Personality, physical activity, and symptoms of anxiety and depression: the HUNT study

Purpose

To analyze the association between physical activity (PA), symptoms of depression and anxiety, and personality traits.

Methods

Cross-sectional study from a Norwegian population-based survey conducted in the period 2006–2008. The sample consisted of a total of 38,743 subjects aged ≥19 years, 56.1 % women and 43.9 % men. Demographic variables, PA, depression and anxiety (The Hospital Anxiety and Depression Scale), and personality (Eysenck Personality Questionnaire) were assessed by self-reporting measurements.

Results

Individuals who reported moderate and high PA had significantly lower scores on depression and anxiety compared with less physically active individuals (p < 0.05). Significantly lower risk of HADS-defined depression and anxiety was associated with frequency, duration, and intensity of activity among women (p < 0.05), and significantly lower risk of HADS-defined depression was associated with frequency, duration, and intensity of activity among men (p < 0.05). There was a significant linear trend between extroversion and levels of PA (p < 0.01) and between neuroticism and PA (p < 0.01).

Conclusions

Subjects reporting regular leisure-time PA were less likely to report symptoms of HADS-defined depression and anxiety. Personality may be an underlying factor in explaining this association.     

Resilience, lifestyle and symptoms of anxiety and depression in adolescence: the Young-HUNT study

Purpose

This study investigated the symptoms of anxiety and depression in adolescence, their associations with lifestyle and resilience and the possibility that resilience factors can attenuate the associations between unhealthy lifestyle and symptoms of anxiety and depression.

Methods

Adolescents (n = 7,639) aged 13–18 years completed a questionnaire regarding lifestyle and health. Symptoms of anxiety and depression were measured by the SCL-5, a five-item shortened version of the Hopkins Symptom Checklist. Resilience factors included questions on friends and family relations and two sub-scales of the Resilience Scale for Adolescents; Family cohesion and Social competence.

Results

Of the total population, 13 % reported symptoms of anxiety and depression. Resilience characteristics were associated with lower symptom levels (ORs ranging from 0.2 to 0.6), and substance use and infrequent physical activity with higher symptom levels (ORs ranging from 2.1 to 4.0). The associations with substance use were strengthened by social competence, but attenuated by family cohesion. The association with physical activity was attenuated by both social competence and family cohesion.

Conclusion

Symptoms of anxiety and depression were frequent in adolescents and were associated with unhealthy lifestyle factors as substance use and low physical activity. Resilience characteristics seemed to protect against symptoms and markedly influenced the associations between lifestyle factors and symptoms of anxiety and depression. The importance of family and other supportive relationships should be emphasized in treatment and prevention of anxiety and depression in adolescence.     

Telephone-Delivered Motivational Interviewing Targeting Sexual Risk Behavior Reduces Depression, Anxiety, and Stress in HIV-Positive Older Adults

Background

Few studies have examined the secondary benefits of HIV risk reduction interventions to improve mental health functioning.

Purpose

This study aimed to examine the effectiveness of telephone-delivered motivational interviewing (MI) targeting sexual risk behavior to reduce depression, anxiety, and stress in HIV-positive older adults.

Methods

Participants were 100 HIV-positive adults 45+ years old enrolled in a sexual risk reduction pilot clinical trial of telephone-delivered MI. Participants were randomly assigned to a one-session MI, four-session MI, or standard of care control condition. Telephone interviews at baseline and 3- and 6-month follow-up assessed sexual behavior, depression, anxiety, and stress.

Results

Relative to controls, participants in the one- and four-session MI conditions reported lower levels of depression, anxiety, and stress at 6-month follow-up. No between group differences were observed at 3-month follow-up or between one- and four-session MI participants at 6-month follow-up.

Conclusions

Preliminary data suggest that telephone-delivered MI to reduce sexual risk behavior may confer secondary benefits of improving mental health functioning in HIV-positive persons.     

