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Objective: To address the impact of the COVID-19 pandemic and its relevant political climate on college-level international students in the United States. Participants: International students aged 18 years and older in the San Francisco Bay Area. Methods: A descriptive cross-sectional survey using PHQ-9 and the GAD-7. Results: The prevalence of depression and anxiety significantly decreased during the last two weeks from the survey completion in April or May in 2021 (Time 2) as compared to the two weeks after the July 6th policy directive in 2020 (Time 1). However, both depression severity, 2.172 (95% CI: 1.900, 2.445), and anxiety severity, 1.897 (95% CI: 1.655, 2.138), during Time 2 were still mild, indicating the ongoing COVID-19 pandemic had still negatively impacted their mental health status. Conclusions: Future research can expand the target population and analyze the long-term effects of policy changes and disease outbreaks on international students in the United States. [ABSTRACT FROM AUTHOR]

Background: The global health burden has surged due to a significant rise in anxiety and depression cases. In India, pandemic-related factors caused an increase in depression and anxiety levels. Various studies highlight the lifetime prevalence of these mental health disorders. It is essential to identify and monitor depression and anxiety symptoms in individuals across age groups. This study aims to gain insight into anxiety and depression prevalence by utilizing Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) to assess symptoms and their correlation with age and gender. Methods: A total of 136 individuals, both male and female, completed PHQ-9 and GAD-7 in a self-report format. Informed consent was obtained from each participant prior to their participation in the research. Data was collected and analyzed using Microsoft Excel. Charts and graphs aided data interpretation. Conclusion: Results revealed correlations between age and anxiety or depression severity. Younger age groups consistently reported higher symptom levels than older individuals. Tailored mental health interventions considering age and gender dynamics are crucial, like severe symptom intervention for ages ‘18-24,’ addressing severe anxiety and depression in the ‘25-44’ group, and implementing prevention initiatives for the ‘45 and above’ group [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine the prevalence of anxiety and depression among patients with glaucoma compared to the average Brazilian prevalence (9.8% of anxiety and 5.8% of depression, according to the World Health Organization) and its correlation with the severity of the disease. Methods: This was a transversal, single-arm trial of patients from four glaucoma centers in São Paulo and Curitiba--Brazil. Patients comprised adults at least 18 years of age with glaucoma diagnosis under treatment for at least 6 months. All subjects of the study answered two questionnaires (PHQ-9 and GAD-7) to evaluate the presence of anxiety and depression, and the results were analyzed accordingly to clinical and demographic characteristics. Results: The protocol included a total of 210 patients. The average age was 61.6 ± 15.3 years, and the female gender was more common (68.86%). Primary open-angle glaucoma was the most common diagnosis (59.90%). The average IOP was 18.5 mmHg, and 1.5 anti-glaucoma drops were the mean treatment. The prevalence of depression and anxiety was 26.90 and 25.71%, respectively. Most patients with anxiety were classified as early glaucoma, while those with depression had severe glaucoma. Conclusion: This study found that the prevalence of anxiety and depression among patients with glaucoma is higher than in the general population in our country. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore the impact of psychological stress on erectile dysfunction (ED) in male patients following the Gaziantep-Kahramanmaras earthquake. The investigation aimed to establish correlations between earthquake-induced stress and changes in sexual function using International Index of Erectile Function (IIEF), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) scores. Materials and Methods: A retrospective analysis was conducted on male ED patients from a Gaziantep urology clinic post-earthquake (March to August 2023). Patients with deteriorated erectile function post-earthquake (group 1) and those with pre-existing ED experiencing worsened symptoms post-earthquake (group 2) were included. Data collected encompassed sexual histories, IIEF scores, laboratory tests, and PHQ-9/GAD-7 evaluations. Patients were also evaluated mild and mild to moderate ED, moderate and severe ED according to IIEF erectile function. Results: Seventy-six patients were evaluated (24 in group 1 and 52 in group 2). Significant reductions in total IIEF scores (58 to 40 in group 1 and 49 to 33 in group 2) were observed post-earthquake in both groups (p<0.001). PHQ-9/GAD-7 scores was 11.12±3.79/9.34±3.11 in mild and mild to moderate ED and 13.17±3.05/12.14±3.17 in moderate and severe ED (p=0.011, p<0.001, respectively). Negative correlations existed between PHQ-9/GAD-7 scores and IIEF erectile function (p<0.05) and total IIEF (p<0.05). Conclusions: This research suggests a plausible connection between the Gaziantep-Kahramanmaras earthquake and heightened ED cases. Psychological stress post-earthquake may contribute to worsened ED symptoms. Further investigations are warranted to comprehensively understand the interplay between natural disasters and sexual dysfunction, essential for optimizing patient care in challenging situations. [ABSTRACT FROM AUTHOR]

Background: Young adults report increased rates of anxiety and depression than other age groups. Furthermore, young adult athletes experience additional stressors that may negatively impact their mental health. The aim of this study was to investigate the prevalence of anxiety and depression symptoms among Division I collegiate athletes and the influences of sex, sport type, and distance from home. Hypothesis: It was hypothesized that self-reported levels of anxiety and depression would increase among this population during this timeframe. Study Design: Cross-sectional. Level of Evidence: Level 3. Methods: Participants included 792 incoming Division I collegiate athletes. The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scores were completed by all incoming student athletes at a single institution as part of their preparticipation examination over 5 years. Both survey scores were categorized into different levels of severity and separately compared with chi-square tests. Continuous scores were modeled separately using negative binomial regression models including year, sex, sport type, and home location as covariates. Results: Results showed consistent levels of anxiety and depression over time. Female athletes reported higher levels of both anxiety and depression than male athletes, and individual sport athletes reported higher levels of depression than team sport athletes. Distance from home was not associated with anxiety or depression levels. Conclusion: Overall, levels of anxiety and depression did not change in this population over this time period. However, differences in anxiety and depression were seen between sexes and depression between sport types. Clinical Relevance: Understanding anxiety and depression risk factors among collegiate athletes can enhance early identification and intervention to improve mental health and allow for better allocation of resources to at-risk groups among Division I collegiate athletes. [ABSTRACT FROM AUTHOR]

Objectives: The study examined the impact of long term COVID-19 infection on the patients' erectile function and anxiety and depression in the same patients as well as the impact of daily tadalafil 5 mg supplementation on their erectile function. Methods: Recovered 114 men were evaluated by the validated Arabic version of the international index of erectile function (ArIIEF-5) and the Arabic versions of the patient health questionnaire-9 (PHQ-9) and the generalized anxiety disorder-7 (GAD-7) at time of presentation, at 3 months and at 6 months, respectively. Forty recovered patients who still complained of ED received tadalafil 5 mg daily for 2 months then were evaluated again at 3 and 6 months by penile duplex, the Arabic versions of the patient health questionnaire-9 (PHQ-9) and the generalized anxiety disorder-7 (GAD-7) at the same periods, respectively. Results: At the time of presentation, there was a positive correlation between the severity of COVID-19 infection, ArIIEF-5 and PHQ-9 (r = 0.249, p = 0.008; r = 0.241, p = 0.010, respectively). Most of the patients showed normal penile duplex parameters. There were 40 ED patients at presentation, 5 ED patients at 3 months and 3 ED patients at 6 months, respectively. Conclusions: ED in COVID-19 patients who were not suffering from chronic illnesses before the affection, is primarily psychological and completely responsive to tadalafil. [ABSTRACT FROM AUTHOR]

