Chaihu Longgu Mulitang Relieves Generalized Anxiety Disorder in Rats via p38 MAPK/NF-κB Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo study whether Chaihu Longgu Mulitang can inhibit hypothalamic inflammation， mitigate anxiety-like behavior， and alleviate anxiety symptoms by regulating the p38 mitogen-activated protein kinase/nuclear factor-κB （p38 MAPK/NF-κB） signaling pathway in the rat model of generalized anxiety disorder （GAD）. MethodTwelve out of 74 Wistar rats were randomly selected as the blank group， and the remaining rats were subjected to chronic restraint stress for the modeling of GAD. The open field test （OFT） and elevated Porteus maze test （PMT） were conducted 14 days after modeling to detect the anxiety-like behaviors. Sixty successfully modeled rats were selected and randomized into model， low-， medium-， and high-dose （6， 12， and 24 g·kg-1， respectively） Chaihu Longgu Mulitang， and diazepam （1 mg·kg-1） groups （n=12） and administrated with corresponding drugs for 14 consecutive days. OFT and PMT were then carried out to examine the anxiety-like behaviors of the rats. The levels of tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， and interleukin-1β （IL-1β） in the hypothalamus and serum of rats were determined by the enzyme-linked immunosorbent assay （ELISA）. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）was conducted to determine the mRNA levels of p38 MAPK， NF-κB p65， nuclear factor κB inhibitor α （IκBα）， and ionized calcium binding adaptor molecule 1 （Iba-1）. The protein levels of p38 MAPK， phosphorylated （p）-p38 MAPK， NF-κB p65， p-NF-κB p65， and IκBα in the hypothalamus of rats were determined by Western blot. The expression of Iba-1 in the hypothalamic microglia was detected by immunofluorescence assay. ResultCompared with the blank group， the model group had decreased body weight， scattered dark yellow fur， increased irritability， and preference to hibernation in the corner. In addition， the modeled rats showed increased edge movement distance and time in OFT （P<0.01） and decreased movement distance and time and the number of entries in the open arm in PMT （P<0.01）. The modeling increased the fluorescence intensity of Iba-1 in paraventricular nucleus of hypothalamus （P<0.01）， elevated the levels of IL-1β， IL-6， and TNF-α in the serum and hypothalamus （P<0.01）， up-regulated the protein and mRNA levels of p38 MAPK， NF-κB p65， p-p38 MAPK， p-NF-κB p65， and Iba-1 （P<0.05， P<0.01）， and down-regulated the protein and mRNA levels of IκBα （P<0.01） in the hypothalamus. Compared with the model group， medium- and high-dose Chaihu Longgu Mulitang and diazepam increased the body weight， improved the fur and behaviors， decreased the edge movement distance and time in OFT （P<0.05， P<0.01）， and increased the movement distance and time in the open arm in PMT （P<0.05， P<0.01）. Furthermore， they decreased the fluorescence intensity of Iba-1 in hypothalamic microglia （P<0.05， P<0.01）， lowered the levels of IL-1β， IL-6， and TNF-α in the serum and hypothalamic tissue （P<0.05， P<0.01）， down-regulated the mRNA and protein levels of p38 MAPK， NF-κB p65， p-p38 MAPK， p-NF-κB p65， and Iba-1 （P<0.05， P<0.01）， and up-regulated the mRNA and protein levels of IκBα （P<0.05， P<0.01） in the hypothalamus. ConclusionChaihu Longgu Mulitang can mitigate anxiety-like behaviors and relieve anxiety in GAD rats by inhibiting the p38 MAPK/NF-κB signaling pathway and reducing the activation of microglia and the levels of pro-inflammatory cytokines in the hypothalamus.

