OBJECTIVE: Recovery from a COVID-19 infection can lead to post-COVID-19 condition (PCC), which causes a multitude of debilitating symptoms that negatively affect an individual\'s health-related quality of life, including depressive and anxiety symptoms. We aim to examine the mediatory effects of anxiety on depressive symptoms in persons with PCC receiving vortioxetine.
METHODS: We performed a post-hoc analysis of a randomized, double-blinded, placebo-controlled clinical trial investigating vortioxetine treatment on cognitive functioning in persons with PCC. Anxiety and depressive symptoms were measured by the 7-Item Generalized Anxiety Disorder (GAD-7) Scale and the 16-Item Quick Inventory of Depressive Symptomatology (QIDS-SR-16), respectively.
RESULTS: Based on data of 147 participants, GAD-7 scores were significantly positively associated with QIDS-SR-16 scores (β=0.038, 95 % CI [0.029,0.047], p < 0.001). After adjusting for covariates, a significant group (χ2=176.786, p < 0.001), time (χ2=8.914, p = 0.003), and treatment x time x GAD-7 score interaction (χ2=236.483, p < 0.001) effect was observed. Vortioxetine-treated participants had a significant difference in overall change in depressive symptoms (mean difference=-3.15, SEM=0.642, 95 % CI [-4.40,-1.89], p < 0.001).
CONCLUSIONS: Anxiety symptoms were significantly associated with depressive symptoms in persons with PCC. Antidepressant efficacy on ameliorating depressive symptoms is dependent on improving anxiety symptoms, underscoring significant implications in improving treatment efficacy and patient quality of life.

The COVID-19 pandemic generated distinct mental health challenges, characterised by stress and anxiety due to its unpredictable duration and continuous threat. This study examined the role of meditation practice on anxiety symptoms and perceived stress, considering co-variables such as self-compassion, acceptance, awareness, brooding, lockdown duration, and sociodemographic characteristics. The study used a longitudinal design and data were collected through online surveys from April 2020 to January 2021 (at four different time points) and included 238 participants from Portugal (165 had prior experience with meditation practices, 73 were non-meditators) with a mean age of 43.08 years (SD = 10.96). Linear mixed models revealed that over time, during the lockdown, the non-meditators group demonstrated a greater increase of anxiety symptoms (β = -0.226, SE = 0.06, p = 0.006) and perceived stress (β = -0.20, SE = 0.06, p = 0.004), whereas the meditators group showed non-significant (p > 0.05) variations in anxiety and stress symptoms during the same period of time. The effect of meditation on anxiety symptoms was moderated by sex, days of lockdown, self-compassion, and acceptance. The effect of meditation on perceived stress was moderated by sex, years of education, days of lockdown, and levels of awareness. Additionally, the study explored the potential predictive effect of different meditation session lengths, indicating that longer meditation practices offered greater protection against an increase in anxiety symptoms. These findings highlight the importance of cultivating self-regulation skills and investing in preventive mental health strategies to promote well-being and autonomy. Mental health professionals should prioritise educating communities on evidence-based practices like meditation and compassion exercises to enhance overall health.

