Objectives To analyze the prevalence and clinical features of depression, anxiety, depression and anxiety in Tibetan patients with epilepsy and to improve the diagnosis and treatment. Methods 102 patients with epilepsy, who had been admitted to the Department of Neurology of the People's Hospital of Tibet Autonomous Region from January 2017 to December 2017, were diagnosed according to the Chinese Standard Classification and Diagnostic Criteria for Mental Disorders (3rd Edition) (CCMD-3). The Hamilton depression scale (HAMD 24 items) and the Hamilton anxiety scale (HAMA 14 items) were used to measure depression and anxiety. Different genders, ages, durations, frequency of attacks, and seizures types were analyzed for depression, anxiety, depression and anxiety. Univariate analysis was used to screen the factors that may cause depression, anxiety, depression and anxiety in patients with epilepsy. Logistic regression was used to analyze the risk factors of depression, anxiety, depression and anxiety in patients with epilepsy. Results Among the 102 patients with epilepsy, 35 (34.31%) comorbid depression, 10 (9.80%) comorbid anxiety, and 54 (52.94%) comorbid depression and anxiety. Univariate analysis showed that there was a significantly statistical difference in the duration of the disease and the frequency of seizures in local patients with epilepsy (P<0.05). There was a statistically significant difference in the frequency of epileptic seizures and anxiety (P<0.05). Multivariate logistic regression analysis showed that the probability of anxiety in patients with a disease duration of ≤2 years was only 10.1% of those with a course >2 years [OR=0.101, 95%CI (0.012, 0.915), P<0.05]; and the frequency of seizures was not an risk factors for epileptic comorbid with anxiety (P>0.05). The rate of depression and anxiety in patients with seizure frequency >2 times per month was 4.853 times higher than that of patients with seizure frequency ≤2 times per month [OR=4.853, 95%CI (2.024, 11.634), P<0.05]. Conclusions Tibetan patients with epilepsy have a high prevalence of depression, anxiety, depression and anxiety. In the diagnosis and treatment, we should strengthen the understanding and provide the appropriate prevention and treatment to improve the diagnosis and treatment level.
ObjectiveTo explore the prevalence of anxiety symptoms and its related factors among the family caregivers of the disabled elderly. MethodsA cross-sectional survey based on convenience sampling was conducted among family caregivers between November and December, 2013 in Dongcheng district in Beijing. The Self-rating Anxiety Scale (SAS) and the Social Support Rating Scale (SSRS) were used to evaluate caregivers' anxious symptoms and social support status respectively. The degree of functional impairment of the elderly was measured by Barthel index. ResultsA total of 243 family caregivers took part in the study including 88 males and 155 females. The average age of the family caregivers was (60±1.7) years old, ranging from 25 to 85. The prevalence rate of anxiety was 29.2% reported by family caregivers. The average score of SAS was 35.6±8.6. The risk factors of caregivers' anxiety included Barthel index score ≤20 (OR=1.51), SSRS score ≤33 (OR=4.56), no time to relax (OR=1.57) and poor health status caregivers feeling (OR=3.48). ConclusionA relative high level of anxiety exists in family caregivers for the disabled elderly. Caregiver anxiety is a complex process, influenced by diverse care receiver and caregiver characteristics.
Objective To evaluate the clinical effectiveness and safety of Jiu Wei Lv Ping particle in the treatment of generalized anxiety disorder (GAD). Methods The multi-center, randomized double-blind method was used to observe 227 GAD patients who were divided into the treatment group (n=114, treated with Jiu Wei Lv Ping particle 6 g, three times a day) and the control group (n=113, treated with buspirone 10 mg, three times a day). HAMD score, and CGI-GI score were used to evaluate the clinical efficacy. TESS score and the list of symptom-recording were used to observe the safety. All the outcomes for evaluation before and after treatment at week 1, week 2, week 3 and week 4. Results According to intention-to-treat analysis (ITT), the level of decrease of HAMA score from baseline at each observational point of the treatment group was similar to that of the control group (t test, Pgt;0.05). At the end point, the effective rate of treatment group was 87.72％, and the effective rate of the control group was 87.61%. There was no significant difference between the two groups (CMH test, Pgt;0.05). According to the score of CGI-GI at each observational point, there was no difference of the effective rate between the treatment group and the control group (student test, Pgt;0.05). The side effect rate of the treatment group was 16.67%, The frequent symptoms were thirst (8.77%), dizziness (7.02%), nausea (2.63%), constipation (2.63%) and diarrhea (1.75%). The side effect rate of the control group was 30.97%, The frequent symptoms were thirst (15.04%), constipation (6.19%), nausea (4.42%), diarrhea (4.42%), dizziness (3.45%) and tachycardia (1.77%). The side effect of the treatment group was lower than that of the control group. But there was no significant difference between the two groups according to the score of TESS (F test, Pgt;0.05). Conclusions The therapeutic action of Jiu Wei Lv Ping particle in the treatment of GAD is affirmed with less side effects. It is valuable to use clinically.
