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Hospital Anxiety and Depression Scale

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Hospital Anxiety and Depression Scale - Volume 152 Issue 3 - R. P. Snaith

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... The HADS comprises 14 items, with seven allocated to a depression subscale and seven to an anxiety subscale. Snaith (2003) suggested that a HADS scale below 11 indicates the presence of anxiety and depressive symptoms, signifying 'caseness' to a mood illness. In this study, the variable was treated as a continuous measure with defined cut-off points. ...
... In this study, the variable was treated as a continuous measure with defined cut-off points. 35 To study violence, we adapted the screening questions proposed by the APAV to detect potential victims of psychological, physical or sexual abuse. 36 We employed Cronbach's alpha to evaluate the reliability of the violence scale, which contributes to ensuring the overall validity of the instrument. ...
... Additionally, the internal consistency of the violence scale was assessed using Cronbach's alpha to measure reliability, resulting in a Cronbach alpha of 0.846, considered good. 35,36 No items were eliminated based on the item scales, and all items remained relevant for the analysis. ...
Article
Objective This study aimed to evaluate psychological and emotional violence in relation with sociodemographic characteristics and anxiety and depression symptoms during the COVID-19 pandemic in a sample of Portuguese residents. Methods A cross-sectional online study using snowball sampling collected data on demographics, socioeconomic factors, mental health (anxiety and depression symptoms) and couple psychological and emotional violence. The study spanned three months and included 519 individuals aged 18 or above in a relationship since January 2020 or earlier. Data analysis involved descriptive statistics, t-tests, chi-squared tests, logistic regression models (Odds-Ratio [OR] and 95% Confident Interval [CI]), and cluster analysis (K-medoids) using R software (significance threshold of 0.05). Results The sample was predominantly composed of women (78.8%) with an average age of 36.8 years and 79% holding higher education degrees. Two clusters emerged: Cluster 1 (n = 420) presented fewer psychological and emotional violence victims, while Cluster 2 (n = 99) presented more. Older age (OR = 1.026, 95%CI 1.000–1.052) and depression symptoms (OR = 1.163, 95%CI 1.080–1.252) increased the likelihood of psychological and emotional abuse. Men also had 2.87 times higher odds of being victims (95%CI 0.203–0.599). Conclusions The study underscores the need for comprehensive interventions and prevention measures to address psychological and emotional violence by acknowledging it as a public health concern and pushing for interdisciplinary methods.
... Symptoms of anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS) (19,20), a 14-item measure of psychological distress divided into two subscales: anxiety (HADS-A) (seven items) and depression (HADS-D) (seven items), with a score range of 0-21 for each subscale. Scores below 8 are considered nonclinical, scores from 8 to 10 as suggestive, and scores of 11 and above as probable presence of mood disorder (19). ...
... Symptoms of anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS) (19,20), a 14-item measure of psychological distress divided into two subscales: anxiety (HADS-A) (seven items) and depression (HADS-D) (seven items), with a score range of 0-21 for each subscale. Scores below 8 are considered nonclinical, scores from 8 to 10 as suggestive, and scores of 11 and above as probable presence of mood disorder (19). ...
Article
Objectives Explore short-term effects of “The Caregiver Pathway,” an intervention for family caregiver follow-up, on Post-Intensive Care Syndrome symptoms among families (PICS-F). Design A randomized controlled trial. Setting A medical ICU at a Norwegian University Hospital. Participants One hundred ninety-six family caregivers of critically ill patients randomized to an intervention ( n = 101) or control group ( n = 95). Interventions “The Caregiver Pathway” four-step model offers individual and structured follow-up, including: 1) mapping family caregivers’ needs and concerns with an assessment tool followed by a conversation with an ICU nurse within the first days at the ICU, 2) a supportive card when leaving the ICU, 3) offer for the family caregivers to receive a phone call after ICU patient discharge, and 4) a follow-up conversation within 3 months. Measurements and Main Results Data were collected at baseline and after 3 months and analyzed using linear regression. No significant effects were detected when comparing all participants completing 3-month outcome measurements ( n = 144). A subgroups analysis stratified on patient survival, however, showed statistically significant effect for family caregivers of patients surviving the ICU stay receiving the intervention compared with controls. Caregivers of surviving patients reported improved symptoms related to post-traumatic stress disorder, measured by Impact of Event Scale-Revised (B = –8.2 [95% CI, –14.2 to –2.2]; p = 0.008), anxiety (B = –2.2 [95% CI, –4.0 to –0.5]; p = 0.014), and depression (B = –1.5 [95% CI, –2.9 to –0.1]; p = 0.035); measured by the Hospital Anxiety and Depression Scale, subscore physical functioning in health-related quality of life (B = 9.7 [95% CI, 0.3–19.0]; p = 0.043); measured by Short Form 12-Item Health Survey; and hope (B = 2.4 [95% CI, 0.4–4.3]; p = 0.017) and measured by the Herth Hope Index. At 3-month, the model did not appear to improve the outcomes for family caregivers of nonsurviving patients. Conclusions “The Caregiver Pathway” intervention was associated with reduced symptoms of PICS-F in family caregivers of surviving ICU patients compared with controls.
... The HADS contains 14 items: 7 for anxiety and 7 for depression. When the HADS scale score reaches 11, as Snaith (2003) recommends, the presence of anxiety and depressive symptoms is considered indicative of "caseness" to a mood illness [37]. Understanding that the HADS scale is a screening tool and does not provide a formal diagnosis is critical. ...
... The HADS contains 14 items: 7 for anxiety and 7 for depression. When the HADS scale score reaches 11, as Snaith (2003) recommends, the presence of anxiety and depressive symptoms is considered indicative of "caseness" to a mood illness [37]. Understanding that the HADS scale is a screening tool and does not provide a formal diagnosis is critical. ...
Article
Background: The COVID-19 pandemic led to widespread lockdowns and remote work and educational practices that have impacted the lives of many families. Objective: We aimed to investigate how parents and caregivers altered their routines due to online schooling and teleworking, exploring their association with increased anxiety and depression symptoms. Methods: We conducted an online cross-sectional study and collected data through snowball sampling. We asked questions about age, gender, dwelling area, educational level, and marital status, as well as an open-ended question about teleworking and homeschooling - "Did your routine change due to your children being forced to stay home and take online classes? If so, please explain how it has influenced your personal and professional life, both positively and negatively". Thematic analysis was used to analyse the responses. Results: A total of 181 respondents, primarily women (72.4%), averaging 36.6 years old, holding bachelor's degrees (44.2%), were included. About 78.5% reported routine adjustments. Four salient themes emerged: 1) Perceived changes in professional and personal life, 2) Perceived changes in learning methods, 3) Mental health issues and 4) Perceived advantages of working from home with children at online school. Regarding mental health, 25.4% exhibited symptoms of anxiety, and 7.7% displayed depression symptoms, predominantly linked (80%) to the pandemic's impact. Conclusion: Family routines were disrupted, causing stress. In future crises, policymakers, public health experts, and researchers must acknowledge these challenges to mitigate negative consequences. Simultaneously, they should focus on strategies that enhance the positive aspects of restrictive measures and related policies.
... 2024;22:1-7 symptoms; 8-15, possible case of anxiety or depression; and 16-21, probable case of anxiety or depression. (16) We measured EDA using an MP36R, a portable, noninvasive instrument from Biopac Systems Inc., USA, following the Psychophysiology American Society guidelines. (17) The chosen technique was exosomatic with constant electric flow of 0.5 Volts, sampling rate of 200,000 Hz (Hertz), high pass filter off, low pass filters at 66.5 Hz and 38.5 Hz, with disposable electrodes of silver hydrochloride and without any external stimuli. ...
... (7) In addition, the HDSS is easy to reproduce and understand, with adequate sensitivity to better assess patients with HH. To measure patients' anxiety and depression, we chose the HADS, (16) a tool widely used and validated in various hospital centers as well as in community medical practice, as an aid in measuring psychological distress secondary to multiple pathologies. The intensities of palmar and plantar sweating were significantly higher in the HH Group than in the Control Group (p<0.01). ...
Article
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Objective To objectively evaluate sweat intensity in patients with primary hyperhidrosis by measuring electrodermal activity using a continuous exosomatic technique without external stimuli. Methods This prospective and transversal study analyzed 10 patients with palmoplantar hyperhidrosis (HH Group) and 10 individuals without it (Control Group) between January and August 2023. All participants underwent one clinical evaluation and completed two multiple-test questionnaires without any intervention from the interviewer, based on their own estimates of sweat perception and anxiety or depression symptoms. Then, the electrodermal activity was measured with the MP36R, a portable instrument from Biopac Systems Inc. (USA), using exosomatic and direct current techniques. Data were tested for normality using the Shapiro-Wilk test. Descriptive statistics were expressed as medians and interquartile ranges (p25-75) for numerical variables and as absolute and relative frequencies for categorical variables. Fisher's exact test and Mann-Whitney U test were used to compare the groups. Statistical significance was set at p<0.05. Results Palmoplantar sweating was significantly higher in the HH Group than in the Control Group (p<0.01). There were no statistically significant differences in anxiety and depression levels between the groups (p=0.87; p=0.32). Continuous exosomatic electrodermal activity resulted in significantly higher skin conductance in patients with hyperhidrosis than in controls. Conclusion Continuous exosomatic electrodermal activity without external stimuli proved to be suitable for the objective analysis of patients with hyperhidrosis in a non-invasive and sensitive manner.
... Emotional distress was assessed using the Hospital Anxiety and Depression scale (HADS) [19], and QoL impact was measured using the Skindex-16 adapted for AA (Skindex-AA) [20]. The HADS is scored into two separate scales: HADS Anxiety and HADS Depression. ...
... The HADS is scored into two separate scales: HADS Anxiety and HADS Depression. Each scale can range from 0 to 21 and scores of 8-10 are interpreted as borderline abnormal, while scores C 11 are considered clinically relevant [19]. The Skindex-AA consists of 16 items grouped under three domains: symptoms (four items), emotions (seven items), and functioning (five items), and these domain scores assess how hair loss affects symptoms, emotions, and functioning. ...
