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The purpose of this study is to explore and compare the effects of drug therapy alone and amitriptyline combined with music therapy on postpartum anxiety and depression in women. The Hamilton Anxiety Scale (HAM-A), Edinburgh Postpartum Depression Scale (EPDS), and World Health Organization Quality of Life Assessment Tool (WHO QOL BREF) were used to analyze the treatment effects of the control group and intervention group on postpartum anxiety and depression in women. There was no significant difference in population baseline data between the control group and the intervention group (p>0.05); There was a significant difference in HAM-A scores between the two groups (p<0.05). In the EPDS score, there was a significant difference between the two groups (p<0.05), but after intervention in both groups, the treatment effect of the intervention group was significantly more significant than that of the control group (p<0.01). In the WHOQOL-BREF score, there were significant differences in physiological, psychological, and independence fields (p<0.05), except for no significant differences in the environmental field (p>0.05). Combining music therapy with conventional drug amitriptyline therapy can effectively alleviate and reduce postpartum anxiety and depression levels in women, improve their quality of life (except in the environmental field), and provide an effective reference plan for postpartum care for women to a certain extent. [ABSTRACT FROM AUTHOR]

Background/Objectives: The anxiolytic effect of transcutaneous electrical nerve stimulation (TENS) is associated with the activation of endogenous inhibitory mechanisms in the central nervous system. Both low-frequency, high-amplitude TENS (LF-TENS) and high-frequency, low-amplitude TENS (HF-TENS) are capable of activating opioid, GABA, serotonin, muscarinic, and cannabinoid receptors. However, there has been no comparative analysis of the effectiveness of HF-TENS and LF-TENS in the treatment of GAD. The purpose of our research was to study the effectiveness of direct HF-TENS and LF-TENS of the right median nerve in the treatment of patients with GAD compared with sham TENS. Methods: The effectiveness of direct HF-TENS and LF-TENS of the right median nerve in the treatment of GAD was studied using Generalized Anxiety Disorder 7-item scale (GAD-7) and the Hamilton Anxiety Rating Scale (HAM-A). 40 patients underwent sham TENS, 40 patients passed HF-TENS (50 Hz—50 μs—sensory response) and 41 patients completed LF –TENS (1 Hz—200 μs—motor response) for 30 days daily. After completion of treatment, half of the patients received weekly maintenance therapy for 6 months. Electroencephalography was performed before and after treatment. Results: Our study showed that a significant reduction in the clinical symptoms of GAD as assessed by GAD-7 and HAM-A was observed after HF-TENS and LF-TENS by an average of 42.4%, and after sham stimulation only by 13.5% for at least 2 months after the end of treatment. However, LF-TENS turned out to be superior in effectiveness to HF-TENS by 51% and only on electroencephalography leads to an increase in PSD for the alpha rhythm in the occipital regions by 24% and a decrease in PSD for the beta I rhythm in the temporal and frontal regions by 28%. The prolonged effect of HF-TENS and LF-TENS was maintained without negative dynamics when TENS treatment was continued weekly throughout the entire six-month observation period. Conclusions: A prolonged anxiolytic effect of direct TENS of the right median nerve has been proven with greater regression of clinical and neurophysiological manifestations of GAD after LF-TENS compared to HF-TENS. Minimal side effects, low cost, safety, and simplicity of TENS procedures are appropriate as a home treatment modality. [ABSTRACT FROM AUTHOR]

Background: Substance use disorder (SUD) often co-occurs with mood disorders like anxiety and depression. This study investigates the relationship between SUD and mood disorders using a dimensional approach. Methods: A total of 290 participants, including 145 with SUD and 145 healthy controls, were assessed. The General Health Questionnaire (GHQ-12) evaluated mental health, followed by interviews using the Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D). Demographic information, substance use behaviours, and mental health symptoms were collected and analysed. Results: Of the participants, 90% were men and 10% women; 68.2% were married. Most SUD patients were smokers (71.0%) and alcohol users (35.8%), with others using drugs or tobacco (33.7% and 19.3%). The majority (84.8%) used drugs for a high. HAM-D results showed moderate to severe depression in 7.5% of SUD patients and 5.5% of controls. HAM-A results indicated 80.6% of the SUD group had anxiety, compared to 88.9% of controls with no anxiety. Conclusion: SUD patients frequently experience concurrent anxiety and depression, highlighting the need for dual diagnosis and integrated treatment for SUD and mood disorders. [ABSTRACT FROM AUTHOR]

