Anxiety disorders

焦虑症
  • 文章类型: Journal Article
    个性化医疗已成为21世纪医疗保健的革命性方法。通过了解患者独特的遗传和生物学特征,它旨在为个人量身定制治疗方法。这种方法考虑了个人的生活方式等因素,基因构成,和环境因素,以提供靶向治疗,有可能更有效,降低副反应或无效治疗的风险。这是从传统的“一刀切”医学方法的范式转变,症状或诊断相似的患者接受相同的标准治疗,而不管他们的差异。它可以改善临床结果并更有效地利用医疗保健资源。药物再利用是一种使用现有药物治疗新适应症的策略,旨在利用已知的安全性,药代动力学,以及这些药物的作用机制,以加速开发过程。因此,精准医学可能会发生革命性的变化,能够利用传统方法无法与之联系的药物快速开发新型治疗计划。在这一章中,我们专注于一些策略,其中药物再利用在精准医学中显示出巨大的成功。该方法在肿瘤学中特别有用,因为癌症患者的遗传物质中有许多变异,所以量身定做的治疗方法有很长的路要走。我们已经讨论过乳腺癌的病例,胶质母细胞瘤和肝细胞癌。除此之外,我们还研究了焦虑症和COVID-19的药物再利用方法。
    Personalized medicine has emerged as a revolutionary approach to healthcare in the 21st century. By understanding a patient\'s unique genetic and biological characteristics, it aims to tailor treatments specifically to the individual. This approach takes into account factors such as an individual\'s lifestyle, genetic makeup, and environmental factors to provide targeted therapies that have the potential to be more effective and lower the risk of side reactions or ineffective treatments. It is a paradigm shift from the traditional \"one size fits all\" approach in medicine, where patients with similar symptoms or diagnoses receive the same standard treatments regardless of their differences. It leads to improved clinical outcomes and more efficient use of healthcare resources. Drug repurposing is a strategy that uses existing drugs for new indications and aims to take advantage of the known safety profiles, pharmacokinetics, and mechanisms of action of these drugs to accelerate the development process. Precision medicine may undergo a revolutionary change as a result, enabling the rapid development of novel treatment plans utilizing drugs that traditional methods would not otherwise link to. In this chapter, we have focused on a few strategies wherein drug repurposing has shown great success for precision medicine. The approach is particularly useful in oncology as there are many variations induced in the genetic material of cancer patients, so tailored treatment approaches go a long way. We have discussed the cases of breast cancer, glioblastoma and hepatocellular carcinoma. Other than that, we have also looked at drug repurposing approaches in anxiety disorders and COVID-19.
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  • 文章类型: Journal Article
    焦虑是儿童时期最常见的心理健康问题之一,并对儿童的生活造成严重和持续的损害。1父母可以在儿童焦虑症状的发展中起关键作用2;然而,以父母为中心的干预措施的证据相对较少。3这可能是因为人们对这些干预措施的最佳内容知之甚少。干预措施通常要么使用父母作为外行治疗师,4这些“一揽子交易”干预措施的传统随机试验对哪些特定的父母风险因素应该有针对性,以最有效地减少儿童焦虑的影响。5我们将研究针对不同的父母风险因素的影响,以提供有关这些因素在儿童焦虑中的作用的更多信息。并指导干预计划的制定。
    Anxiety is one of the most common mental health problems in childhood, and causes severe and persistent impairment in children\'s lives.1 Parents can play a key role in the development of children\'s anxiety symptoms2; yet, the evidence of parent-focused interventions is relatively thin.3 This may be because little is known about what the optimal content of these interventions should be. Interventions typically either use parents as lay therapists, or target multiple different family risk factors at the same time.4 Traditional randomized trials of these \"package deal\" interventions provide little insight into what specific parental risk factors should be targeted to most effectively reduce children\'s anxiety.5 We will examine the effects of targeting distinct parental risk factors to provide more information on the role of these factors in children\'s anxiety, and to guide the development of intervention programs.
