Search Results (341)

Background: Fibromyalgia syndrome (FMS) is a complex condition with poorly understood pathophysiology, characterized by widespread pain and an increasing recognition of its associations with genitourinary symptoms. The objective of this study was to characterize the prevalence, phenotype, and common comorbidities of lower urinary tract symptoms (LUTS) in women with FMS. Methods: A retrospective observational study was conducted using electronic medical records of 440 women diagnosed with FMS at a single institution between 1 January 2018, and 1 January 2024. Study subjects were evaluated for diagnoses associated with LUTS, including interstitial cystitis (IC), overactive bladder (OAB), and stress urinary incontinence (SUI), alongside comorbidities such as irritable bowel syndrome (IBS), generalized anxiety disorder (GAD), and major depressive disorder (MDD). Multivariate analyses were performed to assess predictors of conditions associated with LUTS. Results: LUTS were identified in 37.0% of FM patients. GAD and IBS were significantly associated with conditions associated with LUTS (OR = 4.62; OR = 8.53, p < 0.001). SUI was present in 17.05% of patients, falling between survey-based and confirmed prevalence rates in the general population. IC was diagnosed in 2.95% of FMS patients. OAB was observed in 6.8% of patients and associated with GAD (OR = 5.98, p < 0.001). Conclusions: This study highlights a substantial burden of diagnoses associated with LUTS in patients with FMS. There is relatively high prevalence of SUI and IC in this dataset. IBS and GAD were commonly found to co-occur with one or more LUTS-associated condition. Future prospective studies are needed to investigate a multimodal approach to the treatment of LUTS in these patients. Full article

Objectives: This study assessed the effectiveness of a cognitive behavioral therapy (CBT)-based fine dust education program, grounded in the Health Belief Model (HBM), on elementary students’ fine dust knowledge, related behaviors, and mental health (depression, anxiety, stress, sleep quality). Methods: From September to November 2024, 95 students (grades 4–6) living near a coal-fired power plant in midwestern South Korea were assigned to either an intervention group (n = 44) or a control group (n = 51). The intervention group completed a three-session CBT-based education program; the control group received stress management education. Assessments were conducted at weeks 1, 2, 4, and 8 using standardized mental health and behavior scales (PHQ: Patient Health Questionnaire, GAD: Generalized Anxiety Disorder Assessment, PSS: Perceived Stress Scale, ISI: Insomnia Severity Index). Results: A chi-square test was conducted to compare pre- and post-test changes in knowledge and behavior related to PM2.5. The intervention group showed significant improvements in seven fine dust-related knowledge and behavior items (e.g., PM2.5 awareness rose from 33.3% to 75.0%; p < 0.05). The control group showed limited gains. Regarding mental health, based on a mixed-design ANCOVA, anxiety scores significantly declined over time in the intervention group, with group and interaction effects also significant (p < 0.05). Depression scores showed time effects, but group and interaction effects were not significant. No significant changes were observed for stress, sleep, or group × PM2.5 interactions. Conclusions: The CBT-based education program effectively enhanced fine dust knowledge, health behaviors, and reduced anxiety among students. It presents a promising, evidence-based strategy to promote environmental and mental health in school-aged children. Full article

