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Neuroscience Bulletin ; (6): 342-358, 2022.
Article in English | WPRIM | ID: wpr-929097


Central sensitization is essential in maintaining chronic pain induced by chronic pancreatitis (CP), but cortical modulation of painful CP remains elusive. Here, we examined the role of the anterior cingulate cortex (ACC) in the pathogenesis of abdominal hyperalgesia in a rat model of CP induced by intraductal administration of trinitrobenzene sulfonic acid (TNBS). TNBS treatment resulted in long-term abdominal hyperalgesia and anxiety in rats. Morphological data indicated that painful CP induced a significant increase in FOS-expressing neurons in the nucleus tractus solitarii (NTS) and ACC, and some FOS-expressing neurons in the NTS projected to the ACC. In addition, a larger portion of ascending fibers from the NTS innervated pyramidal neurons, the neural subpopulation primarily expressing FOS under the condition of painful CP, rather than GABAergic neurons within the ACC. CP rats showed increased expression of vesicular glutamate transporter 1, and increased membrane trafficking and phosphorylation of the N-methyl-D-aspartate receptor (NMDAR) subunit NR2B and the α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor (AMPAR) subunit GluR1 within the ACC. Microinjection of NMDAR and AMPAR antagonists into the ACC to block excitatory synaptic transmission significantly attenuated abdominal hyperalgesia in CP rats, which was similar to the analgesic effect of endomorphins injected into the ACC. Specifically inhibiting the excitability of ACC pyramidal cells via chemogenetics reduced both hyperalgesia and comorbid anxiety, whereas activating these neurons via optogenetics failed to aggravate hyperalgesia and anxiety in CP rats. Taken together, these findings provide neurocircuit, biochemical, and behavioral evidence for involvement of the ACC in hyperalgesia and anxiety in CP rats, as well as novel insights into the cortical modulation of painful CP, and highlights the ACC as a potential target for neuromodulatory interventions in the treatment of painful CP.

Animals , Anxiety/etiology , Chronic Pain/etiology , GABAergic Neurons , Gyrus Cinguli/metabolism , Hyperalgesia/metabolism , Pancreatitis, Chronic/pathology , Rats , Rats, Sprague-Dawley , Receptors, N-Methyl-D-Aspartate/metabolism , Trinitrobenzenesulfonic Acid/toxicity
Article in Chinese | WPRIM | ID: wpr-927374


OBJECTIVE@#To observe the effect of thumb-tack needles based on "Biaoben acupoint compatibility" on sequela symptoms, mental state and pulmonary ventilation function in patients with coronavirus disease 2019 (COVID-19) during recovery period.@*METHODS@#Fifty cases of COVID-19 during recovery period were randomly divided into an observation group and a control group, 25 cases in each group. The patients in the observation group were treated with thumb-tack needles at Guanyuan (CV 4), Zusanli (ST 36) and Taiyuan (LU 9). The patients in the control group were treated with sham thumb-tack needles at identical acupoints as the observation group. The treatment in the two groups was given once a day, 7-day treatment was taken as a course of treatment, and totally two courses of treatment were given. The TCM symptom score, Hamilton anxiety scale (HAMA) score, Hamilton depression scale (HAMD) score, pulmonary function (forced vital capacity [FVC], forced expiratory volume in the first second [FEV1], peak expiratory flow [PEF]), the severity of pulmonary ventilation dysfunction and pulmonary imaging changes in the two groups were compared before and after treatment.@*RESULTS@#Compared before treatment, the total scores and each item scores of TCM symptom scale, HAMA scores and HAMD scores in the two groups were reduced after treatment (P<0.05). Except for the symptom scores of dry throat and dry stool, the total score and each item score of TCM symptom scale, HAMA score and HAMD score in the observation group were lower than those in the control group (P<0.05). Compared before treatment, FVC, FEV1 and PEF in the two groups were increased after treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The severity of pulmonary ventilation dysfunction in the two groups was reduced after treatment (P<0.05), and the severity in the observation group was better than that in the control group (P<0.05). After treatment, the lung shadow area in the two groups was decreased (P<0.05), and that in the observation group was smaller than the control group (P<0.05). The improvement of imaging change in the observation group was better than that in the control group (P<0.05).@*CONCLUSION@#The thumb-tack needles based on "Biaoben acupoint compatibility" could significantly reduce the sequela symptoms, anxiety and depression in patients with COVID-19 during recovery stage, and improve the pulmonary ventilation function.