Background: This study was designed to inspect the effectiveness of Mindfulness Yoga and Progressive resistance exercise on anxiety and depression among Parkinson's disease. Purpose: To compare the effectiveness of Mindfulness Yoga and Progressive resistance exercise on anxiety and depression among Parkinson's disease Materials and Methods: The study was conducted with a sample size of 28 participants. The subjects were selected from Sri Saga Physiotherapy Centre, according to inclusion and exclusion criteria. Patients were completely explained about the safety and simplicity of the procedure and informed consent were obtained from the patient. For all the subjects Pre-test outcome measure were assessed using Hamilton anxiety and Hamilton depression scale. The subjects was divided into two groups based on concealed envelope method. Group A were given mindfulness yoga for 4 weeks of duration of 30 mins and Group-B were given Progressive resistance exercise for 4 weeks (10 reps*3 sets where 10RM=1kg). At the end of 4th week post outcome measures were analyzed using Hamilton anxiety and Hamilton depression scale and statistically tabulated. Result: Statistical analysis of Hamilton anxiety and Hamilton depression scale examination post-test values revealed the constantly significant differences, with P value of < 0.0001. Conclusion: Mindfulness yoga was found to be more effective than progressive resistance exercise in reducing anxiety and depression symptoms among Parkinson's patients. [ABSTRACT FROM AUTHOR]

Background: Obsessive compulsive disorder (OCD) is a chronic psychiatric disorder having significant deterioration in patients’ socio-occupational functioning. Stressful life events (SLE) were noted before onset of this disorder. The previous study with Indian population found positive correlation between stressful and traumatic life events and OCD, but was with small sample size and thus result couldn’t be generalized. Aims and Objectives: The aim of the study was to examine the role of life events in patients with OCD and to find out correlation between them, if any. Materials and Methods: Consecutive 30 OPD patients fulfilling ICD-10 DCR criteria for OCD were rated with Yale Brown Obsessive Compulsive Scale (YBOCS), Hamilton Rating Scale for Depression (HAM-D), Hamilton Rating Scale for Anxiety (HAM-A), and Presumptive Stressful Life Events Scale (PSLES). A group of 30 healthy controls from unrelated patient party were also rated on PSLES. Finally, both groups were statistically compared in terms of life events. Results: Two groups were identical in distribution of age and sex. The frequency of life events, 1-year (P=0.000) and lifetime (P=0.000), were significantly higher in OCD group in comparison to healthy controls. There was significant positive correlation between PSLES scores and YBOCS scores. Step-wise linear regression analysis found positively predictability of PSLES score to OCD severity. Conclusion: OCD patients have statistically significant SLE before the onset of their disorder and total number of life events has positive correlation with severity of OCD.

Background Schizophrenia is a debilitating disorder making it a challenge for clinicians to manage its heterogeneous symptom profile. Antipsychotics remain the main modality of its treatment. However, some symptoms persist after an optimal dose of antipsychotics. The affective and cognitive symptoms need a holistic approach for resolution. Biofeedback is a noninvasive procedure showing its effectiveness in various mental illnesses. Integration of biofeedback adjunctive to medications can help in attaining treatment goals in schizophrenia. Objectives It is to determine the role of biofeedback as an adjunctive therapy technique to traditional pharmacotherapy in patients with schizophrenia in improving affective symptoms. Methodology Sixty patients diagnosed with schizophrenia were selected for the study after fulfilling the inclusion and exclusion criteria. Patients were allotted to either the test group or control group by alternate allocation method. All patients were titrated to an optimal fixed dose of antipsychotic medications during 1st week of allotment to study. Biofeedback therapy was given 3 sessions per week for 3 weeks to patients in the test group. Positive and negative syndrome scale (PANSS) was applied for all patients at baseline. Hamilton Anxiety Rating Scale (HAM-A) and Calgary Depression Scale for Schizophrenia (CDSS) were applied at baseline and after 4 weeks to measure anxiety and depressive symptoms respectively. After 4 weeks the results were compared between both groups using statistical analysis. Conclusion The outcome of the study found that biofeedback therapy is effective in reducing anxiety and depressive symptoms in patients receiving biofeedback therapy compared to those who did not receive it. Recommendation Further studies in a larger cohort are needed to formulate sound and consistent conclusions.