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  • 文章类型: Journal Article
    目的:病理性妊娠妇女是一类特别容易发生心理并发症的患者。这项研究的目的是评估抑郁症和焦虑症的风险,症状强度与社会支持的关系。
    方法:研究组为妊娠病理科住院患者300例。这项研究是使用状态特质焦虑量表(STAI)进行的,医院焦虑和抑郁量表(HADS),社会支持行为清单(ISSB),和作者构建的社会人口统计问卷。
    结果:研究组受访者的状态焦虑(STAI)水平更高,与对照组相比。对照组的焦虑水平(HADS-A)高于研究组的女性。对照组的社会信息支持水平较高,与研究组相比。研究组受访者的情绪支持水平较低,与对照组相比。仪器支持与生理妊娠妇女的抑郁症状呈负相关。在分娩前住院的妇女中,缺乏评估支持与焦虑显着相关。
    结论:所获得的结果表明,有必要为妊娠病理科雇用的医疗和心理人员进行实质性准备,为住院妇女提供适当的情感和信息支持。
    OBJECTIVE: Women in pathological pregnancy are a group of patients especially exposed to the risk of occurrence of psychological complications. The aim of the study was assessment of the risk of depressive and anxiety disorders, and the relationship between the intensity of symptoms and social support.
    METHODS: The study group were 300 patients hospitalized in the Department of Pathology of Pregnancy. The study was conducted using the State-Trait Anxiety Inventory (STAI), the Hospital Anxiety and Depression Scale (HADS), the Inventory of Socially Supportive Behaviours (ISSB), and an author-constructed socio-demographic questionnaire.
    RESULTS: The level of State Anxiety (STAI) was higher in respondents from the study group, compared to the control group. The level of anxiety (HADS-A) was higher in the control group than in women from the study group. The level of social informational support was higher in those from the control group, compared to those from the study group. The level of emotional support was lower in respondents from the study group, compared to those from the control group. Instrumental support negatively correlated with the symptoms of depression among women in physiological pregnancy. The lack of evaluative support statistically significantly correlated with anxiety among women hospitalized before labour.
    CONCLUSIONS: The results obtained suggest the necessity for the substantive preparation of medical and psychological staff employed in departments of pathology of pregnancy to provide proper emotional and informational support for hospitalized women.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    背景:糖尿病(DM)和抑郁症是全球主要的公共卫生问题。社区环境中很少报道常见的精神障碍(CMD),包括抑郁症和焦虑症与DM的联系。
    目的:本研究旨在研究居住在印度北部农村地区的成年人口(>30岁)中CMD与DM之间的关联。
    方法:在哈里亚纳邦Faridabad区Ballabgarh街区的28个村庄进行了基于社区的病例对照研究。从社区招募患有至少1年糖尿病的病例(糖尿病)。从同一社区中选择年龄和性别匹配的两个邻居对照。使用糖化血红蛋白确认糖尿病状态。使用PRIME-MD印地语版本对抑郁症和焦虑症等CMD进行了筛查。采用条件logistic回归分析糖尿病与CMDs的关系。
    结果:共211例(糖尿病)和273例对照(非糖尿病)进行了研究,其中173例和175例对照进行分析。病例和对照在年龄方面具有可比性,性别,和社会经济地位。与对照组相比,在病例中发现的CMD更多(67.5%vs.37.5%)(P<0.001)。在条件Logistic回归分析中,CMD在糖尿病病例中显著较高(校正比值比-3.2,95%置信区间:1.9-5.2)。
    结论:来自这项基于人群的研究的CMD和DM共存的有力证据表明,印度有必要将CMD管理纳入糖尿病控制计划。
    BACKGROUND: Diabetes mellitus (DM) and depression are major public health problems globally. Evidence of linkage of common mental disorders (CMDs) including depression and anxiety disorders with DM is sparsely reported from community-based settings.
    OBJECTIVE: The present study aimed to study the association between CMDs and DM among adult population (>30 years) residing in a rural area of North India.
    METHODS: A community-based case-control study was conducted in 28 villages of Ballabgarh block of Faridabad district of Haryana. Cases (diabetes) were recruited from the community with at least 1 year of diabetes. Age- and sex-matched two neighborhood controls were selected from the same community. Diabetic status was confirmed using glycated hemoglobin. CMDs such as depression and anxiety disorders were screened using PRIME-MD Hindi version. Conditional logistic regression was used to study the relationship between diabetes and CMDs.
