Presencia de ansiedad y depresión en pacientes de consulta externa de gastroenterología en Lima Metropolitana

Los objetivos fueron identificar la presencia de ansiedad y depresión en pacientes que acuden a consultorio externo de gastroenterología en la ciudad de Lima y describir los antecedentes gastroenterológicos y síntomas más relacionados a estos trastornos. La muestra estuvo conformada por 200 pacientes adultos pertenecientes a 32 distritos de Lima Metropolitana, atendidos por la especialidad de Gastroenterología en la modalidad de consultorio externo durante marzo a octubre del 2021, a quienes se les aplicó la Escala de Ansiedad y Depresión Hospitalaria (HADS) adaptada por Vilela. El estudio fue descriptivo-correlacional y la muestra prospectiva. Alrededor de 1 de cada 2 pacientes (49%, n=98) presentó ansiedad, 1 de cada 5 (19%, n=38) depresión y 16,5% (n=33) concomitantemente ambos trastornos. Los antecedentes gastroenterológicos de Dispepsia (v=0,216) y Síndrome de Intestino Irritable (v=0,188) mostraron asociación estadística para ambas variables. Diarrea (v=0,214) y dolor torácico (v=0,215) fueron síntomas asociados a ansiedad, así como dolor torácico, con depresión. Los trastornos de ansiedad y depresión tienen alta prevalencia en la población que acude a consulta externa, sugerimos explorar dichas variables y ofrecer un abordaje multidisciplinario a los pacientes atendidos por esta modalidad.

The objectives were to identify anxiety and depression in patients attending a gastroenterology outpatient clinic in the city of Lima, and to describe the gastroenterological history and symptoms most related to these disorders. 200 adult patients belonging to 32 districts of Metropolitan Lima attended from March to October 2021 were enrolled; the Hospital Anxiety and Depression Scale (HADS) adapted by Vilela was applied. The study was descriptive-correlational and prospective sample. 49% (n=98) reported anxiety, 19% (n=38) depression and 16.5% (n=33) both disorders concomitantly. Dyspepsia (v=0.216) and Irritable Bowel Syndrome (v=0.188) showed a statistical association for both variables. Diarrhea (v=0.214) and chest pain (v=0.215) were symptoms associated with anxiety, as well as chest pain with depression. Anxiety and depression are highly prevalent among patients that come to outpatient office visits, we suggest exploring these variables and offering a multidisciplinary approach to patients treated by this modality.

Impact of Psoriasis on Quality of Life of Family Members and Its Association with Anxiety and Depression

Background@#Psoriasis is a chronic immune-mediated, multisystem inflammatory skin disease that can profoundly impact the quality of life (QoL) of both patients and their families. This study aimed to analyse the impact of psoriasis on the QoL of patients’ family members and its association with anxiety and depression. @*Methods@#This was a cross-sectional study which had a total of 240 subjects (80 patients, 80 family members, and 80 healthy controls). The Dermatology Life Quality Index (DLQI) questionnaire was used to evaluate the QoL of patients, and the Family Dermatology Life Quality Index (FDLQI) questionnaire was used to assess the QoL of family members. In addition, the Hospital Anxiety and Depression Scale (HADS) was used to evaluate the state of anxiety or depression of all subjects, including the healthy controls.@*Results@#Up to 82.5% of family members of psoriasis patients had impaired QoL (FDLQI ≥2). The mean DLQI was 8.89±7.58, whereas the mean FDLQI scores was 7.58±6.09, showing the considerable impact of psoriasis on both patients and family members’ quality of life. There was a positive correlation between family members’ QoL with patients’ anxiety (rs =0.348; p=0.002) and depression (rs =0.276; p=0.013) level. However, no association was found between family members’ QoL with patients’ psoriasis severity (rs =0.173; p=0.126) and the DLQI scores (rs =0.137; p=0.224). Based on the HADS, the mean anxiety scores was 5.29±4.07 and the mean depression scores was 4.54±4.20 for family members. An anxiety disorder was suggested in 32.5%, while depression was suggested in 23.8% of family members.@*Conclusion@#Psoriasis has a significant impact on both patients and their family members, who experienced impairment of their QoL and higher levels of anxiety and depression.

