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Objectives: Mindfulness-Based (non-contact) Boxing Therapy (MBBT) is a novel intervention designed to empower and promote self-agency through behavioral interventions, while reducing barriers to exercise for individuals with mental disorders. MBBT is an instructor-led, manualized, non-contact boxing group-exercise program (delivered in 90 min sessions, twice a week, over 10 weeks) that blends principles of mindfulness, meditation and group therapy. The current study tested the acceptability and feasibility of delivering MBBT to adults with major depressive disorder (MDD) or generalized anxiety disorder (GAD). Methods: Nine adult outpatients with MDD or GAD were recruited from a psychiatric outpatient clinic in Toronto, Canada in a 10-week feasibility trial of MBBT using a pre-post design. Feasibility was assessed through recruitment and retention rates, while acceptability was assessed through the CSQ-8, and self-questionnaires. Secondary clinical outcomes included the PHQ-9, GAD-7, K10, CGI, and MAAS. Trial registry: ISRCTN23023309. Results: Eight participants (5 female, 3 male) were included in the final analysis. Results indicated a high user retention (89%), attendance (84%), and satisfaction (98%). The study observed a statistically significant mean percent reduction in depression (54%), anxiety (51%) and distress (36%), alongside a mean percent increase in mindfulness (79%). Post intervention qualitative feedback from participants revealed themes of inclusivity and accessibility, cathartic release and control of emotions, improved self-esteem and confidence, self-agency, community, and trust in leadership. Conclusions: Given the limitation of the study, MBBT appeared to be feasible and acceptable as an exercise/behavioural intervention. Further well-designed randomized clinical trials are warranted to confirm the clinical benefits of MBBT. [ABSTRACT FROM AUTHOR]

Little is known about the impact of environmental pollution on thyroid function in the non-occupationally exposed population of Kazakhstan. This study aimed to investigate serum levels of thyroxine (T4), thyroid-stimulating hormone (TSH), and anti-thyroid peroxidase (TPO) antibodies in the environmentally exposed population of Kazakhstan in relation to symptoms of anxiety. A total of 1,388 nominally healthy individuals residing in areas exposed to three major types of environmental pollution prevalent in Kazakhstan—non-ferrous metallurgy, condensate gas extraction, and activities of the Semipalatinsk Nuclear Test Site (SNTS)—were enrolled. All comparisons were made with 493 individuals residing in settlements without industrial or military pollution. Serum-free T4, TSH, and anti-TPO levels were tested using a solid-phase chemiluminescent immunoassay. The Generalized Anxiety Disorder 7-item (GAD-7) inventory was utilized to screen for anxiety symptoms. The prevalence of subclinical hypothyroidism was significantly higher in residents of settlements near the condensate gas field than in control sites (20.3 vs. 15.0%). In comparison, the prevalence of overt hypothyroidism was insignificantly higher (0.7 vs. 0.6%). The prevalence of subclinical hyperthyroidism was insignificantly higher in residents of settlements around the SNTS. The prevalence of overt hyperthyroidism was insignificantly higher in residents of areas proximal to the condensate gas field compared to the controls. The prevalence of both normal and elevated serum levels of anti-TPO antibodies did not differ significantly between different sites. Moderate and severe anxiety symptoms were the least common in residents of the two control sites (5.9%). This study carries potential implications for tailored public health interventions and policies. [ABSTRACT FROM AUTHOR]

Introduction: Treatment persistence and adherence are essential for achieving therapeutic goals in patients with multiple sclerosis (MS). OroSEP is an independent patient-support program (PSP) in France for patients with relapsing–remitting MS (RRMS) receiving oral disease-modifying therapies. Methods: TEC-ADHERE (NCT04221191; 08/19/2019–09/15/2022) was a prospective, non-interventional, phase 4 study to assess the effect of OroSEP on persistence and adherence to dimethyl fumarate (DMF; Tecfidera™) in patients with RRMS. Outcomes were compared for patients in OroSEP versus non-OroSEP patients who received their neurologists' standard of care (SoC). Patients initiated DMF at month 0 (M0); follow-up visits occurred at M3 and M6. Primary outcome was persistence at M6. Secondary outcomes included persistence at M1 and M3, adherence at M6 (Girerd questionnaire), anxiety (Generalized Anxiety Disorder Assessment), patient satisfaction at M6 (Treatment Satisfaction Questionnaire for Medication), patient and neurologist satisfaction with OroSEP participation, and adverse events (AEs). Results: Per-protocol population included 341 patients (OroSEP, n = 135; SoC, n = 206). Persistence was similar for OroSEP vs SoC (M6, 75.9% vs 76.6%; M1, 96.0% vs 92.4%; M3, 85.5% vs 89.0%). At M6, mean adherence was higher for OroSEP (5.4) vs SoC (4.7; p < 0.0001), and good adherence (Girerd score = 6) was achieved by more OroSEP patients (55.7%) than SoC patients (29.6%; p < 0.01). Mean anxiety scores were lower in the OroSEP group than in the SoC group at baseline (7.1 vs 8.8; p = 0.02) and M6 (3.4 vs 6.1; p < 0.001). Mean satisfaction scores at M6 were higher for OroSEP (77.4) vs SoC (64.2; p < 0.01). Most neurologists (n = 11/14) agreed that OroSEP helped improve adherence. Treatment-related AEs occurred in 62 (36.3%) OroSEP patients and 76 (42.9%) SoC patients; most common were flushing, diarrhea, hot flush, and abdominal pain. Conclusion: These outcomes support the value of PSPs in encouraging adherence, alleviating anxiety, improving patient satisfaction, and supporting patients to be more independent in managing MS. Trial Registration: ClinicalTrials.gov identifier, NCT04221191. [ABSTRACT FROM AUTHOR]

