• Title/Summary/Keyword: Severe anxiety

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Paradoxical Reactions following Intravenous Midazolam in Patients with Severe Anxiety for Dental Treatment -A Case Report- (치과 치료에 대한 심한 공포가 있는 환자들에서 미다졸람 정주 후 나타난 기이반응 -증례보고-)

  • O, Se-Ri
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.9 no.1
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    • pp.30-35
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    • 2009
  • Intravenous midazolam has been frequently used for the relief of anxiety in dental treatment. This is likely the result of the sedative and anterograde amnestic properties of midazolam that are mediated through $\gamma$-Aminobutyric acid agonism. Unfortunately, Paradoxical reactions to midazolam include agitation, talkativeness, confusion, disinhibition, aggression,violent behavior, act of self-injury and need for restraints. These occur in less than 1% of all patients receiving midazolam, may occur at variable times after administration and are difficult to predict and diagnose. Two women with severe anxiety for dental treatment experienced paradoxical reactions associated with the use of intravenous midazolam. We are reviewed the management and prevention of paradoxical reactions and its different etiology.

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The Effect of Venlafaxine in One Patient with Panic Disorder and Generalized Anxiety Disorder : A Case Report (Venlafaxine 투여로 회복을 보인 공황장애와 범불안장애가 병발한 환자의 치료 1예)

  • Choi, Hong;Yoon, Se-Chang
    • Anxiety and mood
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    • v.2 no.1
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    • pp.56-60
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    • 2006
  • Panic disorder is a relatively common psychiatric illness (life time prevalence 3.5%), and it is known that 91% of patients with panic disorder have at least one other psychiatric disorder. And patients with panic disorder, who have coexisting generalized anxiety disorder, tend to have more severe symptoms and less favorable outcome and respond less well to psychological and pharmacologic treatment. The authors report a 51-year old male who was previously diagnosed as panic disorder in the out-patient clinic, showed poor response to antipanic treatment. However, he showed great improvement after he was treated for panic disorder and comorbid generalized anxiety disorder. This case report showed that more effort to identify comorbid conditions is needed in panic disorder patients and the effectiveness of venlafaxine in the treatment of panic disorder with generalized anxiety disorder.

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Levels of Depression and Anxiety Post-Mastectomy in Breast Cancer Patients at a Public Sector Hospital in Karachi

  • Khan, Sara;Khan, Naveed Ali;Rehman, Ata Ur;Khan, Iqra;Samo, Khursheed A;Memon, Amjad Siraj
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1337-1340
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    • 2016
  • Background: There is a noticeable change in the approach with which women nowadays seek help for diseases like breast cancer, primarily due to awareness campaigns, but what happens after surgical procedures is of great significance too. This study focused on the several psychological connotations attached to mastectomy and how the patients cope. Objective: To understand the pattern of anxiety and level of depression among Pakistani patients undergoing mastectomy. Materials and Methods: The sample size consisted of 88 patients who had undergone mastectomy at the different surgical units of the Civil Hospital, Karachi, from January 2012-December 2014; The questionnaire was administered before they were discharged i.e. within 3 days of surgical procedures. The patients were asked if they were willing to participate in this study, those who agreed signed the consent form and then we preceded by asking questions with a standardized tool. A self made questionnaire was constructed keeping in mind the nature and specification of the disease, which consisted of 20 questions related to anxiety and depression, focusing on a mixture of psychological and physiological symptoms. Results: There were a total of 88 patients out of which 36 (41%) were aged 51 to 60 years, 24 (27.2%) of the patients were in the age category of 41 to 50 years, 17 aged 61 and above (19.3%) and only 11 (12.5%) 30-40 years of age, the youngest of all the age categories. The pattern of depression and anxiety was found to be similar among all age categories, severe depression and anxiety predominating over moderate level of such symptoms, with only relatively few patients sufering mild or no depression symptoms. Conclusions: It was concluded that going through mastectomy leads to moderate to severe levels of depression and anxiety, primarily because the females feel incomplete and insecure after losing a part of themselves.