Article
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The present analyses report integrated results from BRAVE-AA1 (NCT03570749) and BRAVE-AA2 (NCT03899259) on the clinical benefits of baricitinib treatment on the basis of the amount of scalp hair regrowth through 52 weeks of treatment. This post hoc analysis was conducted with data from patients who were treated continuously for 52 weeks with baricitinib 4 mg or 2 mg. Clinical outcomes were assessed using the Severity of Alopecia Tool (SALT) and Clinician-Reported Outcome (ClinRO) for Eyebrow (EB) and Eyelash (EL) hair. Secondary measures included the Hospital Anxiety and Depression Scale and Skindex-16 adapted for alopecia areata. At week 52, patients were classified into three subgroups: SALT ≤ 20 response, intermediate response (achieved a 30% improvement from baseline (SALT30) without a SALT score ≤ 20), or nonresponse (never achieved SALT30). The criterion of SALT30 approximates a minimal clinical meaningful response to therapy. At week 52, with baricitinib 4 mg treatment, the greatest (70%) improvement in EB and EL was observed in responders, but approximately 50% of patients with intermediate response and 20% of nonresponders experienced complete/nearly complete EB and EL regrowth. Improvement in emotional distress was directionally related to improvements in scalp hair regrowth, while impact on quality of life was proportionately greater for the responder subgroup. Clinically meaningful regrowth in eyebrow and eyelash hair can occur in the absence of complete scalp hair regrowth after treatment with baricitinib. Emotional distress and quality of life improvement is most associated with obtaining a clinical meaningful improvement in scalp hair. BRAVE-AA1, ClinicalTrials.gov number, NCT03570749, start date, 24 September 2018; BRAVE-AA2, ClinicalTrials.gov number, NCT03899259, start date, 8 July 2019.
... The internal consistency and construct validity of the HADS has been well established (Bjelland, Dahl, Haug, & Neckelmann, 2002;P. Snaith, 1993; R. Snaith, 2002;Zigmond & Snaith, 1983). The HADS is widely used in clinical and community settings (Herrmann, 1997;Kyriacou, Treasure, & Schmidt, 2008;Sumnall, Beynon, Conchie, Riley, & Cole, 2007). ...
... The PC-PTSD scale contains four dichotomous 'yes' -'no' questions. A score of three out of four has been found to correctly identify PTSD in women and in men (R. Snaith, 2002). ...
Thesis
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Violence vicimisation cannot be viewed in isolation - it almost always impacts primary and secondary victim/survivors' cognitive and physiological functioning. Victimisation likely results in a variety of maladaptive coping behaviours. This thesis examined the interplay between victimisation of what many refer to as "domestic violence", mental health impacts and related alcohol and/or other drug use as a coping strategy. The overall aim of the study was to examine the prevalence and nature of the association between Intimate Partner Violence (IPV) victimisation, mental health problems and behavioural responses in a sample of women already in contact with a government or non-government support service. The uniqueness of this study can be seen in that different forms of IVP victimisation (later referred to as 'Victim Types') were examined in their association with different (single or co-occurring) mental health problems and psychoactive substance use issues. Although this thesis presents results of the study in a scientific way, which may be perceived as 'objective' or 'impersonal', it should be noted that the experience of violence is highly personal and often devastating for primary and secondary victims (e.g., children).
... ' The literature review was intended to gather a list of relevant cancer pain assessment questionnaires and previous cancer pain assessment guidelines. We retrieved and focussed our review on advanced cancer patients distress scale, [8] Cost-Prom Patient-reported outcome measure, [9] palliative outcome scale, [10] hospital anxiety and depression scale, [11][12][13][14] MPQ, [15] short form MPQ (SF-MPQ-2), [16][17][18] and revised SF-MPQ-2, [19] Brief Pain Inventory (BPI), [20] and Hindi Brief Pain Inventory, [21] Edmonton symptom assessment schedule, [22,23] The European Organization for Research and Treatment of Cancer (EORTC QLQ-C30), [24,25] Functional Assessment of Chronic Illness Therapy-spiritual well-being scales (FACIT-Sp 12) [26] and cancer pain assessment scales. In addition, we also reviewed the unidimensional scale, visual analogue scale, [27][28][29] numeric rating scale [30,31] , and verbal rating scale. ...
... Statistical analysis was using the IBM SPSS Version 22.0 and STATA 12.0. [11] Bjelland I et al. 2002 [12] Snaith RP et al. 2003 [13] Le Fevre P 1999 [14] 5. ...
Article
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Objectives Cancer pain has all the components of total pain such as physical, social, psychological, and spiritual. These components contribute to the overall pain experience in cancer patients. Many instruments have been developed till date to assess the effect of pain in cancer patients but none of the instruments include all components of total pain. In this article, we describe the development and validation of the total pain scale (TPS) for the evaluation of total pain in cancer patients with pain. This study aimed to develop and validate a questionnaire for the evaluation of total pain in cancer patients with pain. Material and Methods This study included a review of existing pain questionnaires for cancer pain for item pool generation. Items were generated in the Hindi language by six stakeholders to create 23 items to develop TPS. TPS was applied to 300 Hindi-speaking cancer patients. Bivariate correlation was used to reduce the number of items as well as construction of the domain followed by factor analysis to finalise TPS. Confirmatory factor analysis (CFA) was performed for testing the validity and reliability of TPS. Results TPS is an 18-item scale composed of four domains (physical, social, spiritual and psychological domain). The internal consistency of TPS and its subscales was found to be very good (a = 0.84–0.88). CFA and structural equation modeling Goodness of fit has confirmed that model 4 is the best fit as it yielded a lesser root-mean-squared error of approximation value of 0.062 and a greater comparative fit index, Tucker-Lewis index value of 0.944. The convergent and divergent validity of TPS and its domain was good. Conclusion This study reports TPS to be a brief (18-item), valid, and reliable questionnaire in the Hindi language for assessment of all components of total pain in cancer patients with pain.
... The Hospital Anxiety and Depression Scale (HADS; Zigmond & Snaith, 1983) is the most widely used instrument for assessments of degrees of subclinical and diagnosable depression and anxiety in people in physically poor health (Snaith, 2003) and is also popular for studies of healthy individuals (e.g., Gilbert & Meyer, 2004). Controversy exists over the factor structure of responses to this questionnaire. ...
... The HADS (Zigmond & Snaith, 1983; see also Snaith, 2003) was employed to measure levels of anxiety and depression. Each item of this questionnaire asks the respondent to select one of four phrases describing intensity or frequency of a particular affective state over the previous week; seven of the items relate to anxiety (one in terms of positive affect) and seven relate to depression (five with terms for clearly positive affect). ...
Article
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Health Psychology Update (journal of the Health Psychology secion of the British Psychological Society) 14(2) 45-50 (2005). In the widely used Hospital Anxiety and Depression Scale (HADS) most of the items forming the Depression subscale use terms for a pleasant state of mind, whereas most of the items in the Anxiety subscale mention aversive states. Thus the constructs assessed may relate respectively to absence of positive affect and presence of negative affect, rather than to the different sorts of affect intended. In the present study this hypothesis was partly supported by factor analyses of responses to the HADS in a healthy group and in a group with the rheumatic disease Sjögren’s syndrome. Re-analysis showed that it may be feasible to create an eight-item instrument that distinguishes anxiety items from depression items while having items with positive valence in equal number to items with negative valence in each subscale. Patients’ own descriptions and categorisations of such items should be used to develop an affect-balanced and somatic-free inventory that then may be able to separate anxiety from depression among healthy and physically ill populations.
... A score of 8 or higher on HADS-A indicates symptoms of anxiety with a specificity of 0.78 and a sensitivity of 0.90 whereas a score of 8 or higher on HADS-D correlates with symptoms of clinical depression with a specificity of 0.79 and a sensitivity of 0.83. 14,15 Scores between 0 and 7 are within the normal range, scores 8e10 indicate mild symptoms, 11e14 moderate and scores 15e21 indicate severe anxiety or depression, respectively. ...
... The Hospital Anxiety and Depression Scale (HADS) consists of 14 items, with seven relating to the anxiety dimension (HADS-A) and the remaining seven relating to the depression dimension (HADS-D). Lower scores on HADS-A and HADS-D reflect less anxiety and depression [24]. A validated Turkish version of the scale was used in this study [25]. ...
Article
The aim of this study was to assess whether the involvement of major salivary and lacrimal glands in primary Sjögren's syndrome (pSS) affected the psychological resilience of patients. This cross-sectional study included 116 patients with pSS. Data were collected through clinical examinations, measurement of salivary flow rates (SFRs), and from Schirmer's test, as well as from patient-reported outcome measures (PROMs), such as the European League Against Rheumatism (EULAR) Sjögren's Syndrome Patient Reported Index (ESSPRI), Brief Resilience Scale (BRS), Work Productivity and Activity Impairment (WPAI), Oral Health Impact Profile-14 (OHIP-14), and the Hospital Anxiety and Depression Scale (HADS). Hyposalivation was defined as an unstimulated SFR of ≤0.1 mL/min. The BRS score (mean ± SD = 2.60 ± 0.69) was lower in patients with recurrent parotitis (2.11 ± 0.37) than in those without recurrent parotitis (2.67 ± 0.86), in the whole group. In patients with an unacceptable symptom state (ESSPRI score ≥ 5 points), a lower BRS score was observed in patients with both hyposalivation and ocular dryness (2.59 ± 0.69) than in patients with isolated hyposalivation (2.84 ± 0.84). The BRS score was also negatively associated with the WPAI-Daily Impairment and OHIP-14 scores in patients with hyposalivation as well as with HADS-A (the seven items of HADS relating to the anxiety dimension) and HADS-D (the seven items of HADS relating to the depression dimension) in the whole group. The results suggest that psychological resilience in pSS may be affected by recurrent parotitis, the levels of anxiety and depression, as well as hyposalivation with ocular dryness.
... The depression levels of the participants were evaluated using the depression scale originally developed by Zigmond and Snaith (1983) and subsequently refined with modifications by other authors (e.g., Bjelland et al. 2002;Snaith 2003;Hansson et al. 2009;Matsudaira et al. 2009;Terluin et al. 2009) in their studies; it consists of a 10-item scale adapted from the scales in related studies. Responses to the 10 items were measured on a 5-point Likert scale ranging from 1 (=strongly disagree) to 5 (=strongly agree). ...
