Objective To explore the risk factors of postoperative anxiety in patients with pancreatic cancer undergoing total pancreatectomy. Methods A total of 31 patients who underwent total pancreatectomy for pancreatic cancer between July 2011 and December 2016 were collected and analyzed in this retrospective study. The patients’ postoperative Self-Rating Anxiety Scale scores were collected, and the exposure factors were analyzed to identify the risk factors of postoperative anxiety through univariate analysis and multiple logistic regression analysis by SPSS 21.0 statistical software. Results In the 31 patients, there were 17 males and 14 females, with an average age of (66.16±9.09) years, an average body mass index of (21.11±3.10) kg/m2, and an average postoperative hospital stay of (14.58±7.47) days. There were 23 patients (74.2%) with postoperative anxiety, and 30 patients (96.8%) with hyperglycosemia required insulin therapy. The total perioperative mortality was 3.2%. In the univariate analysis, age (P=0.012), smoking history (P=0.043), preoperative diabetes mellitus (P=0.012), postoperative bile leakage (P=0.043), and postoperative abdominal infection (P=0.026) were related factors of the postoperative anxiety. In the multiple logistic regression analysis, patients without preoperative diabetes was an independent risk factor of postoperative anxiety (P=0.013). Conclusions For patients undergoing total pancreatectomy, it is needed to pay attention to the patients’ postoperative psychological conditions and assess the postoperative anxiety, especially for those without preoperative diabetes. To improve the life quality and long-term survival of these patients, health education and psychological intervention are needed.
Objective To assess the effectiveness and safety of trazodone versus alprazolam on adults’ generalized anxiety disorder (GAD). Methods Such databases as PubMed (1980 to May 2012), CBM (1990 to May 2012), VIP (1989 to May 2012), CNKI (1990 to May 2012) and WanFang Data (1990 to May 2012) were searched to collect the randomized controlled trials (RCTs) about trazodone vs. alprazolam for adults’ GAD. According to the inclusion and exclusion criteria, two reivewers screened literature, extracted data and assessed the quality of the included studies, then meta-analysis was conducted using RevMan 5.0 software. Results A total of 5 RCTs involving 403 patients were included. The results of meta-analysis showed that: a) After four-week treatment, there were no significant differences between the two groups in the HAMA scores (RR=1.04, 95%CI 0.95 to 1.13, P=0.38) and cure rate (RR=1.05, 95%CI 0.75 to 1.48, P=0.76); and b) The somnolence rate of the trazodone group was lower than that of the alprazolam group (RR=0.42, 95%CI 0.25 to 0.72, P=0.001). But there were no significant differences between the two groups in dizziness (RR=0.52, 95%CI 0.27 to 1.01, P=0.05), fatigue (RR=0.10, 95%CI 0.01 to 1.41, P=0.09), and poor appetite (RR=2.82, 95%CI 0.28 to 28.23, P=0.38). Conclusion There is no significant difference between razodone and alprazolam in the effectiveness when treating GAD, but razodone has lower side effects while alprazolam tends easily to cause somnolence. For the quantity limitation and low methodological quality of the included studies, this conclusion still needs to be further proved by more high quality RCTs.
This paper is aimed to analyze the topological properties of structural brain networks in depressive patients with and without anxiety and to explore the neuropath logical mechanisms of depression comorbid with anxiety. Diffusion tensor imaging and deterministic tractography were applied to map the white matter structural networks. We collected 20 depressive patients with anxiety (DPA), 18 depressive patients without anxiety (DP), and 28 normal controls (NC) as comparative groups. The global and nodal properties of the structural brain networks in the three groups were analyzed with graph theoretical methods.The result showed that ① the structural brain networks in three groups showed small-world properties and highly connected global hubs predominately from association cortices; ② DP group showed lower local efficiency and global efficiency compared to NC group, whereas DPA group showed higher local efficiency and global efficiency compared to NC group; ③ significant differences of network properties (clustering coefficient, characteristic path lengths, local efficiency, global efficiency) were found between DPA and DP groups; ④ DP group showed significant changes of nodal efficiency in the brain areas primarily in the temporal lobe and bilateral frontal gyrus, compared to DPA and NC groups. The analysis indicated that the DP and DPA groups showed nodal properties of the structural brain networks, compared to NC group. Moreover, the two diseased groups indicated an opposite trend in the network properties. The results of this study may provide a new imaging index for clinical diagnosis for depression comorbid with anxiety.