Changing Sleep Patterns and Anxiety due to Covid?19 Home Confinement among Working Population: A Cross?Sectional Study

Introduction: The COVID?19 pandemic took the entire world unawares and people were forced to stay indoors overnight. Due to this a drastic change ensued in lifestyle with many succumbing to various kinds of stresses and psychological problems. This study aims to study the changing sleep patterns and level of anxiety among the working population due to the COVID?19 Pandemic lockdown. Methodology: An online survey was conducted using a cloud?based website. The sleep patterns both prior to and during the lockdown period of the pandemic were assessed using a self?administered questionnaire. The level of anxiety during both these periods (before and during lockdown) amongst the working population was also assessed using the Generalized Anxiety Disorder Scores (GADS). Results: A total of 224 individuals participated in the study of which 52.7% were males and 47.3% were females. On analysis, the lifestyle and sleep deprivation scores showed that before the lockdown only 2.7% reported a low score out of total participants. However, this number was raised to 13.4% during the lockdown. The percentage of people reporting deteriorated sleep quality gradually increased with females reporting moderate to severe category of Generalized Anxiety Disorder scores as compared to Males. Conclusion: The study suggests that there has been a significant change in the sleep quality of the study participants due to Covid enforced lockdown which if unnoticed might lead to significant health problems. The effective use of programs like yoga, meditation, and deep breathing exercises, if followed timely could reduce psychological distress to some extent.

Acupuncture point selection for prevention and treatment of generalized anxiety disorder from the perspective of Microbiota-Gut-Brain Axis / 国际中医中药杂志

Disorders of the gut flora (GF) affect the level of 5-hydroxytryptamine (5-HT) in the brain of patients with generalized anxiety disorder (GAD) and influence the development of the disease. Most of the acupuncture points selected for GAD are based on the principles of local acupuncture points and acupuncture points following the distant channels of the meridians, regarding Baihui (DU 20), Fengchi (GB 20), and Yintang (GV 29) as the main acupuncture points, and the acupuncture points selected for the regulation of GF are Zhongwan (CV 12), Tianshu (ST 25), and Guanyuan (RN 4) and Zusanli (ST 36). Recently, many studies have been conducted on the mechanism of action of acupuncture in the treatment of GAD from the perspective of GF, but few have investigated the theoretical of acupuncture points used to prevent and treat GAD. This paper discusses the theoretical basis of acupuncture to regulate the "microbiota-gut-brain axis" (MGBA) for the prevention and treatment of GAD, and proposes the method of "regulating the internal organs and calming the mind and relieving anxiety" through analyzing the researches on the regulation of GF and GAD.

Emotional eating in women with generalized anxiety disorder

Abstract Introduction Individuals diagnosed with generalized anxiety disorder (GAD) seek pleasurable foods to avoid their negative emotional experiences. Ineffective regulation of negative emotions may be a risk factor for emotional eating (EE), leading to suffering, dysfunctional behaviors, and weight gain. Objectives The aim of this study is to understand the relationship between emotional dysregulation and EE, investigating potential mediators such as the intensity of the worry, avoidance of internal experiences, mindfulness, and self-compassion in female patients with anxiety. Methods In this cross-sectional study, participants from a randomized clinical trial diagnosed with GAD answered the following instruments at baseline: the Difficulties in Emotion Regulation Scale (DERS), the Three Factor Eating Questionnaire (TFEQ-R21), the Penn State Worry Questionnaire (PSWQ), the Action and Acceptance Questionnaire (AAQ), the Five Facet Mindfulness Questionnaire (FFMQ), and the Self-Compassion Scale (SCS). We estimated Pearson correlation coefficients and performed mediation analyses. Results We evaluated 51 female individuals, 34 of whom completed all the questionnaires. Our data showed that EE was positively correlated with emotional dysregulation (r = 0.593; p < 0.001), worry trait (r = 0.402; p = 0.018), and avoidance of internal experiences (r = 0.565; p < 0.001), whereas it was negatively correlated with self-compassion (r = -0.590; p < 0.001) and mindful state (r = -0.383; p = 0.026). Moreover, we demonstrated that self-compassion mediates the relationship between emotional dysregulation and EE (ab product estimate = 0.043, 95% confidence interval [95%CI] 0.003-0.084). Conclusion Our findings contribute to the literature by identifying psychological factors that could mediate the association between emotional dysregulation and EE, enabling identification of more effective eating behavior intervention targets for patients with GAD.