Impacto en la calidad de vida por la comprensión del tinnitus / The Quality of Life impaction by Tinnitus Comprehension

El tinnitus es la sensación de sonido en ausencia de cualquier fuente externa. Nuestro objetivo fue evaluar la repercusión del tinnitus en la calidad de vida. Se inscribieron 25 pacientes con tinnitus con una amplia gama de umbrales de pérdida auditiva (HLT) y estado de gravedad de tinnitus. La gravedad, la ansiedad y la depresión del tinnitus se evaluaron mediante el inventario de discapacidades por tinnitus (THI), el índice funcional de tinnitus (TFI) y la escala de ansiedad y depresión hospitalaria (HADS), respectivamente. Se realizó una audiometría de conducción aérea de tono puro. El impacto de la percepción del tinnitus en la calidad de vida se encontró más alto en el grupo de sufrimiento. La escala de ansiedad y depresión figuraba en 40% y 60%, respectivamente. El uso de la mano fue de 20 diestros y 5 zurdos. El tinnitus bilateral se está experimentando en el 76%. El LH se presentó en 17 (68%) de los pacientes con tinnitus. La descripción del sonido del tinnitus como silbido (40%), siseo (24%), pulsante (16%), timbre (8%) y ruidos de tono alto (12%). Con respecto al cuestionario THI, los sujetos con tinnitus se dividen en 60% (leve), 30% (moderado) y 10% (grave). Mientras que el cuestionario TFI, el 50% mostró un (leve), el 25% (moderado) y el 25% mostró (severo). Postulamos una fuerte asociación positiva significativa entre HADS y la gravedad del tinnitus: THI (P = 0,000) y TFI (P = 0,001). Esos datos revelaron que la percepción del tinnitus tiene impactos negativos en la calidad de vida mientras que la gravedad puede verse alterada por la lateralidad

Tinnitus is the sensation of sound in the absence of any external source, and the aim is to assess the impaction of tinnitus on QoL. 25-tinnitus sufferers were enrolled with a wide range of hearing loss thresholds (HLT) and tinnitus severity status. Tinnitus severity, anxiety and depression were assessed using tinnitus handicap inventory (THI), tinnitus functional index (TFI), and the hospital anxiety and depression scale (HADS), respectively. Pure tone air conduction audiometry was performed. The impaction of tinnitus perception on QoL was found higher in suffering group. The anxiety and depression scale figured in 40%, and 60%, respectively. The handed use was 20 rights handed and 5 left-handed. Bilateral tinnitus is experiencing in 76%. The HL occurred in 17(68%) of tinnitus patients. The description of tinnitus sound as whistling (40%), hissing (24%), pulsating (16%), ringing (8%), and high pitch noises (12%). Regarding THI questionnaire, tinnitus subjects are divided to 60% (mild), 30% (moderate), and 10% (severe). While TFI questionnaire, 50% showed a (mild), 25% (moderate), and 25% showed (severe). We postulated a strong significant positive association between HADS and tinnitus severity: THI (P=0.000) and TFI (P= 0.001). Those data revealed that tinnitus perception has negative impacts on QoL, and the severity may be altered by laterality.

Measurement of anxiety and depression among cancer patients seen in an outpatient clinic of a tertiary hospital using the validated Hospital Anxiety and Depression Scale – Pilipino Version (HADS-P)

Background@#Anxiety and depression, two of the most common affective disorders in cancer patients can affect one’s compliance to treatment leading to poorer outcomes. Therefore, means of determining the psychological wellness of cancer patients through screening tools for anxiety and depression are an integral part of their management.@*Objectives@#1) To measure the prevalence of anxiety and depression among cancer patients seen in an outpatient clinic of a tertiary hospital using the HADS-P. 2) To assess the impact of the following variables on symptoms of anxiety and depression: demographic, socio-economic, biological and health/clinical parameters.@*Methodology@#This is a cross-sectional analytic study involving 381 cancer patients seen in the outpatient clinic. Symptoms of anxiety and depression were measured using the HADS-P with an 11+ cut-off to identify possible cases of anxiety and depression. Univariate analysis, using STATA Version 13, was performed to identify correlates of anxiety and depression.@*Results@#The prevalence of anxiety, depression and mixed diagnosis (anxiety and depression) amongst this study population were 9.45%,4.72% & 2.89%, respectively. The multivariate analysis described non-college graduates (OR=1.82, CI 0.80-4.14), poor performance status (ECOG 2-3) (OR=5.34, CI 2.44-11.71) and the newly diagnosed and with ongoing treatment patients (OR= 12.02, CI 2.67-54.04 and OR=4.04, CI 0.88-18.58, respectively) as possible correlates of anxiety. Patients with poor performance status and have moderate-severe pain were likely to experience depression (OR= 6.14, CI 2.14-17.62; OR= 2.78, CI 0.92-8.46, respectively).@*Conclusions@#There are several factors that can affect one’s predisposition to having affective disorders. Clearly, there is a necessity to allocate resources for screening and treating affective disorders among cancer patients to improve their compliance, to achieve a more holistic approach in their management and ultimately, to improve their quality of life.

