal condition that is primarily treated surgically.Despite successful procedures,patients frequently experience postoperative anxiety and depression,which can hinder recovery and worsen outcomes.Pharmacological interventions,such as 5-hydroxytryptamine(5-HT)and norepinephrine reuptake inhibitors,are commonly prescribed;however,their efficacy alone or in combination with non-invasive brain stimulation techniques,such as repetitive transcranial magnetic stimulation(TMS),remains unclear.AIM To assess the effect of medications and TMS on post-aortic surgery anxiety and depression.METHODS We analyzed the outcomes of 151 patients with anxiety and depression who were hospitalized for aortic dissection between January 2020 and September 2022.Using the random number table method,75 and 76 patients were allocated to the normal control and study groups,respectively.All the patients were treated using routine procedures.The control group was administered anti-anxiety and antidepression drugs,whereas the study group was treated with TMS in addition to these medications.The patients in both groups showed improvement after two courses of treatment.The Hamilton Anxiety Scale(HAMA)and the Hamilton Depression Scale(HAMD)were used to assess anxiety and depression,respectively.The serum levels of brain-derived neurotrophic factor(BDNF)and 5-HT were determined using enzyme-linked immunosorbent assay.The Pittsburgh Sleep Quality Index(PSQI)was used to estimate sleep quality,and the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)was used to assess cognitive function.RESULTS The HAMD and HAMA scores reduced in 2 groups,with the study group achieving a lower level than control(P<0.05).In the control group,43 patients recovered,17 showed improvement,and 15 were deemed invalid.In the study group,52 recovered,20 improved,and four were invalid.The efficacy rate in study group was 94.74%compared to 80.00%in control(P<0.05).The BDNF and 5-HT levels increased in both groups,with higher levels observed in the experimental group(P<0.05).Moreover,the PSQI scores decreased in 2 groups,but were lower in the intervention group than control(P<0.05).The scores of the RBANS items increased,with the study group scoring higher than control(P<0.05).CONCLUSION Combining anti-anxiety and anti-depressive drugs with repetitive TMS after aortic surgery may enhance mood and treatment outcomes,offering a promising clinical approach.

The Impact of Sleep Determination on Procrastination before Bedtime:The Role of Anxiety

Objective:The importance of good sleep for energy recovery and overall physical and mental health cannot be overstated.However,the increasing competitiveness of society,diversifying lifestyles,and the rapid spread of the internet and electronic devices have significantly impacted people’s sleep patterns,particularly through bedtime procrastination.Therefore,this study aims to investigate the relationship and underlying mechanisms between sleep determination,anxiety,and bedtime procrastination among the Chinese population.Method:The study utilized data from a national survey—the China Residents’Sleep Condition Survey(November 2021,with 6,037 participants).By constructing mediation and moderation models,it analyzed the relationship and mechanisms between sleep determination and bedtime procrastination,highlighting the dual role of anxiety:as a mediator between sleep determination and bedtime procrastination,and as a moderator of their relationship.Results:There was a negative correlation between sleep determination and bedtime procrastination;anxiety was related to an increase in bedtime procrastination behaviors;In the interplay between sleep determination and pre-bedtime procrastination,the regulatory effect of anxiety is found to be more pronounced than its intermediary role,with anxiety significantly diminishing the inverse relationship between sleep determination and procrastination before bedtime.Conclusion:Bedtime procrastination can lead to sleep issues,thus reducing sleep quality.Enhancing sleep determination or alleviating pre-sleep anxiety can help inhibit bedtime procrastination behaviors.Intervening and reducing bedtime procrastination is one of the effective measures to improve sleep quality.

