Objectives To analyze the prevalence and clinical features of depression, anxiety, depression and anxiety in Tibetan patients with epilepsy and to improve the diagnosis and treatment. Methods 102 patients with epilepsy, who had been admitted to the Department of Neurology of the People's Hospital of Tibet Autonomous Region from January 2017 to December 2017, were diagnosed according to the Chinese Standard Classification and Diagnostic Criteria for Mental Disorders (3rd Edition) (CCMD-3). The Hamilton depression scale (HAMD 24 items) and the Hamilton anxiety scale (HAMA 14 items) were used to measure depression and anxiety. Different genders, ages, durations, frequency of attacks, and seizures types were analyzed for depression, anxiety, depression and anxiety. Univariate analysis was used to screen the factors that may cause depression, anxiety, depression and anxiety in patients with epilepsy. Logistic regression was used to analyze the risk factors of depression, anxiety, depression and anxiety in patients with epilepsy. Results Among the 102 patients with epilepsy, 35 (34.31%) comorbid depression, 10 (9.80%) comorbid anxiety, and 54 (52.94%) comorbid depression and anxiety. Univariate analysis showed that there was a significantly statistical difference in the duration of the disease and the frequency of seizures in local patients with epilepsy (P<0.05). There was a statistically significant difference in the frequency of epileptic seizures and anxiety (P<0.05). Multivariate logistic regression analysis showed that the probability of anxiety in patients with a disease duration of ≤2 years was only 10.1% of those with a course >2 years [OR=0.101, 95%CI (0.012, 0.915), P<0.05]; and the frequency of seizures was not an risk factors for epileptic comorbid with anxiety (P>0.05). The rate of depression and anxiety in patients with seizure frequency >2 times per month was 4.853 times higher than that of patients with seizure frequency ≤2 times per month [OR=4.853, 95%CI (2.024, 11.634), P<0.05]. Conclusions Tibetan patients with epilepsy have a high prevalence of depression, anxiety, depression and anxiety. In the diagnosis and treatment, we should strengthen the understanding and provide the appropriate prevention and treatment to improve the diagnosis and treatment level.
Objective To identify the key influencing factors of death anxiety in rural elderly and their mechanisms of action. Methods A total of 701 rural elderly individuals from 6 prefecture-level cities (prefectures) in Sichuan Province were selected for a questionnaire survey on death anxiety, health-related physical fitness, and subjective well-being. A structural equation model was constructed to thoroughly analyze the influencing factors of death anxiety and their mechanisms of action. Results Higher levels of health-related physical fitness, higher levels of subjective well-being, and having more children were the top three protective factors against death anxiety among elderly people in rural Sichuan, with effect values of −0.392, −0.287, and −0.154, respectively. In contrast, suffering from chronic diseases was the leading risk factor for death anxiety, with an effect value of 0.127. Suffering from chronic diseases was the leading risk factor for death anxiety, with an effect value of 0.127. The structural equation model fitting results showed that the medical insurance type of rural elderly in Sichuan (β=−0.062, P=0.002), suffering from chronic diseases (β=0.127, P=0.001), hospitalization due to health reasons in the past year (β=0.086, P=0.002), and educational level (β=−0.067, P=0.001) had indirect effects on death anxiety through health-related physical fitness. Not seeking medical treatment due to financial difficulties in the past year had an indirect effect on death anxiety through subjective well-being (β=0.060, P=0.002). The number of children had both a direct effect on death anxiety (β=−0.119, P=0.004) and an indirect effect through subjective well-being (β=−0.034, P=0.001). Health-related physical fitness had both a direct effect on death anxiety (β=−0.278, P=0.001) and an indirect effect through subjective well-being (β=−0.114, P=0.002). Conclusion Multiple factors directly or indirectly affect the level of death anxiety in the rural elderly population. Health-related physical fitness, subjective well-being, and the number of children are important protective factors. Moreover, health-related physical fitness and subjective well-being act as mediating variables in the chain of effects of multiple factors on death anxiety.
