BACKGROUND: While emotional distress, encompassing anxiety and depression, has been associated with negative clinical outcomes, its impact across various clinical departments and general hospitals has been less explored. Previous studies with limited sample sizes have examined the effectiveness of specific treatments (e.g., antidepressants) rather than a systemic management strategy for outcome improvement in non-psychiatric inpatients. To enhance the understanding of the importance of addressing mental health care needs among non-psychiatric patients in general hospitals, this study retrospectively investigated the impacts of emotional distress and the effects of early detection and management of depression and anxiety on hospital length of stay (LOS) and rate of long LOS (LLOS, i.e., LOS >30 days) in a large sample of non-psychiatric inpatients. METHODS: This retrospective cohort study included 487,871 inpatients from 20 non-psychiatric departments of a general hospital. They were divided, according to whether they underwent a novel strategy to manage emotional distress which deployed the Huaxi Emotional Distress Index (HEI) for brief screening with grading psychological services (BS-GPS), into BS-GPS ( n = 178,883) and non-BS-GPS ( n = 308,988) cohorts. The LOS and rate of LLOS between the BS-GPS and non-BS-GPS cohorts and between subcohorts with and without clinically significant anxiety and/or depression (CSAD, i.e., HEI score ≥11 on admission to the hospital) in the BS-GPS cohort were compared using univariable analyses, multilevel analyses, and/or propensity score-matched analyses, respectively. RESULTS: The detection rate of CSAD in the BS-GPS cohort varied from 2.64% (95% confidence interval [CI]: 2.49%-2.81%) to 20.50% (95% CI: 19.43%-21.62%) across the 20 departments, with a average rate of 5.36%. Significant differences were observed in both the LOS and LLOS rates between the subcohorts with CSAD (12.7 days, 535/9590) and without CSAD (9.5 days, 3800/169,293) and between the BS-GPS (9.6 days, 4335/178,883) and non-BS-GPS (10.8 days, 11,483/308,988) cohorts. These differences remained significant after controlling for confounders using propensity score-matched comparisons. A multilevel analysis indicated that BS-GPS was negatively associated with both LOS and LLOS after controlling for sociodemographics and the departments of patient discharge and remained negatively associated with LLOS after controlling additionally for the year of patient discharge. CONCLUSION Emotional distress significantly prolonged the LOS and increased the LLOS of non-psychiatric inpatients across most departments and general hospitals. These impacts were moderated by the implementation of BS-GPS. Thus, BS-GPS has the potential as an effective, resource-saving strategy for enhancing mental health care and optimizing medical resources in general hospitals.
Humans ; Retrospective Studies ; Male ; Length of Stay/statistics & numerical data* ; Female ; Middle Aged ; Adult ; Psychological Distress ; Inpatients/psychology* ; Aged ; Anxiety/diagnosis* ; Depression/diagnosis*

Coronary artery disease (CAD), one of the most common cardiovascular diseases (CVD), poses a serious threat to physical and mental health, resulting in a severe disease burden. Psychocardiology medicine focuses on the vital role of psychological factors in the development, diagnosis, and treatment of CVD. The prevalence of depression and anxiety is high in patients with CAD. Furthermore, there is a vital interplay among depression, anxiety, mental stress-induced myocardial ischemia, cognitive impairment, and delirium. Both cognitive impairment and delirium adversely impact the prognosis of patients with CAD, warranting increasing attention and the development of interventions. To further direct the clinic diagnosis and treatment of cognitive impairment in patients with CAD complicated with depression and anxiety, and to thus improve the prognosis of such patients, the Psychocardiology Medicine Branch of Chinese Medical Association Beijing Branch, and Psychocardiology Education Professional Committee of China Medical Education Association, together with over 40 other organizations, including more than 50 experts from several related fields, have developed the association standards on guidelines for the cognitive clinical diagnosis and treatment of CAD complicated with depression and anxiety under the framework of the China standard association (No.T/CAS 812-2024).
Humans ; Depression/diagnosis* ; Coronary Artery Disease/psychology* ; Anxiety/diagnosis* ; Practice Guidelines as Topic

