Depression and anxiety correlate with disease-related characteristics and quality of life in Chinese patients with gout: a case-control study

This study aims to evaluate the prevalence of depression and anxiety and investigate the potential risk factors for depression and anxiety in Chinese gout patients. A self-report survey was administered to 226 gout patients and 232 age- and gender-matched healthy individuals. Patients were asked to complete a set of standardized self-report questionnaires. Univariate and mutiple regression were used to analyze the data. We found 15.0% of gout patients had depression, and 5.3% had anxiety. After adjusted demographic variables, the prevalence of depression was significantly higher than the healthy controls (6.0%). There were significant correlations among education, total pain, disease duration, stage of gout, functional disability, number of tophi, number of flares/last year, presence of tender joints, nephropathy comorbidity, health-related quality of life (HRQoL), and psychological status. Meanwhile, logistic regression analysis identified number of tophi, functional disability, and mental component summary (MCS) as predictors of depression in gout patients. Education and MCS were significantly accounted for anxiety. In summary, the prevalence of depressive symptoms among gout patients was higher than healthy individuals. Education, disability, tophi and HRQoL were important risk factors linked to depression/anxiety in Chinese gout population.     

Socioeconomic and sociocultural determinants of psychological distress and quality of life among patients with psoriasis in a selected multi-ethnic Malaysian population

Patients with psoriasis may have increased risk of psychological comorbidities. This cross-sectional study aimed at determining associations between sociocultural and socioeconomic factors with the Depression Anxiety Stress Scale (DASS) scores and the Dermatology Life Quality Index (DLQI) scores. Adult patients with psoriasis were recruited from a Dermatology outpatient clinic via convenience sampling. Interviews were conducted regarding socio-demographic factors and willing subjects were requested to complete the DASS and DLQI questionnaires. The Pearson χ² test, Fisher’s exact test and multivariate logistic regression were used for statistical analysis to determine independent predictors of depression, anxiety, stress and severe impairment of quality of life. Unadjusted analysis revealed that depression was associated with Indian ethnicity (p = .041) and severe impairment of quality of life was associated with Indian ethnicity (p = .032), higher education (p = .013), higher income (p = .042), and employment status (p = .014). Multivariate analysis revealed that Indian ethnicity was a predictor of depression (p = .024). For stress, tertiary level of education (p = .020) was an independent risk factor while a higher monthly income was a protective factor (p = .042). The ethnic Indians and Malays were significantly more likely than the ethnic Chinese to suffer reduced quality of life (p = .001 and p = .006 respectively) and subjects with tertiary education were more likely to have severe impairment of quality of life (p = .002). Our study was unique in determining sociocultural influences on psychological complications of psoriasis in a South East Asian population. This has provided invaluable insight into factors predictive of adverse effects of psoriasis on psychological distress and quality of life in our patient population. Future studies should devise interventions to specifically target at risk groups in the development of strategies to reduce morbidity associated with psoriasis.     

The correlations of psychological status,quality of life,self-esteem,social support and body image disturbance in Chinese patients with Systemic Lupus Erythematosus

This study aimed (i) to complement existing research by focusing on body image disturbance issues in Chinese Systemic Lupus Erythematosus (SLE) patients; (ii) to investigate how Chinese patients make sense of disease diagnosis and perceived cultural influences within the context of their SLE. A total of 118 SLE patients underwent standardized laboratory examinations and completed several questionnaires. Independent sample t-test, Mann–Whitney U-test, Chi-square test, and multivariate analysis using backward stepwise logistic regression model were used to analyze these data. We found 18.3% SLE patients had BID, which were significantly higher than the control group (.8%). SLE patients are more concerned about their physical changes caused by disease. There were significant correlations among personal health insurance, complication of diabetes, appearance of new rash, depression, anxiety, self-esteem and BID in patients with SLE. Meanwhile, logistic regression analysis revealed that appearance of new rash and high anxiety were significantly associated with BID in SLE patients. In conclusion, it is beneficial to pay attention to the physical and mental health of patients with rheumatic disease from the perspective of body image, to understand their needs and to provide effective and effective service for them.     

