This study examines the processes linking physical impairment with symptoms of anxiety. Analyses are based on a representative sample of 967 physically disabled adults (ages 20 to 90) from ten counties of southwestern Ontario, Canada Several hypotheses test the intervening role of disability characteristics, perceived health care efficacy, personal attributes, and social stratification resources. Ordinary least squares (OLS) regression analyses included sets of those intervening variables entered sequentially. Adjustment produces a significant reduction in the association between symptoms of anxiety and impairment--confirming the intervening role of healthcare efficacy and mastery. Moreover, impairment and mastery have synergistic effects such that higher mastery buffers against the anxiety associated with higher impairment. Other findings raise important questions about age, impairment, and the sense of mastery in the contest of healthcare and gender.
In this essay, the prevalence, negative health implications, and clinical management of geriatric anxiety are reviewed. Despite disproportionately high rates of anxiety amongst the elderly, little research effort has been directed at this problem. An interactive model of geriatric anxiety is proposed, whereby physical disease and anxiety processes enter into reciprocal stimulation as a function of 1) diminished capacity to withstand stress, and 2) hypervigilance of stress symptomatology. To date, pharmacotherapy has been virtually the sole approach to managing geriatric anxiety, although special hazards accrue to the elderly when anxiolytics are used. Potentially useful psychological treatments including relaxation, cognitive restructuring, activity structuring, and prevention are outlined. It is concluded that the potential human and financial rewards of increased understanding and control or geriatric anxiety are substantial.
Cystic fibrosis (CF) is the most common autosomal recessive life-shortening disease among Caucasians. Studies exploring the prevalence of anxiety and depression in adult CF patients are few, show inconsistent findings and rarely include comparisons with general populations. Prevalence and degree of anxiety and depression were investigated in adult CF patients in Sweden, Belgium, Germany and the UK, and compared to corresponding general population data.
Adult non-transplanted CF patients from the three largest CF-centres (out of four) in Sweden (N = 129; Age range 18-70 years; 50 % women) completed the Hospital Anxiety and Depression Scale (HADS). Studies using HADS in adult CF populations in the UK, Germany, and Belgium were included, as well as HADS normative data from the corresponding general populations.
No elevated risk for anxiety and depression was found among the CF patients. However, a Country x Group interaction effect emerged; CF patients experienced a higher degree of anxiety than the general population in Sweden, but not in the other countries, though this finding did not remain significant in a logistic regression analysis. In Sweden the effect was limited to women. A Country x Group interaction effect was also found for Depression; CF patients experienced lower degree of depression than the general population in Sweden, Germany and the UK, but not in Belgium/Netherlands.
Contrary to earlier outcomes, the present results do not indicate any general elevated risk for anxiety and depression among CF patients. Anxiety was slightly higher in the Swedish CF population, compared to the general population; this finding was not seen in the other countries. Depression among CF patients was lower than or similar to that in the general populations in the studied countries.
We investigated the associations between symptoms of anxiety and depression and alcohol drinking behavior among adolescents, by focusing on the importance of symptom load, as well as gender differences.
Data was derived from a cross-sectional school based survey among adolescents in upper secondary schools in Norway. Among other variables adolescents reported on symptoms of anxiety and depression, time of onset and extent of alcohol use. The sample consisted of 6238 adolescents aged 16-18 years. We estimated prevalence of alcohol drinking behaviors in relation to severity of symptoms of anxiety and depression.
Higher levels of depression symptoms were associated with earlier onset of alcohol use, more frequent consumption and intoxications. The associations between anxiety and depression symptoms and early drinking onset were stronger for girls than for boys. Higher levels of anxiety symptoms were only associated with alcohol consumption among girls.
Boys and girls with depressive symptoms and girls with anxiety symptoms are more likely to have unhealthy patterns of alcohol drinking. Preventive strategies at all levels could possibly profit from a common approach to mental health and alcohol use, in particular for girls in mid-adolescence.
The study was to determine the association between mental health and the incidence of injury among Canadian immigrants and non-immigrants. We used data from 15,405 individuals aged 12 years or more, who were living in British Columbia, Canada, and participated in the 2007-2008 Canadian Community Health Survey (CCHS). We calculated a 12-month cumulative incidence of fall injury based on self-reporting. Logistic regression model was used to examine the association of the 12-month cumulative incidence of fall injury with immigration status and mental health before and after adjustment for covariates. The results show that self-reported mood and anxiety disorders were significantly associated with an increased incidence of fall injury. The adjusted odds ratios were 1.81 (95% CI: 1.37, 2.38) for mood disorder and 1.55 (95% CI: 1.12, 2.13) for anxiety disorder. Immigrant status was a significant effect modifier for the association between mental health and fall injury, with stronger associations in immigrants than in non-immigrants especially in elderly people. People with poor self perceived health were more likely to have a fall injury. Both mental health and general health were related to fall injury. There was a stronger association between mental health and fall injury in immigrants compared with non-immigrants in the elderly. More attention should be paid to mental health in immigrants associated with fall injury.
This study compared whether self-reported mental health status was associated with likelihood of being abstinent from alcohol and drugs five years after baseline assessment for an addiction disorder in two representative samples; one from Sweden (n = 469) and one from the US (n = 667). Self-reported mental health status was measured through the ASI score of mental health symptoms and history of inpatient and/or outpatient treatment. Through logistic regression modeling the study controlled for demographic characteristics including age, gender, employment status and social network connection with individuals who do not use alcohol/drugs. For both the US and Swedish samples employment status and having a social network that does not use alcohol and drugs were associated with being likely to be abstinent from alcohol and drugs five years after initial assessment. For the US sample only, individuals who reported symptoms of anxiety were 50% more likely not to be abstinent from alcohol and drugs at follow-up. For the Swedish sample, current mental health status was not significantly associated with abstinence. However, reporting a lifetime history of inpatient psychiatric treatment at the baseline assessment was significantly associated with not being abstinent at 5 years post assessment; those with a lifetime history of inpatient mental health treatment were 47% less likely to report abstinence. While specific variables differ across Sweden and the US, psychiatric comorbid status, employment and social network are each associated with drug and alcohol abstinence cross-nationally.
