The Agreement between State-Trait-Anxiety-Inventory (STAI) and Beck Anxiety Inventory (BAI) on Measuring Anxiety Level Among Adult Patients Before Venepuncture Procedure

@#Introduction: Venepuncture procedure is painful and anxiety associated with venepuncture is common. There are many tools for assessing anxiety levels in an outpatient setting. Hence, this study is to compare the degree of agreement between State-Trait-Anxiety-Inventory (STAI) and Beck Anxiety Inventory (BAI) for measuring anxiety levels among adult patients before venepuncture procedure. Methods: A cross-sectional pilot study was conducted among patients while waiting for a venepuncture procedure in the Phlebotomy Unit, UiTMMC in April 2020. The Malay-validated version of the State-Trait-Anxiety-Inventory (STAI) and Beck Anxiety Inventory (BAI) were used to assess the anxiety level. Differences between sets of data were plotted as described by Bland-Altman to determine the agreement between these two assessment tools. Results: A total of 330 patients participated in the study with a mean age of 46.34 ± 14.34 years old and gender was equally distributed. The scores of state-anxiety (STAI-S), trait-anxiety (STAI-T) and BAI score were 30.04 ± 20.74; 29.51 ± 19.11; and 40.98 ± 20.45, respectively. The score of anxiety using BAI was higher compared to STAI-S (p<0.001) and STAI-T (p<0.001). The mean difference between the STAI-S and BAI was -10.94 (95%CI: -53.01, 26.87) and between the STAI-T and BAI was -11.47 (95%CI: -42.26, 19.32). However, very few patients’ scores outside the 95% LOA for both differences. Conclusion: The STAI and BAI are concordances in measuring anxiety levels among these patients. However, the anxiety score using BAI was higher than STAI. Thus, both assessment tools can be used in clinical practice in measuring anxiety in the out-patients setting.

Ansiedad y depresión posparto a largo plazo de las madres con COVID-19 durante el embarazo

La pandemia de COVID-19 se asocia con resultados mentales negativos en el período posparto temprano. Objetivo. Evaluar la salud mental posparto a largo plazo de las mujeres infectadas con COVID-19 durante el embarazo. Métodos. Estudio transversal en 101 gestantes que dieron a luz en un centro terciario durante la pandemia de COVID-19, entre el 31 de marzo de 2020 y el 30 de noviembre de 2021. Se clasificó a las gestantes en 2 grupos como COVID-19 positivo (grupo de estudio, n=52) y COVID-19 negativo (grupo control, n=49). Se recogieron datos sociodemográficos y obstétricos mediante un cuestionario en los períodos posparto temprano (≤6 meses) y tardío (6 a 18 meses). Se calculó la puntuación del Inventario de Depresión de Beck (IDB) y del Inventario de Ansiedad de Beck (IAB) mediante el análisis de los datos de las participantes. Resultados. La puntuación media del IDB y la tasa de depresión (puntuación del IDB >13) en las pacientes con COVID-19 positivo fueron mayores en el período posparto temprano que en el tardío. Según el análisis de regresión lineal multivariante, existió una correlación significativa entre la puntuación IDB de las pacientes con COVID-19 y el nivel educativo y la situación laboral. Según el mismo análisis, existió una correlación significativa entre la puntuación del IAB de los pacientes con COVID-19 y el apoyo del cónyuge, la relación marital y las enfermedades relacionadas con el nacimiento. Se encontró que las pacientes con COVID-19 positivo y COVID-19 negativo tenían puntuaciones IDB e IAB similares en los periodos postparto temprano (≤6 meses) y tardío (6-18 meses). Además, las tasas de ansiedad y depresión fueron similares en ambos grupos en los mismos períodos posparto. Conclusión. En nuestro estudio, la infección por COVID-19 en el embarazo no tuvo un impacto adicional significativo en la salud mental materna en el posparto a largo plazo.