Acupuncture Points , Anxiety/etiology , COVID-19/therapy , Depression/etiology , Humans , Needles , Respiratory Function Tests , Thumb
Neuroscience Bulletin ; (6): 16-28, 2022.
Article in English | WPRIM | ID: wpr-922663


Chronic stress leads to many psychiatric disorders, including social and anxiety disorders that are associated with over-activation of neurons in the basolateral amygdala (BLA). However, not all individuals develop psychiatric diseases, many showing considerable resilience against stress exposure. Whether BLA neuronal activity is involved in regulating an individual's vulnerability to stress remains elusive. In this study, using a mouse model of chronic social defeat stress (CSDS), we divided the mice into susceptible and resilient subgroups based on their social interaction behavior. Using in vivo fiber photometry and in vitro patch-clamp recording, we showed that CSDS persistently (after 20 days of recovery from stress) increased BLA neuronal activity in all the mice regardless of their susceptible or resilient nature, although impaired social interaction behavior was only observed in susceptible mice. Increased anxiety-like behavior, on the other hand, was evident in both groups. Notably, the CSDS-induced increase of BLA neuronal activity correlated well with the heightened anxiety-like but not the social avoidance behavior in mice. These findings provide new insight to our understanding of the role of neuronal activity in the amygdala in mediating stress-related psychiatric disorders.

Amygdala , Animals , Anxiety/etiology , Anxiety Disorders , Avoidance Learning , Mice , Mice, Inbred C57BL , Social Behavior , Stress, Psychological/complications
Rev. bras. ginecol. obstet ; 43(9): 676-681, Sept. 2021. tab
Article in English | LILACS | ID: biblio-1351775


Abstract Objective To assess the most common psychological disturbances in women with deep endometriosis and bowel involvement who are waiting surgical treatment and to evaluate what forms of coping are used to solve the problem. Methods This was a cross-sectional observational study of 40 women diagnosed with deep endometriosis and intestinal symptoms. They completed two questionnaires: one for anxiety and depression (Hospital Anxiety and Depression Scale [ HADS]) and the Scale of Mode of Confronting Problems (EMEP, in the Portuguese acronym). Results We found that 77.1% of the patients had anxiety and depression, with anxiety being the most prevalent (87.5% of the patients); 90% of the patients used problem focused and religious introspection as their main modes of confronting problems. Conclusion In the use of the HADS questionary, two psychological aspects were the most present in women with deep endometriosis awaiting surgical treatment: anxiety and depression. The most used forms of coping to solve the problem were problem coping and religious practices.

Resumo Objetivo Avaliar os distúrbios psicológicos mais comuns em mulheres com endometriose profunda e acometimento intestinal que aguardam tratamento cirúrgico e avaliar as formas de enfrentamento que são usadas para resolver o problema. Métodos Estudo observacional transversal com 40 mulheres com diagnóstico de endometriose profunda e acometimento intestinal. As pacientes responderam dois questionários: para ansiedade e depressão (Hospital Anxiety and Depression Scale [HADS, na sigla em inglês) e outro para enfrentamento dos problemas (EMEP). Resultados Constatamos que 77% das pacientess apresentaram ansiedade e depressão, sendo a ansiedade a mais prevalente (87,5%); 90% das pacientes usaram a forma religiosa e focada no problema como sua principal estratégia de enfrentamento. Conclusão Os aspectos psicológicos mais encontrados em mulheres com endometriose profunda e intestinal que aguardam tratamento cirúrgico são ansiedade e depressão. As formas mais usadas de enfrentamento para resolver o problema foram práticas religiosas e focada no problema.

Humans , Female , Endometriosis/surgery , Endometriosis/complications , Anxiety/etiology , Anxiety/epidemiology , Stress, Psychological , Adaptation, Psychological , Cross-Sectional Studies , Surveys and Questionnaires , Depression/etiology , Depression/epidemiology
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 43(3): 269-276, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1249196


Objective: Sepsis survivors present a wide range of sequelae; few studies have evaluated psychiatric disorders after sepsis. The objective of this study was to define the prevalence of and risk factors for anxiety, depression and post-traumatic stress disorder (PTSD) symptoms in sepsis survivors. Method: Anxiety, depression and post-traumatic stress symptoms in severe sepsis and septic shock survivors 24 h and 1 year after intensive care unit (ICU) discharge were assessed using the Beck Anxiety/Depression Inventories and the PTSD Checklist-Civilian Version. Differences in psychiatric symptoms over time and the influence of variables on these symptoms were calculated with marginal models. Results: A total of 33 patients were enrolled in the study. The frequencies of anxiety, depression and PTSD 24 h after ICU discharge were 67%, 49%, and 46%, respectively and, among patients re-evaluated 1 year after ICU discharge, the frequencies were 38%, 50%, and 31%, respectively. Factors associated with PTSD included serum S100B level, age, and Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) score. Factors associated with depression included patient age and cumulative dose of dobutamine. IQCODE score and cumulative dose of haloperidol in the ICU were associated with anxiety after ICU discharge. Conclusion: Patients who survive sepsis have high levels of psychiatric symptoms. Sepsis and associated treatment-related exposures may have a role in increasing the risk of subsequent depression, anxiety, and PTSD.

Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/epidemiology , Sepsis , Anxiety/etiology , Anxiety/epidemiology , Patient Discharge , Prevalence , Risk Factors , Survivors , Depression/etiology , Depression/epidemiology , Intensive Care Units
Braz. j. otorhinolaryngol. (Impr.) ; 87(3): 310-314, May-Jun. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1285698


Abstract Introduction Anxiety and pain levels of septoplasty patients may vary according to intraday operation time. Objective To investigate the effects of septoplasty operation and intraday operation time on anxiety and postoperative pain. Methods Ninety-eight voluntary patients filled out the hospital anxiety and depression scale to measure the anxiety level three weeks before, one hour before and one week after surgery. Forty-nine patients were operated at 8:00 am (morning group); other 49 were operated at 03:00 pm (afternoon group). We used a visual analogue scale to measure postoperative pain. Preoperative and postoperative scores were compared, as were the scores of the groups. Results Median hospital anxiety and depression scale scores one hour before the operation [6 (2-10)] were significantly higher compared to the median scores three weeks before the operation [3 (1-6)] (p < 0.001), and one week after the operation [2 (1-6)] were significantly lower compared to the median scores three weeks before the operation [3 (1-6)] (p < 0.001). Hospital anxiety and depression scale scores one hour before the operation were significantly greater in the afternoon group [8 (7-10)], compared to the morning group [4 (2-6)] (p < 0.001). Postoperative first, sixth, twelfth and twenty-fourth-hour pain visual analogue scale scores were significantly higher in the afternoon group compared to the morning group (p < 0.001). Conclusion Septoplasty might have an increasing effect on short-term anxiety and postoperative pain. Performing this operation at a late hour in the day might further increase anxiety and pain. However, the latter has no long-term effect on anxiety.

Resumo Introdução Os níveis de ansiedade e dor em pacientes submetidos à septoplastia podem variar de acordo com o tempo de cirurgia intradia. Objetivo Investigar os efeitos da cirurgia de septoplastia e do tempo de cirurgia intradia na ansiedade e dor pós-operatória. Métodos Noventa e oito pacientes voluntários preencheram a Hospital Anxiety and Depression Scale (HADS) para medir o nível de ansiedade três semanas antes, uma hora antes e uma semana após a cirurgia. Quarenta e nove pacientes foram operados às 8h (grupo da manhã) e 49 foram operados às 15h (grupo da tarde). Usamos a Escala Visual Analógica para medir a dor pós-operatória. Os escores pré e pós-operatórios foram comparados, assim como os escores dos grupos. Resultados As medianas dos escores da HADS uma hora antes da operação [6 (2-10)] foram significativamente mais altas em comparação com as medianas dos escores da HADS três semanas antes da operação [3 (1-6)] (p < 0,001) e as medianas dos escores da HADS uma semana após a operação [2 (1-6)] foram significativamente mais baixas em comparação com as medianas dos escores três semanas antes da operação [3 (1-6)] (p < 0,001). Os escores da HADS uma hora antes da operação foram significativamente mais altos no grupo da tarde [8 (7-10)], em comparação ao grupo da manhã [4 (2-6)] (p < 0,001). Os escores da EVA para dor na primeira, sexta, 12ª segunda e 24ª hora do pós-operatório foram significativamente mais altos no grupo da tarde em comparação com o grupo da manhã (p < 0,001). Conclusão A septoplastia pode ter um efeito crescente sobre a ansiedade em curto prazo e na dor pós-operatória e a feitura dessa cirurgia em hora mais tardia pode aumentar ainda mais a ansiedade e a dor. No entanto, isso não tem efeito em longo prazo na ansiedade.

Humans , Rhinoplasty/adverse effects , Anxiety/etiology , Pain, Postoperative/etiology , Pain Measurement , Prospective Studies
Rev. Assoc. Med. Bras. (1992) ; 67(2): 260-264, Feb. 2021. graf
Article in English | LILACS | ID: biblio-1287812


SUMMARY OBJECTIVE: Metabolic changes caused by anxiety can interfere in both the surgery itself and the recovery process. One way to reassure the patient is to clarify how the procedure will be performed and discuss the possible complications. This study aimed to investigate the anxiety level of candidates for radical prostatectomy at a university hospital. METHODS: Thirty-four patients with a diagnosis of prostate cancer were studied prospectively. Data collection involved the administration of the Hospital Anxiety and Depression Scale and a radical prostatectomy knowledge test. RESULTS: The results showed that 94.1% of the patients reported having received clarifications from the physician or healthcare team regarding the surgery and 23.5% reported having received information on the probability of a medical error during surgery. The most cited postoperative complications were sexual impotence and urinary incontinence. A significant association was found between the total Hospital Anxiety and Depression Scale score and the complications cited (p=0.0004); patients who marked a larger number of possible complications had a higher Hospital Anxiety and Depression Scale score. CONCLUSION: The present study demonstrates that the explanations given by the multidisciplinary health team are not achieving their maximum potential in terms of lowering patient anxiety.