The development of socioeconomic inequalities in anxiety and depression symptoms over the lifecourse

Purpose

Socioeconomic inequalities in anxiety and depression widen with increasing age. This may be due to differences in the incidence or persistence of symptoms. This paper investigates the widening of inequalities in anxiety and depression over the lifecourse.

Methods

Data were from the West of Scotland Twenty-07 Study, constituting three cohorts aged approximately 16, 36 and 56 years at baseline and re-visited at 5-yearly intervals for 20 years. Symptoms were measured using the Hospital Anxiety and Depression Scale. Adjusting for age and sex, multilevel models with pairs of interviews (n = 6,878) nested within individuals (n = 3,165) were used for each cohort to estimate associations between current symptoms and education or household social class for both those with and without earlier symptoms, approximating socioeconomic differences in incidence and persistence.

Results

Inequalities in current symptom levels were present for both those with and without earlier symptoms. In the youngest cohort, those with less education were more likely to experience persistent depression and to progress from anxiety to depression. At older ages there were educational and social class differences in both the persistence and incidence of symptoms, though there was more evidence of differential persistence than incidence in the middle cohort and more evidence of differential incidence than persistence in the oldest cohort.

Conclusions

Differential persistence and symptom progression indicate that intervening to prevent or treat symptoms earlier in life is likely to reduce socioeconomic inequalities later, but attention also needs to be given to late adulthood where differential incidence emerges more strongly than differential persistence.     

Relationship quality and levels of depression and anxiety in a large population-based survey

Purpose

There is substantial literature suggesting that the mental health benefits of marriage (compared to being single) are greater for those in ‘good-quality’ relationships in comparison to those in ‘poor-quality’ relationships. However, little of this research utilises large population-based surveys. Large surveys in psychiatric epidemiology have focused almost exclusively on the association between marital status and mental health. The current study explores some of the reasons for this gap in the literature, and adopts a large, representative community-based sample to investigate whether associations between relationship status and levels of depression and anxiety are moderated by relationship quality.

Methods

Participants were from Wave 3 of the PATH Survey, a longitudinal community survey assessing the health and well-being of residents of the Canberra region, Australia (n = 3,820). Relationship quality was measured using the 7 item Dyadic Adjustment Scale (DAS-7), and levels of depression and anxiety were measured using the Goldberg Scales.

Results

Both cross-sectional and prospective analyses showed that associations between relationship status and mental health were moderated by relationship quality for both men and women, such that only good-quality relationships bestowed mental health benefits over remaining single. For women, being in a poor-quality relationship was associated with greater levels of anxiety than being single.

Conclusions

Epidemiological studies need to measure relationship quality to qualify the effect of relationship status on mental health.     

The Role of Spirituality in the Relationship Between Religiosity and Depression in Prostate Cancer Patients

Purpose

This study aims to develop a theoretical framework of the relationship among religiosity, spirituality, and depression, potentially explaining the often mixed and inconsistent associations between religiosity and depression.

Methods

In this cross-sectional study, 367 men (average age of 66?±?9 years) with prostate cancer completed measures of religiosity (extrinsic/intrinsic), spirituality (Functional Assessment of Chronic Illness Therapy Spiritual Well-Being Scale), quality of life (FACT-G), and depression (Hospital Anxiety and Depression Scale).

Results

There was a small relationship between intrinsic religiosity and depression (r?=??0.23, p?<?0.05) but a strong association between spirituality and depression (r?=??0.58, p?<?0.01). Using a mediation model, the meaning/peace subscale of the spirituality measure mediated the relationship between intrinsic religiosity and depression. This model controlled for age, marital status, stage of disease, time since diagnosis, hormone therapy, quality of life, and anxiety.

Conclusions

When examining religiosity and spirituality, the main component that may help reduce depression is a sense of meaning and peace. These results highlight the potential importance of developing a patient’s sense of meaning through activities/interventions (not exclusive to religious involvement) to achieve this goal.     