ObjectiveTo explore the relationship between the impairment of empathy and anxiety and depression in patients with epilepsy. MethodsAll the patients were collected in the Neurology Department of the First Affiliated Hospital of DaLian Medical University from March 2015 to January 2016, included 93 cases of adult patients with epilepsy and 100 cases of normal control group, all of them were given the test of HAMA, HAMD, MoCA and IRI-C.To analyze the relationship between the ability of empathy and anxiety and depression in patients with epilepsy, in the difference seizure type, frequency and duration of onset. Results1.Compared with the control group, the patients with epilepsy showed impaired ability of dissociative empathy, which was impaired cognitive empathy and emotional empathy, anxiety and depression were also significantly higher than those in the control group, the difference was significant.2.Different types:2.1 GTCS:cognitive empathy:no GTCS, pure GTCS group, SGS group, there were no significant differences between the three groups of empathy scores, emotional empathy, the SGS group had decrease in cognitive empathy with no GTCS, anxiety and depression more serious.There was no difference in cognitive empathy between the SGS group and the pure GTCS group, but the anxiety and depression of the SGS group were significantly serious than those of the pure GTCS group.There was no significant difference between no GTCG group and GTCS group in cognitive empathy, anxiety and depression.There was a significant negative correlation between emotional empathy and anxiety and depression in group SGS.There was no correlation between GTCS and pure GTCS group scores and anxiety depression.2.2CPS:CPS group were worse than those of the non CPS group, and the anxiety and depression were higher than those of the non CPS group.The total score of empathy, emotional empathy and anxiety and depression were significantly negatively correlated.There was no correlation in non CPS group.3.Different seizure frequency:high frequency group empathy scores, cognitive empathy lower in low frequency, anxiety and depression is more serious; empathy and anxiety and depression emotion has showed a significant negative correlation, no correlation between empathy scores, cognitive empathy and anxiety and depression.There was no correlation between empathy scores, cognitive empathy, emotional empathy and anxiety and depression.4.Different onset period:>5 years, empathy scores, cognitive empathy were lower than ≤5 years group and anxiety depression was more serious; emotional empathy and anxiety and depression was negatively related, no correlation between empathy score and cognitive empathy and anxiety and depression. ConclusionsEmpathy ability, cognitive empathy injury, emotional empathy retention declined in adult patients with epilepsy.Anxiety and depression were more severe in adult patients with epilepsy.There is negatively correlated in emotional empathy and anxiety and depression in patients with epilepsy, the scores of cognitive empathy and anxiety and depression have no correlation.The types of epilepsy, seizure frequency, age of onset is associated with cognitive empathy and anxiety and depression in epilepsy, and affect the correlation between empathy and anxiety and depression.
Objective To evaluate the effect of visual and audiovisual distraction on anxiety and acceptance levels among patients undergoing colonoscopy. Methods A total of 180 consecutive patients undergoing colonoscopy were randomly divided into three groups: group A received visual distraction; group B received audiovisual distraction; and group C received routine care alone. Levels of anxiety and willingness to accept the same intervention if the procedure needed to be repeated were compared among the three groups. Results The reduction of anxiety score after colonoscopy in group A and group B was greater than that in group C, but the difference was not statistically significant. The rate of willingness to accept the same intervention if the procedure needed to be repeated was significantly different among the three groups: the rates for group A and group B were higher than for group C (Plt;0.05). Conclusions Both visual distraction and audiovisual distraction can significantly improve patients’ acceptance of colonoscopy. Visual distraction and audiovisual distraction have no significant effect on reducing anxiety.