Trajectory of change in anxiety sensitivity in relation to anxiety,depression, and quality of life among persons living with HIV/AIDS following transdiagnostic cognitive-behavioral therapy

ABSTRACT

Persons living with HIV/AIDS (PLHIV) disproportionately suffer from anxiety and depressive symptoms and disorders. Although past work has examined the efficacy of cognitive-behavioral therapy (CBT) for depression, and to a lesser extent anxiety, among PLHIV, little is known regarding potential mechanisms underlying improvement in anxiety/depression among this group. Anxiety sensitivity is a well-established risk/maintenance factor for anxiety and depressive disorders and is hypothesized to play an important role in maintaining anxiety among PLHIV. Past work has identified anxiety sensitivity as a mechanism of action underlying changes in various anxiety domains yet it is unknown whether changes in anxiety sensitivity relate to changes in anxiety symptoms among PLHIV undergoing transdiagnostic CBT for anxiety. The current study sought to examine treatment-related changes in anxiety sensitivity and how the trajectory of change relates to anxiety and depressive symptoms as well as overall quality of life. Individuals (n = 35) with HIV/AIDS and elevated anxiety symptoms received CBT for anxiety. Results indicated that reductions in anxiety sensitivity were significantly related to changes in anxiety, depression, and quality of life. Together, these data suggest that changes in anxiety sensitivity are significantly related to changes in anxiety/depression and quality of life among PLHIV seeking treatment.     

Prediction of Health Patterns from General Appraisal,Attributions, Coping,and Trait Anxiety

We examined the relationships among general appraisal style, attributional style, trait anxiety, coping styles, and health status (i.e., depression, hostility, and flu-like symptoms) in a study for which we also examined the validity of a trait measure of general appraisal. Participants completed personality measures at the beginning of an academic semester, and health assessments at regular intervals throughout the semester. Consistent with our predictions, after removing the influence of neuroticism and attributional style, general appraisal style led to more negative, and less positive affect 2 weeks later, and to more stressful and threatening appraisals of a life event occurring 3 months later. Multiple regression techniques showed that as predicted, after controlling for baseline health general appraisal style and attributional style predicted hostility and flu-like symptoms, and attributional style also predicted depression. These effects were mediated by trait anxiety. We discuss why both negative general appraisal and attributional styles may be risk factors for ill health.     

Dental pain related to quality of life and mental health in South Korean adults

High levels of stress, anxiety and depression have been reported in patients with orofacial pain. Dental pain has the potential to reduce quality of life (QOL), and pain relief is important aspect of QOL. The purpose of this study was to assess the relationships of dental pain with QOL and mental health using a nationally representative, population-based study. This study analyzed data from the 2012 Korea National Health and Nutrition Examination Survey (N = 5469). Oral health status was assessed using the oral health questionnaire, and oral examination was performed by trained dentists. Health-related QOL (HRQOL) was evaluated using EQ-5D and EQ-VAS, and mental health was evaluated by questionnaires. Logistic regression was applied to estimate adjusted odds ratios (AOR) and 95% confidence intervals (CI). Among 5469 adults, 1992 (36.42%) presented self-reported dental pain. Participants with anxiety/depression or pain/discomfort, and participants with stress, melancholy, suicidal thought or depression showed significantly higher prevalence of dental pain. After adjusting for covariates, five aspects of QOL and five aspects of mental health were related with dental pain. The AORs (95% CI) for dental pain were 1.39 (1.06–1.81) for mobility, 1.77 (1.19–2.63) for self-care, 1.38 (1.02–1.85) for usual activities, 1.73 (1.43–2.09) for pain/discomfort and 1.50 (1.13–1.98) for anxiety/depression. For mental health status factors, the AORs (95% CI) for dental pain were 1.29 (1.11–1.51) for stress, 1.37 (1.09–1.74) for melancholy, 1.26 (1.01–1.58) for suicidal thoughts, 1.43 (.93–2.19) for consultation to psychiatrist and 1.53 (1.07–2.19) for depression. This study showed that dental pain has an association with lower HRQOL and worse mental health status in South Korean adults.     