An examination of the effects of intra and inter-individual changes in wellbeing and mental health on self-rated health in a population study of middle and older-aged adults

Purpose

Self-rated health is frequently used as an indicator of health and quality of life in epidemiological studies. While the association between self-rated health and negative mental health is well established, associations with indictors of positive wellbeing are less clear. Data from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project were used to compare the effects of vitality and mental health on self-rated health.

Methods

Participants (n = 40,712) provided information on vitality, mental health and self-rated health, were aged 45–95 years at baseline, and were followed between 1 and 10 years (M = 5.6; SD = 2.9).

Results

In comparison with mental health, multi-level modelling indicated between- and within-person change in vitality was more strongly associated with self-rated health. Bivariate dual change score modelling of the cross-lagged associations between vitality and self-rated health indicated vitality to be a stronger predictor of change in self-rated health. Self-rated health was unrelated to change in vitality.

Conclusion

Vitality accounted for most of the mental health effect on self-rated health and was identified as a significant predictor of change in self-rated health over a 10-year period. Promoting wellbeing and psychological functioning may have significant protective effects on negative health outcomes throughout the adult lifespan and into late life.     

Predictors of prescribed medication use for depression,anxiety, stress,and sleep problems in mid-aged Australian women

Objective

The study examined prevalence of self-reported use of medication recommended or prescribed by a doctor for depression, anxiety, stress, and sleep problems; and modelled baseline factors that predicted use over 3 years for each condition.

Methods

Analyses were undertaken on the 2001 and 2004 surveys of mid-aged women in the Australian Longitudinal Study on Women’s Health. Dependent variables were self-reported use in past 4 weeks of medications recommended or prescribed by a doctor for depression, anxiety, stress, or sleep problems in 2001 and 2004. Generalized Estimating Equations (GEE) were used to predict medication use for each condition over 3 years.

Results

Prevalence of prescribed medication use (2001, 2004) for each condition was depression (7.2, 8.9 %), anxiety (7.4, 9.0 %), stress (4.8, 5.7 %), and sleep problems (8.7, 9.5 %). Multivariable analyses revealed that odds of medication use across 3 years in all four conditions were higher for women with poorer mental and physical health, using hormone replacement therapy (HRT), or having seen a counsellor; and increased over time for depression, anxiety, and stress models. Medication use for depression was also higher for overweight/obese women, ex-smokers, and unmarried. Medication use for anxiety was higher for unmarried and non-working/low occupational women. Medication use for stress was higher for non-working women. Additional predictors of medication for sleep were surgical menopause, and area of residence.

Conclusions

Self-reported use of prescribed medication for four mental health conditions is increased over time after controlling for mental and physical health and other variables. Research needs to explore decision-making processes influencing differential rates of psychoactive medication use and their relationship with health outcomes.     

The influence of different types of war experiences on depression and anxiety in a Ugandan cohort of war-affected youth: the WAYS study

Background

War experiences (WE) are frequently associated with mental health problems. Whether different types of WE vary in predicting which problem, or how severe, in former child soldiers (FCS) remains unknown.

Methods

Using data from the first wave of an on-going longitudinal cohort study (the WAYS study), we investigated relations between types of WE and symptoms of depression/anxiety among FCS in Northern Uganda (N = 539, baseline age = 22.39; SD = 2.03, range 18–25). Using robust Maximum Likelihood estimation in SEM, regression analyses were performed to relate binary indicators of types of WE to a single latent factor capturing symptoms of depression/anxiety.

Results

SEM results showed that “direct personal harm”, “witnessing violence”, “deaths”, “threat to loved ones”, “involvement in hostilities”, and “sexual abuse” indicators were related to reported symptoms of depression/anxiety irrespective of gender and age. Multivariable models revealed independent associations of “witnessing violence” (β = 0.29, SE = 0.09, p < 0.001) and “deaths” (β = 0.14, SE = 0.05, p < 0.001) with symptoms of depression/anxiety in both sexes. “Sexual abuse” (β = 0.32, SE = 0.16, p < 0.001) independently predicted symptoms of depression/anxiety for female but not male youths whilst “threat to loved ones” (β = 0.13, SE = 0.07, p < 0.05) independently predicted symptoms of depression/anxiety in male but not female youths.