Humans , Male , Prostatic Neoplasms/surgery , Urinary Incontinence/etiology , Anxiety/etiology , Postoperative Complications/etiology , Prostate , Prostatectomy/adverse effects , Hospitals
Article in English | WPRIM | ID: wpr-877761


INTRODUCTION@#Frontline healthcare workers (HCWs) exposed to coronavirus disease 2019 (COVID-19) are at risk of psychological distress. This study evaluates the psychological impact of COVID-19 pandemic on HCWs in a national paediatric referral centre.@*METHODS@#This was a survey-based study that collected demographic, work environment and mental health data from paediatric HCWs in the emergency, intensive care and infectious disease units. Psychological impact was measured using the Depression, Anxiety, Stress Scale-21. Multivariate regression analysis was performed to identify risk factors associated with psychological distress.@*RESULTS@#The survey achieved a response rate of 93.9% (430 of 458). Of the 430 respondents, symptoms of depression, anxiety and stress were reported in 168 (39.1%), 205 (47.7%) and 106 (24.7%), respectively. Depression was reported in the mild (47, 10.9%), moderate (76, 17.7%), severe (23, 5.3%) and extremely severe (22, 5.1%) categories. Anxiety (205, 47.7%) and stress (106, 24.7%) were reported in the mild category only. Collectively, regression analysis identified female sex, a perceived lack of choice in work scope/environment, lack of protection from COVID-19, lack of access to physical activities and rest, the need to perform additional tasks, and the experience of stigma from the community as risk factors for poor psychological outcome.@*CONCLUSION@#A high prevalence of depression, anxiety and stress was reported among frontline paediatric HCWs during the COVID-19 pandemic. Personal psychoneuroimmunity and organisational prevention measures can be implemented to lessen psychiatric symptoms. At the national level, involving mental health professionals to plan and coordinate psychological intervention for the country should be considered.

Adult , Anxiety/etiology , COVID-19/psychology , Depression/etiology , Female , Health Surveys , Hospitals, Pediatric , Humans , Logistic Models , Male , Middle Aged , Multivariate Analysis , Occupational Diseases/etiology , Pandemics , Personnel, Hospital/psychology , Prevalence , Risk Factors , Self Report , Severity of Illness Index , Singapore/epidemiology , Stress, Psychological/etiology
Article in English | LILACS, BBO | ID: biblio-1289978


ABSTRACT OBJECTIVE To estimate the prevalence of clinical signs and symptoms of severe/extreme stress, anxiety, and depression, as well as their associated factors, among Brazilians during social distancing. METHODS This is a cross-sectional study conducted in April/May 2020 with 3,200 Brazilians over 18 years old. Respondents' sociodemographic and clinical data were collected using an online questionnaire, which also included the 21-item Depression, Anxiety and Stress Scale (DASS-21) to assess emotional symptoms. Unadjusted and adjusted prevalence ratios and their respective 95% confidence intervals were estimated using Poisson regression models with robust variance. RESULTS Our results show the prevalence of severe/extreme stress was 21.5%, anxiety 19.4%, and depression 21.5%. In the final model, sociodemographic, clinical, and Covid-19-related factors were associated with severe/extreme stress, anxiety, and depression in Brazilians during social distancing due to the Covid-19 pandemic. We found the main factors associated with severe/extreme depression to be young women, brown, single, not religious, sedentary, presenting reduced leisure activities, history of anxiety and depression, increased medication use, and Covid-19 symptoms. CONCLUSION This study may help develop and systematically plan measures aimed to prevent, early identify, and properly manage clinical signs and symptoms of stress, anxiety, and depression during the Covid-19 pandemic.

Humans , Female , Adolescent , Pandemics , COVID-19 , Anxiety/etiology , Anxiety/epidemiology , Stress, Psychological/etiology , Stress, Psychological/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Surveys and Questionnaires , Depression/etiology , Depression/epidemiology , Physical Distancing , SARS-CoV-2
Article in English | LILACS, BBO | ID: biblio-1287501


Abstract Objective: To evaluate the effect of the COVID-19 pandemic on senior undergraduate dental students' psychological health by measuring depression, anxiety, and stress levels. Material and Methods: 259 fifth-year dental students participated in this study, including 156 females (60.2%) and 103 males (39.8%), aged 20-25. An online-based questionnaire was created, including a few questions about learning, post-graduation challenges, and fear of the virus exposure. Students were asked to define their acute anxiety state by visual facial anxiety scale (VFAS) and depression, anxiety, and stress levels by The Depression, Anxiety and Stress Scale (DASS-42). All data were analyzed statistically. Results: Participants stated online learning platforms were insufficient for clinical competence (91.5%), the COVID-19 pandemic changed post-graduation career perspectives (29.3%), and they feared exposure to COVID-19 while performing their profession (82.6%). Acute anxiety levels of the students were recorded as 95.4% mild to highest. Mild to extremely severe depression, anxiety, and stress scores of the participants were 82.1%, 79.6%, and 72.9%, respectively. Higher mean values for all depression, anxiety, and stress parameters were obtained in females than males (p<0.05). Conclusion: Data showed that the psychological health of senior undergraduate dental students had been affected adversely due to the COVID-19 pandemic.