Pain appraisal and quality of life in 108 outpatients with rheumatoid arthritis

Individual differences in emotional functioning, pain appraisal processing, and perceived social support may play a relevant role in the subjective experience of pain. Due to the paucity of data regarding individuals with Rheumatoid Arthritis (RA), the present study aimed to examine pain intensity, emotional functioning (psychological distress and alexithymia), pain appraisal (pain beliefs, pain catastrophizing, and pain-related coping strategies) and social support, and their relationships with the health-related quality of life (HRQoL) in patients with RA. Data were collected from 108 female patients diagnosed with RA. Clinically relevant levels of depressive and anxiety symptoms assessed by the HADS subscales were present in 34% and 41% of the patients, respectively, and about 24% of them exhibited the presence of alexithymia. The results of hierarchical multiple regression analyses showed that pain intensity, alexithymia, the maladaptive beliefs regarding the stability of pain and the coping strategy of guarding explained 54% of the variance in the physical component of HRQoL (p < 0.001). Depression subscale of the HADS, alexithymia, the coping strategy of resting, and the rumination factor of pain catastrophizing significantly explained 40% of the variance in the mental component of HRQoL (p < 0.001). The present findings provide evidence regarding the importance of emotional functioning and pain appraisal in the negative impact of RA on patients’ quality of life. These findings provide additional evidence for the biopsychosocial model of chronic pain, further supporting the complex interaction between emotional, cognitive, and behavioral processes in patients with chronic pain.     

Internet-delivered transdiagnostic and tailored cognitive behavioral therapy for anxiety and depression: a systematic review and meta-analysis of randomized controlled trials

Anxiety and depressive disorders are often comorbid. Transdiagnostic and tailored treatments seem to be promising approaches in dealing with comorbidity. Although several primary studies have examined the effects of Internet-delivered cognitive behavior therapy (iCBT) for anxiety and depression, no meta-analysis including different types of iCBT that address comorbidity has been conducted so far. We conducted systematic searches in databases up to 1 July 2016. Only randomized trials comparing transdiagnostic/tailored iCBT for adult anxiety and/or depression with control groups were included. Nineteen randomized trials with a total of 2952 participants that met inclusion criteria were analyzed. The quality of the studies was high, however the blinding criteria were not fulfilled. The uncontrolled effect size (Hedges’ g) of transdiagnostic/tailored iCBT on anxiety and depression outcomes was large and medium for quality of life. The controlled effect size for iCBT on anxiety and depression outcomes was medium to large (anxiety: g = .82, 95% CI: .58–1.05, depression: g = .79, 95% CI: .59–1.00) and medium on quality of life (g = .56, 95% CI: .37–.73). Heterogeneity was small (quality of life) to moderate (anxiety, depression). There was a large effect on generic outcome measures and a moderate effect on comorbidities. When compared to disorder-specific treatments there were no differences on anxiety and quality of life outcomes, however there were differences in depression outcomes. Transdiagnostic and tailored iCBT are effective interventions for anxiety disorders and depression. Future studies should investigate mechanisms of change and develop outcome measures for these interventions.     

Locus of control,anxiety, and depression in infertile patients

This study aimed to examine the relationship of locus of control (LoC) with anxiety and depression disorders, applying multivariate statistical techniques to control for the effects of demographic/fertility variables. This cross-sectional study included 312 infertile patients in a referral fertility center in Tehran, Iran via convenience sampling. The Hospital Anxiety and Depression Scale and the Levenson’s Locus of Control Scale were administered to all participants. Hierarchical multiple linear regressions were used to identify factors associated with anxiety and depression. After controlling for demographic/fertility variables, hierarchical regression analyses showed that internal LoC was negatively associated with anxiety (β = –.213, p < .001) and depression (β = –.269, p < .001). Powerful others subscale was positively associated with anxiety (β = .176, p < .001), but there was no significant relationship between this subscale and depression (β = .047, p = .467). The findings of this study merit the understanding of the role of demographic/fertility characteristics and LoC orientations in anxiety and depression of infertile patients to identify beforehand those patients who might be at risk of experiencing high anxiety and depression and in need of support.     

