Objective To explore the risk factors of postoperative anxiety in patients with pancreatic cancer undergoing total pancreatectomy. Methods A total of 31 patients who underwent total pancreatectomy for pancreatic cancer between July 2011 and December 2016 were collected and analyzed in this retrospective study. The patients’ postoperative Self-Rating Anxiety Scale scores were collected, and the exposure factors were analyzed to identify the risk factors of postoperative anxiety through univariate analysis and multiple logistic regression analysis by SPSS 21.0 statistical software. Results In the 31 patients, there were 17 males and 14 females, with an average age of (66.16±9.09) years, an average body mass index of (21.11±3.10) kg/m2, and an average postoperative hospital stay of (14.58±7.47) days. There were 23 patients (74.2%) with postoperative anxiety, and 30 patients (96.8%) with hyperglycosemia required insulin therapy. The total perioperative mortality was 3.2%. In the univariate analysis, age (P=0.012), smoking history (P=0.043), preoperative diabetes mellitus (P=0.012), postoperative bile leakage (P=0.043), and postoperative abdominal infection (P=0.026) were related factors of the postoperative anxiety. In the multiple logistic regression analysis, patients without preoperative diabetes was an independent risk factor of postoperative anxiety (P=0.013). Conclusions For patients undergoing total pancreatectomy, it is needed to pay attention to the patients’ postoperative psychological conditions and assess the postoperative anxiety, especially for those without preoperative diabetes. To improve the life quality and long-term survival of these patients, health education and psychological intervention are needed.
Anxiety is a strong behavioral and psychological reaction with fear components, while depression is a mental disorder dominated by high or low mood, both of which are accompanied by cognitive and behavioral changes, and are common comorbidities in patients with heart disease. Cardiac surgery is one of the important factors which trigger specific emotional and physiological reactions of patients. Persistent or initial depression and anxiety after surgery will not only increase surgical complications, short- or long-term mortality and medical costs, but also seriously affect patients' social function and quality of life. With the transformation of bio-psycho-social medical model, it is necessary to evaluate the perioperative psychological state and biological risk of patients undergoing cardiac surgery. This article reviews the characteristics, related mechanisms and therapeutic interventions of anxiety and depression in patients undergoing cardiac surgery.
Anxiety disorder is a common emotional handicap, which seriously affects the normal life of patients and endangers their physical and mental health. The prefrontal cortex is a key brain region which is responsible for anxiety. Action potential and behavioral data of rats in the elevated plus maze (EPM) during anxiety (an innate anxiety paradigm) can be obtained simultaneously by using the in vivo and in conscious animal multi-channel microelectrode array recording technique. Based on maximum likelihood estimation (MLE), the action potential causal network was established, network connectivity strength and global efficiency were calculated, and action potential causal network connectivity pattern of the medial prefrontal cortex was quantitatively characterized. We found that the entries (44.13±6.99) and residence period (439.76±50.43) s of rats in the closed arm of the elevated plus maze were obviously higher than those in the open arm [16.50±3.25, P<0.001; (160.23±48.22) s, P<0.001], respectively. The action potential causal network connectivity strength (0.017 3±0.003 6) and the global efficiency (0.044 2±0.012 8) in the closed arm were both higher than those in the open arm (0.010 4±0.003 2, P<0.01; 0.034 8±0.011 4, P<0.001), respectively. The results suggest that the changes of action potential causal network in the medial prefrontal cortex are related to anxiety state. These data could provide support for the study of the brain network mechanism in prefrontal cortex during anxiety.
Objective To understand the status quo of depression and anxiety emotion in perioperative patients with thoracic neoplasms under the concept of enhanced recovery aftersurgery. Methods Huaxi emotional-distress index scale (HEI) was adopted to investigate the mental status of 195 patients with thoracic neoplasms in Department of Thoracic Surgery, West China Hospital, and the nursing outpatients between September and November in 2016. There were 118 males and 77 females at age of 17–80 (55.72±12.66) years. Results There was significant difference in mental health level between the preoperative patients and the postoperative patients (3.70±3.41vs. 11.01±9.78,P<0.001). The incidence of depression and anxiety emotion in the postoperative patients was significantly higher than that in the preoperative patients (50.00%vs. 9.60%, P<0.001). Besides, there was significant difference of depression and anxiety degree between the preoperative patients and postoperative patients (P<0.001). Moderate to severe depression and anxiety were mostly found in the postoperative patients while mild to moderate depression and anxiety in the preoperative patients. Conclusion Patients with thoracic neoplasms have much emotional obstacle in perioperative period. The incidence and severity degree of depression and anxiety emotion in postoperative patients are higher than those in preoperative patients.
Objective To evaluate the therapeutic efficacy and safety of trazodone versus alprazolam for generalized anxiety disorder (GAD). Methods After the third day of a three-day screening period, 60 patients with generalized anxiety disorder were randomly assigned to the trazodone group (30 patients, 50-150 mg/d), and alprazolam group (30 patients 1.2-4 mg/d) for 4 weeks. Patients and their doctors were blind. Data were analyzed by SPSS 10.0 and intention-to-treat analysis. Results The total effective rate of trazodone was 77% (23/30), while alprazolam was 70% (21/30) (Pgt;0.05) .No difference was seen for adverse events. None was lost to follow in the two groups. Conclusions Trazodone appears to be as effective as alprazolam in treating generalized anxiety disorder. Adverse events may include confusion and loss of appetite, but patients are able to tolerate these.
