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Bipolar disorder （BD） is a complex mental illness characterized by mood fluctuations， excitability and impaired functioning. Anxiety in BD patients frequently leads to increased clinical symptoms， worse social functioning， and a higher risk of suicide. Current research on BD with anxiety symptom primarily examined clinical characteristics， prevalence and treatment， with limited focus and inconsistent findings on its neuro-biogenetic mechanisms. The findings in this area were also inconsistent. Magnetic resonance imaging （MRI）， known for its non-invasive nature and high resolution， is extensively utilized in investigating disease mechanisms. Consequently， this paper gave a comprehensive review on the progress in brain imaging on BD patients with anxiety symptom， seeking to discern stable changes in brain structure and function， thereby enrich our understanding of the neurobiological etiology of this condition and offer valuable insights for clinical diagnosis and treatment strategies making. This paper covered 14 original studies and synthesized their findings on brain structure and function. Conclusively， the changes of brain functional activities in BD patients with anxiety symptom mainly involve the prefrontal lobe， posterior cingulate cortex， temporal lobe and angular gyrus， while the changes of brain structure mainly involve the left hippocampus and middle frontal gyrus， but the consistency of the research results needs to be enhanced. The research in this field is not sufficient, and more homogeneous clinical samples and larger longitudinal studies are needed to verify and supplement the above results. ［Funded by National Natural Science Foundation of China （number， 82071524）］

ABSTRACT Background The COVID‐19 pandeminc has had widespread impacts, but its specific effects on mental health and cognitive function in patients with cancer remain under‐explored. Recent Findings Data from the general population has suggested that mental health problems were frequent during the pandemic, namely during the initial stage of the outbreak. For patients with cancer, a systematic review and meta‐analysis of data published until January 2021 also showed elevated prevalence of depression and anxiety, and suggested that anxiety was more frequent than in health workers and healthy controls. Objective This systematic review aimed to synthesize existing evidence on the impact of the COVID‐19 pandemic on mental health and cognitive function in patients with cancer. Methods Studies were identified through systematic search of three electronic bibliographic databases (PubMed, Web of Science, and EBSCOHOST) with adapted search strings. We included only peer‐reviewed, nonqualitative, original research papers, published between 2019 and 2022, and reporting on mental health and/or cognition outcomes during the COVID‐19 pandemic in adult patients with cancer. Results Of 3260 papers identified, 121 full text articles were retrieved and 71 met inclusion criteria. We found that patients with cancer reported high levels of psychological distress, anxiety and depression, as well as cognitive complaints during the pandemic. However, studies were not consistent in identifying these symptoms as effects of the pandemic specific for this population. In fact, longitudinal studies did not find consistent differences between pre‐ and post‐pandemic periods and, globally, patients with cancer did not report increased severity of these mental health symptoms in relation to the general population. Conclusion Overall, while the COVID‐19 pandemic may have raised mental health challenges for patients with cancer, the diagnosis of cancer and associated treatments seemed to remain the main source of concern for these patients.

