Avaliação da qualidade de sono e ansiedade em profissionais e estudantes da saúde no contexto da pandemia pela covid-19 / Evaluación de la calidad del sueño y la ansiedad en profesionales y estudiantes de la salud en el contexto de la pandemia de COVID-19 / Assessment of sleep quality and anxiety in healthcare professionals and students in the context of the COVID-19 pandemic

Introdução: Na pandemia desencadeada pela COVID-19, o desenvolvimento progressivo de sintomas de ansiedade e a má qualidade do sono devem ser investigados em profissionais e estudantes da área da saúde para o adequado manejo. Objetivo: Identificar a prevalência de problemas de sono e sintomas ansiosos em profissionais e estudantes da saúde, e analisar o efeito de variáveis sociodemográficas-clínicas na ansiedade e sono dessa população.Metodologia: Neste estudo transversal de caráter quantitativo aplicou-se um formulário online a 3.337 profissionais e estudantes da saúde do Brasil participantes de um congresso virtual, contendo 51 perguntas subdivididas em três categorias: Perfil sociodemográfico-clínico, Escala de Sono de Jenkins e Inventário de Ansiedade de BECK.Resultados: Dentre os participantes, 81,4% eram estudantes da área da saúde e 12,8% profissionais de saúde. Os achados obtidos indicam que 41% dos participantes apresentaram problemas de sono muito frequentes e 46,6% sinais de ansiedade moderada a grave. Houve associação estatisticamente significativa entre as variáveis sociodemográficas-clínicas e os questionários validados de sono e ansiedade. Conclusão: Essa pesquisa identificou importante prevalência de problemasde sono e sintomas ansiosos em profissionais e estudantes da saúde, sendo primordial a identificação precoce dessas alterações para um manejo efetivo (AU).

Introduction: In the pandemic triggered by COVID-19, the progressive development of anxiety symptoms and poor sleep quality should be investigated in healthcare professionals and students for proper management.Objective: To identify the prevalence of sleep problems and anxious symptoms in healthcare professionals and students, and to analyze the effect of sociodemographic-clinical variables on anxiety and sleep in this population. Methodology: In this cross-sectional quantitative study, an online form was applied to 3,337 healthcare professionals and students from Brazil participating in a virtual congress, containing 51 questions subdivided into three categories: Sociodemographic-clinical profile, Jenkins Sleep Scale and BECK Anxiety Inventory.Results: Among the participants, 81.4% were healthcare students and 12.8% were healthcare professionals. The findings indicate that 41% of the participants had very frequent sleep problems and 46.6% showed signs of moderate to severe anxiety. There was a statistically significant association between the sociodemographic-clinical variables and the validated sleep and anxiety questionnaires. Conclusion:This study identified a high prevalence of sleep problems and anxiety symptoms among healthcare professionals and students, and early identification of these alterations is essential for effective management (AU).

Introducción: En la pandemia desencadenada por el COVID-19, el desarrollo progresivo de síntomas de ansiedad y la mala calidad del sueño deben ser investigados en profesionales y estudiantes de la salud para su adecuado manejo. Objetivo: Identificar la prevalencia de problemas de sueño y síntomas ansiosos en profesionales y estudiantes de la salud, y analizar el efecto de las variables sociodemográficas-clínicas sobre la ansiedad y el sueño en esta población. Metodología:En este estudio transversal y cuantitativo, se aplicó un formulario línea 3.337 profesionales y estudiantes de la salud de Brasil que participaron en un congreso virtual, conteniendo 51 preguntas subdivididas en tres categorías: perfil sociodemográfico-clínico, Escala de Sueño de Jenkins e Inventario de Ansiedad de BECK. Resultados: Entre los participantes, 81,4% eran estudiantes de salud y 12,8% profesionales de la salud. Los resultados indican que el 41% de los participantes tenía problemas de sueño muy frecuentes y el 46,6% mostraba signos de ansiedad de moderada a grave. Hubo una asociación estadísticamentesignificativa entre las variables sociodemográficas-clínicas y los cuestionarios validados de sueño y ansiedad. Conclusión:Este estudio identificó una alta prevalencia de problemas de sueño y síntomas de ansiedad en profesionales de la salud y estudiantes, y la identificación precoz de estas alteraciones es esencial para un manejo eficaz (AU).

Ansiedade, qualidade do sono e sonolência diurna em estudantes de enfermagem de uma instituição privada / Ansiedad, calidad del sueño y somnolencia diurna en estudiantes de enfermería de un centro privado / Anxiety, sleep quality and daytime sleepiness in nursing students at a privateinstitution

Objetivo:Avaliar a correlação entre a ansiedade com qualidade do sono e sonolência diurna dos estudantes universitários em curso de graduação em enfermagem, assim como caracterizar o perfil sociodemográfico dos estudantes. Metodologia:Estudodescritivo transversalcom abordagem quantitativa envolvendo 255 acadêmicos do curso de Enfermagem de uma instituição privada. A coleta dos dados ocorreu em Outubro de 2022 em salas de aula. Os instrumentos utilizados na coleta dos dados foram o Inventário de Ansiedade de Beck,Índice de Qualidade do Sono de Pittsburgh, Escala de Sonolência de Epwort-th e um questionário sociodemográfico. Utilizou-se o software estatístico R versão 4.0.2 e foram feitas suas correlações. Resultados: Foram encontrados padrões de ansiedade grave, com níveis de sonolência diurna anormal. A correlação entre o Inventário de Ansiedade de Beckcom a Escala de Sonolência de Epworth e o Índice de Qualidade de sono de Pittsburgh, que embora tenha sido considerada fraca a moderada, por sua vez mostrou-se significativa (r=0,29; p=0,01). Ademais, temos que, a relação entre oinventário de Becke o Índice de qualidade de sono de Pittsburgh mostrou-se também com valor de significância (r=0,35; p=0,01). Conclusões:Foi possível compreender que a ansiedade pode interferir na qualidade do sono e sonolência diurna do público de estudantes de Enfermagem (AU).

