Prevalence of anxiety and depression among patients with glaucoma.

Purpose: This study aimed to determine the prevalence of anxiety and depression among patients with glaucoma compared to the average Brazilian prevalence (9.8% of anxiety and 5.8% of depression, according to the World Health Organization) and its correlation with the severity of the disease. Methods: This was a transversal, single-arm trial of patients from four glaucoma centers in São Paulo and Curitiba-Brazil. Patients comprised adults at least 18 years of age with glaucoma diagnosis under treatment for at least 6 months. All subjects of the study answered two questionnaires (PHQ-9 and GAD-7) to evaluate the presence of anxiety and depression, and the results were analyzed accordingly to clinical and demographic characteristics. Results: The protocol included a total of 210 patients. The average age was 61.6 ± 15.3 years, and the female gender was more common (68.86%). Primary open-angle glaucoma was the most common diagnosis (59.90%). The average IOP was 18.5 mmHg, and 1.5 anti-glaucoma drops were the mean treatment. The prevalence of depression and anxiety was 26.90 and 25.71%, respectively. Most patients with anxiety were classified as early glaucoma, while those with depression had severe glaucoma. Conclusion: This study found that the prevalence of anxiety and depression among patients with glaucoma is higher than in the general population in our country.

Caffeine intake during lactation has a sex-dependent effect on the hippocampal excitatory/inhibitory balance and pups' behavior.

During early life, disruptions in glutamatergic and GABAergic synapse development in the hippocampus may contribute to several neurodevelopmental disorders, including cognitive deficits and psychiatric disorders. Caffeine is the most consumed psychoactive drug in the world, and previous work from our group has shown that caffeine disrupts visual system connections at different stages of development. This work aimed to investigate the effects of caffeine consumption during lactation in the glutamatergic and GABAergic synaptic markers in the hippocampus and on the behavior of rat offspring. We found that maternal caffeine intake significantly reduced GluN1 subunits of the NMDA receptor, increased the GluA1/GluA2 ratio of AMPA receptor in the dorsal hippocampus, and decreased GAD content in female pups' ventral hippocampus. On the other hand, an increase in GluN1/GluN2b subunits, a decrease in GAD content in the dorsal hippocampus, and a reduction of the GluA1 content in the ventral hippocampus were observed in male pups. In addition, changes in the behavior of the offspring submitted to indirect caffeine consumption were also sex-dependent, with females developing anxiety-like behavior and males showing anxiety-like behavior and hyper-locomotion. These results highlight that maternal caffeine intake promotes changes in the hippocampal excitatory and inhibitory balance and offspring behavior in a sex-dependent manner, suggesting that the population should be alerted to reduced caffeine consumption by breastfeeding mothers.

Encefalitis autoinmune posible, debut de diabetes mellitus tipo 1 y anticuerpos Anti-GAD65: ¿Coincidencia o relación patogénica? Reporte de un caso / Possible autoimmune encephalitis, onset of type 1 diabetes, and anti-GAD65 antibodies: Coincidence or pathogenic relationship? Case report

Las encefalitis son un grupo de entidades graves caracterizadas por alteración del estado mental, alteraciones de memoria y crisis epiléptica, entre otras manifestaciones neurológicas.El sustrato neuropatológico es la inflamación del tejido cerebral debido a diversas etiologías, entre éstas, las encefalitis inmunomediadas [1]. La encefalitis por anticuerpos anti-GAD65 (AC-AntiGAD65) en niños es una entidad clínica que ha ganado reconocimiento creciente en la última década. Se caracteriza por la presencia de autoanticuerpos dirigidos contra la enzima descarboxilasa de ácido glutámico, esencial en la neurotransmisión inhibitoria del sistema nervioso central. Se manifiesta con una amplia gama de síntomas neurológicos, que dificulta su diagnóstico temprano y preciso, más aún en población pediátrica debido a la diversidad de sus manifestaciones clínicas y a la falta de criterios diagnósticos específicos [2]. En esta revisión se presenta un caso de encefalitis de probable etiología autoinmune, asociado a debut de diabetes mellitus tipo 1 y anticuerpos anti GAD65 en plasma. Palabras clave: Encefalitis, síndrome de persona rígida, encefalitis autoinmune, anticuerpos anti-Gad65.