Background: Obsessive compulsive disorder (OCD) is a chronic psychiatric disorder having significant deterioration in patients' socio-occupational functioning. Stressful life events (SLE) were noted before onset of this disorder. The previous study with Indian population found positive correlation between stressful and traumatic life events and OCD, but was with small sample size and thus result couldn't be generalized. Aims and Objectives: The aim of the study was to examine the role of life events in patients with OCD and to find out correlation between them, if any. Materials and Methods: Consecutive 30 OPD patients fulfilling ICD-10 DCR criteria for OCD were rated with Yale Brown Obsessive Compulsive Scale (YBOCS), Hamilton Rating Scale for Depression (HAM-D), Hamilton Rating Scale for Anxiety (HAM-A), and Presumptive Stressful Life Events Scale (PSLES). A group of 30 healthy controls from unrelated patient party were also rated on PSLES. Finally, both groups were statistically compared in terms of life events. Results: Two groups were identical in distribution of age and sex. The frequency of life events, 1-year (P=0.000) and lifetime (P=0.000), were significantly higher in OCD group in comparison to healthy controls. There was significant positive correlation between PSLES scores and YBOCS scores. Step-wise linear regression analysis found positively predictability of PSLES score to OCD severity. Conclusion: OCD patients have statistically significant SLE before the onset of their disorder and total number of life events has positive correlation with severity of OCD. [ABSTRACT FROM AUTHOR]

Mitigating rating inconsistency can improve measurement fidelity and detection of treatment response. The International Society for CNS Clinical Trials and Methodology convened an expert Working Group that developed consistency checks for ratings of the Hamilton Anxiety Rating Scale (HAM-A) and Clinical Global Impression of Severity of anxiety (CGI S) that are widely used in studies of mood and anxiety disorders. Flags were applied to 40,349 HAM-A administrations from 15 clinical trials and to Monte Carlo-simulated data as a proxy for applying flags under conditions of inconsistency. Thirty-three flags were derived these included logical consistency checks and statistical outlier-response pattern checks. Twenty-percent of the HAM-A administrations had at least one logical scoring inconsistency flag, 4 % had two or more. Twenty-six percent of the administrations had at least one statistical outlier flag and 11 % had two or more. Overall, 35 % of administrations had at least one flag of any type, 19 % had one and 16 % had 2 or more. Most of administrations in the Monte Carlo- simulated data raised multiple flags. Flagged ratings may represent less-common presentations of administrations done correctly. Conclusions-Application of flags to clinical ratings may aid in detecting imprecise measurement. Flags can be used for monitoring of raters during an ongoing trial and as part of post-trial evaluation. Appling flags may improve reliability and validity of trial data. • A set of expert consensus and statistical flags to help identify possible errors in HAMA ratings. • Flags elaborated in paper can be applied. • Flags represent actual patterns of inconsistencies found. • Application of flags to ratings may improve reliability of ratings and validity of trials. [ABSTRACT FROM AUTHOR]

Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious new β-coronavirus that primarily affects the lungs. Because of its unprecedented spread, in a relatively short interval, it is declared a global pandemic. Binding to the angiotensin-converting enzyme 2 receptors, SARS-CoV-2 is easily disseminated through air. Apart from the established clinical panel, individuals exposed to prolonged chronic stress also manifest gastrointestinal (GI) symptoms similar to those exhibited by SARS-CoV-2-infected patients.The present study aims to assess the incidence of GI deficiencies and prevalence of anxiety among healthy medical staff by applying the Visual Analog Scale for Irritable Bowel Syndrome (VAS-IBS) and Hamilton Anxiety Rating Scale (HAM-A) during this global crisis.We found significant differences on several items of the VAS-IBS: regarding the incidence of diarrhea (p = 0.04), bloating/gases (p = 0.02), and nausea/vomiting (p = 0.01) from the physical spectrum. After stratification based on age of the participants and after we applied Kruskal-Wallis test because of heterogeneity between groups, we noted two situations in which the null hypothesis is rejected: nausea/vomiting in women between 20 and 30 years, and between 30 and 40, and between 40 and 50 years, respectively (p = 0.026/0.029). Anxiety was prevalent among young and middle-class people after the centralization of HAM-A data, where 40.4% of the participants had various forms of anxiety: mild (n = 13; 13.82%), severe (n = 13; 13.82%), and moderate (n = 12; 12.76%).This study demonstrates that VAS-IBS is a reliable tool for assessing the incidence of GI deficiencies, as well as HAM-A for anxiety. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the factors associated with anxiety in type 2 diabetes mellitus patients (T2DM) by using Hamilton Anxiety Rating Scale (HAM-A). A cross-sectional quantitative study was conducted after necessary ethical approval from Medicare Hospital Rawalpindi and Capital Development Authority Hospital Islamabad in accordance with Declaration of Helsinki. Three hundred thirty-eight patients with type 2 diabetes mellitus were selected by non-stratified random sampling technique from August 2016 to February 2017. Majority of the T2DM patients (n = 258, 66.5%) had mild anxiety, followed by mild to moderate anxiety (n = 82, 21.1%). A significant association (p < 0.01) was observed between anxiety and patients’ gender, education, and occupation; whereas, statistically insignificant association (p > 0.05) was observed between HAM-A score and patients’ age, family history, and life style. Linear regression analysis revealed gender (OR = − 0.308, CI-0.57-0.299) as a significant predictor (p < 0.01) for anxiety. Findings of this study demonstrate that large proportion of the diabetic patients is suffering with type of anxiety. A significant association of anxiety was identified with gender, education, and occupation of type 2 diabetes patients. [ABSTRACT FROM AUTHOR]