    RESULTS: Total 211 cases (diabetic) and 273 controls (nondiabetic) were approached for the study, of which 173 cases and 175 controls were analyzed. Cases and controls were comparable with respect to age, sex, and socioeconomic status. CMDs were found more among cases as compared to controls (67.5% vs. 37.5%) (P < 0.001). On conditional logistic regression analysis, CMDs were significantly higher among diabetes cases (adjusted odds ratio - 3.2, 95% confidence interval: 1.9-5.2).
    CONCLUSIONS: Strong evidence of coexistence of CMDs and DM from this population-based study necessitates the need of incorporation of management of CMDs into diabetes control program in India.
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  • 文章类型: Journal Article
    多酚是人类饮食中最普遍的天然存在的植物化学物质,其复杂性从简单分子到高分子量聚合物。它们具有广泛的化学结构,通常被归类为“神经保护”,“抗炎”,和“抗氧化剂”,因为它们具有阻止疾病发作和促进健康的主要功能。研究表明,一些多酚及其代谢物可以穿透血脑屏障,从而增加神经保护信号和神经激素作用,从而提供抗炎和抗氧化作用。因此,多靶点调控多酚可预防神经精神疾病的进展,并为难以治疗的神经精神疾病提供新的实用治疗策略.因此,多酚的多靶点调控有可能预防神经精神疾病的进展,并为此类神经系统疾病提供新的实用治疗策略。在这里,我们回顾了多酚对自闭症谱系障碍的治疗益处,焦虑症,抑郁症,和睡眠障碍,以及体外和离体实验和临床试验。尽管他们的行动方法仍在调查中,多酚仍然很少直接用作神经系统疾病的治疗剂。需要全面的机制研究和大规模的多中心随机对照试验来正确评估安全性,有效性,和多酚的副作用。
    Polyphenols are the most prevalent naturally occurring phytochemicals in the human diet and range in complexity from simple molecules to high-molecular-weight polymers. They have a broad range of chemical structures and are generally categorized as \"neuroprotective\", \"anti-inflammatory\", and \"antioxidant\" given their main function of halting disease onset and promoting health. Research has shown that some polyphenols and their metabolites can penetrate the blood-brain barrier and hence increase neuroprotective signaling and neurohormonal effects to provide anti-inflammatory and antioxidant effects. Therefore, multi-targeted modulation of polyphenols may prevent the progression of neuropsychiatric disorders and provide a new practical therapeutic strategy for difficult-to-treat neuropsychiatric disorders. Therefore, multi-target modulation of polyphenols has the potential to prevent the progression of neuropsychiatric disorders and provide a new practical therapeutic strategy for such nervous system diseases. Herein, we review the therapeutic benefits of polyphenols on autism-spectrum disorders, anxiety disorders, depression, and sleep disorders, along with in vitro and ex vivo experimental and clinical trials. Although their methods of action are still under investigation, polyphenols are still seldom employed directly as therapeutic agents for nervous system disorders. Comprehensive mechanistic investigations and large-scale multicenter randomized controlled trials are required to properly evaluate the safety, effectiveness, and side effects of polyphenols.
