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Epidemiological evidence shows a concerning rise in youth mental health difficulties over the past three decades. Most evidence, however, comes from countries in Europe or North America, with far less known about changes in other global regions. This study aimed to compare adolescent mental health across two population-based cohorts in the UK, and two population-based cohorts in Pelotas, Brazil.
Methods
Four population-based cohorts with identical mental health measures were compared. In Brazil, these included the 1993 Pelotas Birth Cohort and the 2004 Pelotas Birth Cohort. In the UK, cohorts included the Avon Longitudinal Study of Parents and Children, and the Millennium Cohort Study. Mental health was measured in all cohorts using identical, parent-rated scores from the Strengths and Difficulties Questionnaire (SDQ). This was assessed in both countries over approximately the same time periods, when adolescents were aged 11 (2004 vs 2015 in Brazil, and 2003 vs 2012 in the UK), with follow-up analyses focused on outcomes in later adolescence.
Results
Mental health problems were higher in the UK for adolescents born in the early 2000s compared to those born in the early 1990s. In Pelotas, the opposite was found, whereby problems were lower for adolescents born in the early 2000s compared to those born in the early 1990s. Despite these promising reductions in mental health problems in Pelotas over time, SDQ scores remained higher in Pelotas compared to the UK.
Conclusions
Our study represents the first to compare two population-based cohorts in the UK, and two population-based cohorts in Pelotas, Brazil, to understand how mental health problems have changed over time across the two settings. Our findings provide the most up-to-date insight into population-level rates of youth mental health problems in Pelotas, and shed novel insight into how these have changed over the last two decades in comparison to the UK. In doing so, our study provides a tentative first step towards understanding youth mental health over time at a more global scale, and presents a valuable opportunity to examine putative contributors to differences across time.
This study evaluated the effects of capsaicin (CAP) supplementation on the intake, nutrient digestibility, ruminal fermentation, nitrogen balance, microbial protein synthesis and health traits of bulls managed on pasture. Eight crossbred (Holstein x Zebu) cattle averaging 313 ± 31 kg of body weight (BW) were arranged in a replicated 4 × 4 Latin square design (one square of four bulls, rumen fistulated with 4-inch silicone cannulas and one square of four non-fistulated bulls), which were kept on Pangola grass pasture (Digitaria decumbens). Each experimental period consisted of 21 days, with 7 days for data collection (no washout between periods). Bulls were randomly assigned to the following treatments: CON (control): concentrate supplementation at 0.5% live weight (BW) and no additive (CAPCIN®), or concentrate supplementation at 0.5% BW in association with CAPCIN® (NutriQuest, Campinas, Brazil) fed at the inclusion rates of 150 (CAP150), 300 (CAP300) and 450 (CAP450) mg/animal/day. Digestibilities of dry matter, organic matter and neutral detergent fibre showed quadratic responses to CAP supplementation. Rumen pH linearly increased with CAP supplementation. The numbers of lymphocytes and eosinophils were linearly increased with CAP supplementation. The use of encapsulated pepper in supplements of crossbred (Holstein x Zebu) bulls managed on D. decumbens pasture up to 450 mg/animal/day improves nutrients digestibility and ruminal fermentation and can positively influence the health status of beef cattle managed under tropical conditions.
To handle well clinical treatments, it is crucial to know the expectations of patients who seek help. We need to ask ourselves: how do patients interpret subjectively their diagnosis, treatments, and self-care? Medical Psychology brings us theories for this understanding. Grave’s Disease is an autoimmune disorder, a form of hyperthyroidism with a goitre, affecting also the eyes and the skin, as well as emotional manifestations. Weight loss, sometimes psychologically welcome, although due to a disease, can mean a psychoanalytic secondary gain. So, the medicine that leads to clinical improvement can be taken with ambivalence and bad adherence to treatment. It is important to differentiate between disease, a scientific entity explained by the clinical professional, and illness as a patient’s subjective perception of an un-health.
Objectives
To understand psychodynamically the fantasies, desires, and views related to Graves’ Disease as reported by patients in hyperthyroidism but without ophthalmopathy interviewed at an endocrinology-specialized outpatient clinic. (in the EPA-2023, it was presented the qualitative results of a sample in hyperthyroidism, with ophthalmopathy, studied at the same service).