Encephalitides are severe conditions marked by altered mental status, memory disturbances and seizures, with brain tissue inflammation as a common feature. Among them, immune-mediated encephalitides, like anti-GAD65 antibody encephalitis, have gained prominence, particularly in children. This condition involves autoantibodies against glutamic acid decarboxylase, an enzyme vital for inhibitory neurotransmission. Its wide range of neurological symptoms complicates early diagnosis, especially in pediatric cases, due to diverse manifestations and the lack of specific diagnostic criteria. This review presents a case of autoimmune encephalitis linked to the onset of type 1 diabetes and the presence of anti-GAD65 antibodies in plasma. Keywords: Encephalitis, stiff person syndrome, autoimmune encephalitis, anti-GAD65 antibodies.

Prevalencia de la ansiedad e insomnio entre los trabajadores de la salud durante la pandemia Covid-19 en Paraguay / Anxiety and insomnia prevalence amongst healthcare workers during the Covid-19 pandemic in Paraguay

RESUMEN Introducción: La pandemia de la Covid-19 ha puesto a prueba los sistemas de salud de los países en todo el mundo, generando angustia y ansiedad en la población en general; el personal sanitario, no ha sido la excepción. Objetivo: Detectar la prevalencia de ansiedad e insomnio en personal de salud pública que trabajan con pacientes y familiares Covid. Método: Estudio descriptivo transversal. Se ha aplicado la GAD-7 Generalized Anxiety Disorder) y la Escala de Insomnio de Atenas (EIA). La muestra estuvo conformada por 130 profesionales del área de la salud. El estudio se realizó en el Hospital Regional e Instituto de Previsión Social, ambos en Ciudad del Este (Paraguay), a lo largo del 2022; los datos obtenidos fueron mediante la aplicación del cuestionario mediado por el formulario Google Forms. Las principales variables fueron género, edad, titulación, experiencia profesional y horas de trabajo en la semana. Resultados: Los resultados pusieron de manifiesto que el 32,1 % de los sanitarios presentaban ansiedad, en especial, los enfermeros y los médicos, mujeres y personal más joven. Se detectó que el 29,5 % padecía de insomnio, en mayor porcentaje en mujeres y sanitarios de menor edad; los fisioterapeutas y radiólogos presentaron menos problemas de sueño. Se observó correlación entre las variables ansiedad e insomnio. Conclusión: Se detectó la prevalencia de la ansiedad e insomnio y sus factores asociados al Covid-19, en trabajadores de la salud de primera línea. Se obtuvieron síntomas de ansiedad (32,1 %) e insomnio (29,5 %). Hay necesidad de desarrollar medidas tanto generales como más específicas que prevengan o mitiguen las principales secuelas psicológicas de estos profesionales.

ABSTRACT Abstract: The Covid-19 pandemic has tested the healthcare systems of countries worldwide, causing distress and anxiety in the general population, and healthcare workers have not been an exception. Objective: To detect the prevalence of anxiety and insomnia in public healthcare personnel working with Covid patients and their families. Method: A cross-sectional descriptive study was conducted using the Generalized Anxiety Disorder 7 (GAD-7) and the Athens Insomnia Scale (AIS). The sample consisted of 130 healthcare professionals. The study took place at the Regional Hospital and the Social Security Institute in Ciudad del Este, Paraguay, throughout 2022. Data was collected using Google Forms. The main variables included gender, age, qualifications, professional experience, and weekly working hours. Results: The results revealed that 32,1 % of healthcare workers experienced anxiety, particularly nurses, doctors, women, and younger personnel. Additionally, 29,5 % suffered from insomnia, with a higher prevalence among women and younger healthcare workers, while physiotherapists and radiologists experienced fewer sleep problems. A correlation between anxiety and insomnia was observed. Conclusion: The study detected the prevalence of anxiety and insomnia and their associated factors in frontline healthcare workers during the Covid-19 pandemic. Anxiety symptoms were present in 32,1 % of participants, and 29,5 % experienced insomnia. There is a need to develop both general and more specific measures to prevent or mitigate the main psychological consequences in these professionals.

Therapeutic role of plasma exchange in the management of stiff person syndrome: experience from a tertiary care centre.

