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).

Acupuncture for generalized anxiety disorder: a study protocol for a randomized controlled trial

During the COVID-19 outbreak, there was a sharp increase in generalized anxiety disorder (GAD). Acupuncture therapy has the advantages of accurate clinical efficacy, safety and reliability, few adverse reactions, and no dependence, and is gradually becoming one of the emerging therapies for treating GAD. We present a study protocol for a randomized clinical trial with the aim of exploring the mechanism of brain plasticity in patients with GAD and evaluate the effectiveness and reliability of acupuncture treatment. Transcranial magnetic stimulation (TMS) will be used to assess cortical excitability in GAD patients and healthy people. Sixty-six GAD patients meeting the inclusion criteria will be randomly divided into two groups: TA group, (treatment with acupuncture and basic western medicine treatment) and SA group (sham acupuncture and basic western medicine treatment). Twenty healthy people will be recruited as the control group (HC). The parameters that will be evaluated are amplitude of motor evoked potentials (MEPs), cortical resting period (CSP), resting motor threshold (RMT), and Hamilton Anxiety Scale (HAMA) score. Secondary results will include blood analysis of γ-aminobutyric acid (GABA), glutamate (Glu), glutamine (Gln), serotonin (5-HT), and brain-derived nerve growth factor (BDNF). Outcomes will be assessed at baseline and after the intervention (week 8). This study protocol is the first clinical trial designed to detect differences in cerebral cortical excitability between healthy subjects and patients with GAD, and the comparison of clinical efficacy and reliability before and after acupuncture intervention is also one of the main contents of the protocol. We hope to find a suitable non-pharmacological alternative treatment for patients with GAD.

Research progress on serum inflammatory biomarkers in post-stroke anxiety disorder / 四川精神卫生

Post-stroke anxiety disorder （PSA） is a common psychiatric complication of stroke， which jeopardizes patients' recovery and their quality of life. Recent studies suggest that inflammation plays an important role in the pathogenesis of PSA. Therefore， this paper reviewed the related licture about the association between PSA and serum inflammatory biomarkers in order to provide references for the intervention of PSA. In this study， a comprehensive search was performed in China National knowledge Infrastructure （CNKI）， Wanfang Data， Web of Science and PubMed database to identify the well qualified literature focusing on the relationship between PSA occurrence and serum inflammatory biomarkers， and a total of 13 studies were retrieved. Analysis indicates a certain association between PSA occurrence and serum inflammatory biomarkers， and denotes that the elevation of inflammatory biomarkers may be a trigger for the disease occurrence and its progression， but the specific mechanism underlying this relationship requires further study.

Application of digital delivery of cognitive behavioral therapy for insomnia in patients with generalized anxiety disorder / 中国现代医生

Objective To explore the effect of digital delivery of cognitive behavioral therapy for insomnia(dCBT-I)based on internet technology on anxiety and sleep quality in patients with generalized anxiety disorder(GAD).Methods A total of 82 GAD patients treated in Huzhou Third Municipal Hospital from April to October 2023 were selected as study objects,and were divided into intervention group and control group according to random number table method,with 41 cases in each group.The intervention group received dCBT-I based on internet technology,and the control group received offline cognitive behavioral therapy for insomnia.The anxiety and sleep quality of two groups were compared.Results After the intervention,the scores of Hamilton anxiety scale and Pittsburgh sleep quality index in intervention group were significantly lower than those in control group,and the score of dysfunctional beliefs and attitudes about sleep was significantly higher than those in control group(P<0.05).Conclusion dCBT-I based on internet technology can effectively relieve the anxiety of GAD patients and improve the quality of sleep.

4-5. A Doctor with a Developmental Disorder (Stuttering) / 医学教育

Stuttering is a speech disorder as well as a developmental disorder. It is distinguished by its dual nature. Typically, one can speak fluently, yet occasionally, stuttering disrupts this fluency. With growth, learning to conceal the stuttering becomes part of adapting to school life. However, it is also important to understand one’s stuttering objectively. As a physician who stutters, it is vital to impart necessary information about facing one’s stuttering and to gain understanding from others.