Methods
Clinical-Qualitative Method designed by Turato. Data collected through Semi-Directed Interviews with Open-ended Questions in-Depth; and Field Notes, transcript fully. Treated by the Seven Steps of Clinical-Qualitative Content Analysis of Faria-Schützer, using psychodynamic concepts from Balintian Medical Psychology. Although we have extracted categories that permit us interesting discussions, we intend to close the sample (through the information saturation criterion by Fontanella) when we obtain other categories. The interviewer, a male psychologist, is the first author. The findings are validated by peer-reviewers of the Lab of Clinical Qualitative Research of the State University of Campinas.
Results
Three categories were chosen for this presentation: 1) “An atomic bomb in my life”: How drastic changes of a hormonal disease re-symbolize the patient’s life; 2) “I didn’t think the thyroid did that much”: the disease seen as a metaphor in a psychological blaming language to own disease and to himself as a sick person. 3) “I have so much medicine!”: a mode of referring to treatment that would justify an undisciplined use of medications.
Conclusions
Our findings can help clinical professionals to have a better understanding of some psychological meanings which have sense in the patients’ conscience, often not verbalized clearly in the conversation, and so to handle better the patients and relatives. In this way, it can reduce the patient’s resistance to recommended treatment, as well as encourage the clinical team to construct empathy with them.
Sucrose yield in sugarcane is a complex process regulated by both environmental and endogenous factors. However, the metabolic balance driving vegetative growth and sucrose accumulation remains poorly understood. Herein, we carried out a comprehensive assessment of carbohydrate dynamics throughout the crop cycle in two sugarcane varieties varying in biomass production, evaluating the carbon metabolism in both leaves and stalks. Our data revealed that the decline in photosynthetic rates during sugarcane maturation is associated not only to accumulation of sugars in leaves but also due to stomatal and non-stomatal limitations. We found that metabolic processes in leaves and stalks were intrinsically linked. While IACSP94-2094 had higher stalk sucrose concentration than IACSP95-5000, this latter produced more biomass. Compared to IACSP95-5000, IACSP94-2094 showed higher sucrose phosphate synthase (SPS) activity in leaves and stalks, along with lower soluble acid invertase (SAI) activity in leaves during the maximum growth stage. Interestingly, IACSP94-2094 also exhibited higher stalk SPS activity and lower stalk SAI activity than IACSP95-5000 during maturation. High biomass production by IACSP95-5000 was associated with higher sucrose synthase (SuSy) and SAI activity in leaves and higher SuSy and soluble neutral invertase (SNI) activity in stalks when compared to IACSP94-2094 during the maximum growth. Despite the contrasting strategies, both varieties displayed similar total sucrose yield, a balance between sucrose concentration and biomass production. This phenomenon implies the presence of a compensatory mechanism in sugarcane, with high biomass production compensating low sucrose accumulation and vice versa.
Healthcare workers (HCWs) were at increased risk for mental health problems during the COVID-19 pandemic, with prior data suggesting women may be particularly vulnerable. Our global mental health study aimed to examine factors associated with gender differences in psychological distress and depressive symptoms among HCWs during COVID-19. Across 22 countries in South America, Europe, Asia and Africa, 32,410 HCWs participated in the COVID-19 HEalth caRe wOrkErS (HEROES) study between March 2020 and February 2021. They completed the General Health Questionnaire-12, the Patient Health Questionnaire-9 and questions about pandemic-relevant exposures. Consistently across countries, women reported elevated mental health problems compared to men. Women also reported increased COVID-19-relevant stressors, including insufficient personal protective equipment and less support from colleagues, while men reported increased contact with COVID-19 patients. At the country level, HCWs in countries with higher gender inequality reported less mental health problems. Higher COVID-19 mortality rates were associated with increased psychological distress merely among women. Our findings suggest that among HCWs, women may have been disproportionately exposed to COVID-19-relevant stressors at the individual and country level. This highlights the importance of considering gender in emergency response efforts to safeguard women’s well-being and ensure healthcare system preparedness during future public health crises.
