Optimizing Care for Pregnancy in Epilepsy: The Need to Address Anxiety and Depression Symptoms.
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ABSTRACT:
SUBMITTER: Munger Clary HM
PROVIDER: S-EPMC10131572 | biostudies-literature | 2023 Mar-Apr
REPOSITORIES: biostudies-literature
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Optimizing Care for Pregnancy in Epilepsy: The Need to Address Anxiety and Depression Symptoms.
Epilepsy currents 20230123 2
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Project description:AimsTo examine the relationship of anxiety and depression symptoms with treatment outcomes (treatment discontinuation, rates of ongoing use of illicit drugs and likelihood of preterm delivery) in opioid-dependent pregnant women and describe their use of psychotropic medications.Design and settingSecondary data analysis from a randomized clinical trial of treatment for opioid dependence during pregnancy.ParticipantsA total of 175 opioid-dependent pregnant women, of whom 131 completed treatment.MeasurementsSymptoms of anxiety and depression were captured with the 15-item Mini International Neuropsychiatric Interview (MINI) screen. Use of illicit drugs was measured by urine drug screening. Preterm delivery was defined as delivery prior to 37 weeks' gestation. Self-reported use of concomitant psychotropic medication at any point during the study was recorded.FindingsWomen reporting only anxiety symptoms at study entry were more likely to discontinue treatment [adjusted odds ratio (OR) = 4.56, 95% confidence interval (CI) : 1.91-13.26, P = 0.012], while those reporting only depression symptoms were less likely to discontinue treatment (adjusted OR = 0.14, 95% CI : 0.20-0.88, P = 0.036) compared to women who reported neither depression nor anxiety symptoms. No statistically significant between-group differences were observed for ongoing illicit drug use or preterm delivery. A majority (61.4%) of women reported use of concomitant psychotropic medication at some point during study participation.ConclusionsOpioid agonist-treated pregnant patients with co-occurring symptoms of anxiety require additional clinical resources to prevent premature discontinuation.
| S-EPMC4315620 | biostudies-literature
Project description:Latina mothers, who have one of the highest fertility rates among ethnic groups in the United States (US), often experience discrimination. Psychosocial influences during pregnancy, such as discrimination stress, promotes inflammation. However, the role of epigenetic markers of inflammation as a mediator between, and predictor of, maternal discrimination stress and neuropsychiatric outcomes has not been extensively studied. The current study investigates the role of DNA methylation at FOXP3 Treg-cell-specific demethylated region (TSDR), as a marker of regulatory T (Treg) cells that are important negative regulators of inflammation, and the promoter of tumour necrosis factor-alpha (TNF-α) gene, an important pro-inflammatory cytokine, in relation to discrimination stress during pregnancy and depression and anxiety symptomatology. A sample of 148 Latina women residing in the US (mean age 27.6 years) were assessed prenatally at 24-32 weeks' gestation and 4-6 weeks postnatally for perceived discrimination exposure (Everyday Discrimination Scale, EDS), emotional distress (depression, anxiety, perinatal-specific depression), acculturation, and acculturative stress. DNA methylation levels at the FOXP3 and TNFα promoter regions from blood samples collected at the prenatal stage were assessed by bisulphite pyrosequencing. Regression analyses showed that prenatal EDS associated with postnatal emotional distress, depression and anxiety symptoms only in those individuals with higher than mean levels of FOXP3 TSDR and TNFα promoter methylation; no such significant associations were found in those with lower than mean levels of methylation for either. We further found that these relationships were mediated by TNFα only in those with high FOXP3 TSDR methylation, implying that immunosuppression via TNFα promoter methylation buffers the impact of discrimination stress on postpartum symptomatology. These results indicate that epigenetic markers of immunosuppression and inflammation play an important role in resilience or sensitivity, respectively, to prenatal stress.
