Latest & greatest articles for anxiety

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Anxiety

Anxiety is the subjectively feelings of dread over anticipated events and it is different from fear. Clinical anxiety is a group of mental disorders with generalised anxiety disorder (GAD) being the most common (approximately 22% of primary care attendances for anxiety are classed as GAD). Overall, there is a lifetime prevalence rate of 4-7%. Anxiety can be caused by a number of factors typically classified as environmental surroundings and genetic.

In the past few decades anxiety research has significantly increased. In 2000 there were approximately 430 trials looking at anxiety and by 2015 to over 1,000. This has allowed medical professionals to develop and improve accurate diagnosis and treatments in patients suffering from the condition.

Anxiety is normal in uncomfortable environments or stressful situations. However, some individuals experience intense and persistent amounts of anxiety which needs to be kept under control. Treatments include pharmaceuticals such as SSRIs, benzodiazepines, pregabalin and gabapentin. Other therapies include CBT, acceptance and commitment therapy, and motivational interviewing.

Trip has all the latest evidence relating to treatments for anxiety, this includes systematic reviews, clinical guidelines, controlled trials, evidence-based synopses, case reports and clinical Q&As.

Top results for anxiety

1. The Impact of 3 Different Distraction Techniques on the Pain and Anxiety Levels of Children During Venipuncture: A Clinical Trial

The Impact of 3 Different Distraction Techniques on the Pain and Anxiety Levels of Children During Venipuncture: A Clinical Trial Invasive procedures are important causes of pain and anxiety during hospitalization. This study aimed to evaluate the effect of 3 different distraction methods on the pain and anxiety levels of children during venipuncture.This was a randomized controlled trial conducted with 180 children of 6 to 10 years of age; data were collected in the months of August (...) to November 2016. Participants were randomized in 4 groups; the children in group 1 watched cartoon movies (CM), the children in group 2 played video games (VG), the children in group 3 were distracted by their parents' verbal interactions (PI), whereas no distraction method was used on the children in group 4 (control group). The levels of anxiety and pain perception were evaluated independently based on the feedback from the children, the nurse observer, and the parents. The Children Fear Scale was used

2019 EvidenceUpdates

2. A systematic review of interventions to facilitate extubation in patients difficult-to-wean due to delirium, agitation, or anxiety and a meta-analysis of the effect of dexmedetomidine

A systematic review of interventions to facilitate extubation in patients difficult-to-wean due to delirium, agitation, or anxiety and a meta-analysis of the effect of dexmedetomidine Delirium, agitation, and anxiety may hinder weaning from mechanical ventilation and lead to increased morbidity and healthcare costs. The most appropriate clinical approach to weaning in these contexts remains unclear and challenging to clinicians. The objective of this systematic review was to identify effective (...) and safe interventions to wean patients that are difficult-to-wean from mechanical ventilation due to delirium, agitation, or anxiety.A systematic review was performed using MEDLINE, EMBASE, and PubMed. Studies evaluating mechanically ventilated patients deemed difficult-to-wean due to delirium, agitation, or anxiety, and comparing the effects of an intervention with a comparator arm were sought. Time-to-extubation was the primary outcome while the secondary outcome was intensive care unit (ICU) length

2019 EvidenceUpdates

3. Pharmacological treatments for generalised anxiety disorder: a systematic review and network meta-analysis. (PubMed)

Pharmacological treatments for generalised anxiety disorder: a systematic review and network meta-analysis. Generalised anxiety disorder is a disease that can be associated with substantial dysfunction. Pharmacological treatment is often the first choice for clinicians because of the cost and resource constraints of psychological alternatives, but there is a paucity of comparative information for the multiple available drug choices.A systematic review and network meta-analysis was performed (...) on randomised trials in adult outpatients with generalised anxiety disorder identified from MEDLINE, Web of Science, Cochrane Library, ClinicalTrials.gov, Chinese National Knowledge Infrastructure (CNKI), Wanfang data, Drugs@FDA and commercial pharmaceutical registries. Placebo and active control trials were included. Data were extracted from all manuscripts and reports. Primary outcomes were efficacy (mean difference [MD] in change in Hamilton Anxiety Scale Score) and acceptability (study discontinuations