Article
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The aim of this study is to investigate the factors related to post-traumatic stress disorder (PTSD), depression and anxiety mental disorders, as well as the quality of life of Syrian refugees and to examine the relationships between mental health disorders and the quality of life of Syrian refugees. Data were collected via face-to-face surveys with 613 adult Syrian refugees in an urban setting. Brislin's methodology was used for translating scale items, involving initial translation, back-translation and review by another professional translator. The study utilised the PTSD Scale, Beck Anxiety Scale, Depression Scale and Quality of Life Scale (QOLS). Descriptive, correlational and multivariate regression analysis were applied. Findings of correlational analysis indicate that PTSD levels among Syrian refugees are significantly related to gender, income level and employment. Depression levels are significantly associated with trauma history, healthcare service use, marital status and employment. Anxiety levels are significantly related to gender, trauma history, healthcare service use, employment and income. According to the findings of the regression analyses, the relationships between depression, quality of life and PTSD are complex. Meanwhile, anxiety decreases quality of life and increases PTSD. Quality of life moderates the relationship between depression and PTSD, as well as between anxiety and PTSD. The study concludes that the mental disorder levels of Syrian refugees, in terms of PTSD, depression and anxiety, are linked to their socio-demographic characteristics. These results highlight the importance of social, economic and cultural factors, healthcare and social services and the socio-demographic characteristics of the region where refugees have settled after displacement.
... Evaluating multifaced HRQOL in patients with pSS may contribute to a better understanding of the disease. HRQOL outcome measures used for pSS such as health-related quality of life in primary Sjögren's syndrome (PSS-QoL) [5], Short Form-36 (SF-36) [6], the Euro-Qol-5D [7], or the Hospital Anxiety and Depression Scale (HADS) [8] are insufficient to measure the biopsychosocial aspects of the disease. Presently, there is a lack of validated outcome measures to standardize the assessment of the biopsychosocial dimension of HRQOL in pSS. ...
Article
Objective The BETY-Biopsychosocial Questionnaire (BETY-BQ) is a scale developed to assess the biopsychosocial domains of patients with rheumatic diseases under a single roof. The study aimed to determine the validity and reliability of the BETY-BQ in patients with primary Sjögren’s Syndrome (pSS). Methods At enrollment and one week, 91 patients with pSS completed the BETY-BQ. Construct validity was measured by correlating the BETY-BQ total score responses with the Health Assessment Questionnaire (HAQ), Hospital Anxiety and Depression Scale (HADS), 36-Item Short-Form Health Survey (SF-36), EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI), EULAR Sjögren’s Syndrome Disease Activity Index (ESSDAI), Primary Sjögren’s Syndrome Quality of Life questionnaire (PSS-QoL), and Euro-QoL 5D (EQ-5D). Results The BETY-BQ correlated high to moderate with HAQ, bodily pain subscale of SF-36, Euro Qol-5D, PSS-QoL, HADS, and ESSPRI (0.776 to 0.557, p <0.05). Spearman’s correlation coefficients between BETY-BQ total scores at baseline and average one week were very high (rho = 0.98, <0.001) and indicated substantial agreement between test-retest scores (ICC = 0.99, <0.001). Internal consistency reliability at baseline was 0.91 for the BETY-BQ. Conclusions BETY-BQ is valid and reliable for assessing biopsychosocial status in patients with pSS and can be used to measure outcomes in pSS.
... These issues were submitted to distinct versions of ChatGPT for Q&A (Supplementary File 3, Supplemental Digital Content 4, http://links.lww.com/JS9/C996). Two senior clinical psychologists independently devised three scales based on the Quick Inventory of Depressive Symptomatology Depression Rapid Scale [23] and the Hospital Anxiety and Depression Scale [24] , aligning them with the practical clinical experience of urologists (Supplementary Table 1, Supplemental Digital Content 5, http://links.lww.com/JS9/C997). Subsequently, two additional psychologists utilized these scales as a reference to blindly assess the plausibility and feasibility of the ChatGPT responses. ...
Article
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Background Artificial intelligence (AI) technologies, particularly large language models (LLMs), have been widely employed by the medical community. In addressing the intricacies of urology, ChatGPT offers a novel possibility to aid in clinical decision-making. This study aimed to investigate the decision-making ability of LLMs in solving complex urology-related problems and assess its effectiveness in providing psychological support to patients with urological disorders. Materials and Methods This study evaluated the clinical and psychological support capabilities of ChatGPT 3.5 and 4.0 in the field of urology. A total of 69 clinical and 30 psychological questions were posed to the AI models, and their responses were evaluated by both urologists and psychologists. As a control, clinicians from Chinese medical institutions provided responses under closed-book conditions. Statistical analyses were conducted separately for each subgroup. Results In multiple-choice tests covering diverse urological topics, ChatGPT 4.0, performed comparably to the physician group, with no significant overall score difference. Subgroup analyses revealed variable performance, based on disease type and physician experience, with ChatGPT 4.0 generally outperforming ChatGPT 3.5 and exhibiting competitive results against physicians. When assessing the psychological support capabilities of AI, it is evident that ChatGPT4.0 outperforms ChatGPT3.5 across all urology-related psychological problems. Conclusions The performance of LLMs in dealing with standardized clinical problems and providing psychological support has certain advantages over clinicians. AI stands out as a promising tool for potential clinical aid.
... Although there is little evidence in sciatica, the numerical pain rating scale has good validity and reliability for low back pain [17]. Anxiety and depression were both extracted from the respective subscales of the hospital anxiety and depression scale (HADS), found to have good validity in identifying anxiety and depression disorders and assessing symptom severity [18]. Reported numbness or tingling was extracted from the SBI sensory subscale, scored from 0 to 6 as per the weakness subscale previously described. ...
Article
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Purpose To establish the prevalence and agreement between reported and observed leg weakness in people with sciatica. To establish which factors mediate any identified difference between reported and observed leg weakness in people with sciatica. Methods 68 people with a clinical diagnosis of sciatica, records from spinal service, secondary care NHS Hospital, England, UK reviewed. Primary outcome measures were the sciatica bothersome index for reported leg weakness and the Medical Research Council scale for observed weakness. Agreement was established with Cohen’s Kappa and intraclass correlation coefficient. Potential factors that may mediate a difference between reported and observed weakness included leg pain, sciatica bothersome index sensory subscale, age, hospital anxiety and depression subscale for anxiety. Results 85% of patients reported weakness but only 34% had observed weakness. Cohen’s Kappa (0.066, 95% CI − 0.53, 0.186; p = 0.317)] and ICC 0.213 (95% CI − 0.26, 0.428, p = 0.040) both showed poor agreement between reported and observed weakness. The difference between reported and observed measures of weakness was mediated by the severity of leg pain (b = 0.281, p = 0.024) and age (b = 0.253, p = 0.042). Conclusion There is a high prevalence of reported leg weakness in people with sciatica, which is not reflected in observed clinical measures of weakness. Differences between reported and observed weakness may be driven by the severity of leg pain and age. Further work needs to establish whether other objective measures can detect patient reported weakness.
... As the score rises, so does the patient's level of fatigue. The Hospital Anxiety and Depression Scale (HADS), established in 1983 by Zigmond and Snaith, 23 consists of two separate scales for assessing anxiety and depression. Each scale contains 14 items, seven evaluating anxiety (A) and seven evaluating depression (D). ...
Article
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Objective This study aims to explore the subgroups and networks of symptom clusters in breast cancer patients undergoing chemotherapy, and to provide effective interventions for the core symptoms. Methods A cross-sectional survey was conducted at four comprehensive hospitals in Foshan City, China, from August to November 2023. A total of 292 participants completed the social determinants of health questionnaire, the numerical rating scale (NRS), the Pittsburgh sleep quality index (PSQI), the Chinese version of the cancer fatigue scale (CFS), and the hospital anxiety and depression Scale (HADS). Latent class analysis (LCA) was utilized to distinguish subgroups, and network analysis was utilized to identify core symptoms among different subgroups. Results Breast cancer patients undergoing chemotherapy exhibit symptoms were divided into two subgroups: the high burden group of symptoms (72.3%, Class 1) and the low burden group of symptoms (27.7%, Class 2). Education attainment, work status, family monthly income per capita, and daily sleep duration (hours) were associated with subgroup membership. “Panic feelings” (# HADS-A11) were the core symptom in both the full sample and Class 2, while “tension or pain” (# HADS-A1) was the core symptom in Class 1. Conclusions The core symptoms of fear, enjoyment, nervousness, and pain varied across subgroups of patients and could inform the current strategies for symptom management in breast cancer chemotherapy patients.
... The mental health status was measured by assessing the general levels of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) instrument [44]. The instrument uses two sub-scales from 0 to 21 for anxiety and depression respectively, with a higher score indicating a higher level of anxiety or depression. ...
Article
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Background Throughout the COVID-19 pandemic, it was a key priority for governments globally to ensure agreement with, and subsequently adherence to, imposed public health measures, specifically non-pharmaceutical interventions (NPIs). Prior research in this regard highlighted the role of COVID-19 information sources as well as sociodemographic and other personal characteristics, however, there is only limited evidence including both. To bridge this gap, this study investigated the associations of COVID-19 information sources such as social media and participant characteristics with agreement with and adherence to NPIs during the first lockdown in Austria. Methods An online survey was conducted in May 2020 among adult Austrian residents asking about their experiences during the first lockdown. Collected data included sociodemographic characteristics, main COVID-19-related information sources, agreement with/adherence to three NPIs (no physical contact to family members not living in the same household, leisurely walks restricted to members of the same household, mandatory face masks) and information about perceived social support using the Multidimensional Scale of Perceived Social Support (MSPSS), anxiety/depression levels using the Hospital Anxiety and Depression Scale (HADS), whether participants felt well advised by the government, and whether participants perceived the pandemic to threaten their income. Ordered and multinomial logistic regression models were employed to achieve the research aims. Results The cross-sectional sample consisted of 559 Austrian residents. Using social media as main COVID-19 information source was consistently associated with lower agreement with NPIs. A positive association with agreement with measures was found for higher educational backgrounds and higher anxiety levels. By contrast, higher levels of depression, not feeling well advised by the government, and perceiving the pandemic as an economic threat were negatively associated with agreement with measures. Moreover, the use of social media as main COVID-19 information source and not feeling well advised by the government were associated with lower adherence to NPIs. By contrast, higher levels of education were associated with higher adherence. Conclusions This comprehensive analysis emphasizes the associations of COVID-19 information sources as well as sociodemographic and other participant characteristics with agreement with and adherence to NPIs, bearing important implications for future public health crisis communication strategies.