• Converging evidence supports the role of Matrix Metalloproteinases (MMPs) in psychiatric disorders. • In the present study we study the associations of plasma MMPs and TIMPs with mental disorders in young adults aged 24 years in the Avon Longitudinal Study of Parents and Children (ALSPAC). • Logistic regression was employed for the primary analyses to investigate associations between markers and mental disorders. Regressions were adjusted for sex, body-mass index (BMI), and smoking. • After adjusting for confounding factors, we found strong associations between TIMP4 levels and depression and generalized anxiety disorder. Weak evidence was found for an association between MMP3 and depressive disorders. • In contrast with previous literature reports our findings did not suggest alterations of MMP9 levels in mental disorders. Converging evidence supports the role of Matrix Metalloproteinases (MMPs) in psychiatric disorders. Originally identified as regulators of the extracellular matrix (ECM), MMPs' functions span multiple processes, including inflammation, synaptic plasticity, neuronal migration, and blood–brain barrier maintenance. Tissue Inhibitors of Metalloproteinases (TIMPs) are major regulators of MMPs. In the present study we examined the associations of plasma MMPs and TIMPs with mental disorders in young adults aged 24 years in the Avon Longitudinal Study of Parents and Children (ALSPAC). The present study was a nested case control study within the Avon Longitudinal Study of Parents and Children and comprised 374 participants who met criteria for psychiatric disorders (35 met the criteria for psychotic disorder, 201 for mild/moderate depressive disorder, and 266 for generalised anxiety disorder) and 401 controls. All cases and controls had were selected from the group of 4019 participants who had attended at age 24 years, completed psychiatric assessments and provided plasma samples. Plasma concentrations of MMP2, MMP3, MMP9 and TIMP-4 were quantified using proximity extension assays available on Olink® Cardiovascular Panel III. Logistic regression analysis compared standardised MMPs and TIMPs levels in cases and controls. Models were adjusted for sex, body mass index, and cigarette smoking. There was evidence for an association between MMP3 and depressive disorder (Odds ratio [OR] 1.35, 95 % confidence interval [CI] 1.06–1.73). There was evidence for an association between TIMP4 and depressive disorder (OR 1.51, 95 % CI 1.22–1.88) and generalised anxiety disorder (OR 1.43, 95 % CI 1.19–1.72). There was no evidence for an association between MMPs and psychotic disorders. The study revealed that 24-year-olds with depressive and anxiety disorders exhibited elevated plasma concentrations of TIMP-4 compared to controls. There was evidence for an association between MMP3 and depressive disorder. These findings provide further support for the involvement of metalloproteinases as biomarkers in the pathophysiology of mental disorders during early adulthood. [ABSTRACT FROM AUTHOR]

This study aimed to explore key characteristics of the out-of-home care subgroup of a nationally representative Australian sample. To ensure that mental health services are appropriately targeted, it is critical that we understand the differential impacts of childhood experiences for this cohort. Using the Australian Child Maltreatment Study (N = 8503), we explored patterns of childhood maltreatment and adversity of participants who reported ever being placed in out-of-home care, such as foster care or kinship care. In addition, the prevalence of current and lifetime diagnosis of four mental health disorders were explored. Results showed that the care experienced subgroup reported more types of maltreatment and adverse experiences than the control group. They were also more likely to meet diagnostic threshold for post-traumatic stress disorder, generalised anxiety disorder and major depressive disorder than the control group. These findings can be used to guide mental health practitioners to target interventions more effectively within the out-of-home care cohort. [ABSTRACT FROM AUTHOR]

Background: It seems that despite the significant role of worry and uncertainty intolerance in occurrence, maintaining and intensify the symptoms of generalized anxiety disorder, few interventions have targeted such variables. Aims: The aim of the present study was to investigate the effectiveness of schema therapy on worry states and intolerance of uncertainty in patient with generalized anxiety disorder. Methods: The research method was a semi-experimental pretest-posttest design with a 45-day follow-up stage by control group. The study population included all people with generalized anxiety disorder referred to 40 psychological counseling centers in the 18th district of Tehran in 2023 which among those 34 cases were selected through available sampling and they were randomly divided into experimental and control groups. The Experimental group received schema therapy (Young, 2008) sessions for eight 90-minutes sessions. All participants were assessed by the generalized anxiety disorder scale- 7 item (Spitzer et al, 2006), Pen state worry questionnaire (Meyer et al, 1990) and Intolerance of Uncertainty Scale (Freeston et al, 1994). Data were analyzed by SPSS-24 software and MANOVA with repeated measure test. Results: The results demonstrated that schema therapy is effective in reducing worry states and intolerance of uncertainty (p< 0.01) and that this effect is long-lasting (p< 0.01). Conclusion: According to the findings of the study, therapists and clinical specialists should consider schema therapy as an effective treatment strategy for generalized anxiety disorder. [ABSTRACT FROM AUTHOR]

