Background Background: Growing evidence from observational studies indicates a high prevalence of anxiety in asthma. However, prevalence rates of coexisting anxiety symptoms and comorbid anxiety disorders vary widely across studies. We aimed to evaluate the associations between anxiety and asthma and provide more precise comorbidity estimates. Methods
 We systematically reviewed the literature from case-controlled studies and conducted a meta-analysis to evaluate the pooled prevalence estimates and risks of anxiety symptoms and anxiety disorders in asthma individuals. Screening, data extraction, and quality assessment were undertaken following PRISMA guidelines for preferred reporting of systematic reviews and meta-analysis. A random-effects model was used to calculate pooled prevalence rates. Meta-analysis was conducted using Review Manager 5.3. Multiple databases including PubMed, ScienceDirect, PsychINFO, and PsycARTICLES were searched for publications before 1 December 2019. The review protocol was registered on PROSPERO (ref: CRD42020176028). Results
 In total, 19 studies involving 106813 participants were included. The pooled prevalence of anxiety symptoms and anxiety disorders in individuals with asthma was 0.32 (95% CI 0.22–0.43) and 0.24 (95% CI 0.13–0.41), respectively. The risks of coexisting anxiety symptoms and comorbid anxiety disorders were significantly higher in asthma patients than in non-asthma controls indicated by OR 1.89 (95% CI 1.42–2.52; Z = 4.37; p < 0.001) and OR 2.08 (95% CI 1.70–2.56; Z = 6.97; p < 0.001), respectively. Anxiety symptoms and anxiety disorders occur at increased frequency among patients with asthma. Conclusions
 Our findings highlight the need for appropriate assessments for these comorbid conditions, which may help to identify a subgroup of patients who might benefit from interventions designed to reduce anxiety and enhance the quality of life.

Anxiety in asthma: a systematic review and meta-analysis.

Prevalence of Depression or Anxiety During Antepartum Hospitalizations for Obstetric Complications: A Systematic Review and Meta-analysis.

https://doi.org/10.1016/j.chb.2022.107424

Network analysis of internet addiction and depression among Chinese college students during the COVID-19 pandemic: A longitudinal study

Objectives Evidence linking end-of-life-care quality in ICUs to bereaved family members' psychologic distress remains limited by methodological insufficiencies of the few studies on this topic. To examine comprehensively the associations of family surrogates' severe anxiety and depressive symptoms with end-of-life-care quality in ICUs over their first 6 months of bereavement. Design Prospective, longitudinal, observational study. Setting/participants Family surrogates (n = 278) were consecutively recruited from seven medical ICUs at two academically affiliated medical centers in Taiwan. Measurements and statistical analysis Family surrogates' anxiety and depressive symptoms were assessed 1, 3, and 6 months postloss using the Hospital Anxiety and Depression Scale. Family satisfaction with end-of-life care in ICUs was assessed 1-month postloss by the Family Satisfaction in the ICU questionnaire. Patients' end-of-life care was documented over the patient's ICU stay. Associations of severe anxiety and depressive symptoms (scores ≥ 8 for each subscale) with end-of-life-care quality in ICUs (documented by patient care received and family satisfaction with end-of-life care in ICUs) were examined by multivariate logistic regression models with generalized estimating equation. Main results Prevalence of severe anxiety and depressive symptoms decreased significantly over time. Surrogates' lower likelihood of severe anxiety or depressive symptoms 3-6 month postloss was associated with death without cardiopulmonary resuscitation, withdrawing life-sustaining treatments, and higher family satisfaction with end-of-life care in ICUs. Bereaved surrogates' higher likelihood of these symptoms was associated with physician-surrogate prognostic communication and conducting family meetings before patients died. Conclusions End-of-life-care quality in ICUs is associated with bereaved surrogates' psychologic well-being. Enhancing end-of-life-care quality in ICUs by improving the process of end-of-life care, for example, promoting death without cardiopulmonary resuscitation, withdrawing life-sustaining treatments, and increasing family satisfaction with end-of-life care, can lighten bereaved family surrogates' severe anxiety symptoms and severe depressive symptoms.