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）］

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

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

Ansiedade e Depressão: rastreio entre profissionais da estratégia de saúde da família na Amazônia / Anxiety and Depression: screening among family health strategy professionals in the Amazon / Ansiedad y Depresión: tamizaje entre profesionales de estrategias de salud familiar en la Amazonía

Objetivo: realizar rastreamento de depressão e transtorno de ansiedade generalizada entre profissionais da Estratégia de Saúde da Família em um município no interior da Amazônia. Método:estudo transversal desenvolvido com 63 profissionais atuantes em 12 equipes de ESF na cidade de Santarém, Pará, Brasil. Foram utilizadas ferramentas validadas e adaptadas transculturalmente: o Patient ́s Health Questionaire ­9 e o Generalizes Anxiety Disorder ­7. Os dados foram analisados a partir de ferramentas da estatística descritiva (frequências absolutas e relativas) a partir do software Microsoft Excel 2018. Resultados:Houve predomínio de indivíduos do sexo feminino, na idade de 40 a 44 anos e raça/cor pardo. O estado civil predominante foi casado, a categoria profissional mais representada na amostra foram os agentes comunitários de saúde e o a maioria dos participantes possuía nível superior completo. 57.1% tiveram rastreamento positivo para depressão e 42.1% para ansiedade. Conclusão:Observou-se elevada frequência de ansiedade e depressão entre os profissionais incluídos na amostra. Nossos dados reforçam a necessidade de ações preventivas na área de saúde mental visando reduzir os impactos dos fatores de risco. Além disso, é fundamental a realização de grandes estudos voltados à investigação dos fatores associados à saúde mental dos trabalhadores da saúde no Brasil

Objective: To screen for depression and generalized anxiety disorder among Family Health Strategy professionals in a municipality in the interior of the Amazon. Method:A cross-sectional study was carried out with 63 professionals working in 12 FHS teams in the city of Santarém, Pará, Brazil. Cross-culturally adapted and validated tools were used: the Patient's Health Questionnaire -9 and the Generalized Anxiety Disorder -7. The data was analyzed using descriptive statistics tools (absolute and relative frequencies)using Microsoft Excel 2018 software. Results:There was a predominance of females, aged between 40 and 44 and of brown race/color. The predominant marital status was married, the most represented professional category in the sample were community health agents and the majority of participants had completed higher education. 57.1% were screened positive for depression and 42.1% for anxiety. Conclusion:There was a high frequency of anxiety and depression among the professionals included in the sample. Our data reinforces the need for preventive action in the area of mental health in order to reduce the impact of risk factors. In addition, it is essential to carry out large-scale studies investigating the factors associated with the mental health of health workers in Brazil.

Objetivo: Detectar depresión y ansiedad generalizada en profesionales de la Estrategia Salud de la Familia de un municipio del interior de la Amazonia. Método:Se realizó un estudio transversal con 63 profesionales que trabajan en 12 equipos de la ESF en la ciudad de Santarém, Pará, Brasil. Se utilizaron instrumentos validados y adaptados transculturalmente: el Cuestionario de Salud del Paciente -9 y el Trastorno de Ansiedad Generalizada -7. Los datos se analizaron mediante herramientas de estadística descriptiva (frecuencias absolutas y relativas) utilizando el software Microsoft Excel 2018. Resultados:Hubo un predominio de mujeres, con edades comprendidas entre 40 y 44 años y de raza/color moreno. El estado civil predominante fue casado, la categoría profesional más representada en la muestra fue la de agentes de salud comunitarios y la mayoría de los participantes habían completado estudios superiores. El 57,1% dieron positivo en depresión y el 42,1% en ansiedad. Conclusión:Hubo una elevada frecuencia de ansiedad y depresión entre los profesionales incluidos en la muestra. Nuestros datos refuerzan la necesidad de acciones preventivas en el área de la salud mental para reducir el impacto de los factores de riesgo. Además, es fundamental la realización de grandes estudios dirigidos a investigar los factores asociados a la salud mental de los trabajadores de la salud en Brasil

Factors associated with voice-related quality of life among patients with temporomandibular disorders