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Introduction: Anxiety is a prevalent psychological issue among cancer patients, significantly affecting their quality of life and potentially influencing treatment outcomes. This study aims to investigate the prevalence and associated factors of anxiety among cancer patients at the University of Gondar Comprehensive Specialized Hospital in Northwest Ethiopia. Methods: A cross-sectional study design was used, involving 384 cancer patients, selected by systematic random sampling technique, from the oncology ward. Data were collected using the Generalized Anxiety Disorder 7-item (GAD-7) scale and the Oslo Social Support Scale (OSS-3). Descriptive and inferential statistics, including bi-variable and multi-variable logistic regression analyses, were employed to analyze the data. Results: The prevalence of anxiety was 88.3%, with 34.4% of patients experiencing severe anxiety, 29.2% moderate anxiety, and 24.7% mild anxiety. Significant predictors of anxiety included participants age>= 61years (AOR = 2.99, 95% CI = 1.31–6.79), participants age 30-60 years (AOR = 4.13, 95% CI = 1.53–11.07), female sex (AOR = 2.04, 95% CI = 1.02–4.07), advanced cancer stage (AOR = 3.08, 95% CI = 1.11–8.53), and ongoing treatment (AOR = 2.40, 95% CI = 1.14–5.10). Conclusion: The study found a high prevalence of anxiety among cancer patients, compared to the previous studies, highlighting the need for integrated psycho-oncology services. Specific interventions are necessary for high-risk groups, including older patients, females, and those with advanced-stage cancer. [ABSTRACT FROM AUTHOR]

Objective: This study examined mental health literacy and predictors of disorder recognition among primary care providers (PCPs) in Hungary. Methods: 208 PCPs in Hungary completed a survey assessing demographics, mental health stigma, and exposure to mental health (i.e., personal experiences and having a family member/friend with a mental health condition). Participants read six vignettes describing obsessive-compulsive disorder (OCD) harm/aggression subtype (OCD-Aggression), OCD order/symmetry subtype (OCD-Order), generalized anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder (PD), and major depressive disorder (MDD) and were asked to identify each condition, perceived disorder causes, and provide treatment referrals. Descriptive analyses were used to characterize disorder recognition rates, perceived disorder causes, and treatment referrals. Binary logistic regression analyses were conducted to examine the degree to which demographic characteristics, mental health stigma, and exposure to mental health conditions predict accurate disorder recognition. Results: Identification rates for each vignette were: OCD-Aggression (27.9%), OCD-Order (75.5%), SAD (34.1%), GAD (76.0%), PD (78.8%), and MDD (91.3%). First-choice treatment referrals were a psychiatrist for OCD-Aggression (63.0%), OCD-Order (53.8%), and MDD (46.6%), a psychologist/therapist for SAD (58.7%) and GAD (48.6%), and a PCP for PD (39.9%). Mislabeling conditions was significantly associated with older age (for GAD, OCD-Aggression, PD and MDD), male gender (for GAD), greater mental health stigma (for OCD-Order), and lack of exposure to mental health conditions (for SAD). Conclusions: Findings highlight strengths (e.g., depression recognition) and limitations in knowledge of mental health conditions among PCPs in Hungary and identifies targets to address to improve mental health literacy. [ABSTRACT FROM AUTHOR]

Background: Uric acid has antioxidant properties, and several studies have suggested its neuroprotective effects. Despite reports of increased oxidative damage and decreased antioxidants in anxiety disorders, findings remain inconclusive. This study investigated the association between serum uric acid levels and anxiety symptoms, stratified by sex, using nationwide data from South Korea. Methods: Data were derived from the Korea National Health and Nutrition Examination Survey, which included 2,228 males and 2,805 females. Presence of anxiety symptoms was defined as a Generalized Anxiety Disorder 7-item scale (GAD-7) score of ≥ 10. Study participants were categorized into three groups based on serum uric acid levels: 1 (lowest) to 3 (highest). Multivariable logistic regression analyzed the association between uric acid levels and anxiety symptoms, stratified by sex. Results: Compared to reference group 2, females in group 1 had increased anxiety symptoms (odds ratio (OR) 2.28, 95% confidence interval (CI) 1.48–3.49). When anxiety symptoms were defined as a GAD-7 score of ≥ 5, females in groups 1 (OR 1.68, 95% CI 1.30–2.16) and 3 (OR 1.35, 95% CI 1.04–1.74) both showed more anxiety symptoms than group 2, with a U-shaped relationship between uric acid levels and anxiety symptoms. In males, uric acid levels weren't significantly linked to anxiety symptoms. Conclusions: This study indicates that low serum uric acid levels are associated with a higher prevalence of anxiety symptoms only in females, suggesting involvement of oxidative stress in anxiety disorders and its sex-based variation. [ABSTRACT FROM AUTHOR]