Aims/Background Trait emotional intelligence is associated with anxiety and depression symptoms and quality of life in cancer patients. However, studies on the relationship of trait emotional intelligence with anxiety, depression, and quality of life in gastric cancer patients are limited. This study investigates the relationship of trait emotional intelligence with depression and quality of life in gastric cancer patients to provide a theoretical basis for clinical management. Methods A total of 270 patients with gastric cancer treated in our hospital from July 2020 to July 2023 were selected, of which 31 patients with missing questionnaire entries and missed visits were screened out, resulting in the enrolment of 239 gastric cancer patients in this study. In this survey, self-administered general information questionnaires, namely Trait Emotional Intelligence Short Form (TEIQue-SF), European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), and Hospital Anxiety and Depression Scale (HADS) were used. Results TEIQue-SF total scores were positively correlated with QLQ-C30 scores (p < 0.001) and negatively correlated with HADS-A and HADS-D scores (p < 0.001). TEIQue-SF total score was a superior positive predictor of the QLQ-C30 score (β = 0.412, p < 0.001) and a superior negative predictor of the HADS score (β = -0.740, p < 0.001). TEIQue-SF total score (β = 0.141, p = 0.006) and HADS score (β = -0.665, p < 0.001) were good predictors of QLQ-C30 score. The direct effect of TEIQue-SF total score on QLQ-C30 score was 0.141, while HADS score between TEIQue-SF total score and QLQ-C30 score had a mediated effect value of 0.492. Conclusion Trait emotional intelligence not only directly affects the quality of life, but also indirectly affects the quality of life through anxiety and depression. Clinicians should pay attention to the anxiety, depression, and emotional intelligence of patients with gastric cancer to help them improve their quality of life.

BACKGROUND: Given the high prevalence of adolescent mental health problems, promoting understanding and implementation of protective factors is crucial for prevention and intervention efforts addressing adolescent mental health problems. This study aims to investigate whether consistency and inconsistency in protective factors are associated with adolescent mental health problems and to inform adolescent mental health interventions that target the unique needs of adolescents and promote adolescent mental health.
METHODS: We used multistage cluster sampling to conduct psychological resilience, social support, and mental health questionnaires from April to June 2023 among 10,653 Chinese adolescents (52.3 % were boys). Data were analyzed using polynomial regressions with response surface analysis.
RESULTS: The higher levels of psychological resilience and social support in adolescents were associated with fewer mental health problems (anxiety: a1 = -1.83, P < 0.001; depression: a1 = -2.44, P < 0.001; and perceived stress: a1 = -1.20, P < 0.001). When the level of psychological resilience was greater than social support, the greater the discrepancy the higher the perceived stress among adolescents (a3 = 1.19, P < 0.001). Moreover, the consistency of psychological resilience and social support had a greater impact on girls\' mental health (anxiety: a1 = -1.97, P < 0.001; depression: a1 = -2.71, P < 0.001; perceived stress: a1 = -1.23, P < 0.001).
CONCLUSIONS: The cross-sectional study design limited the inference of causal relationships between variables.
CONCLUSIONS: These results emphasize that adolescents need a balanced development of protective factors and targeted intervention programs for different mental health problems.

UNASSIGNED: Anxiety symptoms are widely observed among the youth, and engagement in sports has been demonstrated to mitigate these symptoms. Nonetheless, the effectiveness of specific sports and the potential moderating role of psychological factors, such as self-esteem and self-efficacy, on the influence of sports on anxiety, remains to be elucidated. This study was designed to longitudinally assess the impact of sports participation on anxiety symptoms among young individuals.
UNASSIGNED: The study encompassed 163 university students, with a male predominance of 81.6%, and explored the influence of sport-related factors (such as mastery of table tennis skills, level and engagement) and psychological aspects (including self-efficacy, self-esteem and resilience) on anxiety symptoms, employing an 8-month longitudinal approach. Physical activity, sedentary and sleep behaviour, along with age, body mass index (BMI), and sex, were accounted for as confounding variables.
UNASSIGNED: The study found that high table tennis performance score was found to buffer the development of anxiety symptoms in students with decreased self-esteem in an exploratory moderation model. Self-esteem and self-efficacy were negatively associated with the development of anxiety symptoms, whereas physical activity factors did not have a direct effect.
UNASSIGNED: This study highlights the potential of table tennis as a form of sport to alleviate anxiety symptoms in university students, particularly among those with decreased self-esteem. Future research should address the study\'s limitations and explore the potential moderating effects of other psychological factors. Overall, these findings suggest a potential new approach to treating anxiety symptoms among university students.