Objective: To evaluate the correlation between anxiety and sleep quality and daytime sleepiness among undergraduate nursing students, as well as to characterize the students' sociodemographic profile. Methodology: A cross-sectional descriptive study with a quantitative approach involving 255 nursing students from a private institution. Data collection took place in October 2022 in classrooms. The instruments used to collect the data were the Beck Anxiety Inventory, the Pittsburgh Sleep Quality Index, the Epwort-Th Sleepiness Scale and a sociodemographic questionnaire. Statistical software R version 4.0.2 was used and correlations were made. Results:Patterns of severe anxiety were found, with abnormal levels of daytime sleepiness. The correlation between the Beck Anxiety Inventory, the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index, although considered weak to moderate, was significant (r=0.29; p=0.01). Furthermore, the relationship between the Beck Inventory and the Pittsburgh Sleep Quality Index was also found to be significant (r=0.35; p=0.01). Conclusions:It was possible to understand that anxiety can interfere with the quality of sleep and daytime sleepiness among nursing students (AU).

Objetivo:Evaluar la correlación entre la ansiedad y la calidad del sueño y la somnolencia diurna en estudiantes universitarios de enfermería, así como caracterizar el perfil sociodemográfico de los estudiantes. Metodología:Estudio descriptivo transversal con enfoque cuantitativo en el que participaron 255 estudiantes universitarios de enfermería de una institución privada. La recogida de datos tuvo lugar en octubre de 2022 en las aulas. Los instrumentos utilizados para la recogida de datos fueron el Inventario de Ansiedad de Beck, el Índice de Calidad del Sueño de Pittsburgh, la Escala de Somnolencia de Epwort-Th y un cuestionario sociodemográfico. Se utilizó el software estadístico R versión 4.0.2 y se realizaron correlaciones. Resultados:Se encontraron patrones de ansiedad severa, con niveles anormales de somnolencia diurna. La correlación entre el Inventario de Ansiedad de Beck con la Escala de Somnolencia de Epworth y el Índice de Calidad del Sueño de Pittsburgh, aunque se consideró de débil a moderada, fue significativa (r=0,29; p=0,01). Además, la relación entre el Inventario de Beck y el Índice de Calidad del Sueño de Pittsburgh también resultó significativa (r=0,35; p=0,01). Conclusiones: Se pudo comprender que la ansiedad puede interferir en la calidad del sueño y en la somnolencia diurna de los estudiantes de enfermería (AU).

Adaptación y validación de la Patient Health Questionnaire for Depression and Anxiety (PHQ-4) en una muestra de quechua hablantes peruanos

Introducción: El Patient Health Questionnaire for Depression and Anxiety (PHQ-4) es una medida de autoinforme ultrabreve de síntomas depresivos y ansiosos. El PHQ-4 no ha sido adaptado ni validado en la población quechua hablante. Objetivo: Este estudio tuvo como objetivo adaptar y validar el PHQ-4 en una muestra de población peruana quechua hablante en su variante Collao de Puno-Perú. Metodología: Participaron 221 personas hablantes de quechua variante collao (promedio de edad de 31,2 años, SD = 11,7, 47,1 % hombres y 52,9 % mujeres). Se evaluó la evidencia de validez basada en la estructura interna, mediante el análisis factorial confirmatorio (CFA), la fiabilidad con el método de consistencia interna y las características de dificultad y discriminación de los ítems en base a la Teoría de Respuesta al Ítem (IRT). Resultados: Los resultados indicaron que todos los ítems del PHQ-4 son relevantes, coherentes y claros para representar adecuadamente los síntomas de ansiedad y depresión. El resultado del AFC apoyó un modelo unifactorial, donde los ítems de ansiedad y depresión conforman una sola variable latente con una fiabilidad alta. Todos los ítems del PHQ-4 presentas buenos parámetros de discriminación y los parámetros de dificultad indican que los ítems son comparativamente difíciles. Por lo tanto, se necesita una mayor presencia del rasgo latente (ansiedad y depresión) para responder las categorías de respuesta más altas. Discusión: En conclusión, la PHQ-4 presentó buenas propiedades psicométricas como una medida de detección primaria rápida, confiable y válida para personas quechuahablantes que necesitan una evaluación profunda, monitoreo de los síntomas para diagnóstico y tratamiento para la ansiedad o depresión.

Introduction: The Patient Health Questionnaire for Depression and Anxiety (PHQ-4) is an ultra-brief self-report measure of depression and anxiety symptoms. The PHQ-4 has not been adapted or validated in the Quechua-speaking population. Objective: This study aimed to adapt and validate the PHQ-4 in a sample of the Peruvian Quechua-speaking population with its Collao variant from Puno-Peru. Methods: A total of 221 Quechua speakers of the Collao variant (mean age 31.2 years, SD = 11.7, 47.1% male and 52.9% female) participated. Evidence of validity based on internal structure was evaluated using confirmatory factor analysis (CFA), reliability using the internal consistency method, and item difficulty and discrimination characteristics based on Item Response Theory (IRT). Results: The results indicated that all items of the PHQ-4 were relevant, consistent, and clear enough to adequately represent anxiety and depressive symptoms. The CFA results supported a one-factorial model, in which anxiety and depression items form a single latent variable with high reliability. All items of the PHQ-4 had good discrimination parameters, and the difficulty parameters indicated that the items were comparatively difficult. Therefore, a higher presence of the latent trait (anxiety and depression) is needed to answer higher response categories. Discussion: In conclusion, the PHQ-4 presented good psychometric properties as a rapid, reliable, and valid primary screening measure for Quechua speakers in need of in-depth assessment and symptom monitoring for the diagnosis and treatment of anxiety and depression.