ObjectiveTo investigate the psychology and sleep statuses of liver transplantation recipients during the outbreak of COVID-19.MethodsCluster sampling was used to investigate the patients who underwent liver transplantation in the West China Hospital of Sichuan University from January to February 2020. The psychology and sleep statuses were evaluated by the self-designed questionnaire, State-Trait Anxiety Inventory (SAI), Center for Epidemiological Studies Depression Scale (CES-D), and Pittsburgh sleep quality index (PSQI).ResultsTwenty-seven liver transplantation recipients were included in this study. The questionnaires of the 27 patients were collected. The SAI score was (46.41±8.77); The score of CES-D was (13.11±7.87), there were 2 (7.4%) patients with depression; The PSQI score was (6.44±4.02), there were 7 (25.9%) patients with sleep disorders. The points of anxiety and depression of the patients with different gender, age, education level, marital status, residence, living conditions, primary disease, Child-Pugh classification, whether suffered SARS epidemics, COVID-19 knowledges level, medical insurance, family annual income per capita, and income and expenditure of cash had no significant differences (P>0.05) during the outbreak of COVID-19. However, the points of patients with male or suffered SARS or the family annual income per capita ≥60 000 yuan were higher than those of patients with female or not-suffered SARS or the family annual income per capita <60 000 yuan (P<0.05).ConclusionsAnxiety and sleep disorder of liver transplantation recipients are common during the outbreak of COVID-19, which could not be ignored. Knowledges of COVID-19 should be paid to spread so as to reduce psychological pressure and improve sleep quality.
This paper is aimed to analyze the topological properties of structural brain networks in depressive patients with and without anxiety and to explore the neuropath logical mechanisms of depression comorbid with anxiety. Diffusion tensor imaging and deterministic tractography were applied to map the white matter structural networks. We collected 20 depressive patients with anxiety (DPA), 18 depressive patients without anxiety (DP), and 28 normal controls (NC) as comparative groups. The global and nodal properties of the structural brain networks in the three groups were analyzed with graph theoretical methods.The result showed that ① the structural brain networks in three groups showed small-world properties and highly connected global hubs predominately from association cortices; ② DP group showed lower local efficiency and global efficiency compared to NC group, whereas DPA group showed higher local efficiency and global efficiency compared to NC group; ③ significant differences of network properties (clustering coefficient, characteristic path lengths, local efficiency, global efficiency) were found between DPA and DP groups; ④ DP group showed significant changes of nodal efficiency in the brain areas primarily in the temporal lobe and bilateral frontal gyrus, compared to DPA and NC groups. The analysis indicated that the DP and DPA groups showed nodal properties of the structural brain networks, compared to NC group. Moreover, the two diseased groups indicated an opposite trend in the network properties. The results of this study may provide a new imaging index for clinical diagnosis for depression comorbid with anxiety.
Chronic obstructive pulmonary disease is often accompanied by anxiety or depression. The exacerbation of anxiety and depression can lead to the deterioration of chronic obstructive pulmonary disease, reduce patients’ quality of life, worsen poor prognosis, and increase the risk of death. Anxiety and depression are one of the important causes of death in patients with chronic obstructive pulmonary disease, but the complexity of their risk factors and pathogenesis often lead to clinicians being unable to make accurate diagnosis and treatment in a timely manner. Based on existing research, this article elaborates on the risk factors and pathogenesis of chronic obstructive pulmonary disease complicated with anxiety or depression, aiming to improve the diagnosis and treatment ability of clinical physicians for chronic obstructive pulmonary disease complicated with anxiety or depression, achieve timely diagnosis and treatment, improve patients’ prognosis, and improve quality of life.
Objective To investigate the status quo and influencing factors of depression and anxiety in postoperative patients with thoracic neoplasms. Methods The general information questionnaire and Huaxi emotional-distress index scale (HEI) were adopted to survey 70 patients after surgery of thoracic neoplasms at the thoracic nursing outpatients from September to November 2016. There were 43 males and 27 females with age of 18-78 (56.20±11.34) years. Results The prevalence rate of depression and anxiety among postoperative patients with thoracic neoplasms was 50.0%, and moderate to severe negative emotions predominated. There was significant difference in educational levels, postoperative hospitalization and postoperative complications (P<0.05), while no significant difference in age, gender, disease types, complicated diseases, surgical procedures, pathological stages and hospitalization expenditures between patients with unhealthy emotions and normal emotions (P>0.05). Conclusion There is a high prevalence rate of negative emotion among postoperative patients with thoracic neoplasms. Educational levels, postoperative hospitalization and postoperative complications are important factors for negative emotion.
Music has a powerful influence on people’s psychology and emotions. Many clinical research reports confirm that music therapy can directly affect and improve people’s psychological and physiological status, alleviate patients’anxiety and other adverse physiological emotions, improve the effectiveness of surgical treatment, and promote rapid recovery. Lung cancer surgery has the characteristics of great trauma, high incidence of postoperative complications and poor prognosis. Therefore, music therapy has its unique advantages for lung cancer. With the rapid development of thoracic surgery (ERAS), as an important part of psychological intervention, music therapy plays an irreplaceable role in the surgical treatment of lung cancer. This article reviews the impact of music therapy on anxiety in lung cancer surgery.