Background and objective: The COVID-19 pandemic substantially impacted mental health globally, leading to increased levels of anxiety and fear. Although it is well known that socioeconomic factors and ethnicity play a role in mental health outcomes, the intersectional effects of these determinants during the pandemic are unclear, especially among adolescents. Thus, this study sought to explore the relationship between socioeconomic factors, ethnicity, and two mental health parameters—fear of COVID-19 (FCV) and generalized anxiety disorder (GAD)—among high school students in California, United States. Methods: A cross-sectional analysis was performed with 990 high school-aged participants from the San Joaquin Valley and Santa Clara County, California, recruited via convenience/snowball sampling using an online questionnaire from 15 June to 14 August 2022. The Fear of Coronavirus Scale (FCV-19S) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure fear and anxiety, respectively. Results: The results reveal significant associations between ethnicity, socioeconomic status (i.e., family income), and FCV-19S and GAD-7 scores. Severe GAD and FCV were reported in 9.8% (n = 97) and 8.38% (n = 83) of participants. Black participants reported significantly higher levels of FCV (F = 6.867, p < 0.001) and generalized anxiety (F = 17.066, <0.001) than their counterparts Additionally, girls exhibited higher anxiety scores (t = 2.960, p = 0.003, CI = 0.23–1.15) and fear scores (t = 3.619, p = 0.001, CI = 0.40–1.37) than boys. Furthermore, fear and anxiety scores exhibited a strong positive correlation (r = 0.702, p < 0.001). Conclusion: This study suggests that gender, ethnicity, and socioeconomic factors are significantly linked to higher levels of FCV and GAD in teenagers during the pandemic. These findings underscore the importance of considering social determinants of mental health when addressing the psychological impact of COVID-19 on teenagers, particularly for vulnerable populations. [ABSTRACT FROM AUTHOR]

Background: Anxiety disorders are the second most common mental health disorders in terms of disability-adjusted life years and years of life lost across all age groups. A bidirectional relationship between anxiety disorders and diabetes mellitus has been documented. This study aimed to determine the prevalence of anxiety and its associated factors among patients with diabetes receiving care at public primary care clinics in Kuwait during the first quarter of 2024. Methodology: A cross-sectional study was conducted in the first quarter of 2024 at three primary healthcare centres within the Capital Governate in Kuwait City. Adults with diabetes mellitus for longer than six months duration were requested to participate by the health promoters and the Generalised Anxiety Disorder questionnaire was shared via a mobile link/QR scan. Data were collected through self-or interviewer-administered surveys, cleaned and coded in Microsoft Excel, and analysed using STATA version 18. Descriptive analysis was initially conducted followed by bivariate and multivariate analysis with a p < 0.05 and a 95% confidence interval used to determine the association between demographic and clinical factors and GAD. Results: A total of 554 patients participated, yielding an 80% response rate. Anxiety symptoms were observed in 48% of respondents, though only 4% (n = 25) had a GAD score > 10. Among participants with moderate-to-severe anxiety (n = 21), 52% were aged 50–59 years, 90% were non-native Kuwaiti citizens, and 62% had an HbA1C measurement > 7 mmol/L. Multivariate analysis indicated that non-native Kuwait citizens were significantly more likely to have moderate-to-severe anxiety (AOR: 6.99, 95% CI: 1.42–34.43) compared to Kuwaiti nationals. Conversely, participants attending clinic visits every two months were less likely (AOR: 0.30, 95% CI: 0.00–0.50) to report moderate-to-severe anxiety symptoms than those attending monthly. Conclusion: While nearly half of patients with diabetes displayed anxiety symptoms, only a small proportion (4%) experienced moderate-to-severe anxiety. Non-native Kuwaiti residents were significantly more likely to have GAD scores > 10. Integrating anxiety screening into diabetes care may improve outcomes for this high-risk group. [ABSTRACT FROM AUTHOR]

Anxiety disorder is one of the most prevalent mental disorders in China. However, there are obvious subjective factors in the current assessment of anxiety disorders, which may lead to certain diagnostic errors. The identification and diagnosis of anxiety disorders can be further improved if objective biological indicators are added in the assessment process. The current research validates facial expression recognition as a screening tool to assist in detecting generalized anxiety disorder. Based on the International Affective Picture System, we constructed an aided diagnostic experimental paradigm and recorded their facial expression. The split-half reliability was displayed by the Pearson correlation heatmap. The paradigm, GAD-7 and HAMA scales were administered to 60 generalized anxiety disorder patients and 60 matched healthy controls to evaluate the criterion-related validity. Additionally, we conducted a diagnostic study by using MINI as a gold standard and calculated ROC analysis to examine the screening performance of the facial expressions. The heatmap showed very high correlations (r > 0.60, PS < 0.05) along the diagonal of the square heatmap (from the bottom left corner to the top right). The Pearson correlation coefficients between the GAD-7, HAMA and seven facial expressions ranged from −0.35(neutral, P < 0.01) to 0.34(angry, P < 0.01). The intergroup effects of neutral, anger and fear emotions were statistically significant (F = 18.893, P < 0.001; F = 20.535, P < 0.001; F = 9.091, P = 0.003). ROC analysis showed AUC for neutral, angry and scared facial expressions were 0.723, 0.792 and 0.727 respectively. This study constructed a tool for auxiliary screening of GAD patients and provided an objective automatic facial expression recognition method to assist psychological diagnosis. • This study aims to provide an efficient and accurate intelligent method for further psychological diagnosis and treatment. • This research combined with facial expression recognition technology to assist in screening people with GAD. • The heatmap showed satisfactory split-half reliability. • The criterion-related validity and screening validity were excellent. • Three facial expressions are significant between GAD and HC: neutral, angry and scared facial expressions. [ABSTRACT FROM AUTHOR]

