Post-COVID Syndrome and health-related quality of life (HrQoL): A prospective, population-based study
Christian NeumannTim J. HartungKlara BojeThomas BahmerJulian KeilWolfgang LiebKatrin FranzpoetterJulius WelzelIrina Chaplinskaya-SobolMatthias EndresJohanna GeritzKarl Georg HæuslerPeter U. HeuschmannAndréas HinzSina M. HopffAnna HornCarolin NuernbergerLena SchmidbauerMichael KrawczakAnne-Kathrin RußLilian KristThomas KeilJennifer KudelkaCorina MaetzlerAnja MehnertFelipe A. MontellanoCaroline MorbachSein SchmidtJan HeyckendorfFlo SteigerwaldS StoerkChristina LemhoeferStefan SchreiberCarsten FinkeWalter Maetzler
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Long-term changes in health-related quality of life (HrQoL) after SARS-CoV-2 infection are common, but the causes and consequences of these changes are not well understood. HrQoL was assessed using the European Quality-of-Life-5-Dimensions-5-Level-Version (EQ-5D-5L) in 2,618 participants (56% female; aged 18–88 years) approximately 9 months (baseline) and 26 months (follow-up) after their first infection. The results were compared to 40 different demographic and clinical variables. A clinically important improvement in HrQoL was noted during the observation period. At baseline, the number of remaining symptoms from the infection (RS), fatigue (FACIT-Fatigue Scale), depressive symptoms (PHQ-8), muscle pain, age, and anxiety (GAD-7) explained 43% of the variance in HrQoL. At follow-up, fatigue, RS, depressive symptoms, anxiety, and muscle pain explained 50% of the variance. Although changes in fatigue, depressive symptoms, anxiety, and RS were associated with a change in HrQoL, the predictive value of the variables was virtually zero. The study suggests that HrQoL improves statistically significantly during the observation period. However, the extent of recovery is difficult to predict from concurrent changes in demographic and clinical variables. Besides a high RS number, fatigue is the main predictor of poor HrQoL after infection, followed by the presence of depressive and anxiety symptoms.Keywords:
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Background: To assess anxiety symptoms in pregnant women living in the quarantine conditions in Greece, due to the COVID-19 pandemic.Methods: All pregnant women that received routine antenatal care in a university clinic following total lockdown in Greece were eligible to participate in the study. The Greek version of the State-Trait Anxiety Inventory (Form Y) was employed. Associated risk factors for maternal anxiety were also investigated.Results: In total, 146 women consented to participate in the survey. Αnxiety in pregnancy was estimated to affect 53.4% of the participants (S-Anxiety) whereas lifetime anxiety (T-Anxiety) was reported in 34.2% of the women (p<0.001). Moreover, the median S-Anxiety score was higher than the median T-Anxiety value [40 (range 21-67) versus 34 (range 23-67) respectively; p<0.001], thus indicating a significant increase in anxiety levels during the lockdown. For S-anxiety, 28.1% of the women were classified as non-anxious (score<35), 35.6% with mild anxiety (score 35-45), 20.5% with moderate anxiety (score 46-55), 12.3% with high anxiety (score 56-65) and 3.4% with very high anxiety (score > 65). The number of weeks after lockdown (first week - OR: 6.924; 95% CI: 2.807-17.027, second week - OR: 2.654; 95% CI: 1.138-6.192, third week – OR: 1.000) and smoking (OR: 3.815; 95% CI: 1.215-11.985) in pregnancy were identified as independent risk factors for anxiety. No differences were found in the incidence of anxiety between the three trimesters of pregnancy.Conclusion: A significant increase in anxiety levels during the lockdown was observed in pregnant women, with the increase being highest in the first week of the quarantine, gradually regressing in the second and reaching almost normal levels in the third week. This finding may be associated with the effective mitigation measures on the spread of the disease in Greece.Funding Statement: None.Declaration of Interests: None to declare.Ethics Approval Statement: The research complied with all the relevant national regulations, institutional policies and in accordance with the tenets of the Helsinki Declaration. Moreover, the study protocol was approved by the bioethics committee of the Aristotle University of Thessaloniki and a written informed consent was necessary in order to participate.
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Background: driving anxiety and fear can have a marked impact on mobility and independence, although there is no data on the prevalence of this problem, and specific information about the rate of driving anxiety and fear in older adults is unknown. Methods: the present study examines the prevalence of self-reported driving anxiety and fear in a sample of 2,491 adults aged 55–72 from a longitudinal survey of health and ageing in New Zealand. Results: most of the sample (90%) described themselves as drivers who drove daily or weekly. Around 70% of the sample reported no driving anxiety or fear, yet 17–20% endorsed a mild and 4–6% rated a moderate to severe level of driving anxiety and fear. Women reported higher levels of anxiety and fear about driving than men, but there were no age differences. Those who reported some level of driving anxiety engaged various alternative modes of transport, and a small number (2.4%) reported that their driving anxiety had affected their usual activities or work for at least a day in the previous month. Duration of driving anxiety was highly variable, from relatively recent onset to being present for much of some participants' lifetimes. Conclusion: driving anxiety and fear may be a significant problem for some young older adults that is likely to affect their independence and mobility. Further research to clarify the content and nature of driving anxiety, pathways to driving anxiety and the effect of factors associated with ageing on driving anxiety is needed in order to better understand this experience for older adults and develop effective interventions.