INTRODUCTION: The stiff person syndrome (SPS) is a rare and disabling neurological disorder characterized by muscle stiffness, painful spasms and rigidity involving the proximal and axial limb muscles, with an estimated incidence of 1 case per million per year. The first line of treatment for symptomatic management includes gamma-aminobutyric acid (GABA)ergic agonists, benzodiazepines and baclofen. The therapeutic plasma exchange (TPE), alone or as an adjuvant to other forms of immunomodulation, has been used as a therapeutic option, particularly in refractory cases. METHODS: An observational study was performed to review SPS patient symptoms, comorbidities, electromyography (EMG) studies and treatment, identifying autoantibodies, therapeutic plasma exchange (TPE) procedural details and clinical response. MAIN RESULTS: Five patients (4 male and one female) were treated with TPE during the study period as adjuvant therapy. The average age was 47 years (range 34 - 61 years), and anti-glutamic acid decarboxylase 65-kilodalton isoform (anti-GAD65) antibodies were positive in 80 % (4/5) of the patient population. All patients received immunosuppressive drugs along with TPE. Four patients received TPE during the first admission and one received it during the third hospital admission. All patients showed good improvement immediately after TPE, but it was not a sustainable effect. CONCLUSION: TPE may be helpful as adjuvant therapy for SPS patients to provide relief from clinical symptoms.

Clinical and epidemiological profile of patients with mental disorders in a specialized outpatient clinic and its role in the psychosocial care network.

Introduction: Mental health disorders (MHDs) are responsible for much impairment of quality of life in Brazil and worldwide. Early diagnosis and effective treatment strategies are required due to the heterogeneous symptoms and multifactorial etiology. Methods: A descriptive retrospective observational study was performed aiming to characterize the clinical and psychiatric profiles of patients with MHD attending a Brazilian public tertiary psychiatric outpatient clinic, which is a reference health service for more than 2 million inhabitants. Predominant clinical and sociodemographic aspects of patients were evaluated between March 2019 and March 2021. Results: A total of 8,384 appointments were analyzed. The majority of patients were female, and the mean age was 45 years old. Generalized anxiety disorder (GAD) was the most common MHD. The prevailing symptoms were sadness, anxiety, and irritability, with the most prescribed medications being selective serotonin reuptake inhibitors. Conclusion: The epidemiological characterization of mental disorders in specialized mental health outpatient clinics provides evidence for the establishment of more specific protocols and advocates a dimensional transdiagnostic approach as an aid to public mental health services.

An animal model of trait anxiety: Carioca high freezing rats as a model of generalized anxiety disorder.

Despite being one of the main components of anxiety and playing a pivotal role in how an individual perceives and copes with anxiogenic situations or responds to a given treatment, trait anxiety is paradoxically omitted in most animal models of anxiety. This is problematic and particularly more concerning in models that are used to screen drugs and other treatments for specific anxiety disorders and to investigate their neurobiological mechanisms. Our group has been engaged in the search for specific anxiety-related traits in animal models of anxiety. We developed two new lines of rats with strong phenotypic divergence for high (Carioca High-conditioned Freezing [CHF]) and low (Carioca Low-conditioned Freezing [CLF]) trait anxiety as expressed in the contextual fear conditioning paradigm. Here, we summarize key behavioral, pharmacological, physiological, and neurobiological differences in one these lines, the CHF rat line, relative to randomized-cross controls and discuss how far they represent a valid and reliable animal model of generalized anxiety disorder and so high trait anxiety.

Anxiety and depression in healthcare workers during the COVID-19 pandemic / Ansiedade e depressão em profissionais da saúde durante a pandemia da COVID-19

Objective To investigate the prevalence and associated factors of depression and anxiety among hospital healthcare workers during the COVID-19 pandemic in the extreme south of Brazil. Method Cross-sectional study was conducted with 264 healthcare workers, between August and December 2020. Depression and anxiety were assessed using the Patient Health Questionnaire and the Generalized Anxiety Scale. Multivariable linear regression analysis was performed. Results The prevalence of depression and anxiety among healthcare workers was 32.4% and 26.2%, respectively. The profession of nursing technician, having a family member who had lost a job, being responsible for family income, being 50 or more years old, being divorced or widowed, having a test for COVID-19, having suffered a traumatic event in life and having received psychological counseling at work were associated with depression and anxiety. Conclusion In this study, receiving psychological counseling at work was a protective factor for anxiety and depression.