Suicide ideation among oncologic patients in a Spanish ward

Oncologic patients are exposed to a higher risk of suicidal behaviors than the general population. In this study, we aim to examine the severity of suicidal ideation in a sample of oncologic patients considering different psychological and clinical features. We interviewed 202 inpatients receiving curative or palliative treatment in a medical oncology ward of a Spanish hospital during the period 2012–2014. A complete assessment of psychosocial factors, cancer diagnoses (lung, colon rectum, and genitourinary system), and suicidal behaviors were made during admission, including validated questionnaires about depression, anxiety, personality, quality of life, body image, life threatening events, hopelessness, and suicidal ideation. The characteristics of inpatients with high and low suicidal ideation were retrospectively compared. A logistic regression model was constructed to examine the relationship between the significant factors retained after the univariate analyses. One of every four patients (n = 51; 25.24%) presented high scores of suicidal ideation. Logistic regression analyses retained depression (OR = 3.55; 95% CI = 1.25–11.68; p = .016), hopelessness (OR = 8.78; 95% CI = 3.44–25.88; p ≤ .001), personality (OR = .44; 95% CI = .2–.96; p = .038), and advanced age (OR = 2.60; 95% CI = 1.18–5.98; p = .016) as the main risk factors for high suicidal ideation. Suicidal ideation was frequent among oncologic patients. These patients should receive closer monitoring, especially, when old, retired, or severely depressed.     

Personality,life events and the course of anxiety and depression

Using data from the Netherlands Study of Depression and Anxiety, we examined among 1322 participants with a DSM‐IV diagnosis of depression or anxiety: (i) whether positive and negative life events influence 1‐year course of anxiety and depressive symptoms; (ii) whether personality traits (neuroticism and extraversion) predict symptom course and moderate the impact of life events on symptom course; and (iii) whether life events mediate relationships of neuroticism and extraversion with symptom course. Negative life events were predictive of both anxiety and depressive symptoms, while positive life events predicted the course of depressive symptoms only. Personality traits had significant predictive and moderating effects on symptom course, though these effects were rather small. Copyright © 2011 John Wiley & Sons, Ltd.     

Rates and Correlates of DSM-IV Diagnoses in Women Newly Diagnosed with Breast Cancer

Although the presence of psychological distress has been documented in women with breast cancer, previous studies have not established rates of DSM-IV diagnoses in this population, nor have prior investigations compared the utility of diagnostic interviewing vs. symptom checklists to assess distress. DSM-IV diagnoses of anxiety disorders and major depression, symptoms of anxiety and depression, and quality of life were examined in 207 women with newly diagnosed breast cancer. Eighteen percent of breast cancer patients met criteria for a current DSM-IV anxiety or depressive disorder and 54% met criteria for a disorder at some point in their lifetime. These rates are comparable to those found in recent community epidemiological studies (e.g., R. C. Kessler, K. A. McGonagle, S. Zhao, C. B. Nelson, M. Hughes, S. Esheman, et al., 1994). Sensitivity, specificity, and positive predictive value for anxiety and depression symptoms as predictors of DSM disorders were relatively poor. However, after accounting for demographic, treatment, and cancer variables, self-reported anxiety symptoms were significantly related to the presence of an anxiety disorder and self-reported depressive symptoms were significantly related to a diagnosis of a depressive disorder. Symptoms of anxiety and depression contributed significantly and uniquely to physical, medical, and sexual quality of life; DSM-IV diagnoses were not significantly related to quality of life after controlling for symptoms of depression and anxiety. The importance of measuring both symptoms of distress and psychiatric diagnoses in cancer patients and the clinical practice implications of the results are discussed.     

Clarifying the unique associations among intolerance of uncertainty,anxiety, and depression*

Increasing evidence suggests that intolerance of uncertainty (IU) may be a transdiagnostic factor across the anxiety disorders, and to a lesser extent, unipolar depression. Whereas anxiety inherently involves uncertainty regarding threat, depression has traditionally been associated with certainty (e.g. the hopelessness theory of depression). Some theorists posit that the observed relationship between depression and IU may be due to the relationship between depression and anxiety and the relationship between anxiety and IU. The present study sought to elucidate the unique relationships among trait anxiety, depression, and IU in undergraduate (N = 554) and clinical (generalized anxiety disorder; N = 43) samples. Findings suggest that IU may play a larger role in anxiety than depression, although some evidence indicates that inhibitory IU and depression may have a modest but independent relationship.     