Humans , Male , Female , Adult , Anxiety/etiology , Anxiety/epidemiology , Students, Dental , Mental Health , Depression/etiology , Depression/epidemiology , COVID-19/psychology , Turkey/epidemiology , Surveys and Questionnaires , Data Interpretation, Statistical
Rev. ANACEM (Impresa) ; 15(1): 63-71, 2021. tab
Article in Spanish | LILACS | ID: biblio-1281434


La literatura ha estudiado los efectos de anteriores epidemias en la salud mental de la población. En el contexto de la actual pandemia COVID-19, resulta de interés estudiar lo publicado referente a esta temática, considerando que, a diferencia de epidemias recientes, la actual se ha presentado a nivel mundial, con mayores cifras de contagio y mortalidad, con períodos de restricciones sociales más prolongados, alterando diversas dimensiones en la vida de la población. Las distintas implicaciones de la pandemia COVID-19 en la salud mental y las enfermedades psiquiátricas se recopilaron, de forma general, mediante la literatura publicada en PubMed durante los primeros meses de pandemia. La literatura evidencia que la actual pandemia ha influido negativamente en diversas dimensiones de la salud mental de la población general y específicas. Otras implicaciones revisadas son: abuso de alcohol y drogas, reacciones de duelo, agravamiento de trastornos mentales previos, y el rol e importancia de las redes sociales, servicios de salud mental y telepsiquiatría, entre otros.

The literature has studied the effects of previous epidemics on the mental health of the population. In the context of the current COVID-19 pandemic, it is of interest to study what has been published regarding this issue, considering that unlike recent epidemics, the current one has occurred worldwide, with higher numbers of contagion and mortality, with periods of longer social restrictions, altering various dimensions in the life of the population. The different implications of the COVID-19 pandemic with mental health and psychiatric diseases were collected in a general form, using the literature published in PubMed during the first months of the pandemic. The literature shows that the current pandemic has negatively influenced various dimensions of mental health in the general and specific population. Other implications reviewed are: alcohol and drugs, grief, patients with previous mental disorders, social networks, mental health services, telepsychiatry, among others.

Humans , Mental Health , Pandemics , COVID-19 , Mental Disorders/psychology , Mental Disorders/epidemiology , Anxiety/etiology , Anxiety/epidemiology , Sleep Wake Disorders , Stress, Psychological , Depression/epidemiology , Social Networking , Mental Health Services
Int. braz. j. urol ; 46(6): 993-1005, Nov.-Dec. 2020. tab
Article in English | LILACS | ID: biblio-1134264


ABSTRACT Purpose To investigate the course of anxiety and depression before and after transrectal ultrasound-guided prostate biopsy (TRUS-Bx) and in the postoperative 1st month when the histopathological biopsy result was obtained. Methods In between June 2017- January 2019, 204 patients who underwent TRUS-Bx and completed the questionnaires assessing anxiety and depression were included in the study. Questionnaires were completed immediately before the biopsy, immediately after the biopsy and at the end of the first month when the histopathological biopsy results were given. State-Trait Anxiety Inventory (STAI), Hospital Anxiety and Depression Scale (HADS) and perceived stress scale (PSS) forms were used to assess anxiety and depression. After the histopathological examination patients were divided into two groups as patients without cancer (Group 1) and with cancer (Group 2). Data was compared between the groups. Results PSA level was negatively correlated with STAI TX-1 scores of the patients immediately after TRUS-Bx, whereas it was positively correlated with STAI TX-1 and TX-2 30 days after the TRUS-Bx. PSA level was positively correlated with HADS-A and HADS-D scores immediately before and 30 days after TRUS-Bx. Biopsy results showed a significant difference in 30 day post-biopsy related data. STAI TX-1, STAI TX-2, HADS-A, HADS-D and PSS scores were higher in Group 2 compared with Group 1. Conclusions Pre-biopsy anxiety disappeared after bx, but there was a significant increase in anxiety and depression in patients after the diagnosis of malignancy. Patients were seriously concerned about the diagnosis of prostate cancer.

Humans , Male , Aged , Prostatic Neoplasms , Depression/etiology , Anxiety/etiology , Biopsy , Prospective Studies , Prostate-Specific Antigen , Ultrasonography, Interventional , Image-Guided Biopsy , Middle Aged
Rev. Hosp. Ital. B. Aires (2004) ; 40(4): 164-170, dic. 2020. tab
Article in Spanish | LILACS | ID: biblio-1145436