Depression syndromes(anxiety and depression), as typical psychological disorders, often coexist with and mutually influence coronary heart disease(CHD). They constitute a psycho-cardiology disease involving both the blood vessels of the heart and the spirit of the heart. Based on the theory of "coexistence of diseases and depression syndromes", it was proposed that CHD and depression syndromes coexisted independently and were causally related. The factors of depression syndromes go through the entire course of CHD and have different causal relationships at different stages, leading to a pathogenic process of "depression causing disease" or "disease causing depression". In the chronic latent period, phlegm predominates, with depression leading to the production of phlegm. Phlegm accumulation and Qi stagnation initiate a mutual damage process of psycho-cardiology, marking the onset of the disease. In the pathological development period, blood stasis becomes predominant. Depression leads to blood stasis, which further obstructs Qi circulation, accelerating disease progression. In the acute attack period, toxicity becomes crucial. Depression transforms into toxicity, damaging Qi and blood, disturbing the balance of the mind, and inducing a sudden and severe exacerbation of the disease. Based on this, the approach of treating phlegm and depression together, treating blood stasis and depression together, and treating toxicity and depression together by stages was established. Research has found that this approach can simultaneously improve organic damage and emotional disorders, and also has a regulating effect on micro-level syndrome indicators, achieving harmonization of psycho-cardiology in the treatment.
Humans ; Medicine, Chinese Traditional ; Depression/diagnosis* ; Coronary Disease/diagnosis* ; Mucus ; Syndrome ; Anxiety

Tinnitus and anxiety disorder are common clinical symptoms. Comorbidity between tinnitus and anxiety state is increasing year by year. The relationship between tinnitus and anxiety state has always been a hot topic, and this paper reviews the literature on the relationship between chronic subjective tinnitus and anxiety state in recent years.
Humans ; Tinnitus/diagnosis* ; Anxiety ; Anxiety Disorders/epidemiology* ; Comorbidity

OBJECTIVE: To explore the risk factors of anxiety and depression in patients with suspected coronavirus disease 2019 (COVID-19) so as to achieve early intervention and better clinical prognosis. METHODS: Seventy-six patients with suspected COVID-19 in fever isolation wards of Second Hospital of Lanzhou University were enrolled From January 31, 2020 to February 22, 2020. Their clinical baseline data were collected. The anxiety of patients was assessed by Hamilton Anxiety Scale, and the depression of patients was assessed by Hamilton Depression Scale. Multivariate Logistic regression analysis was performed to explore the risk factors of anxiety and depression in these patients. RESULTS: Female patients are more likely to have anxiety (=3.206, 95%: 1.073-9.583, <0.05) and depression (=9.111, 95%: 2.143-38.729, <0.01) than male patients; patients with known contact history of epidemic area and personnel in epidemic area are more likely to have depression (=3.267, 95%: 1.082-9.597, <0.05). CONCLUSIONS During the isolation treatment of suspected COVID-19 patients, early psychological intervention should be carried out for the female patients with known contact history of epidemic area and personnel in epidemic area, and drug treatment should be given in advance if necessary.
Anxiety ; diagnosis ; etiology ; therapy ; Betacoronavirus ; isolation & purification ; Coronavirus Infections ; complications ; diagnosis ; psychology ; Depression ; diagnosis ; etiology ; Female ; Humans ; Logistic Models ; Male ; Pandemics ; Pneumonia, Viral ; complications ; diagnosis ; psychology ; Risk Factors