Patients with facial trauma often experience a psychological burden from their injuries. This study aimed to identify risk factors for adverse mental health outcomes in patients affected by facial trauma, using the 'Integrating Mental and Physical Healthcare: Research, Training and Services' (IMPARTS) screening tool. All patients >18 years of age who completed more than one IMPARTS screening tool in the Oral and Maxillofacial Trauma Clinic between 2019 and 2021 were included in this study. This tool was used to assess the risk of post-traumatic stress disorder (PTSD), generalized anxiety disorder, and depression. Included patients completed the IMPARTS questionnaire at initial follow-up (mean 18 days post-trauma) and one subsequent time point (mean 82 days). 167 patients were included in the study. On multivariable analysis, a history of psychiatric illness (P = 0.015) and interpersonal violence as the mechanism of injury (P = 0.010) were identified as predictive of risk of PTSD. Risk of PTSD was lower in zygomatic injuries (P = 0.001), while nasal involvement increased at-risk status for depression (P = 0.009). 47.3% of patients screened positive on initial IMPARTS assessment, while 35.3% screened positive on follow-up IMPARTS assessment. This study supports the IMPARTS tool in allowing the prompt identification of mental health adversity in facial trauma. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore the impact of psychological stress on erectile dysfunction (ED) in male patients following the Gaziantep-Kahramanmaras earthquake. The investigation aimed to establish correlations between earthquake-induced stress and changes in sexual function using International Index of Erectile Function (IIEF), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) scores. Materials and Methods: A retrospective analysis was conducted on male ED patients from a Gaziantep urology clinic post-earthquake (March to August 2023). Patients with deteriorated erectile function post-earthquake (group 1) and those with pre-existing ED experiencing worsened symptoms post-earthquake (group 2) were included. Data collected encompassed sexual histories, IIEF scores, laboratory tests, and PHQ-9/GAD-7 evaluations. Patients were also evaluated mild and mild to moderate ED, moderate and severe ED according to IIEF erectile function. Results: Seventy-six patients were evaluated (24 in group 1 and 52 in group 2). Significant reductions in total IIEF scores (58 to 40 in group 1 and 49 to 33 in group 2) were observed post-earthquake in both groups (p

Background: The main objective of this study was to provide Spanish normative data for the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder Assessment-7 (GAD-7) in a community-derived sample of adolescents. Method: A total of 2,235 adolescents (M = 14.68 years, SD = 1.76 years), selected through stratified cluster sampling, participated in the study. Results: Self-reported symptoms of depression and anxiety were common. Statistically significant differences were found when comparing the means scores of PHQ-9 and GAD-7 across sex and age. Percentile scores were computed for both total scores and were stratified by sex and age. Conclusions: Both the PHQ-9 and the GAD-7 are brief, simple, and useful measurement instruments with adequate psychometric properties for the assessment of self-reported depressive and anxious symptomatology among Spanish adolescents. A reliable and valid assessment of mental health is essential, as it allows for early detection and identification, which in turn can help in guiding psychological preventive interventions in a critical human developmental stage such as adolescence.

Abstract Background Pregnant women faced great challenges and psychological and physiological changes of varying degrees during the omicron epidemic outbreak. It is important to recognize the potential impact of these challenges on the mental health of pregnant women and to provide appropriate resources and support to mitigate their effects. Method By using the convenience sampling approach, a total of 401 pregnant women from two hospitals of different grades in two cities were included in the survey. The cross-sectional survey was conducted by basic characteristics, Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), Insomnia Severity Index (ISI) and self-made questionnaire. Results Insomnia affected 207 participants (51.6%), depression affected 160 participants (39.9%) and anxiety affected 151 participants (37.7%). Moreover, pregnant women in provincial capital city were more likely to experience anxiety, depression and insomnia than those in county-level city (P 0.05). Conclusion Pregnant women frequently suffer from anxiety disorder, depression and insomnia as a result of the omicron pandemic in China. During this period, the community and medical professionals should provide more psychological counseling, conduct health education and offer virtual prenatal care to pregnant women (particularly in the provincial capital city).

Background: The main objective of this study was to provide Spanish normative data for the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder Assessment-7 (GAD-7) in a community-derived sample of adolescents. Method: A total of 2,235 adolescents (M = 14.68 years, SD = 1.76 years), selected through stratified cluster sampling, participated in the study. Results: Self-reported symptoms of depression and anxiety were common. Statistically significant differences were found when comparing the means scores of PHQ-9 and GAD-7 across sex and age. Percentile scores were computed for both total scores and were stratified by sex and age. Conclusions: Both the PHQ-9 and the GAD-7 are brief, simple, and useful measurement instruments with adequate psychometric properties for the assessment of self-reported depressive and anxious symptomatology among Spanish adolescents. A reliable and valid assessment of mental health is essential, as it allows for early detection and identification, which in turn can help in guiding psychological preventive interventions in a critical human developmental stage such as adolescence. [ABSTRACT FROM AUTHOR]

Objective: Currently, the relationship between parathyroidectomy and objective neuropsychiatric outcomes are not clearly defined. The purpose of this study is to perform the first ever Meta‐analysis of preoperative and postoperative PHQ‐9 and GAD‐7 scores in patients with primary hyperparathyroidism undergoing parathyroidectomy with the goal of identifying a specific psychometric score that could be used as an indication for surgical intervention. Data Sources: A comprehensive search of the literature was performed using PubMed, Embase, PsycINFO, Web of Science, and Ovid All EBM Reviews. Review Methods: Studies met inclusion criteria if they evaluated preoperative and postoperative PHQ‐9 and/or GAD‐7 scores in patients with primary hyperparathyroidism undergoing parathyroidectomy. Random effects Meta‐analyses were used to analyze the compiled data. Results: The literature search returned 1433 articles for initial review of which 6 (1105 participants) met criteria for inclusion and Meta‐analysis. Meta‐analysis revealed that primary hyperparathyroidism patients had significantly higher presurgical PHQ‐9 scores when compared to control groups. Additionally, patients experienced a statistically significant and sustained decrease in PHQ‐9 scores following parathyroidectomy. Notably, there was a dramatic decrease in the percentage of patients with PHQ‐9 scores ≥10 (considered clinically significant for depression) following parathyroidectomy. Conclusion: Patients with primary hyperparathyroidism experience a statistically significant and sustained improvement in PHQ‐9 scores following parathyroidectomy. Additionally, symptoms of anxiety and suicidal ideation appear to decrease after parathyroidectomy. We propose that a PHQ‐9 score ≥10 could potentially be used as an indication for parathyroidectomy in patients with asymptomatic primary hyperparathyroidism. [ABSTRACT FROM AUTHOR]

Background: Pregnant women faced great challenges and psychological and physiological changes of varying degrees during the omicron epidemic outbreak. It is important to recognize the potential impact of these challenges on the mental health of pregnant women and to provide appropriate resources and support to mitigate their effects. Method: By using the convenience sampling approach, a total of 401 pregnant women from two hospitals of different grades in two cities were included in the survey. The cross-sectional survey was conducted by basic characteristics, Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), Insomnia Severity Index (ISI) and self-made questionnaire. Results: Insomnia affected 207 participants (51.6%), depression affected 160 participants (39.9%) and anxiety affected 151 participants (37.7%). Moreover, pregnant women in provincial capital city were more likely to experience anxiety, depression and insomnia than those in county-level city (P < 0.01). Pregnant women's anxiety, depression and insomnia were positively correlated with the severity of COVID-19 infection (P < 0.05). However, COVID-19 infection had no appreciable impact on maternal demand for termination of pregnancy and cesarean section (P > 0.05). Conclusion: Pregnant women frequently suffer from anxiety disorder, depression and insomnia as a result of the omicron pandemic in China. During this period, the community and medical professionals should provide more psychological counseling, conduct health education and offer virtual prenatal care to pregnant women (particularly in the provincial capital city). [ABSTRACT FROM AUTHOR]