Temporomandibular disorders (TMDs) encompass a heterogeneous group of musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ) and masticatory system. Due to academic stress and parafunctional habits, dental students may be particularly vulnerable to TMD. Objective: To determine the prevalence of TMD symptoms and their psychosocial and functional correlates among students at the Faculty of Dental Medicine, UMPh Iasi, Romania, using the diagnostic criteria for TMD (DC/TMD) self-report axis and axis II instruments. Methods: In this cross-sectional survey, 356 volunteer students (66.0% female; mean age, 22.9 ± 3.6 years) out of a total population of 1874 completed an online DC/TMD–based questionnaire. Axis I assessed orofacial pain, joint noises, and mandibular locking. Axis II instruments included the Graded Chronic Pain Scale (GCPS), Jaw Functional Limitation Scale (JFLS-20), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Oral Behaviors Checklist (OBC). Descriptive statistics summarized frequencies, means, and standard deviations; χ² tests and t-tests compared subgroups by sex; Pearson correlations explored relationships among continuous measures (α = 0.05). Results: A total of 5% of respondents reported orofacial pain in the past 30 days; 41.6% observed TMJ noises; 19.7% experienced locking episodes. Mean JFLS score was 28.3 ± 30.5, with 4.8% scoring > 80 (severe limitation). Mean PHQ-9 was 5.96 ± 5.37 (mild depression); 15.5% scored ≥ 10. Mean GAD-7 was 5.20 ± 4.95 (mild anxiety); 16.0% scored ≥ 10. Mean OBC score was 12.3 ± 8.5; 30.1% scored ≥ 16, indicating frequent parafunctional habits. Symptom prevalence was similar by sex, except temporal headache (43.4% females vs. 24.3% males; p = 0.0008). Females reported higher mean scores for pain intensity (2.09 vs. 1.55; p = 0.0013), JFLS (32.5 vs. 18.0; p < 0.001), PHQ-9 (6.43 vs. 5.16; p = 0.048), and OBC (13.9 vs. 9.7; p = 0.0014). Strong correlation was observed between PHQ-9 and GAD-7 (r = 0.74; p < 0.001); moderate correlations were observed between pain intensity and PHQ-9 (r = 0.31) or GAD-7 (r = 0.30), between JFLS and pain intensity (r = 0.33), and between OBC and PHQ-9 (r = 0.39) (all p < 0.001). Conclusions: Nearly half of dental students reported TMD symptoms, with appreciable functional limitation and psychosocial impact. Parafunctional behaviors and psychological distress were significantly associated with pain and dysfunction. These findings underscore the need for early screening, stress-management interventions, and interdisciplinary care strategies in the dental student population. Full article

Background/Objectives: Heart transplantation is a life-saving procedure for patients with end-stage heart failure, yet it involves significant psychological and emotional challenges throughout its various stages. International guidelines recommend a multi-professional approach to the care of these patients and a psycho-social assessment for listing. The recommendations focus on content aspects, but not on the psychometric measure to be administered to patients as part of the assessment. Therefore, the purpose of this study is to provide the preliminary results of administering the protocol used by our center, measuring coping strategies, cognitive functioning, quality of life, and psychological distress in a sample of patients who are candidates for and undergo cardiac transplantation, and to observe any variations after the procedure. Methods: We conducted a comprehensive psychological-clinical assessment involving 40 patients, focusing on psychosocial functioning, cognitive reserves, mental health, and coping strategies. Tools such as the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT), Beck Depression Inventory-II (BDI-II), Montreal Cognitive Assessment (MoCA), General Anxiety Disorder 7 (GAD-7), and Medical Outcomes Survey Short Form 36 (SF-36) were employed to evaluate readiness for transplantation and post-transplant adaptation. Results: Results showed high levels of clinical anxiety (52.5%) and low perceived physical health (98%) before the transplant, while post-operative evaluations indicated reduced anxiety (13.51%) and depressive symptoms (10.81%), along with improved psychological well-being and reintegration into daily life. Conclusions: These results show improvement in physical and cognitive levels, accompanied by a state of enhanced psychological well-being after transplantation. A longitudinal psychological approach, from pre-transplant screening to post-discharge follow-up, is needed to address distress, improve coping mechanisms, and promote treatment adherence. This integrative strategy is critical to improving the quality of life and long-term outcomes for heart transplant recipients. Full article