The COVID-19 pandemic is associated with negative mental outcomes in the early postpartum period. Objective: To assess the long-term postpartum mental health of women infected with COVID-19 during pregnancy. Methods: Cross-sectional study in 101 pregnant women who gave birth in a tertiary center during the COVID-19 pandemic, between March 31, 2020, and November 30, 2021. The pregnant women were classified into 2 groups as COVID-19 positive (study group, n=52) and COVID-19 negative (control group, n=49). Sociodemographic and obstetric data were collected by questionnaire in the early (≤6 months) and late (6-18 months) postpartum periods. Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) scores were calculated by analysis of the participants' data. Results: The mean BDI score and the rate of depression (BDI score >13) in COVID-19 positive patients were higher in the early postpartum period than in the late postpartum period. According to multivariate linear regression analysis, there was a significant correlation between the BDI score of COVID-19 patients and educational level and employment status. According to the same analysis, there was a significant correlation between the BAI score of COVID-19 patients and spousal support, marital relationship, and birthrelated diseases. We found that COVID-19 positive and COVID-19 negative patients had similar BDI and BAI scores in the early (≤6 months) and late (6-18 months) postpartum periods. In addition, rates of anxiety and depression were similar in both groups at the same postpartum periods. Conclusion: In our study, COVID-19 infection in pregnancy had no significant additional impact on long-term postpartum maternal mental health.

Prevalence and risk factors for anxiety and depression among school going adolescent of Rajkot, Gujarat, India

Background: Adolescence is a period of turmoil, leading to several mental health challenges including anxiety and/or depression. Anxiety and depressive disorders affects 10-15% of adolescents. Anxiety and depression are associated with substantial negative effects on adolescent's social, emotional and academic success. This leads to poor social and coping skills, low self-esteem, perceptions of social rejection, and difficulty forming friendships. This study was carried out with an objective to study prevalence and risk factors for anxiety and depression among adolescents.Methods: A cross sectional study conducted from April 2014 to December 2015 among 1026 school going adolescents from 4 schools of Rajkot, Gujarat, India. Anxiety and depression were measured using Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) respectively. Chi-square test was applied as test of significance.Results: Majority of the students (58.1%) was belonged to early adolescent age group. Two third were males. Maximum adolescents (42.5%) were coming from class III. Prevalence of moderate-severe anxiety and depression was 9.9% and 18.5%. Anxiety was not significantly associated with age, gender and socio economic class. Prevalence of depression was significantly higher in boys (20.5%) as compared to girls (14.5%, p=0.02). Moderate to severe depression was gradually increased with increasing in age. Adolescent from upper socio economic class (I, II, III- 19.1%) were severely depressed than adolescent from lower socio economic class (IV, V- 4.1%).Conclusions: Anxiety and depression was significantly present in adolescent age group. Depression was commonly observed in boys and gradually increased with increasing in age. There is need of strengthening school health services with screening and cost effective interventions to minimize the risk of drug abuse, suicide and violence.

Reliability and validity of self-rated Family Burden Scale in families of the patients with anorexia nervosa / 上海交通大学学报（医学版）

Objective • To explore the reliability and validity of self-rated Family Burden Scale (FBS) evaluating caregiver burden in families of the patients with anorexia nervosa (AN). Methods • The study included female AN patients (n=103) treated in the Eating Disorder Center of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine from Jul. 2017 to Jul. 2019 and their caregivers (parents, n=148). General demographic information of the patients and their caregivers, the course of illness and body mass index (BMI) of patients, and the time each caregiver spent in caring for the patient per day were recorded. FBS, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and the MOS item short form health survey (SF-36) were self-rated by the caregivers. One-third of the caregivers were selected by random number method for FBS rating by specialists. The reliability of the scale was evaluated by calculating Cronbach's α coefficient, self-rating and other-rating consistency and the consistency between husband and wife (41 couples). The validity of the scale was evaluated by calculating the correlation of FBS score with the course of disease, patients' BMI, the time spent in caring per day, scores of BAI and BDI, and vitality, social function, role-emotion and mental health domain of SF-36. Results • The Cronbach's α coefficient of FBS was 0.921, the correlation coefficient between self-rating and other-rating by specialists was 0.705 (P=0.000), and the correlation coefficient of consistency score between couples was 0.547 (P=0.000). FBS score showed no correlation with the course of disease, %BMI and the time spent in caring per day. Scores of BAI and BDI, and vitality, social function, role-emotion and mental health domain of SF-36 showed low correlation with FBS score (all P<0.05). Conclusion • Self-rated FBS shows good reliability when used in families of AN patients. The validity is not as ideal, which suggests further revision of the scale.