OBJECTIVES: To understand the psychological status of the staff in a general hospital during the coronavirus disease 2019 and its influential factors, and to provide references for the mental health services to hospital staff. METHODS: Using star platform of questionnaire, the staff in the general hospital were investigated via Depression, Anxiety, Stress Scale (DASS-21), Social Support Rating Scale (SSRS) and Simplified Coping Style Questionnaire (SCSQ). The influential factors were discussed by descriptive analysis, rank sum test, single factor analysis, correlation analysis and multiple factors binary logistic regression analysis. RESULTS: A total of 2 060 valid questionnaires were collected. The negative emotions of nurses and cleaners were the most obvious. The depression scores, anxiety scores and stress scores for nurses and cleaners were 5.06±7.47, 6.36±7.84, 9.75±8.65, and 6.72±8.84, 4.51±6.56, 9.69±9.56, respectively. Multivariate binary logistic regression analysis showed that staff types, education levels, job status, economic situation and concerns on the supplies of protective goods were the main influential factors for depression; staff types, contacting status with infected patients, economic situation, concerns on the supplies of protective goods, history of disease were the main influential factors for anxiety; contacting status with infected patients, economic situation, concerns on the supplies of protective goods were the main influential factors for stress. CONCLUSIONS There are differences in psychological characteristics among different groups of staff in the general hospital under the outbreak. Thus psychological protection and intervention measures should be formulated according to different groups and work status.
Adaptation, Psychological ; Anxiety ; diagnosis ; Betacoronavirus ; China ; Coronavirus Infections ; psychology ; Cross-Sectional Studies ; Depression ; diagnosis ; Disease Outbreaks ; Hospitals, General ; Humans ; Pandemics ; Personnel, Hospital ; psychology ; Pneumonia, Viral ; psychology ; Stress, Psychological ; Surveys and Questionnaires

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic is a global public health crisis, which elicits psychological problems in different population This study is to investigate the impact of COVID-19 on mental health in the front-line staff. METHODS: Patient Health Questionnare-9 (PHQ-9), Self-Rating Anxiety Scale (SAS), and Fatigue Self-assessment Scale (FSAS) were used to assess the depression, anxiety, and fatigue in front-line staff. RESULTS: The detection rates of depression, anxiety, and fatigue were 49.1%, 21.8%, and 76.0% among the front-line staff. The rates of depression, anxiety, and fatigue in community workers were higher than those in medical workers and other occupational staff (<0.01). The PHQ-9 of front-line staffs was negatively correlated with age, family income, family members' support, satisfaction of service objects, and sleep quality (all <0.01), while positively correlated with education level, fatigue, fear of pneumonia, and the duration of daily attention to the COVID-19 (all <0.01). SAS was negatively correlated with age, family income, family support, satisfaction of objects service, and sleep quality (all <0.01), while positively correlated with gender, fatigue, fear of pneumonia, and duration of daily attention to the COVID-19 (all <0.01). CONCLUSIONS The front-line workers should manage work and rest time reasonably to adjust their negative mood and fatigue. The government and the society should pay more attention to the psychological state of the front-line staff, particularly for the staff working in the community or villages and towns in preventing the COVID-19 pandemic. Thus, front-line staff can be obtained mental intervention or be taken a rest from the high-intensive work.
Anxiety ; diagnosis ; Betacoronavirus ; Coronavirus Infections ; prevention & control ; psychology ; Depression ; diagnosis ; Fatigue ; diagnosis ; Health Personnel ; psychology ; Humans ; Mental Health ; Pandemics ; prevention & control ; Pneumonia, Viral ; prevention & control ; psychology

PURPOSE: This study was conducted to better understand the illness experiences and palliative care needs in community-dwelling persons with cardiometabolic diseases. METHODS: This qualitative descriptive study was conducted with 11 patients (and three family members) among 28 patients contacted. Interviews were led by the principal investigator in her office or at participants' home depending on their preference. All interviews were digitally recorded and transcribed by a research assistant. The interviews were analyzed by two independent researchers using a conventional method. RESULTS: Participants' ages ranged from 42 to 82 years (nine men and two women). Three themes were identified: (1) same disease, but different illness experiences; (2) I am in charge of my disease(s); (3) preparation for disease progression. Participants were informed of the name of their disease when they were diagnosed, but not provided with explanation of the diagnosis or meant or how to do self-care to delay the disease progression, which increased the feelings of uncertainty, hopelessness and anxiety. Taking medication was considered to be the primary treatment option and self-care a supplemental one. Advanced care plans were considered when they felt the progression of their disease(s) while refraining from sharing it with their family or health care professionals to save their concerns. All participants were willing to withhold life-sustaining treatment without making any preparation in writing. CONCLUSION: Education on self-care and advanced care planning should be provided to community-dwelling persons with cardiometabolic diseases. A patient-centered education program needs to be developed for this population.
Anxiety ; Chronic Disease ; Delivery of Health Care ; Diagnosis ; Disease Progression ; Education ; Humans ; Independent Living ; Male ; Methods ; Palliative Care ; Qualitative Research ; Research Personnel ; Self Care ; Uncertainty ; Writing