End-of-Life-Care Quality in ICUs Is Associated With Family Surrogates' Severe Anxiety and Depressive Symptoms During Their First 6 Months of Bereavement.

Objectives: The COVID-19 pandemic and aligned social and physical distancing regulations increase the sense of uncertainty, intensifying the risk for psychopathology globally. Anxiety disorders are associated with intolerance to uncertainty. In this review we describe brain circuits and sensorimotor pathways involved in human reactions to uncertainty. We present the healthy mode of coping with uncertainty and discuss deviations from this mode.

Methods: Literature search of PubMed and Google Scholar.

Results: As manifestation of anxiety disorders includes peripheral reactions and negative cognitions, we suggest an integrative model of threat cognitions modulated by sensorimotor regions: “The Sensorimotor-Cognitive-Integration-Circuit.” The model emphasizes autonomic nervous system coupling with the cortex, addressing peripheral anxious reactions to uncertainty, pathways connecting cortical regions and cost-reward evaluation circuits to sensorimotor regions, filtered by the amygdala and basal ganglia. Of special interest are the ascending and descending tracts for sensory-motor crosstalk in healthy and pathological conditions. We include arguments regarding uncertainty in anxiety reactions to the pandemic and derive from our model treatment suggestions which are supported by scientific evidence. Our model is based on systematic control theories and emphasizes the role of goal conflict regulation in health and pathology. We also address anxiety reactions as a spectrum ranging from healthy to pathological coping with uncertainty, and present this spectrum as a transdiagnostic entity in accordance with recent claims and models.

Conclusions: The human need for controllability and predictability suggests that anxiety disorders reactive to the pandemic's uncertainties reflect pathological disorganization of top-down bottom-up signaling and neural noise resulting from non-pathological human needs for coherence in life.

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Between Action and Emotional Survival During the COVID-19 era: Sensorimotor Pathways as Control Systems of Transdiagnostic Anxiety-Related Intolerance to Uncertainty

Anxiety disorders are debilitating psychological disorders characterized by a wide range of cognitive and somatic symptoms. Anxiety sufferers have a higher lifetime prevalence of various medical problems. Chronic medical conditions furthermore increase the likelihood of psychiatric disorders and overall dysfunction. Lifetime rates of cardiovascular, respiratory, gastrointestinal, and other medical problems are disproportionately high in anxiety and panic/fear sufferers. The heightened comorbidity is not surprising as many symptoms of anxiety and panic/fear mimic symptoms of medical conditions. Panic disorder specifically is strongly linked to medical conditions due to its salient somatic symptoms, such as dyspnea, dizziness, numbness, chest pain, and heart palpitations, all of which can signal danger and deterioration for chronic disease sufferers. This chapter identifies shared correlates of medical illness and anxiety disorders and evidence for misinterpretation of symptoms as medically relevant and offers an analysis of implications for treatment of both types of conditions. We will concentrate on medical conditions with high associations for anxiety and panic by aspects of symptomatology, specifically neurological disorders (fibromyalgia, epilepsy, cerebral palsy), diabetes, gastrointestinal illness (irritable bowel syndrome, gastroesophageal reflux disease), and cardiovascular and respiratory illnesses (asthma).

Anxiety Disorders and Medical Comorbidity: Treatment Implications.

