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.

Impact of Anxiety and Depression on Physical Health Condition and Disability in an Elderly Korean Population

OBJECTIVE: This study aimed to investigate the longitudinal effects of anxiety, depression, and their comorbidity on physical disorders and disability in an elderly Korean population. METHODS: In total, 1,204 community-dwelling elders were evaluated at baseline, and of these 909 (75%) were re-assessed two years later. Anxiety and depression were identified at baseline using questions from the community version of the Geriatric Mental State diagnostic schedule (GMS-B3). Participants were assessed for functional disability and for 11 physical disorders both at baseline and at follow-up. RESULTS: Anxiety alone was associated with the incidence of heart disease, depression alone with the incidence of asthma, and comorbid anxiety and depression with incidence of eyesight problem, persistent cough, asthma, hypertension, heart disease, and gastrointestinal problems. Comorbid anxiety and depression were associated with an increase in the number of physical disorders and the degree of disability during the two-year follow-up, compared to anxiety or depression alone or the absence of anxiety or depression. CONCLUSION: Anxiety, depression, and particularly their comorbidity should be assessed in the elderly population considering their longitudinal effects on physical disorders and disability. Future study is required to determine whether interventions aimed at these disorders can mitigate their impacts.

Clinical Characteristics of Comorbid Anxiety and Depression after Cerebral Infarction / 中国康复理论与实践

@#Objective To determine the clinical characteristics of comorbid anxiety and depression after cerebral infarction. Methods All the patients enrolled were divided into post-stroke comorbid anxiety and depression (PSCAD) group (84 cases) and the control group (121 cases). Their condition of smoke, alcohol intake, education background, carotid plaque and brain blood vessels were investigated, and they were evaluated with Hamilton Anxiety Scale (HAMA), Hamilton Depressive Scale (HAMD), Barthel index, and Mini-Mental State Examination (MMSE). Results There was not significant difference in condition of smoke, alcohol intake, education background, carotid plaque and brain blood vessels between these groups （P＞0.05）, but were in total scores and all the factors scores of HAMA and HAMD （P＜0.05）. PSCAD group showed more obvious anxious mood, depressive mood, tension, insomnia, cognitive impairment and autonomic nervous symptoms. Psycho-anxiety, soma-anxiety, despair, guiltiness, decreased interest were also more significant in the PSCAD group. The scores of MMSE and Barthel index were also impaired. Conclusion The cognitive function and daily living ability are worse in the patients with PSCAD. The prominent symptoms includes: anxious mood, depressive mood, tension, insomnia, cognitive impairment, autonomic nervous symptoms, soma-anxiety, despair, guiltiness, decreased interest.

Clinical study of post-stroke comorbid anxiety and depression treated with integrated Chinese and western medicine / 中国康复理论与实践

@#ObjectiveTo evaluate the clinical effect of integrated Chinese and western medicine (ICWM) on the post-stroke comorbid anxiety and depression (PSCAD).Methods35 PSCAD patients were treated with ICWM therapy and scores of self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were analyzed statis tically before and after treatment.ResultsThe curi ng rate of PSCAD is about 74.29% and scores of SAS and SDS were significantly d ecreased after treatment (P<0.001).Conclusions The treatment of ICWM can produce a good effect on PSCAD.