PurposeThis study aimed to determine the prevalence of anxiety and depression among patients with glaucoma compared to the average Brazilian prevalence (9.8% of anxiety and 5.8% of depression, according to the World Health Organization) and its correlation with the severity of the disease.MethodsThis was a transversal, single-arm trial of patients from four glaucoma centers in São Paulo and Curitiba—Brazil. Patients comprised adults at least 18 years of age with glaucoma diagnosis under treatment for at least 6 months. All subjects of the study answered two questionnaires (PHQ-9 and GAD-7) to evaluate the presence of anxiety and depression, and the results were analyzed accordingly to clinical and demographic characteristics.ResultsThe protocol included a total of 210 patients. The average age was 61.6 ± 15.3 years, and the female gender was more common (68.86%). Primary open-angle glaucoma was the most common diagnosis (59.90%). The average IOP was 18.5 mmHg, and 1.5 anti-glaucoma drops were the mean treatment. The prevalence of depression and anxiety was 26.90 and 25.71%, respectively. Most patients with anxiety were classified as early glaucoma, while those with depression had severe glaucoma.ConclusionThis study found that the prevalence of anxiety and depression among patients with glaucoma is higher than in the general population in our country.

Abstract Background Sleep disturbances are serious public health issues that warrant increased attention, especially in adolescents. The aim of this study was to investigate the prevalence and factors associated with sleep disorders among urban adolescents in China. Methods This study utilized an online survey to assess the demographic characteristics and mental health status of secondary school students in Lianyungang City. The Patient Health Questionnaire-9 (PHQ-9) was used to evaluate sleep disturbances in adolescents. The seven-item Generalized Anxiety Disorder (GAD-7) assessed anxiety symptoms, and the Perceived Social Support Scale (PSSS) was used to measure perceived social support. Results Among 3443 adolescents, the prevalence of sleep disorders were 10.8%, with significantly higher proportions of sleep disorders (13.7% VS 8.3%, P

Objective: To investigate the psychosocial burden in children and adolescents with juvenile rheumatic diseases during the COVID-19 pandemic. Methods: As part of the multicentre observational KICK-COVID study linked to the National Pediatric Rheumatology Database, adolescents < 21 years and parents of children < 12 years with rheumatic diseases answered questions on perceptions of health risk (PHR) due to SARS-CoV2, stress, well-being (WHO-5) and symptoms of depression (PHQ-9) and anxiety (GAD-7). Data were collected at routine visits from June to December 2021 and assessed for association with demographic and clinical parameters, treatment and patient-reported outcomes by multivariable regression analyses. Results: Data from 1356 individuals (69% female, 50% adolescents) were included. Median PHR on a numeric rating scale (NRS, 0–10) was 4 (IQR 2–6), median perceived stress was 3 (IQR 1–6). Adolescents reported a worse well-being with a significantly lower median WHO-5-score (60, IQR 40–76) than parents reported for their children < 12 years (80, IQR 68–84). Moderate to severe symptoms of depression and anxiety were reported by 14.3% and 12.3% of the adolescents, respectively. PHR was significantly higher in patients with systemic lupus erythematosus, methotrexate or biologic disease-modifying anti-rheumatic drug therapy than in patients without these characteristics, whereas lower WHO-5 or higher PHQ-9 or GAD-7 scores were only associated with poorer patient-reported health status and physical functioning. Conclusion: The perception of health risk due to SARS-CoV2 infection was not paralleled by an impairment of mental health, which were, however, significantly correlated with self-rated health status and functional capacity, highlighting the importance of patient-reported outcome assessment. Trial registration: German Clinical Trials Register (DRKS), no. DRKS00027974. Registered on 27th of January 2022. [ABSTRACT FROM AUTHOR]

Background: Sleep disturbances are serious public health issues that warrant increased attention, especially in adolescents. The aim of this study was to investigate the prevalence and factors associated with sleep disorders among urban adolescents in China. Methods: This study utilized an online survey to assess the demographic characteristics and mental health status of secondary school students in Lianyungang City. The Patient Health Questionnaire-9 (PHQ-9) was used to evaluate sleep disturbances in adolescents. The seven-item Generalized Anxiety Disorder (GAD-7) assessed anxiety symptoms, and the Perceived Social Support Scale (PSSS) was used to measure perceived social support. Results: Among 3443 adolescents, the prevalence of sleep disorders were 10.8%, with significantly higher proportions of sleep disorders (13.7% VS 8.3%, P < 0.001) among female adolescents when compared to males. Binary regression analysis revealed that anxiety symptoms (OR = 1.305, 95% CI: 1.269–1.342, P < 0.001) was risk factor for sleep disturbances, and significant other support (OR = 0.944, 95% CI: 0.896–0.994, P = 0.028) and good annual household income (OR = 0.616, 95% CI: 0.394–0.963, P = 0.034) were protective factors. Furthermore, multinomial logistic regression analysis showed that age, sex, and anxiety symptoms were associated with an elevated risk of experiencing more frequent sleep disturbances (all P < 0.05). Conclusions: We have found that 10.8% of adolescents experience sleep disorders, and it is evident that various factors can influence healthy sleeping. These results underscore the significance of addressing these factors to enhance sleep health among this population. [ABSTRACT FROM AUTHOR]

The nine-item Patient Health Questionnaire (PHQ-9) and seven-item Generalised Anxiety Disorder (GAD-7) scale are widely used clinically and within research, and so it is important to determine how the measures, and individual items within the measures, are answered by adults of differing ages. This study sought to evaluate measurement invariance and differential item functioning (DIF) of the PHQ-9 and GAD-7 between working age and older adults seeking routine psychological treatment. Data of working age (18–64 years old) and older (≥65) adults in eight Improving Access to Psychological Therapies (IAPT) services were used. Confirmatory factor analysis (CFA) was used to establish unidimensionality of the PHQ-9 and GAD-7, with multiple-group CFA to test measurement invariance and The Multiple Indicators, Multiple Causes Models approach to assess DIF. The employed methods were applied to a propensity score matched (PSM) sample in sensitivity analyses to control for potential confounding. Data from 166,816 patients (159,325 working age, 7491 older) were used to show measurement invariance for the PHQ-9 and GAD-7, with limited evidence of DIF and similar results found with a PSM sample (n = 5868). The localised sample creates an inability to detect geographical variance, and the potential effect of unmeasured confounders cannot be ruled out. The findings support the use of the PHQ-9 and GAD-7 measures for working age and older adults, both clinically and in research settings. This study validates using the measures for these age groups to assess clinically significant symptom thresholds, and monitor treatment outcomes between them. • Testing response differences to the PHQ-9 and GAD-7 by working age and older adults • Confirmatory factor analysis established unidimensionality in the sample (n = 166,816). • Found measurement invariance and limited evidence of differential item functioning • Propensity score matched sample (n = 5868) provided robust sensitivity analyses. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of depression and anxiety in COVID-19-positive people. Study Design: Cross Sectional study. Setting: Qateef Hospital Kingdom of Saudia Arabia. Period: 25th April, 2021 to 18th May, 2021. Material & Methods: 450 participants were enrolled in this study. Both genders were included who had COVID positive but suffering from depression and anxiety were included in this study. In this study all participants were completed questionnaires describing their social and demographic status, as well as PHQ-9 for depression and GAD-7 for anxiety. To analyze the continuous and categorical data the SPSS version 20 was used. Results: Over four hundred and fifty subjects participated in this cross-sectional study with the age of 49.91±12.2 years. In addition, according to the findings when the PHQ-9 scoring is significant in old age people whereas the GAD-7 is significantly found in young age. Conclusion: The study found the evidence about the probable psychologic difficulties associated with this pandemic and underline the necessity for PHQ-9 and GAD-7 for assessing mental health. The findings of this research provide light on the emotional condition of post-COVID-19 patients and indicate the necessity for depression and anxiety treatment by a psychiatrist. This research will focus in the future on how strongly depression and anxiety in the participants predict mental disorders following COVID-19. [ABSTRACT FROM AUTHOR]