Efeitos de uma intervenção com universitários sobre como lidar com a ansiedade / Effects of an intervention with college students on how to deal with anxiety / Efectos de una intervención con universitarios sobre como lidiar con la ansiedad

Diante dos desafios que concernem a adaptação acadêmica, a ansiedade que se dá em meio às múltiplas dificuldades inerentes a este contexto é um aspecto considerável. Considerando diferentes potenciais fontes de ansiedade na experiência universitária, foram elaboradas duas oficinas em formato online, cada uma composta por cinco sessões, com o intuito de auxiliar estudantes universitários a lidar com a ansiedade em meio acadêmico. O estudo teve como objetivo avaliar a efetividade dessas oficinas. Participaram17 estudantes, dos quais, de acordo com o método de análise estatística utilizado, pautado no índice de mudança confiável, 14 apresentaram melhoras em seus quadros de ansiedade e, destes, dois apresentaram mudanças particularmente notáveis em termos estatísticos. Com os resultados apresentados, pode-se perceber que o desenvolvimento de intervenções com estudantes universitários em diferentes formatos pode ser de grande valia para essa população no que tange suas dificuldades de adaptação à universidade(AU).

Faced with the challenges related to academic adaptation, the anxiety that occurs amid the multiple difficulties inherent in this context is a considerable aspect. Considering different sources of anxiety in the university experience, two online workshops were developed, each consisting of five sessions, in order to help university students deal with anxiety in academia. The study aims to evaluate the effectiveness of the intervention. Participated in the workshops 17 students, of which, according to the statistical analysis method used, based on the index of reliable change, 14 showed improvements in their anxiety of these, two showed particularly remarkable changes in statistical terms. With the results presented, it is possible to see that the developmentof interventions with university students in different formats can be of great value to this population regarding their difficulties of adaptation to the university (AU).

Frente a los desafíos que afectan a la adaptación académica, la ansiedad que se da en medio de las múltiples dificultades inherentes a este contexto es un aspecto considerable. Considerando diferentes fuentes de ansiedad en la universidad, se elaboraron dos talleres en formato online, compuestos por cinco sesiones, con el fin de ayudar a estudiantes a lidiar con la ansiedad en medio académico. El estudio tuvo como objetivo evaluar la efectividad de la intervención. Participaron 17 estudiantes, de los cuales, de acuerdo con el método de análisis estadístico utilizado, pautado en el índice de cambio confiable, 14 presentaron mejoras en sus cuadros de ansiedad y, de ellos, dos presentaron cambios particularmente notables en términos estadísticos. Con los resultados presentados, se puede percibir que el desarrollo de intervenciones con estudiantes universitarios en diferentes formatos puede ser de gran valor para esa población en lo que respecta a sus dificultades de adaptación universitaria (AU).

Neuropharmacological and anxiolytic effects of extracts of Passiflora tripartita var. mollissima on mice / Efecto neurofarmacológico y ansiolítico de extractos de Passiflora tripartita var. mollissima en ratones

Anxiety and depression cause alterations in the physiology of an organism. Extracts from the leaves of several Passiflora species are traditionally use d Peru and in many countries as anxiolytic and in treatment for inflammatory problems. T his study aimed to determine the neuropharmacological effect of the ethanolic extract of Passiflora tripartita var. mollissima (Kunth) Holm - Niels. & P. Jørg. and its an xiolytic effect on mouse ( Mus musculus var. albinus ). A nxiety was evaluated with the marble burying test and the depressant effect with the Irwin test (locomotor activity, base of support, wobbly gait, immobility, escape, ease of handling, muscular strengt h, tight rope, inclined plane, catatonia, nociceptive reflex and death). Doses of 100 mg/Kg/body weight and 200 mg/kg/body weight by intraperitoneal route (i.p.) significantly decreased anxiety levels (p<0.05) in mice, and had a non - significant depressant effect in 11 of the 12 tests, showing a similar direction of correlation between diazepam and Passiflora extract effect. A greater anxiolytic and anti - depressant effects in mice was observed with the extract dose of 200 mg/kg/body weight with neuropharmaco logical manifestations found where no death was observed at any dose used.

L a ansiedad y la depresión provocan alteraciones fisiológicas. Las especies de Pa ssiflora se utilizan tradicionalmente en Perú como ansiolíticos y para tratar problemas inflamatorios. D eterminar el efecto neurofarmacológico del extracto etanólico de Passiflora tripartita var. mollissima (Kunth) Holm - Niels. & P. Jørg. y su efecto ansiol ítico en ratones. S e evaluó la ansiedad con el test de enterramiento de canicas y el efecto depresor con el test de Irwin . Las dosis de 100 mg/kg/peso corporal y 200 mg/kg/peso corporal por vía intraperitoneal (i.p.) disminuyeron significativamente la ansi edad ( p <0,05) con efecto depresor no significativo en 11 de las 12 pruebas, mostrando una correlación similar entre el diazepam aplicado a dosis de 1 mg/Kg/p.c. (i.p) y el efecto de Passiflora . S e observó un mayor efecto ansiolítico y antidepresivo en rato nes con 200 mg/kg/peso corporal encontrándose manifestaciones neurofarmacológicas pero no se observó muerte a ninguna de las dosis empleadas.

Effect of Agaricus blazei Murill on exploratory behavior of mice-model

Abstract Increased anxiety and depressive symptoms have reported to be its association with long term illness. Because of having unwanted effects of newly available drugs, patients administering anxiolytic drugs usually discontinue the treatment before they are completely recovered. Therefore, there is a serious need to develop new anxiolytic drugs. The anxiolytic effect of hydro-alcoholic extract of Agaricus blazei in animal models was assessed. 24 male mice (Mus musculus genus) were included in the study. Four groups were prepared and each group contained six animals. The groups were vehicle control, positive control (diazepam 1.0 mg/kg, i.p.) as well as two treatment groups receiving Agaricus blazei hydro-alcoholic extract at a dose of 136.50 mg/kg and 273.0 mg/kg orally. The Marble burying test, Nestlet shredding test and Light and Dark box test used to assess anxiolytic activity. Mice administered with diazepam 1.0 mg/kg, i.p. while hydro-alcoholic extract of AbM (136.50 and 273.0 mg/kg, respectively) was administered via oral route which exhibited marked reduction in number of marbles-burying as compared to vehicle control group. Mice administered with diazepam 1.0 mg/kg, i.p. and Oral administration of hydro-alcoholic extract of AbM (136.50 and 273.0 mg/kg, respectively) exhibited significant decrease in nestlet shredding in comparison to vehicle control group. The oral administration of hydro-alcoholic extract at a dose of 136.5mg/kg and 273mg/kg showed elevation in time spent in light box and was comparable to standard treated group while time spent by mice following oral administration of hydro-alcoholic extract of Agaricus blazei at a dose of 273.0 mg/kg also showed elevation and was found to be more near to standard treated group (diazepam 1 mg/kg, i.p.).

