Chronic obstructive pulmonary disease is often accompanied by anxiety or depression. The exacerbation of anxiety and depression can lead to the deterioration of chronic obstructive pulmonary disease, reduce patients’ quality of life, worsen poor prognosis, and increase the risk of death. Anxiety and depression are one of the important causes of death in patients with chronic obstructive pulmonary disease, but the complexity of their risk factors and pathogenesis often lead to clinicians being unable to make accurate diagnosis and treatment in a timely manner. Based on existing research, this article elaborates on the risk factors and pathogenesis of chronic obstructive pulmonary disease complicated with anxiety or depression, aiming to improve the diagnosis and treatment ability of clinical physicians for chronic obstructive pulmonary disease complicated with anxiety or depression, achieve timely diagnosis and treatment, improve patients’ prognosis, and improve quality of life.
ObjectiveTo explore the distribution pattern of respiratory symptoms and relevant factors in patients with pulmonary nodules. MethodsDemographic and clinical information were collected from patients who visited the Thoracic Surgery Outpatient Clinic of Guangdong Provincial People’s Hospital from January 2021 to January 2022. Hospital Anxiety and Depression Scale (HADS) was used to assess their anxiety and depression level. ResultsA total of 1173 patients were enrolled, including 449 males and 724 females, with an average age of 46.94±11.43 years. Among the patients with pulmonary nodules, 37.7% of them had at least one respiratory symptom; 24.4% had cough, 14.0% had expectoration, 1.3% had hemoptysis and 14.9% had chest pain. Old age, male, exposure to second-hand smoking or environmental smoke, hair coloring and history of tuberculosis were major risk factors for respiratory symptoms (P<0.05). Middle age, old age, male, exposure to environmental smoke were major risk factors for cough (P<0.05); old age, smoking, larger maximum nodules diameters, exposure to environmental smoke and history of pneumonia were major risk factors for expectoration (P<0.05); male, multiple nodules, hair coloring, exposure to second-hand smoking and history of tuberculosis were major risk factors for chest pain (P<0.05). Symptomatic patients showed generally higher HADS scores than asymptomatic patients (P<0.001). ConclusionCough, expectoration and chest pain are the predominant respiratory symptoms for patients with pulmonary nodules. The presentation of respiratory symptoms increases patients' anxiety and depression.
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.
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.
Anxiety is a strong behavioral and psychological reaction with fear components, while depression is a mental disorder dominated by high or low mood, both of which are accompanied by cognitive and behavioral changes, and are common comorbidities in patients with heart disease. Cardiac surgery is one of the important factors which trigger specific emotional and physiological reactions of patients. Persistent or initial depression and anxiety after surgery will not only increase surgical complications, short- or long-term mortality and medical costs, but also seriously affect patients' social function and quality of life. With the transformation of bio-psycho-social medical model, it is necessary to evaluate the perioperative psychological state and biological risk of patients undergoing cardiac surgery. This article reviews the characteristics, related mechanisms and therapeutic interventions of anxiety and depression in patients undergoing cardiac surgery.
Objective To investigate the status quo and influencing factors of depression and anxiety in postoperative patients with thoracic neoplasms. Methods The general information questionnaire and Huaxi emotional-distress index scale (HEI) were adopted to survey 70 patients after surgery of thoracic neoplasms at the thoracic nursing outpatients from September to November 2016. There were 43 males and 27 females with age of 18-78 (56.20±11.34) years. Results The prevalence rate of depression and anxiety among postoperative patients with thoracic neoplasms was 50.0%, and moderate to severe negative emotions predominated. There was significant difference in educational levels, postoperative hospitalization and postoperative complications (P<0.05), while no significant difference in age, gender, disease types, complicated diseases, surgical procedures, pathological stages and hospitalization expenditures between patients with unhealthy emotions and normal emotions (P>0.05). Conclusion There is a high prevalence rate of negative emotion among postoperative patients with thoracic neoplasms. Educational levels, postoperative hospitalization and postoperative complications are important factors for negative emotion.