2019 Lancet

4. Cartoons are promising for reducing dental anxiety in children

Cartoons are promising for reducing dental anxiety in children Dental anxiety in children may be reduced through cartoons Discover Portal Discover Portal Cartoons are promising for reducing dental anxiety in children Published on 3 July 2018 doi: Cartoons delivered on laptops, projectors or 3D goggles with sound can help distract anxious children who fear dental procedures. Dental anxiety can prevent children from attending the dentist for care, and this type of distraction could offer a useful (...) tool to help them. This review looked at a range of audiovisual approaches tested in trials of healthy children receiving dental treatment under local anaesthetic. The children were assessed for physiological measures related to emotional state (such as pulse rate), anxiety and observed behaviour. Childhood dental anxiety is a common problem, and these distraction approaches sound promising, safe and relatively easy to implement. Share your views on the research. Why was this study needed

2019 NIHR Dissemination Centre

5. Talking therapy may relieve high levels of anxiety about health conditions

Talking therapy may relieve high levels of anxiety about health conditions Talking therapy may relieve high levels of anxiety about health conditions Discover Portal Discover Portal Talking therapy may relieve high levels of anxiety about health conditions Published on 24 October 2017 doi: A specific talking therapy called ‘cognitive behavioural therapy for health anxiety’ may help people who are excessively worried about their health. Health anxiety reduced by a small, but meaningful amount (...) , among the medical outpatients who were identified and treated. Delivered in one-hour sessions every two weeks, therapy lasted about four months. It was provided by junior therapists and trained nurses with no previous experience of the therapy. Benefits lasted for about five years. This UK-based NIHR trial is the largest so far to screen and treat people for health anxiety in the outpatient setting. Therapy improved health anxiety, but quality of life benefits varied depending on the scale used

2019 NIHR Dissemination Centre

6. Staying on antidepressants may prevent a relapse of anxiety

Staying on antidepressants may prevent a relapse of anxiety Staying on antidepressants may prevent a relapse of anxiety Discover Portal Discover Portal Staying on antidepressants may prevent a relapse of anxiety Published on 17 January 2018 doi: People with anxiety disorders who continued taking antidepressants after successful treatment were less likely to experience a relapse, and relapsed later, than people who stopped taking antidepressants. About 16% of people had a relapse (...) if they remained on antidepressants for on average 44 weeks compared with 36% who stopped after 20 weeks. Anxiety disorders are common and can interfere with people’s everyday work, family and social life. Antidepressants and psychological therapies are the mainstays of treatment. Reducing the likelihood of relapse after successful treatment is important for the individual and the cost of additional care. There remains a need for evidence about the effectiveness of continuing treatment beyond 12 months after

2019 NIHR Dissemination Centre

7. Talking therapy given by parents shows promise for childhood anxiety disorders

Talking therapy given by parents shows promise for childhood anxiety disorders Talking therapy given by parents shows promise for childhood anxiety disorders Discover Portal Discover Portal Talking therapy given by parents shows promise for childhood anxiety disorders Published on 8 August 2017 doi: Brief guided cognitive behavioural therapy (CBT) delivered by parents was as good as a commonly used treatment, delivered by a therapist, in improving anxiety levels in children. Anxiety continued (...) to improve after the end of treatment and by six months about 70% had recovered. The brief CBT was potentially the more cost-effective option. This NIHR-funded trial compared recovery from a range of common anxiety disorders in children aged five to 12 following these brief psychological treatments. CBT was delivered by parents instructed and supported in its use by a mental health worker. It was compared with a treatment commonly used in the NHS, a solution-focused brief therapy delivered directly