Resumo O aumento da ansiedade e dos sintomas depressivos têm relatado sua associação com doenças de longa duração. Por causa dos efeitos indesejáveis dos novos medicamentos disponíveis, os pacientes que administram medicamentos ansiolíticos geralmente interrompem o tratamento antes de estarem completamente recuperados. Portanto, há uma necessidade séria de desenvolver novos medicamentos ansiolíticos. Foi avaliado o efeito ansiolítico do extrato hidroalcoólico de Agaricus blazei em modelos animais. Vinte e quatro camundongos machos (gênero Mus musculus) foram incluídos no estudo. Quatro grupos foram preparados, e cada grupo continha seis animais. Os grupos foram controle de veículo, controle positivo (diazepam 1,0 mg/kg, i.p.), bem como dois grupos de tratamento recebendo extrato hidroalcoólico de Agaricus blazei na dose de 136,50 mg/kg e 273,0 mg/kg por via oral. O teste de enterrar Marble, o teste de retalhamento Nestlet e o teste de caixa clara e escura são usados para avaliar a atividade ansiolítica. Camundongos foram administrados com diazepam 1,0 mg/kg, i.p., enquanto o extrato hidroalcoólico de AbM (136,50 e 273,0 mg/kg, respectivamente) foi administrado por via oral, que exibiu redução acentuada no número de mármores enterrados em comparação com o grupo de controle de veículo. Camundongos administrados com diazepam 1,0 mg/kg, i.p. e a administração oral de extrato hidroalcoólico de AbM (136,50 e 273,0 mg/kg, respectivamente) exibiu diminuição significativa na trituração de ninhos em comparação ao grupo de controle de veículo. A administração oral de extrato hidroalcoólico na dose de 136,5mg/kg e 273mg/kg mostrou elevação no tempo gasto na caixa de luz e foi comparável ao grupo tratado padrão, enquanto o tempo gasto por camundongos após a administração oral de extrato hidroalcoólico de Agaricus blazei na dose de 273,0 mg/kg também mostrou elevação e foi mais próximo do grupo tratado padrão (diazepam 1 mg/kg, ip).

Effect of Agaricus blazei Murill on exploratory behavior of mice-model / Efeito de Agaricus blazei Murill no comportamento exploratório de modelo de camundongo

Abstract Increased anxiety and depressive symptoms have reported to be its association with long term illness. Because of having unwanted effects of newly available drugs, patients administering anxiolytic drugs usually discontinue the treatment before they are completely recovered. Therefore, there is a serious need to develop new anxiolytic drugs. The anxiolytic effect of hydro-alcoholic extract of Agaricus blazei in animal models was assessed. 24 male mice (Mus musculus genus) were included in the study. Four groups were prepared and each group contained six animals. The groups were vehicle control, positive control (diazepam 1.0 mg/kg, i.p.) as well as two treatment groups receiving Agaricus blazei hydro-alcoholic extract at a dose of 136.50 mg/kg and 273.0 mg/kg orally. The Marble burying test, Nestlet shredding test and Light and Dark box test used to assess anxiolytic activity. Mice administered with diazepam 1.0 mg/kg, i.p. while hydro-alcoholic extract of AbM (136.50 and 273.0 mg/kg, respectively) was administered via oral route which exhibited marked reduction in number of marbles-burying as compared to vehicle control group. Mice administered with diazepam 1.0 mg/kg, i.p. and Oral administration of hydro-alcoholic extract of AbM (136.50 and 273.0 mg/kg, respectively) exhibited significant decrease in nestlet shredding in comparison to vehicle control group. The oral administration of hydro-alcoholic extract at a dose of 136.5mg/kg and 273mg/kg showed elevation in time spent in light box and was comparable to standard treated group while time spent by mice following oral administration of hydro-alcoholic extract of Agaricus blazei at a dose of 273.0 mg/kg also showed elevation and was found to be more near to standard treated group (diazepam 1 mg/kg, i.p.).

Resumo O aumento da ansiedade e dos sintomas depressivos têm relatado sua associação com doenças de longa duração. Por causa dos efeitos indesejáveis dos novos medicamentos disponíveis, os pacientes que administram medicamentos ansiolíticos geralmente interrompem o tratamento antes de estarem completamente recuperados. Portanto, há uma necessidade séria de desenvolver novos medicamentos ansiolíticos. Foi avaliado o efeito ansiolítico do extrato hidroalcoólico de Agaricus blazei em modelos animais. Vinte e quatro camundongos machos (gênero Mus musculus) foram incluídos no estudo. Quatro grupos foram preparados, e cada grupo continha seis animais. Os grupos foram controle de veículo, controle positivo (diazepam 1,0 mg/kg, i.p.), bem como dois grupos de tratamento recebendo extrato hidroalcoólico de Agaricus blazei na dose de 136,50 mg/kg e 273,0 mg/kg por via oral. O teste de enterrar Marble, o teste de retalhamento Nestlet e o teste de caixa clara e escura são usados ​​para avaliar a atividade ansiolítica. Camundongos foram administrados com diazepam 1,0 mg/kg, i.p., enquanto o extrato hidroalcoólico de AbM (136,50 e 273,0 mg/kg, respectivamente) foi administrado por via oral, que exibiu redução acentuada no número de mármores enterrados em comparação com o grupo de controle de veículo. Camundongos administrados com diazepam 1,0 mg/kg, i.p. e a administração oral de extrato hidroalcoólico de AbM (136,50 e 273,0 mg/kg, respectivamente) exibiu diminuição significativa na trituração de ninhos em comparação ao grupo de controle de veículo. A administração oral de extrato hidroalcoólico na dose de 136,5mg/kg e 273mg/kg mostrou elevação no tempo gasto na caixa de luz e foi comparável ao grupo tratado padrão, enquanto o tempo gasto por camundongos após a administração oral de extrato hidroalcoólico de Agaricus blazei na dose de 273,0 mg/kg também mostrou elevação e foi mais próximo do grupo tratado padrão (diazepam 1 mg/kg, ip).