The effects of anxiety and depression on in vitro fertilisation outcomes of infertile Chinese women

The object was to assess anxiety and depression during in vitro fertilisation (IVF) treatment and determine IVF-related psychological factors in infertile Chinese women. The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate anxiety and depression among 842 patients, respectively. A univariate analysis was used to compare variables among three SAS groups and three SDS groups. Anxiety and depression were both represented in 21.3% of the cases. Patients <35 years tended to be more anxious. In women <35 years, the SDS scores were higher with lower educational backgrounds and female or couple’s infertility, while the SAS scores were higher in female or couple’s infertility. In older ones, the SDS scores were higher in those with lower educational backgrounds and longer time for infertility, while the SAS scores were higher in those with lower educational backgrounds. In SAS groups 1–3, the embryo availability was 5.0 (3.0–8.0), 5.0 (3.0–8.0), and 3.0 (2.0–4.5) (p = .013); and the fertilisation rate was 91.9, 90.4, and 81.8% (p < .001), respectively. We concluded that infertile women experience anxiety and depression during IVF treatment, especially in women <35 years. Younger women with female infertility would be more anxious and depressive while higher education can protect them from depression. In older ones, they would experience more depressive with longer time for infertility and be less anxious and depressive with higher education. Anxiety affects the fertilisation rate and embryo availability.     

The dermatology life quality index (DLQI) and the hospital anxiety and depression (HADS) in Chinese rosacea patients

The study aims to investigate the quality of life (QOL) and the psychological situation in Chinese patients with rosacea. A total of 196 healthy controls and 201 rosacea patients were involved in the final analysis. The general information, the Dermatology Life Quality Index (DLQI) and the Hospital Anxiety and Depression Scale (HADS) were collected. Significantly higher DLQI, anxiety and depression score were observed in the rosacea group compared to the control group (p < .01). Total DLQI score of patients was positively related with anxiety (r = .526, p < .001) and depression scores (r = .399, p < .001) in HADS. Rosacea had significant psychological impact on Chinese patients and had substantial influence on their QOL. Physicians should address the psychosocial needs of rosacea patients as much as its physical symptoms.     

Victimized Children’s Adjustment Difficulties: The Role of Parenting Styles and Parents’ Childhood Peer Victimization Status

The purpose of the present study was to examine the role of parents’ childhood victimization status in the associations among parenting styles and victimized children’s depression and anxiety. Participants were 203 parents (86% mothers; M age = 43.75, SD = .76) and their children in the fourth or fifth grade (n = 203; 56% female; M age = 9.74, SD = .34). Children completed measures on peer victimization, their perceptions of their parents’ parenting styles, depression, and anxiety, while parents completed a measure on their childhood peer victimization while in elementary school. Parents’ childhood peer victimization status moderated relationships among authoritarian and permissive parenting styles and victimized children’s adjustment difficulties. These findings highlight the importance of considering parents’ experience of childhood peer victimization and its impact on their parenting styles and their children’s adjustment difficulties.     

Psychological health in long-term cancer survivorship: an Italian survey on depression and anxiety

Since long-term survivorship is now a reality for an increasingly number of people with a history of cancer, understanding their psychological health can inform health care policy as well as help supporting individual patients. This study was aimed to describe depression and anxiety (i.e. two of the most common psychological symptoms reported in oncology) in a sample of Italian long-term cancer survivors (LTCSs) defined as people who have been free from cancer and cancer treatments for at least five years. Four hundred and four Italian adult LTCSs completed a battery of questionnaires including the Zung Self-rating Depression Scale and the State Anxiety sub-scale of the State-Trait Anxiety Inventory respectively for depression and anxiety assessment. 16.5% of the sample displayed mild depression, 11.1% moderate depression, and 7.1% severe depression. depression was negatively associated with education (p = .017), perceived social support as provided by the family (p = .028), and perceived social support provided by friends (p = .008), and it was positively associated with occupational status (p = .023), presence of health issues (p = .010), and anxiety (p < .001). 8.7 and 15.8% of the sample were respectively possible and probable cases of anxiety. Anxiety was negatively associated with occupational status (p = .038) and it was positively associated with depression (p < .001). These data support ongoing assessment and monitoring of depression and anxiety in LTCSs, and stimulate the development and testing of psychological interventions for such individuals. In addition, they encourage further study on the psychological health of this specific population.     