Objective To understand the status quo of depression and anxiety emotion in perioperative patients with thoracic neoplasms under the concept of enhanced recovery aftersurgery. Methods Huaxi emotional-distress index scale (HEI) was adopted to investigate the mental status of 195 patients with thoracic neoplasms in Department of Thoracic Surgery, West China Hospital, and the nursing outpatients between September and November in 2016. There were 118 males and 77 females at age of 17–80 (55.72±12.66) years. Results There was significant difference in mental health level between the preoperative patients and the postoperative patients (3.70±3.41vs. 11.01±9.78,P<0.001). The incidence of depression and anxiety emotion in the postoperative patients was significantly higher than that in the preoperative patients (50.00%vs. 9.60%, P<0.001). Besides, there was significant difference of depression and anxiety degree between the preoperative patients and postoperative patients (P<0.001). Moderate to severe depression and anxiety were mostly found in the postoperative patients while mild to moderate depression and anxiety in the preoperative patients. Conclusion Patients with thoracic neoplasms have much emotional obstacle in perioperative period. The incidence and severity degree of depression and anxiety emotion in postoperative patients are higher than those in preoperative patients.
ObjectiveTo explore the distribution pattern of respiratory symptoms and relevant factors in patients with pulmonary nodules. MethodsDemographic and clinical information were collected from patients who visited the Thoracic Surgery Outpatient Clinic of Guangdong Provincial People’s Hospital from January 2021 to January 2022. Hospital Anxiety and Depression Scale (HADS) was used to assess their anxiety and depression level. ResultsA total of 1173 patients were enrolled, including 449 males and 724 females, with an average age of 46.94±11.43 years. Among the patients with pulmonary nodules, 37.7% of them had at least one respiratory symptom; 24.4% had cough, 14.0% had expectoration, 1.3% had hemoptysis and 14.9% had chest pain. Old age, male, exposure to second-hand smoking or environmental smoke, hair coloring and history of tuberculosis were major risk factors for respiratory symptoms (P<0.05). Middle age, old age, male, exposure to environmental smoke were major risk factors for cough (P<0.05); old age, smoking, larger maximum nodules diameters, exposure to environmental smoke and history of pneumonia were major risk factors for expectoration (P<0.05); male, multiple nodules, hair coloring, exposure to second-hand smoking and history of tuberculosis were major risk factors for chest pain (P<0.05). Symptomatic patients showed generally higher HADS scores than asymptomatic patients (P<0.001). ConclusionCough, expectoration and chest pain are the predominant respiratory symptoms for patients with pulmonary nodules. The presentation of respiratory symptoms increases patients' anxiety and depression.
Objective To evaluate the therapeutic efficacy and safety of trazodone versus alprazolam for generalized anxiety disorder (GAD). Methods After the third day of a three-day screening period, 60 patients with generalized anxiety disorder were randomly assigned to the trazodone group (30 patients, 50-150 mg/d), and alprazolam group (30 patients 1.2-4 mg/d) for 4 weeks. Patients and their doctors were blind. Data were analyzed by SPSS 10.0 and intention-to-treat analysis. Results The total effective rate of trazodone was 77% (23/30), while alprazolam was 70% (21/30) (Pgt;0.05) .No difference was seen for adverse events. None was lost to follow in the two groups. Conclusions Trazodone appears to be as effective as alprazolam in treating generalized anxiety disorder. Adverse events may include confusion and loss of appetite, but patients are able to tolerate these.
