Objective Observational studies have shown an association between Parkinson disease （PD） and mental illness， but further studies are needed to explore the causal relationship between them. This study aims to investigate such causal relationship using the method of two-sample Mendelian randomization （MR）. Methods Related data were extracted from GWAS， and summary statistics associated with PD， depression， sleep disorders， and anxiety phenotype-variants were obtained. Single nucleotide polymorphisms （SNPs） for PD were selected as instrumental variables， and MR-PRESSO was used to exclude outliers. Inverse variance weighting was used as the main method to assess causal effect estimates， and MR Egger， weighted median， simple mode， and weighted mode were used to verify the robustness of the findings. A sensitivity analysis was used to validate the reliability of the results， including the Cochran Q test， the MR-Egger intercept test， funnel plots， and the leave-one-out method. Results A total of 21 SNPs associated with PD were identified. The MR analysis showed that PD had a causal relationship with depression （OR=0.974，95%CI 0.934‒1.015， P=0.210）， sleep disorders （OR=1.056， 95%CI 0.970-1.149， P=0.211）， and anxiety （OR=0.998， 95%CI 0.996‒1.001， P=0.118）， with no statistical significance. Different MR analyses and sensitivity analyses showed that PD did not directly contribute to the development of mental illness. Conclusion There is no direct causal relationship between PD and depression/sleep disorders/anxiety. In clinical practice， healthcare professionals should pay attention to the mental health of patients with PD. Randomized controlled studies should be conducted in the future to further validate the results of this study.
Depression ; Anxiety

Objective To investigate the association between sleep behaviors （including bedtime， sleep quality， and nap duration） and academic performance among college students， as well as the regulatory effect of test anxiety and exercise habit on the association between sleep and academic performance. Methods A questionnaire survey was conducted to collect data. The grade of compulsory courses （with higher grades indicating better academic performance） was used as an ordinal dependent variable. All independent variables were coded by levels： for bedtime during exam and non-exam periods， higher levels indicated later bedtimes； for anxiety during the exam period， higher levels indicated more severe anxiety； for sleep quality during both exam and non-exam periods， higher levels indicated better sleep quality； for nap duration， higher levels indicated longer naps. Exercise habit was treated as a binary variable （yes/no）. Ordinal logistic regression （proportional odds model） was used for multivariable analysis， and OR and 95%CIwere calculated. In addition， sex-stratified models were established to investigate sex differences in the associations between these factors and academic performance. Results A total of 1 221 college students were included， among whom male students accounted for 33.7%. After controlling for confounding factors， bedtime during the exam period was significantly positively associated with the grade of compulsory courses， indicating that later bedtime was associated with a greater likelihood of achieving a higher grade （OR=1.32，95%CI 1.08‒1.62， P=0.007）. Sex was also an independent predictive factor， and the OR of achieving a higher grade in female students was 2.4 times that in male students （OR=2.41， 95%CI 1.90‒3.06， P<0.001）. Sleep quality during the exam period （OR=1.18，95%CI 0.99‒1.42， P=0.070） and exercise habit （OR=1.24， 95%CI 0.99‒1.55， P=0.064） showed marginally significant associations with grade. In contrast， bedtime during the non-exam period， nap duration， anxiety during the exam period， and self-rated sleep quality during the non-exam period showed no statistical significance （all P>0.05）. Sex-stratified analysis showed that among the male students， later bedtime during the exam period was associated with a greater likelihood of achieving a higher grade （OR=1.48， 95%CI 1.05‒2.09， P=0.025）， whereas higher anxiety during the exam period was associated with a lower likelihood （OR=0.79，95%CI 0.63‒0.98， P=0.032）； among the female students， better sleep quality during the exam period was associated with a greater likelihood of achieving a higher grade （OR=1.27， 95%CI 1.02‒1.57， P=0.033）， and bedtime during the exam period showed a positive association with academic performance， but without statistical significance （OR=1.25，95%CI 0.96‒1.62，P=0.091）. Conclusion The association between sleep behaviors and academic performance among college students varies with academic period and sex. Later bedtime during the exam period is associated with better academic performance， but this effect is observed only among male students. In addition， the academic performance of male students is negatively affected by test anxiety， whereas the academic performance of female students is positively associated with subjective sleep quality. Future interventions aimed at improving academic health should consider sex-specific strategies.
Anxiety ; Exercise

