Anxiety and Depression in Patients with Amyotrophic Lateral Sclerosis and Their Caregivers

A large number of studies have investigated a variety of psychological aspects in people with Amyotrophic Lateral Sclerosis, but there is still considerable uncertainty concerning the actual morbidity, in particular for anxiety. We aim to evaluate depression levels and anxiety disposition in ALS patients and their caregivers, in comparison to healthy controls. We conducted a cross-sectional comparison between people with ALS, their caregivers and a non-clinical control group in order to evaluate anxiety and depression levels. 40 ALS patients, their caregivers and 40 healthy adult subjects completed the Beck Depression Inventory II (BDI-II) and the State-Trait Anxiety Inventory—Y2 scale (STAI). We compared overall and single item scores in order to find differences between the three groups. BDI-II scores were significantly different between groups. Depression scores were higher for patients than for healthy controls, in both somatic and psychological sub-scales. Caregivers presented higher levels of psychological depression in comparison with healthy controls, and lower scores of somatic depression in comparison to patients. No differences were found in trait anxiety levels comparing the three groups. ALS patients and their caregivers developed more depression related symptomatology than the non-clinical sample. However, susceptibility to anxiety for both patients and caregivers seemed to be at a normal level.     

Effectiveness of therapy group in women with localized breast cancer

Background/ObjectiveBreast cancer causes high levels of anxiety and depression, deteriorating quality of life of patients. Several studies have found that group therapy reduces depression and anxiety also improves the quality of life. The aim of this study is to analyze group therapy effectiveness in emotional state and quality of life in women with breast cancer after finalized medical treatments.MethodParticipants in this study were 100 adult women diagnosed of breast cancer non-mestastasic and were divided into two types of intervention groups (Self-esteem-Social Skills and Cognitive-Behavioral Therapy). Evaluation instruments were questionnaire Functional Assessment of Breast-cancer Therapy (FACT-B) and Hospital Anxiety and Depression Scale (HADS).ResultsA statistically significant effect of group therapy in reducing anxiety and depression were observed. Quality of life and emotional well-being significantly improved. These effects remain three months after intervention.ConclusionsThe results show that the psychological intervention group is efficient to improve emotional state and quality of life of women with breast cancer.     

Role of the Disease in the Psychological Impact of Pre-Symptomatic Testing for SCA2 and FAP ATTRV30M: Experience with the Disease, Kinship and Gender of the Transmitting Parent

To identify possible factors affecting the psychological impact of pre-symptomatic testing for spinocerebellar ataxia type 2 (SCA2) and familial amyloid polyneuropathy (FAP ATTRV30M), we studied (1) the effect of previous experience with the disease in the family, (2) kinship with the closest affected relative and (3) gender of affected parent, when adapting to test results; as well as (4) differences in the course of psychological wellbeing in 63 subjects ( 28 at-risk for FAP ATTRV30M, and 35 at risk for SCA2), who pursued predictive testing for these diseases, in Cuba and in Portugal. Our research shows that individuals with little or no experience with the disease in their family exhibited more anxiety; at-risk subjects for SCA2 or FAP ATTRV30M who had a first degree relative with the disease showed lower levels of anxiety and depression during pre-symptomatic testing. Also those with an affected mother had lower levels of depression, either immediately, or one year after receipt of test results. Adaptation to pre-symptomatic testing results differed for subjects at-risk for the two different conditions. Unlike the FAP ATTRV30M families, carriers for SCA2 reported pathological levels of depression immediately after-testing (3 weeks), although those levels had returned to normal levels at 6 months. Subjects at-risk for FAP ATTRV30M tended to have less anxiety than those tested for SCA2, at the one-year follow-up. Overall, depression levels improved over time, while anxiety remained more constant. A longer awareness of the disease in the family, closer kinship, and a transmitting mother all lessened the impact of pre-symptomatic testing, as expressed by the post-test levels of anxiety and depression.     

Anxiety and depression in women with advanced cancer: Implications for counselling

Fifty-three patients with advanced cancer were studied prospectively for 6 months to assess whether the site and method of chemotherapy administration influence levels of anxiety and depression. Patients received chemotherapy either at home or in hospital. Cases of clinical anxiety (36%) and depression (27%) were highest in the hospital treated group during the middle period of therapy. Patients treated at home had a lower psychiatric morbidity for anxiety (21%) and depression (21%) at the same period. There was no statistically significant difference in the mean scores on anxiety and depression between the groups. Overall, anxiety was more prevalent than depression. This study indicates that a minority of patients with advanced cancer treated by chemotherapy experience measureable psychiatric morbidity. Counselling services should be provided for these women throughout treatment, not just at the outset.     