Background/Objectives: Juvenile idiopathic arthritis (JIA) and inflammatory bowel disease (IBD) are chronic autoimmune conditions that impact the physical and psychological well-being of pediatric patients. While previous studies have shown a high prevalence of mental health challenges among youth with chronic conditions, the prevalence of mental health issues in Canadian pediatric patients with JIA and IBD remains unclear. We aimed to estimate the prevalence of documented mental health disorders and related medication use of youth with JIA or IBD at a tertiary care centre. Methods: We conducted a retrospective chart review of youths aged 12–17 diagnosed with JIA or IBD at McMaster Children’s Hospital (MCH) to understand the prevalence of generalized anxiety disorder (GAD), separation anxiety disorder, social anxiety disorder (SAD), obsessive–compulsive disorders (OCD), eating disorders, major depressive disorder (MDD), adolescent adjustment disorder, suicide attempt/suicide ideation, self-harm behaviour, substance use disorder, and attention deficit disorders (ADD). Results: We reviewed 429 patient charts, including 303 patients with IBD and 126 with JIA. Our findings identified 90 IBD patients and 20 JIA patients who had one or more documented mental health conditions. Proportionately, there was a higher prevalence of mental health conditions among IBD patients (30%) compared to JIA patients (16%). The most frequently observed conditions in both IBD and JIA patients were GAD (63%, 50%), ADD (33%, 35%), and MDD (29%, 15%). Conclusions: These findings highlight the critical need for early mental health screening and integrated care approaches that address both medical and psychosocial needs in adolescents with chronic illnesses. Future research should incorporate prospective study designs, include diverse geographic and demographic populations, and explore targeted interventions to improve mental and physical health outcomes in this vulnerable group. Full article

This research aims to establish the prevalence of imposter syndrome among Sultan Qaboos University (SQU) undergraduate students while assessing its association with depression symptoms and anxiety symptoms. A cross-sectional design recruited 504 undergraduate students selected through stratified random sampling. Data collection employed the Clance Imposter Phenomenon Scale (CIPS), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7). Data analysis included Pearson’s correlation, chi-square tests, and logistic regression analyses. In total, 56% of participants had imposter syndrome. The CIPS scores showed a moderate relationship with depression (r = 0.486, p < 0.001) and anxiety (r = 0.472, p < 0.001). Students who experienced imposter syndrome showed a higher probability of developing depressive symptoms (χ² = 45.63, p < 0.001, OR = 3.49) and anxiety symptoms (χ² = 32.96, p < 0.001, OR = 2.86). The logistic regression analysis showed that depression (B = 0.096, p < 0.001) and anxiety (B = 0.075, p = 0.003) acted as significant predictors for imposter syndrome. This study reveals a strong link between imposterism, depression, and anxiety among students. This highlights the need for university counseling programs to address imposter feelings and the role of clinical psychology in managing this phenomenon in academic and clinical settings. Full article

Background and objectives: Duloxetine is widely used for the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), and various types of neuropathic pain. While its efficacy is well documented in clinical trials, less is known about how it is perceived and utilized in routine psychiatric practice. To address this knowledge gap, we conducted a cross-sectional observational study involving 80 psychiatrists from Spain to assess real-world clinical attitudes toward duloxetine. Methods: Participants completed a 20-item multiple-choice questionnaire that examined familiarity, perceived efficacy in multiple conditions (MDD, GAD, neuropathic pain, somatization, and quality of life), and perspectives on tolerability, safety, adherence, and overall satisfaction. Results: Survey results indicated that a large majority of psychiatrists frequently prescribe duloxetine, particularly for patients with MDD and comorbid chronic pain. Notably, 94% rated it as either “more effective” or “much more effective” for diabetic peripheral neuropathic pain. Psychiatrists reported a high perceived efficacy of duloxetine: 94% rated it as “more effective” or “much more effective” for diabetic peripheral neuropathy, and 93% gave similarly positive ratings for general neuropathic pain. For somatization, 70% found it “effective” or “very effective”, and 83% observed improvements in quality of life for many of their patients. Psychiatrists generally reported favorable perceptions of duloxetine’s tolerability profile: 97.5% rated it as the antidepressant associated with the least weight gain, and 82.5% perceived fewer sexual side effects compared to other options. Sedation and gastrointestinal side effects were generally considered mild or less severe. In terms of treatment adherence, 69% rated it as “better” or “much better” than other antidepressants, and 80% found its combination with other antidepressants to be “favorable” or “very favorable”. Overall satisfaction was high, with 99% of psychiatrists reporting being either “satisfied” or “very satisfied” with its use. The side effect profile was generally viewed as manageable, with low perceived rates of weight gain, sedation, and sexual dysfunction. Furthermore, 96% of respondents expressed a willingness to recommend duloxetine to their colleagues. Conclusions: Psychiatrists reported highly favorable attitudes toward duloxetine, viewing it as a flexible treatment option in routine care. However, these findings reflect clinicians’ subjective perceptions rather than objective clinical outcomes and should be interpreted accordingly. Full article