Validation and clinical application of the Metacognitions Questionnaire in a sample of Brazilian generalized anxiety disorder patients: the effects of different treatment interventions

Abstract Introduction Metacognitive beliefs about worry may trigger anxiety. However, the effect of generalized anxiety disorder (GAD) treatment on metacognition has not yet been investigated. Objectives To validate the Metacognitions Questionnaire (MCQ-30) in a Brazilian GAD sample and verify whether different interventions reduce metacognitive beliefs. Method We recruited 180 GAD individuals and randomized them to Body in Mind Training (BMT), Fluoxetine (FLX), or an active control group (Quality of Life [QoL]) for 8 weeks. The MCQ-30 was assessed for internal consistency, was evaluated with confirmatory and exploratory factor analyses, and was tested for convergent validity with the Penn State Worry Questionnaire (PSWQ). Generalized estimating equations (GEE) were employed to analyze differences after the interventions. Results The MCQ-30 demonstrated good internal consistency and acceptability; the original five-factor model was supported. There was a positive moderate correlation between MCQ-30 scores and worry. GEE showed a significant group x time interaction (p < 0.001). Both BMT (mean difference [MD] = -6.04, standard error [SE] = -2.39, p = 0.034) and FLX (MD = -5.78, SE = 1.91, p = 0.007) reduced MCQ-30 scores. FLX was superior to QoL, but not BMT, at weeks 5 and 8. There were no differences between BMT and QoL. Conclusion The Brazilian-Portuguese version of MCQ-30 showed good psychometric properties. Furthermore, the positive effect of FLX and BMT on metacognition suggests it may represent a potential therapeutic target.

Improvement of inflammatory cytokines level in peripheral blood, anxiety and depressive symptoms in patients with pulpitis by root canal therapy / 口腔疾病防治

Objective@# To investigate the effect of root canal therapy (RCT) on inflammatory cytokines level in peripheral blood, anxiety, and depression in patients with pulpitis.@*Methods @#A total of 155 patients with pulpitis admitted to the Stomatology Hospital of the Fourth Military Medical University from June 2021 to June 2022 were treated with root canal therapy. Another 155 persons who received health examinations during the same period were selected as the control group. The Generalized Anxiety Disorder-7 (GAD-7) scores and the Patient Health Questionnaire-9 (PHQ-9) scores of the two groups were compared. The GAD-7, PHQ-9 and pain scores of the test group before treatment and 3 and 6 weeks after treatment were compared. Pain was assessed with a visual analog scale (VAS). Inflammatory cytokine [interleukin-8 (IL-8), interleukin-1 β (IL-1β), tumor necrosis factor-α (TNF-α), c-reactive protein (CRP)] levels in the test group before treatment and 3 and 6 weeks after treatment were compared. @*Results @#The GAD-7 and PHQ-9 scores in the test group were higher than those in the control group before treatment (P<0.05). The GAD-7 and PHQ-9 scores in the test group at 3 and 6 weeks after treatment were lower than those before treatment (P<0.05); there was no significant difference between the GAD-7 and PHQ-9 scores at 3 and 6 weeks after treatment(P>0.05). The pain scores of the experimental group at 3 and 6 weeks after treatment were lower than those before treatment (P<0.05), and the pain scores 6 weeks after treatment were lower than those at 3 weeks after treatment (P<0.05). The levels of IL-8, IL-1β, TNF-α and CRP in the peripheral blood of the experimental group were lower 3 and 6 weeks after treatment than before (P<0.05), and the levels of IL-8 and IL-1β in the peripheral blood at 6 weeks after treatment were significantly lower than at 3 weeks after treatment (P<0.05). The levels of TNF-α and CRP in the peripheral blood at 6 weeks after treatment were not significantly different from those at 3 weeks after treatment (P>0.05).@*Conclusion @#The peripheral blood of patients with pulpitis has a high level of inflammatory cytokines, and the patients suffer from obvious anxiety and depression. Root canal therapy can relieve their anxiety and depression by reducing their level of inflammatory cytokines in peripheral blood.

Efficacy of Draksadi Phantam in Generalized Anxiety Disorder- An Uncontrolled Clinical Trial