Introduction: The COVID-19 pandemic accelerated the adoption of alternative instructional approaches, including distance and online learning. This study aimed to determine factors associated with preference for online learning modality among medical students at a private medical school in the National Capital Region (NCR). Methods: An analytical cross-sectional study was conducted among 367 medical students using convenience sampling. Participants completed an online survey assessing preferred learning modality, general anxiety, self-efficacy, and satisfaction with online learning. Factors associated with preference for online learning were identified using logistic regression analysis. Results: Most respondents (79.3%) preferred traditional face-to-face learning, whereas 20.7% preferred online learning. Male students were more likely to prefer online learning than female students (OR = 2.19, p = 0.003). Married students were more likely to prefer online learning than unmarried students (OR = 9.71, p = 0.021). Students who reported greater satisfaction with their online learning experience were more likely to prefer online learning (OR = 2.28, p = 0.024). Self-efficacy demonstrated a borderline association with preference for online learning (OR = 0.42, p = 0.053). Conclusion Sex, civil status, and satisfaction with online learning were significantly associated with preference for online learning modality. Self-efficacy demonstrated a borderline association. Despite the increased use of online learning during the COVID-19 pandemic, most respondents continued to prefer traditional face-to-face instruction.
Education ; Anxiety ; Self-efficacy

BACKGROUND AND OBJECTIVES

Climate anxiety is an emerging concept defined as increased anxiety about climate change and has been linked to negative mental health outcomes. As a relatively new concept, only a few have characterized it and its relationship with mental health, especially in the Global South populations. This study aimed to investigate the relationship between climate anxiety and depressive symptoms among undergraduate students from a college in a higher education institution in Manila, Philippines. Specifically, it aimed to (1) determine the proportion of undergraduate students who reported high levels of climate anxiety and depressive symptoms; and (2) determine the association between climate anxiety and depressive symptoms.

Using a cross-sectional design and a convenience sampling method, the investigators collected data through an online survey to assess levels of climate anxiety and depressive symptoms using the Climate Change Anxiety Scale (CCAS) and the Patient Health Questionnaire 9 (PHQ-9), respectively. Data was analyzed using multiple logistic regression.

Among the 148 respondents (N=325), 14.86% had high climate anxiety (i.e., CCAS score >= 3) and 62.84% had high depressive symptoms (i.e., PHQ-9 score >= 10). Regression analysis showed that the odds of those having high climate anxiety reporting high depressive symptoms are higher than those with low climate anxiety, though this is not significant (OR = 2.53, p=0.144).

The study verifies the existence of climate anxiety among undergraduate students and reflects an alarming mental health situation in the selected college. It is recommended that wide-scope investigations on the current state of climate anxiety and mental health among the youth be done to verify their impacts, along with inter-sectoral efforts such as increasing awareness through health education interventions to improve the youths’ mental health literacy and resilience to the effects of climate change, and promoting climate change-responsive mental health services to address these as pressing threats to youth health.

BACKGROUND AND OBJECTIVE

Filipino farmers face unique occupational challenges that increase the risk of mental health issues, particularly anxiety. This study aims to determine the different personal, environmental, socioeconomic, occupational, and psychosocial factors associated with anxiety symptoms among Filipino farmers in Central Luzon.

Chain referral sampling method was used to recruit participants for the study, who underwent screening based on the eligibility criteria. Eligible participants were then asked about anxiety symptoms using the Generalized Anxiety Disorder-7 (GAD-7), while the validated, researcher-constructed Data Collection Tool for Factors Associated with Anxiety Symptoms (DCFAAS) was used to determine the farmers’ exposure to a variety of factors. Microsoft Excel was utilized in computing for frequency and percent distribution of participants, in each factor. Binary logistic regression was used to compute crude and adjusted odds ratio of each factor thru IBM SPSS Statistics®.