Analysis of influencing factors of anxiety and depression in patients with periodontitis

BACKGROUND Periodontitis is a chronic oral disease caused by pathogenic microorganisms that corrode tooth tissue,form periodontal pockets,absorb alveolar bone,and finally lead to tooth loss.During treatment,patients are prone to anxiety,tension,and other negative emotions,which affect their ability to face the disease and may also lead to aggravation of the original condition and affect oral health.Therefore,it is important to improve the negative psychology of patients with periodontitis to clarify the factors that may lead to negative psychological emotions.AIM To investigate the risk factors that may lead to anxiety and depression in patients with periodontitis.METHODS One hundred patients with periodontitis were selected between March 2022 and March 2023 at our hospital.All patients were assessed with the Zung Self-rating Depression Scale(SDS)(≥53 points indicate a depressive state)and Zung Selfrating Anxiety Scale(SAS)(≥50 points indicates an anxious state).In this study,patients who experienced anxiety or depression were included in the occurrence group and those without anxiety or depression were included in the nonoccurrence group.The baseline data of the two groups were compared to explore the risk factors for anxiety and depression in patients with periodontitis.RESULTS A total of 100 patients with periodontitis were included in this study.According to the SDS,38 patients(38.00%)developed depression,with an average SDS score of(68.52±5.85)points.According to the SAS,40 patients(40.00%)developed anxiety,and the average SAS score was(72.15±4.15)points.In this study,56 patients with anxiety or depression were included.Compared with the nonoccurrence group,the occurrence group had higher ages(≥60 years),lower level of hope(low level),educational level(high school or below),disease perception(poor),and sleep disorder(yes).The negative coping dimension scores of the simplified coping style questionnaire(SCSQ)and Dental Fear Scale(DFS)in the occurrence group were higher,whereas the score of the positive coping dimension of the SCSQ was significantly lower(P<0.05).There were no significant differences in the other data between the groups(P>0.05).The results of multiple logistics regression analysis showed that age(≥60 years),level of hope(low level),educational level(high school or below),disease perception(poor),sleep disorder(yes),high negative coping dimension scores of SCSQ,high score of DFS,and low positive coping dimension scores of SCSQ were all factors contributing to the anxiety and depression in patients with periodontitis(odds ratio>1,P<0.05).CONCLUSION Age,hope level,educational level,disease perception,sleep disorders,coping style,and dental fear were all associated with anxiety and depression in patients with periodontitis.

The Influence of Vulnerable Narcissism on Social Anxiety among Adolescents:The Mediating Role of Self-Concept Clarity and Self-Esteem

Social anxiety (SA) is a prevalent mental health issue among adolescents, and vulnerable narcissism (VN) can exacerbate thiscondition. This study aims to investigate the impact of vulnerable narcissism on social anxiety in adolescents, specificallyfocusing on the mediating effects of self-concept clarity (SCC) and self-esteem (SE) in the relationship between vulnerablenarcissism and social anxiety. Through cluster sampling, a questionnaire survey was conducted among 982 students from threesecondary schools in two provinces. The data was analyzed using structural equation modeling (SEM). The results revealedthat there was a significant negative correlation between vulnerable narcissism and both self-concept clarity and self-esteem,while there was a significant positive correlation between vulnerable narcissism and social anxiety. Additionally, self-conceptclarity showed a significant positive correlation with self-esteem but had a negative correlation with social anxiety. Both selfconceptclarity and self-esteem played an intermediary role in the chain linking vulnerable narcissism to social anxiety. Thisstudy confirms the mediating role of both self-concept clarity and self-esteem in explaining how vulnerable narcissisminfluences social anxiety, providing valuable insights into its underlying mechanism.

Nomogram for predicting the risk of anxiety and depression in patients with non-mild burns

