Objective: To investigate the association between testosterone deficiency and depressive and/or anxiety symptoms.
Methods: A cross-sectional study was conducted at the urology outpatient clinic from Ludus County Hospital. A set of validated questionnaires ((International Prostate Symptoms Score (IPSS), Depression Anxiety and Stress Scale (DASS-21), Zung Self-rating Depression Scale (Zung SDS)) were self-administrated. Inclusion criteria: age > 40 years. Exclusion criteria: any relevant psychiatric, cardiovascular, or cancer comorbidity. Statistical analyzes were performed using the statistical software Statistical Package for Social Sciences (SPSS, version 23, Chicago, IL, USA).
Results: From the total of 55 participants included in the study, 23 (41.8%) had testosterone deficiency. Most were from the 60-69 years decade, 23 participants (41.8%), and the mean age was 59.3 (SD 9.03) years. Eleven (20%) patients had depressive symptoms according to the depression subscale, of these, 7 had mild symptoms and 4 according to Zung SDS. Testosterone deficiency was associated with an increased DASS-21 global score, p=0.021, and depression score, p=0.047.
Conclusions: Patients with testosterone deficiency are presenting symptoms of depression. Therefore, these patients need a multi-disciplinary approach that should include a psychological evaluation before making a further management decision.
Tag Archives: anxiety
Study of the anxiolytic effect of propranolol and dextromethorphan in mice using a model of psychogenic stress
Objective: To find the anxiolytic effects in a psychogenic stress model in mice, the present study has investigated the interaction between propranolol and dextromethorphan.
Methods: 50 Albino Swiss male mice were housed in groups of 10 per cage. The beta-adrenergic receptor blocker propranolol (20 mg/kg bw), the N-methyl-D-aspartate (NMDA) receptor dextromethorphan (30 mg/kg bw), and their combination were administered 10 minutes after exposure to predator odor. The treatments included diazepam as positive control and normal saline as negative control. Anxiety-like behaviors were evaluated using the elevated plus-maze test (EPM) 7 days after stress induction.
Results: Regarding the length of stay (F=25.53; p<0.0001)/ number of entries in the open arms (F=3.533; p=0.0416), time (F=6.127; p=0.0045)/ number of entries in the closed arms (F=5.690; p=0.0141), time in center-point (F=3.577; p=0,0295), and total distance traveled (F= 4.711; p=0.0145), there was a significant difference among the treated groups. Propranolol and dextromethorphan treated groups expressed lower time in the closed arms vs Placebo (p=0.0089, respectively p=0.0111). In addition, the time spent in the open arms was higher in propranolol group vs placebo group (p=0.0215).
Conclusions: Considering obtained data, there was a decrease of symptoms in the sympathetic nervous system and the psychological stress disappeared in mice applying a treatment of 20 mg/kg bw propranolol. Our findings indicated that dextromethorphan partially mediated the anxiolytic-like activity. However, the combination of these two drugs did not express anxiolytic effects.
Emotional disorders associated to multiple sclerosis and psychological interventions: a literature review
Multiple sclerosis is an unpredictable neurologic disease affecting 2.8 million people worldwide. Individuals with MS experience multiple physical and psychological symptoms such as depression, anxiety, fatigue, and pain that impact their general functioning and quality of life. The aim of this review is to highlight the importance of psychological interventions in reducing depression and anxiety symptoms associated with the diagnosis of multiple sclerosis. Cognitive and behavioral techniques are also useful in relieving the specific symptoms of multiple sclerosis. However, few studies have captured the psychological processes involved in reducing the symptoms of depression and anxiety, which is why greater concern is recommended in future studies in order to develop better psychological interventions tailored for patients with multiple sclerosis.
The impact of the COVID-19 pandemic on the educational process of Dental Medicine Department students in Oradea University during the lockdown period
Aim: This cross-sectional study assesses the opinions regarding the abrupt change in dental health education of students from the Department of Dentistry, Faculty of Medicine and Pharmacy, Oradea University during the lockdown period.
Materials and methods: An on-line survey was distributed, from 30th of April 2020 until the 2nd of May 2020, collecting data about gender, nationality, year of study, sources of information about the virus, measures taken to avoid contamination, rating online teaching versus face-to face teaching, experiencing anxiety about the future of the profession, perceived impact of the COVID-19 pandemic on their life and professional future and possible measures that can be implemented in order to avoid or reduce contamination. Data was analyzed using IBM SPSS and Chi-Square test.
Results and discussions: Reopening was associated with anxiety concerning the future of the profession for 44.8% of the respondents; almost half of the students experienced anxiety caused by the possibility of being infected in case of reopening (49.7%), while 62.6% were afraid of the possibility to infect their family, peers or patients. From the total number of students, 12.9% were considering changing their profession. A quarter of respondents (25.2%) declared that they will wait for a decrease in number of cases in order to reevaluate their professional career options.
Conclusions: Government provided data was preferred by the female respondents’ group, versus the men respondents’ group who preferred the information provided by the WHO. The highest percentage of respondents that considered professional psychological support from university during the lockdown period useful were in the first 4 years of study. Most of the foreign students preferred to open their own dental office, while most of the Romanian students opted for being an employee in a big Dental Clinic or for reevaluating their options at a later point.