Objetivo Investigar a prevalência e os fatores associados à depressão e ansiedade entre profissionais de saúde durante a pandemia de COVID-19 no extremo sul do Brasil. Método Estudo transversal realizado com 264 profissionais de saúde, entre agosto e dezembro de 2020. Depressão e ansiedade foram avaliadas por meio do Questionário de Saúde do Paciente e da Escala de Ansiedade Generalizada. Foi realizada análise de regressão linear multivariável. Resultados A prevalência de depressão e ansiedade entre os profissionais de saúde foi de 32,4% e 26,2%, respectivamente. Ser técnico de enfermagem, ter familiar que tenha perdido o emprego, ser responsável pela renda familiar, ter 50 anos ou mais, ser divorciado/viúvo, ter feito exame para COVID-19, ter sofrido evento traumático na vida e ter recebido aconselhamento psicológico no trabalho esteve associado a depressão e ansiedade. Conclusão Neste estudo, receber aconselhamento psicológico no trabalho foi um fator de proteção para ansiedade e depressão.

Adaptación y análisis psicométrico del cuestionario de ansiedad generalizada (GAD-7) al Quechua Collao en Perú / Adaptation to Quechua Collao and psychometric analysis of the generalized anxiety questionnaire (GAD-7) in Puno, Peru

OBJETIVOS. Adaptar del inglés al contexto cultural y lingüístico del Quechua Collao y analizar las propie-dades psicométricas del Cuestionario de Ansiedad Generalizada de 7 ítems (GAD-7) en Puno, Perú. MATERIALES Y MÉTODOS. El GAD-7 en su versión original fue traducido a la variedad del quechua Collao y se analizaron sus propiedades psicométricas, los participantes fueron bilingües (español y quechua) mayores de 18 años y de ambos sexos. Se evaluó el análisis factorial exploratorio (AFE) empleando el análisis paralelo, el análisis factorial confirmatorio (AFC) y los índices de bondad de ajuste; asimismo se analizó la fiabilidad mediante el alfa clásico y Omega de Mc Donald. RESULTADOS. Los jueces y par-ticipantes del grupo focal realizaron la adaptación cultural y lingüística del GAD-7 al Quechua Collao; el AFE reportó la presencia de un único factor (KMO=0,88, p=0,01); mientras que el AFC confirmó adecuados ajustes en el modelo unifactorial (CFI=0,994; TLI=0,991; SRMR=0,027; RMSEA=0,092), una buena confiabilidad (α=0,896; ω=0,894) y además fue invariante en grupos de edad, sexo, estado civil y grado de instrucción. CONCLUSIONES. El cuestionario presentó validez para un modelo unidimensional del GAD-7 adaptado al Quechua Collao, así como una óptima confiabilidad e invarianza por los grupos evaluados. Su uso podría beneficiar la investigación y atención de la ansiedad.

GAD-7 Generalised Anxiety Disorder scale in Colombian medical professionals during the COVID-19 pandemic: Construct validity and reliability.

INTRODUCTION: The detection of anxiety symptoms among health workers who care for patients infected with COVID-19 is a current priority. Fast and valid instruments are required for this population group. The objective is to establish the construct validity and reliability of the Generalised Anxiety Disorder (GAD-7) scale in Colombian doctors during the COVID-19 lockdown. METHODS: E-health study, in which cross-sectional data were collected online (n = 1030) from 610 COVID doctors and 420 non-COVID doctors, during the Colombian lockdown, between 20 April and 10 August 2020. Each subject was contacted, and they confirmed their participation, identity and professional role. RESULTS: A single factor factorial structure was found, made up of the 7 items of the instrument, which managed to explain 70% of the variance. The goodness of fit indices (RMSEA = 0.080; CFI = 0.995; SRMR = 0.053; p < 0.001) showed an "acceptable" unidimensionality and adequate factor loadings in each item of the GAD-7, >0.070. Finally, the internal consistency of the instrument was good, with a Cronbach's alpha of 0.920 (95%IC, 8.80-9.71). CONCLUSIONS: The GAD-7 is an instrument that presents adequate indicators of validity and reliability. It is an excellent tool that is reliable and easy and fast to use for the detection of generalised anxiety symptoms in medical personnel caring (or not) for patients infected with COVID-19.