Background Cardiac rehabilitation improves health and quality of life and reduces risk of further cardiac events. Twenty-eight per cent of cardiac rehabilitation patients experience clinically significant anxiety and 19% suffer depression. Such patients are at greater risk of death, further cardiac events and poorer quality of life and use more health care, leading to higher NHS costs. The available psychological treatments for cardiac patients have small effects on anxiety and depression and quality of life; therefore, more effective treatments are needed. Research shows that a thinking style dominated by rumination and worry maintains anxiety and depression. A psychological intervention (metacognitive therapy) effectively reduces this style of thinking and alleviates depression and anxiety in mental health settings. The PATHWAY study evaluated two versions of metacognitive therapy applied in cardiac rehabilitation services. Objectives The primary aim was to improve psychological outcomes for cardiac rehabilitation patients. We evaluated two formats of metacognitive therapy: (1) a group-based face-to-face intervention delivered by cardiac rehabilitation staff (group-based metacognitive therapy) and (2) a paper-based, self-directed intervention (home-based metacognitive therapy). Each was compared with usual cardiac rehabilitation alone in separate randomised controlled trials. Design A randomised feasibility trial (work stream 1) and a full-scale randomised controlled trial (work stream 2) evaluated group-metacognitive therapy, while separate feasibility and full-scale trials (work stream 3 and work stream 3+, respectively) evaluated home-based metacognitive therapy. A cost-effectiveness analysis of group-metacognitive therapy was conducted, along with stated preference surveys and qualitative studies examining patient psychological needs and therapists’ perspectives on metacognitive therapy. Setting Seven NHS cardiac rehabilitation services across the north-west of England. Participants Adults aged ≥ 18 years who met cardiac rehabilitation eligibility criteria, scored ≥ 8 on depression or anxiety subscales of the Hospital Anxiety and Depression Scale, and were able to read, understand and complete questionnaires in English. Interventions Work stream 1 and work stream 2 – a 6-week group-metacognitive therapy intervention delivered by cardiac rehabilitation staff plus usual cardiac rehabilitation compared with usual cardiac rehabilitation alone. Group-metacognitive therapy was delivered once per week for 6 weeks, with each session lasting 90 minutes. Work stream 3 and work stream 3+ – home-based metacognitive therapy plus usual cardiac rehabilitation compared with usual cardiac rehabilitation alone. Home-metacognitive therapy was a paper-based manual that included six modules and two supportive telephone calls delivered by cardiac rehabilitation staff. Main outcome measures The Hospital Anxiety and Depression Scale total score at 4-month follow-up was the primary outcome in all trials. A range of secondary outcomes were also evaluated. Results Our qualitative study with 46 patients across three cardiac rehabilitation services suggested that cardiac rehabilitation patients’ psychological needs were not met by current approaches and that metacognitive therapy might offer an improved fit with their psychological symptoms. The internal pilot feasibility study (work stream 1; n = 54) demonstrated that a full-scale randomised controlled trial was feasible and acceptable and confirmed our sample size estimation. A subsequent full-scale, single-blind randomised controlled trial (work stream 2; n = 332) showed that adding group-based metacognitive therapy to cardiac rehabilitation was associated with statistically significant improvements on the Hospital Anxiety and Depression Scale (primary outcome) in anxiety and depression compared with cardiac rehabilitation alone at 4-month (adjusted mean difference −3.24, 95% confidence interval −4.67 to −1.81, p < 0.001; standardised mean difference 0.52) and 12-month follow-up (adjusted mean difference −2.19, 95% confidence interval −3.72 to −0.66, p = 0.005; standardised mean difference 0.33). The cost-effectiveness analysis suggested that group-metacognitive therapy was dominant, that it could be cost saving (net cost −£219, 95% confidence interval −£1446 to £1007) and health increasing (net quality-adjusted life-year 0.015, 95% confidence interval −0.015 to 0.045). However, confidence intervals were wide and overlapped zero, indicating high variability in the data and uncertainty in the estimates. A pilot feasibility trial (work stream 3; n = 108) supported a full-scale trial of home-metacognitive therapy and was extended (work stream 3+; n = 240). In the full trial, the adjusted mean difference on the Hospital and Anxiety and Depression Scale favoured the metacognitive therapy + cardiac rehabilitation arm (adjusted mean difference −2.64, 95% confidence interval −4.49 to −0.78, p = 0.005; standardised mean difference 0.38), with statistically significant greater improvements in anxiety and depression in home-metacognitive therapy plus cardiac rehabilitation than in cardiac rehabilitation alone at 4-month follow-up. A stated preference survey on clinic-delivered psychological therapy (not specific to metacognitive therapy) indicated a preference for including psychological therapy as part of cardiac rehabilitation. Participants favoured individual therapy, delivered by cardiac rehabilitation staff, with information provided prior to therapy and at a lower cost to the NHS. A pilot stated preference study focused on preferences for home- or clinic-based psychological therapy. Preferences were stronger for home-based therapy than for centre-based, but this was not statistically significant and participants highly valued receiving therapy and having reduced waiting times. Limitations Limitations include no control for additional contact as part of metacognitive therapy to estimate non-specific effects. Work stream 3+ did not include 12-month follow-up and therefore the long-term effects of home-based metacognitive therapy are unknown. The health economics analysis was limited by sample size and large amount of missing data in the final follow up. Findings from the qualitative study cannot necessarily be generalised. Conclusions Both group-based and home-based metacognitive therapy were associated with significantly greater reductions in anxiety and depression symptoms at 4 months, compared with cardiac rehabilitation alone. The results in group-based metacognitive therapy appeared to be stable over 12 months. Introducing metacognitive therapy into cardiac rehabilitation has the potential to improve mental health outcomes. Future work Future studies should evaluate the long-term effects of home-metacognitive therapy and the effect of metacognitive therapy against other treatments offered in cardiac rehabilitation. Given the uncertainty in the economic evaluation, further work is needed to determine the cost-effectiveness of metacognitive therapy. Trial registration Work stream 1/work stream 2: NCT02420431 and ISRCTN74643496; work stream 3: NCT03129282; work stream 3+: NCT03999359. The trial is registered with clinicaltrials.gov NCT03999359. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Programme Grants for Applied Research Programme (NIHR award ref: RP-PG-1211-20011) and is published in full in Programme Grants for Applied Research; Vol. 12, No. 7. See the NIHR Funding and Awards website for further award information. Plain language summary Depression and anxiety are common among cardiac rehabilitation patients. Cardiac patients with anxiety and depression are at greater risk of death, further cardiac events and poorer quality of life and use more health care, leading to higher NHS costs. Current talking-based therapies have small effects on anxiety and depression in patients with cardiovascular disease. It is important that more effective treatments for mental health are added to cardiac rehabilitation. We applied two versions of a recent treatment called metacognitive therapy in cardiac rehabilitation: a group version and a home-based (self-help) paper-based manual. The programme had three work streams conducted across seven NHS trusts. In work stream 1, we ran a pilot trial showing that adding group-metacognitive therapy to cardiac rehabilitation was feasible and acceptable A full-scale trial (work stream 2) followed, and this showed that adding group-metacognitive therapy to cardiac rehabilitation was associated with greater improvement in anxiety and depression than cardiac rehabilitation alone. In work stream 3, we created a home-based version of metacognitive therapy and ran a feasibility trial, which was extended to a full-scale trial and showed that home-metacognitive therapy plus cardiac rehabilitation was associated with improved anxiety and depression outcomes compared with cardiac rehabilitation alone. Interview studies of patients’ needs, treatment preferences and reactions to treatment were included, and our patient and public involvement group advised the research team throughout the trial. The originator of metacognitive therapy, Adrian Wells, was the chief investigator of the study and is the director of the Metacognitive Therapy Institute. He has funding for the study ‘Implementing Group Metacognitive Therapy in Cardiac Rehabilitation Services (PATHWAY-Beacons; NIHR29567)’ as chief investigator. To maintain objectivity along with the trial statistician and research assistants he did not know patient treatment allocation, data were managed by a separate clinical trials unit and a plan for analysis was devised before analysis took place. Project oversight and monitoring were undertaken by an independent Trial Steering Committee. Scientific summary Background Cardiac rehabilitation (CR) aims to improve heart disease patients’ health and quality of life and reduce the risk of further cardiac events: 28% of cardiac patients have clinically significant anxiety and 19% have depression. Such patients are at greater risk of death, further cardiac events and poorer quality of life and use more health care, leading to higher NHS costs. Available psychological treatments for patients with heart disease have small effects on improving anxiety, depression and quality of life. Therefore, more effective treatments for depression and anxiety need to be explored and made available in CR services. Research in mental health contexts shows that a style of thinking dominated by rumination and worry maintains distress. A psychological intervention [metacognitive therapy (MCT)] reduces this style of thinking and alleviates depression and anxiety. The PATHWAY study evaluated two versions of MCT applied in heart disease patients attending CR: (1) a 6-week intervention delivered face to face in a group setting by CR staff (group-based MCT) and (2) a paper-based, six-module, self-directed intervention (home-based MCT). Objectives The primary aim is to improve access to more effective psychological interventions for the range of heart disease patients attending CR services. The specific objectives were to: conduct a pilot randomised controlled trial (RCT) of group-based MCT (Group-MCT) to evaluate the acceptability and feasibility of delivering the intervention to CR patients who have symptoms of anxiety and depression establish evidence of the effectiveness and cost-effectiveness of Group-MCT in CR in a full-scale RCT produce a rigorous, well-specified Group-MCT package develop a home-based metacognitive intervention (Home-MCT) for CR patients with depression and/or anxiety establish the feasibility and acceptability of integrating Home-MCT into the CR pathway in a pilot RCT establish provisional evidence of the effectiveness and cost-effectiveness of Home-MCT develop a protocol and manual for Home-MCT to inform a full-scale RCT conduct a full-scale RCT evaluating the effectiveness of Home-MCT. Methods We conducted a randomised controlled pilot trial and a full-scale RCT comparing usual CR alone against CR plus group-based MCT [work stream (WS) 1 and WS2; n = 332)]. We also conducted a randomised controlled pilot trial and a full-scale RCT of home-based metacognitive therapy (WS3 and WS3+; n = 240). All trials included integrated qualitative (n = 52) and economic evaluations (n = 339; stated preference survey). Participants A total of seven NHS trusts that provided a routine CR service participated in the research, with the number of participants and specific sites varying by trial. Work streams 1 and 2 explored the acceptability and effectiveness of Group-MCT integrated into usual CR in hospital settings, whereas WS3 and WS3+ explored the acceptability and effectiveness of Home-MCT integrated into usual CR in hospital and community settings. Work stream 1 recruited participants from three NHS trusts in north-west England. Participant recruitment for WS2 took place in five NHS trusts across north-west England. WS3 and WS3+ patients were recruited from CR services at five NHS hospital trusts across north-west England. Participating CR patients in all trials had to score ≥ 8 on the anxiety and/or depression subscale of the Hospital Anxiety and Depression Scale (HADS), be aged ≥ 18 years and meet the British Association for Cardiovascular Prevention and Rehabilitation criteria for attending CR. Participants were randomly allocated in a one-to-one ratio to receive either MCT plus usual CR or usual CR only using a randomisation procedure that balanced the trial arms with respect to gender, HADS scores and trial sites. Interventions Group-MCT: a 6-week manualised MCT intervention delivered face to face in a group setting. Therapists were CR staff who were not mental health specialists (e.g. clinical psychologists) but were trained to deliver the intervention. The intervention was developed by Adrian Wells based on the metacognitive model of psychological disorder and uses effective metacognitive therapy methods tested in mental health settings. Home-MCT: a paper-based, self-directed MCT intervention consisting of six modules in a treatment manual following a structure and content like that of the group-based MCT intervention. Adrian Wells provided pre-trial training for staff but was not involved in the ongoing supervision of staff delivering the intervention to maintain blinding and objectivity. Outcome measures The primary outcome was HADS total score at 4 months, with HADS total scores at 12 months as a secondary outcome (WS1 and WS2, i.e. Group-MCT only). Other secondary outcomes were the separate HADS anxiety and depression subscales, traumatic stress symptoms, and psychological mechanisms including metacognitive beliefs and repetitive negative thinking. For both interventions, qualitative interviews were conducted to assess patients’ emotional experiences and needs following cardiac events, and their understanding and experience of MCT. In Group-MCT, practitioners were interviewed to understand their experience of delivering the intervention and their understanding of patients’ responses to it and patients’ emotional needs. Statistical analysis For the pilot studies, statistical analysis was principally descriptive. We assessed the acceptability of adding Group-MCT and Home-MCT to usual CR regarding rates of recruitment into the study, attrition by the primary end point, and numbers of MCT and CR modules/sessions completed. The feasibility of conducting a full RCT was assessed against the completion of follow-up questionnaires, adequate variability in the outcome measures, and re-estimation of the required sample size based on pilot study findings. Therapist adherence to the Group-MCT treatment protocol was also assessed. The full-scale RCTs of Group-MCT and Home-MCT were designed to detect a standardised mean difference (SMD) between trial arms of 0.4 in HADS total score at 4-month follow-up with 90% power, based on effect sizes reported for other psychological interventions for depression. Analysis was conducted following a prespecified plan detailing the analytic models, primary and secondary outcomes, choice of covariates, sensitivity analyses, and all other key aspects of the analysis. The primary analyses used intention-to-treat principles. To reduce bias, data from the trial were managed by a separate clinical trials unit and locked prior to analysis. The chief investigator (AW), trial statisticians and research assistants were kept unaware of patient treatment allocation throughout the programme and the analyses followed a prespecified plan. Cost-effectiveness analysis For Group-MCT only, a within-trial cost-effectiveness analysis with a 12-month time horizon compared the cost-effectiveness of MCT plus usual CR with that of CR alone, from a UK health and social care perspective. Key measures included health status (measured using the EuroQol-5 Dimensions, five-level) and self-reported health and social care use. Total costs and quality-adjusted life-years (QALYs) were calculated for the trial follow-up. Missing values were addressed using multiple imputation. The primary outcome was the incremental cost-effectiveness ratio. Regression analysis was used to estimate net costs and net QALYs, and 10,000 bootstrapped pairs of net costs and QALYs were generated to inform the probability of cost-effectiveness. For the home-based MCT pilot study, a simple between-group comparison of the available economic data (health status and NHS and social care costs), using summary statistics, was performed. Two stated preference studies (using discrete choice experiment designs), one focused on Group-MCT and the other on Home-MCT, were conducted to explore patient preferences for the delivery of psychological therapy in CR. Participants were asked to choose between two hypothetical interventions, described using five attributes. The cost to the NHS was used to estimate willingness to pay for aspects of intervention delivery. Results Group-MCT Fifty-two CR patients were consented to the pilot trial of Group-MCT + CR versus CR alone, of whom 23 were randomly allocated to Group-MCT + CR and 29 to CR. The trial recruited to target, and > 70% of participants completed the 4-month follow-up questionnaire. More than half of the patients in both arms attended at least six CR sessions, and 57% of Group-MCT participants completed an a priori defined minimal dose of the intervention likely to produce the benefit of at least four of the six MCT sessions. The addition of MCT to rehabilitation did not negatively impact on CR attendance, and we observed high therapist adherence to the protocol. The trial concluded that Group-MCT is an acceptable and feasible intervention to deliver in CR services. The Trial Steering Committee and NIHR as funder agreed to support the progression to a full-scale RCT of the Group-MCT intervention. No substantive changes were required to the trial procedures; therefore, the pilot and full RCT samples were pooled for final analysis. A total of 332 patients (including 52 from the pilot trial) consented to the full-scale RCT of Group-MCT + CR versus CR alone, with 163 randomly allocated to Group-MCT + CR and 169 randomly allocated to CR alone; 81% returned data at 4-month follow-up. The adjusted group difference on the primary outcome of HADS total score at 4 months significantly favoured Group-MCT + CR [–3.24, 95% confidence interval (CI) –4.67 to –1.81, p < 0.001; SMD 0.52], as did the difference at the 12-month secondary outcome point (–2.19, 95% CI –3.72 to –0.66, p < 0.01; SMD 0.33). Patients in the Group-MCT + CR arm also had lower mean HADS anxiety and depression subscale scores at 4 months (p < 0.001). Differences in anxiety remained statistically significant at 12 months (p < 0.01), but those in depression did not (p = 0.065). Most of the other secondary outcomes also favoured the MCT intervention. Attendance at CR sessions did not differ between trial arms. Over 60% of Group-MCT + CR participants attended four or more of the six MCT intervention sessions. However, Group-MCT did not appeal to some patients, with 40 (25%) of the 163 patients randomised to receive MCT attending no MCT intervention sessions. Home-MCT One hundred and eight CR patients consented to the pilot trial of Home-MCT, with 54 randomised to Home-MCT + CR and 54 randomised to CR alone. The trial recruited to target, with 96% of CR only and 83% of Home-MCT + CR participants completing 4-month follow-up measures. Forty-four per cent of patients in the MCT arm completed a minimally effective dose of more than four out of six modules. Exit questionnaire ratings were good. However, views about telephone support were mixed and the quality of calls was rated low. Home-MCT appeared to be acceptable and feasible to deliver in CR services. The Trial Steering Committee and NIHR as funder agreed to support the progression to a full-scale RCT of the Home-MCT intervention. We submitted a no-additional-cost variation to contract (VTC) on 29 January 2019 to progress WS3 to a full-scale RCT (WS3+). The VTC was awarded on 12 March 2019. No substantive changes were required to the trial procedures; therefore, the pilot sample was pooled with the sample from the full RCT in final analysis. A total of 240 patients (including 108 from the pilot trial) were consented to the full-scale RCT of Home-MCT, with 118 randomly allocated to Home-MCT + CR and 122 randomly allocated to CR alone; 89% returned 4-month follow-up data. The adjusted group difference on the primary outcome of HADS total score at 4 months significantly favoured the MCT + CR arm (−2.64, 95% CI −4.49 to −0.78, p = 0.005; SMD 0.38). Patients in the MCT + CR arm also reported significantly lower mean HADS anxiety and depression scores (p < 0.05). Most other secondary outcomes also favoured the MCT intervention. Attendance at CR sessions did not differ between the trial arms. Over 70% of participants in the Home-MCT arm completed more than four MCT modules, but the intervention did not appeal to some patients; 21 participants (18%) withdrew or were not contactable at 4 months, compared with only one in the CR-alone arm. An investigation of the impact of differential attrition on the findings using last-observation-carried-forward resulted in no changes in statistical significance for the primary outcome and most of the secondary outcomes. In the primary cost-effectiveness analysis, the Group-MCT intervention was dominant, that is cost saving (net cost −219, 95% CI −£1446 to £1007) and health increasing (net QALY 0.015, 95% CI −0.015 to 0.045). However, the CIs are wide and overlap zero, indicating a high level of variability in the data and uncertainty in the estimates. Stated preference research indicated a preference for the inclusion of psychological therapy as part of a programme of CR. Conclusions There is not currently a standardised approach for psychological interventions in CR, and interventions can vary. There is a preference for the inclusion of psychological therapy in rehabilitation. Group-based MCT and Home-MCT were associated with significantly better anxiety and depression outcomes when added to CR compared with CR alone. The implications for health care are (1) MCT could be provided as part of the menu of approaches used in CR and (2) patients could be given the option to choose between group-based or home-based treatment to increase access. The recommendations for future research are (1) implementation studies that assess barriers to and enablers of roll-out in the NHS, (2) studies of longer-term outcomes of home-based MCT and (3) an evaluation of MCT against alternative therapies. Trial registration Work stream 1/work stream 2: NCT02420431 and ISRCTN74643496; work stream 3: NCT03129282; work stream 3+: NCT03999359. The trial is registered with clinicaltrials.gov NCT03999359. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Programme Grants for Applied Research programme (NIHR award ref: RP-PG-1211-20011) and is published in full in Programme Grants for Applied Research; Vol. 12, No. 7. See the NIHR Funding and Awards website for further award information.

