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Prevalence of Depression in Pre-Dialytic Chronic Kidney Disease Patients Attending at a Tertiary Care Hospital in Bangladesh
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作者 A. K. M. Shahidur Rahman Mohammad Shamsul Ahsan +7 位作者 Mohammad Kamrul Ahsan A. B. M. Mobasher Alam Tanvir Rahman Shahida Mullah Md. Mustafizur Rahman Salahuddin Feroz Amir Mohammad Kaiser Md. Shariful Haque 《Journal of Biosciences and Medicines》 2020年第12期135-148,共14页
<strong>Background:</strong> Depression is a common and serious medical illness around the world. It occurs more frequently in patients with chronic illness than in the general population. It is a common p... <strong>Background:</strong> Depression is a common and serious medical illness around the world. It occurs more frequently in patients with chronic illness than in the general population. It is a common psychiatric problem in patients with chronic kidney disease (CKD). <strong>Objective: </strong>To assess the level of depression in pre-dialytic CKD patients attending at a tertiary care hospital in Bangladesh. <strong>Methodology:</strong> This cross sectional study was conducted at Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2020 to June 2020. A total of 100 pre-dialytic CKD patients were selected by convenience sampling technique and their level of depression was assessed by Zung Self-Rating Depression Scale (ZSDS). Data were collected by existing questionnaire with face to face interview and analyzed by statistical test. <strong>Results:</strong> The mean age of the participants was 49.70 ± 11.80 years. Among them 64% were male, 95% were muslim, 98% were married, 65% were completed secondary/above higher secondary level education, 65% were unemployed and 55% were lived in urban area. It was observed that 65% participants were economically dependent to their family, only 6% were engaged in regular exercise, 14% had family history of depression, 8% were smoker and 12% were alcohol/drug abuser. According to the Zung Self-Rating Depression Scale (ZSDS) we found 29% participants were mildly depressed, 39% participants were moderately depressed and 18% participants were severely depressed. Prevalence of depression was 86% in pre-dialytic CKD patients. Of them, 7% was in CKD stage-I, 17.4% was in CKD stage-II, 19.8% was in CKD stage-III, 22.1% was in CKD stage-IV and 33.7% was in CKD stage-V. <strong>Conclusion:</strong> Depression is highly prevalent in pre-dialytic CKD patients and more frequent in the advanced stages of CKD. 展开更多
关键词 Chronic Kidney Disease (CKD) depression Zung self-rating depression scale (ZSDS)
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Risk of Adverse Perinatal Outcomes and Antenatal Depression Based on the Zung Self-Rating Depression Scale 被引量:2
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作者 Xin-Ning Chen Yao Hu +2 位作者 Wei-Hong Hu Xian Xia Xiao-Tian Li 《Reproductive and Developmental Medicine》 CSCD 2021年第1期23-29,共7页
Objective:The aim of the study is to investigate the relationship between antenatal depression and adverse perinatal outcomes.Methods:This prospective cohort study enrolled pregnant women between gestational ages of 1... Objective:The aim of the study is to investigate the relationship between antenatal depression and adverse perinatal outcomes.Methods:This prospective cohort study enrolled pregnant women between gestational ages of 12-20 weeks to complete the Chinese version of the Zung Self-Rating Depression Scale(SDS)and followed them for delivery from September 2015 to September 2016.Participants were classified into mild,moderate,and severe depression groups according to the SDS scores.Logistic regression was performed to assess the association between antenatal depression and perinatal outcomes including preterm birth(PTB),cesarean section use,hypertension disorders,gestational diabetes,and thyroid diseases during pregnancy.An age-stratified analysis was performed.Results:A total of 4,663 pregnant women were analyzed.As a result,13.8%,1.7%,and 0.2%of women were classified as mild,moderate,and severe depression,respectively.Severely depressed mothers were at higher risk for PTB(adjusted odds