Search Results (14)

Introduction: Knee osteoarthritis (OA) is defined by articular cartilage loss, increased discomfort, and functional restrictions. Changes in lifestyle, painkillers, intra-articular injections, and, as a last resort, surgery are all part of clinical therapy. In this setting, intra-articular injections of hyaluronic acid (HA) represent a relevant and diffused therapeutic option. Materials and Methods: A prospective observational study was performed from October 2024 to May 2025 in 70 patients with knee OA. HA was administered in three intra-articular injections and was followed up at 3 and 6 months from the last injection. Knee Injury and Osteoarthritis Outcome Score (KOOS) was evaluated as primary outcome measure; Visual Analogue Scale (VAS), time up and go test, six-minute walking test, general health assessment with 36-Item Short Form Health Survey (SF-36), Zung’s Self-Rating Anxiety Scale (Zung SAS), and Zung’s Self-Rating Depression Scale (Zung SDS) as secondary outcome measures. Results: We observed a statistically significant improvement in clinical scores at 3 months in both HA formulations compared to the control group. No relevant side effects were described during the study. Conclusion: Hyalubrix 30 mg/2 mL and DIART 1.8%/2 mL are two safe and effective therapeutic options to manage knee OA, offering benefits in pain control, functionality and emotional wellness. Full article

Objective: This study aimed to assess the prevalence of depression and anxiety among patients with acute leukemia in Vietnam and to identify associated sociodemographic and clinical factors. Methods: A cross-sectional study was conducted at the Hematology and Blood Transfusion Center of Bach Mai Hospital, a national tertiary care facility in Hanoi, Vietnam. A total of 82 patients diagnosed with acute leukemia were recruited using a convenience sampling method. Data on sociodemographic characteristics (e.g., age, gender, residence, education, occupation, marital status, and income) and clinical information (e.g., leukemia type, treatment stage, comorbidities, substance use) were collected. Depression and anxiety were assessed using the Beck Depression Inventory (BDI) and Zung’s Self-Rating Anxiety Scale (SAS). Multivariate logistic and Tobit regression analyses were applied to explore associated factors. Results: Participants had a mean age of 43.4 years (SD = 14.0), with 53.7% male and 69.5% residing in rural areas. Most were married (82.9%) and had completed high school (45.1%). Farmers constituted the largest occupational group (29.3%). The mean BDI score was 13.7 (SD = 9.8), and the mean SAS score was 39.2 (SD = 6.3). Overall, 50.0% of patients met criteria for depression, while 26.8% exhibited clinically significant anxiety symptoms. Among those with anxiety, 59.1% had mild symptoms, 22.7% moderate, and 18.2% severe or very severe. Patients with education above high school (OR = 7.32; 95% CI: 1.01–53.23), a spouse (OR = 25.10; 95% CI: 2.14–294.55), or comorbidities (OR = 8.05; 95% CI: 1.63–39.68) had significantly higher odds of depression. A higher income (>10 million VND/month) was associated with lower depression scores (Coef. = −6.05; 95% CI: −11.65 to −0.46). Regarding anxiety, the female gender was associated with higher odds (OR = 3.80; 95% CI: 1.21–11.93) and SAS scores (Coef. = 4.07; 95% CI: 1.64–6.51), while higher income predicted lower anxiety severity (Coef. = −3.74; 95% CI: −6.57 to −0.91). Conclusions: This Vietnamese hospital-based study highlights a high prevalence of depression and anxiety among patients with acute leukemia. Routine mental health screening and culturally appropriate psychosocial interventions are strongly recommended to improve patient well being. Full article