Background: Depression is a widespread and incapacitating mental health disorder that impacts millions of people worldwide, playing a substantial role in the overall global health challenges. Depression has a big impact on a person's quality of life, cognitive and social functioning, risk of suicide, risk of heart disease and other illnesses, as well as death from all causes., Objective: It may be challenging to choose the best tools to screen for severe depression in patients with recurrent depression disorder (PRD) considering the diversity of psychological scales in Vietnam. The aim of this study was to evaluate diagnostic value for detect severe depression of four psychological scales including Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Beck Depression Inventory Scale (BECK), and Zung's Self-Rating Anxiety Scale (SAS) by genders and age groups among PRD in Vietnam., Methods: This study was conducted at National Institute of Mental Health, Bach Mai Hospital, Vietnam, from 2020 to 2021. There were 109 PRD evaluated with HAM-D, HAM-A, BECK, and SAS by qualified psychiatrists. By analysing Area Under the Curve (AUC) of Receiver Operating Characteristic (ROC) curve, we determined sensitivity, specificity and cut points of four above scales., Results: Among four scales, the BECK scale had the best diagnostic effect with the most optimal sensitivity and specificity (61.64% and 75%, respectively). We proposed the new cut-off of HAM-D, HAM-A, BECK, and SAS for detecting severe depression among PRD were 20, 34, 30, and 45, respectively. By genders, the cut points for the HAM-D, HAM-A, BECK, and SAS in males were 20, 27, 34, and 44, respectively, while those figure in females were 14, 34, 30, and 46, respectively. By age groups, adults had cut values for four above scales of 20, 34, 27, and 45, respectively, whereas those for the elderly were 16, 17, 35, and 44, respectively., Conclusion: We highly recommended that BECK is the most optimal method to screen severe depression in PRD in Vietnam. It is essential to utilize varied cut values of HAM-D, HAM-A, BECK, and SAS for different genders and age groups., Competing Interests: There are no conflicts of interest., (© 2023 Vu Son Tung, Nguyen-Van Thong, Nguyen-Thi Phuong Mai, Le-Thi Thao Linh, Dang Cong Son, Tran-Thi Thu Ha, Nguyen-Thi Hoa, Nguyen Thanh Long, Nguyen-Van Tuan.)

Aim: Mental retardation is a social stigma and children affected by this condition always require love and compassion. Pets have a positive role in human life to relieve stress and anxiety. Pets are therefore considered to be a very important aspect of psychological therapy. Those children who are suffering from mental retardation have to be given regular stress and anxiety-relieving sessions. Hence this study aims to analyze the psychosocial effects of pet dog ownership on mentally challenged children., Methodology: A total of 112 children were included in the study and were counseled at the Department of Pediatrics, District Hospital, Amritsar. Twenty patients were lost to follow up and pet ownership materialized in 52 patients. The study was divided into 2 groups, the compliant group (n=52) and the non-compliant group (n=40). Hamilton anxiety scale (HAM-A) was applied to all the children before pet dog ownership (PRE) and after 3-6 months with a pet dog (POST). The pre and post-scores of all the children were recorded and subjected to statistical analysis., Results: The HAM-A score before pet ownership was comparable, before pet ownership (p=.825), but after 3-6 months of pet ownership significant difference was observed between compliant and non-compliant groups (p<.001). Also, the HAM-A score in children with mild mental retardation (mild MR) and moderate mental retardation (moderate MR) was significantly less than the non-compliant group after 3-6 months. We also observed that the decrease in the anxiety levels was comparable in children who owned local breeds and foreign breeds., Conclusion: This short-term follow-up research highlights the potential advantages of keeping a companion dog for youngsters with mental problems in terms of improving their lives. Many of these long-term gains might be attributed to lessening tensions within families., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Aggarwal et al.)