Depression is a common disorder for which there are several treatments options including different psychological treatments. The aim of this study was to investigate the effects of internet-based interpersonal psychotherapy (IPT) for symptoms of depression in randomized controlled trial. Following recruitment via advertisement a total of 113 participants with mild to moderate symptoms of depression were included and randomized to either a ten-week internet-based IPT with weekly therapist guidance or a waitlist control condition. The primary outcome was symptoms of depression measured weekly with the Montgomery Åsberg Depression Rating Scale (MADRS-S) and at pre- and post-treatment assessment with the Beck's Depression Inventory (BDI-II). Secondary outcomes were self-rated quality of life and symptoms of generalized anxiety disorder. We also measured therapeutic alliance and treatment credibility. Outcomes were evaluated with a latent growth curve model (for MADRS-S) and robust linear regression models (for the other measures). The trial was conducted during the Covid-19 pandemic in the spring of 2021. Significant differences favoring the treatment group were found on three of the four outcomes: BDI-II, quality of life ratings, and ratings of generalized anxiety. Between-group effect sizes for these outcomes were moderate (BDI-II, quality of life) or small (generalized anxiety). The latent growth curve model did not indicate a significant difference on the weekly MADRS-S ratings. Exploratory analyses did not show an association between therapeutic alliance, treatment credibility and outcome. Missing data at post-treatment was high in the treatment group (37 %), though the missingness was not significantly related to observed ratings at pre-treatment or estimated trajectories during the treatment. Few participants completed all modules. The Covid-19 pandemic situation may have affected both effects and dropout rates. Internet-based IPT can lead to significant improvements, though the reductions in symptoms of depression were not consistent across the two measures used. Completion rates and dropout patterns suggest a need for improved acceptability. The trial was preregistered at Clinicaltrials.gov (Identifier: NCT04721678). Registered January 2021. https://clinicaltrials.gov/study/NCT04721678 • Internet-supported interpersonal psychotherapy has only been tested in a few trials • In this study internet-supported IPT for depression was tested against a waitlist condition. • Significant differences favoring the treatment group were found on three of the four outcomes: BDI-II, BBQ, and GAD-7. • The study adds to the literature on internet-delivered psychological treatments for depression. [ABSTRACT FROM AUTHOR]

Valid, reliable, and easy-to-administer scales are crucial for identifying mental health conditions, especially in LMICs where such scales tend not to be validated. This study aims to address this gap by investigating the psychometric properties and factorial structure of the PHQ-9 and GAD-7 in a sample of young women in Soweto, South Africa. The PHQ-9 and GAD-7 were administered to 6028 women aged 18–28 years old. Cronbach's alpha, Mokken scale analysis, and Confirmatory Factor Analysis were used to provide support for the internal consistency and construct validity of these scales. Both scales demonstrated good internal consistency (α = 0.81 for PHQ-9 and α = 0.84 for GAD-7). Internal consistency reliability was further supported by positive inter-item correlations and item-by-scale correlations for all items on both measures. CFA of the PHQ-9 and GAD-7 showed a reasonable fit for the 1-factor model and 2-factor models (depression and anxiety with somatic and cognitive subtypes). This study was limited to young African women in urban Soweto who were proficient in English, which may affect generalizability. Differences in language or cultural context may impact the accuracy and applicability of these scales to other African populations. The PHQ-9 and GAD-7 are valid and reliable for identifying psychological distress in the studied population. Despite showing good psychometric properties, further diagnostic assessment is needed to confirm clinical diagnoses. The scales are useful for identifying those at risk but not a substitute for comprehensive diagnostic evaluations. • Investigation of psychometric properties of PHQ-9 and GAD-7 mental health scales • Support for internal consistency and construct validity among South African women • Further diagnostic assessment is required to confirm clinical diagnoses. [ABSTRACT FROM AUTHOR]