(1) Background: This study compares the immediate effects of Rest Redistribution Training (RR) and Traditional Set Structure Training (TS) on vertical jump performance, heart rate variability (HRV), and perceived exertion (RPE) in anxious female college students. (2) Methods: In a randomized experimental design, 14 anxious female college students (ages 18–25, screened via Zung’s Self-Rating Anxiety Scale (SAS) with scores ≥50) underwent a familiarization session followed by two trials involving either a RR or TS conditioning routine. Vertical jump, HRV, and RPE were measured pre- and post-session, and during training, respectively. (3) Results: Both protocols induced significant decrements in squat jump (SJs) and countermovement jump (CMJs) metrics (p < 0.05), but no statistically significant between-group differences emerged (p > 0.05; SJ height: d = 0.059, 95% CI [−0.05, 0.05]; CMJ peak power: d = 0.253, 95% CI [−0.02, 0.02]). TS induced significant decreases in time-domain HRV indices (SDNN: d = 0.888, 95% CI [1.07, 16.13; RMSSD: d = 1.511, 95% CI [8.87, 27.63]) and high-frequency power (HF: d = 0.788, 95% CI [2.73, 379.71]), whereas RR preserved these indices. RR significantly reduced RPE compared to TS (p < 0.05; barbell bench press: d = 1.132, 95% CI [0.28, 1.48]; leg press: d = 0.784, 95% CI [0.01, 1.31]). (4) Conclusions: RR and TS protocols induced comparable decrements in vertical jump performance among untrained anxious female college students under equivalent loads; however, RR demonstrated superior autonomic regulation, reduced perceived fatigue, and equivalent performance outcomes, highlighting its potential as a low-stress alternative to traditional resistance training for anxiety-prone populations. Full article

Background: The objective of this work is to investigate the effectiveness of a cognitive remediation intervention on anxiety symptoms in people with bipolar disorder and the therapeutic effect on people whose anxiety symptoms were above the threshold for a screener and whose comorbidity could be identified as an anxiety disorder. Methods: The experimental intervention included 24 sessions (around 45 min each), two for each week over three months. The entire program was inspired by user-centered rehabilitation principles in a recovery-oriented perspective and an approach to bipolar disorder in an evolutionary and non-discriminating vision. The primary outcomes measure the score of the Zung Self-Rating Anxiety Scale (SAS), hypothesizing a higher decrease in the experimental group than in the control group. The survey has been conducted per the CONSORT guidelines for feasibility studies. Results: We evaluate a decrease in the overall SAS score from T0 to T1 to be higher in the experimental group compared to the control group, indicating an improvement in anxiety symptoms (p < 0.0001). Conclusions: The study suggests that virtual reality could have a role in treating anxiety symptoms and disorders in young adults with bipolar disorders or anxiety symptoms in people with hyperactivity and novelty-seeking behaviorsunder stress and high risk for bipolar disorder. Full article

Background: This cross-sectional study aimed to assess the correlation between subjective oral health status and mental health in a group of university students in Serbia. Methods: The study included 948 students, aged between 18 and 27, from the Faculty of Medical Sciences, University of Kragujevac, Serbia, and was conducted in 2020. The World Health Organization’s Oral Health Questionnaire for Adults was utilized to evaluate the respondents’ self-perceived oral health and oral hygiene practices. The existence of depressive symptoms was evaluated using the Beck Depression Inventory-II (BDI-II), and the Zung self-rating anxiety scale (SAS) was used for determining anxiety symptoms. Results: It is observed that 28.9% of respondents exhibit symptoms of depression and 42.3% showed symptoms of anxiety. Results show that students with severe depression and anxiety symptoms very often reported lower self-perceived oral health and oral health problems. Although the nature of this relationship has not been thoroughly evaluated, several studies have shown a mutually dependent connection between oral health and mental health. Conclusions: The results suggest that some aspects of oral health are associated with higher risks of developing symptoms of depression or anxiety, and vice versa. Full article

