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1.
Cien Saude Colet ; 26(2): 693-710, 2021 Feb.
Article in Portuguese | MEDLINE | ID: mdl-33605344

ABSTRACT

This study sets out to identify the prevalence of anxiety among health professionals during the COVID-19 pandemic. It involves a systematic review and meta-analysis of studies published in any language in 2020. A search was conducted in the Embase, LILACS and PubMed databases using the keywords anxiety, COVID-19, health workers, and synonyms. The estimated overall prevalence of anxiety with a 95% confidence interval was calculated using the random effects model. Of the 861 records identified, 36 articles were included in the systematic review and 35 in the meta-analysis. The overall prevalence of anxiety was 35% (95%CI: 29-40). A higher risk of anxiety was identified among women compared to men (Odds Ratio: 1.64 [95%CI: 1.47-1.84]), and in nurses, in comparison with physicians (Odds Ratio: 1.19 [95%CI: 1.07-1.33]). Being on the front line of COVID-19, being infected with coronavirus and having chronic diseases were also factors associated with a higher risk of anxiety. A high prevalence of anxiety among health professionals was observed, with higher risk among women and nurses. There is a pressing need for measures aimed at prevention of anxiety and providing early and appropriate treatment for those suffering from moderate and severe anxiety.


O objetivo deste estudo é identificar a prevalência de ansiedade em profissionais de saúde durante a pandemia da COVID-19. Trata-se de revisão sistemática de estudos publicados em qualquer idioma em 2020. Foi realizada busca nas bases de dados Embase, LILACS e PubMed utilizando os descritores anxiety, COVID-19, health workers, e sinônimos. A estimativa da prevalência geral de ansiedade com intervalo de confiança de 95% foi calculada utilizando o modelo de efeitos aleatórios. Dos 861 registros identificados, 36 artigos foram incluídos na revisão sistemática e 35 na metanálise. A prevalência geral de ansiedade foi de 35% (IC95%: 29-40). Foi identificado maior risco de ansiedade nas mulheres em relação aos homens (Odds Ratio: 1.64 [IC95%: 1,47-1,84]), e nos enfermeiros, na comparação com médicos (Odds Ratio: 1.19 [IC95%: 1,07-1,33]). Atuar na linha de frente no combate a COVID-19, estar infectado com coronavírus e apresentar doenças crônicas também foram fatores associados com maior risco de ansiedade. Observa-se alta prevalência de ansiedade entre profissionais de saúde, com maior risco entre mulheres e enfermeiros. Há necessidade de medidas que visem sua prevenção, bem como o fornecimento de tratamento precoce e adequado aos com ansiedade moderada e grave.


Subject(s)
Anxiety/epidemiology , COVID-19 , Health Personnel , Occupational Diseases/epidemiology , Humans , Prevalence
2.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(4): 280-288, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1011515

ABSTRACT

Objective: The incidence rate of major depression in adolescents reaches approximately 14%. This disorder is usually recurrent, without remission of symptoms even after pharmacological treatment, and persists throughout adult life. Since the effects of antidepressants take approximately 2 weeks to begin, new pharmacological therapies are under continuous exploration. Recent evidence suggests that psychedelics could produce rapid antidepressant effects. In this study, we evaluated the potential antidepressant effects of ayahuasca in a juvenile non-human primate model of depression. Methods: While living with their families, juvenile marmosets (8 males; 7 females) were observed on alternate days for four weeks during a baseline phase. This was followed by 8 weeks of an induced depressive state protocol, the social isolated context (IC), in which the animals were monitored in the first and last weeks. Subsequently, five males and four females were randomly selected for treatment, first with a single administration of saline vehicle (1.67 mL/300 g of body weight, via gavage), followed by a single dose of ayahuasca (1.67 mL/300 g of body weight, via gavage). Both phases lasted 1 week and the animals were monitored daily. A third week of sampling was called the tardive-pharmacological effects phase. In all phases the marmosets were assessed for behavior, fecal cortisol levels, and body weight. Results: After IC, the animals presented typical hypocortisolemia, but cortisol recovered to baseline levels 24 h after an acute dose of ayahuasca; this recovery was not observed in vehicle-treated animals. Additionally, in males, ayahuasca, but not the vehicle, reduced scratching, a stereotypic behavior, and increased feeding. Ayahuasca treatment also improved body weight to baseline levels in both sexes. The ayahuasca-induced behavioral response had long-term effects (14 days). Thus, in this translational juvenile animal model of depression, ayahuasca presented beneficial effects. Conclusions: These results can contribute to the validation of ayahuasca as an antidepressant drug and encourage new studies on psychedelic drugs as a tool for treating mood disorders, including for adolescents with early-onset depression.


Subject(s)
Humans , Animals , Male , Female , Banisteriopsis , Depressive Disorder, Major/drug therapy , Hallucinogens/administration & dosage , Antidepressive Agents/administration & dosage , Primates , Hydrocortisone/analysis , Callitrichinae , Disease Models, Animal , Feces/chemistry
3.
Braz J Psychiatry ; 41(4): 280-288, 2019.
Article in English | MEDLINE | ID: mdl-30427388