A Case Study en the Effect of Ca Intake on Depression and Anxiety (칼슘섭취가 60세 전후 성인의 우울 및 불안 성향에 미치는 영향에 관한 사례연구)

  • 박귀선;이경애
    • Journal of Nutrition and Health
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    • v.35 no.1
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    • pp.45-52
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    • 2002
  • This study was to investigate 1) the correlation of serum Ca, with depression and anxiety ; and 2) the effect of Ca intake on those symptoms. The subjects were three females and two males who were 53-66 years old with the severe subjective symptoms of depression and anxiety. They have taken more than twice Ca of RDA(recommended dietary allowances for Koreans) daily for 6 months(dietary treatment). The prestudy Ca intake of the subjects was low: 60% of RDA for Koreans. Their serum Ca concentration was also low: 6.67 $\pm$ 0.15mg/d1 before the dietary treatment. They expressed severs depression and anxiety, with high self scores in a psychological test. Their serum Ca concentration increased to 8.32 $\pm$ 0.17mg/dl after six months of dietary treatment, while the symptoms of depression and anxiety decreased significantly after two months and nearly disappeared after six months. This result seemed to be an effect of the dietary high Ca intake. Serum Ca and the psychological states of depression and anxiety correlated negatively, and the coefficients of determination were high in the results of linear regression analysis of depression and anxiety by serum Ca. Therefore the serum Ca concentration could be a good marker to predict depression or anxiety relatively well. The continuous high Ca intake could decrease the probability of developing depression or anxiety and mitigate their symptoms because serum Ca concentration increased, while the state of depression and anxiety decreased with the increased Ca intake.

Depression and Anxiety in Outpatients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자에서 우울과 불안심리 평가)

  • Ryu, Yon Ju;Chun, Eun Mi;Sim, Yun Su;Lee, Jin Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.11-18
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    • 2007
  • Background: Patients with chronic obstructive pulmonary disease (COPD) have often been reported to suffer from depression and anxiety possibly due to the exacerbation, hospitalization and mortality of COPD. However,scarce data are available in Korea. This study assessed degree of depression and anxiety, and evaluated the factors associated with depressive symptoms in COPD. Methods: The cross-sectional data on the lung function measurements, smoking behavior, body mass index (BMI), age, gender, depressive symptoms using Beck Depression Inventory (BDI) and anxiety using the State-Trait Anxiety Inventory (STAI) were evaluated in 72 outpatients with COPD and 50 controls without underling lung diseases from September, 2005 to October, 2006 in the Ewha medical center. Results: 1) The age, body mass index (BMI) and serum albumin levels were similar in the patients and controls. The BDI scores (16(0-37) vs. 12(1-30), p=0.001) and the prevalence of depression (36% vs. 6%, p<0.0001) were higher in the COPD patients than in the controls. In the COPD group, the prevalence of depression increased with increasing GOLD stage (p=0.008). The prevalence was 18%(4/22), in mild cases, 30%(6/20) in moderate cases, 52%(13/25) in severe cases and 60%(3/5) in very severe cases. 2) The SAI and TAI scores were higher in the COPD patients (44(20-67) and 47(20-66)) than in the healthy controls (39(26-65) and 44(33-90)). There were a significant correlation between the depression and anxiety scores (p<0.001). 3) A lower BMI, lower postbronchodilator $FEV_1$, current smoking behavior and severity of COPD were univariately associated with the depressive group in COPD, 4) while multivariate logistic analysis revealed only the severe-to-very severe group (OR 3.9, 95% CI 1.2 to 12.9) to be independently associated with depressive symptoms. Conclusion: COPD is strongly associated with depression and anxiety. Therfore, screening for psychological problems in COPD patients is essential, particularly in patients with severe-to-very severe COPD.