Objective To assess the effectiveness and safety of trazodone versus alprazolam on adults’ generalized anxiety disorder (GAD). Methods Such databases as PubMed (1980 to May 2012), CBM (1990 to May 2012), VIP (1989 to May 2012), CNKI (1990 to May 2012) and WanFang Data (1990 to May 2012) were searched to collect the randomized controlled trials (RCTs) about trazodone vs. alprazolam for adults’ GAD. According to the inclusion and exclusion criteria, two reivewers screened literature, extracted data and assessed the quality of the included studies, then meta-analysis was conducted using RevMan 5.0 software. Results A total of 5 RCTs involving 403 patients were included. The results of meta-analysis showed that: a) After four-week treatment, there were no significant differences between the two groups in the HAMA scores (RR=1.04, 95%CI 0.95 to 1.13, P=0.38) and cure rate (RR=1.05, 95%CI 0.75 to 1.48, P=0.76); and b) The somnolence rate of the trazodone group was lower than that of the alprazolam group (RR=0.42, 95%CI 0.25 to 0.72, P=0.001). But there were no significant differences between the two groups in dizziness (RR=0.52, 95%CI 0.27 to 1.01, P=0.05), fatigue (RR=0.10, 95%CI 0.01 to 1.41, P=0.09), and poor appetite (RR=2.82, 95%CI 0.28 to 28.23, P=0.38). Conclusion There is no significant difference between razodone and alprazolam in the effectiveness when treating GAD, but razodone has lower side effects while alprazolam tends easily to cause somnolence. For the quantity limitation and low methodological quality of the included studies, this conclusion still needs to be further proved by more high quality RCTs.
This paper is aimed to analyze the topological properties of structural brain networks in depressive patients with and without anxiety and to explore the neuropath logical mechanisms of depression comorbid with anxiety. Diffusion tensor imaging and deterministic tractography were applied to map the white matter structural networks. We collected 20 depressive patients with anxiety (DPA), 18 depressive patients without anxiety (DP), and 28 normal controls (NC) as comparative groups. The global and nodal properties of the structural brain networks in the three groups were analyzed with graph theoretical methods.The result showed that ① the structural brain networks in three groups showed small-world properties and highly connected global hubs predominately from association cortices; ② DP group showed lower local efficiency and global efficiency compared to NC group, whereas DPA group showed higher local efficiency and global efficiency compared to NC group; ③ significant differences of network properties (clustering coefficient, characteristic path lengths, local efficiency, global efficiency) were found between DPA and DP groups; ④ DP group showed significant changes of nodal efficiency in the brain areas primarily in the temporal lobe and bilateral frontal gyrus, compared to DPA and NC groups. The analysis indicated that the DP and DPA groups showed nodal properties of the structural brain networks, compared to NC group. Moreover, the two diseased groups indicated an opposite trend in the network properties. The results of this study may provide a new imaging index for clinical diagnosis for depression comorbid with anxiety.
Objective To investigate the incidences of anxiety and depressive symptoms among patients with intrauterine adhesions (IUA) managed by day surgery model, and explore their influential factors. Methods Convenience sampling was used to select patients who underwent day surgery at West China Second University Hospital, Sichuan University between January 2021 and December 2022. General information questionnaire and Hospital Anxiety and Depression Scale were used to assess the socio-demographic data and anxiety and depressive symptoms of the participants. Logistic regression was used to analyze the influential factors of anxiety and depressive symptoms. Results A total of 1100 patients were included. The incidence of anxiety and depressive were 16.5% (181/1 100) and 16.9% (186/1 100) among patients undergoing day surgery for IUA respectively. Longer waiting days for admission [odds ratio (OR)=1.012, 95% confidence interval (CI) (1.004, 1.020), P=0.004], married [OR=0.547, 95%CI (0.344, 0.869), P=0.011], more times of adhesion separation [OR=0.826, 95%CI (0.691, 0.986), P=0.034], older age [OR=0.947, 95%CI (0.909, 0.987), P=0.010] were influencing factors for anxiety symptoms in patients with IUA. Unemployment [OR=0.504, 95%CI (0.256, 0.994), P=0.048], university or undergraduate education [OR=0.326, 95%CI (0.208, 0.512), P<0.001], and high school or vocational school education [OR=0.532, 95%CI (0.319, 0.888), P=0.016] were the influencing factors for depressive symptoms in patients with IUA. Conclusions There is a high incidence of anxiety and depressive symptoms among patients with IUA under the management of day surgery mode. The influential factors include socio-demographic factors (age, education level, marital status and occupation) and disease factors (times of adhesion). Medical staff should pay attention to the early screening of mental health status of patients with IUA, and give targeted prevention and treatment measures.
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.