An Assessment of the Relationship Between the Beck Anxiety Inventory and Stress Hormones Among Intern Doctors in the Emergency Department


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DOI:

https://doi.org/10.58600/eurjther2169

Keywords:

Emergency Medicine, Intern Doctors, Stress, Anxiety, Back Anxiety Inventory, Stress Hormones

Abstract

Objective: We aimed to investigate the anxiety effect of working conditions on intern doctors in emergency department (ED), the severity of this effect according to the Beck Anxiety Inventory (BAI), and the hormonal factors involved in the etiology of anxiety.

Methods: A prospective analysis was conducted on a group of 74 intern doctors who completed training in the ED between May and October 2017. Participants were asked to complete the BAI form and have their blood samples taken at 07:00 a.m. during both the first and last night shifts. The blood samples have been utilized in the study of Adrenocorticotropic Hormone (ACTH), Atrial Natriuretic Peptide (ANP) and Cholecystokinin (CCK), hormones that have been found to have a strong correlation with stress levels. A comparison of hormone levels and BAI scores was conducted before and after the internship to assess any changes.

Results: The sample size for the study consisted of seventy-four interns, of which 47.3% (n=35) were identified as male. The average age was 25 +/- 2 years. No significant difference was detected in ACTH levels before and after the internship (p = 0.087), although the end-of-internship BAI score and ANP and CCK levels were found to be significantly higher in the entire group (p=0.001, p=0.001, p=0.048; respectively). While the post-internship BAI score and ANP levels were significantly higher in males (p=0.001, p=0.015, respectively), no significant difference was detected in the ACTH and CCK levels before and after the internship (p=0.128, p=0.077, respectively). While post-internship BAI score, ACTH and ANP levels were found to be significantly higher in female (p=0.001, p=0.026, p=0.001; respectively); No significant difference was detected in CCK levels (p = 0.155).

Conclusion: Emergency departments are places where stress and anxiety are intensely experienced. The post-internship hormone levels reveal a predominantly anxiolytic pattern (with no notable alteration in ACTH levels but a rise in ANP), while the elevated BAI score can be attributed to the subjective nature of this assessment tool. Identifying the hormones that increase or decrease in response to stress and conducting further research on treatment may be one method of coping with stress.

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References

Erçim R.E, Köse H, Budak Y, Yıldırım H. (2020), Investigation of The Change in Depression, Anxiety and Stress Situation and Nutritional Habits of University Students Before, During and After Exam Period (Üniversite Öğrencilerinin Sınav Dönemi Öncesi, Sırası ve Sonrasında Depresyon, Anksiyete ve Stres Durumu ile Beslenme Alışkanlıklarındaki Değişimin İncelenmesi) CUSBED 5(3):133-143. (In Turkish)

Tavlı F ve Ünsal G (2016), Assesment of Sources of Stress among Factory Employees and Their Attitudes to Cope with Stress (JAREN 2(1):9-15. http://doi.org/10.5222/jaren.2016.009

Elkin Ö. O (2020), Comparison of Anxiety, Stress, Life Satisfaction Levels and Related Variables Between Male and Female Students at University (Üniversite Öğrencilerindeki Anksiyete, Stres, Yaşam Doyumu Düzeyleri ve İlişkili Değişkenleri Kız ve Erkek Öğrenciler Arasında Karşılaştırma), İstanbul Gelişim Üniv, Yüksek Lisans Tezi, İstanbul. (In Turkish)

Steiner H, Erickson SJ, Hernandez NL, Pavelski R (2002) Coping styles as correlates of health in high school students. J Adolesc Health 30(5):326-35. http://doi.org/10.1016/s1054-139x(01)00326-3

Budak S (2021), Dictionary of Psychology (Psikoloji Sözlüğü) Bilim ve Sanat Yayınları, (P: 700-701) Ankara. (In Turkish)

M.T.Tsuang, M.Tohen, P.B.Jones (2011), Textbook of Psychiatric Epidemiology 3nd edn. In: Epidemiology of anxiety disorders, E Horwath, R.S. Cohen, M.M. Weissman s.311-28.

Savcı M. Aysan F (2014), The relationship between the perceived stress level and the stress coping strategies in university students (Üniversite öğrencilerinde algılanan stres düzeyi ile stresle başa çıkma stratejileri arasındaki ilişki) UTES 2(3):44-56. (In Turkish)

Houngbadji MSTS, Niang B, Boiro D, Mbaye A, Seck A, Ndongo AA, Ly ID, Ndiaye O. (2018) Adrenocorticotropic hormone (ACTH) insensitivity syndrome: about a case, PAMJ;2(30):244. https://doi.org/10.11604/pamj.2018.30.244.15541

Burford NG, Webster NA, Cruz-Topete D. (2017), Hypothalamic-Pituitary-Adrenal Axis Modulation of Glucocorticoids in the Cardiovascular System. IJMS 18(10):2150 https://doi.org/10.3390/ijms18102150

John E. Hall PhD, Arthur C. Guyton MD (2021), Guyton Medical Physiology,14th edn, (P: ANP:277,399; ACTH:956-957; CCK :816-819) Elsevier.