Escala de ansiedad generalizada GAD-7 en profesionales médicos colombianos durante pandemia de COVID-19: validez de constructo y confiabilidad

Introducción: La detección de síntomas de ansiedad entre el personal sanitario que atiende a pacientes contagiados de COVID-19 es una prioridad actual. Se requieren instrumentos rápidos y válidos para esta población. El objetivo es establecer la validez de constructo y la confiabilidad de la Escala de Ansiedad Generalizada (GAD-7) en médicos colombianos durante la cuarentena por la COVID-19. Métodos: Estudio eSalud, en el que se recopilaron datos transversales en línea (n = 1.030) de 610 médicos de COVID y 420 no de COVID durante la cuarentena colombiana, entre el 20 de abril y el 10 de agosto de 2020. Se contactó con cada sujeto, que confirmó participación, identidad y función profesional. Resultados: Se encontró una estructura factorial de 1 solo factor, conformado por los 7 ítems del instrumento, que logró explicar el 70% de la varianza. Los índices de bondad de ajuste (RMSEA = 0,080; CFI = 0,995; SRMR = 0,053; p 0,07. Por último, la consistencia interna del instrumento fue buena, con alfa de Cronbach = 0,920 (IC95%,8,80-9,71). Conclusiones: El GAD-7 es un instrumento que presenta indicadores adecuados de validez y confiabilidad. Es un excelente instrumento, confiable, fácil y rápido de usar para la detección de los síntomas de ansiedad generalizada en personal médico, atienda o no a pacientes contagiados de COVID-19.

Introduction: The detection of anxiety symptoms among health workers who care for patients infected with COVID-19 is a current priority. Fast and valid instruments are required for this population group. The objective is to establish the construct validity and reliability of the Generalized Anxiety Disorder (GAD-7) scale in Colombian doctors during the COVID-19 lockdown. Methods: E-health study, in which cross-sectional data were collected online (n = 1,030) from 610 COVID doctors and 420 non-COVID doctors, during the Colombian lockdown, between 20 April and 10 August 2020. Each subject was contacted, and they confirmed their participation, identity and professional role. Results: A single factor factorial structure was found, made up of the 7 items of the instrument, which managed to explain 70% of the variance. The goodness of fit indices (RMSEA = 0.080; CFI = 0.995; SRMR = 0.053; p 0.070. Finally, the internal consistency of the instrument was good, with a Cronbach's alpha of 0.920 (95%IC, 8.80-9.71). Conclusions:The GAD-7 is an instrument that presents adequate indicators of validity and reliability. It is an excellent tool that is reliable and easy and fast to use for the detection of generalised anxiety symptoms in medical personnel caring (or not) for patients infected with COVID-19.

Development of an immunoassay for the simultaneous detection of GADA and ZnT8A in autoimmune diabetes using a ZnT8/GAD65 chimeric molecule.

Introduction: The combined presence of autoantibodies to the 65 kDa isoform of glutamic acid decarboxylase (GADA) and to the islet-specific cation efflux transporter ZnT8 (ZnT8A) in serum is the best predictive sign of the loss of immune tolerance and the clinical manifestation of autoimmune diabetes mellitus (DM). The screening of GADA and ZnT8A could help to reach to a correct diagnosis and to start an early and adequate treatment. The aim of the study was to develop an immunoassay for the simultaneous detection of these autoantibodies using a chimera molecule that includes the immunodominant regions of ZnT8 and GAD65, expressed by baculovirus-insect cells system. Materials and Methods: ZnT8/GAD65 was expressed using the Bac to Bac™ baculovirus expression system. The recombinant chimera was purified by an His6-tag and identified by SDS-PAGE and western blot analysis, and by an indirect ELISA using specific antibodies against ZnT8 and GAD65. A fraction of ZnT8/GAD65 was biotinylated. A bridge ELISA (b-ELISA) was developed using ZnT8/GAD65 immobilized in polystyrene microplates, human sera samples from healthy individuals (n = 51) and diabetic patients (n = 49) were then incubated, and afterwards ZnT8/GAD65-biotin was added. Immune complexes were revealed with Streptavidin-Horseradish Peroxidase. Results were calculated as specific absorbance and expressed as standard deviation scores: SDs. Results: ZnT8/GAD65 was efficiently produced, yielding 30 mg/L culture medium, 80% pure. This recombinant chimera retains the immunoreactive conformation of the epitopes that are recognized by their specific antibodies, so it was used for the development of a high sensitivity (75.51%) and specificity (98.04%) b-ELISA for the detection of ZnT8A and/or GADA, in a one-step screening assay. The ROC curves demonstrated that this method had high accuracy to distinguish between samples from healthy individuals and diabetic patients (AUC = 0.9488); the cut-off value was stablished at 2 SDs. Conclusions: This immunoassay is useful either to confirm autoimmune diabetes or for detection in routine screening of individuals at risk of autoimmune DM. As DM is a slow progress disease, remaining asymptomatic for a long preclinical period, serological testing is of importance to establish a preventive treatment.