Association of diabetic retinopathy with anxiety and depression / 国际眼科杂志(Guoji Yanke Zazhi)

As society advances and living standards improve, there is a growing emphasis on the impact of mental health on illness and the interaction between them. Diabetes mellitus is one of the most common underlying diseases, and it is often accompanied by depression and anxiety. There are also many complications of diabetes, such as diabetic retinopathy(DR). DR is the leading cause of vision loss in diabetes. Vision loss inevitably increases anxiety and/or depression, which in turn may directly or indirectly affect the treatment or progression of patients with DR. This article reviews how to determine the anxiety and depression status of patients with DR, related assessment tools and methods, and their interaction with the treatment of DR. The interaction of anxiety-depressive states with DR treatment was also discussed. This review aims to raise awareness of the mental health of patients with DR, enhance doctor-patient communication and build doctor-patient trust, thus enhancing treatment adherence and clinical efficacy for individuals with DR and helping them to improve the quality of life.

Mental health status and influencing factors of permanent residents in Yichang, Hubei Province / 公共卫生与预防医学

Objective To investigate the characteristics and influencing factors of mental health status of permanent residents in Yichang, Hubei Province. Methods A total of 9 576 permanent residents aged 18 years and older from Yichang City were selected by a multistage random sampling method between June and October 2022. The PHQ-9 was used to assess the residents’ depressive symptoms, the GAD-7 was used to assess their anxiety symptoms, the ISI was used to assess their insomnia status, and the PCL-5 was used to assess their stress status. The influence factors of depression and anxiety were analyzed using χ2 test and logistic regression. Results A total of 9 122 valid questionnaires were completed. The detection rate of depression, anxiety, insomnia, and stress symptoms were 29.98%, 19.03%, 11.97% and 1.58%, respectively. Gender, education level, monthly family income, self-rated health status, mental health literacy level, total GAD-7 score, total ISI score, and total PCL-5 score were the main factors that caused residents' anxiety symptoms, while gender, education level, self-rated health status, total PHQ-9 score, total ISI score, and total PCL-5 score were the main factors that caused residents' anxiety symptoms. Conclusion The prevalence of depression and anxiety is high among the permanent residents in Yichang, while the situation of insomnia and stress is relatively good. Measures such as improving the level of mental health literacy can be taken to improve mental health level of residents in Yichang.

Application of narrative pharmacy in cardiovascular pharmacy clinic / 中国药房

OBJECTIVE To explore the effects of narrative pharmacy management on medication compliance， negative emotions， and quality of life in patients with cardiovascular disease complicated with negative emotions. METHODS A total of 49 patients with drug use problems and negative emotions attending the cardiovascular pharmacy clinic of Wuhan First Hospital from February to August 2023 were selected as the study objects， narrative pharmacy model was applied for patient management during their visits； pharmaceutical care and emotional management were performed after 2 weeks of treatment and a follow-up visit was conducted to evaluate and record the management effect one month later. RESULTS Adopting a narrative pharmacy management model， 49 patients were involved in 114 drug related consultation questions. Compared with the visit， after one month of management， the number of medication types taken by patients significantly decreased [4.00 （2.00， 6.00） vs. 3.00 （1.50， 5.00）， P＜0.05]， the incidence of adverse reactions significantly decreased （32.65% vs. 2.04%， P＜0.001）， the rate of blood pressure and lipid compliance significantly increased （30.61% vs. 95.92%， P＜0.001）， and the score of the patient’s medication compliance significantly improved （[ 3.94±2.44） vs. （6.78±2.07）， P＜0.01]. The depression score significantly decreased [3.00 （2.00， 4.50） vs. 2.00 （0.00， 3.00）， P＜0.001]， the anxiety score significantly reduced [3.00 （2.00， 4.50） vs. 1.00 （0.00， 2.00）， P＜0.001]， quality of life score was significantly improved [22.00 （19.00， 22.00） vs. 23.00 （23.00， 24.50）， P＜0.01]. In the satisfaction survey， there was a slight increase in the overall satisfaction proportion （91.84% vs. 97.96%， P＞0.05）. CONCLUSIONS The application of narrative pharmacy in cardiovascular pharmacy clinic can improve patient compliance， reduce adverse drug reactions， enhance the effectiveness of drug treatment， avoid drug interactions， effectively improve the anxiety and depression， and ultimately improve the quality of life.

Expression levels of serum biomarkers in adolescents with generalized anxiety disorder / 中国学校卫生

Objective@#To investigate the expression levels of serum neuron specific enolase (NSE), interleukin-1β (IL-1β)and brain derived neurotrophic factor(BDNF) in adolescents with generalized anxiety disorder(GAD), so as to provide reference for the early diagnosis and evaluation of GAD in adolescents.@*Methods@#From March 2020 to February 2023, 97 first episode adolescents with generalized anxiety disorder aged 13-18 years were selected in the study. According to the score of generalized anxiety disorder questionnaire (GAD-7) on admission, they were divided into mild moderate GAD group (58 cases) and severe GAD group (39 cases). At the same time, 90 healthy adolescents who participated in routine physical examination in the same period were selected as the control group. Variance analysis was conducted for comparison among serum NSE, IL-1β and BDNF level. LSD t was applied for further comparison, and the bivariate Pearson linear correlation analysis was carried out for the relationship among serum NSE, IL-1β and BDNF level.@*Results@#The differences among 3 groups of subjects on NSE and IL-1β, and BDNF were of statistical significance( F =10.73, 12.80, 20.67, P <0.01), and the differences between groups were statistically significant ( P <0.05). In the control group, serum NSE level was(8.70±1.35) μg/L, IL-1β was (18.42±5.43) pg/mL, both were the lowest. The levels of NSE and IL-1β in severe GAD group were(14.21±3.25) μg/L, (26.04±5.39)pg/mL, which were the highest. The serum BDNF level in control group was (27.16±4.42) ng/mL, which was the highest; and the severe GAD group was (10.46±3.27) ng/mL, which was the lowest. The bivariate Pearson linear correlation analysis showed that the serum NSE and IL-1β levels in GAD group were negatively correlated with the serum BDNF level ( r =-0.49, -0.57); the serum NSE level was positively correlated with the IL-1β level ( r =0.40) ( P <0.05).@*Conclusions@#The serum levels of NSE and IL-1β are abnormally increased in adolescents with GAD, and the serum levels of BDNF are significantly decreased. The serum levels of NSE, IL-1β and BDNF can be used as detection markers for adolescent GAD, which is helpful for early diagnosis and disease evaluation.