2019 NIHR Dissemination Centre

8. Depression and anxiety common in people with heart disease

Depression and anxiety common in people with heart disease Depression and anxiety common in people with heart disease Discover Portal Discover Portal Depression and anxiety common in people with heart disease Published on 28 June 2016 doi: This multi-part NIHR study found that depression and anxiety were more common in people with coronary heart disease, than the general population. Anxiety increased people’s risk of a future heart attack. The people included in the study were generally older (...) , white males, so the findings may not apply to everyone. Patients considered a nurse-led intervention to personalise care was acceptable. The intervention included optimising medicines and facilitating referrals for psychological support. When asked, people with depression and coronary heart disease generally favoured non-medical treatments. These findings provide an insight into the scale of depression and anxiety amongst people with coronary heart disease. Overall costs of NHS care were increased

2019 NIHR Dissemination Centre

9. Music can reduce pain and anxiety following surgery

Music can reduce pain and anxiety following surgery Music can reduce anxiety and pain following surgery Discover Portal Discover Portal Music can reduce pain and anxiety following surgery Published on 7 August 2018 doi: Recorded music played before, during or after surgery in adults reduces self-reported post-operative pain and anxiety, compared with usual care. The average effect is equivalent to a reduction in anxiety of 21 percentage points and a 10 percentage point reduction in pain within (...) a few days of surgery. It is thought that placebo and distraction effects probably play a role, but in this review music still improved pain when used for patients under a general anaesthetic. Nearly two-thirds of patients experience severe pain after surgery. Anxiety can amplify perceptions of pain and lead to slower recovery. This systematic review included over 90 small-scale trials with a small effect, and it was not possible to blind conscious patients to which intervention they had received

2019 NIHR Dissemination Centre

10. Effect of Lavender Oil on the Anxiety of Patients Before Breast Surgery. (PubMed)

Effect of Lavender Oil on the Anxiety of Patients Before Breast Surgery. Anxiety is a common problem before surgery. This study aimed to investigate the effects of inhaling lavender oil on anxiety levels in patients before breast surgery.A randomized controlled design was used.The study was conducted in surgery clinics of a university hospital in Adana, Turkey. The study included a total of 80 patients, 40 patients in the intervention group, and 40 patients in the control group, who were (...) scheduled for breast surgery. Lavender oil was used by inhalation. A Personal Information Form and the State Anxiety Inventory were used to collect data.The mean State Anxiety Inventory pretest and post-test scores were 43.00 ± 11.48 and 37.28 ± 9.93, respectively, in the intervention group, indicating a statistically significant difference (P < .05). The mean pretest and post-test State Anxiety Inventory scores were 44.6 ± 11.45 and 42.43 ± 11.48, respectively, in the control group; however

2019 Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses

11. A web-based platform to accommodate symptoms of anxiety and depression by featuring social interaction and animated information in patients undergoing lumbar spine fusion: a randomized clinical trial

A web-based platform to accommodate symptoms of anxiety and depression by featuring social interaction and animated information in patients undergoing lumbar spine fusion: a randomized clinical trial Approximately one-third of patients undergoing spine surgery have symptoms of anxiety and depression that correlate with pain, disability, and lower health-related quality of life. The use of web-based informative strategies before surgery and principles from cognitive behavioral therapy, have been (...) applied in other patient groups, facilitating mobility and encouraging beneficial coping behavior.To examine the effect of a web-based Spine Platform featuring Interaction and Information by Animation (w-SPIINA) on symptoms of anxiety and depression, pain, disability, and health-related quality of life.A single-center, two-arm, randomized controlled trial PATIENT SAMPLE: One hundred fourteen consecutive patients scheduled for instrumented lumbar spine fusion due to degenerative disc disease

2019 EvidenceUpdates

12. Psychological therapies for anxiety and depression in children and adolescents with long-term physical conditions. (PubMed)