Systemic Chronic Treatment with Cannabidiol in Carioca High- and Low-Conditioned Freezing Rats in the Neuropathic Pain Model: Evaluation of Pain Sensitivity.

Studies have shown high comorbidity of anxiety disorder and chronic pain; generalized anxiety disorder (GAD) and neuropathic pain are among these pathologies. Cannabidiol (CBD) has been considered a promising treatment for these conditions. This study investigated whether chronic systemic treatment with CBD alters pain in high- (CHF) and low-freezing (CLF) Carioca rats (GAD model) and control rats (CTL) submitted to chronic neuropathic pain. The rats were evaluated in the sensory aspects (von Frey, acetone, and hot plate tests) before the chronic constriction injury of the ischiatic nerve (CCI) or not (SHAM) and on days 13 and 23 after surgery. Chronic treatment with CBD (5 mg/kg daily) was used for ten days, starting the 14th day after surgery. The open field test on the 22nd also evaluated locomotion and anxiety-like behavior. CBD treatment had an anti-allodynic effect on the mechanical and thermal threshold in all lineages; however, these effects were lower in the CHF and CLF lineages. Considering emotional evaluation, we observed an anxiolytic effect in CTL+CCI and CHF+CCI after CBD treatment and increased mobility in CLF+SHAM rats. These results suggest that the CBD mechanical anti-allodynic and emotional effects can depend on anxiety level.

Real-world data of non-invasive stimulation of the human insula-prefrontal cortices using deep TMS to treat anxiety for occupational stress and generalized anxiety disorder.

Activation of the insula is found in all anxiety-related disorders and increased insular-prefrontal cortex (PFC) functional connectivity is associated with reduced anxiety. In this study, the combined stimulation of the insula and PFC using the dTMS H4 (insula+LPFC) and H2 (PFC) coils were used to reduce anxiety in 13 subjects experiencing occupational stress, and 55 participants suffering from generalized anxiety disorder (GAD). The combined HF stimulation of the insula and PFC significantly decreased anxiety scores according to the HARS, CAS, and STAI anxiety scales, leading to a reduction in anxiety according to HARS of 88.7% and 70.7% in participants with occupational stress and the clinical sample of participants diagnosed with GAD, respectively. The findings suggest that the prefrontal-insular axis is critical for the regulation of anxiety and its stimulation can be used for the treatment of anxiety in people suffering from occupational stress and GAD.

Psychometric Properties of the Generalized Anxiety Disorder 7-item Scale in Adolescents: An Effective Screening Tool for School and Community Settings.

OBJECTIVE: Anxiety disorders are prevalent among children and adolescents. Identifying anxiety symptoms in primary care, school, and community settings has implications for service planning, resource allocation, and prevention and treatment programming. The Generalized Anxiety Disorder 7-item (GAD-7) scale is a commonly used instrument for evaluating anxiety symptoms. Still, it has yet to be validated in vulnerable groups, such as Spanish-speaking adolescents who are at risk due to socioeconomic disadvantages. METHODS: This study aimed to examine the psychometric properties of the Spanish version of the GAD-7 for adolescents in a sample of middle and high school students in Puerto Rico. Secondary data from 566 students in fifth to twelfth grade in Puerto Rico were collected as part of a school-based services program. RESULTS: A confirmatory factor analysis evidenced the 1-factor structure of the GAD-7, while a test of invariance supported the equality of the factor loadings across gender and school level. The scores of the GAD-7 showed positive and significant correlations with the 8-item Patient Health Questionnaire depression scale-providing evidence of convergent validity-and the reliability estimates of the GAD-7 were adequate. CONCLUSION: Thus, the GAD-7 has optimal psychometric properties in terms of construct and convergent validity and internal consistency. It is a useful instrument for assessing anxiety in Spanish speaking youth in Puerto Rico.