Preoperative education reduces preoperative anxiety in cancer patients undergoing surgery: Usefulness of the self-reported Beck anxiety inventory / A informação no pré-operatório reduz a ansiedade pré-operatória em pacientes com câncer submetidos à cirurgia: utilidade do Inventário Beck de Ansiedade

Abstract Background and objectives: Preoperative instruction is known to significantly reduce patient anxiety before surgery. The present study aimed to investigate the effects of preoperative education on the level of anxiety of cancer patients undergoing surgery using the self-reported Beck anxiety inventory. Methods: This study is a short-term observational study, including 72 female patients with a diagnosis of endometrial cancer who were scheduled to undergo surgical treatment under general anesthesia. During the pre-anesthetic consultation 15 days before surgery, one group of patients (Group A, n = 36) was given comprehensive information about their scheduled anesthetic and surgical procedures, while the other group of patients (Group B, n = 36) did not receive any information pertaining to these variables. The Beck anxiety inventory, blood pressure and heart rate were evaluated before and after the preoperative education in Group A. In Group B, these parameters were evaluated at the beginning and at the end of the consultation. Results: The hemodynamic values were lower in the group that received preoperative education, in comparison with the group that did not receive preoperative education. Educating the patients about the procedure resulted in a reduction in the levels of anxiety from mild to minimum, whereas there was no change in the group that did not receive the preoperative education. This latter group kept the same level of anxiety up to the end of pre-anesthetic consultation. Conclusions: Patient orientation in the preoperative setting should be the standard of care to minimize patient anxiety prior to surgery, especially for patients with cancer.

Resumo: Justificativa e objetivos: A informação transmitida no pré-operatório é conhecida por reduzir de modo significativo a ansiedade do paciente antes da cirurgia. O presente estudo teve como objetivo investigar os efeitos da orientação pré-operatória sobre o nível de ansiedade de pacientes com câncer submetidos à cirurgia, utilizando o inventário Beck de ansiedade. Métodos: Estudo observacional de curto prazo, incluindo 72 pacientes do sexo feminino com diagnóstico de câncer endometrial, programadas para receber tratamento cirúrgico sob anestesia geral. Durante a consulta pré-anestésica, 15 dias antes da cirurgia, um grupo de pacientes (Grupo A, n = 36) recebeu informações abrangentes sobre seus procedimentos anestésicos e cirúrgicos, enquanto o outro grupo de pacientes (Grupo B, n = 36) não recebeu qualquer informação referente a essas variáveis. O inventário Beck de ansiedade, a pressão arterial e a frequência cardíaca foram avaliados antes e após a transmissão de informações ao Grupo A. No Grupo B, esses parâmetros foram avaliados no início e no final da consulta. Resultados: Os valores hemodinâmicos foram menores no grupo que recebeu informação pré-operatória, em comparação com o grupo que não recebeu informação pré-operatória. Informar os pacientes sobre o procedimento resultou em uma redução dos níveis de ansiedade de leve a mínimo, enquanto não houve mudança no grupo que não recebeu informação pré-operatória. Esse último grupo manteve o mesmo nível de ansiedade até o final da consulta pré-anestésica. Conclusões: A orientação do paciente no período pré-operatório deve ser o atendimento padrão para minimizar a ansiedade dos pacientes antes da cirurgia, especialmente os pacientes com câncer.