Quality of life in transplant patients, compared to other stressful health situations in pulmonary patients

Transplantation may imply severe biopsychosocial impairments. In order to know the quality of life of patients one year after transplantation, 58 subjects were compared to three different groups of patients (stabilized and acute COPD patients, and lung cancer patients in a surgery unit). Patients filled in two questionnaires: EORTC QLQ-C30 (quality of life) and HAD (anxiety and depression). The quality of life dimensions with inter-group differences were physical, role, emotional and cognitive functioning, global health status, and a number of symptoms (fatigue, dyspnea, insomnia and appetite loss). There were differences in depression, and but not in anxiety. Transplant and surgical patients showed better quality of life and affective status than chronic pulmonary patients. Discriminant analysis showed that the transplant group was the best described group. We conclude that patients, one year after transplantation, show similar quality of life as asymptomatic hospitalised patients, somewhat better than chronic patients in a stabilized stage of the disease, and much better than severe chronic patients.     

肿瘤化疗患者的心理分析和指导

肿瘤是一种常见的恶性疾病、病死率很高,化疗是主要治疗方法。由于化疗毒副作用较大,会引起肿瘤患者出现生理上和心理上较大的变化,产生烦躁、焦虑、沮丧等心理活动,并有可能引起病情的恶化,因此极有必要对病人进行心理指导。本文从心理方面对化疗患者进行指导探讨,使医务人员在治疗过程中能帮助患者减轻痛苦,体现人道主义精神。     

The correlations of socioeconomic status,disease activity,quality of life,and depression/anxiety in Chinese patients with rheumatoid arthritis

This study aimed (i) to investigate the relationships among socioeconomic status, disease activity, quality of life, and the psychological status in Chinese rheumatoid arthritis (RA) patients; (ii) to explore the possible risk factors of anxiety and depression. A total of 160 RA patients underwent standardized laboratory examinations and completed several questionnaires. Independent samples t-tests, χ² analyses, and logistic regression modeling were used to analyze the data. We found 30.6% RA patients were anxiety, and 27.5% had depression, which were significantly higher than the control group (7.8 and 11.7%, respectively). And there were significant correlations among education, pain, disease activity, medication adherence, functional capacity, quality of life, and anxiety/depression. Meanwhile, logistic regression analysis revealed that poor quality of life and low education level were significantly associated with anxiety/depression in RA patients. In conclusion, there were significant relationships among education, quality of life, and anxiety/depression in Chinese RA patients.     

Hospitalization of Children with Cystic Fibrosis Adversely Affects Mothers’ Physical Activity,Sleep Quality,and Psychological Status

Having a child with a chronic disease can cause anxiety and depression, which may impair the sleep quality of mothers. The aim of this study was to compare physical activity level, sleep quality, anxiety and depression in mothers of hospitalized cystic fibrosis patients, cystic fibrosis outpatients and healthy controls. Twenty-three of the patients were hospitalized and 38 were outpatients and 37 age-matched healthy children served as controls. The mothers’ fatigue levels, sleep disturbances, stress levels and perceptions of their child’s disease severity were assessed with a Visual Analog Scale. The International Physical Activity Questionnaire, Pittsburgh Sleep Quality Index and Hospital Anxiety and Depression Scale were administered to the mothers of children. Mothers of hospitalized and outpatient cystic fibrosis children had significantly higher fatigue severity, sleep disturbance, and stress level according to Visual Analog Scale than mothers of healthy controls. All of International Physical Activity Questionnaire scores were significantly lower in cystic fibrosis patients’ mothers than healthy controls’. Hospital Anxiety and Depression Scale depression score, Pittsburgh Sleep Quality Index subdomains and total scores of hospitalized patients’ mothers were higher than those of the other two groups (p?<?0.05). Chronic illness in children with cystic fibrosis may impair the physical activity level, sleep quality and psychological state of their mothers, especially during hospitalization period.     

Depression, Anxiety and Anger in Subtypes of Irritable Bowel Syndrome Patients

The present study aimed to elucidate the differences in depression, anxiety, anger, and quality of life in a sample of non-psychiatric IBS patients, starting from the hypothesis that IBS subtypes may have different symptomatic expressions of negative emotions with different outcomes on quality of life measures. Forty-two constipation-predominant IBS (C-IBS) subjects and 44 diarrhea-predominant IBS (D-IBS) subjects, after an examination by a gastroenterologist and a total colonoscopy, underwent a clinical interview and psychometric examination for the assessment of depression, anxiety, anger and quality of life. IBS subtypes showed different symptomatic profiles in depression, anxiety and anger, with C-IBS patients more psychologically distressed than D-IBS subjects. Affective and emotional symptoms should be considered as specific and integral to the syndrome, and recognizing the differences between IBS subtypes may have relevant implications for treatment options and clinical outcome.     