Conclusions

Dimensions of WE predicted symptoms of depression/anxiety differently, but it is hard to establish their causal status. Our findings suggest that it might be fruitful to consider such exposure variations of WE when designing interventions to mitigate the symptoms of depression/anxiety on male and female FCS.     

Anxiety and depression in the general population in Colombia: reference values of the Hospital Anxiety and Depression Scale (HADS)

Purpose

The objective of this study was to generate normative values and to test psychometric properties of the Hospital Anxiety and Depression Scale (HADS) for the general population of Colombia. While there are several normative studies in Europe, Latin American normative values are missing. The identification of people with mental distress requires norms obtained for the specific country.

Methods

A representative face-to-face household study (n = 1,500) was conducted in 2012. The survey questionnaire contained the HADS, several other questionnaires, and sociodemographic variables.

Results

HADS mean values (anxiety: M = 4.61 ± 3.64, depression: M = 4.30 ± 3.91) were similar to those reported from European studies. Females were more anxious and depressed than males. The depression scale showed a nearly linear age dependency with increasing scores for old people. Mean scores and percentiles (75 and 90 %) are presented for each age decade for both genders. Both anxiety and depression correlated significantly with the total score of the multidimensional fatigue inventory and with the mental component summary score of the quality of life questionnaire SF-8. Internal consistency coefficients of both scales were satisfying, but confirmatory factorial analysis results only partially supported the two-dimensional structure of the questionnaire.

Conclusion

This study supports the reliability of the HADS in one Latin American country. The normative scores can be used to compare a patient’s score with those derived from a reference group. However, the generalizability to other Latin American regions requires further research.     

Effects of a Multiple Health Behavior Change Intervention for Colorectal Cancer Survivors on Psychosocial Outcomes and Quality of Life: a Randomized Controlled Trial

Background

Multiple health behavior change can ameliorate adverse effects of cancer.

Purpose

The purpose of this study was to determine the effects of a multiple health behavior change intervention (CanChange) for colorectal cancer survivors on psychosocial outcomes and quality of life.

Methods

A total of 410 colorectal cancer survivors were randomized to a 6-month telephone-based health coaching intervention (11 sessions using acceptance and commitment therapy strategies focusing on physical activity, weight management, diet, alcohol, and smoking) or usual care. Posttraumatic growth, spirituality, acceptance, mindfulness, distress, and quality of life were assessed at baseline, 6 and 12 months.

Results

Significant intervention effects were observed for posttraumatic growth at 6 (7.5, p?p?=?0.033), spirituality at 6 months (1.8, p?=?0.011), acceptance at 6 months (0.2, p?=?0.005), and quality of life at 6 (0.8, p?=?0.049) and 12 months (0.9, p?=?0.037).

Conclusions

The intervention improved psychosocial outcomes and quality of life (physical well-being) at 6 months with most effects still present at 12 months. (Trial Registration Number: ACTRN12608000399392).     

Antenatal and postnatal maternal mental health as determinants of infant neurodevelopment at 18 months of age in a mother–child cohort (Rhea Study) in Crete, Greece

Purpose

A growing body of evidence links poor maternal mental health with negative outcomes on early child development. We examined the effect of antenatal and postnatal maternal mental health on infant neurodevelopment at age 18 months in a population-based mother–child cohort (Rhea Study) in Crete, Greece.