Anxiety,depression, and health-related quality of life in aging people living with HIV compared to diabetes patients and patients with minor health conditions: a longitudinal study

HIV infection has evolved from a fatal to a treatable condition, leading to an increase in the rate of elderly People Living with HIV (PLWH). However, little is known about the psychosocial burden of elderly PLWH. Thus, the aim of this longitudinal multi-center cohort study was to investigate whether elderly PLWH experience more anxiety and depression and reduced health related quality of life (HRQOL) compared to elderly patients with other chronic conditions. PLWH were compared to diabetes patients (DM) and patients with minor health conditions (MHC), e.g. patients with hypertension or allergic conditions. All patients were over 50 years old. Anxiety and depression (HADS) as well as HRQOL (SF-36) were assessed at baseline and after 12 months. 218 PLWH, 249 DM and 254 MHC were included. At baseline, the study groups did not differ in anxiety, depression, and physical HRQOL. However, PLWH indicated lower mental HRQOL than DM and MHC patients (p = 0.001). We did not obtain any moderating effects showing a differential effect of patient characteristics on anxiety, depression, and HRQOL in the three patient groups. At follow-up, the level of anxiety, depression, and HRQOL did not change significantly. The prevalence of anxiety ranged between 27 and 35%, and that of depression between 17 and 28%. Thus, the results of our investigation tentatively suggest that the psychosocial adaptation to HIV among elderly PLWH resembles those of other chronic diseases. There may be some subtle impairments, though, as PLWH experienced lower mental HRQOL.     

Replication and Extension of a Hierarchical Model of Social Anxiety and Depression: Fear of Positive Evaluation as a Key Unique Factor in Social Anxiety

Wang, Hsu, Chiu, and Liang (2012, Journal of Anxiety Disorders, 26, 215–224) recently proposed a hierarchical model of social interaction anxiety and depression to account for both the commonalities and distinctions between these conditions. In the present paper, this model was extended to more broadly encompass the symptoms of social anxiety disorder, and replicated in a large unselected, undergraduate sample (n = 585). Structural equation modeling (SEM) and hierarchical regression analyses were employed. Negative affect and positive affect were conceptualized as general factors shared by social anxiety and depression; fear of negative evaluation (FNE) and disqualification of positive social outcomes were operationalized as specific factors, and fear of positive evaluation (FPE) was operationalized as a factor unique to social anxiety. This extended hierarchical model explicates structural relationships among these factors, in which the higher-level, general factors (i.e., high negative affect and low positive affect) represent vulnerability markers of both social anxiety and depression, and the lower-level factors (i.e., FNE, disqualification of positive social outcomes, and FPE) are the dimensions of specific cognitive features. Results from SEM and hierarchical regression analyses converged in support of the extended model. FPE is further supported as a key symptom that differentiates social anxiety from depression.     

Generalized Anxiety Disorder in Older Medical Patients: Diagnostic Recognition, Mental Health Management and Service Utilization

Background Primary care physicians often treat older adults with Generalized Anxiety Disorder. Objective To estimate physician diagnosis and recognition of anxiety and compare health service use among older adults with GAD with two comparison samples with and without other DSM diagnoses. Methods Participants were 60+ patients of a multi-specialty medical organization. Administrative database and medical records were reviewed for a year. Differences in frequency of health service use were analyzed with logistic regression and between-subjects analysis of covariance. Results Physician diagnosis of GAD was 1.5% and any anxiety was 9%, and recognition of anxiety symptoms was 34% in older adults with GAD. After controlling for medical comorbidity, radiology appointments were increased in the GAD group relative to those with and without other psychiatric diagnoses, χ² (2, N = 225) = 4.75, p < .05. Conclusions Most patients with anxiety do not have anxiety or symptoms documented in their medical records.