Anxiety disorders are one of the most prevalent class of mental disorders in the general population. Generalized anxiety disorder (GAD) is a common anxiety disorder that comprises continuous and long-lasting worrying, tension, which making normal life problematic and relaxation impossible The prevalence rate of GAD disorder is increasing constantly in modern era. Though many different types of modern medications used currently to treat anxiety disorders provide temporary relief, they come with various side effects, Drug dependence and safety concerns. In Ayurveda the symptoms of this disease show resemblance with the condition. Cittodvega (excited state of mind) which is one among the Manovikara in Ayurveda caused by dysfunction of increased Vata and Pitta dosha. The present study was conducted as an Uncontrolled clinical trial to study the Efficacy of Drakshadi Phantam in 38 diagnosed participants of Generalized Anxiety Disorder with the age group 20–50 were administered with 100ml of Drakshadi Phantam twice daily before food continuously for a period of 45 days. Five assessments were done staring from 0th day of treatment to 60 the day of the study with a gap of 15 days, using Hamilton anxiety rating scale and Rajas Tams rating scale. The assessment scores of different intervals were statistically analysed using RM ANOVA. Effect of the therapy were statistically analysed in each domain of HAM – A rating scale in different intervals of the study. The therapy was found statistically significant in reducing the symptoms of GAD in all the 14 domains of the HAM- A Rating scale. Based on results it has been concluded that Drakshadi Phantam has statistically significant effect in reducing the symptoms of all the 14 domains of Hamilton anxiety rating scale and reducing the Rajasika and Tamasika qualities of the study participants.

Prevalence of Anxiety, Depression and Self-Care Behaviour during the Covid-19 Pandemic in the General Population

Introduction: SARS-CoV-2 has affected not only physical health but also devastated mental wellbeing. The government of India ordered a nationwide lockdown limiting movement of the entire 1.3 billion populations. The impact of the pandemic on depression, anxiety and self-care behaviour among the general population was investigated. Methods: An online cross-sectional survey was carried out with an anonymous questionnaire using validated instruments. Multivariable linear regression analysis was carried out to find the role of each variable in determining the relevant scores. Result: The mean age of the 1052 participants was 30.52 (SD � 13.42) years. The mean score of depression and anxiety was 5.96 and 5.27 respectively. Moderate to severe depression was noted among 18.68% and moderate to severe anxiety was noted among 16.1% of the respondents. Gender was a significant predictor of all three (depression, anxiety, and coping) scores, while the civil status predicted both depression and anxiety scores and age predicted only the depression score. Conclusion: A considerable proportion of the surveyed population in our setting has manifested symptoms of anxiety and depression. Gender, civil status and age predicted various scores.

Complete Recovery from Generalized Anxiety Disorder Through Anchusan / 日本東洋医学雑誌

We had a female patient who had stagnation of qi and recovered not only by adjusting qi but also by warming interior cold. A 67-year-old woman visited our clinic for generalized anxiety disorder and whole body overstrain on the basis of domestic problems. She had taken anxiolytic, which brought about some relief. She also suffered from uterine cancer, and had operation of uterine resection. After operation, she took radiation therapy, which caused ileus. Although she took daikenchuto, ileus sometimes recurred. At first, we diagnosed her condition as stagnation of liver qi and deficiency of liver blood according to Kampo medical findings, and prescribed yokukansankachimpihange. However, she felt little effectiveness. We focused on her condition as spleen-stomach deficiency cold, and switched to anchusan, which gradually improved her symptom and led to discontinuation of daikenchuto and anxiolytic. She continued to take it for 7 years, and gradually reduced. She stopped taking medication 2 years later, and has had no recurrence ever since. It suggests that anchusan was effective in warming her latent severe interior cold. We should consider anchusan as a therapeutic candidate for stagnation of qi and interior cold, although it is well known Kampo medicine that is suitable for stomach pain.

Study of the effects of cognitive behavioral therapy versus dialectical behavior therapy on executive function and reduction of symptoms in generalized anxiety disorder

Abstract Introduction The effects of dialectical behavior therapy on generalized anxiety disorder have not been examined to date, whereas cognitive behavioral therapy is a well-known psychotherapy for generalized anxiety disorder. Objectives This study investigated the effects of cognitive behavioral therapy versus dialectical behavior therapy on executive function and reduction of symptoms in generalized anxiety disorder. Method In the present study, 72 generalized anxiety disorder patients were randomly assigned to one of two groups: dialectical behavior therapy or cognitive behavioral therapy. Evaluations were performed at baseline, post-test, and three months after interventions as a follow-up. Measures included the Structured Clinical Interview for DSM-IV Axis I disorders, the Generalized Anxiety Disorder scale, the Beck Anxiety Inventory, the Beck Depression Inventory, the Tower of London Task, and the Wisconsin Card Sorting Task.Results: The results of the present study showed that both groups had reduced scores for depression and anxiety and increased scores for executive function after the psychotherapies. These changes were maintained at follow-up. Conclusion Although depression and anxiety symptoms were significantly reduced by cognitive behavioral therapy, dialectical behavior therapy was more effective for improving executive function.