Objective To investigate the current situation of anxiety and depression in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and analyze the related influencing factors. Methods A questionnaire survey was conducted among AECOPD patients admitted to the Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Anhui Medical University from August 2022 to October 2023. The survey included basic demographic information, anxiety and depression scores, quality of life and dyspnea symptoms in the AECOPD patients. The clinical data of patients in the electronic medical record system were also collected. According to the anxiety score or depression score, the patients were divided into an anxiety group and a non-anxiety group, or a depression group and a non-depression group. The indicators between two groups were compared and the influencing factors were analyzed. Results Among the 164 patients with AECOPD, 123 patients (75.0%) were complicated with anxiety, 125 patients (76.2%) were complicated with depression, and 105 patients (64.0%) were complicated with anxiety and depression. Education level, place of residence, monthly income, smoking index, and chronic obstructive pulmonary disease assessment test (CAT) score were associated with AECOPD and anxiety (P<0.05). Higher CAT score was an independent risk factor for anxiety in the patients with AECOPD. Residence, monthly income, smoking index, CAT score, modified British Medical Research Council (mMRC) dyspnea questionnaire rating, actual bicarbonate, neutrophilic granulocyte percentage (NEU%), lymphocyte percentage (LYM%), basophile percentage (BASO%), alkaline phosphatase, total carbon dioxide concentration, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were associated with AECOPD and depression (P<0.05). Among them, higher CAT score and PLR value were independent risk factors of AECOPD and depression. Conclusion Anxiety and depression have higher prevalence in AECOPD patients, and the influencing factors include quality of life, dyspnea symptoms, education level, place of residence, monthly income, smoking index, acid base balance, NEU%, LYM%, BASO%, NLR和PLR, etc.
Psychological problems are significant factors that contribute to the occurrence of postoperative complications, reduced quality of life, and prolonged hospital stays. Lung cancer patients who require surgery often experience high psychological stress related to both the disease and the treatment, making them more susceptible to depression and anxiety. Therefore, timely intervention to address these psychological issues is crucial for promoting postoperative recovery and improving patients' quality of life. This paper will review the current status, impact, and interventions for depression and anxiety-related psychological problems in lung cancer surgery patients.
ObjectiveTo evaluate the predictors of generalized anxiety disorder (GAD) among teachers in 3 months after Lushan earthquake. MethodsA prospective cohort study was conducted to diagnostically evaluate the psychological sequelae and GAD during 14-20 days and 85-95 days after the earthquake. The possible predictive factors of psychological sequelae were assessed by a self-made questionnaire and the GAD was assessed by the GAD symptom criterion of M.I.N.I. in 3 months. The univariate and multivariate logistic regression analysis (ULRA, MLRA) were applied to analyze the predictors of GAD after the two-staged assessments. ResultsThere were a total of 319 teachers completed the two-staged assessments. The total response rate was 51.3%. Seventy teachers were diagnosed as GAD and the prevalence of GAD in 3 months was 21.9%. The predictive factors by ULRA included:male, older than 35 years old, having unlivable house, living in tents, sleeping difficulties, easy to feel sad, physical discomfort, loss of appetite, feeling short of social support, unable to calm down for working, feeling difficult for teaching, observing more inattention of students, and wanting to ask for a leave. The independent predictors by MLRA included:male, having unlivable house, feeling short of social support, and feeling difficult for teaching. ConclusionThe teachers have a higher likelihood of GAD after earthquake. It is essential to pay more attention to those male teachers, who feel short of social support and don't have a livable house thus to prevent the GAD at the early stage of post-earthquake.
ObjectiveTo investigate the psychology and sleep statuses of liver transplantation recipients during the outbreak of COVID-19.MethodsCluster sampling was used to investigate the patients who underwent liver transplantation in the West China Hospital of Sichuan University from January to February 2020. The psychology and sleep statuses were evaluated by the self-designed questionnaire, State-Trait Anxiety Inventory (SAI), Center for Epidemiological Studies Depression Scale (CES-D), and Pittsburgh sleep quality index (PSQI).ResultsTwenty-seven liver transplantation recipients were included in this study. The questionnaires of the 27 patients were collected. The SAI score was (46.41±8.77); The score of CES-D was (13.11±7.87), there were 2 (7.4%) patients with depression; The PSQI score was (6.44±4.02), there were 7 (25.9%) patients with sleep disorders. The points of anxiety and depression of the patients with different gender, age, education level, marital status, residence, living conditions, primary disease, Child-Pugh classification, whether suffered SARS epidemics, COVID-19 knowledges level, medical insurance, family annual income per capita, and income and expenditure of cash had no significant differences (P>0.05) during the outbreak of COVID-19. However, the points of patients with male or suffered SARS or the family annual income per capita ≥60 000 yuan were higher than those of patients with female or not-suffered SARS or the family annual income per capita <60 000 yuan (P<0.05).ConclusionsAnxiety and sleep disorder of liver transplantation recipients are common during the outbreak of COVID-19, which could not be ignored. Knowledges of COVID-19 should be paid to spread so as to reduce psychological pressure and improve sleep quality.