Abstract Research would be important for obtaining a better understanding of voice complaints among patients with temporomandibular disorders (TMD). Objective The identification of predictors of voice disorders associated with TMD pain was made according to Diagnostic Criteria for TMD (DC/TMD) Axis I. Methodology Functional limitations were measured using the Jaw Functional Limitation Scales for mastication (JFLS-M), jaw mobility (JFLS-JM), and verbal and emotional expression (JFLS-VEE). Patients also completed the Hospital Anxiety and Depression Scale (HADS). The primary outcome was social-emotional and physical functioning as indicated by scores on the Voice-Related Quality of Life (V-RQOL) questionnaire. Multiple linear regression was used to model the relationship between the domains on the V-RQOL questionnaire and scores on the HADS and JFLS after adjusting for age, gender, DC/TMD diagnosis, pain intensity, and time since pain onset. Results The HADS-D (B=-1.15; 95% CI, -1.718 to -0.587; p<.001) and JFLS-VEE (B=-0.22; 95% CI, -0.40 to -0.06; p=.008) were significant predictors of scores on the V-RQOL questionnaire. Conclusion Higher scores on depression measures and limitations in verbal and emotional expression could exacerbate voice problems among TMD pain patients. Future research should promote multidisciplinary treatments for TMD pain-related voice disorders.

Brazilian Psychiatric Association treatment guidelines for generalized anxiety disorder: perspectives on pharmacological and psychotherapeutic approaches

Generalized anxiety disorder is a highly prevalent mental disorder. Previous data indicate that more than 18 million Brazilians suffer from this condition. Traditionally, generalized anxiety disorder has been considered a mild mental health disorder, despite its links to lower life expectancy, cardiovascular disease, and suicide. The aim of this article is to combine elements of systematic and critical reviews to produce a synthesis of the best evidence about generalized anxiety disorder treatment. Systematic reviews, meta-analyses, and randomized controlled trials were included. The descriptor used in the search was "generalized anxiety disorder," which resulted in 4,860 articles and seven other studies, of which 59 were selected. Antidepressants and benzodiazepines were indicated, as was pregabalin, and atypical antipsychotics, such as quetiapine, have been studied. Individual cognitive behavior therapy (third wave) has proven effective. There is extensive literature on many effective treatments for generalized anxiety disorder. The present review summarizes the therapeutic possibilities, emphasizing those available in Brazil. Further studies are needed to compare other available medications, assess psychotherapies and new treatments in greater depth, as well as to assess the ideal duration of therapy. Registration number: PROSPERO CRD42021288323.

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

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

Instrumentos para diagnóstico e rastreamento do transtorno de ansiedade social adaptados para à realidade brasileira / Social anxiety disorder diagnostic and screening tools adapted for the brazilian reality

Objetivo: descrever perante a literatura os instrumentos para diagnóstico e rastreamento do Transtorno de Ansiedade Social (TAS) que sejam adaptados à realidade brasileira. Método: revisão de literatura exploratória e descritiva, realizado através das bases de dados: PubMED, BVS e Scielo. No mês de agosto de 2022 com recorte temporal de 2017 a 2022. Sendo inclusos, documentos que versavam a respeito dos instrumentos para diagnóstico e rastreamento do TAS, adaptados à realidade brasileira. Resultado: ao revisar a literatura foram encontrados 14 documentos dentre as escalas de reconhecimento e rastreamento do TAS com validação e adaptação transcultural para realidade brasileira, foram encontrados quatro: Questionário de Ansiedade social para Adultos; Escala de Ansiedade em Interação Social Reduzida; Escala de Ansiedade Social Reduzida e a Escala de Ansiedade Social de Liebowitz versão auto aplicada. Conclusão:há uma minoria de estudos validados e adaptados aos brasileiros dificultando assim o diagnóstico, tratamento precoce e a avaliação multidisciplinar.(AU)

Objective: to describe in the literature the instruments for diagnosis and screening of Social Anxiety Disorder (SAD) that are adapted to the Brazilian reality. Method: exploratory and descriptive literature review, conducted through the databases: PubMED, BVS and Scielo. In August 2022, with a time frame of 2017 to 2022. Included were documents about the instruments for diagnosis and screening of SAD, adapted to the Brazilian reality. Result: After reviewing the literature, 14 documents were found among the SAD recognition and screening scales with validation and cross-cultural adaptation for the Brazilian reality, four were found: Adult Social Anxiety Questionnaire; Reduced Social Interaction Anxiety Scale; Reduced Social Anxiety Scale, and the Liebowitz Social Anxiety Scale, self-applied version. Conclusion: there is a minority of studies validated and adapted to Brazilians thus hindering diagnosis, early treatment and multidisciplinary assessment.(AU)