Associations of family functioning and parental styles with anxiety symptoms among high grade primary school students / 中国学校卫生

Objective@#To investigate the prevalence of anxiety symptoms among high grade primary school students in Guangzhou and their correlation with family functioning and parental parenting styles, so as to provide theoretical basis and guidance for family based interventions for children s anxiety symptoms.@*Methods@#From June to September 2022, a multi stage cluster random sampling method was employed to select 5 396 students from grades 4 to 6 in 13 primary schools in Guangzhou. The Family Functioning Assessment Scale for Children, Parental Bonding Instrument, and Spence Children s Anxiety Scale Short Version were used for the survey. Inter group comparison was analysed by t test or analysis of variance. Linear regression analysis was used to explore the effects of family function and parental parenting styles on anxiety symptoms in primary school students.@*Results@#The average score for anxiety symptoms among high grade primary school students in Guangzhou was (11.63±10.88). In terms of parenting styles, mothers scored higher than fathers in the dimensions of "care" (25.63±4.92) and "control" (5.08±2.58) compared to fathers ( 24.74± 5.50, 5.00±2.51) ( t =15.80, 4.21, P <0.01). However, there was no statistically significant difference in the scores of parents on the dimension of "encouragement of independence"（12.98±4.06,13.05±3.95)( t =-1.77， P >0.05）. After adjusting for general demographic characteristics, the results of linear regression analysis showed that primary school students family functioning ( B =0.47) and parental "control" ( B =0.67, 0.75) were positively associated with anxiety symptoms scores ( P <0.01). Meanwhile, parental "care" ( B =-0.53,-0.55) and "encouragement of independence" ( B =-0.62,-0.68) were negatively associated with anxiety symptom scores ( P <0.01). These associations remained statistically significant even after further adjusting for family functioning ( P <0.01).@*Conclusions@#Family functioning, parenting styles are closely associated with anxiety symptoms among high grade primary school students. Positive family functioning and parenting styles may mitigate childhood anxiety symptoms, whereas excessive parental control may increase the risk of childhood anxiety symptoms.

Correlation between screen time, screen behavior type and anxiety, depression among children and adolescents in Jiangxi Province / 中国学校卫生

Objective@#To analyze the status and correlation between screen time, screen behavior type, and anxiety, depression among children and adolescents in Jiangxi Province, so as to provide a basis for effective intervention measures.@*Methods@#Using the method of stratified random sampling, 8 851 primary and secondary school students in 11 districts of Jiangxi Province were investigated by questionnaire during September to December in 2020. Anxiety and depression status were investigated using the State Trait Anxiety Inventory (STAI) and the Center for Epidemiological Studies Depression Scale for Children(CES-DC), respectively. Single factor analysis using χ 2-test, t-test,analysis of variance,and multivariate analysis using generalized linear models.@*Results@#On school days and weekends, 4.7% and 20.4% of primary and secondary school students in Jiangxi Province had a total screen time of over 2 hours per day, respectively. The weighted scores of the total screen time (primary school students: 1.88± 0.68, junior middle school students: 1.96±0.71, high school students: 2.03±0.80) and time spent for playing video games (primary school students: 1.51±0.64, junior middle school students: 1.62±0.69, high school students: 1.68±0.75) daily showed an upward trend with the increase of educational stage ( F =31.48, 42.13), and with significantly higher in boys (1.97±0.74, 1.66± 0.72) than girls (1.93±0.72, 1.53±0.66)( t =2.48, 9.07)( P <0.05). The average scores of state anxiety and trait anxiety were (42.20±9.05) and (40.65±9.85), which showed an upward trend with the increase of educational stage ( F =168.12, 241.98 ), and were higher in girls than boys ( t =6.63, 8.48)( P <0.01). The average score of depression was (11.99±11.00), which was lower in elementary school students than middle school students and high school students ( F =136.42), with significantly higher in girls ( t =6.85)( P <0.01). On school days, with the increase of total screen time and time spent for playing video games daily, the risk of state anxiety, trait anxiety, and depression among primary and secondary school students significantly increased ( OR = 6.70- 818.98, P <0.01). On weekends, among primary and secondary school students, the total screen time of >1-2 hours daily reduced the risk of state anxiety ( OR =0.30). The risk of developing trait anxiety among students playing video games for more than 2 hours daily was 2.50 times higher than those without screen behavior ( OR =2.50). The risk of developing depression with a total screen time of more than 2 hours daily was 3.15 times higher those whithout screen behavior ( OR =3.15). The risk of developing depression among students playing video games >0-1, >1-2, >2 h daily was 2.14, 2.50, 4.90 times that of those without screen behaviors ( OR =2.14, 2.50, 4.90), and showed an upward trend with the increase of educational stage ( P <0.05).@*Conclusions@#Screen behaviors of primary and middle school students in Jiangxi Province are positively associated with the risk of anxiety and depression, but the total daily video time of >1-2 h on weekends was negatively associated with state anxiety. It is necessary to control the screen time as much as possible and reduce the risk of anxiety and depression.