Bowers ME, Choi DC, Ressler KJ. (2012), Neuropeptide regulation of fear and anxiety: Implications of cholecystokinin, endogenous opioids, and neuropeptide y. Physiology -Behavior 107(5):699–710. https://doi.org/10.1016/j.physbeh.2012.03.004

Nakagawa Y, Nishikimi T, Kuwahara K. (2019) Atrial and brain natriuretic peptides: Hormones secreted from the heart. Peptides 111:18-25. https://doi.org/10.1016/j.peptides.2018.05.012

Cannone V, Cabassi A, Volpi R, Burnett JC, (2019) Jr. Atrial Natriuretic Peptide: A Molecular Target of Novel Therapeutic Approaches to Cardio-Metabolic Disease. IJMS 20(13):3265. https://doi.org/10.3390/ijms20133265

Uçar F, Turhan S, (2005), Natriuretıc Peptides (Natriüretik peptidler) Turk Hij Den Biyol Derg. 62(1): 49-54. (In Turkish)

Gürgül S, Şeker F.B, (2022), Determination of depression, anxiety, hopelessness, and worry levels of medical faculty students (Tıp fakültesi öğrencilerinin depresyon, anksiyete, umutsuzluk ve endişe düzeylerinin belirlenmesi) Mersin Üniversitesi Sağlık Bilimleri Dergisi, 15(2), 361-369. (In Turkish) https://doi.org/10.26559/mersinsbd.1111159

Ulusoy M, Şahin N, Erkman H. (1998), Turkish version of the beck anxiety ınventory: psychometric properties. Journel of Cognitive Psychotherapy: An Int Quaterly 12(2): 28-35.

Onaka T (2004), Neural pathways controlling central and peripheral oxytocin release during stress. J. Neuroendocrinol; 16(4):308-12. https://doi.org/10.1111/j.0953-8194.2004.01186.x

Dolu N, Elalmış D D, Keloğlan S, (2013), The Investigation of Attention Level in Nurses Working Night Shifts and the Relationship Between Sex Hormone and Electrodermal Activity (Vardiyalı Çalışan Hemşirelerde Dikkat Düzeyinin Elektrodermal Aktivite ile Cinsiyet Hormonları Arasındaki İlişkisi Yönünden İncelenmesi, Nöropsikiyatri Arşivi Dergisi 50:197-201 (In Turkish). http://doi.org/10.4274/npa.y6094

Strohle A, Kellner M, Holsboer F, Wiedemann K (2001), Anxiolytic activity of atrial natriuretic peptide in patients with panic disorder. Am J Psychiatry 158:1514-6. https://doi.org/10.1176/appi.ajp.158.9.1514

Wiedemann K, Jahn H, Yassouridis A, Kellner M (2001) Anxiolyticlike effects of atrial natriuretic peptide on cholecystokinin tetrapeptide-induced panic attacks: preliminary findings. Arch Gen Psychiatry 58(4): 371-7. https://doi.org/10.1001/archpsyc.58.4.371

Krogh J, Ströhle A, Westrin A, Klausen T, Jorgensen M B, Nordentoft M. (2011), N-terminal proatrial natriuretic peptide response to acute exercise in depressedpatients and healthy controls. Psychoneuroendocrinology 36(5): 656-663. https://doi.org/10.1016/j.psyneuen.2010.09.009

Wisen AG, Ekberg K, Wohlfart B, Ekman R, Westrin A (2011), Plasma ANP and BNP during exercise in patients with major depressive disorder and in healthy controls. Journel of Affect Disorders; 129(1-3): 371-375. https://doi.org/10.1016/j.jad.2010.09.002

Herrmann-Lingen C, Binder L, Klinge M (2003), High plasma levels of N-terminal proatrial natriuretic peptide associated with low anxiety in severe heart failure. Psychosomatic Medicine; 65(4): 517- 522. https:/doi.org/10.1097/01.psy.0000073870.93003.c4

Meyer T, Herrmann-Lingen C. (2017), Natriuretic Peptides in Anxiety and Panic Disorder. Vitamines and Hormones 103: 131-145. https://doi.org/10.1016/bs.vh.2016.08.002

Algül S (2015), Psychiatric disorders and Nesfatin-1 (Psikiyatrik hastalıklar ve Nesfatin-1), International Journal of Human Sciences 12(1): 1397-1407. (In Turkish) https://doi.org/10.14687/ijhs.v12i1.3149

Rotzinger S, Lovejoy D.A, Tan L.A (2010), Behavioral effects of neuropeptides in rodent models of depression and anxiety. Peptides; 31(4): 736–756. http://doi.org/10.1016/j.peptides.2009.12.015

Ballaz S (2017), The unappreciated roles of the cholecystokinin receptor CCK (1) in brain functioning; Reviews in the Neurosciences 28(6): 573-585. http://doi.org/10.1515/revneuro-2016-0088

Ströhle A, Romeo E, di Michele F, Pasini A, Hermann B, Gajewsky G, Holsboer F, Rupprecht R. (2003), Induced panic attacks shift gamma-aminobutyric acid type A receptor modulatory neuroactive steroid composition in patients with panic disorder: preliminary results. Arch Gen Psychiatry 60(2): 161-168. http://doi.org/10.1001/archpsyc.60.2.161

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Published

2024-08-19

How to Cite

Nogay, S., Sabak, M., & Yıldırım, C. (2024). An Assessment of the Relationship Between the Beck Anxiety Inventory and Stress Hormones Among Intern Doctors in the Emergency Department. European Journal of Therapeutics. https://doi.org/10.58600/eurjther2169

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