Different fertilization strategies can be adopted to optimize the productive components of an integrated crop–livestock systems. The current research evaluated how the application of P and K to soybean (Glycine max (L.) Merr.) or Urochloa brizantha (Hochst. ex A. Rich.) R. D. Webster cv. BRS Piatã associated with nitrogen or without nitrogen in the pasture phase affects the accumulation and chemical composition of forage and animal productivity. The treatments were distributed in randomized blocks with three replications. Four fertilization strategies were tested: (1) conventional fertilization with P and K in the crop phase (CF–N); (2) conventional fertilization with nitrogen in the pasture phase (CF + N); (3) system fertilization with P and K in the pasture phase (SF–N); (4) system fertilization with nitrogen in the pasture phase (SF + N). System fertilization increased forage accumulation from 15 710 to 20 920 kg DM ha/year compared to conventional without nitrogen. Stocking rate (3.1 vs. 2.8 AU/ha; SEM = 0.12) and gain per area (458 vs. 413 kg BW/ha; SEM = 27.9) were higher in the SF–N than CF–N, although the average daily gain was lower (0.754 vs. 0.792 kg LW/day; SEM = 0.071). N application in the pasture phase, both, conventional and system fertilization resulted in higher crude protein, stocking rate and gain per area. Applying nitrogen and relocate P and K from crop to pasture phase increase animal productivity and improve forage chemical composition in integrated crop–livestock system.
In tropical regions, water stress is one of the main causes of the reduction in forage productivity, and irrigation strategies can mitigate the problem, especially for highly productive species. The objective of this study was to evaluate the effects of irrigation, genotype and plant size on productive responses and water use efficiency (WUE) of elephant grass (Cenchrus purpureus [Schumach.] Morrone), in the rainy and dry season. The experimental design was randomized in blocks, arranged in split plots, the main plots were established based on the use of irrigation and the subplots were the tall-sized genotypes (IRI 381 and Elephant B) and dwarfs (Taiwan A-146 2.37 and Mott). The genotypes were evaluated for two years and harvested every 60 days. Water use efficiency, total forage accumulation per year and harvest, forage accumulation rate and forage density were evaluated. There was a significant difference between the genotypes in terms of total forage accumulated (P < 0.05). The most productive genotype was IRI 381, which showed the greatest total forage accumulation (42 168 kg of DM/ha in two years) in the irrigated plots. During the rainy seasons, IRI 381 stood out in terms of forage accumulated (24 667 kg of DM/ha). Irrigation favoured increases in forage accumulation around 60%, in both years of evaluation. Irrigation and plant size influenced the productivity and WUE of elephant grass harvested in 60-day intervals. Tall genotypes and Taiwan A-146 2.37 (dwarf size) stood out in most of the productive traits analysed, while Mott was highlighted by its forage density.
Preantral to early antral follicles transition is a complex process regulated by endocrine and paracrine factors, as well as by a precise interaction among oocyte, granulosa cells and theca cells. Understanding the mechanisms that regulate this step of folliculogenesis is important to improve in vitro culture systems, and opens new perspectives to use oocytes from preantral follicles for assisted reproductive technologies. Therefore, this review aims to discuss the endocrine and paracrine mechanisms that control granulosa cell proliferation and differentiation, formation of the antral cavity, estradiol production, atresia, and follicular fluid production during the transition from preantral to early antral follicles. The strategies that promote in vitro growth of preantral follicles are also discussed.
Soybean production contributes to ca. 60% of global plant-based protein used for food and feed. Brazil is the largest soybean producer and exporter, with 60% from tropical and 40% from subtropical environments. Nitrogen (N) can play an essential role in the storage of proteins in seeds; thus, it could be a key factor in increasing the quantity and quality of seeds in high-yielding soybean crops. Unlike in temperate environments, there is a gap of knowledge on whether soybean grown under tropical and subtropical climates are limited by N-fertilization to sustain the seed yield increase without detriments in seed protein concentration. This study aimed to evaluate the effect of N-fertilization on soybean seed yield, protein and oil concentrations in tropical and subtropical environments in Brazil, thus contributing to agricultural intensification procedures and food security studies. Two levels of N-fertilization (0 and 1000 ka/ha) were tested across 11 tropical or subtropical environments. The range of latitudes explored here was from 12°S to 29°S, representing the major soybean-producing regions in Brazil either under rainfed or irrigated conditions. We found that seed yield responses to N-fertilization were significant (in some environments under rainfed with an average increase of 7%) or not significant (in irrigated). Seed protein increases due to improved N-fertilization (on average 4% for irrigated and 12% for rainfed conditions) were much higher than previous reports from temperate environments. Regardless of N supply and water deficit, there was a trend of seed protein and oil concentration increasing toward lower latitudes.