Prevalence of Depression, Anxiety and Cognitive Impairment in Patients with Type 2 Diabetes from the Central Part of Romania
Objective: The aim of this study was to assess the prevalence of depression, anxiety and cognitive impairment in patients with type 2 diabetes (T2D).
Material and methods: We conducted a cross-sectional study in patients with T2D. Depression and anxiety were assessed by questionnaires (PHQ-9, CES-D and GAD-7 respectively), cognitive function by the MoCA test. Additionally, 503 patients’ clinic charts were separately analyzed in order to compare the data recorded in the charts with that resulted from the active assessment.
Results: In the screening study 216 subjects with T2D were included (62.2 ± 7.8 years old). 34.3% of them had depression and 7.4% presented major depression. 44.9% of patients with T2D had anxiety (9.2% major anxiety) and this was highly correlated with depression (OR: 21.139, 95%CI: 9.767-45.751; p<0.0001). Women had significantly higher prevalence of depression and anxiety compared to men (42.1% vs. 21.7%; p: 0.0021 and 51.1% vs. 34.9%; p: 0.02), but severe depression was similar between genders (9.0% vs. 4.8%; p: 0.29). Significantly more patients had depression and anxiety than recorded in their charts (34.3% vs. 13.9% and 44.9% vs. 9.3%,respectively; p<0.0001 for both). 69.0% of T2D patients had mild, 6.0% had moderate and none had severe cognitive dysfunction, respectively. Significantly more patients with depression and anxiety had mild and moderate cognitive impairment (p: 0.03 and p: 0.04, respectively).
Conclusions: Patients with T2D had a high prevalence of comorbid depression, anxiety and cognitive impairment. Depression and anxiety were significantly more frequent in women. These conditions were under-evaluated and/or under-reported.
Is Psychiatry a Profession Associated with High Anxiety?
Background: Depending on intensity, anxiety can have an adapting and mobilizing role, or it can represent a serious risk.
Aim: To examine the prevalence of anxiety symptoms for those who work in a clinic of psychiatry.
Material and method: Group consists of 35 persons who work in the Acute Psychiatric Clinic II – Targu Mures. Anxiety was measured as a current emotional state and as a trait by Spielberger’s State-Trait Anxiety Inventory (STAI).
Results: Applying Spielberger’s Inventory 33.3% of the female and 28.5% of the male might be suspected of suffering from significant anxiety symptoms as a state. Also the subject’s predisposition to anxiety as a trait of the subject’s personality is important, 24% of female and 43% of men had levels of anxiety over 60% compared with standards.
Conclusions: An important number of people who work in psychiatry have high scores of anxiety. Further studies are needed to clarify to what extent this relates to a high prevalence of anxiety disorders.
Pain and Distress in Cancer Patients
Background: A significant number of patients with cancer suffer from anxiety and depressive disorder. Perceived emotional distress, anxiety and depressive symptoms are significantly more frequent in cancer patients with pain than in patients without pain. Despite their high prevalence cancer pain and distress are frequently undertreated.
Material and method: Thirty two oncology patients were included in the study who were receiving concurrent oncologic and pain treatment in the Oncology Clinic TgMures. Patient demographic and clinical information was obtained from medical records and patient report. Patients were screened for pain scores using the Visual Analog Scale and distress scores, using the Distress Thermometer.
Results: The gender proportion of the sample is: 38% female, 62% male. More than 75% of the sample was over 50 years of age , and more than half of the patients (59.3%) had metastatic disease. Significant decreasing trend were seen for pain score difference before and after the pain treatment was reassessed (dosage increase or conversion) (p<0.0001), and decreasing trend seen for distress score (p<0.0001) also.
Conclusions: Pain and distress occurred concomitant in this population. An adequate pain management and pain reassessment contributes to improve the cancer patient emotional distress score, anxiety and depressive symptoms. An accurate screening instrument can facilitate the recognition of patients who needs further assessment and psychiatric treatment.
Association Between Increased Waist Circumference and Depression and Anxiety Trend
Introduction: Abdominal adiposity assessed by increased waist circumference and depression have both a high incidence and prevalence and are associated with increased general mortality and cardiovascular risk. Several studies showed a significant association between abdominal obesity, metabolic syndrome and depression. Early detection of these associations is important for for prevention and treatment of this disease.
Material and method: Eighty patients were enrolled in a cross-sectional descriptive study. Waist circumference was measured in all patients and an increased waist circumference was considered for subjects with values higher than 80 cm in women and higher than 94 cm in men as. Patients completed standardized questionnaires HADS for assessment of depression and anxiety. A depression (D) score higher than 10 points showed a trend to depression while an anxiety (A) score higher than 10 indicated a tendency to anxiety. The association between increased waist circumference, depression and anxiety was studied.
Results: We interviewed 80 patients, 34 (43%) men (mean age 62+/-6.43) and 46 (57%) women (mean age 59+/-5.16). Increased waist circumference was recorded in 22 men, and in 30 women. We noticed a good association between increased waist circumference and both depression (p=0.0006, RR=2.007, 95%CI 1.24-3.24) and anxiety (p=0.017, RR=2.046, 95%CI 1.21-3.45). We found both anxiety and depression risks rather equal in men, while in women we observed a higher depression risk.
Conclusions: Increased waist circumference is associated to depression and anxiety tendency in both genders. Depression trend is more powerful in women, while in men both depression and anxiety seen to have an equal frequency. Psychotherapy should be added to lifestyle changes in patients with abdominal adiposity.