Measurement invariance of the GAD-5 Generalized Anxiety Disorder Scale in a Mexican general population sample.

The primary objective of this study was to evaluate the measurement of invariance by sex, age, and educational level of an online version of the Generalized Anxiety Disorder Scale in a five-item version (GAD-5). Configural, metric, scalar, and strict invariance were evaluated using data from 79,473 respondents who answered a mental health questionnaire during the COVID-19 pandemic in Mexico. The sex variable was classified as male or female; age was categorized as minors, youth, young adults, adults, and older adults; and educational level was divided into basic, upper secondary, higher, and graduate education. To test for configural invariance, confirmatory factor models were constructed. For metric invariance, equality restrictions were established for the factor loadings between the construct and its items; for scalar invariance, equality restrictions were established between the intercepts; strict variance implied the additional restriction of the residuals. Statistical analysis was performed in R software with the lavaan package. The results show that with respect to sex, age, and educational level, configural and metric measurement invariance was confirmed (ΔCFI < 0.002; ΔRMSEA < 0.015). However, with respect to scalar and strict invariance, the results showed significant differences regarding the fit model (ΔCFI > 0.002; ΔRMSEA > 0.015). We conclude that the GAD-5 presents configural and metric invariance for sex, age, and educational level, and scalar invariance for sex and age groups. However, the scale does not demonstrate strict invariance. We discuss the implications and suggest that this result could be related to the evaluation of sociodemographic variables.

The evaluation of pancreas β-cell autoantibodies in non-diabetic COVID-19 patients

ABSTRACT Objective: This study aims to evaluate potential pancreas endocrine damage due to SARS-CoV-2 by measuring β-cell autoantibodies in COVID-19 patients. Subjects and methods: Between June and July 2020, 95 inpatients with a positive COVID-19 test result after polymerase-chain-reaction (PCR) and who met the inclusion criteria were enrolled in our study. Laboratory parameters that belong to glucose metabolism and β-cell autoantibodies, including anti-islet, anti-glutamic acid decarboxylase, and anti-insulin autoantibodies, were measured. β-cell autoantibodies levels of the patients were measured during COVID-19 diagnosis. Positive results were reevaluated in the 3rd month of control. Results: In the initial evaluation, 4 (4.2%) patients were positive for anti-islet autoantibody. Only one (1.1%) patient was positive for anti-glutamic acid decarboxylase autoantibody. No patient had positive results for anti-insulin autoantibody. FPG, HbA1c, and C-peptide levels were similar in patients who were split into groups regarding the initial positive or negative status of anti-islet and anti-GAD autoantibodies (p>0.05). In the 3rd month after the initial measurements, anti-islet autoantibody positivity of 2 (50%) of 4 patients and anti-glutamic acid decarboxylase positivity of 1 (100%) patient were persistent. Finally, 3 (3.1%) patients in the whole group were positive for anti-islet autoantibody in the 3rd month of control. No difference was determined between the initial and the 3rd month of parameters of glucose metabolism. Conclusion: Following an ongoing autoantibody positivity in the present study brings the mind that SARS-CoV-2 may be responsible for the diabetogenic effect. Clinicians should be aware of autoantibody-positive DM as a potential autoimmune complication in patients with SARS-CoV-2.

Neuropsychiatric and sleep study in autosomal dominant dopa-responsive dystonia.