Among the 113 eligible farmers enrolled in the study, only 19 (16.8%) experienced anxiety symptoms, with excessive worrying, which was seen among 45 participants (39.8%). The mental health of Filipino farmers was significantly affected by the presence of physical illness (OR = 10.70 [95% CI 1.367, 83.773]) and having relatives affecting work completion (OR = 6.45 [95% CI 1.346, 30.896]). 

Despite the low prevalence of anxiety symptoms in this study, the findings suggest government policies to improve mental health service access to farmers, to integrate psychosocial support into agricultural programs, and to address family-related work pressures. By addressing these factors, it can improve farmer productivity and promote overall well-being, putting emphasis on the mental health of the Filipino farmers.

Objective To investigate the potential genetic mechanisms of insomnia and anxiety and the bidirectional causal relationship between them using Linkage Disequilibrium Score Regression （LDSC） and Mendelian Randomization （MR）. Methods Based on the data from genome-wide association studies， LDSC was used to analyze the genetic correlation of insomnia with anxiety and its subtypes. The inverse variance weighted （IVW） method was used as the main analytical method， supplemented by MR-Egger regression， weighted median， the simple model method， and weighted model. The Cochran’s Q test was used for heterogeneity testing， MR-Egger was used for pleiotropy testing， and the leave-one-out method was used for sensitivity analysis. Results The LDSC analysis revealed the genetic correlation of insomnia with anxiety and its subtypes. The results of IVW analysis showed that insomnia had a causal relationship with the increased risk of anxiety （OR=1.448，95%CI 1.025‒2.045，P=0.036，PFDR=0.178） and generalized anxiety disorder （OR=2.098，95% CI 1.105‒3.986， P=0.024， PFDR=0.314）. Conversely， the reverse MR analysis showed a causal relationship between generalized anxiety disorder and the increased risk of insomnia （OR=1.010， 95% CI 1.003‒1.017， P=0.008， PFDR=0.329）. No significant horizontal pleiotropy was detected for the instrumental variables （P>0.05）， and the sensitivity analysis showed that the results of MR analysis were stable. Conclusion Insomnia may be used as a risk factor for anxiety， and there is a genetic correlation between the two diseases.
Insomnia ; Anxiety

BACKGROUND

Anxiety and depression are prevalent during pregnancy. There is significant evidence that antenatal anxiety and depression are risk factors for adverse maternal and neonatal outcomes.

This study aims to determine the prevalence of anxiety and depression among pregnant women who undergo ultrasonographic detection of structural fetal anomalies in the Department of Maternal and Fetal Medicine of University of the Philippines–Philippine General Hospital, Manila, Philippines, for a 13-month period.

The study utilized a comparative cross-sectional study design comparing those who underwent congenital anomaly scan (CAS) with those who just underwent routine biometry. There were 177 research respondents for each group. The Filipino version of the Hospital Anxiety and Depression Scale (HADS-P) was used. The psychiatric interview was based on the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM V) particularly on the Major Depressive DIsorder and the Generalized Anxiety Disorder.

The results showed that the mean pre-diagnostics anxiety score of women who underwent CAS was significantly higher than the mean pre-diagnostics anxiety score of women who had biometry. The mean post-diagnostics depression score of women who underwent CAS was significantly higher than the mean post-diagnostics depression score of women who had biometry. However, all pregnant women had normal HADS-P score before and after CAS and biometry. Psychiatric evaluation showed that none was diagnosed to have generalized anxiety disorder or major depression in the conduct of the diagnostic tests.

This study indicates that generalized anxiety and depression among pregnant patients subjected to routine biometry and congenital scan were not problems in this tertiary hospital. Knowledge of CAS and awareness of risk factors for congenital anomalies are important for providing care and counseling pregnant women.