Relationship of Affective Symptoms and Resilience with Childhood Abuse in Patients with Depressive or Anxiety Disorders (우울 및 불안장애 환자에서 아동기 학대와 정서증상 및 리질리언스와의 관계)

  • Kyoung, Miha;Min, Jung-Ah;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.9 no.1
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    • pp.68-73
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    • 2013
  • Objective : The aim of this study is to identify the relationship between childhood abuse and affective symptom including resilience in patients with depression or anxiety. Methods : A total 256 outpatients diagnosed with depressive disorder or anxiety disorder according to DSM IV-TR, were evaluated with Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Parent-Child Conflict Tactics Scale (PCCTS), Connor-Davidson Resilience Scale (CD-RISC). Independent t-test, Chi-square analysis and analysis of covariance (ANCOVA) were performed to identify the demographics of patients and the relationship between affective symptoms including resilience and childhood abuse. Results : Among demographic and clinical variables, patients with childhood abuse history were significantly higher rate in patients who were living alone and unemployed. In affective symptoms, patients with childhood abuse history were significant more severe in depressive symptoms, and state anxiety score than patients without history of childhood abuse. Patients with childhood abuse history had higher score for trait anxiety and lower score for resilience than patients who had no history of childhood abuse. Conclusion : These finding suggest that history of childhood abuse might be risk factor on depressive and anxiety symptoms severity. And this might be a predictable factor of poor treatment outcome.

Influence of Nursing Students' Anxiety during Simulation Training on Personal Satisfaction of Simulation, Self-efficacy, Clinical Competence (간호대학생의 시뮬레이션 교육 시 발생하는 불안정도가 시뮬레이션 교육만족도, 자기효능감, 임상수행능력에 미치는 영향)

  • Kim, Mi Young;Park, Soohyun;Won, Jongsoon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.23 no.4
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    • pp.411-418
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    • 2016
  • Purpose: The purposes of this study were to identify nursing students' levels of anxiety in simulation based nursing education and to understand the relationship of anxiety and personal satisfaction of simulation, self-efficacy, and clinical competence during simulation. Methods: This study was a descriptive study with 84 senior nursing students at a private university in South Korea. Level of anxiety was measured with STAI (the State- Trait Anxiety Inventory) prior to the stimulation practice. After the debriefing, satisfaction scores were measured with SSE (Satisfaction with Simulation Experience scale), self-efficacy scores with the modified measurement developed by Roh and Park, and scores for clinical skills with a scale developed by the Korea Association of Cardiopulmonary Resuscitation. Results: Nursing students exhibited moderate to severe anxiety in simulation practice (Mean 49.51, SD 8.60). Self-efficacy was negatively correlated to anxiety (r=-.25, p=.022). Conclusion: Decreasing students' anxiety levels needs to be addressed to increase the self-efficacy of the simulation practice.

Computational Impact Analysis of Mental Health and Stress Coping of University Students amid COVID-19 Pandemic

  • Hussain Saleem;Kiran Fatima Mehboob Ali Bana;Samina Saleem
    • International Journal of Computer Science & Network Security
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    • v.24 no.6
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    • pp.216-222
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    • 2024
  • Objectives: To compare the levels of anxiety on GAD-7 scale among undergraduates of dental, medical and engineering students during COVID-19. The secondary objectives were to correlate the factors influencing level of anxiety and to assess the coping strategies practiced by undergraduates' students of Karachi duri.ng COVID-19 outbreak. Methodology: The cross-sectional based survey was conducted online among the medical, dental and engineering undergraduates' university students of private sector in Karachi through purposive sampling technique during COVID-19 lock down period. The GAD-7 validated tool was used along with the demographic variables, related stress factors and the coping skills practiced during this outbreak. Total 571 questionnaires were found completed in all sections. The data was analyzed on SPSS version 23. P-value <0.05 was considered as statistically significant. Results: The mental health of the students was assessed on GADS-7 scale as normal, mild, moderate and severe levels. From the total (n=18-3.2%) were normal, (n=132-23.1%) had mild, (n=343-60.1%) had moderate and (n=78-13.7%) had severe anxiety level on GADS-7. The levels of anxiety on GAD-7 scale were all positively associated with the related stressors at p-value of 0.000. Moreover the results depicted that there was a moderate and positive correlation found (0.456, 0.447, 0.512 and 0.452) for all related stressors and GAD-7 scale. Taking breaks from watching, reading news regarding the outbreak of COVID-19, meditation and engaging in some other activities were the most frequently used coping strategies for all levels of anxiety among three cohorts of undergraduates'. Conclusion: Undergraduates has shown 96.9% drastically increased level of anxiety during the outbreak of COVID 19 pandemic. Taking breaks from watching, reading news regarding the outbreak of COVID-19 was the most frequent behavior practiced by the students.