Introducción: como profesionales de la salud hemos observado distintas conductas en los pacientes pediátricos, sin psicoprofilaxis, que ingresan para ser intervenidos quirúrgicamente de urgencia; pacientes que, según su edad, su entorno social, familiar y cultural, podrán manifestar dichas conductas interpretadas como estrés, de distintas maneras. Objetivo: se midió el estrés prequirúrgico de los niños que fueron intervenidos quirúrgicamente de urgencia, los sábados y domingos por Guardia, en el Hospital de Niños Sor María Ludovica en la ciudad de La Plata. Materiales y métodos: hemos realizado un estudio piloto de diseño observacional, descriptivo, de corte transversal, aplicando para la recolección de datos la escala de YALE modificada (EAPY-m). Resultados: reclutamos 16 pacientes, de los cuales 10 fueron varones (62,50%), que ingresaron para ser tratados quirúrgicamente por las especialidades de traumatología y cirugía general en partes iguales. La mediana en edad fue de 7 años y la mediana en escolarización obligatoria de 6 años. Dentro de la muestra obtenida, un 56,25% concurrían a la escuela primaria y el 25% se encontraban en la etapa preescolar. La mitad de los niños tomaron como referente a su madre como la persona que lo calma y que les gustaría que estuviese presente en el momento previo a la cirugía. La conjunción de los resultados obtenidos ha superado los valores referenciales mínimos para la medición del estrés prequirúrgico: un 80% de los niños sufría de estrés prequirúrgico. Conclusiones: el estrés prequirúrgico es un hecho presente en los pacientes pediátricos que han sido incluidos en la realización del estudio, quedando en evidencia que la cirugía es un factor estresante para los niños. (AU)

Introduction: As health professionals, we have observed different behaviors in pediatric patients, without psychoprophylaxis, who are admitted for emergency surgery; patients who, according to their age, their social, family and cultural environment may manifest such behaviors interpreted as stress, in different ways. Objective: Therefore, the general objective of our research was to measure the presurgical stress of children who would undergo emergency surgery, on Saturdays and Sundays by guard, at the Sor María Ludovica children's hospital in the city of La Plata. Materials and methods: We have conducted a pilot study of observational, descriptive, cross-sectional design; applying the modified YALE scale (EArPY-m) for data collection. Results: We recruited 16 patients of which 10 were male (62.50%), who were admitted to be treated surgically by the specialties of traumatology and general surgery in equal parts. The median in age was 7 years and the median in compulsory schooling was 6 years. Within the sample obtained 56.25% attended primary school and 25% were in the preschool stage. 50% of the participants indicated that the mother was the one who calms them when they are nervous; while 43.75% was the mother who would like to be present at the time before surgery. The combination of the results obtained has exceeded the minimum reference values for the measurement of presurgical stress, 80% of children suffered from presurgical stress. Conclusions: We conclude that presurgical stress is a fact present in pediatric patients who have been included in the study, making it clear that surgery is a stressful factor for children. (AU)

Humans , Male , Female , Child , Stress, Psychological/etiology , Surgical Procedures, Operative/psychology , Anxiety/diagnosis , Anxiety/etiology , Argentina , Stress, Psychological/diagnosis , Preoperative Care/psychology , Cross-Sectional Studies , Ambulatory Surgical Procedures/psychology
Rev. Assoc. Med. Bras. (1992) ; 66(12): 1685-1689, Dec. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1143669


SUMMARY OBJECTIVE: Workers describe many physical and mental symptoms when working in radiation areas. This study aimed to assess these symptoms in radiation workers using the Beck Anxiety Inventory (BAI). METHODS: A total of 42 radiation workers (22 males and 20 females, mean age 34±7 years) and 47 control subjects (22 males and 27 females, mean age 31± 8 years) who work in non-radiation areas in the hospital were included in the study. All participants anonymously filled out the Beck Anxiety Inventory (BAI) questionnaire. RESULTS: The demographic data of workers were not significantly different between groups. In the BAI, the dizzy or lightheaded (p =0.01), terrified (p= 0.01), unsteady (p=0.02), heart-pounding and racing (p=0.02) items were significantly higher in the radiation-exposed group compared to the control group. -The BAI score was also significantly higher in the radiation-exposed group (11.1±6.8 vs. 8.7±3.8, p =0.04) CONCLUSION: These results suggest the possibility that radiation may play a role in the psychometric properties of workers. The effects of radiation on the health of employees need to be further investigated and understood.

RESUMO OBJETIVO: Ao trabalhar em áreas de radiação, trabalhadores descrevem muitos sintomas físicos e mentais. Este estudo teve como objetivo avaliar esses sintomas em trabalhadores expostos à radiação utilizando a Escala de Ansiedade de Beck (BAI - Beck Anxiety Inventory). MÉTODOS: Um total de 42 trabalhadores expostos à radiação (22 homens e 20 mulheres, com idade média de 34±7 anos) e 47 controles (22 do sexo masculino e 27 do sexo feminino, com idade média de 31±8 anos) que trabalham em áreas do hospital sem radiação foram incluídos no estudo. Todos os participantes responderam anonimamente ao questionário da BAI. RESULTADOS: Os dados demográficos dos trabalhadores dos dois grupos não apresentaram diferenças significativas. Na BAI, os itens de tonturas ou vertigens (p =0,01), medo (p= 0,01), instabilidade (p=0,02) e batimento cardíaco mais forte e acelerado (p=0,02) foram significativamente mais elevados no grupo exposto à radiação em comparação ao grupo de controle. A pontuação da BAI também foi significativamente maior no grupo exposto à radiação (11,1 ± 6,8 versus 8,7 ± 3,8, p = 0,04). CONCLUSÃO: Esses resultados sugerem a possibilidade de que a radiação pode desempenhar um papel importante nas propriedades psicométricas dos trabalhadores. Os efeitos da radiação na saúde dos funcionários precisam ser mais bem investigados e compreendidos.