Exploratory Factor Analysis of the Beck Anxiety Inventory and the Beck Depression Inventory-II in a Psychiatric Outpatient Population

BACKGROUND: To further understand the relationship between anxiety and depression, this study examined the factor structure of the combined items from two validated measures for anxiety and depression. METHODS: The participants were 406 patients with mixed psychiatric diagnoses including anxiety and depressive disorders from a psychiatric outpatient unit at a university-affiliated medical center. Responses of the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI)-II, and Symptom Checklist-90-Revised (SCL-90-R) were analyzed. We conducted an exploratory factor analysis of 42 items from the BAI and BDI-II. Correlational analyses were performed between subscale scores of the SCL-90-R and factors derived from the factor analysis. Scores of individual items of the BAI and BDI-II were also compared between groups of anxiety disorder (n = 185) and depressive disorder (n = 123). RESULTS: Exploratory factor analysis revealed the following five factors explaining 56.2% of the total variance: somatic anxiety (factor 1), cognitive depression (factor 2), somatic depression (factor 3), subjective anxiety (factor 4), and autonomic anxiety (factor 5). The depression group had significantly higher scores for 12 items on the BDI while the anxiety group demonstrated higher scores for six items on the BAI. CONCLUSION: Our results suggest that anxiety and depressive symptoms as measured by the BAI and BDI-II can be empirically differentiated and that particularly items of the cognitive domain in depression and those of physical domain in anxiety are noteworthy.

The Relationship between Ghrelin and Copeptin Levels, and Anxiety and Depression Levels in Suicide Attempts

OBJECTIVE: It was aimed to detect acylated ghrelin (AG), unacylated ghrelin (UG) and copeptin levels in patients with suicide attempts and to determine if these biomarkers are risk factors for suicide attempts. METHODS: Serum copeptin, AG and GU levels were screened in 128 patients who were admitted to emergency department with suicide attempts and 59 healthy controls. Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) were applied simultaneously, and the data were compared statistically. RESULTS: AG, UG and copeptin levels were higher in the patient group compared with the healthy control group. BAI scores of patients were found to be positively correlated with BDI scores. While there was a significant difference (p=0.0064) between psychiatric and non-psychiatric patients with suicide attempts in terms of BAI scores, there were no differences in BDI scores and levels of biomarkers. We found significantly increased BDI and BAI scores and increased levels of AG, UG and copeptin in psychiatric and non-psychiatric patients compared with healthy individuals. The specificities yielded by receiver operating characteristic curve analysis in patients with suicide attempts were as follows: 91.53% for AG, 72.88% for UG and 94.92% for copeptin. CONCLUSION: Serum levels of AG, UG and copeptin increase with increasing anxiety and depression in patients with suicide attempts. Increased levels of AG, UG and copeptin could be considered a risk factor for suicide attempts.

Validity study of the Beck Anxiety Inventory (Portuguese version) by the Rasch Rating Scale model / Estudo de validade da versão portuguesa do Beck Anxiety Inventory mediante o modelo Rasch Rating Scale

Our objective was to conduct a validation study of the Portuguese version of the Beck Anxiety Inventory (BAI) by means of the Rasch Rating Scale Model, and then compare it with the most used scales of anxiety in Portugal. The sample consisted of 1,160 adults (427 men and 733 women), aged 18-82 years old (M=33.39; SD=11.85). Instruments were Beck Anxiety Inventory, State-Trait Anxiety Inventory and Zung Self-Rating Anxiety Scale. It was found that Beck Anxiety Inventory's system of four categories, the data-model fit, and people reliability were adequate. The measure can be considered as unidimensional. Gender and age-related differences were not a threat to the validity. BAI correlated significantly with other anxiety measures. In conclusion, BAI shows good psychometric quality...

Foi objetivo a validação da versão portuguesa do Beck Anxiety Inventory (BAI) mediante o modelo Rasch Rating Scale e a sua comparação com as escalas mais usadas de ansiedade em Portugal. A amostra consistia de 1160 adultos (427 homens e 733 mulheres) com idades entre 18-82 anos (M = 33,39; DP = 11,85). Os instrumentos utilizados foram: BAI, State-Trait Anxiety Inventory e Zung Anxiety Scale. Verificou-se que o sistema de quatro categorias, o ajuste dos dados ao modelo e a fidelidade das pessoas eram adequados. A medida é unidimensional. O género e as diferenças relacionadas com a idade não se mostraram ameaças à validade. O BAI correlaciona-se significativamente com as restantes medidas de ansiedade. Conclui-se que o instrumento apresenta boa qualidade psicométrica...