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Many cancer patients are anxious even when disease is in remission. Anxiety about health, ‘health anxiety’, has distinct features, notably seeking medical reassurance about symptoms. Doctors may then communicate that these symptoms are not due to serious illness, a process known as ‘reassurance’. However, reassurance may inadvertently perpetuate some patients' anxiety. We aimed to observe the relation between symptoms, anxiety and reassurance in consultations with cancer patients. A total of 95 outpatients, with breast or testicular cancers in remission, completed questionnaires measuring health anxiety at study entry, then general anxiety – before a consultation, immediately afterwards, 1 week later, and before their next consultation. We examined symptoms reported and reassurance by oncologists from audio recordings of consultations, and the outcome of subjects' anxiety. The results showed that substantial health anxiety was reported by one-third of the patients. Patients with higher levels of health anxiety reported more symptoms during consultations. Reassurance was ubiquitous, but not followed by an enduring improvement in anxiety. Certain forms of reassurance predicted increased anxiety over time, particularly for subjects who were most anxious. In conclusion, health anxiety can be a problem after cancer. Reassurance may not reduce patients' anxiety. Some reassurance was counterproductive for the most anxious patients. Oncologists may need to use reassurance as a procedure, balancing risk, and benefits, and patient selection and to manage cancer patients in remission.
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Purpose: The purpose of this article is to investigate how age-related macular degeneration (AMD) is associated with anxiety and depression. Methods: An online repository of deidentified patient data was queried to identify and retrospectively analyze patients with AMD, depression, or anxiety via ICD-9 and ICD-10 codes. Odds ratios were calculated between AMD and anxiety and depression, respectively. Results: Of the 51 019 patients analyzed in this study, 11 681 (22.9%) had depression, 8727 (17.1%) had anxiety, and 2752 (5.4%) had AMD. The prevalence of anxiety among AMD patients was 18.2%, and the prevalence of depression among AMD patients was 25.0%. The odds of a patient with AMD carrying a diagnosis of anxiety are 1.3 (95% CI 1.2, 1.5) times higher than a patient without AMD, and the odds of carrying a diagnosis of depression are also 1.3 (95% CI 1.1, 1.4) times more likely. Conclusions: Patients with AMD have increased odds of suffering from comorbid anxiety and depression. Ophthalmologists should consider mental health screens and appropriate referrals as new diagnoses of AMD are made or as the disease progresses.
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In order to help nurse to identify the difference between anxiety reaction and nervous anxiety, grasp the key points of anxiety's identification and interference skills of anxiety, and offer scientific and effective psychological nursing to patients, the paper stated clinical features and identification of common anxiety systematically, focusing on clinical features and countermeasures of hospitalization anxiety, operative anxiety, separation anxiety, comprehensive anxiety.
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Objective To investigate the incidence of type 2 diabetic inpatients' anxiety and depression,and discuss the treatment effect of health education.Methods We investigated the anxiety and depression of type 2 diabetic inpatients between January 2009 and May 2012,gave health education to the anxious and depressed patients,and reevaluation was carried out when the patients were discharged from the hospital.Results The result showed that 22.45% of the type 2 diabetic inpatients had anxiety,and 11.37% of them had depression.After the health education,the number of anxious patients was markedly reduced(P 0.05),especially in patients with mild and moderate anxiety,but it had no distinct improvement in severely anxious patients.To all the depressed patients,health education had bad curative effect,especially in those with moderate and serious depression.Conclusion Anxiety and depression have high incidence in type 2 diabetic inpatients,and health education is an effective treatment for patients with mild and moderate anxiety.
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Abstract Conflicting results are reported regarding the prevalence of depression in myasthenia gravis (MG) compared to the general population. One suggestion is that the psychiatric instruments used to assess depression confounded symptoms of disease activity with common features of depression. Objectives: We investigated the prevalence of depression in MG using psychiatric instruments that allowed for delineation between a patient's medical and psychological state. Methods: Thirty-six patients with MG and 20 patients with neurologic and neuromuscular diseases (NNMD) were evaluated with 3 self-administered depression scales and a psychiatric interview. Results: Patients with MG had a similar prevalence of depression as that of patients with NNMD. Both groups showed a higher prevalence of depression compared to the general population, which was a frequency similar to a population with chronic illness. No difference was observed between the 2 groups in the physical symptoms of depression. Conclusion: This suggests the physical symptoms of depression do not influence the depression rates in MG when compared to NNMD.
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Review question: What is the effectiveness of bright light therapy (BLT) on depressive symptoms in older adults with non-seasonal depression? Review objective: The review objective is to determine the current evidence related to the effectiveness of BLT on depressive symptoms in older adults with non-seasonal depression.
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