Associations between lifestyle and comorbid anxiety and depression in pregnant women / 环境与职业医学

Background Anxiety and depression are common perinatal mental health issues that often occur together and can have serious negative effects on both maternal and infant health. Objective To examine the relationships between lifestyle factors and comorbid anxiety and depression (CAD) among pregnant women in Shanghai. Methods The study estimated the prevalence of CAD during the first, second, and third trimesters of pregnancy using the Self-rating Anxiety Scale (SAS) and Center for Epidemiological Studies-Depression (CES-D) based on data from the China National Birth Cohort (CNBC) embryonic-derived diseases with assisted reproductive technology (ART) sub-cohort. Information on demographics, sleep status, nutritional intake, and exercise during each trimester was collected through self-made questionnaires, the Pittsburgh Sleep Quality Index (PSQI), and the Food Frequency Questionnaire (FFQ). Lifestyle factors (such as sleep status, nutritional intake, and exercise during each trimester) were analyzed using logistic regression and generalized linear mixed models (GLMM) to determine their impacts on the prevalence of CAD (yes or no) among pregnant women. Results A total of 2876 pregnant women were included in this study. The prevalence of CAD was 10.6% (305), 3.6% (103), and 5.5% (159) in the first, second, and third trimesters of pregnancy, respectively. The logistic regression analysis revealed that poor sleep quality throughout the entire pregnancy were statistically associated with an increased prevalence of CAD, and the odds ratios (OR) with 95% confidence intervals (CI) were 2.817 (1.845, 4.301), 2.840 (1.855, 4.347), and 9.316 (5.835, 14.876) for the first, second, and third trimesters, respectively, when compared to good sleep quality. Additionally, compared to an intake frequency of 7 times per week, the frequency of egg intake ≤3 times per week in the first trimester (OR=2.025, 95%CI: 1.197, 3.425) and the frequency of egg intake of 4–6 times per week (OR=1.896, 95%CI: 1.117, 3.216) or ≤3 times per week (OR=1.906, 95%CI: 1.082, 3.357) in the third trimester were associated with an increased risk of CAD (P<0.05). Moreover, when compared to a frequency of exercise >3 times per week, never or almost never exercising in the second trimester (OR=2.218, 95%CI: 1.220, 4.035) was associated with an increased risk of CAD (P<0.05). The GLMM analysis also demonstrated a significant association between poor sleep quality, lower exercise frequency, or lower intake frequency of vegetables, eggs, or milk and an increased risk of CAD (P<0.05). Conclusion The prevalence of CAD among pregnant women in Shanghai follows a U-shaped distribution, with the highest rate occurring in early pregnancy and the lowest rate in mid-pregnancy. Factors such as poor sleep quality, inadequate intake of vegetables, eggs, or milk, and lack of exercise during pregnancy may increase the risk of CAD. Implementing lifestyle interventions during pregnancy could potentially reduce the risk of mental health problems and improve the overall health of both mothers and babies.

Effect of Therapeutic Communication on Anxiety and Hope Level of Cervical Cancer Surgery Patients / 中国医学伦理学

The aim is to evaluate the effect of therapeutic communication on cervical cancer patients’ preoperative anxiety and hope level. The convenience sampling method was used to select the inpatients who will receive radical surgery for cervical cancer in the department of obstetrics and gynecology of the Second Affiliated Hospital of Xi’an Jiaotong University from November 2016 to November 2019 as the research object. 50 patients were grouped by the random number table method: 25 patients were in the intervention group, and 25 patients were in the control group. Patients in the intervention group were given therapeutic communication on the basis of routine nursing, and patients in the control group were given routine nursing. Both groups were investigated with the Self-Rating Anxiety Scale (SAS) and Herth Hope Index (HHI) on the first day of admission and the day before surgery. Before the intervention, there was no statistically significant difference between the two groups (P>0.05) . After the intervention, the anxiety level of the intervention group was lower than that of the control group (P<0.05), and the hope level was higher than that of the control group (P<0.05). It can be seen that therapeutic communication can alleviate preoperative anxiety of cervical cancer patients, improve their hope level, promote patient recovery, and ease tense medical relationship.

Ramadan Fasting: Effect on Anxiety Using The DASS-42 Scoring System

@#Introduction: Ramadan fasting affects dietary propensity and mental health. As part of their courses, medical students encounter stressors such as examinations, college assignments, and others that can impact their mental health and contribute to conditions such as anxiety. Limited research has been conducted to date on the impact of Ramadan fasting on anxiety scores among college students. This study aimed to explore the impact of Ramadan fasting on anxiety using DASS-42 scoring system. Methods: A prospective cohort analytic study was conducted with a cross-sectional approach and a one-group pretest-posttest design. A total of 242 medical students were sampled and selected by consecutive sampling. The DASS-42 questionnaire was used to evaluate the respondents’ anxiety scores. Results: We found 99 respondents were experiencing anxiety while 143 were normal. The findings revealed that the anxiety scores fell during the pre- to post-Ramadan period for all respondents (p = 0.003), the respondents who had anxiety (p = 0,000), and the normal respondents (p = 0.001). Conclusion: The current study reports that Ramadan fasting was proven to reduce the anxiety scores of all students including those who experienced anxiety and normal subjects.

Physiological Response and Impact of COVID-19 Pandemic among Malaysian Citizens: A Cross-sectional Study

@#Introduction: Studies have shown that staying at home for prolonged periods of crisis can pose a significant challenge to individuals and affect their mental health. Hence, this study was conducted to identify the susceptible subgroups among Malaysian citizens that are prone to mental health problems during the lockdown period of the COVID-19 pandemic and its association with sociodemographic factors. Methods: The mental health status was assessed using the Depression, Anxiety, and Stress Scale -21 (DASS-21) questionnaire. The survey link was distributed online between October and December 2020. Results: Of 637 respondents, one-third experienced mild to extremely severe depression and anxiety (31.1% and 35.1%, respectively). Female respondents (odds ratio = 1.516, 95% confidence interval (CI) 1.057-2.172) were 1.5 times more likely to experience mild to severe depression than male respondents. Unmarried and divorced respondents were 2.1 times more prone to experience mild to severe depression than married respondents. A significant association was also found between employment status and age with depression symptoms among the respondents. For anxiety, a significant association was observed between the age group with mild to severe anxiety symptoms. Marital status, age, and employment status were socio-demographic factors significantly impacting stress levels. Conclusion: According to our findings, females, individuals aged 18-30 years old, students, unmarried and divorced respondents were more susceptible to mental health problems, suggesting that mental health support shall also be provided for these vulnerable groups during the COVID-19 crisis.