... The tool has a maximum score of 90, with higher scores representing worse outcomes. The Hospital Anxiety and Depression Scale (HADS) [28] is a two-subscale questionnaire used to assess symptoms of anxiety and depression over the previous week. Each subscale has a scoring range of 0-21, with higher scores representing worse anxiety and/or depression symptoms. ...
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Vitiligo was historically regarded as a cosmetic disorder; however, it is an autoimmune disease. As a visible condition, it affects patient well-being. We assessed the impact of disease severity, lesion location, and body surface area (BSA) affected on patient health-related quality of life (HRQoL). Retrospective data were from the Adelphi Real World Vitiligo Disease Specific Programme: a cross-sectional survey of physicians and their patients with vitiligo (10/2021–07/2022). Patient-reported outcomes were assessed by the Vitiligo-Specific Quality of Life Instrument (VitiQoL), Hospital Anxiety and Depression Scale (HADS), and EQ-5D-5L. The Work Productivity and Impairment Questionnaire (WPAI) questionnaire was used to assess disease-related impairment of daily activities. Data were stratified by physician-reported disease severity, presence/absence of vitiligo on the face, and BSA percentage affected. In total, 1388 patients were included. Mean (SD) VitiQoL, HADS depression, and anxiety scores were higher for those with severe disease [40.5 (26.1), 5.2 (4.4), and 6.8 (4.7)] than those with mild [24.8 (18.8), 3.6 (3.8), 4.2 (3.8)] or moderate [27.1 (22.6), 3.8 (4.5), 4.3 (4.4)] disease. Patients with face affected reported higher VitiQoL [30.0 (22.3) versus 23.2 (19.3)], and HADS scores [depression, 4.3 (4.3) versus 3.2 (3.9); anxiety, 5.0 (4.3) versus 3.8 (3.9)] than those without. Patients with ≥ 5% BSA affected had higher VitiQoL, depression and anxiety scores [27.9 (21.8), 4.0 (4.4), and 4.5 (4.2)] than those with 0–5% [24.6 (19.7), 3.4 (3.7), and 4.3 (4.1)]. Patients with severe vitiligo, facial lesions, or ≥ 5% BSA reported higher activity impairment. Mean EQ-5D-5L-utility score was approximately 0.9 regardless of disease severity or total BSA affected. These data demonstrate the impact disease severity can have on HRQoL and daily activities for patients with vitiligo. Lesions that are more severe, on the face, or covering a greater BSA are more often associated with poorer outcomes and activity impairment. These data also highlight the potential insensitivity of commonly used HRQoL measures and a need for more sensitive disease-specific measures.
... Each item is rated on a 4-point severity scale, with a maximum score of 21 for anxiety and depression, respectively. Scores of [11 represent the presence of anxiety/ depression, scores of 8-10 represent borderline presence of anxiety/depression and scores of 0-7 represent a normal range [19,20]. ...
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Alopecia areata (AA) is characterized by non-scarring scalp and/or body hair loss and can negatively impact patient mental health. Data are limited on the alignment of patient and physician perceptions of AA severity with each other and with Japanese Dermatological Association (JDA) guideline criteria, and of patient-physician alignment on treatment satisfaction. Therefore, we performed analyses to compare JDA severity groupings with patient-physician alignment on disease severity and to explore treatment satisfaction in AA in Japan. Data were drawn from the Adelphi AA Disease Specific Programme (DSP)™, a real-world survey of physicians and patients with AA in Japan conducted January-March 2021. Patients and physicians reported patient AA severity as mild, moderate or severe based on their subjective judgement. Patients were then categorized into five hair loss severity groups according to JDA criteria (S1-5), and patient-physician pairs were matched to assess alignment on severity and treatment satisfaction. Subjective patient- and physician-reported disease severity generally followed JDA severity groupings. The percentage of patient-physician alignment on severity recognition was 76.3% in the overall population. In misaligned pairs, 20.2%, 14.5%, 7.3%, 25.0% and 0.0% of physicians rated disease as more severe than patients in S1, S2, S3, S4 and S5, respectively. Regarding treatment satisfaction, patient-physician alignment was 57.6% in the overall population. In S5, 46.2% of physicians reported being less satisfied than patients. Both physicians and patients cited lack of efficacy as the main reason for dissatisfaction. Of 221 patients, 39.8% and 29.9% were categorized as borderline-abnormal cases for anxiety and depression, respectively. This study highlights previously unreported patient-physician misalignment on disease severity, level of treatment dissatisfaction and unmet needs due to the lack of effective treatment. Further study on how improvement of the misalignment between physicians and patients could increase both patient and physician satisfaction with treatment and improve the quality of life for patients with AA.
... In addition to PDSS and KSCL95 scores, all subjects completed several self-report questionnaires that evaluate psychometric characteristics the Anxiety Sensitivity Index (ASI), 31 the Perceived Stress Scale (PSS), 32 the Pittsburgh Sleep Quality Index, 33 the Hospital Anxiety and Depression Scale (HADS), 34 and the State-Trait Anxiety Inventory (STAI). 35 HADS consists of HADS depression (HADS-D) and HADS anxiety (HADS-A) scores, and STAI consists of STAI-state and STAI-trait scores. ...
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Purpose This study aimed to compare the clinical features of panic disorder (PD) with comorbid agoraphobia to those of PD alone. We focused on autonomic nervous system (ANS) alterations reflected in heart rate variability (HRV) and executive function deficits reflected in the Stroop test. Materials and Methods We retrospectively compared psychometric features, Stroop test results, and resting-state HRV across three groups: a subclinical group with anxiety attack history, a PD group without agoraphobia, and a PD group with agoraphobia. The subclinical group included 10 male and 34 female, the PD without agoraphobia group included 17 male and 19 female, and the PD with agoraphobia group included 11 male and 18 female. Results The PD with agoraphobia group had higher Symptom Checklist–95 scores than the other groups. Both PD groups had longer reaction times in the Stroop test than the subclinical group. There were no significant differences in HRV parameters between the PD groups with and without agoraphobia. Compared with the subclinical group, the PD with agoraphobia group showed significantly lower values of the natural logarithm of low-frequency HRV. Conclusion Our results do not support that executive function deficits and ANS alterations are more pronounced with comorbid agoraphobia among PD groups. However, PD with agoraphobia patients showed more complex and severe clinical symptoms in their self-reports. Compared with the subclinical group, PD patients with agoraphobia showed specific features in the natural logarithm of low-frequency HRV. Our findings suggest that agoraphobia comorbidity should be considered when evaluating or treating patients with PD.
... Te SF-MPQ pain scale comprises 15 questions related to patients' distress due to pain and was originally written in English. Te Japanese version of the SF-MPQ has been proven to be reliable, valid, and equivalent to the original questionnaire [28]. Patients rate each question on a 4-point intensity scale as follows: 0 � none, 1 � mild, 2 � moderate, and 3 � severe. ...
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Background: Accurate identification of neuropathic pain is necessary for appropriate treatment; however, the relationship between nontraumatic shoulder disorders and neuropathic pain remains unknown. Therefore, this retrospective observational study aimed to investigate the relationship, features, background factors, and prevalence of neuropathic pain among patients with nontraumatic shoulder disorders. Methods: We evaluated 198 patients who visited our outpatient clinic, which specializes in shoulder disorders, from April 2015 to March 2016. The patients' age, sex, affected side, diagnosis, and pain duration were recorded, and the results of physical examination, including passive range of motion, impingement sign, and muscular strength assessments, were analyzed. The presence of neuropathic pain was assessed using the painDETECT questionnaire. Participants were divided into two groups according to the presence of neuropathic pain. Pain intensity was assessed using a visual analog scale, and the patient's mental status was assessed using the short-form McGill Pain Questionnaire and Hospital Anxiety and Depression Scale. The scores were compared between the groups. Results: Neuropathic pain was observed in 7.6% of patients. The visual analog scale score for pain, short-form McGill Pain Questionnaire score, and Hospital Anxiety and Depression Scale score were significantly associated with the presence of neuropathic pain in the univariate analysis. Patient background factors and physical function were not associated with the presence of neuropathic pain. The prevalence of neuropathic pain in patients with frozen shoulder was 33.3%, which was significantly higher than that in patients with other shoulder disorders. Conclusion: The occurrence of neuropathic pain may aggravate pain in patients with nontraumatic shoulder disorders. Neuropathic pain was not a rare condition in patients with nontraumatic shoulder disorders, particularly in those with frozen shoulder. The coexistence of neuropathic pain cannot be determined from background factors or physical function. Accurate diagnosis of neuropathic pain is essential in patients with nontraumatic shoulder disorders.
... Symptoms of anxiety and depression were evaluated with the Hospital Anxiety and Depression Scale (HADS). 19 The HADS consists of two 7-item scales evaluating self-reported symptoms of anxiety (HADS-A) and symptoms of depression (HADS-D) for the past week. The highest possible score for each scale is 21, with higher scores representing more psychological distress. ...