Breast cancer (BC) is the leading cancer diagnosis among women in Puerto Rico. Psychological distress is prevalent in this population, and social determinants may exacerbate this risk. This study examines whether sociodemographic characteristics, financial burden, and social support levels are associated with symptoms of anxiety and depression in Puerto Rican women with BC. A quantitative secondary analysis was conducted on a sample of 208 Hispanic women with BC, utilizing the Patient Health Questionnaire (PHQ-8) and the Generalized Anxiety Disorder (GAD-7) questionnaire. These scores were compared with sociodemographic values and Interpersonal Support Evaluation List (ISEL-12) scores, establishing statistical significance through association, parametric, and non-parametric tests, and regression models. 38.5% and 26.4% of participants showed clinically significant symptoms of depression and anxiety, respectively. Age and perceived income showed significant associations with psychological outcomes. However, regression analysis revealed perceived income as the only significant predictor for both depression and anxiety. Tangible and belonging support were significantly lower in participants with symptoms of depression, while appraisal support was significantly lower in participants with symptoms of anxiety. Findings highlight the influence of perceived financial stress on mental health and the need for psychosocial interventions tailored to the patients’ economic context. Full article

Exposure to fine particulate matter (PM2.5) has become an increasing public health concern, particularly in urban areas facing severe air pollution. In response, individuals are increasingly turning to real-time tracking systems and self-monitoring tools. This study aimed to examine the association between PM2.5 risk perception, self-monitoring behaviors, and anxiety levels in the general population of Thailand. A cross-sectional survey was conducted during the dry season using an online questionnaire, which included the 7-item Generalized Anxiety Disorder (GAD-7) scale. A total of 921 participants residing in Bangkok and Chiang Mai were included. Binary logistic regression analysis, adjusted for sex, age, marital status, monthly income, and years of residence, revealed a significant association between anxiety and perceived health risks of PM2.5 exposure (OR = 1.09; 95% CI: 1.06–1.13). Daily self-monitoring of air quality over the past two weeks was also significantly linked to higher anxiety levels compared to non-monitoring individuals: OR = 1.92 (95% CI: 1.11–3.33) for websites, OR = 1.65 (95% CI: 1.01–2.72) for mobile apps, OR = 1.72 (95% CI: 1.12–2.64) for air purifiers, and OR = 3.34 (95% CI: 1.77–6.31) for air quality detectors. Monitoring 4–6 days per week using apps and air detectors was similarly associated with increased anxiety (OR = 1.64 and 2.30, respectively). Heightened perception of PM2.5 health risks and frequent self-monitoring behaviors are associated with increased anxiety among urban residents in Thailand. Public health interventions should consider implementing targeted alert systems during high-pollution periods and prioritize strategies to reduce PM2.5 emissions to alleviate public anxiety. Full article

Depressive and anxiety symptoms are associated with a greater likelihood of disordered eating behaviors (DEBs), but the role of sex in these associations is unclear. Objectives: The aim of this study was to analyze the associations between depression, anxiety, and DEBs in a sample of Spanish university students. Methods: Depression was assessed with the Beck Depression Inventory-II (BDI-II), anxiety with the Generalized Anxiety Disorder (GAD-7) instrument, and DEBs with the Sick, Control, One stone, Fat, Food (SCOFF) questionnaire. Statistical analyses included generalized linear regression models adjusted for sociodemographic, body composition, and lifestyle covariates as the main confounders. Results: Among the 453 students analyzed (71.5% female), the frequencies of mild-to-severe depression, mild-to-severe anxiety, and of DEBs were higher in the females (42.0%, 77.5%, and 32.7%, respectively) than in the males (24.0%, 52.7%, and 20.2%, respectively). The results of the adjusted GLMs were similar for both the sexes, indicating higher estimated marginal means of the SCOFF total score and greater odds of DEBs among those with mild-to-severe depression or anxiety than among those without these conditions. Conclusions: Depression and anxiety symptoms are cross-sectionally associated with DEBs in Spanish university students of both sexes. Future prospective studies are needed to examine the direction of these associations separately for females and males. Full article