Abstract: Introduction: Regular yoga practice positively affects physical and mental health, including stress reduction, emotional regulation, and cognitive enhancement. Recent research highlights yoga's potential to strengthen the nervous system's adaptability, promoting well-being and managing stress and anxiety. Aim of the study: This review aimed to demonstrate yoga's influence on nervous system adaptability and provide an overview of how yoga practices enhance neuroadaptation, highlighting benefits in improving neural resilience and adaptive capacities. Materials and methods: This paper analyzes current knowledge on the neurological consequences of excessive body weight. The review focused on clinical studies from 2018 to 2024, including review papers and meta-analyses. Literature was reviewed from PubMed and Google Scholar using keywords: “yoga,” “nervous system,” “stress,” “anxiety,” “depression,” “sleep problems,” “Alzheimer's disease,” “Parkinson's disease,” “epilepsy,” and “emotion regulation.” Discussion: Yoga significantly impacts the nervous system's adaptive capacity, improving mental and physical health. Regular practice enhances neuronal plasticity, aiding stress management and cognitive functions. Yoga breathing techniques reduce cortisol levels and increase certain neurotransmitters, regulating mood and autonomic nervous system function. The study did not explore different types of yoga on specific disorders, indicating a need for further research. Conclusions: This paper underscores yoga's role in enhancing the nervous system's adaptive capacity. Yoga shows promise in improving neural resilience and adaptive capacities, making it a valuable holistic healthcare approach. Understanding these benefits can guide healthcare professionals in integrating yoga into strategies to improve patient well-being, emphasizing its role in fostering physical and mental resilience.

BackgroundWe carried out a systematic review of the medical literature on potential effects of caregiving on the health and well being of spouses of Fibromyalgia (FM) patients and pooled the results in a meta-analysis.MethodsThe review is comprised of original studies that examined the mood states and well-being of husbands/wives, or long-term intimate partners, of FM patients. The authors searched the PubMed, Scopus, APA PsycNet and Web of Science databases using the key words “fibromyalgia and spouses,” “fibromyalgia and partners,” and “fibromyalgia and husbands.” Of 570 papers that were initially identified using the search words, 18 papers were considered eligible. We used the Joanna Briggs Institute Critical Appraisal Checklist (JBICAC) and Critical Appraisal Skills Program (CASP) tools to assess the risk of bias in the analytical cross-sectional and qualitative studies, respectively.ResultsThe overall score in mood states was significantly higher among spouses of FM patients than among spouses of individuals without FM (SMD [95% CI] = 0.52 [0.30; 0.74]). The strongest evidence was found for depression, SMD [95% CI] = 0.68 [0.33; 1.03]. The overall standardized score of quality of life was significantly lower among spouses of FM patients, SMD [95% CI] = −0.59 [−0.79; −0.38], with significant differences in physical function and role, emotional role, and mental health subscales.LimitationLimitation of this review is the scant number of studies that addressed several health domains, which made it impossible to carry out meta-analyses in these domains.ConclusionSpouses of FM patients show the emotional and physical consequences of caregiving, and impaired quality of life. Addressing these problems can prevent deterioration of their health and improve their quality of life.

This article explores the intersection of 19th-century philosophy with historical events, spotlighting Nietzsche, Bentham, Kierkegaard, and Schopenhauer and their distinct perspectives on suffering as a positive element, reflective of the era's cultural and historical nuances. The first part of the paper is a summary of the 19th century and its noteworthy events. The second part argues that suffering is a constant element of human existence by highlighting conceptual similarities between all four philosophers when they describe the challenges that humans must face. The third part of the paper analyzes the relationship between suffering and self-knowledge. The fourth and last part of the paper explores the mechanism of suffering as an epiphenomenon.

IntroductionMachine learning (ML) algorithms have been heralded as promising solutions to the realization of assistive systems in digital healthcare, due to their ability to detect fine-grain patterns that are not easily perceived by humans. Yet, ML algorithms have also been critiqued for treating individuals differently based on their demography, thus propagating existing disparities. This paper explores gender and race bias in speech-based ML algorithms that detect behavioral and mental health outcomes.MethodsThis paper examines potential sources of bias in the data used to train the ML, encompassing acoustic features extracted from speech signals and associated labels, as well as in the ML decisions. The paper further examines approaches to reduce existing bias via using the features that are the least informative of one’s demographic information as the ML input, and transforming the feature space in an adversarial manner to diminish the evidence of the demographic information while retaining information about the focal behavioral and mental health state.ResultsResults are presented in two domains, the first pertaining to gender and race bias when estimating levels of anxiety, and the second pertaining to gender bias in detecting depression. Findings indicate the presence of statistically significant differences in both acoustic features and labels among demographic groups, as well as differential ML performance among groups. The statistically significant differences present in the label space are partially preserved in the ML decisions. Although variations in ML performance across demographic groups were noted, results are mixed regarding the models’ ability to accurately estimate healthcare outcomes for the sensitive groups.DiscussionThese findings underscore the necessity for careful and thoughtful design in developing ML models that are capable of maintaining crucial aspects of the data and perform effectively across all populations in digital healthcare applications.

Qianyuan Zhang,1 Haiju Sun,1 Yinuo Xin,1 Xiaoyu Li,1 Xiaomei Shao1,2 1Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, People’s Republic of China; 2Key Laboratory for Research of Acupuncture Treatment and Transformation of Emotional Diseases, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310009, People’s Republic of ChinaCorrespondence: Xiaomei Shao, Email 13185097375@163.comBackground: The prevalence of pain comorbid and anxiety/depression in clinical observations has been high, and the number of related publications has increased in recent years. Nevertheless, few studies have used bibliometric methods to analyze the scientific research on comorbid pain and depression/anxiety. The aim of this study was to systematically examine the trends in global scientific research on comorbid pain and depression/anxiety from 2012 to 2022.Methods: Papers published between 2012 and 2022 were identified in the Web of Science database. Publications that examined comorbid pain and depression/anxiety were included. The language was limited to English. CiteSpace, Excel and VOSviewer were used to analyze the volume of publications, countries, institutions, authors, cocited authors, and keywords.Results: A total of 30,290 papers met the inclusion criteria of the study. Using CiteSpace, VOSviewer and Excel, the results showed that the United States (10,614 publications), Harvard University (1195 publications), and Jensen, Mark P. (77 publications) were the most productive country, institution, and author, respectively. The hotspots and frontiers were “relationship between depression and pain”, “gender differences in pain and depression/anxiety domains”, “study of specific pain types with depression/anxiety”, “treatment of pain combined with anxiety/depression”, and “effects of COVID-19 on patients with pain combined with depression/anxiety”.Conclusion: These findings indicate a growing interest in the field of comorbid pain and depression/anxiety. The research has been broad and deep, but there is still much room for growth. Furthermore, there is a need for more mature global collaborative networks as well as more high-quality research results in the future.Keywords: pain, depression, anxiety, bibliometric analysis, CiteSpace, VOSviewer

This paper is a narrative that explores the experiences of two medical students, Annabel Ricci and Richard Rubin. At the age of 18, they each moved away to attend a rigorous program. Throughout the paper, they discuss how they have been affected by the stresses of attending an international medical school on a Caribbean island, and what they have each done to cope and strive to succeed personally and academically. They describe their experiences using a holistic theoretical framework.

This paper presents a systematic review of extant research investigating the effectiveness of Internet-based group cognitive behavioral therapy （IGCBT） for depression and anxiety symptoms with an emphasis on the treatment modalities， treatment protocols， efficacy and mechanism， together with a summary of research limitations and suggestions for future research. Cognitive behavioral therapy （CBT） is a structured， short-term and present-oriented psychotherapeutic treatment， its Internet- and group-delivered modalities have led to its wider application， and has proven to be clinically effective in alleviating depression and anxiety symptoms caused by different diseases， whereas some drawbacks have been reported. Thus this paper elaborates the clinical application， therapeutic effect and underlying mechanisms of IGCBT intervention for depression and anxiety symptoms， so as to provide references for its future application. ［Funded by the Natural Science Foundation of the Inner Mongolia Autonomous Region （number， 2019MS03038）

Abstract Background Binge-watching has become increasingly popular in recent years. Although it can provide a form of entertainment and mood regulation, it has also been associated with adverse mental health issues. In this study, we explored the association between binge-watching behavior and mental health. Methods Using a cross-sectional survey conducted from May to November 2018, we surveyed 535 participants over 18 years old from Ain Shams University by using a combination of online and pen-and-paper methods. Data on sociodemographic characteristics and TV series watching patterns were collected, and participants completed the Binge-Watching Engagement and Symptoms Questionnaire (BWESQ), the Brief Symptom Inventory (BSI-18), and the Subjective Happiness Scale (SHS). Results Among the 535 participants surveyed, 333 were retained and divided into three groups (i.e., non-binge-watchers, trouble-free binge-watchers, and problematic binge-watchers) in accordance with previous binge-watching research. Significant between-group differences were found in terms of relationship status, commonly used devices (mobile, laptop, TV), and perceived dependency on TV series watching. Problematic binge-watchers showed significantly higher scores for all BWESQ and BSI-18 subscales. Conclusion Trouble-free binge-watchers and problematic binge-watchers were more likely to be single than non-binge-watchers and demonstrated a marked preference for using mobile phones and laptops over traditional television. A significant positive relationship was found between problematic binge-watching and symptoms of depression, anxiety, and somatization.