Current evidence is insufficient to support specific tools for screening Major Depressive Disorder (MDD). Early detection of subthreshold depression (SD) is crucial in preventing its progression to MDD. This study aims to develop nomograms that visualize the weights of predictors to improve the performance of screening tools. Participants were recruited from Peking University Sixth Hospital and Beijing Physical Examination Center between October 2022 and April 2024. The Mini-International Neuropsychiatric Interview (MINI) 5.0.0 was employed as the diagnostic gold standard, and Generalized Anxiety Disorder questionnaire-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Pittsburgh Sleep Quality Index (PSQI) were employed to assess anxiety, depression, and sleep state. The nomograms were constructed by incorporating optimal predictors, selected through the Least Absolute Shrinkage and Selection Operator (LASSO), into a multivariate logistic regression model to estimate the probability of MDD and SD. After matching age and education, 164 participants were included in each group for analysis. Both nomograms demonstrated superior discrimination, calibration, and clinical applicability compared to PHQ-9. Anxiety emerged as a most significant predictor for SD, while sleep problems exhibited high rankings for both SD and MDD. The two predictors subsequently affect concentration and daytime functioning. With a lack of external validation data, the performance of nomograms may be overestimated. This study is the first attempt to develop a nomogram for predicting SD, while also providing a nomogram for MDD. The crucial predictors offer valuable insights into potential variables for clinical intervention. • Predicting subthreshold depression or major depressive disorder needs six items. • Two nomograms enhance predictive performance compared to PHQ-9. • Anxiety is the most influential factor in predicting subthreshold depression. • Insomnia consistently ranks high across both nomograms. [ABSTRACT FROM AUTHOR]

Which adverse childhood experiences are causally associated with anxiety in adulthood is unclear. Sensitive Period Model states that early adverse experiences can influence anxiety levels in adulthood. However, it remains unknown which adverse experience is the most important early adverse factor for anxiety in adulthood, and whether early alleviation or aggravation of this adverse experience predicts a decrease or increase in anxiety levels in adulthood. A national cross-sectional survey was conducted from 20 June 2023 to 31 August 2023, with a total of 30,054 adults aged 18 years or older recruited on questionnaires that completed the Adverse Childhood Experiences Scale and Generalised Anxiety Disorder Scale. We used network analysis and computer simulation techniques to simulate aggravating and simulate alleviating interventions to observe changes in anxiety levels to identify early adverse experiences causally associated with anxiety levels in adulthood. The results of both the network analysis and the nodeIdentifyR algorithm (NIRA) indicated that in the Adverse Childhood Experiences-Anxiety Network (ACE-GAD Network), being cursed and insulted (CUR) by parents in childhood was the most severe early adverse experience contributing to anxiety in adulthood. In particular, simulated aggravation interventions targeting CUR in young and middle-aged adults resulted in significantly higher levels of anxiety in adulthood. This suggests that preventing verbal curses or insults in childhood can be an early preventive measure for future anxiety interventions. This study has important theoretical and practical implications, providing new insights for early prevention of anxiety and family education. • Adverse childhood experiences can affect anxiety in adulthood. • Being insulted is the most severe early adverse experience of anxiety in adulthood. • Adverse childhood experiences influence more in youth and middle life. [ABSTRACT FROM AUTHOR]

Background: A standard questionnaire for generalized anxiety disorders is the GAD-7. Attempts to improve its screening capacity in oncological settings resulted in a discussion about lowering its cut-off. This study examines the diagnostic accuracy of the GAD-7 items depending on applied cut-offs and whether, similar to depressive symptoms, a distinction between somatic-emotional and cognitive items might be relevant. Patients and methods: Screening data from 4705 patients with cancer who were treated at the outpatient clinic of the National Centre for Tumour Diseases in Heidelberg were analysed. For the individual GAD-7 items sensitivity, specificity, positive and negative predictive values, and Clinical Utility Index were determined for cut-off ≥ 7, ≥ 8, ≥ 10 and ≥ 15 in the GAD-7 questionnaire. Results: The best overall diagnostic accuracy was found for a cut-off ≥ 8. The cognitive items had the best diagnostic accuracy for identifying severe GAD (cut-off ≥ 15), and the somatic-emotional items had the best diagnostic accuracy for identifying mild to moderate GAD (cut-off ≥ 7, ≥ 8 and ≥ 10). Conclusions: Our data support the recommendation of lowering the GAD-7 cut-off in oncology settings and suggest that in anxiety disorders, a symptom overlap between the physical illness and a possible mental disorder should be considered. [ABSTRACT FROM AUTHOR]

Introduction: Generalized anxiety disorder (GAD) is the most common type of anxiety disorders. GAD usually occurs in adolescence or early adulthood, and the prevalence of GAD is higher among college-enrolled young adults than in the general adult population. However, there is a lack of evidence regarding the effectiveness of acupuncture in the treatment of GAD. This study's objective is to evaluate the efficacy of acupuncture in the treatment of GAD in college students and its stability. Methods: A total of 142 subjects will be recruited for the randomized controlled trial (RCT) of current undergraduate and graduate students with GAD and will be randomized into treatment and control groups. The treatment group will receive conventional acupuncture, while the control group will receive sham acupuncture using Streitberger needles. Both groups will be administered 8 acupuncture treatment (2 times per week for 4 weeks). The follow-up duration will be 2 months. The Hamilton Anxiety Scale (HAMA) will be used as the primary outcome of the study to measure the severity of anxiety disorder. The secondary outcomes of this study will be included the Pittsburgh Sleep Quality Index (PSQI) and Self-rating anxiety Scale (SAS). The study will also evaluate the success of blinding and the safety. Discussions: Findings of this RCT will help evaluate the efficacy of acupuncture treatment for GAD in college students, potentially promoting it as an alternative treatment option. The protocol was registered at clinicaltrials.gov (Identifier: ChiCTR2400080688) [ABSTRACT FROM AUTHOR]