Migraine is a common disabling primary headache disorder with significant personal and socio-economic impacts. A combination of medication and non-pharmacological therapies is essential for migraine management. Outpatient multidisciplinary headache therapy has not yet been evaluated in Switzerland. This study evaluates the effectiveness of the headache management program at Inselspital, Bern University Hospital, in improving headache-related disability in migraine patients. This open-label pilot study used prospectively assessed routine data from our headache registry. Participants aged 18 years or older with a diagnosis of migraine, confirmed by a headache specialist, were included. The program consisted of seven weekly sessions, each with a 50 min educational lecture and a 30 min progressive muscle relaxation (PMR) exercise. Primary outcomes were headache-related impact and disability, measured by the Headache Impact Test 6 (HIT-6) and Migraine Disability Assessment (MIDAS). Secondary outcomes included symptoms of anxiety, measured by the Generalized Anxiety Disorder 7-item scale (GAD-7), and symptoms of depression, assessed using the eight-item Patient Health Questionnaire depression scale (PHQ-8). Data were analysed using paired t-test and Wilcoxon signed rank tests. Significant improvements were observed in HIT-6 scores (pre-program: 65.2; post-program: 61.9; p = 0.012) and MIDAS scores (pre-program: 38; post-program: 27; p = 0.011), while PHQ-8 also showed a statistically significant reduction. Although the GAD-7 scores improved numerically, this change was not statistically significant. These findings suggest that the headache management program may reduce headache burden and disability; however, further research with larger samples is needed to confirm these preliminary results. Full article

Obsessive–compulsive disorder (OCD) has an estimated prevalence between 1 and 2.3%. Existing treatments may not be suitable or effective for all people with OCD, and there is increasing interest in whether these individuals may benefit from the use of cannabis-based medical products (CBMPs). We document the characteristics of 257 people reporting a diagnosis of OCD within Project T21, a study of medical cannabis patients, and examined whether the use of prescribed cannabinoids improves quality of life. Individuals with OCD were prescribed an average of 2.2 CBMPs, with most products classified as THC-dominant flowers (73.7%). Three months after initiating treatment, there were substantial improvements in quality of life (Cohen’s d = 0.48; 95% CI = 0.29–0.65), general health (Cohen’s d = 0.43; 95% CI = 0.26–0.61), mood/depression (Cohen’s d = 0.85; 95% CI = 0.65–1.04), and sleep (Cohen’s d = 0.61; 95% CI = 0.43–0.79). There was a corresponding reduction in anxiety symptoms among the subsample who completed the GAD-7 (Cohen’s d = 1.14; 95% CI = 0.84–1.44). Eight individuals (5.7%) reported a total of 14 adverse effects, with the majority of these (57%) being described as mild. Given emerging evidence that those with OCD can benefit from CBMPs, coupled with the increased availability of these unlicensed products internationally, there is a need for more research, including clinical trials, to identify those who may benefit most from the use of these medicines. Full article