Psychological therapies for anxiety and depression in children and adolescents with long-term physical conditions. Long-term physical conditions affect 10% to 12% of children and adolescents worldwide. These individuals are at greater risk of developing psychological problems, particularly anxiety and depression, sometimes directly related to their illness or medical care (e.g. health-related anxiety). There is limited evidence regarding the effectiveness of psychological therapies for treating (...) anxiety and depression in this population. Therapies designed for children and adolescents without medical issues may or may not be appropriate for use with those who have long-term physical conditions.This review was undertaken to assess the effectiveness and acceptability of psychological therapies in comparison with controls (treatment-as-usual, waiting list, attention placebo, psychological placebo, or non-psychological treatment) for treating anxiety and depression in children and adolescents

2018 Cochrane

13. An anxiety prevention programme is not effective over the long term in UK primary schools

An anxiety prevention programme is not effective over the long term in UK primary schools An anxiety prevention programme is not effective over the long term in UK primary schools Discover Portal Discover Portal An anxiety prevention programme is not effective over the long term in UK primary schools Published on 18 January 2016 doi: This NIHR funded trial of an anxiety prevention programme in UK primary schools found it was effective after one year if led by health practitioners, but not after (...) two years. The programme was not effective at all if led by a teacher. After two years, anxiety had reduced a similar amount for both the intervention group and controls, who received the usual curriculum, including personal, social and health education (PSHE) lessons. The nine-week programme, delivered in the classroom, is based on cognitive behavioural therapy (CBT) and leads nine- and ten-year-olds through activities and tasks that, through changing the way they think, help them to counter

2018 NIHR Dissemination Centre

14. Anxiously Awaiting Evidence: Pregabalin in generalized anxiety disorder

Anxiously Awaiting Evidence: Pregabalin in generalized anxiety disorder Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,800 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care research (...) . www.acfp.ca July 16, 2018 Anxiously Awaiting Evidence: Pregabalin in generalized anxiety disorder Clinical Question: Is pregabalin effective for generalized anxiety disorder (GAD)? Bottom Line: Evidence for pregabalin in GAD is inconsistent and at high-risk of bias (industry-written, short-term, poorly described methods, high drop-outs, and run-in periods that overinflate benefit). If real, an additional one in 6-8 people may respond to pregabalin compared to placebo at 4-8 weeks. However, the change

2018 Tools for Practice

15. Anxiety Associated with Colonoscopy and Flexible Sigmoidoscopy: A Systematic Review

Anxiety Associated with Colonoscopy and Flexible Sigmoidoscopy: A Systematic Review Addressing procedure-related anxiety should improve adherence to colorectal cancer screening programs and diagnostic colonoscopy. We performed a systematic review to assess anxiety among individuals undergoing colonoscopy or flexible sigmoidoscopy (FS).We searched multiple electronic databases for studies evaluating anxiety associated with colonoscopy or FS published from 2005 to 2017. Two reviewers (...) independently identified studies, extracted data, and assessed study quality. The main outcomes were the magnitude of pre-procedure anxiety, types of concerns, predictors of anxiety, and effectiveness of anxiety-lowering interventions in individuals undergoing lower endoscopy. The protocol was prospectively registered in PROSPERO.Fifty-eight studies (24,490 patients) met the inclusion criteria. Patients undergoing colonoscopy had a higher mean level of anxiety than that previously reported in the general

2018 EvidenceUpdates

16. The Effect of Foot Massage on Pain Intensity and Anxiety in Patients Having Undergone a Tibial Shaft Fracture Surgery: A Randomized Clinical Trial

The Effect of Foot Massage on Pain Intensity and Anxiety in Patients Having Undergone a Tibial Shaft Fracture Surgery: A Randomized Clinical Trial To determine the effect of massage therapy on pain intensity and anxiety in patients who have undergone tibial shaft fracture surgery.This study was a randomized clinical trial with a pre-post design. As the study included 2 treatment groups, it was a parallel study.Khatam-Al-Anbia Hospital in Zahedan, Iran, between July and August 2017.In all, 66 (...) patients who underwent a tibial shaft fracture surgery were enrolled and randomly assigned to intervention and control groups (33 patients each).The intervention included a 10-minute foot massage (5 minutes per leg) using sweet almond oil, the most common lubricant used in massage therapy.Data were collected using pain numeric rating scale and Spielberger State-Trait Anxiety Inventory before and after intervention.After intervention, the mean scores for pain intensity, and anxiety in the intervention