Objective To explore the risk factors of postoperative anxiety in patients with pancreatic cancer undergoing total pancreatectomy. Methods A total of 31 patients who underwent total pancreatectomy for pancreatic cancer between July 2011 and December 2016 were collected and analyzed in this retrospective study. The patients’ postoperative Self-Rating Anxiety Scale scores were collected, and the exposure factors were analyzed to identify the risk factors of postoperative anxiety through univariate analysis and multiple logistic regression analysis by SPSS 21.0 statistical software. Results In the 31 patients, there were 17 males and 14 females, with an average age of (66.16±9.09) years, an average body mass index of (21.11±3.10) kg/m2, and an average postoperative hospital stay of (14.58±7.47) days. There were 23 patients (74.2%) with postoperative anxiety, and 30 patients (96.8%) with hyperglycosemia required insulin therapy. The total perioperative mortality was 3.2%. In the univariate analysis, age (P=0.012), smoking history (P=0.043), preoperative diabetes mellitus (P=0.012), postoperative bile leakage (P=0.043), and postoperative abdominal infection (P=0.026) were related factors of the postoperative anxiety. In the multiple logistic regression analysis, patients without preoperative diabetes was an independent risk factor of postoperative anxiety (P=0.013). Conclusions For patients undergoing total pancreatectomy, it is needed to pay attention to the patients’ postoperative psychological conditions and assess the postoperative anxiety, especially for those without preoperative diabetes. To improve the life quality and long-term survival of these patients, health education and psychological intervention are needed.
Music has a powerful influence on people’s psychology and emotions. Many clinical research reports confirm that music therapy can directly affect and improve people’s psychological and physiological status, alleviate patients’anxiety and other adverse physiological emotions, improve the effectiveness of surgical treatment, and promote rapid recovery. Lung cancer surgery has the characteristics of great trauma, high incidence of postoperative complications and poor prognosis. Therefore, music therapy has its unique advantages for lung cancer. With the rapid development of thoracic surgery (ERAS), as an important part of psychological intervention, music therapy plays an irreplaceable role in the surgical treatment of lung cancer. This article reviews the impact of music therapy on anxiety in lung cancer surgery.
Objective To evaluate the reliability and validity of the Chinese version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS) in preoperative anxiety in patients with local anesthesia. Methods From May to December 2020, a convenient sampling method was used to conduct an APAIS questionnaire survey on patients undergoing percutaneous renal biopsy in the Department of Nephrology, West China Hospital, Sichuan University, and the reliability and validity of the scale were analyzed. ResultsA total of 460 questionnaires were distributed and 444 valid questionnaires were returned, with a valid response rate of 96.5%. The Cronbach α of APAIS was 0.896, the Guttman split-half reliability was 0.811, and the content validity index was 0.891. The model fit was 12.122 for the chi-square fit index/degree of freedom, 0.916 for the goodness-of-fit index, 0.902 for the value-added fit index, 0.079 for the root mean square error of approximation, and 0.946 for the comparative fit index. The APAIS anxiety subscale score was positively correlated with the 7-item Generalized Anxiety Disorder Scale score (r=0.518, P<0.001). Conclusion The APAIS has good reliability and validity for evaluating the level of preoperative anxiety in patients with local anesthesia, but the application of the scale in other conditions requires further testing.
ObjectiveTo investigate the psychology and sleep statuses of liver transplantation recipients during the outbreak of COVID-19.MethodsCluster sampling was used to investigate the patients who underwent liver transplantation in the West China Hospital of Sichuan University from January to February 2020. The psychology and sleep statuses were evaluated by the self-designed questionnaire, State-Trait Anxiety Inventory (SAI), Center for Epidemiological Studies Depression Scale (CES-D), and Pittsburgh sleep quality index (PSQI).ResultsTwenty-seven liver transplantation recipients were included in this study. The questionnaires of the 27 patients were collected. The SAI score was (46.41±8.77); The score of CES-D was (13.11±7.87), there were 2 (7.4%) patients with depression; The PSQI score was (6.44±4.02), there were 7 (25.9%) patients with sleep disorders. The points of anxiety and depression of the patients with different gender, age, education level, marital status, residence, living conditions, primary disease, Child-Pugh classification, whether suffered SARS epidemics, COVID-19 knowledges level, medical insurance, family annual income per capita, and income and expenditure of cash had no significant differences (P>0.05) during the outbreak of COVID-19. However, the points of patients with male or suffered SARS or the family annual income per capita ≥60 000 yuan were higher than those of patients with female or not-suffered SARS or the family annual income per capita <60 000 yuan (P<0.05).ConclusionsAnxiety and sleep disorder of liver transplantation recipients are common during the outbreak of COVID-19, which could not be ignored. Knowledges of COVID-19 should be paid to spread so as to reduce psychological pressure and improve sleep quality.