Second language learning is closely linked to the attitude of the learners. Positive attitudes contribute exponentially to effective learning. Likewise, negative attitudes can hinder learning. The aims of this study are, firstly, to check whether negative attitudes towards second language learning exist and, secondly, to analyse the effect that the use of an educational portfolio can have on these attitudes. Research shows that e-portfolios are useful tools in language learning, however there is scarce scientific evidence that relate the use of e-portfolios with attitude. This paper aims to fill this gap in relation to the effect e-portfolios may have on students’ attitudes. The Mahara e-portfolio was used along with a sample of 207 students pursuing the degree in early childhood education. They were administered a questionnaire to measure a range of attitudinal factors before and after the use of the e-portfolio. A descriptive analysis and comparison analysis of the independent samples was carried out using the non-parametric Mann-Whitney U test. The results show that there are indeed negative attitudes related to language learning and that the use of an e-portfolio contributes to mitigating them. It is also an effective tool for the promotion of positive attitudes and, therefore, using an e-portfolio in language classrooms can be very beneficial for both students and teachers since it will help generating a better classroom atmosphere which will eventually lead to a better learning. These findings are expected to bring light to stakeholders to consider e-portfolio to encourage students’ motivation and pleasantness.

This paper delves into the increasingly recognized yet complex relationship between air pollution and Neurological Diseases. Although the detrimental effects of air pollution on respiratory and cardiovascular health are well-documented, its impact on neurological and cognitive disorders is an emerging area of concern. In this mini review, we explore the intricate mechanisms by which various air pollutants, such as particulate matter, nitrogen oxides, and polycyclic aromatic hydrocarbons, contribute to neurological pathologies. The focus lies on the role of oxidative stress and inflammation in exacerbating conditions like Alzheimer’s disease and Parkinson’s disease. By unraveling these connections, the paper sheds light on the broader implications of environmental factors on neurological health and underscores the urgent need for policy interventions to mitigate air pollution’s impact on the nervous system.

The issue of the relationships between anxiety and aggressiveness among Ukrainian women in war conditions has been dealt with in this article. The relevance of the chosen topic is beyond doubt, since social problems based on psychological factors are especially relevant during the war. It is substantiated that a change in the usual living conditions leads to a significant increase in anxiety and aggressiveness among women. In this paper, the attention is paid specifically to the study of anxiety and manifestation of aggressiveness by women who are in war conditions. It is worth noting that currently in the psychological and social literature, the number of publications about the problem of anxiety is increasing, since anxiety occupies a special place, as it often leads to a decrease in work capacity, productivity, difficulties in communication, etc. It has been found out that the level of anxiety can be manifested in the aggressive women’s behaviour in the war conditions. It is noted that the state of anxiety and aggressiveness is the most common phenomenon among women in war conditions. The results of the analysis and generalization of scientific sources are presented in this paper. It has been identified that the problem of anxiety and aggressiveness is one of the topical issues of modern psychology. The need for timely identification and work with the anxiety, anxious behaviour and aggressiveness of women in war conditions and after military aggression has been emphasized. The analysis of the questionnaire conducted among Ukrainian women in war conditions has been carried out, and the degree of their influence on women’s daily lives and life activities in war time has been determined. The purpose of this work is theoretical substantiation and empirical study of the specific of the relationships between anxiety and the manifestation of aggressive behaviour of Ukrainian women in war conditions. The object of this study is the anxiety of Ukrainian women in war conditions, whereas the subject of this study is the character of the relationship between anxiety and the manifestation of aggressiveness of Ukrainian women in war conditions. The conceptual hypothesis of this research lies in the assumption of the presence of significant relationship between anxiety and the manifestation of aggressiveness of Ukrainian women in war conditions, and it has been fully confirmed. Considering the influence of war conditions on the anxiety and aggressiveness of Ukrainian women, the relationship between the mentioned psychological categories has been claimed. It has been revealed that the state of anxiety can be manifested in the aggressive behaviour of women in war conditions. It is noted that the state of anxiety and aggressiveness is the most common phenomenon among women in war conditions. According to the results of this study, there have been identified those significant relationships between indicators of anxiety and certain forms of aggressiveness among Ukrainian women in war conditions. It is substantiated that the high level of manifestation of anxiety is caused by certain psychological features. It has been found out that the increase in the level of anxiety, indicators of family anxiety and anxious behaviour is associated with an increase in the level of aggressiveness of Ukrainian women. The practical significance lies in the fact that the obtained results can be used by employees of psychological services, practical psychologists during counselling at various stages of psychotherapeutic work with women in war conditions.

Tong Zhang,&ast; Rui Yang,&ast; Juhua Pan, Shijing Huang Research and Development Center of Traditional Chinese Medicine, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Shijing Huang; Juhua Pan, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, People’s Republic of China, Email gamhsj@126.com; panjuhua@126.comBackground: Parkinson’s disease (PD) is one of the common neurodegenerative diseases. Depression and anxiety are the most common psychiatric symptoms of PD. It is important to study the potential relationship between PD and depression or anxiety.Aim: This study aimed to use bibliometrics to analyze the papers about parkinson’s disease related depression and anxiety over the last 22 years, and to characterize the current status of research and predict future hotspots.Methods: In the Web of Science Core Collection (WoSCC) from 2000 to 2022, documents are searched according to specific subject words. The selected literature was retrospectively analyzed and mapped using CiteSpace and Vosviewer software. We analyzed countries, institutions, journals, authors, references and keywords.Results: A total of 7368 papers were included from 2000 to 2022, and the number of publications has shown an upward trend year by year. Movement Disorder is the journal with the highest number of publications (391 publications, 5.31%) and citations (30,549 times), with the United States (2055 publications, 27.9%) and the University of Toronto (158 publications) being the countries and institutions with the highest number of publications. The high-frequency keywords focused on “quality of life”, “deep brain stimulation” and “non-motor symptoms”. “Functional connectivity”, “gut microbiota” and “inflammation” may be at the forefront of future research.Conclusion: Parkinson’s disease related depression and anxiety have been increasingly studied over the past 22 years. Functional connectivity, gut microbiota, and inflammation will be the subject of active research hotspots in the future, and these findings may provide new research ideas for researchers.Keywords: Parkinson’s disease, depression, anxiety, bibliometric analysis, Citespace, VOSviewer

There is growing recognition of the demands and health challenges experienced by esports athletes. The purpose of this perspective paper is to draw specific attention to the mental health of competitive gamers and spur on both future research and applied initiatives focussing on this important but under-addressed topic. We will briefly discuss the prevalence of mental health concerns, domain-specific stressors, and the need for comprehensive mental health support systems tailored to the esports context. It is our hope that, with this perspective paper, we can help set a new research agenda addressing mental health in esports.

The purpose of this paper is to establish the possible influence of personal and reactive anxiety on personality characteristics, cognitive abilities and performance of basketball actions of basketball players. An empirical study is conducted with basketball players (which are also students at University of Economics – Varna - UEV) in 2016, playing basketball at the Sports Club at the UEV. To establish the level of effectiveness of the students’ game actions, their performances in 9 meetings (10 units of observation) are recorded. ANOVA is used to determine differences in basketball performance measures for individuals with relatively high levels of anxiety and for individuals with relatively low levels of anxiety. One of the indicators is “personal anxiety” (Q6). Another indicator is available. It is “reactive anxiety” (Q7). PSPP is used to analyze the dataset. The ANOVA test shows that there is a statistically significant difference (p

To quantitatively analyze the effects of acoustic neurostimulation on the symptoms of depression, anxiety, stress, and sleep quality in healthy workers. Eleven physiological and psychological variables (V1–V11) representing stress levels, sleep quality, and cortisol levels were acquired from a recent article (https://doi.org/10.37349/ent.2023.00064) that analyzed the effects of brainwave entrainment (BWE) techniques—binaural beats (BB), isochronic tones (IT), or a combination of the two (BB + IT). Principal component analysis (PCA) was used to create principal components to analyze the contribution of each variable to the efficacy. A thermodynamic cycle and equations based on a Venn diagram were used to understand the differences in treatment effectiveness in individual and combined auditory stimulations. PCA reduced the dimensionality of variables from eleven to three. PC1 represented auditory treatment efficacy, while neither PC2 nor PC3 did. All eleven variables had a negative correlation to PC1, with stress (V3) showing the most negative correlation and salivary cortisol level (V11) showing the least. Treatments using BB were more effective than treatments with IT or BB + IT. PCA successfully aided in the analysis of auditory treatment efficacies. All examined variables, especially the stress scale (V3), had a negative correlation in treatment efficacy, aligning with the results of the original paper. Analysis using the thermodynamic cycle and Venn diagram based on PCA provided an explanation why a combined treatment (BB + IT) was less effective than BB alone in the collective consideration of all eleven variables. This study demonstrates that the thermodynamic cycle and Venn diagram in conjunction with PCA are useful analytical tools for the quantitative analysis of multi-factor systems.

This paper summarized the nursing interventions based on the knowledge-attitude-practice model on anxiety and treatment compliance in an elderly patient with Ramsay-Hunt Syndrome and vestibular neuritis. This elderly female patient was diagnosed as vertigo of wind-Yang disturbance syndrome by Traditional Chinese Medicine syndrome differentiation, and she was suffered from anxiety and low treatment compliance. Based on the Traditional Chinese Medicine syndrome differentiation, nursing interventions based on the knowledge-attitude-practice model were carried out to relieve the anxiety and improve the treatment compliance. The Self-rating Anxiety Scale score dropped form 60 to 25 before discharge form hospital. The Morisky medication adherence scale score increased from 2. 5 to 8, indicating a improved level of medication adherence of the patient after intervention. (本文总结基于知信行理论(KAP)模式干预1例耳带状疱疹合并前庭神经炎老年患者焦虑情绪和治疗依从性的护理体会。本例高龄女性患者中医诊断为眩晕(风阳上扰证), 且存在焦虑情绪和治疗依从性差的问题。基于中医辨证分型, 运用KAP模式进行护理干预。患者焦虑自评量表(SAS)评分从60分(轻度焦虑)降低至25分(无焦虑), 焦虑情绪得到改善; Morisky服药依从性量表评分从2. 5分上升至8分, 治疗依从性得到提高。)

The mathematics performance of Australian high-school students in Year 9 and their participation in mathematics subjects in Year 12 has plummeted in the last 20 years. In this paper, a retrospective cohort study was conducted to understand how non-cognitive variables controlled or explained the correlation between mathematics performance in Year 9 and mathematics participation in Year 12. The sample consisted of a cohort of Australian students (N = 6653; n = 3115, 46.8% male) who participated in the Longitudinal Survey of Australian Youth (LSAY) in 2007 to 2017. Partial least squares structural equation modelling (PLS-SEM) was conducted to explore the degree to which one moderating variable and five mediating variables intervened in the relationship between mathematics performance in Year 9 and mathematics participation in Year 12. Mathematics performance in Year 9 predicted mathematics participation in Year 12 (R2 = 18.4%). The positive correlation was moderated by gender and mediated by five non-cognitive factors associated with self-related beliefs: mathematics self-concept, self-efficacy, interest, motivation, and anxiety (R2 = 28.9%). At any given level of mathematics performance in Year 9, a male student with a higher level of mathematics self-concept, self-efficacy, interest, and motivation, and a lower level of anxiety, was more likely to participate in mathematics subjects in Year 12 than a female student with a lower level of mathematics self-concept, self-efficacy, interest, and motivation, and a higher level of anxiety. These finding have implications for ameliorating the declining levels of mathematics performance and participation.