冠心病患者的抑郁和焦虑

许多临床研究表明,冠心病患者常发生抑郁及焦虑。而在严重精神症状（如抑郁或/和焦虑）者中有较高的冠心病发生率。抑郁增加冠心病患者的不良心血管事件发生率,影响预后。其机制有如下几个方面：对医疗措施及生活方式改变的依从性差、血小板功能异常、血管内皮功能紊乱以及心率变异性降低。选择性5-羟色胺再摄取抑制剂由于其较好的耐受性且无明显的心血管副作用而应用于冠心病合并抑郁及焦虑的药物治疗并改善患者的生活质量。但仍需要更大规模的临床研究以确定抑郁及焦虑对冠心病预后的影响。临床上应更加关注焦虑对冠心病的影响,进一步探讨焦虑能否作为冠心病的危险因素。     

Dissociating effects of subclinical anxiety and depression on cognitive control

Even at subclinical levels, anxiety and depression are associated with impaired cognitive control. It is unclear, though, to what extent these deficits reflect a common underlying dysfunction. Using a non-affective hybrid masked prime-Simon task, we obtained several measures of within- and between- trial inhibitory behavioral control in 80 young, healthy volunteers, together with measures of their anxiety and depression levels. Neither depression nor anxiety affected low-level within-trial control, or any of the between-trial control measures. However, increased levels of depression, but not of anxiety, were associated with impaired high-level within-trial control (increased Simon effect). Results indicate that depression, but not anxiety, impairs voluntary online response-control mechanisms independent of affective content.     

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.     

Dimensions of perfectionism in unipolar depression

We tested the hypothesis that self-oriented perfectionism, other-oriented perfectionism, and socially prescribed perfectionism are related differentially to unipolar depression. The Multidimensional Perfectionism Scale was administered along with measures of depression and anxiety to 22 depressed patients, 22 matched normal control subjects, and 13 anxiety patients. It was found that the depressed patients had higher levels of self-oriented perfectionism than did either the psychiatric or normal control subjects. In addition, depressed patients and anxious patients reported higher levels of socially prescribed perfectionism than did the normal control subjects. The results suggest that various dimensions of perfectionism may play an important role in clinical depression.     

Relationship of depression and anxiety to cancer patients' medical decision-making

The purpose of this study was to examine the relation of depression and anxiety to cancer patients' medical decision-making. Participants were 79 rural and urban cancer patients undergoing chemotherapy. The four decisional styles of the Decisional Processing Model were the independent variables. Dependent variables were anxiety and depression, measured by Spielberger's State-Trait Anxiety and the Center for Disease Control Depression Scale, respectively. Consistent with the Decisional Processing Model, analysis suggested that patients make medical decisions by information seeking, information processing, advice following, or ruminating. Decisional style did not vary according to type or stage of cancer, prognosis, time elapsed since initial diagnosis, or whether cancer was initial or recurrent. Decisional style did not systematically vary with depression and anxiety suggesting how a person makes decisions is a stable personality trait. Thus, decision-making may follow a cognitive schema. It is likely that patients' decisional styles help to manage anxiety and depression when confronted with life-threatening illness. Implications for informed consent and patients' involvement in decision-making are discussed.     

States-of-Mind in Psychopathology and Psychological Well-Being

This study investigated the states-of-mind model of depression, anxiety, anger, life satisfaction and happiness in four ways. Three hundred and ninety-eight undergraduate students from Singapore participated in this study. First, states-of-mind ratio and positive automatic thoughts were positively correlated with life satisfaction and happiness, and negatively correlated with anxiety, depression, and anger. In contrast, negative automatic thoughts were positively correlated with anxiety, depression, and anger, and negatively correlated with life satisfaction and happiness. Second, the BSOM categories based depression-related automatic thoughts was able to significantly differentiate among levels of depression, happiness, life satisfaction, anxiety, and anger in ANOVA and in terms of variance accounted for as indicated by partial Eta squared. Third, the BSOM ratio was the best predictor for happiness and life satisfaction and second best predictor for depression, anxiety, and anger in terms of variance accounted for as indicated by adjusted R², in comparison to the negative cognition model and positive cognition model. Fourth, both ANOVA results and multiple regression results showed that there is cognitive content-specificity for the BSOM based on depression-related automatic thoughts. Implications and limitations of these findings were discussed.     