Humans , Male , Female , Adult , Young Adult , Anxiety/etiology , Anxiety Disorders , Psychometrics , Radiation, Ionizing , Risk Factors
Arq. neuropsiquiatr ; 78(11): 708-712, Nov. 2020. tab
Article in English | LILACS | ID: biblio-1142357


ABSTRACT Background: Restless legs syndrome (RLS) is one of the most common and burdensome sleep disorders in the course of multiple sclerosis (MS). Objective: To evaluate common MS-related symptoms and consequences between groups with and without RLS and further assess the association of quality of life determinants with RLS symptom severity. Methods: According to their RLS status, 46 relapsing-remitting MS patients were divided into MS-RLS+ (n=19) and MS-RLS- groups (n=27). Specific questionnaires were administered to assess the patients' health-related quality of life (HRQoL), fatigue levels, sleep quality, daily sleepiness, anxiety, and depression symptoms. Functional capacity was examined using the Expanded Disability Status Scale (EDSS). Results: The prevalence of RLS was 41.3%. Compared to the MS-RLS- group, those with RLS had higher EDSS scores, more cranial and spinal lesions, longer disease duration, and were older. In the MS-RLS+ group, symptom severity scores were positively correlated with higher anxiety and poorer sleep quality. The symptom severity score was negatively correlated with mental HRQoL and pain scores. Conclusion: In conclusion, the findings of the current study indicate the negative impact of RLS on functional capacity, anxiety, sleep quality, and mental HRQoL of MS patients. Further studies using more accurate diagnostic strategies for identifying RLS and other sleep disorders are necessary to clarify the association of MS with RLS and explore relevant clinical implications.

RESUMEN Antecedentes: El síndrome de piernas inquietas (SPI) es uno de los trastornos del sueño más comunes y onerosos en el curso de la esclerosis múltiple (EM). Objetivo: El objetivo de este estudio fue evaluar los síntomas y las consecuencias comunes asociados con la EM entre los grupos con y sin SPI y evaluar aún más la asociación de los determinantes de la calidad de vida con la gravedad de los síntomas del SPI. Métodos: De acuerdo con su estado de SPI, 46 pacientes con EM recurrente-remitente se dividieron en los grupos EM-SPI+ (n=19) y EM-SPI- (n=27). Se utilizaron cuestionarios específicos para evaluar la calidad de vida relacionada con la salud (CVRS), los niveles de fatiga, la calidad del sueño, la somnolencia diaria, la ansiedad y los síntomas de depresión de los pacientes. La capacidad funcional se examinó mediante la escala ampliada del estado de discapacidad (Expanded Disability Status Scale — EDSS). Resultados: La prevalencia de SPI fue del 41,3%. Em comparación com el grupo EM-SPI-, aquellos com SPI tenían púntuaciones más altas em la EDSS, más lesiones craneales y espinales, mayor duración de la enfermedad y eran mayores. Los puntajes de gravedad de los síntomas em el grupo EM-SPI+ se correlacionaron positivamente con una mayor ansiedad y una peor calidad del sueño. Se observaron correlaciones negativas entre la puntuación de gravedad de los síntomas y la CVRS mental y los puntajes de dolor. Conclusiones: En conclusión, el estudio actual indica el impacto negativo del SPI en la discapacidad funcional, la ansiedad, la calidad del sueño y la CVRS mental de los pacientes con EM. Se necesitan más estudios que utilicen estrategias de diagnóstico más precisas para identificar el SPI y otros trastornos del sueño para aclarar la asociación de la EM con el SPI y para explorar implicaciones clínicas relevantes.

Humans , Restless Legs Syndrome/epidemiology , Sleep Wake Disorders/etiology , Sleep Wake Disorders/epidemiology , Multiple Sclerosis/complications , Anxiety/etiology , Anxiety/epidemiology , Quality of Life , Cross-Sectional Studies , Surveys and Questionnaires
Dental press j. orthod. (Impr.) ; 25(5): 30-37, Sept.-Oct. 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1133685


ABSTRACT Objective: This prospective study aimed at assessing the effects of anxiety and a follow-up text message on pain perception after the installation of fixed orthodontic appliances and its impact on the patients' routine. Methods: The sample of this study consisted of 103 orthodontic patients, 40 males and 63 females (mean age 20.5 years), distributed in two groups: G1 (n=51), including control patients that did not receive any post-procedure communication; and G2 (n=52), including patients that received a structured text message. In baseline phase, the patients completed a questionnaire to assess their level of anxiety prior to treatment. Pain was assessed by using 100-mm visual analog scale (VAS) in baseline and ten times prospectively in predetermined time points. VAS was also applied to assess the patient's routine alterations caused by the pain. All data were analyzed using ANOVA, Tukey, Mann-Whitney, t-test, chi-square and Spearman's correlation tests. All statistical tests were performed with significance level of 5%. Results: Low-level and high-level anxiety was observed in 42.7% and 7.8% of the patients, respectively. Statistically significant correlation was observed between anxiety and pain (p< 0.05). Maximum mean pain intensity was detected in the second treatment day (G1=36.9mm and G2=26.2mm) and was significantly higher in G1. Nearly 53% of the patients in G1 reported alterations in the routine (18.8mm), while in G2 the percentage rate reached 28.8% (9.9mm) (p=0.013). Conclusions: Anxious patients report more pain after the installation of orthodontic appliances. Text messages were effective to reduce pain levels and to decrease the negative effects on patients' daily routine.