Objetivo:describir através de la literatura los instrumentos para el diagnóstico y rastreodelTrastorno de Ansiedad Social (TAS) que se adaptan a la realidade brasileña. Método:revisión bibliográfica exploratoria y descriptiva, realizada a través de las bases de datos: PubMED, BVS y Scielo. En agosto de 2022 conunplazo de 2017 a 2022. Se incluyeron documentos sobre los instrumentos de diagnóstico y cribadodelTAS, adaptados ala realidade brasileña. Resultados: al revisar la literatura se encontraron 14 documentos dentro de las escalas de reconocimiento y rastreo de laTASconvalidación y adaptación transcultural a la realidade brasileña, se encontraroncuatro: Questionário de Ansiedade social para Adultos; Escala de Ansiedade em Interação Social Reduzida; Escala de Ansiedade Social Reduzida y la Escala de Ansiedade Social de Liebowitzversión auto aplicada. Conclusión:hay una minoría de estudios validados y adaptados a losbrasileños, lo que dificulta el diagnóstico, el tratamento precoz y laevaluación multidisciplinar. (AU)

Instrumentos para diagnóstico e rastreamento do transtorno de ansiedade social adaptados para à realidade brasileira / Instrumentos de diagnóstico y cribado del trastorno de ansiedad social adaptados a la realidad brasileña / Social anxiety disorder diagnostic and screening tools adapted for the brazilian reality

Objetivo: descrever perante a literatura os instrumentos para diagnóstico e rastreamento do Transtorno de Ansiedade Social (TAS) que sejam adaptados à realidade brasileira. Método: revisão de literatura exploratória e descritiva, realizado através das bases de dados: PubMED, BVS e Scielo. No mês de agosto de 2022 com recorte temporal de 2017 a 2022. Sendo inclusos, documentos que versavam a respeito dos instrumentos para diagnóstico e rastreamento do TAS, adaptados à realidade brasileira. Resultado: ao revisar a literatura foram encontrados 14 documentos dentre as escalas de reconhecimento e rastreamento do TAS com validação e adaptação transcultural para realidade brasileira, foram encontrados quatro: Questionário de Ansiedade social para Adultos; Escala de Ansiedade em Interação Social Reduzida; Escala de Ansiedade Social Reduzida e a Escala de Ansiedade Social de Liebowitz versão auto aplicada.Conclusão:há uma minoria de estudos validados e adaptados aos brasileiros dificultando assim o diagnóstico, tratamento precoce e a avaliação multidisciplinar.(AU)

Objective: to describe in the literature the instruments for diagnosis and screening of Social Anxiety Disorder (SAD) that are adapted to the Brazilian reality. Method: exploratory and descriptive literature review, conducted through the databases: PubMED, BVS and Scielo. In August 2022, with a time frame of 2017 to 2022. Included were documents about the instruments for diagnosis and screening of SAD, adapted to the Brazilian reality. Result: After reviewing the literature, 14 documents were found among the SAD recognition and screening scales with validation and cross-cultural adaptation for the Brazilian reality, four were found: Adult Social Anxiety Questionnaire; Reduced Social Interaction Anxiety Scale; Reduced Social Anxiety Scale, and the Liebowitz Social Anxiety Scale, self-applied version. Conclusion: there is a minority of studies validated and adapted to Brazilians thus hindering diagnosis, early treatment and multidisciplinary assessment.(AU)

Objetivo:describir através de la literatura los instrumentos para el diagnóstico y rastreodelTrastorno de Ansiedad Social (TAS) que se adaptan a la realidade brasileña. Método:revisión bibliográfica exploratoria y descriptiva, realizada a través de las bases de datos: PubMED, BVS y Scielo. En agosto de 2022 conunplazo de 2017 a 2022. Se incluyeron documentos sobre los instrumentos de diagnóstico y cribadodelTAS, adaptados ala realidade brasileña. Resultados: al revisar la literatura se encontraron 14 documentos dentro de las escalas de reconocimiento y rastreo de laTASconvalidación y adaptación transcultural a la realidade brasileña, se encontraroncuatro: Questionário de Ansiedade social para Adultos; Escala de Ansiedade em Interação Social Reduzida; Escala de Ansiedade Social Reduzida y la Escala de Ansiedade Social de Liebowitzversión auto aplicada. Conclusión:hay una minoría de estudios validados y adaptados a losbrasileños, lo que dificulta el diagnóstico, el tratamento precoz y laevaluación multidisciplinar.(AU)

Clinical application and development of digital therapy in psychiatry / 中国神经精神疾病杂志

Digital therapeutics(DTs)refers to a non-drug intervention method that uses electronic devices such as computers,smartphones,and wearable devices to evaluate and intervene through software programs and Internet technologies.It has been confirmed that there is a good therapeutic effect on a variety of mental disorders.Digital therapeutics can improve the insomnia problems of insomniacs,enhance the attention and work memory ability of patients with attention deficit hyperactivity disorder,and can also alleviate symptoms such as depression and anxiety disorder.Digital therapy will develop towards personalized treatment,popular treatment,fragmented treatment,and entertainment treatment in the future and have broad development prospects.