Social media is viewed to be a key contributor to worsening mental health in adolescents, as most recently reflected in a public health advisory by the US Surgeon General. We provide new evidence on the causal effects of social media on mental health of college students during the Covid-19 pandemic, exploiting unique, longitudinal data collected before the Covid-19 pandemic began and at two points during the pandemic. We find small insignificant effects of social media 4 months into the pandemic during a period of social distancing, but large statistically significant negative effects 18 months into the pandemic when colleges were mostly back to normal operations. Using rich data on substance use, exercise, sleep, stress, and social support, we find some evidence of substitution away from activities that better support mental health at later stages of the pandemic but not at early stages. We find that the negative effects of social media are mostly concentrated among socially-isolated students. Both social support and resilience protect students from the negative effects of social media use. Policy implications include regulating social media while also bolstering social support and resilience as important protective factors.

BACKGROUND: Patients undergoing radiation therapy (RT) often experience anxiety, which may jeopardize the treatment success. The efficacy of music interventions in reducing anxiety remains contentious. This randomized trial aimed to evaluate the impact of music listening on anxiety symptoms in patients undergoing initial RT.
METHODS: First-time RT patients were randomly allocated to experimental and control groups. The Brief Symptom Rating Scale (BSRS-5), Distress Thermometer (DT), and Beck Anxiety Inventory (BAI-C) were administered pre- and post-RT. Changes in physiological anxiety symptoms were monitored over 10 consecutive days starting from the first day of RT. The experimental group received music during RT; the control group did not. The generalized linear mixed model was used to estimate the pre-post difference in the BSRS-5, DT, and BAI-C scores between the music intervention and control group.
RESULTS: This study included 50 patients each in the experimental and control groups. BSRS-5 and DT scores were significantly reduced in the experimental group post-RT (p = 0.0114 and p = 0.0023, respectively). When music listening was discontinued, these scores rebounded. While the posttest BAI-C score was significantly lower in the experimental group (p < 0.0001), the pre-post difference between the two groups was not significant (p = 0.0619). On cessation of music listening, the BAI-C score also rebounded.
CONCLUSIONS: For cancer patients undergoing initial RT, music listening intervention significantly reduced anxiety symptoms measured using the BSRS-5, DT, and BAI-C scores after two weeks. Our results demonstrate the effectiveness of music listening intervention in reducing anxiety symptoms, thereby potentially improving the quality of life of cancer patients undergoing RT.

UNASSIGNED: Causal relationships between psychopathological symptoms, personality traits, coping mechanisms, and sleep bruxism (SB) were studied in the past, giving inconsistent results mostly based on self-assessment evaluations. This polysomnography-based cross-sectional study aimed to explore the relationships between severe SB, personality traits (according to the Big Five model), and coping strategies with objective polysomnographic verification.
UNASSIGNED: The study included 66 participants divided into severe SB (SSB) (n=32) and no or mild SB (n=34) groups based on video-polysomnography performed in the sleep laboratory. Questionnaire assessment included the use of the Beck Depression Inventory, Beck Anxiety Inventory, Mini-COPE, International Personality Item Pool Big Five Markers 20-Item version, and Oral Behavior Checklist.
UNASSIGNED: Participants with SSB presented with fewer self-reported anxiety (p=0.008) and depressive (p=0.01) symptoms than the non- or mild-SB groups. The SSB group scored significantly higher in Big Five personal traits such as extraversion (p=0.007), emotional stability (p=0.013), and intellect (p=0.004), while regarding coping strategies, the SSB group was less likely to use negative strategies: self-distraction (p=0.036), denial (p=0.006), venting (p=0.03), behavioral disengagement (p=0.046), and self-blame (p=0.003), and turning to religion (p=0.041). The intensity of oral parafunctional behaviors was comparable in both groups (p=0.054). Emotional stability was a moderate protective factor (p=0.004), and the self-blame strategy was a strong risk factor (p<0.001) for increased oral parafunctional behavior intensity. Phasic activity negatively correlated with anxiety symptom severity (p=0.005), whereas tonic (p=0.122) and mixed (p=0.053) phenotypes did not. SB intensity was a protective factor against anxiety symptoms (p=0.016).
UNASSIGNED: In terms of psychopathology, severe sleep bruxers tend to present less severe anxiety and depressive symptoms, while some of their personality traits (extraversion, emotional stability, and intellect) were more strongly pronounced. SSB is possibly related to the lesser use of the \"maladaptive\" coping strategies and there were no specific coping strategies preferred by SSB participants, compared to the other group. These observations require further studies, as it should be determined whether SB (especially phasic activity) might be a form of a somatization/functional disorder. Further research should focus on the psychogenic background of oral parafunctional behaviors, which occur more often in less emotionally stable personalities and in people using self-blame coping strategies.