In the last ten years, technological innovations have led to the development of new, advanced sensory stimulation (SS) tools, such as PC-based rehabilitative programs or virtual reality training. These are meant to stimulate residual cognitive abilities and, at the same time, assess cognition and awareness, also in patients with a minimally conscious state (MCS). Our purpose was to evaluate the clinical and neurophysiological effects of multi-sensory and emotional stimulation provided by Neurowave in patients with MCS, as compared to a conventional SS treatment. The psychological status of their caregivers was also monitored. In this retrospective study, we have included forty-two MCS patients and their caregivers. Each MCS subject was included in either the control group (CG), receiving a conventional SS, or the experimental group (EG), who was submitted to the experimental training with the Neurowave. They were assessed before (T0) and after the training (T1) through a specific clinical battery, including both motor and cognitive outcomes. Moreover, in the EG, we also monitored the brain electrophysiological activity (EEG and P300). In both study groups (EG and CG), the psychological caregiver’s aspects, including anxiety levels, were measured using the Zung Self-Rating Anxiety Scale (SAS). The intra-group analysis (T0-T1) of the EG showed statistical significances in all patients’ outcome measures, while in the CG, we found statistical significances in consciousness and awareness outcomes. The inter-group analysis between the EG and the CG showed no statistical differences, except for global communication skills. In conclusion, the multi-sensory stimulation approach through Neurowave was found to be an innovative rehabilitation treatment, also allowing the registration of brain activity during treatment. Full article

Background: The London Classification for anorectal physiological dysfunction specifically proposes rectoanal areflexia (RA), which means the absence of a rectoanal inhibitory reflex (RAIR) based on a manometric diagnosis. Although RA is not observed in healthy people, it can be found in adult patients with functional constipation (FC). This study describes the clinical manifestations of adult patients with FC and RA and their response to biofeedback therapy (BFT). Methods: This retrospective study reviewed the reports of high-resolution anorectal manometry (HR-ARM) and the efficacy of BFT in adult patients with FC. In addition, the Constipation Scoring System (CSS) scale, Patient Assessment of Constipation Symptoms (PAC-SYM) scale, Patient Assessment of Constipation Quality of Life (PAC-QOL) scale, Zung’s Self-Rating Anxiety Scale (SAS), Zung’s Self-Rating Depression Scale (SDS), balloon expulsion test (BET), and the use of laxatives were assessed. Results: A total of 257 adult patients diagnosed with FC were divided into the RA group (n = 89) and the RAIR group (n = 168). In the RA and RAIR groups, 60 (67.4%) and 117 (69.6%) patients, respectively, had dyssynergic defecation (DD) during simulated defecation. Type II pattern of dyssynergia was most frequently observed in both groups. Compared with the RA group, the RAIR group showed a higher CSS score, physical discomfort score, and prevalence of inadequate relaxation of the anal sphincter (p < 0.001, p = 0.036, and p = 0.017, respectively). The anxiety and depression scores were not different between the two groups. The proportion of patients using volumetric and stimulant laxatives and their combination was significantly higher in FC patients with RA, whereas the efficacy of BFT was significantly lower (p = 0.005, p < 0.001, p = 0.045, and p = 0.010, respectively). Conclusion: Adult FC patients with RA may suffer more severe constipation and have a lower efficacy of BFT compared with those with RAIR. Full article

Objectives: There are reports of mental health worsening during the COVID-19 pandemic. We aimed to assess whether this occurred in women who were pregnant at baseline (late 2019) and unaware of the pandemic, and who delivered after the implementation of COVID-19 restrictions and threat (March–April 2020). To compare the pandemic period with the pre-pandemic, we capitalized on a retrospective 2014–2015 perinatal sample which had had affective symptoms assessed. Methods: The COVID sample were administered the Postnatal Depression Scale (EPDS), Zung Self-Rating Anxiety Scale (SAS), Hypomania Checklist-32 (HCL-32), Pittsburgh Sleep Quality Index (PSQI), and Perceived Stress Scale (PSS) at T0 (pregnancy) and T1 (post-delivery). The Non-COVID sample had completed EPDS and HCL-32 at the same timepoints. Results: The COVID sample included 72 women, aged 21–46 years (mean = 33.25 years ± 4.69), and the Non-COVID sample included 68 perinatal women, aged 21–46 years (mean = 34.01 years ± 4.68). Our study showed greater levels of mild depression in T1 among the COVID sample compared to the Non-COVID sample. No significant differences in terms of major depression and suicidal ideation were found. The levels of hypomania were significantly different between the two groups at T1, with the COVID sample scoring higher than the Non-COVID sample. This may be related to the high levels of perceived stress we found during the postpartum evaluation in the COVID sample. Limitations: There was a relatively small sample size. Conclusions: New mothers responded to the pandemic with less mental health impairment than expected, differently from the general population. Women delivering amidst the pandemic did not differ in depressive and anxiety symptoms from their pre-pandemic scores and from pre-pandemic women. Because stress responses have high energy costs, it is optimal for maternal animals to minimize such high metabolic costs during motherhood. Evidence suggests that reproductive experience alters the female brain in adaptive ways. This maternal brain plasticity facilitates a higher purpose, the continuation of the species. This may point to the recruitment of motherhood-related resources, for potentially overcoming the effects of the pandemic on mental health. Full article