Abstract Objective To investigate the prevalence and associated factors of depression and anxiety among hospital healthcare workers during the COVID-19 pandemic in the extreme south of Brazil. Method Cross-sectional study was conducted with 264 healthcare workers, between August and December 2020. Depression and anxiety were assessed using the Patient Health Questionnaire and the Generalized Anxiety Scale. Multivariable linear regression analysis was performed. Results The prevalence of depression and anxiety among healthcare workers was 32.4% and 26.2%, respectively. The profession of nursing technician, having a family member who had lost a job, being responsible for family income, being 50 or more years old, being divorced or widowed, having a test for COVID-19, having suffered a traumatic event in life and having received psychological counseling at work were associated with depression and anxiety. Conclusion In this study, receiving psychological counseling at work was a protective factor for anxiety and depression.

BackgroundThis study investigates outcomes from two federal grant programs: the Evidence-Based Tele-Behavioral Health Network Program (EB THNP) funded from September 2018 to August 2021 and the Substance Abuse Treatment Telehealth Network Grant Program (SAT TNGP) funded from September 2017 to August 2020. As part of the health services implementation program, the aims of this study were to evaluate outcomes in patient symptoms of depression and anxiety across the programs' 17 grantees and 95 associated sites, with each grantee having data from telehealth patients and from an in-person comparison group.MethodsThe research design is a prospective multi-site observational study. Each grantee provided data on a nonrandomized convenience sample of telehealth patients and an in-person comparison group from sites with similar rural characteristics and during the same time period. Patient characteristics were collected at treatment initiation, and clinical outcome measures were collected at baseline and monthly. The validated clinical outcome measure instruments included the Patient Health Questionnaire-9 (PHQ-9) for depression symptoms and the Generalized Anxiety Disorder-7 (GAD-7) scale for anxiety-related symptoms. Linear mixed models, with grantee as the random effect, were used to determine the association of behavioral health delivery (telehealth versus in-person) on the one-month change in PHQ-9 and GAD-7 while adjusting for covariates.ResultsAcross a total of 1,514 patients, one-month change scores were improved indicating that PHQ-9 and GAD-7 scores decreased from baseline to the one-month follow-up at similar rates in both the in-person and telehealth groups. Reduction in scores averaged 2.8 for the telehealth treatment group and 2.9 for the in-person treatment group in the PHQ-9 subsample and 2.0 for the telehealth treatment group and 2.4 for the in-person treatment group in the GAD-7 subsample. There was no statistically significant association between the modality of care (telehealth treatment group versus in-person comparison group) and the one-month change scores for either PHQ-9 or GAD-7. Individuals with higher baseline scores demonstrated the greatest decrease in scores for both measures. Upon adjusting for baseline scores and grantee program, patient demographics were not found to be significantly associated with change in anxiety or depression symptoms.ConclusionIn our very large pragmatic study comparing behavioral health treatment delivered to a population of patients in rural, underserved communities, we found no clinical or statistical differences in improvements in depression or anxiety symptoms as measured by the PHQ-9 and GAD-7 between patients treated via telehealth or in-person.

Purpose: Patient-reported outcome measures (PROMs) are commonly collected in trials and some care settings, but preference-based PROMs required for economic evaluation are often missing. For these situations, mapping models are needed to predict preference-based (aka utility) scores. Our objective is to develop a series of mapping models to predict preference-based scores from two mental health PROMs: Patient Health Questionnaire-9 (PHQ-9; depression) and Generalised Anxiety Questionnaire-7 (GAD-7; anxiety). We focus on preference-based scores for the more physical-health-focussed EQ-5D (five-level England and US value set, and three-level UK cross-walk) and more mental-health-focussed Recovering Quality-of-Life Utility Index (ReQoL-UI). Methods: We used trial data from the Improving Access to Psychological Therapies (IAPT) mental health services (now called NHS Talking Therapies), England, with a focus on people with depression and/or anxiety caseness. We estimated adjusted limited dependent variable or beta mixture models (ALDVMMs or Betamix, respectively) using GAD-7, PHQ-9, age, and sex as covariates. We followed ISPOR mapping guidance, including assessing model fit using statistical and graphical techniques. Results: Over six data collection time-points between baseline and 12-months, 1340 observed values (N ≤ 353) were available for analysis. The best fitting ALDVMMs had 4-components with covariates of PHQ-9, GAD-7, sex, and age; age was not a probability variable for the final ReQoL-UI mapping model. Betamix had practical benefits over ALDVMMs only when mapping to the US value set. Conclusion: Our mapping functions can predict EQ-5D-5L or ReQoL-UI related utility scores for QALY estimation as a function of variables routinely collected within mental health services or trials, such as the PHQ-9 and/or GAD-7. [ABSTRACT FROM AUTHOR]

Objective This study aimed to explore the relationship between dermatological conditions and psychiatric disorders in patients attending a tertiary care hospital. Methods In a cross-sectional study at tertiary care Hospital, 200 participants (15-55 years) with dermatological conditions were observed from January to August 2023. Exclusions were those with primary psychiatric disorders, non-participants, and cognitive impairments. Socio-demographics were collected via a questionnaire. Psychiatric symptoms were assessed using PHQ-9 or GAD-7, while dermatological conditions were sourced from patient records. Results A youthful cohort showed acne predominance in females and younger ages, while eczema increased with age, particularly in males. Notably, 54.5% had psychiatric conditions, with only 5% receiving treatment. Findings underscore an urgent need for integrated dermatological-psychiatric care. Conclusion This Pakistan-based study identified a notable link between dermatological conditions and psychiatric disorders. With 54.5% of dermatological patients also exhibiting psychiatric symptoms, there is a significant gap in therapeutic engagement. The findings underscore the need for integrated medical interventions in the region. [ABSTRACT FROM AUTHOR]

Background: Nurses/midwives and Community Health Volunteers (CHVs) are exposed to chronic stressors putting them at risk of developing mental health problems. This has been exacerbated by the COVID-19 pandemic. There is limited empirical evidence of the burden of mental health problems among health care workers partly due to the lack of adequately standardized and validated measures for use among health care workers in Sub-Saharan Africa. This study aimed to perform the psychometric evaluation of the PHQ-9 and GAD-7 administered to nurses/midwives and CHVs across 47 counties in Kenya. Methods: Between June and November 2021, a national survey on mental wellbeing and resilience among nurses/midwives and CHVs was conducted via telephone interviews. The survey had a total sample size of 1907 nurses/midwives and 2027 CHVs. Cronbach's alpha and MacDonalds' omega were used to evaluate the scale's internal consistency. Confirmatory Factor Analysis (CFA) was used to test the one-factor structure of the scales. Multi-group CFA was applied to evaluate the generalizability of the scales across the Swahili and English versions, and among male and female health workers. The Spearman correlation was used to assess the tools' divergent and convergent validity. Results: The internal consistency of PHQ-9 and GAD-7 was good, with alpha and omega values above 0.7 across study samples. CFA results indicated a one-factor structure of the PHQ-9 and GAD-7 for both nurses/midwives and CHVs. Multigroup CFA showed that both scales were unidimensional across both language and sex. The PHQ-9 and GAD-7 were positively correlated with perceived stress, burnout, and post-traumatic stress disorder, indicating convergent validity. The PHQ-9 and GAD-7 were significantly negatively correlated with resilience and work engagement, supporting divergent validity. Conclusion: The PHQ-9 and GAD-7 are unidimensional, reliable, and valid tools for screening depression and anxiety among nurses/midwives and CHVs. The tools can be administered in a similar population or study setting using either Swahili or English. [ABSTRACT FROM AUTHOR]

