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.

El efecto de algunos factores sociodemográficos y psicosociales en los síntomas de ansiedad que presenta una muestra de personas con diabetes mellitus tipo 2 en una comunidad del área Oeste de Puerto Rico / The effect of some socio-demographic and psychosocial factors on anxiety symptoms in a sample of type 2 diabetes mellitus patients in a community in the western region of Puerto Rico / O efeito de alguns fatores sociodemográficos e psicossociais nos sintomas de ansiedade que tem um grupo de pacientes com diabetes mellitus tipo 2 em uma comunidade da área oeste do Porto Rico

Resumen Introducción Este estudio pretende hacer un análisis de cómo y por qué la diabetes mellitus tipo 2 afecta psicológicamente a los pacientes. No obstante, somos conscientes del amplio espectro de condiciones mentales que puede desencadenar el padecimiento de esta condición y hemos decidido enfocar esta investigación en la relación existente entre este tipo de diabetes y la ansiedad comórbida. Materiales y Métodos Estudio descriptivo correlacional de corte transversal. Se utilizó un cuestionario semiestructurado y validado internacionalmente para medir la ansiedad y el análisis estadístico de regresión múltiple. Resultados Nuestra muestra estuvo compuesta por sesentaicinco pacientes diagnosticados con la condición en el área oeste de Puerto Rico. Los resultados revelaron que la edad (p = .014) y la actividad física (p = .031) tienen efectos significativos sobre los síntomas de ansiedad. Discusión La ansiedad en pacientes de diabetes mellitus tipo 2 pudiera estar influenciada por otras variables intervinientes y moderadoras. Conclusiones Los profesionales de enfermería al momento de controlar los síntomas de ansiedad en el paciente diabético debe considerar la importancia del entorno y el contexto cultural y psicosocial en la atención del cuidado holístico.

Abstract Introduction This study aims to analyze how and why type 2 diabetes mellitus affects patients psychologically. However, we are aware of the broad spectrum of mental conditions that can trigger this condition and have decided to focus this research on the relationship between this type of diabetes and comorbid anxiety. Materials and Methods A descriptive, correlational, cross-sectional study was conducted. A semi-structured and internationally validated questionnaire was used to measure anxiety and statistical multiple regression analysis. Results Our sample was composed of sixty-five patients diagnosed with this condition in the western area of Puerto Rico. The results revealed that age (p =.014) and physical activity (p =.031) have significant effects on anxiety symptoms. Discussion Anxiety in type 2 diabetes mellitus patients may be influenced by other intervening and moderating variables. Conclusions Nursing professionals in managing anxiety symptoms in the diabetic patient should consider the importance of the environment and the cultural and psychosocial context in the holistic care.

Resumo Introdução Esta pesquisa pretende fazer uma análise de como e porque a diabetes mellitus tipo 2 afeta psicologicamente os pacientes. No entanto, somos conscientes do amplo espectro de condições mentais que podem ser desencadeadas por esta doença, por isso decidimos abordar nesta pesquisa a relação entre ela e a comorbidade na ansiedade. Materiais e Métodos Pesquisa descritiva correlacional de tipo transversal. Foi utilizado um questionário semiestruturado e validado internacionalmente para medir a ansiedade e a análise estatística de regressão múltipla. Resultados Nossa amostra esteve constituída por sessenta e cinco pacientes com o diagnóstico da condição exposta anteriormente na área oeste do Porto Rico. Os resultados revelaram que a idade (p= .014) e a atividade física .031) têm efeitos significativos em relação aos sintomas de ansiedade. Discussão A ansiedade em pacientes com diabetes mellitus tipo 2 poderia ser influenciada por outras variantes que intervêm e que a moderam. Conclusões Os profissionais da enfermagem, quando controlam os sintomas de ansiedade no paciente diabético, devem levar em conta a importância do entorno e do contexto cultural e psicossocial quando o paciente estiver recebendo um cuidado holístico.

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.

Comparison of anxiety in patients of bipolar disorder with and without suicidal behaviour.

Introduction: Suicidal behaviour is common in bipolar disorder. This is especially true in anxious patients or comorbid anxiety disorder. The effect of subsyndromal anxiety in this group of patients in India needs to be assessed. This study was undertaken to assess comorbid anxiety in patients of bipolar disorder with and without suicidal behavior and to study the relationship of co-morbid anxiety with suicidal behavior in patients with bipolar disorder. Material & Method: 60 bipolar disorder patients in remission coming to the Central Institute of Psychiatry diagnosed as per DSM IV-TR (American Psychiatric Association, 2000) criteria, 30 with suicidal ideation and 30 without suicidal ideation were taken in the study. Co-morbid conditions other than anxiety were ruled out. They were further assessed on Hamilton Rating Scale for Anxiety. Results: The suicidal group was significantly more depressed than the Non-suicidal group with p < 0.001. Statistically significant positive correlation was found between General Somatic Symptoms (Muscular) item and duration of illness (r=0.481, p<0.01). Statistically significant positive correlation were found between the item anxious (r=0.380, p<0.05) and BSI scores. Statistically significant positive correlation were found between the item tension (r=0.435, p<0.05) and BSI scores. Statistically significant positive correlation was found between depressed mood (r=0.368, p< 0.05) and age of onset. Statistically significant positive correlation was found between General Somatic Symptoms (Muscular) (r=0.434, p< 0.05) and age of onset. Conclusions: Suicidal patients were significantly more depressed than the non suicidal patients. Within the suicidal group it was noted that patients who were more anxious and had more tension had higher scores on the suicidal ideation scale. These two items may be taken as indicators of higher suicidal tendencies in patients of bipolar disorders. Also, somatic symptoms were related to duration of illness. Within the Non-suicidal group, age of onset was related to depressed mood and somatic symptoms.

Prevalence of abnormal liver function tests and comorbid psychiatric disorders among patients with anorexia nervosa and eating disorders not otherwise specified in the anorexia nervosa DSM-IV criteria

<p><b>INTRODUCTION</b>Anorexia nervosa (AN) and eating disorders not otherwise specified (EDNOS) are on the rise in Singapore. Abnormal liver function tests have been reported for up to 12.2% of patients with AN. These patients are also known to present with comorbid psychiatric disorders. This study aims to investigate the correlation between body mass index (BMI) and the severity of abnormal liver function tests, and between BMI and the presence of comorbid psychiatric disorders.</p><p><b>METHODS</b>A retrospective cohort analysis of 373 patients diagnosed with AN or EDNOS at a tertiary hospital was performed. The clinical course of transaminitis and comorbid psychiatric disorders was correlated with the patient's BMI.</p><p><b>RESULTS</b>Patients with a BMI of ≥ 16.6 kg/m(2) at their first consult had a significantly lower risk of having comorbid psychiatric disorders (χ(2) = 32.08, p < 0.001). These patients were five times less likely to have comorbid psychiatric disorders as compared to patients from the other BMI groups (odds ratio [OR] 0.21). On the other hand, patients with a BMI of < 14.6 kg/m(2) had a significantly higher risk of having transaminitis (χ(2) = 72.5, p < 0.001). They were 11.1 times more likely to develop transaminitis as compared to patients with a BMI of ≥ 14.6 kg/m(2) (OR 11.05).</p><p><b>CONCLUSION</b>Severity of BMI can be used by clinicians as an indicator to assess for secondary psychiatric comorbidities and/or transaminitis during the first consultation. This could help reduce the morbidity and mortality rates in patients with AN or EDNOS.</p>

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.