Low family support perception: a 'social marker' of substance dependence? / A baixa percepção de suporte familiar pode ser um "marcador social" da dependência de substâncias?

OBJECTIVE: Simultaneously assess the relationship between the family support perception and the intensity of hopelessness, depression, and anxiety symptoms in alcohol or drug dependent (AOD) patients and in non-AOD dependent control group (CON). METHOD: 60 patients who met the DSM-IV criteria for AOD dependence and 65 individuals with similar profile, but not dependent on AOD completed the Family Support Perception Inventory (FSPI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Beck Hopelessness Scale (BHS). RESULTS: Logistic regression analysis indicated that high scores in family autonomy (OR = 0.08), and low scores in hopelessness (OR = 0.64) were negatively correlated with AOD dependence. Individuals with high scores in BAI had higher probability (OR = 1.22) of belonging to the AOD group, as well as those who reported previous psychiatric treatment (OR = 68.91). Only in the AOD group the total FSPI scores presented significant correlation with depression, anxiety, and hopelessness. CONCLUSIONS: Individuals with AOD dependence and low scores of family support perception also presented high scores of depression, anxiety, and hopelessness, suggesting that FSPI scores could be a useful 'social marker' of AOD dependence with psychiatric comorbidities. These data also reinforce the relevance of evaluating family support in AOD treatment planning.

OBJETIVO: Estudar as relações entre a percepção do suporte familiar e sintomas de desesperança, depressão e ansiedade em pacientes dependentes de álcool ou drogas (AOD) e um grupo-controle (CON). MÉTODO: Sessenta pacientes que preencheram critérios do DSM-IV para dependência de AOD e um grupo-controle com 65 indivíduos com perfil similar, mas não dependentes de AOD preencheram o inventário de Percepção de Suporte Familiar (IPSF), o Inventário de Depressão de Beck (BDI), o Inventário de Ansiedade de Beck (BAI) e a Escala de Desesperança de Beck (BHS). RESULTADOS: Segundo a análise de regressão logística, altos escores de autonomia familiar (OR = 0,08) e baixos escores de desesperança (OR = 0,64) correlacionaram-se negativamente com ser dependente de AOD. Pessoas com altos escores no BAI apresentaram maior chance (OR = 1,22) de pertencer ao grupo AOD, assim como as que relataram já terem sido submetidas a tratamento psiquiátrico (OR = 68,91). Somente no grupo AOD os escores totais no IPSF se correlacionaram significativamente com sintomas de depressão, ansiedade e desesperança. CONCLUSÕES: Dependentes de AOD com baixa percepção de suporte familiar apresentaram também altos escores de depressão, ansiedade e desesperança, sugerindo que o IPSF poderia ser um útil "marcador social" da dependência de AOD associada a comorbidades psiquiátricas. Os dados reforçam a relevância de avaliar o suporte familiar no planejamento de tratamento para dependência de AOD.

The Beck Anxiety Inventory for Malays (BAI-Malay): A Preliminary Study on Psychometric Properties

Introduction: The purpose of the present study was to investigate exploratory factor analysis of the Beck Anxiety Inventory (BAI) and reports its reliability and validity in Malaysia. Method: One thousand and ninety participants from four different samples (namely students, general population, medical and psychiatric patients) completed the Malay version of Beck Anxiety Inventory, as well as additional questionnaires such as Fear Questionnaire, Anxiety Sensitivity Index, Depression Anxiety Stress Scale, and Catastrophic Cognition Questionnaire. Results: Exploratory factor analysis revealed a three factor solution and accounted for 48.01% of the total variance. The three-factor structure appeared to be; subjective anxiety, autonomic, and neurophysiology. The Cronbach alpha coefficients (α) ranged from 0.66 to 0.89 with satisfactory overall alpha value (.91). Evidence was also found acceptable concurrent validity of the BAI-Malay (range between r=.22 to r=.67). Conclusion: This study shows that the BAIMalay is a reliable and valid instrument to measure symptoms of anxiety in the Malay population and can be used in research and clinical service in Malaysia. However, replication of study by using confirmatory factor analysis and application of the instrument among anxiety patients worth of further investigation.