ratio[OR]=11.31,95%confidence interval[CI]2.13-60.03),especially spontaneous PTB.Moderate-depressed women were at higher risk for hyperthyroidism during pregnancy(adjusted OR=3.67,95%CI 1.10-12.27),while women with mild depression tended to choose cesarean sections(OR=1.24,95%CI=1.04-1.49).Age-stratified analysis indicated an elevated risk of adverse outcomes associated with depression in women aged<25 years,but the association was not significant.Conclusions:Antenatal depression was associated with PTB,hyperthyroidism,and cesarean use.Studies with large sample sizes should verify the relationship between PTB and antenatal depression to avoid casual events. 展开更多
关键词 Antenatal depression Cesarean Section Preterm Birth Zung self-rating depression scale
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Narrative nursing for negative emotions in patients with acute pancreatitis:Based on model construction and application
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作者 Ling-Jun Zhou Juan Wu +4 位作者 Wen-Jie Huang Ai-Wu Shen Yu-Ping Yin Hai-Li Sun Yu-Ting Yuan 《World Journal of Psychiatry》 SCIE 2024年第11期1631-1640,共10页
BACKGROUND Acute pancreatitis(AP),as a common acute abdomen disease,has a high incidence rate worldwide and is often accompanied by severe complications.Negative emotions lead to increased secretion of stress hormones... BACKGROUND Acute pancreatitis(AP),as a common acute abdomen disease,has a high incidence rate worldwide and is often accompanied by severe complications.Negative emotions lead to increased secretion of stress hormones,elevated blood sugar levels,and enhanced insulin resistance,which in turn increases the risk of AP and significantly affects the patient's quality of life.Therefore,exploring the intervention effects of narrative nursing programs on the negative emotions of patients with AP is not only helpful in alleviating psychological stress and improving quality of life but also has significant implications for improving disease outcomes and prognosis.AIM To construct a narrative nursing model for negative emotions in patients with AP and verify its efficacy in application.METHODS Through Delphi expert consultation,a narrative nursing model for negative emotions in patients with AP was constructed.A non-randomized quasi-experimental study design was used in this study.A total of 92 patients with AP with negative emotions admitted to a tertiary hospital in Nantong City of Jiangsu Province,China from September 2022 to August 2023 were recruited by convenience sampling,among whom 46 patients admitted from September 2022 to February 2023 were included in the observation group,and 46 patients from March to August 2023 were selected as control group.The observation group received narrative nursing plan,while the control group was given with routine nursing.Self-rating anxiety scale(SAS),self-rating depression scale(SDS),positive and negative affect scale(PANAS),caring behavior scale,patient satisfaction scale and 36-item short form health survey questionnaire(SF-36)were used to evaluate their emotions,satisfaction and caring behaviors in the two groups on the day of discharge,1-and 3-month following discharge.RESULTS According to the inclusion and exclusion criteria,a total of 45 cases in the intervention group and 44 cases in the control group eventually recruited and completed in the study.On the day of discharge,the intervention group showed significantly lower scores of SAS,SDS and negative emotion(28.57±4.52 vs 17.4±4.44,P<0.001),whereas evidently higher outcomes in the positive emotion score,Caring behavior scale score and satisfaction score compared to the control group(P<0.05).Repeated measurement analysis of variance showed that significant between-group differences were found in time effect,inter-group effect and interaction effect of SAS and PANAS scores as well as in time effect and inter-group effect of SF-36 scores(P<0.05);the SF-36 scores of two groups at 3 months after discharge were higher than those at 1 month after discharge(P<0.05).CONCLUSION The application of narrative nursing protocols has demonstrated significant effectiveness in alleviating anxiety,ameliorating negative emotions,and enhancing satisfaction among patients with AP. 展开更多