Effects of group cognitive behavioral therapy on clinical efficacy and executive function in patients with generalized anxiety disorder / 四川精神卫生

BackgroundPrevious studies have found that patients with generalized anxiety disorder （GAD） have impaired performance in executive function， and group cognitive behavioral therapy （CBT） has been shown to be effective in alleviating negative affect in patients with GAD， while its efficacy on executive function remains unclear. ObjectiveTo explore the efficacy of group CBT on anxiety symptom and executive function in GAD patients， so as to provide references for the rehabilitation program for GAD. MethodsA total of 80 consecutive patients with GAD who were hospitalized in Sleep and Psychosomatic Medical Center of Shiyan Taihe Hospital from March 2021 to August 2022 and met the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） diagnostic criteria for GAD were enrolled， and they were assigned into study group （n=40） and control group （n=40） using random number table methods. All patients were subjected to routine medication treatment and regular health education， based on this， study group received group CBT once a week （6 weeks， 60 to 90 minutes per session）. At the enrollment and after 6 weeks of treatment， patients were assessed using Hamilton Anxiety Scale （HAMA） and Frontal Assessment Battery （FAB）. ResultsANOVA with repeated measures on HAMA score revealed a significant time effect （F=1 870.320， P<0.01）， no significant group effect and no significant time×group interaction effect （F=1.254， 0.293， P>0.05）. Significant time effect， group effect and time×group interaction effect were reported on FAB scores （F=311.190， 4.399， 7.021， P<0.05 or 0.01）. Further analysis indicated that FAB scores of both groups after treatment were higher than those at baseline （t=200.569， 115.401， P<0.01）.And the FAB score of study group was higher than that of control group after treatment （t=-3.211， P<0.01）. ConclusionGroup CBT combined with medication treatment for GAD may alleviate the anxiety symptoms and improve executive function in GAD patients. ［Funded by Shiyan Science and Technology Bureau Pilot Scientific Research Project （number， 21Y21）］

Longitudinal study on anxiety and intolerance of uncertainty among Chinese college students / 中国学校卫生

Objective@#To explore the longitudinal changes and related predictive factors of anxiety and intolerance of uncertainty (IU) among Chinese college students, so as to provide theoretical reference for promoting students mental health.@*Methods@#Intolerance of Uncertainty Scale-short Form and the 7 item Generalized Anxiety Disorder Scale were administered among 5 683 students from 22 universities in Guangdong Province from September 10 to October 17, 2021 (T1, baseline survey), and from March 15 to April 22, 2023 (T2). Using paired sample t-test to analyze the changes in anxiety and IU among college students, a linear regression model was established to explore factors that can predict anxiety, IU and their changes during T1 and T2 periods.@*Results@#During the T1 period, the average scores of anxiety and IU among college students were (3.26±3.46, 34.88±7.96), while during the T2 period, they were (4.41±4.16, 36.40±8.07). During the T2 period, the levels of anxiety and IU among college students were higher than those during the T1 period ( t=19.59, 13.67, P <0.01). The linear regression results showed that age ( B = -0.02 ), moderate ( B =-0.18) and poor ( B =-0.88) mental health status, as well as online browsing of Corona Virus Disease 2019 (COVID-19) epidemic (later called as epidemic) related information for >1-<3 hours ( B =-0.30) and ≥3 hours ( B =-0.22), all of which could negatively predict changes in anxiety during T1 to T2 periods. Living in rural areas ( B =0.11) could positively predict changes in anxiety during T1 to T2 periods ( P <0.05). Moderate ( B =-0.19) and poor ( B =-0.47) mental health status, browsing epidemic related information online for >1-<3 hours ( B =-0.32) and ≥3 hours ( B =-0.33), academic performance being moderately affected by the epidemic ( B =-0.10), and personal planning being moderately affected by the epidemic ( B =-0.13) and severely affected ( B =-0.22), all of which could negatively predict changes in IU during T1 to T2 periods ( P <0.05).@*Conclusions@#Levels of anxiety and intolerance of uncertainty increases significantly after epidemic. Mental health status of college students should need long term monitoring, and students with poor mental health should need special attention.

Longitudinal association between processed food consumption and anxiety symptoms among college students in Yunnan Province / 中国学校卫生

Objective@#To explore the association between processed food consumption and anxiety symptoms among college students in Yunnan Province, so as to provide a reference for the prevention and treatment of anxiety symptoms in this population.@*Methods@#A cluster random sample of 2 515 first year students from two universities in Yunnan Province was selected to carry out a longitudinal investigation which included a baseline survey (November 2021, T1) and three follow up visits (June 2022, T2; November 2022, T3; June 2023, T4). The food frequency questionnaire was administered to assess processed food consumption, and the Depression Anxiety Stress Scale-21 (DASS-21, Chinese version) was used to evaluate anxiety symptoms. A generalized estimation equation model was used to analyze the relationship between processed food consumption and anxiety symptoms.@*Results@#The detection rates of T1-T4 anxiety symptoms among college students in Yunnan Province were 29.70%, 36.70%, 37.69% and 38.73 %, respectively, and the corresponding anxiety symptom scores were 4(0,8), 4(0,10), 4(0,12), 2(0,14). After controlling for demographic variables and confounding factors in the generalized estimation equation model, a statistically significant association was found between consumption of carbonated beverages ( β=0.06, 95%CI =0.03-0.08), and other processed snacks ( β= 0.04 , 95%CI =0.01-0.07) ( P <0.05). The stratified analysis by gender showed that the consumption of carbonated beverages ( β=0.08, 95%CI =0.05-0.12) and fast food ( β=0.03, 95%CI =0.00-0.06) was significantly associated with anxiety symptoms in female college students ( P <0.05). There was no significant association between processed food consumption and anxiety symptoms in male college students ( P >0.05).@*Conclusions@#Processed food consumption by college students in Yunnan Province may increase the risk of anxiety symptoms, particularly among female students. There is a need to strengthen guidance in respect to processed food consumption, so as to prevent and treat anxiety symptoms.