Introduction: Anxiety disorders are among the most common mental illnesses in the US. An estimated 31.1% of U.S. adults experience any anxiety disorder at some time in their lives. Understanding some of the molecular underpinnings of anxiety could lead to improved treatments over current strategies focusing on symptom relief rather than root causes. One significant neurotransmitter system exerting control over anxiety is the nicotinic receptor subdivision of the cholinergic system. The murine Lynx2 gene, encoding a protein modulator of nicotinic acetylcholine receptors, is expressed in anxiety-related neural circuitry in rodents and has been functionally associated with anxiety-like behavior. Methods: We examined variations in the human LYNX2 (LYPD1) gene and their potential effects on anxiety levels in a cohort of 624 participants. Participants completed validated anxiety questionnaires (e.g., STICSA and STAI), which assessed both their current anxiety and their general tendency to experience anxiety. Possible functional alterations due to one such mutation was assessed through atomic force microscopy (AFM) and computational modeling. Results: We identified a previously unreported single nucleotide polymorphism (SNP) in the mature protein-coding region of LYNX2 that was associated with significantly higher than normal anxiety scores. These elevated scores resembled those seen in patients clinically diagnosed with generalized anxiety disorder and panic disorder, although this genetically defined subpopulation did not typically report such diagnoses. Through computational modeling of the homopentameric α7 nicotinic receptor subtype and in vitro atomic force microscopy (AFM), we discovered that a specific LYNX2 SNP is linked to a reduced binding affinity between the LYNX2 protein and nAChRs, offering a potential functional explanation for the role that this mutation may play in anxiety. Discussion: A polymorphism in LYNX2, which codes for an inhibitory modulator of nicotinic acetylcholine receptors, has the potential to lead to sensitized nicotinic receptor activity in anxiety-related circuits. The LYNX2 protein has been shown to bind to multiple nicotinic acetylcholine receptor subtypes, including α4β2, α7, and α3β4 subtypes, each of which have been shown to be involved in affective behaviors. This work suggests that a subpopulation of individuals harboring a deleterious mutation in LYNX2 may predispose them to anxiety through abnormal nicotinic receptor control. In the future, this work may lead to the development of a biomarker for anxiety or a diagnostic tool for the early detection of individuals with susceptibility to anxiety. [ABSTRACT FROM AUTHOR]

Context: Internet gaming disorder (IGD) was included in the 5th edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Addiction to Internet gaming is prevalent among Indian medical students. This study aims to measure the severity and pattern of gaming behavior along with the impact and association of IGD on different psychological conditions such as depression and anxiety. Methods: A cross-sectional study was conducted through an online survey among 845 medical students at a tertiary care teaching hospital in India. The Internet GD Scale-Short Form (IGDS9-SF) was used to assess the intensity of gaming disorders, while patient health questionnaire-9 (PHQ-9) and generalized anxiety disorder assessment (GAD-7) were used to assess the severity of depression and anxiety, respectively. Results: A total of 194 students were identified as current gamers, out of which 36 had gaming disorders based on DSM-5 diagnostic criteria for IGD from the current study sample. Multiple regression was calculated for the following age (B = 0.85, P = 0.002), weight (B = 0.07, P = 0.02), average time spent on gaming/day in hours (B = 1.01, P < 0.0001), PHQ-9 scores (B = 0.35, P ≤ 0.0001), GAD-7 scores (B = −0.24, P = 0.01) - Model R 2 = 0.35, F = 19.41, P < 0.0001. Conclusions: Potentially problematic gaming was found to be associated with psychological symptoms, negative affectivity, and a preference for solitude. There is a need for other studies that can help in creating awareness about the prevalence of gaming disorders in medical students. [ABSTRACT FROM AUTHOR]

The Correction Notice in the Journal of Clinical Medicine addresses errors in Tables 1, 2, 5, and 6 of a study on the efficacy of Cognitive-Behavior Therapy for Generalized Anxiety Disorder delivered by videoconference. The corrections include adjustments to probabilities, standard deviation abbreviations, and values in the tables. The study analyzed factors influencing treatment efficacy, such as motivation, working alliance, therapist competence, and client satisfaction, with a focus on the change in intolerance of uncertainty. The findings indicate the significant role of intolerance of uncertainty in the regression analysis. [Extracted from the article]