The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) are short self-report questionnaires used to screen and assess depression and anxiety severity in medical and community samples. However, little is known about their psychometric properties in individuals with anxiety and mood disorders (AMD) This study evaluated the psychometric properties of the PHQ-9 and GAD-7 in individuals with AMD. Individuals (n = 244, mean age 39.9 ± 12.3 years) with AMD completed the PHQ-9, GAD-7, as well as other measures of depression, anxiety, and a structured diagnostic interview. The PHQ-9 and GAD-7 demonstrated good internal consistency (Cronbach's alpha 0.87 and 0.84, respectively). The PHQ-9 and GAD-7 showed a weak correlation with clinician-rated scales HAM-D and HAM-A (r = 0.316, p < 0.01, r = 0.307, p < 0.01, respectively). For the PHQ-9, a cut score of ≥11 resulted in 72% sensitivity and 72% specificity at recognizing depression symptoms. For the GAD-7, a cut score ≥7 resulted in 73% sensitivity and 54% specificity at recognizing any anxiety disorders. The confirmatory factor analysis suggested a two-factor structure ("cognitive/affectional", "somatic") for both the PHQ-9 and GAD-7. In conclusion, the PHQ-9 and GAD-7 have adequate formal psychometric properties as severity measures for symptoms of anxiety and depression in individuals with AMD. The PHQ-9 performs well as a screener using a cut score of ≥11. However, the clinical utility of the GAD-7 as a diagnostic tool for recognition of anxiety disorders is limited. • The PHQ-9 and GAD-7 demonstrated good internal consistency. • For the PHQ-9, a cut-score of ≥11 resulted in good sensitivity and specificity. • GAD-7 was not an adequate screening tool for any anxiety disorders. • The PHQ-9 and GAD-7 had a two-factor structure. [ABSTRACT FROM AUTHOR]

Abstract Background The nine-item Patient Health Questionnaire (PHQ-9) and the seven-item Generalised Anxiety Disorder scale (GAD-7) are routinely used in research and clinical practice. Whilst measurement invariance of these measures across gender has been demonstrated individually in general population studies and clinical samples, less is known about invariance of the distinct but correlated latent factors (‘depression’ and ‘anxiety’). The current study assessed measurement invariance of these constructs across males and females seeking treatment for common mental health disorders. Methods Data were provided from eight psychological treatment services in London, England. Data from initial assessments with the services where individual items on the PHQ-9 and GAD-7 were available were included in analyses. Measurement invariance was explored across self-identified genders, with ‘male’ and ‘female’ categories available in the dataset. Sensitivity analyses were conducted using propensity score matching on sociodemographic and clinical variables. Results Data were available for 165,872 patients (110,833 females, 55,039 males). There was evidence of measurement invariance between males and females in both the full sample and a propensity score matched sample (n = 46,249 in each group). Conclusions Measurement invariance of the correlated depression and anxiety factors of PHQ-9 and GAD-7 were indicated in this sample of individuals seeking psychological treatment for CMHDs. These results support the use of these measures in routine clinical practice for both males and females. This is of particular importance for assessing the prevalence of clinically significant levels of symptoms as well as comparing treatment outcomes across genders.

Psoriasis is a common, chronic T cell–mediated disease characterised by erythematous, scaly plaques. Psoriasis is associated with depression, anxiety, poor quality of life, harmful use of alcohol and suicidal ideation. We performed this study to find out prevalence of psychological morbidity in our patients with severe psoriasis and to know clinical variables associated with higher risk of psychological morbidity. This study is a cross-sectional, observational study conducted in a dermatology outpatient department (OPD) of a tertiary care centre. Study population included patients with severe psoriasis area severity index (PASI>10). Clinical and epidemiological data, Patient health questionnaire-9, Generalised anxiety disorder-7, Dermatology life quality index (DLQI) and Alcohol Use Disorders Identification Test questionnaires were recorded. Data were analysed using SPSS, version 24. Chi-square test and Spearman's rank correlation test (ρ) were performed, and p value of <0.05 was considered statistically significant. A total of 140 patients were included in the study and consisted of 67 men and 73 women. The median age was 44 years, median duration of disease was 10 years and median PASI was 13.6. Scoring revealed moderate-to-severe depression in 69 (49.3%) patients, moderate-to-severe anxiety in 40 (28.6%), severe impairment in quality of life in 98 (70%), harmful use of alcohol in 23 (16.4%) and suicidal ideation in 11 (7.8%) patients. Young age, recent onset, higher PASI and facial involvement show significant association with depression, anxiety and poor quality of life. Screening for psychological morbidity should be performed in patients with severe psoriasis especially younger patients with recent onset disease. Higher DLQI points to concomitant psychological morbidity and it should be performed in all the patients. [ABSTRACT FROM AUTHOR]

Background: The nine-item Patient Health Questionnaire (PHQ-9) and the seven-item Generalised Anxiety Disorder scale (GAD-7) are routinely used in research and clinical practice. Whilst measurement invariance of these measures across gender has been demonstrated individually in general population studies and clinical samples, less is known about invariance of the distinct but correlated latent factors ('depression' and 'anxiety'). The current study assessed measurement invariance of these constructs across males and females seeking treatment for common mental health disorders. Methods: Data were provided from eight psychological treatment services in London, England. Data from initial assessments with the services where individual items on the PHQ-9 and GAD-7 were available were included in analyses. Measurement invariance was explored across self-identified genders, with 'male' and 'female' categories available in the dataset. Sensitivity analyses were conducted using propensity score matching on sociodemographic and clinical variables. Results: Data were available for 165,872 patients (110,833 females, 55,039 males). There was evidence of measurement invariance between males and females in both the full sample and a propensity score matched sample (n = 46,249 in each group). Conclusions: Measurement invariance of the correlated depression and anxiety factors of PHQ-9 and GAD-7 were indicated in this sample of individuals seeking psychological treatment for CMHDs. These results support the use of these measures in routine clinical practice for both males and females. This is of particular importance for assessing the prevalence of clinically significant levels of symptoms as well as comparing treatment outcomes across genders. [ABSTRACT FROM AUTHOR]

The Centers for Medicare and Medicaid Services covers the cost of collaborative care for Medicare beneficiaries. However, only 24 states cover the costs of collaborative care in their Medicaid programs despite evidence indicating the cost-effectiveness of delivering behavioral health services in primary care. This study examines benchmark data from a behavioral health medical group embedded within primary care practices across the United States using a large dataset of patients treated in collaborative care. The study explores the effectiveness of collaborative care in reducing depression and anxiety symptoms by comparing Medicare, Medicaid, and privately insured populations, seeking to inform the importance of supporting advocacy for continued Medicaid fee adoption for collaborative care. [ABSTRACT FROM AUTHOR]

Introduction: Anxiety and depression considered as the risk factors for diabetes, as well as they are two of its complications. This study was conducted to explain the prevalence of depression and anxiety among T2DM and its associated factors. Methods: A cross-sectional study was conducted at the Al-Wafaa (Diabetes Center in Mosul). Patient Health Questionnaire (PHQ - 9) and Generalized Anxiety Disorders (GAD - 7) were used to evaluate all patients for anxiety and depression. Results: In this study 380 patients participated their mean age was 55.47 ± 8.35 ranging between 35 – 82 years and the mean BMI was 29.69 ± 5.04. More than half of these patients (54.7%) were men and (98.7%) of them were married. The mean HbA1c level was 8.68 ± 1.47 and the mean duration of diabetes was 10.18 years. The reported prevalence of depression and anxiety were 79.5% and 79.2% respectively. Conclusion: Anxiety and depression are common problems among diabetic patients, more than two third of the study population had varying degrees of anxiety and depression. Anxiety and depression in diabetic patients were significantly related to HbA1c, gender, educational level, employment, and monthly income.