Article
Background: Anxiety, depression, and post-traumatic stress disorder (PTSD) among out-of-hospital cardiac arrest (OHCA) survivors may impact long-term recovery. Coping and perception of symptoms may vary between sexes. The aim was to explore sex-differences in psychological consequences following OHCA. Methods: Prospective observational study of OHCA survivors that attended structured three-month follow-up. Symptoms of anxiety/depression was measured using Hospital Anxiety and Depression Scale (HADS), range 0-21, with a cut-off score of ≥8 for significant symptoms. PTSD were measured with the PTSD Checklist for DSM-5 (PCL-5), range 0-80. A score of ≥33 indicated PTSD-symptoms. Cognitive function was assessed by Montreal Cognitive Assessment. Results: From 2016-2021, 381 consecutive comatose OHCA survivors were invited. Of these, 288 patients (76%) participated in the follow-up visit (53 (18%) females, out of 80 survivors and 235 (82%) out of 300 alive at follow-up (78%). Significant symptoms of anxiety were present in 47 (20%) males and 19 (36%) females, p=0.01. Significant symptoms of PTSD were present in 30% of males and 55% of females, p=0.01. Adjusting for prespecified covariates using multivariable logistic regression, the female sex as significantly associated with anxiety (odds ratio: 2.18, confidence interval: 1.09-4.38, p=0.03). This difference was especially pronounced among young females (below median age, odds ratioadjusted 3.31 CI 1.32-8.29, p=0.01), compared to young males. No sex-significant difference was observed for depression or cognitive function. Conclusions: Symptoms of anxiety and PTSD are frequent in OHCA survivors, and female survivors report significantly more symptoms of anxiety, and PTSD compared to males. Especially, young females were significantly more symptomatic than young males.
... A commonly used cut-of of ≥10 was applied to indicate the presence of depressive symptoms [17]. Anxiety symptoms were examined by the Hospital Anxiety and Depression scale (HADS-A, 0-21), using a cut-of of ≥8 to identify anxious participants (Cronbach's alpha 0.82) [18]. Mastery was measured by an abbreviated version of the Pearlin Mastery scale, consisting of the 5 negative items of the Pearlin Mastery scale with a scale score of 5-25 (Cronbach's alpha 0.87) [19]. ...
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Objectives. The aim of this study was to explore self-reported changes in personal development and meaning in life of older adults in the Netherlands during the COVID-19 pandemic and characteristics of the groups that reported these changes. Methods. Older adults from the Longitudinal Aging Study Amsterdam completed a questionnaire on the impact of the COVID-19 pandemic. Participants were asked to rate changes in personal development and meaning in life. These variables were descriptively analysed and logistic regression analyses were used to explore characteristics of the groups that reported these changes. Results. Of the 1099 older adults (aged 62–102 years), 25.7% paid more attention to things one enjoys doing in spare time, 36.6% reflected more on important things in life, and 16.8% made less future plans during the COVID-19 pandemic. Self-reported changes in meaning in life and personal development differed between specific subgroups of older adults. The largest changes in aspects of personal development and meaning in life were reported by older adults who experienced personal adverse experiences such as death of a loved one (ORs 2.03) and/or health problems such as functional limitations (ORs ranging from 1.59 to 2.84) and depression (ORs ranging from 1.69 to 2.77). Discussion and Implications. A substantial share of the participants reported changes in specific aspects of personal development and meaning in life. This was especially true for certain subgroups of older adults. Relatives and caregivers should be aware of changes in personal development and meaning in life since lower scores are known to be associated with poor physical, psychological, and social well-being outcomes.
... The total scores were obtained by the addition of all answer scores, performed separately by category. Scores between 0 and 7 indicate no anxiety and no depression, scores between 8 and 10 indicate borderline anxiety or borderline depression, and scores greater than or equal to 11 indicate probable anxiety or depression [20][21][22][23]. ...
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Purpose: This study aimed to assess the quality of life (QOL), before and after surgery, of patients who underwent open reduction and internal fixation for orbital fractures. Study design: A prospective study PARTICIPANTS AND SETTING: The self-report outcome measures of 50 patients treated at the Department of Oral and Maxillofacial Surgery of the Second Affiliated Hospital of Jiamusi University from January 2016 to June 2019 were prospectively collected. Main measures: The quality of life was assessed using four patient-reported outcome measures (PROMs): the 15D questionnaire, Oral Health Impact Profile-14 (OHIP-14), Hospital Anxiety and Depression Scale (HADS), and 36-item Short Form Survey (SF-36). Both descriptive and comparative data analyses were calculated. Results: Zygomaticomaxillary complex fractures were the most encountered (40.3%). The total OHIP-14 scores before and after treatment were 1.72 and 1.68, respectively. Vision, breathing, sleeping, eating, usual activities, discomfort and symptoms, and vitality showed minimal changes in the 15D questionnaire. The HADS scores were ranged from 0 to 7, indicating no anxiety or depression. The comparison of SF-36 scores after 3 months and after ≥6 months of treatment revealed no significant difference. Conclusions: Patients' QOL was minimally impacted by orbital fractures and their treatments. The severity of the negative impact can be minimized if appropriate management strategies are taken.
... SSCS-TICS was developed to assess chronic concerns, lacking social recognition, work overload, excessive demands, and social stress three months prior to assessment. Furthermore, the German version of Hospital Anxiety and Depression Scale (HADS), referring to symptoms of anxiety and depression in the last week prior to completion of the questionnaire was used [19]. Summary scores of eleven or more in each subscale indicate moderate to severe, scores between 8 and 10 mild symptoms, and scores < 8 are considered normal. ...
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Background Child overweight remains a prevalent public health concern, but the impact of maternal psychosocial stress and related constructs, the timing, and possible trajectories on child body mass index (BMI) is controversial. We aimed to investigate the association of maternal stress, depression and anxiety symptoms, and maternal hair cortisol concentrations (HCC) at delivery, 6, and 12 months postpartum with child BMI and age- and sex-standardized BMI (BMI-SDS) at age 3 years. Methods Data were derived from the Ulm SPATZ Health Study with a baseline examination between 04/2012 and 05/2013 at the University Medical Centre Ulm, Germany, the only maternity clinic in Ulm, with a good representation of the source population. Adjusted regression analyses based on BMI/BMI-SDS (dependent) and trajectories of stress, depression, and anxiety (independent variables) were investigated in 596 mothers and children. Multiple imputation of missing covariates was performed. Results Various trajectories in independent variables were identified, trajectories of maternal anxiety symptom differed between child sexes. We did not find an association between trajectories of maternal chronic stress, depression symptoms, or HCC and child BMI/BMI-SDS. However, trajectories of low-increasing maternal anxiety symptoms were linked to higher child BMI compared to a low-stable trajectory group (b = 0.58 kg/m², 95% Confidence Interval: 0.11; 1.04) in girls. Conclusions Trajectories of maternal anxiety symptoms were associated with the child’s BMI/BMI-SDS in girls at age 3 years. However, further large scale studies should include variables to determine the causal pathway and enlighten sex-specific differences.
... A higher score represents a higher risk of symptoms of anxiety and/or depression. Scores > 11 on the total HADS scale and scores > 7 on the two subscales represent clinically relevant symptoms of anxiety and/ or depression [51][52][53][54]. The HADS has shown a high reliability among different Dutch populations [50]. ...
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Purpose During the first SARS-CoV-2-infection wave, a deterioration in emotional well-being and increased need for mental health care were observed among patients treated or being treated for breast cancer. In this follow-up study, we assessed patient-reported quality of life (QoL), physical functioning, and psychosocial well-being during the second SARS-CoV-2-infection wave in a large, representative cohort. Methods This longitudinal cohort study was conducted within the prospective, multicenter UMBRELLA breast cancer cohort. To assess patient-reported QoL, physical functioning and psychosocial well-being, COVID-19-specific surveys were completed by patients during the first and second SARS-CoV-2-infection waves (April and November 2020, respectively). An identical survey was completed by a comparable reference population during the second SARS-CoV-2-infection waves. All surveys included the validated EORTC-QLQ-C30/BR23, HADS and “De Jong-Gierveld Loneliness” questionnaires. Pre-COVID-19 EORTC-QLQ-C30/BR23 and HADS outcomes were available from UMBRELLA. Response rates were 69.3% (n = 1106/1595) during the first SARS-CoV-2-infection wave and 50.9% (n = 822/1614) during the second wave. A total of 696 patients responded during both SARS-CoV-2-infection waves and were included in the analysis comparing patient-reported outcomes (PROs) during the second SARS-CoV-2-infection wave to PROs during the first wave. Moreover, PROs reported by all patients during the second SARS-CoV-2-infection wave (n = 822) were compared to PROs of a similar non-cancer reference population (n = 241) and to their pre-COVID-19 PROs. Results Patient-reported QoL, physical functioning, and psychosocial well-being of patients treated or being treated for breast cancer remained stable or improved from the first to the second SARS-CoV-2-infection wave. The proportion of emotional loneliness reduced from 37.6 to 29.9% of patients. Compared to a similar non-cancer reference population, physical, emotional, and cognitive functioning, future perspectives and symptoms of dyspnea and insomnia were worse in patients treated or being treated for breast cancer during the second SARS-CoV-2-infection wave. PROs in the second wave were similar to pre-COVID-19 PROs. Conclusion Although patients scored overall worse than individuals without breast cancer, QoL, physical functioning, and psychosocial well-being did not deteriorate between the first and second wave. During the second wave, PROs were similar to pre-COVID-19 values. Overall, current findings are cautiously reassuring for future mental health of patients treated or being treated for breast cancer.
... The ADRD diagnostic process was comprehensive and involved 1) patient-based subjective ratings of dementia (i.e., Quick Dementia Rating Scale (QDRS) (reliability range 0.9-0.94) [32]); reports of cognitive change (i.e., Cognitive Change Index [33]; Cognitive Function Instrument [34])); and memory complains (i.e., AD8 [35]); 2) neuropsychological testing (i.e., Montreal Cognitive Assessment [36], Hopkins Verbal Learning Task [37]; Digit Span forward/backward [38]; Number Symbol Coding Test [39]; Trail Making tests [40]; Animal Naming and Multilingual Naming Test (MINT) [38]; Noise Pareidolia Test [41]; Hospital Anxiety and Depression Scale [42]); and 3) caregiver assessments of PLwD cognitive, functional, and behavioral symptoms (i.e., informant version of the QDRS; Functional Activity Questionnaire [43]; and Neuropsychiatric Inventory-Questionnaire (NPI-Q) [44]). Cognition was not assessed in caregivers. ...
