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Background Prenatal anxiety is one of the most prevalent mental disorders during pregnancy. This study assessed the prevalence of prenatal anxiety and examined whether resilience could play the mediating role in the association between self-efficacy and symptoms of prenatal anxiety among pregnant women in China. Methods A nationwide smartphone cross-sectional study was carried out in three cities (Shenyang of Liaoning Province, Zhengzhou of Henan Province and Chongqing Municipality) in China from July 2018 to July 2019. The questionnaire consisted of questions on demographic characteristics, the Generalized Anxiety Disorder Scale (GAD-7), the Chinese version of General Self-efficacy Scale (GSES), and the 14-item Wagnild and Young Resilience Scale (RS-14). A total of 665 pregnant women were recruited in this study. A hierarchical multiple regression model was employed to explore the associate factors and mediators of symptoms of prenatal anxiety. A structural equation model was employed to test the hypothesis that resilience mediates the association between self-efficacy and symptoms of prenatal anxiety. Results The prevalence of symptoms of prenatal anxiety was 36.4% in this study. Self-efficacy was negatively correlated with symptoms of prenatal anxiety (r = -0.366, P r = 0.612, P r = -0.427, P Conclusions Self-efficacy was a negative predictor of symptoms of prenatal anxiety among pregnant women. Moreover, resilience mediated the relation between self-efficacy and symptoms of prenatal anxiety among pregnant women in China. It was observed in this study that psychological interventions might be beneficial for pregnant women to relieve symptoms of prenatal anxiety through improved self-efficacy and resilience.

Background: The purpose of our study was to investigate the prevalence of anxiety and depressive symptoms and their risk factors among doctors during the coronavirus disease 2019 (COVID-19) pandemic.Methods: A hospital-based survey study was conducted. Anxiety symptoms were assessed using the Self-Rating Anxiety Scale (SAS), and depressive symptoms were assessed using the Self-Rating Depression Scale (SDS). Multivariable logistic regression was used to analyze anxiety and depressive symptoms across independent variables.Results: A total of 1,521 doctors were included; 11.11% (169/1,521) of the doctors had anxiety symptoms, and 16.90% (257/1,521) had depressive symptoms. Female sex [adjusted odds ratio (aOR), 1.69; 95% confidence interval (CI), 1.21–2.34; P = 0.002] and having a minor child (aOR, 2.31; 95% CI, 1.50–3.56; P < 0.001) were associated with an increased risk of anxiety symptoms. Female sex (aOR, 1.56; 95% CI, 1.18–2.06; P = 0.002) and having a minor child (aOR, 1.48; 95% CI, 1.06–2.01; P = 0.022) were associated with an increased risk of depressive symptoms. Older age (aOR, 0.97; 95% CI, 0.98–0.99; P = 0.008) was associated with a decreased risk of depressive symptoms.Conclusions: Anxiety and depressive symptoms have been common mental health problems in doctors during the COVID-19 pandemic. We found that female sex, having a minor child, and younger age were major risk factors for the development of anxiety and depressive symptoms among doctors during the COVID-19 pandemic.

Background: Patients with breast cancer-related lymphedema (BCRL) have lower quality of life (QOL). However, some important predictors, such as the effect of age, lymphedema severity, depression, a...

The aim of this study was to determine the effects of psychological interventions (e.g. cognitive restructuring, relaxation) on physiological and psychological health in osteoarthritis patients. A systematic literature search was done using PubMed, Embase, PsycINFO, Web of Science, China National Knowledge Infrastructure, and Wanfang Database through November 2016. Studies were included if they used a randomized controlled trial designed to explore the effects of psychological interventions in osteoarthritis patients. Two independent authors assessed the methodological quality of the trials using criteria outlined by Jadad et al. Meta-analysis was done with the Revman5.0. Twelve randomized controlled trials, including 1307 osteoarthritis patients, met the study inclusion criteria. Meta-analysis showed that psychological interventions could reduce the levels of pain [standard mean difference (SMD) -0.28, 95% CI -0.48, -0.08, P-value 0.005)] and fatigue (SMD -0.18, 95% CI -0.34, -0.01, P-value 0.04). In addition, psychological interventions significantly improved osteoarthritis patients' self-efficacy (SMD 0.58, 95% CI 0.40, 0.75, P-value 0.00) and pain coping (MD 1.64, 95% CI 0.03, 3.25, P-value 0.05). Although the effects on physical function, anxiety, depression, psychological disability were in the expected direction, they were not statistically significant. In conclusion, the role of psychological interventions in the management of osteoarthritis remains equivocal. Some encouraging results were seen with regard to pain, pain coping, self-efficacy, and fatigue. We believe that more methodologically rigorous large-scale randomized controlled trials are necessary to answer this study question.