Pilots are highly susceptible to anxiety symptoms due to the uncertainty of the dangers of aviation operations and the potential terror and insecurity that pilots experience over time. This research aims to understand the complex relationship between the occupational stress and group anxiety symptoms of Chinese civil aviation pilots, and to analyze the type A behavior pattern (TABP) as a mediator for both issues. The occupational stress, anxiety symptoms and TABP of Chinese civil aviation pilots are investigated by using questionnaires based on the effort-reward-imbalance (ERI) scale, the Zung Self-Rating Anxiety Scale (SAS) and a TABP scale established based on Chinese people’s inherent characteristics. The study revealed that higher occupational stress experienced by Chinese civil aviation pilots exacerbated their anxiety symptoms, and that overcommitment and TABP mediated the relationship between occupational stress and anxiety symptoms. Full article

This epidemiological study aimed to develop an X-AI that could explain groups with a high anxiety disorder risk in old age. To achieve this objective, (1) this study explored the predictors of senile anxiety using base models and meta models. (2) This study presented decision tree visualization that could help psychiatric consultants and primary physicians easily interpret the path of predicting high-risk groups based on major predictors derived from final machine learning models with the best performance. This study analyzed 1558 elderly (695 males and 863 females) who were 60 years or older and completed the Zung’s Self-Rating Anxiety Scale (SAS). We used support vector machine (SVM), random forest, LightGBM, and Adaboost for the base model, a single predictive model, while using XGBoost algorithm for the meta model. The analysis results confirmed that the predictive performance of the “SVM + Random forest + LightGBM + AdaBoost + XGBoost model (stacking ensemble: accuracy 87.4%, precision 85.1%, recall 87.4%, and F1-score 85.5%)” was the best. Also, the results of this study showed that the elderly who often (or mostly) felt subjective loneliness, had a Self Esteem Scale score of 26 or less, and had a subjective communication with their family of 4 or less (on a 10-point scale) were the group with the highest risk anxiety disorder. The results of this study imply that it is necessary to establish a community-based mental health policy that can identify elderly groups with high anxiety risks based on multiple risk factors and manage them constantly. Full article

COVID-19 has speedily immersed the globe with 72+ million cases and 1.64 million deaths, in a span of around one year, disturbing and deteriorating almost every sphere of life. This study investigates how students in Pakistan have coped with the COVID-19. Zung’s self-rating anxiety scale (SAS) was used for measuring anxiety and the coping strategies were measured on four strategies i.e., seeking social support, humanitarian, acceptance, and mental disengagement. Among 494 respondents, 61% were females and 77.3% of the students were in the age group of 19–25 years. The study findings indicate that approximately 41 percent of students are experiencing some level of anxiety, including 16% with severe to extreme levels. Seeking social support seemed to be the least preferred coping strategy and that female students seek social support, humanitarian, and acceptance coping strategies more than males. Students used both emotion-based and problem-based coping strategies. The variables of gender, age, ethnicity, level and type of study, and living arrangement of the students were associated with usage of coping strategies. Findings showing that students do not prefer to seek social support. The study outcomes will provide basic data for university policies in Pakistan and the other countries with same cultural contexts to design and place better mental health provisions for students. Full article