Validation of the Malay Version of the Hospital Anxiety and Depression Scale among Patients with Traumatic Brain Injury

@#Introduction: Depression and anxiety are common complications associated with traumatic brain injury (TBI) patients but screening tools which are validated to assess these complications in the TBI population are scarce. This study investigated the validity of the Malay version of Hospital Anxiety and Depression Scale (HADS) to screen for depression and anxiety among Malaysian TBI patients. Materials and Methods: This cross -sectional study recruited 101 TBI patients in which they were administered the Malay version of HADS and the Structured Clinical Interview for Diagnostic and Statistical Manual for Mental Disorder 4th Edition (DSM-IV) for Axis I Disorders (SCID-I) (as comparison tool). Internal consistency (Cronbach’s α) and concurrent validity (using receiver operating characteristics) of the Malay version of HADS were evaluated. Results: The total Malay version of HADS score and its anxiety subscale exhibited good internal consistency of 0.80 and 0.78 respectively, but the internal consistency of its depressive subscale was low at 0.57. The depressive subscale of the Malay version of HADS exhibited high area under the curve (AUC) of 0.86, specificity of 82%, sensitivity of 76% and negative predictive value of 91% but its positive predictive value was 58%, at cut-off point of 8/9. While the anxiety subscale also demonstrated high AUC of 0.88, specificity of 71%, sensitivity of 93% and negative predictive value of 98% its positive predictive value was only 34%. Conclusion: The Malay version of HADS is a valid screening tool for depression and anxiety among Malaysian TBI population.

The prevalence of anxiety and depression among cervical cancer patients seen in a tertiary government hospital using the Hospital Anxiety and Depression Scale-English/Pilipino version (HADS/HADS-P) / Philippine Journal of Obstetrics and Gynecology

Background@#Due to improving survival longevity among cervical cancer patients, ensuring the quality of life becomes important to the gynecologist. Cancer, as a chronic disease, afflicts the patient both physically and psychologically. Anxiety and depression have been the two most common psychopathologic conditions affecting the cancer patient. Hence, recognizing their presence is important for holistic management.@*Objective@#The objective of this study is to determine the prevalence of anxiety and depression among cervical cancer patients seen in a tertiary government hospital.@*Methods@#This is a cross-sectional study performed on 384 cervical cancer patients from a tertiary government hospital. The Hospital Anxiety and Depression Scale-Pilipino (HADS-P) was the screening tool used to determine the presence of anxiety and depression. A score of 8 and above was used to detect depression and anxiety. Data were analyzed using Stata 15. Multivariate analysis was also utilized. Pearson chi square and Fisher’s Exact tests were used. Variables that were significant were subjected to logistic regression analysis.@*Conclusion@#The prevalence rates of anxiety, depression, and anxiety and depression among cervical cancer patients in our setting are 8.6%, 35.7%, and 6.5% respectively. Factors related to anxiety included receiving psychological support from family and friends, stage III/IV cancer, and being at 4 to 6 months from time of diagnosis. Depression had significant relationships with age, employment status, chemoradiation, and stage II cancer. Although rates in general were lower compared to other countries, the mere presence of anxiety and/or depression among cervical cancer patients implies the need for the gynecologist to give attention not only to the physical aspects of cervical cancer but to the psychological effects as well. Psychological screening could be performed even if by means of a simple validated tool in order to detect psychopathology early on.