In this study, we explored the network structure of intolerance of uncertainty (IU) using a community sample. We tested the interplay of emotions, behaviors, and beliefs about uncertainty (as measured by the Serbian Intolerance of Uncertainty-11 Scale) and evaluated whether our results would align with those obtained by the Italian researchers, considering the use of somewhat different versions of the scale in somewhat different cultural settings. The walktrap community detection algorithm yielded two communities referring to 1) Inhibitory anxiety and 2) Prospective anxiety. Thus, our findings suggest that IU can be decomposed into these two aspects regardless of which approach is used – network approach or factor analysis. The three most central nodes referred to perceiving uncertainty as upsetting and intolerable and believing one must avoid all the uncertainty. Two central nodes belonged to the Prospective anxiety community, and the third one belonged to the Inhibitory anxiety community and indicated reduced overall quality of life due to uncertainty. The roles of these three constituents in understanding the nature of IU are discussed further in the paper.

IntroductionEndometriosis is a chronic gynecological disease associated with chronic debilitating pain, poor mental health and quality of life. The objective of this paper is to evaluate the effectiveness of psychological interventions aimed at improving the pain, quality of life and mental health of women with endometriosis.MethodsA systematic review (SR) of the literature with meta-analysis (MA) was carried out. MEDLINE, Embase, PsycINFO and CENTRAL were searched to locate Randomized Controlled Trials (RCTs). The risk of bias assessment of each study was conducted using the Cochrane Collaboration’s RoB 2.0 tool.ResultsSeven RCTs were included (N = 757). The data obtained suggest that psychological interventions reduce dyspareunia [standardized mean difference (SMD): -0.54, 95% CI: −0.86, −0.22] and dyschezia [mean difference (MD): -2.90, 95% CI: −4.55, −1.26] and increase mental health levels (SMD: 0.70, 95% CI: 0. 42, 0.99); they also point to a large reduction in levels of trait anxiety (MD: -6.63, 95% CI: −8.27, −4.99) and depression (MD: -2.49, 95% CI: −3.20, −1.79), and a likely reduction in state anxiety (MD: -9.72, 95% CI: −13.11, −6.33) experienced by women with endometriosis. It was also identified that psychological interventions probably slightly reduce pelvic pain and may increase physical health. However, most of the included studies have a high overall risk of bias or have certain concerns, which limit conclusions about the certainty of the evidence.DiscussionThe available evidence indicates that psychological interventions are effective in improving the pain, quality of life and mental health variables of women with endometriosis.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, CRD42024516100.

Abstract Background The COVID‐19 pandemic, caused by the SARS‐CoV‐2 virus, has resulted in illness, deaths and societal disruption on a global scale. Societies have implemented various control measures to reduce transmission of the virus and mitigate its impact. Individual behavioural changes are crucial to the successful implementation of these measures. One commonly recommended measure to limit risk of infection is frequent handwashing. It is important to identify those factors that can predict the uptake and maintenance of handwashing. Objectives We aimed to identify and synthesise the evidence on malleable psychological and psychosocial factors that determine uptake and adherence to handwashing aimed at reducing the risk of infection or transmission of COVID‐19. Search Methods We searched various literature sources including electronic databases (Medline ALL, Child Development & Adolescent Studies, ERIC, PsycInfo, CINAHL and Web of Science), web searches, conference proceedings, government reports, other repositories of literature and grey literature. The search strategy was built around three concepts of interest including (1) context (terms relating to COVID‐19), (2) behaviour of interest and (3) terms related to psychological and psychosocial determinants of COVID Health‐Related Behaviours and adherence or compliance with handwashing, to capture malleable determines. Searches capture studies up until October 2021. Selection Criteria Eligibility criteria included observational studies (both retrospective and prospective) and experimental studies that measure and report malleable psychological and psychosocial determinants and handwashing at an individual level, amongst the general public. Screening was supported by the Cochrane Crowd. Titles and abstracts were screened against the eligibility criteria by three independent screeners. Following this, all potentially relevant studies were screened at full‐text level by the research team. All conflicts between screeners were resolved by discussion between the core research team. Data Collection and Analysis All data extraction was managed in EPPI‐Reviewer software. All eligible studies, identified through full‐text screening were extracted by one author. We extracted data on study information, population, determinant, behaviour and effects. A second author checked data extraction on 20% of all included papers. All conflicts were discussed by the two authors until consensus was reached. We assessed methodological quality of all included studies using an adapted version of the Joanna Briggs Institute Quality appraisal tool for cross‐sectional studies. Main Results Our initial searches yielded 23,587 results, of which 56 studies were included in this review. The included studies were cross sectional in design, came from 22 countries and had a combined sample of 199,376 participants. The vast majority of studies had samples from the general public, with eight of the studies focusing on specific samples. All included studies considered people over the age of 18. The quality of the majority of the studies was good (n = 30 rated low risk of bias), with 8 rated high risk of bias, predominately due to lack of reporting of recruitment, sample characteristics and methodology. Thirty‐four studies were included in the narrative synthesis and 28 in the meta‐analysis. Findings indicated that emotions about COVID‐19 (worry [0.381, confidence interval [CI] = 0.270–0.482, I2 = 92%) and anxiety (0.308, CI = 0.154–0.448, I2 = 91%]), knowledge of COVID‐19 (0.323, CI = 0.223–0.417, I2 = 94%), and perceived social norms (0.303, CI = 0.184–0.413, I2 = 92%) were among the malleable determinants most associated with handwashing. Perceived severity (0.006, CI = ‐0.011–0.023) and susceptibility of COVID‐19 (0.041, CI = −0.034 to 0.115) had little to no effect on handwashing behaviour. Authors' Conclusions Understanding the effects of various malleable determinants on COVID‐related handwashing can aid in the development and implementation of interventions and public health campaigns to promote handwashing behaviour in potential new waves of COVID‐19 or other respiratory infections. Emotions about COVID, knowledge of COVID and perceived social norms warrant further consideration in future research and policy.

ObjectiveThis study analyzes the presence and reverberations of stress, anxiety, and other mental health issues on primary and middle school students using bibliometric analysis. The aim of this study is to map the research landscape by statistically analyzing existing literature and identifying key themes, trends, and research hotspots in the domain of stress in students. This study also presents analysis related to top contributing countries, journals, authors, citations, and collaboration networks.MethodA total of 1,335 publications from 1962 to 10 September 2023 were included in this study using the Web of Science, PubMed, and Scopus databases. The steps involved in the bibliometric study included data collection, cleaning, and various analyses such as performance analysis, citation analysis, and network analysis. Biblioshiny by RStudio and Microsoft Excel were used for bibliometric analysis to determine the collaboration between countries and authors and to explore keyword analysis and thematic evolution.ResultsThe findings show that China and USA have contributed the highest number of publications. Frontiers in Psychology with 50 publications turns out to be the most prominent journal. The study presents the thematic evolution and the trend topics in this research domain. Some of the trend topics are stress, test anxiety, bullying, depression, cyberbullying, virtual reality, mathematics anxiety, childhood maltreatment and self-compassion, primary school, and middle school. The paper also highlights the prominent authors and their collaboration network.DiscussionThe study has highlighted the various reasons for stress and its potential repercussions on students. This information can be used to help parents, teachers, and the school administration to spot the most susceptible group of students who need immediate intervention to address various mental health issues. We see a gradual progress in the research areas being covered under this domain. More relevant areas of concern related to stress are being explored with time. With the technological advancement and the vast unmonitored internet usage (especially for primary and middle school students), the stress caused by cyberbullying and peer victimization has also become an important topic of research in later years.

Abstract Background Dramatherapy, a creative form of psychotherapy, may be a useful treatment for child and adolescent mental health. As there is a growing evidence base, this systematic review sought to identify, describe and evaluate dramatherapy with children and adolescents who were experiencing emotional distress (anxiety, depression and trauma) in order to inform future research in this area. Methods Seven databases (PsychInfo, PubMed, Scopus, Web of Science, CINAHL, EMBASE and Cochrane) were searched for peer‐reviewed articles exploring dramatherapy as a treatment for child and adolescent emotional distress. Hand searches of relevant journals were also conducted. Two reviewers coded articles for eligibility and independently appraised papers using the Joanna Briggs Institute Critical Appraisal Tools. Details relating to intervention and participant characteristics were extracted and, where data were available, effect sizes on measures relating to emotional distress were calculated. Results Fifteen papers were included. Studies showed that dramatherapy was often delivered in schools (46%) and clinical settings (20%) and was more frequently delivered to adolescents (53%) (>11 years) than children (26%) (8–11 years). Dramatherapy was used as a treatment for diagnostically heterogeneous groups (40%), for emotional and behavioural difficulties (33%) and following a shared, traumatic, experience (20%). Seven papers reported relevant quantitative data however, just three of these studies were controlled and none were blinded. Pre‐to‐post intervention effect sizes ranged from d = 0.17 to d > 2 yet samples were small and participant response to treatment was not always consistent. The largest effects were seen in dramatherapy employed following trauma and in clinical settings. Medium to large effects were also seen in early intervention school‐based dramatherapy. Conclusion Despite promising results with regards to the treatment of child and adolescent emotional distress, the evidence base for dramatherapy is small and methodologically flawed. Larger, methodologically robust trials should test the efficacy of dramatherapy in future research.

The purpose of this paper is to review the research on the influence and mechanism of intolerance of uncertainty （IU） on anxiety both at home and abroad in recent years. IU refers to the individual's disgust response due to the intolerance of perceived lack of prominent， critical or sufficient information， and it has individual tendency. IU plays an important role in the occurrence and development of anxiety， but the specific process and mechanism remain unclear. This paper reviews the influence of IU on anxiety， and clarifies its mechanism of action on the generation and development of anxiety from the perspectives of cognition， emotion and behavior， so as to provide references for preventing the development of general anxiety into anxiety disorders and developing new psychological intervention and treatment strategies.