Research progress of mindfulness therapy in the treatment of common mental diseases / 中国神经精神疾病杂志

Mindfulness-based psychotherapy was developed from mindfulness-based psychotherapy,including mindfulness-based stress reduction therapy,mindfulness-based cognitive therapy,dialectical behavior therapy,acceptance and commitment therapy.Mindfulness therapy alleviates the symptoms of mental illness by regulating the cognitive and emotional systems.A large number of studies have shown that mindfulness therapy is helpful in the treatment of depression,anxiety,substance dependence,post-traumatic stress disorder,eating disorder,schizophrenia,bipolar disorder and other mental diseases.The therapeutic effect in depression and anxiety is the same as that of first-line treatment,which provides a new idea for the treatment of mental diseases.

Prevalence of anxiety disorder in adults in Ningxia Hui Autonomous Region / 中国心理卫生杂志

Objective:To investigate the prevalence of anxiety disorder and its distribution,and related factors in adults in Ningxia community.Methods:Using the method of China Mental Health Survey,anxiety disorder was investigated with the Composite International Diagnostic Interview,and related factors were analyzed.Twelve-month prevalence and life-time prevalence and their distributions were calculated according to DSM-Ⅳ criteria.Results:A total of 4 085 respondents were interviewed in the survey.The 12-month prevalence rate of any anxiety disorder was 4.2％,and the lifetime prevalence rate was 5.6％.The 12-month prevalence rates of social phobia,special phobia and generalized anxiety disorder were higher in women than in men(P＜0.05).The prevalence of special phobia and any anxiety disorder in rural area was higher than that in urban area.Logistic regression model revealed that fe-male(OR=1.86,95％CI:1.32-2.64)had higher prevalence risk of anxiety disorder,and individuals with somat-ic pain had higher risk of anxiety disorder than those without(P＜0.05).Conclusion:Anxiety disorder is prevalent in Ningxia.It suggests that strengthening somatic pain community mental health service is necessary to develop tar-geted intervention programs among the high-risk population.

Role of the synaptic plasticity in chronic pain comorbidity anxiety disorder / 中华行为医学与脑科学杂志

Chronic pain patients are often accompanied with anxiety disorder, which promote the development of each other's disease process to a certain extent and seriously affect the quality of life of patients.However, the mechanism regulating the comorbidity between the two has not been clarified.Synaptic remodeling is the alteration of synaptic structure and function, which affects the transmission of signals between neurons.Synaptic remodeling is a hot topic in the field of chronic pain and anxiety disorders, but only few studies have explored its pathological changes in chronic pain and anxiety disorders.By summarizing the relevant researches in recent years, the occurrence of chronic pain co-anxiety disorder is closely related to changes in synaptic structure, synaptic transmission efficiency and synaptic function in brain regions.Synaptic remodeling could lead to the decline of centra pain regulation ability and aggravate the progression of chronic pain accompanied by anxiety disorder through ionic amino acid receptors, neuronal transmission and interactions between neurons and glial cells.Understanding the latest research progress of the co-morbidity mechanism of chronic pain and anxiety disorder is helpful to provide theoretical basis and potential new targets for its treatment.

The intervention study of mindfulness-based cognitive therapy on mindful attention awareness, experiential avoidance and cognitive fusion in patients with generalized anxiety disorder / 中华行为医学与脑科学杂志