Anxiety and depression in heart failure patients: A prospective, cross-sectional study

Introduction@#Anxiety and depression are the two most common mental disorders among medically ill patients with prevalence of 10%-50%. Anxiety and depression are prevalent in patient with heart disease and are associated with high morbidity and mortality. This study aims to determine the prevalence of anxiety and depression and its correlation with clinical profile in heart failure patients using the Hospital Anxiety and Depression Scale Filipino Version (HADS-P). @*Methods@#A prospective cross-sectional study was conducted. HADS-P questionnaire was administered to heart failure patients admitted at the University of Santo Tomas Hospital from December 2013 to November 2014. After securing consent from the attending physicians and patients, the HADS-P questionnaires were then administered to the patients at the end of hospitalization by the investigator/s. The recommended cut-off score for HADS-P is score of 11. Chi-square and Independent T-tests were used in this study.@*Results@#144 heart failure patients were enrolled in this study. The prevalence of depression and anxiety among heart failure patients is 13.2% and 25.7%, respectively. Having prior coronary angiography, coronary angioplasty, EF < 40%, and multiple co-morbidity diseases/s are significant factors for depression. While among patients with anxiety, the significant factor is the length of hospital stay.@*Conclusion@#This study shows that depression and anxiety are common among heart failure patients. Heart failure patients should be screened for depression and anxiety especially among those having above mentioned clinical profile. The HADS-P questionnaire is an easily applied screening method. A formal psychiatric referral can be taken and should be a part of the comprehensive management among heart failure patients with depression and anxiety.

Screening for symptoms of anxiety and depression in patients admitted to a university hospital with acute coronary syndrome / Rastreio de sintomas ansiosos e depressivos em pacientes com síndrome coronariana aguda internados em um hospital universitário

Abstract Objective: To investigate the prevalence of anxiety and depression in patients admitted for acute coronary syndrome to a university hospital and to examine associations with use of psychotropic drugs. Methods: Ninety-one patients who had had an acute coronary event were enrolled on this cross-sectional prevalence study. Characteristics of the study population and the prevalence rates of depression and anxiety in the sample were assessed using the Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) psychiatric consultation protocol, which includes clinical and sociodemographic data, and the Hospital Anxiety and Depression Scale (HADS). Results: The prevalence of symptoms of anxiety was 48.4% (44 patients) and the prevalence of depressive symptoms was 26.4% (24 patients). Of these, 19 patients (20.9% of the whole sample) had scores indicative of both types of symptoms concomitantly. Considering the whole sample, just 17 patients (18.7%) were receiving treatment for anxiety or depression with benzodiazepines and/or antidepressants. Conclusions: Anxiety and depression are disorders that are more prevalent among patients with acute coronary syndrome than in the general population, but they are generally under-diagnosed and under-treated. Patients with anxiety and depression simultaneously had higher scores on the HADS for anxiety and depression and therefore require more intensive care.

Resumo Objetivo: Investigar a prevalência de ansiedade e depressão em pacientes com síndrome coronariana aguda internados em um hospital universitário e examinar sua associação com o uso de drogas psicotrópicas. Métodos: Noventa e um pacientes que sofreram evento coronariano agudo foram incluídos nesse estudo transversal de prevalência. O protocolo de interconsulta psiquiátrica do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), com os dados clínicos e sociodemográficos, e a Escala Hospitalar de Ansiedade e Depressão (HADS) foram utilizados para avaliar as características da população estudada e a prevalência de depressão e ansiedade nessa amostra. Resultados: A prevalência de sintomas ansiosos foi de 48,4% (44 pacientes), e a de sintomas depressivos, de 26,4% (24 pacientes). Desses, 19 (20,9% do total da amostra) pontuaram para os dois sintomas concomitantemente. Considerando a amostra como um todo, apenas 17 pacientes (18,7%) estavam recebendo tratamento para ansiedade ou depressão com benzodiazepínicos e/ou antidepressivos. Conclusão: Ansiedade e depressão são transtornos mais prevalentes em pacientes com síndrome coronariana aguda do que na população geral, mas geralmente são subdiagnosticados e subtratados. Os pacientes com presença simultânea de ansiedade e depressão apresentam escores mais altos na escala HADS para ansiedade e depressão e necessitam, portanto, de um controle mais intensivo.