A mailed questionnaire assessed personality traits of a cohort of 194 subjects followed from 1988 to 1998 measured by the Karolinska Scales of Personality and Sense of Coherence Scale, medical symptoms, and 3 VAS scales on Perceived Psychosocial Work Satisfaction. Subjects initially worked in 19 Swedish buildings with indoor environmental problems. There was a relatively high correlation between SOC scores and KSP scale scores (R2=.54 in men and .55 in women), and there was a sex-KSP interaction on the association between the two sets of scores. An increase of symptom score (SC difference) during the follow-up period was associated with higher psychic anxiety (p
There is a higher prevalence of anxiety and depression among adults with lower educational attainment. Delayed completion of high school (HS) is common and represents a potentially complicating factor in the relationship between educational attainment and anxiety and depression. This study aims to investigate whether delayed HS completion is associated with symptom levels of anxiety and depression in adulthood and whether it interacts with later educational attainment in predicting symptom-levels of anxiety and depression in adulthood.
The sample consisted of 10 149 participants from the Nord-Trøndelag Health Survey (HUNT 3) between 30 and 46 years of age in 2006. The outcome variables were symptoms of anxiety and depression as measured by the HADS scale. Variables measuring educational attainment were obtained from the National Educational Database in Norway. We used linear regression to estimate associations between educational attainment, delayed HS completion and symptom levels of anxiety and depression in adulthood.
We found delayed HS completion to be associated with higher symptom levels of both anxiety and depression. There was a dose-response association suggesting that each additional year of delay in HS was associated with higher symptom levels for both anxiety and depression. Mean symptom levels of both anxiety and depression were significantly lower among individuals who completed HS within a normative timeframe vs those who were substantially delayed in their HS completion. For anxiety symptoms, we found a statistically significant interaction between delayed HS completion and later educational attainment. This interaction suggested that individuals with a combination of being delayed in HS and having no higher educational attainment had significantly higher levels of anxiety symptoms than all other combinations of later educational attainment and normative/delayed HS completion. For depression, associations between predictors and symptom levels were additive.
Delayed HS completion is associated with symptom levels of both depression and anxiety and interacts with later educational attainment in predicting symptom levels of anxiety. Individuals with a combination of delayed HS completion and lower educational attainment had particularly high symptom levels of anxiety.
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Night work has been reported to be associated with various mental disorders and complaints. We investigated relationships between night work and anxiety, depression, insomnia, sleepiness and fatigue among Norwegian nurses.
The study design was cross-sectional, based on validated self-assessment questionnaires. A total of 5400 nurses were invited to participate in a health survey through the Norwegian Nurses' Organization, whereof 2059 agreed to participate (response rate 38.1%). Nurses completed a questionnaire containing items on demographic variables (gender, age, years of experience as a nurse, marital status and children living at home), work schedule, anxiety/depression (Hospital Anxiety and Depression Scale), insomnia (Bergen Insomnia Scale), sleepiness (Epworth Sleepiness Scale) and fatigue (Fatigue Questionnaire). They were also asked to report number of night shifts in the last 12 months (NNL). First, the parameters were compared between nurses i) never working nights, ii) currently working nights, and iii) previously working nights, using binary logistic regression analyses. Subsequently, a cumulative approach was used investigating associations between NNL with the continuous scores on the same dependent variables in hierarchical multiple regression analyses.
Nurses with current night work were more often categorized with insomnia (OR = 1.48, 95% CI = 1.10-1.99) and chronic fatigue (OR = 1.78, 95% CI = 1.02-3.11) than nurses with no night work experience. Previous night work experience was also associated with insomnia (OR = 1.45, 95% CI = 1.04-2.02). NNL was not associated with any parameters in the regression analyses.
Nurses with current or previous night work reported more insomnia than nurses without any night work experience, and current night work was also associated with chronic fatigue. Anxiety, depression and sleepiness were not associated with night work, and no cumulative effect of night shifts during the last 12 months was found on any parameters.
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The aim of the present study was to investigate associations between problematic gaming and psychiatric symptoms among adolescents. Data from adolescents in the SALVe cohort, including adolescents in Västmanland who were born in 1997 and 1999 (N=1868; 1034 girls), and data from consecutive adolescent psychiatric outpatients in Västmanland (N=242; 169 girls) were analyzed. Adolescents self-rated on the Gaming Addiction Identification Test (GAIT), Adult ADHD Self-Report Scale Adolescent version (ASRS-A), Depression Self-Rating Scale Adolescent version (DSRS-A), Spence Children's Anxiety Scale (SCAS), and psychotic-like experiences (PLEs). Multivariable logistic regression analyses were performed, and adjusted for sex, age, study population, school bullying, family maltreatment, and interactions by sex, with two-way interactions between psychiatric measurements. Boys had higher self-rated problematic gaming in both samples, whereas girls self-rated higher in all psychiatric domains. Boys had more than eight times the probability, odds ratio (OR), of having problematic gaming. Symptoms of ADHD, depression and anxiety were associated with ORs of 2.43 (95% CI 1.44-4.11), 2.47 (95% CI 1.44-4.25), and 2.06 (95% CI 1.27-3.33), respectively, in relation to coexisting problematic gaming. Problematic gaming was associated with psychiatric symptoms in adolescents; when problematic gaming is considered, the probability of coexisting psychiatric symptoms should also be considered, and vice versa.