Methods

Self-reported measures of maternal depression (EPDS), trait anxiety (STAI-Trait) and personality traits (EPQ-R) were assessed in a sample of women during pregnancy and at 8 weeks postpartum (n = 223). An additional sample of 247 mothers also completed the EPDS scale at 8 weeks postpartum (n = 470). Neurodevelopment at 18 months was assessed with the use of Bayley Scales of Infant and Toddler Development (3rd edition).

Results

Multivariable linear regression models adjusted for confounders revealed that antenatal depressive symptoms (EPDS ≥ 13) were associated with decrease in cognitive development independently of postnatal depression. High trait anxiety and extraversion were associated with decrease and increase, respectively, in social–emotional development. Also, high trait anxiety and neuroticism had a positive effect on infants’ expressive communication. Finally, postpartum depressive symptoms (EPDS ≥ 13) were associated with decrease in cognitive and fine motor development independently of antenatal depression.

Conclusions

These findings suggest that antenatal and postnatal maternal psychological well-being has important consequences on early child neurodevelopment.     

Mood instability, mental illness and suicidal ideas: results from a household survey

Purpose

There is weak and inconsistent evidence that mood instability (MI) is associated with depression, post traumatic stress disorder (PTSD) and suicidality although the basis of this is unclear. Our objectives were first to test whether there is an association between depression and PTSD, and MI and secondly whether MI exerts an independent effect on suicidal thinking over and above that explained by common mental disorders.

Methods

We used data from the Adult Psychiatric Morbidity Survey 2007 (N = 7,131). Chi-square tests were used to examine associations between depression and PTSD, and MI, followed by regression modelling to examine associations between MI and depression, and with PTSD. Multiple logistic regression analyses were used to assess the independent effect of MI on suicidal thinking, after adjustment for demographic factors and the effects of common mental disorder diagnoses.

Results

There are high rates of MI in depression and PTSD and the presence of MI increases the odds of depression by 10.66 [95 % confidence interval (CI) 7.51–15.13] and PTSD by 8.69 (95 % CI 5.90–12.79), respectively, after adjusting for other factors. Mood instability independently explained suicidal thinking, multiplying the odds by nearly five (odds ratio 4.82; 95 % CI 3.39–6.85), and was individually by some way the most important single factor in explaining suicidal thoughts.

Conclusions

MI is strongly associated with depression and PTSD. In people with common mental disorders MI is clinically significant as it acts as an additional factor exacerbating the risk of suicidal thinking. It is important to enquire about MI as part of clinical assessment and treatment studies are required.     

Effectiveness of peer-delivered interventions for severe mental illness and depression on clinical and psychosocial outcomes: a systematic review and meta-analysis

Purpose

To evaluate the effectiveness of peer-delivered interventions in improving clinical and psychosocial outcomes among individuals with severe mental illness (SMI) or depression.

Methods

Systematic review and meta-analysis of randomised controlled trials comparing a peer-delivered intervention to treatment as usual or treatment delivered by a health professional. Random effect meta-analyses were performed separately for SMI and depression interventions.

Results

Fourteen studies (10 SMI studies, 4 depression studies), all from high-income countries, met the inclusion criteria. For SMI, evidence from three high-quality superiority trials showed small positive effects favouring peer-delivered interventions for quality of life (SMD 0.24, 95 % CI 0.08–0.40, p = 0.003, I ² = 0 %, n = 639) and hope (SMD 0.24, 95 % CI 0.02–0.46, p = 0.03, I ² = 65 %, n = 967). Results of two SMI equivalence trials indicated that peers may be equivalent to health professionals in improving clinical symptoms (SMD ?0.14, 95 % CI ?0.57 to 0.29, p = 0.51, I ² = 0 %, n = 84) and quality of life (SMD ?0.11, 95 % CI ?0.42 to 0.20, p = 0.56, I ² = 0 %, n = 164). No effect of peer-delivered interventions for depression was observed on any outcome.