| S-EPMC7739167 | biostudies-literature
Project description: Not available
| S-EPMC10924443 | biostudies-literature
Project description:Household food insecurity (HFI) has been related to adverse maternal-child health outcomes and mental health worsening during pregnancy. Few studies evaluated the temporal association between HFI and anxiety and depressive symptoms in pregnant women, and this association remains not completely understood. This study aimed to systematically review the association between HFI and symptoms of depression and anxiety in pregnant individuals. The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (CRD42022373615). Systematic searches were conducted on 10 electronic databases and grey literature. Two researchers independently conducted the study selection, data extraction process, and the risk of bias assessment. Random-effects meta-analysis models were used, and I2 > 40% indicated high heterogeneity across studies. Eighteen articles were included for the systematic review, comprising n = 27,882, and a total of 18,987 pregnant individuals aged between 14 and 45 years were included in the meta-analysis. The prevalence of HFI reported in studies ranged from 12.6% to 62.1% (n = 17). The prevalence of depressive and anxiety symptoms ranged from 18% to 49% (n = 11) and 23% to 34% (n = 2), respectively. HFI during pregnancy was associated with increased odds of experiencing symptoms of depression [(OR: 2.52; 95% CI: 2.11-3.02), I2 = 73.23%]. The quality of evidence was very low due to high heterogeneity. Our findings highlighted the association between HFI and depression symptoms during pregnancy. Findings from this study suggest the importance of assessing HFI and mental health during pregnancy.
| S-EPMC11650026 | biostudies-literature
Project description:BackgroundPrenatal anxiety and depression are distressing for the expectant mother and can have adverse effects on her fetus and subsequently, her child. This study aimed to determine whether listening to specially composed songs would be an effective intervention for reducing symptoms of prenatal anxiety and depression.MethodsPregnant women were recruited online and randomly assigned to one of two groups: the music group (daily listening to specially composed songs) or control group (daily relaxation) for 12 weeks each. Self-report questionnaires were used to assess symptoms of State and Trait anxiety (Spielberger) and depression (Edinburgh Postnatal Depression Scale (EPDS)). Trait anxiety was measured as the primary outcome, while State anxiety and depression were the secondary outcomes. 111 participants were randomised to each group. 20 participants in the intervention group and 16 participants in the active control group completed the study.ResultsThe music group demonstrated lower Trait Anxiety (p = .0001) (effect size 0.80), State Anxiety (p = .02) (effect size 0.64), and EPDS (p = .002) (effect size 0.92) scores at week 12 compared to baseline, by paired t test. There were no such changes in the control group.ConclusionsThough this pilot study had high levels of attrition, the results do suggest that regular listening to relaxing music should be explored further as an effective non-pharmacological means for reducing prenatal anxiety and depression.Trial registrationClinicalTrials.gov NCT02776293 LV-001. Registered 17 May 2016. Retrospectively registered.
| S-EPMC5423008 | biostudies-literature
Project description:IntroductionDecreased motivational tendency to seek out, engage in, and enjoy investing in complex cognitive processes in a sustained manner (need for cognition; NFC) may be a predictor and consequence of heightened anxiety and depression symptoms (ADS). However, the majority of investigations on this topic have been cross-sectional, which hinders causal inferences.MethodsThe current study thus determined the within-person relations between NFC and ADS by using random intercept cross-lagged panel model (RI-CLPM) and bivariate dual latent change score (BLCS) approaches to separate between- and within-person effects. RI-CLPM and BLCS also present with advantages of adjusting for regression to the mean, baseline scores, autoregressive and lagged effects, and minimizing measurement error. Community-dwelling adults (n = 6750) completed the Mental Health Inventory-5 and trait-level NFC scales approximately every one year across 10 years.ResultsRI-CLPM showed that within persons, lower level of NFC predicted higher future level of ADS, and vice versa (d = -0.852 to -0.498). Likewise, BLCS demonstrated that within persons, smaller change in NFC forecasted larger subsequent increase in ADS, and conversely (d = -0.631 to -0.519). Findings remained after adjusting for socio-demographic covariates.ConclusionConsistent with theories, findings suggested that the within-person level-to-future level and change-to-future change relations among NFC and ADS were bi-directional and negative, with moderate-to-large effect sizes. Targeting NFC may treat or prevent the emergence of depression and anxiety disorders. Such efforts may include augmenting or personalizing evidence-based cognitive-behavioral therapeutic strategies for individuals with or at-risk for heightened ADS.