Objective To investigate the current situation of anxiety and depression in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and analyze the related influencing factors. Methods A questionnaire survey was conducted among AECOPD patients admitted to the Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Anhui Medical University from August 2022 to October 2023. The survey included basic demographic information, anxiety and depression scores, quality of life and dyspnea symptoms in the AECOPD patients. The clinical data of patients in the electronic medical record system were also collected. According to the anxiety score or depression score, the patients were divided into an anxiety group and a non-anxiety group, or a depression group and a non-depression group. The indicators between two groups were compared and the influencing factors were analyzed. Results Among the 164 patients with AECOPD, 123 patients (75.0%) were complicated with anxiety, 125 patients (76.2%) were complicated with depression, and 105 patients (64.0%) were complicated with anxiety and depression. Education level, place of residence, monthly income, smoking index, and chronic obstructive pulmonary disease assessment test (CAT) score were associated with AECOPD and anxiety (P<0.05). Higher CAT score was an independent risk factor for anxiety in the patients with AECOPD. Residence, monthly income, smoking index, CAT score, modified British Medical Research Council (mMRC) dyspnea questionnaire rating, actual bicarbonate, neutrophilic granulocyte percentage (NEU%), lymphocyte percentage (LYM%), basophile percentage (BASO%), alkaline phosphatase, total carbon dioxide concentration, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were associated with AECOPD and depression (P<0.05). Among them, higher CAT score and PLR value were independent risk factors of AECOPD and depression. Conclusion Anxiety and depression have higher prevalence in AECOPD patients, and the influencing factors include quality of life, dyspnea symptoms, education level, place of residence, monthly income, smoking index, acid base balance, NEU%, LYM%, BASO%, NLR和PLR, etc.
Objective To evaluate the therapeutic efficacy and safety of trazodone versus alprazolam for generalized anxiety disorder (GAD). Methods After the third day of a three-day screening period, 60 patients with generalized anxiety disorder were randomly assigned to the trazodone group (30 patients, 50-150 mg/d), and alprazolam group (30 patients 1.2-4 mg/d) for 4 weeks. Patients and their doctors were blind. Data were analyzed by SPSS 10.0 and intention-to-treat analysis. Results The total effective rate of trazodone was 77% (23/30), while alprazolam was 70% (21/30) (Pgt;0.05) .No difference was seen for adverse events. None was lost to follow in the two groups. Conclusions Trazodone appears to be as effective as alprazolam in treating generalized anxiety disorder. Adverse events may include confusion and loss of appetite, but patients are able to tolerate these.
Objective To understand the status quo of depression and anxiety emotion in perioperative patients with thoracic neoplasms under the concept of enhanced recovery aftersurgery. Methods Huaxi emotional-distress index scale (HEI) was adopted to investigate the mental status of 195 patients with thoracic neoplasms in Department of Thoracic Surgery, West China Hospital, and the nursing outpatients between September and November in 2016. There were 118 males and 77 females at age of 17–80 (55.72±12.66) years. Results There was significant difference in mental health level between the preoperative patients and the postoperative patients (3.70±3.41vs. 11.01±9.78,P<0.001). The incidence of depression and anxiety emotion in the postoperative patients was significantly higher than that in the preoperative patients (50.00%vs. 9.60%, P<0.001). Besides, there was significant difference of depression and anxiety degree between the preoperative patients and postoperative patients (P<0.001). Moderate to severe depression and anxiety were mostly found in the postoperative patients while mild to moderate depression and anxiety in the preoperative patients. Conclusion Patients with thoracic neoplasms have much emotional obstacle in perioperative period. The incidence and severity degree of depression and anxiety emotion in postoperative patients are higher than those in preoperative patients.
ObjectiveTo evaluate the predictors of generalized anxiety disorder (GAD) among teachers in 3 months after Lushan earthquake. MethodsA prospective cohort study was conducted to diagnostically evaluate the psychological sequelae and GAD during 14-20 days and 85-95 days after the earthquake. The possible predictive factors of psychological sequelae were assessed by a self-made questionnaire and the GAD was assessed by the GAD symptom criterion of M.I.N.I. in 3 months. The univariate and multivariate logistic regression analysis (ULRA, MLRA) were applied to analyze the predictors of GAD after the two-staged assessments. ResultsThere were a total of 319 teachers completed the two-staged assessments. The total response rate was 51.3%. Seventy teachers were diagnosed as GAD and the prevalence of GAD in 3 months was 21.9%. The predictive factors by ULRA included:male, older than 35 years old, having unlivable house, living in tents, sleeping difficulties, easy to feel sad, physical discomfort, loss of appetite, feeling short of social support, unable to calm down for working, feeling difficult for teaching, observing more inattention of students, and wanting to ask for a leave. The independent predictors by MLRA included:male, having unlivable house, feeling short of social support, and feeling difficult for teaching. ConclusionThe teachers have a higher likelihood of GAD after earthquake. It is essential to pay more attention to those male teachers, who feel short of social support and don't have a livable house thus to prevent the GAD at the early stage of post-earthquake.