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This study was partially supported by a grant (PI 19/00458) from the Instituto de Salud Carlos III (Spanish Ministry of Science and Innovation, Madrid, Spain, and European Regional Development Fund-ERDF); a grant (PI 016/2019) from the Fundacion DISA (Las Palmas, Spain); a grant (BF1-19-13) from the Fundacion Espanola del Dolor (Spanish Pain Foundation, Madrid, Spain); a grant I42/20 from the Ilustre Colegio Oficial de Medicos de Las Palmas, Spain; a grant (CIGC2021) from the Cabildo de Gran Canaria, Las Palmas, Spain; and a grant (ENF22/10) from the Fundacion Canaria Instituto Investigacion Sanitaria de Canarias (FIISC), Las Palmas, Spain. The use of the other ozone therapy device in this study (Ozonobaric-P, SEDECAL, Madrid, Spain) was supported by a grant (COV20/00702) from the Instituto de Salud Carlos III (Spanish Ministry of Science and Innovation, Madrid, Spain).

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Gonzalez-Beltran, DamianAuthor

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Effects of ozone therapy on anxiety and depression in patients with refractory symptoms of severe diseases: a pilot study

Publicated to:Frontiers in Psychology. 14 1176204- - 2023-08-04 14(), DOI: 10.3389/fpsyg.2023.1176204

Authors: Clavo, Bernardino; Canovas-Molina, Angeles; Diaz-Garrido, Juan A; Canas, Silvia; Ramallo-Farina, Yolanda; Laffite, Horus; Federico, Mario; Rodriguez-Abreu, Delvys; Galvan, Saray; Garcia-Lourve, Carla; Gonzalez-Beltran, Damian; Carames, Miguel A; Hernandez-Fleta, Jose L; Serrano-Aguilar, Pedro; Rodriguez-Esparragon, Francisco

Affiliations

Complejo Hosp Univ Insular Maternoinfantil Gran Ca, Med Oncol Dept, Las Palmas Gran Canaria, Spain - Author
Complejo Hosp Univ Insular Maternoinfantil Gran Ca, Psychiat Dept, Las Palmas Gran Canaria, Spain - Author
Fdn Canaria Inst Invest Sanitaria Canarias FIISC, Palmas Gran Canaria Tenerife, Las Palmas Gran Canaria, Spain - Author
Hosp Univ Gran Canaria Dr Negrin, Chron Pain Unit, Las Palmas Gran Canaria, Spain - Author
Hosp Univ Gran Canaria Dr Negrin, Med Oncol Dept, Las Palmas Gran Canaria, Spain - Author
Hosp Univ Gran Canaria Dr Negrin, Psychiat Dept, Las Palmas Gran Canaria, Spain - Author
Hosp Univ Gran Canaria Dr Negrin, Radiat Oncol Dept, Las Palmas Gran Canaria, Spain - Author
Hosp Univ Gran Canaria Dr Negrin, Res Unit, Las Palmas Gran Canaria, Spain - Author
Inst Salud Carlos III, CIBER Enfermedades Infecciosas CIBERINFEC, Madrid, Spain - Author
Network Res Chron Primary Care & Hlth Promot RICAP, Santa Cruz De Tenerife, Spain - Author
Serv Evaluac & Planificac Serv Canario Salud SESCS, Santa Cruz De Tenerife, Spain - Author
Spanish Grp Clin Res Radiat Oncol GICOR, Madrid, Spain - Author
Univ La Laguna, Inst Tecnol Biomed ITB, Santa Cruz De Tenerife, Spain - Author
Univ La Laguna, Inst Univ Enfermedades Trop & Salud Publ Canarias, Santa Cruz De Tenerife, Spain - Author
Univ Las Palmas Gran Canaria, Univ Inst Res Biomed & Hlth iUIBS, Mol & Translat Pharmacol Grp, Las Palmas Gran Canaria, Spain - Author
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Abstract

BackgroundPatients with refractory symptoms of severe diseases frequently experience anxiety, depression, and an altered health-related quality of life (HRQOL). Some publications have described the beneficial effect of ozone therapy on several symptoms of this kind of patient. The aim of this study was to preliminarily evaluate, in patients treated because of refractory symptoms of cancer treatment and advanced nononcologic diseases, if ozone therapy has an additional impact on self-reported anxiety and depression. MethodsBefore and after ozone treatment, we assessed (i) anxiety and depression according to the Hospital Anxiety and Depression Scale (HADS); (ii) the HRQOL (according to the EQ-5D-5L questionnaire), which includes a dimension on anxiety and depression and a visual analog scale (VAS) measuring self-perceived general health. ResultsBefore ozone therapy, 56% of patients were on anxiolytic and/or antidepressant treatment. Before and after ozone therapy, the anxiety and depression HADS subscales (i) significantly correlated with the anxiety/depression dimension of the EQ-5D-5L questionnaire and (ii) inversely correlated with the health status as measured by the VAS. After ozone therapy, we found a significant improvement in anxiety and depression measured by both the (i) HADS subscales and (ii) EQ-5D-5L questionnaire. ConclusionThe addition of ozone therapy for patients with refractory symptoms of cancer treatment and advanced chronic nononcologic diseases can decrease anxiety and depression severity levels. Additional, more focused studies are ongoing to provide the needed explanatory information for this finding.

Keywords

ActivationAdvanced diseasesAnxiety and depressionAssociationCancer survivorsChemotherapy-induced neuropathChemotherapy-induced neuropathyChemotherapy-induced side effectsDisorderHealthHealth-related quality of lifeHospital anxietyInflammationManagementModelOxidative stressOzone therapyQuality-of-lifeRadiation-induced side effects

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Frontiers in Psychology due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2023, it was in position 56/219, thus managing to position itself as a Q2 (Segundo Cuartil), in the category Psychology, Multidisciplinary. Notably, the journal is positioned en el Cuartil Q2 para la agencia Scopus (SJR) en la categoría Psychology (Miscellaneous).

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 3.29, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jun 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-06-26, the following number of citations:

  • Scopus: 2
  • OpenCitations: 2

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-06-26:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 14.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 14 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 9.75.
  • The number of mentions on the social network X (formerly Twitter): 5 (Altmetric).
  • The number of mentions in news outlets: 1 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.