Objective To evaluate the effect of music therapy for childbirth. Methods Such databases as The Cochrane Library, PubMed, EMbase, EBSCO host, SpringerLINK Online Journals, CBM and WanFang Data were searched from January of 2000 to December of 2010 to collect randomized controlled trials (RCTs) of music therapy for childbirth. The quality of RCTs was appraised and the data were extracted. Meta-analyses were conducted with RevMan5.02 software for the standarded RCTs. Results A total of nine RCTs were included. Five RCTs indicated the music therapy could alleviate the labor pain; five RCTs indicated the music therapy could reduce the event risk of cesarean section due to the failure of transvaginal trial labor; three RCTs indicated the music therapy could shorten the first stage of labor; two RCTs indicated the music therapy could stabilize the systolic pressure and heart rate when complete cervical dilation was done, and three RCTs indicated the music therapy could relieve anxiety. In addition, music therapy had no influence on neonate Apgar’s score; and the result of meta-analyses on postpartum hemorrhage was not reliable through sensitivity analyses. Conclusion The music therapy applied during childbirth can relieve the labor pain and anxiety, stabilize the heart rate and systolic pressure when complete cervical dilation is done, reduce the event risk of cesarean section due to the failure of transvaginal trial labor, shorten the first stage of labor, and is beneficial to the mind and body of parturient.
ObjectiveTo systematically evaluate the effect of repeated transcranial magnetic stimulation (rTMS) in treating epilepsy.MethodsThe randomized controlled trials (RCTs) of rTMS for epilepsy and related diseases were collected from PubMed, EMbase, Cochrane Library, CBM, CNKI, VIP, and Wanfang databases by computer. The retrieval time was from establishment to June 2019. Two researchers independently screened the literature, extracted the data and evaluated the deviation risks of the included studies. RevMan5.3 software was used for Meta analysis.ResultsA total of 21 RCTs were included, including 1 587 patients. The results showed that rTMS assisted antiepileptics drugs (AEDs) could improve the effective rate of epilepsy treatment [RR=1.28, 95% CI (1.19, 1.37)], significantly reduced HAMA, HAMD and NFDS scores in the treatment of patients with epilepsy combined with anxiety and depression [MD=?3.94, 95% CI (?4.25, ?3.63)], and improve DQ and GMFM-88 scores in children with cerebral palsy combined with epilepsy [MD=7.95, 95% CI (7.00, 8.90)]. In addition, using rTMS will not cause additional adverse reaction [peto OR=0.52, 95% CI (0.31, 0.84)].ConclusionsThe current evidence showed that rTMS combined AEDs can improve the efficient of AEDs therapy. When treat anxiety depression comorbidity, it can significantly reduce the anxiety depression score. In addition in children with cerebral palsy merger, it can improve muscle strength and development. And rTMS will not cause additional adverse reactions. Limited by the quantity and quality of the selected studies, the conclusions need to be verified by more high-quality studies.
ObjectiveTo explore the disability of social function of gastrointestinal outpatients with depressive or anxiety disorders in general hospitals. MethodsA multicenter cross-sectional study was conducted from May to June in 2007. A total of 1 995 subjects from 13 general hospitals in China were screened by using the Hospital Anxiety and Depression Scale (HADS). The subjects scored≥8 on HADS were diagnosed via the Mini International Neuropsychiatric Interview by psychiatrists. The Sheehan Disability Scale (SDS) was used to assessed patients' disability of life, work, and social intercourse aspects. Then, compared the subjective quality of life, number of doctor visits, and monthly loss of working days between outpatients with and without depressive or anxiety disorders in last six months. Further, compared the social dysfunction between patients with depression/anxiety disorders (the case group) and without depression/anxiety disorders (the control group) in functional disorders group and organic disease group of gastroenterology respectively. ResultsIn comparison to the control group, the case group had much higher score of SDS, including life, work, and social intercourse (P<0.05) aspect and had more doctor visits and loss of more working days (P<0.05). In functional disorders group of gastroenterology, the case group had much higher score of SDS, including life, work, and social intercourse (P<0.05) aspect and had more doctor visits, loss of more working days (P<0.05) compared with those in the control group. In organic disease group of gastroenterology, the case group had much higher score of SDS, including life, work, and social intercourse (P<0.05) aspect and had loss of more working days (Z=-4.307, P<0.001) compared with those in the control group. ConclusionFor the patients with functional disorders or organic disease of gastroenterology, the depressive and anxiety disorders may lead to the disability of social function.