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  • 文章类型: Journal Article
    背景:重度抑郁症(MDD)的患病率在全球范围内呈上升趋势,使用抗抑郁药物治疗通常不会导致完全缓解。然而,体育锻炼和心理治疗相结合治疗MDD可提高患者的完全缓解率。这个三臂,平行组,双盲随机对照试验(RCT)旨在评估和比较exergame与接受和承诺治疗(e-ACT)方案相结合的效果,仅ACT和照常治疗(TAU)对照组对抑郁和焦虑症状的严重程度,经验性回避程度和生活质量(QoL)以及抑郁症生物标志物的血清水平(例如脑源性神经营养因子,C反应蛋白和血管内皮生长因子)在三个时间点的MDD患者中。
    方法:本次RCT将招募126名MDD患者,使用分层排列区组随机化方法将其随机分为三组,这是合并的电子行动方案,仅ACT和TAU控制组的分配比例为1:1:1。e-ACT和仅ACT干预组的参与者将每周接受一次干预会议,为期8周。评估将在三个时间点进行,例如干预前评估(T0),在完成干预后8周(t1)立即进行评估,并在完成干预后24周进行评估(t2)。在每次评估中,要评估的主要结果包括抑郁症状的严重程度,而要评估的次要结果是焦虑症状的严重程度,经验性回避,QoL和抑郁生物标志物。
    背景:这项研究的批准来自马来西亚大学人类研究伦理委员会(USM/JEPeM/PP/23050420)。这项研究的结果将发表在学术同行评审的期刊上。
    背景:NCT05812001(ClinicalTrials.gov)。2023年4月12日注册。
    BACKGROUND: The prevalence of major depressive disorder (MDD) is on the rise globally, and the use of antidepressant medications for its treatment does not usually result in full remission. However, the combination of physical exercise and psychotherapy for the treatment of MDD increase the rate of full remission among patients. This three-armed, parallel-group, double-blinded randomised controlled trial (RCT) aims to assess and compare the effects between the combination of exergame and acceptance and commitment therapy (e-ACT) programme, ACT only and treatment-as-usual (TAU) control groups on the severity of depression and anxiety symptoms, the degree of experiential avoidance and quality of life (QoL) and the serum levels of depression biomarkers (such as brain-derived neurotrophic factor, C-reactive protein and vascular endothelial growth factor) among patients with MDD across three time points.
    METHODS: This RCT will recruit 126 patients with MDD who will be randomised using stratified permuted block randomisation into three groups, which are the combined e-ACT programme, ACT-only and TAU control groups in a 1:1:1 allocation ratio. The participants in the e-ACT and ACT-only intervention groups will undergo once a week intervention sessions for 8 weeks. Assessments will be carried out through three time points, such as the pre-intervention assessment (t0), assessment immediately after completion of the intervention at 8 weeks (t1) and assessment at 24 weeks after completion of the intervention (t2). During each assessment, the primary outcome to be assessed includes the severity of depression symptoms, while the secondary outcomes to be assessed are the severity of anxiety symptoms, experiential avoidance, QoL and depression biomarkers.
    BACKGROUND: Approval of this study was obtained from the Human Research Ethics Committee of Universiti Sains Malaysia (USM/JEPeM/PP/23050420). The findings of the study will be published in academic peer-reviewed journals.
    BACKGROUND: NCT05812001 (ClinicalTrials.gov). Registered on 12 April 2023.
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  • 文章类型: Journal Article
    焦虑和抑郁障碍是世界范围内非常普遍的精神健康状况。然而,关于它们在初级保健机构中的具体患病率知之甚少.这项研究旨在确定初级保健人群中抑郁和焦虑的患病率,并确定相关的患者特征。
    我们于2021年12月至2022年4月在新加坡国家医疗保健集团综合诊所进行了一项横断面研究,采用按年龄分层的抽样方法,并进行了自我问卷调查。患者健康问卷-9(PHQ-9)总分≥10代表临床抑郁症,广泛性焦虑症-7(GAD-7)总分≥10表示临床焦虑。采用多变量logistic回归分析抑郁和焦虑的相关因素。
    共与5694名患者接触,3505名患者同意该研究(缓解率=61.6%)。与仅临床抑郁(3.3%)和仅临床焦虑(1.9%)相比,并存的临床抑郁和焦虑(DA)(患病率=5.4%)的患病率更高。与年龄≥65岁的人群相比,年龄在21-39岁(比值比[OR]13.49;95%置信区间[CI]5.41-33.64)和40-64岁(OR2.28;95%CI1.03-5.03)的人群患DA的几率更高。与男性相比,女性患DA的几率更高(OR2.33;95%CI1.54-3.50)。与没有糖尿病的受访者相比,患有糖尿病的受访者患DA的几率更高(OR1.78;95%CI1.07-2.94)。
    在初级保健环境中,并存的临床抑郁和焦虑显著存在,尤其是在年轻人中,糖尿病患者和女性。心理健康筛查计划应包括筛查抑郁和焦虑,针对这些高危人群。
    UNASSIGNED: Anxiety and depressive disorders are highly prevalent mental health conditions worldwide. However, little is known about their specific prevalence in primary care settings. This study aimed to determine the prevalence of depression and anxiety in the primary care population and identify associated patient characteristics.