BACKGROUND AND OBJECTIVES

Depression and anxiety are common among patients with cardiovascular disease. With increased stress from the ongoing pandemic, it is important to evaluate these conditions. Hence, this study aimed to identify the prevalence of depression and anxiety among outpatient consults via telemedicine through the HADS-P questionnaire and to compare the clinical and socioeconomic profile of patients with HADS-P score of >/=11.

This is a cross-sectional descriptive study including participants, outpatients in the cardiology clinic through an online survey regarding their socioeconomic demographic profile and the HADS-P questionnaire. Patients with scores of >/=11 for anxiety or depression were identified and the two groups were compared using a chi-square test analysis.

One hundred and twelve patients were recruited. Majority were females, with a partner, unemployed and living below the poverty line. The most common cardiovascular condition was ischemic heart disease and most patients were at least functional class II. The measured prevalence of probable anxiety and depression were 22% and 8%, respectively. A significant difference between the presence of both anxiety and depression was seen in participants with no partners; and for depression alone, in employed participants.

Anxiety and depression are common in this sample population. HADS-P is a simple way of screening patients for these conditions so that holistic care may be instituted and appropriate referrals for psychological intervention may be done.

Objective To investigate the state of anxiety and depression in patients with Parkinson disease due to high-altitude exposure in Tibet， China and its impact on quality of life. Methods A total of 93 patients with Parkinson disease who attended Tibet Autonomous Region People’s Hospital from February 2023 to November 2024 were enrolled， and basic information and assessment scales were collected. The Unified Parkinson’s Disease Rating Scale Part Ⅲ （UPDRS-Ⅲ） and Hoehn-Yahr （H-Y） stage were used to evaluate disease severity； Parkinson’s Disease Quality of Life Questionnaire （PDQ-39） was used to evaluate the quality of life of patients； the diagnostic criteria for depression and anxiety in Parkinson disease were used for the diagnosis of depression and anxiety in patients with Parkinson disease； Hamilton Depression Scale （HAMD） and Hamilton Anxiety Scale （HAMA） were used to assess the severity of depression and anxiety. Results Among the 93 patients with Parkinson disease， the prevalence rates of depression and anxiety were 59.1% and 44.1%， respectively. There were significant differences between the depression group and the non-depression group in the somatization， despair， cognitive impairment， block factor， and day-night changes of anxiety， but there were no significant differences in sleep disorders and body weight between the two groups. The depression group had significantly higher PDQ-39 scores than the non-depression group， and the anxiety group had significantly higher PDQ-39 scores than the non-anxiety group. Depressive state was negatively correlated with folate and was positively correlated with blood homocysteine. Anxiety state was positively correlated with H-Y stage and UPDRS Ⅲ score. Conclusion There are relatively high prevalence rates of depression and anxiety in patients with Parkinson disease in Tibetan plateau area， which significantly affects the quality of life of patients.
Parkinson Disease ; Depression ; Anxiety

Objective To investigate the effect of Baduanjin on mood and sleep quality in patients with mild to moderate Parkinson disease （PD） and related mechanisms. Methods A total of 110 patients with Hoehn-Yahr stage 1-3 stable PD were randomly divided into Baduanjin group and control group， with 55 patients in each group. The patients in the Baduanjin group received Baduanjin exercise for 30 minutes each time， 5 days a week for 12 weeks， and those in the control group did not do any exercise. Motor function， anxiety and depression mood， and sleep quality were assessed before exercise and after exercise for 12 weeks. Results Compared with the control group， the Baduanjin group had significant improvements in UPDRS-Ⅲ score and 6-minute walk test results. There was a significant difference in Berg Balance Scale in terms of the interaction between time and intervention. There were significant differences between the two groups in HAMA14，HAMD24，and PSQI scores. Conclusions Baduanjin can improve mood and sleep quality in patients with mild to moderate PD.
Parkinson Disease ; Anxiety ; Depression