Prevalencia de Ansiedad y Depresión en Pacientes Hospitalizados

La ansiedad como la depresión conllevan una serie de respuestas emocionales en los pacientes, que alteran el funcionamiento general, la morbimortalidad y los costos de atención en salud, al prolongar la estancia del paciente en el hospital. Es importante detectar oportunamente los estados de ánimo depresivos y ansiosos en pacientes hospitalizados, esto con el fin de mejorar la recuperación del paciente, disminuir la vulnerabilidad a diversas enfermedades y evitar prolongar la estancia hospitalaria. El propósito del presente fue evaluar a pacientes hospitalizados en los servicios de medicina interna y hematología del Hospital Juárez de México, para: 1) determinar niveles de ansiedad y depresión, y 2) determinar relaciones entre depresión, ansiedad y tiempo con la enfermedad. Participaron 111 pacientes hospitalizados a los cuales se les aplicó la Escala de ansiedad y depresión hospitalaria (Hospital Anxiety and Depression Scale, HADS).Se identificó mayor presencia de ansiedad y depresión a mayor tiempo de enfermedad.

Anxiety and depression lead to a series of emotional responses in patients which alter general functioning, morbidity-mortality, and health care costs, by prolonging the patient's stay in the hospital. It is important to timely detect depressive and anxious moods in hospitalized patients in order to improve patient ́s recovery and to avoid a longer hospital stay. The propose of this paper was to assess hospitalized patients in intern and hematological medicine services areas in the Juarez ́s hospital in Mexico to 1) determine anxiety and depression levels, and 2) determine the relationship between depression, anxiety and period with an illness. A total of 111 hospitalized patients participated, whom which the Hospital Anxiety and Depression Scale (HADS) was applied. It was identified as a major presence of anxiety and depression when the period with an illness variable was high.

Association between psychological distress and occlusion among temporomandibular disorder patients – a clinical study.

Background: TMD is a multifactorial disorder significant research efforts have been invested in finding its etiologies and management to improve their quality of life. Objectives: To evaluate and compare digital occlusal parameters, depression, anxiety and serum cortisol level between temporomandibular disorder patients and control group. Material and methods: A sample size of 24 TMD patients and 24 apparently healthy age and sex matched controls were recruited in the study. The patients occlusion time and disclusion time was recorded using T-Scan III, the level of anxiety and depression was evaluated by using Hospital Anxiety and Depression scale questtionaire and serum cortisol was evaluated by collecting fasting blood sample, under aseptic conditions. Results: The incidence of premature contacts (occlusal interferences), clusion time and disclusion time was significantly longer in TMD group than in control subjects. The anxiety and depression scores were statistically significant in TMD group compared to control group, but no statistically significant difference was observed in serum cortisol levels. Conclusion: The present study demonstrated increase in the premature contacts i.e occlusal interferences were high with increase in clusion time, disclusion time, anxiety and depression scores in TMD group, where as no significant increase in serum cortisol levels was seen among TMD group even though their anxiety and depression levels were high. Hence, patients with temporomandibular disorders should always be evaluated for stress and anxiety along with the T- Scan evaluation of occlusal prematurities and correction of the same.

A descriptive study of the prevalence of depression, anxiety, body dysmorphic disorder among cosmetic surgery patients in a private tertiary hospital in Metro Manila from February to September 2011

OBJECTIVES: This study was conducted to determine the prevalence of anxiety, depression, and BDD among patients about to undergo cosmetic surgery in the Center for Wellness and Aesthetics from February to September 2011.METHODOLOGY: This descriptive study included 50 patients who were scheduled to undergo cosmetic surgery in the Aesthetic and Wellness Center. Patients who consented to participate, complete the Hospital Anxiety and Depression scale (HADS) and Body Image Disturbance Questionnaire (BIDQ). Those who scored >8 for HADS-A and HADS-D and 3 and above for BIDQ had a follow up diagnostic clinical interview based on the Diagnostic and Statistics Manual of Mental Disorders (DSM-IV) for diagnosis.RESULTS: Out of the 50% patients, 76% were female, majority were married (54%) and College graduate (68%). The most common surgical procedure is EVLT (Endovenous Laser Treatment), followed by rhinoplasty and blepharoplasty (16%). 18% of the patients had probable anxiety, 6% depression and 6% BDD. Upon further clinical interview, 2 (4%) were diagnosed with mild BDD, 2 (4%) had panic disorder without agoraphobia and 1 (2%) had generalized anxiety disorder. No patient was clinically depressed. The 3 patients who were positive in BIDQ were likewise positive in HADS-A.CONCLUSION: The prevalence of anxiety was high (18%) in the subject population. However, BDD was lower (4%) than expected in the cosmetic surgery subjects. A high proportion of the participants had significant body image concerns.