Many evidences support the anxiety-headache-depression syndrome as a distinct disorder, and also its association with psychiatric illness. This study highlights the importance of prospective research for studying the developmental course and consequences of headache syndromes. The relevant information for the sample of 100 patients was recorded on a Performa designed for this purpose comprising of socio-demographic variables like age, gender and triggering factors. The correlation-coefficient indicated a significant positive relationship between the anxiety and depression in chronic headache patients. These findings implicate high prevalence of anxiety and depression in the general population, and indicate an association between headache and psychological disorders. Also, various psychotherapies should be applied to the headache patients so as to treat them right at the onset level of anxiety and depression. [ABSTRACT FROM AUTHOR]

Background  Escitalopram is widely used for the management of the major depressive disorder and generalized anxiety disorder, but there is no to very limited data available regarding efficacy and safety in Pakistani patients. This study was conducted to evaluate the efficacy and safety of escitalopram oral drops to manage the major depressive disorder and generalized anxiety disorder in a local cluster within Pakistan. Methods This prospective multicenter observational study was conducted in the department of psychiatry from August 2018 - August 2019. Eighty-five patients meeting the selection criteria were included in the study. Adolescent, adult, and geriatric patients of either gender with generalized anxiety disorder having Hamilton Anxiety Rating Scale (HAM-A) rate ≥ 10 and major depressive disorder having Montgomery-Asberg Depression Rating Scale (MADRS) rate ≥ 7 or patients with co-morbid generalized anxiety disorder (GAD), major depressive disorder (MDD) were selected for the study. We are reporting patients' improvement from baseline, response rate, and remission rate. Data analysis is performed by using SPSS version 21 (IBM Inc, Armonk, USA). Results Among enrolled patients, 42 were adolescents, 22 were adults, and 21 were geriatric. The mean age of an adolescent, adult, and geriatric patients was 14.92 ± 2.04, 44.54 ± 12.08, and 64.61 ± 3.16 years, respectively. Among enrolled patients, the mean change in a total score of HAM-A for anxiety and MADRS for depression were -10.04 ± 4.32 and -17.67 ± 14.42, respectively. At the end of the study, the remission rate and response rate for depression were 82 % and 75%, respectively. Similarly, the remission rate and the response for anxiety were 76% and 81%, respectively. Mean HAM-A and MADRS scores were significantly improved for adolescent, adult, and geriatric patients. Adverse events were reported in eight (9.41%) patients with six having gastrointestinal (GI) disturbance and two having to worsen anxiety. All reported adverse events were of mild severity.  Conclusion  Escitalopram oral drops are found effective and tolerable in reducing both anxiety and depression over the duration of study in all age groups, including adolescents, adults, and geriatrics., Competing Interests: The authors have declared financial relationships, which are detailed in the next section., (Copyright © 2020, Afridi et al.)

Aim: A comparative analysis of the psycho-emotional status and quality of life of patients with acne and post-acne., Material and Methods: There were 147 patients included in the study, 84 (57%) women and 63 (43%) men, aged from 14 to 48 years. The following parameters were studied: CADI score, APSEA score, DLQI score. Anxiety and depression were assessed with HAM-D and HAM-A., Results: Higher scores on CADI, APSEA and DLQI and dissatisfaction with the results of therapy were noted in older patients. Significant changes in CADI, APSEA and DLQI scores in patients with post-acne symptoms were recorded later compared to patients with acne. Anxiety and depression symptoms measured with HAM-D and HAM-A reached the level of depressive disorder of moderate severity and moderate anxiety in patients over 20 years old. Mental disorders were qualified within the nosogenic anxiety-phobic reactions developing in connection with dermatosis manifestation., Conclusion: Acnes substantially better give in to correction than post-acne symptom complex. Regardless of age, post-acne symptoms considerably reduce quality of life of patients, sometimes causing more expressed changes (anxiety and depression) than dermatosis.