This paper summarized the nursing practice of Traditional Chinese Medicine emotion regulation in relieving anxiety of a patient undergoing total laparoscopic hysterectomy. Based on the routine care, a comprehensive plan of emotion regulation including psychological support, relaxation training; music-guided imagination and interview-based interventions were carried out to relieve the anxiety before and after surgery, and improve the patient’s sleep quality and postoperative recovery. (本文总结1例应用中医情志护理三部曲缓解腹腔镜子宫全切术患者围手术期焦虑状态的护理体会。在常规护理基础上, 采用心理支持、放松训练、引导性音乐想象及访谈干预措施, 有效缓解患者术前、术后焦虑情绪, 改善患者睡眠质量, 促进早期康复。)

The incidence of type diabetes mellitus tends to increase with gradual aging of the population, leading to the increasing number of patients with diabetic foot ulcers. Patients may suffer from emotional disorder at any stage of disease. The emotional status is highly related to the development of diabetic foot ulcers, and has a major influence on following treatment and quality of life of patients. The current therapy model combines two evidence-based treatments: drug therapy including anxiolytics and newer antidepressants, non-drug therapy including cognitive-behavioral therapy, psychological care, music therapy and Traditional Chinese Medicine emotional nursing. This paper reviewed studies on pathogenesis, development and interventions on diabetic foot complicating anxiety disorder. (随着我国老龄化逐渐加剧, 老年2型糖尿病患者也日益增多, 同时伴随着足部溃疡的患者数量呈上升趋势。患者在疾病发生、发展的过程中均会出现不同程度的情绪障碍, 而情绪又与糖尿病足的发生、发展息息相关, 对于患者的治疗以及生存质量有着重大的影响。在治疗上主要包括药物治疗和非药物治疗两种方式, 药物治疗主要包括抗焦虑药物和新一代抗抑郁的药物; 非药物治疗主要有认知行为干预、心理护理、音乐疗法、中医情志护理的方法等。本文从糖尿病足合并焦虑的发病机制、发展原因、干预措施等方面进行综述, 并做简要分析。)

Anxiety disorders are characterized by persistent and excessive fear, anxiety and concern, accompanied by avoidance behaviors and physical symptoms such as increased heart rate, shortness of breath and muscle tension, which is one of the most prevalent psychiatric disorders. Research has shown that early life stress (ELS) can increase individual susceptibility to developing anxiety disorders during childhood and adulthood by modifying brain structure and functions. A large number of papers have reviewed the pathophysiological mechanisms of ELS-related anxiety disorders, while only a few have reviewed interventional techniques for ELS-related anxiety disorders. The phenomenon of tactile deprivation is prevalent in individuals experiencing ELS. Most current researches on affective touch and anxiety disorders suggest that affective touch is an intervention for ELS-related anxiety disorders. The review firstly introduces the phenomenon of touch deprivation in individuals experiencing ELS, discusses the effect of affective touch intervention on ELS-related anxiety disorders, and then summarizes the mechanism of affective touch in terms of neural circuits and neuroendocrinology, in order to provide reference for complementary intervention treatment of ELS-related anxiety disorders.

Background. Currently, there is no «golden standard» in terms of correction of adherence to treatment of patients with tuberculosis and its adequate assessment. This paper presents the experience of applying the 3D lung reconstruction method, which was used among patients with tuberculosis to modify their level of adherence, as well as to increase the effectiveness of treatment and change the indicators of anxiety and depression. Aims. To give a brief description of the level of adherence to treatment and the overall effectiveness of chemotherapy in newly diagnosed patients with tuberculosis according to the data of the department for patients with respiratory tuberculosis of the Nizhny Novgorod Regional Clinical Tuberculosis Dispensary. To increase the level of adherence to treatment and increase the effectiveness of chemotherapy in newly diagnosed patients with destructive forms of pulmonary tuberculosis using additive technologies using the method of three-dimensional reconstruction of lung tissue. To assess and correct the dynamics of manifestations of symptoms of anxiety and depression among newly diagnosed patients with destructive forms of pulmonary tuberculosis using additive technologies using the method of three-dimensional reconstruction of lung tissue. Materials and methods. The present work is based on a retrospective-prospective analysis of the results of treatment of newly diagnosed patients with destructive forms of pulmonary tuberculosis (167 people), who were observed in the Nizhny Novgorod Regional Clinical Tuberculosis Dispensary. The patients included in the study were divided into two groups. For patients of the 1st group, lung models were made, among them a questionnaire was conducted using the MMAS-4 questionnaire and the HADS scale. For patients of the 2nd group, lung models were not made, and no survey was conducted. Results. According to the results of the study in the department for patients with respiratory tuberculosis of the Nizhny Novgorod Regional Clinical Tuberculosis Dispensary (observation period from 2016 to 2020), a negative trend was found in an increase in the number of unauthorized departures from the structural unit and violations of the regimen among patients. A course of polychemotherapy was recognized as effective in the 1st group (in terms of bacterial excretion) in 93.0% of patients (64/69), and in the 2nd group (the same indicator) – in 67.3% (66/98); χ2=16.940, df=1; p0.001. The largest number of abacilated patients was observed in the 1st group. In the case of showing patients three-dimensional anatomical tactile models of the lungs, the probability of closing decay cavities increased by 32.2% (γ-test=-0.322; p=0.034). The absence of the demonstration of personalized three-dimensional anatomical tactile models of the lungs contributed to an increase in the occurrence of disadvantage in the outcome of therapy by 77.2% (γ-test=-0.772; p0.001). The chance of achieving an effective course of chemotherapy was 4.2 times higher among patients of the 1st group (odds ratio 4.267, 95% confidence interval 1.523–11.953). In the absence of data on the patient’s interaction with the tactile pulmonary model, the risk of noncompliance increased by 47.6% (γ-test=-0.476; p=0.020). After the use of three-dimensional anatomical tactile models of the lungs among patients of the 1st group, their level of adherence to treatment increased (according to the MMAS-4 questionnaire) with a result of 4 points [4; 4] – maximum score of the MMAS-4 questionnaire – (W=2278, Z=-7.267; p0.001) and the psychological load significantly decreased (according to the HADS scale) with a score of 7 points [5; 10] – «no significant symptoms of anxiety and depression» (W=2405, Z=-7.165; p0.001). Conclusion. The use of additive technologies in the anti-tuberculosis organization has made it possible to improve the profile of adherence of tuberculosis patients to polychemotherapy, increase the effectiveness of treatment, and correct indicators of anxiety and depression among newly diagnosed patients with destructive pulmonary tuberculosis.

Post-stroke anxiety disorder （PSA） is a common psychiatric complication of stroke， which jeopardizes patients' recovery and their quality of life. Recent studies suggest that inflammation plays an important role in the pathogenesis of PSA. Therefore， this paper reviewed the related licture about the association between PSA and serum inflammatory biomarkers in order to provide references for the intervention of PSA. In this study， a comprehensive search was performed in China National knowledge Infrastructure （CNKI）， Wanfang Data， Web of Science and PubMed database to identify the well qualified literature focusing on the relationship between PSA occurrence and serum inflammatory biomarkers， and a total of 13 studies were retrieved. Analysis indicates a certain association between PSA occurrence and serum inflammatory biomarkers， and denotes that the elevation of inflammatory biomarkers may be a trigger for the disease occurrence and its progression， but the specific mechanism underlying this relationship requires further study.

Abstract Background Anxiety and depressive disorders typically emerge in adolescence and can be chronic and disabling if not identified and treated early. School-based universal mental health screening may identify young people in need of mental health support and facilitate access to treatment. However, few studies have assessed the potential harms of this approach. This paper examines some of the potential mental health-related harms associated with the universal screening of anxiety and depression administered in Australian secondary schools. Methods A total of 1802 adolescent students from 22 secondary schools in New South Wales, Australia, were cluster randomised (at the school level) to receive either an intensive screening procedure (intervention) or a light touch screening procedure (control). Participants in the intensive screening condition received supervised self-report web-based screening questionnaires for anxiety, depression and suicidality with the follow-up care matched to their symptom severity. Participants in the light touch condition received unsupervised web-based screening for anxiety and depression only, followed by generalised advice on help-seeking. No other care was provided in this condition. Study outcomes included the increased risk of anxiety, depression, psychological distress, decreased risk of help-seeking, increased risk of mental health stigma, determined from measures assessed at baseline, 6 weeks post-baseline, and 12 weeks post-baseline. Differences between groups were analysed using mixed effect models. Results Participants in the intensive screening group were not adversely affected when compared to the light touch screening condition across a range of potential harms. Rather, participants in the intensive screening group were found to have a decreased risk of inhibited help-seeking behaviour compared to the light touch screening condition. Conclusions The intensive screening procedure did not appear to adversely impact adolescents’ mental health relative to the light touch procedure. Future studies should examine other school-based approaches that may be more effective and efficient than universal screening for reducing mental health burden among students. Trial registration Australian and New Zealand Clinical Trials Registry (ACTRN12618001539224) https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375821 .

Abstract Background Family and school environment play a crucial role across the different developmental stages of adolescence. This paper investigates the potential mediating role of family and school environments in the relationship between the three psychosocial predictors of depression, anxiety, stress, and Internet addiction (IA). Specifically, it focuses on the two stages of early and middle adolescence. Methods The study involved a survey of 407 adolescents from Qatar, comprising 250 early adolescents and 157 middle adolescents. Inclusion criteria for the study included adolescents between the ages of 10 to 17 years old, residents of Qatar and studying in a Qatar-based school. To assess the constructs of the three psychosocial predictors, IA, family environment, the study utilized the Depression, Stress, and Anxiety Scale (DASS), the Internet Addiction Diagnostic Questionnaire (IADQ), and the Brief Family Relationship Scale, respectively. School environment was measured using questions from the “Health Behavior in School-aged Children: WHO Collaborative Cross-National survey/study (HBSC) 2013–2014. The study applied standard mediation analysis between the DASS components and IA with family and school environment as the mediators. Results Results from the mediation analysis reveal insights into the relationships between psychosocial predictors and IA. The findings indicate that family and school environments partially mediated the relationship with regards to depression, stress, and anxiety in early adolescents. In middle adolescents, family environment partially mediated the relationship with depression and stress and fully mediating the relationship with anxiety. Meanwhile, school environment only exhibited partial mediation in the relationship with anxiety in middle adolescence. Conclusions These results highlight the crucial role parents and schools play in addressing problematic technology usage that develops as a response to depression, anxiety, and stress among adolescents. Moreover, the study reveals nuances in the mediating role of family and school environment in early and middle adolescence. This highlights the evolving nature of these influences across the different stages of development. Notably, this study contributes to the literature by moving beyond the conventional focus on the so-called WEIRD population, and offering valuable insights from a region that is underrepresented in current research.