Conclusions

The limited evidence base suggests that peers may have a small additional impact on patient’s outcomes, in comparison to standard psychiatric care in high-income settings. Future research should explore the use and applicability of peer-delivered interventions in resource poor settings where standard care is likely to be of lower quality and coverage. The positive findings of equivalence trials demand further research in this area to consolidate the relative value of peer-delivered vs. professional-delivered interventions.     

Non-fatal burden of disease due to mental disorders in the Netherlands

Purpose

To estimate the disease burden due to 15 mental disorders at both individual and population level.

Methods

Using a population-based survey (Nemesis, N = 7,056) the number of years lived with disability per one million population were assessed. This was done with and without adjustment for comorbidity.

Results

At individual level, major depression, dysthymia, bipolar disorder, panic disorder, social phobia, eating disorder and schizophrenia are the disorders most markedly associated with health-related quality of life decrement. However, at population level, the number of affected people and the amount of time spent in an adverse health state become strong drivers of population ill-health. Simple phobia, social phobia, depression, dysthymia and alcohol dependence emerged as public health priorities.

Conclusions

From a clinical perspective, we tend to give priority to the disorders that exact a heavy toll on individuals. This puts the spotlight on disorders such as bipolar disorder and schizophrenia. However, from a public health perspective, disorders such as simple phobia, social phobia and dysthymia—which are highly prevalent and tend to run a chronic course—are identified as leading causes of population ill-health, and thus, emerge as public health priorities.     

Perceived social support helps, but does not buffer the negative impact of anxiety disorders on quality of life and perceived stress

Purpose

Anxiety disorders are prevalent and substantially hinder quality of life, in all domains, including social connections, mental and physical health. Past research on stress indicates that perceived social support improves wellbeing both directly by providing positive experiences and indirectly through buffering the effects of stress. This study examined whether social support moderates the negative impact of anxiety disorders on quality of life.

Method

The study was conducted on a community sample in Cyprus, screened for anxiety disorders. The hypothesized model takes into account potential differences between individuals with and without anxiety in health, tendency to seek support, stressful life events, and depression. Furthermore, differences between different anxiety disorders on these variables were examined.

Results

Results indicate that perceived social support has a positive, direct effect on quality of life and perceived stress for all participants but that it does not appear to moderate the adverse effects of having a disorder on quality of life or stress. The negative effects of anxiety appeared to mostly be carried by comorbid depression.

Conclusions

Social support is important for quality of life. Potential interventions for anxiety disorders should take this into account, as well as the substantially detrimental role of co-morbid depression symptoms on wellbeing outcomes.     

Psychological distress, depression and generalised anxiety in Turkish and Moroccan immigrants in Belgium

Background

This study assesses the prevalence of and risk and protective factors for common mental health complaints in a general population sample of Turkish and Moroccan immigrants living in Belgium. Focus is on between- and within-group variation.

Methods

The study is based on pooled data from the Belgian Health Interview Surveys 2001 and 2004 and focuses on the Turkish and Moroccan immigrant population aged 18–65 (N = 147 Turks, N = 359 Moroccans). Mental health status is assessed with the General Health Questionnaire—12 and the Symptom Checklist 90-R subscales for depression and generalised anxiety. Risk and protective factors considered are gender, age, household type, labor market position, educational level, household income, homeownership, being foreign- or native born and social support.

Results

Between-group variance was not significant. Within-group analysis showed significant effects of gender and social support. Although not significant, the results suggested positive associations between social adversity and mood status. In addition, there was a tendency for higher risks for psychological distress, depression and generalised anxiety in foreign-born as compared to Belgian-born Turkish and Moroccan immigrants.     

Anxiety and depression among caregivers of patients with eating disorders and their change over 1 year

Purpose

Limited data are available on the difficulties experienced over time by caregivers of patients with eating disorders (CPED). The aim of this study was to describe changes in anxiety and depression among such caregivers over 1 year and to identify factors predicting any change in both.