Effectiveness Of Homoeopatic Medicine In Cases Of Generalized Anxiety Disorders

Background:In today’s era cases of Anxiety Disorders are increasing all over the world. The present study shows the efficacy of Homoeopathic Medicine in cases of Generalized Anxiety Disorders.Objective: To ascertain the Role of Homoeopathic Medicine in Management of Generalized Anxiety Disorders. Material And Methods:Purposive Sampling for research purpose will be done. Selection of the medicine will be according to concept of Method of Repertorisation. Selection of the potency and repetition was based on laws of Homeopathic Posology which is described in Organon of medicine. Result:In study mostly adults are more affected and acute cases are more present. Mostly higher potency was used. Conclusion:Our study has concluded theGreat utility of Homoeopathic Medicine in finding the indicated medicines for cases of Anxiety Disorder.

A review on anxiety disorders during covid-19 pandemic-homoeopathic perspective

The unprecedented Covid-19 pandemic has created havoc in most areas of human lives. Anxiety disorders are the most prevalent psychiatric disorders, and the incidence increased in recent times. Homoeopathy is an alternative system of medicine with evidence-based effectiveness in mental health issues. There is a dearth of literature concerning the potential utility of Homoeopathy in the management of psychological issues during this pandemic.Objectives:This overview aims to assess the commonly prevalent anxiety disorders during Covid-19 and assess the usefulness of homoeopathic medicines in managing anxiety.Materials and methods:Selective literature in PubMed search engine to identify most prevalent anxiety disorders during Covid-19 using terms "Covid-19" and "Anxiety" and available research studies in homoeopathy on anxiety have been put forward in this narrative review.Results:The identified anxiety disorders during Covid-19 and the role of Homoeopathy in managing anxiety disorders have been summarized in the article. The homoeopathic perspective of anxiety and the rubrics related to anxiety disorders in different repertories are discussed.Conclusion:mental health is a critical concern in the pandemic's scenario, and Homoeopathy can be a safe and effective alternative or adjunctive to the conventional system in the management of anxiety disorders during this chaotic situation

Generalized anxiety disorder and prevalence of suicide risk among medical students / Prevalência do transtorno de ansiedade generalizada e do risco de suicídio em estudantes de medicina

Abstract: Introduction: Generalized anxiety disorder (GAD) is a common pathology in modern life. Furthermore, Brazil ranks among one of the countries in Latin America with the highest increase in the number of suicides. Objective: The goal of this study is to evaluate the prevalence of GAD and suicide risk and their association in medical students from Belém - PA. Methods: The observational, cross-sectional and quantitative study included undergraduate medical students attending the 1st, 3rd and 5th years of Universidade do Estado do Pará as subjects of this research, totaling 153 students. It used a protocol created by the authors and the Mini International Neuropsychiatric Interview. The software BioEstat® 5.3 was used to perform the statistical analysis. Results: 52 (32,7%) of the 159 students have GAD and 48 (30,2%) pose a suicide risk, of which 18 have a mild risk (11,3%), 17 a moderate risk (10,7%) and 13 a high risk (8,2%). 46,7% and 50% of the 1st and 3rd-year students, respectively, have higher risk of suicide, which could be related to the competition faced during the University admission process and also during the first years of the clinical cycle. Of the 5th year students who pose a suicide risk, only 21,7% have high risk. Conclusion: It can be observed that GAD and suicide risk show high prevalence among medical students, which has to be investigated and treated aiming to reduce the impacts of those disorders on health professionals and students.