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Background Greater mindfulness, the practice of awareness and living in the moment without judgement, has been linked to positive caregiving outcomes in dementia caregivers and its impact attributed to greater decentering and emotion regulation abilities. Whether the impact of these mindfulness-based processes varies across caregiver subgroups is unclear. Objective Analyze cross-sectional associations between mindfulness and caregiver psychosocial outcomes, considering different caregiver and patient characteristics. Methods A total of 128 family caregivers of persons living with Alzheimer’s disease and related disorders were assessed on several mindfulness measures (i.e., global; decentering, positive emotion regulation, negative emotion regulation) and provided self-reported appraisals of caregiving experience; care preparedness; confidence, burden, and depression/anxiety. Bivariate relationships between mindfulness and caregiver outcomes were assessed with Pearson’s correlations and stratified by caregiver (women versus men; spouse versus adult child) and patient (mild cognitive impairment (MCI) versus Dementia; AD versus dementia with Lewy bodies; low versus high symptom severity) characteristics. Results Greater mindfulness was associated with positive outcomes and inversely associated with negative outcomes. Stratification identified specific patterns of associations across caregiver groups. Significant correlations were found between all mindfulness measures and caregiving outcomes in male and MCI caregivers while the individual mindfulness component of positive emotion regulation was significantly correlated to outcomes in most caregiver groups. Conclusion Our findings support a link between caregiver mindfulness and improved caregiving outcomes and suggest directions of inquiry into whether the effectiveness of dementia caregiver-support interventions may be improved by targeting specific mindfulness processes or offering a more inclusive all-scope approach depending on individual caregiver or patient characteristics.
... For estimating the presence of anxiety and depression, we used HADS (Hospital Anxiety and Depression Scale) and Hamilton anxiety Rating Scale (HAM-A). [9,10] ...
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Key message Hospitalization is a nerve-wrecking experience for patients and their families (Lam et al. in Int J Nurs Stud 43:535–545, 2006). The financial burden of hospitalization is the prime perpetrator, however, multiple other factors also contribute significantly to the underlying problem which can be eliminated by efforts of the doctors and other healthcare workers and by modifying the hospital policies (Bassett et al. in J Hosp Med 15:652–658, 2020). We can reduce the number of outpatient visits and switch to telemedicine for rescheduling the cases. The pre-anaesthetic clearance and all the relevant investigations can be done on a single OPD visit thereby reducing the requirement of repeated commutes to the hospital. The free of charge category of the hospital can be extended to the patient requiring prolonged hospital stay or for solid tumor patients who require repeated hospital admissions for chemotherapy. Association with child welfare Non-government organizations (NGO’s) can also solve major monetary issues for parents of patients suffering from complex congenital anomalies and solid tumors. The pre-operative NPO period can be shortened to 2–4 h, antibiotic use can be completely avoided or minimized in clean elective cases, children living in the same city requiring dressing/catheter removal after a few days (e.g. hypospadias, posterior sagittal anorectoplasty) can be discharged and called for a OPD visit after 5–7 days if the parents are willing to take care of the child at home. Patients undergoing minor elective surgeries can be followed up on telemedicine visits only. Parents of patients suffering from complex congenital anomalies should be referred to a clinical psychologist and receive periodic counseling sessions. A child psychologist should also be included in the management of cases which have social stigma attached as bladder exstrophy, anorectal malformations, spina bifida requiring lifelong follow-up and bowel washes or repeated clean intermittent catheterisation. Anxiety assessment questionnaires must be incorporated in the management of chronic patients and high-risk parents must be identified (Tiedeman in J Pediatr Nurs 12:110–119, 1997). We hereby propose adoption of family centric approach during the management of a patient as this may minimize the overall burden of the hospitalization of the family. Background Hospital admission of a child leads to a myriad responses in the parents. Thus, we conducted a hospital-based cross-sectional study to determine the prevalence of anxiety and depression among the primary caregivers of hospitalized children and the factors causing it. Methods Parents of 228 children admitted in the pediatric surgery ward at a tertiary care hospital were interviewed using the HADS-A and Hamilton Anxiety Questionnaire to assess the prevalence of anxiety and depression during hospital admission. They were also subjected to a questionnaire comprising of 52 questions spread over 5 segments—demographic details, monetary burden, effect on siblings and other family members, practical problems faced, and surgery-specific concerns. Findings Thirty percent of the parents had severe anxiety and 20% developed depression due to the hospitalization of their child. We tested the association of this depression and anxiety against 56 variables in this study. Exorbitant loan amounts (ra − 0.449, rd− 0.557), repeated commute to the hospital (ra − 0.274, rd − 0.231), monetary burden (ra − 0.193, rd − 0.186), repetitive sampling (ra − 0.248, rd − 0.203), prolonged absence from work (ra − 0.440, rd − 0.424) were found to be the chief perpetrators of this anxiety and depression. Interpretation The burden of anxiety and depression in the primary caregivers of pediatric surgical patients is enormous. Identification of the implicating factors is essential. Simple reforms such as reduction in the number of OPD visits, extension of free of charge category, association with non-governmental organizations and involvement of a clinical psychologist can significantly meliorate the hospital journey of both the patients and their parents. (rd—correlation coefficient of for depression, ra—correlation coefficient of for anxiety).
... 17,18 Status of depression and anxiety was evaluated using the hospital anxiety and depression scale (HADS). 19,20 Fur-thermore, we assessed the severity of IBS-like symptoms using a questionnaire based on the Japanese version of the IBS severity index. 21,22 ...
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Background/aims: Diarrhea-predominant irritable bowel syndrome (IBS-D)-like symptoms frequently occur in patients with quiescent Crohn's disease (CD). To investigate the factors underlying IBS-D-like symptoms in patients with quiescent CD, we performed a comprehensive analysis of the clinical features and intestinal environment in those patients. Methods: We performed a prospective observational study of 27 patients with quiescent CD (CD activity index [CDAI] ≤ 150; C-reactive protein ≤ 0.3 mg/dL). The presence and severity of IBS-D-like symptoms, health-related quality of life, disease-specific quality of life, and status of depression and anxiety were evaluated. The level of intestinal permeability, fecal calprotectin and organic acids and the profiles of gut microbiome were analyzed. Results: Twelve of the 27 patients with quiescent CD (44.4%) had IBS-like symptoms, and these patients showed a significantly higher CDAI, IBS severity index and anxiety score than those without. The inflammatory bowel disease questionnaire score was significantly lower in the patients with IBS-D-like symptoms. There were no significant differences in small intestinal/colonic permeability or the levels of organic acids between the patients with and without IBS-D-like symptoms. Fusicatenibacter was significantly less abundant in the patients with IBS-D-like symptoms whereas their fecal calprotectin level was significantly higher (384.8 ± 310.6 mg/kg) than in patients without (161.0 ± 251.0 mg/kg). The receiver operating characteristic curve constructed to predict IBS-D-like symptoms in patients with quiescent CD using the fecal calprotectin level (cutoff, 125 mg/kg) showed a sensitivity and specificity of 73.3% and 91.7%, respectively. Conclusion: Minimal inflammation is closely associated with the development of IBS-D-like symptoms in patients with quiescent CD.
... It consists of two subscales: HADS-Anxiety and HADS-Depression with each subscale having 7 items with a response-scale with four alternatives (from 0 to 3). 24,25 The Turkish version of the HADS was also found to be a valid and reliable measure. 26 The cut-off points of the Turkish version were 10 for HADS-Anxiety and 7 for HADS-Depression. ...
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The Hospital Anxiety and Depression Scale (HADS) is commonly used to detect depressive or anxious states, but its 14-item questionnaire is time-consuming. Visual analog scales (VAS) are easy to use and quick to implement. Although the VAS has been validated to assess pain and occupational stress, VAS scores for anxiety and mood have never been evaluated in the workplace. We aimed to validate the use of visual analog scales (VAS) for anxiety and mood compared to HADS in workers. A HADS self-reported questionnaire associated with VAS assessing perceived anxiety and mood on a horizontal line of 100 mm was administered to 182 workers, with a second test (retest) proposed one week later. Sociodemographic, characteristics of work, sleep, well-being, and stress were also assessed. VAS anxiety and mood correlated with the HADS sub-scores (0.70 and 0.65, respectively). The test-retest reliability was good. Optimal VAS cut-offs were ≥ 60/100 for anxiety and ≤ 60/100 for mood, to define at-risk patients. The VAS is quick to perform, easy to use, and reliable for screening depression and anxiety in occupational medicine. We recommend validated questionnaires for at-risk patients. Trial registration. Clinicaltrials.gov: NCT02596737. Available at: https://www.clinicaltrials.gov/ct2/show/NCT02596737.
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Background: Patient-reported outcomes (PROs) are reports provided by patients themselves detailing their medical health state or behavior related to an illness or medication use, without any interpretation by healthcare professionals. PROs are used to evaluate health status that cannot be quantified through tangible measures, for primary outcomes such as pain severity, and secondary outcomes such as quality of life. Patient reported outcome measures (PROMs) are instruments or methods developed by professionals to assess data on PROs directly provided by patients during reporting procedures. In the oncology field, they are important to determine the impact of cancer and chemotherapy on patient's physical symptoms, mental well-being, and social functioning. The health system turned towards using PROMs as tools for remote monitoring, conducting visits when needed, and alerting stakeholders at the right time. Aim: To describe the uses and types of PROMs in use in clinical practice and the simplified PROMs that have been developed in oncology. Conclusion: PROMs are widely used in oncology for data collection. It became necessary to simplify measures by using patients' language, downsizing content, and promoting electronic PROMs through technological programs.