The objective of this study was to evaluate the radiation use efficiency (RUE) and canopy structure of elephant grass varieties (Cenchrus purpureus Schum.) of contrasting statures, under monocropping or intercropped with butterfly pea (Clitoria ternatea L.) in cut-and-carry systems. Two tall varieties (elephant B and IRI-381), and two dwarf ones (Mott and Taiwan A-146 2.37), were evaluated as monocrops or binary intercrops with the legume in a 2-year trial with eight harvests. Greater annual leaf biomass accumulation was observed in the monocrops of the tall variety elephant B (7.76 t/ha per year) and dwarf Mott (8.08 t/ha per year). Greater herbage bulk density (59 kg/ha per cm) and leaf area index (3.83) were recorded in canopies of dwarf Mott than in those composed of IRI-381 (37 kg/ha per cm and 3.48, respectively). In the first year, dwarf varieties Mott and Taiwan A-146 2.37 showed less RUE (0.89 and 0.84 g dry matter (DM)/MJ, respectively) than the elephant B (1.46 g DM/MJ). Higher non-fibre carbohydrate (NFC) contents were found in dwarf Mott under monocrop (180 g/kg) and in the intercrop systems. Tall varieties elephant B and IRI-381 showed greater efficiency in intercepting the radiation to accumulate herbage via stem accumulation. Dwarf Mott variety exhibited short stems and great leaf biomass accumulation that favoured denser canopies with higher content of NFCs in vegetal tissue. Planting butterfly pea into rows of elephant grass varieties can be adopted with no significant losses in RUE caused by light extinction, regardless of the grass stature.
The home-field advantage (HFA) hypothesis establishes that plant litter decomposes faster at ‘home’ sites than in ‘away’ sites due to more specialized decomposers acting at home sites. This hypothesis has predominantly been tested through ‘yes or no’ transplanting experiments, where the litter decomposition of a focal species is quantified near and away from their conspecifics. Herein, we evaluated the occurrence and magnitude of home-field effects on the leaf litter decomposition of Myrcia ramuliflora (O.Berg) N. Silveira (Myrtaceae) along a natural gradient of conspecific litterfall input and also if home-field effects are affected by litter and soil traits. Litter decomposition of M. ramuliflora was assessed through litterbags placed in 39 plots in a tropical heath vegetation over a period of 12 months. We also characterized abiotic factors, litter layer traits, and litter diversity. Our results indicated the occurrence of positive (i.e. Home-field advantage) and negative (i.e. Home-field disadvantage) effects in more than half of the plots. Positive and negative effects occurred in a similar frequency and magnitude. Among all predictors tested, only the community weighted mean C/N ratio of the litterfall input was associated with home-field effects. Our results reinforce the lack of generality for home-field effects found in the literature and thus challenge the understanding of litter-decomposer interaction in tropical ecosystems.
There is a greater prevalence of oral problems in patients suffering from severe mental illness than in the general population. The psychiatrist use to be, naturally, a health professional with great clinical influence over these patients. Do young psychiatrists in training include oral evaluations on their patients? How does this doctor perceive oral health care in the context of follow-up of people with chronic mental disorders?
Objectives
To interpret the meanings of the practice or not, regarding oral health guidelines, as reported by residents in psychiatry working in care and follow-up services to patients with severe disorders at a public university.
Methods
Clinical-qualitative design. Semi-directed interviews with open-ended questions in-depth carried out with six participants. Sample closed by saturation information criterion. Residents see their patients at the General Hospital of the State University of Campinas. Interview material, audio-recorded and transcribed in full, was treated by Clinical-Qualitative Content Analysis, using concepts of theoretical framework from Medical Psychology. Interviewer was a female professor of dentistry.
Results
From the discussion, two categories of analysis were selected for this presentation. (1) medical practice obeys the natural logic of construction of paradigmatic areas: historically, dentistry has created a care model with independence from medicine; (2) dentist is not called to participate in “collusion of anonymity”. This is an expression construct by the psychoanalyst Balint to describe the taking of relevant clinical decisions, without no professional assume the responsibility for these.
Conclusions
These meanings may guide changes in professional conduct as well as in the curriculum of medical training programs.
Humanistic studies that explore symbolic aspects of the experience of working on the COVID-19 frontline are necessary. Do these professionals have psychic time to symbolize such acute experiences? We expect these preliminary findings of this research provide subsidies for discussing psychological management in groups with these professionals.
Objectives
To interpret emotional meanings reported by physicians and nurses on their experiences of working at COVID-19 intensive care units.
Methods
Clinical-qualitative design. Data collection with semi-directed interviews with open-ended questions in-depth applied to a sample of six professionals, closed by theoretical information saturation, in a Brazilian university general hospital. Trigger question: “Talk about psychological meanings of your experience in face of management of patients with COVID-19 at ICU”. Data treatment by the Seven Steps of the Clinical-Qualitative Content Analysis. Theoretical framework of Medical Psychology using Balintian concepts.