The COVID-19 pandemic and the lockdown has taken the world by storm. This study examines its impact on the anxiety level of university students in Malaysia during the peak of the crisis and the pertinent characteristics affecting their anxiety. A cross-sectional online survey, using Zung’s self-rating anxiety questionnaire was conducted during the COVID-19 pandemic and lockdown. Out of the 983 respondents, 20.4%, 6.6%, and 2.8% experienced minimal to moderate, marked to severe, and most extreme levels of anxiety. Female gender (OR = 21.456, 95% CI = 1.061, 1.998, p = 0.020), age below 18 years (OR = 4.147, 95% CI = 1.331, 12.918, p = 0.014), age 19 to 25 (OR = 3.398, 95% CI = 1.431, 8.066, p = 0.006), pre-university level of education (OR = 2.882, 95% CI = 1.212, 6.854, p = 0.017), management studies (OR = 2.278, 95% CI = 1.526, 3.399, p < 0.001), and staying alone (OR = 2.208, 95% CI = 1.127, 4.325, p = 0.021) were significantly associated with higher levels of anxiety. The main stressors include financial constraints, remote online teaching and uncertainty about the future with regard to academics and career. Stressors are predominantly financial constraints, remote online learning, and uncertainty related to their academic performance, and future career prospects. Full article

Physical disorders and anxiety are frequently comorbid. This study investigates the characteristics of physical disorders, self-rated heath, subjective well-being and anxiety in adolescents. Data were drawn from the Saving and Empowering Young Lives in Europe cohort study. From 11 countries 11,230 adolescents, aged 14–16 years were included. Zung Self-Rating Anxiety Scale (SAS), WHO-5 Well-Being Index and five questions prepared for this study to evaluate physical illnesses and self-rated heath were administered. Anxiety levels were significantly higher in adolescents who reported having physical disability (p < 0.001, Cohen’s d = 0.40), suffering from chronic illnesses (p < 0.001, Cohen’s d = 0.40), impairments associated to health conditions (p < 0.001, Cohen’s d = 0.61), or reported poor to very poor self-rated health (p < 0.001, Cohen’s d = 1.11). Mediational analyses revealed no direct effect of having a chronic illness/physical disability on subjective well-being, but the indirect effects through higher levels of anxiety were significant. Functional impairment related to health conditions was both directly and indirectly (through higher levels of anxiety) associated with lower well-being. The co-occurrence of anxiety and physical disorders may confer a greater level of disability and lower levels of subjective well-being. Clinicians have to screen anxiety, even in a subthreshold level in patients with choric physical illness or with medically unexplained physical symptoms. Full article

There is a high incidence of benign breast lumps among women, and these lumps may lead to physical and psychological problems. This study aims to evaluate anxiety and depressive symptoms among patients with benign breast lumps diagnosed via ultrasonography and investigate their impacts on health-related quality of life (HRQOL). A cross-sectional survey was conducted in Shenyang, China, from January to November 2013. Data were collected with self-administered questionnaires, including the Zung Self-Rating Anxiety Scale (SAS), the Center for Epidemiologic Studies Depression Scale (CES-D), and the 36-item Short-Form Health Survey (SF-36), together with demographic characteristics, from patients of the Department of Breast Surgery of the First Affiliated Hospital of China Medical University. Hierarchical multiple regression analysis (HMR) was performed to explore the effects of anxiety and depression on HRQOL. The overall prevalences of anxiety (SAS score ≥ 40) and depression (CES-D scores ≥ 16) were 40.2% and 62.0%, respectively, and 37.5% of the participants had both of these psychological symptoms. The means and standard deviations of PCS and MCS were 75.42 (15.22) and 68.70 (17.71), respectively. Anxiety and depressive symptoms were significantly negatively associated with the HRQOL of patients with benign breast lumps diagnosed via ultrasonography. Women with benign breast lumps diagnosed via ultrasonography in China experienced relatively high levels of anxiety and depressive symptoms. Anxiety and depressive symptoms had significant negative impacts on both the mental and physical quality of life (QOL) of women with benign breast lumps. Beyond the necessary clinical treatment procedures, psychological guidance and detailed explanations of the disease should be offered to alleviate the anxiety and depressive symptoms and enhance the HRQOL of patients with benign breast lumps. Full article