BACKGROUND Post-burn anxiety and depression affect considerably the quality of life and recovery of patients;however,limited research has demonstrated risk factors associated with the development of these conditions.AIM To predict the risk of developing post-burn anxiety and depression in patients with non-mild burns using a nomogram model.METHODS We enrolled 675 patients with burns who were admitted to The Second Affiliated Hospital,Hengyang Medical School,University of South China between January 2019 and January 2023 and met the inclusion criteria.These patients were randomly divided into development(n=450)and validation(n=225)sets in a 2:1 ratio.Univariate and multivariate logistic regression analyses were conducted to identify the risk factors associated with post-burn anxiety and depression dia-gnoses,and a nomogram model was constructed.RESULTS Female sex,age<33 years,unmarried status,burn area≥30%,and burns on the head,face,and neck were independent risk factors for developing post-burn anxiety and depression in patients with non-mild burns.The nomogram model demonstrated predictive accuracies of 0.937 and 0.984 for anxiety and 0.884 and 0.923 for depression in the development and validation sets,respectively,and good predictive per-formance.Calibration and decision curve analyses confirmed the clinical utility of the nomogram.CONCLUSION The nomogram model predicted the risk of post-burn anxiety and depression in patients with non-mild burns,facilitating the early identification of high-risk patients for intervention and treatment.

Analysis of acupoint massage combined with touch on relieving anxiety and pain in patients with oral implant surgery

BACKGROUND Oral implant surgery is an effective procedure for artificial implants in missing tooth areas under local anesthesia.Because patients under local anesthesia are conscious during this procedure,compared with general anesthesia-related operations,they are more likely to experience negative emotions,such as anxiety and tension.These emotional reactions result in shivering and chills in the limbs,leading to poor doctor-patient cooperation and even avoidance of treatment.In traditional Chinese medicine,it is believed that acupoint massage regulates blood and Qi,dredge menstruation,and relieve pain,which is beneficial for patients’emotional adjustment;however,there are few related clinical studies.AIM To observe the changes in anxiety and pain in patients with oral implant after acupoint massage combined with touch therapy.METHODS One hundred patients undergoing oral implantation in our hospital between May 2020 and May 2023 were randomly divided into control and study groups,according to a random number table,with 50 patients in each group.The control group received routine intervention,and the study group received acupoint massage combined with touch on the basis of the control group.Anxiety[assessed using the Modified Dental Anxiety Scale(MDAS)],pain severity,blood pressure,heart rate,and satisfaction were compared between the two groups.RESULTS Before intervention,the difference in MDAS score between the two groups was not significant(P>0.05),while after the intervention,the MDAS scores decreased in both groups compared with those before the intervention(P<0.05);the MDAS score of the study group was lower than that of the control group,with a statistically significant difference(P<0.05).The degree of pain in the intervention group was significantly lower than that in the control group(P<0.05).Before the intervention,there were no significant differences in systolic and diastolic blood pressures or heart rate between the two groups(P>0.05).The systolic and diastolic blood pressures and heart rate in the intervention group,during and after the intervention,were significantly lower than those in the control group(P<0.05).The total degree of satisfaction in the study group was significantly higher than that in the control group(P<0.05).CONCLUSION Acupoint massage combined with touch better relieves anxiety and pain in patients undergoing dental implant surgery,improving the perioperative comfort of these patients and ensuring safety and a smooth operation.

Post-COVID-19 Challenges for Full-Time Employees in China: Job Insecurity, Workplace Anxiety and Work-Life Conflict

Background:Though the COVID-19 pandemic recedes,and our society gradually returns to normal,Chinese people’s work and lifestyles are still influenced by the“pandemic aftermath”.In the post-pandemic era,employees may feel uncertainty at work due to the changed organizational operations and management and perceive the external environment to be more dynamic.Both these perceptions may increase employees’negative emotions and contribute to conflicts between work and life.Drawing from the ego depletion theory,this study aimed to examine the impact of job insecurity during the post-pandemic era on employees’work-life conflicts,and the mediating effect of workplace anxiety in this relationship.Besides,this study also considered the uncertainty of the external macro environment as a boundary condition on the direct and indirect relationship between job insecurity and work-life conflicts.Methods:A two-wave questionnaire survey was conducted from October to December 2023 to collect data.MBA students and graduates from business school with full-time jobs are invited to report their perception of job insecurity,work anxiety,perceived environment uncertainty,and work-life conflict.This resulted in 253 valid responses.Data analysis was performed using the SPSS,Amos,and PROCESS.Results:The results showed that:(1)Employees’job insecurity would directly intensify the work-life conflict(B=0.275,p<0.001,95%CI[0.182,0.367]).(2)Employees’workplace anxiety mediates the relationship between job insecurity and work-life conflict(B=0.083,p<0.001,95%CI[0.047,0.130]).(3)The mediating effect of workplace anxiety between job insecurity and work-life conflict exists when perceived environmental uncertainty is high(B=0.049,95%CI[0.011,0.114]),while vanishes when perceived environmental uncertainty is low(B=0.024,95%CI[−0.005,0.068]).Conclusion:Job insecurity combined with perceived environmental uncertainty in the postpandemic era fuels employees’workplace anxiety and work-life conflicts.Post-pandemic trauma lingers,necessitating urgent attention and response.