Abstract Background This study investigates outcomes from two federal grant programs: the Evidence-Based Tele-Behavioral Health Network Program (EB THNP) funded from September 2018 to August 2021 and the Substance Abuse Treatment Telehealth Network Grant Program (SAT TNGP) funded from September 2017 to August 2020. As part of the health services implementation program, the aims of this study were to evaluate outcomes in patient symptoms of depression and anxiety across the programs’ 17 grantees and 95 associated sites, with each grantee having data from telehealth patients and from an in-person comparison group. Methods The research design is a prospective multi-site observational study. Each grantee provided data on a nonrandomized convenience sample of telehealth patients and an in-person comparison group from sites with similar rural characteristics and during the same time period. Patient characteristics were collected at treatment initiation, and clinical outcome measures were collected at baseline and monthly. The validated clinical outcome measure instruments included the Patient Health Questionnaire-9 (PHQ-9) for depression symptoms and the Generalized Anxiety Disorder-7 (GAD-7) scale for anxiety-related symptoms. Linear mixed models, with grantee as the random effect, were used to determine the association of behavioral health delivery (telehealth versus in-person) on the one-month change in PHQ-9 and GAD-7 while adjusting for covariates. Results Across a total of 1,514 patients, one-month change scores were improved indicating that PHQ-9 and GAD-7 scores decreased from baseline to the one-month follow-up at similar rates in both the in-person and telehealth groups. Reduction in scores averaged 2.8 for the telehealth treatment group and 2.9 for the in-person treatment group in the PHQ-9 subsample and 2.0 for the telehealth treatment group and 2.4 for the in-person treatment group in the GAD-7 subsample. There was no statistically significant association between the modality of care (telehealth treatment group versus in-person comparison group) and the one-month change scores for either PHQ-9 or GAD-7. Individuals with higher baseline scores demonstrated the greatest decrease in scores for both measures. Upon adjusting for baseline scores and grantee program, patient demographics were not found to be significantly associated with change in anxiety or depression symptoms. Conclusion In our very large pragmatic study comparing behavioral health treatment delivered to a population of patients in rural, underserved communities, we found no clinical or statistical differences in improvements in depression or anxiety symptoms as measured by the PHQ-9 and GAD-7 between patients treated via telehealth or in-person.

Introduction: Awareness of psychological disorders such as smartphone addiction, anxiety, and depression is a trending research area in the scientific community that has further escalated with the impact of COVID-19. In this regard, young adults and medical students are already considered to be under a high level of stress academically and culturally. This study aimed to investigate the relationship between depression, anxiety, and smartphone addiction among medical students in Jordan. Methods: A cross-sectional study was conducted using an online structured questionnaire. The survey was completed by 164 male and female medical students stratified by years one to three in the basic medical sciences. The survey consisted of items from the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and Smartphone Addiction Scale-Short Version (SAS-SV), in addition to two questions concerning the impact of the COVID-19 pandemic on smartphone addiction. Results: Among the students who participated, the mean age was 18.9, with almost half (47.2%) being first-year students. The results showed no significant difference in stress, anxiety or cell phone addiction based on gender or academic year. The logistic regression model was not statistically significant regarding the covariates, except for GAD, which had an OR=1.15 (CI: 1.06 -1.25). Furthermore, SASSV was positively correlated with GAD-7 and PHQ-9 scores (r=0.42, r=0.2, p< 0.000, p=0.029, respectively). Conclusions: The results of the study showed a statistically significant positive correlation between smartphone addiction, depression, and anxiety. These variables were not statistically different among medical students in terms of gender and academic year. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has impacted college students worldwide. International students are a significant group of college students in the United States, making up approximately 5% of enrollment. While research has examined the mental health effects of the COVID-19 pandemic on college students, its impact on international students in the U.S. has not been well-documented. This study examined anxiety and depression levels of 170 international students enrolled in three public U.S. universities. Data were collected using the Generalized Anxiety Disorder (GAD-7) survey and the Patient Health Questionnaire (PHQ-9). Over 60% of the sample reported anxiety and depressive symptoms, with 35.1% showing moderate-to-severe anxiety and 32.9% moderate-to-severe depression. Both anxiety and depression were significantly higher among students with a previous history of mental health illness and those with a colleague who contracted COVID-19. In addition, depression was significantly higher for unmarried students. In addition to these significant differences, the prevalence of moderate-to-severe depression and anxiety levels was observed for female students and unmarried or had a family member who contracted the virus. [ABSTRACT FROM AUTHOR]

BackgroundNurses/midwives and Community Health Volunteers (CHVs) are exposed to chronic stressors putting them at risk of developing mental health problems. This has been exacerbated by the COVID-19 pandemic. There is limited empirical evidence of the burden of mental health problems among health care workers partly due to the lack of adequately standardized and validated measures for use among health care workers in Sub-Saharan Africa. This study aimed to perform the psychometric evaluation of the PHQ-9 and GAD-7 administered to nurses/midwives and CHVs across 47 counties in Kenya.MethodsBetween June and November 2021, a national survey on mental well-being and resilience among nurses/midwives and CHVs was conducted via telephone interviews. The survey had a total sample size of 1907 nurses/midwives and 2027 CHVs. Cronbach’s alpha and MacDonalds’ omega were used to evaluate the scale’s internal consistency. Confirmatory Factor Analysis (CFA) was used to test the one-factor structure of the scales. Multi-group CFA was applied to evaluate the generalizability of the scales across the Swahili and English versions, and among male and female health workers. The Spearman correlation was used to assess the tools’ divergent and convergent validity.ResultsThe internal consistency of PHQ-9 and GAD-7 was good, with alpha and omega values above 0.7 across study samples. CFA results indicated a one-factor structure of the PHQ-9 and GAD-7 for both nurses/midwives and CHVs. Multi-group CFA showed that both scales were unidimensional across both language and sex. The PHQ-9 and GAD-7 were positively correlated with perceived stress, burnout, and post-traumatic stress disorder, indicating convergent validity. The PHQ-9 and GAD-7 were significantly negatively correlated with resilience and work engagement, supporting divergent validity.ConclusionThe PHQ-9 and GAD-7 are unidimensional, reliable, and valid tools for screening depression and anxiety among nurses/midwives and CHVs. The tools can be administered in a similar population or study setting using either Swahili or English.