Background Gout is a painful, inflammatory disease that may cause decreased function and health-related quality of life (HRQoL). Limited study did not take the influence of gout characteristics and anxiety on HRQoL into consideration and there are no studies associated with functional disability in individuals with gout from China. This study aims to investigate the related factors of functional disability and HRQoL in gout patients recruited from China. Methods A total of 226 consecutive gout patients and 232 age- and gender-matched healthy individuals were involved in the study. A series of questionnaires (the Short Form 36 health survey, the Patient Health Questionnaire, the Generalized Anxiety Disorder questionnaire, the 10 cm Visual Analog Scale, and the Health Assessment Questionnaire-Disability Index) were applied. Blood samples were taken to examine the level of serum uric acid. Independent samples t-tests, Chi square tests, U test, Spearman rank correlation, logistic regression modeling, and linear regression were used to analyze the data. Results After adjusted demographic variables, individuals with gout have poorer HRQoL compared to healthy controls. Univariate tests presented that patients with functional disability had longer disease duration, more frequent flares/last year, more severe total pain, more number of tophi, higher degree of depression and anxiety, with a trend toward diabetes, the treatment of colchicine and corticosteroids use, compared to patients without functional disability. Meanwhile, place of residence, hypertension, DM, disease duration, cardiovascular disease, number of flares/last year, total pain, more number of tophi, presence of tender joints, depression, anxiety, currently using colchicine and corticosteroids were correlated significantly with HRQoL. Additionally, multiple regression analysis identified severe pain, depression, and colchicine use as predictors of functional disability. Cardiovascular disease, total pain, number of flares/last year, presence of tender joints, depression, anxiety, colchicine and corticosteroids use contributed to low HRQoL. Conclusions After adjusted demographic variables, gout subjects have poorer HRQoL compared to healthy controls. Chinese gout population experiencing poor HRQoL and functional disability were likely to suffer from gout-related features and psychological problems. The results underscore the need of effective interventions including psychological nursing and appropriate treatment approaches to reduce their functional disability and improve their HRQoL.

This study aims to evaluate the prevalence of depression and anxiety and investigate the potential risk factors for depression and anxiety in Chinese gout patients. A self-report survey was administered to 226 gout patients and 232 age- and gender-matched healthy individuals. Patients were asked to complete a set of standardized self-report questionnaires. Univariate and mutiple regression were used to analyze the data. We found 15.0% of gout patients had depression, and 5.3% had anxiety. After adjusted demographic variables, the prevalence of depression was significantly higher than the healthy controls (6.0%). There were significant correlations among education, total pain, disease duration, stage of gout, functional disability, number of tophi, number of flares/last year, presence of tender joints, nephropathy comorbidity, health-related quality of life (HRQoL), and psychological status. Meanwhile, logistic regression analysis identified number of tophi, functional disability, and mental component summary (MCS) as predictors of depression in gout patients. Education and MCS were significantly accounted for anxiety. In summary, the prevalence of depressive symptoms among gout patients was higher than healthy individuals. Education, disability, tophi and HRQoL were important risk factors linked to depression/anxiety in Chinese gout population.

Background Poor sleep quality is common in patients with chronic diseases and may lead to disease aggravation and decreased quality of life. The increasing prevalence of poor sleep in individuals with chronic medical conditions is associated with adverse demographic, clinical, and psychological characteristics. However, there are currently no known reported studies related to the sleep quality of gout patients. Objectives This study aims to evaluate the prevalence of poor sleep quality and investigate the contributors of poor sleep in Chinese gout patients. Methods A self-report survey was administered to 226 gout patients and 232 healthy individuals using the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, the Patient Health Questionnaire (PHQ-9) for depression, and the Generalized Anxiety Disorder (GAD-7) questionnaire for anxiety. Gout patients completed the 10 cm Visual Analog Scale (VAS) for total pain, and the Health Assessment Questionnaire-Disability Index (HAQ-DI) for functional capacity. Blood samples were taken to examine the level of uric acid (UA). Independent samples t-tests, Chi square analyses, and logistic regression were used to analyze the data. Results Our results found that the prevalence of poor sleep (PSQI≥5) was 55.3% and the mean global score of PSQI was 6.69 (SD 3.48) in patients, which were significantly higher than the controls (17.7% and 3.83 (SD 1.88), respectively). There were significant correlations among alcohol use, HAQ-DI, PHQ-9, GAD-7 and sleep quality in gout patients. Patients with yellow rice wine and wine use preferred to have better sleep quality. While, disease stage was associated with hypertension, total pain, number of tophi, presence of tender joints and swollen joints. Meanwhile, logistic regression models identified alcohol use and depression as predictors of poor sleep quality. Conclusions More than half of Chinese gout population suffered from poor sleep, which significantly higher than healthy individuals. These findings suggested medical personnel should pay more attention to the sleep quality of gout patients, especially those with depression. Additionally, it is beneficial for the patients with normal UA level to take moderate yellow rice wine and wine to improve their sleep quality. Acknowledgements This study was supported by Grants from the Chinese National Natural Science Foundation (no. 81671616 and 81471603). Disclosure of Interest None declared