Introduction: Although the diurnal fluctuation of motor dysfunction, reversible with small doses of dopamine, is a cornerstone for the phenotype of the autosomal dominant Segawa syndrome, the non-motor symptoms of this neurotransmitter deficiency have still received limited attention. Objective: This study aims to evaluate non-motor symptoms of this dopa-responsive dystonia through an intrafamilial comparative cross-sectional study. Methods: Seventeen individuals with a c.IVS5 + 3insT (c.626 + 3insT) variation in the GTP cyclohydrolase-1 gene (GCH1, HGNC: 4193) and 34 intrafamilial controls were studied using the Beck Depression Inventory-II, the Wiener Matrizen Test 2, the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index, the MINI/MINI PLUS Questionnaires, the World Health Organization Quality of Life - BREF Instrument and a drug use assessment questionnaire. Results: No significant difference was found between the groups in the prevalence of sleep disorders and in cognitive function. Nevertheless, generalized anxiety disorder (p = 0.050) and attention-deficit/hyperactivity disorder in childhood (p = 0.011) were observed only in individuals without the molecular variation. The group with the GCH1 variation presented a worse perception about how safe they feel in their daily lives (p = 0.034), less satisfaction with themselves (p = 0.049) and with their relationships (p = 0.029), and a higher prevalence of past major depressive episodes before use of L-Dopa (p = 0.046). Conclusion: Low dopamine could have been protective against generalized anxiety disorder and attention-deficit/hyperactivity disorder in childhood in Segawa group individuals. The prevalence of depression was higher in individuals with the molecular variant prior to the L-Dopa treatment. Considering it, the penetrance estimates for the variant carriers increased from 58.8% to up to 88% in this large studied family. Additionally, neuropsychiatric tests of all individuals with a molecular diagnosis in an affected family are a valuable instrument for its clinical management.

Second Wave of COVID-19 Pandemic in Argentinian Population: Vaccination Is Associated With a Decrease in Depressive Symptoms.

Background: Since the irruption of the coronavirus disease 2019 (COVID-19) the planet has submerged in a time of concern and uncertainty, with a direct impact on people's mental health. Moreover, the recurrent outbreaks that periodically harry different regions of the world constantly refocus people's concerns to the pandemic. Yet, each new wave heats the diverse countries in different situations, including the advances in their vaccination campaigns. In this research, we studied the levels of the general anxiety disorder (GAD) and depression in the Argentine population across the first and second waves of infections that occurred in our country. Methods: We conducted an on-line survey, within each peak of the pandemic. People were asked to self-report GAD and depression symptoms using the GAD-7 and PHQ-9 questioners, inform their vaccination status, the frequency they performed physical activity as well as working condition and modality. Here, we identified the more vulnerable groups and evaluated factors that could mitigate the rise of these mental disorders, focusing on vaccination. Results: Our data shows that reported GAD and depression levels were higher during the second wave than during the first one. More importantly, vaccinated people were less depressed than non-vaccinated people, while GAD levels remained equivalent in both groups. Other factors directly associated with lower GAD and depression levels were performing frequent physical activity and being employed, regardless of the employment modality. These observations were replicated in different age ranges and genders. Conclusion: This work evidences GAD and depression in different pandemic waves in Argentina, as well the factors that may contribute to reducing the magnitude of these disorders, including vaccination.

Food insecurity and symptoms of anxiety and depression disorder during the COVID- 19 pandemic: COVID-Inconfidentes, a population-based survey.

This study aimed to investigate the association between adult food insecurity (FI) and symptoms of generalized anxiety disorder (GAD) and major depressive disorder (MDD) in two Brazilian cities during the coronavirus disease (COVID-19) pandemic. This study used data derived from a cross-sectional survey of 1693 adults. Interviews were conducted using an electronic questionnaire. The FI was measured using the Brazilian Food Insecurity Scale. The Generalized Anxiety Disorder-7 was used to measure the symptoms of GAD. The Patient Health Questionnaire-9 was used for MDD symptoms. The association between FI, GAD, and MDD symptoms was investigated using a Poisson regression model with robust variance to estimate the prevalence ratio and 95% confidence interval (95% CI). In regression models, a linear association between FI levels and outcomes was observed, with severe food insecurity having a 3.56 higher prevalence of GAD symptoms (95% CI: 2.23, 5.68) and a 3.03 higher prevalence of MDD (95% CI: 1.55, 5.90). In the stratified analyses, worse results were observed for females and males, individuals with non-white race/skin color, those without children, and those with lower monthly family income. In conclusion, the FI was associated with symptoms of GAD and MDD, and the sociodemographic characteristics interfered in this association. Therefore, we recommend the improvement of public health and social protection policies for food-insecure people.