OBJECTIVE: To explore the association between green space, multiple ambient air pollutants and depressive/anxiety symptoms and the mediating role of physical activity (PA) in Chinese adolescents.
METHODS: A school-based health survey was conducted in eight provinces in China in 2021. 22,868 students aged 14.64 (±1.77) years completed standard questionnaires to record details of depressive, anxiety symptoms and PA. We calculated the average normalized difference vegetation index (NDVI) in circular buffers of 200 m, 500 m and 1000 m and estimated the concentrations of PM10, PM2.5, CO, NO2, O3, SO2 around the adolescents\' school addresses.
RESULTS: The exposure-response curves showed that the lower the NDVI value, the higher the risk of depressive and anxiety symptoms. CO, PM2.5 and SO2 and air pollution score were associated with increased risk of depressive and anxiety symptoms. NDVI in all circular buffers decreased the risk of depressive and anxiety symptoms at low levels of PA, but the associations were not significant at high levels of PA. In the subgroup analysis, PM10, PM2.5, CO, NO2, SO2, AQI and air pollution score increased the risk of depressive and anxiety symptoms at low PA levels, but the associations were not significant at high levels of PA. Mediation analysis indicated that the mediating effect of PA on the association between NDVI, NDVI-200 m NDVI-500 m, CO, PM10, PM2.5, SO2, AQI and depressive/anxiety symptoms was statistically significant（p < 0.05）.
CONCLUSIONS: Middle-high level PA could reduce the strength of association between air pollution and depressive and anxiety symptoms. Meanwhile, the association between green space/air pollution and depressive/anxiety symptoms was partly mediated by PA.

Individuals with mental health problems are at higher risk of musculoskeletal diseases. However, the association between low muscle mass (LMM) and anxiety symptoms remains uninvestigated. This cross-sectional study enrolled 174,262 adults (73,833 women, 100,429 men), aged 18 to 89, who completed the anxiety scale and body composition analyses. Using bio-electrical impedance analysis, skeletal muscle mass index (SMI) was calculated based on appendicular skeletal muscle mass (ASM) (kg)/height (m2). LMM was defined as SMI < 7.0 kg/m2 in men and <5.4 kg/m2 in women. Anxiety symptoms were screened using the Clinical Useful Anxiety Outcome Scale (CUXOS) with cut-off scores of 20, 30, and 40. Multivariable logistic regression analyses were performed. LMM prevalence was 20.17% in women, 3.86% in men (p < 0.001). The prevalence of anxiety symptoms in LMM group decreased from mild (CUXOS > 20: women, 32.74%, men, 21.17%) to moderate (CUXOS > 30: 13.34%, 7.32%), to severe anxiety symptoms (CUXOS > 40: 4.00%, 1.73%). In multivariable-adjusted models, LMM was associated with mild (aOR (95% confidence interval)), women, 1.13 (1.08-1.17); men, 1.17 (1.08-1.27)), moderate (1.17 (1.11-1.24); 1.35 (1.19-1.53) and severe anxiety symptoms (1.18 (1.07-1.3), 1.36 (1.06-1.74)), demonstrating an increased risk of ORs with escalating anxiety severity. LMM was independently associated with a higher prevalence of anxiety symptoms.