Stroke has seriously threatened the health of all mankind as one of the global public health problems. As a common complication, post-stroke anxiety not only reduces the patient’s quality of life , but also increases the risk of stroke recurrence and delays the recovery process. This paper reviews the influencing factors, clinical manifestations, evaluation methods and interventions of post-stroke anxiety, in order to provide a theoretical basis and new ideas for further understanding of post-stroke anxiety and improving patients' anxiety. (脑卒中后焦虑(PSA)是脑卒中患者常见的精神并发症, 不仅影响患者生存质量, 而且可能增加再次脑卒中的风险。本研究对PSA的影响因素、临床表现、评估方法及干预措施进行阐述, 旨在为进一步认识PSA, 改善患者的焦虑情绪, 提供理论依据和新思路。)

Background. The use of clinical and economic analysis in practical healthcare allows for a more rational use of the resources allocated by the state and contributes to the achievement of optimal indicators in terms of the quality of disease identification and the effectiveness of its treatment. Aim. To conduct a clinical and economic analysis of the prospects for introducing the 3D lung reconstruction method into tuberculosis practice, which is used to correct the level of adherence, reduce the severity of symptoms of anxiety and depression, and increase the effectiveness of chemotherapy. Materials and methods. In this scientific work, the results of treatment (more than 90 people) of newly diagnosed patients with destructive pulmonary tuberculosis, which were observed in the Nizhny Novgorod Regional Clinical Tuberculosis Dispensary, were used. The patients were divided into two groups. For the 1st group of patients, tactile lung models were made, among them a questionnaire was conducted using the MMAS-4 questionnaire and the HADS scale. For patients of the 2nd group, lung models were not made, and no survey was conducted. Each group was assessed the effectiveness of chemotherapy. Clinical and economic analysis of the cost of introducing the method of three-dimensional lung reconstruction into tuberculosis practice was carried out on the basis of two evaluation criteria «cost – effectiveness» and «cost-effectiveness increment» with additional mathematical calculations of the necessary indicators. The results obtained were compared with the existing known method of increasing adherence to tuberculosis treatment - the issuance of food packages. Results. Based on the results of the study, it was proved that the use of tactile models of the lungs in phthisiatric practice is more than 8 times cheaper than the method of issuing food kits with, in fact, comparable results of treatment effectiveness. If there is a need to increase the effectiveness of the treatment of tuberculosis patients by increasing the subsidy of food packages, the cost of one additional percent of efficiency is not economically viable. Conclusion. The clinical and economic analysis of the prospects for introducing the method of three-dimensional lung reconstruction into phthisiatric practice presented in the paper looks promising, which is confirmed by the performed mathematical calculations and comparisons, and can be recommended for use in the routine practice of phthisiatricians to correct the level of adherence of tuberculosis patients to chemotherapy, reduce the severity symptoms of anxiety and depression, as well as an increase in the effectiveness of treatment.

Background: The extensive use of various electronic games and communication devices, particularly among children and adolescents, has raised concerns, particularly during the COVID-19 pandemic. This study investigated the link between screen time and internalizing disorders, such as anxiety and depression, among individuals aged ≤18 during the global COVID-19 pandemic. Methods: This systematic review aims to summarize scientific publications from 2019 to early 2022 by searching databases, including the Cochrane Library, PubMed, Web of Science, Scopus, and PsycINFO, to identify suitable studies. In each paper, we searched the following keywords and their synonyms: screen, child, high school, middle school, and psychiatric disorders. The quality of the selected papers was evaluated using a checklist recommended by the National Institutes of Health (NIH) for observational cohort studies. Results: Out of 986 reports identified, we included 12 papers with 14,483 participants. The study revealed a negative correlation between screen time (TV, computer, video games, and mobile phones) and behavioral outcomes. Smartphones were the most frequently used devices, with video games being more prevalent among older participants for education, communication, and entertainment purposes. The prevalence of depression ranged between 10% and 25%. Furthermore, anxiety and depression were identified as predictors of increased screen usage. Some results displayed variation based on the type of screen exposure, the questionnaires used, and the age of the participants. Conclusions: The findings imply an indirect association between increased screen time and depression and anxiety. It is crucial to consider limitations on screen time exposure and parental supervision as measures to prevent certain mental disorders.

Introduction: Previous studies have reported changes in executive functions (working memory, inhibition, cognitive flexibility) and mood (anxiety and depression) in patients with Mild Cognitive Impairment (MCI). Different tools have shown to improve cognitive performance in this population, and computerized cognitive training is one of the most studied strategies. However, there is no consensus about near-transfer or far-transfer effects. Therefore, a systematic review is relevant for determining the effects of cognitive training on executive functions and mood. Aim: This systematic review aims to identify the effect of cognitive training on executive functions and anxiety in patients with MCI. Methods: For the systematic search, the following search equation was used: “mild cognitive impairment” AND “executive functioning” AND “cognitive training” AND “anxiety”. We retrieved a total of 525 papers, but only 37 of them met the inclusion criteria. Articles published between January 2003 and February 2023 were included. Results: The results revealed two research trends: (a) the effect of computerized cognitive training and virtual reality on executive functions and anxiety in people with MCI and (b) the effect of emerging intervention strategies on executive functions and anxiety in people with MCI. The effect of cognitive training on inhibitory control, working memory, reasoning, and attention was found to be predominant, even when it is not significant on all these variables. Studies on the effect of cognitive training on anxiety are still limited in number. Conclusion: Conducting longitudinal studies is necessary to understand the effect and underlying mechanisms of cognitive training.

ObjectivesMental health is essential for overall health and is influenced by different social determinants. The aim of this paper was to examine which determinants are associated with mental health inequalities among people with selected citizenships in Germany.MethodsData were derived from the multilingual interview survey “German Health Update: Fokus (GEDA Fokus)” among adults with Croatian, Italian, Polish, Syrian, or Turkish citizenship (11/2021–05/2022). Poisson regressions were used to calculate prevalence ratios for symptoms of depression (PHQ-9) and anxiety disorder (GAD-7).ResultsSociodemographic (sex, income, age, household size) and psychosocial (social support and self-reported discrimination) determinants were associated with symptoms of depression and/or anxiety disorder. The prevalence of mental disorders varied most by self-reported discrimination.ConclusionOur findings suggest mental health inequalities among people with selected citizenships living in Germany. To reduce these, social inequities and everyday discrimination need to be addressed in structural prevention measures as well as in interventions on the communal level. Protective factors (e.g., social support) are also important to reduce mental health inequalities on the individual and community level.

Introduction: Yoga is well-regarded for its diverse health benefits, potentially impacting psychiatric, asthma, cardiovascular, autoimmune, and neurological conditions. It is also associated with broader positive effects such as improving quality of life, fitness levels, and psychosocial outcomes for individuals. Hatha yoga, widely practiced and studied worldwide, emphasizes physical postures (asana) and breathing exercises (pranayama), both of which contribute positively to overall mental and physical health. Aim of the study: The aim of this study is to review the benefits of practicing yoga based on the latest scientific research. Both physical benefits, such as improved flexibility, strength, and balance, and psychological benefits, including stress reduction, anxiety relief, and enhanced overall well-being, will be analyzed. This paper aims to demonstrate how regular yoga practice can contribute to an improved quality of life and support the treatment of various health conditions.The mechanisms through which yoga impacts health will also be discussed, and the effectiveness of yoga will be compared with other forms of physical activity and relaxation techniques. Material and methods: We have gathered the available materials and scientific reports, analyzing and summarizing them in a single study. Conclusions: Yoga's diverse health benefits, supported by extensive research, highlight its potential as a valuable therapy for improving overall health and well-being across various medical conditions.

ObjectivesThe purpose of this paper is to explore the relationship between blood levels of cadmium, lead, and mercury and anxiety in American adults.MethodsBlood metals and self-reported anxiety days were extracted from laboratory data and questionnaire data, respectively, using NHANES data from 2007–2012. Weighted logistic regression was used to assess the relationship between cadmium, lead and mercury with anxiety. Restricted cubic spline was used to visualize the non-linear relationship between metal concentrations and anxiety. Weighted quantile sum (WQS) regression was used to investigate the effect of combined exposure to the three metals on anxiety.ResultsThe prevalence of anxiety in adults was 26.0%. After adjusting for potential confounding variables, cadmium levels in the highest quartile (Q4) were associated with a higher risk of anxiety compared to the lowest quartile (Q1) (OR = 1.279, 95% CI: 1.113–1.471, p < 0.01). Restricted cubic spline analysis indicated a positive association between blood cadmium levels and anxiety. Furthermore, co-exposure to multiple heavy metals was positively associated with anxiety risk (WQS positive: OR = 1.068, 95% CI: 1.016–1.160, p < 0.05), with cadmium contributing the most to the overall mixture effect. Compared to the Light RPA, the Vigorous/Moderate RPA group had a relatively low risk of anxiety after cadmium exposure.ConclusionHigh levels of blood cadmium are positively associated with the development of anxiety disorders, which needs to be further verified in future studies.

BACKGROUND AND OBJECTIVES: Music therapy promotes positive effects on cognition, psychosocial aspects, control of somatic symptoms and quality of life. The influence on pain is still a controversial topic. The objective of this study was to investigate the state of the art of musical interventions and music therapy in the treatment of acute or chronic pain, as well as developing criteria to facilitate the creation of strategies for applying music in clinical research. CONTENTS: This research was based on papers published between August 2010 and March 2023 in the Pubmed database. Of these, open access literature review articles were selected. A total of 44 studies whose results and conclusions showed that there is evidence of pain relief in many clinical and environmental conditions were selected, although there is great heterogeneity in methods and controversy in the literature regarding positive and adverse or side effects. The music chosen by a professional or patient alleviates significantly the painful experience by many mechanisms, although statistical data is limited or controversial. CONCLUSION: Music appears to have a positive impact on various environmental situations or biological conditions that result in painful experience and, therefore, can significantly alleviate pain, which is supported by evidence of complex neural mechanisms involving the descending pain inhibitory system. The benefits justify the use of music as a low-cost and low-risk therapeutic strategy, and the methodological challenges justify a more careful design in future research, including details of the type of musical intervention performed.

BackgroundRising anxiety and depression in primary school students adversely affect their development and academics, burdening families and schools. This trend necessitates urgent, focused research within this young demographic. This alarming trend calls for a systematic bibliometric analysis to develop effective preventative and remedial strategiesObjectivesThis study aims to identify and analyze the prevailing research hotspots and emerging trends concerning anxiety and depression in primary school students, thereby furnishing a foundational reference for future academic endeavors in this area.MethodsThis study uses the Web of Science (WOS) Core Collection database as the data source, focusing on literature published between 2013 and 2023 concerning anxiety and depression in primary school students. An initial search identified 1852 articles, which were then manually screened to exclude duplicates, conferences, announcements, and unrelated literature, resulting in 1791 relevant articles. The analysis, executed on December 31, 2023, employed CiteSpace and Vosviewer tools to assess various bibliometric indicators including authorship, country, institutional affiliations, publication trends, keyword frequency, and citation analysis.ResultsThe analysis revealed a corpus of 1,791 English-language articles, with a discernible upward trend in publications over the decade. The USA and China were the leading countries in this field, with 482and 272 papers, respectively. The research predominantly addresses the etiological factors of anxiety and depression, various intervention strategies, and the comorbidities associated with these conditions in the target population. Key research focuses have been identified in areas such as suicidal thoughts, bullying in schools, the impact of COVID-19, mindfulness interventions, and anxiety related to mathematics. Future research is projected to increasingly focus on the effects of mathematics anxiety on the psychological and behavioral outcomes in students.ConclusionThis study provides a critical visual and analytical overview of the key research areas and trends in the field of anxiety and depression among primary school students. It underscores the necessity of concentrating on the underlying causes and potential interventions. Such focused research is imperative for mitigating the mental health challenges faced by young students and enhancing their educational and developmental outcomes.