Resumo: Introdução: O transtorno de ansiedade generalizada (TAG) é uma patologia comum da modernidade. Além disso, o Brasil figura entre um dos países da América Latina com o maior aumento do número de suicídios. Objetivo: Este estudo teve como objetivo avaliar a prevalência de TAG e risco de suicídio e a associação entre eles em estudantes de Medicina de Belém, no Pará. Métodos: O estudo observacional, transversal e quantitativo teve como sujeitos da pesquisa graduandos do curso de Medicina que estavam matriculados no primeiro, terceiro e quinto anos na Universidade do Estado do Pará, totalizando 159. Utilizaram-se questionário de autoria dos pesquisadores e o Mini International Neurophsychiatric Interview, sendo a análise estatística feita com o software BioEstat® 5.3. Resultados: Dos 159 estudantes, 52 (32,7%) apresentaram TAG; e 48 (30,2%), risco de suicídio, dos quais 18 tiveram risco leve (11,3%); 17, risco moderado (10,7%); e 13, risco elevado (8,2%). Dos alunos, 46,7% e 50%, respectivamente do primeiro e terceiro anos, apresentaram risco elevado de suicídio, fato que pode estar associado com a pressão do vestibular e do início do ciclo clínico. Dos alunos do quinto ano com risco de suicídio, somente 21,7% apresentaram risco elevado. Conclusão: Percebe-se uma importante taxa de TAG e de risco de suicídio entre os estudantes de Medicina, o que precisa ser investigado e trabalhado para minimizar os impactos desses transtornos nos discentes.

Associations between osteoarthritis and GAD/depression among rural middle-aged and elderly people in Bayannur, Inner Mongolia Autonomous Region / 中华地方病学杂志

Objective:To investigate the relationship between osteoarthritis and generalized anxiety disorder (GAD)/depression among rural middle-aged and elderly people in Bayannur, Inner Mongolia Autonomous Region.Methods:From 2016 to 2018, a one-to-one interview questionnaire survey was conducted among 832 rural middle-aged and elderly people aged 45 or above in Bayannur. Logistic regression model was used to explore the relationship between osteoarthritis and GAD/depression.Results:Of 832 rural middle-aged and elderly participants, 28.73% (239/832) were diagnosed with osteoarthritis. The risk of GAD and depression increased by 71% [adjusted odds ratio ( AOR): 1.71, 95% confidence interval ( CI): 1.12 - 2.60] and 68% ( AOR: 1.68, 95% CI: 1.10 - 2.58), respectively, in patients with osteoarthritis compared with those without osteoarthritis. Conclusions:The prevalence of osteoarthritis is high among the middle-aged and elderly people in Bayannur, Inner Mongolia Autonomous Region. Osteoarthritis may increase the risk of GAD/depression. It is necessary to take corresponding intervention measures to prevent the occurrence of osteoarthritis to reduce GAD/depression.

Generalized anxiety disorder in type 2 diabetes mellitus: prevalence and clinical characteristics

Objective: This study investigated the prevalence of generalized anxiety disorder (GAD) in Taiwanese patients with type 2 diabetes mellitus (T2DM). Methods: This retrospective observational study was conducted with a random sample of patients from the entire population of National Health Insurance enrollees during 2000-2010 and used ICD-9-CM diagnostic codes to identify T2DM patients and GAD. The prevalence of GAD was compared between T2DM patients and the general population. Results: Between 2000 and 2010, the prevalence of GAD was significantly greater in the T2DM patients than the general population, while the increase of GAD was higher in the general population (from 0.25 to 0.63%) than among T2DM patients (from 0.81 to 1.03%). In T2DM patients, GAD was associated with female gender, a Charlson Comorbidity Index ≥ 1, diabetes mellitus duration > 9 years, and the following comorbidities: congestive heart failure, peripheral vascular disease, and depressive disorder. The prevalence of GAD among T2DM patients was negatively associated with rapid-acting insulin injection therapy and with the use of metformin and sulfonylureas. Conclusion: Since the prevalence of GAD was greater among T2DM patients than the general population, public health initiatives are needed to prevent and treat GAD in T2DM patients, specifically those with the above mentioned risk factors.

Impulsivity influences food intake in women with generalized anxiety disorder

Objective: Eating behavior is affected by psychological and neurocognitive factors. However, little is known about this relationship in anxious patients. Our aim was to investigate the associations between impulsivity, inhibitory control, energy-dense food consumption, and body mass index (BMI) in women with generalized anxiety disorder (GAD). Methods: In this cross-sectional study, 51 adult females with GAD answered the Barratt Impulsiveness Scale (BIS-11) and participated in a go/no-go task using food images. Anthropometric measurements were evaluated. A food frequency questionnaire and a snack test were used to study eating behavior. Pearson correlation and multiple linear regression were performed to analyze the variables of interest, adjusted by age. Results: Impulsivity predicted intake of sugar (p = 0.016, 95%CI 0.67-6.05), total fat (p = 0.007, 95%CI 0.62-3.71), and saturated fat (p = 0.004, 95%CI 0.30-1.48). The snack test showed a positive correlation between presence of impulsivity and intake of biscuits (R = 0.296; p = 0.051). Response inhibition to food images in the go/no-go task paradigm did not predict BMI or food intake. Conclusion: Impulsivity was predictive of higher sugar and saturated fat intake in women diagnosed with GAD. Our findings add to the literature regarding the association between neuropsychological factors and food consumption in this specific population.