Article
Objective: Up to 50% of patients recovering from pulmonary embolism (PE) experience negative long-term outcomes. Patient-reported outcome measures (PROMs) are important in identifying what matters to patients. We aimed to identify PROMs used in clinical studies and recommended by the International Consortium of Health Outcomes (ICHOM) and compare individual items with factors considered important by patients recovering from PE. Methods: This was a convergent mixed-methods systematic review, including quantitative studies, using PROMs and qualitative studies with non-cancer-related PE patients. Items from each PROM and qualitative findings were categorised using a International Classification of Function linking process to allow for integrated synthesis. Results: A total of 68 studies using 34 different PROMs with 657 items and 13 qualitative studies with 408 findings were included. A total of 104 individual ICF codes were used, and subsequently sorted into 20 distinct categories representing patient concerns. Identified PROMs were found to adequately cover 17/20 categories, including anxiety, fear of bleeding, stress, depression, dizziness/nausea, sleep disturbance, pain, dyspnea, fatigue, activity levels, family and friends, socializing, outlook on life, and medical treatment. PROMs from the ICHOM core set covered the same categories, except for dizziness/nausea. Conclusions No single PROM covered all aspects assessed as important by the PE population. PROMs recommended in the ICHOM core set cover 16/20 aspects. However, worrisome thoughts, hypervigilance around symptoms, and uncertainty of illness were experienced by patients with PE but were not covered by PROMS.
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Limited evidence suggests that the SARS-CoV-2 infection can accelerate the progression of neurodegenerative diseases, but this has been not verified in the spinocerebellar ataxias (SCA). The objective of this study is to assess the impact of COVID-19 on the mental health and motor features of SCA2. A follow-up study was carried out in 170 Cuban SCA2 subjects and 87 community controls between 2020 and 2021. All subjects underwent a structured questionnaire to assess the risks of exposure to COVID-19, the confirmation of COVID-19 diagnosis, and the Hospital Anxiety and Depression Scale (HADS). Moreover, 36 subjects underwent the Scale for the Assessment and Rating of ataxia (SARA). The risk of exposure to SARS-CoV-2 and the frequency of COVID-19 were similar between the ataxia cohort and the community controls. Within the ataxia group, significantly increased HADS scores existed at the 2nd visit in both groups, but this increase was more evident for the infected group regarding the depression score. Moreover, a significant within-group increase of SARA score was observed in the infected group but not the non-infected group, which was mainly mediated by the significant increase of the speech item score in the infected group. Similar results were observed within the subgroup of preclinical carriers. Our study identified no selective vulnerability nor protection to COVID-19 in SCA2, but once infected, the patients experienced a deterioration of mental health and speech function, even at preclinical disease stage. These findings set rationales for tele-health approaches that minimize the detrimental effect of COVID-19 on SCA2 progression and identify SCA2 individuals as clinical model to elucidate the link between SARS-CoV-2 infection and neurodegeneration.
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Context: Working in the police force is an operationally and organizationally stressful job. Suitable psychometric tools are needed to detect and study the psychosocial risks of these professionals. The original version contains 40 items, which may be too long for clinical use or as a research control measure. The main aim of this study is to validate the Police Stress Questionnaire (PSQ) in German. The secondary objective is to validate a shorter version. Method: After translation and counter translation of the PSQ-G by a committee of experts, 10 participants pre-tested the comprehension of an intermediate version, allowing the development of a final version that was submitted to a psychometric validation plan with 2314 German-speaking officers. Structure, reliability, and convergent, divergent, and discriminant validities were tested for each sample. Results: The German version of the PSQ performed well psychometrically. We have created a short version of 14 items with good psychometric properties, 7 items for each subscale: operational stressors and organizational stressors. Conclusion: This study validated a German version of the PSQ and provides a reliable measure of stress processes in the police force. A short version is now available.
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Objective: To find sensitive neurophysiological correlates of non-motor symptoms in Huntington's disease (HD), which are essential for the development and assessment of novel treatments. Methods: We used resting state EEG to examine differences in oscillatory activity (analysing the isolated periodic as well as the complete EEG signal) and functional connectivity in 22 late premanifest and early stage people with HD and 20 neurotypical controls. We then assessed the correlations between these neurophysiological markers and clinical measures of apathy and processing speed. Results: Significantly lower theta and greater delta resting state power was seen in the HD group, as well as significantly greater delta connectivity. There was a significant positive correlation between theta power and processing speed, however there were no associations between the neurophysiological and apathy measures. Conclusions: We speculate that these changes in oscillatory power and connectivity reflect ongoing, frontally concentrated degenerative and compensatory processes associated with HD. Significance: Our findings support the potential utility of quantitative EEG as a proximate marker of processing speed, but not apathy in HD.
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Background: While attention has been drawn to the impact of the coronavirus disease 2019 (COVID-19) pandemic on the mental health of healthcare workers generally, little is known regarding mental health changes over time in frontline and non-frontline physiotherapists during this period. Objectives: Our study aimed to investigate differences in mental health trends among frontline and non-frontline physiotherapists across three time periods during the pandemic. Method: Survey-based data were collected from 366 practising physiotherapists across three time periods during the pandemic (Time 1: n = 171; Time 2: n = 101; Time 3: n = 94). Variations in reported mental health of frontline and non-frontline respondents generally and over time were analysed using comparative statistical techniques and trend analysis. Results: Frontline physiotherapists reported significantly lower levels of general mental well-being and resilience, and significantly higher levels of burnout and maladaptive strategy use. Only frontline physiotherapists’ general mental well-being and resilience decreased over time, whereas depression decreased over time for both groups. Anxiety decreased over time for non-frontline physiotherapists but initially decreased and then increased for frontline physiotherapists. Burnout increased initially and then decreased for non-frontline physiotherapists. Conclusion: Varying mental health trends were found between frontline and non-frontline physiotherapists over time. Nuanced mental health interventions that consider the period of the pandemic and degree of exposure are needed. Clinical implications: Understandings of the mental health trajectories experienced by physiotherapists across the pandemic can inform long-term, targeted interventions that effectively enhance well-being, retention, and sustainability of practitioners, and thus the care delivered, in the healthcare system.
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Background Patient Global Assessment (PtGA) has been recommended as one of the core domains in psoriasis clinical trials. Among multiple versions of PtGA, the single-question 11-point PtGA numeric rating scale (NRS) remains to be validated in patients with plaque psoriasis. Objectives To evaluate the psychometric charateristics of a 11-point PtGA NRS for disease severity in patients with moderate-to-severe plaque psoriasis. Methods Data were analyzed from 759 patients with moderate-to-severe psoriasis in the Shanghai Psoriasis Effectiveness Evaluation CoHort (SPEECH), a prospective, multicenter, and observational registry assessing the comparative effectiveness and safety of biologics (adalimumab, ustekinumab, secukinumab or ixekizumab), conventional systemic therapies (acitretin or methotrexate), or phototherapy. Results The test-retest reliability of the PtGA NRS showed good agreement (intraclass correlation coefficient range 0.79-0.83). No floor or ceiling effects of PtGA NRS were observed. The PtGA NRS was significantly correlated with Psoriasis Area and Severity Index (PASI), static Physician Global Assessment (sPGA), body surface area, Dermatology Quality of Life Index (DLQI), and Hospital Anxiety and Depression Scale. Relatively large correlations of PtGA NRS with PASI and DLQI Symptoms and feelings domain (all correlations ≥ 0.4 except at baseline) supported convergent validity. The presence of psoriatic arthritis or joint symptoms had no significant association with the PtGA NRS. In multivariate regression analyses, the PtGA NRS at baseline was predicted by age, lesion extent, lesion intensity, patients’ symptoms and feelings, and impact on work or school. The PtGA NRS displayed known-groups validity with the PASI, sPGA and DLQI score bands. The PtGA NRS was responsive to change in PASI and DLQI after treatment. Anchor- and distribution-based approaches supported -3 as the minimal important difference for PtGA NRS. An absolute PtGA NRS ≤ 2 during follow-ups was concordant with the state of minimal disease activity based on PASI 90 or PASI 90 plus DLQI 0/1. Sensitivity analysis using subgroup comparison and multiple imputation model yielded consistent conclusions. Conclusions The PtGA NRS showed good reliability, validity, and responsiveness in patients with psoriasis, and was feasible in clinical trials and daily practice.
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Rationale Nurses working in the intensive care unit (ICU) are constantly bombarded with stressful events and traumatic situations that may have deleterious effects on their health. The implications and the outcomes of exposure to these constant stressors by this workforce, on their mental health, are largely unknown. Objective To determine and measure if critical care nurses are having more work-related mental disturbances compared to their counterparts who are working in less stressful environments such as wards. Materials and methods We collected data from three large tertiary care hospitals in south India spanning over two states (n = 383 and 220 respectively) using various validated tools. Relevant data and results In both cohorts of nurses, we determined the prevalence of symptoms of post-traumatic stress disorder (PTSD), depression, and anxiety using various validated tools such as PTSS-10 and hospital anxiety and depression scale (HADS). About 29% (CI 95%,18–37) of the ICU nurses were found to have symptoms PTSD, in comparison to 15% (95% CI,10–21) of the ward nurses (p = 0.04). The stress levels apart from the workplace reported by both groups were statistically similar. In the sub-domains of depression and anxiety, both groups faired equal probabilities. Conclusion From this multicenter study, we have found that the staff nurses working in critical care areas of the hospital suffering from PTSD to a greater extent compared to their counterparts working in calmer ward conditions. This study will shower vital information to hospital administration and nursing leadership in improving the workplace mental health and satisfaction at jobs of ICU nurses working in tedious working conditions. How to cite this article Mathew C, Mathew C. The Prevalence of Post-traumatic Stress Disorder Symptoms in Critical Care Nurses of Tertiary Care Hospitals in South India: A Multicenter Cross-Sectional Cohort Study. Indian J Crit Care Med 2023;27(5):330–334.