关键词 Acute pancreatitis Negative emotions Narrative nursing model Adverse emotions self-rating anxiety scale Selfrating depression scale
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Analysis of mental health status and related factors in patients with acute cerebral infarction 被引量:3
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作者 Qing-Qin Chen Fu-Mei Lin +5 位作者 Dan-Hong Chen Yi-Min Ye Guo-Mei Gong Fen-Fei Chen Su-Fen Huang Shan-Ling Peng 《World Journal of Psychiatry》 SCIE 2023年第10期793-802,共10页
BACKGROUND Acute cerebral infarction(ACI)is characterized by a high incidence of morbidity,disability,recurrence,death and heavy economic burden,and has become a disease of concern in global researchers.As ACI has ser... BACKGROUND Acute cerebral infarction(ACI)is characterized by a high incidence of morbidity,disability,recurrence,death and heavy economic burden,and has become a disease of concern in global researchers.As ACI has serious effects on patients’physical status,life and economy,often causing anxiety,depression and other psychological problems,these problems can lead to the aggravation of physical symptoms;thus,it is very important to understand the factors affecting the mental health of these patients.AIM To understand the elements that affect the mental health of patients who have suffered an ACI.METHODS A questionnaire survey was conducted among patients with ACI admitted to three tertiary hospitals(Quanzhou First Hospital,Fuqing City Hospital Affiliated to Fujian Medical University,and the 900 Hospital of the Joint Service Support Force of the People’s Liberation Army of China)in Fujian Province from January 2022 to December 2022 using the convenience sampling method.ACI inpatients who met the inclusion criteria were selected.Informed consent was obtained from the patients before the investigation,and a face-to-face questionnaire survey was conducted using a unified scale.The questionnaire included a general situation questionnaire,Zung’s self-rating depression scale and Zung’s self-rating anxiety scale.All questionnaires were checked by two researchers and then the data were input and sorted using Excel software.The general situation of patients with ACI was analyzed by descriptive statistics,the influence of variables on mental health by the independent sample t test and variance analysis,and the influencing factors on psychological distress were analyzed by multiple stepwise regression.RESULTS The average age of the 220 patients with ACI was 68.64±10.74 years,including 142 males and 78 females.Most of the patients were between 60 and 74 years old,the majority had high school or technical secondary school education,most lived with their spouse,and most lived in cities.The majority of patients had a personal income of 3001 to 5000 RMB yuan per month.The new rural cooperative medical insurance system had the largest number of participants.Most stroke patients were cared for by their spouses and of these patients,52.3%had previously smoked.Univariate analysis showed that gender,age,residence,course of disease,number of previous chronic diseases and smoking history were the main factors affecting the anxiety scores of patients with ACI.Age,living conditions,monthly income,course of disease and knowledge of disease were the primary variables influencing the depression score in patients with ACI.The findings of multivariate analysis revealed that the course of disease and gender were the most important factors influencing patients’anxiety scores,and the course of disease was also the most important factor influencing patients’depression scores.CONCLUSION Long disease course and female patients with ACI were more likely to have psychological problems such as a high incidence of emotional disorders.These groups require more attention and counseling. 展开更多
关键词 Acute cerebral infarction Mental health self-rating depression scale self-rating anxiety scale Influencing factor Correlation analysis
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越鞠丸联合帕罗西汀治疗抑郁发作的临床疗效观察 被引量:1
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作者 高丽丽 吴成翰 王谨敏 《中国卫生标准管理》 2022年第1期96-99,共4页