Prevalence and correlates of generalized anxiety disorder among elderly people in primary health care / Prevalência e correlatos do transtorno de ansiedade generalizada em idosos atendidos em atenção primária

OBJECTIVE: To examine the prevalence of generalized anxiety disorder (GAD) and its associations with sociodemographic and health factors. METHODS: A cross-sectional study with a population-based sample of 578 individuals aged 60 years or older from the Family Health Strategy (FHS) program of Porto Alegre, RS, Brazil. Home visit screening and general data collection were made by trained Community Health Workers (CHWs). Diagnoses of psychiatric disorders were made by board-certified psychiatrists using the Mini International Neuropsychiatric Interview plus (MINIplus) in the Hospital São Lucas of the Pontifical University of Rio Grande do Sul (PUCRS). RESULTS: GAD was found in 9% of the sample (n = 52; CI 95% = 6.9-11.6). The main results of the multivariate analysis show associations between GAD and retirement (PR: 0.43, CI: 0.25-0.76), history of falls (PR: 2.52, CI: 1.42-4.49), cohabitation with four or more people (PR: 1.80, CI: 1.04-3.13), having more than one hospitalization in the last year (PR: 2.53, CI: 1.17-5.48) and self-perception of health as regular (PR: 2.75, CI: 1.02-7.47). Retirement in the elderly shows 2.32x less risk of GAD, although confounding factors may have overestimated this finding and underestimated the association with female gender (PR: 1.61, CI: 0.83-3.10). CONCLUSIONS: We estimate a high prevalence of GAD in this population. Associations were found between GAD and health self-perceived as regular, cohabitation with four or more people, history of falls and more than one hospitalization in the last year. These epidemiological data from the Family Health Strategy are important to develop further strategies for this age group that could improve the health care practice.

OBJETIVO: Examinar a prevalência do transtorno de ansiedade generalizada (TAG) em idosos e suas associações com fatores sociodemográficos e de saúde. MÉTODOS: Estudo transversal, composto por uma amostra de base populacional de 578 indivíduos com 60 anos ou mais, participantes do programa Estratégia Saúde da Família (ESF) de Porto Alegre, RS, Brasil. Agentes de saúde treinados realizaram coleta de dados dos indivíduos durante as visitas domiciliares. A avaliação diagnóstica psiquiátrica foi realizada por psiquiatras, no Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), por meio da aplicação do Mini International Neuropsychiatric Interview plus (MINIplus). RESULTADOS: O TAG foi encontrado em 9% (n = 52; IC 95% = 6,9-11,6) da amostra. Os principais resultados da análise multivariada evidenciaram associações entre TAG e aposentadoria (RP: 0,43; IC: 0,25-0,76), história de quedas (RP: 2,52; IC: 1,42-4,49), coabitação com quatro ou mais pessoas (RP: 1,80; IC: 1,04-3,13), ter mais de uma hospitalização no último ano (RP: 2,53, IC: 1,17-5,48) e autopercepção de saúde avaliada como regular (RP: 2,75, IC: 1,02-7,47). Idosos aposentados apresentaram risco 2,32 menor de TAG, embora fatores confundidores possam ter superestimado esse achado e subestimado a associação com gênero feminino (RP: 1,61; IC: 0,83-3,10). CONCLUSÕES: Estimou-se uma alta prevalência de TAG nessa população de idosos. Foram encontradas associações de TAG com autopercepção de saúde regular, coabitação com quatro ou mais pessoas, mais de uma hospitalização no último ano e história de quedas. Esses dados oriundos da Estratégia Saúde da Família são importantes para o desenvolvimento de estratégias adicionais que possam melhorar a prática de assistência à saúde na população idosa.