Background Depression and anxiety are common worldwide and may lead to disease aggravation and decreased health-related quality of life (HRQoL). The increasing prevalence of depression and anxiety in gout patients is associated with demographic and gout characteristics. However, there are currently no known reported studies related to the association between HRQoL and depression/anxiety. Objectives This cross-sectional study aims to evaluate the prevalence of depression and anxiety and investigate the potential risk factors for depression and anxiety in Chinese gout patients. Methods A self-report survey was administered to 193 gout patients and 208 healthy individuals from September 2015 to September 2016. Patients were asked to complete a set of standardized self-report questionnaires [Visual Analog Scale (VAS), Health Assessment Questionnaire-Disability Index (HAQ-DI), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7) questionnaire, Short Form 36 health survey (SF-36)]. Independent samples t-tests, χ2 analyses, and logistic regression were used to analyze the data. Results We found 15% of gout patients had depression, and 5.2% had anxiety, which were significantly higher than the healthy controls (1.4 and 1.0%, respectively). There were significant correlations among education, pain, disease duration, stage of gout, disability, number of tophi, presence of tender joints, HRQoL, and psychological status. Meanwhile, logistic regression analysis identified number of tophi, HAQ-DI, and MH scale as predictors of depression in gout patients. Education, GH, and VT domains were significantly accounted for anxiety. Conclusions The prevalence of depressive and anxious symptoms among gout patients was higher than healthy individuals. Education, disability, tophi and HRQoL were important risk factors linked to this disorder in Chinese gout population. These findings suggested medical personnel should pay more attention to the psychological health of gout patients and make objective interventions to relieve their depression and anxiety, especially those with low education level, more than two tophi, severe disability, and poor HRQoL. Acknowledgements This study was supported by Grants from the Chinese National Natural Science Foundation (no. 81671616 and 81471603). Disclosure of Interest None declared

Background As the most common arthritis in adults, gout is a painful, inflammatory disease that may cause functional disability and decreased health-related quality of life (HRQoL). However, there are currently no known reported studies related to functional disability and HRQoL of gout patients from China. Objectives This cross-sectional study aims to investigate the effect of demographic variables, disease parameters, and psychological status on functional disability and HRQoL of Chinese gout patients. Methods A self-report survey was administered to 226 gout patients and 232 healthy individuals using the Short Form 36 health survey (SF-36) for HRQoL and the Health Assessment Questionnaire-Disability Index (HAQ-DI) for functional disability. Gout patients were asked to complete the 10 cm Visual Analog Scale (VAS) for total pain, the Patient Health Questionnaire (PHQ-9) for depression, and the Generalized Anxiety Disorder (GAD-7) questionnaire for anxiety. Blood samples were taken to examine the level of uric acid (UA). Independent samples t-tests, Chi square tests, spearman and/or pearson correlation and multiple linear regression were used to analyze the data. Results Our results found that individuals with gout have poorer HRQoL compared to healthy controls and the mean disability score was 0.32 (SD 0.54), representing mild disability. SF-36 and almost all components of the SF-36 score were associated with place of residence, hypertension, DM, cardiovascular disease, disease duration, number of flares/last year, total pain, number of tophi, presence of tender joints, colchicines use, corticosteroids use, depression, and anxiety (p Conclusions Chinese gout patients experienced mild disability and poor HRQoL. Disease status and psychological status were important risk factors linked to functional disability and HRQoL in Chinese gout population. These data suggest medical personnel should pay more attention to functional disability and HRQoL of gout patients and make suitable interventions to relieve their psychological disorders and finally to reduce their functional ability and improve their HRQoL. Acknowledgements This study was supported by Grants from the Chinese National Natural Science Foundation (no. 81671616 and 81471603). Disclosure of Interest None declared

