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Background: Anxiety is a common comorbidity in patients with COPD, yet it remains underrecognized. Existing anxiety measures contain somatic items that can overlap with symptoms of COPD and side effects of medications. There is a need for a disease-specific nonsomatic anxiety scale to screen and measure anxiety in patients with COPD., Methods: In phase 1, 88 patients with COPD (mean age 71 years, 36% men) completed a 16-item scale developed with patients and clinicians. Six items were removed using item and factor analysis. In phase 2, 56 patients with COPD (mean age 70 years, 48% men) completed the 10-item scale and other self-report measures of anxiety, quality of life, and functional limitations. Of these, 41 patients completed the scale on a second occasion, 14 days later. Construct validity (using confirmatory factor analysis [CFA]), discriminant validity, convergent validity, and anxiety screening accuracy were explored., Results: The Anxiety Inventory for Respiratory Disease (AIR) had high internal consistency (Cronbach α = 0.92) and test-retest reliability (intraclass correlation coefficient = 0.81) and excellent convergent validity, correlating with the Hospital Anxiety and Depression-Anxiety subscale (r = 0.91, P < .001). The scale also discriminated between patients with clinical anxiety (measured using the Patient Health Questionnaire) and those without (U = 9, P < .001). A cutoff score of 14.5 yielded a sensitivity of 0.93 and specificity of 0.98 for detection of clinical anxiety. A two-factor model of general anxiety and panic symptoms had the best fit according to CFA., Conclusions: The AIR is a short, user-friendly, reliable, and valid scale for measuring and screening anxiety in patients with COPD.

Objective: This study sought to elicit and describe the first-hand experiences of anxiety in community patients with stable chronic obstructive pulmonary disease (COPD). Anxiety is common among patients with COPD. Clinical anxiety affects up to two thirds of patients, leading to reduced quality of life and physical functioning. There has been little research exploring the experiences of anxiety in patients with COPD, particularly in individuals with stable respiratory symptoms., Methods: We interviewed 14 community patients with stable COPD and self-reported symptoms of anxiety. Data were analyzed using thematic network analysis to develop basic, organizing, and global themes., Results: Patients reported intense thoughts of fear, hopelessness, and confusion that were associated with the anxiety and panic attacks. Self-management was important, particularly self-talk coping strategies., Conclusions: Unmanaged anxiety seems to be particularly distressing for patients with COPD. Self-management strategies can be highly effective in preventing and managing anxiety., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Ninety five men who accompanied their wives to the fertility clinic of a Nigerian teaching hospital (index group) were compared with 95 matched controls using the Hospital Anxiety and Depression Scale (HADS). Their rates of significant anxiety symptoms (24.2%) and depressive symptoms (20.0%) were higher than the corresponding rates of 13.7% and 9.5% for the controls. The higher rate of significant depressive symptoms in the infertility group was significant (p < 0.05). Their mean scores on the two subscales of HADS (anxiety and depressive subscales) were also significantly higher (p < 0.001). Results of multiple regression analysis indicated that lower anxiety symptoms were predicted by age group among subjects in the index group, indicating that belonging to higher age groups was associated with lower anxiety symptoms. In addition, lower anxiety symptoms were predicted by 'being very religious'. However, higher anxiety symptoms were predicted by previous exposure to couple counselling. On the predictors of depressive symptoms, lower symptoms were predicted by age group and religiosity while higher symptoms were predicted by respondents' previous exposure to couple counselling and higher number of wives. Other factors investigated such as level of education, duration of infertility, attitude towards child adoption, pressure from extended family members on account of infertility, expectation of the respondents on the possible outcome of treatment and the result of semen analysis were not observed as predictors of anxiety and/or depressive symptoms. The observations on emotional distress among these men, together with previous observations that counselling/support received from gynecological consultations is usually inadequate indicates that the quality of psychological support that is available to them needs to be improved and modified. Involvement of mental health professionals (psychiatrists and clinical psychologists) in the provision of psychological couple counselling for infertility-related emotional distress could improve the quality of support provided. The establishment of special counselling units in hospitals providing treatment for infertility is advocated.

The aims of this study were to compare anxiety and depressive symptoms between a sample of Nigerian women and their husbands on treatment for infertility, and to identify factors, which are associated with emotional burden in their families. In total, 82 women and their spouses completed the two subscales of the Hospital Anxiety and Depression Scale (HADS) at the gynaecology clinics of a Nigerian teaching hospital. The women had a significantly higher mean anxiety score (p<0.001) and higher mean depression score (p <0,001) than their husbands. On both anxiety and depression subscales of the HADS, the scores of the women were positively correlated with their husbands' scores (p<00.1). Emotional burden in the family was significantly associated with low religious inclination of husband and wife; strained relationship of couple; extended family pressure on husband; husbands' negative attitude towards child adoption; and lower age group of wife. Women with infertility in this subregion experience higher emotional burden than their husbands. Psychological couple counselling is required to ameliorate the emotional burden of infertility imposed by these factors.

The goals of this study were to compare symptoms of anxiety and depression between patients with epilepsy and a healthy control group, and to determine the possible factors associated with clinically significant anxiety and depression symptoms in patients with epilepsy. One hundred and four adult Nigerians (52 with epilepsy and 52 matched healthy controls) were assessed with the Hospital Anxiety and Depression Scale (HADS). The results obtained indicated a statistically significant difference in anxiety and depression symptoms between patients with epilepsy and controls. The association between anxiety symptoms and polytherapy was significant (P=0.008), as was the association between depression symptoms and duration of epilepsy longer than 10 years (P=0.04). Emotional problems are more common in patients with epilepsy than in the general population. Identifying and monitoring those with epilepsy of long duration and rational prescription of antiepileptic drugs are important in reducing the risk of affective problems.

Objectives: The objectives of this study were to compare depressive and anxiety symptoms between Nigerian women with a difficult delivery (cesarean or instrumental) and those with an unassisted vaginal delivery during the puerperium and to highlight other factors of predictive value for symptoms., Methods: Women (n=83) who had a difficult delivery (index group) were compared with matched control subjects (n=83) who had an unassisted vaginal delivery. They were all evaluated using the State-Trait Anxiety Inventory (state form) and Zung's Self-Rating Depression Scale. Information was also collected on their sociodemographic characteristics, obstetric factors, and general health problems., Results: After delivery, 19 subjects from the index group (22.9%) obtained scores higher than the threshold for significant depressive symptoms, as compared with 13 subjects from the control group (15.7%). Six weeks later, the rates were 10 (12.0%) and 8 (9.6%), respectively. The mean anxiety and depressive symptom scores for the difficulty delivery group were significantly higher at birth. Although both groups improved over time, the differences were still significant after 6 weeks. Using stepwise regression analysis, we observed cesarean delivery and polygamy to predict depressive symptoms after birth but not after 6 weeks. Previous induced abortions were also observed to predict anxiety and depressive symptoms throughout. Depressive symptoms at 6 weeks were predicted by depressive symptoms at birth and by anxiety symptoms at 6 weeks. The same pattern was observed for anxiety symptoms., Conclusion: Although difficult delivery was associated with higher levels of symptoms, it was not predictive of postpartum depressive and anxiety symptoms at 6 weeks. Also, of other possible risk factors studied, only illegal abortions were observed to be important in the study population during the puerperium.