ABSTRACT

OBJECTIVE: The incidence rate of major depression in adolescents reaches approximately 14%. This disorder is usually recurrent, without remission of symptoms even after pharmacological treatment, and persists throughout adult life. Since the effects of antidepressants take approximately 2 weeks to begin, new pharmacological therapies are under continuous exploration. Recent evidence suggests that psychedelics could produce rapid antidepressant effects. In this study, we evaluated the potential antidepressant effects of ayahuasca in a juvenile non-human primate model of depression. METHODS: While living with their families, juvenile marmosets (8 males; 7 females) were observed on alternate days for four weeks during a baseline phase. This was followed by 8 weeks of an induced depressive state protocol, the social isolated context (IC), in which the animals were monitored in the first and last weeks. Subsequently, five males and four females were randomly selected for treatment, first with a single administration of saline vehicle (1.67 mL/300 g of body weight, via gavage), followed by a single dose of ayahuasca (1.67 mL/300 g of body weight, via gavage). Both phases lasted 1 week and the animals were monitored daily. A third week of sampling was called the tardive-pharmacological effects phase. In all phases the marmosets were assessed for behavior, fecal cortisol levels, and body weight. RESULTS: After IC, the animals presented typical hypocortisolemia, but cortisol recovered to baseline levels 24 h after an acute dose of ayahuasca; this recovery was not observed in vehicle-treated animals. Additionally, in males, ayahuasca, but not the vehicle, reduced scratching, a stereotypic behavior, and increased feeding. Ayahuasca treatment also improved body weight to baseline levels in both sexes. The ayahuasca-induced behavioral response had long-term effects (14 days). Thus, in this translational juvenile animal model of depression, ayahuasca presented beneficial effects. CONCLUSIONS: These results can contribute to the validation of ayahuasca as an antidepressant drug and encourage new studies on psychedelic drugs as a tool for treating mood disorders, including for adolescents with early-onset depression.


Subject(s)
Antidepressive Agents/administration & dosage , Banisteriopsis , Depressive Disorder, Major/drug therapy , Hallucinogens/administration & dosage , Animals , Callitrichinae , Disease Models, Animal , Feces/chemistry , Female , Humans , Hydrocortisone/analysis , Male , Primates
4.
Exp Clin Psychopharmacol ; 25(2): 105-113, 2017 04.
Article in English | MEDLINE | ID: mdl-28287793

ABSTRACT

Anxiety disorders are associated with increased impairments in psychosocial functioning, work productivity and health-related quality of life. In addition, anxiety is a common symptom of ethanol withdrawal and it strongly contributes to relapse. Benzodiazepines are frequently prescribed for relief of anxiety and ethanol withdrawal symptoms but considerable side effects, such sedation, tolerance and dependence, are observed during treatment. Therefore, better drugs are needed for the treatment of anxiety states. The purpose of this study was to investigate whether topiramate would reduce basal levels of anxiety and ethanol-withdrawn induced anxiety in male rats; the elevated plus maze (EPM) was used as an animal model of anxiety. In Experiment 1, topiramate (0, 10, and 40 mg/kg, i.g.) and diazepam (1 mg/kg, i.p.) was acutely and repeatedly administered to naive rats. In Experiments 2 and 3, topiramate (0 or 40 mg/kg, i.g.) was acutely and chronically administered in early (72 hr after ethanol removal) and protracted (21 days after ethanol removal) ethanol-withdrawn rats, respectively. Acute and repeated topiramate treatment induced anxiolytic-like effects in naive rats. Early ethanol withdrawal increased anxiety, and acute topiramate administration counteracted the anxiogenic-like effects of ethanol removal. Protracted withdrawal did not produce lasting changes in anxiety but topiramate was equally effective at reducing anxiety in ethanol-withdrawn and control animals. Importantly, no signs of tolerance to the anxiolytic effects of topiramate were observed. In conclusion, these data support a role for topiramate in the treatment of basal levels of anxiety and ethanol withdrawal-induced anxiety. (PsycINFO Database Record


Subject(s)
Anti-Anxiety Agents/pharmacology , Anxiety/drug therapy , Fructose/analogs & derivatives , Substance Withdrawal Syndrome/drug therapy , Animals , Anti-Anxiety Agents/administration & dosage , Anxiety/etiology , Anxiety Disorders/drug therapy , Anxiety Disorders/etiology , Behavior, Animal/drug effects , Diazepam/pharmacology , Disease Models, Animal , Dose-Response Relationship, Drug , Ethanol/administration & dosage , Ethanol/adverse effects , Fructose/administration & dosage , Fructose/pharmacology , Male , Rats , Rats, Wistar , Topiramate
5.
Physiol Behav ; 147: 319-23, 2015 Aug 01.
Article in English | MEDLINE | ID: mdl-25980629

ABSTRACT

Clinical studies have shown that women during perimenopause and menopause have a higher incidence in the diagnoses of psychiatric problems compared with men. However, little literature information about the influence of spontaneous perimenopause on anxiety- and mood-related behaviors in mice is available. To this aim, we compared the behavioral responses of middle-aged and young adult female mice both in the diestrus phase in the elevated plus-maze, open field and forced swimming tests. In middle-aged mice, the duration of the estrous cycle was significantly prolonged compared to young adults, thus indicating that our middle-aged mice are in the perimenopausal period. In the elevated plus-maze test, middle-aged mice explored less the open arms when compared to young adults, suggesting an anxiogenic-like phenotype. No significant differences were observed in the estrogen plasma levels and emotional behavior in the forced swim and open field tests. In conclusion, the spontaneous failure of the estrous cycle increased anxiety in middle-aged females. These data suggest that the perimenopausal period has a significant influence on anxiety-related behaviors in female mice.


Subject(s)
Aging/physiology , Anxiety/etiology , Anxiety/physiopathology , Estrous Cycle/physiology , Animals , Anxiety/blood , Anxiety/psychology , Disease Models, Animal , Electrochemistry , Estrogens/blood , Exploratory Behavior/physiology , Female , Locomotion , Maze Learning/physiology , Mice , Single-Blind Method , Swimming/psychology
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