Results
We raised 3 categories. (1) Psychic time and absence of symbolization in face of the pandemic; (2) Denial as a defense or psychosocial adaptation mechanisms; (3) Tensions and family support: triggers of ambivalent emotional experiences.
Conclusions
Raw experience of COVID-19 pandemic did not allow for realization of symbolization. Psychological defenses are manifested, either to maintain balance or to deny the existence of dangers related to mental health. Presence of families and health team confirm that the feeling of loneliness is avoided. Anxieties related to the fear of contamination are recurrent. There is dual relationship regarding the emotional experiences of health professionals, but the data point to importance of looking at how these individuals perceive and experience the pandemic.
Health Psychology is a scientific branch that studies interpersonal relationships in the field of emotions and behavior in clinical settings. Violence against women is a gender-based action that alarmingly affects the population, with sexual violence (SV) being one of its main phenomena. The complexity of the care offered to SV patients by clinical professionals impacts themselves, affecting their personal lives and the quality of their work.
Objectives
To explore symbolic emotional meanings attributed by health professionals to care and follow-up of women victims of SV in state service of reference of the Unified Health System.
Methods
Clinical-Qualitative design was used to guide semi-directed interviews with open-ended questions in-depth. Clinical-Qualitative Content Analysis was employed to treat data. Five participants make up the multi-professional team at the Hospital of the Woman of the State University of Campinas. Theoretical framework chosen to interpret categories was Balintian Medical Psychology.
Results
Three categories were selected for this presentation: The human anguishes as the main challenge and handling of working with sexual violence; “To see things progressing”: to the patient and together with the team, a facilitator of the work; and “I try to leave it on the three’s leaves”: the difficult attempt to separate work from personal life.
Conclusions
Taking care of SV is a very emotionally demanding task. Working with the team and see expected outcomes help clinical professionals deal with negative feelings, avoiding, for example, compensatory traumas. New research about social-cultural impacts of working with SV is important to develop institutional approaches of coping for health teams.
The objective of this study was to describe and explain the effect of adding corn meal (CM) on losses, fermentation characteristics and nutritional value of silages from two elephant grass [Cenchrus purpureus (Schumach.) Morrone] genotypes (Taiwan A-146 2.37 and IRI-381) mixed with butterfly pea (Clitoria ternatea L.) legume. The forage was harvested at 75 days of regrowth from elephant grass plots intercropped with butterfly pea legume and ensiled with or without CM at 5% of dry matter (DM) content. Greater gas losses (12 g/kg) and pH (4.2) were observed in the Taiwan A-146 2.37 + butterfly pea silages. The greatest crude protein content was observed in the ‘Taiwan A-146 2.37’ + butterfly pea silage added with CM (116 g/kg). Silages with additive and those containing IRI-381 had a greater acid detergent fibre content (367 and 366 g/kg, respectively). CM increased the silage DM (221 g/kg), remaining water-soluble carbohydrates contents (26 g/kg) and in vitro digestibility of DM. The aerobic stability was maintained until 45 h after opening the silos. All silages presented a good fermentative profile and were not affected by the relatively large proportion of butterfly pea (>34%) in the ensiled mass as indicated by the reduced contents of butyric acid and ammonia nitrogen. CM reduces total losses, increases DM recovery and improves the nutritional value of silages from mixed elephant grass–butterfly pea legume.
This study aims to determine the effects of dietary crude protein (CP) content of early-weaned calves; and the influence of flint maize processing methods on intake, total tract nutrient digestibilities and performance of Nellore heifer calves. Fifteen early-weaned Nellore female calves (4 ± 0.5 months; 108 ± 13.1 kg) were used. In phase 1, animals were fed one of the following diets for 112 days: 130, 145 or 160 g CP/kg dry matter (DM). In phase 2, animals received one of the two diets for 84 days: 0.60 dry ground maize grain, 0.30 whole-plant maize silage plus 0.10 mineral-protein supplement or 0.90 snaplage plus 0.10 mineral-protein supplement. In phase 1, intake and digestibility of dietary components were not affected (P > 0.05) by increasing dietary CP content. Daily total urinary nitrogen (N) and urinary urea N increased (P < 0.05) in response to increasing dietary CP content. Animal performance was not affected (P > 0.05) by dietary CP content. In phase 2, maize processing methods did not affect (P > 0.05) intake and digestibility of dietary components as well as animal performance, carcase characteristics and carcase composition. Therefore, based on the current experimental condition, we conclude that dietary CP concentrations of 130 g/kg DM can be indicated for early-weaned Nellore calves. However, more studies are recommended to validate this result and to evaluate concentrations below 130 g CP/kg DM for early-weaned Nellore calves. Moreover, snaplage could be used as an exclusive fibre and energy source for finishing cattle in feedlot.