ObjectiveThe Outcomes – Short and Long term in ICU patient with COVID-19 “OUTSTRIP COVID-19” study was initiated to assess overall mortality, physical and psychiatric co-morbidities, reduction in lung function, and the ability to return to work post-ICU discharge with a follow-up period of 2 years in COVID-19 patients admitted to ICUs in Qatar. This paper focuses on the prevalence of cognitive impairment, depression, anxiety, and stress at baseline and 3 months after ICU discharge.MethodsThis prospective cohort study included 100 ICU survivors reviewed at baseline within 7 weeks of ICU discharge, with a 3-month follow-up. Demographics, clinical characteristics, and relevant medical history were collected at baseline. Cognitive outcomes were assessed using the Montreal Cognitive Assessment-Basic (MoCA-B) tool, while psychological outcomes were evaluated using the Depression Anxiety and Stress Scale-21 (DASS-21).ResultsAt baseline, 72% of ICU survivors exhibited mild cognitive impairment, which significantly improved to 56% at 3 months. However, severe cognitive impairment persisted in 20% of survivors at 3 months.For psychological outcomes, the mean depression score remained below 9 (5.64 ± 6.90) at both time points, with no significant change. At baseline, 25% of survivors had clinical depression, which reduced to 16% at 3 months.The mean anxiety score at baseline (9.35 ± 8.50) significantly decreased to 6.51 ± 7.74 (p = 0.002) at 3 months. Anxiety was not reported by 48% of survivors at baseline and this increased to 66% at 3 months. Severe to extremely severe anxiety decreased from 19% to 12% during the same period.The mean stress score at baseline (8.34 ± 8.07) did not significantly change at 3 months. At baseline, 18% experienced stress, which decreased to 12% at 3 months, with 5.3% facing severe to extremely severe stress.ConclusionCOVID-19 ICU survivors experience significant cognitive impairment, anxiety, and stress. While cognitive impairment and anxiety showed improvements at 3 months, depression and stress remained unchanged. These outcomes strongly emphasize the requirement for thorough post-ICU care and comprehensive mental health assistance for individuals recovering from COVID-19. Customized interventions and additional research endeavors are crucial to effectively manage the cognitive and psychological consequences faced by these patients. The exploration of telemonitoring and innovative approaches can offer avenues to enhance the overall quality of life for survivors. Further investigation should encompass extended timeframes to analyze prolonged effects and consider the broader socioeconomic impact.

To gain a better understanding of the factors that contribute to anxiety among PhD students and the reasons for poor regulation in the current situation, this paper analyses the existing literature on anxiety among PhD students using Green's model. It also compares and evaluates various methods of regulating anxiety. The literature review to extract information on the causes and levels of anxiety, methods and outcomes of anxiety intervention and regulation, and to make comparisons. The study reveals that the phenomenon of PhD students' anxiety has intensified globally in recent years, especially after the end of the epidemic. PhD students experience anxiety due to research pressure, economic pressure, future development, and interpersonal pressure. The main influencing factors are currently the relationship with the supervisor, development prospects, social support, and peer comparison. Among the stress relief methods, the regulation of self-relaxation was found to have better effects on mild anxiety, such as positive thinking, meditation, yoga and physical exercise can be helpful for emotion release then help focus on problem solved. Whereas severe anxiety may require institutional and pharmacological support, also including using psychological therapy such as behavioral cognitive therapy and systematic desensitization methods. For university, competence to provide course-assisted guidance, such as writing groups, peer support, and time management, is also important. Academic communities should pay attention to the guidance on academic fairness. However, PhD students are often unaware of the resources available to them for coping with stress and may not take the initiative to seek psychological counseling or institutional assistance. Therefore, PhD students should receive support from various sources, be guided to express their thoughts, and receive additional education and academic assistance to manage stress. This will enhance their confidence and aid in improving their scientific research.

Anxiety is the most common form of mental health disorder, affecting millions of people worldwide. Psychosocial interventions such as mindfulness and cognitive behavioral therapy (CBT) have been suggested as an effective treatment in the management of general anxiety and anxiety disorders, with emerging evidence also suggesting the effectiveness of hypnosis. Moreover, anxiety has shown to be linked to the onset and development of several cardiovascular diseases (CVD), which are the leading cause of global death. In this paper, we review the current literature to examine the role that anxiety has on the onset and development of CVD and summarize the current knowledge on the role that hypnosis and hypnotherapy have in reducing anxiety, also explaining how this can impact the cardiovascular system and the prevention of CVD. Review of the evidence suggests that hypnosis and hypnotherapy are effective in treating anxiety and may positively affect the heart and the cardiovascular system, reducing sympathetic activation and increasing parasympathetic tone, potentially preventing the onset of CVD related to increased sympathetic activation. However, further studies are required to further understand how hypnosis and hypnotherapy affect the cardiovascular system through investigation of the neurophysiological components of the hypnotic state and of the mind-body relationship. Healthcare systems should embed mental health screening in patients at risk of developing CVD as part of the clinical pathway and consider the role that hypnosis and hypnotherapy may play in the management of CVD.

Summary: Research has examined the relationship between interoception and anxiety, depression, and psychosis; however, it is unclear which aspects of interoception have been systematically examined, what the combined findings are, and which areas require further research. To answer these questions, we systematically searched and narratively synthesised relevant reviews, meta-analyses, and theory papers (total n = 34). Existing systematic reviews and meta-analyses (anxiety n = 2; depression n = 2; psychosis n = 0), focus on cardiac interoceptive accuracy (heartbeat perception), and indicate that heartbeat perception is not systematically impaired in anxiety or depression. Heartbeat perception might be poorer in people with psychosis, but further evidence is needed. Other aspects of interoception, such as different body systems and processing levels, have been studied but not systematically reviewed. We highlight studies examining these alternative bodily domains and levels, review the efficacy of interoception-based psychological interventions, and make suggestions for future research. Funding: Wellcome Trust UK.

ObjectiveCOVID-19 led to a horrific global pandemic, with strict lockdowns and prolonged indoor stays increasing the risk of mental health problems, affecting people of different ages, genders, regions, and types of work to varying degrees. This study provides a bibliometric summary of the knowledge map related to mental health during and post COVID-19 pandemic.MethodsPublications related to mental health during and post COVID-19 pandemic were searched in the Web of Science Core Collection (WoSCC) database through March 19, 2024. After screening the search results, the literature included in the final was first quantitatively analyzed using GraphPad Prism software and then visualized using VOSviewer, CiteSpace, and R (the bibliometrix package).ResultsThe 7,047 publications from 110 countries were included, with the highest number of publications from China and the United States, and the number of publications related to mental health during and post the COVID-19 pandemic increased annually until 2023, after which it began to decline. The major institutions were University of Toronto, University of London, Harvard University, King’s College London, University College London, University of California System, University of Melbourne, Institut National De La Sante Et De La Recherche Medicale (Inserm), Mcgill University, and University of Ottawa; Frontiers in Psychiatry had the highest number of publications, and the Journal of Affective Disorders had the highest number of co-citations; 36,486 authors included, with Xiang, Yu-Tao, Cheung, Teris, Chung, Seockhoon published the most papers, and World Health Organization, Kroenke K, and Wang CY were the most co-cited; epidemiologically relevant studies on mental health related to COVID-19, and the importance of mental health during normalized epidemic prevention and control are the main directions of this research area, especially focusing on children’s mental health; “pandemic,” “sars-cov-2,” “epidemic,” “depression,” “coronavirus anxiety,” “anxiety,” “longitudinal,” “child,” “coronavirus anxiety,” “longitudinal,” “child,” and “coronavirus” are the top keywords in recent years.ConclusionThis comprehensive bibliometric study summarizes research trends and advances in mental health during and after the COVID-19 Pandemic. It serves as a reference for mental health research scholars during and after the COVID-19 pandemic, clarifying recent research preoccupations and topical directions.

Attachment styles influence mental health and relationships through life. Few studies examine the adolescent factors associated with adult attachment styles. This paper examines the association between adolescent emotional and behavioral problems and maternal-adolescent communication with attachment style in early adulthood. Data from 3423 participants in a birth cohort study were examined. At 14-years, participants' mothers completed the Parent-Adolescent Communication Scale. Participants completed the Youth Self-Report at 14-years which measures internalizing and externalizing symptoms, and the Attachment Style Questionnaire (ASQ) at 21-years. The ASQ comprises five domains of internal working models of interpersonal relationships and attachment style: confidence (security), discomfort with closeness and relationships as secondary (avoidance), need for approval and preoccupation with relationships (anxiety). Associations were examined using general linear models. After adjustments, internalizing symptoms score was associated with all domains of attachment and externalizing symptoms score was associated with four domains of attachment insecurity, but not attachment security. Low openness in maternal-adolescent communication was most strongly associated with decreased confidence and high problem maternal-adolescent communication was associated with viewing relationships as secondary. Adolescents with emotional and behavioral problems and maternal-adolescent communication may benefit from attachment-based interventions to support the development of healthy relationships and attachments in young adulthood.

The COVID-19 pandemic is affecting human behavior, increasing the demand for the cooperation between psychologists and computer scientists to develop technology solutions that can help people in order to promote well-being and behavior change. According to the conceptual Character-Behavior-Situation (CBS) triad of Character Computing, behavior is driven by an individual’s character (trait and state markers) and the situation. In previous work, a computational ontology for Character Computing (CCOnto) has been introduced. The ontology can be extended with domain-specific knowledge for developing applications for inferring certain human behaviors to be leveraged for different purposes. In this paper, we present a framework for developing applications for dealing with changes in well-being during the COVID-19 pandemic. The framework can be used by psychology domain experts and application developers. The proposed model allows the input of heuristic rules as well as data-based rule extraction for inferring behavior. In this paper, we present how CCOnto is extended with components of physical and mental well-being and how the framework uses the extended domain ontologies in applications for evaluating sleep habits, anxiety, and depression predisposition during the COVID-19 pandemic based on user-input data.

Background: The COVID-19 pandemic caused unprecedented changes to the lives of many. The aim of this paper was to understand how the COVID-19 pandemic impacted behavioral inflexibility (BI) and anxiety among autistic children and how autistic children and their families have adapted to COVID-19-related routine changes. Methods: This sequential mixed-method study included two phases. During the first phase, parents of autistic children (N = 48) completed an online survey consisting of the Behavioral Inflexibility Scale (BIS) and the Parent-Rated Anxiety Scale – Autism Spectrum Disorder (PRAS-ASD). During the second phase, a subset of parents (parents of adolescents, N = 11) was invited to participate in a virtual focus-group. Results: The parents reported a wide range of BI during the pandemic (BIS M = 2.03, SD = 1.02, range = 0.21 – 3.86). Child BI was a significant predictor of anxiety (t[40] = 5.56, p < .0001). From the focus groups, 155 codes were organized into four themes, two of which are discussed in this paper: child client factors that have changed during the pandemic and changes to family routines. Conclusions: In this preliminary study, the parents identified problematic BI and anxiety among their autistic children. The outcomes of this small-scale study indicate that some of the changes to routines brought about by the pandemic may be helpful for autistic children after the pandemic restrictions have ended. We provide a unique perspective on how to leverage occupational changes that resulted from the COVID-19 pandemic to aid autistics during non-pandemic times.