Abstract Objective The aim of this study was to test factor structure, measurement invariance, and concurrent validity of the nine item Patient Health Questionnaire-9 (PHQ-9) and the seven item Generalized Anxiety Disorder scale-7 (GAD-7) in a heterogeneous outpatient sample. Method Outpatients completed the PHQ-9, GAD-7, and the Working Social Adjustment Scale (WSAS) before starting treatment. Study design was cross-sectional, with convenience sampling. The total sample consisted of 831 participants (61% women). Results Both PHQ-9 and GAD-7 demonstrated better fit statistics with two-factor and bifactor solutions consisting of a cognitive and somatic factor. Omega hierarchical was .78 for PHQ-9 and .81 for GAD-7. Both instruments achieved scalar invariance across gender, diagnosis, and comorbidity. However, the somatic factors demonstrated poor discriminant validity. These factors are not well separatable and risks being too similar if used together. The general factors of both instruments were most associated with functional impairment, although PHQ-9 demonstrated a stronger association with WSAS (γ = .74, r 2 = .62) than GAD-7 (γ = .54, r 2 = .32). Using latent mean difference, women and patients with comorbidity had significantly higher scores of both depression and anxiety. Conclusion This study shows that the PHQ-9 and GAD-7 may be used as one-dimensional instruments in clinical settings. Tests for measurement invariance supported that both measures are understood and interpreted comparably across gender and diagnostic subgroups.

Screening tools such as the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) could potentially be used in resource-limited settings to identify adolescents who need mental health support. We examined the criterion validity of the isiXhosa versions of the PHQ-9 and GAD-7 in detecting depression and anxiety among adolescents (10–19 years) in South Africa. Adolescents were recruited from the general population and from nongovernmental organizations working with adolescents in need of mental health support. The PHQ-9 and GAD-7 were culturally adapted and translated into isiXhosa and administered to 302 adolescents (56.9% female). The Kiddie Schedule for Affective Disorders and Schizophrenia was administered by trained clinicians as the gold standard diagnostic measure for depression and anxiety. For the PHQ-9, the area under the curve was 0.88 for the full sample of adolescents (10–19 years old). A score of ≥10 had 91% sensitivity and 76% specificity for detecting adolescents with depression. For the GAD-7, the area under the curve was 0.78, and cutoff scores with an optimal sensitivity-specificity balance were low (≥6). A score of ≥6 had 67% sensitivity and 75% specificity for detecting adolescents with anxiety. The culturally adapted isiXhosa version of the PHQ-9 can be used as a valid measure for depression in adolescents. Further research on the GAD-7 for use with adolescents is recommended. [ABSTRACT FROM AUTHOR]

Intraindividual change over time is commonly used to estimate treatment effectiveness. However, patients may not respond similarly to a scale after treatment, rendering pre–post change an unreliable metric. The current objective was to investigate longitudinal measurement invariance of the Patient Health Questionnaire–9 and Generalized Anxiety Disorder Scale–7 among 4,323 patients completing a partial hospital program. We used confirmatory factor analysis to determine (1) factor structure at pretreatment and posttreatment and (2) longitudinal invariance, accounting for dependent observations, using both classical and approximate measurement invariance approaches. Results indicated a two-factor solution for both scales. Longitudinal invariance was not established for either scale, thus, using raw score differences from the Patient Health Questionnaire–9 and Generalized Anxiety Disorder Scale–7 for measuring symptom change over time may be problematic. The most longitudinally consistent items captured somatic as opposed to affective/cognitive symptoms. We discuss the potential use of these measures for diagnostic screening and between-group comparisons and suggest alternative ways to monitor client progress over time. Limitations included a majority White sample and uniqueness of a partial hospital setting. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this non interventional study was to define changes in anxiety, depression, and sleep quality of medical students in their first two years of medical school while considering potential risk factors of self-reported chronic disease, sleep quantity, year of medical school and exercise habits. Since this study was ongoing during the COVID-19 pandemic, its effect was also evaluated.Participants: /METHODS: A cohort of 197 medical students was evaluated longitudinally using survey methods to quantify changes from pre-medical school and summer break to each semester in medical school throughout years one and two. This study was performed from July 2019 through June 2021. Data was analyzed using Generalized Linear Mixed Models (GLMMs) on the numeric responses of General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Sleep Quality (SQ-3) and Pittsburg Sleep Quality Index (PSQI). Additional assessments evaluated exercise habits, chronic disease, and impact of COVID-19 Pandemic. The COVID-19 Pandemic was evaluated directly in the model (pre- and post-COVID-19 period variable), and through additional questions on their perceived effect.Results: Depression, anxiety, and sleep habits displayed a cyclical change that was associated with the academic/seasonal cycle. The COVID-19 pandemic was never found significant. Medical students who had a chronic disease diagnosis and fewer hours of sleep had increased severity. Exercise did not play a role.Conclusion: Based on our sample, the main driver for depression, anxiety, and poor sleep quality appears to be the academic/seasonal cycle, while the COVID-19 pandemic did not have an impact on mental health. [ABSTRACT FROM AUTHOR]

Depression and anxiety are common and often co-occur. The PHQ-9 and GAD-7 scales are frequently used to measure symptoms and track treatment response in these conditions. These instruments show substantial correlation. This study investigates the similarity between concurrent pairs of PHQ-9 and GAD-7 when used to monitor treatment outcomes. Data originated from a clinical registry within a behavioral health collaborative care program for a large primary care network. A total of 31,974 pairs of PHQ-9 and GAD-7 scores, from 5402 patient care episodes, were analyzed for correlation coefficient, distribution of score differences, and overlap in symptom burden categories. A Number Needed to Identify was calculated to quantify the marginal effect of performing both scales. The correlation coefficient (Spearman's rho) was 0.74. 78.4% of concurrent scores were within 4 points of each other, and 56.4% of score pairs fell into the same severity class. The Number Needed to Identify for PHQ-9 was 8 while the NNI for GAD-7 was 14.1. Concurrent pairs of PHQ-9 and GAD-7 were strongly associated and often similar in severity. In terms of identifying clinically significant symptoms, the marginal effect of using both measures appears moderate. [ABSTRACT FROM AUTHOR]

Abstract Background The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) are self-report measures of major depressive disorder and generalised anxiety disorder. The primary aim of this study was to test for differential item functioning (DIF) on the PHQ-9 and GAD-7 items based on age, sex (males and females), and country. Method Data from nationally representative surveys in UK, Ireland, Spain, and Italy (combined N = 6,054) were used to fit confirmatory factor analytic and multiple-indictor multiple-causes models. Results Spain and Italy had higher latent variable means than the UK and Ireland for both anxiety and depression, but there was no evidence for differential items functioning. Conclusions The PHQ-9 and GAD-7 scores were found to be unidimensional, reliable, and largely free of DIF in data from four large nationally representative samples of the general population in the UK, Ireland, Italy and Spain.

Background: Prevalence trends from Arabic speaking countries on psychiatric symptoms before and after the first wave of the COVID-19 pandemic are lacking. We estimated the point prevalence and change in depression and anxiety symptoms scores in relation to sociodemographic variables following the resolution of the first wave in Qatar compared with before the pandemic.Methods: We conducted a trend analysis using repeated nationally representative cross-sectional surveys spanning 2017, 2018, 2020/2021 and using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) to assess depressive and anxiety symptoms. Negative binomial regression was used to model changes in these symptoms in relation sociodemographics and survey year.Results: The two-week prevalence of depressive symptoms (≥10 on the PHQ-9) was 6.6% in 2017 and 6.5% in 2020/2021 (p = 0.986). The two-week prevalence of anxiety symptoms (≥10 on the GAD-7) was 3.6% in 2018 and 5.1% in 2020/2021 (p = 0.062). The data for 2020/21 showed a 35.1% and 29.2% decrease in depression and anxiety symptoms scores compared to pre-pandemic years (2017/2018) after adjusting for sociodemographic factors.Limitations: Screening tools rather than structured interviews were used to assess depressive and anxiety symptoms CONCLUSIONS: The prevalence of depression and anxiety after the first COVID wave did not differ significantly to pre-pandemic estimates. The end of the first wave of the pandemic weakened the associations of these symptoms with traditional sociodemographic risk factors. The 2020/21 depression and anxiety symptoms scores remained high for Qataris and Arabs, suggesting that these cultural groups may benefit most from public mental health interventions. [ABSTRACT FROM AUTHOR]

