Factores asociados a la ansiedad durante el aislamiento social por COVID-19 en estudiantes universitarios, Cusco-Perú

Adapting to a different routine has a psychological cost with alterations in response capacity, predisposing people to develop pathologies related to anxiety. Objectives: To determine the association between the factors of the media, psychosomatic, health history, socioeconomic, coping, behaviors towards isolation and anxiety during quarantine by COVID-19 (SARS-COV-2) in university students. Material and Methods: Analytical observational study, using a “Snowball” strategy; 436 responses were collected through an online survey. The instrument used was a questionnaire containing sociodemographic data, epidemiological data referring to the disease (Covid-19) and DASS-21. Anxiety was considered as a dependent variable, and as variables independent the media, health history, socioeconomic status, coping, and finally, isolation behaviors. Results: It consisted of 436 participants, where 58.5% presented anxiety. Conclusions: We found higher levels than the national average prior to the pandemic and higher in comparison to other studies and reviews on anxiety.Adaptarse a la pérdida de la rutina habitual conlleva, muchas veces, un costo psicológico que, según las circunstancias personales, se manifiesta en alteraciones en la capacidad de respuesta, predisponiendo a las personas a desarrollar patologías relacionadas a la ansiedad. Objetivo: Determinar la asociación entre los factores de medios de información, psicosomáticos, antecedentes en salud, socioeconómicos, estilos de afrontamiento, conductas frente al aislamiento y la ansiedad durante la cuarentena por la COVID-19 (SARS-COV-2) en estudiantes universitarios. Método y materiales: Estudio observacional analítico, realizado a través de la estrategia de «bola de nieve»; serecolectaron 436 respuestas mediante una encuesta en línea. El instrumento usado fue un cuestionario que recogió datos sociodemográficos y datos epidemiológicos referentes a la COVID-19, al COPE-28 y al DASS-21. Se consideró como variable dependiente a la ansiedad; y como variables independientes a los medios de información, antecedentes en salud, socioeconómicos, estilos de afrontamiento y conductas frente al aislamiento. Resultados: De los 436 participantes, el 58,5 % tenía ansiedad. Obtuvieron correlaciones significativas con la ansiedad los siguientes: los medios de información, los factores psicosomáticos, los antecedentes de salud, las conductas frente alaislamiento. Conclusiones: Encontramos niveles superiores al promedio nacional previo a la pandemia, y mayores en comparación con otros estudios y revisiones sobre la ansiedad

Pharmacological Treatment of Anxiety Disorders: The Role of the HPA Axis

Stress in general, and early life stress in particular, has been associated with the development of anxiety and mood disorders. The molecular, biological and psychological links between stress exposure and the pathogenesis of anxiety and mood disorders have been extensively studied, resulting in the search of novel psychopharmacological strategies aimed at targets of the hypothalamic-pituitary-adrenal (HPA) axis. Hyperactivity of the HPA axis has been observed in certain subgroups of patients with anxiety and mood disorders. In addition, the effects of different anti-anxiety agents on various components of the HPA axis has been investigated, including benzodiazepines, tricyclic antidepressants (TCAs), and selective serotonin reuptake inhibitors (SSRIs). For example, benzodiazepines, including clonazepam and alprazolam, have been demonstrated to reduce the activity of corticotrophin releasing factor (CRF) neurons in the hypothalamus. TCAs and SSRIs are also effective anti-anxiety agents and these may act, in part, by modulating the HPA axis. In this regard, the SSRI escitalopram inhibits CRF release in the central nucleus of the amygdala, while increasing glucocorticoid receptor (GRs) density in the hippocampus and hypothalamus. The molecular effects of these anti-anxiety agents in the regulation of the HPA axis, taken together with their clinical efficacy, may provide further understanding about the role of the HPA axis in the pathophysiology of mood and anxiety disorders, paving the way for the development of novel therapeutic strategies

The Links Between Stress and Depression: Psychoneuroendocrinological, Genetic, and Environmental Interactions

The role of stress in the origin and development of depression may be conceived as the result of multiple converging factors, including the chronic effect of environmental stressors and the long-lasting effects of stressful experiences during childhood, all of which may induce persistent hyperactivity of the hypothalamic-pituitary-adrenal axis. These changes, including increased availability of corticotropin-releasing factor and cortisol, are also associated with hyperactivity of the amygdala, hypoactivity of the hippocampus, and decreased serotonergic neurotransmission, which together result in increased vulnerability to stress. The role of other monoaminergic neurotransmitters, genetic polymorphisms, epigenetic mechanisms, inflammatory processes, and altered cognitive processing has also been considered in the development of a comprehensive model of the interactions between different factors of vulnerability. Further understanding of the underlying mechanisms that link these factors may contribute significantly to the development of more effective treatments and preventive strategies in the interface between stress and mood disorders