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Objective: To investigate anxiety, depression, and health-related quality of life (HRQoL) over 15 years and associations between demographic, disease-related variables, anxiety and depression, and HRQoL in patients with AS. Study design: Descriptive study. Place and Duration of the Study: Istanbul Medeniyet University Goztepe Prof. Dr. Suleymsan Yalcin City Hospital, from June to December 2021. Methodology: Seventy-five patients with AS, who were followed up in Physical Medicine and Rehabilitation outpatient clinic for 15 years, were included in this study, after their diagnosis was confirmed by the hospital system. The demographic information (gender, age, accommodation status, educational status, employment status, and time unemployed), diagnosis time, remission time, drugs used, usage of TNF-inhibitor drugs and duration of usage were recorded. Bath ankylosing spondylitis disease activity index (BASDAI) was used to the measure the disease activity, the hospital anxiety depression scale (HADS) was used for anxiety and depression screening and Short Form-36 (SF-36) was used for HRQoL. Results: SF-36 physical component summary score, general health, social functioning, and role limitations due to physical health subscale scores improved significantly (p=0.004; p<0.000; p=0.024; p=0.002, respectively). It was observed that the effects of BASDAI, HADS anxiety and depression scores were significant on SF-36 (p=0.044; p=0.050; p=0.023), and time has a substantial impact on SF-36 (p=0.003). The effects of gender, education level, and occupation were not found statistically significant (p>0.05 for each). Conclusion: Within 15 years, quality of life increased, anxiety and depression decreased in AS patients. Along with disease activity, anxiety and depression were found to be the most important factors affecting the change in quality of life over time. Key words: Ankylosing spondylitis, Anxiety, Depression, Disease activity, Quality of life.
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Background Patients who completed the originating studies, BREEZE-AD1 (NCT03334396), BREEZE-AD2(NCT03334422), and BREEZE-AD7 (NCT03733301), were eligible for enrollment in the multicenter,phase-3, long-term extension study BREEZE-AD3 (NCT03334435). Methods At week 52, responders and partial responders to baricitinib 4 mg were re-randomized (1:1) into the sub-study to dose continuation (4 mg, N = 84), or dose down-titration (2 mg, N = 84). Maintenance of response was assessed from week 52 to 104 of BREEZE-AD3. Physician-rated outcomes included vIGA-AD (0,1), EASI75, and mean change from baseline in EASI. Patient-reported outcomes included DLQI, P OEM total score, HADS, and from baseline: WPAI (presenteeism, absenteeism, overall work impairment, daily activity impairment) and change from baseline in SCORAD itch and sleep loss. Results With continuous treatment with baricitinib 4 mg, efficacy was maintained up to week 104 in vIGA-AD (0,1), EASI75, EASI mean change from baseline, SCORAD itch, SCORAD sleep loss, DLQI, P OEM, HADS, and WPAI (all scores). Patients down-titrated to 2 mg maintained most of their improvements in each of these measures. Conclusion The sub-study of BREEZE AD3 supports flexibility in baricitinib dosing regimens. Patients who continued treatment with baricitinib 4 mg and down-titrated to 2 mg maintained improvements in skin, itch, sleep, and quality of life for up to 104 weeks.
Article
Background: Poorly managed cancer treatment toxicities negatively impact quality of life, but little research has examined patient activation in self-management (SM) early in cancer treatment. Methods: We undertook a pilot randomized trial to evaluate the feasibility, acceptability, and preliminary effectiveness of the SMARTCare (Self-Management and Activation to Reduce Treatment Toxicities) intervention. This intervention included an online SM education program (I-Can Manage) plus 5 sessions of telephone cancer coaching in patients initiating systemic therapy for lymphoma or colorectal or lung cancer at 3 centers in Ontario, Canada, relative to a usual care control group. Patient-reported outcomes included patient activation (Patient Activation Measure [PAM]), symptom or emotional distress, self-efficacy, and quality of life. Descriptive statistics and Wilcoxon rank-sum tests were used to examine changes over time (baseline and at 2, 4, and 6 months) within and between groups. We used general estimating equations to compare outcomes between groups over time. The intervention group completed an acceptability survey and qualitative interviews. Results: Of 90 patients approached, 62 (68.9%) were enrolled. Mean age of the sample was 60.5 years. Most patients were married (77.1%), were university educated (71%), had colorectal cancer (41.9%) or lymphoma (42.0%), and had stage III or IV disease (75.8%). Attrition was higher in the intervention group than among control subjects (36.7% vs 25%, respectively). Adherence to I-Can Manage was low; 30% of intervention patients completed all 5 coaching calls, but 87% completed ≥1. Both the continuous PAM total score ( P <.001) and categorical PAM levels (3/4 vs 1/2) ( P =.002) were significantly improved in the intervention group. Conclusions: SM education and coaching early during cancer treatment may improve patient activation, but a larger trial is needed. ClinicalTrials.gov Identifier: NCT03849950
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Background: People with chronic kidney disease (CKD) experience high levels of psychological distress, which is associated with higher mortality and adverse health outcomes. Little is known about the rates of a range of mental health difficulties or rates of suicide attempts in people with CKD. Methods: Individuals with CKD (N = 268; age range 18-94 years, M = 49.96), on haemodialysis (n = 79), peritoneal dialysis (n = 46), transplant recipients (n = 84) and who were not on renal replacement therapy (RRT) (n = 59) were recruited through the Irish Kidney Association social media pages and three Irish hospitals. Participants completed surveys to gather demographics and mental health histories, the Hospital Anxiety and Depression Scale (HADS) and the Short-form-12 to measure health-related quality of life (HRQoL). Results: 23.5% of participants self-reported they had received a mental health diagnosis, with depression (14.5%) and anxiety (14.2%) being the most common. 26.4% of participants had experienced suicidal ideation and 9.3% had attempted suicide. Using a clinical cut-off ≥8 on the HADS subscales, current levels of clinically significant anxiety and depression were 50.7% and 35.4%, respectively. Depression levels were slightly higher for those on haemodialysis compared to those with a transplant and those not on RRT. Depression, anxiety, and having a mental health diagnosis were all associated with lower HRQoL. Conclusions: People with CKD in Ireland experience high levels of psychological distress, mental health difficulties, suicidal ideation and suicide attempts. The identification of and intervention for mental health difficulties in CKD should be prioritised in clinical care.
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Background Evidence suggests an association between atopic eczema (AE) or psoriasis and mental illness. However, factors associated with mental illness are unclear. Objectives To synthesise and evaluate all available evidence on factors associated with depression, anxiety, and severe mental illness (SMI) among adults with AE or psoriasis. Methods We searched electronic databases, grey literature databases, and clinical trial registries from inception to February 2022 for studies in adults with AE or psoriasis. Eligible studies were randomised controlled trials (RCTs), cohort, cross-sectional or case-control studies where effect estimates of factors associated with depression, anxiety, or SMI were reported. We did not apply language or geographical restrictions. We assessed risk of bias using the Quality in Prognosis Studies tool. We synthesised results narratively, and if at least two studies were sufficiently homogenous, we pooled effect estimates in a random-effects meta-analysis. Results We included 21 studies (11 observational, 10 RCT). No observational studies in AE fulfilled our eligibility criteria. Observational studies in people with psoriasis mostly investigated factors associated with depression or anxiety – one cross-sectional study investigated factors associated with schizophrenia. Pooled effect estimates suggest being female, and psoriatic arthritis, were associated with depression (female sex:OR = 1.62,95%CI = 1.09-2.40,95%PI = 0.62-4.23, I2 = 24.90%, Tau2 = 0.05; psoriatic arthritis:OR = 2.26,95%CI = 1.56-3.25,95%PI = 0.21-24.23, I2 = 0.00%, Tau2 = 0.00) and anxiety (female sex:OR = 2.59,95%CI = 1.32-5.07,95%PI = 0.00-3956.27, I2 = 61.90%, Tau2 = 0.22; psoriatic arthritis:OR = 1.98,95%CI = 1.33-2.94, I2 = 0.00%, Tau2 = 0.00). Moderate/severe psoriasis was associated with anxiety (OR = 1.14,95%CI = 1.05-1.25, I2 = 0.00%, Tau2 = 0.00), but not depression. Evidence from RCTs suggested adults with AE or psoriasis given placebo had higher depression and anxiety scores compared to comparators given targeted treatment (e.g., biologic agents). Conclusions Our review highlights limited existing research on factors associated with depression, anxiety, and SMI in adults with AE or psoriasis. Observational evidence on factors associated with depression or anxiety in people with psoriasis was conflicting or from single studies, but some identified factors were consistent with those in the general population. Evidence on factors associated with SMIs in people with AE or psoriasis was particularly limited. Evidence from RCTs suggested AE and psoriasis treated with placebo was associated with higher depression and anxiety scores compared to skin disease treated with targeted therapy, however, follow-up was limited, therefore long-term effects on mental health are unclear.
Article
A study was undertaken to validate the Hospital Anxiety and Depression Rating Scale in an elderly psychiatric population. The depression subscale (HAD-D) was shown to relate well to global measures of depression and to be sensitive to changes in the severity of the depression. No conclusion could be drawn about the anxiety subscale of the HAD. The advantages of this observer-assisted self-rating scale in the elderly are discussed.
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ABSTRACT– A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
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The term 'depression' is now used to cover a wider range of emotional disturbances than was the case when psychiatrists confined their attention to patients referred to psychiatric hospitals. There is considerable confusion about the variety of meanings and the loose terminology leads to claims and counter-claims about aetiology and treatment. The current classificatory systems and the variety of rating scales do not clarify issues concerning appropriate management. The guidelines for a clearer definition of a biogenic form of the concept of depression, which is likely to respond to antidepressant drug therapy, would be of considerable value to psychiatrists, non-psychiatric physicians and others who try to treat or help people in states of disordered emotion. Such guidelines are proposed.
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A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
WArns, 3. & CUNNANs, 3. (1987) Validation of the Hospital Anxiety and Depression rating scale in an elderly psychiatric population
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KENN, C., Wooo, H., Kucyi, M., WArns, 3. & CUNNANs, 3. (1987) Validation of the Hospital Anxiety and Depression rating scale in an elderly psychiatric population. InternationalJournal of Geriatric Psychiatry. 2, 189â€"193.
863) appropriately indicate that the term ‘¿ AIDS phobia' is a misnomer, and that the fear of AIDS may be part of the content of any psychopathology (affective, obsessional, schizophrenic, or delusional disorders). In general
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Pseudo-AIDS, AIDS Panic, or AIDS Phobia Sm: Riccio & Thompson (Journal, December 1987, 151,863) appropriately indicate that the term ‘¿ AIDS phobia' is a misnomer, and that the fear of AIDS may be part of the content of any psychopathology (affective, obsessional, schizophrenic, or delusional disorders). In general, one would agree that the fact that AIDS is the content or object is of little 424