2018 EvidenceUpdates

17. Music intervention for pain and anxiety management of the primiparous women during labour: A systematic review and meta-analysis

Music intervention for pain and anxiety management of the primiparous women during labour: A systematic review and meta-analysis To determine the effect of music on the management of pain and anxiety in primiparous women during labour.Music is cost-effective intervention in clinical practice to reduce pain, stress, and anxiety. However, a systematic review with meta-analysis for investigating its effects during labour is still lacking.A systematic review with meta-analysis.MEDLINE, EMBASE (...) included in this review. Music as an intervention seemed to lower the pain scores for primiparous women during labour, but the effect was not statistically significant. However, there was a significant benefit of music intervention compared with routine care for primiparous women during labour. In the sensitivity analysis, music intervention showed significant effect on the improvement of pain and anxiety for primiparous women during labour.Music intervention may be an effective intervention

2018 EvidenceUpdates

18. The effect of a very low calorie diet on subjective depressive symptoms and anxiety: meta-analysis and systematic review

The effect of a very low calorie diet on subjective depressive symptoms and anxiety: meta-analysis and systematic review There are conflicting findings regarding the effect very low calorie diets (VLCDs) have on self-reported depressive symptoms and anxiety levels. Some studies have reported decreased subjective depressive symptoms and anxiety post-diet, whereas other studies have not. Further complicating matters, the protocol for VLCDs vary substantially across studies, which could account (...) for the mixed findings. The primary goal of this meta-analysis and systematic review was to determine the effect VLCDs have on subjective depressive symptoms and anxiety pre- to post-diet. In addition, potential moderators (the presence/absence of behavioral therapy, duration of diet, inclusion/exclusion of low intensity exercise, and amount of weight lost) were examined to assess the effect of procedural deviations across VLCD studies on depressive symptoms and anxiety. A random-effects model was used

2018 EvidenceUpdates

19. Alleviating anxiety in patients prior to MRI: A pilot single-centre single-blinded randomised controlled trial to compare video demonstration or telephone conversation with a radiographer versus routine intervention. (PubMed)

Alleviating anxiety in patients prior to MRI: A pilot single-centre single-blinded randomised controlled trial to compare video demonstration or telephone conversation with a radiographer versus routine intervention. Patients undergoing MRI often experience anxiety prior and during scanning. The aim of this study was to explore two simple, cost-effective and easily implemented interventions to reduce anxiety pre MRI scanning.Seventy four patients attending first time for a MRI head, spine (...) or cardiac scan were randomised into one of three interventions: video demonstration; telephone conversation with a radiographer; or routine MRI preparation (appointment letter). The State-Trait Anxiety Inventory (STAI) questionnaire was used to measure anxiety levels both pre and post intervention. Motion artefacts were visually assessed by 2 observers and a post scan survey was used to capture patient's satisfaction.ANCOVA revealed a significant reduction of anxiety in the video group (F = 13.664, p

2018 Radiography (London, England : 1995)

20. The experience of patients participating in a small randomised control trial that explored two different interventions to reduce anxiety prior to an MRI scan. (PubMed)

The experience of patients participating in a small randomised control trial that explored two different interventions to reduce anxiety prior to an MRI scan. This paper reports qualitative findings from within a larger randomised control trial where a video clip or telephone conversation with a radiographer was compared to routine appointment letter and information sheet to help alleviate anxiety prior to their MRI scan.Questionnaires consisting of three free-text response questions were (...) administered to all of the 74 patients recruited to the MRI anxiety clinical trial. The questionnaire was designed to establish patients' experiences of the intervention they had received. These questionnaires were administered post-scan. Two participants from each trial arm were also interviewed. A thematic approach was utilised for identifying recurrent categories emerging from the qualitative data which are supported by direct quotations.Participants in the interventional groups commented positively

2018 Radiography (London, England : 1995)