Objective:To investigate the effect of mindfulness-based cognitive therapy (MBCT) on mindfulness attention awareness, experiential avoidance, and cognitive fusion in individuals with general anxiety disorder(GAD).Methods:A total of 53 patients aged 18-60 years who met the GAD diagnostic criteria of DSM-5 were selected from the Seventh People's Hospital of Hangzhou from May 2021 to September 2022.After receiving routine treatment, patients were randomly assigned to two groups: MBCT group( n=26) for an 8-week mindfulness cognitive therapy and health education group( n=27) for an 8-week health education program. Participants were evaluated using the generalized anxiety disorder scale(GAD-7), acceptance and action questionnaire-2nd edition(AAQ-Ⅱ), cognitive fusion questionnaire(CFQ), and mindful attention awareness scale (MAAS) before and after the intervention.Data were analyzed using SPSS 26.0 software, with the chi-square test, independent sample t-test, and paired sample t-test. Results:(1)There was no significant difference in MAAS score between the two groups before the intervention (42.63±10.18, 47.67±9.52, t=-1.55, P=0.13). However, after the intervention, the MAAS score in MBCT group was significantly higher than that in the health education group(54.42±9.87, 47.83±7.59, t=-2.27, P=0.03). (2) No significant difference was observed in CFQ score between the two groups before the intervention (57.11±15.97, 53.50±12.01, t=-0.77, P=0.45). However, after the intervention, the CFQ score in the MBCT group was significantly lower than that in the health education group(38.32±10.31, 47.11±10.66, t=-2.51, P<0.01). (3) There was no significant difference in AAQ-Ⅱ scores between the two groups before the intervention(33.79±7.90, 30.00±7.23, t=1.52, P=0.14). After the intervention, the AAQ-Ⅱ score in the MBCT group was significantly lower than that in the health education group(21.89±8.69, 30.22±8.68, t=-3.51, P<0.01) . Conclusion:MBCT has a positive effect on enhancing mindfulness attention awareness, reducing cognitive fusion, and mitigating experiential avoidance in GAD patients.

Research Progress of Chinese Medicine on Generalized Anxiety Disorder / 世界科学技术-中医药现代化

Generalized Anxiety Disorder(GAD)is a common mental illness with anxiety as its main clinical symptom.Its prevalence is increasing year by year,and it has the risk of chronic disability,which seriously affects human physical and mental health.This article mainly from the etiology and pathogenesis,syndrome differentiation and treatment method has combed the GAD′s research progress of traditional Chinese medicine(TCM),the results show that the occurrence of GAD may be a stimulus such as poor social life events,applies to susceptible individuals,heart and other internal viscera function disorder,further produce sputum,drinks,water,dampness,blood stasis,fire as the main etiology and pathogenesis,pathological factors.The syndrome differentiation types are mainly heart and kidney non-communication type,liver stagnation and fire type,phlegm and fire on the disturbance type,heart and spleen deficiency type,heart and gallbladder qi deficiency and Yin deficiency internal heat type.Treatment mainly include syndrome differentiation and treatment,acupuncture and massage,etc.,the clinical curative effect is distinct,and the forward curative effect is superior to western medicine treatment,but there is also a lack of objective and syndromes curative effect evaluation standard,lack of the mechanism and system of TCM in the treatment of GAD targets into issues of scientific research,in order to optimization and the pathogenesis of GAD for the future of the diagnosis and treatment to provide reference for further studies.

Caffeine Intake and Its Association with Mental Health Status among Pharmacy Students at UiTM Puncak Alam

@#Introduction: Caffeine is a psychoactive substance widely consumed over the past decades. The effect of caffeine can be either beneficial or harmful. It increases cognitive performances, including attention, alertness and concentration. However, high caffeine intake may also induce an anxiogenic effect, causing symptoms such as rapid heart rate, restlessness and nervousness. This study aimed to determine the association between caffeine intake and mental health disorders such as anxiety and depression among undergraduate pharmacy students at UiTM Puncak Alam. Methods: This was a cross-sectional study with stratified random convenience sampling. A total of 270 undergraduate pharmacy students in UiTM Puncak Alam, Selangor participated in this study. A set of questionnaires was distributed using the Google Form platform. Standard General Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) scoring were used to assess the level of anxiety and depression among the respondents, respectively. SPSS version 27.0 was used to analyse the data. Results: About 70.4% of the students consumed caffeine, while 29.6% of the students did not consume caffeine. No significant association was found between caffeine status and the mental health scoring of GAD-7 (χ2 =4.639, p=0.200) and PHQ-9 (χ2 =5.256, p=0.262). Conclusion: Non-daily consumption and a low dose of caffeine intake patterns are good practises to prevent the development of anxiety or depression conditions, although the associations were not significant. Public awareness on possible anxiogenic effect and mental related disorders due to caffeine consumption need to be initiated, as nowadays, the caffeine intake behaviour has become a trendy lifestyle among the young adults.