Pregnancy is a period of great complexity and potential psychological vulnerability which may increase in unfavorable conditions, such as hospitalization. Therefore, early identification of emotional, anxious, or depressive difficulties is important in terms of maternal and fetal well-being. International guidelines recommend the use of brief screening tools to identify perinatal women for further investigation, but which of the measures is optimal remains to be clarified. The objective of this study was to compare the Whooley depression questions used together with the Generalized Anxiety Disorder-2 (GAD-2), versus the Matthey Generic Mood Questionnaire (MGMQ), to evaluate their concordance in screening results and their clinical usefulness in the hospital setting. Hospitalized pregnant women, numbering 228, and 55 male partners completed both questionnaires. The women’s results showed high similar screen positive rates on both measures, but the screen positive concordance between the two instruments was low (around 50%). The Whooley/GAD-2 missed a significant percentage of women who, on the MGMQ, wished to talk with a professional, or who expressed moderate to high distress. The data from male partners were too few to be interpretable. Findings suggest that screening is important in hospitalized women, and clinicians should consider the respective merits and possible weaknesses of different screening tools. Full article

Background/Objectives: Psychological vulnerability in individuals with obesity represents a significant concern in the context of bariatric surgery. This study aimed to assess psychosocial functioning and identify the psychological, clinical, and sociodemographic predictors of impairment among patients undergoing preoperative evaluation. Methods: A retrospective observational study was conducted on patients referred for bariatric surgery at a single academic medical center. Data were collected through clinical interviews and validated psychometric tools: the Clinical Impairment Assessment (CIA), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7). Robust multiple regression analysis determined associations between CIA scores and psychological and demographic factors. Results: A total of 688 patients were evaluated (median age: 46 years; 70.3% female). Most had a high school education (56.9%) and were employed (69%). Elevated scores on the Clinical Impairment Assessment (CIA) were significantly associated with female gender (β = 1.075, p = 0.029), moderate anxiety (GAD-7 ≥ 10; β = 3.85, p < 0.001), and severe depressive symptoms (PHQ-9 ≥ 15; β = 16.67, p < 0.001). Other significant predictors included prior psychotherapy (β = 1.18, p = 0.044), aesthetic motivation for surgery (β = 0.92, p = 0.120), and expectations that weight loss would improve self-esteem (β = 2.11, p = 0.001) or social relationships (β = 1.98, p = 0.002). Conversely, physical activity was associated with lower CIA scores (β = –1.23, p = 0.050). The regression model showed strong explanatory power (McFadden R² = 0.529). Conclusions: This study highlights key predictors of psychosocial distress in bariatric candidates, underscoring the importance of comprehensive psychological assessment before surgery. The CIA appears to be a valuable screening and monitoring tool. Future research should explore the longitudinal evolution of psychosocial functioning and support the integration of psychological care into multidisciplinary bariatric programs. Full article

Background: Perinatal depression and anxiety can be experienced simultaneously and change over time. This study aimed to explore the independent and joint developmental trajectories and predictors of perinatal depression and anxiety. Methods: From January 2022 to December 2023, a total of 1062 pregnant women from Affiliated Women’s Hospital of Jiangnan University were surveyed for depression and anxiety symptoms using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7) in early pregnancy (T1, 0–13⁺⁶ weeks), mid-term pregnancy (T2, 14–27⁺⁶ weeks), late pregnancy (T3, 28–41 weeks), and 42 days postpartum (T4). Parallel-process latent class growth model (PPLCGM) was performed to identify the joint developmental trajectories of perinatal depression and anxiety, and logistic regression was used to analyze factors of joint trajectories. Results: Perinatal depression and anxiety each showed four heterogeneous developmental trajectories, and three joint developmental trajectories were identified: “high–slightly decreasing depression and high decreasing anxiety group” (3%), “low–stable depression and low–stable anxiety group” (71%), and “moderate–slightly increasing depression and moderate–decreasing anxiety group” (26%). Adverse maternal history, history of anxiety and depression, and work stress were risk factors for the joint developmental trajectory of perinatal depression and anxiety, while regular exercise, paid work and social support were protective factors. Conclusions: Three joint developmental trajectories for perinatal depression and anxiety were identified, demonstrating group heterogeneity. Perinatal healthcare providers should pay attention to the mental health history of pregnant women, conduct multiple assessments of perinatal anxiety and depression, prioritize individuals with risk factors, and advocate for regular exercise, work participation, and provide greater social support. Full article