La Escala de Ansiedad y Depresión Hospitalaria (HAD) en fibromialgia: análisis de sensibilidad y especificidad / Hospital Anxiety and Depression Scale (HADS) in fibromyalgia: sensitivity and specificity analysis

La sociedad española de Reumatología (SER) (rivera et al., 2006) recomienda la escala de ansiedad y Depresión Hospitalaria (Hospital anxiety and Depression Scale - HADS, Zigmond y Snaith, 1983) para la evaluación clínica de ansiedad y depresión en Fibromialgia (FM). sin embargo, no constan índices de sensibilidad/especificidad ni puntos de corte en FM. Con el objetivo de comprobar aplicabilidad, propiedades psicométricas y sensibilidad/especificidad del HAD en FM, se evaluó a 131 pacientes ambulatorios del Hospital de san Vicente (alicante, España), utilizando como criterios externos BDI y STAI-E. se analizaron ítems, consistencia interna y estructura factorial mediante análisis confirmatorio y puntos de corte con curvas ROC. Se replicó la estructura de dos factores. La fiabilidad es adecuada (HADA=.80, HADD=.85). Se muestran diferentes puntos de corte con sensibilidad/especificidad superior al 70 por ciento para cada subescala. El Had presenta propiedades psicométricas óptimas en población FM, mostrándose útil como instrumento de "screening" de sintomatología ansioso-depresiva en esta población.

Spanish Society of Rheumatology (SER) (Rivera et al., 2006) suggests the Hospital Anxiety and Depression Scale (HADS, Zigmond y Snaith, 1983) for clinical assessment of anxiety and depression in fibromyalgia (FM). However, there is no HAD-FM cut-off yet. Aiming to assess applicability, psychometric properties and sensitivity/specificity of HADS in FM, 131 outpatients were assessed at San Vicente Hospital (Fibromyalgia service, Alicante, Spain), using like external criteria BDI and STAI-E. Item analysis was performed, calculating the internal consistency and factor structure study by confirmatory factor analysis (CFA). The cut-off points were found by ROC curves. Two-factor structure was replicated. Reliability is adequate (HADA=.80, HADD=.85). Several cut-off points are showed with sensitivity and specificity levels >70 percent for both subscales. HADS has optimal psychometric properties in FM and its useful as a screening tool to assess anxious-depressive symptoms in FM patients.

Análise Fatorial Confirmatória e Normatização da Hospital Anxiety and Depression Scale (HADS) / Confirmatory Factor Analysis and Standardization of the Hospital Anxiety and Depression Scale (HADS)

RESUMOOs principais objetivos deste estudo foram realizar a análise fatorial confirmatória da Hospital Anxiety and Depression Scale (HADS) e conduzir análises de curvas ROC para a normatização de seus pontos de corte, em uma amostra não-clínica. Os resultados exibiram evidências de validade estrutural da HADS e foram propostas mudanças para os parâmetros diagnósticos da ansiedade (≥7 pontos) e depressão (≥6 pontos). Ao final, destaca-se a necessidade de cautela na interpretação dos escores e decisão diagnóstica, principalmente na mensuração da depressão.

ABSTRACTThe main objectives of this study were to perform a confirmatory factor analysis of the Hospital Anxiety and Depression Scale (HADS) and to conduct ROC curves for standardization of cut-off points, in a nonclinical sample. The results showed evidences of the structural validity of HADS and changes were proposed to the diagnostic parameters of anxiety (≥7 points) and depression (≥6 points). Finally, we highlight that caution is needed for the interpretation of the scores and diagnostic decision, especially for the depression measure.