PURPOSE: There is increasing prevalence of psychiatric disorders among inflammatory bowel Disease (IBD) population. Further, presence of psychiatric disorders has been shown as an independent predictor of quality of life among patients with IBD. We intended to explore the prevalence of various psychiatric disorders among pediatric and young adult population with IBD as a population-based analysis. METHODS: We did a retrospective case control analysis using a deidentified cloud-based database including health care data across 26 health care networks comprising of more than 360 hospitals across USA. Data collected across different hospitals were classified and stored according to Systematized Nomenclature of Medicine-Clinical Terms. We preidentified 10 psychiatric disorders and the queried the database for the presence of at least one of the ten psychiatric disorders among IBD patients between 5 and 24 years of age and compared with controls. RESULTS: Total of 11,316,450 patients in the age group between 5 and 24 years and the number of patients with a diagnosis of IBD, Crohn's disease or ulcerative colitis were 58,020. The prevalence of psychiatric disorders was 21.6% among IBD mainly comprising of depression and anxiety disorder. Multiple logistic regression analysis showed, IBD is 5 times more likely associated with psychiatric disorders than controls, p<0.001). We showed a steady increasing trend in the incidence of psychiatric disorders among IBD patients (2% in 2006 to 15% in 2017). CONCLUSION: Largest population-based analysis demonstrated an increased prevalence of psychiatric disorders among IBD patients. Our study emphasizes the need for psychological and mental health services to be incorporated as a part of the routine IBD clinic.
Adjustment Disorders ; Anxiety ; Anxiety Disorders ; Case-Control Studies ; Colitis, Ulcerative ; Crohn Disease ; Delivery of Health Care ; Depression ; Diagnosis ; Humans ; Incidence ; Inflammatory Bowel Diseases ; Logistic Models ; Mental Health Services ; Prevalence ; Quality of Life ; Retrospective Studies ; Young Adult

OBJECTIVE: Suicide is the leading cause of death in 10–39-year-olds in South Korea, and the second highest rate among the OECD countries. However, few studies have investigated the particularity of completed suicide in South Korea. METHODS: Study subjects consisted of 2,838 suicide cases and 56,758 age and sex matched living controls from a national representative sample of 1,025,340 South Koreans. They were obtained from the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC) with follow-up up to 12 years. We obtained information on primary diagnosis of any ICD-10 disorder along with suicide cases during their lifetime. RESULTS: Among ICD-10 disorders, depression was the most common disorder (19.10%, n=542), found in victims of completed suicides except for common medical disorders such as hypertensive crisis, respiratory tract infection or arthropathies. After adjusting for sex, age, economic status, disability, and disorders, schizophrenia showed the strongest association with suicide (AOR: 28.56, 95% CI: 19.58–41.66) among all ICD-10 disorders, followed by psoriasis, multiple body injury, epilepsy, sleep disorder, depression, and bipolar disorder. For age groups, ≤19 years was associated with anxiety disorder (AOR=80.65, 95% CI: 13.33–487.93), 20–34 years with epilepsy (AOR=134.92, 95% CI: 33.69–540.37), both 35–49 years (AOR=108.57, 95% CI: 37.17–317.09) and 50–65 years (AOR=189.41 95% CI: 26.59–1349.31), with schizophrenia, and >65 years (AOR=44.7, 95% CI: 8.93–223.63) with psoriasis. CONCLUSION: Psychiatric and physical disorders carried greatly increased risks and numbers of suicides in South Korea. Schizophrenia was the strongest risk factor, especially 35–65 years, and depression was the most common in suicide victims among ICD-10 disorders in South Korea.
Anxiety Disorders ; Bipolar Disorder ; Case-Control Studies ; Cause of Death ; Cohort Studies ; Depression ; Diagnosis ; Epilepsy ; Follow-Up Studies ; Humans ; Insurance, Health ; International Classification of Diseases ; Korea ; National Health Programs ; Organisation for Economic Co-Operation and Development ; Psoriasis ; Respiratory Tract Infections ; Risk Factors ; Schizophrenia ; Sleep Wake Disorders ; Suicide