目的观察越鞠丸联合帕罗西汀治疗抑郁症的临床效果及安全性。方法选取医院100例抑郁症患者为研究对象,按照随机数字法分为对照组和观察组两组,观察组给予越鞠丸组联合帕罗西汀治疗,对照组给予帕罗西汀治疗。观察两组的临床疗效及安全性... 目的观察越鞠丸联合帕罗西汀治疗抑郁症的临床效果及安全性。方法选取医院100例抑郁症患者为研究对象,按照随机数字法分为对照组和观察组两组,观察组给予越鞠丸组联合帕罗西汀治疗,对照组给予帕罗西汀治疗。观察两组的临床疗效及安全性。结果治疗前两组汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、贝克抑郁量表(Beck depression rating scale,BDI)评分差异无统计学意义(P>0.05),治疗后,观察组HAMD、BDI评分低于对照组,差异有统计学意义(P<0.05);观察组不良反应程度明显低于对照组,差异有统计学意义(P<0.05)。结论越鞠丸与帕罗西汀联合治疗抑郁症效果显著,可明显改善患者抑郁情绪,且不良反应程度较轻。 展开更多
关键词 越鞠丸 帕罗西汀 抑郁症 汉密尔顿抑郁量表 贝克抑郁量表 临床疗效
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Effects of nursing care in fast-track surgery on postoperative pain, psychological state, and patient satisfaction with nursing for glioma 被引量:14
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作者 Yan-Hong Deng Yi-Mei Yang +2 位作者 Jian Ruan Lin Mu Shi-Qiang Wang 《World Journal of Clinical Cases》 SCIE 2021年第20期5435-5441,共7页
BACKGROUND The brain is the most complex organ in the human body.Treatment for a glioma always involves a multi-disciplinary team.Nursing care in fast-track surgery or enhanced recovery after surgery is such kind of w... BACKGROUND The brain is the most complex organ in the human body.Treatment for a glioma always involves a multi-disciplinary team.Nursing care in fast-track surgery or enhanced recovery after surgery is such kind of work implemented by an interdisciplinary team to provide services to patients to improve their outcomes.AIM To explore the effects of nursing care in fast-track surgery on postoperative pain,psychological state,and patient satisfaction with nursing for glioma.METHODS From June 2018 to June 2020,138 patients who underwent operation for glioma at Cancer Hospital Affiliated to Chongqing University were selected.They were categorized into groups according to different nursing care that they received.Of them,69 patients receiving nursing care in fast-track surgery were included in an experimental group,and 69 patients receiving conventional postoperative nursing were included in a control group.Visual analogue scale was used to evaluate postoperative pain in the two groups immediately after the operation and at 3 d after the operation.Self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used to evaluate the psychological status of patients immediately after operation and on the 3rd postoperative day.A self-made satisfaction scale for patient satisfaction with nursing was used to evaluate and compare patient satisfaction with nursing between the two groups.RESULTS Time to excretion,time to out-of-bed activities,and length of hospital stay were significantly shorter in the observation group than in the control group(P<0.05).There was no significant difference in duration of operative time or intraoperative bleeding between the two groups(P>0.05).There was no significant difference in postoperative pain score between the two groups(P>0.05).The pain score was significantly lower in the observation group than in the control group at 3 d after the operation(P<0.05).There was no significant difference in postoperative SAS or SDS score between the two groups(P>0.05).SAS and SDS scores were significantly lower in the observation group than in the control group at 3 d after operation(P<0.05).The rate of patient satisfaction with nursing was 94.2%in the observation group,which was significantly higher than that(81.2%)of the control group(P<0.05).CONCLUSION Nursing care in fast-track surgery can relieve postoperative pain,anxiety,and depression,and improve patient satisfaction with nursing in patients with glioma,which is worthy of clinical application. 展开更多
关键词 Nursing care in fast-track surgery GLIOMA Visual analogue scale self-rating anxiety scale self-rating depression scale
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Investigation of the effect of military stress on the prevalence of functional bowel disorders 被引量:4
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作者 Xian-Zhao Yu Hai-Feng Liu Zhen-Xue Sun 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第23期3004-3007,共4页