Background Systemic lupus erythematosus (SLE) patients are at high risk for depression and anxiety. However, the estimated prevalence of these disorders varies substantially between studies. This systematic review aimed to establish pooled prevalence levels of depression and anxiety among adult SLE patients. Methods We systematically reviewed databases including PubMed, Embase, PsycINFO, and the Cochrane database library from their inception to August 2016. Studies presenting data on depression and/or anxiety in adult SLE patients and having a sample size of at least 60 patients were included. A random-effect meta-analysis was conducted on all eligible data. Results A total of 59 identified studies matched the inclusion criteria, reporting on a total of 10828 adult SLE patients. Thirty five and thirteen methods of defining depression and anxiety were reported, respectively. Meta-analyses revealed that the prevalence of major depression and anxiety were 24% (95% CI, 16%-31%, I2 = 95.2%) and 37% (95% CI, 12%–63%, I2 = 98.3%) according to clinical interviews. Prevalence estimates of depression were 30% (95% CI, 22%–38%, I2 = 91.6%) for the Hospital Anxiety and Depression Scale with thresholds of 8 and 39% (95% CI, 29%–49%, I2 = 88.2%) for the 21-Item Beck Depression Inventory with thresholds of 14, respectively. The main influence on depression prevalence was the publication years of the studies. In addition, the corresponding pooled prevalence was 40% (95% CI, 30%–49%, I2 = 93.0%) for anxiety according to the Hospital Anxiety and Depression Scale with a cutoff of 8 or more. Conclusions The prevalence of depression and anxiety was high in adult SLE patients. It indicated that rheumatologists should screen for depression and anxiety in their patients, and referred them to mental health providers in order to identify effective strategies for preventing and treating depression and anxiety among adult SLE patients. Trial registration Current Meta-analysis PROSPERO Registration Number: CRD 42016044125. Registered 4 August 2016. Electronic supplementary material The online version of this article (doi:10.1186/s12888-017-1234-1) contains supplementary material, which is available to authorized users.

The aim of this meta-analysis was to evaluate the effect of telephone-based interventions on prognostic outcomes and health-related quality of life (HRQoL) in breast cancer patients and survivors. A systematic search of the Cochrane Library, Web of science, Medline, EMBASE, CNKI and CBM database was carried out. Randomised, controlled trials (RCTs) examining the effects of telephone-based intervention versus a control group receiving no telephone intervention, on prognostic outcomes and HRQoL with breast cancer were included. A meta-analysis was conducted to quantify the effects of telephone-based interventions on anxiety, depression, fatigue, self-efficiency, physiological function, social-domestic function and quality of life. In total, 14 studies involving 2002 participants were included. Due to the effect of telephone-based interventions, statistically significant results were found on anxiety (standard mean difference [SMD] = −0.16, 95% confidence intervals [CI] [0.01, 0.30], p = .04), self-efficiency (SMD = 0.22, 95% CI [−0.34, −0.10], p = .0004), social-domestic function (SMD = 0.19, 95% CI [−0.35, −0.03], p = .02) and quality of life (SMD = 0.54, 95% CI [−1.00, −0.08], p = .02). Although the effects on depression, fatigue and physiological function were in the expected direction, these effects were not statistically significant (p > .05) based on the insufficient evidence.

Background Poor sleep quality is common in rheumatoid arthritis (RA) patients and may lead to disease aggravation and decreased health-related quality of life (HRQoL). The increasing prevalence of poor sleep in RA patients is associated with adverse demographic, clinical, and psychological characteristics. However, there are currently no known reported studies related to the effects of sleep quality on HRQoL in RA patients from China. This cross-sectional study aims to evaluate the contributors of poor sleep and the effects of sleep quality on HRQoL in Chinese RA patients. Methods A self-report survey was administered to 131 RA patients and 104 healthy individuals using the Pittsburgh Sleep Quality Index (PSQI) for sleep quality. RA patients completed the Hospital Anxiety and Depression Scale for anxiety and depression, the 28-joint Disease Activity Score for disease activity, the 10 cm Visual Analog Scale for pain, the Health Assessment Questionnaire-Disability Index for functional capacity and the Short Form 36 health survey for HRQoL. Blood samples were taken to gain some biochemical indicators (e.g., erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, and anti-cyclic citrullinated peptide). Independent samples t-tests, Chi square analysis, logistic regression modeling and linear regression were used to analyze these data. Results Our results found that the prevalence of poor sleep (PSQI ≥ 5) was 78.6% and the mean global score of PSQI was 7.93 (SD 3.98) in patients, which were significantly higher than the controls (18.7% and 3.88 (SD 1.89), respectively). There were significant correlations among synthetic disease-modifying antirheumatic drugs, erythrocyte sedimentation rate, pain, disease activity, functional capacity, anxiety/depression and sleep quality in RA patients. Meanwhile, logistic regression models identified disease activity and depression as predictors of poor sleep quality. Poor RA sleepers had impaired HRQoL than good RA sleepers, and sleep quality was independently and significantly associated with social function and mental components summary. Conclusions The majority of Chinese RA patients suffered from poor sleep, which significantly impairs their HRQoL. The data suggested the need for holistic assessment and management of RA patients and the importance of objective interventions to improve their sleep quality and finally to improve their HRQoL. Electronic supplementary material The online version of this article (doi:10.1186/s12955-016-0550-3) contains supplementary material, which is available to authorized users.