Background: The Patient Health Questionnaire (PHQ-9), the Beck Depression Inventory (BDI-II) and the Generalised Anxiety Disorder Assessment (GAD-7) are widely used in the evaluation of interventions for depression and anxiety. The smallest reduction in depressive symptoms that matter to patients is known as the Minimum Clinically Important Difference (MCID). Little empirical study of the MCID for these scales exists. Methods: A prospective cohort of 400 patients in UK primary care were interviewed on four occasions, 2 weeks apart. At each time point, participants completed all three questionnaires and a 'global rating of change' scale (GRS). MCID estimation relied on estimated changes in symptoms according to reported improvement on the GRS scale, stratified by baseline severity on the Clinical Interview Schedule (CIS-R). Results: For moderate baseline severity, those who reported improvement on the GRS had a reduction of 21% (95% confidence interval (CI) −26.7 to −14.9) on the PHQ-9; 23% (95% CI −27.8 to −18.0) on the BDI-II and 26.8% (95% CI −33.5 to −20.1) on the GAD-7. The corresponding threshold scores below which participants were more likely to report improvement were −1.7, −3.5 and −1.5 points on the PHQ-9, BDI-II and GAD-7, respectively. Patients with milder symptoms require much larger reductions as percentage of their baseline to endorse improvement. Conclusions: An MCID representing 20% reduction of scores in these scales, is a useful guide for patients with moderately severe symptoms. If treatment had the same effect on patients irrespective of baseline severity, those with low symptoms are unlikely to notice a benefit. Funding: Funding. National Institute for Health Research. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to test factor structure, measurement invariance, and concurrent validity of the nine item Patient Health Questionnaire-9 (PHQ-9) and the seven item Generalized Anxiety Disorder scale-7 (GAD-7) in a heterogeneous outpatient sample. Method: Outpatients completed the PHQ-9, GAD-7, and the Working Social Adjustment Scale (WSAS) before starting treatment. Study design was cross-sectional, with convenience sampling. The total sample consisted of 831 participants (61% women). Results: Both PHQ-9 and GAD-7 demonstrated better fit statistics with two-factor and bifactor solutions consisting of a cognitive and somatic factor. Omega hierarchical was.78 for PHQ-9 and.81 for GAD-7. Both instruments achieved scalar invariance across gender, diagnosis, and comorbidity. However, the somatic factors demonstrated poor discriminant validity. These factors are not well separatable and risks being too similar if used together. The general factors of both instruments were most associated with functional impairment, although PHQ-9 demonstrated a stronger association with WSAS (γ =.74, r2 =.62) than GAD-7 (γ =.54, r2 =.32). Using latent mean difference, women and patients with comorbidity had significantly higher scores of both depression and anxiety. Conclusion: This study shows that the PHQ-9 and GAD-7 may be used as one-dimensional instruments in clinical settings. Tests for measurement invariance supported that both measures are understood and interpreted comparably across gender and diagnostic subgroups. [ABSTRACT FROM AUTHOR]

Background: Since the irruption of the coronavirus disease 2019 (COVID-19) the planet has submerged in a time of concern and uncertainty, with a direct impact on people's mental health. Moreover, the recurrent outbreaks that periodically harry different regions of the world constantly refocus people's concerns to the pandemic. Yet, each new wave heats the diverse countries in different situations, including the advances in their vaccination campaigns. In this research, we studied the levels of the general anxiety disorder (GAD) and depression in the Argentine population across the first and second waves of infections that occurred in our country. Methods: We conducted an on-line survey, within each peak of the pandemic. People were asked to self-report GAD and depression symptoms using the GAD-7 and PHQ-9 questioners, inform their vaccination status, the frequency they performed physical activity as well as working condition and modality. Here, we identified the more vulnerable groups and evaluated factors that could mitigate the rise of these mental disorders, focusing on vaccination. Results: Our data shows that reported GAD and depression levels were higher during the second wave than during the first one. More importantly, vaccinated people were less depressed than non-vaccinated people, while GAD levels remained equivalent in both groups. Other factors directly associated with lower GAD and depression levels were performing frequent physical activity and being employed, regardless of the employment modality. These observations were replicated in different age ranges and genders. Conclusion: This work evidences GAD and depression in different pandemic waves in Argentina, as well the factors that may contribute to reducing the magnitude of these disorders, including vaccination. [ABSTRACT FROM AUTHOR]

Head and neck cancers (HNC) have higher rates of emotional distress than other cancer types and the general population. This paper compares the prevalence of emotional distress in HNC across various distress screening measures and examines whether significant distress or distress screening are associated with cancer-related survival. A retrospective observational cohort design was employed, with data collected from the Distress Assessment and Response Tool (DART) and linkages to administrative databases from 2010 to 2016. Descriptive and prevalence data were reported using multiple concurrently administered distress tools, including the Patient Health Questionaire-9 (PHQ-9), Generalized Anxiety Disorders-7 (GAD-7), Edmonton Symptom Assessment Scale-revised (ESAS-r), and MD Anderson Symptom Index-Head and Neck module (MDASI-HN). Across measures, 7.8 to 28.1% of the sample reported clinically significant emotional distress, with PHQ-9 and GAD-7 identifying lowest prevalence of moderate/severe distress, and the ultrashort distress screens within ESAS-r and MDASI-HN performing equivalently. Cox hazards models were used in univariate and multivariate survival analyses. ESAS depression (≥4), but not anxiety, was associated with increased risk of cancer-related mortality and patient completion of DART was associated with greater cancer-related survival. The findings underscore the importance of implementing routine distress screening for HNC populations and the utility of ultra-brief screening measures. [ABSTRACT FROM AUTHOR]

Chronic hepatitis C (CHC) is an ongoing epidemiological problem. The hepatitis C virus (HCV) may infect brain tissue, worsening mental health outcomes. The new era of highly effective oral Direct-Acting Agents (DAA) has brought a chance to eradicate the infection by 2030, however, screening campaigns are urgently needed as the majority of the infected are still undiagnosed. The aim of this study was to assess the prevalence of anxiety and depression among HCV patients, and the correlation with health-related quality of life (HRQoL) in the real-world setting, before and after DAA treatment. Data on anxiety, depression, and HRQoL, were collected by using self-reported questionnaires in a single center in Poland. The study group involved 90 respondents, 50% female, with a mean age of 43.8 years. HCV eradication decreased anxiety prevalence from 30.4% to 19.1% and depression from 35.2% to 18.2%. Significant improvement in 3 out of 4 of the WHOQOL-BREF (TheWorld Health Organization Quality of Life-BREF) domains and 8 out of 10 of the HQLQv.2 domains was obtained. Anxiety diminished the somatic domain scores by 3.5 (p < 0.0001), psychological by 2.3 (p = 0.0062), social by 1.75 (p = 0.0008), and environmental by 2.68 points (p = 0.0029). Depression diminished the somatic domain scores by 3.79 (p < 0.001), psychological by 2.23 (p < 0.001), social by 1.84 (p < 0.001), and environmental by 2.42 points (p = 0.004). In the Hepatitis Quality of Life Questionnaire version 2 (HQLQ v.2), the presence of depression and/or anxiety-impaired mental health, physical health, well-being, and vitality. These results indicate the need for an active search for HCV-infective people, especially among patients in psychiatric and psychological care. [ABSTRACT FROM AUTHOR]