Objective: Postoperative nausea and vomiting (PONV) was one of the common complications in patients with HCC who had undergone TACE. This study was a prospective analysis of patient data to investigate risk factors for PONV in patients after TACE. Material and Methods: Data were collected from 212 patients undergoing TACE in the interventional department between August 2022 and August 2023. Including: gender, age, education, BMI, operation time, concomitant underlying diseases and drugs, preoperative limosis, history of nausea and vomiting, history of kinetosis, history of smoking or drinking, and occurrence of PONV. A visual analog scale was used to measured pain. Neuropsychological status was also assessed, using the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7) and the Patient Health Questionnaire-9(PHQ-9). To identify risk factors for PONV, multiple logistic regression analysis was used. The receiver operating characteristic (ROC) curve was plotted to assess the regression model. The clinical trial number did not apply in the study. Results: In this study, 212 out of a total of 904 patients with HCC undergoing TACE during their hospital stay were included for analysis. Among the included patients, the incidence of PONV was as high as 42% (89/212). Multiple logistic regression analysis showed that chronic gastritis (odds ratio [OR] = 10.350; p = 0.020), VAS (OR = 3.835; p = 0.003), epirubicin (OR = 26.685; p < 0.001), and the dosage of lipiodol (≥5 mL) (OR = 1.385; p < 0.001) were independent risk factors of PONV after TACE. The ROC curve demonstrated that the AUC was 0.902, the sensitivity was 84.3%, and the specificity was 87%. Conclusions: PONV is highly prevalent among patients with HCC after TACE. Chronic gastritis, pain, epirubicin, and the dosage of lipiodol were independent risk factors for PONV. The risk prediction model that was constructed according to the aforementioned factors demonstrated good discriminatory capacity for predicting the risk of post-TACE PONV, which can improve the recognition of medical providers, and has a good ability to prevent and treat nausea and vomiting. [ABSTRACT FROM AUTHOR]

Objective: Social psychological research has indicated that people strive for self-consistent feedback and interactions, even if negative, to preserve the epistemic security of knowing themselves. Without such self-verification, any interpersonal exchange may become frustrated, anxiety-riddled, and at risk for deterioration. Thus, it may be important for therapists to meet patients' self-verification needs as a responsive precondition for early alliance establishment and development. We tested this hypothesis with patients receiving cognitive behavioral therapy for generalized anxiety disorder—a condition that may render one's self-verification needs especially strong. We also tested the hypothesis that better early alliance quality would relate to subsequent adaptive changes in and posttreatment level of patients' self-concepts. Method: Eighty-four patients rated their self-concepts at baseline and across treatment and follow-up, their postsession recollection of their therapist's interpersonal behavior toward them during session 2, and their experience of alliance quality rated after sessions 3–6. Results: As predicted, the more therapists verified at session 2 a patient's baseline self-concepts (which trended toward disaffiliative and overcontrolling, on average), the more positively that patient perceived their next-session alliance. Moreover, better session 3 alliance related to more adaptive affiliative and autonomy-granting self-concepts at posttreatment. Conclusion: Results are discussed within a therapist responsiveness framework. [ABSTRACT FROM AUTHOR]

Body-focused repetitive behavior (BFRB) disorders, including hair pulling disorder (trichotillomania [TTM]) and skin picking disorder (SPD), frequently co-occur with anxiety disorders, but reported comorbidity rates vary widely. Additionally, research on the relationship between anxiety and BFRB symptoms has yielded inconsistent findings. This meta-analysis and systematic review examined (1) the prevalence of comorbid anxiety disorders in individuals with BFRB disorders and (2) correlations between anxiety and BFRB symptom measures. The study protocol was pre-registered on PROSPERO. A systematic search of PsycInfo, PubMed, and Web of Science identified 119 studies (N=15,902) reporting anxiety prevalence rates in BFRB disorders and/or correlations between anxiety and BFRBs. Random-effects meta-analyses were conducted, including subgroup analyses for TTM and SPD, and meta-regression to examine potential moderators. Results indicated that comorbid anxiety disorders, including generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), social anxiety, panic disorder, and specific phobia, were relatively common in BFRBs. Current prevalence rates were 19.2% for GAD, 12.8% for OCD, 10.6% for social anxiety, and 27.5% for 'any anxiety disorder.' Lifetime prevalence rates were 22.4% for GAD, 13.8% for OCD, 11.0% for social anxiety, and 35.9% for 'any anxiety disorder.' Pooled correlations between anxiety and BFRB severity were low to moderate (all BFRBs r =.29; TTM r =.27; SPD r =.34). Anxiety symptoms showed stronger correlations with focused BFRB measures (r =.42) than automatic (r =.15). These findings highlight a nuanced relationship between anxiety and BFRBs. While comorbid anxiety disorders are frequently observed in BFRB populations, anxiety severity is only modestly associated with BFRB severity. Implications for future research and clinical practice are discussed. • BFRB disorders, including trichotillomania and skin picking, are often associated with anxiety. • Meta-analysis of 119 studies examined comorbid anxiety in BFRBs and correlations between anxiety and BFRB measures. • Current and lifetime anxiety disorders in BFRBs were prevalent, including GAD, OCD, and social anxiety. • Correlations between anxiety and BFRB severity were weak to moderate. Correlations were stronger for focused BFRB measures. • While comorbid anxiety disorders are common in BFRBs, anxiety severity may not be a strong predictor of BFRB severity. [ABSTRACT FROM AUTHOR]