RESUMO Objetivo: O presente estudo prospectivo teve como objetivo avaliar os efeitos da ansiedade e de mensagens de texto de acompanhamento na percepção da dor após a instalação de aparelhos ortodônticos fixos e seu impacto na rotina dos pacientes. Métodos: A amostra deste estudo foi composta por 103 pacientes ortodônticos, 40 homens e 63 mulheres (idade média de 20,5 anos), distribuídos em dois grupos: G1 (n = 51), que incluiu pacientes controle, que não receberam comunicação pós-procedimento; e G2 (n = 52), incluindo os pacientes que receberam mensagem de texto estruturada. Na fase inicial, os pacientes responderam a um questionário para avaliar seu nível de ansiedade antes do tratamento. A dor foi avaliada por meio de escala visual analógica (EVA) de 100 mm antes da instalação dos aparelhos e em 10 períodos consecutivos predeterminados. A EVA também foi aplicada para avaliar as alterações de rotina do paciente causadas pela dor. Os resultados foram analisados usando ANOVA, Tukey, Mann-Whitney, teste t, Qui-quadrado e testes de correlação de Spearman. Todos os testes estatísticos foram realizados com nível de significância de 5%. Resultados: Níveis baixos e altos de ansiedade foram observados em 42,7% e 7,8% dos pacientes, respectivamente. Foi observada correlação estatisticamente significativa entre ansiedade e dor (p< 0,05). A intensidade média máxima da dor foi detectada no segundo dia de tratamento (G1 = 36,9mm e G2 = 26,2mm) e foi significativamente maior no G1. Quase 53% dos pacientes do G1 relataram alterações na rotina (18,8mm), enquanto no G2 o percentual atingiu 28,8% (9,9mm) (p= 0,013). Conclusões: Pacientes ansiosos relatam mais dor após a instalação de aparelhos ortodônticos. As mensagens de texto foram eficazes para reduzir os níveis de dor e diminuir os efeitos negativos na rotina diária dos pacientes.

Humans , Male , Female , Adult , Anxiety/etiology , Text Messaging , Pain Measurement , Prospective Studies , Pain Perception
Article in English, Portuguese | LILACS, SES-SP | ID: biblio-1136724


ABSTRACT Objective: To report a case of recurrent isolated sleep paralysis (RISP), a benign parasomnia with worrisome and frightening sleep paralysis episodes. Case description: We describe a case of RISP in a sixteen-year-old girl who seeks medical attention for anxiety symptoms. The sleep paralysis and associated auditory and tactile hallucinations began three years before with worsening in the last year, causing fear of sleeping. The episodes were intensely frightening causing negative impact in patient's sleep, school performance and social function. Medical conditions were excluded, and she started treatment with a selective serotonin reuptake inhibitor with complete resolution of symptoms. Comments: Sleep complaints are often devalued. Therefore, clinicians should actively ask their patients about their sleep during health assessment.

RESUMO Objetivo: Relatar um caso de paralisia do sono isolada e recorrente (PSIR), uma parassonia benigna com episódios inquietantes e assustadores de paralisia do sono. Descrição do caso: Descreve-se um caso de PSIR de uma adolescente de dezesseis anos que buscou cuidados médicos devido a sintomas de ansiedade. A paralisia do sono e as alucinações auditivas e táteis associadas haviam começado três anos antes, com agravamento no último ano, causando medo de dormir. Os episódios eram extremamente perturbadores, gerando um impacto negativo no sono, desempenho escolar e vida social da paciente. Condições médicas foram excluídas e começou um tratamento com um inibidor seletivo da recaptação de serotonina, com resolução completa dos sintomas. Comentários: Queixas relacionadas ao sono são frequentemente subvalorizadas. Portanto, os médicos devem perguntar aos seus pacientes sobre problemas relacionados com o sono durante a avaliação clínica.

Humans , Female , Adolescent , Sleep Wake Disorders/diagnosis , Sleep Paralysis/complications , Sleep Paralysis/psychology , Fear/psychology , Anxiety/etiology , Anxiety/psychology , Recurrence , Sleep Wake Disorders/etiology , Social Change , Administration, Oral , Treatment Outcome , Fluvoxamine/administration & dosage , Fluvoxamine/therapeutic use , Serotonin Uptake Inhibitors/administration & dosage , Serotonin Uptake Inhibitors/therapeutic use , Sleep Paralysis/diagnosis , Sleep Paralysis/drug therapy , Diagnosis, Differential , Academic Performance/psychology , Hallucinations/etiology , Hallucinations/psychology