Investigating trajectories of change in psychological distress amongst patients with depression and generalised anxiety disorder treated with internet cognitive behavioural therapy

Internet based cognitive behavioural therapy (CBT) is efficacious for the treatment of anxiety and depression. The current study aimed to examine the effectiveness of internet based CBT prescribed by primary care clinicians for the treatment of depression and generalised anxiety disorder. Psychological distress data from 302 patients who completed an online CBT course for depression and 361 patients who completed an online CBT course for generalised anxiety disorder were subjected to growth mixture analysis. For both disorders psychological distress decreased across each lesson in a quadratic trend. Two classes of individuals were identified with different trajectories of change: a large group of individuals who responded well to the courses and a smaller group of individuals with a lower response. Both groups were similar with respect to socio-demographic characteristics however the Low Responders tended to have higher levels of symptom severity and psychological distress at baseline in comparison to the responders. For the majority of patients (75-80%) the internet CBT courses for depression and generalised anxiety disorder were effective. Further research is required to identify and effectively treat the smaller proportion of patients who did not improve during internet CBT.     

The Effectiveness of Mindfulness Training on the Grieving Process and Emotional Well-Being of Chronic Pain Patients

Losses in relationships, work, and other areas of life often accompany the physical discomfort of chronic pain. Often the depth and intensity of the grief associated with chronic pain are overlooked or possibly misdiagnosed and treated as depression. We used an 8-week mindfulness meditation program to determine its effectiveness in addressing the grieving process among 39 patients diagnosed with chronic pain. Eighteen patients volunteered to be in a comparison group. The study was conducted in a regional hospital's pain clinic and patients completed the Response to Loss Scale (measuring grief), the Beck Depression Inventory, and the State Trait Anxiety Inventory. Results indicated that the treatment group advanced significantly more quickly through the initial stages of grieving than the comparison group. In addition, the treatment group demonstrated significant reductions in depression and state anxiety, but no significant differences emerged when comparing groups on the final stages of grieving or trait anxiety.     

抑郁和焦虑与心律失常

焦虑抑郁广泛存在于各种心血管疾病中已成共识。心律失常患者合并心理问题在临床上十分常见,焦虑抑郁导致的自主神经对心脏的调节失衡会进一步促使心律失常的发生与发展。对于非器质性心脏病,β受体阻滞剂与抗焦虑药物合用有很好的疗效;器质性心脏病患者并发心律失常时患者的焦虑抑郁会进一步加重,甚至导致恶性室性心律失常的发生,增加器质性心脏病患者的病死率;心律失常介入治疗引起的焦虑抑郁更为常见。临床上对焦虑抑郁症状要有充分的重视,积极识别并诊断,以期进一步提高心律失常患者的生活质量,减少病死率。     

Attention Deficit/Hyperactivity Disorder in Adults with Sleep Apnea

AAttention deficit hyperactivity disorder (ADHD) is a common childhood illness. In some patients, this illness may persist into adulthood and an association between ADHD and Obstructive Sleep Apnea (OSA) has been found in childhood. However, it is unclear how OSA and ADHD coincide in adulthood. Therefore, to explore the relationship between OSA and adult ADHD the current investigation utilized a clinically-based cross-sectional survey. Subjects consisted of 81 treatment-naïve OSA patients and 32 controls. Measures included each patient completed a questionnaire regarding sleep, Adult ADHD scale. Clinical information, body mass index, 36-item Short Form Health Survey (SF-36), Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale, and polysomnography.The subjects with Apnea-Hypopnea Index (AHI) ≥ 5 events/h were defined as patients with OSA. The control group was accepted as individuals with AHI > 0 events/h. The prevalence of adult ADHD was not different between the patients with OSA and the control group [(7.4 % (6/75) vs. 6.3 % (2/30), p = 0.8, respectively]. OSA patients with ADHD, as compared with those without, had higher anxiety scores and poorer physical component scores of quality of life and higher ESS scores. ADHD scores in patients with OSA were associated with anxiety and depression scores and SF36 physical and mental component scores in bivariate analyses. Thus, in our sample ADHD was not a frequent illness in adult patients with OSA. However, in patients with OSA and ADHD higher levels of anxiety and daytime sleepiness and poorer quality of life was found.     

Exploring Associations Between Self-Compassion,Self-Criticism,Mental Health,and Quality of Life in Adults with Cystic Fibrosis: Informing Future Interventions

Self-compassion is increasingly recognised as an important and beneficial factor in quality of life and mental health-related research, but research within the adult cystic fibrosis (CF) population is scarce. In a cross-sectional study, 114 (56 female, 58 male) adults with CF completed and returned a series of validated questionnaires that assessed CF-related quality of life, negative emotional states (depression, anxiety and stress), self-compassion, and self-criticism. Quality of life and self-compassion were positively correlated, and each in turn were inversely correlated with negative emotional states and self-criticism. Negative emotional states correlated positively to self-criticism. Self-compassion and/or self-criticism moderated ten relationships between various sub-domains of quality of life and negative emotions. Psychological interventions that increase self-compassion may be beneficial for enhancing mental health and quality of life for adults with CF.