Methods

At recruitment, 145 ED patients and their 246 caregivers completed sociodemographic and clinical instruments, including the Hospital Anxiety and Depression Scale (HADS), and the Short-Form 12 (SF-12). Patients also completed the Eating Attitudes Test-26 (EAT-26), and their psychiatrists assessed clinical variables. Patients and caregivers completed the same instruments 1 year later.

Results

At baseline, prevalence of anxiety and depression among caregivers was 56 and 32 %, respectively. Scores were essentially the same 1 year later. Factors associated with the changes in anxiety were higher anxiety level at baseline and caring for a patient with a restrictive ED. Factors associated with changes in depression included higher depression at baseline and caring for a patient with a restrictive ED. Neither health-related quality of life among patients and caregivers nor patients’ eating attitudes was related to caregiver anxiety or depression.

Conclusions

These findings confirm the presence of substantial and continuing emotional distress among caregivers of patients with ED, highlighting the importance of offering them more extended follow-up and treatment.     

Utilization of traditional,complementary and alternative medicine and mental health among patients with chronic diseases in primary health care settings in Cambodia

Background

Coping with chronic illnesses often involves major lifestyle changes that may lead to poor mental health. Furthermore, in order to treat the chronic conditions, many sufferers in Asia turn to traditional, complementary and alternative medicines (TCAM). This study explores prevalence of TCAM use and factors associated with anxiety and depressive symptoms among patients with chronic diseases in Cambodia.

Methods

In 2015, this cross-sectional study was conducted with outpatients receiving treatment and care for chronic diseases in two urban and two rural primary health centers. Every eligible patient was randomly selected at the health centers using a systematic sampling procedure. Symptoms of anxiety and depression were assessed by using the Hospital Anxiety and Depression Scale (HADS). Multivariate logistic regression models were constructed to explore factors associated with anxiety and depressive symptoms.

Results

The study participants included 1528 patients, of whom 77.2% were female, with a mean age of 46.5 years (SD = 15.3). After adjustment, patients with depressive symptoms remained significantly more likely to be in the age groups between 41 and 60 years old and to be married, separated/divorced or widowed compared to those without depressive symptoms. Regarding the use of TCAM, patients with depressive symptoms remained significantly more likely to report using an herbalist, practicing visualization and praying for own health, but less likely to report using vitamins or supplements in the past 12 months. For quality of life, patients with depressive symptoms remained significantly less likely to agree that they had enough energy for their everyday life and had enough money to meet their daily needs. Similar risk factors were also found to be significantly associated with anxiety symptoms.

Conclusions

Cambodian patients with chronic diseases who experienced symptoms of anxiety or depression were more likely to report reduced quality of life, greater chronic disease-related stigma and more TCAM use. Given the potential interaction of TCAM, mental health and other chronic conditions, a history of TCAM use and mental health should be elicited in clinical practices in primary health care settings, particularly in developing countries.

     

Randomized Controlled Trial of a Behavior Change Intervention to Increase Physical Activity and Quality of Life in Prostate Cancer Survivors

Background

Physical activity improves health in prostate cancer survivors; however, participation rates are low.

Purpose

This study aims to determine the effects of an implementation intention intervention on physical activity and quality of life in prostate cancer survivors.

Methods

Prostate cancer survivors (N?=?423) were randomly assigned to a standard physical activity recommendation, a self-administered implementation intention, or a telephone-assisted implementation intention. Physical activity and quality of life were assessed at baseline, 1, and 3 months.

Results

Analyses of covariance using multiple imputation showed that physical activity at 1 month increased by 86 min/week in the standard physical activity recommendation group compared with 168 min/week in the self-administered implementation intention group (P?=?0.023) and 105 min/week in the telephone-assisted implementation intention group (P?=?0.35).

Conclusions

A self-administered implementation intention intervention resulted in a meaningful short-term increase in physical activity. Supplementation with additional intervention strategies and more frequent intervention may improve longer-term exercise. (ClinicalTrials.gov number NCT01410656).