AIM: To investigate the morbidity of functional bowel disorders (FBD) under military stress conditions in order to lay foundations for the prevention and treatment of this disease. METHODS: Four hundred and fifty-seve... AIM: To investigate the morbidity of functional bowel disorders (FBD) under military stress conditions in order to lay foundations for the prevention and treatment of this disease. METHODS: Four hundred and fifty-seven soldiers who were assigned to specified services and 471 soldiers who were assigned to routine services were enrolled using cluster sampling, with the latter as a control group. They were surveyed using the Rome Ⅲ FBD standard questionnaire. The FBD symptom question-naire included FBD-related symptoms, severity, dura- tion or attack time, and accompanying symptoms. RESULTS: The morbidity of the military stress group (14.6%) was significantly higher than in the control group (9.98%) ( 2 = 4.585, P < 0.05). The incidence of smoking, abdominal pain and acid regurgitation ( 2 = 4.761, P < 0.05) as well as the ZUNG anxiety/depression scores ( 2 = 7.982, P < 0.01) were also sig- nificantly higher in the military stress group compared with the control group. ZUNG anxiety ( 2 = 11.523, P < 0.01) and depression ( 2 = 5.149, P < 0.05) scores were higher in the FBD group compared with the non-FBD group. The differences in the ZUNG self-rated anxiety and depression scales between the 2 groups were statistically significant ( 2 = 14.482, P < 0.01 and 2 = 6.176, P < 0.05). CONCLUSION: The morbidity of FBD was higher under military stress conditions. 展开更多
关键词 Military stress Functional bowel disorders SOLDIER self-rating anxiety depression scale
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Effect of biofeedback combined with high-quality nursing in treatment of functional constipation 被引量:3
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作者 Xiu Zhao Jin Meng +1 位作者 Jin Dai Zhi-Tao Yin 《World Journal of Clinical Cases》 SCIE 2021年第4期784-791,共8页
BACKGROUND Functional constipation(FC)is a common functional gastrointestinal disease with various clinical manifestations.It is a physical and mental disease,which seriously affects patient physical and mental health... BACKGROUND Functional constipation(FC)is a common functional gastrointestinal disease with various clinical manifestations.It is a physical and mental disease,which seriously affects patient physical and mental health and quality of life.Biofeedback therapy is the treatment of choice for FC,especially outlet obstructive constipation caused by pelvic floor dysfunction.High-quality nursing is a new nursing model in modern clinical work and a new concept of modern nursing service.AIM To explore the effect of biofeedback combined with high-quality nursing in the treatment of FC.METHODS A total of 100 patients with FC admitted to our hospital from March 2015 to July 2019 were selected for clinical observation.These patients were randomly divided into two groups of 50:Experimental group(biofeedback combined with highquality nursing treatment group)and control group(biofeedback group).RESULTS The constipation symptom score of the experimental group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).The anal canal resting pressure and initial defecation threshold of the experimental group were significantly lower than those of the control group,and the maximum squeeze systolic pressure of the anal canal of the experimental group was significantly higher than that of the control group(P<0.05).The Self-Rating Anxiety Scale and Zung’s Self-Rating Depression Scale scores of the two groups were significantly lower than before treatment.The Self-Rating Anxiety Scale and Self-Rating Depression Scale scores of the experimental group were significantly lower than those of the control group(P<0.05).The patient satisfaction score of the experimental group was significantly higher than that of the control group(P<0.05).CONCLUSION The application of biofeedback combined with high-quality nursing in the treatment of FC has significant advantages over pure biofeedback treatment,and it is worthy of promotion in clinical work. 展开更多
关键词 High quality care Functional constipation BIOFEEDBACK Pelvic floor dysfunction self-rating anxiety scale self-rating depression scale
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功能性健康型态模式在抑郁症患者护理中的应用研究 被引量:3
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作者 王秋 王洋 徐天朝 《武警后勤学院学报(医学版)》 CAS 2021年第11期47-49,52,共4页