Psychological intervention based on social cognitive theory: Treating pain, anxiety, and depression in perioperative patients

BACKGROUND Surgery is an effective method for treating certain diseases.Factors such as disease,preoperative fear and tension,surgical stress,postoperative pain,and related complications directly affect the smooth progression and outcome of surgery.Patients may experience a series of psychological and physiological changes during the perioperative period,resulting in anxiety and depression,which may reduce the pain threshold and worsen their prognosis.METHODS We enrolled 200 patients who underwent surgical care at The First People’s Hospital of Lin’an District,Hangzhou between January and December 2023.They were categorized into a routine intervention group(n=103)and a psychological intervention group(n=97),based on the intervention strategies used.Various assessment tools,including the self-rating anxiety scale(SAS),the self-rating depression scale(SDS),and the Connor–Davidson Resilience scale,were used to measure patients’negative states and emotions.The pre-and post-intervention scores for these metrics in the two groups were then analyzed.RESULTS In the psychological intervention group,the SAS and SDS scores(31.56±5.18 and 31.46±4.57,respectively)were significantly reduced compared to the routine intervention group(P<0.05).The visual analog scale pain scores at 12 and 24 hours after intervention(6.85±1.21,4.24±0.72)were notably higher than those in the routine intervention group(P<0.05).The psychological intervention group also demonstrated superior scores in perseverance(36.08±3.29),self-reliance(22.63±2.91),optimism(11.42±1.98),and resilience(70.13±5.37),compared to the routine intervention group(P<0.05).Additionally,the psychological intervention group’s confrontation score(23.16±4.29)was higher(P<0.05).This group also reported lower scores in avoidance(9.28±1.94)and yielding(6.19±1.92)(P<0.05).Lastly,the Short Form 36 Health Survey scores were significantly higher in the psychological intervention group,indicating a better quality of life(P<0.05).CONCLUSION Psychological intervention measures based on SCT can effectively alleviate pain,anxiety,and depression in periop-erative patients.

Status quo and factors of depression and anxiety in patients with non-muscle invasive bladder cancer after plasma electrocision

BACKGROUND Bladder cancer is a type of cancer with a high incidence in men.Plasma electrosurgery(PES)is often used in the treatment of bladder cancer.Postoperative complications often cause depression and anxiety in patients after surgery.AIM To investigate the current state of depression and anxiety after PES in patients with non-muscle-invasive bladder cancer and analyze the factors affecting them.METHODS A retrospective study was conducted to compare the baseline data of patients by collecting their medical history and grouping them according to their mental status into negative and normal groups.Logistic regression analysis was used to explore the risk factors affecting the occurrence of anxiety and depression after surgery in patients with bladder cancer.RESULTS Comparative analyses of baseline differences showed that the patients in the negative and normal groups differed in terms of their first surgery,economic status,educational level,and marital status.A logistic regression analysis showed that it affected the occurrence of anxiety in patients with bladder cancer,and the results showed that whether the risk factors were whether or not it was the first surgery,monthly income between 3000 and 3000-6000,secondary or junior high school education level,single,divorced,and widowed statuses.CONCLUSION The risk factors affecting the onset of anxiety and depression in bladder cancer patients after PES are the number of surgeries,economic status,level of education,and marital status.This study provides a reference for the clinical treatment and prognosis of bladder cancer patients in the future.