Prevalence of anxiety and depression among Filipino patients with chronic obstructive pulmonary disease: A multi-center study

BACKGROUND: One under-explored area in chronic obstructive pulmonary disease (COPD) patients is anxiety and/or depression, which may have negative impact in the patients' condition. This is possibly the first study to possibly assess the burden of anxiety and depression in COPD patients in the Philippines. STUDY DESIGN: This is a prospective descriptive survey in three tertiary care hospitals in Manila, Philippines. PARTICIPANTS: A total of 204 patients were enrolled in the study with the following inclusion criteria: Filipino patients who are aged more than or equal to 40 years with a diagnosis of COPD (documented post-bronchodilator FEV1/FVC ratio less than 0.7) by a physician seen at the outpatient clinics of three tertiary care hospitals with no primary diagnosis of asthma, no previous lung volume reduction surgery, lung transplantation or pneumonectomy and at least finished Grade 2 education. Exclusion criteria include pregnant patients and patients previously diagnosed to have an anxiety, depression, or on any anti-depressant medications. METHODS: Descriptive statistics was obtained with frequency and percentages of the demographic and physiologic variables in the study by tabulation and graph. The prevalence of anxiety and depression was determined by calculating the percentage of each patient with a score of 8 or higher on the Hospital Anxiety and Depression Scale (HADS) with validated Tagalog version, respectively. RESULTS: The prevalence of anxiety in Filipino COPD patients is 47.55%. The prevalence of depression in Filipino COPD patients is 31.37%. CONCLUSION: The prevalence of depression in Filipino COPD patients is comparable to the prevalence of depression from other general medical conditions nationwide according to the study of Batar (31.37% vs. 31%). Anxiety is slightly more prevalent in COPD from other general medical conditions (47.55% vs. 36%). A study on the risk factors of anxiety and depression among Filipino COPD patients is recommended.

Comparison between the first and sixth year medical students in the arabian gulf university of bahrain regarding anxiety and depression.

A cross sectional study involving all year 1 and 6 medical student of Arabian Gulf University in Bahrain in the year 2011-2012 was performed by self reporting anxiety and depression using HADS forms. The results showed that 33.96 % of year 1 and 55.07% of year 6 students showed anxiety, while student of year 1 and 6 showed 18.87% and 31.88% depression state respectively. Statistically the anxiety and depression were significantly higher in year 6 compared to year 1 students (Analysis of Variance ANOVA, p< 0.05). Neither of these mental states were significantly different in males and females students. The averaged score of male medical student was 9.64±0.4 for anxiety and 8.01±0.4 for depression compared to 9.88±0.5 and 8.13±0.5 which were scored in females for anxiety and depression respectively (ANOVA p˃0.05). It is concluded that the stress associated with studying medicine is continuous and accumulative during the years of the study and that medical students confrontation with extra stressors related to their studies in addition to the normal daily stressors of life making them more vulnerable to anxiety and depression states.

Validation of Hospital Anxiety and Depression Scale as a screening tool for psychological distress in advanced cancer patients undergoing chemotherapy

Advanced cancer patients experience stress and are at risk for developing psychological problems. Early diagnosis and suitable intervention are very important for their quality of life and compliance with chemotherapy. The Hospital Anxiety and Depression Scale (HADS) is one of the most commonly used mood scales; however, HADS has not been validated for use with cancer patients undergoing chemotherapy. The purpose of this study was to validate HADS as a screening tool for psychological distress among cancer patients undergoing chemotherapy. We also identified possible factors contributing to psychological distress and explored the development of original screening tools. Fifty subjects agreed to complete HADS and consult with psychiatric specialists. Possible contributing factors to psychological distress were identified by HADS and logistic regression analysis. The mean score for patients with psychological distress was 20.0 ± 8.93, and for patients without distress was 9.67 ± 6.11; scores for patients with psychological distress were significantly higher. The optimal cutoff point of psychological distress appeared to be 17. This cutoff point was associated with 72.7% sensitivity and 82.1% specificity. The factor “recurrent cancer” (p=0.043) had an odds ratio of 7.24 (1.21-61.2). We verified that HADS is a useful screening tool for cancer patients undergoing chemotherapy. The factor “recurrent cancer” was shown to contribute to psychological distress. Palliat Care Res 2011; 6(2): 150-157