| S-EPMC8759714 | biostudies-literature
Project description:This study aimed to investigate and compare the executive functions of students with depression, anxiety, and stress symptoms with those functions in healthy ones.This study was a comparative and non-clinical analysis. The study population comprised all students of Shahid Beheshti University, Tehran, Iran. A total of 448 students were recruited using convenience sampling method. They were also screened using the Depression Anxiety Stress Scales (DASS) test comprising 21 items. Of study participants, 30 people were depressed, 27 had anxiety, and 15 suffered from stress. Then, 50 control people were matched with them. Next, both groups were compared using the Stroop test, Wisconsin card sorting, and cognitive ability test.Using MANOVA test, data analysis revealed no significant differences among 4 groups with regard to selective attention and shifting attention. Depressed group reacted rapidly as opposed to the anxiety group with regard to measures of shifting attention and cognitive abilities; it was observed that the memory, inhibition control, planning, and flexibility of the healthy group were better than those of the 3 other groups.The findings of this research raised specific issues in relation to the role of depression, anxiety, and stress in the disruption of the executive functions of sufferers. Selective and shifting attention and cognitive abilities are specifically affected in this regard. Meanwhile, the role of stress in impairing decision making and the major role of anxiety in impairing sustained attention was shown to be considerable.
| S-EPMC5535328 | biostudies-other
Project description:Up to 60% of the 50 million persons with epilepsy (PWE) worldwide have depression and anxiety and 80% of PWE live in low-income regions. Common psychiatric comorbidities are often unrecognized and undertreated. We developed and validated a 10-item screening tool for the detection of depression and anxiety at primary healthcare clinics in Zambia in which the baseline detection rate among PWE was 1%. We trained primary care clinic workers in selected clinics to use this screening tool. A retrospective chart review was conducted for 120 consecutive PWE who received care one month after training. Detection improved from 1% to 49%, and treatment was frequently initiated. Of the 120 screened, 59 (49.2%) scored above cutoff point of 18. Of these persons, 43 (73.0%) were positive for depression, 16 (23.0%) were positive for anxiety, 38 (64.4%) received counseling, 18 (30.5%) received antidepressants, and 3 (5.1%) were referred to a psychiatrist. Use of this screening tool resulted in improved mental health care for PWE.
| S-EPMC3820329 | biostudies-literature
Project description: Not available
| S-EPMC261661 | biostudies-literature
Project description:ObjectiveFrequent co-occurrence and bidirectional longitudinal associations have led some researchers to question the boundaries between depression and anxiety. A longitudinal investigation of the interconnected symptom structure of these constructs may help determine the extent to which they are distinct, and whether this changes over development. Therefore, the present study used network analysis to examine these symptom-symptom associations developmentally from early childhood to mid-adolescence.MethodWe analyzed data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (N = 1,147). Depression and anxiety symptoms were assessed on 7 occasions between ages 5 and 14 years using maternal reports. Regularized partial correlation networks were constructed at each time point, and diagnostic boundaries were explored using empirical tests of network modularity (ie, clustering of symptom nodes). Nonparametric permutation tests were used to determine whether symptoms became more associated over development, and network centrality was examined to identify developmental changes in the overall importance of specific symptoms.ResultsSymptoms formed highly interconnected networks, as evidenced by strong associations between depression and anxiety symptoms and a lack of distinct clustering. There was some evidence of an increase in overall connectivity as children aged. Feeling "anxious/fearful" and "unhappy/sad" were consistently the most central symptoms over development.ConclusionMinimal clustering of nodes indicated no separation of depression and anxiety symptoms from early childhood through mid-adolescence. An increase in connectivity over development suggests that symptoms may reinforce each other, potentially contributing to the high levels of lifetime continuity of these disorders.
| S-EPMC6290121 | biostudies-literature