    UNASSIGNED: We conducted a cross-sectional study using stratified sampling by age with a self-administered questionnaire survey in Singapore\'s National Health-care Group Polyclinics from December 2021 to April 2022. A total score of Patient Health Questionnaire-9 (PHQ-9) ≥10 represents clinical depression, and a total score of Generalised Anxiety Disorder-7 (GAD-7) ≥10 indicates clinical anxiety. Multivariable logistic regression was used to identify the factors associated with depression and anxiety.
    UNASSIGNED: A total of 5694 patients were approached and 3505 consented to the study (response rate=61.6%). There was a higher prevalence of coexisting clinical depression and anxiety (DA) (prevalence=5.4%) compared to clinical depression only (3.3%) and clinical anxiety only (1.9%). The odds of having DA were higher among those aged 21-39 years (odds ratio [OR] 13.49; 95% confidence interval [CI] 5.41-33.64) and 40-64 years (OR 2.28; 95% CI 1.03-5.03) compared to those ≥65 years. Women had higher odds of having DA (OR 2.33; 95% CI 1.54-3.50) compared to men. Respondents with diabetes had higher odds of having DA (OR 1.78; 95% CI 1.07-2.94) compared to those without diabetes.
    UNASSIGNED: Coexisting clinical depression and anxiety are significantly present in the primary care setting, especially among younger individuals, patients with diabetes and women. Mental health screening programmes should include screening for both depression and anxiety, and target these at-risk groups.
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  • 文章类型: Journal Article
    焦虑是一种常见且致残的疾病,严重影响生活质量。亚综合征焦虑(SSA)是指不符合焦虑症的全部诊断标准但具有发展此类疾病的风险的焦虑症状。我们旨在为初级保健机构中SSA的治疗提供实用建议。
    进行了叙述性综述,以确定识别和治疗SSA患者的策略。
    治疗SSA的建议包括改变生活方式,如运动和减压技术,心理治疗,和药物治疗,包括天然化合物,如薰衣草油提取物Silexan。定期随访护理对于监测治疗反应和解决持续症状至关重要。此外,建议使用GAD-7工具准确识别SSA患者.
    在初级保健中实施这些建议可以导致SSA的有效治疗,预防更严重的焦虑症的发展。综合方法,结合生活方式的改变,心理治疗,和药物治疗,包括天然化合物,为管理焦虑提供了显著的好处。
    焦虑是普遍存在的,消除亚显焦虑是焦虑障碍的危险因素。亚显焦虑可以用GAD-7(广义焦虑症-7量表)评估亚显焦虑可以用生活方式改变来治疗。心理治疗和药物治疗,包括Silexan,一种天然化合物.
    UNASSIGNED: Anxiety is a common and disabling condition that significantly impacts quality of life. Subsyndromal anxiety (SSA) refers to anxiety symptoms that do not meet the full diagnostic criteria for an anxiety disorder but pose a risk for developing such disorders. We aimed to provide practical recommendations for the treatment of SSA in primary care settings.
    UNASSIGNED: A narrative review was conducted to identify strategies for recognizing and treating patients with SSA.
    UNASSIGNED: The recommendations for treating SSA include lifestyle modifications such as exercise and stress reduction techniques, psychotherapy, and pharmacological treatments, including natural compounds like the lavender oil extract Silexan. Regular follow-up care is essential to monitor treatment response and address ongoing symptoms. Additionally, the use of the GAD-7 tool is recommended for accurately identifying patients with SSA.
    UNASSIGNED: Implementing these recommendations in primary care can lead to effective treatment of SSA, preventing the development of more severe anxiety disorders. An integrative approach, combining lifestyle modifications, psychotherapy, and pharmacotherapy, including natural compounds, offers significant benefits for managing anxiety.
    Anxiety is prevalent and disablingSubsyndromal anxiety is a risk factor for anxiety disordersSubsyndromal anxiety can be assessed with the GAD-7 (Generalised Anxiety Disorder-7 scale)Subsyndromal anxiety can be treated with life-style modification, psychotherapy and pharmacological treatment, including silexan, a natural compound.
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