Model Predicting Irritable Bowel Syndrome Severity in University Students (대학생의 과민대장증후군 중증도 예측모형)

  • Park, Bin-Hee;Lee, Kyung-Sook
    • Journal of Korean Biological Nursing Science
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    • v.22 no.2
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    • pp.90-101
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    • 2020
  • Purpose: The purpose of this study was to build and verify a structural model that could predict the severity of irritable bowel syndrome in university students. Methods: Participants were 205 students enrolled in college with irritable bowel syndrome using the irritable bowel syndrome module of the ROME IV Adult Questionnaire. The data were collected using online questionnaires in AprilMay 2019. The data were analyzed using the SPSS WIN 25.0 and AMOS 20.0 programs. Results: 1) The symptom severity that participants experienced were mild (14.6%), moderate (45.4%), and severe (40%). 2) Fit indices of the model were x2= 79.66 (df = 52, p= .009), CFI= .94, TLI= .96, RMSEA= .05, RMR= 1.59, GFI= .94, and TLI= .96.3). The severity of irritable bowel syndrome was influenced directly by anxiety and sleep, and indirectly by family history, perfectionism, social support, coping, and stress. The severity of irritable bowel syndrome was indirectly affected by the following: family history through anxiety; perfectionism through stress, anxiety, and sleep; social support through coping, stress, anxiety, and sleep; coping through stress and anxiety; and stress through anxiety and sleep. Conclusion: Based on the results of this study, a nursing intervention is needed to reduce the anxiety and stress and improve the quality of sleep to improve the health of the college students and manage the symptoms of patients with irritable bowel syndrome.

Chronic Non-Social Stress Affects Depressive Behaviors But Not Anxiety in Mice

  • Yoon, Sang Ho;Kim, Byung-Hak;Ye, Sang-Kyu;Kim, Myoung-Hwan
    • The Korean Journal of Physiology and Pharmacology
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    • v.18 no.3
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    • pp.263-268
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    • 2014
  • The etiology of most psychiatric disorders is still incompletely understood. However, growing evidence suggests that stress is a potent environmental risk factor for depression and anxiety. In rodents, various stress paradigms have been developed, but psychosocial stress paradigms have received more attention than non-social stress paradigms because psychosocial stress is more prevalent in humans. Interestingly, some recent studies suggest that chronic psychosocial stress and social isolation affects mainly anxiety-related behaviors in mice. However, it is unclear whether chronic non-social stress induces both depression- and anxiety-related phenotypes or induces one specific phenotype in mice. In the present study, we examined the behavioral consequences of three chronic non-social stress paradigms: chronic predictable (restraint) stress (CPS), chronic unpredictable stress (CUS), and repeated corticosterone-HBC complex injection (RCI). Each of the three paradigms induced mild to severe depression/despair-like behaviors in mice and resulted in increased immobility in a tail suspension test. However, anxiety-related phenotypes, thigmotaxis and explorative behaviors, were not changed by the three paradigms. These results suggest that depression- and anxiety-related phenotypes can be dissociated in mouse stress models and that social and non-social stressors might affect brain circuits and behaviors differently.