Objective Women hospitalized for high-risk pregnancies, including those with preterm premature rupture of membranes (PPROM), are at a greater risk for experiencing distress, as well as symptoms of anxiety and depression. An acceptance-based therapy would be particularly suitable for such women, as it encourages them to experience uncomfortable sensations and thoughts. The aim of this study was to pilot-test the feasibility and acceptability of a brief acceptance-based therapy for pregnant women on hospitalized bedrest, and to report preliminary symptom changes. Method Five women admitted to the hospital for PPROM participated in a 7-day acceptance-based therapy. Treatment feasibility and tolerability along with psychological symptoms (positive and negative affect, depression, anxiety, stress, post-traumatic stress, pregnancy-related distress and psychological flexibility) were assessed at baseline, mid-intervention, post-intervention and at a 1-month postpartum follow-up (1MFU). Results Treatment feasibility, credibility, tolerability, and homework adherence were high. Participants reported clinical levels of positive and negative affect upon admission and indicated stress as a result of hospitalization. The intervention was associated with an increase in positive affect into a non-clinical range, which was maintained through the 1MFU. Psychological flexibility was high at admission and remained high post-partum. Depression, anxiety, prenatal distress, and PTSD symptoms were in a non-clinical range, and remained non-clinical following admission and at 1MFU. Conclusions Overall, our brief acceptance-based therapy was feasible and an acceptable intervention to implement in a medical setting. Findings suggest preliminary evidence that our brief intervention was associated with symptom improvements or maintenance of non-clinical levels in women hospitalized for high-risk pregnancies.

Brief acceptance-based therapy for women with high-risk pregnancies: Uncontrolled pilot of an intervention for inpatients

Habituation or Normalization? Experiential and Respiratory Recovery From Voluntary Hyperventilation in Treated Versus Untreated Patients With Panic Disorder.

S94 Patient-Level Factors Driving Medication Non-adherence in Crohn's Disease

Psychophysiological theories postulate respiratory dysregulation as a mechanism contributing to panic disorder (PD). Additionally, symptomatic and respiratory recovery from voluntary hyperventilation (HVT-recovery) have been shown to lag in PD and it is unclear if HVT-recovery normalizes with treatment. Thirty-seven panic disorder patients were randomized to hypoventilation therapy (TX, n=20) or waitlist control (WL, n=17) (Meuret et al., 2008). In a secondary analysis, their HVT-recovery was analyzed at pre- and post-TX/WL, together with 29 healthy controls (HC). HVT included three phases: 5-min baseline, 3-min hyperventilation, and 8-min recovery. HVT-elicited symptom severity and anxiety were rated following each phase, and end-tidal PCO 2 and respiratory rate (RR) were recorded throughout. Treatment, compared to WL, was highly effective in reducing PD pathology (d=2.21, Meuret et al., 2008). At pre-TX/WL, PD demonstrated delayed HVT-recovery PCO 2 and higher RR. Treated patients demonstrated normalization of HVT-recovery for PCO 2 and RR; however, improvements of HVT-recovery for symptom severity and anxiety did not differ between TX and WL. Results replicate pretreatment HVT-recovery abnormalities in PD and further demonstrate normalization, comparable to HC, following successful treatment. Overall, results provide support for respiratory dysregulation as a feature of PD and demonstrate the utility of HVT respiratory recovery as outcome measure for respiration-based PD therapy. aim of the current study was to replicate previous findings indicating slowed HVT-recovery in experiential (symptom severity and anxiety) and respiratory (PCO 2 and RR) responses in patients with PD. The second aim was to test whether sustained hyperventilation in recovery from the HVT is reduced in treated but not untreated (wait-list) PD patients, while also controlling for repeated HVT habituation effects by testing healthy controls twice. Insights would provide further support for the notion that PD sufferers tend to recover more slowly from hyperventilation and that recovery from hyperventilation can be accelerated with successful treatment. This would further help establishing the HVT as a biobehavioral outcome measure for PD.

Habituation or normalization through treatment? Experiential and respiratory recovery from voluntary hyperventilation in treated versus untreated patients with panic disorder

Natalie C. Tunnell

Papers

Anxiety Disorders and Medical Comorbidity: Treatment Implications.

Brief acceptance-based therapy for women with high-risk pregnancies: Uncontrolled pilot of an intervention for inpatients

Habituation or Normalization? Experiential and Respiratory Recovery From Voluntary Hyperventilation in Treated Versus Untreated Patients With Panic Disorder.

S94 Patient-Level Factors Driving Medication Non-adherence in Crohn's Disease

Habituation or normalization through treatment? Experiential and respiratory recovery from voluntary hyperventilation in treated versus untreated patients with panic disorder