【摘要】 目的 探討降高血壓藥物聯合抗焦慮抑郁藥物萬拉法新治療老年性原發高血壓伴焦慮抑郁障礙的療效及安全性。 方法 納入2006年10月-2008年10月我院門診和住院診治的老年性原發高血壓伴焦慮抑郁障礙患者100例,隨機分為干預組和對照組。所有患者給予常規降壓藥物治療,干預組另外給予萬拉法新治療,治療12周后評價臨床療效。結果 干預組臨床降壓療效總有效率940%,顯著高于對照組總有效率800%(Plt;005)。兩組患者的收縮壓、舒張壓與治療前比較均顯著改善(Plt;005),干預組患者與對照組比較血壓明顯改善(Plt;005)。干預組臨床抗焦慮抑郁療效總有效率960%,顯著高于對照組總有效率580%(Plt;005)。兩組均無明顯的不良反應。結論 降高血壓藥物聯合抗焦慮抑郁藥物萬拉法新治療老年性原發高血壓伴焦慮抑郁障礙療效肯定,且安全可靠,值得臨床推廣應用。【Abstract】 Objective To investigate the efficacy and safety of antihypertensive drugs combined with antianxiety depression drug venlafaxine for treatment of patients with senile primary hypertension (SPH) and anxietydepression disorder (AD). Methods One hundred SPH patients with AD with were randomly divided into an intervention group and a control group. All cases were given antihypertensive drugs medication,while the intervention group was given venlafaxine. After 12 weeks of treatment,the clinical efficacy was evaluated. Results The antihypertensive efficacy rate in the intervention group was 940%,significantly higher than that of the control group 800% (Plt;005). The systolic blood pressure(SBP)and diastolic blood pressure (DBP) of the two groups significantly improved compared with those before treatment (Plt;005), and the intervention group’ SBP and DBP improved significantly than those of the control group (Plt;005). The total effective rate of antianxiety depression efficacy of the intervention group was 960%, significantly higher than that of the control group 580% (Plt;005). The two groups had no significant adverse reactions. Conclusion For patients with senile primary hypertension and anxietydepression disorder,the combination medication with antihypertensive drugs and venlafaxine was safe,reliable and worthy of clinical application.
Objective To investigate the prevalence of anxiety and depression in patients with epilepsy (PWE) in West China, and to explore the related risk factors. Methods The Chinese version of Generalized Anxiety Disorder (GAD)-7 and Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) scales were used to evaluate the anxiety and depression in 176 PWE patients between December 2016 and February 2017. Univariate analysis was used to screen the factors that may cause anxiety and depression in PWE, and then logistic regression analysis was performed on the possible risk factors. Results In the 176 PWE, about 27.3% had anxiety, and about 28.4% had depression. Multivariate logistic regression analysis showed that seizure occurrence in the recent six months [odds ratio (OR)=3.481, 95% confidence interval (CI) (1.292, 9.380),P=0.014], seizure occurring more than once in a month [OR=3.231, 95%CI (1.468, 7.111),P=0.004], and focal seizures with conscious disorders [OR=2.416, 95%CI (1.082, 5.397),P=0.031] were risk factors for anxiety in PWE. Unmarried status [OR=0.428, 95%CI (0.195, 0.940),P=0.035], seizure occurring more than once in a month [OR=2.685, 95%CI (1.206, 5.979),P=0.016], focal seizures with conscious disorders [OR=2.541, 95%CI (1.112, 5.808),P=0.027] and seizure occurrence in the last six months [OR=7.582, 95%CI (2.416, 23.794),P=0.001] were risk factors for depression in PWE. Conclusions Anxiety and depression are common comorbidities in PWE. For patients with risk factors, early identification and intervention should be performed.