Acupuncture combined with cranial electrotherapy stimulation on generalized anxiety disorder: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the therapeutic effect of acupuncture combined with cranial electrotherapy stimulation (CES) on generalized anxiety disorder (GAD).@*METHODS@#A total of 200 patients with GAD were randomized into an acupuncture+CES group, an acupuncture group, a CES group and a medication group, 50 cases in each one. In the medication group, patients were treated with tandospirone citrate tablet orally, 10 mg after breakfast, lunch and dinner respectively. In the CES group, CES was adopted by SCS brain electromedical instrument, 60 min each time, once a day. In the acupuncture group, acupuncture was applied to Baihui (GV 20), Sishencong (EX-HN 1), Yintang (GV 29), Shenting (GV 24), etc., 30 min each time, once a day. In the acupuncture+CES group, CES was adopted before acupuncture. Treatment of sixty days was required in the 4 groups. Before and after treatment, the scores of Hamilton anxiety scale (HAMA), World Health Organization's quality of life questionnaire-brief version (WHOQOL-BREF) and treatment emergent symptom scale (TESS) were observed, the clinical effect was evaluated, and the relapse of anxiety during follow-up of 1 year after treatment was recorded in the 4 groups.@*RESULTS@#Compared before treatment, the scores of HAMA after treatment were decreased (@*CONCLUSION@#Acupuncture combined with CES can effectively relieve the symptoms in patients with GAD, improve the quality of life, reduce the occurrence of adverse reactions and the relapse rate, and its clinical effect is obviously superior to the western medication, the simple application of acupuncture or CES.

Level of intolerance of uncertainty and related factors in patients with anxiety disorders / 上海交通大学学报（医学版）

Objective: To investigate the level of intolerance of uncertainty (IU) and possible related factors in the patients with anxiety disorders. Methods: The patients' diagnosis was made according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM- ). Thirty-five cases of generalized anxiety disorder (GAD), 15 cases of panic disorder (PD) and 31 healthy controls (HC group) were recruited at the same time. IU level was assessed by using the Chinese version of Intolerance of Uncertainty Scale (IUS). The characteristics of anxiety symptoms, depressive symptoms and body perception were assessed by Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and Body Perception Questionaire (BPQ), respectively. Results: The IU levels of both GAD group and PD group were significantly higher than those of HC group (P=0.000). There was no significant difference in IU levels between GAD group and PD group (P=0.491). The IU levels of GAD patients were positively correlated with HAMA-somatic anxiety (r=0.377, P=0.025) and BPQ-awareness (r=0.342, P=0.044). Conclusion: The patients with anxiety disorders have elevated IU levels, compared with healthy people. Possibly, somatic anxiety and body perception-awareness are related factors to IU in GAD patients.

Effect of simplified cognitive behavioral therapy on generalized anxiety disorder / 上海交通大学学报（医学版）

Objective • To explore the effect of simplified cognitive behavioral therapy (SCBT) on generalized anxiety disorder (GAD). Methods • GAD patients were recruited from Shanghai Hongkou Mental Health Center, Shanghai Putuo Mental Health Center, Tenth People's Hospital of Tongji University, The Affiliated Brain Hospital of Nanjing Medical University and Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, who were divided into SCBT group, SCBT+medication group and medication group. The Generalized Anxiety Disorder Scale-7(GAD-7) was used to assess the patients' generalized anxiety symptoms, Hamilton Anxiety Scale-14(HAMA-14) to assess the patients' anxiety level, and Hamilton Depression Scale-17(HAMD-17) to assess the patients' depression level. SCBT and/or medication were used. Three groups of patients were evaluated by single blind method. Variance analysis and χ2 test were used to compare the cure rate and the severity of anxiety and depression at different time points. Results • A total of 134 cases were included in the statistical analysis, 39 cases in SCBT group, 53 cases in SCBT+medication group, and 42 cases in medication group. There was no significant difference in gender, education level and marital status among the three groups, and there was significant difference in age (P=0.033). The cure rate of SCBT group was higher than those of SCBT+medication group and medication group (P=0.005). The scores of anxiety and depression of the three groups decreased with the prolongation of treatment time. Conclusion • SCBT can effectively alleviate the anxiety and depression symptoms of GAD patients, and has a better prognosis for GAD patients.