To assess the influence of presbylarynx and presbycusis on Voice Handicap Index and emotional status.
Methods
A case–control, prospective, observational, cross-sectional study was conducted of patients aged 65 years or older referred to an otorhinolaryngology department from January to September 2020. Presbycusis was assessed by pure tone and vocal audiometry. Each subject underwent fibre-optic videolaryngoscopy with stroboscopy, and presbylarynx was considered when two or more of the following endoscopic findings were identified: vocal fold bowing, prominence of vocal processes in abduction, and a spindle-shaped glottal gap. Each subject completed two questionnaires: Voice Handicap Index and Geriatric Depression Scale (short-form).
Results
The studied population included 174 White European subjects, with a mean age of 73.99 years, of whom 22.8 per cent presented both presbylarynx and presbycusis. Multivariate linear regression revealed that only presence and severity of presbylarynx had an influence on Voice Handicap Index-30 scores. However, both spindle-shaped glottal gap and presbycusis influenced Geriatric Depression Scale scores.
Conclusion
Presbylarynx has a strong association with the impact of voice on quality of life. Presbylarynx and presbycusis seem to have a cumulative effect on emotional status.
Individual abilities to perceive internal and external sensations are defined respectively as interoception and exteroception: the dysregulation of these functions can explain many psychotic symptoms. (Ardizzi et al. 2016)
Objectives
We evaluated the differences in the interoceptive and exteroceptive perception between 39 patients with psychosis and 250 healthy controls using self-administered questionnaires. The association between interoception and exteroception in the two groups was also tested.
Methods
The tests we used are AASP (Adolescent / Adult Sensory Profile) and MAIA (Multidimensional Assessment of Interoceptive Awareness). Differences were measured with t-tests, associations with spearman’s correlation.
Results
Significant differences emerged between the two samples in the AASP total score and in its Low registration (LR) and Sensory Avoiding (SA) sub-scales and in the MAIA total score and in all its sub-scales except “Not Worrying” (Fig.1). Different patterns of associations between AASP and MAIA were observed: psychotic patients showed negative correlations between MAIA and AASP in the LR and Sensation Seeking (SS) sub-scales and in the auditory (AU) and tactile (TO) sensory channels. Healthy controls, positive correlations emerged between MAIA and AASP in the Sensation Seeking (SK) sub-scale and in the “perception of movement” (MO) sub-score (Fig.2)(Fig.3).
Conclusions
Higher scores of psychotic patients in AASP and MAIA reveal both a disregulated sensory related behavior and a hightened awareness towards internal stimuli. The negative correlation between the two scales in psychotic subjects highlights the importance of the interaction between internal and external perception in determining the global subjective experience.
Heart failure (HF) is a worldwide public health problem and the main cause of morbidity and mortality in older people. Previous studies have demonstrated that psychological symptoms are associated with worse cardiovascular outcomes. Nevertheless, the research regarding the association between anxiety and HF is still scarce.
Objectives
To analyse the levels of anxiety in HF patients and its association with New York Heart Association (NYHA) class in HF patients.
Methods
This study takes part of a wider project named Deus Ex-Machina project (NORTE-01-0145-FEDER-00026). HF patients were recruited from an outpatient clinic at a University Hospital. Patient with inability to communicate, with severe visual impairment or with NYHA class IV were excluded. Sociodemographic data and NYHA class were recorded. Anxiety was assessed using the Generalized Anxiety Disorder-7 (GAD-7).
Results
Overall, 136 patients were included, with a mean age of 57(±13) years old. Most of them were men (66%) and married (76%), with mean education of 8 years (±4). Regarding NYHA class, 36%, 49% and 15% were at class I, II and III, respectively. The mean GAD-7 total score was 6.4 (±5.2) and 32% of patients showed moderate to severe anxiety symptoms. No association between the NYHA functional class and anxiety was found (p=0.106).
Conclusions
The results reveal that anxiety is frequent among HF patients. However, as found in previous studies, it was not associated with more severe HF symptoms. The coexistence of HF and anxiety deserves further studies, in order to build a better understanding of this association.