【目的】评估功能性健康型态模式(FHPM)在抑郁症患者中减少抑郁症状、增加希望和自我效能感中的效果。【方法】从北部战区总院的心理科共招募68名抑郁症患者,随机分为对照组和干预组,每组34名患者,其中干预组根据FHPM制定了干预措施。... 【目的】评估功能性健康型态模式(FHPM)在抑郁症患者中减少抑郁症状、增加希望和自我效能感中的效果。【方法】从北部战区总院的心理科共招募68名抑郁症患者,随机分为对照组和干预组,每组34名患者,其中干预组根据FHPM制定了干预措施。采用问卷形式,利用贝克抑郁量表(BDI)、贝克绝望量表(BHS)和抑郁症应对自我效能感量表(DCSES)收集两组患者基线、干预后及3个月随访时的量表评分数据。【结果】两组受试者的人口统计学特征无明显差异。干预组和对照组的基线BDI、BHS和DCSES评分没有显著性差异。干预后,干预组的BDI和BHS评分显著低于对照组,但干预组的DCSES评分与对照组没有显著性差异。干预组在3个月后随访时的BDI、BHS评分显著低于对照组,干预组DCSES评分显著高于对照组。【结论】FHPM在收集资料、确定、实施和评价护理问题的过程是一个系统化的模式。它引入了标准的专业术语,简化了护理工作的流程。这使得它在心理健康和精神病学护理实践中成为一种有益和有效的模式。 展开更多
关键词 功能性健康型态模式 抑郁症 贝克抑郁量表 贝克绝望量表 抑郁症应对自我效能感量表
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踝关节屈伸锻炼对膝骨关节炎病人膝关节功能和抑郁情绪的影响 被引量:5
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作者 张力 《安徽医药》 CAS 2021年第6期1220-1224,共5页
目的观察踝关节屈伸锻炼对膝骨关节炎(KOA)病人膝关节功能和抑郁情绪的影响。方法以攀枝花市中西医结合医院2018年8月至2019年8月收治的120例KOA病人为对象展开研究,采用随机数字表法分为四组:仰卧踝屈伸组(G1)、坐位踝屈伸组(G2)、站... 目的观察踝关节屈伸锻炼对膝骨关节炎(KOA)病人膝关节功能和抑郁情绪的影响。方法以攀枝花市中西医结合医院2018年8月至2019年8月收治的120例KOA病人为对象展开研究,采用随机数字表法分为四组:仰卧踝屈伸组(G1)、坐位踝屈伸组(G2)、站立踝屈伸组(G3)和散步组(G4),每组30例。干预12周后随访。采用膝关节WOMAC关节炎量表评估膝关节功能、贝克抑郁自评量表13项(Beck Depression Inventory,BDI)评分评估抑郁情绪在干预前后的变化。结果120例KOA病人进行踝关节屈伸锻炼12周后,膝关节WOMAC总评分均显著低于锻炼干预前(P<0.05),G1、G2、G3、G4四组WOMAC总评分干预前分别为78(73,81)分、79(74,82)分、78(72,83)分、79(74,82)分,干预后分别为68(67,73)分、67(68,74)分、67(65,72)分、65(62,70)分。具体指标方面,G1、G2、G3三组KOA病人膝关节疼痛、日常生活困难均有改善,但僵硬程度无改善;G4组KOA病人膝关节疼痛、僵硬、日常生活困难都有改善。四组病人干预后的BDI评分分布为正常的病人比例均显著高于干预前(P<0.05),干预前四组均无评分为正常的病人,干预后四组正常病人例数分别为6例、6例、4例、7例;干预后各组BDI评分的分布组间比较差异无统计学意义(P>0.05)。结论踝关节屈伸锻炼对KOA病人膝关节功能改善有一定的好处,适用于不方便到户外散步锻炼的KOA病人。 展开更多
关键词 骨关节炎 运动疗法 踝关节屈伸锻炼 膝关节WOMAC关节炎量表 贝克抑郁自评量表 膝关节功能
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Chronic fatigue syndrome treated by the traditional Chinese proce-dure abdominal tuina:a randomized controlled clinical trial 被引量:3
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作者 Li Huanan Wang Jingui +7 位作者 Zhang Wei Zhao Na Hai Xinhua Sun Shiquan Sun Qing Han Yihao Zhang Runchen Ma Fei 《Journal of Traditional Chinese Medicine》 SCIE CAS CSCD 2017年第6期819-826,共8页
OBJECTIVE: To evaluate the effect of the traditional Chinese procedure abdominal Tuina(AT) on chronic fatigue syndrome(CFS).METHODS: This randomized, single assessor-blinded clinical trial was carried out from May 201... OBJECTIVE: To evaluate the effect of the traditional Chinese procedure abdominal Tuina(AT) on chronic fatigue syndrome(CFS).METHODS: This randomized, single assessor-blinded clinical trial was carried out from May 2014 to April 2015. Eighty participants in the trial were divided randomly into two groups: experimental group and control. The experimental group(40 cases) was treated by AT and the control group(40 cases) by acupuncture. Each treatment was conducted once a day, 5 d for one course, at an interval of 2 d between each course. The whole treatment course lasted for 4 weeks. To ascertain the effect of AT and acupuncture, Fatigue Scale-14(FS-14), Self-rating Anxiety Scale(SAS) and Hamilton Rating Scale for Depression(HAMD) scores were used before and after treatment. Patients were followed up for3 months after treatment.RESULTS: After treatment for 4 weeks, 77 patients(39 cases in the experimental group and 38 cases in the control group) completed the trial. The FS-14,SAS and HAMD scores decreased(P < 0.05) significantly compared with those before treatment in both groups. The FS-14 and HAMD(P < 0.05) scores in the experimental group were much lower than those in the control group. The difference in SAS scores between the two groups was not significant.In the final follow-up, CFS in two cases in the experimental group and three in the control group recurred, but the difference was not significant. The scores for the FS-14, SAS and HAMD in the experimental group were superior to those of the control group, and the difference was significant(P < 0.05).No serious adverse events and few adverse events were observed.CONCLUSION: AT elicited a more efficacious effect than acupuncture alone on CFS. 展开更多
关键词 Tui Na Acupuncture Fatigue syndrome chronic RANDOMIZED controlled trial Fatiguescale-14 self-rating ANXIETY scale HAMILTON ratingscale for depression
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